ABSTRACT
Clinical practice became clinical science in the years 1720-1820. There were many reasons for this transformation. The discoveries by Santorio Santorio, William Harvey, Marcello Malpighi, Giovanni Alfonso Borelli, Lorenzo Bellini, Thomas Sydenham, Giovanni Maria Lancisi, were perceived by students who asked for changes in the medical curriculum. In 1761 Morgagni centered the study of diseases on morbid anatomy, a way to control at autopsy the validity of diagnosis. J.P. Frank who worked on public health and John Locke who supported a method of scientific reasoning based on asking questions were also instrumental for changes. Hospitals, formerly hospices for the poor, became places for curing and healing. Military hospitals represented models to be followed. In Vienna Marie Therese inaugurated the Allegemein Krankenhaus in 1785. In revolutionary France Fourcroy with the law Frimaire An III, 1794 gave a new rationale. Medicine and surgery were unified in the curriculum. Basic sciences were introduced. Dissection became compulsory, practical teaching became the rule. But it was with John Hunter, Domenico Cotugno and P. Joseph Desault that the great advancement was achieved. They were anatomists and therefore they made the knowledge of human body the core of medical curriculum. However experimentation on animals, as well as practical bedside teaching at the hospital also became important. Through their work hospitals and universities were associated in a common goal.
Subject(s)
Anatomy/history , Clinical Medicine/history , Education, Medical/history , Hospitals, Teaching/history , Teaching/history , Anatomy/education , Clinical Medicine/education , Curriculum , Europe , History, 18th Century , History, 19th Century , Teaching/methodsABSTRACT
Cryptococcosis is an opportunistic infection caused by the yeast-like fungus Cryptococcus neoformans. The infection predominantly strikes patients with cell-mediated immunodeficiency, that is, patients with organ transplants, leukemia, lymphoma, AIDS, and those receiving steroids or immunosuppressants. We describe a patient with skin lesions and anasarca secondary to intestinal infection from Cryptococcus neoformans after heart transplantation. We based diagnosis on histologic examination of the cutaneous lesions and of the duodenal mucosa. This case demonstrates that in immunosuppressed patients with anasarca of unknown origin, a diagnosis of intestinal opportunistic infection also should be considered.
