Thursday, May 14, 2009

Medicine now, Medicine then...

In 1931, Dr P D White noted that high blood pressure is a compensatory mechanism. So no intervention is needed.
The treatment of the hypertension itself is a difficult and almost hopeless task in the present state of our knowledge, and in fact for aught we know . . . the hypertension may be an important compensatory mechanism which should not be tampered with, even were it certain that we could control it

Dr Hay said that the worst danger on a person is to discover his high blood pressure. A may try to control it!

In 1931 Hay in the British Medical Journal (1931; 2:43-47):"The greatest danger to a man with high blood pressure lies in its discovery, because then some fool is certain to try and reduce it,"

Today, no one would involve beta blockers as a contraindications in Heart failure. Before, you should enumerate it in top of a list.
Befor, PVCs were benign but now, not so benign...In last article in BMJ:

Although the prognosis in patients with frequent PVCs frequent PVCs (>1000/24 hr) was considered relatively benign, attention should be paid to the progression of the LV dysfunction during a long-term observation, especially in patients with a high PVC prevalence.

President Eisenhower had a heart attack in 1955. Dr White was criticized for mobilizing the President too rapidly. Now patients should be early mobilized. Thanks for the improvement in intervention and revascularization methods.
Dear visitors,What is your opnion in medicine then and now?

NB: Image from my recent lecture of (Post MI Rehabilitation).

I power

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