Abraham Freedberg

http://www.nytimes.com/2009/08/24/health/24freedberg.html?_r=0

A. Stone Freedberg, Pioneer in Study of Ulcers, Dies at 101 TWITTER LINKEDIN E-MAIL PRINT REPRINTS SHARE

By LAWRENCE K. ALTMAN Published: August 23, 2009 Dr. A. Stone Freedberg, a Harvard cardiologist who developed an early treatment for angina and whose pioneering work in identifying the bacteria that cause stomach ulcers was initially all but ignored, died Tuesday at his home in the Jamaica Plain section of Boston. He was 101 and active until his death.

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Jodi Hilton for The New York Times Dr. A. Stone Freedberg at his home office in Boston in 2005. The cause was heart and lung complications following a gash in his leg, said his son Dr. Leonard E. Freedberg.

As a young researcher at the Harvard-affiliated Beth Israel Hospital in Boston in 1940, Dr. Freedberg became curious about stomach ulcers while studying the effects of fever on the heart and circulatory system when infections caused it to collapse. Scientific reports taught him that many such patients developed tiny bleeding ulcers in the stomach and small bowel.

Since at least 1906, doctors had reported seeing curved bacteria in the stomach of patients who died with ulcers but less often in people without them. Still, doctors paid little attention to the observation in the belief that bacteria could not thrive in the acid-filled stomach. Doctors assumed that the bacteria appeared after death.

Were the bacteria present in living patients? Dr. Freedberg examined pieces of stomach removed during operations for ulcers and other ailments. Using a silver chemical stain, he identified the bacteria in more than a third of ulcer patients, but his colleagues’ efforts to culture them failed.

In a 2005 interview with The New York Times, Dr. Freedberg said he was “very upset” when others did not confirm the findings he published because it implied that his work was wrong.

Even his boss, Dr. Herrman Blumgart, suggested that he had erred and discouraged him from continuing the research. Other doctors tried and failed to find the evidence until 1983, when two Australians, Dr. Barry J. Marshall and Dr. J. Robin Warren, identified the bacteria, now known as Helicobacter pylori, among ulcer patients.

In 2005, the two Australians received Nobel Prizes in medicine for that work.

On Thursday, Dr. Marshall recalled a letter Dr. Freedberg sent after the Australians’ report in 1984. At the time, he said, he “found it hard to imagine” that a doctor “from 1940” was still reading the literature.

The two later met. In an interview in The Times in 2005, Dr. Marshall said that if Dr. Freedberg had been able to pursue his ulcer research, researchers would have developed treatments for ulcers decades earlier. “They would have won the Nobel Prize about 1951, as I was getting born,” Dr. Marshall said.

Abraham Stone Freedberg, who was known as Al, was born on May 30, 1908, in Salem, Mass. He graduated from Harvard College in 1929 and the University of Chicago Medical School in 1934.

After an internship and residency at Cook County Hospital in Chicago, he trained as a specialist in pathology and microbiology at Rhode Island Hospital in Providence. But he abandoned that career choice because he could find no permanent pathology job.

In the late 1940s, when doctors had little to offer heart patients with severe angina, Dr. Freedberg developed a treatment that was used for several years to relieve such pain safely. The treatment involved adapting a radioactive iodine technique, typically used to destroy an overactive thyroid gland, for the purpose of reducing the body’s metabolism enough to relieve the angina pain, said Dr. Milton W. Hamolsky, who worked with Dr. Freedberg in Boston before becoming a professor at Brown University.

Dr. Freedberg later became chairman of cardiology and internal medicine at what is now Beth Israel Deaconess Medical Center. For many years, he taught Harvard medical students the traditional art of physical diagnosis — how to use their hands, eyes and ears to detect abnormalities.

In recent years, Dr. Freedberg criticized what he called an overreliance on imaging and other laboratory tests, saying it had diminished the practice of physical diagnosis and contributed to the increased cost of medical care. He gave up his medical license in his late 90s.

In addition to his son Leonard, of Newton, Mass., Dr. Freedberg is survived by another son, Richard, of Miami; a brother, Milton, of Weston, Mass.; four grandsons; and three great-grandchildren.

In his last days, Dr. Freedberg patiently assessed the state of his own vital organs and concluded that there were no prospects “of a significant improvement in my basic status,” as Dr. Hamolsky recalled his telling him.

“It is time to draw the curtain,” Dr. Freedberg told Dr. Hamolsky.

He then refused food and water, invited family and friends to say goodbye and died in his sleep.