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| ==Historical Perspective== | | ==Historical Perspective== |
| [[Image:Hippocrates.jpg|thumb|180px|left|[[Hippocrates]], the ancient Greek physician known as the "father of medicine."]] | | ===Discovery=== |
| The symptoms of pneumonia were initially described by [[Hippocrates]] in (c. 460 BC–380 BC):
| | *[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event]. |
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| ''Peripneumonia, and pleuritic affections, are to be thus observed: If the fever be acute, and if there be pains on either side, or in both, and if expiration be if cough be present, and the sputa expectorated be of a blond or livid color, or likewise thin, frothy, and florid, or having any other character different from the common. [...] When pneumonia is at its height, the case is beyond remedy if he is not purged, and it is bad if he has dyspnoea, and urine that is thin and acrid, and if sweats come out about the neck and head, for such sweats are bad, as proceeding from the suffocation, rales, and the violence of the disease which is obtaining the upper hand.''}}
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| However, Hippocrates himself referred to pneumonia as a disease "named by the ancients." He also reported the results of surgical drainage of empyemas. Maimonides (1138–1204 AD) also described the symptoms of pneumonia in his writings: "The basic symptoms which occur in pneumonia and which are never lacking are as follows: acute fever, sticking [[pleuritic pain]] in the side, short rapid breaths, serrated pulse and cough."<ref name=maimo>Maimonides, ''Fusul Musa'' ("''Pirkei Moshe''").</ref> This clinical description is quite similar to those found in modern textbooks, and it reflected the extent of medical knowledge through the Middle Ages into the 19th century.
| | *The association between [important risk factor/cause] and [disease name] was made in/during [year/event]. |
| | | *In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name]. |
| Bacteria was first seen in the airways of individuals who died from pneumonia by [[Edwin Klebs]] in 1875.<ref name=klebs>Klebs E. Beiträge zur Kenntniss der pathogenen Schistomyceten. VII Die Monadinen. ''Arch. exptl. Pathol. Parmakol.'' 1875 Dec 10;4(5/6):40–488.</ref> Initial work identifying the two common bacterial causes ''Streptococcus pneumoniae'' and ''Klebsiella pneumoniae'' was performed by [[Carl Friedländer]]<ref name=fried>Friedländer C. Über die Schizomyceten bei der acuten fibrösen Pneumonie.'' Virchow's Arch pathol. Anat. u. Physiol.'' 1882 Feb 4;87(2):319–324.</ref> and Albert Fränkel (1848-1916)<ref name=fraenkel>Fraenkel A. Über die genuine Pneumonie, Verhandlungen des Congress für innere Medicin. ''Dritter Congress''. 1884 April 21;3:17–31.</ref> in 1882 and 1884, respectively. Friedländer's initial work introduced the [[Gram staining|Gram stain]], a fundamental laboratory test still used to identify and categorize bacteria. Christian Gram's paper describing the procedure in 1884 helped differentiate the two different bacteria and showed that pneumonia could be caused by more than one microorganism.<ref name=gram>Gram C. Über die isolierte Färbung der Schizomyceten in Schnitt- und Trocken-präparaten.'' Fortschr. Med''. 1884 March 15;2(6):185–189.</ref>
| | *In [year], [gene] mutations were first implicated in the pathogenesis of [disease name]. |
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| Sir [[William Osler]], known as "the father of modern medicine," appreciated the morbidity and mortality of pneumonia, describing it as the "captain of the men of death" in 1918. However, several key developments in the 1900s improved the outcome for those with pneumonia. With the advent of [[penicillin]] and other antibiotics, modern surgical techniques, and intensive care in the twentieth century, mortality from pneumonia dropped precipitously in the developed world. Vaccination of infants against ''[[Haemophilus influenzae]]'' type b began in 1988 and led to a dramatic decline in cases shortly thereafter.<ref name=adams>Adams WG, Deaver KA, Cochi SL, et al. Decline of childhood Haemophilus influenzae type b (Hib) disease in the Hib vaccine era.''JAMA''1993;269:221-6. PMID 8417239</ref> Vaccination against ''Streptococcus pneumoniae'' in adults began in 1977 and in children it began in 2000, resulting in a similar decline.<ref name=whit>Whitney CG, Farley MM, Hadler J, et al. Decline in invasive pneumococcal disease after the introduction of pneumococcal protein-polysaccharide conjugate vaccine.'' New Engl J Med''. 2003;348:1737–1746. PMID 12724479</ref>
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| ===Early Classification Schemes===
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| Pathologists originally classified pneumonias by the [[anatomy|anatomic]] changes that were found in the lungs either by direct inspection at [[autopsy]] or by its appearance under a [[microscope]]. . A ''lobar'' pneumonia was described as an infection that only involves a single lobe, or section, of a [[lung]]. ''Multilobar'' pneumonia involved more than one lobe, and it often causes a more severe illness. ''Interstitial'' pneumonia involved the areas in between the [[alveoli]]. As more became known about the microorganisms causing pneumonia, a [[microbiology|microbiologic]] classification arose, and with the advent of [[x-ray]]s, a [[radiology|radiological]] classification was created as well.The discovery of x-rays made it possible to determine the anatomic type of pneumonia without direct examination of the lungs at autopsy. Early investigators distinguished between typical lobar pneumonia and atypical or [[viral pneumonia]] using the location, distribution, and the appearance of the opacities they saw on chest x-rays. Certain x-ray findings can be used to help predict the course of illness, although it is not possible to clearly determine the microbiologic cause of a pneumonia with x-rays alone. Another important system of classification is the combined clinical classification, which combines factors such as age, risk factors for certain microorganisms, the presence of underlying lung disease and underlying systemic disease, and whether the person has recently been hospitalized.
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| ==References== | | ==References== |