It was the year 1812 , exactly 100 years before the Titanic sank over the Atlantic , a small bulletin from Massachusetts General Hospital was released . It later on became the single most important journal for the medical community. The appearance of an article about angina pectoris in the inaugural issue , reiterates the importance of cardiology even in those days of primitive medical care .
The volume. 1 : No. 1 issue of NEJM egan with a classical and critical observation of angina pectoris written by Jhon Warren .
http://www.nejm.org/doi/pdf/10.1056/NEJM181201010010101
The first issue of NEJM . . . Witness to 200 years of medical excellence
Those were the days when angina was treated with tincture opium and Fowler solution (Arsenic potash ) .They can be termed as height of inappropriateness and also condemnable acts . . . is it not ?
200 years later . . . in 2012 what do you think has changed , in terms of appropriateness of management of angina pectoris ?
What a surprise , two centuries later , even as we are treating angina in hi-tech cath labs with bio-degradable stents and metabolic modulators , bulk of our population is grappling with inappropriate therapy for angina pectoris .
Today ,patients are subjected to questionable modalities in the management of CAD , which the following paper tries to expose !
Keeping the inappropriate flag high . . .200 years later in 2012
What a way to progress in Medicine ! The reason for this “200 year old ailment” is attributed to extreme scarcity of common sense !
( A study , which says regular exercise can be as good as PTCA in multivessel CAD , would sound as a “nonsense article” for most cardiologists of current generation !)
Finale
When we look at human history , where billions lived ( and continue to live ) in this age old planet , it would appear a trivial matter whether you treat angina pectoris with Tincture opium / Arsenical potash or Prasugrel / Rosuvsatin . . .
Whatever be the scientific advancement the ultimate outcome on human health will depend on how we apply it. So, all young medical fellows beware of this !
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Dr.S.Venkatesan MD 