2. âHistory is a flame in the
hands of the present to
light the futureâŠâ
Ibn-Khaldun
3. The concept of the stomach as an organ
actively secreting acid and pepsin and
responsible for digestion was not
appreciated until the early 19th century.
4. circa 350BCcirca 350BC
âșâș DioclesDiocles ofof CarystosCarystos described symptoms ofdescribed symptoms of
sour watery eruptions, gas and uppersour watery eruptions, gas and upper
abdominal middle (abdominal middle (epigastricepigastric) pains with) pains with
occasional vomiting and splashing sounds..occasional vomiting and splashing sounds..
§§ Melancholic gassy illnessMelancholic gassy illness
5. 30BC30BC--25AD25AD
âșâșCelsusCelsus recognized that certain foods wererecognized that certain foods were
acidic and recommended that..acidic and recommended that..
§§ ââif the stomach is infested with an ulcer, light andif the stomach is infested with an ulcer, light and
gelatinous food must be usedgelatinous food must be usedâŠâŠand everythingand everything
acid must be avoidedacid must be avoidedâŠââŠâ
6. 14931493--15141514
âșâșParacelsusParacelsus believed there to be acid in thebelieved there to be acid in the
stomach, responsible for digestion, whichstomach, responsible for digestion, which
came from drinking of acidic spa watercame from drinking of acidic spa water
7. 15771577--16441644
âșâșJeanJean BaptisteBaptiste vanvan HelmoutHelmout believed thatbelieved that
digestion began in stomach by intermittentdigestion began in stomach by intermittent
fermentation of acid which is neutralized byfermentation of acid which is neutralized by
the gall in the duodenum.the gall in the duodenum.
âșâșMobiusMobius andand BorelliBorelli denied the presence ofdenied the presence of
acid. They interpreted all functions in termsacid. They interpreted all functions in terms
of mechanical grindingof mechanical grinding
8. 16921692
âșâșViredetViredet was experimenting with animalswas experimenting with animals
and concluded the presence of acid that canand concluded the presence of acid that can
even regurgitate to the oesophagus. Heeven regurgitate to the oesophagus. He
wrote..wrote..
§§ ââWe experience it by an acid in the mouthWe experience it by an acid in the mouthââ
9. 17831783
âșâș LazzaroLazzaro SpallanzaniSpallanzani, by self, by self--inducedinduced
vomiting at regular times, proved thatvomiting at regular times, proved that
digestion is a chemical process that startsdigestion is a chemical process that starts
30 min after eating and is concluded 230 min after eating and is concluded 2
hours later. But asserted that gastric juicehours later. But asserted that gastric juice
waswas Neutral!!Neutral!!
10. 11/12/182311/12/1823
âșâșWilliumWillium ProutProut presented the land markpresented the land mark
paper at the Royal society of London..paper at the Royal society of London..
§§ Described nature of acid and proposed thatDescribed nature of acid and proposed that
chloride was secreted from blood to lumen bychloride was secreted from blood to lumen by
electrical means leaving it alkaline after eatingelectrical means leaving it alkaline after eating
(now known as(now known as postprandial alkaline tidepostprandial alkaline tide))
§§ Classified foods into subgroupsClassified foods into subgroups
âșâșSaccharinousSaccharinous (carbohydrates)(carbohydrates)
âșâșOleaginous (fats)Oleaginous (fats)
âșâșAlbuminousAlbuminous (proteins)(proteins)
11. 18331833
âșâșWilliamWilliam BeamountBeamount outlined the principles ofoutlined the principles of
digestion and established the presence ofdigestion and established the presence of
HClHCl in gastric juice.in gastric juice.
âșâșThanks to his experiments with St. Martin aThanks to his experiments with St. Martin a
soldier surviving a wound which left him withsoldier surviving a wound which left him with
a gastric fistula open to abdominal wall.a gastric fistula open to abdominal wall.
12. 18361836
âșâșTheodorTheodor SchwannSchwann, In Berlin Laboratories,, In Berlin Laboratories,
described a water soluble factor in gastricdescribed a water soluble factor in gastric
juice which digested egg white. He called itjuice which digested egg white. He called it
PEPSINPEPSIN after the Greek word for digestion.after the Greek word for digestion.
13. 18541854
âșâșEpstein &Epstein & GrutznerGrutzner postulated thepostulated the existanceexistance
ofof PepsinogenPepsinogen..
âșâșLangleyLangley of Trinity college, Cambridge, fewof Trinity college, Cambridge, few
years later formalized the study ofyears later formalized the study of
pepsinogenpepsinogen and the mechanism of itsand the mechanism of its
secretion from gastric mucosasecretion from gastric mucosa
14. 18981898
âșâșGillespieGillespie published the first photographs ofpublished the first photographs of
pepsinogenpepsinogen granules in the gastric mucosagranules in the gastric mucosa
ofof salmosalmo salarsalar..
15. 19041904 Nobel PrizeNobel Prize
âșâșIvan PavlovIvan Pavlov of Russia was awarded Nobelof Russia was awarded Nobel
prize in physiology for much of his work onprize in physiology for much of his work on
reflexes through which he proved..reflexes through which he proved..
§§ ââThat the effect of feeding was transmitted byThat the effect of feeding was transmitted by
nervous channels to the gastric glandsnervous channels to the gastric glands ââ
§§ TheThe VagusVagus
16. Gastric surgeryGastric surgery
âșâș The standard operationsThe standard operations early in the 20early in the 20thth centurycentury
were partialwere partial gastrectomygastrectomy oror gastroenterostomygastroenterostomy..
âșâș After Pavlov's work on theAfter Pavlov's work on the vagusvagus,, BiecherBiecher workedworked
onon vagotomyvagotomy, later modified by, later modified by LatarjetLatarjet and aboutand about
30 years later by30 years later by DragstedtDragstedt..
âșâș GriffithGriffith introduced the concept of selectiveintroduced the concept of selective
vagotomyvagotomy whilewhile HolleHolle &Hart&Hart refined this byrefined this by
selectivelyselectively denervatingdenervating thethe fundusfundus but addedbut added
gastrojeujonostomygastrojeujonostomy..
18. 19151915
âșâșBertramBertram SippySippy advocated a feeding regimenadvocated a feeding regimen
containing calcium & sodium bicarbonatecontaining calcium & sodium bicarbonate
known asknown as SippySippy Powder.Powder.
âșâșRichard DollRichard Doll introduced another regimenintroduced another regimen
involving continuous milk dripping through ainvolving continuous milk dripping through a
nasogastricnasogastric tube.tube.
19. 19361936 Nobel PrizeNobel Prize
âșâș Dale & BargerDale & Barger were awarded Nobel prize forwere awarded Nobel prize for
identifying the base Histamine.identifying the base Histamine.
âșâș Sir Henry DaleSir Henry Dale,, President of the Royal SocietyPresident of the Royal Society
(1940(1940--1945), President of the British Association1945), President of the British Association
(1947), and President of the Royal Society of(1947), and President of the Royal Society of
Medicine (1948Medicine (1948--1950)1950) quoted..quoted..
§§ ââBeta I, as we called it, is, of course the now almost tooBeta I, as we called it, is, of course the now almost too
familiar histamine.familiar histamine.ââ
20. 19501950
âșâșCodeCode identified the role of histamine as aidentified the role of histamine as a
principle regulator of parietal cell secretions.principle regulator of parietal cell secretions.
âșâșAndrew KayAndrew Kay of Glasgow firmly establishedof Glasgow firmly established
the concept bythe concept by ââaugmented histamine testaugmented histamine testââ
âșâșA long list of antiA long list of anti--histamines was studiedhistamines was studied
without identifying an effective agent.without identifying an effective agent.
21. 19581958 First World Congress of GastroenterologyFirst World Congress of Gastroenterology
âșâș First symposium dealt with Epidemiological and ClinicalFirst symposium dealt with Epidemiological and Clinical
Features of Peptic Ulcer Disease through the World.Features of Peptic Ulcer Disease through the World.
Henry L. Bockhus,
President of the First
World Congress and First
President of the World
Organisation of
Gastroenterology
H. Marvin Pollard, Secretary-
General, First World Congress
of Gastroenterology and
President of WGO (1970-1974)
Washington D.C.Washington D.C.
2525ââ31 May 195831 May 1958
22. 19621962
âșâșGregory & TracyGregory & Tracy identifiedidentified GastrinGastrin I and II,I and II,
and published their structure in the 5and published their structure in the 5thth
December 1964 issue ofDecember 1964 issue of ââNatureNatureââ
âșâșInIn 19671967,, James McJames Mc GuiganGuigan was able towas able to
measuremeasure gastringastrin levels in serum and linkedlevels in serum and linked
it to theit to the ZollingerZollinger Ellison syndrome.Ellison syndrome.
23. 19601960ââss--19701970ââss
âșâșMany AntacidsMany Antacids--surfactants preparationsurfactants preparation
became available but not very popular duebecame available but not very popular due
to the high dosageto the high dosage needeneede associated withassociated with
numerous undesirable side effects.numerous undesirable side effects.
24. 19881988 Nobel PrizeNobel Prize
âșâșJames BlackJames Black of Smith Kline & Frenchof Smith Kline & French
Laboratories was awarded a late Nobel prizeLaboratories was awarded a late Nobel prize
for developingfor developing propranololpropranolol and the first H2and the first H2
receptor antagonist, the legendary,receptor antagonist, the legendary,
CimetidineCimetidine back inback in 1976.1976.
25. 19731973
âșâșGanserGanser & Forte& Forte experimented onexperimented on oxynticoxyntic
cells of bullfrog and concluded that a uniquecells of bullfrog and concluded that a unique
enzyme existed in the parietal cell.enzyme existed in the parietal cell.
âșâșAlthough the Na pump was described asAlthough the Na pump was described as
early as 1957, its close relationship to theearly as 1957, its close relationship to the
acid pump of the stomach was not as yetacid pump of the stomach was not as yet
recognized.recognized.
26. 19731973--19801980ââss
âșâșPrecise understanding of the proton pumpPrecise understanding of the proton pump
allowed the emergence of compounds thatallowed the emergence of compounds that
inhibit H+/K+inhibit H+/K+ ATPaseATPase thus blocking thethus blocking the
final step of acid secretion.final step of acid secretion.
âșâșNow Known asNow Known as PPIPPIââss..
27. 20052005 Nobel PrizeNobel Prize
âșâș Barry J. Marshall and J. RobinBarry J. Marshall and J. Robin
WarrenWarren of Australiaof Australia werewere
awarded Nobel Prize for theirawarded Nobel Prize for their
discovery ofdiscovery of Helicobacter PyloriHelicobacter Pylori
and its critical role in ulcerand its critical role in ulcer
genesis back ingenesis back in 1998.1998.
28. GI EndoscopyGI Endoscopy
The word "endoscopy" is derived from theThe word "endoscopy" is derived from the
Greek by combining the prefix "Greek by combining the prefix "endoendo""
meaning "within" and the verb "meaning "within" and the verb "skopeinskopein",",
"to view or observe"."to view or observe".
29. âșâșHippocrates II wrote ofHippocrates II wrote of
examining the rectum withexamining the rectum with
a speculum.a speculum.
30. 936936 -- 10131013
âșâșAbdulAbdul--KasKasıımm ElEl ZahraviZahravi, Arabian physician, Arabian physician
known asknown as AlbucasisAlbucasis of Cordoba was the firstof Cordoba was the first
to use a mirror to reflect light into anto use a mirror to reflect light into an
internal organ.internal organ.
âșâșHe used the device to inspect a cervix.He used the device to inspect a cervix.
31. 13851385 -- 14681468
âșâșSerefeddinSerefeddin Sabuncuog|uluSabuncuog|ulu describeddescribed ââa thina thin
and hollow tube of almost 35 cm, which wasand hollow tube of almost 35 cm, which was
made of silvermade of silverââ and used it to inspect theand used it to inspect the
interior of the bladderinterior of the bladder
32. 18061806
âșâș PhilipPhilip BozinniBozinni of Frankfurt invented aof Frankfurt invented a "Lichtleiter""Lichtleiter"
(light conductor)(light conductor) which used concave mirrors towhich used concave mirrors to
reflect candlelight through an open tube into thereflect candlelight through an open tube into the
upper esophagus, bladder, or rectum.upper esophagus, bladder, or rectum.
âșâș Vienna medical society disapproved of suchVienna medical society disapproved of such
curiosity.curiosity.
33. 18221822
âșâș William BeaumontWilliam Beaumont, army surgeon at Mackinac, army surgeon at Mackinac
Island Michigan, introduced the first endoscope toIsland Michigan, introduced the first endoscope to
the stomach of soldier Martin.the stomach of soldier Martin.
âșâș This was through a pathological fistulae, as aThis was through a pathological fistulae, as a
sequelae of a healed gun fire wound in his uppersequelae of a healed gun fire wound in his upper
abdomen.abdomen.
34. 18661866
âșâș JuliusJulius BruckBruck produced light by using an exposedproduced light by using an exposed
electrically heated platinum loop, which at thatelectrically heated platinum loop, which at that
time was the most powerful light source known.time was the most powerful light source known.
âșâș He placed source of light in the distal end of anHe placed source of light in the distal end of an
instrument and invented a double glass tube withinstrument and invented a double glass tube with
a watera water--cooling compartment,cooling compartment, ââdiaphanoscopediaphanoscopeââ
âșâș It was used in rectum or vagina.It was used in rectum or vagina.
35. 18681868
âșâș AdolfAdolf KussmaulKussmaul was the first GIwas the first GI endoscopistendoscopist,,
intubatingintubating a sworda sword--swallowerswallower from India.from India.
âșâș Instrument rigidity & poor illumination wereInstrument rigidity & poor illumination were
obstacles.obstacles.
âșâș VonVon MikuliczMikulicz,, LeiterLeiter,, NitzeNitze,, KellingKelling,, andand JacobaeusJacobaeus
contributed to the development of rigidcontributed to the development of rigid
instruments that could be usedinstruments that could be used endoscopicallyendoscopically..
36. 19301930ââss
âșâșRudolph SchindlerRudolph Schindler developed thedeveloped the semiflexiblesemiflexible
endoscope.endoscope.
âșâșHe teamed with a Berlin instrument makerHe teamed with a Berlin instrument maker
GeorgGeorg WolfWolf, to develop a flexible instrument, to develop a flexible instrument
capable of viewing approximately 80% ofcapable of viewing approximately 80% of
the stomach.the stomach.
37. 19501950
âșâșThe FirstThe First gastrocameragastrocamera was developed inwas developed in
Japan, making it possible to takeJapan, making it possible to take colourcolour
photographs of the inside of the stomach inphotographs of the inside of the stomach in
30 pictures.30 pictures.
âșâșThe first atlas was produced in 1960The first atlas was produced in 1960
38. 19541954
âșâșHopkins andHopkins and KapanyKapany from Great Britainfrom Great Britain
developed tdeveloped the theory ofhe theory of fibreopticsfibreoptics..
âșâșThis has marked a breakthrough in modernThis has marked a breakthrough in modern
endoscopy.endoscopy.
39. 19571957
âșâșBasilBasil HirschowitzHirschowitz made use of the theorymade use of the theory
and developed the firstand developed the first fiberopticfiberoptic endoscpeendoscpe..
âșâșHe passed the first prototype instrumentHe passed the first prototype instrument
down his own throat.down his own throat.
âșâșIn October,In October, 19601960, he received the first, he received the first
production model, and presented it inproduction model, and presented it in
LancetLancet
40. 1959/19601959/1960
âșâșThe first meeting ofThe first meeting of ââJapanJapan GastrocameraGastrocamera
SocietySocietyââ (forerunner(forerunner organisationorganisation of theof the
Japan Gastroenterological EndoscopyJapan Gastroenterological Endoscopy
Society).Society).
âșâșthe first photographic atlases were in print.the first photographic atlases were in print.
41. 19681968
âșâșReport on endoscopicReport on endoscopic polypectomypolypectomy;;
development of endoscopic retrogradedevelopment of endoscopic retrograde
cholangiopancreatographycholangiopancreatography (ERCP).(ERCP).
42. 19721972
âșâșFreeman, a British pediatric surgeon,Freeman, a British pediatric surgeon,
reported using fiberreported using fiber--optic bronchoscope foroptic bronchoscope for
examination of the upper GIT in children.examination of the upper GIT in children.
âșâșHe noted..He noted..
ââthe need for pediatric endoscopy is wellthe need for pediatric endoscopy is well
established and the indications will likelyestablished and the indications will likely
increase.increase.ââ
43. Early 1970Early 1970ââss
âșâșNotable endoscope refinements includedNotable endoscope refinements included
§§ rere--positioning of lenses for wider field of vision,positioning of lenses for wider field of vision,
§§ addition of channels for biopsy forceps,addition of channels for biopsy forceps,
suction, air, or water, andsuction, air, or water, and
§§ fourfour--way controlled tip deflection.way controlled tip deflection.
44. Therapeutic EndoscopyTherapeutic Endoscopy
âșâș 19711971 coloncolon polypectomypolypectomy with a wire loop snare.with a wire loop snare.
âșâș 19721972 cannulationcannulation of the pancreatic duct.of the pancreatic duct.
âșâș 19751975 removal ofremoval of biliarybiliary stone.stone.
âșâș 19791979 placement of feeding tubes byplacement of feeding tubes by gastrostomygastrostomy..
âșâș 19801980 BiliaryBiliary stentingstenting..
45. 19761976
âșâș OMEDOMED (Organisation(Organisation MondialeMondiale d'Endoscopied'Endoscopie
Digestive), was constituted as an internationalDigestive), was constituted as an international
society, independent from Gastroenterology, insociety, independent from Gastroenterology, in
19621962 during the World Congress ofduring the World Congress of
Gastroenterology in Munich.Gastroenterology in Munich.
âșâș The selected name at the time wasThe selected name at the time was "International"International
Society of Endoscopy"Society of Endoscopy" (ISE).(ISE).
âșâș Changed to OMED on July 3,Changed to OMED on July 3, 19761976 in Mexico.in Mexico.
46. 19861986
âșâșDevelopment of a video computer chipDevelopment of a video computer chip
allowed the magnification and projection ofallowed the magnification and projection of
images onto television screens.images onto television screens.
âșâșVideoscopesVideoscopes..
48. âșâșSome people are living in the pastSome people are living in the past
âșâșSome people struggle to stay in the presentSome people struggle to stay in the present
âșâșSome people have a vision to the futureSome people have a vision to the future
âșâșFew are making the futureFew are making the future
âșâșWhere do you want to be??Where do you want to be??
