What Historical Records Teach Us about the Discovery of Quinine.

The origin of quinine from Peru remains a mystery because of the lack of primary data-in particular, those produced by the Jesuits working in Peru. The discovery of cinchona bark and its use in malaria treatment must have come from the Jesuits, who worked with the native Andeans, the Quichuan people, and learned how the bark of the cinchona tree could be used for chills. Unknown is whether the Andean people used it for fever that may have been the result of malaria. We explored the literature of the 1600s, 1700s, and later to trace the history of quinine that is available. All these secondary sources lack the primary data of the Jesuits in their work with native Andeans, nor is there information on how the discovery of its use for malaria-like fevers came about. One clue comes from the Jesuits who talked with the Andean people and learned about quinine. But was it used for fever? Why did the Jesuits test it against (tertian or quartan) fevers that could have been the result of malaria? The gap in our knowledge can only be resolved with the discovery of written documents by the Jesuits about quinine for malaria.

Regulating assisted reproduction in Italy: a 5-year assessment.

In 2004, the Italian parliament comprehensively regulated medically assisted reproduction. Law 40/2004 has outlawed several techniques and tightly compressed the freedom of research in the area of human reproduction and regenerative medicine. This article analyses the post-2004 political, bioethical and legal debate on assisted reproduction in Italy. The analysis is grounded on empirical evidence on fertilisation outcomes released in 2007 and 2008 by the Italian government, on recent amendments related to the regulation of preimplantation genetic diagnosis and on the debates on the status of spare embryos as for their availability for scientific researches. The analysis shows that Law 40/2004 has failed to improve the access of infertile couples to assisted reproduction techniques and keeps supporting practices that the other jurisdictions have rejected because they are unwise from a clinical standpoint. Moreover, Law 40/2004 created severe limitations to scientific researches in the fields of medical embryology, gynaecology and regenerative medicine. With the political support of some Italian political parties and the Catholic Church, Law 40/2004 disregards the expectations of the majority of Italian citizens, international guidelines of good clinical practice, international codes of medical ethics, the interests of infertile couples and the social and economic relevance of biomedical research.

Areas of intervention for genetic counselling of dementia: cross-cultural comparison between Italians and Americans.

OBJECTIVE: Purposes of this study are: (1) to evaluate attitudes, beliefs and experiences towards dementia among relatives of Italian familial cases; (2) to perform a cross-cultural comparison between Italian and American samples; (3) to identify predictors of intentions to undergo hypothetical genetic testing. METHODS: Participants were 134 relatives of patients affected by familial forms of dementia. We administered tests measuring health psychological styles, social variables, illness perceptions, intentions regarding genetic testing, and perceptions of the pros and cons of genetic testing. RESULTS: Respondents had a poor Alzheimer's disease knowledge and a low perceived dementia threat. When compared to Americans, Italians reported greater willingness to undergo genetic testing and perceived a different subset of benefits and risks. The strongest predictors of test intention were decisional balance, homemaker status and two beliefs concerning dementia causes. CONCLUSIONS: Italians had a poor knowledge of the disease and a low awareness of personal risk of developing dementia. As compared to Americans, they expressed higher intentions to undergo genetic testing and they have a different perception of benefits and risks. PRACTICE IMPLICATIONS: Understanding of cultural differences in knowledge, attitudes and perception of the disease is important to design optimal health services and education programs for dementia.

Lessons learned from malaria: Italy's past and sub-Sahara's future.

No longer a major public health concern in developed countries, malaria kills 1-3 million people annually, mostly children under the age of five in sub-Saharan Africa. In 1998, the WHO launched the Roll Back Malaria (RBM) drive to halve malaria mortality by 2010. This article contrasts the problems confronting RBM with the successful Italian drive to eradicate malaria between the late 19th and mid 20th centuries. The Italians employed education and applied socio-political will; however, ecological and socio-economic conditions in sub-Saharan Africa are more hospitable to the disease. RBM strategies should consider the Italian experience while awaiting a major scientific breakthrough necessary to achieve success.

[AGAINST PATERNALISTIC VIEWS ON NEUROENHANCEMENT: A LIBERTARIAN EVOLUTIONARY ACCOUNT].

The term "enhancement" has come to represent a very precise form of improving individual skills. By means of pharmaceutics, surgery, and reproductive technology, all originally intended for clinical use, healthy individuals may improve their cognitive and emotional capacities for many reasons, such as to gain a competitive edge. In today's society, cognitive performance and mood assume a more relevant role than physical ability if one aspires to emerge above the average. In this paper, we present and discuss common views on "neuroenhancement," a term often used to describe the use of artificial means that interfer with brain function to improve cognitive skills. Most philosophical arguments and beliefs on the topic are based on some inappropriate distinctions and definitions which favour unfruitful alarmist attitudes and may obscure the complexity of the issue. In particular we point out that both radical prohibitionist and libertarian approaches are affected by paternalistic ideas which we refute. We also show that even though enhancement nowadays is occurring at an impressive rate, we cannot infer that it is a present-day phenomenon, because enhancement is a human disposition, shared between most species and has always existed. We argue against moralistic views on neuroenhancement and defend a reasoned libertarian perspective. We believe that case-by-case evolutionary-medical heuristics is the best approach to help individuals in their autonomous choices.

From Nuremberg to bioethics: an educational project for students of dentistry and dental prosthesis.

In the lessons of medical-scientific methodologies of the medical faculty at the Sapienza University of Rome, basic notions on the ethical and deontologic aspects characterizing the history of the medical profession are provided, including the formulation and application of bioethical principles to clinics and biomedical research. Within such framework, an educational project has been initiated on the historical origin of the current normative and juridic dispositions in the regulation of experimental biomedical research and the relationship between health operators and patients, with particular attention to the procedure, the meaning the value either professional or deontologic, of ethics and the legality of the informed consensus. Emphasis is put on medical and experimental abuses that occurred in Germany during the nazi regime.

Scientific method, history, Darwinism and laicism: a Giovanni Jervis's intellectual biography.

Some authors marked a change of perspective from the early to the late Jervis's thought, in terms of a supposed turn towards conservatism. That laid him open to criticism from some Leftist Italian intellectuals. The aim of this paper is to show that conservatism never was a Jervis's thought feature. Mainly, subjects and methods leading the development of his philosophical views suggest a continuity between earlier writings and later ones. All over his thought, in fact, the idea of preeminence of scientific method and historical contextualization convinced him about naturalistic approaches to human behavior, which came to support his Darwinism and laicism in approaching socio-psychological and socio-political issues.

['Specificity' in microbiology and immunochemistry between 1880 and 1930]. / Il problema della specificità nella microbiologia e nell'immunochimica tra il 1880 e il 1930.

During the second half of the XIX Century, microbiological sciences acquired a set of conceptual, methodological and technological tools that radically transformed theoretical and empirical knowledge of the microorganisms, with particular regard to their biochemical properties and their etiopathological role in infectious diseases. During that period, theoretical and experimental researches in general microbiology and immunochemistry addressed the nature and empirical appearances of microbes, both pathogens and not, and the origins of chemical properties of immune sera. In other words, microbiologists tried operatively explaining the origins of the morphological, physiological, and pathogenetic differences between the microbial species. At the same time physiologists and biochemists investigated the chemical basis of the selective or specific interactions between microorganisms or their chemical components and humoral factors contained into the sera produced by the body in response to the contact with microbes. During the half a century, between 1880 and 1930, qualitative and quantitative experimental studies demonstrated that the specificity of microbiological phenomena depended on the biology of microbes and that the specificity of immune reactions hinged upon the biochemical properties of special molecules synthesized by some physiological system which can recognize and react against any foreign substance.

Evolution based medicine (ebm) an epistemological framework for thinking of, and dealing with the so called "crisis of medicine".

A growing interest toward the evolutionary or Darwinian approaches in medicine stimulates today's debates about the future of medical knowledge and practice. A rising number of symposia, essays, and books are questioning if medicine still makes sense without evolution, arguing that an understanding of how natural selection shaped human vulnerability to disease could provide new insights into medical research and practice, and contribute to a more pertinent idea of health and disease than the ones emerging from the understanding of physiology and biochemistry. The aim of this paper is to provide an historical and epistemological perspective for an evolution based medicine (ebm). Starting from a schematic analysis of the most controversial issues debated within the literature dealing with the so called "crisis of medicine", I will guess that medical theory and philosophy of medicine find it difficult to manage the crisis because they are suffering from a historical fallacy. A schematic reconstruction of the historical advancements of medical epistemology, both at the level of theoretical thinking and of methodological strategies will then be put forward, to demonstrate the epistemological pluralism of medicine. Instead of considering medical pluralism as a demonstration that medical knowledge is socially constructed, the essay argues that it is a consequence of the fact that the living beings who become sick and those that try to understand how and why it happens are temporary endpoints of the ongoing process of biological evolution by natural selection. The main assumptions and theories which inspire "evolution based medicine" will finally be listed and analyzed in terms of their the epistemological implications, showing why and how an evolutionary and Darwinian perspective about medical knowledge and practice can improve and complete the epistemological understanding and foundation of medicine.

Toward an evolutionary historiography and epistemology of medicine. The legacy of Mirko Grmek.

Mirko Grmek has proved that a naturalistic approach to the history of medicine is possible. In his works he showed that the historical and epistemological research can use different kind of conceptual tools and knowledge, borrowed from history, anthropology and medicine, to understand more deeply the historic development of medical thinking. Moving from Grmek original concept of "pathocenosis" is possible to link his ideas to the evolutionary perspective, present in the contemporary medical thought as "evolutionary medicine" or "Darwinian medicine". The last one sees the disease as an inconsistency between phenotypes and environmental conditions, and a by-product of the necessity to stock variations to respond to the mutability of external conditions. Today, the evolutionary approach to medicine gives us a new way for taking care of the sick. At the same time it supplies a new way to solve the eternal theoretical problem of determining a shared and consistent definition of the disease's concept and medicine status.

Scientists, bioethics and democracy: the Italian case and its meanings.

In June 2005, Italy held a referendum on repealing the law on medically assisted fertilization (Law 40/2004), which limits access to artificial reproduction to infertile couples, and prohibits the donation of gametes, the cryopreservation of embryos, preimplantation genetic diagnosis (PDG), and research on human embryos. The referendum was invalidated, and the law remained unchanged. The Italian political e bioethical debate on assisted reproduction was manipulated by the Catholic Church, which distorted scientific data and issues at stake with the help of Catholic politicians and bioethicists. What happened in Italy shows that some perverse socio-cultural e political mechanisms are spreading the absurd and anti-historical view that scientific and technological advancements are threatening democracy and personal freedom. Scientists should not only contrast the political attempts at limiting freedom of scientific research, but also tell politicians, humanists and citizens that the invention of Western science with its view of scientific community as an "open society", contributed and still contributes, through scientific education, to the construction and maintaining of the moral and political values underlying Western democracies.