Hypertension

Abstract

For most of its history medicine has not been a matter of numbers. Just as an early modern physician felt entirely justified in diagnosing without a fine-level grasp of anatomy, so he could confidently prognosticate and prescribe without a great deal of quantifying. Although the classical tradition took a close interest in the movement of blood, seeing it as a kind of nutritious tide originating in the liver, practitioners were more concerned with pulse rate and quality—hard, soft, languid—as markers of general health. The historian will see you now: introducing Case Histories“I hope that Lord Grey and you are well”, wrote the Regency wit and clergyman Sydney Smith to his confidante Lady Mary Grey in February, 1836, “no easy thing, seeing that there are about fifteen hundred diseases to which man is subject”. Last year the editors of the Lancet journals announced the launch of The Lancet Clinic, a major online initiative which draws together an overview Seminar with the best current research from across the Lancet journals on 135 of the most globally important diseases. Full-Text PDF Alcohol use disordersPhysicians have been arguing over alcohol, and the meaning of moderation and excess, for more than two millennia. In the classical tradition wine was held in high regard, embodying the heat and moisture characteristic of living things. Like any medicine, though, it was only beneficial in the correct proportions. In excess it could dry the body by provoking urination, and its vapours could rise to the head and fog the faculty of reason. Medical attitudes began to shift most radically after the 18th-century Gin Craze, as mainstream opinion turned against intoxication in its most potent forms. Full-Text PDF ObesityWhen does “large” become “obese”? In more technical terms, at what point does an acceptable variation in bodyweight become a pathological condition? And how does an individual's lifestyle become subject to public and medical scrutiny? A stroll round any gallery offers a striking insight into these questions. Contemporary stars may prefer the lean, tense lines of a Mario Testino photograph, but well into the Enlightenment European elites favoured the ample, sensuous contours of Peter Lely and Peter Paul Rubens. Full-Text PDF Sickle cell anaemiaIntersectional scholarship is all the rage, and if one wished to write an intersectional history of modern medicine there are few better case studies than sickle cell anaemia (SCA). The story of SCA is the story of an encounter between two harbingers of modernity: a potent molecular frame for disease, rooted in laboratory science, and a set of anxieties and prejudices about race and human difference. Full-Text PDF RubellaUntil the mid-20th century physicians and patients alike might greet a diagnosis of rubella with a sigh of relief. A red rash and a fever could be portents of serious sickness, in the form of measles or scarlet fever, or even disfigurement and death from a bout of smallpox. Rubella, by comparison, was merely a few days of mild sickness—often in childhood—granting a lifetime's immunity. One mid-19th-century American physician noted that “the constitutional symptoms were so mild that it was difficult to keep the children in bed”. Full-Text PDF EpilepsyWhoever wrote the Hippocratic treatise On the Sacred Disease—almost certainly not the historical Hippocrates— had an eye for an ironic title. This short text is a manifesto for the secular, materialistic medicine we associate with the Hippocratics, and a blistering attack on the claims of ancient Greek folk healers and “temple medicine”. The sacred disease—a condition characterised by fits, foaming lips, and loss of consciousness—was not, the author argued, caused by a demon or a heavenly thunderbolt, but was the result of a blockage in the flow of chilly phlegm around the body. Full-Text PDF