Hektoen International

A Journal of Medical Humanities

Budapest: medicine and paprika

L. J. Sandlow
George Dunea
Chicago, Illinois, United States


The Magyars, ancestors of modern Hungarians, came from the region of the Ural Mountains and invaded Europe around AD 800. Crossing the Carpathian Mountains, they conquered the Pannonian plain and established a large and important medieval kingdom. In 1526 they were defeated at the decisive battle of Mohacs, their king killed, and their country conquered and partitioned by the Turks. Not until a century and a half later was Hungary liberated and the Turks expelled by the Austrian Habsburgs. Hungary grew in size and importance, and in 1867 it became an equal partner in the Austro-Hungarian Dual Monarchy. It lost much of its territory after World War I and was greatly reduced in size. It is now a member of the European Union and has a population of 9.6 million inhabitants, of whom 1.7 million live in the capital Budapest. Hungarian is part of the Finno-Ugric group of languages, and should be of current interest in that it has no grammatical gender and no separate words for “he” and “she.”


Scientists and physicians

Hungary has given the world many important scientists and physicians. Of these, the best known is Ignaz Semmelweis, about whom this journal has several articles. He has gone down in history as the man who first showed that childbed fever could be prevented by the simple expedient of washing one’s hands. He was not listened to and ended his life in a mental asylum. There were also many prominent Hungarian scientists and physicians, of whom only a few are presented here.

Budapest born Albert Szent-Gyorgyi (1893–986) had his education at Semmelweis University interrupted by World War I, but later was able to continue at various universities. Working at the University of Szeged in the 1930s, he and his team established the chemical structure of the anti-scurvy vitamin C, using, not surprisingly, paprika as the source for their experiments. He received the Nobel Prize in Physiology or Medicine in 1937, and after World War II came to the United States and worked on cancer research and quantum physics.

Hans Selye (1907–1982), born in Vienna of a Hungarian father and always proud of his heritage, studied in Prague and worked at John Hopkins University and McGill University in Montréal. He described how the body copes with stress through the hypothalamic-pituitary-adrenal axis (HPA axis) system, exhibiting various nonspecific symptoms, activating the endocrine glands to secrete hormones, and developing lymphatic atrophy, adrenal hyperactivity, and peptic ulcers. These features became known as general adaptation syndrome or Selye’s syndrome—an initial acute reaction followed by a more chronic stage of resistance and eventual exhaustion. Selye was nominated for the Nobel prize in Physiology or Medicine for the first time in 1949. Although he received a total of seventeen nominations in his career, he never won the prize.

Robert Bárány (1876–1936) was born in Vienna of a Hungarian father, studied medicine there, and as a doctor serendipitously observed that instilling cold liquid into the ear caused vertigo and nystagmus. He then studied the role of the inner ear in the process of hearing and maintaining balance. His further research made possible the development of surgical modes of treating inner ear diseases, and he also investigated the role of the cerebellum in equilibrium control. It is believed that he was the first to describe the symptoms of paroxysmal positional vertigo. He served in the Austro-Hungarian army during World War I and was captured by the Russians. He was a prisoner of war while being awarded the Nobel Prize in 1914 but was released following diplomatic negotiations. After the war, he left Vienna and moved to Sweden, where he was a professor at Uppsala University until his death.


Goulash and paprika

To think of Hungary is to think of paprika. Even the word itself comes from there, as does the paprika-spiked goulash beef stew that is served in restaurants all over the world. Paprika itself is a spice made by grinding up the pods of the pepper plant capsicum annuum. The plant was brought to Europe from the New World by Christopher Columbus. It found its way to Hungary, then under Turkish rule, and grew there in abundance because of the favorable climate. It was at first used to decorate houses, as a medicine for treating typhus, and eventually to season food. It was originally too spicy, but this was remedied in the 1920s when a way was found to graft the pepper onto other plants and make it tolerable as a seasoning agent.

All pepper plants, including chili peppers, are members of the genus capsicum. They come in many shapes, colors, and spiciness, depending on the soil, temperature, and weather. They are used to prepare exotic dishes as well as common chilis. Their “hotness” is determined by the concentration of their main active ingredient, capsaicin. This can be measured directly by high-performance liquid chromatography (HPLC) or more indirectly by tasting increasingly diluted pepper solutions until their taste can no longer be detected by the human tongue. The results are expressed in Scoville units. Hot peppers such as cayenne may have a score of 10,000–80,000 units, up to millions, and undiluted would cause a burn on the skin or mucus membranes. The mild or moderate peppers in common culinary use fall within the 100 to 3,000 range. Capsaicin has been used in a cream to deaden the nerve endings and relieve neuropathic pain; it is advertised as exerting all kinds of other beneficial health effects and cures, most remaining scientifically unproven and not approved for clinical use.


Budapest sights

Budapest is a sheer delight to visit. It consists of two parts on either side of the Danube, Buda high up on its right bank and Pest lower down on the plains in the east. Its grand buildings and open squares often surpass in stateliness those of Vienna. Notable are the house of parliament, the opera, St. Stephen’s Cathedral, the Heldenplatz (Hero’s Square) with its imposing statues, the ancient and more recent historic sites in Buda, the markets, shopping areas, bridges, and renowned hotels. It is most certainly worth exploring and enjoying, and below follows a selection of its most impressive sights.


Note: Unless otherwise specified, photographs courtesy of the authors.


Panorama of Budapest Budapest at night
St. Stephen's Cathedral, Budapest Opera House, Budapest
Great Synagogue, Budapest Fisherman's Bastion, Budapest
Hungarian Parliament, Budapest Budapest: Heroes' Square
Hungarian Parliament, Budapest by Anund Knutsen. Via Wikimedia. CC BY-SA 4.0.  Budapest: Heroes’ Square by Jorge Franganillo. Via Flickr. CC BY 2.0. 



LESLIE J. SANDLOW, MD, is Emeritus Professor of Internal Medicine and Medical Education at the UIC College of Medicine. He was a practicing gastroenterologist and served as Senior Vice President for Academic and Professional Affairs at Michael Reese Hospital. He also served as Senior Associate Dean for Academic and Education Affairs at UIC. He has been active in medical education for over fifty years and developed a continuum of programs in medical education from certificate programs to a doctoral program to prepare educators and physicians for active leadership roles in medical education. He has coordinated the development of an online core curriculum for medical and dental residents which is used at over twenty institutions across the United States.


GEORGE DUNEA, MD, Editor-in-Chief


Summer 2020  |  Sections  |  Travel

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