Dansk medicinhistorisk arbog最新文献

When the cholera-epidemic came to Copenhagen in the summer of 1853, the doctors had to deal with a lot of problems. What was the disease after all? How did it spread and was it infectious between human beings? The doctors were not sure and did not agree about these questions, but still they had to handle the great epidemic, which nearly after it ended, had killed 5000 people. This article illuminate some of the problems which faced the doctors in their fight against the disease. Copenhagen was a very unhygienic city at that time with no sewerage, bad water supply, very densely built-up, and densely populated. The doctors wanted the politicians to solve these problems, but it was mostly in the field of better hygienic and nutrition, where the doctors could handle the problems themselves, that something happened. The fear of the disease didn't overrule the political and economic agendas and it wasn't clear which measures that had to be done to combat the cholera. The epidemic itself didn't create many changes in Copenhagen.

From 1874 to 1906 regular examinations for venereal diseases were mandatory for prostitutes in Copenhagen. The leading physician Rudolph Bergh saw the opportunity to obtain detailed knowledge of the genital anatomy through his studies of almost 3.000 prostitute women: He accounted for details as the size of the clitoris, the amount and curliness of the pubic hair, hymeneal remains etc. He related his findings to classical artworks and literature. But he gave no explicit reason for his studies apart from the unique opportunity to study live anatomy. Neither did he conclude on or interpret his findings. Though in late life he supplemented his studies on the genital sphere with an account of the occurrence of some small depressions in the female sacral region; to obstetricians these depressions are known as the lateral demarcations of the rhombus of Michaelis. These depressions were by the classical writer Alciphron called gelasini- dimples; they were seen as characteristics of the hetaera. Bergh found these depressions absent only on a small percentage of the prostitutes he had studied. As he may have, as his contemporary Cesare Lombroso did for criminals, searched for physical characteristics or deviations, these dimples may to Bergh have represented positive signs of the lascivious body.

Beginning around 1879 the efforts to develop methods for treating burn wounds were fuelled by necessity. Before this time no specifik treatment existed. Following the revolutionary work by the Swiss doctor Jacques-Louis Reverdin in 1869, the first skin graft was performed in Denmark in 1870. Skin grafts were used to treat burn wounds until World War I but due to poor results, the method was abandoned for ointment treatments. Tannic acid was one of the substances used as ointment in this period. During World War II, however, tannic acid treatment was linked to liver damage due to absorption from the wound. At the same time, the many burn injuries of World War II brought about new advances in skin grafting methods, which again became the principle treatment for burn injuries. Up to 1959 patients with burn wounds were treated in dermatological wards at Danish hospitals, but the efforts were then gathered at the surgical ward of the Kommunehospitalet in Copenhagen. In 1961 a burns ward opened at the same hospital, treating all burn injuries from Copenhagen, as well as serious cases from the whole country.

It is commonly accepted, that the Reformation heavily influenced scientific thinking in Europe. But in many historical accounts, this effect is presented as a fundamental break at the beginning of the 16th century with previous ideas and methods. In this view, scientists turned their back on explanations based on religion and began deliberately and determinedly to pull society away from the church. After studying Bartholin's writings, particularly some of the less well known texts such as his treatises on biblical medicine, I have come to the conclusion, that he in fact saw himself primarily as a theologian. For him anatomy was merely a tool, and so it had been for scientist all over Europe from its gradual evolvement as a field of study from Antiquity to the Renaissance. It had been a tool to illustrate the greatness and perfection of God's Creation in artistic ways, a tool to prove sanctity, a tool to establish causes of death in both judicial and medical contexts etc.

Acetylsalicylic acid is one of the most widely used drugs in the world. Its ancestry the salicylates, including salicin and salicylic acid, are found in the bark and leaves of the willow and poplar trees. The ancient Sumerians and Egyptians, as well as Hippocrates, Celsus, Pliny the Elder, Dioscorides and Galen used these natural products as remedies for pain, fever and inflammation. In the Middle Ages these remedies were used for fever and rheumatism by Hildegard of Bingen and Henrik Harpestreng. The first "clinical trial" was reported by Edward Stone in 1763 with a successful treatment of malarial fever with the willow bark. In 1876 the antirheumatic effect of salicin was described by T. MacLagan, and that of salicylic acid by S. Stricker and L. Riess. Acetylsalicylic acid was synthesized by Charles Gerhardt in 1853 and in 1897 by Felix Hoffmann in the Bayer Company. The beneficial effect of acetylsalicylic acid (Aspirin) on pain and rheumatic fever was recognized by K. Witthauer and J. Wohlgemuth, and the mechanism of action was explained in 1971 by John Vane. Today the antithrombotic effect of acetylsalicylic acid and new aspects of ongoing research demonstrates a still living drug.

Terra Sigillata is clay. It has been used as medicine for different diseases through Centuries even millenniums. This specific clay has been used from Hippocrates until the 20th cent. more or less for the same kind of diseases, mostly various poisonings. The earliest known clay in use as medicine came from the Greek island Lemnos. Later on, when the clay became a very popular medicine, it was manufactured as tablets all over Europe where this specific type of clay was available. But Terra Sigillata is also a type of Roman Samian ware, used in the widespread Roman Empire.

In 1749 Buffon proposed a general law for the longevity of species. In retrospect this law laid the foundation for modern studies of correlations between biological variables. Buffon refers to "la durée totale de la vie", the maximum lifespan, and claims that there is a systematic relationship between this variable and a measure of the growth period. It transpires that Buffon believed that by multiplying the age at the termination of the growth period by 7 one obtains the maximum lifespan. In vol III o the supplements to "Histoire Naturelle" he presents a table with, i.a., age at first reproduction and maximum lifespan for 31 Mammalian species, Furthermore, he claims that the growth period is equivalent to 2 times the age at first reproduction. From Buffon's data, one obtains a mean ratio of approximately 13 between maximum lifespan and age at first reproduction, where the expected ratio is 14 (2x7), i.e. very close to the observed ratio. Inspired by Buffon's proposition, we have investigated the same relationship in a modern dataset, comprising 564 Mammalian species. The best fitting statistical model for the relationship is not a simple multiplication, but an allometric equation: maximum lifespan = 11.47x(age at first reproduction)0.65. Taking into account the variation due to, i.a., phylogenetic constraints and adaptive divergence, Buffon's idea represents a basic biological relationship between life history characters.

From ancient time the history of mercury has been connected with that of the medicine and chemistry. Mercury therefore contributes to the history of science throughout times. Knowledge of cinnabar (HgS) is traced back to ancient Assyria and Egypt, but also to China. The Greek philosophers were the initiators of theoretical science. The idea of the four elements, earth, air, water and fire, was introduced mainly by Empedocles and Aristotle in the 5th and 4th century BC. The theory encouraged the hope of transmuting metal to gold. The early development of practical alchemy is obscure, but some hints are given in the encyclopedia compiled by Zosimos about 300 A.D. in Alexandria. It also includes the invention of equipment such as stills, furnaces and heating baths. Medical treatment is described by Pliny and Celsus, e.g. the use of cinnabar in trachoma and venereal diseases. When the Arabs learned Greek alchemy by the Nestorians, they introduced or improved chemical equipments and new chemicals were obtained such as sublimate (HgCl2), different salts, acids, alkaline carbonates and metal oxides. The first recorded account of animal experimentation on the toxicity of mercury comes from Rhazes (al-Razi) in the 9th century and in the 11th century Avicenna (Ibn Sina) had the foresight to recommend the use of mercury only as an external remedy, and quicksilver ointments were used by the Arabs in the treating of skin diseases. In the medieval west scientific experiments were forbidden since the interpretation of the world order should not be changed. Greek and Arabic medicine and alchemy were therefore authoritative and the breakthrough in scientific inventions first appeared after the introduction of the Renaissance. The Renaissance medicine included ancient medicine as well as "modern medicine", based on iatrochemistry, and this chemical approach was introduced by Paracelsus. The medicine included sulphur and salts or oxides of for instance mercury, copper, iron, antimony, bismuth and lead. Most important was mercury when the outbreak of syphilis appeared in Europe at the end of the 15th century. The Arabian quicksilver ointment was remembered and used for the treatment of syphilis, but the treatment also included pills and ointments of sublimate and calomel (Hg2Cl2). The breakthrough in science was the discovery of oxygen by Priestley in the late 18th century. Priestley heated the oxide of mercury and examined the gas and thereafter Lavoisier recognized that combustion involves oxidation. All this led to a new understanding of respiration and furthermore established the basis of modern chemistry. The apothecaries of the 19th and 20th century showed many colourful mercurials as calomel, sublimate, cinnober, oxides of mercury and mercury. Calomel pills were used in acute and chronic diseases and furthermore as a diuretic drug before the organomercurials appeared in the 1920s. Skin diseases were treated with ointments or plasters of the mercurials o

The first intraabdominal operation where the patient survived was an ovariotomy performed by Ephraim McDowell Christmas Day 1809. The patient was mrs. Jane Todd Crawford and in her pain and desperation she appeared willing to undergo the operation. After five weeks she was cured and on horseback she went back to Greensburg where she lived. In Great Britain the famous surgeon Spencer Wells was the most important of the pioneers. He performed over twelve hundred ovariotomies. But in Denmark the first nine patients died. Then Julius Boye - a general practitioner and a farmer, but also a selfmade surgeon - published a case in 1867 where the patient survived.. He had performed the operation and many others in a little house in the country far from hospitals. You may say that the house was a Private Hospital When Boye had presented his case the ovariotomy soon became a routine operation like others.

The interplay of factors contributing to the development of adrenal cortical hormones into drugs is reviewed. Clinical research performed during long periods by the physicians T. Addison and P.S. Hench in a nearly obsessional way stimulated basic research in physiology and biochemistry of the adrenal glands. From about 1900 increasing public interest in the "new hormones"coincided with expansion in research and development in academic and industrial settings. Pharmaceutical companies developed skill by production of much demanded organ-extracts, both effective ones as insulin and preparations of questionable clinical value. In 1949 the powerful anti-inflammatory effect of the cortical hormone, cortisone was discovered. As the supply of that hormone was scanty, it had temporarily to be substituted by the adrenocorticotropic hormone (ACTH) from animal hypophyses. Thereafter development accelerated through the combined effect of many years' painstaking research on the adrenal cortical hormones, technological breakthroughs, a climate positive for bold clinical experimentation and vigorous competition among mainly American pharmaceutical companies. Within a decade prednisone, the successor of cortisone, was launched, its clinical use established and large-scale inexpensive production instituted.