JEBCAM: Rebirth Brings New Life to an Old Journal and Scientific Scrutiny to the Field

Abstract

Beginning with the dawn of human consciousness, disease and death have perplexed mankind and resulted in a variety of mystical, religious, and mythological explanations. Stories such as ‘‘Pandora’s box’’ helped provide a reason for disease and other human afflictions. As human societies appeared, certain individuals claimed to be endowed with a special knowledge concerning disease and death, and such personages are evident in early writings from communities in Asia, Africa, and Europe and in the oral traditions of other groups. With advancing civilization, knowledge concerning disease and death became codified and treatises were developed, such as the various papyri attributed to Imhotep in Egypt, the Corpus Hippocraticum from ancient Greece, the writings of Galen of Pergamon in Imperial Rome, the alQ an un fi’l-tibb (Canon of Medicine) by the Central Asian Islamic physician Ab u ‘Al i al-Husayn ibn ‘Abd All ah ibn S in a (also known as Ibn S in a or Avicenna), the Nei Ching Su Wen attributed to the Chinese Yellow Emperor Huang Ti, and the Hindu texts Atharvaveda, Caraka Samhita, and Sushruta Samhita. Over centuries, various adherents came to view these writings as hallowed texts. Although scientific inquiry provided stuttering advances in a variety of disciplines such as mathematics, chemistry, and physics (particularly after the European Renaissance), medicine tended to adhere to the ancient wisdom of these sacred teachings. For example, even though the Dutch scientist Antonie van Leeuwenhoek could see microorganisms with his microscope as early as the 1600s, the germ theory of disease did not reach ascendency until the late 1800s. Until science finally insinuated its way into medical thought in the 19th century, more harm than good generally resulted from care by the supposed healers. Even during the American Civil War (1861-1865), the accepted medical therapy for injuries and illness that could not be treated by amputation was either bloodletting or administration of calomel (mercurous chloride) purgatives, and not unexpectedly most patients receiving such treatments did not survive. Although by the 1800s university-trained physicians in Europe and America could finally begin to categorize and diagnose diseases based on some scientific understanding, the results of their treatments were generally no better than that of any other healing discipline. In fact, the famous 1891 painting The Doctor by Sir Luke Fildes depicted the ‘‘physician in our time’’ who could offer no effective therapy but instead could only sit in vigil until the child either miraculously recovered or died (Figure 1). Thus, from the early-1800s until the mid-1900s (through World War II), there was an explosion of health care theories and disciplines, many offering treatments that were less gruesome and equally effective (or ineffective) as compared with those advocated by the universitytrained medical establishment. Unfortunately, this was also a period of exponential growth for charlatanism and quackery. Even following reforms to medical education as a result of the famous 1910 Flexner report, there were still few successful treatment options for most diseases. Interestingly, despite the relatively poor therapeutic options, death rates had actually fallen and longevity had increased, presumably in part due to improvements in public health as a result of better understanding of infectious disease. Astonishing breakthroughs during the heady half-century from the 1930s to the 1980s brought medical science to the forefront, and the public came to believe that all disease was finally conquerable and that the modern medical therapies dispensed by physicians were ‘‘magic bullets.’’ This period saw the introduction of effective antibiotics, which led the Surgeon General William Stewart to tell the US Congress in 1969 that it was time to ‘‘close the book on infectious diseases. The war against pestilence is over.’’ Medications to treat mental illness obviated the need for asylums and associated barbaric procedures such as shackling, shock therapy, and frontal lobotomy. Surgical procedures became safer and more routine, including open heart surgery and organ transplantation of kidneys, heart, and liver. Vaccinations were developed that basically eliminated the threat of childhood scourges such as poliomyelitis, measles, and mumps. Women who would otherwise have been childless could be made fertile with drugs or