Showing 1 - 10 of 509 annotations tagged with the keyword "History of Medicine"

Summary:

This is a gripping, informative, and well-researched book about human blood. An accomplished journalist, Rose George, covers a variety of topics, largely in the U.S., Britain, and Canada but also in Nepal, India, and South Africa. She describes many current issues, provides historical background, and speculates on future technologies, such as replacement of blood by other fluids. There are nine sections:

 “My Pint”  While the book’s title refers to the author's volume of blood, this chapter’s title refers to a single pint she is donating. We read about blood supply (donated and stored blood) in the U.S. and—by contrast—in India.

“The Most Singular and Valuable Reptile” refers to the leech. This arresting chapter describes both historical and  modern uses of leeches to gather blood from humans. She visits a company called Biopharm in Wales where leeches are raised and prepared for shipment to medical clinics and hospitals.  

 “Janet and Percy” is a historical chapter focusing on Dame Janet Maria Vaughan, a central figure in creating the Blood Transfusion Service in England during WWII and Percy Oliver, who guided its predecessor, the London Blood Transfusion Service.  

“Blood Borne.”  This chapter describes Khayelitsha, South Africa, “the ugly backside of Cape Town” (p. 100): a place of poverty, crime, rape, sexual predation, and HIV. While rich nations provide assessment and treatment for people with HIV, poor nations have many citizens infected with the virus and, over time, rising rates of infection. 

 “The Yellow Stuff” describes the plasma portion of blood; it can be frozen (as FFP) and used as a filler for bleeding or trauma patients. Unlike blood—which can only be given without payment—plasma can be collected from paid donors. It is a largely traded commodity, part of a multi-billion dollar industry worldwide. Plasma carries Factor VIII, a crucial protein for clotting blood; hemophiliacs lack this and are at risk for death by bleeding externally or internally. Some plasma has been tainted, for example by HIV.

“Rotting Pickles.”  In Western Nepal (and other places), menstruation is taboo. George writes, “We are in a minority among species, and among mammals, to bleed every month.” She reviews historical views of women’s periods, mostly negative. Worldwide, there are many taboos, but also some educational efforts for public health that are helpful in impoverished areas.  

 “Nasty Cloths.” This tells the unusual story of an Indian man named Muruga, “a poorly educated workshop helper” who became a leader in creating sanitary protection for menstruating women. Worldwide, the feminine hygiene industry is some $23 billion. George also reviews related history, including Toxic Shock Syndrome from tampons.  

 “Code Red.” Bleeding is often a fatal factor in trauma, even with the best efforts to transfuse blood into the patient, unit after unit. George observes open chest techniques at a resuscitation. She reviews breakthroughs in blood typing, component therapy, and “buddy transfusions.”  

“Blood like Guinness: The Future.” George starts with images from the past: vampires, human drinkers of blood, past and, even, present. She interviews a purveyor of the concept that “young blood” is healthier than older blood. Can there be, discovered or created, blood substitutes that also save lives? 

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Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Biography

Summary:

In That Jealous Demon, My Wretched Health (subtitled “Disease, Death and Composers”), Jonathan Noble, a retired surgeon gives us the medical and psychiatric history of seventy classical music composers. Chapters are organized by illness, ranging from cancer to syphilis to alcoholism.  Famous composers such as Schubert and Shostakovich predominate, but many lesser-known composers, ranging from Jeremiah Clarke to Gerald Finzi, are also included.  

Mozart is one composer whose cause of death has long been the subject of controversy, and the various theories are comprehensively explored here. However, the author goes even further, developing a detailed medical case study of the composer beginning in childhood.  He examines the toll that Leopold Mozart’s exploitation took on his prodigy son’s constitution, what Wolfgang’s appearance in the surviving portraits has to say about his general health, and even whether he may have had Tourette’s Syndrome. Finally, the author ties all of this together, methodically refuting or confirming each diagnosis, offering far deeper analysis than one would expect to find in a standard biography.  

Another example, the case of Tchaikovsky, reads like a veritable whodunit. The composer’s activities during the last two months of his life are scrutinized, with the likely causes of death systematically disproven or confirmed.  

A list of composers who suffered accidental or violent deaths provides some surprises. You will learn that Lully accidentally stabbed himself with his conductor’s baton, and that Alkan may have been crushed to death by a bookcase upon pulling his Talmud off a shelf.

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Heart: A History

Jauhar, Sandeep

Last Updated: Feb-05-2019
Annotated by:
Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: History

Summary:

The author, Sandeep Jauhar, attributes his “obsession” with the human heart to family history, which includes fatal heart attacks that took both of his grandfathers from him, and to the beginnings of his own coronary artery disease revealed on screening tests. That he became a practicing cardiologist, though after first becoming a PhD-level theoretical physicist, is no surprise then.  

It was this obsession with the heart and his chosen profession that drove him to write this book, which he says, “is about what the heart is, how it has been handled by medicine, and how we can most wisely live with—as well as by—our hearts in the future.” (p. 10) In form, the book is a series of brief accounts of selected events in the history of medicine involving the human heart and circulatory system, interwoven with personal anecdotes and reflections. 
 

Some of the historical events and developments include how the heart and circulatory system work, and the methods used to assess how well they are working such as echocardiography and coronary catheterization. How heart-lung bypass, first person to person then mechanical, made cardiac surgery possible is described, as are many of the surgical procedures it enabled to treat coronary artery disease and to replace malfunctioning valves. Nonsurgical procedures Jauhar explains encompass those for intervening during acute heart attacks (e.g., angioplasty, stents, thrombolysis), managing life-threatening heart rhythm disturbances (e.g., external and implantable pacemakers and defibrillators, radio-frequency ablation), and replacing parts or all of the heart (e.g., coronary artery bypass, heart valve replacement, left ventricular assist devices, heart transplant). Little mention is made about the use of drugs despite having contributed to both important advances and surprising failures in heart disease. 
 

Topics related to the heart indirectly include the effects of emotions and psychological problems (e.g., stress), social determinants of disease (e.g., social economic status), and wellness concepts (e.g., diet, exercise). Some history of heart disease and the reduction of deaths from it over the past several decades are also touched upon. Parts of the book take the form of memoir, which add to his previous two books (Intern: A Doctor’s Initiation and Doctored: The Disillusionment of an American Physician).

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Annotated by:
Thomas, Shawn

Summary:

What is an atlas? To most people, an atlas is a collection of maps constructed by cartographers who meticulously plot the surface of the earth, inch by inch. In the medical field, we use the word atlas to refer to textbooks of human anatomy, but the endeavor is much the same, and no less painstaking – the human body is quite complex, after all. Though some anatomy atlases are famous for their beautiful depictions of anatomical structures, it is more important that they are accurate. What good would a map be otherwise?  

Yet this quest for accuracy is founded on an inherent dishonesty. Anatomy atlases are supposed to be our guides to the human body, but in reality, they depict the anatomical structures of only a human body. Every person is different, and that goes for their underlying anatomy as well. That being said, these minor variations are fairly unimportant for learners at the novice level. At the same time, one can’t help but feel like these books have been stripped of the key element that defines what it means to be human.
 

It is fitting that an artist would be the one to bring light to this issue. Laura Ferguson, Artist-In-Residence in the Master Scholars Program in Humanistic Medicine (MSPHM) at the NYU School of Medicine, has lived nearly her whole life with scoliosis. She saw in her own story the tendency of clinicians to boil a person down to a diagnosis – normal or abnormal. For doctors, this categorization is often necessary. But the artist recognizes that a person is more than just the sum of their parts. Laura saw past the medicalization of her anatomy and cherished the beauty of her curved spine.  

Laura’s arrival at the medical school ushered in a renewed focus on the humanism of medicine, starting with the Art & Anatomy seminar she began in 2009, open to students, doctors, researchers, and all other staff members at NYU Langone Health. In the seminar, students spend 90 minutes a week undertaking illustrations of various anatomical specimens: bones, organs, and even cadavers in the anatomy lab.  

Now almost a decade into this project, Laura has showcased her students’ work in her recent book Art & Anatomy: Drawings, co-edited by Katie Grogan, Associate Director of the MSPHM. Unlike with other anatomy books, the goal for her students was never to be “accurate”; such a word has limited meaning in the world of art. Instead, Laura taught students to observe things that they had never taken the time to see before. Then, she encouraged them to draw what they saw, as they saw it. The result is the compilation of drawings into a different kind of atlas – an atlas of the mind, of creative spirit, and of humanistic expression.

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The Anatomy Lesson

Siegal, Nina

Last Updated: Jul-31-2018
Annotated by:
Ratzan, Richard M.

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1632, at the age of only 26, Rembrandt finished a large (85.2 in × 66.7 in) oil painting that was destined to become one of his best known works and certainly one of the linchpins in the nexus between the graphic arts and the medical humanities. "The Anatomy Lesson of Dr. Nicolaes Tulp" depicts the dissection of the flexor tendons of the left arm of a cadaver by the eponymous doctor while an attentive audience of his peers, identifiable members of the medical and anatomical community of early 17th century Amsterdam, looks on. Nina Siegal's novel tells her imagined back story of this richly illustrated anatomy lesson which, once you read her captivating novel, will make you ask yourself, as I did, why no one has thought fit to do so heretofore.

Using multiple first person narrators, Siegal examines the characters (some historical, others wholly fictional) and events leading up to the anatomy lesson and Rembrandt's artistic rendering of it. Inventing a life for Aris Kindt (born Adriaen  Adriaenszoon), the historically real career criminal whose recently judicial hanging provides the body we see in the painting, Siegal provides him with Flora, a lover who is carrying his illegitimate child at the time of his public - and quite raucous - hanging. Growing up in Leiden, in the same neighborhood as Flora and Rembrandt himself, Kindt was the physically and emotionally abused son of a leather worker and, in Siegal's imagination, a petty but persistent thief hanged for his inveterate and irremediable life of crime. As was the custom of the day, his body was legally assigned to an anatomist for public dissection. With a non-linear narrative, organized into brief chapters entitled for body parts, Siegal traces the beginnings of three of the protagonists - Kindt, Flora, and Rembrandt. She constructs  how their lives intersect not only before, during and after the hanging, but also in more philosophical strokes, namely the medical, theological and artistic tapestry on which this image rests. There are several minor characters, like Tulp and his family; Jan Fetchet, the "famulus" responsible for securing and preparing Kindt's body immediately following the hanging; and even René Descartes, who seems to have been in town during this momentous occasion pursuing his own polymathic research, which included anatomy at the time.  Siegal adds a few reports dictated by a fictional modern- day conservator offering her interpretation of many of the details of Rembrandt's masterpiece, details that serve to highlight aspects of Siegal's narrative, such as the possible artistic re-implantation of Kindt's amputated right hand.

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Summary:

This entertaining and wide-ranging book discusses the importance of the human foot and many related topics. There are five alliteratively named chapters.  

1. Destiny

Drawing on anthropological research, Rinzler discusses the deep history of humans and their primate ancestors. Our bipedalism—our upright stance—preceded our large brain, making possible a larger diet and working well with our bodies as they evolved away from other primates. She discusses the idealized ratios of Leonardo’s Vitruvian man. Leonardo considered our foot as “a masterpiece of engineering and a work of art” (p. 6).  

2. Disability
Rinzler discusses historical senses of disability, notably clubfoot. She mentions various people with a clubfoot:  Joseph Goebbels, Sir Walter Scott, King Tut, Cludius I, Dudly Moore, Kristi Yamaguchi, and Mia Hamm; the last are two successful athletes. Rinzler reviews the history of surgical approaches, many of which were harmful. X-ray and sonography provided new insights, and genetics may have further promise, given that families and ethnic groups often have higher instances of clubfoot.  

3. Difference
This chapter describes the anatomy of the foot, bones, arches, tendons, and on as well as artistic representations and, of course, ballet and other forms of dance. A footprint is as individual as the much-used fingerprint. In Nazism and the American south, a flat foot was discriminated against as Jewish or Negro. Various treatments have been proposed for flat feet.  

4. Diet
Gout has been known since antiquity, but only in modern times has the underlying biochemistry and, now, genetic heritage been understood. The chapter mentions many famous names of people who suffered from gout. rheumatism, or corns. The closing pages discuss pharmaceutical approaches.  

5. Desire
The foot as sexual symbol: Rinzler discuss folklore (Cinderella’s slipper), pheromones, and Biblical topics: God’s feet, footwashing, and feet as symbols for sex and urination. Foot fetishism can be understood in terms of the lavish sensory innervation that links to our brain. Discussion mentions the bound feet of China, the folktale The Red Shoes, also Fifty Shades of Grey, Sex and the City, and Judy Garland’s red shoes in The Wizard of Oz

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Annotated by:
Glass, Guy

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Victorians Undone is no ordinary history book.  If you have ever felt dissatisfied by a sterile biography, wondering if its subject actually possessed bodily functions, look no further.  Here, British historian Kathryn Hughes undoes centuries of sheltering the reader from the unseemly by putting it on full display.  While the very term “Victorian” evokes an image of propriety, it was also a time of population displacement from the country to cities where “other people’s sneezes, bums, elbows, smells, snores, farts and breathy whistles were, quite literally, in your face”  (p. xi). The author seeks to rectify the imbalance by creating a history that puts “mouths, bellies and beards back into the nineteenth century“ (p. xiv), which she hopes will “add something to our understanding of what it meant to be a human animal“ (p. xv) during the Victorian Era.  

The book consists of five essays, each following a part of the body of an historical figure. In the first, entitled “Lady Flora’s Belly,” we learn about the tragic saga of Queen Victoria’s lady-in-waiting.  Did Flora’s protuberant abdomen conceal a tumor or a baby?  It was harder to find out than one might think.  Most women went through their lives without ever exposing their private parts to anyone but their husband.   Medical consultation when unavoidable might be conducted discretely, by post. 
 

Other essays focus on George Eliot’s hands, Fanny Cornforth’s (the lover of Dante Gabriel Rossetti, the Pre-Raphaelite painter) sensual mouth, and the beard that Charles Darwin’s grew to hide his eczema.  The book concludes with the gruesome tale of the dismemberment of Fanny Adams, an early case study in forensic pathology. The term "Fanny Adams" soon came, in navy slang, to mean unpleasant meat rations.

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Annotated by:
Galbo, Sebastian

Primary Category: Literature / Nonfiction

Genre: History

Summary:

From the late 18th to mid-19th centuries a peculiar trend swept through European fashion. Through couture and cosmetics, this vogue emulated the physical ravages of a much-feared disease, tuberculosis, aestheticizing its symptoms as enviable qualities of physical beauty. Pale skin, stooped posture, white teeth, an emaciated figure, and a white complexion that evinced delicate blue veins were lauded by the era’s posh fashion journals. Carolyn A. Day aptly terms this craze a “tubercular moment,” a cultural phenomenon that elevated the grim realities of physical illness to a plane of desirable beauty. Medical discourses promoting the fragility and refinement of the “sensible” body were inspired by romanticized notions of morbidity, suffering, and illness. These discourses coincided with the the ideologies of Romanticism, a philosophical movement that was popularly understood to be a counter-discourse to the Enlightenment through its emphasis on emotion and imagination. Day cites the English poet, John Keats, whose legacy emphatically contributed to the cult of sensibility, as he embodied a living example of the refined tubercular body endowed with artistic genius but doomed to illness. The male artist was an example of a body too sensitive, too delicate to endure earthly life, but one whose intellect left an indelible imprint on culture.  

The romanticized construction of tuberculosis, however, waned in the 1830s and 1840s due to dominant Victorian views that emphasized the inherent biological weakness of the female body. This shift in rationalizing consumption was the direct result of understanding women as burdened with a surfeit of sensibility. By contrast, consumption was understood differently to be an emasculating illness that denoted male weakness and was therefore no longer popularly considered to be a portent of gifted creativity. During this period, a number of women’s fashions dictated the tastes of the middle and upper classes. Corsets, cosmetics, and the gossamer neoclassical style of dress were used to emulate the frail frames, drooping postures, narrow torsos, and pale complexions of the consumptive body. Thin fabrics, sandals, and hair pieces also contributed to styling the ‘gorgeously’ spectral image of the tubercular body. Dresses were contrived to feature the bony wing-like shoulder blades of the consumptive back, emphasizing an emaciated frame. Physicians and cultural pundits condemned the trappings of this fashionable dress because they were thought to impose health risks. Tight corsets, for example, were considered to harmfully compress the lungs, while diaphanous dresses and sandals exposed women to cold weather. Despite the stentorian warnings of physicians, the tubercular wardrobe continued to house articles that were thought to excite tuberculosis.  


By the 1850s, public health and sanitary reforms reshaped cultural discourses that associated tuberculosis with beauty. Tuberculosis was gradually viewed as a pernicious biological force that needed to be controlled. As a result, the Victorian model of womanhood—the weak and susceptible female body—gave way to a model of health and strength. Literature, as Day points out, contributed significantly to altering the consumptive chic discourse and the link between tuberculosis and ideal femininity. She references Alexandre Dumas fils, whose influential novel, La Dame aux Camélias, presents redemption for moral transgressions through tubercular suffering. Through popular literature, tuberculosis was gradually supplanted from the sphere of upper-class women and placed in association with ‘fallen’ women, an unsavory association that led the genteel public to change perspective. Literary influence was important, but the increased visibility of consumption in the lower classes was likely the most visceral reality that forced upper classes to distance themselves from fashions that beautified the illness.

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In 1869 in the remote northern Scottish village of Culduie, teenager Roderick (Roddy) Macrae brutally murders his neighbor, Lachlan “Broad’ Mackenzie, and two others. He readily admits to his crime, motivated, he says, by a desire to end the dreadful vendetta that Broad waged against his widowed father. The sympathetic defence lawyer, Andrew Simpson, urges him to write an account of the events leading up to the tragedy.  

Roddy agrees. In a surprisingly articulate essay, the young crofter describes his motive, originating with his birth and escalating through the lad’s mercy killing of an injured sheep belonging to Broad (interpreted as wanton), Broad’s sexual torment of his sister and mother, and his abuse of power as a constable that strips the family of land, crops, and finally their home.  

Given Roddy’s passivity, intelligence, and previously clean record, Simpson prepares a defence of temporary insanity and brings two physicians to assess his client, one a purported expert in the new field of medical criminology.  
 

The jury trial proceeds with an almost verbatim transcript derived from newspaper sources. The reader is able to juxtapose Roderick’s account with that presented in court. To report the outcome here would reveal too much.

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The River of Consciousness

Sacks, Oliver

Last Updated: Mar-01-2018

Primary Category: Literature / Nonfiction

Genre: Essay

Summary:

Two weeks before his death in 2015, Sacks oversaw this collection of essays and charged Kate Edgar, Daniel Frank, and Bill Hayes to arrange its publication. The essays touch on various fields—evolution, botany, chemistry, medicine, neuroscience, and the arts, and focus on major figures such as Darwin, Freud, and William James. The major theme—as indicated by the volume’s title—is how minds (of humans, chimps, even jellyfish) interpret and remember what the senses perceive in normal and in limited states. While we read in the Foreword that “a number” of the pieces originally appeared in The New York Review of Books, there are no citations for dates and places.  

“Darwin and the Meaning of Flowers”: Sacks describes Darwin’s research with flowers that support evolution; flowing plants display qualities of sensitivity to “contact, pressure moisture, chemical gradients, etc” (p. 19). Sacks recalls the pleasures of investigating flowers as a youth in his London garden.  

“Speed” : Drawing on personal experience and a wide variety of anecdotes (including his encephalitic patients described in Awakenings), Sacks muses about mental perceptions, slow and fast, normal and drug-enhanced, dreams, and our ability to imagine “all speeds, all time” (p. 59).  

“Sentience: The Mental Lives of Plants and Worms”: Starting with Darwin and coming forward, Sacks discuss how worms, jellyfish, and even trees may be considered to exhibit “mind.” Near the end, we read, “if one allows that a dog may have consciousness of a significant and individual sort, one has to allow it for an octopus too” (p. 76).  
   
“The Other Road: Freud as Neurologist”: The opening paragraph ably sums up the essay. “Everyone knows Freud as the father of psychoanalysis, but relatively few know about the twenty years (from 1876 to 1896) when he was primarily a neurologist and anatomist; Freud himself rarely referred to them in later life. Yet his neurological life was the precursor to his psychoanalytic one, and perhaps an essential key to it (p. 79).   
   
The next three may be considered as a group because they deal with lapses or outright failures in perception, memory, or health. Because Sacks reports on his own life experience, these are the most personal.
“The Fallibility of Memory” describes Sacks’s memories of the bombing of London in the winter of 1940-41. It turns out that one memory, according to family members, is right, but the other is actually a version of a letter describing a bombing.

The essay continues to discuss such topics as false memories, auto-plagiarism, unconscious plagiarism, and fabulation. He concludes, “Our only truth is narrative truth, the stories we tell each other and ourselves—the stories we continually recategorize and refine” (p. 121). In a short piece, “Mishearings,” Sacks reports how his increasing deafness makes new (and sometimes hilarious) perceptions of spoken words.  

Surely the last written—and in many ways the most poignant—“A General Feeling of Disorder” discusses feelings of being ill. Sacks, at age 81, describes his metastatic liver cancer and, in detail, an arduous treatment. Although warned of weakness and pain, he writes of “a sort of negative orgasm of pain” and other disturbing side effects (pp. 155-59) in vivid detail.  

“The Creative Self” discusses forms of creativity including play, scholarship, unconscious borrowing, and subconscious insight. Sacks is less interested in a Freudian model than an evocation of “an entire hidden, creative self” (p. 144).            

The final two, “The River of Consciousness” and “Scotoma: Forgetting and Neglect in Science” deal with theories of how the mind works and, more collectively, how scientific breakthroughs occur. The former essay explores cinematic models for perception in James and Bergson and much later models of the 100 billion neurons of the brain working on networks, coalitions, or populations. He finds that a specific mechanism is unlikely to be found and, “Even the highest powers of art—whether in film or theater, or literary narrative—can only convey the faintest intimation of what human consciousness is really like” (p. 174).

In “Scotoma” (or “memory hole”), he looks at discoveries that were over-looked for many years . Later they were rediscovered as important for understanding various phenomena: Tourette’s syndrome, phantom limbs, and, his specialty, migraines.

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