Posts Tagged ‘history of medicine’
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In 1960, hospital costs were were 38% of total U.S.healthcare costs; in 2010, they were 37%. But in 1960, hospital costs were $9 billion of a total $23.4 billion in healthcare costs; in 2010, they were $814 billion of a total $2, 186 billion. (Simple inflation, using the CPI as a metric, means that the 1960 figure, in 2010 dollars, would be around $1.8 billion.)
But in many ways more interesting than the growth in the overall total are the changes in how healthcare is financed– in who pays. In 1960, for example, almost 100% of the spending on prescription drugs came out of the consumer’s pocket; by 2010, out-of-pocket spending was down to 20%.
Watch the healthcare economy evolve in the California Healthcare Foundation’s interactive graphic, “U.S. Healthcare Spending: Who Pays?“
As we stock up on supplements, we might spare an anatomically-correct thought for Guillaume-Benjamin-Amand Duchenne (de Boulogne); he died on this date in 1875. Regarded by many to be the “father of modern neurology,” Duchenne developed the first working understanding of the conductivity of neural pathways; he was the first to understand the effect of lesions on these structures; and he innovated diagnostic techniques including deep tissue biopsy, nerve conduction tests, and clinical photography. He’s probably best remembered for identifying the myopathies that came to bear his name: Duchenne Muscular Dystrophy, Duchenne-Aran spinal muscular atrophy, Duchenne-Erb paralysis, Duchenne’s disease (Tabes dorsalis), and Duchenne’s paralysis (progressive bulbar palsy).
Mo Costandi, the Neurophilosophy blogger for The Guardian, has created a wonderful side-site, Neuro Images, a collection of pictures of the brain. From the scientific (like the image above) through the historical…
… to the fanciful…
… readers will find a treasure trove at Neuro Images.
[The title of this post is borrowed from the title of Charles Hampden-Turner's extraordinary survey of theories of consciousness and mind through the ages. It's sadly out of print at the moment, but readily available used (e.g., here)-- and well worth the effort.]
As we wrestle with mental maps, we might spare an incisive thought for William Williams Keen; he died on this date in 1932. A pioneering physician, Keen was the first “brain surgeon” in the U.S.; he successfully removed a brain tumor from a patient in 1887. He was the first physician to perform a decompression of the skull and the first physician in Philadelphia to use Lister’s antiseptic surgical practices. Indeed, in 1892 Keen, with James White, wrote the first American surgery text based on Listerian principles.It was later superseded by Keen’s Surgery its Principles and Practices, which became the “Bible” of American surgeons. Keen is also remembered for having assisted in the now famous secret operation performed on then-President Grover Cleveland in 1893, in which was the Commander-in-Chief’s upper left jaw was removed to rid him of a malignant tumor.
photo: Minden/plainpicture (source)
Many biologists have long believed that, before the point 2.9 billion years ago that the three domains of life emerged, there was no speciation– genetic material of all sorts was freely exchanged in every direction. In this “pre-Darwinian” period, which lasted hundreds of millions of years, there was no “evolution”; rather, cells struggling to survive on their own exchanged useful parts with each other without competition.
Now, as a function of the effort to identify the Last Universal Common Ancestor (LUCA)– the organism from which all life on earth must be descended– scientists have begun to suspect that all of those cells trading parts were part of a single entity: an enormous mega-organism that filled the planet’s oceans before splitting into three and giving birth to the ancestors of all living things on Earth today.
It was around 2.9 billion years ago that LUCA split into the three domains of life: the single-celled bacteria and archaea, and the more complex eukaryotes that gave rise to animals and plants (see timeline). It’s hard to know what happened before the split. Hardly any fossil evidence remains from this time, and any genes that date that far back are likely to have mutated beyond recognition.
That isn’t an insuperable obstacle to painting LUCA’s portrait, says Gustavo Caetano-Anollés of the University of Illinois at Urbana-Champaign. While the sequence of genes changes quickly, the three-dimensional structure of the proteins they code for is more resistant to the test of time. So if all organisms today make a protein with the same overall structure, he says, it’s a good bet that the structure was present in LUCA. He calls such structures living fossils, and points out that since the function of a protein is highly dependent on its structure, they could tell us what LUCA could do…
LUCA had a rich metabolism that used different food sources, and it had internal organelles. So far, so familiar. But its genetics are a different story altogether. For starters, LUCA may not have used DNA. Poole has studied the history of enzymes called ribonucleotide reductases, which create the building blocks of DNA, and found no evidence that LUCA had them (BMC Evolutionary Biology, DOI: 10.1186/1471-2148-10-383). Instead, it may have used RNA: many biologists think RNA came first because it can store information and control chemical reactions.
The crucial point is that LUCA was a “progenote“, with poor control over the proteins that it made, says Massimo Di Giulio of the Institute of Genetics and Biophysics in Naples, Italy. Progenotes can make proteins using genes as a template, but the process is so error-prone that the proteins can be quite unlike what the gene specified. Both Di Giulio and Caetano-Anollés have found evidence that systems that make protein synthesis accurate appear long after LUCA. “LUCA was a clumsy guy trying to solve the complexities of living on primitive Earth,” says Caetano-Anollés…
Only when some of the cells evolved ways of producing everything they needed could the mega-organism have broken apart. We don’t know why this happened, but it appears to have coincided with the appearance of oxygen in the atmosphere, around 2.9 billion years ago. Regardless of the cause, life on Earth was never the same again.
As we rethink the roots of our family trees, we might spare a thought for the Spanish-Arab philosopher, physician, and astronomer known in the West as Averroes; he died on this date in 1198. The most famous of medieval Muslim philosophers, he was an authority on Aristotle, whose thought he defended against the charge that it was an affront to Islam. His Kulliyat fi ab tb (Generalities on Medicine) attempted to codify logically all existing medical knowledge– from organ anatomy and hygiene to the prevention, diagnosis, and treatment of diseases– and spread widely via translations. In astronomy, he argued for strictly concentric orbital organization, believing that the motion of the planets had to be around a physical center (the Earth)– thus rejecting Ptolemy’s system of epicycles.
Two out of three ain’t bad.
“The individual with a straw was asked to instruct the blindfolded individual to do a dance routine.”
- Science of Dating: Topics of Conversation
“It can then use this information to change the rhythm of its hair.”
- In Brachiopods’ Eyes, the Theory of Evolution
“The spermatophore executed a surprise attack, penetrating and embedding itself deep in the flesh”
- Self-injecting Squid Sperm
“When the subjects… were sleeping deeply, the researchers played a variety of noises, from a jet engine to an ice machine”
- Brain Waves Foretell Whether We’ll Sleep Soundly
More nifty non sequiturs at Out of Context Science…
As we slip into our lab coats, we might recall that it was on this date in 1867 that Joseph Lister published the first of his series of articles in The Lancet on “The Antiseptic Principle of the Practice of Surgery.” Lister, having noticed that carbolic acid (phenol) was used to deodorize sewage, had experimented with using it to spray surgical instruments, surgical incisions, and dressings. The result, he reported, was a substantially reduced incidence of gangrene.