Bedside Rounds

Mesmerism has had an outsize influence on medicine, despite the rapid rise and fall of its inventor Dr. Franz Mesmer and hostility from the medical establishment. This curious story covers the healing powers of magnets, secret societies in pre-Revolutionary France, fundamental questions about what makes someone alive, and one of the most fascinating medical investigations in history led by a dream team of Benjamin Franklin, Lavoisier, and Guillotine on behalf of King Louis XVI. Plus, a #AdamAnswers about the origin of the phrase “Code Blue.”   Sources: Damton R. Mesmerism and the End of the Enlightenment in France. Cambridge, MA: Harvard University Press, 1968.   Dyer R, Mesmerism, Ancient and Modern. Victorian Web. Franklin B et al, The Reports of the Royal Commission on Mesmer’s System of Animal Magnetism and other contemporary documents, James Lind Library, translated by Iml Donaldson. Retrieved online at https://www.rcpe.ac.uk/sites/default/files/files/the_royal_commission_on_animal_-_translated_by_iml_

Bacteriophages -- viruses that target and kill bacteria -- were one of the most promising medical treatments of the early 20th century, and were used to treat all sorts of infections, from cholera to staph, and everything in between. But by the 1950s, they had all but died out in the West. This episode tells the story of the humble phage, from its discovery in the waters of the Ganges, love trysts ending in a KGB execution, and to a resurgence of this once forgotten therapy in the 21st century as an answer to antibiotic resistance. Sources:   Abedon ST, Bacteriophage prehistory: Is or is not Hankin, 1896, a phage reference? Bacteriophage. 2011 May-Jun; 1(3): 174–178. Blair JE and Williams REO, “Phage Typing of Staphylococci,” Bull Org mond. Ste, 1961, 24, 771-784. Davis BM and Waldor MK, Filamentous phages linked to virulence of Vibrio cholera, Current Opinion in Microbiology 2003, 6:35-42. d’Herelle F, “Bacteriophage as a treatment in acute medical and surgical infections,” Bull N Y Acad Med. 1931 May; 7(5)

Tuberculosis has been humanity’s oldest and greatest killer. Starting at the turn of the nineteenth century, the White Plague was decimating entire generations in the crowded and unclean cities of Europe, North America, and across the globe. But as medical science learned more about the disease, doctors and reformers developed new ways to combat it, most notably specialized tuberculosis hospitals that sought to heal their patients with fresh air, rest, and a nutritious diet. This episode discusses the sanatorium movement and the gradual conquest of tuberculosis, long before effective antibiotic therapy existed. Along the way we’re going to talk about the King’s Evil, the dangers of rebreathed air, the healing powers of mountains, and the social determinants of health. Plus, a brand new #AdamAnswers about maternal placentophagy. All this and more on Episode 39 of Bedside Rounds, monthly podcast on the weird, wonderful, and intensely human stories that have shaped modern medicine, brought to you in partnership

The first population study in history was born out of a dramatic debate involving leeches, “medical vampires,” professional rivalries, murder accusations, and, of course, bloodletting, all in the backdrop of the French Revolution. The second of a multipart series on the development of population medicine, this episode contextualizes Pierre Louis’ “numerical method,” his famous trial on bloodletting, and the birth of a new way for doctors to “know”. Plus a brand new #AdamAnswers about Occam’s razor and Hickam’s Dictum. All this and more on Episode 38 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine! To claim CME and MOC credit, please go to www.acponline.org/BedsideRounds.   Best M and Neuhauser D, “Pierre Charles Alexandre Louis: Master of the spirit of mathematical clinical science,” Qual Saf Health Care 2005;14:462–464. Duffin J, “Laennec and Broussias: The ‘Sympathetic’ Duel,” from La Berge A and Hannaway C, Paris Medicine: Perspective Past and Present. (1977) The French Re

Many podcasts start with an “Episode 0”, basically a mission statement for the podcast. Well, better late than never! This episode explores why I make Bedside Rounds, my philosophy about medical history, and a little bit about who I am and my research methods. Hopefully listeners new and old alike will find it interesting!

For thousands of years, bloodletting was the standard of care for any number of medical conditions, but at the turn of the nineteenth century, often acrimonious debates about the practice would lead to a new method of medical knowledge. The first of a multi-part series on the birth of population medicine, this episode visits the controversies surrounding the death of George Washington and Benjamin Rush’s bleeding of Philadelphia during the 1793 yellow fever epidemic and asks the big question -- how do doctors truly “know” what actually helps their patients? Plus, a brand new #AdamAnswers about military metaphors in medicine. All this and more on Episode 37 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Sources: Brickell J, Observations on the Medical Treatment of General Washington in His Illness, retrieved from https://books.google.com/books?id=YXA3AQAAMAAJ&pg=PA90&lpg=PA90&dq=craik+dick+washington+medical+repository&source=bl&ots=IZB72sSdaS&sig=k

The southern United States was hit by a dramatic epidemic of a mysterious disease called pellagra in the early twentieth century. This episode discusses the cultural and scientific sources of the outbreak -- from the cotton fields of the south, to the cow pastures of rural Germany, to the river basins of Uganda -- and the incredible lengths a young doctor named Joseph Goldberger went through to try and put an end to this plague. Plus, a new #AdamAnswers about the source of the name “internal medicine.” All this and more on episode 36 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Bean WB,  “Origin of the Term Internal Medicine,” N Engl J Med 1982; 306:182-183 Blevins SM and Bronze MS, Robert Koch and the ‘golden age’ of bacteriology, Int J of Inf Dis, Vol 14, #9, Sep 2010. Bloomfield AL, “The origin of the term ‘internal medicine,” JAMA, April 4, 1959. Bressani R et al, Corn Nutrient Losses, Chemical Changes in Corn during Preparation of Tortillas, J Agr and Food Chem, 6,

Sir Arthur Conan Doyle considered The Adventure of the Speckled Band to be his best Holmes story, and Adam does too. Meant to be a companion to Episode 35 (Sherlock), this is the story in its entirety. THIS IS NOT AN EPISODE! It's Adam reading for almost 50 minutes. Consider yourself forewarned!

Why do doctors love Sherlock Holmes so much? In this episode, we’ll explore this endearing, nerdy obsession with the good detective, from Holmes’ medical origins and influences, the parallels with medical reasoning, and how the Holmes stories still influence medicine to this day. Plus a new #AdamAnswers about the origin of the white coat. All this and more in Episode 35 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine! Sources: Blumhagen DW, “The Doctor’s White Coat,” Annals of Internal Medicine, Vol 91, No. 1, July 1979. Conan Doyle A, “The Adventure of the Speckled Band,”  retrieved from https://sherlock-holm.es/stories/pdf/a4/1-sided/spec.pdf Hochberg MS, “The Doctor’s White Coat -- an Historical Perspective,” Virtual Mentor. April 2007, Volume 9, Number 4: 310-314. Levine D, Revalidating Sherlock Holmes for a role in medical education.Clin Med April 1, 2012 vol. 12 McDaniels, AK, “In change in tradition, Johns Hopkins interns will no longer wear short white coats,” Baltimo

The physical exam has become a ritual of the modern doctor’s appointment, with pokes, prods, and strange tools. How did this become a normal thing to do? In this episode, I’ll discuss how the physical exam went from the medieval examination of a flask of urine to basically what we have today in just a few decades in early 19th century France, and how the exam is still developing in the 21st century. Plus, a brand new #AdamAnswers about why Americans insist on using the Hermes’ Staff as a symbol for medicine. All this and more in episode 34 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Sources: Antic T, DeMay RM. “The fascinating history of urine examination,” Journal of the American Society of Cytopathology (2014) 3, 103e107 Ghasemzadeh N and Zafari AM, “A Journey into the History of the Arterial Pulse,” Cardiology Research and Practice Volume 2011 (2011). McGee S, Evidence Based Physical Diagnosis 4th edition. Amazon link: https://www.amazon.com/Evidence-Based-Physical

Alexis St. Martin and William Beaumont have one of the strangest relationships in the history of medicine -- a young French-Canadian fur trapper with a hole in his stomach from an errant shotgun blast and the American army physician who cared for him, and then made his own career by turning Alexis into a human guinea pig. Through the decades of their complicated relationship, they’d revolutionize our understanding of the physiology of the stomach, put American medicine on the map, and start a conversation about the ethics of human experimentation that goes on to this day. Plus there’s a new #AdamAnswers about whether or not your body temperature and fevers can “run low”. All this and more on the latest episode of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine.   Sources:   Beaumont W. Experiments and Observations of the Gastric Juice and the Physiology of Digestion. Plattsburgh, NY: FP Allen; 1833. Mackowiak PA et al, “A critical appraisal of 98.6 degrees F, the upper limit of

The Four Humors are probably the longest-lasting idea in the history of medicine, even though they’ve been more or less completely abandoned for the past century or so. In this episode, we’ll explore how the ancient Greek idea of disease coming from imbalances in body fluids touched every aspect of medicine for two millennia, well into the modern era. And we’ll discuss how humoral explanations likely hampered adoption of the first clinical trial in history, James Lind’s famous scurvy study. Plus we have a brand new #AdamAnswers about germ theory. Listen to all this and more in Episode 32 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Sources: Arikha N, Passions and Tempers: A History of the Humors. 2007. Baron JH, “Sailors' scurvy before and after James Lind--a reassessment,” Nutr Rev. 2009 Jun;67(6):315-32. Bartholomew M, “James Lind and scurvy: a revaluation,” Journal for Maritime Research. Published online: 08 Feb 2011. Lind J. A Treatise of the Scurvy in Three Parts.

Malariotherapy -- infecting comatose syphilis patients with malaria to cure them of the disease -- was once the cutting edge of medicine, and earned its inventor Julius Wagner-Jauregg the Nobel Prize in Medicine or Physiology in 1927. In this episode, we’re going to talk about the fascinating story behind this remarkable treatment, from the murky beginnings of syphilis through its sordid sexual connotations, to the birth of modern psychiatry and Nazi experiments. Plus, there’s a brand new #AdamAnswers about whether or not ancient doctors thought hair served to store semen (seriously).  Listen to all this and more in Episode 31 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine. Sources: Crellato E et al, “The Hippocratic treatise ‘On glands’: the first document on lymphoid tissue on lymph nodes,” Leukemia. Retrieved online at https://www.nature.com/articles/2404618 Farhi D, Dupin N, Origins of syphilis and management in theimmunocompetent patient: Facts and controversies. Clinic

Two hundred years ago, a few doctors, a matron, and 22 orphans set sail in a gutsy attempt to spread the new invention of vaccination across three continents in the world’s first attempt to eliminate smallpox. Learn about their epic journey, the Balmis-Salvany Expedition, as well as the medical context surrounding the invention of vaccination in “The Orphan Vaccine”. Plus, a new #AdamAnswers about why you always get sick when you first go on vacation. You can find all this and more in the latest episode of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Sources: Domingo P, “Smallpox: The triumph over the most terrible of the ministers of death,” Annals of Internal Medicine, November 1997. Fenner F et al, “Smallpox and its Eradication,” World Health Organization, 1988, Franco-Paredes C, et al. “The Spanish Royal Philanthropic Expedition to Bring Smallpox Vaccination to the New World and Asia in the 19th Century”, Clinical Infectious Diseases, Volume 41, Issue 9, 1 November 200

Did the famous composer Gustav Mahler work his fatal heart murmur into his final ninth symphony? To try and answer this question, I’m joined by Dr. Kevin Nordstrom of the Great Composers Podcast. We’ll delve into Mahler’s diseases, a history of heart sounds, musical theory, his obsession with mortality, and the unfortunate circumstances of his own death. Classical music and medicine, in one podcast! What more could you want? And included (at no extra charge!) is a new #AdamAnswers about the origins of respiratory therapy.   You can listen to Dr. Nordstrom’s Great Composers Podcast on iTunes or on his website.   Sources: Amenta C, “The Opening of Mahler's Ninth Symphony and the Bernstein "Heart-beat" Hypothesis by Charles Amenta,” Naturlaut 4(1): 17-18, 2005. Cardoso F and Leese AJ. “Did Gustav Mahler have Syndenham’s chorea?” Mov Disord. 2006 Mar;21(3):289-92. Christy NP et al, “Gustav Mahler and his illnesses,” Trans Am Clin Climatol Assoc. 1971; 82: 200–217. Ferretti J et al, “History of Streptococcal Res

The story of smallpox blankets offered as gifts to indigenous peoples as a weapon of war is ubiquitous -- but is it based in truth? And did our increased medical understanding of smallpox lead to its use as a biological weapon?  In this episode, we confront these questions and explore the history of biological warfare, smallpox, and medicine. Listen to all this, a new #AdamAnswers, and more in this episode of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine. Sources: Barras V and Groub G, “History of biological warfare and bioterrorism,” Clin Microbiol Infect 2014. Carus W, “The history of biological weapons use: what we know and what we don’t,” Health Security, Vol 13, No4, 2015. Fenner F et al, “Smallpox and its Eradication,” World Health Organization, 1988, Chapters 5 and 6. Mayor A, “The Nessus Shirt in the New World: Smallpox Blankets in History and Legend,” J Am Folklore, Vol. 108, No. 427 (Winter, 1995), 54-77. Mear C, “The origin of the smallpox outbreak in Sydney in 1789

The United States is in the midst of an epidemic of addiction and overdose deaths due to opiate painkillers. Its causes are varied, but there’s no question that physicians share a large part of the blame. Little discussed is that this is actually the second time this has happened. Almost a century ago, a remarkably similar epidemic struck the country. In this episode, called “The First Opiate Epidemic,” I discuss what happened, the parallels to today, and the lessons we can learn from our forebearers. Learn about all this and a new #AdamAnswers in this month’s Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Sources:   Courtwright DT. Dark Paradise: A History of Opiate Addiction in America. Harvard University Press, 2001. Meldrum ML, “The ongoing opiod prescription epidemic: historical context,” Am J Public Health. 2016 August; 106(8): 1365–1366. Courtwright DT, “Preventing and treating narcotic addiction -- a century of federal drug control,” N Engl J Med 2015; 373:2095-2097.

In 2005, a mysterious plague called Corrupted Blood hit the online denizens of World of Warcraft, ripping through cities and decimating player characters. After the smoke cleared, it became clear that this virtual plague shared many characteristics with real-world diseases and almost immediately attracted the attention of researchers. In this Summer Short, I go over the details of the in-game Corrupted Blood incident, and the very real-world epidemiological research that followed. Learn about all this and more on the latest short of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine.   Sources: Bohannon J. Slaying monsters for science. Science  20 Jun 2008. Messner S. How Blizzard coped with World of Warcraft's blood plague and other early disasters. PC Gamer. Henderson M. Analysis: Absence of risk limits parallels with real life. Times Online. October 28, 2008 Oultram S. Virtual plagues and real-world pandemics: reflecting on the potential for online computer role-playing games to

The invention of dialysis -- essentially artificial kidneys for people with kidney failure -- revolutionized medicine. It also started a debate about medical rationing and ethics that rages to this day. Producer Cam Steele brings us a story about the God Squad, the group of lay people and doctors tasked with deciding who lived and who died in the early days of dialysis, and how it has informed every debate about medical rationing since. Learn about all this and more, plus a new #AdamAnswers in the latest episode of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine. Sources: Blagg CR, Development of ethical concepts in dialysis: Seattle in the 1960s. Nephrology, 1998.4, 235-238 Scheunemann L and White D, The Ethics and Reality of Rationing in Medicine, Chest, 140; 6. December 2011 White DB et al, Who should receive life support during a public health emergency? Using ethical principles to improve allocation decisions. Ann Intern Med. 2009 January 20; 150(2): 132–138. Jonson AR, The

The eclipse is coming! Get out your eclipse glasses (or your camera obscura, if you didn't prepare like me), and enjoy a review of the medical literature on eclipses with our guest Dr. Avi O'Glasser in our first summer short. Beyond solar retinopathy (a very good reason to not look into the sun), are there health effects on humans? Is there anything to the widespread belief of an eclipse being a bad omen? Find out all this and more in our first Bedside Rounds Summer Short. And thanks so much to Dr. O'Glasser!   References: http://www.asrs.org/patients/retinal-diseases/special-safety-edition-2017-great-american-eclipse A New Way to Look Up. Solar Retinopathy Risks and Methods of Prevention Prior to the 2015 Solar Eclipse Public health warnings of solar retinopathy risk in European newspapers prior to the 2006 solar eclipse. (http://www.oftalmo.com/seo/archivos/maquetas/C/1C6CE602-7C96-3DE8-336A-00001A483D3C/articulo.pdf) EFFECT OF ECLIPSE OF THE SUN IN 1999 ON THE PSYCHIC STATE OF PEOPLE http://www.prolekare