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Thursday, June 5, 2008

Rosebury 1973 letter in JAMA, on 'fecal body odor' case by Dobson (part 2 of 3)

JAMA, Mar 5, 1973, Vol 223, No 10
Theodor Rosebury, DDS
Shelburne Falls, Mass

After a trip to the university library and some swift research, the Rosebury 'fecal body odor' paper mystery has been solved, albeit disappointingly. It turns out to be a letter to the editor of a medical journal, in reply to an 'ask the dermatologist' question and answer section that must have been in the journal too. Instead of Professor Rosebury being a visionary in this syndrome, he turns out to be sceptical and critical, and he may be the first promoter of the dreaded 'olfactory reference syndrome' 'threat'.

In reference to Dr. Richard Dobson's reply (222:1654. 1972) to a question on the case of a patient who presents with fecal body odor, Dr. Rosebury calls for substantiation or documentation.

To the Editor...The wording of the question (". . . an intense body odor which he [the patient] describes as fecal. . ." and ". . .lincomycin [treatment for a respiratory infection] seemed to make the body odor less noticeable) leave open a possibility of olfactory hallucination or synesthesia... Yet the answer reads that the "odor is undoubtedly due to decomposition by bacteria or keratin, sebum (or) apocrine gland secretion" and the prescription not only localized the odor with some assurance in the axillae, but recommends such remedies as an antibacterial soap and antiperspirant-deodorant.

Dr. Rosebury, goes on to say that, "This field, being poorly studied and litte understood, is presumably for that reason widely exploited in advertising to the public. Not many bacteria can decompose keratin and those that can are not likely to be present in the axillae; metabolic products of sebum lipids and apocrine sweat are unlikely to have fecal odor. "

It is ironic to note that the conundrum that haunts sufferers today is asked back then by Rosebury, and in this context almost seems sensible : " It is not stated that the odor was perceived by the physician himself or by anyone other than the patient. "

It leads to a 2nd mystery; what did Dr Dobson say to the expert asking the question ? I visited the library again and managed to solve the mystery,which I will post later today.



related post (this is 'part 2')

part 1 : http://mpdela.blogspot.com/2008/06/fecal-body-odor-paper-by-theodor.html
part 3 : http://mpdela.blogspot.com/2008/06/1972-dobson-fecal-body-odor-reply-to.html

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