Hektoen International

A Journal of Medical Humanities

Erik Jorpes: from Kökar to Helsingfors, Moscow, and Stockholm

Frank A. Wollheim
Lund, Sweden

Fig. 1 Jorpesgården (Jorpes farm) on Kökar where Jorpe was born. (reference 9)

Johan Erik Johansson was born in 1894 in Jorpesgården in the village of Overbroad on the small, barren island of Kökar in the archipelago of Åland, a Swedish-speaking part of Finland. His father, Johan Eriksson, was a fisherman and his mother struggled on the lean, arable farm. When Erik was six and attending the primitive local school, a volunteer student teacher from Åbo was impressed by the boy’s remarkable learning ability. With considerable difficulty, she convinced his parents to let Erik attend high school in Åbo, despite great economic barriers. She arranged a stipend covering the tuition in the Swedish gymnasium and accommodated him with her family. Most of his classmates came from upper-class families. Erik had to borrow the textbooks, but he was often the number-one student in the class and graduated in 1914 with top grades. In Åbo, he mixed with people in Marxist circles. He decided to study medicine at the Imperial University in Helsingfors and changed his name to Erik Jorpes. In Helsingfors, Erik managed to convince some rich people to guarantee the student loan that he needed. Jorpes was a serious student and earned the highest grade in medical chemistry from the famous professor Robert Tigerstedt (1853-1923), an achievement that would help him later in life.

Jorpes became a teetotaler, having witnessed tragic consequences from alcohol, and had strong sympathy for the underprivileged. He was a devout Christian but despised the clergy for living in luxury while the congregation struggled with poverty. After the Russian Revolution in 1917, Finland declared independence. A civil war started between the socialist “Red” and conservative “White” sides. Jorpes did not like violence but sympathized with the revolutionaries. Although he had no training in patient care, a friend talked him into becoming the only “doctor” for wounded Red soldiers. In April 1918, the Red side lost the fight and fled. In a camp north of Moscow, Jorpes cared for almost 5,000 soldiers.


Fig 2. Erik Jorpes Student in Åbo 1914. From the Per Jorpes Private Archive. Source.

Passing through Petrograd, he became a cofounder of the Finnish communist party. Jorpes soon noticed that the Soviet leaders did little to improve the living conditions of poor people. In December of 1918, he escaped to the West, walking form Petrograd to Viborg. There he took a train to Åbo, where his friend from the gymnasium helped him hide until he was smuggled onto a freighter to Kökar. In Finland he risked being punished as a traitor. From Kökar, two fishermen smuggled him to the Swedish island of Waxholm, fifteen miles east of Stockholm. Jorpes then walked to Stockholm carrying only his credentials from medical school in Helsingfors. He applied to the Karolinska Institute but as a foreigner he needed permission from the authorities. An interview was arranged with a cabinet member, the chairman of the Social Democratic Party, Hjalmar Branting, a future prime minister. Branting helped Jorpes obtain the needed permission but made him promise to abstain from all political activities while in Sweden. Jorpes kept the promise and devoted the rest of his life to science.


Fig 3. The barque Pamir with 4000 m2 of sails from an undergraduate lecture by Jorpes in 1960. (Reference 10)

To finance his studies, Jorpes needed an income. The Helsingfors credentials helped him to be hired as an amanuensis in the lab of the associate professor of chemistry and pharmacology, Einar Hammarsten. The Hammarsten laboratory was well equipped for analytical studies of biologic material. With Hammarsten, Jorpes worked on the composition of nucleic acids. His first paper was published in 1923 and in 1928 he presented a noted doctoral thesis written in German: Über Pentosennucleinsäuren im Tierorganismus unter besonderer Berücksichtigung der Pancreasnucleinsäuren. It contained new observations on ribose and deoxyribose. His data became useful for other investigators, but Jorpes moved out of this increasingly popular field. That same year, he was promoted to succeed his mentor, who had been promoted to the chair of medical chemistry at the Karolinska Institute. In 1928-9 Jorpes was also awarded a Rockefeller fellowship and worked with Phoebus Levene (1869-1940) at the Rockefeller Institute in New York. Urged by a senior physician at Karolinska, Jorpes visited the laboratory of Charles Best (1899-1978) in Toronto in 1929 to explore the secrets of insulin production. Best was a friendly host who, besides insulin, also was interested in heparin as a possible anticoagulant as had recently been suggested by its discoverer, William Howell.1


Fig 4. Erik Jorpes at work in 1960. Unknown photographer. From Hufvudstadsbladet, 1 August 2021, p. 25. Via Wikimedia

Throughout his life in science, Jorpes prioritized research that might impact clinical practice. In Stockholm it did not take him long to establish insulin production with a friend at the small drug company Vitrum. When Sweden was isolated during World War II, Jorpes helped Vitrum to scale up production and make Sweden self-sufficient in its insulin supply. In 1930 Jorpes then concentrated on investigating heparin. The preparation Howell was working with contained potentially harmful impurities. Jorpes refined the isolation and showed that heparin consisted of heavy sulfated mucopolysaccaride with unusual carbohydrates, glucosamine, and glucuronic acid.2,3 This enabled Vitrum to market heparin in 1936 as a reliable anticoagulant for the treatment of thromboembolism. Heparin became crucial for prevention of coagulation and enabled Crafoord and Senning to pioneer extracorporeal heart surgery.4,5 One of Jorpes’ many outstanding fellows, Sune Bergtröm (1916-2004), a future Nobel laureate, participated in the heparin work.6 Jorpes later commented that his largest obstacle was overcoming the misconceptions of other assertive investigators. His commitment to the work was total. When asked in 1935 why he remained in the lab when his son was born, he answered: “Sons you can have more of, but the structure of heparin is unique.”7

Stable and pure fibrinogen was needed for the standardization of heparin. Two young research fellows of Jorpes, Birger and Margareta Blombäck, were working on the purification of fibrinogen using Cohn fractionation. An intermediate fraction named I-0 turned out to contain antihemophilic factor, AHF. Inga Marie Nilsson, a postdoctoral fellow from Jan Waldenström in Malmö and expert in hemophilia, helped with her assay for AHF (AHG). In Malmö she was the first ever to use fraction I-0 to treat bleeding episodes in hemophilia patients in 1956, a major therapeutic breakthrough. Prophylactic treatment of hemophilia was successfully introduced in Sweden a decade earlier than in other countries. Another bleeding condition, von Willebrand disease, which is endemic in Åland, also responded to AHF. This was amply confirmed at a field expedition to Åland organized by Jorpes in 1958. One of nineteen patients had been examined by Erik von Willebrand (1870-1949) who described the disease in 1926.

Jorpes was also a demanding but popular teacher for undergraduate students. His lectures were always carefully prepared and he would use unconventional teaching tricks. He asked the class, “What happened in 1628?” All students knew that “The Wasa warship capsized that year.” Jorpes answered, “That is right, but William Harvey (1578-1657) also described blood circulation in 1628.” He used the image of a three-masted barque with 4,000 square meters of sails to illustrate the total surface area of circulating erythrocytes.

Fig 5. Runmarö in the the outer archipelago of Stockholm. Photo by Jan Augustsson. 2010. Swedish National Heritage Board. Via Wikimedia. CC BY 2.5.

Jorpes trained many fellows who went on to leading academic positions. They remember his diligence, working from 9:00 AM until midnight. The best time to talk to the boss was between 9 and 10 PM when tea or coffee was provided in the lab. Royalties made Jorpes wealthy but he spent most of that money in the lab for equipment and salaries. Jorpes was a co-founder of the Swedish Medical Research Council in 1947, and he served on several important committees and boards. He continued scientific activity long after the compulsory retirement age of sixty-six.

Jorpes acquired a cottage on Runmarö in the archipelago of Stockholm, where he relaxed with friends, colleagues from the lab, and visiting scientists. He was an expert in botany, ornithology, and fishing. He enjoyed taking his small boat to the outer areas of the archipelago and knew the waters so well that he did not need a nautical chart. Jorpes did not forget his roots on Kökar and was generous with support to its pauper inhabitants, making sure that most of the money was given to those most in need.

Jorpes also had a profound interest in medical history. He was a great admirer of Jöns Jacob Berzelius and in 1970 rearranged the Berzelius Museum at the Swedish Academy of Sciences. Jorpes was elected a member of the Academy in 1962. In 1960 he published a Berzelius biography in Swedish and an extended English translation was published in 1966.8 He also wrote essays on other investigators and one on Alfred Nobel.

Erik Jorpes received many honors and prizes. In 1963 he was the fourth winner of the distinguished annual Nordic Jahre Prize. Distinguished previous winners had included Asbjörn Fölling, Ragnar Granit, and Jan Waldenström, so Erik Jorpes was in august company. He died in 1973 and is buried on Runmarö.

References

  1. Howell WH, Holt E. The purification of heparin and its chemical and physiological reactions. Bull Johns Hopkins Hospital1928;42:199-206.
  2. Jorpes E. The chemistry of heparin. Biochem J 1935;29:1817-30.
  3. Jorpes E, Bergström S. On the relationship between the sulphur content and the anticoagulant activity of heparin preparations. Biochem J. 1939;33:47-52.
  4. Crafoord C, Senning Å.. Utvecklingen av extracorporeal cirkulation med hjärtlungmaskin [The development of extracorporeal circulation with heart-lung machine]. Nord Med. 1956 Sep 6;56(36):1263-8.
  5. Crafoord C, Norberg B, Senning Å. Clinical studies in extracorporeal circulation with a heart-lung machine. Acta Chir Scand. 1957 Mar 28;112(3-4):220-45.
  6. Bergström S. Prostaglandins: members of a new hormonal system. These physiologically very potent compounds of ubiquitous occurrence are formed from essential fatty acids. Science. 1967 Jul 28;157(3787):382-91.
  7. Mutt V, Blombäck M.Erik Jorpes –a pragmatic physiological chemist. In Semenza G, Jaenicke R. Selected topics in the histoty of biochemistry. Personal recollections VI. Elsevier Science B.V. 2000, pp 363-389.
  8. Jorpes E. Jac Berzelius. His life and work. Bidr K Sv Vetenskapsakademins Historia VII.1966 pp 1-156. Almqvist & Wiksell, Uppsala.
  9. Erik Jorpes : *15.7.1894 †10.7.1973, invald 11.4.1945 : minnesteckning vid Kungl. Vetenskapsakademiens högtidssammankomst den 31 mars 2000/av Ulf Lagerkvist.
  10. Nyman D. Erik Jorpes – en pragmatisk polyhistor. Finska läkarsällskapets handlingar 2018;178:66-7 (a pragmatic polyhistor).

FRANK A. WOLLHEIM, MD Lund 1958, PhD Lund 1968, Instructor Department of Medicine, U of Minnesota 1963-5. Associate professor of medicine in Malmö 1972-82. Professor and Chairman, Departemnt of Rheumatology, Lund 1982-1998. Areas of research: Bromine containing hypnotics (1956-8); Common variegated hypogammaglobulinemia (1959-1965); Polyclonal and monoclonal hyper-IgM (1963-69). From 1968 rheumatoid arthritis, cartilage macromolecules as biomarkers, clinical aspect of SLE, systemic sclerosis. 1996 Sabbatical in the lab of Jean-Michel Dayer. 2003 cofounder of EUSTAR, the European scleroderma research initiative.

Summer 2021

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