William Edwin Hardy--an appreciation.
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It is now 200 years since L. L. Finke wrote his treatise on a global medical geography, Versuch einer allgemeinen medicinisch-praktischen Geographie. It was both the most extensive book in substantive content, and the most detailed in conceptual discussion on medical geography written to that point. Although it is one of the foundation pieces of medical geography, modern day practitioners seldom refer to Finke's work. There are two main reasons for this: with the exception of two passages, the work has never been translated from the original German, and many contemporary medical geographers believe that the field only developed in the mid-twentieth century. This paper's purpose is to demonstrate that this last point is unfounded and that recognition of Finke's seminal contribution is long over-due. On the 200th anniversary of the publication of An Attempt at a General Medical-Practical Geography Finke's great achievement is honoured.
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There is much talk now of "defense conversion" and the need to turn a given country's "peace dividend" into improving its "infrastructure." Beyond the obvious political rhetoric, those terms bode well for the field of biotechnology. Every facet of technology must attend to its "delivery system," for the same obvious reason, roads and bridges must be maintained and improved. In the case of biosensors and their delivery into the human body, for example, it stands to reason that adequate focus should be paid to advancements in the field of the biomaterials from which they are made, or that house or carry them.
During my medical school years, I became acquainted with Dr. Guyton's physiology textbook. This book was very instrumental in shaping my future career in cardiovascular medicine.
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Multiple sclerosis (MS) has recently been classified according to its clinical course. Despite relapses and remissions, its course is invariably progressive, and the observed progression from the remitting-relapsing to the secondary progressive form represents the accumulation of permanent damage to the nervous system. Discussions of the nomenclatural position of Schilder's, Marburg's, and Baló's diseases, ignore the fact that the unique, pathognomonic, sharp-edged plaque of MS, is also the pathologic end-result in the three variants. Devic's disease or neuromyelitis optica (NMO) is quite different and with some exceptions, is a particular form of disseminated encephalomyelitis (DEM). There is no evidence that the 'oriental form of MS' is anything but NMO. The suggestion that MS and DEM are variants of the same condition is contradicted by the fact that the pathological characteristics of the two are quite different. While it is probable that the two share aspects of pathogenesis, the patients differ because of their genetic endowment. This was dramatically demonstrated in a group of Japanese patients who died after anti-rabies vaccination and were found to have the typical sharp-edged lesions of MS. The genetic determinant was also crucial in the marmoset in which EAE uniquely resulted in a chronic relapsing-remitting (RR) disease characterized by the classic sharp-edged lesions of MS. The question 'ADEM: distinct disease or part of the MS spectrum?' can be answered with a resounding no. A new classification is proposed separating the different forms of MS from the various types of DEM.
Since his first years at Turin until the last years of his life at Padua, Vincenzo Malacarne devoted most of his time to the examination of the structures and the various parts of which the cerebellum and the human brain are composed. He is rightly considered as one of the first to have correctly described the anatomy of the cerebellum, as well in the field of human anatomy and comparative anatomy. However, his work cannot be reduced to these studies. He worked out a cerebral physiology, with organic and intellectual phenomena in mind, established on an anatomopsychic parallelism. This parallelism is itself founded on a rational and mathematical criterion: the number of lamellae contained in the cerebellum. A letter written by him in 1792 and addressed to Abbot Denina was recently found by the present author in November 2005 at the Academy of Sciences of Turin. Malacarne exposed his project of studying the animal electricity put forward by Galvani within the cerebral organ. May it be that Malacarne had in mind the physiology of his time while trying to record an electric activity within the brain?
With their mythical creatures and arcane symbolism, coats of arms seem to have little connection with modern science. Yet despite its chivalric origins, the ancient language of heraldry has long fascinated famous scientists. Although this idiosyncratic tradition was parodied by Victorian geologists, who laughingly replaced unicorns and griffins with images of dinosaurs that they had recently discovered, it has been perpetuated since by Ernest Rutherford, who liked to present himself as a new alchemist.
The Swedish 18th-century naturalist Carolus (Carl) Linnaeus is habitually credited with laying the foundations of modern taxonomy through the invention of binominal nomenclature. However, another innovation of Linnaeus' has largely gone unnoticed. He seems to have been one of the first botanists to leave his herbarium unbound, keeping the sheets of dried plants separate and stacking them in a purpose built-cabinet. Understanding the significance of this seemingly mundane and simple invention opens a window onto the profound changes that natural history underwent in the 18th century.
The Organon of Medicine is the seminal text of Homeopathy. However, its grammar and structure make it obtuse and remote to both new students and veterans. We propose a demarcation of the Organon into sections, exposing the didactic structure of the Organon, and display this demarcation in concise graphic form. It is hoped that this representation will improve accessibility and understanding of the Organon for readers at all levels.
The sixth edition of Samuel Hahnemann's Organon of Medicine is an obligatory work of reference for homeopathy. Nevertheless, its philosophy can be questioned with constructivistic and historistic objections. Three levels of content may be distinguished: (1) practical directions and maxims, (2) theoretical explanations and hypotheses, (3) conceptual foundations and premises. Ideally, these levels should be considered, studied, and taught separately and gradually. My new German edition of the Organon, published in 2003, tries to meet these demands. It contains: (A) a complete version of Hahnemann's original text, in the original order of paragraphs, but in modern German with section headings, summary boxes, etc added, (B) another full version of its content, organized in three levels, as indicated above, (C) a glossary of about 400 problematic terms.
This article briefly describes the origin of one of the more common (food-related) pathologic terms--"bread and butter pericarditis." The eminent French physician, Laennec, the inventor of the stethoscope amongst several other important medical contributions, can be credited for having coined the term that is still in common usage amongst pathologists.
The construct of bipolar disorder, or bipolar spectrum disorders, has been a source of controversy in recent years. Some have argued that subtle variants within the putative bipolar spectrum are merely the creation of overzealous clinicians, perhaps encouraged by various special interest groups. In reality, the concept of a bipolar spectrum may be inferred from numerous classical sources, dating back to the 19th century and even into antiquity. The Greek philosopher Aristotle, usually considered the author of a work called Problemata, appears to have recognized some form of the bipolar spectrum, more than two millennia ago. This recognition continues throughout the 19th century, and into our own time. Such transcultural findings across many centuries have implications for the "objective" nature of psychiatric disease.
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The French physiologist Claude Bernard (1813-1878) has the unfair reputation of being ferociously opposed to the use of probabilities and statistics in medicine. In the 19th century, he would have been included among those who opposed the emergence of what would eventually become clinical epidemiology. The truth is that Bernard valued the role of medical statistics in clinical medicine but viewed it as potentially misleading in laboratory-based physiology. He posited that clinical medicine had to be guided by probabilistic evidence as long as physiological mechanisms remained unknown. Bernard praised the clinical researches of Pierre Louis aiming to assess the efficacy of bloodletting in the treatment of pneumonitis. The real objects of Bernard's contempt were the physicians who pretended that medicine was an art strictly based on intuition and tact and who pretended that comparative trials and statistics were useless for clinical medicine. Overall, Bernard was a strong and explicit proponent of the importance of scientific evidence in medical knowledge, be it from experiments or from comparative trials.
Statistics is the study of populations, how they relate to one another and what effect sampling has in terms of representing the original population. Use of statistical tools has been facilitated by modern computer technology; however, given the ease in which results are obtained, it is easy to overlook potentially incorrect use of the various statistical tests. Statistical tools are invaluable for investigators because they make it possible to determine if scientific results are important. When a test is used, it is important to know that the result of any statistical test is valid to avoid erroneous conclusions. To do so, the investigator must have a basic understanding of the test's assumptions and limitations. Modern statistical packages often include a variety of results relating to the test's applicability to the data analyzed. Not uncommonly, biologists are unfamiliar with these analyses. This review intends to improve the reader's understanding of t-tests by providing a history of Student's t-test, and its assumptions, applications, and limitations. Part 1 of the series ("The Mean and Standard Deviation: What Does It All Mean?") reviewed basic aspects of distributions, measures of central tendency, and dispersion assessment. Small sample size effects on accurate estimation of a population mean and group comparisons for continuous data are presented in this review.
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