Solidarity in medicine: the role of medical students and young doctors.

The descriptions of medical caring and of highly technical specialism and science utilize different vocabularies and language. Medical caring has an ancient glossary of words, gestures, and behavior which is rapidly being transformed by specialization and advances in the technology of communication. The technologic capabilities of intensive care have, for example, exceeded the human life span and forced redefinition of the meaning of being olive. There are risks for the contemporary profession as linguistic and technical evolution proceed at a faster pace than the evolution of human health and illth. The accentuation and acceleration of generational disparity between the young and the old diminishes the solidarity of the profession and the quality of care that it provides.

The broken branch: Darwin's evolutionary tree and the progress of medicine, the evolution of specialism and generalism.

The landscape of medical practice and health care has been transformed by specialization over the past Century. There has been an extraordinary acceleration in the proliferation of specialty practice, coincident with rapid growth in technological devices and their clinical applications during the past fifty years. Medicine and medical care are evolving rapidly, a process that has similarities to biologic evolution. Medical educators, policy makers, and practitioners might find a Darwinian overview of medicine and health care of interest.

Darwin's earthquake.

Charles Darwin experienced a major earthquake in the Concepción-Valdivia region of Chile 175 years ago, in February 1835. His observations dramatically illustrated the geologic principles of James Hutton and Charles Lyell which maintained that the surface of the earth was subject to alterations by natural events, such as earthquakes, volcanoes, and the erosive action of wind and water, operating over very long periods of time. Changes in the land created new environments and fostered adaptations in life forms that could lead to the formation of new species. Without the demonstration of the accumulation of multiple crustal events over time in Chile, the biologic implications of the specific species of birds and tortoises found in the Galapagos Islands and the formulation of the concept of natural selection might have remained dormant.

Darwin’s Earthquake / El terremoto de Darwin

Charles Darwin experienced a major earthquake in the Concepción-Valdivia region of Chile 175 years ago, in February 1835. His observations dramatically illustrated the geologic principles of James Hutton and Charles Lyell which maintained that the surface of the earth was subject to alterations by natural events, such as earthquakes, volcanoes, and the erosive action of wind and water, operating over very long periods of time. Changes in the land created new environments and fostered adaptations in life forms that could lead to the formation of new species. Without the demonstration of the accumulation of multiple crustal events over time in Chile, the biologic implications of the specifc species of birds and tortoises found in the Galapagos Islands and the formulation of the concept of natural selection might have remained dormant. Hace 175 años (febrero de 1835) Charles Darwin presenció un gran terremoto en Concepción y Valdivia, en Chile. Sus observaciones ilustraron dramáticamente los principios geológicos de James Hutton y Charles Lyell, quienes sostenían que la superfcie de la tierra estaba expuesta a alteraciones por eventos naturales, tales como terremotos, erupciones volcánicas y la acción erosiva del viento y el agua, operando durante largos períodos de tiempo. Cambios en la tierra crearon nuevos ambientes y fomentaron adaptaciones en las formas de vida que pudieron conducir a la formación de nuevas especies. Sin la demostración de múltiples eventos acumulados en la corteza terrestre a través del tiempo, en Chile, las implicaciones biológicas de las especies de aves y tortugas descubiertas en las Islas Galápagos y la formulación del concepto de selección natural habrían permanecido latentes.

A letter from the United States: The fox in our backyard - Science, Serendipity and Surprise / Un mensaje desde Norteamérica: El zorro en nuestro patio trasero - Ciencia, "Serendipia" y Sorpresa

The story of how Charles Darwin composed The Origin of Species, published in November of 1859, has been told many times during the bicentennial of Darwin s birth and the sesquicentennial of the publication of the book. It is a history well known to biologists and historians of science. The heated debate that accompanied the demonstration of natural selection as a mechanism of speciation and continues to the present is surprising. Human beings do not welcome surprise: "the emotion aroused by something unexpected." The history of science and human intellect, however, illustrate the creative stimulus of surprise and serendipity in the development of human knowledge and the evolution of culture. The lives of Homo sapiens would not change if our intellect was unable or unwilling to respond to the unexpected and to make connections between surprising and commonplace events. The rich diversity of South American life was surprising to the European travelers of the 18th and 19th centuries: surprising by its beauty and profusion, but also by its similarities to the creatures of Europe and Africa. Darwin s curiosity sought and welcomed surprise).

La historia sobre cómo escribió Charles Darwin 'El origen de las especies", publicado en noviembre de 1859, ha sido relatada muchas veces durante el bicentenario del nacimiento de Darwin y el sesquicentenario de la publicación del libro. Es una historia bien conocida por los biólogos y los historiadores de la ciencia. La demostración de la selección natural como mecanismo de formación de las especies generó un acalorado debate que continúa hasta el presente. Los seres humanos no acogemos con simpatía la sorpresa, concebida como "la emoción despertada por algo inesperado". La historia de las ciencias y del intelecto humano, sin embargo, ilustran el estímulo creativo de la sorpresa y la "serendipia" en el desarrollo del conocimiento y la evolución de la cultura. La vida del Homo sapiens no cambiaria si nuestro intelecto fuera incapaz o adverso para responder ante lo inesperado y de hacer conexiones entre los eventos sorprendentes y los rutinarios. La rica diversidad de formas de vida en Sudamérica fue sorprendente para los viajeros europeos de los siglos XVIII y XIX: sorprendente por su belleza y profusión, pero también por sus similitudes con las creaturas de Europa y África. La curiosidad de Darwin buscó y dio su bienvenida a la sorpresa.

A letter from the United States: the fox in our backyard--science, serendipity and surprise.

The story of how Charles Darwin composed The Origin of Species, published in November of 1859, has been told many times during the bicentennial of Darwin s birth and the sesquicentennial of the publication of the book. It is a history well known to biologists and historians of science. The heated debate that accompanied the demonstration of natural selection as a mechanism of speciation and continues to the present is surprising. Human beings do not welcome surprise: "the emotion aroused by something unexpected." The history of science and human intellect, however, illustrate the creative stimulus of surprise and serendipity in the development of human knowledge and the evolution of culture. The lives of Homo sapiens would not change if our intellect was unable or unwilling to respond to the unexpected and to make connections between surprising and commonplace events. The rich diversity of South American life was surprising to the European travelers of the 18th and 19th centuries: surprising by its beauty and profusion, but also by its similarities to the creatures of Europe and Africa. Darwin s curiosity sought and welcomed surprise).

Medical journals: old, not senescent. A tribute to Revista Médica de Chile on its 135th anniversary.

Medical journals, like the Revista Médica de Chile, are the product of a long history of printing, literary styles, and scientific inquiry. They would not have developed without the craft of paper making, the invention of movable type, the need to communicate ideas and observations in a timely and digestible format, and the growth of "natural philosophy" during the European Renaissance and Enlightenment. The proliferation of scientific and medical periodical literature during Europe's industrialization in the nineteenth and twentieth centuries followed the emergence of medical science and care as a separate discipline and the creation of common and worldwide professional expectations and credentials. Medical journals continue to evolve with the advent of digital paperless publishing. Prognostication remains uncertain but it seems to me unlikely that printed paper, so called "hard copy, "journals will become extinct any time soon.

Medical journals: Old, not senescent. A tribute to Revista Médica de Chile on its 135th Anniversary

Medical journals, like the Revista Médica de Chile, are the product of a long history of printing, literary styles, and scientific inquiry. They would not have developed without the craft of paper making, the invention of movable type, the need to communicate ideas and observations in a timely and digestible format, and the growth of "natural philosophy" during the European Renaissance and Enlightenment. The proliferation of scientific and medical periodical literature during Europe's industrialization in the nineteenth and twentieth centuries followed the emergence of medical science and care as a separate discipline and the creation of common and worldwide professional expectations and credentials. Medical journals continue to evolve with the advent of digital paperless publishing. Prognostication remains uncertain but it seems to me unlikely that printed paper, so called "hard copy, "journals will become extinct any time soon.

Las revistas médicas, como Revista Médica de Chile, son el producto de una larga historia de impresores, estilos literarios e investigación científica. No se habrían desarrollado sin la pericia de fabricar papel, la invención de los tipos mecánicos en la imprenta, la necesidad de comunicar ideas y observaciones en un formato oportuno y digerible, y el desarrollo de una "filosofía de la naturaleza" durante el Renacimiento y la Ilustración en Europa. La proliferación de publicaciones periódicas científicas y médicas durante la industrialización de Europa en los siglos 19 y 20 siguió a la emergencia de la ciencia médica y la atención de salud como disciplina aparte, y a la creación de expectativas y credenciales profesionales comunes y universales. Las revistas médicas siguen evolucionando con el advenimiento de las publicaciones digitales electrónicas, sin papel. Pronosticar es incierto pero al autor de este artículo le parece improbable que las revistas impresas en papel vayan a desaparecer en un futuro próximo.

Obstretic medicine: interdisciplinary care for pregnancy and for women wishing to conceive.

The concept of 'obstetrical medicine' was established in the late 19th century, but overshadowed during most of the 20th century by dramatic improvements in surgical, anesthetic, antimicrobial therapeutics, and obstetrical methods and practice. During the last quarter of the 20th century the causes of maternal morbidity and mortality increasingly became pre-existing hereditable and acquired medical disorders and treatable or preventable medical complications of pregnancy. The role of obstetric medicine re-emerged because of surgical, therapeutic, and medical success. New professional associations have been formed to support, through education and research, the growth in numbers of clinicians from many specialties concerned with the medical care of the pregnant patient.

Obstretic Medicine: Interdisciplinary care for pregnancy and for women wishing to conceive

El concepto de «Medicina Obstétrica¼ se originó a fines del siglo 19, pero quedó sobrepasado durante la mayor parte del siglo 20 por los avances dramáticos en la terapéutica quirúrgica, en la anestesia, en la disponibilidad de antimicrobianos, y en los métodos y la práctica de la obstetricia. Durante las últimas décadas del siglo 20 las causas de morbilidad y mortalidad maternas cambiaron progresivamente hacia patologías médicas preexistentes, hereditarias o adquiridas, y a complicaciones médicas del embarazo que son prevenibles y tratables. El rol de la medicina obstétrica emergió nuevamente debido a los éxitos quirúrgicos, terapéuticos y médicos. Se han constituido nuevas sociedades profesionales que apoyan a través de la educación y la investigación al número creciente de clínicos de distintas especialidades que se involucran en la atención médica de las embarazadas.

Nausea and vomiting of pregnancy: an evolutionary hypothesis.

Nausea and vomiting of pregnancy, "morning sickness", is a common contemporary complaint. Many pregnant patients note alterations in smell and taste which can precipitate "morning sickness", symptoms that characterize early gestation. Epidemiologic studies suggest that pregnancies accompanied by "morning sickness" have better outcomes than asymptomatic pregnancies. The intimate connection between immunogenetic identity, chemoidentity, and chemocommunication by olfactory mechanisms suggests a relationship between maternal symptoms and maternal accommodation of paternal antigens contained in the fetoplacental unit. Most mammalian species utilize olfaction to reduce inbreeding and thus do not require an intimate placental connection between mother and fetus. The evolution of Homo sapiens included prolonged periods of small, genetically homogeneous foraging groups which limited selection of genetically heterogeneous mates. Adaptation to this circumstance included a reduction of olfactory precision in mate selection and a more intimate association between mother and fetus, the hemochorial placenta.

Nausea and vomiting of pregnancy: an evolutionary hypothesis

Nausea and vomiting of pregnancy, "morning sickness", is a common contemporary complaint. Many pregnant patients note alterations in smell and taste which can precipitate "morning sickness", symptoms that characterize early gestation. Epidemiologic studies suggest that pregnancies accompanied by "morning sickness" have better outcomes than asymptomatic pregnancies. The intimate connection between immunogenetic identity, chemoidentity, and chemocommunication by olfactory mechanisms suggests a relationship between maternal symptoms and maternal accommodation of paternal antigens contained in the fetoplacental unit. Most mammalian species utilize olfaction to reduce inbreeding and thus do not require an intimate placental connection between mother and fetus. The evolution of Homo sapiens included prolonged periods of small, genetically homogeneous foraging groups which limited selection of genetically heterogeneous mates. Adaptation to this circumstance included a reduction of olfactory precision in mate selection and a more intimate association between mother and fetus, the hemochorial placenta

Spirochetal infection in isolated Indian populations

Black, Francis L

Lee, Richard V

Meeting of the Advisory Committee on Medical Research, 15. Pan American Health Organization; Jun. 13-17, 1976