Los inicios de la cardioangiología mexicana en los albores de la Academia Nacional de Medicina / The beginning of Mexican cardiology in the springtime of the Mexican National Academy of Medicine

Resumen La Academia Nacional de Medicina se fundó hace 141 años, durante la intervención francesa. A la sombra de la flamante corporación, se dieron los primeros pasos de la cardioangiología mexicana tanto en el campo médico como en el quirúrgico. Después de la desintegración del segundo imperio siguieron los adelantos médicos y quirúrgicos de dicha disciplina. Las publicaciones correspondientes figuran en los primeros volúmenes de la "Gaceta Médica de México", órgano de la Academia, la cual sigue publicándose en nuestros días. Estos diferentes eslabones permitieron el surgimiento de la verdadera especialidad cardiológica en los años 40 del siglo XX, gracias a la clarividencia del Maestro Ignacio Chávez, padre de la cardiología mexicana. Como ejemplos de la aplicación de criterios epistemológicos en los dominios de la cardioangiología, se citan la construcción del esfigmomanómetro de Riva-Rocci en la Italia del siglo XIX y la introducción de la llamada terapéutica metabólica de ciertas cardiopatías en el México contemporáneo del siglo XX.

Abstract The National Academy of Medicine was founded 141 years ago during the French intervention. Under the sponsorship of this brand-new medical association, Mexican cardioangiology took its first steps in the medical and surgical field as well. After the falling of the second empire, the medical and surgical advances of this discipline continued. The corresponding publications appeared in different volumes of the "Gaceta Médica de México"; at present journal of the Academy still published in our time. These steps permitted the development of the true cardiologic speciality during 40s of the twentieth century, due to the vision of Professor Ignacio Chávez, father of Mexican cardiology. Some examples of application are the epistemologic criteria in cardiologycal domains such as the conception of Riva-Rocci's sphygmomanometer in Italy in the nineteenth century and the so-called cardiac metabolic therapy in Mexico of our time, are included.

[From the medieval hospitals hospices to modern National public Health Institutes]. / De los hospitales u hospicios a los modernos institutos nacionales de salud.

Since the most ancient times, hospital constructions and progresses in the clinical practice advanced pari passu. We can find exampless of this statement in Greek regions as well as in Greek citie overseas. Thus, during the renaissance, great figures ot that time converged in Italy: The genius Leonardo da Vinci (1452-1519) and Leon Battista Alberti (1404-1472), a humanist and innovator of architecture. Michelangelo Buonarroti (1475-1564) and his contemporany artists performed anatomical dissection to perfect their art by studying the human body. Anatomical studies flourished at the University of Padua, driven by the Flemish Master. Based on the rigorous study of the anatomical substrate, the studies on the function of the already known organic structures excelled in the xvii century. That century started with the revelation of the major blood circulation by the British physician William Harvey, alumni of the University of Padua, and continued with the description of the minior or pulmonary circulation by ancient or contemporany authors and of the peripheral connections between the arterial and the venous system (Marcelo Malpighi, 1661). All these researchers, and others, were membres of the University of Padua, were the beneficial influence of the teachings of Galileo persisted. In the following centuries, together with the embryological and normal anatomy, the pathological anatomy, systematized by G.B. Morgani, became the cornerstone of the clinical practice. The model of the ancient hospitals evolved to ward the National Institutes of Health in Mexico fostered by Dr. Ignacio Chávez.

[The beginning of Mexican cardiology in the springtime of the Mexican National Academy of Medicine]. / Los inicios de la cardioangiología mexicana en los albores de la Academia Nacional de Medicina.

The National Academy of Medicine was founded 141 years ago during the French intervention. Under the sponsorship of this brand-new medical association, Mexican cardioangiology took its first steps in the medical and surgical field as well. After the falling of the second empire, the medical and surgical advances of this discipline continued. The corresponding publications appeared in different volumes of the "Gaceta Médica de México"; at present journal of the Academy still published in our time. These steps permitted the development of the true cardiologic speciality during 40s of the twentieth century, due to the vision of Professor Ignacio Chávez, father of Mexican cardiology. Some examples of application are the epistemologic criteria in cardiologycal domains such as the conception of Riva-Rocci's sphygmomanometer in Italy in the nineteenth century and the so-called cardiac metabolic therapy in Mexico of our time, are included.

La cardiología en la obra anatomopatológica de G.B. Morgagni / Cardiology in the Morgagni's anatomo pathological work

En el siglo XVIII, bajo el influjo del <

In the XVIII century, under the influence of the <

[On the evolution of scientific thought]. / En torno a la evolución del pensamiento científico.

The Nominalists of the XIV century, precursors of modern science, thought that science's object was not the general, vague and indeterminate but the particular, which is real and can be known directly. About the middle of the XVII Century the bases of the modern science became established thanks to a revolution fomented essentially by Galileo, Bacon and Descartes. During the XVIII Century, parallel to the development of the great current of English Empiricism, a movement of scientific renewal also arose in continental Europe following the discipline of the Dutch Physicians and of Boerhaave. In the XIX Century, Claude Bernard dominated the scientific medicine but his rigorous determinism impeded him from taking into account the immense and unforeseeable field of the random. Nowadays, we approach natural science and medicine, from particular groups of facts; that is, from the responses of Nature to specific questions, but not from the general laws. Furthermore, in recent epistemology, the concept that experimental data are not pure facts, but rather, facts interpreted within a hermeneutical context has been established. Finally a general tendency to retrieve philosophical questions concerning the understanding of essence and existence can frequently be seen in scientific inquiry. In the light of the evolution of medical thought, it is possible to establish the position of scientific medicine within the movement of ideas dominating in our time.

Contribuciones de la electrovectocardiografía mexicana / Contributions of the Mexican electrovectorcardiography

Se relatan las etapas principales del largo camino que llevó a la estructuración de la electrovectocardiografía moderna a partir de las bases establecidas por Willem Einthoven (1860-1927), catedrático de fisiología en la Universidad de Leyden (Holanda), quien presentó su electrocardiógrafo de cuerda en 1901, tiempo en que se llegó a asentarse la electrovectocardiografía mexicana gracias a los desvelos del Dr. Demetrio Sodi Pallares, discípulo de F.N. Wilson en Ann Arbor. El Dr. Sodi creó la Escuela Mexicana, la cual tuvo primacía en dicho campo y fue reconocida internacionalmente durante algunas décadas. Tal hecho se debe al enfoque racional y no empírico de la exploración eléctrica del corazón, gracias a la aplicación del procedimiento galileano de carácter inductivodeductivo. Allí fue posible llegar a través del estudio de los procesos de despolarización y repolarización miocárdicas, en condiciones normales y con bloqueo de rama, realizado por el Dr. Gustavo A. Medrano y sus colaboradores. En la década de 1950, se estudiaron las manifestaciones electrovectocardiográficas del infarto miocárdico no complicado y complicado por trastornos del ritmo y de la conducción, así como de los bloqueos proximales o tronculares y distales o periféricos. Los discípulos actuales de dicha Escuela se ocupan ahora de problemas de arritmología cardiaca con resultados muy prometedores.

We narrate the main stages of the long journey that led to the structuring of modern electrovectorcardiography based on the fundamentals established by Willem Einthoven (1860-1927), who held the physiology chair of the Leyden University (The Netherlands), and presented his string electrocardiograph in 1901. The Mexican electrovectorcardiography became strong thanks to the endeavor of Dr. Demetrio Sodi Pallares, a disciple of F.N. Wilson of Ann Arbor. Dr. Sodi Pallares founded the Mexican School of Electrovectorcardiography, which was a cornerstone in the field and was widely recognized internationally for several decades. This fact is due to the rational and not empirical approach to the electrical exploration of the heart, thanks to the application of the inductive-deductive Galilean procedure. It was then possible to obtain these results, through the study of myocardial depolarization and repolarization processes, under normal conditions and with bundle branch block, performed by Dr. Gustavo A. Medrano and collaborators, in the 1950 decade. The electrovectorcardiographic manifestations of the non complicated myocardial infarct were the object of studies, as well as those of the infarction complicated with rhythm and conduction disorders. Likewise, proximal and distal or peripheral blocks were studied. The current disciples of that School are now studying of cardiac arrhythmias with promising results.

La cardiología nació con la ciencia médica moderna / Cardiology was born with the modern medical science

La ciencia médica moderna nació en la época posrenacentista y comenzó a afianzarse a mediados del siglo XVII por obra de físicos, fisiólogos y biólogos, quienes eran discípulos directos o indirectos de Galileo. El descubrimiento de la circulación sanguínea por Harvey se considera actualmente como el único adelanto en fisiología de principios del siglo XVII, comparable a los avances contemporáneos de las ciencias físicas. La historia de esta hazaña podría escribirse fácilmente desde el punto de vista del avance progresivo del conocimiento. Se ha afirmado con toda justicia que el descubrimiento de la circulación de la sangre es la primera explicación adecuada de un proceso orgánico y el punto de partida del camino hacia la fisiología experimental. Puede aseverarse, por lo tanto, que la ciencia médica moderna no surgió de manera subitánea y global, sino que se estructuró gradualmente desde mediados del siglo XVII, por la senda seguida por William Harvey, a la luz del pensamiento de Galileo.

Modern medical science was born in the post-Renaissance age and began to consolidate towards the middle of the XVII century thanks to physicists, physiologists and biologists, most of whom were direct or indirect pupils of Galileo. The discovery of blood circulation by Harvey is now considered the only progress in physiology at the beginning of the XVII century, comparable to the current advances seen in physical sciences. The history of this exploit could be written from view point of the progressive advance in knowledge. In his experiments, Harvey referred to the authentic not imaginary experiments, and put forward irrefutable quantitative arguments. We can therefore claim that his discovery of blood circulation was the first proper explanation of an organic process and the starting point leading to experimental physiology. So it seems justified to assert that modern medical science did not all rise suddenly, but was gradually structured starting from the middle of the XVII century following the path traced by William Harvey in light of Galileo's thought.

[Cardiology in the Morgagni's anatomo pathological work]. / La cardiología en la obra anatomopatológica de G.B. Morgagni.

In the XVIII century, under the influence of the "systematic spirit", characteristic of the Enlightenment age, pathological anatomy was systematized in the Morgagni's fundamental treatise De sedibus et causis morborum per anatomen indagatis, published as letters in 1761. Certain biographical data of the author are reported here as well as some his more important contributions to cardiology such as the Morgagni's, Adams', Stokes' syndrome. His points of view on sudden death and his observations on post-infarct myocardial rupture, are related also. In his global evaluation of these facts, the speculative approach always predominates. Indeed, in these anatomist's works, we find a good example of the application of epistemologic principles to the medical field.

[The tobacco in the light of history and medicine]. / El tabaco a la luz de la historia y la medicina.

Super trajectory is reported of tobacco from his first meeting with the European man October 15, 1492. This plant was known in Europe by the publications of the Sevillan physician Nicolas Monardes (1574), the relations of friar Andrés Thevet (1575) and the famous botanical treatise of Charles de l'Écluse (1605). The Swedish botanist Karl Linnaeus inclused tobacco plant in the family Solanaceae and deleted from this group other plants that were intermixed with it. Its botanical name (Nicotiana tabacum) derived from the surname of the French ambassador to Portugal, Jean Nicot of Villemain, who in 1560 sent it to the Queen Mother of France Cathérine de Medicis. The use of snuff quickly spread throughout Europe, were it became common in the seventeenth century. By the late eighteenth century in New Spain, in addition to cigars, cigarettes and due in packs of different content the tobacco is concocted and price. The preparation of the different presentations of snuff, tobacco made in factories in the capital and several provincial cities, originated in 1796 the creation of the first kindergartens for the children of those working in them. This thanks to the successful initiative of then viceroy Marquis of Branciforte. But contrary to the forecasts of Father F. J. Clavijero and Mrs. F. Calderón de la Barca, wife of the first Spanish diplomatic representative to the government of Mexico, the use of tobacco, with the passage of time, far from waning has been increasing in every social class. And now, more than men, women are smokers.

Obras cardiológicas en la Nueva España y en el primer siglo de la independencia / Cardiology writings in New Spain and in the first century of the Independent period

Se mencionan las principales obras de carácter cardioangiológico presentes en las bibliotecas públicas y particulares novohispanas desde el siglo XVI hasta el primer siglo de la independencia nacional. Estas van desde los verdaderos incunables, libros impresos hasta el año 1500, a los tratados de fisiología publicados por autores europeos en los siglos XVII y XVIII así como a los textos de cardiología de autores franceses de la primera mitad del siglo XIX. Tales obras figuraban en los catálogos de la biblioteca universitaria, fundada en 1762, así como en la biblioteca de un maestro de obras de la catedral metropolitana del siglo XVII y en la de un médico del siglo XVIII, el Dr. José Ignacio Bartolache. Este, a su vez, editó durante una breve temporada, desde octubre de 1772 hasta febrero de 1773, un periódico científico-médico: el «Mercurio Volante¼, primera publicación científica hebdomadaria de América. En bibliotecas novohispanas se hallaban asimismo varias revistas científicas europeas como la editada por el abate Rozier, en la cual aparecieron los escritos iniciales de Lavoisier. Los intercambios de ideas y conocimientos aquí señalados atestiguan el interés siempre vivo de elementos novohispanos selectos para los extensos y apasionantes dominios de la cardioangiología.

The first writings on cardioangiology found in public and private libraries of New Spain from the XVI century to the first century of the Independent period in Mexico are mentioned. These go from the truly incunabular ones, books printed until the year 1500, to the physiology treatises published by European authors in the XVII and XVIII centuries, as well as the cardiology texts from French authors of the first half of the XIX century. The writings were depicted in the catalogs of the University library, founded in 1762, as well as in the library of a master builder of the Metropolitan Cathedral of the XVII century and that of a physician of the XVIII century, Dr. José Ignacio Bartolache. The latter, in turn, edited for a brief period, from October 1772 to February 1773, a scientific-medical journal, «Mercurio Volante¼, which was the first scientific-hebdomadary publication in the Americas. Likewise, in the libraries of New Spain, several European scientific journals could be found, such as the one edited by the abbot Rozier, in which the initial writings of Lavoisier appeared. The exchange of ideas and knowledge, pointed out herein, attests to the always enthused interest of given individuals from New Spain on the boundless and passionate domains of cardioangiology.

[Cardiology was born with the modern medical science]. / La cardiología nació con la ciencia médica moderna.

Modern medical science was born in the post-Renaissance age and began to consolidate towards the middle of the XVII century thanks to physicists, physiologists and biologists, most of whom were direct or indirect pupils of Galileo. The discovery of blood circulation by Harvey is now considered the only progress in physiology at the beginning of the XVII century, comparable to the current advances seen in physical sciences. The history of this exploit could be written from view point of the progressive advance in knowledge. In his experiments, Harvey referred to the authentic not imaginary experiments, and put forward irrefutable quantitative arguments. We can therefore claim that his discovery of blood circulation was the first proper explanation of an organic process and the starting point leading to experimental physiology. So it seems justified to assert that modern medical science did not all rise suddenly, but was gradually structured starting from the middle of the XVII century following the path traced by William Harvey in light of Galileo's thought.

[Contributions of the Mexican electrovectorcardiography]. / Contribuciones de la electrovectocardiografía mexicana.

We narrate the main stages of the long journey that led to the structuring of modern electrovectorcardiography based on the fundamentals established by Willem Einthoven (1860-1927), who held the physiology chair of the Leyden University (The Netherlands), and presented his string electrocardiograph in 1901. The Mexican electrovectorcardiography became strong thanks to the endeavor of Dr. Demetrio Sodi Pallares, a disciple of F.N. Wilson of Ann Arbor. Dr. Sodi Pallares founded the Mexican School of Electrovectorcardiography, which was a cornerstone in the field and was widely recognized internationally for several decades. This fact is due to the rational and not empirical approach to the electrical exploration of the heart, thanks to the application of the inductive-deductive Galilean procedure. It was then possible to obtain these results, through the study of myocardial depolarization and repolarization processes, under normal conditions and with bundle branch block, performed by Dr. Gustavo A. Medrano and collaborators, in the 1950 decade. The electrovectorcardiographic manifestations of the non complicated myocardial infarct were the object of studies, as well as those of the infarction complicated with rhythm and conduction disorders. Likewise, proximal and distal or peripheral blocks were studied. The current disciples of that School are now studying of cardiac arrhythmias with promising results.

[Cardiology writings in New Spain and in the first century of the Independent period]. / Obras cardiológicas en la Nueva España y en el primer siglo de la independencia.

The first writings on cardioangiology found in public and private libraries of New Spain from the xvi century to the first century of the Independent period in Mexico are mentioned. These go from the truly incunabular ones, books printed until the year 1500, to the physiology treatises published by European authors in the xvii and xviii centuries, as well as the cardiology texts from French authors of the first half of the xix century. The writings were depicted in the catalogs of the University library, founded in 1762, as well as in the library of a master builder of the Metropolitan Cathedral of the xvii century and that of a physician of the xviii century, Dr. José Ignacio Bartolache. The latter, in turn, edited for a brief period, from October 1772 to February 1773, a scientific-medical journal, «Mercurio Volante¼, which was the first scientific-hebdomadary publication in the Americas. Likewise, in the libraries of New Spain, several European scientific journals could be found, such as the one edited by the abbot Rozier, in which the initial writings of Lavoisier appeared. The exchange of ideas and knowledge, pointed out herein, attests to the always enthused interest of given individuals from New Spain on the boundless and passionate domains of cardioangiology.

En torno a los orígenes, la evolución y las irradiaciones de la cardiología mexicana / About the origin, evolution and irradiation of the Mexican cardiology

La cardiología mexicana se inició en el siglo XIX con las primeras hazañas de cirujanos y médicos relacionados con las academias locales y con la Escuela de Medicina, creada en 1833 por iniciativa del Dr. Valentín Gómez Farías. Así, el Dr. Manuel Carpio, primer catedrático de Fisiología en dicha Escuela, tradujo y publicó en 1823 el artículo Sobre el uso del pectoriloquo del médico francés Marat, y realizó algunos experimentos sobre la actividad motora del corazón. En la época del segundo imperio, el médico austriaco Samuel von Basch, miembro correspondiente de nuestra Academia de Medicina, realizó estudios que le llevaron a definir la existencia de la hipertensión arterial esencial, por él denominada «aterosclerosis latente¼. Más aún, regresado a su patria, ideó en 1880 un esfigmomanómetro de columna de mercurio que sirvió de modelo al instrumento construido por Scipione Riva-Rocci y presentado en 1896. Y, en nuestra época, Demetrio Sodi Pallares sistematizó una modalidad de terapia metabólica, que anunció en 1961 bajo la denominación de terapéutica polarizante, i.e. capaz de repolarizar las células cardiacas parcialmente despolarizadas por efecto de la hipoxia o por agresiones directas. De este modo se dieron los primeros pasos en México por derroteros prometedores de muchos éxitos futuros y se inició la gran aventura de la cardioangiología mexicana.

The Mexican cardioangiology started in the nineteen century thanks to first endeavors of surgeons and physicians related to local academies and to School of Medicine, established in 1833 by Dr. Valentin Gómez Farías. Dr. Manuel Carpio, the future first head of department of physiology in this school, translated to Spanish language and published, in 1823, the article On pectoriloquo of the French physician Marat and later performed some experiments on the heart' motion. During the Secont Empire (1864-1867), the physician Samuel von Basch performed studies to define the arterial hypertension, called by him "latent atherosclerosis", i.e. the "essential hypertension". Once he had returned to his country, he invented in 1880, a sphygmomanometer of mercury column, that was the model for the instrument constructed by the Italian physician Scipione Riva-Rocci and presented in 1896. In our time, Dr. Demetrio Sodi Pallares systematized a metabolic therapy called "polarizing therapy", i.e. capable of repolarizing the heart's cells partly depolarized due to hypoxia or direct aggressions. These were the first steps in Mexico on the way to a promising medicine starting and the great adventure of Mexican cardiology.

[About the origin, evolution and irradiation of Mexican cardiology]. / En torno a los orígenes, la evolución y las irradiaciones de la cardiología mexicana.

The Mexican cardioangiology started in the nineteen century thanks to first endeavors of surgeons and physicians related to local academies and to School of Medicine, established in 1833 by Dr. Valentin Gómez Farías. Dr. Manuel Carpio, the future first head of department of physiology in this school, translated to Spanish language and published, in 1823, the article On pectoriloquo of the French physician Marat and later performed some experiments on the heart' motion. During the Secont Empire (1864-1867), the physician Samuel von Basch performed studies to define the arterial hypertension, called by him "latent atherosclerosis", i.e. the "essential hypertension". Once he had returned to his country, he invented in 1880, a sphygmomanometer of mercury column, that was the model for the instrument constructed by the Italian physician Scipione Riva-Rocci and presented in 1896. In our time, Dr. Demetrio Sodi Pallares systematized a metabolic therapy called "polarizing therapy", i.e. capable of repolarizing the heart's cells partly depolarized due to hypoxia or direct aggressions. These were the first steps in Mexico on the way to a promising medicine starting and the great adventure of Mexican cardiology.