Julio Escámez Contreras y su original mural Historia de la Medicina y de la Farmacia en Chile / Julio Escámez Contreras and his masterful mural History of the Medicine and Pharmacy in Chile

Julio Escámez Contreras was a highly creative, skilled and versatile Chilean painter who painted in Chile from 1940 to 1974 when he went into exile to Costa Rica and died there in 2015. In 1953-54, Escámez painted a large mural in a private pharmacy in the city of Concepcion, Chile, The History of Medicine and Pharmacy in Chile. This mural describes the origins and development of medicine and pharmacy in Chile, placing that origin in the medicinal activities of the mapuche indigenous population. The mural consists of three sections, each painted on the upper segment of three adjacent walls in the pharmacy, with each section focused on one period in the evolution of medicine and pharmacy in Chile. The first section is devoted to indigenous medical practices including its pharmacopeia and religious practices, the second describes medical approaches during colonial times, still with strong indigenous components but also with indigenous and Catholic hybrid religious elements, while the third depicts modern medicine, including chemistry, anatomical, physical and pharmacological activities complemented with public health components such as nursing, vaccination and health education. Read from left to right, the mural provides a highly lively, accurate and valid depiction of the evolution of medicine and pharmacy in Chile. Escámez' artistry and skill in the use of perspective, color, landscape, architecture and Chilean subjects, including real life individuals, produces a typical Chilean mural. However, his originality and consummate use of a non-verbal visual language delivers a more universal message, one that helps to explain the repeated efforts, of the government responsible for his exile, to destroy some of the works produced by him.

[Pet cats, medicine and art]. / Mascotas felinas, medicina y arte.

The author in this short text remembers the passing of a beloved pet cat. Cats are beautiful animals and wonderful companions. They evolved together with humans in Africa, subsequently spread over the five continents with them, and became the subject of many human cultural activities, including art, poetry and religion. Abandoned and roaming free, cats readily return to the wild, potentially acquiring many zoonotic infections. Surprisingly, feline company is increasingly used for therapy of mental and other illnesses such as cardiovascular disorders. Responsible ownership and good veterinary care of these marvelous animals under the One Health paradigm are essential to their well-being as well as to that of humans. They are an ethical and small price to pay for the affectively rewarding relationships humans have with these endearing and evocative animals.

[Julio Escámez Contreras and his masterful mural History of the Medicine and Pharmacy in Chile]. / Julio Escámez Contreras y su original mural Historia de la Medicina y de la Farmacia en Chile.

Julio Escámez Contreras was a highly creative, skilled and versatile Chilean painter who painted in Chile from 1940 to 1974 when he went into exile to Costa Rica and died there in 2015. In 1953-54, Escámez painted a large mural in a private pharmacy in the city of Concepcion, Chile, The History of Medicine and Pharmacy in Chile. This mural describes the origins and development of medicine and pharmacy in Chile, placing that origin in the medicinal activities of the mapuche indigenous population. The mural consists of three sections, each painted on the upper segment of three adjacent walls in the pharmacy, with each section focused on one period in the evolution of medicine and pharmacy in Chile. The first section is devoted to indigenous medical practices including its pharmacopeia and religious practices, the second describes medical approaches during colonial times, still with strong indigenous components but also with indigenous and Catholic hybrid religious elements, while the third depicts modern medicine, including chemistry, anatomical, physical and pharmacological activities complemented with public health components such as nursing, vaccination and health education. Read from left to right, the mural provides a highly lively, accurate and valid depiction of the evolution of medicine and pharmacy in Chile. Escámez' artistry and skill in the use of perspective, color, landscape, architecture and Chilean subjects, including real life individuals, produces a typical Chilean mural. However, his originality and consummate use of a non-verbal visual language delivers a more universal message, one that helps to explain the repeated efforts, of the government responsible for his exile, to destroy some of the works produced by him.

Mascotas felinas, medicina y arte / Pet cats, medicine and art

The author in this short text remembers the passing of a beloved pet cat. Cats are beautiful animals and wonderful companions. They evolved together with humans in Africa, subsequently spread over the five continents with them, and became the subject of many human cultural activities, including art, poetry and religion. Abandoned and roaming free, cats readily return to the wild, potentially acquiring many zoonotic infections. Surprisingly, feline company is increasingly used for therapy of mental and other illnesses such as cardiovascular disorders. Responsible ownership and good veterinary care of these marvelous animals under the One Health paradigm are essential to their well-being as well as to that of humans. They are an ethical and small price to pay for the affectively rewarding relationships humans have with these endearing and evocative animals.

Realismo pictórico y medicina: las dos clínicas quirúrgicas de Thomas Eakins / Painting realism and medicine: the two surgical clinics of Thomas Eakins

Realism is a painting style that began with Millet and Courbet in politically convulsed France in the middle of the nineteenth century. In the second half of that century, the pragmatic and democratic tradition of the United States fostered the careers of many realist painters, including that of Thomas Eakins. Eakins, trained in France, developed his career completely associated with Philadelphia at a time when this city was in the vanguard of American emerging industry, culture and medicine. Eakins The clinic of Dr. Gross and the The clinic of Dr. Agnew are icons of these developments and symbolize a perfect union of art and medicine. Both paintings permit the viewer to appreciate the artist s mastery, originality and Americanism while simultaneously tracking the progress of surgery as evidenced by the introduction of asepsis, anesthesia and nursing. Eakins mastery is revealed by its use of some European Old Masters approaches to portray medical professionals undertaking their daily duties in their work environments with critical and unadorned vision. This combination of vision and skills led Eakins to create a highly original yet analytical art. Unfortunately, his representations were far ahead of his time and resulted in under appreciation of his paintings and a censorious reaction to their content. His contemporaries rejection of Eakins work negatively affected his career as a painter, as a teacher and even his private life. This judgment was overturned in subsequent years and by the twentieth century Eakins was recognized as an American master without parallel.

Diego Rivera: gran maestro y un didáctico y lúcido historiador de la medicina / Diego Rivera: a great master and a didactic and discerning medical historian

Diego Rivera is one of the artistic giants of the 20th century. His many original creations included landscapes, portraits and large murals created in both Mexico and the United States. Rivera ventured into many styles-cubism, naturalism and narrative realism-with great success. Rivera’s murals build on those of the Renaissance, pre-historic and colonial civilizations of Mexico. Biological and medical topics and their history form an important concern in Rivera’s work, present in many of his murals in a highly informative and creative manner. His two History of Cardiology murals present an original and comprehensive account of the developments of this medical specialty from pre-historic to modern times. His History of Medicine in Mexico (The people demands health) mural is a creatively and vigorously fashioned and highly dynamic and synthetic vision of the relationships between pre-historic and modern medicine in Mexico and its social foundations. Medical topics such as vaccines and vaccination, embryology and surgery are inventively and accurately presented in the large mural, Detroit Industry. The trigger and impetus for the concern of Rivera for these topics of life and death, and the exceedingly ground-breaking way he presents them, appear to stem from his rational materialism, his concern for collective wellbeing, his belief in progress through scientific developments and political action and his commitment to understand Mexican and American history.

[Diego Rivera: a great master and a didactic and discerning medical historian]. / Diego Rivera: gran maestro y un didáctico y lúcido historiador de la medicina.

Diego Rivera is one of the artistic giants of the 20th century. His many original creations included landscapes, portraits and large murals created in both Mexico and the United States. Rivera ventured into many styles-cubism, naturalism and narrative realism-with great success. Rivera's murals build on those of the Renaissance, pre-historic and colonial civilizations of Mexico. Biological and medical topics and their history form an important concern in Rivera's work, present in many of his murals in a highly informative and creative manner. His two History of Cardiology murals present an original and comprehensive account of the developments of this medical specialty from pre-historic to modern times. His History of Medicine in Mexico (The people demands health) mural is a creatively and vigorously fashioned and highly dynamic and synthetic vision of the relationships between pre-historic and modern medicine in Mexico and its social foundations. Medical topics such as vaccines and vaccination, embryology and surgery are inventively and accurately presented in the large mural, Detroit Industry. The trigger and impetus for the concern of Rivera for these topics of life and death, and the exceedingly ground-breaking way he presents them, appear to stem from his rational materialism, his concern for collective wellbeing, his belief in progress through scientific developments and political action and his commitment to understand Mexican and American history.

[The Great European Georg Friedrich Nicolai: physician and pacifist. Berlin, Germany, 1874 - Santiago, Chile, 1964]. / El gran europeo Georg Friedrich Nicolai: médico y pacifista. Berlín, Alemania, 1874 - Santiago, Chile, 1964.

Georg Friedrich Nicolai (1874-1964) was a German physician and physiologist whose pacifism during the First World War led him in 1914 to cosign with W. J. Foerster, A. Einstein and O. Bueck a "Manifesto to the Europeans" against the entry of Germany into the war and the invasion of Belgium. As a result of this appeal and his strong pacifism, Nicolai lost his positions as cardiologist to the German royal family, professor at the University of Berlin and chief of laboratory at the Charite hospital also in Berlin, and was sent as a garrison physician in Graundenz, in today's Poland. There he began to write his book, The Biology of War. It managed to avoid censorship and was published in Leipzig in 1916. He was court-martialed in Danzig in 1916 but escaped to Denmark. Nicolai was reinstated to his faculty positions by the Weimar Republic after the war but was subsequently forced to emigrate from Germany to South America by the pressure of right wing student groups who accused him of being a deserter and a traitor. From 1922 to 1932 Nicolai lived in Argentina, and from 1932 until his death in 1964, in Chile. In this later country Nicolai was professor in the University of Chile and interacted with members of the Chilean intelligentsia, including the poets Vicente Huidobro, Gonzalo Rojas and Pablo Neruda. Through his friendship with Chilean psychiatrist Agustin Tellez, Nicolai influenced the development of phenomenological psychiatric school in Chile. The Chilean novelist Fernando Alegria compared him favorably with Robert J. Oppenheimer and Linus Pauling.

El gran europeo Georg Friedrich Nicolai: médico y pacifista. Berlín, Alemania, 1874 - Santiago, Chile, 1964 / The Great European Georg Friedrich Nicolai: physician and pacifist. Berlin, Germany, 1874 - Santiago, Chile, 1964

Georg Friedrich Nicolai (1874-1964) was a German physician and physiologist whose pacifism during the First World War led him in 1914 to cosign with W. J. Foerster, A. Einstein and O. Bueck a "Manifesto to the Europeans" against the entry of Germany into the war and the invasion of Belgium. As a result of this appeal and his strong pacifism, Nicolai lost his positions as cardiologist to the German royal family, professor at the University of Berlin and chief of laboratory at the Charite hospital also in Berlin, and was sent as a garrison physician in Graundenz, in today's Poland. There he began to write his book, The Biology of War. It managed to avoid censorship and was published in Leipzig in 1916. He was court-martialed in Danzig in 1916 but escaped to Denmark. Nicolai was reinstated to his faculty positions by the Weimar Republic after the war but was subsequently forced to emigrate from Germany to South America by the pressure of right wing student groups who accused him of being a deserter and a traitor. From 1922 to 1932 Nicolai lived in Argentina, and from 1932 until his death in 1964, in Chile. In this later country Nicolai was professor in the University of Chile and interacted with members of the Chilean intelligentsia, including the poets Vicente Huidobro, Gonzalo Rojas and Pablo Neruda. Through his friendship with Chilean psychiatrist Agustin Tellez, Nicolai influenced the development of phenomenological psychiatric school in Chile. The Chilean novelist Fernando Alegria compared him favorably with Robert J. Oppenheimer and Linus Pauling.

[Thoughts on the complex relationship between medicine and animals: a death prayer for a loyal cat]. / Meditación sobre la compleja relación entre medicina y animales: un responso para un gato fiel.

From its basis in the writings of the philosopher Peter Singer and the bioethical shortcomings of animal experimentation and animal husbandry, the animal rights movement has evolved into an important societal movement critical of animal experimentation in biomedical research. A lack of dialogue and transparency, an absence of understanding and an unreasonable radicalization of different positions regarding animal experimentation has frequently resulted in an adversarial relationship between some members of the scientific community and societal groups aggressively protecting animal rights. In response to this problem, both the bioethical regulations pertaining to biomedical experimentation with animals and the powers of animal care committees (IACUCs) have been strengthened. Careful analysis of the relevance of animal models to human conditions, replacement of these models with non-animal models when possible, adequate re-examination of existing knowledge before undertaking new experimental projects involving animals, and the improvement of methods to avoid animal stress and pain have further strengthened the bioethical basis of animal experimentation. To improve the ethical integrity of research conducted with animals, it is also necessary to increase the editorial scrutiny of the bioethical standards of potentially publishable research utilizing animals. Of note is also the recent use of animals in alternative animal associated therapies (AAT) to ameliorate several medical conditions. Education of the biomedical community, including students and professionals, and of societal groups concerned about this issue as well as directness and continuous dialogue among all the stakeholders are essential to insure the wellbeing of animals and the ethical integrity of biomedical research.

[Tuberculosis: steady dynamics between past and present to imagine the future]. / Tuberculosis: una dinámica continua entre el pasado y el presente, para imaginar el futuro.

Progress in understanding the biological processes that allow Mycobacterium tuberculosis to be a successful parasite have accelerated in the last twenty years. This progress has been stimulated by the return of tuberculosis (TB) as an important disease in industrialized countries, by its increase in emergent nations in the tail of population increases and poverty and by the spread of multiple drug resistant (MDR) and extensively drug resistant (XDR) M. tuberculosis as a result of treatment failures. Progress on M. tuberculosis biology has also been fueled by advances in microbiology and molecular biology, including molecular genetics, genomics, proteomics and in vitro and in vivo models of infection. The study of latency or dormancy, a phenomenon central to understanding the persistence of M. tuberculosis and the development of TB in individuals, its spread in human populations and the emergence of antibiotic-resistant/tolerant organisms, has been preferred targets for investigators in this area. In this manner, factors that trigger M. tuberculosis latency (e. g, hypoxia, nutrient starvation, NO exposure) have been characterized and the metabolic shifts to host lipid utilization, tolerance to antimicrobials and resistance to host immune mechanisms involved in latency have been determined. Similarly, genetic changes and the resulting antimicrobial mechanisms mediating the MDR and XDR states have been characterized and potential new vaccines that avoid reactivation from latency and infection are being developed. Despite this progress, and given the fact that effective anti tuberculosis therapy was developed and first introduced clinically at the end of the 1940s, there are now more cases of latent and active TB worldwide than ever before. This reinforces the concept of TB as a bacterial disease with strong social and economical! determinants which are presently stimulating increased transmission in many human groups, undermining diagnostics, treatment and prevention. It suggests that in a scenario of global economical crisis the struggle against TB will be weakened, unless efforts are included to alleviate poverty, decrease economic inequality, improve public health and allow democracy and political organization.

175 años de la National Library of Medicine, de los EE.UU. de NA: un tesoro científico y cultural digno de admiración / 175 years of the National Library of Medicine, of the Unites States of America: a scientific and cultural treasure worthy of admiration

The National Library of Medicine (NLM) of the United States of America, celebrates in 2011 its 175th anniversary. This Library, the largest biomedical library in the world, has a proud and rich history serving the health community and the public, especially since its transfer to the National Institutes of Health in Bethesda, Maryland, in 1968. It holds 17 million publications in 150 languages, and has an important collection of ancient and modern historical books as well as original publications of Vesalius and other founders of biomedicine. Its modern document collections illustrate the progress of medical sciences. These collections include laboratory notes from many scientists whose work forms the foundations of contemporary life sciences. The Library also provides several services for health research and for the public, including databases and services such as MedLine and BLAST. The NLM constantly strives to fulfill the information needs of its customers, whether scientists or the public at large. For example, as the Hispanic population of the Unites States has increased in recent years, the NLM has made larger and larger amounts of data available in Spanish to fulfill the health information needs of this population. NLM programs train professionals in library science and biomedical informatics and link biomedical libraries of 18 academic centers throughout the United States. The NLM funds competitive grants for training at the Library, organizing short instruction courses about library science and informatics, and writing books on health related matters including the history of medicine and public health. The NLM is managed and maintained by an outstanding and farsighted group of professionals and dedicated support staff. Their focus on serving and reaching both the biomedical community and the public at large has been crucial to its development into a world icon of biomedical sciences, information technology and the humanities.

Tuberculosis: una dinámica continua entre el pasado y el presente, para imaginar el futuro / Tuberculosis: steady dynamics between past and present to imagine the future

Progress in understanding the biological processes that allow Mycobacterium tuberculosis to be a successful parasite have accelerated in the last twenty years. This progress has been stimulated by the return of tuberculosis (TB) as an important disease in industrialized countries, by its increase in emergent nations in the tail of population increases and poverty and by the spread of multiple drug resistant (MDR) and extensively drug resistant (XDR) M. tuberculosis as a result of treatment failures. Progress on M. tuberculosis biology has also been fueled by advances in microbiology and molecular biology, including molecular genetics, genomics, proteomics and in vitro and in vivo models of infection. The study of latency or dormancy, a phenomenon central to understanding the persistence of M. tuberculosis and the development of TB in individuals, its spread in human populations and the emergence of antibiotic-resistant/tolerant organisms, has been preferred targets for investigators in this area. In this manner, factors that trigger M. tuberculosis latency (e. g, hypoxia, nutrient starvation, NO exposure) have been characterized and the metabolic shifts to host lipid utilization, tolerance to antimicrobials and resistance to host immune mechanisms involved in latency have been determined. Similarly, genetic changes and the resulting antimicrobial mechanisms mediating the MDR and XDR states have been characterized and potential new vaccines that avoid reactivation from latency and infection are being developed. Despite this progress, and given the fact that effective anti tuberculosis therapy was developed and first introduced clinically at the end of the 1940s, there are now more cases of latent and active TB worldwide than ever before. This reinforces the concept of TB as a bacterial disease with strong social and economical! determinants which are presently stimulating increased transmission in many human groups, undermining diagnostics, treatment and prevention. It suggests that in a scenario of global economical crisis the struggle against TB will be weakened, unless efforts are included to alleviate poverty, decrease economic inequality, improve public health and allow democracy and political organization.

[175 years of the National Library of Medicine, of the United States of America: a scientific and cultural treasure worthy of admiration]. / 175 años de la National Library of Medicine, de los EE.UU. de NA: un tesoro científico y cultural digno de admiración.

The National Library of Medicine (NLM) of the United States of America, celebrates in 2011 its 175th anniversary. This Library, the largest biomedical library in the world, has a proud and rich history serving the health community and the public, especially since its transfer to the National Institutes of Health in Bethesda, Maryland, in 1968. It holds 17 million publications in 150 languages, and has an important collection of ancient and modern historical books as well as original publications of Vesalius and other founders of biomedicine. Its modern document collections illustrate the progress of medical sciences. These collections include laboratory notes from many scientists whose work forms the foundations of contemporary life sciences. The Library also provides several services for health research and for the public, including databases and services such as MedLine and BLAST. The NLM constantly strives to fulfill the information needs of its customers, whether scientists or the public at large. For example, as the Hispanic population of the Unites States has increased in recent years, the NLM has made larger and larger amounts of data available in Spanish to fulfill the health information needs of this population. NLM programs train professionals in library science and biomedical informatics and link biomedical libraries of 18 academic centers throughout the United States. The NLM funds competitive grants for training at the Library, organizing short instruction courses about library science and informatics, and writing books on health related matters including the history of medicine and public health. The NLM is managed and maintained by an outstanding and farsighted group of professionals and dedicated support staff. Their focus on serving and reaching both the biomedical community and the public at large has been crucial to its development into a world icon of biomedical sciences, information technology and the humanities.

[The roles that the environment, the sanitary conditions, the epidemiology and vaccines play in the challenge of infectious diseases]. / Los roles del ambiente, de la higiene, de la epidemiología y de las vacunas en el desafío de las enfermedades infecciosas.

This commentary uses a recent article in the press about the failure of the Gates Foundation's plans to eradicate poliomyelitis in Asia and Africa as a basis for discussing the often limited historical role that vaccines have played in controlling many infectious diseases when compared to increases in living standards. A recent book on the Epidemic Intelligence Service of the Centers for Disease Control and Prevention, USA, is used to illustrate the importance of epidemiological surveillance and public health laboratories in past and present efforts to control infectious diseases. On the basis of these publications, the author discusses and proposes solutions for some of the shortcomings of the Chilean sanitary services demonstrated when dealing with a recent epidemic of more than 26, 000 cases of acute diarrhea in the Northern Chilean city of Antofagasta.