Friday, October 27, 2006

Old foes

The lecture for the second-year history of medicine elective class today was given by Dr. Alan Barker from the Department of Pulmonary and Critical Care Medicine. He spoke on the history of mankind's struggle with pneumonia, one of the oldest known diseases, first recorded by Hippocrates about four hundred years before the common era. He hit all the high spots: Auenbrugger and Laennec, Frankel and Friedlander, blood-letting versus sulfa drugs, the terrible illness and miraculous cure of Winston Churchill on the eve of war.

Pneumonia shares its antiquity with the White Plague, tuberculosis, evidence of which has been found in mummies dating from 4,000 years before the common era. Both of these diseases are caused by hardy germs, and there's new evidence that TB may only be getting hardier. The current issue of American Scientist (Nov/Dec 2006; 94(6)) has a small article about research originally published in Science (June 30, 2006; 312(5782)) by Sebastien Gagneux and Clara Davis Long which shows that prolonged treatment for TB can result in multi-drug resistant strains with no fitness defect--meaning that these bugs are better by far.

What does this portend for mankind? While it is an unexpected discovery, it's probably not yet time to panic. For thousands of years we have been engaged in this battle, now an escalating arms race, but I for one have faith that medical researchers will parry this thrust with new treatments.

By the way, if you're interested in pursuing the history of pneumonia through primary sources, we have a couple of 19th century texts and an 18th century text in the History of Medicine Collection, as well as books by Hippocrates, Auenbrugger, and Laennec; we also have a good amount of material on tuberculosis.

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