Bulletin of the history of medicine
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Biography Historical Article
Harvey Cushing's paradigmatic contribution to neurosurgery and the evolution of his thoughts about specialization.
The modern era of neurosurgery began in 1879 with the amalgamation of three technologies: anesthesia, antisepsis/asepsis, and cerebral localization. However, when Harvey Cushing (1869-1939) took his first tentative steps toward a neurosurgical career in 1901, the outlook for the field was dismal, because mortality and morbidity rates were horrific. For brain tumors, surgical mortality rates were 30-50%. ⋯ His mortality rate for tumors was 10-15%. Nonetheless, the successful paradigm was not fully instantiated until a community of practitioners formed a neurosurgical society in 1920. As this process unfolded, Cushing's ideas about specialization also evolved in interesting ways.
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In 1959, cytologic studies demonstrated that Down syndrome was associated with a nondisjunction now known as trisomy 21. Twenty years earlier (1932-39), at least three writers conjectured, independently of one another, that Down syndrome might be a form of nondisjunction: Petrus J. Waardenburg (1932), Adrien Bleyer (1934), and G. ⋯ Penrose (1939) also proposed that Down syndrome could be a chromosomal anomaly, but without specifying nondisjuction. However, these conjectures were largely ignored by contemporary medical writers. This essay (1) explores the background and context of early conjectures that Down syndrome is a form of nondisjunction, (2) provides some possible reasons why these conjectures were not given greater credence, and (3) traces early efforts to assimilate Down syndrome and other genetic disorders to what Robert Koch called the etiologic standpoint.
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Historical Article
The disease of the self: representing consumption, 1700-1830.
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Biography Historical Article
A crippling fear: experiencing polio in the era of FDR.
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Historical Article
Poliomyelitis and the neurologists: the view from England, 1896-1966.