An ordinary malaria? Intermittent fever in Denmark, 1826-1886

Intermittent fever is a historical diagnosis with a contested meaning. Historians have associated it with both benign malaria and severe epidemics during the Early Modern Era and early nineteenth century. Where other older medical diagnoses perished under changing medical paradigms, intermittent fever 'survived' into the twentieth century. This article studies the development in how intermittent fever was framed in Denmark between 1826 and 1886 through terminology, clinical symptoms and aetiology. In the 1820s and 1830s, intermittent fever was a broad disease category, which the diagnosis 'koldfeber'. Danish physicians were inspired by Hippocratic teachings in the early nineteenth century, and patients were seen as having unique constitutions. For that reason, intermittent fevers presented itself as both benign and severe with a broad spectrum of clinical symptoms. As the Parisian school gradually replaced humoral pathology in the mid-nineteenth century, intermittent fever and koldfeber became synonymous for one disease condition with a nosography that resembles modern malaria. The nosography of intermittent fever remained consistent throughout the second half of the nineteenth century. Although intermittent fever was conceptualized as caused by miasmas throughout most of the nineteenth century, the discovery of the Plasmodium parasite in 1880 led to a change in the conceptualization of what miasmas were. The article concludes that the development of how intermittent fever was framed follows the changing scientific paradigms that shaped Danish medicine in the nineteenth century.

Pierre-Charles-Alexandre Louis and the Evaluation of Bloodletting

Additional material for this article is available from The James Lind Library website [ www.jameslindlibrary.org ] where this paper was previously published.

Facing the ongoing challenge of the febrile young infant

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .

Human Brucellosis in Febrile Patients Seeking Treatment at Remote Hospitals, Northeastern Kenya, 2014-2015

During 2014–2015, patients in northeastern Kenya were assessed for brucellosis and characteristics that might help clinicians identify brucellosis. Among 146 confirmed brucellosis patients, 29 (20%) had negative serologic tests. No clinical feature was a good indicator of infection, which was associated with animal contact and drinking raw milk.

Tropical Colonial Ports: Shifting concepts, 1500s-1800s

Based on a study of the history of exploration and settlement in North Australia in the 18th and 19th centuries, I became particularly interested in the concept of a 'good port' in the tropics and how in time this concept shifted. The threat of fevers played a significant part in these shifts. In this overview, I examine how similar shifts in the concept of a good port occurred in the maritime silk and spice routes of South and Shout East Asia.

Magical-medical prescriptions against fever: an edition of BM 42272

Containing twenty prescriptions, the Neo- or Late-Babylonian tablet edited here is one of the most comprehensive sources for the phylacteries against fever. Although a duplicate of the whole text is yet unknown to me, several parallels or text variants of the single prescriptions can be identified in the published and unpuplished medical tablets from A9sur and Ninive. In the present paper I transliterate and translate the tablet, with special attention to the fever prescriptions and their parallels?

[Preliminarily analysis on traditional Chinese medicine advices in Treatise on Febrile Diseases]

To make a systematic analysis on literatures concerning traditional Chinese medicine (TCM) advices in Treatise on Febrile Diseases, and summarize the main connotations of traditional Chinese medicine advices, relevant TCM advices in Treatise on Febrile Diseases were collected, screened, compared, summarized and analyzed according to TCM dosage form preparation methods, TCM administration methods, medication contraindications and nursing after TCM administration. The literatures concerning medications in Treatise on Febrile Diseases were consulted, summarized and compared to standardize medicine advices and facilitate rational clinical application of TCMs. The standard medicine advices were as follows. The boiling water for TCMs shall be tap water and well water. The decoctions that have effects in promoting blood and meridians can be boiled with wine. The decoctions containing toxic components can be boiled with honey. Some TCMs shall be boiled with special methods, e. g. Herba Ephedra that could be boiled before other medicine and skimmed. Japonica rice could be added in decoctions to measure the duration of decoctions. Different dosages were required for different forms (litre, pill, medicine spoon). Administration times, temperature and frequency shall be adjusted according to target positions, functions and stage of illness. As for dietary contraindications during medication, thick porridges are recommended, where foods impacting medicine efficacy are prohibited. Regarding nursing after medication is important to recover physical functions, particularly warm porridges can go with diaphoretic recipes, while thick porridges can go with purgative recipes. And drug efficacies shall be defined by observing urine and excrements, and blood form. In conclusion, Treatise on Febrile Diseases is the first book that discusses TCM advices and records them in details. In this study, new standard medicine advices were proposed to provide important basis for improving clinical advices of TCMs and supports for developing the TCM dispensing technology.

Typhoid Fever in nineteenth-century Colombia: between medical geography and bacteriology

This paper analyses how the Colombian medical elites made sense of typhoid fever before and during the inception of bacteriological ideas and practices in the second half of the nineteenth century. Assuming that the identity of typhoid fever has to be understood within the broader concerns of the medical community in question, I show how doctors first identified Bogotá's epidemics as typhoid fever during the 1850s, and how they also attached specificity to the fever amongst other continuous fevers, such as its European and North American counterparts. I also found that, in contrast with the discussions amongst their colleagues from other countries, debates about typhoid fever in 1860-70 among doctors in Colombia were framed within the medico-geographical scheme and strongly shaped by the fear of typhoid fever appearing alongside 'paludic' fevers in the highlands. By arguing in medico-geographical and clinical terms that typhoid fever had specificity in Colombia, and by denying the medico-geographical law of antagonism between typhoid and paludic fevers proposed by the Frenchman Charles Boudin, Colombian doctors managed to question European knowledge and claimed that typhoid fever had distinct features in Colombia. The focus on paludic and typhoid fevers in the highlands might explain why the bacteriological aetiology of typhoid fever was ignored and even contested during the 1880s. Anti-Pasteurian arguments were raised against its germ identity and some physicians even supported the idea of spontaneous origin of the disease. By the 1890s, Pasteurian knowledge had come to shape clinical and hygienic practices.

[Institutional iatrogeny and maternal death: Semmelweis and puerperal fever]

Puerperal fever is a disease that becomes epidemic in the eighteenth century as a result of two factors: the urban working masses generated by the industrial revolution and the progressive hegemonization and medicalization of birth care in large public hospitals. Institutionalized maternal death reached figures above 30%, while in the case of birth care provided by midwives, it was than 2%. Semmelweis, an Hungarian physician, sustained that physicians contaminated women in labor due to insufficient hygiene after performing necropsies and established prophylactic measures in the Vienna Hospital that reduced mortality dramatically. However, his ideas were rejected because they affected the institutionalization process of medicine, based on altruism and honor, which would make it impossible to cause harm to patients. He was forced to leave Vienna Hospital and he continued his struggle in Budapest, but the rejection and disagreement of his peers with his doctrine affected his mental health. He died in an asylum, a few years before Pasteur and Koch proved the existence of the bacteria that caused diseases such as puerperal fever.

["Purified empiricism": Johann Christian Reil's (1759-1813) attempts at a foundation of medicine in relation to its tradition, kantianism, and speculative philosophy]

Johann Christian Reil's (1759-1813) importance lies in his theoretical approach to medicine. Following Kant in his early work, he attempts to combine medical experience with an underlying conceptual structure. This attempt is directed against both the chaotic empiricism of traditional medicine and speculative theories such as vitalism. The paper starts from his early reflections on the concept of a life force, which he interprets in the way of a non-reductive materialism. In the following, the basic outlines of his Theory of Fever will be shown. The Theory is a systematic attempt at finding a new foundation for diagnosis and therapy on the basis of the concept of fever, which is understood as modification of vital processes. The paper ends with a discussion of his later work, which has remained controversial so far. It shows that the combination of practical empiricism and scientific theory remained rather unstable in this early phase of the development of modern medicine.

'Abhorreas pinguedinem': Fat and obesity in early modern medicine (c. 1500-1750)

Contrary to a widely held belief, the medicalization of obesity is not a recent development. Obesity was extensively discussed in leading early modern medical textbooks, as well as in dozens of seventeenth- and eighteenth-century dissertations. Drawing upon ancient and medieval writings, these works discussed the negative impact of obesity upon health and linked it with premature death. Obesity was particularly associated with apoplexy, paralysis, asthma and putrid fevers, and a range of therapeutic options was proposed. This paper offers a first survey of the medical understanding of the causes, effects and treatment of obesity in the early modern period. It examines the driving forces behind the physicians' interest and traces the apparently rather limited response to their claims among the general public. Comparing early modern accounts of obesity with the views and stereotypes prevailing today, it notes the impact of changing medical, moral and aesthetic considerations and identifies, among other things, a shift in the early modern period from concepts of pathological compression to images of the obese body as lax and boundless.

Weather, geography, and vehicle-related hyperthermia in children

Vehicle-related hyperthermia is an unfortunate tragedy that leads to the accidental deaths of children each year. This research utilizes the most extensive dataset of child vehicle-related hyperthermia deaths in the United States, including 414 deaths between 1998 and 2008. Deaths follow a seasonal pattern, with a peak in July and no deaths in December or January. Also, deaths occurred over a wide range of temperature and radiation levels and across virtually all regions, although most of them took place across the southern United States. In particular, the Phoenix, Houston, Dallas, and Las Vegas metropolitan areas had the greatest number of deaths. We utilize our vehicle hyperthermia index (vhi) to compare expected deaths versus actual deaths in a metropolitan area, based on the number of children in the area who are under the age of five and on the frequency of hot days in the area. The vhi indicates that the Memphis, West Palm Beach-Boca Raton, and Las Vegas metropolitan areas are the most dangerous places for vehicle-related hyperthermia. We conclude by discussing several recommendations with public health policy implications.

[Epidemics and diseases during the Independence period in Mexico]

The epidemics and endemic diseases in Mexico were not a problem before the Independence period. Hunger was less than in the past. The 1806 Influenza epidemics had been forgotten. Measles was considered a benign illness. In 1810, there was an increase in the number of cases of black vomit in Veracruz. Sixty percent of 541 hospitalized patients die of the disease. In 1812, an outbreak of yellow fever spread from Veracruz to Jalapa accompanying the movement of troops and killing over 300 soldiers of the Castilla's Battalion. The appearance of petechial fever, maybe typhus marketed in 1813 the onset of the most important epidemics. The preceding was the indirect effect of war: diseases of prisons and military quarters which became overwhelming in times where the movements of troops and of important groups of populations along with crowing, loss homes, hunger and bad hygiene habits. There was also Influenza or "pestilent cold." Measures of detection and quarantine were taken. "Naranjate" mixed with tartaric cremor was used against fever. Fumigation with nitric acid and burners, where they incinerated gun powder were among the health protection policies. It is noteworthy the advance and relief provided by the introduction of smallpox vaccine, the only preventive mean useful against smallpox which was a breakthrough in public health.

[Heat and Fever in ancient Greek physiology]

This paper aims at clarifying the relationship of physiological heat and pathological heat(fever) using the theoretical scheme of Georges Canguilhem as is argued in his famous book The Normal and the Pathologic. Ancient authors had presented various views on the innate heat and pathological heat. Some argued that there is only pathological heat while others, like Galen, distinguished two different kinds of heat. Galen was the first medial author who had the clear notion of the relationship between the normal heat and the pathological heat. He conceptualized their difference as the heat conforming to nature (kata phusin) and the heat against nature (para phusin). However, the Peripatetic authors, such as ps-Alexander Aphrodisias, who laid more emphasis on physiology tended to regard pathology in continuation with physiology as Claude Bernard attempted to do it. Therefore, Canguilhem's theoretical scheme turns out to be very useful in analysing the relationship of normal heat and pathological heat as is manifested in ancient Greek physiology.

Living history: Clark M. Blatteis

In 2005, the American Physiological Society (APS) initiated the Living History Project to recognize senior members who have made extraordinary contributions during their career to the advancement of the discipline and profession of physiology. During 2007, the APS Section of Environmental and Exercise Physiology selected Clark M. Blatteis to be profiled in Advances in Physiology Education.

Diverse biologies and experiential continuities: did the ancient Chinese know that qinghao had anti-malarial properties?

This article treats Chinese medical theories and concepts as cultural constructs that arose as much from practice-oriented concerns as from socio-political negotiations within the medical field. It further explores the interface of the biological and cultural. It is often futile to investigate how Chinese medical descriptions relate to biological processes, because the local biologies that the Chinese physicians recognized in the past and continue to describe in the present, are contested by mainstream medicine, but recent bioscientific research on the anti-malarial properties of the Chinese medical drug qinghao opens up new avenues for the historian. To be sure, no attempt is made to equate ancient nosologies to modern ones, nor to justify the cultural through the biological. In order to avoid pitfalls of simple equations, this article takes the experiential not merely as a subjective but as an inter-subjective reality that mediates the biological and cultural. The findings are striking: once one reads the Chinese medical texts as reporting on the experiential, one of their many possible readings is that they provide concrete descriptions of morbid conditions that also the contemporary mainstream physician recognizes.