Public health
Hey Doc
medical headlines and memories of the good old days of medicine
Monday, July 28, 2025
Sunday, July 27, 2025
Ivermectin lowers malaria rate
Malaria reduction in Kenya In Kwale County, Kenya, children who received ivermectin experienced a 26% reduction in malaria infection incidence compared to those who received albendazole, the control drug used in the study. The trial involved over 20,000 participants and more than 56,000 treatments, demonstrating that ivermectin significantly reduced malaria infection rates -- particularly among children living further from cluster borders or in areas where drug distribution was more efficient. Moreover, the safety profile of ivermectin was favorable, with no severe drug-related adverse events and only mild, transient side effects already seen with ivermectin in campaigns against neglected tropical diseases. "We are thrilled with these results," says Carlos Chaccour, co-principal investigator of the BOHEMIA project and ISGlobal researcher at the time of the study. "Ivermectin has shown great promise in reducing malaria transmission and could complement existing control measures. With continued research, ivermectin MDA could become an effective tool for malaria control and even contribute to elimination efforts," Chaccour, who is now a researcher at the Navarra Centre for International Development at the University of Navarra, adds. "These results align with the World Health Organization's (WHO) criteria for new vector control tools," states Joseph Mwangangi, from the KEMRI-Wellcome Trust Research Programme. "The findings suggest that ivermectin MDA could be a valuable complementary strategy for malaria control, particularly in areas where mosquito resistance to insecticides is a growing concern,"
Wednesday, July 23, 2025
organ transplant scandal gets publicity thanks to RFK Jr
This was supposed to be an urban legend, but I have been told of many cases by people who said they heard it from someone who heard it from someone, which often means it wasn't happening.
This video is from a Catholic network, which is not a hysterical anti science site, since Catholics recognize brain death as death. But the cardiac death criteria which has been used in receent years, is the real problem, since the brain is still alive and is a fuzzier criteria since if the heart stops too long the organs are unusable, so often there is a rush to declare death.
here is the information off of a twitter post which for some reason I am unable to post:from the HHS:The US Department of Health and Human Services under RFK Jr. is announcing a major initiative to overhaul the organ transplant system after an HRSA investigation uncovered significant problems: HRSA examined 351 cases where organ donation was authorized, but ultimately not completed. It found: •103 cases (29.3%) showed concerning features, including 73 patients with neurological signs incompatible with organ donation. •At least 28 patients may not have been deceased at the time organ procurement was initiated—raising serious ethical and legal questions. •Evidence pointed to poor neurologic assessments, lack of coordination with medical teams, questionable consent practices, and misclassification of causes of death, particularly inoverdose cases.
30 years ago, when bioethicist Dr Caplan went for his Pennsylvania driver's license, when he asked the clerk how to add organ donor to his license, she cautioned him: Don't sign it or they will let you die. He wrote a letter about this to JAMA (sorry no date or link). But I know that I have heard too many people tell me of anecdotes they heard from someone who heard it from someone that a person was waking up when they tried to take their organs.
Trust is already being destroyed in the medical profession, and this will not help.
Saturday, July 19, 2025
WHO Treaty
the argument is that of course this doesn't overcome national soverieignty, but as I quoted in an earlier post, once there is a rule like this in the UN laws, if a government tries to refuse to go along with it, there are powerful lobbies to pressure you to follow the law.
---------------update: Powerlineblog quotes an article from Breitbart about how international organizations will pressure/control governments that don't go along with the Climate treaty stuff that they refused to sign:
The International Court of Justice (ICJ) in The Hague on Wednesday will reveal a host of proposed penalties the U.N. can implement against countries that defy climate diktats. Activists hope the legal opinion from the ICJ judges will have far-reaching consequences in the fight against “climate change”….
Wednesday, July 2, 2025
Carbon monoxide poisoning
Carbon monoxide is a silent killer. And this case on Homicide Hunter starts out as a ritual suicide and an investigation finally revealed it was an accident in venting the furnace because the landlord did a DIY instead of paying for an expert.
smallpox and... yogurt in ancient Japan
reading the Tale of Genji has made me curious about that era.
I am working my way through this book because it gives information on disease in Haien period Japan
before the Haien period, there was a lot of trade and immigration from Korea and even China, and this included the introduction of diseases and Buddhism.
Buddhism and an unknown disease that caused an epidemic, probably smallpox arrived at the same time, but it wasn't until 200 years later in 735 that a verified smallpox epidemic depopulated Japan and much of the aristocracy (25 percen mortality).
and I ran into a quote describing the household of a rich guy during the Haien period, whose servants include.... a yogurt maker.
Yogurt? as in milk based yogurt? Yup. Apparently along with small pox and sutras, yogurt and ghee came to Japan with Buddhist monks. After all, Buddhism was originally an Indian religion, and yogurt and ghee were commonly used in India.
the use of milk products died out in Japan, but continued in some parts of China. But milk products continued to be used as medicine.
Dairy was also known to early Chinese civilization. Huang (2002, p. 809) states that “oracle-bone and bronze inscriptions suggest that the collecting of milk from cows and mares was not an unfamiliar art during the Shang Dynasty (ca. 1520–1030 b.c.)”. We might ask the extent to which dairy was consumed not only in China in later centuries—particularly during the first millennium CE—but also whether contemporary Japan had a comparable industry. Buddhism, medicine, astronomy and the Chinese script were transmitted from the mainland to Japan, but what about cattle rearing and the production of dairy products? The role of dairy in premodern China is slowly becoming recognized today, despite some past preconceived notions that peoples in East Asia seldom enjoyed milk and cheese until the twentieth century. Miranda Brown recently published a study of a text from 1504 that includes a recipe for cheese-stuffed pasta by a certain Mr. Song. The use of cheese in Chinese culture, particularly in premodern periods, is generally not recognized today by historians of food
there are several papers out there about trade between China Korea and Japan, which introduced Buddhism and disease among other things. This one states;
Smallpox was first introduced to the islands of Japan by merchants and Buddhist missionaries from the Korean kingdom of Paekche in the sixth century CE. Once it reached the shores of Japan, smallpox did not disappear but emerged in waves that were sometimes manageable and were at other times catastrophic. In 735, a second smallpox epidemic afflicted Japan, reducing the population by 30 percent and resulting in labor shortages and declines in agricultural production and tax revenue for the court
and periodic epidemics continued: The author of Tale of Genji lost her husband to small pox. But there is not a lot of information about epidemics in either that novel or the diaries and books of other court ladies, nor is there any mention of smallpox scars....
in Genji several deaths are described: Post partum eclampsia death of Genji's wife (such seizures can occur up to six weeks post partum), the lingering death of the seducer of the Third princess that sounds like Beri beri, and the lingering death of Murasaki, probably from tuberculosis.
But no mention of yogurt or ghee/clarified butter.
so how was smallpox treated?
At the height of the epidemic, Emperor Shomu consulted his officials at the Bureau of Medicine. They recommended various remedies and guidelines, including a prohibition against drinking water, an encouragement to eat boiled rhubarb, and a recommendation to apply powdered silkworm cocoons to boils.
When these guidelines did not help to quell the disease, Emperor Shomu ordered Buddhist monks and nuns to read sutras to the afflicted and prayers to kami, whom he interpreted to be deities that were part of the Buddhist universe.
....
....
So what does Grok say
about all of this?
In Heian period Japan (794–1185), yogurt and butter were rare and valued mostly for their medicinal uses, mainly among the aristocracy and in Buddhist practices. Dairy was not widely consumed due to Buddhist prohibitions on animal products, but it held a special place in elite and religious contexts.
**Medicinal Yogurt**: A yogurt-like product called *raku* (possibly fermented milk) was documented in texts like the *Ishinpō* (984 CE), a medical treatise. It was considered a health-promoting food, used to aid digestion and treat illnesses, especially among nobles. Its use was influenced by Chinese medicine, where dairy was seen as beneficial for vitality. *Raku* was likely consumed in small amounts by the elite, as dairy production was limited and tied to imperial or aristocratic estates.[](https://www.incrediblediscourse.com/post/dairy-in-japan)[](https://traditional-foods.maff.go.jp/en/bunrui/chikusankakohin)
**Medicinal Butter**: Butter, referred to as *so* or *gyuuraku*, was also a luxury item, primarily supplied to the imperial court, as noted in the *Engi Shiki* (927 CE). It was used medicinally to support health and digestion, often prescribed in Chinese-influenced medical practices. Butter was sometimes processed into forms like *hakugyūraku* (a condensed milk product) for its nutritional value. Its production was overseen by the Bureau of Medicine, showing its link to health rather than everyday diet.[]>
(https://www.incrediblediscourse.com/post/dairy-in-japan)[]
(https://www.thechinastory.org/dairy-the-deep-historical-link-between-china-and-japan/)[](https://gochisohistory.com/cheese-dairy-in-japan/)
**Buddhist Context**: Dairy, including yogurt and butter, was used in Buddhist rituals, inspired by Indian traditions via China. Texts like the *Vairocanābhisambodhi* mention dairy in offerings, such as yogurt rice or butter in magical rituals. While direct evidence of ritual use in Japan is limited, the influence of Chinese Buddhism suggests dairy was likely part of similar practices, especially in aristocratic temples.[](https://www.incrediblediscourse.com/post/dairy-in-japan)[](https://www.thechinastory.org/dairy-the-deep-historical-link-between-china-and-japan/)
**Limitations**: Dairy was scarce, expensive, and mostly inaccessible to commoners. Its use declined toward the end of the Heian period as aristocratic power waned and Buddhist vegetarianism grew stronger, reducing dairy’s presence until the modern era.[](https://www.incrediblediscourse.com/post/dairy-in-japan)
In summary, yogurt and butter were elite, medicinal products in Heian Japan, tied to Chinese medical traditions and Buddhist rituals, with limited use beyond the aristocracy.
Thursday, June 26, 2025
Diptheria
all the cases of so-called “severe dengue” were relatively mild. Sanofi’s definition of “severe dengue” also contained much milder symptoms than other international definitions.
A lot of hysteria about measles vaccine in the USA, but I wondered why the autism epidemic blamed on measles vaccine waited 30 years to start causing problems. But never mind. Parents want answers. Hopefully RFKJr will figure it out.
Measles is rarely fatal in well nourished Americans, but it is highly fatal in Africa and Asia, where a lot of children have borderline malnutrition...
from Grok:
Diphtheria is extremely rare in the United States due to widespread vaccination. ... a few cases have been noted in recent years: - In 2012, one provisional case was reported. - In 2019, two cases were reported, the most recent data available from sources like Our World in Data (https://ourworldindata.org/grapher/diphtheria-cases-in-the-united-states) - A 2020 case report described a 33-year-old unvaccinated man in Georgia with respiratory diphtheria, likely linked to his recent incarceration and lack of childhood vaccinations.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC7753149/)[](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753149/) These cases are exceptions, often tied to unvaccinated or under-vaccinated individuals, international travel, or contact with travelers from areas where diphtheria is more common, like parts of Africa, Asia, or conflict zones. The disease remains under control in the U.S. thanks to high vaccination coverage with DTaP, Tdap, or Td vaccines.[](https://www.cdc.gov/diphtheria/about/index.html)[](https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/diphtheria)[](https://www.hhs.gov/immunization/diseases/diphtheria/index.html)
And there was a cure: Anti toxin.
Depending on the way it is treated, diphtheria is one of the least dangerous or one of the most dangerous diseases. It is one of the least dangerous when promptly treated with antitoxin; it is one of the most[8] dangerous when the antitoxin treatment is not given, or is delayed or insufficient.
In the days before we had antitoxin one out of every three children who had diphtheria died. Now, if antitoxin is used on the first or second day of the disease ninety-eight out of every hundred children recover. The sooner diphtheria is attended to the more certain is a cure.
The toxin is the reason for those tough membranes that cause choking.
Breathing problems. Diphtheria-causing bacteria may produce a toxin. This toxin damages tissue in the immediate area of infection — usually, the nose and throat. At that site, the infection produces a tough, gray membrane made up of dead cells, bacteria and other substances. This membrane can obstruct breathing.
there is also a real danger of myocarditis and neurological complications from the toxin produced by the germ.
Nowadays, there is treatment: antibiotics and anti toxin.
Alas, diphtheria is still present here in the Philippines, and seen in various Asian and African countries: right now there is an outbreak of diphteria in the Rohingye refugees in Bengladesh
Luckily, antibiotics will help stop the infection, but the problem is the toxin produced by the germ: For this we still use anti toxin. Here is Grok's answer to diphtheria before treatment available:
In the 19th and early 20th centuries, diphtheria was a major cause of death, especially in children, with mortality rates as high as 20-50% in some outbreaks.
....Antitoxin and antibiotics, developed later in the 1890s and 1940s respectively, drastically reduced mortality, but before these, diphtheria was a terrifying and often fatal illness.
when I first started medical school in the 1960s, we still had an infectious disease hospital in our city and outside there was a bell. We were told if a child came in choking from the membrane, they could be saved by immediate tracheostomy, so they would ring the bell and any doctor in the area would come to the ER and do it.
In Dr. Versghese's book The Covanant of water, there is a description of a child being saved from choking by one of the young protagonists who does a tracheostomy under supervision of a local doctor can't do it due to hand injury.
I am surprised that there isn't more descriptions of this in various historical dramas: Dr Quinn series had one episode, but not a lot of clinical details.
The history of treatment is here:
In 1890, an effective treatment for diphtheria – antitoxin – was discovered by Shibasaburo Kitasato and Emil von Behring in Germany...
more HERE.
it was made by giving the toxin to horses, starting with a small dose then increasing the dosage until the horse provided lots of antibodies, which then were removed and purified to give to people
Horse serums have a danger of severe allergic reactions that can be fatal, so now newer technology is used to produce antibodies.
Horses were given gradually increased doses of diphtheria toxins, and their bodies built up antitoxins (antibodies) to neutralize those toxins. The horses were only weakly affected by the toxins, yet their bodies were capable of producing large amounts of antitoxin serum. The horses were bled, and the antitoxin serum was harvested from the blood and processed. When given to a human diphtheria patient, the horse’s antibodies neutralized the toxins poisoning the patient. The Department’s laboratories had a stable of serum production horses with which they provided New York and other areas of the country with diphtheria antitoxin.
what brought the treatment to the attention of the public was the outbreak in Nome Alaska:
Balto, one of the dogs who carried the serum, became the poster child for publicizing that there was a treatment for sipheria, (but some purists correctly point out that Togo was actually the first dog to arrive with the serum)
Wikipedia article has a lot of details: not a one time delivery, but several deliveries of the needed vaccine.And Balto became the poster dog for those who risked their lives to save the children of Nome.
“Dedicated to the indomitable spirit of the sled dogs that relayed antitoxins 660 miles over rough ice, across treacherous waters, through Arctic blizzards from Nenana to the relief of stricken Nome in the winter of 1925.”