Historically, some of the most famous medical breakthroughs have featured epidemiology. An early success was James Lind’s dramatic treatment of scurvy.10 Lind had been familiar with the disease during his service as a naval surgeon and by comparing seamen who developed scurvy with those who remained healthy, he deduced that it was a deficiency disease caused by lack of fruit and vegetables. In 1747, aboard HMS Salisbury, Lind put his theory to the test and treated some patients with oranges and lemons while others received non- dietary remedies. The experiment worked beautifully but it was not until 1795 that the Admiralty finally accepted his conclusions and included limes or lime juice in the diet of seamen. As a result, British seamen became known as “limeys.”
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(1)Ignaz Philip Semmelweiss
1818-1865: Using common-sense and epidemiological methods, he saved countless women from certain death, only to see his discoveries vilified by the medical establishment.
In 1846 Ignaz Philipp Semmelweiss joined the obstetric staff at Vienna’s General Hospital and within months showed how the appalling mortality from puerperal, or childbed, fever could be cut and the disease banished.1 By the time Semmelweiss arrived, the first ward in the hospital had acquired such a bad reputation on account of its high mortality rate that expectant mothers begged not to be placed in it. Semmelweiss carried out a meticulous epidemiological study, comparing the first ward with the second which had a much lower mortality. The key difference, he soon discovered, was that students entered the first ward for their instruction in obstetrics, straight from the dissecting room, whereas in the second ward, the work was done by midwives who had nothing to do with the dissecting and post-mortem rooms. The final clue came when a colleague fell victim to blood poisoning caused by a wound inflicted during a post-mortem examination: the symptoms, Semmelweiss observed, were similar to those of women who had died of puerperal fever. Convinced now that childbed fever was due to an infection carried from the dissecting room on the hands of doctors and students, he issued strict orders that their hands be thoroughly washed between each case they attended. As a result, the death rate promptly dropped from one in eight confinements to one in a hundred.
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