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.

Jim Peters' collapse in the 1954 Vancouver Empire Games marathon

On 7 August 1954, the world 42 km marathon record holder, Jim Peters, collapsed repeatedly during the final 385 metres of the British Empire and Commonwealth Games marathon held in Vancouver, Canada. It has been assumed that Peters collapsed from heatstroke because he ran too fast and did not drink during the race, which was held in windless, cloudless conditions with a dry-bulb temperature of 28 degrees C. Hospital records made available to us indicate that Peters might not have suffered from exertional heatstroke, which classically produces a rectal temperature > 42 degrees C, cerebral effects and, usually, a fatal outcome without vigorous active cooling. Although Peters was unconscious on admission to hospital approximately 60 minutes after he was removed from the race, his rectal temperature was 39.4 degrees C and he recovered fully, even though he was managed conservatively and not actively cooled. We propose that Peters' collapse was more likely due to a combination of hyperthermia-induced fatigue which caused him to stop running; exercise-associated postural hypotension as a result of a low peripheral vascular resistance immediately he stopped running; and combined cerebral effects of hyperthermia, hypertonic hypernatraemia associated with dehydration, and perhaps undiagnosed hypoglycaemia. But none of these conditions should cause prolonged unconsciousness, raising the possibility that Peters might have suffered from a transient encephalopathy, the exact nature of which is not understood.

['Charitable brothers' in charge of hospitals in early modern times: The hospital in Linz/Austria and its patients up to c. 1780]

The article deals with the history of the Hospital of the Brothers of St. John of God (in German: "Barmherzige Brüder"; official name "Ordo Hospitalarius Sancti Joannis a Deo") in the capital of Upper Austria, Linz, from its founding in 1757 to c. 1780. Primarily, the organisational development and the patients of the institute are discussed. The order's hospital already functioned as a medical hospital for the treatment of acute diseases: It was oriented towards the reestablishment of health of its inmates during short time and offered treatment by a staff of learned medical experts, among them academically trained physicians. The accommodation of the patients yet took place in a largely undifferentiated manner, as most of them were situated in a large common hall. This was obviously a consequence of the comparatively little capacity of the organisation, too, which sustained about 12 beds in the beginning, and about 20 around 1780. Nonetheless, the number of patients treated there summed up to nearly 1% of the entire male population of Upper Austria even during the first decade of its existence. In early modern time, only men were admitted to this hospital, the average age of them being only ca. 30 years. As far as social status is concerned, most of them (according to a representative sample out of the admissions of 1757-1767) were handicraftsmen (more than two thirds), labourers and servants. Thus, the organisation was obviously destined to broad social strata, but by no way displays itself as a poorhouse. Average annual mortality was 10 to 13%, which is comparable to that of other hospitals of the order in 18th century Austria. Most of the admitted persons suffered from "fever" or inner diseases and were dismissed as healed already after some weeks of stay.

Zepherina Veitch (1836-94), childbed fever and the registration of midwives

At a time when hospital infections are rarely out of the news, it is important to reflect that the origins of midwifery as a profession owe much to the actions of a group of determined women who, in the face of much opposition from within the medical profession, strove to improve upon standards of hygiene in maternity care to reduce the high levels of maternal and infant mortality associated with some of the most prestigious hospitals in the land.

The isolation hospital in the training of nurses: subject of the BJN over 100 years ago

A Doctor Knyvett Gordon, who was a lecturer on Infectious Diseases at the University of Manchester, wrote a fascinating article on why a period of time spent in an isolation hospital may be of an advantage to a nurse for her future career. Sadly such hospitals no longer exist and the special fever training certificate and registration as a fever nurse (RFN) have disappeared.

Disease and medicine in the armies of British India, 1750-1830: the treatment of fevers and the emergence of tropical therapeutics

The East India Company's extensive medical establishment was noted for innovation and experimentation, it tested economical mass remedies. The service's control of its patients was significant, prefiguring the birth of the clinical anatomical medicine of Paris of the 1790s. The unique environment created a distinctive medical discipline: the medicine of warm climates. This chapter focuses on fever in particular; attention was focused on malfunction of the liver and the favoured treatment was purgation via mercury. The dominance of this method resulted partly from senior military officers imposing their views on the juniors.

['Magdalena fevers': medicine and society in the construction of a Colombian medical notion, 1859-1886]

In this article, I explore the theoretical, social and ideological bases of the emergence and consolidation of the Colombian medical notion of the 'Magdalena fevers'. Firstly I show how, in the late 1850s, the emerging Colombian body of medical doctors elaborated peculiar notions on fevers by articulating the European medical theories (i.e. the miasmatic theory and the climatic determination of diseases) with the negative valuation of the hot climate. Secondly, I explain how free trade policies in the mid-1800s, and the economic and ideological impacts of the agricultural export of tobacco and indigo determined doctors' interest in the epidemics occurring in the production centers and also, therefore, the emergence of the notion of 'Magdalena fevers'. I also show how doctors established a causal association between the productive process of those goods and the fevers.

Not just malaria: Mary Slessor (1848-1915) and other Victorian missionaries in West Africa

Fear of 'fever' was uppermost in the minds of many travellers to West Africa in Victorian times. 'Not just malaria...' chronicles attitudes, treatments and discoveries regarding malaria from the time of David Livingstone through the early 20th century. Missionaries often found themselves in the position of serving as untrained doctors and nurses among the people they went to evangelize. In addition, they suffered from the same maladies as the people did, and many died from malaria or other afflictions. Mary Slessor arrived in Calabar, in what is now southeastern Nigeria, to serve with the Scottish Presbyterian Mission in 1876. With only a few furloughs, she remained there until her death in 1915. The article relates instances of the illnesses and injuries she treated as well as those she suffered herself. She is remembered in Nigeria with statues and, along with David Livingstone, is one of Scotland's best-known missionary figures.

From Fahrenheit to cytokines: fever, inflammation and the kidney

People have used the words inflammation and fever for millennia, but the meaning of inflammation has gradually changed whereas that of fever has remained reasonably constant. Whereas inflammation originally referred to the combination of heat, redness, swelling and pain in a local area, it has gradually evolved to focus upon cellular and humoral processes that occur in tissues when external or internal agents cause damage to them. The classical manifestations are no longer obligatory. Diseases that affect internal organs such as the kidneys are nowadays commonly described as inflammatory despite entirely lacking those classical manifestations, but possessing evidence of cellular proliferation and/or involvement of factors such as cytokines. These conceptual changes have resulted from the application of progressively improved investigational techniques such as microscopy, thermometry, experimental pathology, and tissue culture. The consequence of them has been largely to extinguish the fire that previously epitomised inflammation.

Robert Robertson, FRS (1742-1829): physician to the Royal Hospital, Greenwich, 18th-century authority on 'fever', and early practitioner in care of the elderly

Robert Robertson was born in Scotland and trained to be a surgeon. In 1760, he served briefly on a whaling ship and then entered the Royal Navy. He subsequently had many postings, several of them to the tropics. He recorded his observations on fevers, scurvy and other illnesses. After 23 years of active service, he retired to private practice in Hampshire. However, later he rejoined the service and was appointed physician to the Royal Hospital, Greenwich, where later he was made a Director. During this period, he addressed the problems of illness after the days of active service. Robertson was thus an early practitioner in the care of the elderly. He retired in 1807 and died at Greenwich at the age of 87.

The identification of medieval fevers according to Al-Isra'ili, Avenzoar and Bernard Gordon

In this work, which derives from a study into the prevention of illness in medieval Spain, and which forms part of a larger work on medieval fevers in all their aspects, we concern ourselves with their causes, symptoms, prognostications and treatment. We are grateful for the support of the British Academy and The Wellcome Trust in funding this study. Through this work we aim to establish a certain order in the fevers which figure in medical texts of the Middle Ages which we have analysed. We have grouped them, following the example of Galen, according to their point of origin: spirits, humours and solid matter. Then, within each of these categories, we have classified them by the spirit or humour affected. The basic elements of each fever are described in order to differentiate them. We offer, finally, over one hundred names by which the different fevers can be known.

Hempelian and Kuhnian approaches in the philosophy of medicine: the Semmelweis case

Semmelweis's investigations of puerperal fever are some of the most interesting in the history of medicine. This paper considers analysis of the Semmelweis case. It argues that this analysis is inadequate and needs to be supplemented by some Kuhnian ideas. Kuhn's notion of paradigm needs to be modified to apply to medicine in order to take account of the classification schemes involved in medical theorising. However with a suitable modification it provides an explanation of Semmelweis's failure which is argued to be superior to some of the external reasons often given. Despite this success in applying Kuhn's ideas to medicine, it is argued that these ideas must be further modified to take account of the fact that medicine is not a natural science but primarily a practice designed to prevent and cure diseases.

Hippocrates in the context of Galen: Galen's commentary on the classification of fevers in Epidemics VI

This paper elucidates the relationship between Hippocrates and Galen concerning the classification of fever and illustrates Galen's use and abuse of Hippocrates. Galen used Epidemics VI in order to justify his own arguments on the classification of fever, based on the three forms of matter. A close examination of Galen's use of Epidemics VI does not support his justification. It turns out that it was Galen's theory-laden eyes that made Epidemics VI a founding ground for his fever theory.

Carl Liebermeister (1833-1901): a pioneer of the investigation and treatment of fever and the developer of a statistical test

In the second half of the nineteenth century, when the typical course of various febrile clinical phenomena was found to be specific to particular infectious diseases, Carl Liebermeister successfully pioneered the investigation of the patho physiology of fever and the regulation of body temperature. He applied biophysical and pharmacological antipyresis, especially for the treatment of typhoid fever, and developed new statistical tools for the evaluation of therapeutic results.

"It is wisest here, as always, to maintain a balance": the medical dissertations of Friedrich Schiller

Johann Christoph Friedrich Schiller (1759-1805) is remembered today for his contributions to literature and aesthetic theory-it is less well known that his first career was in medicine (an army appointment). Scholars have generally held that his primary interest lay in psychology and the psychological aspects of medicine, and that his commitment to other aspects of medicine was perfunctory at best. The present paper argues that a study of Schiller's three medical dissertations-two on psychological aspects of medicine and one on fevers-reveals his attempt "to maintain a balance" between the mind and the body in his approach to medicine.

The evolution of the concept of ‘fever’ in the history of medicine: from pathological picture per se to clinical epiphenomenon (and vice versa)

The medical concept of 'fever' has undergone profound changes throughout the centuries. Galen of Pergamon considered fever as a systemic disease in itself, and it was only between 17th and 18th century that Hermann Boerhaave provided a more careful evaluation of the clinical phenomena related to fever. Apart from incorrect theories, a major obstacle to the development of a rational study of fever has been the lack of appropriate instruments of measurement; in effect, the clinical thermometer was not diffusely used in everyday medical practice until the mid 19th century. During this same period Ignaz Semmelweiss postulated that the pathological-anatomical changes recorded in women who had died because of puerperal fever represented a pathological reality clinically suggested by a whole cohort of symptoms and signs, among them fever. Even if enormous progress has been made in the 20th century with regard to fever, which is currently considered a clinical sign of many different diseases, its etiologic assessment remains a challenge. In fact, in 1961 the clinical picture of 'Fever of Unknown Origin' was officially defined. Since such diagnostic labelling is in effect a cover for our inability to discover the real causes of fever, in this case, paradoxically, fever goes back to being the whole pathological picture, just as it was retained to be many centuries ago.

[Japanese nonprescription drugs (1) "Pediatric Formulas" for five kinds of "Gan"]

The genealogy of children's sedatives such as Kio-gan and Kyumei-gan, which remain in use even today for pediatric conditions including convulsions and nocturnal crying, was traced and the significance of these formulas was investigated. In the Edo Era, pediatric formulas for five kinds of gan (infantile malnutrition) combined four prescriptions to treat individual symptoms of "re (heat) gan," "leng (cool) gan," "hui (helminth parasite) gan," and "ji (spinal) gan" into one prescription. In contrast, during and after the Meiji Era, pediatric formulas for these five kinds of gan have used only one prescription to treat "re (heat) gan". Moreover, these formulas have tended to use a greater proportion of components that are used to treat "re gan". From this information, it readily became apparent that : 1) Edo Era pediatric formulas for the five kinds of gan were intended to improve the physical condition of the children prone to the illness; and, 2) modern (Meiji Era) prescriptions were intended to alleviate the acute symptoms of gan.

[Febres paulistas and the São Paulo society of medicine and surgery: a controversy among spokespeople from different arenas of knowledge]

At the close of the nineteenth century, São Paulo physicians were debating a disease they classified as "febres paulistas" (São Paulo fevers). The article present a brief overview of the role of fevers within Brazilian nosology at that time and describes how science then explained febres paulistas, malaria, and typhoid fever. Changes in the medical field meant febres paulistas were no longer classified as forms of malaria but instead considered cases of typhoid fever. Following the Society's debates surrounding this shift, the article analyzes the scientific lines that tended to identify febres paulistas with malaria or typhoid fever and also the line that believed these fevers were an independent nosological entity.

Dr William Coley and tumour regression: a place in history or in the future

Spontaneous tumour regression has followed bacterial, fungal, viral, and protozoal infections. This phenomenon inspired the development of numerous rudimentary cancer immunotherapies, with a history spanning thousands of years. Coley took advantage of this natural phenomenon, developing a killed bacterial vaccine for cancer in the late 1800s. He observed that inducing a fever was crucial for tumour regression. Unfortunately, at the present time little credence is given to the febrile response in fighting infections-no less cancer. Rapidly growing tumours contain large numbers of leucocytes. These cells play a part in both defence and repair; however, reparative functions can also support tumour growth. Intratumoural infections may reactivate defensive functions, causing tumour regression. Can it be a coincidence that this method of immunotherapy has been "rediscovered" repeatedly throughout the centuries? Clearly, Coley's approach to cancer treatment has a place in the past, present, and future. It offers a rare opportunity for the development of a broadly applicable, relatively inexpensive, yet effective treatment for cancer. Even in cases beyond the reach of conventional therapy, there is hope.