Disease versus disease: Paolo Zacchia on syphilis and epilepsy.

The lawyer and physician Paolo Zacchia (1584-1659) was the chief physician at the Vatican and an important advisor to the papal court. He is considered a founder of the field of forensic pathology, and the influence of his masterwork, Quaestiones medico-legales, spread throughout Europe. In this essay, we focus on one of Zacchia's consultations, first published posthumously in 1661. Emerging from a cause for beatification, the case features the intriguing medical notion of one disease curing another. Zacchia was to determine if a young man's recovery from epilepsy was miraculous or not. We will briefly review Zacchia's career, examine his argument and the sources on which he based his reasoning in this case, trace the status of the disease-versus-disease notion to the present, and demonstrate that this consultation represents a rare, if not the only example of syphilis being the curative agent - rather than the disease cured.

A Brief History of the Discovery of Gene Cloning in 1975.

An important but little-known step in the cloning of genes took place in Geneva in 1975. Bypassing the enormous complexity of total genomic DNA, it allowed for the cloning, identification, study, and use of all genes that have been isolated ever since. Bernard Mach was head of the Geneva laboratory where this discovery took place. As interviewed by physician-historian Jacalyn Duffin, he explains the nature of the 1975 procedure and highlights the role that this discovery played in the fields of biology, genetic medicine, and biotechnology.

Robert Bruce Sloane and the mid-twentieth-century struggles of academic psychiatry.

In 1957, British-born R Bruce Sloane became the founding head of a Canadian academic department of psychiatry in a city that had already been served by a busy asylum for more than a century. He plunged into the work with enthusiasm, but encountered blatant opposition and skepticism, prompting his departure. He went on to conduct research in the United States. Archives and oral testimony reveal the attitudes thwarting Sloane's plans to improve teaching, research, and service-attitudes that may typify a general hostility toward psychiatry in other centers at that time.

Mrs. Robinson's Revenge: Pete Seeger, Earl Robinson, and the Medicare Protest Song.

In 1962, Pete Seeger recorded "The Ballad of Doctor Dearjohn" about Canadian Medicare and the Saskatchewan doctors' strike of the same year. How had this New Yorker, recently relieved of a jail sentence, learned of Medicare in the distant prairie province? And why was his song never released? This paper traces the ballad's fortunes through the papers of composer Earl Robinson (University of Washington) and the archives of the American Medical Association. It is situated in the historiography of folk revival and the expatriate adventures of artistic Americans persecuted in the McCarthy era.

En 1962, Pete Seeger a enregistré « La ballade du docteur Dearjohn ¼ à propos de l'assurance-maladie canadienne et de la grève des médecins en Saskatchewan la même année. Comment ce New-Yorkais, récemment libéré de prison, a-t-il eu connaissance des événements survenant dans une province éloignée ? Et pourquoi sa chanson n'a-t-elle jamais été commercialisée ? Cet article retrace le parcours de la ballade à travers les archives du compositeur Earl Robinson (Université de Washington) et les archives de l'American Medical Association (Chicago). Il se situe dans l'historiographie du renouveau folk et des aventures d'artistes américains expatriés suite aux persécutions vécues à l'époque du maccarthysme.

Mrs. Robinson's Revenge: Pete Seeger, Earl Robinson, and the Medicare Protest Song.

In 1962, Pete Seeger recorded "The Ballad of Doctor Dearjohn" about Canadian Medicare and the Saskatchewan doctors' strike of the same year. How had this New Yorker, recently relieved of a jail sentence, learned of Medicare in the distant prairie province? And why was his song never released? This article traces the ballad's fortunes through the papers of composer Earl Robinson (University of Washington) and the archives of the American Medical Association. It is situated in the historiography of folk revival and the expatriate adventures of artistic Americans persecuted in the McCarthy era.

Doctors as Stewards of medicare, or not: CAMSI, MRG, CDM, DRHC and the thin alphabet soup of physician support.

Physicians are deeply involved in Canadian medicare because it is through medicare that they are paid. However, from its origins to the present physicians -as a profession - have not been strong supporters of medicare. Fearing loss of income and individual autonomy, they have frequently opposed it with criticisms, strikes, threatened job action and lawsuits. Some opponents are unaware that medicare was a boon to physician income, and many fail to connect medicare with responsibility for improving the health status of the country. This paper will trace physician involvement, support and opposition to medicare from its inception to the present, with special attention to small physician organizations that have supported medicare. It will close with a proposal for how doctors could display greater stewardship.

Hospitals of Rome in the Early Nineteenth Century: The Apostolic Visit of 1825.

Pope Leo XII marked the 1825 Jubilee by visiting the hospitals of Rome. Italy was recovering from the French invasion that had disrupted social and religious structures. The Visitors investigated conditions, and recommended changes. By 1826, eight large hospitals were ordered to unite, but, three years later, the order was rescinded. Based on the Visit's mostly unexamined records in the Vatican Secret Archives, hospital registers, and minutes of the governing council held in the Archivio di Stato di Roma, this paper reconstructs the network of Rome's hospitals in the early 19th century. It also compares Roman hospitals to its Parisian counterparts, especially with respect to governance and education. Finally, it examines the merger as an early example of a practice that remains vibrant (if controversial) today.

Making the Case for History in Medical Education.

Historians of medicine have struggled for centuries to make the case for history in medical education. They have developed many arguments about the value of historical perspective, but their efforts have faced persistent obstacles, from limited resources to curricular time constraints and skepticism about whether history actually is essential for physicians. Recent proposals have suggested that history should ally itself with the other medical humanities and make the case that together they can foster medical professionalism. We articulate a different approach and make the case for history as an essential component of medical knowledge, reasoning, and practice. History offers essential insights about the causes of disease (e.g., the non-reductionistic mechanisms needed to account for changes in the burden of disease over time), the nature of efficacy (e.g., why doctors think that their treatments work, and how have their assessments changed over time), and the contingency of medical knowledge and practice amid the social, economic, and political contexts of medicine. These are all things that physicians must know in order to be effective diagnosticians and caregivers, just as they must learn anatomy or pathophysiology. The specific arguments we make can be fit, as needed, into the prevailing language of competencies in medical education.

Catatonia in the History of Psychiatry: Construction and Deconstruction of a Disease Concept.

Catatonia is a psychomotor disorder that has gone through numerous descriptions since 1874, reflecting the many changes in psychiatric disease conceptualization that have occurred within that time frame. Catatonia has been variously described as a distinct disease entity, as a part of schizophrenia, and as a nonspecific manifestation of many disorders. Because of its association with schizophrenia, the description of catatonia was particularly affected by the psychopharmacological era, beginning in the 1950s, and by the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Changing trends in psychiatric research--especially the brain-based disease model, research methods favoured by the evidence-based medicine movement, and the codes and categories of the DSM--also profoundly influenced the evolving concept of catatonia. This paper discusses these important factors that affected recognition, treatment, and study of catatonia in order to reveal the biases and assumptions made when constructing a disease concept.

A tale of two diseases: the history of inflammatory bowel disease.

'Inflammatory bowel disease' (IBD) sounds like a straightforward term - a disease of inflammation in the bowel. However, the history of IBD reveals a story of a nefariously complex set of idiopathic conditions. IBD defies definition, in part because its pathophysiology is not completely understood. For the same reason and despite substantial advances in research, IBD also defies cure. At best, IBD can be defined as a disease of disruption - disrupted physiology, microbiology, immunology and genetics. The term 'IBD' is most often used to describe two separate conditions: ulcerative colitis (UC) and Crohn's disease (CD). This paper reviews the history of IBD, considering the ever-evolving understanding of both UC and CD. Beyond its intrinsic interest, the history of IBD exemplifies a pattern that is becoming increasingly familiar in the 21st century - the story of a chronic, incurable disease that defies the best efforts to treat it.

Palliative Care: The Oldest Profession?

By the 1960s, the forces that had slowly turned medicine away from comfort toward a greater emphasis on cure had generated a need for better care of the dying and the chronically ill. With reference to the growth of peer-reviewed literature on palliative care, the history of this seemingly new specialty is traced through the hallmarks of professionalization to outline and document the changes in the leaders, the issues, the publications, and the treatment modalities over the last five decades. The focus is on Canada within an international context.