Sunday, February 28, 2016
Friday, February 26, 2016
CHD - Coronary Heart Disease
The most dramatic and fatal manifestation of the disease now called ‘CHD’ is what we now call a myocardial infarction, or ‘heart attack’.
Various technologies have continued to play a role in the twentieth-century history of CHD, albeit in more complicated ways than have often been appreciated. Consider the use of technology for diagnosis of asymptomatic disease. Early disease diagnosis has been a major goal ever since the realisation that while some people may survive a myocardial infarction, too many did – and still do – die at the initial manifestations of the disease. CHD’s natural history led physicians to search for ways of diagnosing the disease before it manifests as a possibly fatal heart attack. Starting in the 1920s–1930s, three different tools shared the stage.
One started in 1929 as the ‘Master’s two-step’, during which medical personnel monitored a person’s heart while she or he exercised. This test eventually became the twenty-first century multi-stage exercise test. But historically to focus exclusively on this test, as though it somehow led inevitably to current procedures for CHD diagnosis, would be to ignore two other tests that were also widely advocated for exactly the same sort of diagnosis. One was the anoxaemia test, in which patients breathed in oxygen-depleted air in order to deprive the heart of adequate oxygen and thus to produce cardiac ischaemia. Another was the ballistocardiogram, a test that recorded the body’s motions produced by the heartbeat. All three were thought to diagnose CHD in the 1940s and 1950s. To focus on only one implies a unanimity of thought that simply did not exist.
Treatment 1910-1960s:
1910-1930s:
* Absolute bedrest for 2-3 weeks
* At least 6 weeks of hospital stay followed by a prolonged recovery at home
* Resumption of normal activity was rarely encouraged
* Chest pain was sometimes alleviated with Morphine
* Digitalis (now commonly known as digoxin) was used for treatment of heart failure following a heart attack
1930-1950s
* Heart attack (acute myocardial infarction) was recognized as a medical emergency
* Intramuscular adrenaline was used if slowing or stopping of the heart rhythm was encountered
* Quinidine was used for suspected fatal irregular heart rhythm
1950-1960s:
* Heart attack (acute myocardial infarction) was recognized as the most common cause of death in Europe and North America
* Oxygen was recommended only if patients with heart attack developed excessive amount of fluid in the lung due to heart failure
* Nitroglycerin placed under the tongue was used to relax the heart arteries
*Physical and emotional rest was always recommended as the mainstay of treatment
* There was an increased awareness that prolonged bedrest could result in blood clots in legs and lungs. Therefore, absolute bedrest was shortened to 5 days and total duration of hospitalization was limited to about 1 month
* Blood thinners like heparin and warfarin at times were used in some centers to prevent a second heart attack and/or a blood clot in the lung
* Death and disability from heart attacks remained extremely high and most of the treatment was geared towards relieving pain and suffering only
* Absolute bedrest for 2-3 weeks
* At least 6 weeks of hospital stay followed by a prolonged recovery at home
* Resumption of normal activity was rarely encouraged
* Chest pain was sometimes alleviated with Morphine
* Digitalis (now commonly known as digoxin) was used for treatment of heart failure following a heart attack
1930-1950s
* Heart attack (acute myocardial infarction) was recognized as a medical emergency
* Intramuscular adrenaline was used if slowing or stopping of the heart rhythm was encountered
* Quinidine was used for suspected fatal irregular heart rhythm
1950-1960s:
* Heart attack (acute myocardial infarction) was recognized as the most common cause of death in Europe and North America
* Oxygen was recommended only if patients with heart attack developed excessive amount of fluid in the lung due to heart failure
* Nitroglycerin placed under the tongue was used to relax the heart arteries
*Physical and emotional rest was always recommended as the mainstay of treatment
* There was an increased awareness that prolonged bedrest could result in blood clots in legs and lungs. Therefore, absolute bedrest was shortened to 5 days and total duration of hospitalization was limited to about 1 month
* Blood thinners like heparin and warfarin at times were used in some centers to prevent a second heart attack and/or a blood clot in the lung
* Death and disability from heart attacks remained extremely high and most of the treatment was geared towards relieving pain and suffering only
- Myocardial revascularization had its beginnings in the early 1900s with extracardiac operations, such as sympathetic denervation and thyroid ablation.
- Evolved through neovascularization via pericardial poudrage and cardiopexy in the 1930s to 1950s,
- mammary artery myocardial implantation in the 1940s
- endarterectomy in the 1950s,
- saphenous vein– and mammary artery–coronary artery bypass grafting in the 1960s.
Chelsea Physic Garden, WW2
Chelsea Physic Garden, WW2 - Gresham > .
Cultivated Rx - Healing Plants, Grow Your Own Medications - anth >> .
Plants - Medicinal & Toxic - Ben >> .
Medicinal Foraging, Grow Your Own - Savoir >> .
With over 5000 species of plants - many of them medicinal or otherwise 'useful' to our lives - Chelsea Physic Garden still serves the same purpose almost 350 years after it was founded by the Worshipful Society of Apothecaries.
The Garden was considerably affected by both World Wars; with the Home Front fully mobilised to do everything it could to support the war effort, Chelsea Physic Garden contributed.
Plants and medicines were in short supply in both conflicts, so the public was encouraged to start collecting or growing plants to help with the effort. Many of plants had previously been imported from Europe, but this was no longer possible. The Government even issued leaflets helping people to identify plants outdoors and with advice on growing essential plants. The types of plants that needed to be grown were similar in both wars, and the Government issued lists of these plants. (Ayres 2015)
Kew Gardens contributed to growing food for the Second World War effort, but Chelsea Physic Garden made other contributions; in light of the enhanced need for medicine, the Garden made use of their extensive medicinal collection. The Garden sent belladonna (Atropa belladonna) and Digitalis (heart medicines) and Hyoscyamus (anaesthetic) to the University College Hospital in 1940, and they also supplied Atropa belladonna to the Ministry of Health in 1943. During World War II the demand led to a resurgence in the interest in medicinal plants. (Minter 2000)
Plants - Medicinal & Toxic - Ben >> .
Medicinal Foraging, Grow Your Own - Savoir >> .
With over 5000 species of plants - many of them medicinal or otherwise 'useful' to our lives - Chelsea Physic Garden still serves the same purpose almost 350 years after it was founded by the Worshipful Society of Apothecaries.
The Garden was considerably affected by both World Wars; with the Home Front fully mobilised to do everything it could to support the war effort, Chelsea Physic Garden contributed.
Plants and medicines were in short supply in both conflicts, so the public was encouraged to start collecting or growing plants to help with the effort. Many of plants had previously been imported from Europe, but this was no longer possible. The Government even issued leaflets helping people to identify plants outdoors and with advice on growing essential plants. The types of plants that needed to be grown were similar in both wars, and the Government issued lists of these plants. (Ayres 2015)
Kew Gardens contributed to growing food for the Second World War effort, but Chelsea Physic Garden made other contributions; in light of the enhanced need for medicine, the Garden made use of their extensive medicinal collection. The Garden sent belladonna (Atropa belladonna) and Digitalis (heart medicines) and Hyoscyamus (anaesthetic) to the University College Hospital in 1940, and they also supplied Atropa belladonna to the Ministry of Health in 1943. During World War II the demand led to a resurgence in the interest in medicinal plants. (Minter 2000)
Chelsea Physic Garden, WW2 ..
Wednesday, February 24, 2016
Early Clinics - Sexual Health
Impact of Britain's early sexual health service - Birb > .
The first UK clinics for venereal disease (VD) were established during the interwar years. These clinics were available to anyone, you could walk in off the street or be referred by a GP and importantly they were also free at the point of use... they changed the way that British people thought about their relationship with state-provided healthcare. The VD clinics are by no means a precursor to the NHS, but they did provide a blueprint for modern health services.
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sī vīs pācem, parā bellum
igitur quī dēsīderat pācem praeparet bellum therefore, he who desires peace, let him prepare for war sī vīs pācem, parā bellum if you wan...
