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When examining the medical doctrines of previous empires, they reveal the influence of religion, societal attitudes, and the historical context that influenced the scholars that penned them. The advancements during the Islamic Golden age can be seen in the field of medicine, which had the Greco-Roman medical corpus as their foundation and the source of the theory of the four humors and anatomical beliefs. This paper will analyze the effect of cultural, societal, and historical influences on the medical doctrines of Muslim medieval physicians in the Golden Age and the works of the Roman physician Galen, and demonstrate how these effects result in similarities and differences in medical practice and the understanding of disease and anatomy. Due to translation efforts that were supported by religious views on the accumulation of knowledge and the efforts of the Abbasid empire, resultant acceptance of the theory of the four humors and anatomical doctrines is observed in the treatment and perception of disease, which would consist of this paper's focus on surgery, diet therapy and associations with nature. However, with further analysis of the extent of this acceptance and the findings in the Islamic medical doctrines, the differences in experimental methods, religious interpretations, and cultural attitudes shows a deviation from the Galenic tradition, with the second set of the paper's focus being human dissection, cause of disease, and experimentation. The purpose of this research is to demonstrate the impact of religion, societal attitudes, culture and the accepted paradigm on the practice of medicine and the study of anatomy, and what would cause a challenge against the legacy of Galen.
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Methods: Using archival death certificates from 1954 to 1961, this study quantified the age-specific seasonal patterns, excess-mortality rates, and transmissibility patterns of the 1957 pandemic in Maricopa County, Arizona. By applying cyclical Serfling linear regression models to weekly mortality rates, the excess-mortality rates due to respiratory and all-causes were estimated for each age group during the pandemic period. The reproduction number was quantified from weekly data using a simple growth rate method and generation intervals of 3 and 4 days. Local newspaper articles from The Arizona Republic were analyzed from 1957-1958.
Results: Excess-mortality rates varied between waves, age groups, and causes of death, but overall remained low. From October 1959-June 1960, the most severe wave of the pandemic, the absolute excess-mortality rate based on respiratory deaths per 10,000 population was 17.85 in the elderly (≥65 years). All other age groups had extremely low excess-mortality and the typical U-shaped age-pattern was absent. However, relative risk was greatest (3.61) among children and young adolescents (5-14 years) from October 1957-March 1958, based on incidence rates of respiratory deaths. Transmissibility was greatest during the same 1957-1958 period, when the mean reproduction number was 1.08-1.11, assuming 3 or 4 day generation intervals and exponential or fixed distributions.
Conclusions: Maricopa County largely avoided pandemic influenza from 1957-1961. Understanding this historical pandemic and the absence of high excess-mortality rates and transmissibility in Maricopa County may help public health officials prepare for and mitigate future outbreaks of influenza.
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