Robert Bartholow draft

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Robert Bartholow or Roberts Bartholow (November 28, 1831 – May 10, 1904) was an American physician and a professor at several American medical colleges. He is best known for his experiments involving a 30-year-old patient named Mary Rafferty. Rafferty was admitted to Good Samaritan Hospital in 1874 with a 2-inch-diameter (51 mm) hole in her skull caused by a cancerous ulcer. Bartholow's experimented with applying current to Rafferty's exposed dura using needle electrodes. His report detailed the first observations of how electrical stimulation of the brain affects motor functions of the body, but many ethical concerns were raised about the way in which he carried out his experiments.[1]

EDUCATION AND CAREER

Robert Bartholow was born in New Windsor, Maryland. He attended Calvert College in his hometown, and graduated in 1848 with a Bachelor of Arts degree. He earned his degree in medicine from the University of Maryland in 1852. After graduating, he worked in Baltimore's clinics and hospitals before enlisting in the army in 1857. During the Civil War, Bartholow was sent to Fort Union in New Mexico, and a series of other Union military posts in the West from 1861 to 1864. During this time, he worked as assistant surgeon and headed several military hospitals. He also published several papers including A Manual of Instructions for Enlisting and Discharging Soldiers, which was adopted at military recruiting stations to identify disqualifying diseases in recruits. He married Maria Walker in 1862 and before the war's end, he left the army and moved with his family to Cincinnati, Ohio.[1][3]

While in Cincinnati, Bartholow worked as a physician in several hospitals with rivaling medical systems. Bartholow worked with practitioners of allopathic, homeopathic, and eclectic medicine, and he used ideas from each in his research. He worked at the Good Samaritan Hospital starting in 1866.[1] He also created his own practice, which grew to be the largest in the city. From 1864 to 1879 he was a professor at the Medical College of Ohio in Cincinnati, and he accepted the position of chair of materia medica in 1869.[3]

Following his publication of Materia Medica and Therapeutics, Bartholow accepted a professorship at the Jefferson Medical College in Philadelphia in 1879.[1][2]

RESEARCH METHODS

Bartholow's research often used live animals, which caused backlash from advocates of anti-vivisectionism.[3] He argued that medical practice should be advanced beyond simply observing and comparing different patients' cases. In his view, performing experiments on live animals helps uncover basic biological mechanisms, which provides insight into what treatments are effective. He studied the effects of new drugs on animals in own his experiments, and for his later experiments on Mary Rafferty, he took inspiration from David Ferrier's experiments involving localized electrical stimulation of the brains of live dogs, cats and other non-primates.[1]

EXPERIMENTS ON MARY RAFFERTY

Prior to the experiments, Bartholow studied the effects of electrotherapy, and used electricity in his practice at Good Samaritan Hospital for polyps, tumors, aneurysms and peripheral paralyses. These treatments used either faradic (alternating) and galvanic (direct) current, and Bartholow's main goal was to test the effects of each when applied to the human cortex. Some subgoals included comparing bodily reactions to stimuli on the left and right sides of the brain, and verifying if Ferrier's findings could be generalized to the human brain. Bartholow recorded the patient's blood pressure, arterial tension, and body temperature during the experiments to determine how safe the procedure was, and possibly study function specialization and locate cerebral embolisms.[1]

Using a pair of electrolytic needles inserted into the dura and underlying tissues, Bartholow applied a small electric current to different sections of Rafferty's exposed brain and noticed that this caused movements in corresponding parts of her body. The low electric current he applied to the brain did not seem to cause her any pain. However, when Bartholow applied a larger amount of current, Rafferty became distressed, experienced convulsions and went into a coma. She revived from the coma three days later, but the following day she had a major seizure and died. After her death, Bartholow examined the needle wounds by cutting her brain into sections. The tracks of the wounds were filled with liquified cerebral matter, suggesting that the wounds caused a glial scar to form.[1]

Bartholow published his findings in his paper "Experimental Investigations into the Functions of the Human Brain" in April 1874.[2] The paper was favorably reviewed by Ferrier, who found Bartholow's observations "quite in accordance" with the results of his own experiments when applying current to the brains of monkeys. Opponents noted that it was impossible to verify that the applied current was localized to specific sections of Rafferty's brain.[1]

Though Bartholow claimed that he received consent from Rafferty, critics pointed out that Bartholow himself described Rafferty as "feeble-minded", which cast doubt on her ability to understand the proposed experiments. It was also known that Rafferty had sustained injuries to her brain from her ulcer, as well as from surgical incisions made to remove pus from her skull. He was also heavily criticized for carrying out the experiments with no intention of healing the patient, and for proceeding without administering anesthesia until after Rafferty experienced several seizures and was nearly unconscious. Bartholow maintained that his actions were not the ultimate cause of Rafferty's death, though he did admit that he had caused some injury. Although he was censured by the American Medical Association following the experiments, his career did not suffer. Bartholow continued to publish books and articles, and his practice remained highly popular.[1]

In the aftermath of the controversy, the American Medical Association banned any human experimentation that disregards saving the life of the patient.[2] The anti-vivisectionist movement in Great Britain cited Bartholow's unethical treatment to successfully lobby bills restricting experiments on animals.[1]

TODO: get pictures!

Vincent Priessnitz draft

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NOTE: lots of the statements below may seem somewhat fragmented, but they fit in with what exists on the page already.

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The use of cold water as a curative is recorded in the works of Hippocrates and Galen[4], and techniques such as spas, bathing, and drinking were used by various physicians in Europe and the US through to the 18th century.[5] The practice was becoming less prevalent entering the 19th century however, until Priessnitz revived the technique after having major success applying it on patients in his spa in Gräfenberg (now Lázně Jeseník).

YOUNG AGE -> EARLY LIFE

He relieved pain after spraining his wrist by applying wet bandages which lessened the inflammation.

Priessnitz refused to accept the doctor's diagnosis, and over the next year, he healed after applying wet bandages to his chest and drinking large quantities of water.[4][5] His recovery strengthened his conviction in the practice, and brought him local fame. Priessnitz began healing animals on his farm and in his village, and later began developing techniques and protocols for healing people. Different types of baths focused on healing different body parts and various afflictions, including paralysis, insanity and poisoning.[4]

SUCCESS

As Priessnitz's experience grew, the procedures of his treatments became more precise and regular. To treat many diseases, he would wrap the patient in wet bandages and many layers of blankets to cause heavy perspiration from the heat. After several hours, the patient was then instructed to bathe in cold water, and also drink plenty of water.[6] He believed that the rapid changes in temperature allowed the pores of the skin to open and evacuate bad substances in the blood. Another theory Priessnitz held was that the body tended towards health naturally. His treatments, which involved no drugs or herbal medicines, were designed then to help the body remove foreign matter from the body. The extreme conditions disturbs this matter, which prompts a bodily response. Priessnitz also required his patients to add strenuous exercise to their daily regimen, and sometimes required his patients to fast. The food served was bland and hard, and water was the only drink served. Cold water was sometimes added to the food to promote water intake, and patients were required to drink twelve glasses of water per day at a minimum, with some drinking as many as thirty glasses.[4]

In 1842, R. T. Claridge published The Cold Water Cure, its Principles, Theory, and Practice, which detailed Preissnitz's treatments. Claridge was himself a patient of Preissnitz, and his book's descriptions contain notes on the process of his own treatment at the spa, and the effectiveness of Preissnitz's treatments on other patients with various diseases.[4]

Before Priessnitz's spa was built near his family house, Priessnitz mostly made house calls. As his popularity grew, Priessnitz limited his practice to his residence, and began expanding the Gräfenberg spa with lodgings, dining rooms, showers and bathhouses. Some patients lived in the spa for up to four years. He constructed several douches, which were heavy showers of cold water that flowed from nearby mountains. The water from these douches fell from up to 20 feet in the air, with a stream so strong that new patients were sometimes "flattened by the force of the stream."[6] Other baths were created for different body parts, such as eye baths, foot baths and head baths[4]

Early opponents of Priessnitz brought him to court several times, but he was acquitted each time, and inspections of his spa confirmed that water was the sole healing agent used in the facility. These high profile cases only served to expand his fame throughout Europe.[4] As hydrotherepy became more widely accepted, his opponents became more concerned with his exact methods than the overall practice, finding Priessnitz's treatments far too extreme and taxing on the body. The food offered at the spa was also notoriously bad-tasting and unhealthy. One visitor complained about being served "veal 10 days old." Dr. Robert Hay Graham, who visited the Gräfenberg spa in October 1842, noted that Preissnitz did not keep any records of his patients, and that his practice was based on hunch and experience over any systematic approach. Graham suggested that Preissnitz's treatment worked on one out of twenty people at best, and that a milder water-cure that was combined with other medicines would be preferable.[4]

Preissnitz's practice spread to the U.S. soon after becoming established in Europe, and several hydropathic medical schools and medical journals were created in the U.S. Some practitioners performed scientific experiments on the effects of known water-cures, and they developed new methods and theories about the field. The usage of extreme temperature was toned down to account for differences in patients' age and condition. One notable theory that emerged was that osmosis contributed to the healing effects of water. The skin was thought to act as a membrane, and impurities in the body would flow out into pure water applied by bandages and baths.[6]

  1. ^ a b c d e f g h i j k Harris, Lauren J.; Almerigi, Jason B. (2009). "Probing the human brain with stimulating electrodes: The story of Roberts Bartholow's (1874) experiment on Mary Rafferty". Brain and Cognition. 70: 92–115.
  2. ^ a b c d Zago, Stefano; et al. (2008). "Bartholow, Sciamanna, Alberti: Pioneers in the Electrical Stimulation of the Exposed Human Cerebral Cortex". History of Neuroscience. 14(5): 521–528. {{cite journal}}: Explicit use of et al. in: |first= (help)
  3. ^ a b c d Morgan, James P. (January 1982). "The First Reported Case of Electrical Stimulation of the Human Brain" (PDF). Journal of the History of Medicine.
  4. ^ a b c d e f g h Weiss and Kemble (1967). The Great American Water-Cure Craze: A History of Hydropathy in the United States. Trenton: Past Times.
  5. ^ a b Legan, Marshall Scott (1971). "Hydropathy in America: A Nineteenth Century Panacea". Bulletin of the History of Medicine. 45, Issue 3: 267–280 – via ProQuest.
  6. ^ a b c Whorton, James C. (2002). Nature Cures: The History of Alternative Medicine in America. Oxford: Oxford University. pp. 77–102. ISBN 0-19-514071-0.