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

Does medicine have a place for renegades who play by their own rules? Producer Cam Steele brings us a story about medical mavericks drinking toxic cocktails of their own creation, threading rubber tubes through their veins, and trying to disrupt entire industries, all in the attempt to change the world. Learn about all this and more, plus a new #AdamAnswers, in Episode 21 of Bedside Rounds!

The nineteenth century was struck by a collective panic about being buried alive, leading to a bevy of new laws, regulations, and inventions like the safety coffin.  In this episode, we explore how medical science created and fueled this fear by blurring the line between life and death with the invention of new tests for death, developing life-saving technologies like rescue breathing, and even re-animating corpses. And just in case you thought the fear of premature interment was something of the past, we explore how issues raised in this panic still inform medicine today. Learn about all this, a brand new #AdamAnswers, and more in Episode 20 of Bedside Rounds, Buried Alive!

Can the moon make you crazy? The superstition is rampant in medicine, but the idea that a full moon awakens psychiatric pathologies traces back thousands of years. In Episode 19 of Bedside Rounds, producer Cam Steele looks at evidence behind the belief and traces the origins of this cultural fossil that has managed to last until the 21st century. Learn about all this and more in Of Madness and Moons!

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!