A doctor today may refer to their paper diploma as a “sheepskin”, perhaps unaware that this refers to parchment. In ancient Egypt such a diploma would have been written on papyrus, also derived from a plant, in this case the pith of Cyperus papyrus. Papyrus was abundant in the wetlands along the Nile Delta and was used for 4000 years to make boats, baskets, sandals—and for archiving the collective knowledge of a civilization, including several millennia of empiric medicine.
Rayleigh, Coulter, Gohde, Swift and Herzenberg—no, not a law firm. These people occupy points on a graph that plots the evolution of a device for medical diagnosis that, for hematologists anyway, is a bit like a (non-portable) Tricorder. Known as a FACS machine (Fluorescent Activated Cell Sorter), it is a technology so advanced that, as Arthur C. Clarke would say, it is “indistinguishable from magic.”
A normal temperature is 98.6°F, so they say. This dogmatic fact persisted for 150 years, ever since a single physician derived it fact from compulsively prodding thousands of patients with primitive thermometers. He was close (the average temperature is actually 98.2). But it is variation in temperature, both normal and pathologic, that is more interesting.
Not up to snuff on your emmenagogues and discutients? Grab a copy of the Merck Manual of the Materia Medica 1st edition,1899. It went through nineteen editions until 2011, when it transitioned to online only. It was the oldest continuously published English–language textbook of medicine, and Merck, a drug company founded 350 years ago, sold it at cost.
I had read quite a bit of history about my alma mater, the University of Michigan Medical School, before encountering two of it’s most ‘famous’ students, both from the class of 1882. Eventually I learned of them not from institutional histories but in the pages of two engaging books by Erik Larson: The Devil in the White City and Thunderstruck. Each doctor in turn was found out and hung as one of the most notorious murderers of a generation.
As Mephistopheles said to Dr. Faustus “blood is a very special fluid.” Long before there was an appreciation of its astonishingly complex biology, blood was regarded with reverence as the life giving humor that it is. Severe trauma can cause blood to exit the body as drops, sprays and splatters, or flow into puddles. In any case, there was little to make of such a sight other than outward signs of tragedy. That is, until 1895 when a certain Polish professor decided that some rabbits needed to contribute to a new science—blood stain analysis.
It’s safe to say most doctors, whether clinician, researcher or both, did not enter the field with an ambition to win a prize. Most simply seek the satisfaction of helping the sick, the excitement of critical thinking and some degree of financial security. But societies fixate on rank-ordering achievements in almost every field of endeavor. For medicine, the best known is the Nobel Prize. We bring attention here to a worthy companion—the Copley Medal.
Who was the ‘father’ of blood banking and where on Earth was the first blood bank established? We look for answers in the curious life stories of four largely unsung physicians. Without the ability to bank blood, the benefit of transfusion would be lost to the majority of those who need it. While we start with a brief history of blood transfusion, the main story here is the evolution of those miraculous storehouses known as ‘blood banks’.
In 1788 King George III, in the middle of a sixty year reign, was suddenly acting crazy. The ‘mad doctors’ were called in and parliament considered the need for his son to assume power as ‘regent’. This eventually happened in 1811. But in the mean time, the King’s episodic ill health, mental and physical, continued to distress and perplex the court and his doctors. What was going on with the King? Can pathography solve the puzzle?
We recently discussed the evolution of medical literature as a searchable archive, noting that the National Library of Medicine grew out of the efforts of Dr. John Shaw Billings and the US Army. Here we give due credit to Joseph Lovell, the first Surgeon General, who started the library in 1838. The holdings as of 1840 were 130 titles, listed by hand. We began exploring this list and quickly digressed into paleography and genealogy.
Physicians pondering second careers are sometimes chided for over-reaching ambition, as is the point of this variation on a common anecdote, meant to be both humorous and instructive: “‘When I retire’, a surgeon told an historian, ‘I plan to be a medical historian.’ The historian replied that when he retired he planned to practice surgery.” While some might find the implied absurdity amusing, those who know of John Shaw Billings won’t get the joke.
Genetics in Art and Art in Genetics is an engaging article published in Gene in 2014 by Bukvic and Elling. They gathered the pictorial evidence that reveals the fact that artists have recognized for centuries, if not millennia, at least four inherited anomalous of appearance. And they throw in Akhenaten too—as a wild card.
At 1 Hoxton Square in London there is one of the city’s famous Blue Plaques—it says “James Parkinson, 1755-1824, Physician and Geologist, lived here.” Were It bigger it could continue”…surgeon, apothecary, paleontologist, social reformer, political activist and pamphleteer, the later as ‘Old Hubert’”. He wrote on gout and appendicitis, tracts for patients and political essays. He was even touched by rumors of a plot to kill King George III. But it was hIs Essay on Shaking Palsy that earned his place in medical history, and was mostly ignored for forty years after publication.
While I am interested in many aspects of history, I am not an historian. My knowledge of medical history derives from eager exploration, not special training. I have stumbled upon a number of open source reference sites that I’d like to share with you. I’m sure you will enjoy making your own discoveries there.
Shakespeare scholars have been astounded for centuries at the breadth and depth of his knowledge of diverse subjects, not just life at court but engineering, law, geography, botany, falconry, the classics—and medicine. Some might even suggest that Shakespeare’s, (the glover’s son of Avon), knowledge of medicine derived in part from his physician son-in-law, John Hall. I think not—since the actual author of the plays was Edward de Vere, 17th Earl of Oxford. The Earl’s bona fides as the tr author and his sweeping intellect have been well argued elsewhere. Here we discuss what the text of the plays themselves tell us of Elizabethan notions of medicine.
The Greek Gods had their own physician—Paeon. In fact Paeon eventually became a descriptor for ‘physician’—and the name of my medical school’s student magazine. We did not take the Hippocratic oath there (it has become somewhat passé). But had we done so we would have sworn by Apollo, Asclepius, Hygieia and Panacea. The most medically prominent in this pantheon is Asclepius, who was a physician of, dare we say it, mythical proportions.
Between bleeding and thrombosis is a precarious state of fluidity wherein blood cells zip about, suspended and contained in plasma, a complex elixir of proteins.
Under circumstances both normal and pathologic, the blood is called upon to clot. In such a case, plasma interacts with it’s cellular milieu, triggering a cascading waterfall of serial enzymatic changes that activate clotting factors, terminating in a mesh of fibrin gel and platelets.
The resultant clot can be a life saving response to a penetrating injury, a nuisance if small and in a leg vein, or quickly deadly if lodged in the lung vasculature. In any case, the deep vain thrombosis (DVT) is common and we would expect there to be some record of historical observations. And so there is.
The Western World today has astonishing prowess in the medical arts and sciences. But let’s be honest—during the middle ages European medicine was pitiably archaic, consisting mostly of palliative care at monastic hospitals, the surgical services of a barber, and herbalism. Europe had misplaced the gift of the Galenic medical tradition of intellectual inquiry, and it went missing for hundreds of years. In the meantime in the islamic world there emerged “…a republic of physician-philosophers under the neutral umbrella of Galenic medicine, which survived to transcend cultures and centuries”.