Oskar Minkowski

MINKOWSKI, Oskar (born 1858); studied in Königsberg, Freiburg, and Strasbourg, where Minkowski was a student of Naunyn. Already at the age of 26, he succeeded in making an important discovery, namely, finding β-hydroxybutyric acid in the urine of severe diabetics, as well as clarifying its relationship to urinary ammonia, the excretion of acetone, acetoacetic acid, and sugar. Furthermore, he established the reduced carbon dioxide tension in the blood and the reduced alkali reserve in diabetes, which led to the treatment of diabetic coma with alkalis. Shortly after this, he succeeded in establishing, through the removal of the liver in birds, that the liver plays an important role in the formation of bile pigment. Long before Kupffer, he noted the special physiological significance of the stellate cells of the liver. Furthermore, he established the role of the liver in the synthesis of uric acid and urea and in the regulation of blood sugar and carbohydrate metabolism; at the same time, he clarified the role of lactic acid as an intermediate phase of carbohydrate combustion. Minkowski established the concept of "jaundice by diapedesis" and developed the clinical picture of familial acholuric hemolytic jaundice. This opened a new era in the surgical treatment of hepatolienal diseases and, in particular, the removal of the spleen in hemolytic jaundice; the method of Hijmans van den Bergh for detecting bilirubin in blood serum is based on these same data. Already 3 years before P. Marie, Minkowski expressed the idea of the pituitary origin of acromegaly. The new era of internal secretion should be dated not from June 1889, when Brown-Séquard made a report about his discovery, but from the beginning of that year, when Mering, together with Minkowski, established the existence of pancreatic diabetes by removing the pancreas (Zentralbl. f. klin. Med., 1889, No. 5). This discovery gave impetus to the discovery of insulin. Minkowski also studied the external secretion of the pancreas. He did much to study the metabolism of uric acid and the pathogenesis of gout. He also authored major works on the pathology of respiration and on insulin. The most important works of Minkowski: "Über das Vorkommen von Oxybuttersäure im Harn bei Diabetes mellitus" (Arch. f. exp. Path., B. XVIII, 1884); "Versuche über den Einfluss der Leberexstirpation auf den Stoffwechsel" (Zentralbl. f. d. med. Wissensch., 1885, No. 2); "Untersuchungen über den Diabetes mellitus nach Exstirpation des Pankreas" (Lpz., 1893); "Untersuchungen zur Physiologie und Pathologie der Harnsäure" (Leipzig, 1898).