Actress Nathalie Kay “Tippi” Hedren, who had starred in Alfred Hitchcock’s film “The Birds” (1963), once remarked, “Osteoporosis is for the birds”. She was then promoting the cause of “osteoporosis awareness and prevention to educate women about this bone-thinning disease” [Business Wire, 2001]. Tippi was about to receive state-of-the-art DEXA screening at Orthopaedic Hospital in Los Angeles on April 27, 2001.
At the time, it was estimated that 28 million Americans suffer from osteoporosis each year, 80% being women, most being unaware of the importance of routine screenings. This was some six decades after Fuller Albright and his colleagues [1941] had reported that postmenopausal osteoporosis was largely due to oestrogen deficiency.
Albright was an endocrinologist whose insights into gender differences and bone health formed the foundation of our understanding of the relationship between menopause and osteoporosis [Manring & Calhoun 2011].
He had been aware of research in the 1930s linking ovarian function and the metabolism of calcium in pigeons. Male pigeons had been shown to be osteoporotic compared to ovulating females [Kyes & Potter 1934]. Injection of male pigeons with oestrogen led to improved bone formation [Pfieffer & Gardner 1938].
After observing that a large number of his patients with osteoporosis were post-menopausal women, Albright named the condition “Menopausal Osteoporosis”. Three of his patients responded favourably to oestrogen therapy. His work through the 1940s confirmed the practical value of this therapy [Albright 1947].
He also published a description of a congenital disorder, which became known as McCune-Albright Syndrome (polyostotic bone dysplasia, light brown skin pigmentation and endocrine disorders such as precocious puberty in girls), and described pseudohypoparathyroidism. He chose the name Seabright-Bantam for this condition, because the male fowl has feathers similar to the female despite having normally functioning testes.
Other important work included his description of the chronic form of milk-alkali syndrome, of renal tubular acidosis, reporting the association of kidney stones with hyperparathyroidism, his description and study of vitamin D resistant rickets, and his contributions to the understanding of the pathogenesis of Cushing’s Syndrome. Albright was the first clinician to recognise that immobilization could cause hypercalcaemia, and particularly so in patients with Paget’s disease of bone.
… all the great scientists have one thing in common: each snatched from the subtle motions of nature one irrevocable secret; each caught one feather of the plumage of the Great White Bird that symbolizes everlasting truth.” – From: Moulton FR, Schifferes JJ, The Autobiography of Science (1945)
Albright first described or contributed to the description of 14 major clinical syndromes and his name was attached to 118 scientific reports.
The book he published in 1948 together with Edward Reifenstein, “The Parathyroid Glands and Metabolic Bone Disease”, became a classic work in the bone literature.
As well as being the consummate investigator [Kleeman et al. 2009], Albright had quite a sense of humour. There was always a twinkle in his eye.
He had a disregard for statistical methods: “I’m sure (statistics) are important, but if you have to use them, I don’t believe it” [Axelrod 1970].
Albright [1947] concluded one of his important papers with the following whimsical remarks:
- I have told you more than I know about osteoporosis.
- What I have told you is subject to change without notice.
- I hope I have raised more questions than I have given answers.
- In any case, as usual, a lot more work is necessary.
His career as a researcher was cut short by the onset of Parkinson’s disease at the age of 36. The disease progressed relentlessly over the final two decades of his life.
But, as Albright said, “the condition does have its compensations: one is not taken away from interesting work to be sent to Burma, one avoids all forms of deadly committee meetings…”
In 1956, at his own insistence, Albright underwent chemopallidectomy, the newly developed surgical treatment for Parkinson’s Disease. The procedure was successful on the right side. But soon after surgery on the left side he suffered a cerebral haemorrhage and was to spend the next 13 years as a helpless invalid [Kleeman et al.2009].
Although his medical career ended prematurely, Fuller Albright’s accomplishments vastly exceeded any other persons’ lifetime’s work.
Tippi was indeed close to the truth about the avian contribution to osteoporosis research.
By John Quintner, Consultant Physician in Rheumatology and Pain Medicine (retired)
Photo: Fuller Albright, 1900-1969, Harvard Medical Alumni Bulletin
Photo Credit: By Unknown – https://collections.countway.harvard.edu/onview/items/show/5897
REFERENCES
Albright F. Osteoporosis. Ann Int Med 1947;27(6):861-882.
Albright F, Smith PH, Richardson AM. Postmenopausal osteoporosis. JAMA 1941;116:2465-2474.
Axelrod. Bones, stones and hormones: the contributions of Fuller Albright. NEJM 1970;283:964-970.
Kleeman CR, Levine BS, Felsenfeld AJ. Fuller Albright: the consummate clinical investigator. Clin J Am Soc Neprol 2009;4(10):1541-1546. doi: 10./CJN.03030509.2215/
Kyes P, Potter TS. Physiological marrow ossification in female pigeons. Anat Rec 1934;60:377-379.
Manring MM, Calhoun JH. Biographical sketch: Fuller Albright, MD 1900-1969. Clin Orthop Relat Res 2011; 469:2092-2095. doi: 10.1007/s11999-011-1831-0.
Pfeiffer CA, Gardner WU. Skeletal changes in and blood serum calcium level in pigeons receiving estrogens. Endocrinology 1938;23:485-491.
