1850s 3,000 deaths per million;
1973 –20 per million
The decline started before medication intervention. Similar reductions occur with pneumonia, influenza, etc.
What accounts for the decline of infectious disease?
The advances in agriculture in the 18th and 19th centuries allowed people to eat much more varied and nutritious food.
Pp.23
Pp.24
Medicine has made some contribution to health, but its interventions in diseases have been greatly emphasized as to their real effectiveness and worth to society.
24
People are healthier today not because they receive all this well-publicized better treatment when ill, but simply because they tend not to become ill in the first place.
Pp.25
Geography
Climate
Income
Education
Degree of urbanization
Similar number of physicians and
hospital beds per capita
Utah
Religion—abstain from smoking and drinking
Rigid social organization
Quiet stable life
Nevada
Adult death rate 40% higher
Liberal doses of alcohol and tobacco
100-600% higher death rate from cirrhosis and lung cancer
Lifetyle more transient
Socially unstable—more divorced, sinlge, separated and widowed
Pp.26
San Francisco study—7,000 adults for seven years
Not smoking
Drinking in moderation or not at all
Exercising regularly
Eating regular meals
Getting adequate sleep
2002 Sept news – one hong kong company reported less people sick under the no smoking rule
1870 silk industry nearly destroyed by a disease that killed the silkworm. Louis Pasteur was called to look into it. He noticed that it as not just the presence of the germ but the physiological state of the silkworm that also determined the susceptibility to infection.
54
Connects output of nerve, muscle, gland cells
Monitors all organs
Controls heartbeat, blood pressure, blood composition and volume, breathing,
entrance of oxygen to bloodstream, production, combination and distribution of thousands of chemicals of the internal pharmacy, integrity of the internal organs, safety of the organizm, avoidance of danger, attachments to family, friends, and society, creation of mental processes, mental routine
http://ep.llnl.gov/msds/pdb/acetylcholine.gif
“hate” dislike – “crazy, silly”
68
73
80-81
*one group did the operation
*one group opened and closed
90% reported improved symptoms
75% better on exercise test
BUT – of those who claimed well—only 20% showed actual improvement in heart function; 60% no improvement; 20% worse following the operation