Month: October 2024
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The illness and death of Jane Austen
The final years of Jane Austen were overshadowed by a mysterious illness that has long since been a subject of speculation and debate. Her health began to decline in early 1816, when she was around forty years old. Her letters from that period make occasional references to fatigue and bouts of illness, but she tended…
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Doctoring while pregnant
Katie TaylorOakland, California, United States “Are you sexually active?” “No, but you are,” a patient, one day in early spring, responds. Her timing is good, and the point is obvious. I am twenty weeks pregnant and showing, belly at two-thirds basketball. When I tell an older male patient I’m pregnant, he congratulates me, tells me…
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Patient choice—Is it always appropriate?
Denis ChenNewcastle-under-Lyme, United Kingdom Beauchamp and Childress published Principles of Biomedical Ethics in 1979, introducing the “Four Principles” of medical ethics: beneficence, non-maleficence, autonomy, and justice.1 They argued that “best” treatment depends on patient preferences and applied to all cultures and societies. These principles were philosophically underpinned by the duty-based ethics of Immanuel Kant (1724–1804)…
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Gangrene, history, and war
Among the many afflictions that have plagued soldiers in war, gangrene has been one of the most devastating and feared. Caused by the death of tissue because of lack of blood supply or infection, gangrene has haunted military campaigns since antiquity. Hippocrates described the condition, recognizing the blackened, decomposing flesh associated with untreated wounds. In…
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Jean-Baptiste Lamarck (1744–1829): Pioneer of evolutionary thought
The French naturalist and biologist Jean-Baptiste Lamarck was one of the earliest proponents of the evolutionary theory. Born in 1744 into an aristocratic family in Bazentin-le-Petit, Picardy, he initially pursued a military career but following a severe illness turned to zoology and botany. By the late eighteenth century, he had established himself as an eminent…
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Early observations of the pulse
JMS PearceHull, England Over the centuries, various devices bearing names now unfamiliar (Clepsydra, water clock, pulsilogium, Sphygmologia, Pulse Watch) were used to measure the pulse.The examination of the pulse to assist in diagnosis and prognosis dates back to ancient Egyptian, Indian, and Chinese physicians. Because they had little understanding of cardiovascular physiology, we might wonder…
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De l’acromegalie: Maladie de Pierre Marie
JMS PearceHull, England Pierre Marie (1853–1940) described two patients in Charcot’s clinic who showed enlargement of the extremities and face, for which he proposed the term acro-megalie.1 He established and named acromegaly as distinct from other causes of somatic overgrowth. He also acknowledged Saucerotte’s unmistakable earlier account of 1801.2 Pierre Marie described the now classical…
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Finding our way back to healing
Frances MilatMelbourne, Australia “Tell me about despair, yours, and I will tell you mine.” —Mary Oliver Early in 2020, as my family flew home to Australia from a medical sabbatical in the United States, we started to hear reports of serious illness and death among our colleagues. Soon, the medical institutions and communities that had…
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The diverticulum of Meckel
Johann Friedrich Meckel the Younger, a German anatomist, identified and described Meckel’s diverticulum in 1809, building on earlier observations by Fabricius Hildanus in the sixteenth century. The diverticulum is the most common congenital abnormality of the gastrointestinal tract, found in about 2% of the population. It is a pouch or bulge in the small intestine…
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Francis Glisson and his capsule
Francis Glisson (1597–1677) was a highly successful physician, so famous in London that in 1668 he was consulted along with Ashley Cooper and Thomas Sydenham to advise whether the future Earl of Shaftesbury should undergo surgery to drain a perihepatic abscess. In 1650, he published a comprehensive account of infantile rickets (“Glisson’s disease”). Four years…