This article analyses long-term changes in the mean age at menarche (MAM) as a biological indicator of changes in the standard of living in Indonesia. It finds that MAM was about 15.5 for birth cohorts in the late-19th century, decreasing to 14.5 by the 1930s, at which level it stagnated until the gradual decrease resumed since the early 1960s to around 12.5 in the mid-2000s. The article considers that long-term improvements in nutrition, educational attainment and health care explain these trends. An international comparison of long-term changes finds that MAM in Indonesia was much lower than in Korea and China until respectively 1970 and 1990, but comparable to Japan until 1950 and to Malaysia until 1930. The article presents reasons why these differences are unlikely to be related to dissimilarities in climate and ethnicity, and concludes that they are indicative of relative standards of living.
This article examines six main elements in the modern story of the impact of Alfred Russel Wallace's 1855 Sarawak Law paper, particularly in the many accounts of Charles Darwin's life and work. These elements are: Each of these are very frequently repeated as straightforward facts in the popular and scholarly literature. It is here argued that each of these is erroneous and that the role of the Sarawak Law paper in the historiography of Darwin and Wallace needs to be revised.
Rheumatoid arthritis (RA) is thought to be a 'recent' disease in that descriptions of it were only noted in the 17th century. However, a study of paintings would suggest that RA could have been present as early as the 15th century, when artists started to paint the human body accurately rather than figuratively. Thus, it was possible to deduce from their paintings the occurrence of various medical conditions. If present, RA with its typical finger deformities should be apparent. This review discusses the known occurrences of RA-type deformities in paintings and places this in the context of the origins of the disease.
Cholera has been in existence in Sarawak for many years and since 1873 many major epidemics have occurred. The epidemics usually occur during the dry months of May, June and July and the population affected are those in coastal areas. As in other outbreaks the areas affected were those which had poor environmental sanitation, poor water supply, poor refuse disposal and indiscriminate disposal of faeces. Malays are more affected as in Peninsular Malaysia outbreaks. The classical biotype was common prior to 1961. In later years the El Tor (biotype) has been responsible for most outbreaks.
Falciparum malaria may have infected Homo sapiens (and perhaps H erectus) in the Asia Pacific region for more than 100,000 years. This estimate is based on the gene frequency of alpha-thalassaemia, the protection it affords against falciparum malaria and assumptions of untreated mortality from the infection. Up until the end of the 19th century, there was a high mortality from malaria in the coastal parts of Malaya, but the malaria control campaign, begun in 1901 at Klang, was described by Sir Ronald Ross as the first successful antimalarial work in the (then) British Empire. This was extended to Singapore in 1911. When the Far Eastern Association of Tropical Medicine held its Fifth Biennial Congress in Singapore in 1923, malaria was still a major killing disease in parts of Malaya and Sarawak. The mechanism of life-threatening malaria involves cytoadherence of parasitised erythrocytes in microvascular beds, a process enhanced by the products of macrophage activation induced by malarial pyrogen. Improvements in the chemotherapy of life-threatening falciparum malaria with chloroquine and quinine have been countered by the emergence of resistant strains. Artemisinin derivatives may become the treatment of choice during the coming decade. Apart from traditional anti-mosquito methods, control of malaria now involves the use of insecticide-impregnated bed nets, new entomological strategies, including genetic manipulation of mosquitoes and selective chemoprophylaxis. Antigenic diversity and antigenic variation of the malaria parasite have so far defeated attempts to produce an effective vaccine.
Throughout human history, doctors and healers have gathered and refined the knowledge inherited from the previous generations. Different methods of effective therapy have been designed during various historical periods; when each was developed, it was considered "modern scientific medicine" for their time. Mankind has gone through natural and social disasters and survived; hence, history has proved there was no time when medical knowledge was erroneous or ineffective. Classic medicine has grown to be divided into narrow, specialized branches, causing it to lose its holistic approach and general view on health, sickness and therapeutic methods. Many of traditional medicine's effective methods have been forgotten and removed from the mainstream medicine. It would be good for modern medical education to incorporate the general knowledge of historically effective therapeutic modalities and study practical cases. Medical students should be taught how to choose a "good method" or "good medicine" independent of when that method or remedy was discovered. However, he has to keep in mind the primary goal of medicine: "I will use treatment to help the sick according to my ability and judgment…"(from Hippocratic Oath).
The life of Lord Moynihan is briefly reviewed. Incidence of stones in Peninsular Malaysia appears to show the same trend as in other industrialised countries. Management of urinary calculi both prior to and after the introduction of ESWL in a personal series is discussed. More than 90% of urinary stones are now treated by ESWL threatening the place of surgery in Urology. The pattern of incorporating renal transplantation into the urological training programme as practised in the Institute of Urology and Nephrology in Malaysia is suggested as a way to assure a place for surgery in Urology.
Over the past 50 years, a variety of surgical procedures have been advocated for the treatment of operable breast cancer, ranging from local excision to supraradical mastectomy. Today, the surgical treatment of breast cancer remains highly contentious. We review the historical development of breast cancer surgery and analyse the available evidence supporting conservative procedures. We also express our opinions on the treatment of early breast cancer and illustrate the changing patterns of surgery with our experience at National University Hospital.
The history of medical physics in Asia-Oceania goes back to the late nineteenth century when X-ray imaging was introduced, although medical physicists were not appointed until much later. Medical physics developed very quickly in some countries, but in others the socio-economic situation as such prevented it being established for many years. In others, the political situation and war has impeded its development. In many countries their medical physics history has not been well recorded and there is a danger that it will be lost to future generations. In this paper, brief histories of the development of medical physics in most countries in Asia-Oceania are presented by a large number of authors to serve as a record. The histories are necessarily brief; otherwise the paper would quickly turn into a book of hundreds of pages. The emphasis in each history as recorded here varies as the focus and culture of the countries as well as the length of their histories varies considerably.