Advocacy and community: the social roles of physicians in the last 1000 years. Part II.
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Medicine in the 16th through the 18th centuries underwent profound changes -- from its understanding of the human body to its growing significance in the body politic. Key to advances in medicine as well as to the growth of nations was a conceptual shift in the perception of the natural world, which would ultimately provide a methodology for therapeutic advances as well as for the building of wealthy, strong nations. (+info)
Brief history of antipyretic therapy.
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Both external cooling and pharmacotherapy have been used to treat fever since time immemorial. In the past century such treatments have proliferated at an astonishing rate. The COX-2 inhibitors are the most recent additions to the antipyretic pharmacopoeia. Additional research is needed to determine whether they represent an important new chapter in antipyretic therapy's long history or, for that matter, if the benefits of any currently available treatment for fever outweigh its cost. (+info)
Facts and fiction surrounding the discovery of the venous valves.
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Venous valves are delicate structures, the integrity of which is crucial for the normal function of the venous system. Their abnormalities lead to widespread disorders, ranging from chronic venous insufficiency to life-threatening thromboembolic phenomena. The discovery of the venous valves, however, has been the subject of hot controversy. Even though Fabricius ab Aquapendente is credited with the discovery by most historians, we demonstrate in this paper that other anatomists described them many years before Fabricius ab Aquapendente publicly demonstrated them in Padua in 1579. A thorough review of the historical literature surrounding the discovery of the venous valves was carried out from 1545 to the present under the supervision of the Medical History Department of our institution. Research was performed at the History of Medicine Division of the National Library of Medicine and through MEDLINE access to the medical literature. The Parisian Charles Estienne first mentioned the venous valves in his 1545 publication when he described "apophyses membranarum" in the veins of the liver. Lusitanus and Canano publicly demonstrated them in the azygos vein during cadaver dissections performed in Ferrera, Italy. The Parisian Jacques Sylvius described valves in the veins of the extremities in 1555. The work of these anatomists, however, could not achieve full recognition, because Andreas Vesalius, the leading anatomist at that time, was unable to confirm their findings and strongly denied the existence of venous valves. Vesalius's influence was so powerful that research on the subject was idle until 1579, when Fabricius ab Aquapendente "discovered" the venous valves. About the same time, the German Salomon Alberti published the first drawings of a venous valve (in 1585). William Harvey, a disciple of Fabricius ab Aquapendente, finally postulated the function of the venous valves, providing anatomical support for one of the greatest discoveries in medicine: the blood circulation. Therefore, our investigations revealed that Estienne and Canano discovered the venous valves in the 1530s. Fabricius ab Aquapendente's achievement was their full recognition 64 years later. However, it was not until 1628 that their function was fully understood, with the discovery of the blood circulation by William Harvey. (+info)
Deafness and liver disease in a 57-year-old man: a medical history of Beethoven.
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Ludwig van Beethoven had a number of medical conditions, including deafness and chronic liver disease, for which there are contemporary descriptions. An autopsy was performed on the day after his death. Physicians and historians have tried to reinterpret original sources to determine the causes of his deafness and systemic illnesses. We have reviewed the differential diagnoses that have been proposed by otologists and physicians. Clinical and post-mortem findings point to renal papillary necrosis and liver cirrhosis of unknown aetiology. In the absence of further histological examination, there is no definitive answer to the cause of his deafness and gastro-intestinal symptoms. (+info)
Eduard Jaeger's Test-Types (Schrift-Scalen) and the historical development of vision tests.
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PURPOSE: Eduard Jaeger's original Test-Types were carefully evaluated: (1) to determine whether Jaeger had maintained a consistent standard, (2) to establish the correct Snellen equivalent for Jaeger's Test-Types, (3) to answer the question of why and how the standard was lost, and (4) to compare the visual angle of optotypes to lines of continuous text. METHODS: All original Viennese editions of Jaeger's Test-Types, as well as first generation United Kingdom (UK) and United States (US) versions, were evaluated. Data were collected objectively using a microruler with a 20X loupe and subjectively using a laser distance-measuring device. The data were analyzed using Microsoft Excel. All previous measurements of Jaeger's Test-Types, objective and subjective, collected over the past 133 years were compared to the current data and to each other. RESULTS: The correct Snellen equivalent of Jaeger's Test-Types was determined. The visual angle created from the measurement of the height of lowercase letters, without ascenders or descenders, provides an accurate method of assigning a visual angle of a line of continuous text. Comparing the typefaces used in printing first generation UK and US versions of Jaeger's Test-Types to the Viennese editions provided an explanation for the absence of a consistent standard for Jaeger's Test-Types today. CONCLUSIONS: All 10 versions of Jaeger's original Test-Types are virtually identical and established a gold standard for reading vision tests. Jaeger's standard was lost when his Test-Types were first printed in the UK and the US using local typefaces. The Jaeger standard has been re-established. Visual angles determined using continuous text are comparable to those obtained by using optotypes. (+info)
Illustrating cerebral function: the iconography of arrows.
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For over a century the arrow has appeared in illustrations of cerebral function, yet the implications of using such symbols have not been previously considered. This review seeks to outline the nature, evolution, applications and limitations of this deceptively simple graphic device when it is used to picture functions of the brain. The arrow is found to have been used in several different ways: as a means of endowing anatomical structures with functional properties; as a method of displaying neural function either in free-standing form or in a structural or spatial framework; as a device for correlating functional data with underlying brain topography; and as a technique for linking functions of the brain with the world outside and with various philosophical concepts. For many of these uses the essential feature of the arrow is its directional characteristic. In contrast to the line, it is direction that enables the arrow to display information about time, which in turn can be exploited to depict functional rather than structural data. However, the use of the arrow is fraught with difficulties. It is often unclear whether an arrow has been used to illustrate fact, hypothesis, impression or possibility, or merely to provide a decorative flourish. Furthermore, the powerful symbolic nature of the arrow can so easily confer a spurious validity on the conjectural. Increasingly now there are insuperable difficulties when attempting to illustrate complex mechanisms of brain function. In the iconography of cerebral function, therefore, arrows with all their ambiguities may in certain circumstances become superseded by more non-representational symbols such as the abstract devices of the computational neuroscientist. (+info)
Words of Tohkaku Wada: medical heritage in Japan.
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The origins of Japan's medical ideas, which are deeply rooted in its religion, culture and history, are not widely understood in medical societies of other countries. We have taken up the task of summarising this tradition here so that some insight can be gained into the unique issues that characterise the practice of medicine in Japan. We borrow from the sayings of Tohkaku Wada, a medical philosopher of late eighteenth-century Japan, for a look at Japanese medical tradition. Wada's medical thought was very much reflective of the Buddhism, Zen, and swordsmanship that informed eighteenth-century philosophy in Japan. His central concepts were "chu" and "sei", that is, complete and selfless dedication to the patient and the practice of medicine. This paper explores Wada's thought, explaining it mainly from the standpoint of Japanese traditional culture. (+info)
History of sentinel node and validation of the technique.
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Sentinel node biopsy is a minimally invasive technique to select patients with occult lymph node metastases who may benefit from further regional or systemic therapy. The sentinel node is the first lymph node reached by metastasising cells from a primary tumour. Attempts to remove this node with a procedure based on standard anatomical patterns did not become popular. The development of the dynamic technique of intraoperative lymphatic mapping in the 1990s resulted in general acceptance of the sentinel node concept. This hypothesis of sequential tumour dissemination seems to be valid according to numerous studies of sentinel node biopsy with confirmatory regional lymph node dissection. This report describes the history and the validation of the technique, with particular reference to breast cancer. (+info)