Abstracts fra Bibliotek for Læger 2/2009

Originalartikel: Lægernes sidste bastion. Sundhedsstyrelsen 1909–2009 
Kurt Jacobsen

The last bastion of Danish doctors

Bibl Læger 2009;201:179–215.

The Collegium Medicum was founded in 1740 as the superior medical authority in Denmark, and for centuries the council was led by a physician. This, however, changed in 2007, when the Ministry of Health placed a Master of Political Science in charge of the Board of Health. The appointment caused both indignation and disbelief within the medical community, who feared that economic arguments would soon supersede medical judgments. However, the article argues that medical development in combination with an increasing politization of the health sector and growing focus on public spending render both medical, political, and economical competences necessary in the management of a modern Board of Health.

Originalartikel: Prinsessen på ærten. Eventyr eller medicinsk kasuistik? 
Peter Twachtmann & Hans Levander 

“The Princess and the Pea”. Fairy tale or medical case report?

Bibl Læger 2009;201:216–222.

The authors discuss, whether the Danish author Hans Christian Andersen’s (1805–1875) story “The Princess and the Pea” (1835) is a fairy tale at all or rather a description of a common medical condition today known as fibromyalgia. The story, which does not meet the academic criteria for a fairytale, could very well be an allegoric description from a keen observer and listener of a dysfunctional medical pain condition. Two out of three core fibromyalgia symptoms are included in the description of the young main character: The muscle tenderness and the disturbed sleep. Worsening by cold weather and rain are highly relevant symptoms too. The story ends with the sentence “See, det var en rigtig Historie!”, and most translations have translated this as “Look, that was a good story!”. However, the Danish word “rigtig” is open to interpretation, because it can also mean “correct”, “true” and “real”. Clearly, credit for this early case report on fibromyalgia must go to Hans Christian Andersen!

Originalartikel: Syfilis. En medicinhistorisk oversigt 
Kaare Weismann

Syphilis. An overview of its medicaehistory. 

Bibl Læger 2009;201:223–82.

Syphilis was probably brought to Europe at the turn of the 15th century by Christoffer Columbus’ crew after his first voyage to Hispaniola in 1492–93. It spread rapidly as a deadly epidemic all over Europe. Mercury was soon introduced as treatment in the form of ointments and fumigatio. Due to the severity of the infection, patients endured the toxicity of mercury. In the middle of the 19th century mercury was still a well-established therapy in hospitals despite its severe, sometimes lethal, sequelae. “The Oslo Study” was based on patients who were housed in a hospital with no specific treatment in the years 1890–1910. About 50 years later most of the patients were investigated for sequelae of their untreated syphilis. 72% had no symptoms at all. 13% had benign syphilis, and a few percent had neurosyfilis. Salvarsan was introduced in 1910, since 1912 in the form of Neosalvarsan, and it remained the drug of choice for the next three decades. Side-effects were common and sometimes serious, and many patients abstained from the repeated series of injections. Penicillin was introduced in 1943 and has been in use ever since as a safe and effective treatment. During the 1970s the incidence of syphilis was on the rise until 1982–1983, when AIDS appeared as a new STI. Today in Denmark there are less than 100 yearly cases with a high frequency of HIV infected males among them. Known historical persons who have suffered from syphilis are mentioned. The Danish writer Karen Blixen (1885–1962) was believed to have syphilis in an incurable stage, but the evidence for this is questionable. More likely her disease was a consequence of mercury intoxication in her younger age and later therapy with Salvarsan, arsenic and mercury. In one of her short stories lady Flora’s fateful syphilis is described. The parallels between Karen Blixen’s and lady Flora’s life stories are discussed.

Replik I: »… den værste Fjende, vi have at kjæmpe imod«.

– Kritiske bemærkninger til Jesper Vaczy Kraghs artikel om malariabehandling af dementia paralytica. 
Peter Kramp 

Replik II: Psykiatri, historie og kildekritik. Svar til Peter Kramp. 
Jesper Vaczy Kragh

Forside: »Kapløb med døden«. Fransk oplysningsplakat fra omkring år 1900.