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Posts Tagged ‘medicine

“Law; an ordinance of reason for the common good, made by him who has care of the community”*…

 

vaccination

 

In the fall of 1713, measles struck the city of Boston, where Cotton Mather, a Puritan theologian and pastor, lived with his pregnant wife and numerous children. Within a month, his wife, their twin newborn babies, another child, and their maidservant had all died. On November 12, Mather wrote in his journal, “The epidemical Malady began upon this Town, is like to pass thro’ the Countrey. . . . it [might] be a service unto the public, to insert in the News-paper, a brief Direction for the managing of the sick. I will advise with a Physician or two.” On November 21, he wrote, “Lord I am oppressed; undertake for me!” On November 23, he wrote, “My poor Family is now left without any Infant in it, or any under seven Years of Age.”

Eight years later, when an explosive smallpox epidemic threatened Boston’s population of eleven thousand, Mather became an outspoken advocate for a new prophylactic against the virus: inoculation. Dr. William Douglass, one of the few doctors in town with a medical degree, rallied others to oppose Mather, claiming that the method was untested (which was true, at least in the new colony) and that it jeopardized the lives of all those who received it. In young Boston, the fight over inoculation tore at epidemic-addled nerves. In November 1721, a bomb was thrown through Mather’s window. A letter attached to it read, “Cotton Mather, you dog, dam you! I’ll inoculate you with this; with a pox to you.”

Douglass won out, quashing Mather’s plans for a systematic inoculation of the town’s population. Eight hundred and forty-four people died of the virus, accounting for 75 percent of all deaths in Boston that year. The unexploded bomb on Mather’s floorboards disabuses those of us living in 2019 of the impression—generated over the past two years by endless news stories about the current global measles outbreak—that inoculation controversies are a novel feature of our present hyper-mediated, hyper-politicized time.

Measles was considered to be eliminated in the United States in 2000. Still, the virus has regained extraordinary ground—and claimed an increasing number of lives—in recent years. Seven hundred and four cases were reported in the United States in the first four months of 2019, according to the Centers for Disease Control and Prevention. The count reached 1,077 by mid-June, occurring in twenty-eight states. More than six hundred cases have occurred in New York City alone since September of 2018.

In June, the CDC issued a warning to travelers planning to leave the country, by which point outbreaks were occurring in all the places you’d expect, countries beset by depressed economies, poor public health management, war, or extreme poverty, including Ethiopia, Madagascar, Kyrgyzstan, the Democratic Republic of Congo, the Philippines, Sudan, and Georgia (not the U.S. state, although cases have been reported there as well). But also, cases were appearing in countries where entrenched vaccination systems existed and where measles had been thought largely a disease of the past: Belgium, France, Germany, and Italy.

The grand cause for these infections—and for the 300 percent growth of reported measles cases around the world in the first quarter of the year over the same quarter the previous year—is precisely the absence of what Cotton Mather proposed for 1721-era Boston: systematic vaccination of the population. The more interesting question, beyond simple international vaccination logistics, is: What ideological and historical shifts have allowed the reemergence of a disease once believed to be under controlled decline?…

A history of the debates over vaccination that asks, can the social contract be protected from a measles outbreak?: “Herd Immunity.”

* Thomas Aquinas

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As we pull up our sleeves, we might send healing birthday greetings to Giovanni Maria Lancisi; he was born on this date in 1654.  A doctor (he was personal physician to three popes), epidemiologist (he made the correlation between mosquitoes and malaria), and anatomist (his study of the heart resulted in the eponymous Lancisi’s sign), he is considered the first modern hygienist.

He carried out extensive anatomical and physiological studies, also epidemiology studies on malaria, influenza and cattle plague.  Contrary to the then-traditional conception of “mal’ aria ” – literally, “bad air” – Lancisi observed that the lethal fever, malaria, disappeared when the swamps near to the city were cleared.  He concluded that injurious substances transmitted from flies and mosquitoes were the origin of the disease.

250px-Giovanni_Maria_Lancisi source

 

 

Written by LW

October 26, 2019 at 1:01 am

“The rule of thumb is the more profound the experience, the longer you should wait before doing it again”*…

 

sartretrippinmane2

 

Beyond their visual qualities, mescaline’s hallucinations posed profound philosophical questions. During the mid-1930s three prominent writers and thinkers left records of their experiments with it. In 1934 and 1935 respectively, Walter Benjamin and Jean-Paul Sartre participated in the now-familiar modus operandi of private session between psychiatrist and artist, with the scientific gaze and the philosopher’s insights informing—or, more often, pitted against—one another…

Sartre wrote little directly about his experience, describing it briefly in notes that later found a place in L’imaginaire, his 1940 study of the phenomenology of the imagination. He found its effects elusive and sinister. “It could only exist by stealth,” he wrote; it distorted every sensation, yet whenever he attempted to perceive it directly it withdrew into the background or shifted shape. Its action on the mind “inconsistent and mysterious,” offering no solid vantage point from which to observe it. In contrast to previous descriptions of the “double consciousness” or état mixte, in which the normal self was able to observe its hallucinations dispassionately, Sartre found it impossible to be a spectator of his own experience. On the contrary, he felt submerged against his will in a miasma of sensations that assailed him viscerally at every turn, a world of grotesque extreme close-ups in which everything disgusted him.

The best-known detail of Sartre’s bad trip is Simone de Beauvoir’s anecdote of him being haunted for weeks after by lobster-like creatures scuttling just beyond his field of vision. Sartre, like Aldous Huxley, was partially sighted—a curious coincidence linking two of the most celebrated intellectuals to have taken the vision-producing drug—and his poor vision may have exacerbated his anxieties about shapes lurking just beyond its reach. Later in life he claimed that it had driven him to a nervous breakdown. “After I took mescaline, I started seeing crabs around me all the time,” he recalled in 1971; “I mean they followed me into the street, into class.” Even though he knew they were imaginary he spoke to them, requesting them to be quiet during his lectures. Eventually he sought psychotherapeutic help from a young Jacques Lacan, which generated “nothing that he or I valued very much,” though “with the crabs, we sort of concluded that it was fear of becoming alone.”…

Caveat comedenti: “Sartre’s bad trip.”

* Dr. James Fadiman

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As we contemplate crustacea, we might spare a thought for Jerome Phillip Horwitz; he died on this date in 2012.  A chemist active in cancer research, Horowitz was the first to synthesized AZT (azidothymidine), in 1964, in the hope that it might retard the growth of malignant cells.  It failed at that task, and lay dormant for two decades… until Burroughs Wellcome tested– and patented– Horowitz’s development as a treatment for HIV-AIDS.  The drug company got FDA approval in 1986, and went on to reap enormous financial returns, of which Horowitz saw none.

After AZT, Horowitz went on to create many successful treatments for cancer and other diseases.

(While some believe that Horwitz was referenced in the Captain Underpants books, the Jerome Horwitz Elementary School in the children’s book series was in fact named after Curly Howard (Jerome Lester Horowitz) of The Three Stooges.

jerome_horwitzX400_0 source

 

Written by LW

September 6, 2019 at 1:01 am

“I lit a thin green candle to make you jealous of me, but the room just filled up with mosquitoes”*…

 

NewYorker_Mosquito_Vertical_v5

 

It turns out that, if you’re looking for them, the words “mosquitoes,” “fever,” “ague,” and “death” are repeated to the point of nausea throughout human history. (And before: … when the asteroid hit, dinosaurs were already in decline from mosquito-borne diseases.) Malaria laid waste to prehistoric Africa to such a degree that people evolved sickle-shaped red blood cells to survive it. The disease killed the ancient Greeks and Romans—as well as the peoples who tried to conquer them—by the hundreds of thousands, playing a major role in the outcomes of their wars. Hippocrates associated malaria’s late-summer surge with the Dog Star, calling the sickly time the “dog days of summer.” In 94 B.C., the Chinese historian Sima Qian wrote, “In the area south of the Yangtze the land is low and the climate humid; adult males die young.” In the third century, malaria epidemics helped drive people to a small, much persecuted faith that emphasized healing and care of the sick, propelling Christianity into a world-altering religion…

In total… mosquitoes have killed more people than any other single cause—fifty-two billion of us, nearly half of all humans who have ever lived. [They are] “our apex predator,” “the destroyer of worlds,” and “the ultimate agent of historical change.”…

They slaughtered our ancestors and derailed our history– and they’re not finished with us yet: “How Mosquitoes Changed Everything.”

* Leonard Cohen

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As we nestle under our nets, we might spare a thought for Girolamo Fracastoro; he died on this date in 1553.  A physician, poet, and scholar of mathematics, geography, and astronomy, he he proposed (in 1546) that epidemic diseases are caused by transferable tiny particles or “spores” that could transmit infection by direct or indirect contact or even without contact over long distances; he called these infectious agents fomes, from the Latin, meaning tinder.  His theory was influential for three centuries, until it was sufficiently refined and extended to become modern germ theory, which superseded Fracastoro’s model.

220px-Titian_Girolamo_Fracastoro

Girolamo Fracastoro, by Titian c. 1528

source

 

Written by LW

August 6, 2019 at 1:01 am

“Let It Bleed”*…

 

bloodletting

Science sometimes goes down an incorrect path. Though the path is wrong, a detailed superstructure of learning gets built on top of the incorrect premise. Such was the case with the medical practice of bloodletting in the early 1800s, where detailed procedures were developed regarding which veins to open for a given set of symptoms. One leader in this practice was America’s Dr. Benjamin Rush:

Early in the [1800s], … physicians put their faith in bloodletting, to draw out the evil humors which were believed to cause disease. With bloodletting, it took years of learning to know precisely which veins, by what rituals, were to be opened for what symptoms. A superstructure of technical complication was erected in such deadpan detail that the literature still sounds almost plausible.

However, because people, even when they are thoroughly enmeshed in descriptions of reality which are at variance with reality, are still seldom devoid of the powers of observation and independent thought, the science of bloodletting, over most of its long sway, appears usually to have been tempered with a certain amount of common sense. Or it was tempered until it reached its highest peaks of technique in, of all places, the young United States. Bloodletting went wild here. It had an enormously influential proponent in Dr. Benjamin Rush, still revered as the greatest statesman-physician of our revolutionary and federal periods, and a genius of medical administration. Dr. Rush Got Things Done. Among the things he got done, some of them good and useful, were to develop, practice, teach and spread the custom of bloodletting in cases where prudence or mercy had heretofore restrained its use. He and his students drained the blood of very young children, of consumptives, of the greatly aged, of almost anyone unfortunate enough to be sick in his realms of influence.

His extreme practices aroused the alarm and horror of European bloodletting physicians. And yet as late as 1851, a committee appointed by the State Legislature of New York solemnly defended the thoroughgoing use of bloodletting. It scathingly ridiculed and censured a physician, William Turner, who had the temerity to write a pamphlet criticizing Dr. Rush’s doctrines and calling ‘the practice of taking blood in diseases contrary to common sense, to general experience, to enlightened reason and to the manifest laws of the divine Providence.’ Sick people needed fortifying, not draining, said Dr. Turner, and he was squelched…

As in the pseudoscience of bloodletting, just so in the pseudoscience of city rebuilding and planning, years of learning and a plethora of subtle and complicated dogma have arisen on a foundation of nonsense…

Via DelanceyPlace.com, an excerpt from Jane Jacobs’ classic The Death and Life of Great American Cities: “Bloodletting.”

* The Rolling Stones

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As we drip, we might recall that it was on this date in 1949 that the first science fiction series debuted on American television, the DuMont Network’s Captain Video and His Video Rangers.  Written by such luminaries as Isaac Asimov, Arthur C. Clarke, James Blish, and Jack Vance, it was– even in its time, when early television productions often were thrown-together affairs– considered crude, owing much to the fact that the daily show was done live on a meager budget.  Indeed, the actors were paid so little they actually made more money from appearing in character at supermarket openings, county fairs, and the like than they did from their salaries.

Still, it ran for a total of 1,537 episodes, and quickly spawned competitive sci-fi offerings like Tom Corbet, Space Cadet and Space Patrol.

Captain_Video_title_card source

 

Written by LW

June 27, 2019 at 1:01 am

“Life is a DNA software system”*…

 

stranger-visions-wellcome-collection-2305-1

 

DNA from discarded cigarette butts and chewed up gum has been used to create a series of life-sized 3D printed portraits for a new exhibition at the Wellcome Collection.

American artist Heather Dewey-Hagborg walked the streets of New York picking up cigarettes and hair for her project called Stranger Visions.

She then analysed the DNA to work out the gender and ethnicity of the people involved as well as their likely eye colour and other traits including the size of their nose, before using face-generating software and a 3D printer to create a series of speculative portraits

More– and more photos– at “3D printed portraits made with DNA from cigarette butts to feature in new Wellcome Collection display.”

See also the analogically-related “Artificial Intelligence Generates Humans’ Faces Based on Their Voices.”

* Craig Venter

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As we noodle on nature and nurture, we might recall that it was on this date in 1981 that the USDA announced the first genetically-engineered vaccine for any animal or human disease: an immunization against Hoof and Mouth Disease (also known as Foot and Mouth Disease, or FMD), created using gene splicing.

NHF-FMD-Keep-Out source

 

“No woman can call herself free until she can choose consciously whether she will or will not be a mother”*…

 

women

 

If you’re in possession of a uterus, at some point in your life you’ve likely gotten the message that having children isn’t a choice—it’s your duty. For well over a century, doctors, psychologists, and politicians have engaged in intense public campaigns to persuade American women to bear children, publicly exalting motherhood and warning of personal, and societal, peril if they don’t comply.

There’s a word for this: pronatalism, the promotion of baby-making for a nation’s social, political, and economic purposes…

The techniques that have been used to pressure American women to keep breeding are even more shocking than you might think– proselytizing, pseudoscience, and shaming–all committed in the name of turning women into mothers: “A Brief History of Bullying Women to Have Babies.”

* Margaret Sanger

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As we cherish choice, we might send healing birthday greetings to Helen Brooke Taussig; she was born on this date in 1898.  The founder of pediatric cardiology, Dr. Taussig pioneered the use of X-rays and fluoroscopy to identify heart defects in newborns; then in 1944, with surgeon Alfred Blalock, she developed a surgical procedure for treating blue baby syndrome. In the 1960s, Taussig was a leader in the identification of Thalidomide (a fertility drug) as a cause of birth defects, and an effective campaigner for its banning.

Though she chose never to marry nor have children herself, Taussig was responsible for advances that have saved millions of children’s lives.

220px-Helen_B._Taussig source

 

“The midpoint in medicine between excessive emotional involvement with patients and a complete lack of empathy is not a simple one to locate”*…

 

elphant nose

 

In sixteenth-century Leuven, a troubled man sent for a physician to help him with his unusually long nose. The man believed that his nose was of ‘such a prodigious length’, it resembled the ‘snoute’ of an elephant. It hindered him in everything he did, to the extent that sometimes it ‘lay in the dish’ where his supper was served. His physician, at this point, artfully and carefully, ‘conveighed a long pudding’ onto the nose of the desperate man, and then with a Barber’s razor ‘finely cut away’ the offending pudding nose while his patient was drowsy from a sleeping draft. The physician prescribed him a wholesome diet and sent the man away, relieved of his extraordinarily long nose, and the burden of ‘fear of harme and inconvenience.’

This case history was described in the English translation of the medical treatise, The Touchstone of Complexions (1576) by the Dutch physician, Levinus Lemnius, as an example of ‘melancholicke’ fantasy. Instead of assuming the man was possessed by a malevolent spirit or demon (a possible diagnosis at this time), that he was a ‘lunatic’ and beyond treatment, or dismissing his delusion to his face, the sixteenth-century physician in the story entered into the world of the ‘phantasie’ to try and help his patient’s obvious distress.

We very rarely read histories of incidents from this period where physicians are concerned for the emotional and mental wellbeing of their patients to this degree. Usually the tendency has been to emphasize the ‘barbarous and debilitating’ treatments of early modern medicine – its bloodletting, purging, and surgery without anaesthetic, or to highlight the moralizing religious doctrine behind treatments of illnesses of the mind or ‘passions’. Yet, here was a doctor trying an imaginative solution to a problem he believed stemmed from an imbalance of the humour ‘melancholy’ in his patient’s body….

More examples of empathetic early healers and the bizarre cases they “cured– the man with frogs in stomach, the man whose buttocks were made of glass– at “The Man with an Elephant’s Nose.”

* Christine Montross, Body of Work: Meditations on Mortality from the Human Anatomy Lab

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As we make it better, we might send revolutionary birthday greetings to Edward Donnall “Don” Thomas; he was born on this date in 1920.  A physician and medical researcher, Thomas shared (with Joseph E. Murray) the 1990 Nobel Prize for Physiology or Medicine for his work in transplanting bone marrow from one person to another – an achievement related to the cure of patients with acute leukemia and other blood cancers or blood diseases.  Although this prize usually goes to scientists doing basic research with test tubes, Thomas was a doctor doing hands-on clinical research with patients.

230px-Edward_Donnall__Don__Thomas source

 

Written by LW

March 15, 2019 at 12:01 am

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