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Facial maskings have been part of the human story since time began, and the reasons for their needs and the materials that went into their making would vary according to the reasons and materials available. The health-related needs took centuries to become established, but not until the germ theory of disease became recognized. The facial mask, seen as an essential defensive tool for prevention of respiratory transmitted disease continues to be the prime personal protective piece of equipment. With air-born contaminations, such as the present pandemic SARS- CoV-2 viral infestation, why would there be opposition to the use of this personal protective cover of our airways, when until an immunologic answer is available, it is the best single prevention we have. When supported with other measures, like distancing, washing and non-crowding, society would be much safer and secure, with probable less acute and drastic outcomes due to the spread of this virus.

Aim: The aim of this article is to articulate the distinctive features on the Nightingale School of Nursing on the occasion of the 2020 bicentenary of her birth. Design: This is a historical study, based on all the available printed and archival sources of Nightingale’s writing. Methods: The article draws on Nightingale sources (full books, articles, chapters, pamphlets and unpublished letters in more than 200 libraries and archives worldwide) published in The Collected Works of Florence Nightingale , 16 volumes, peer-reviewed; transcriptions are available on its website [1]. Results: Nine key findings are discussed in the article: (1) how different Nightingale’s nursing was from what was called ‘nursing’ at the time; (2) that the central role of training allowed nursing to move from being a women’s profession to being open to all qualified; (3) the evolution of Nightingale nursing as medical science and public health advanced; (4) the academic content in her training; (5) team building in her system; (6) her (often misrepresented) views on germ theory; (7) her late work on preventing cholera; (8) the worldwide influence of her work; (9) her work upgrading workhouse infirmaries and advocacy of what would be later called universal access to health care. Conclusion: Nightingale’s ongoing relevance is evident in many of today’s concerns, such as lack of access to quality health care; the shortage of nurses in the United Kingdom’s National Health Service (and in some other countries) and inadequate wages and salaries of nurses and nurse practitioners; the ongoing dangers in nursing and the need to give nurses a safe working environment (the coronavirus is an extreme example); and inadequate data for health care planning purposes. Doi: 10.28991/SciMedJ-2021-0301-7 Full Text: PDF

Healthcare-associated infections (HCAIs) are those infections acquired by an individual who is seeking medical care in any healthcare facility, including acute care hospitals, long-term care facilities (including nursing homes), outpatient surgical centres, dialysis centres or ambulatory care clinics.1 They are further defined as occurring at least 48 hours after hospitalisation or within 30 days of receiving medical care.2 HCAIs have plagued hospitals, physicians and patients for centuries and likely played a role in the reputation that hospitals historically had as dangerous places.3 In the mid-19th century, Ignaz Semmelweis observed that labouring mothers in an obstetrics unit had a high incidence of Puerperal (Childbed) fever, which he thought was related to direct contact with medical students. After working with cadavers, students often moved directly from the anatomy lab to the hospital, leading Semmelweis to postulate that students were contaminated and bringing a pathogen into the unit. He saw dramatic improvements in maternal mortality after introducing a chlorinated lime hand wash for healthcare providers.4 Though not quickly accepted at large, his observations would become part of the foundation of the germ theory that we intuitively accept today. Over a century after Semmelweis introduced the idea of hand hygiene, infection prevention in healthcare settings has been thrust into the spotlight worldwide. In the 1960s, the US Centers for Disease Control and Prevention (CDC) conducted research within the Comprehensive Hospital Infections Project and introduced surveillance and control techniques still used today. The creation of the National Healthcare Safety Network (NHSN) propelled infection control onto a national public health platform in the USA.3 Today, reduction of HCAIs has become a regulatory, financial and quality imperative across the world. Healthcare frequently involves the use of invasive devices and procedures that can increase the risk of HCAIs, including catheter-associated urinary tract infections, …

Highlights • We have considered theories on impact of human exposure to non-pathogenic microbes • A new Microbial Theory of Health is proposed, encouraging targeted hygiene • Microbiome research and insights from Bidirectional Hygiene inform targeted hygiene, Background: The growing understanding of the importance of a healthy microbiome is challenging traditional thinking that resulted in the general acceptance of the germ theory of disease. We propose a more encompassing Microbial Theory of Health that will have implications for the way that we address our relationship with microbes, including hygiene policy and community-based infection control practices. Methods: This paper considers theories over the last 30 years that have impacted hygiene policy and consumer practice, from the Germ Theory of Disease and the Hygiene Hypothesis, to the Microbial Theory of Health, including the concept of Bidirectional Hygiene. Here we present a high-level review of the literature on pathogen transmission and the cycle of infection in the home and everyday settings. Results: Targeted hygiene is an evidence-based hygiene policy that is employed to prevent transmission of pathogens and the transmission of infectious diseases through targeting only sites, surfaces, and practices that are considered high risk for pathogen transmission. Targeted hygiene also discourages the indiscriminate use of broad-spectrum microbicides for lower-risk activities and surfaces. Conclusions: The Microbial Theory of Health, including age-appropriate and health-appropriate hygiene practices for home and everyday life, should usher in a new era in which pathogen reduction can be accomplished without indiscriminate elimination of potentially beneficial microbes from the human and environmental microbiomes.

Ignaz Philipp Semmelweis was a Hungarian obstetrician who discovered the cause of puerperal or childbed fever (CBF) in 1847 when he was a 29-year-old Chief Resident (“first assistant”) in the first clinic of the lying-in division of the Vienna General Hospital. Childbed fever was then the leading cause of maternal mortality, and so ravaged lying-in hospitals that they often had to be closed. The maternal mortality rate (MMR) from CBF at the first clinic where Semmelweis worked, and where only medical students were taught, was 3 times greater than at the second clinic, where only midwives were taught, and Semmelweis was determined to find out why. Semmelweis concluded that none of the purported causes of CBF could explain the difference in MMR between the 2 clinics, as they all affected both clinics equally. The clue to the real cause came after Semmelweis’ beloved professor, Jacob Kolletschka, died after a student accidentally pricked Kolletscka’s finger during an autopsy. Semmelweis reviewed Kolletschka’s autopsy report, and noted that the findings were identical to those in mothers dying of CBF. He then made 2 groundbreaking inferences: that Kolletschka must have died of the same disease as mothers dying of CBF, and that the cause of CBF must be the same as the cause of Kolletschka’s death, because if the 2 diseases were the same, they must have the same cause. Semmelweis quickly realized why the MMR from CBF was higher on the first clinic: medical students, who assisted at autopsies, were transferring the causative agent from cadavers to the birth canal of mothers in labor with their hands, and he soon discovered that it could also be transferred from living persons with purulent infections. Bacteria had not yet been discovered to cause infections, and Semmelweis called the agent “decaying animal organic matter.” He implemented chlorine hand disinfection to remove this organic matter from the hands of the attendants, as soap and water alone had been ineffective. Hand disinfection reduced the MMR from CBF 3- to 10-fold, yet most leading obstetricians rejected Semmelweis’ doctrine because it conflicted with all extant theories of the cause of CBF. His work was also used in the fight raging over academic freedom in the University of Vienna Medical School, which turned Semmelweis chief against him, and forced Semmelweis to return to Budapest, where he was equally successful in reducing MMR from CBF. But Semmelweis never received the recognition that his groundbreaking work deserved, and died an ignominious death in 1865 at the age of 47 in an asylum, where he was beaten by his attendants and died of his injuries. Fifteen years later, his work was validated by the adoption of the germ theory, and honors were belatedly showered on Semmelweis from all over the world; but over the last 40 years, a myth has been created that has tarnished Semmelweis’ reputation by blaming the rejection of his work on Semmelweis’ character flaws. This myth is shown to be a genre of reality fiction that is inconsistent with historical facts.

Infectious disease has burdened European armies since the Crusades. Beginning in the 18th century, therefore, the British Army has instituted novel methods for the diagnosis, prevention and treatment of tropical diseases. Many of the diseases that are humanity's biggest killers were characterised by medical officers and the acceptance of germ theory heralded a golden era of discovery and development. Luminaries of tropical medicine including Bruce, Wright, Leishman and Ross firmly established the British Army's expertise in this area. These innovations led to the prevention of many deaths of both military personnel and civilians. British Army doctors were instrumental in establishing many of the teaching facilities that we now consider to be global leaders in tropical medicine. The impact of the Army in this field has certainly been significant in the past and its contribution continues to this day.

When contagious bovine pleuropneumonia (CBPP) was first detected on a farm north of Melbourne, at Bundoora, in 1858, the predominant theory of miasma was being challenged by contagionist theories of disease transmission. This well-documented case was recorded during a period of change in the scientific assessment of disease and therefore affords an exploration of what aspects of the landscape were considered important for livestock health at the time. Although the introduction, vaccination programs and eventual eradication of CBPP on mainland Australia has been well explored, scholars have neglected this aspect of the disease's history. By comparing 19th century records of farmland with how the site appears today, it is also possible to highlight the limited information provided by contemporary texts, while at the same time developing an appreciation of the ways in which the perception of the rural landscape has changed. This differing perception has implications for the utilisation of these sources for veterinary and environmental historians seeking to understand the mid-19th century agricultural landscape and how it relates to animal health.

Surgical antisepsis and asepsis established the standard of using scientific evidence to determine surgical practice. The microbiological discoveries of Louis Pasteur (1822–1895) were the inspiration for Joseph Lister's (1827–1912) use of carbolic acid as an antiseptic on surgical wounds. German and Swiss surgeons invented aseptic surgical practice based on the studies of Robert Koch (1843–1910), a life-saving revolution in medicine as profound as anesthesia. Together they changed human history, sparing millions the horrors of hospital gangrene and making the entire body accessible to surgical intervention. In the United States, surgeons followed the lead of their brethren across the Atlantic. Americans, characteristically pragmatic, naturally resisted what they saw as unnecessary complexity in Listerism. Once they accepted germ theory, the undeniable scientific evidence led to the rapid acceptance of asepsis. Among the wide-ranging effects of this transition in practice were the creation of the current model of the academic department of surgery and the modern concept of surgical professionalism.

Vaccines are one of the most important achievements of medicine. Starting with Edward Jenner in 1796, more than 50 years before the germ theory of disease was described by Louis Pasteur in 1861, the ability to eradicate diseases from the population has been a public health goal. Since their inception, many vaccines have been created and utilized to avoid morbidity and mortality related to a plethora of diseases. When a disease is rampant, and the individual is impacted either through direct infection themselves, or infection of a close associate, the benefits of vaccination are clear and far outweigh the risks. However, what is left to remind the individual of the past suffering when the disease is controlled, or eradicated? How do future generations reconcile the risk of a faded memory of suffering with the pain of a needle prick? When the disease itself is less common than the adverse drug event, how do you encourage the individual to comply with vaccination for the greater good? Is resurgence of vaccine preventable disease required to motivate a new generation? Perhaps the emergence of a novel disease will have a similar effect. Severe acute respiratory coronavirus 2 (SARS-CoV-2), which causes the novel betacoronavirus 2019 disease (COVID-19), was first reported in Wuhan, China, in December 2019. Disease manifestations varied significantly, ranging from an asymptomatic carrier …

The human microbiome is changing the way experts and non-experts think about germs and microorganisms. This essay is a gender analysis of contemporary discourses surrounding the human reproductive microbiome, specifically the vaginal microbiota and the penile microbiota. I first historically situate the human reproductive microbiome within the germ theory of disease. Then, I draw on Heather Paxson's Foucauldian and Latourian concept of microbiopolitics to argue that microbiopolitics is not only about how humans should live with microorganisms; but it also impacts how humans and microbes live together as gendered beings. I illustrate this gendering through two figures: the microbial mother and the independent organ.

Background: Today there has been a change in the perception of disease from germ theory to the involvement of multiple factors in the causation. Methods: With this notion, this cross sectional study made an effort to delineate the socio-cultural factors associated with health in six teaching districts of B.P. Koirala Institute of Health Sciences in the Eastern region of Nepal among the mothers of reproductive age surveying 1985 households. Results: This study revealed association of chronic disease and acute illness with various socio-demographic variables like religion, ethnicity, family size, number of children, respondent’s literacy and occupation. Number of jobholders in the family and poverty line were found to be associated with acute illness. Treatment of shaman healers and restrictions during pregnancy period showed association with health inequalities. Mortality in the family was associated with ethnicity, number of children, and literacy of respondent. Conclusion: As a consequence of these associated factors, the effective utilization of the modern health facilities may not be proper which may lead to ill health consequences. Multifaceted development program from the government along with effective awareness program can help out the people to combat the evil of health life. Health Renaissance 2015;13 (3): 114-128

This paper examined whether the preventive measures taken by the Hong Kong's colonial authorities were legitimate during the 1894 Hong Kong plague epidemic, and illuminated the correlation between the plague epidemic and hospital space in Hong Kong in the late 19th century. The quarantine measures taken by the colonial authorities were neither a clear-cut victory for Western medicine nor for a rational quarantine based on scientific medical knowledge. Hong Kong's medical officials based on the miasma theory, and focused only on house-to-house inspections and forced quarantine or isolation, without encouraging people to wear masks and without conducting disinfection. Even after Hong Kong plague spread, the Hong Kong's colonial authorities were not interested in what plague bacilli were, but in where they were to be found and how to prevent and control an outbreak of the disease. The germ theory brought significant changes to the disease classification system. Until the 1890s, Hong Kong's colonial authority had classified cause of death mainly on the basis of symptoms, infectious diseases, parts of the body and diseases of systems. Microbiological analysis of the cause of death in Hong Kong was started by Hunter, a bacteriologist, in 1902. He used bacteriological tests with a microscope to analyze the cause of death. New disease recognition and medical recognition brought large changes to hospital space as well. In particular, from the 1880s to the early 1900s, Western medical circles witnessed shifts from miasma theory to the germ theory, thereby influencing Hong Kong's hospital spaces. As the germ theory took ground in Hong Kong in 1894, the bacteriological laboratory and isolation ward became inevitable facilities, and hospital space were reorganized accordingly. However, the colonial authorities and local elites' strategy was different. As a government bacteriologist, Hunter established a central facility to unify several laboratories and to manage urban space from ouside the hospital. On the contrary, the Tungwah Hospital tried to transform hospital space with isolation ward and Receiving Ward System as the eclectic form of Chinese and Western medicine. The 1894 Hong Kong plague promoted the introduction of germ theory and the reorganization of hospital space.

Contains fulltext : 241175.pdf (Publisher’s version ) (Open Access) The development of vaccines is one of the greatest medical interventions in the history of global infectious diseases and has contributed to the annual saving of at least 2 to 3 million lives worldwide. However, many diseases are not preventable through currently available vaccines, and the potential of modulating the immune response during vaccination has not been fully exploited. The first golden age of vaccines was based on the germ theory and the use of live, attenuated, inactivated pathogens or toxins. New strategies and formulations (e.g., adjuvants) with an immunomodulatory capacity to enhance the protective qualities and duration of vaccines have been incompletely exploited. These strategies can prevent disease and improve protection against infectious diseases, modulate the course of some noncommunicable diseases, and increase the immune responses of patients at a high risk of infection, such as the elderly or immunocompromised patients. In this minireview, we focus on how metabolic and epigenetic modulators can amplify and enhance the function of immunity in a given vaccine. We propose the term "amplifier" for such additives, and we pose that future vaccines will have three components: antigen, adjuvant, and amplifier.

With the advancements in technology, the ways of killing and terrorizing people changed from metallurgical weapons to microbial bombs containing bacteria or viruses. The practice of bioweapons is not new; it started in antiquity, before germ theory of disease came into force. Being cheap and easy to handle, they are considered as “poor man’s weapons.” Viruses as bioweapons have been used since the 16th century and they have been classified as potential biothreat agents by CDC. Although viruses like smallpox and hemorrhagic fever viruses had been a threat for society since ancient times, Nipah virus, Hantaviruses, and Ebola virus are considered to be emerging viral threats. High dissemination and transmission rate of viruses, lack of efficient diagnostic techniques, and availability of limited therapeutics make them the primary bioweapon of choice for terrorist groups or the military services. High risk of disruption of healthcare system of population and socioeconomic impact of viral attacks demands public health care programs and intensive research for development of sensitive diagnostic techniques and effective therapeutics. The current chapter focuses on various viral agents employed as bioweapons throughout history or having potential to be used in the future, signs for identification of viral bioterrorism, diagnostic techniques, and future perspectives of viruses as biothreat agents.

Spontaneous generation is usually stated to have been laid to rest by Louis Pasteur with his swan-necked flask experiments. However, a century and a half earlier an Italian physician-Rabbi, Isaac Lampronti, was so convinced of the falsity of spontaneous generation that he was willing to overturn Jewish legal precedent.

There is now considerable evidence that several infectious agents (viruses, bacteria, or parasites) may play a contributing role in the development of Alzheimer’s disease (AD). The six primary suspects are herpes viruses, spirochetal bacteria, Chlamydia pneumoniae, Porphyromonas gingivalis, mycobacteria, and toxoplasma parasites. Also, some of the antimicrobial and antiviral agents that are used to treat them have shown promise for AD interventions. I describe this evidence and assert it is now time to accelerate clinical trials of these existing drugs, already federally approved, to determine if such treatments can delay, halt, or reverse AD.

This article has twin objectives: First, the article briefly examines major theoretical interpretations of disease causations in Western medicine, their limitations in understanding social epidemiology, and the gradual development of the population health approach to health promotion and disease prevention in the context of chronic diseases in Western industrialized societies. Second, the article examines the current epidemiological trends in China and the relevance of population health perspectives and strategies to promote health. While analyzing some recent findings on social determinants of health in China, the article argues that effective population health strategies for health promotion must be based on a social epidemiology that provides information necessary to promote health. Although infectious diseases still make a significant contribution to China’s mortality and morbidity figures, the incidence of chronic diseases such as malignancies, heart disease, respiratory disease, and cerebrovascular disease is steadily increasing. Finally, in view of the current epidemiological trend, and the need to tackle the multiple health challenges, this discursive analysis proposes a number of key research areas within the broader context of social epidemiology that may facilitate future health policies in China.

This review describes medical and surgical care during the American Civil War. This era is often referred to in a negative way as the Middle Ages of medicine in the United States. Many misconceptions exist regarding the quality of care during the war. It is commonly believed that surgery was often done without anesthesia, that many unnecessary amputations were done, and that care was not state of the art for the times. None of these assertions is true. Physicians were practicing in an era before the germ theory of disease was established, before sterile technique and antisepsis were known, with very few effective medications, and often operating 48 to 72 hours with no sleep. Each side was woefully unprepared, in all aspects, for the extent of the war and misjudged the degree to which each would fight for their cause. Despite this, many medical advances and discoveries occurred as a result of the work of dedicated physicians on both sides of the conflict.

Scientists investigating human health and disease are now reformulating the basic tenets upon which disease theory is based. For generations, the delivery of health care services was built upon the “one-germ, one-disease, one-treatment” formulations that arose from the work of Louis Pasteur. Although clearly one of the great advances in medicine, yielding massive gains against the infectious diseases that plagued humanity, the “germ theory” of disease also represents an intellectual quagmire that threatens to entrap us in a unidimensional quest to improve human health.

Aortic disease, known for centuries, originally resulted from infectious processes or trauma. Treatment programs were primarily symptomatic and included diet and rest. The timeline for a vascular concept and disease development along with successful treatment programs has been slow and punctuated by multiple failures. With the scientific and community developments of the 1800s, such as electricity, the germ theory, the improved understanding of the cardiovascular system and circulation, along with anesthetics, the past 150 years has seen a progressive change in the diagnosis and successful treatment of aortic diseases whether infectious, obstructive, hemorrhagic, or aneurysmal in nature. Evolution has seen the virtual disappearance of syphilitic aneurysms and the appearance of atherosclerotic degenerative aneurysms, obstructive aortic disease, aortic dissection, inflammatory and genetic lesions. Our timeline progresses through nearly 2000 (especially the last 200) years of vascular and aortic disease diagnosis and treatment.

The objective of this review is to provide an integrated historical account of the complex, often convoluted events impacting milk hygiene and its resultant effect on infant mortality from 1875 to 1925. Heat pasteurization of cow's milk is necessary for rendering this important nutrient source safe for humans-particularly infants. Developed by Louis Pasteur in 1864, pasteurization evolved from the commercially important parboiling of wine and beer when the Industrial Revolution was effecting rapid societal change in Western societies. In European and American societies of the early and mid-19th century, infant mortality rates were 30- to 60-fold higher than the current rates of five or six deaths per 1,000 live births per year. With proof of the germ theory of disease came convincing evidence of the role of microbes in the transmission of infections, which led to the discovery that microbial pathogens were transmissible via milk. Diseases caused by milkborne pathogens include human and bovine tuberculosis, brucellosis, salmonellosis, streptococcal infections, diphtheria, and "summer diarrhea." With pasteurization of milk, infectious diseases with their high infant mortality rates decreased by only half by the early 20th century, despite concurrent medical and dairy hygiene advances. To further mitigate unacceptably high infant mortality rates, social support providers-including public health nurses and midwives-encouraged breastfeeding, especially among socioeconomically disadvantaged mothers. Improvements in pulsating vacuum milking machines also favorably impacted food safety by providing a clean, enclosed environment. Currently, bottle feeding still competes with breastfeeding as the preferred method, and the sale of raw, unpasteurized milk remains a contentious issue. Informed and responsible food safety professionals, physicians, and public health officials currently view breastfeeding as the preferred feeding method and milk pasteurization as the safer and more prudent alternative.

I am reading a book on 16th-century Italian medicine. There were no journals then; there were books, and scholarship was defined as knowledge of texts. Competence in Latin and Greek, and a comprehensive knowledge of Hippocrates and Galen were the coin of the realm. (For clinical renown, excellence was defined by the number of cures accomplished by the practitioner, mostly self-defined). Little had changed in 1500 years; publications rehashed Galen, perhaps with some new insights, none driven by what we consider ‘‘the scientific method.’’ The anatomic explorations of Vesalius were new; it would be hundreds of years more before the germ theory and Pasteur and Koch, the rise of experimental medicine and Claude Bernard, of chemistry/pharmacology and of Paul Ehrlich. It is sobering to realize that essentially all we do in the discovery and development of medical products is a product of the past 50 years. President Roosevelt died of conditions easily treated by what we consider ‘‘old’’ generic drugs. President Kennedy’s son died as a premature neonate. He would have greater than a 95% chance of survival today. So, what is journal? Journals have been filled with articles that might help authors achieve academic promotions and grants. They hopefully act as a way of stimulating new experimentation, better understanding of human biology in health and disease (or whatever field they focus upon). Disciplinary journals are crucial to continuing education and assurance of high standards of practice within that discipline. However, at a time of an explosion of new information and of the need for interdisciplinary collaboration to drive discovery, development, regulation, and use of new novel therapeutics, a journal such as ours needs to be more than that. DIA membership (and those libraries, consortia, and academics who find TIRS valuable and who are not DIA members) represents a huge diversity of backgrounds, interests, and work environments. They include basic scientists, clinical trialists, statisticians, regulatory experts, and medical writers. They may work in large or small pharma, in CROs, in consulting companies, in academia, and/or in government. They may well move from one arena to another. At a recent retreat at which we began defining the future of

Germ theory of disease and Koch's postulates has been governing our understanding of the role of microbes in human health since 19th century. The discovery of Helicobacter pylori (H. pylori) and H. pylori associated diseases has typically represented the concept and framework of Koch's postulates. Eradication of H. pylori to prevent peptic ulcers recurrence and gastric cancer is the triumph of this microbiology paradigm. Advances of next generation sequencing provide great insight into the unculturable microbes and show trillions of microbes have evolved with human beings. Research into the microbiome-the microbial communities (microbiota) and the host environment that they inhabit-has changed our understanding about microbes in human health and disease. The gut microbiota, the largest reservoir of the microbiome in human, plays a critical role in our catabolic-metabolism and immunity. This review will show the changes of the view of microbes on human health. We will briefly discuss dysbiosis, the disruption of symbiotic relationship between the host and microbiota, and the associated diseases. This leads to an idea to manipulate the microbiota, either by restoring missing functions or by eliminating harmful functions, to prevent or treat a variety of diseases. Current evidences of two common germ therapies, fecal microbiota transplantation and probiotics, in treating diseases will be reviewed.

The 19th and 20th centuries heralded the advancement of our understanding of surgical infections, reducing the risk of morbidity and mortality to patients by overturning long-held dogmas surrounding infections and perioperative care. These advancements impacted the development and establishment of the field of neurological surgery by minimizing surgical risk through aseptic techniques and promoting surgical benefit via improved neurological localization and surgical technique. Infections were significant contributors to morbidity and mortality for all surgical patients, and historically almost half of patients lost their lives as a consequence of perioperative wound contamination. With advancing understanding of germ theory, contagion, antisepsis, and subsequently asepsis, the surgeon began embracing the knowledge and techniques which would hone their craft and allow for a renaissance in the management of neurological disorders in an unprecedented manner.

Introduction Felix Platter is one of the pioneer anatomists and physicians of the 16th century who described various human diseases including meningioma. In this historical article, we present the details of Platter's life and his pioneering work on meningioma. First case of Meningioma In 1614, Dr. Platter described the first case of meningioma. He described the tumor as a round, fleshy mass shaped like an acorn and as large as a medium-sized apple, and full of holes. The tumor was covered with its own membrane, had no connection with the matters of the brain, and left behind a cavity after removal. This first clear description of an intracranial tumor is most consistent with encapsulated meningioma. The succeeding scholar, Harvey Cushing, coined the term “meningioma” for this tumor; neurosurgeons today describe the tumor as “parasagittal or falcine meningioma.” Other contributions In addition to his contribution to meningioma study, Dr. Platter was also the first to describe Dupuytren's disease, hypertrophy of the thalamus, and the retina as the sensory organ of the eye. He contributed to the germ theory of disease and gave substantial accounts of mental illnesses, gynecological disorders, and certain dermatological conditions. Publications Dr. Platter published numerous accounts on various diseases. In 1614 he reported the case of meningioma in the book entitled “Platerus Observations in Hominis”. Additionally, Dr. Platter published his work, ‘Praxeos Medicae,’ which contains his most important contribution on psychiatry and his classification of psychiatric diseases. Conclusion Because of his many contributions to neuroscience, particularly his identification of meningioma, Dr. Platter should be highly credited as a pioneer in the field of neurosurgery.

When Britain and the United States began to respond to outbreaks of disease in the 19th century they developed two distinct systems of disease control. While not polar opposites, Britain focused primarily on sanitation, whereas the United States adopted policies of quarantine. Utilizing the approach of path dependency I argue that this divergence can be partly explained by the timing of disease control formation in each country. As Britain formed its system of disease control earlier, during the 1840s, it was influenced by a miasmatic understanding of disease (the belief that disease is caused by noxious gases that emanate from filthy environments), while as the United States formed its disease control system later, around the end of the 1870s, it was more influenced by new ideas about contagion and the rise of germ theory. Once formed, the public health system of each country began to travel down divergent historical paths; Britain came to connect disease control to the social problems of the working classes (e.g. poverty, working conditions, overcrowding) while the United States developed a militaristic approach that, at times, used quite coercive measures to isolate the contagious bodies of the sick. The origins of public health formation in each country helped shape the overall development of disease control in Britain and the United States over the long-term.

Military metaphors have a long history within biomedical discourse. Pasteur used them as a way to explain the germ theory of disease. President Nixon declared “war” on cancer in the National Cancer...

Louis Pasteur became a dominant figure in European science as a young man demonstrating conclusive evidence of the Germ Theory and applying it for industrial use in the wine, beer, and milk industries inventing “pasteurization,” a term in common use worldwide. Pasteur’s brilliant laboratory work demonstrated that microbes were the cause of contamination. He developed key veterinary vaccines for anthrax and chicken cholera, and subsequently human vaccine against rabies. His proof of the concept of attenuation or weakening of live disease-causing organisms enabled development of antibodies to protect against later exposure to the natural organisms for many diseases by follow-up scientists. He strongly advocated the work of Semmelweis in Vienna promoting handwashing by obstetricians and boiling instruments for preventing high rates of mortality from childbirth fever and for hygiene in surgery as advocated by Lister in England. Pasteur is recognized as one of the all-time giants of science and his contributions to public health were essential for the evolution of modern society.

Acute gastrointestinal illness is a common, life-threatening complication for rural villagers in developing countries such as Turkey. My study identifies and describes the classification schemes surrounding acute gastrointestinal illness and its folk etiologies and treatments among Central Anatolian villagers. I conducted informal small group interviews with rural Turkish villagers in the spring of 2009 and used scenarios, recall, free-listing, and ranked saliency techniques to determine the shared knowledge that residents held about diarrheal disease. The perceived causes of illness included germ theory, food preparation, evil eye, hot/cold values, and other folk theories. Common treatments included foods immediately available in the home as well as plants collected nearby. Central Anatolian villagers had a malleable, shifting understanding of gastrointestinal disease, influenced by recent biomedical education campaigns along with traditional village beliefs and practices. These findings are evidence of a culture dealing with change at local, national, and global levels.

In the past 100 years, there have been myriad medical discoveries—giant steps—from Louis Pasteur’s germ theory, to the understanding of gut physiology and metabolic processes—that are the essential underpinnings of modern day medicine. The beginnings of surgery to promote weight loss, now known as bariatric surgery, date back to the 1880s when it was noted that gut resections resulted in weight loss. It was not long afterward that articles started to appear documenting nutritional “disturbances” and the patient’s likelihood of survival based upon the location and the length of bowel removed. Numerous articles have been penned citing the first bariatric surgeries, but to date, there has not been a comprehensive look back at the origins of the science as well as the severe metabolic complications that furthered understanding, prompted innovative medical and surgical approaches, and ultimately led to modern day practice. This article endeavors to do exactly that. Intestinal bypass surgeries to treat obesity are here to stay. Some of the most profound complications of intestinal bypass manifest in the skeleton and include skeletal demineralization, hyperoxaluria, nephrolithiasis, and fractures. Much has been done to further elucidate the underlying mechanisms, identify preventive strategies, and implement practice guidelines, but this patient population remains at increased risk for metabolic bone disease.

Perception of reproductive illness by the women themselves is important in understanding the women's reproductive health in a particular society. It also indicates the possibility of taking perception as a tool for measuring reproductive illness. Though women do not have a “germ theory” to explain their reproductive illness they have a sense of illness pathology. Reproductive illness perceived by women is related to physical symptoms and situations in a network of meanings and different meanings are socially generated to articulate their experiences.

From the time the Sumerian civilization began to form during the Uruk period, approximately four millennia BCE until fairly recently, the most medicine had to offer people to keep them alive and postpone death was not very much. Some people lived to become very old; some died very young, and most died earlier than they do in the present day. The probability curve for longevity of life was more centered. Fast forward six thousand years, give or take, and we have developed an understanding of human anatomy, general anesthesia, the germ theory, antibiotics, organized medical training programs, cardiopulmonary bypass, the ability to ventilate and oxygenate via endotracheal means outside of an operating room, hemodialysis, solid organ transplantation, implantable hardware for repair of fractures and joint replacement, artificial heart valves, central venous access, total parenteral nutrition, new antibiotics to deal with organisms resistant to the old antibiotics, vasoactive agents, implantable cardioverter-defibrillators, and a whole host of other devices, drugs, procedures, and imaging devices. Yet, despite our profound advances in knowledge and technological sophistication, we did not necessarily develop the wisdom to know why we developed it or when not to use it. Until the 1950s or 1960s, when someone told a doctor, “Do whatever you can, Doc,” it was a pretty limited request, albeit not recognized as such. Today, the same request has very few limitations. There is certainly marked disparity between countries and cultures about how much health care is available, expected, or provided. There are clear differences in how people allocate and pay for health care. Nonetheless, one thing holds true across all types of health care systems: the better you get at dealing with problems that end life prematurely, the larger number of elderly people you get.

Chronic disease epidemiology currently lacks the mono-causal focus germ theory provides infectious diseases. However, the discovery of a form of low-grade, systemic, and chronic inflammation (“metaflammation) underlying many, if not all, chronic diseases induced by a range of stimulants labeled “anthropogens” may help change this. Anthropogens are “man-made environments, their by-products, and/or lifestyles encouraged by these, some of which are detrimental to human health.” While an exhaustive list of anthropogens associated with chronic disease may be as elusive as a comprehensive list of “germs” with the potential to cause infection, a broad taxonomy provides a focus for the practice of lifestyle medicine. Such a list is considered here under the acronym NASTIE ODOURS.

Studies on 19th-century British literature have, in the last decade, become increasingly aware of the literary representations of medicine in general and medical ethics in particular. The Romantic and Victorian periods are the beginning of the professionalization of both science and medicine; it is important, therefore, to study the ways in which the literature of those periods both reflected and informed emerging public debates on medical ethics. Medicine, during Victoria's reign, became standardized, professionalized, and, eventually, specialized. Medical research and the medical technology made tremendous advancements including germ theory and the stethoscope. Given the amount of progress made during the period, Victorian studies contributing to medical humanities can and should further research how Victorian literature shaped contemporary conceptions of medical ethics. Issues of patient privacy that we recognize today did not exist for Victorian medical professionals, and, therefore, the study of ethical implementation of medical research is a more productive line of inquiry for Victorian studies. While Gothic fiction like Wells' The Island of Dr. Moreau and Stevenson's The Strange Case of Dr. Jekyll and Mr. Hyde (1886) are fruitful starting points for this continuance, it is also crucial to consider issues of medical ethics as they appear in other novel genres of the same period. Lesser-studied works – including Eliot's The Lifted Veil (1859), Charles Dicken's “A Curious Dance Round a Curious Tree” (1852), Charles Reade's Hard Cash (1870), Anthony Trollope's The Fixed Period (1882), and Mary Augusta Ward's Marcella (1894) – warrant further scholarly consideration of their engagement with medical ethics.

Infectious and tropical diseases have been a problem for British expeditionary forces ever since the Crusades. Outbreaks were especially common on Navy ships from the 16th to 18th centuries due to poor living conditions and travel to the tropics. However, since these occurred in small, isolated and controlled environments it meant that naval medical practitioners were able to keep detailed records and develop empirical approaches for their prevention. The first Royal Naval Hospitals were established in response to these diseases and Royal Navy doctors made valuable early contributions towards understanding them. Even larger outbreaks of infectious and tropical diseases occurred in the Army during the Napoleonic, Crimean and Boer Wars and throughout the colonial era, which strongly influenced the formation of the Army Medical Services including provision for teaching and research. The establishment of germ theory led to a golden era of discovery regarding these diseases and British Army doctors made numerous important contributions. Subsequent improvements in prevention, diagnosis and treatment reduced the mortality from infectious and tropical diseases during the World Wars, but they remained a significant problem in the non-European campaigns and also the numerous 'small wars' that followed. Even in the 21st century some of these diseases still cause outbreaks with significant morbidity and impact on deployments, but the military clinical and academic resources to deal with them are now much reduced. Preventive measures such as hygiene, sanitation, infection control, vaccination and chemoprophylaxis are invaluable, but history shows that these can become neglected over time and disrupted or overwhelmed during the early or most intense stages of military operations. This is why military specialists in infectious diseases, tropical medicine, sexual health, medical microbiology and communicable diseases control are still required.

The importance of the human microbiome in health may be the single most valuable development in our conception of the microbial world since Pasteur’s germ theory of the 1860s. Its implications for our understanding of health and pathogenesis are profound. Coupled with the revolution in diagnostics that we are now witnessing – a revolution that changes medicine from a science of symptoms to a science of causes – we cannot continue to develop antibiotics as we have for the past 80 years. Instead, we need to usher in a new conception of the role of antibiotics in treatment: away from single molecules that target broad phylogenetic spectra and towards targeted molecules that cripple the pathogen while leaving the rest of the microbiome largely intact.

This paper focuses on Lister's inaugural lecture at King's College, London, in October 1877. As the new Professor of Clinical Surgery, Lister had much to report, including impressively high survival rates from complex operations previously regarded as foolhardy. Instead, he chose to address the processes of fermentation in wine, blood and milk. His reasons are not obvious to a modern audience, just as they probably were not to those who heard him in the Great Hall at King's. Having brought microbiological apparatus from his laboratory to the lecture theatre and presented proof of bacterial variety and specificity, Lister publicly demonstrated the creation of the first pure bacterial culture in the history of microbiology. It was an ingenious and well-thought-out strategy designed to generate a frame of mind among his new colleagues and future students, receptive to the causative role of bacteria in septic diseases. His timing was impeccable.

There is a parallel between local and bio-medical perceptions of malaria among the Ibibio people of South-coastal Nigeria, as in many other societies of sub-Saharan Africa where malaria is endemic. Despite the fact that this accounts for resilience of the disease, earlier studies on malaria in Africa focused on causes, prevalence and socio-environmental factors. Local meanings of malaria and their influence on therapeutic choices have been largely ignored. This study examines local perceptions of malaria among the Ibibio and explains how attitudes are generated from indigenous meanings. It also examines how such attitudes inform a local aetiology of malaria. Similarly, our study examines how local meanings of, and attitudes towards malaria, set the pathway of care in malaria management among the Ibibio. Through qualitative and descriptive ethnography, Key Informant Interview (KII), Focus Group Discussion (FGD) and the textual analysis of documents, our study seeks to establish that malaria is caused by parasites–protozoa. 83% of the respondents held that malaria is due to witchcraft, exposure to sunlight and eating of yellowish food items such as yellow maize, paw-paw, orange and red oil. These local perceptions are drawn from local conceptions which in turn encourage malaria patients to seek assistance outside modern health care facilities. This also discourages local communities from attending health education workshops that link malaria with germ theory and care. Treatment of malaria is thus mostly home-based where a wide variety of traditional remedies is practiced. Our study concludes that the lack of convergence between local knowledge-contents and bio-medical explanations account for a high prevalence rate and the lack of effective management. For proper management of malaria, there is a need to understand local knowledge and indigenous concepts in order to establish a convergence between bio-medical explanations and indigenous perceptions. Only then can a community acceptable means of changing bio-medical perceptions of the disease be facilitated.

The chapter examines the medical model the paradigm education uses to designate children educationally disabled. Contending that the disability designation is both faulty and counterproductive, the chapter counters with a brief look at the effect Sputnik had on American education, proposing that children’s achievement struggles, though quite real, derive from a systemic error germane to general education. While the disability debate continued, the numbers of schoolchildren declared educationally disabled increased dramatically across the USA. Their numbers soon caused financial havoc for school districts and state budgets. Questions were raised regarding special education’s ability to diagnose the supposed educational disabilities, thereby highlighting the disturbing issue of false positive identifications. An interchange between practicing school psychologists, professionals often responsible for declaring a child learning-disabled, suggests that special education’s diagnostic procedure suffers serious problems.

The improvement in the health profile of populations is strongly associated with investments in technological innovations. Hospitals are fixed elements that constantly incorporate these innovations. The objective of this chapter is to analyze the metamorphoses that has taken place in different time periods leading to changes in the psychosphere and technosphere of hospitals. As demonstrated by Michel Foucault, until the 18th century hospitals were not seen as a place of cure and a psychosphere of fear prevailed. It was only around the 1780s that hospitals became a therapeutic instrument. In the technical-scientific period, thanks to new scientific discoveries and new inventions that were incorporated into diagnosis and treatment, the hospital technosphere formed and strengthened a favorable psychosphere. In the current technical-scientific-informational period, there is a complex hospital technosphere that incorporates innovations from the medical/hospital equipment industry, as well as new drugs and research centres. The hospital psychosphere reflects approval of this constant technical-scientific incorporation and, as a consequence, hospitals have become a fixed element that is valued by society as a whole.

The “germ theory” that evolved over centuries allowed a monocausal focus on infections that facilitated the development of effective treatments (public health, hygiene, antibiotics). A single causal focus for chronic disease, however, has been lacking. The finding of a form of low-grade, systemic inflammation (“metaflammation”) underlying much, if not all, chronic disease has led to a consideration, outlined here, on “anthropogens,” or man-made disease determinants. This is the main focus for chronic disease management through Lifestyle Medicine.

Historical evidence suggests that humans have been using bacteria to ferment dairy products for more than 10 millennia, allowing life-long consumption of dairy foods by humans, despite the downregulation of the lactase gene, which is common in childhood. From whence these bacteria were initially derived is unknown, but it is likely that they originated from milk itself. Indeed, traditional cheese and yogurt-making methods either allow fresh milk to curdle on its own volition or add a dairy-derived “mother culture.” Despite these long-held traditions, advent of germ theory in the 19th century supported the contention that bacteria, in general, cause illness. This general belief coupled with limiting microbiological techniques fostered the dogma that milk produced by a healthy animal (or human) must be sterile. The advent of microbiological media not specifically designed to only detect pathogens along with culture-independent molecular methods has now led to a paradigm shift in this regard and has opened a new doorway into understanding the impact of early microbial exposures on short- and long-term health in humans.

Surgery has come a long way since the days of Hippocrates when operations were often deemed to be the last resort, and doctors preferred to practice conservative measures before reaching for the knife. The past 2000 years have seen huge paradigm shifts in the theories of science and medicine, and surgery has by no means separated from this. Without the advent of germ theory, the discovery of both asepsis and antibiotics, and the development of anaesthesia, surgery as we know it today would simply not exist.

The Twa of south-west Uganda have reported high morbidity and mortality rates since eviction from their traditional forest lands in 1991. This study seeks to identify their current beliefs with regard to health and hygiene practices. The study is based on semi-structured interviews with 20 individuals in three communities in Kanungu district, Uganda. The Twa attributed most illnesses to changes in their lives, such as food and smells, which fitted a narrative of leaving an idealized forest life. Views with regard to illness prevention ranged from a belief that nothing could be done, to using practices without understanding the reasons for their efficacy (or otherwise), to a use of practices informed by an understanding of Western germ theory. Hygiene behaviours have been adopted where external teachings or practices of neighbours make sense in the Twa world view. It is therefore recommended that future hygiene promotion takes a participatory form, rigorously identifying and working with existing beliefs.