[The 125th anniversary of the DMW (Deutsche Medizinische Wochenschrift): development and perspectives].
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Biomedical subjects
Publications and source records attributed to W U Eckart.
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Medical theories and practices concerning illness and health in old age as well as several aspects of society that do influence the aging process are described from a historical perspective integrating classical antiquity, middle ages, and modern times. From the present state of research it is distinguished between "primary illnesses in old age" and chronical diseases which might principally also begin in younger ages but take a different course in old age. Even if the frequency of disease and multimorbidity is increasing, negative stereotypes of the aging process have to be invalidated. Advances in medical sciences are a good pre-condition for increasing physical and mental health in old age.
The epidemiological and pharmacological fight against malaria and German malaria research during the Nazi dictatorship were completely under the spell of war. The Oberkommando des Heeres (German supreme command of the army) suffered the bitter experience of unexpected high losses caused by malaria especially at the Greek front (Metaxes line) but also in southern Russia and in the Ukraine. Hastily raised anti-malaria units tried to teach soldiers how to use the synthetic malaria drugs (Plasmochine, Atebrine) properly. Overdoses of these drugs were numerous during the first half of the war whereas in the second half it soon became clear that it would not be possible to support the army due to insufficient quantities of plasmochine and atebrine. During both running fights and troop withdrawals at all southern and southeastern fronts there was hardly any malaria prophylaxis or treatment. After war and captivity many soldiers returned home to endure heavy malaria attacks. In German industrial (Bayer, IG-Farben) and military malaria laboratories of the Heeres-Sanitäts-Akademie (Army Medical Academy) the situation was characterised by a hasty search for proper dosages of anti-malaria drugs, adequate mechanical and chemical prophylaxis (Petroleum, DDT, and other insecticides) as well as an anti-malaria vaccine. Most importantly, large scale research for proper atebrine and plasmochine dosages was conducted in German concentration camps and mental homes. In Dachau Professor Claus Schilling tested synthetic malaria drugs and injected helpless prisoners with high and sometimes lethal doses. Since the 1920s he had been furiously looking for an anti-malaria vaccine in Italian mental homes and from 1939 he continued his experiments in Dachau. Similar experiments were also performed in Buchenwald and in a psychiatric clinic in Thuringia, where Professor Gerhard Rose tested malaria drugs with mentally ill Russian prisoners of war. Schilling was put to death for his criminal research in 1946, Rose was condemned to lifelong imprisonment in 1947, though, not for his malaria research but for his dreadful experiments with epidemic typhus sera which he also had performed in concentration camps and with prisoners of war in Russia.
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German malaria research during the colonial period took place between medical and political interests. In the field of zoological and clinical research of malaria Germany was not a pioneer. Nevertheless, Robert Koch forced by impressive Italian results tried to participate in malaria research on the field of acquired malaria immunity and by optimizing the therapeutic doses of quinine in German New Guinea. In the German Cameroons, on the other hand, the fight against malaria was completely dominated by racial and political arguments. The paper tries to shed light on this dichotomy, which turned out to be not very productive.
There is no doubt that medical semiotics are having a revival at the moment. Different aspects of yesterday's and today's interest in semiotics and in the historical interpretation of signs of disease in the context of theory and history of medicine can be illuminated: their deciphering as the history of the sign in medicine by historic science, their overestimation by philosophy during the Age of Enlightenment, their reduction to a phenomenology of medicine and natural science during the first half of the 19th century and their transformation to medical diagnostics since the middle of the 19th century and recently even their functionalization as methodical instrument within the history of science. The following will show the change in meaning of medical semiotics. Modern development and especially the transition to medicine, based on natural science, will be emphasized.
The paper is to point out some characteristic facts on the medieval christian and early modern hospital, its hygienic situation, and its critique. Light will be thrown on the unhealthy effects of keeping cattle in the medieval town, on its problems with water supply and the removal of feces, on the challenges of pestilence and leprosy, and finally on the hygienic state of the early modern European hospital. The source for that will be the didactic picaresque novel "Landstörtzer: Gusman von Alfarche oder Picaro genannt" (1615) by the Jesuit pupil Aegidius Albertinus (1560-1620). Albertinus' novel shows that the early modern hospital sometimes was far from being a clean place, and that someone could catch something like a gastrointestinal disease or even the worse more easily in a hospital than elsewhere.
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Topicality, expressiveness and universal validity of current ethical vows in medicine are compared critically. Instead of outmoded formula Pellegrino's and Thomasma's suggestion for a new and mainly at patient autonomy-oriented vow is favored.
The historical period of the Weimar Republik has to be looked upon as the blossom time of municipal public health care under the influence of the theory of social hygiene. This leading theory originated from the idea of a social policy and a social medicine worked out during the German revolution of 1848. Its theoretical foundation as a social science was laid by Alfred Grotjahn in the years before 1914. The article describes the practical transformation of this theory in municipal public health care during the twenties, using the capital Berlin as an example. It is shown how racial hygiene influenced this process. In 1933 the idea of racial hygiene became dominant and the progressive representatives of social hygiene either had to emigrate or they were eliminated by the Nazis. After 1945 this double break in continuity caused considerable difficulties in the practical reorganization as well as in the theoretical reorientation of public health care.
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