Historical development of the anesthetic machine: from Morton to the integration of the mechanical ventilator.

The first anesthetic machines appeared following their public demonstration by Morton in 1846. These initial devices were simple inhalers based on the evaporation of the anesthetic agent. Their main problem was the loss of effectiveness with cooling. More complex inhalers were subsequently developed, in which the main difference was the possibility to provide more than one agent. Moreover, the concentration of the inhaled anesthetic was regulated for greater efficiency. At the beginning of the twentieth century, gas machines emerged, allowing the application of an anesthetic flow independent of the patient's inspiratory effort. These machines incorporated technological advances such as flow meters, carbon dioxide absorption systems and fine adjustment vaporizers. In this period, in the field of thoracic surgery, intraoperative artificial ventilation began to be employed, which helped overcome the problem of pneumothorax associated with open pleura by applying positive pressure. From the 1930s, the gas machines were fitted with a ventilator, and by the 1950s this had become a basic component of the anesthesia system. Later still, in the 1980s, alarm and monitoring systems were incorporated, giving rise to the current generation of workstations.

50 años de trasplante de corazón: la operación que enmudeció al mundo y cambió para siempre el concepto de muerte / 50 years after the first heart transplant: the operation that stunned the world and forever changed the concept of death

Resumen: Cuando el 3 de diciembre de 1967 Christiaan Barnard efectuó el primer trasplante de corazón no solo efectuó una operación que enmudeció al mundo sino que también cambió el concepto de muerte para siempre. Pero esta operación fue la culminación de un proceso que se inició con Alexis Carrel en 1910 y que no solo incumbe a la cirugía, sino que también a la inmunología y la infectología, así como a la ética, la filosofía y la teología. Como en todos los grandes avances de la cirugía, es posible reconocer 3 grandes etapas en el desarrollo histórico del trasplante cardiaco: investigativa, clínica y moderna, las cuales se revisan en esta publicación.

Abstracts: When on December 3, 1967, Christiaan Barnard performed the first human-to-human heart transplant, he not only performed an operation that stunned the world, but it also changed for ever the concept of death. This operation was the culmination of a process initiated by Alexis Carrel in 1910 concerning not only surgery but also immunology and infectious diseases as well as ethics, philosophy and theology. In the historical development of heart transplantation, as in all major advances in surgery, it is possible to recognize 3 eras: the research, the clinical and the modern eras, which are reviewed in this paper.

Sobre el sentido y la utilidad de la Historia de la Medicina (1895-1970) / On the meaning and usefulness of History of Medicine (1895-1970)

Resumen El conocimiento de la historia de la Medicina no parece aportar "utilidad" a la ejecución de las acciones del médico. No obstante, para el médico deseoso de buena información intelectual -o perfección del espíritu llamada "cultura"- el autor da algunas razones de por qué estar familiarizado con la historia de la Medicina tiene cierta "utilidad", mediante los siguientes ítems: Dignidad intelectual: por asumir deliberada y agradecidamente lo mejor de quienes aportaron elementos técnicos, como la auscultación, o elaboraciones intelectuales, como el esquema etiológico de Galeno. Claridad moral: ejecutar, viéndolas como propias, hazañas de la sucesión de personajes cuyos hallazgos construyeron los conceptos y procedimientos actualmente en uso. Claridad intelectual: poseer la razón de ser y el sentido de aquello que se hace. Libertad intelectual: conocer la historia, de un modo comprensivo, libera de la tentación de considerar las nociones científicas como incuestionablemente ciertas y definitivas. Cierta opción a la originalidad: estimulado por una voluntad de emulación, emprender la búsqueda de saberes menos inseguros o más satisfactorios, que tiendan a "completar" lo actualmente aceptado.

The knowledge of the history of Medicine does not seem to add "utility" to the activities of a physician. Nevertheless, for a doctor eager to get good intellectual information -or the spiritual perfection called "culture"- the autor gives some reasons on why being acquainted with the history of medicine has some "utility" through the following items: Intellectual dignity: by deliberately and gratefully assuming the best of those who introduced technical devices or methods, as auscultation, or intellectual elaborations, like the etiologic model of Galen. Moral clarity: to perform as if they were his own, great deeds of the personages whose discoveries built the concepts and procedures used nowadays. Intellectual clarity: assuming the reason for being and the sense of what is being done. Intellectual liberty: knowing history in a comprehensive way, frees a doctor from the temptation of considering scientific notions as unmistakably true and definite. A possible option to originality: stimulated by a will of emulation, to search for less insecure or more rewarding knowledge, tending to "complete" what is at present accepted.

Acerca de la Fundación de la Sociedad Argentina de Historia de la Medicina de la Asociación Médica Argentina / About the Foundation of the Argentine Society of History of Medicine of the Argentine Medical Association

La Sociedad Argentina de Historia de la Medicina de la Asociación Médica Argentina fue fundada en 1936. Este trabajo analiza la historia y las circunstancias asociadas en ese período.

The Argentine History Medicine Society. Argentine Medicine Association was founded in 1936. In this article covers the history and circustances associated with this period.

Formación del discurso en salud mental en la primera mitad del siglo XX / Discourse formation in mental health duringthe first half of the 20th century / Formação do discurso em saúde mental no primeiro semestre do século XX

La formación del discurso en salud mental durante la primera mitad del siglo XX tiene en el Movimiento de Higiene Mental y en el Comité Nacional de Higiene Mental sus principales influencias. Como depositarios de un estilo de pensamiento biomédico, los dos entes mencionados tomaron la vocería en el campo de la salud mental, el cual para la época bajo estudio adolecía de una clara diferenciación conceptual. Con el objeto de comprender la influencia que ejerció este estilo de pensamiento en la formación del discurso en salud mental durante la primera mitad del siglo XX, se desarrollo una revisión de literatura de la época, empleando para tal fin una propuesta teórica que combinó el análisis del discurso de Michel Foucault y la sociología del conocimiento de Ludwik Fleck. Los resultados evidencian una hegemonía del estilo de pensamiento biomédico para abordar la salud mental, representada principalmente en el empleo de la prevención como estrategia de trabajo; de igual forma se constató que fueron los médicos, psiquiatras y salubristas de la época quienes asumieron para sí, como colectivo de pensamiento, la autoridad para hablar y actuar sobre la salud mental de la población, relegando a un segundo plano otros colectivos de pensamiento. [Mojica-Perilla M, Cadena-Afanador LP. Formación del discurso en salud mental en la primera mitad del siglo XX.

The discourse formation in mental health during the first half of the twentieth century has been influenced by the Mental Hygiene Movement and the National Committee for Mental Hygiene. As depositories of the biomedical thinking style, the aforementioned institutions have taken the lead in the field of mental health, which for the period under study suffered from a conceptual differentiation. In order to understand the influence that this thinking style had during the first half of the twentieth century, a review of the literature of the period was developed, using for this purpose a theoretical proposal that combined the discourse analysis of Michel Foucault and the sociology of knowledge of Ludwik Fleck. The results show a dominance of biomedical thinking style to address mental health, represented mainly in the use of prevention as a working strategy, and likewise found that were doctors, psychiatrists and public health professionals who took the time to themselves, as a collective of thinking, the authority to speak and act about the mental health of the population, relegating to the background other groups of thinking. [Mojica-Perilla M Cadena-Afanador LP. Discourse formation in mental health during the first half of the 20th century.

A formação discurso em saúde mental durante a primeira metade do século XX tem sido influenciada pelo Movimento Higiene Mental e da Comissão Nacional de Higiene Mental. Como depositárias do estilo de pensamento biomédico, as instituições acima referidas assumiram a liderança no campo da saúde mental, que durante o período em estudo sofreu uma diferenciação conceitual. A fim de compreender a influência que este estilo de pensamento teve durante a primeira metade do século XX, uma revisão da literatura do período foi desenvolvido, utilizando para o efeito uma proposta teórica que combinava a análise do discurso de Michel Foucault ea sociologia da conhecimento do Ludwik Fleck. Os resultados mostram uma predominância do estilo de pensamento biomédica para tratar da saúde mental, representado, principalmente, no uso da prevenção como uma estratégia de trabalho, e também descobriram que eram médicos, psiquiatras e profissionais de saúde pública que tomaram o tempo para si, como um coletivo de pensamento , a autoridade para falar e agir sobre a saúde mental da população, relegando para segundo plano outros grupos de pensamento. [Mojica-Perilla M Cadena-Afanador LP. formação discursiva em saúde mental durante a primeira metade do século XX.