JEBCAM:重生给旧杂志带来了新的生命,并对该领域进行了科学审视

R. Brumback
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For example, even though the Dutch scientist Antonie van Leeuwenhoek could see microorganisms with his microscope as early as the 1600s, the germ theory of disease did not reach ascendency until the late 1800s. Until science finally insinuated its way into medical thought in the 19th century, more harm than good generally resulted from care by the supposed healers. Even during the American Civil War (1861-1865), the accepted medical therapy for injuries and illness that could not be treated by amputation was either bloodletting or administration of calomel (mercurous chloride) purgatives, and not unexpectedly most patients receiving such treatments did not survive. Although by the 1800s university-trained physicians in Europe and America could finally begin to categorize and diagnose diseases based on some scientific understanding, the results of their treatments were generally no better than that of any other healing discipline. In fact, the famous 1891 painting The Doctor by Sir Luke Fildes depicted the ‘‘physician in our time’’ who could offer no effective therapy but instead could only sit in vigil until the child either miraculously recovered or died (Figure 1). Thus, from the early-1800s until the mid-1900s (through World War II), there was an explosion of health care theories and disciplines, many offering treatments that were less gruesome and equally effective (or ineffective) as compared with those advocated by the universitytrained medical establishment. Unfortunately, this was also a period of exponential growth for charlatanism and quackery. Even following reforms to medical education as a result of the famous 1910 Flexner report, there were still few successful treatment options for most diseases. Interestingly, despite the relatively poor therapeutic options, death rates had actually fallen and longevity had increased, presumably in part due to improvements in public health as a result of better understanding of infectious disease. Astonishing breakthroughs during the heady half-century from the 1930s to the 1980s brought medical science to the forefront, and the public came to believe that all disease was finally conquerable and that the modern medical therapies dispensed by physicians were ‘‘magic bullets.’’ This period saw the introduction of effective antibiotics, which led the Surgeon General William Stewart to tell the US Congress in 1969 that it was time to ‘‘close the book on infectious diseases. The war against pestilence is over.’’ Medications to treat mental illness obviated the need for asylums and associated barbaric procedures such as shackling, shock therapy, and frontal lobotomy. Surgical procedures became safer and more routine, including open heart surgery and organ transplantation of kidneys, heart, and liver. Vaccinations were developed that basically eliminated the threat of childhood scourges such as poliomyelitis, measles, and mumps. Women who would otherwise have been childless could be made fertile with drugs or","PeriodicalId":10611,"journal":{"name":"Complementary Health Practice Review","volume":"15 1","pages":"11 - 4"},"PeriodicalIF":0.0000,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"12","resultStr":"{\"title\":\"JEBCAM: Rebirth Brings New Life to an Old Journal and Scientific Scrutiny to the Field\",\"authors\":\"R. 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引用次数: 12

摘要

自人类意识出现以来,疾病和死亡一直困扰着人类,并产生了各种神秘的、宗教的和神话的解释。像“潘多拉的盒子”这样的故事为疾病和其他人类苦难提供了一个原因。随着人类社会的出现,某些人声称被赋予了关于疾病和死亡的特殊知识,这些人物在亚洲、非洲和欧洲社区的早期著作以及其他群体的口头传统中都很明显。随着文明的进步,关于疾病和死亡的知识被编纂成法典,论文也得到了发展,比如埃及印和阗的各种纸莎草纸,古希腊的《希波克拉底文集》,罗马帝国佩加蒙的盖伦的著作,中亚伊斯兰医生Ab u ' Al ' i Al - husayn ibn ' Abd All ah ibn S in a(也被称为ibn S in a或Avicenna)的alQ an un fi ' l-tibb(医学经典),《内经苏文》被认为是中国的《黄** Ti》,而印度教的《阿达婆吠陀》、《卡拉卡Samhita》和《苏斯鲁塔Samhita》。几个世纪以来,各种信徒开始将这些著作视为神圣的文本。尽管科学探究在数学、化学和物理等学科上提供了断断续续的进步(尤其是在欧洲文艺复兴之后),但医学倾向于坚持这些神圣教义的古老智慧。例如,尽管荷兰科学家安东尼·范·列文虎克(Antonie van Leeuwenhoek)早在17世纪就可以用显微镜看到微生物,但细菌致病理论直到19世纪末才占据主导地位。直到19世纪科学最终进入医学思想之前,所谓的治愈者的治疗通常造成的伤害大于好处。即使在美国南北战争(1861-1865)期间,对于无法通过截肢治疗的伤病,公认的医学治疗方法要么是放血,要么是使用甘汞(氯化汞)泻药,不出所料,大多数接受这种治疗的病人都没有活下来。尽管到了19世纪,欧洲和美国受过大学教育的医生终于可以根据一些科学知识对疾病进行分类和诊断,但他们的治疗结果总体上并不比任何其他治疗学科好。事实上,卢克·菲尔德斯爵士1891年的著名画作《医生》描绘了“我们这个时代的医生”,他不能提供有效的治疗,只能坐在那里守夜,直到孩子奇迹般地康复或死亡(图1)。因此,从19世纪初到20世纪中期(直到第二次世界大战),医疗保健理论和学科出现了爆炸式增长。许多医院提供的治疗方法不那么可怕,而且与那些受过大学教育的医疗机构所提倡的治疗方法一样有效(或无效)。不幸的是,这也是一个骗子和江湖骗子呈指数增长的时期。即使根据1910年著名的Flexner报告对医学教育进行了改革,大多数疾病仍然没有成功的治疗方案。有趣的是,尽管治疗选择相对较差,但死亡率实际上下降了,寿命延长了,部分原因可能是由于对传染病有了更好的了解,公共卫生得到了改善。从20世纪30年代到80年代,在令人兴奋的半个世纪里,医学取得了惊人的突破,使医学走到了最前沿,公众开始相信,所有的疾病最终都是可以征服的,医生们开出的现代医学疗法是“灵丹妙药”。这一时期引入了有效的抗生素,这使得外科医生威廉·斯图尔特(William Stewart)在1969年告诉美国国会,是时候“结束传染病的历史了”。抗击瘟疫的战争结束了。治疗精神疾病的药物消除了对精神病院和相关野蛮程序的需求,如镣铐、休克疗法和额叶切除术。外科手术变得更安全、更常规,包括心脏直视手术和肾脏、心脏和肝脏的器官移植。疫苗的发展基本上消除了小儿麻痹症、麻疹和腮腺炎等儿童疾病的威胁。本来没有孩子的妇女可以通过药物或
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JEBCAM: Rebirth Brings New Life to an Old Journal and Scientific Scrutiny to the Field
Beginning with the dawn of human consciousness, disease and death have perplexed mankind and resulted in a variety of mystical, religious, and mythological explanations. Stories such as ‘‘Pandora’s box’’ helped provide a reason for disease and other human afflictions. As human societies appeared, certain individuals claimed to be endowed with a special knowledge concerning disease and death, and such personages are evident in early writings from communities in Asia, Africa, and Europe and in the oral traditions of other groups. With advancing civilization, knowledge concerning disease and death became codified and treatises were developed, such as the various papyri attributed to Imhotep in Egypt, the Corpus Hippocraticum from ancient Greece, the writings of Galen of Pergamon in Imperial Rome, the alQ an un fi’l-tibb (Canon of Medicine) by the Central Asian Islamic physician Ab u ‘Al i al-Husayn ibn ‘Abd All ah ibn S in a (also known as Ibn S in a or Avicenna), the Nei Ching Su Wen attributed to the Chinese Yellow Emperor Huang Ti, and the Hindu texts Atharvaveda, Caraka Samhita, and Sushruta Samhita. Over centuries, various adherents came to view these writings as hallowed texts. Although scientific inquiry provided stuttering advances in a variety of disciplines such as mathematics, chemistry, and physics (particularly after the European Renaissance), medicine tended to adhere to the ancient wisdom of these sacred teachings. For example, even though the Dutch scientist Antonie van Leeuwenhoek could see microorganisms with his microscope as early as the 1600s, the germ theory of disease did not reach ascendency until the late 1800s. Until science finally insinuated its way into medical thought in the 19th century, more harm than good generally resulted from care by the supposed healers. Even during the American Civil War (1861-1865), the accepted medical therapy for injuries and illness that could not be treated by amputation was either bloodletting or administration of calomel (mercurous chloride) purgatives, and not unexpectedly most patients receiving such treatments did not survive. Although by the 1800s university-trained physicians in Europe and America could finally begin to categorize and diagnose diseases based on some scientific understanding, the results of their treatments were generally no better than that of any other healing discipline. In fact, the famous 1891 painting The Doctor by Sir Luke Fildes depicted the ‘‘physician in our time’’ who could offer no effective therapy but instead could only sit in vigil until the child either miraculously recovered or died (Figure 1). Thus, from the early-1800s until the mid-1900s (through World War II), there was an explosion of health care theories and disciplines, many offering treatments that were less gruesome and equally effective (or ineffective) as compared with those advocated by the universitytrained medical establishment. Unfortunately, this was also a period of exponential growth for charlatanism and quackery. Even following reforms to medical education as a result of the famous 1910 Flexner report, there were still few successful treatment options for most diseases. Interestingly, despite the relatively poor therapeutic options, death rates had actually fallen and longevity had increased, presumably in part due to improvements in public health as a result of better understanding of infectious disease. Astonishing breakthroughs during the heady half-century from the 1930s to the 1980s brought medical science to the forefront, and the public came to believe that all disease was finally conquerable and that the modern medical therapies dispensed by physicians were ‘‘magic bullets.’’ This period saw the introduction of effective antibiotics, which led the Surgeon General William Stewart to tell the US Congress in 1969 that it was time to ‘‘close the book on infectious diseases. The war against pestilence is over.’’ Medications to treat mental illness obviated the need for asylums and associated barbaric procedures such as shackling, shock therapy, and frontal lobotomy. Surgical procedures became safer and more routine, including open heart surgery and organ transplantation of kidneys, heart, and liver. Vaccinations were developed that basically eliminated the threat of childhood scourges such as poliomyelitis, measles, and mumps. Women who would otherwise have been childless could be made fertile with drugs or
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