1 Brief History Brief History of Travel of Travel Medicine Medicine Peter Felkai MD.PhD. associate professor head of department Internal Medicine Faculty Travel Medicine Faculty Group dr. Peter Felkai: Travel Medicine Travel Travel Medicine Medicine – what is that ? what is that ? In 1988 a new medical discipline In 1988 a new medical discipline has appeared has appeared As far as the men has left the cave, their travel has accompanied different kind of external harmnesses -The weather and hostile environment -The enemy and the wild animals -The diseases in the strange country -Illnesses related to the travel ...And the Philistines fought, and Israel was smitten, and they fled every man into his tent: and there was a very great slaughter; for there fell of Israel thirty thousand footmen... And the ark of God was taken.... When the Philistines took the ark of God, they brought it into the house of Dagon, and set it by Dagon. ...But the hand of the LORD was heavy upon them of Ashdod, and he destroyed them, and smote them with emerods, even Ashdod and the coasts thereof... And it was so, that, after they had carried it about, the hand of the LORD was against the city with a very great destruction: and he smote the men of the city, both small and great, and they had emerods in their secret parts... 1Samuel 5,1 – 6,1 Main forms of traveling from stone Main forms of traveling from stone age till the medieval ages age till the medieval ages Building Building – up commercial up commercial roads roads Military actions Military actions Pilgrimages Pilgrimages
7
Embed
Brief History of Travel Travel Medicine Peter Felkai MD ...soshungary.hu/wp-content/uploads/2016/03/TMhistbriefEN.pdf · of Travel Medicine Peter Felkai MD.PhD. associate professor
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
1
Brief History Brief History
of Travel of Travel
MedicineMedicinePeter Felkai MD.PhD.
associate professorhead of department
Internal Medicine FacultyTravel Medicine
Faculty Group
dr. Peter Felkai: Travel Medicine
Travel Travel
Medicine Medicine ––
what is that ?what is that ?
In 1988 a new medical discipline In 1988 a new medical discipline
has appearedhas appeared
As far as the men has left the cave, their travel has
accompanied different kind of external harmnesses
-The weather and hostile environment
-The enemy and the wild animals
-The diseases in the strange country
-Illnesses related to the travel
...And the Philistines fought, and Israel was smitten, and they fled every man
into his tent: and there was a very great slaughter; for there fell of Israel thirty
thousand footmen... And the ark of God was taken.... When the Philistines took
the ark of God, they brought it into the house of Dagon, and set it by Dagon.
...But the hand of the LORD was heavy upon them of Ashdod, and
he destroyed them, and smote them with emerods, even Ashdod and the coasts thereof...
And it was so, that, after they had carried it about, the hand of the LORD was against the city with a very great destruction: and he
smote the men of the city, both small and great, and they had emerods in their secret parts...
1Samuel 5,1 – 6,1
Main forms of traveling from stone Main forms of traveling from stone age till the medieval agesage till the medieval ages
Building Building –– up commercial up commercial roadsroads
Military actionsMilitary actions
PilgrimagesPilgrimages
2
It was said that Julius Caesar suffered from sea-sickness.
That’s why he ordered a day rest for the Army and the
horses after crossing the English Channel.
Dr. Felkai Péter: Utazási orvostan
The „Big Headache Mountain „The „Big Headache Mountain „
Kilik Kilik -- pass, pass, 4,824 m.4,824 m. Afganishtan.Afganishtan.
The Chinese were the first to document the effects of The Chinese were the first to document the effects of altitude, in a classic text, the altitude, in a classic text, the Ch'ien Han Shu,Ch'ien Han Shu, that that
describes the route between China and what is probably describes the route between China and what is probably
Afghanistan around 37Afghanistan around 37--32 BC:32 BC:
‘‘From Pe Shan...From Pe Shan...Again on passing the Again on passing the Great Headache Mountain, the Little Great Headache Mountain, the Little
Headache Mountain, the Red Land and Headache Mountain, the Red Land and the Fever Slope, the men's bodies the Fever Slope, the men's bodies
become feverish, they lose colour and become feverish, they lose colour and are attacked with headache and are attacked with headache and
vomiting; the asses and the cattle all vomiting; the asses and the cattle all being in like condition.‘being in like condition.‘**
*Marc Aurel Stein: Innermost Asia, detailed report of exploratio*Marc Aurel Stein: Innermost Asia, detailed report of explorations in Central Asia ns in Central Asia
etc. 1928, Vol.1 , Chapt.8: The search for the ancient Chinese hetc. 1928, Vol.1 , Chapt.8: The search for the ancient Chinese high roadsigh roads
Kohat – pass (2,500 m.), the „Little Snowy Mountain”
in Pakistan
FaFa--hien and the two others, proceeding southwards, crossed the hien and the two others, proceeding southwards, crossed the
Little Snowy mountains. On them the snow lies accumulated Little Snowy mountains. On them the snow lies accumulated
both winter and summer. On the north (side) of the mountains, both winter and summer. On the north (side) of the mountains,
in the shade, they suddenly encountered a cold wind which made in the shade, they suddenly encountered a cold wind which made
them shiver and become unable to speak. Hwuythem shiver and become unable to speak. Hwuy--ying could not ying could not
go any farther. A go any farther. A white froth came from his mouthwhite froth came from his mouth, and he said , and he said
to Fato Fa--hien, “I cannot live any longer. Do you immediately go hien, “I cannot live any longer. Do you immediately go
away, that we do not all die here;” and with these words he diedaway, that we do not all die here;” and with these words he died. .
FaFa--hien stroked the corpse, and cried out piteously, “Our hien stroked the corpse, and cried out piteously, “Our
original plan has failed;original plan has failed;——it is fate. What can we do?” Heit is fate. What can we do?” He thenthen
againagain exerted himselfexerted himself, and, and they succeeded in crossing to the they succeeded in crossing to the
southsouth ofof the rangethe range, and, and arrived in the kingdomarrived in the kingdom ofof LoLo--e. e.
FaFa TsienTsien:: DeahDeah ofof HwuyHwuy--king in theking in the „„little Snowylittle Snowy mountain” XIV.mountain” XIV. chapterchapter
The shivering, coldness, dyspnoe and finally the „white foam from the mouth” is an exact
description of the acute mountain sickness and its consequence, the high altitude pulmonary
oedema in Fa- Tsien book ( „Fa Tsien Record of His Travel”).
Forms of traveling in the Forms of traveling in the medieval ages till the medieval ages till the
industrial revolution yearsindustrial revolution years
In the middle ages the great plaque pandemy In the middle ages the great plaque pandemy
killed the onekilled the one--third of inhabitants of Europethird of inhabitants of Europe
Dr. Felkai Péter: Utazási orvostan
3
The Venetian council ordered the arriving ships for waiting outside the lagunas for 40 days - quaranta giorni . The island of Lazzaretto Vecchio was the decided place for that, where the old plaque-hospital and the cloister was found.
dr. Felkai Péter: Az utazási orvostan rövid története
2. A karanténok története
dr. Felkai Péter: Az utazási orvostan rövid története
2. A karanténok története
Peter Felkai: History of Travel Medicine
„ April 14th.
I am so sea-sick, that I cannot
write another line; except, to
say--God Almighty bless you,
my dearest beloved Emma!
prays, ever,
your faithful
NELSON & BRONTE.*”
Dr. Felkai Péter: Utazási orvostan
*Letter XLI. April 14th. The Letters of Lord Nelson to Lady Hamilton, Vol II. With A
Supplement Of Interesting Letters By Distinguished Characters, 1814, Smithfield
Edward Jenner (1749 –
1823) English surgeon,
the discoverer of the
vaccination and methods
In 1797, Jenner informally submitted to the Royal Society a brief paper describing his experiment, along with an account of the traditional folk wisdom of cowpox's preventative powers. It was returned to him with the hint that if he valued the scientific reputation he had established, he should not argue for his idea on the basis of one experiment.
The recent form of travelling 3.The recent form of travelling 3.
Trafficking, international prostitutionTrafficking, international prostitutionDr. Felkai Péter: Utazási orvostan
1492 Kolombusz crossed the Ocean 10 weeks
1838 Sirius, the first steam-engined ship sailed to
America 18 days
1920 Lindbergh flew over the Ocean 33 hours 30 minutes
1946 Super Constellation, the first scheduled
transatlantic flight 12 hours
1958 Comet, the first jet-engined commercial
airplane - flight 7 hours
1969 Concorde supersonic commercial 3 hours 32 min.dr. Peter Felkai: Travel Medicine
The The ttravel ravel -- iindustrial ndustrial rrevolution had a evolution had a
profound effect on profound effect on travel medicine travel medicine in in
Europe, Europe, and subsequently spread and subsequently spread
throughout eventually the worldthroughout eventually the world..
dr. Peter Felkai: Travel Medicine
1990: RUNWAY MALARIA
1996: AIDS
2001: SARS
2003: AVIAN FLU
2009: SWINE FLU
2010: H1N1
2015: Ebola virus
In our ages new, travelIn our ages new, travel--related illnesses related illnesses
have appeared, which weren’t known have appeared, which weren’t known
before:before:
• jet – lag
• „economy class syndrome” ( DVT)
• high altitude sickness
• AIDS, SARS
• air- and space sickness
• „mal de ski”
• Traveler’s psychosis
• traveler’s diarrhoea
Dr. Felkai Péter: Utazási orvostan
5
The lowThe low--cost airlines and „last cost airlines and „last
minute” offers appeared. These minute” offers appeared. These
made the travel accesible even for made the travel accesible even for
the less wealthy people.the less wealthy people.Dr. Felkai Péter: Utazási orvostan
dr. Peter Felkai: Travel Medicine
The travel business The travel business
developed the olddeveloped the old--
age people and the age people and the
pensioners, as a pensioners, as a
potential buyers of potential buyers of
the prethe pre-- and post and post
tourist seasons’ tourist seasons’
offeroffer
Because of the multiplying of the number Because of the multiplying of the number
of travels, and the cheaper forms of of travels, and the cheaper forms of
traveling respectively, three new and high traveling respectively, three new and high
risk groups have appeared:risk groups have appeared:
• family travelers
• young travelers („backpackers”)
• old age travelers
Dr. Felkai Péter: Utazási orvostan
The traditional trias of the primary (biomedicinal)
profilaxis,
- the vaccination
- the chemoprofilaxis
- and the infectiological-based travel advice
has already unabled to prevent the whole spectrum of
peri-travel illnesses, accidents, neither their
therapeutical procedures, too.
„More travel advice and fewer vaccination More travel advice and fewer vaccination
needed”*needed”**Hoveyda N, Behrens R.: More travel advice and fewer vaccinations
are needed. BMJ. 2002 Aug 3;325(7358):260-4.Dr. Felkai Péter: Utazási orvostan
That’s why the westernThat’s why the western-- European European
travel medicine’s priorities have travel medicine’s priorities have
changed. The idea of „travel health” was changed. The idea of „travel health” was
replaced by the „travel medicine”.replaced by the „travel medicine”.
Travel health = prevention
Travel medicine = prevention and therapy*
*Steffen R.,Dupont H.L.: Travel medicine 2010 in: Dupont-Steffen ed.: Textbook of Travel
Medicine and Health, sec.ed.2001, 534 p.Dr. Felkai Péter: Utazási orvostan
The fourThe four--leave clover theoryleave clover theory•Prevention. Vaccinations, chemoprophylaxis and giving information.
•Wilderness medicine. Preparing travelers for extreme sports and adventure travel, and providing advice regarding the safety of the sports (especially for winter sports and diving) and the safety aspects of the equipment involved.
•Travel insurance medicine: Advising travelers about travelers' insurance. Policies have changed from the simple travel insurance into the modern assistance based travel
insurance (BBP). Travelers are made aware of the risks of activities, the benefits and costs of available insurance, and how
to file for claims when necessary.
•Assistance medicine. This deals with organizing medical
providers abroad for Hungarian travelers, managing repatriation processes, and treating travelers when they return home sick or injured.
6
The fourThe four--leaved clover theoryleaved clover theory
TRAVEL
MEDICINE
assistance medicine
wilderness
medicinebiomedicinal
prevention
travel insurance
medicine
Belgyógyászat
Infektológia
Népegészségtan
Traumatology
Sport medicine
Toxicology
Internal medicine
Infectology
Public health-care
Insurance
medicine
Forensic
medicine
Emergency medicine
Intensive therary
Internal medicine
TRAVEL MEDICINETRAVEL MEDICINEThe four- leave clover theory of the travel medicine
Challenge of Space Challenge of Space AgeAge
Dr. Felkai Péter: Utazásorvostan
The space research business ( NASA, The space research business ( NASA,
Russian Federal Space Agency) has Russian Federal Space Agency) has
offered space visit for the civilians since offered space visit for the civilians since
2001. The fare of an extraterrestrial ride 2001. The fare of an extraterrestrial ride
costs 25 million US$. The seats has costs 25 million US$. The seats has
already fully booked...already fully booked...
Dr. Felkai Péter: Utazási orvostan
The experience of space tourism was exhilarating. The experience of space tourism was exhilarating.
You could gobble like a pig and weight nothing...You could gobble like a pig and weight nothing...Dr. Felkai Péter: Utazási orvostan
7
Returning from the MoonReturning from the Moon-- the the
cosmonauts was quarantined cosmonauts was quarantined