Bedside Rounds

Intravenous or IV fluids are a ubiquitous treatment in medicine, and one of the most cost-effective treatments that we have, costing less than a cup of coffee in the developing world. But it wasn’t always this way. In this episode, called Salt Water, we go back to the second great cholera epidemic, where a young doctor developed IV fluids to help fight this mysterious disease, only to see his invention abandoned for over half a century. We also have a new #AdamAnswers about bloodletting. So join us for another rollicking adventure of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Sources:   Foex B. How the cholera epidemic of 1831 resulted in a newtechnique for fluid resuscitation. Emerg Med J 2003;20:316–318. Gill G. William O’Shaughnessy and the forgotten cure for cholerain the 1832 British epidemic. Letter from Lord Cavendish: Online at: http://mssweb.nottingham.ac.uk/elearning/view-text.asp?resource=HealthHousing&ref=pwh287&theme=3&view=text&page=1 O'Shaughnessy, W.B. (1838–40). "Case of Tetanus, Cured by a Preparation of Hemp (the Cannabis indica.)". Transactions of the Medical and Physical Society of Bengal. 8: 462–469. Chan C, et al. Historical Epidemiology of the Second Cholera Pandemic: Relevance to Present Day Disease Dynamics. PLOS One: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0072498 BB4: Diary of an Epidemic. Online at: http://www.bbc.co.uk/radio4/history/longview/longview_20030415.shtml Kresta R. The Origin of IV Fluids. Discover Magazine. Online at: http://blogs.discovermagazine.com/bodyhorrors/2016/05/31/intravenous-fluids-cholera/#.WX9z4JdtmUl Prasad V and Cifu A, Medical Reversal: Why We Must Raise the Bar Before Adopting New Technologies. Yale J Biol Med. 2011 Dec; 84(4): 471–478.   Further reading: r/AskHistorians thread: https://www.reddit.com/r/AskHistorians/comments/6nzbfz/if_bloodletting_was_rubbish_why_was_it_considered/ Ending Medical Reversal by Cifu and Prasad. On Amazon at: https://www.amazon.com/Ending-Medical-Reversal-Improving-Outcomes/dp/1421417723

In this month's #AdamAnswers, he discusses his #TipsforNewInterns (seriously, it's trending on Twitter). And we introduce the Summer Shorts for this summer -- and discuss how you can contribute and be on the show! (#spoileralert -- Tweet me @AdamRodmanMD). This is NOT an episode! Make sure you listen to Episode 24.

What makes a disease? And who gets to decide? Producer Cam Steele brings us a story that spans migrating uteruses in ancient Egypt, a disease that makes slaves want to run away in the antebellum south, and the accidental discovery of an erection pill while trying to treat heart disease. Join us in our journey to disassemble the concept of disease in Episode 24 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!   Sources: Bynum B. Discarded Diagnoses. The Lancet. Volume 356, No. 9241, p1615, 4 November 2000. Conrad P. The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. Drescher J. Out of DSM: Depathologizing Homosexuality. Behav Sci (Basel). 2015 Dec; 5(4): 565–575. Robison J. Look Me in the Eye: A Brief History of Nosology. Retrieved from: http://jerobison.blogspot.com/p/a-brief-history-of-nosology.html Shorter E. The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders. Dialogues Clin Neurosci. 2015 Mar; 17(1): 59–67. Tasca C, et al. Women And Hysteria In The History Of Mental Health. Clin Pract Epidemiol Ment Health. 2012; 8: 110–119. Music credits: Sad Marimba Planet by Lee Rosevere Pookatori and Friends by Kevin MacLeod

A darkened laboratory with an eerie green glow; a photograph of the bones of a woman’s hand published on the front pages of newspapers throughout the globe; mysterious rays that promise to change medicine forever but also cause horrific disease in their champions and pioneers. In this episode, called Bone Portraits, I tell the story of two men -- Wilhelm Roentgen, the discoverer of x-rays who would later win a Nobel Prize, and Clarence Dally, the first victim of x-ray radiation. Listen to the thrilling conclusion of our to part series on the dawn of diagnostic imaging! We’ve got all this, plus a double-header #AdamAnswers, in Episode 23 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine. Sources: Mahroo, et al. 'Dilatation' and 'dilation': trends in use on both sides of the Atlantic. Br J Ophthalmol. 2014 Jun;98(6):845-6. doi: 10.1136/bjophthalmol-2014-304986. Epub 2014 Feb 25. King, Gilbert. “Clarence Dally — The Man Who Gave Thomas Edison X-Ray Vision.” Smithsonian.com, March 14, 2012. Goodman, et al. Medical Writing: A Prescription for Clarity. P37. Gagliardi, Raymond A. “Clarence Dally: An American Pioneer,”  American Journal of Roentgenology, November, 1991, vol. 157, no. 5, p. 922 Dunlop, Orrin. Deleterious effects of X-rays on the human body. Electrical Review 1896;29:95 Cheng, Tsung. Dilation vs. Dilatation. American Journal of Cardiology. February 15, 1994. Volume 73, Issue 5, Page 421 Brown, Percy. American martyrs to radiology. Clarence Madison Dally (1865-1904). 1936. Obrien, Frederick. In Memoriam: Percy Brown, MD. Radiology. December 1950Volume 55, Issue 6 Sansare K, et al. Early victims of X-rays: a tribute and current perception. Dentomaxillofac Radiol. 2011 Feb;40(2):123-5.

A mortally wounded American president and the quest to find his assassin’s bullet unexpectedly opened up a potentially new era of medical diagnostics in the late nineteenth century. In this episode, learn about the assassination of James Garfield and how the controversy surrounding his medical care led Alexander Graham Bell to develop an “induction balance” that could locate a piece of metal inside a human body. This is the first part of a two part series called “Sound and Light.” Also included -- a new #AdamAnswers about … hiccups! All this and more in Episode 22 of Bedside Rounds! Sources: Bell AG. Upon the electrical experiments to determine the location of the bullet in the body of the late President Garfield; and upon a successful form of induction balance for the painless detection of metallic masses in the human body, Retrieved from: https://archive.org/details/uponelectricalex00bell Paulson G. Death of a president and his assassin--errors in their diagnosis and autopsies. J Hist Neurosci. 2006 Jun;15(2):77-91. Trunkey D, et al. Medical and surgical care of our four assassinated presidents. J Am Coll Surg. 2005 Dec;201(6):976-89. Epub 2005 Jun 16. Reyburn R. Clinical history of the case of James Abram Garfield. JAMA. 1894;XXII(13):460-464. Steger M et al. Systemic review: the pathogenesis and pharmacological treatment of hiccups. Aliment Pharmacol Ther. 2015 Nov;42(9):1037-50

Discover the world of renegade medical mavericks who challenge norms and break boundaries in healthcare. Explore the stories of groundbreaking figures like Barry Marshall and their unconventional approaches that revolutionized medicine. Unveil the struggles and triumphs of renegades throughout history, from self-infection for research to pioneering cardiac catheterization. Delve into the impact of pushing boundaries in medicine, comparing past renegades to modern figures like Elizabeth Holmes. Reflect on the discrepancies between doctors' beliefs in high value care and their own end-of-life care decisions, exploring potential influencing factors.

Explore the 19th-century fear of being buried alive and how medical advancements blurred the line between life and death. Learn about primitive death diagnosis methods, advancements in artificial respiration, galvanism experiments, and the evolution of death diagnosis in medicine. Discover the debates on suspended animation, ethical dilemmas in defining death, and the progress in neuroscience and stroke treatments. Plus, find out which medical specialty is most likely to survive on a desert island!

Explore the origins and validity of the belief that a full moon can affect psychiatric disturbances. Debunk the myth of the moon's influence on human health and behavior. Trace the historical treatment of fever and the shift from natural remedies to synthetic drugs. Learn about fever-inducing treatments throughout history, including the use of malaria to combat neurosyphilis.

By the time that David Livingstone died on the banks of Lake Bangweulu, his name was already legend -- first, as a great explorer, becoming the first European to lay eyes on Victoria Falls and Lake Malawi, and second as a fierce advocate against the slave trade. But we often forget that he was a medical doctor, and made significant contributions to the nascent field of tropical medicine. In Episode 18 of Bedside Rounds, I recount his innovations in fighting malaria and discuss all the fun (by which I mean quite gross, and very deadly) tropical diseases that he described in his journals. Even though the phrase was almost certainly made up, you should still listen to "Dr. Livingstone, I presume?" 

In 1991, two hikers near the Austrian-Italian border discovered the 5,000 year-old mummified body of Otzi the Iceman buried in a glacier. What have we learned about medicine from the Iceman? From a fungus-based first aid kit, ancient acupuncture , analysis of paleofeces, hints about his violent demise -- and of course the good old fashioned physical exam -- the answer is more surprising than you might think. Learn more with Episode 17 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine!