Hansen T W
Section on Neonatology, Department of Pediatrics, Rikshospitalet, University of Oslo, Oslo, Norway.
Pediatrics. 2000 Aug;106(2):E15. doi: 10.1542/peds.106.2.e15.
Neonatal jaundice must have been noticed by caregivers through the centuries, but the scientific description and study of this phenomenon seem to have started in the last half of the 18th century. In 1785 Jean Baptiste Thimotée Baumes was awarded a prize from the University of Paris for his work describing the clinical course in 10 jaundiced infants. The work by Jaques Hervieux, which he defended for his doctor of medicine degree in 1847, was, in many respects, a landmark. He had autopsied 44 jaundiced infants and apparently had clinical observations on many others. His descriptions of pathoanatomical findings were very detailed and systematic. A number of his clinical observations are still thought to be accurate today, such as the essentially benign nature of neonatal jaundice in most cases, the appearance of neonatal jaundice during the first 2 to 4 days of life as well as its disappearance within 1 to 2 weeks, and the cephalocaudal progression of jaundice. He described jaundice of the brain in 31 of his 44 autopsied cases, with variable intensity of staining. Johannes Orth was an assistant to the famous Virchow in Berlin, when in 1875 he published the results of an autopsy of a jaundiced term infant. The brain was notable for an intense yellow staining of the basal ganglia, the wall of the third ventricle, the hippocampus, and the central parts of the cerebellum. While the contribution of Orth was limited to this single case report, in 1903 Christian Schmorl presented the results of his autopsies of 120 jaundiced infants to the German Society for Pathology. All of these infants' brains were jaundiced, but only 6 cases demonstrated a staining phenomenon similar to that previously described by Orth. Schmorl coined the term kernicterus (jaundice of the basal ganglia) for this staining pattern. Although the following century of scientific study has added an enormous amount of information about the epidemiology and pathophysiology of neonatal jaundice and kernicterus, the contributions of Hervieux, Orth, and Schmorl will undoubtedly continue to be seen as historical landmarks in our quest for understanding of these phenomena.
几个世纪以来，照顾者肯定都注意到了新生儿黄疸，但对这一现象的科学描述和研究似乎始于18世纪后半叶。1785年，让·巴蒂斯特·蒂莫泰·鲍姆斯因其描述10名黄疸婴儿临床病程的著作，获得了巴黎大学的奖项。雅克·埃尔维厄于1847年为其医学博士学位所做的论文答辩工作，在很多方面都是一个里程碑。他对44名黄疸婴儿进行了尸检，显然还对其他许多婴儿进行了临床观察。他对病理解剖学发现的描述非常详细且系统。时至今日，他的一些临床观察结果仍被认为是准确的，比如在大多数情况下新生儿黄疸本质上是良性的，新生儿黄疸在出生后的头2至4天出现，并在1至2周内消退，以及黄疸从头部向尾部发展。在他解剖的44个病例中，有31个他描述了脑黄疸，染色强度各不相同。1875年，约翰内斯·奥尔特在柏林时是著名的魏尔啸的助手，当时他发表了一名足月黄疸婴儿的尸检结果。该婴儿的大脑因基底神经节、第三脑室壁、海马体和小脑中部强烈的黄色染色而引人注目。虽然奥尔特的贡献仅限于这份单一病例报告，但1903年克里斯蒂安·施莫尔向德国病理学会展示了他对120名黄疸婴儿的尸检结果。所有这些婴儿的大脑都有黄疸，但只有6例表现出与奥尔特之前描述的类似的染色现象。施莫尔为这种染色模式创造了“核黄疸”（基底神经节黄疸）一词。尽管在接下来的一个世纪里，科学研究增加了大量关于新生儿黄疸和核黄疸的流行病学和病理生理学的信息，但埃尔维厄、奥尔特和施莫尔的贡献无疑将继续被视为我们理解这些现象过程中的历史里程碑。
