Chapter 3 - Meningitis, a Whirlpool of Death: Literary Reflections and Russian Cultural Beliefs

Meningitis is an inflammation of the meninges, the membranes that cover the central nervous system. The most frequent causes of the disease are viruses and bacteria. In the past, the disease was commonly referred to as “brain fever” or “brain inflammation,” and extreme temperatures, sun, rain, mental distress, and other factors were believed to be its potent triggers. By the beginning of the twentieth century, these beliefs faded away in the United States and most western European countries. In contrast, some of these archaic notions persist in Russia, where cold air, draft, wet hair, and failure to cover one\u27s head with a hat during winter are perceived as serious risks for contracting meningitis. These sentiments are reflected in the prose of Solzhenitsyn and other contemporary Russian authors. However, in the fictional literature of the nineteenth century, emotional or intellectual disturbances rather than the wrath of winter were portrayed worldwide as the most frequent cause of brain inflammation. Both physicians and laity blamed nervous breakdown or mental distress for the development of meningitis and the tragic deaths of the eminent Russian writer Gogol, talented poet Nadson, and heir to the Imperial throne Grand Duke Nicholas Romanov. Even in the twentieth century, esteemed Russian artists, including Pasternak, Paustovsky, and Roerich, highlighted this belief. Following the discovery of the infectious nature of meningitis, fictional depictions of the illness changed. While literary accounts of brain inflammation by the realists (e.g., Dostoevsky and Flaubert) were rather imprecise, the descriptions of the course and symptoms of meningitis by the modernists (e.g., Balmont, Hesse, and Huxley) became detailed and recognizable. Typically, the victim of the disease is a boy, and his imminent agony is preceded by immense suffering that devastates his parents. The dreadful experience of seeing children in the merciless clutches of meningitis had a profound personal effect on Maugham, Twain, and Russian philosopher Tikhomirov, changing their spiritual convictions. However, several authors, among them Avseenko, Davydov, Gazdanov, and Shmelyov, created uplifting stories of survival of the affliction. In this chapter, references to meningitis in the medical and fictional literature are explored through a cultural and historical prism, which may help readers to understand how and why this disease has held a special significance in the Russian psyche.https://nsuworks.nova.edu/hpd_medsci_faculty_books/1001/thumbnail.jp

Meningitis: Controversies and Understanding Etiology of the Disease in the 19th Century

meningitis, and how accurately medical literature reflects these historical developments. Background. Bacteriological discoveries in the last quarter of the 19th century brought rapid progress in understanding various infections including meningitis. Significant challenges and confusion surrounded early reports that implicated Salmonella species in producing meningeal inflammation. These studies escaped historical analysis. Methods. As part of this study, 65 original articles and numerous other sources that discuss 26 etiology of bacterial meningitis in the last quarter of the 19th century were critically reviewed. In addition, more than 50 case reports and reviews of the infection published after 1960 were investigated for historical accuracy. Results. Not a single article since 1960 honored German physicians Neumann and Schaeffer who described the earliest known case of typhoid meningitis with solid bacteriological evidence in 1887. Instead, a remark of a prominent Austrian pathologist Ghon made in 1907 is inaccurately referenced as the first report of Salmonella meningitis. The 1887 paper of Neumann and Schaeffer prompted reassessment of then existing erroneous assumptions about typhoid bacilli such as their inability to produce pus and cause infection without Peyer’s patches. It also promoted search for reliable methods in differentiation among strains of Salmonellae and Coli bacteria. Conclusion. Controversies sparked by early studies of typhoid meningitis stimulated efforts to improve knowledge about the pathological and bacteriological properties of Salmonellae. Acknowledgment of the pioneers in the battle against bacterial meningitis is long overdue

Austrian Pathologist Anton Ghon and Curious Cases of Namesake Misattribution in the Medical Literature: A Form of the Matthew Effect?

Objective. This study explored the origin of author-name misattribution of colleagues of Austrian researcher Anton Ghon and relevance of the Matthew effect as a contributing casual factor to these types of errors. Background. The term Matthew Effect derives from a quote in the Gospel of St. Matthew; “For to all those who have, more will be given, and they will have abundance; but from those who have nothing, even what they have will be taken away.” The term is used on occasions when a piece of research, an idea or a quotation gets associated or attributed to a more famous person rather than to its originator. Results. I have investigated two examples of erroneous substitution of original authors for a better known namesake in the medical literature. In the first example, the description of Moraxella catarrhalis has been misattributed to a publication of Ghon with prominent Prussian bacteriologist Richard Pfeiffer. In fact, Hermann Pfeiffer, a less prominent Austrian specialist, co-authored the paper. In the second example, description of the certain features of Clostridium chauvei was misattributed to the efforts of Ghon with Hans Sachs, another renowned bacteriologist. In fact, the real co-author of the paper was Milan Sachs, who is not well known. Omission of the first names of authors was common in citations early in the 20th century. Conclusion. Omission of the first names of authors underlies substitution of their names with more prominent namesakes. These examples can be seen as a peculiar form of the Matthew effect

Emotional Engagement And Movie Images: Laughing Matters In Lecturing?

Objective. To determine various forms, benefits and general principles underlying the use of film images during lectures in education of health care professionals. Background. Demonstration of motion pictures has been described as a method to facilitate learning of psychosocial and behavioral aspects of medicine. Application of movies or actors’ images for instruction in basic sciences has received little attention. In this research, I have focused on how to evoke a positive emotional engagement of students by infusing humor via cinematic images during lectures. Methods. Literature search on the topic has been performed. Students’ comments on the effect of movie images shown during my Physiology course were analyzed. The comments were obtained from evaluations completed by four different groups of students: Osteopathic Medicine, Dentistry, Optometry and Pharmacy. Results. Pictures from 16 movies were shown during lectures. Displaying actors’ images creates 1-2 minute transition intervals during lectures that help listeners to stay receptive to the complicated material, shift attention to the ideas and points to remember and build memorable associations between physiological concepts and clinical conditions. Movie titles can serve as effective punch lines in humorous transition to a new topic or in imposing an accent on a previously discussed topic. Students referred positively to certain Hollywood celebrities or movie titles. Their comments confirmed the engaging effect of actors’ images. Conclusion. Cinematic images can be used as effective elements of medical presentations that help to gain and hold audience attention, facilitate creative thinking and memory, and impart information in an enjoyable way

Emotional Engagement and Movie Images: Laughing Matters in Lecturing?

Objective. To determine various forms, benefits and general principles underlying the use of film images during lectures in education of health care professionals. Background. Demonstration of motion pictures has been described as a method to facilitate learning of psychosocial and behavioral aspects of medicine. Application of movies or actors’ images for instruction in basic sciences has received little attention. In this research, I have focused on how to evoke a positive emotional engagement of students by infusing humor via cinematic images during lectures. Methods. Literature search on the topic has been performed. Students’ comments on the effect of movie images shown during my Physiology course were analyzed. The comments were obtained from evaluations completed by four different groups of students: Osteopathic Medicine, Dentistry, Optometry and Pharmacy. Results. Pictures from 16 movies were shown during lectures. Displaying actors’ images creates 1-2 minute transition intervals during lectures that help listeners to stay receptive to the complicated material, shift attention to the ideas and points to remember and build memorable associations between physiological concepts and clinical conditions. Movie titles can serve as effective punch lines in humorous transition to a new topic or in imposing an accent on a previously discussed topic. Students referred positively to certain Hollywood celebrities or movie titles. Their comments confirmed the engaging effect of actors’ images. Conclusion. Cinematic images can be used as effective elements of medical presentations that help to gain and hold audience attention, facilitate creative thinking and memory, and impart information in an enjoyable way

“Bury Me in the Enclosure”: Reflection of the Extraordinary Grave Practice in the Materials of the Tobolsk Spiritual Consistory

В публикации с привлечением архивного дела Тобольской духовной консистории от 1913 г. рассматривается вопрос организации экстраординарных захоронений на территории поселений. Изученный материал ценен в первую очередь тем, что вскрывает механизм принятия решений о похоронах на закрытых кладбищах. Несомненная ценность этих данных в том, что исследований, касающихся разбора данной темы в контексте погребального законодательства Российской империи, не известно. В работах затрагивались лишь вопросы организации кладбищ за городской чертой после 24 декабря 1771 г. Однако имеется слабое представление о порядке совершения захоронений на закрытых приходских кладбищах. Мотивы же просителей, желающих быть похороненными на таких кладбищах, вообще остаются в области догадок. Дело рассмотрено в нескольких аспектах. Во-первых, выяснен юридический характер дела с позиции генезиса законодательства второй половины XVII — XIX в., касающегося санитарно-эпидемиологического порядка при погребении усопших. Во-вторых, изучен социальный, половой состав, а также география просителей, их мотивы. В-третьих, проанализирован механизм принятия решений по таким исключительным делам. Выяснено, что, несмотря на указ Сената от 1771 г., запрещавший хоронить на погостах в жилой зоне и регламентирующий перенос кладбищ, отдельные рецидивы старинной традиции остались. Послабления в организации захоронений отразились и в законодательстве, к примеру, в указе Священного синода от 1833 г. и ряде других. Законодательно в исключительных случаях разрешалось погребать покойных при церквях, в жилой зоне. Однако все действия духовенства по совершению погребений, особенно в исключительных случаях, регламентировались и . This article aims at studying the archival files of the Tobolsk spiritual consistory from 1913 and analyzing the issue of extraordinary graves organization in the settlements territory. The studied material is valuable, first of all, as it reveals the mechanism of making decisions about funerals in closed cemeteries. The indisputable value of these data is that there is no other known research relevant to this topic in the context of the Russian Empire’s burial legislation. The existing works concern only the organization of cemeteries outside the city limits after 24 December 1771. However, there is little understanding of the procedure for burial in closed parish cemeteries within settlements. The motives of petitioners who wish to be buried in such cemeteries remain generally in the field of conjecture. The author considers several aspects. First, the legal nature of the case has been clarified from the point of genesis of legislation of the second half of the 17th-19th centuries, concerning the sanitary-epidemiological order in the burial of the deceased. Secondly, the social and gender composition, as well as the geography of petitioners, and their motives were studied. Thirdly, the mechanism of decision-making on such exceptional cases is analyzed. The author has revealed that, despite the Senate’s decree of 1771, which forbade burying on the cemeteries in the residential area and regulating the transfer of cemeteries, some relapses of the old tradition remained. Flexibilities in the organization of graves were reflected in legislation, for example, in the decree of the Holy Synod of 1833 among others. Legislatively, in exceptional cases, it was permitted to bury the deceased at churches, in a residential area. However, all the actions of the clergy for the burial, especially in exceptional cases, were regulated and controlled

Developing leadership by recognizing strengths in ourselves and others

OBJECTIVES: The purpose of this workshop is: 1) to engage participants in the discussion of important concepts of positive psychology with emphasis on identifying their own personal strengths. 2) to review approaches for assessment of individual strengths and implementation of these qualities for productive teamwork in education. TEACHING METHODS: The group will be given a list of qualities which can be identified as examples of strengths. Each individual will be asked to select particular qualities which, in their opinion, are key features of their personality. We will discuss the value of different items from the list as the basis for creating a working team. CONTENT OVERVIEW: As health professions educators, one of the significant challenges we face on a daily basis is dealing with different personality types. Creating a working team is the key to success in any organization or endeavor. As part of their training, we encourage our students to engage in studies with their classmates. To achieve this goal, an effective leader should be able to identify strengths in themselves and others. Various categories of individual traits can be distinguished as assets. It is crucial to develop awareness of our own strengths and the ability to evaluate their spectrum in other people. This knowledge can be instrumental in utilizing individual strengths most effectively for productive work. PROJECT IMPACT: Recognition of strengths in ourselves and others is fundamental in developing effective healthcare teams. A good example is the story described by Jessica Wapner, author of The Philadelphia Chromosome, who said “It is a miracle what a group of committed people can do.” Furthermore, current trends in education, such as interprofessional communication and cooperation currently emphasized at Nova Southeastern University, create an additional avenue where determination of the strengths of each person will contribute to the success of our mission. Finally, this workshop will help us in an ability to maximize our potential as health professions educators and will also help to foster leadership qualities in our students

Salmonella Meningitis: A Rare, Deceptive and Often Fatal Infectious Disease

Objective: Our study aims to highlight the challenges, which this disease can present to health professionals including diagnosis and treatment. Background: Salmonella meningitis is a rare, but potentially fatal infection. The risk factors for acquiring this infection and its neurological outcomes were also analyzed. Methods: Using PubMed database, we selected 32 cases of salmonella meningitis reported during the last twenty years globally. We found that the infection is most common in patients who are under the age of 1 year and/or immunosuppressed. Additional risk factors included exposure to reptiles and poultry, and recent brain surgery. Overall, a total 12 different serovars of Salmonella were identified as causative agents. The most concerning finding was that 16 patients (50%) did not receive prompt treatment, due to misdiagnose or failure to seek medical care in a timely manner. The most common treatment regiments included 3rd generation of cephalosporins, often in various combination with other drugs. Conclusions: Our research helps to increase awareness about this infrequent form of meningitis, its diagnosis and treatment. Our study stresses the importance of recognizing rare causes of infection and recommend the use of a 3rd generation cephalosporin in combination with other medications for patients diagnosed with Salmonella Meningitis

Neural nitric oxide mediates Edinger-Westphal nucleus evoked increase in choroidal blood flow in the pigeon

Nitric oxide (NO) has been identified as a putative neurotransmitter in choroidal perivascular nerve fibers originating parasympathetically. Although constitutively produced NO has been implicated in the regulation of the choroidal circulation, the specific role of neurally derived NO in choroidal vasodilation has not been determined. This study examined the role of neurally derived NO in the control of the choroidal blood flow (ChBF) in vivo