Jean Hissette
Jean Hissette (born August 30, 1888 in Leuven , † August 26, 1965 in Forest / Brussels ) was a Belgian ophthalmologist. Hissette is the discoverer of African ocular onchocerciasis (river blindness) and he was the first to clarify the origin of blindness in the filarial disease onchocerciasis.
Life
Philippe Jean Hissette was born in Louvain (Leuven), the father died before he was even born, his mother and stepfather spent their holidays with the family on the Semois en Gaume in Lacuisine. In Louvain and Melle near Ghent, Jean went to school as he was called. He began his medical studies in Louvain, and when the First World War broke out on August 1, 1914, he was still a medical student. Hissette did four years of military service in the medical service as a medically decorated medical officer until the end of the war. In 1919 he passed his state examination at the University of Gand (Gent), then he married the Anversoise Hilda de Vriendt from an old Flemish family of painters and set up as a private doctor and obstetrician in an independent practice in Florenville-sur-Semois in southern Belgium. With a total of four practicing doctors there, Hissette doesn't have too much to do. During this time he regularly visits the University Eye Clinic in Ghent under van Duyse and soon also visits his friends and colleagues de Mets and Moorkens in Antwerp for his own further training in ophthalmology. On the farms around Florenville he collects pig's eyes, on which he practiced. His five children were born in quick succession between 1920 and 1926, who are daughters, born in the order, Madeleine, Marguerite, Marie-Thérèse, Gabrielle and son George. Money is short. In 1928 he decided to go to the Belgian Congo with the Belgian National Mission. Hilda and Jean and the two youngest children boarded the “Anversville” in Antwerp on February 27, 1929 to go via the port of Matadi to the scheutist mission station (Mission nationale) in Thielen Saint-Jacques in the Kasai (Belgian Congo). The three older children initially stay in Belgium to attend school.
Hissette is a general practitioner in the Congo, but his specialty is ophthalmology. With the approval of the sending mission, he set up an ophthalmological center in Thielen Saint-Jacques and carried out eye operations right from the start. In doing so, he by no means neglects general tropical medicine, obstetrics and newborn care. Hissette tries to gain the confidence of the sick and shows as best he can a deep empathy for the misery and suffering of people, black and white. After about a year and a half, an attentive priest made him discover his life: He found the first river blind people in Africa at the Sankuru and Lomami rivers in the Belgian Congo in September 1930.
After acquiring the certificates he had previously lacked, Jean Hissette returned to the Congo as a graduate ophthalmologist in 1932. He is commissioned by the Colonial Minister to follow up on whether the trachoma, which has been rampant in North Africa for centuries, could also reach the Congo. To do this, he travels via Tunisia, Egypt and Sudan to the northeast of the Congo and finds that there are only a few cases of trachoma there , but instead he finds another foyer of ocular onchocerciasis here on the Uéle. He traveled to Thielen Saint-Jacques, where he broke away from the Scheutists with the approval of the colonial administration and founded a dispensary for eye patients in Lubumbashi (Elisabethville), the capital of Katanga (Shaba). His family lived there for the next few decades, he was the only practicing ophthalmologist in the Congo. In 1934 he accompanied the Harvard expedition to research onchocerciasis under Richard Pearson Strong as a consultant and guide to the Sankuru, the results of which appear in a supplement to the American Journal of Tropical Medicine (1938). His reputation as a successful ophthalmologist is growing to such an extent that patients from French and English colonies also visit him.
In 1936 Hissette gave a lecture in London and exhibited his watercolors on the pathology of ocular onchocerciasis at a colonial exhibition in Bruxelles.In 1937 he investigated the ocular complications of a measles epidemic in the Pweto region of the Congo colony, with many children suffering from spontaneous double-sided corneal perforations and blindness is coming. At the beginning of the Second World War he was appointed Provincial Doctor of Katanga (spokesman for the doctors there, in principle an officer). After 12 years of uninterrupted residence in the Congo, he and his wife returned to Belgium in 1952. At the same time he feels tired and used up, from which he never fully recovers and which never allows him to be medically active again. Some of his children stay with their families in the Congo until the colony became independent (1960) and beyond and only come to Belgium later. Hissette and his wife now live in Lacuisine across from Florenville on the banks of the Semois, where his creative career began, and they also have an apartment in Brussels. He died on August 26, 1965 in a hospital in Forest / Brussels. He and his wife are buried in a family grave in Lacuisine / Florenville-sur-Semois.
Discovery of ocular onchocerciasis in Africa and Central America
Rudolf Leuckart had discovered the pathogen Onchocerca volvulus in an onchocercoma that had been sent to him from Africa in 1891 in Leipzig. Onchocerciasis appeared to be a harmless filariasis that produced a few lumps under the skin. That changed when Rodolfo Robles discovered the pathogen in Guatemala, outside of Africa, in 1915, and established the triad, which in South and Central America is still called "Robles' disease" today:
- American onchocerciasis
- Erysipela de la costa
- Eye involvement: keratitis and uveitis (Pacheco Luna)
From then on the pathogen in Central America was called Onchocerca caecutiens, which could cause eye involvement, and the actually identical African pathogen Onchocerca volvulus was considered completely harmless as far as eye involvement was concerned.
This is the situation where the discovery of thousands of river blinds by Dr. Jean Hissette at Sankuru in the Belgian Congo in 1930. Hissette clarified the pathomechanism as early as 1932: microfilariae in the individual eye tissues can cause uveitic inflammation. He had brought an enucleated eye from an onchocerciasis patient with him from Sankuru to Belgium and worked it up there in detail. He found microfilariae of Onchocerca volvulus in the cornea, iris and chorioidea (choroid).
At the same time, he described the chorioretinic scar fund in 1932, while Harold Ridley , who for a long time carried the name of the alteration alone, published his description with a drawing only in 1945. Hissette recognized that uveitis in ocular onchzerkosis only develops when the microfilariae have died. That alone shows his precision in the clinical observations and he suspected a toxin being released, but today we know that this mechanism is due to the release of the endobacteria found in the microfilariae, the Wolbachia . This is because they are easily recognized by the immune system as Gram-negative Rickettsiales . The living worm and its microfilariae, however, have a surface covering that the immune system cannot penetrate. That is exactly what Hissette had seen, that there are actually only insignificant defensive reactions as long as the worm is alive.
Control Commission to the Sankuru
In addition to science and tropical medicine, the Colonial Ministry in Brussels under Colonial Minister Charles had become aware of the little doctor from the Kasai by 1933 at the latest. The Belgian press had spread horrific reports about the possibility of blindness in the Congo, which frightened its own officials. It was foolishly said that even small children would go blind from river blindness, which annoyed Hissette because such nonsense fell back on him. Minister Charles felt it was time to do something. It was decided to send a review commission, in the truest sense of the word: on the neck of the little doctor.
The choice fell on Harvard professor Richard Pearson Strong as head and organizer of such a commission. Strong was the first professor of tropical medicine at Harvard USA. In his work on onchocerciasis in West Africa and the Congo, there was no information about eye involvement. Strong traveled in May / June 1934 with his employees to Antwerp and then by steamer in 16 days to West Africa to Lobito Bay (Angola) and from there by rail in 4 days east through Angola to Elisabethville, where they were expected by Hissette . Strong's team included: the helminthologist Jack Sandground , the entomologist Josef Baequert and the photographer Henry Mallinckrodt. It took the team three more days on the colonial railway to Luputa and on with trucks via Kabinda to Pania Mutombo until they were in the land of the Babindi and could finally concentrate on their studies on oncholecosis patients. Hissette accompanied the Harvard expedition for 17 strenuous days as a guide and ultimately as the superior expert on onchocerciasis and its complicated modes of transmission thanks to his previous studies with the Babindi. The result of the Harvard expedition in the summer of 1934 was the full confirmation of all previous communications from Hissette about the processes involved in severe eye affections up to blindness caused by the filarial disease onchocerciasis. The Americans expected Hissette to show them a few patients with eye problems, but he drove up the blind by the thousands. Hissette knew the individual chiefs very well from his visits in 1930/31 and enjoyed their trust through his manner. For his sake, they organized that the individual blind people were taken out of the huts, namely where they were actually left to be forgotten - as is still the case today, and so they were presented to the Americans with their cameras running.
literature
- J. Hissette: Mémoire sur l'Onchocerca volvulus “Leuckart” et ses manifestations oculaires au Congo belge. In: Ann Soc Belge Méd Trop. 12, 1932, pp. 433-529.
- G. Kluxen: Dr. Jean Hissette's research expeditions to elucidate river blindness. Kaden, Heidelberg 2011.
- G. Kluxen, A. Hoerauf: The significance of some observations on African ocular onchocerciasis described by Jean Hissette (1888-1965). In: Bull Soc belge Ophtalmol. 307, 2008, pp. 53-58.
- Pacheco R. Luna: Disturbances of vision in patients harboring certain filarial tumors. In: Am J Ophthalmol. 1, 1918, pp. 122-125.
- NHL Ridley: Ocular Onchocerciasis, Including an Investigation in the Gold Coast. In: Br J Ophthalmol. 29 (Suppl 10), 1945, pp. 3-58.
- R. Robles: Onchocercosis humaine au Guatémala produisant la cécité et 'l'érysipèle du littoral' (Erisipela de la costa). In: Bull Soc Path Exot. 12, 1919, pp. 442-463.
- Av Saint André, NM Blackwell, LR Hall, A. Hoerauf, NW Brattig, L. Volkmann, MJ Taylor, L. Ford, AG Hise, JH Lass, E. Diaconu, E. Pearlman: The role of endosymbiotic Wolbachia bacteria in the pathogenesis of river blindness. In: Science. 295, 2002, pp. 1892-1895.
- RP Strong: Onchocerciasis in Africa and Central America. (Part I Suppl) In: Am J Trop Med Suppl. 18, 1938, pp. 1-57.
Web links
| personal data | |
|---|---|
| SURNAME | Hissette, Jean |
| BRIEF DESCRIPTION | Belgian ophthalmologist |
| DATE OF BIRTH | August 30, 1888 |
| PLACE OF BIRTH | Lions |
| DATE OF DEATH | August 26, 1965 |
| Place of death | Forest, Brussels |