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Biomedical subjects

Charles S Bryan

Publications and source records attributed to Charles S Bryan.

At least 19 recordsLinked to original sources
PubMed2026

Addressing racism as a clinical competence: Robert Wilson, Jr. (1867-1946).

Addressing health inequity is now recognized as a clinical competency in medical education. We examined the career and writings of Robert Wilson Jr. (1867-1946), longtime dean of the Medical College of the State of South Carolina during the Jim Crow Era, using primary and secondary sources within the context of systemic and structural racism, particularly in South Carolina. Wilson used public health data to refute the "Black Extinction Hypothesis" rooted in social Darwinism. He challenged assumptions of inherent Black susceptibility to tuberculosis, linking disease instead to social determinants of health. He also identified disproportionate mortality from kidney and cardiovascular disease among Black populations, anticipating modern health disparities research. Wilson further acknowledged systemic injustice and implicated structural conditions, including housing, in shaping outcomes. In an era of continuing health inequity and racial health disparities, Wilson applied empirical evidence to reject biological determinism, identify outcomes disparities, and advocate for racial justice.

History, 20th Century↗
PubMed2006

Discontinuation of respiratory isolation for possible tuberculosis: do two negative sputum smear results suffice?

Analysis of acid-fast bacillus smear results at a hospital with a moderate incidence of tuberculosis confirms recent recommendations that 2 negative smear results suffice for discontinuation of respiratory isolation. Use of polymerase chain reaction analysis further increases the confidence with which the diagnosis of active tuberculosis likely to be transmitted to others can be excluded.

Aged↗
PubMed2006

Beyond the physician charter: reflections on medical professionalism.

The numerous challenges now facing the profession of medicine have led to an intense focus on professionalism by individual physicians and by their professional and academic organizations. In 2002, a distinguished group of leaders in internal medicine created the Physician Charter, which calls on physicians to reaffirm medical professionalism through commitment to three principles and 10 responsibilities. The Charter reflects a duty-based ethic that is chiefly concerned with physician competence. This article offers a critical analysis of the Physician Charter from the perspective of the traditional values of medicine as articulated in medical oaths and championed by leaders of past generations, exemplified by William Osler. The authors argue that medical professionalism should reflect the values of a virtue-based ethic that stresses compassion and beneficence, rather than the values of a duty-based ethic. The challenges that now confront the practice of medicine can be addressed successfully only to the extent that physicians promote virtue-ethics, act collectively in the public interest, and render service that clearly transcends their own self-interests.

Codes of Ethics↗
PubMed2006

"Aequanimitas" Redux: William Osler on detached concern versus humanistic empathy.

Recent critics make William Osler "the father of cool detachment" in medicine, largely because of his "Aequanimitas" address emphasizing objectivity and imperturbability. Closer analysis suggests that Osler's aequanimitas resembles more nearly the metriopatheia of later Stoic philosophy than the apatheia of the early Stoics. A previously unpublished memoir clarifies at least in part Osler's motive for teaching control of the "medullary centres" to minimize facial expression: he did not want to frighten patients, who typically had serious illnesses for which he lacked effective therapy. Twenty-first century challenges to medicine as a profession differ substantially from those of Osler's era. Physicians and educators must focus more closely on the tension between detached concern ("competence") and humanistic empathy ("caring") if medicine is to thrive as a learned profession as opposed to a technical service, a commodity to be bought and sold like any other.

Empathy↗
PubMed2005

The influence of Sir Andrew Clark (1826-93) on William Osler (1849-1919).

Three lines of evidence suggest that Sir Andrew Clark had a significant influence on William Osler's postgraduate training: (1) numerous references to Clark in Osler's textbook of medicine; (2) the similarity of Clark's and Osler's aphoristic messages for students; and (3) personal encounters, including Clark's reminiscence that he 'had striven ten years for bread, ten years for bread and butter, and twenty years for cakes and ale'. Clark's meticulous approach to clinical problems, his work ethic and his enthusiasm for bedside teaching may have fostered or reinforced these same attributes in Osler. Osler honoured Clark's memory by helping Sir John MacAlister and others realize Clark's ambition to unite various London medical societies into a single organization, which, in 1907, became the Royal Society of Medicine.

Clinical Medicine↗
PubMed2005

Medicine as business, learned profession, and moral enterprise: an evolution of emphasis, 1905-2005.

Despite criticisms of the medical profession from certain quarters, organized medicine has in many ways been a positive force for advancing physicians' ethics and professionalism. Review of articles published in The Journal of the South Carolina Medical Association through the past century suggests sustained concern and increasing sophistication in how we deal with these topics.

Ethics, Medical↗
PubMed2004

Yellow fever in the Americas.

Dutch slave traders brought yellow fever to the Americas from Africa during the mid-seventeenth century. For the next two and a half centuries, the disease terrorized seaports throughout the Americas. Proof of the mosquito hypothesis was delayed because of two aspects of the disease: patients are viremic only during the first several days of clinical illness, and most mosquitoes require about 2 weeks of viral incubation before becoming infectious. Control of Aedes aegypti in urban centers failed to eliminate the disease because of its transmission by tree-hole-breeding mosquitoes that spend their winged lives mainly in forest canopies. Yellow fever continues to be a significant public health problem in parts of South America and Africa.

Americas↗