Clinical Social Science

Abstract

In the three and a half decades since the Second World War, there have been remarkable gains in the effectiveness of preventive and therapeutic measures in medicine. To mention but a few examples of the former: vaccines which can prevent poliomyelitis, rubella and measles; Rho (D) immune human globulin administered to Rh negative mothers at the birth of an Rh positive infant to prevent sensitization of the mother and hemolytic disease in subsequent children; screening measures leading to appropriate management to minimize the consequences of inherited metabolic disorders; and prenatal diagnosis to assure a normal birth. As examples of the latter, consider only: antibiotic treatment of infectious diseases; diuretics and alpha blockers to control hypertension; open heart surgery to correct valvular defects; total hip replacement; chemotherapy for childhood leukemias; drugs capable of aborting acute psychotic episodes and of minimizing their recurrence. To a medical graduate of the mid-1940's who has seen these changes during his own professional lifetime, the new capabilities are a continuing source of wonder and gratification.