The mother gazes at her naked, lethargic infant, wan with a pustular red rash dotting his chest. She’s dressed in the fashion of the day: a high-necked black blouse with leg-of-mutton sleeves, a heavy full-length skirt, a formless red feather jutting from her hat. She holds a white handkerchief to her distorted scarlet face, one arm hanging limply at her side, seemingly in despair over the lamentable circumstances that have brought her to this bare waiting room.
The Nuremberg Code was drafted in 1947 following the appalling revelations of human experimentation committed in Nazi concentration camps. The overarching goal of the Code was to establish a set of rules for the ethical conduct of research using human subjects, guaranteeing that the rights and welfare of such participants would be protected. Two important principles guide and define this Code: the concept of voluntary, informed consent and that no experiment shall be conducted in which “there is an a priori reason to believe that death or disabling injury will occur.”
It seems to have started, as many things medicinal do, with Hippocrates. We may not understand precisely why, some 2000 years ago, the great Greek physician chose to insert the bladder of a pig into a patient’s chest and then inflate this porcine balloon. But it may have had something to do with tuberculosis and with the phenomenon of “pulmonary collapse,” which has had a surprisingly long and fruitful run in the annals of medical history.
Ringworm is one of the most common and widespread childhood maladies. Deceptive in its naming, ringworm is no parasite but rather a fairly mild, though atrociously itchy, fungal skin infection that affects 300 million people worldwide. An infection with the contagious Tinea capitis fungus is usually summarily dismissed by means of antifungal medications, but for decades prior to the discovery of such cures in the 1950s, infections with ringworm and other species of fungus were as intractable and as challenging as their bacterial counterparts. The mid-twentieth century, as modern an era as it seems, marked the early days of effective antimicrobial treatments, and though practical pharmaceuticals for bacterial, viral, and fungal afflictions were on the horizon, they were still far from universally available.
Laissez les bons temps rouler! Tomorrow is the final and momentous hurrah of the Carnival season, which culminates with Mardi Gras, otherwise known as Fat Tuesday. In New Orleans, the city I call home, Carnival is a season of festivities, decadence, and tradition, one that is celebrated amongst neighbours and visitors alike. Our revelry is an egalitarian one – everyone is welcome to come witness and participate in Carnival. But, for over a century, just a couple of hours away from the Crescent City, there lived a community of exiles, quarantined and barred from society, who were forced to forge their own Mardi Gras traditions. In honor of the biggest party of the year, I’m republishing my article on the celebration of Mardi Gras at one of America’s last leper colonies, just a few hours up the Mississippi river in Carville, Louisiana.
The measles outbreak emerging from “the happiest place on Earth” in Anaheim, California, is grabbing headlines and provoking conversation in the media regarding how best to appeal to parents opposed to vaccines.
Using clear facts and appealing to common logic has failed, repeatedly. Blaming and shaming only seem to provoke heel-in-the-sand reactions and encourage retreat. So how does one persuasively sway opinion and convince the skeptics of the safety and utility of vaccinating against preventable diseases?
Abracadabra! Many of us are familiar with this mystical incantation. Its arcane staccato and euphonious intonation has become deeply ingrained in our language through the word’s use as a magical catchphrase. The hex was, in my childhood experience, rather useless when it came to opening locked cabinets and provoking instantaneous transformations; nothing was conjured and very little materialized except for my own disappointment. But millennia past, this word was held in reverence, and it was used for a whole other purpose altogether. Abracadabra was not a silly-sounding piece of magician’s gibberish, but the “most famous of the ancient charms or talismans employed in medicine” and a powerful invocation against a very specific and very dangerous curse: malaria.
In March of 1942, a young woman was dying of sepsis in a New Haven hospital. In just one day, she would be miraculously revived by a newly discovered experimental drug, seemingly by “black magic” as one consulting physician would mutter. The woman’s full recovery with the new antibiotic known as penicillin was the very first occasion of its usage in the United States and would jump-start the pharmaceutical industry’s interest in and manufacture of the drug (1).
Tensions can run high when living with roommates. Quibbles over dishes, the rent and utilities, and even questionable hygiene practices can inflame tempers and sabotage relationships, leaving passive-aggressive notes and broken homes in their wake. There are many ways of managing a good home life within a shared household of semi-strangers, but we’ll save that for another time in another column. This is about a roommate dispute gone totally to the worms.
The Hajj, the pilgrimage to Mecca by millions of Muslims from around the world, is one of the largest gatherings of man on the face of the earth. This annual event took place just last month with relatively little fanfare from the news media, which is, from an epidemiological standpoint, a very good thing. Every year, public health officials wring their hands at the thought of possible outbreaks caused by the global pathogen du jour capitalizing upon the convergence of millions of worshipers in the Saudi Arabian desert. SARS stole the headlines in 2009, Middle Eastern Respiratory Virus or MERS had it last year, and Ebola seemed a likely contender for this calendar year.