History 5—third part lecture

Personages Who Contributed to the Development of Medicine in the Philippines, 20th Century

1910—Honoria Acosta –Sison returned with an MD degree from the Women’s Medical College in Philadelphia. As the first Filipino woman physician, she immediately joined the obstetrics department of the PGH as assistant resident and taught in the college. The second was Olivia Salamanca who dedicated herself to fight against tuberculosis but who herself unfortunately succumbed to the disease.

1912—Maria Paz Mendoza Guazon was one of the women graduates from UP who became a well-known pathologist, especially with her studies on bangungut, said to cause the mysterious sudden deaths of solely young, apparently healthy males who die in their sleep.

Dr. Gregorio Singian was the first president of the Philippine College of Surgery, which he founded before his death in 1937 and was a professor of Surgery at UST, renowned as “el mago del bisturie” (wizard of the scalpel).

Dr. Jose Albert chaired the weekly clinical conferences at PGH where he was professor and head of Pediatrics, as well as director of Scientific Studies and Research, and continued to author and co-author more than 40 papers, several on infantile beriberi.

Dr. Fernando Calderon was a recognized authority on obstetrics and gynecology who was appointed to the concurrent positions of dean of the College of Medicine and director of PGH, besides being head of Obstetrics.

Dr. Ramon Ongsiako and Victor Sevilla were the leading EENT specialists in private practice of the time.

Dr. William J. Butler Burke was the first to bring from England a Cambridge electrocardiograph and the first to practice what was then a very new discipline of cardiology. In his honor, the Philippine Heart Association established the Burke Award for budding cardiologists in 1952. He first came to visit in 1903, and, convinced by his uncle to practice medicine here, stayed and became a well-loved and respected professor of Medicine at UST.

Dr. Andreas Trepp, a Swiss physician who pioneered in the Philippines the Sanatorium treatment of TB so that he became the head of the Santol Sanatorium, the nucleus of the Quezon Institute in 1935.

Dr. Jose Tee Han Kee (1880-1943), was a medical doctor from Amoy, China who came to the Philippines in 1902 and was hired by the Board of Health to do sanitary work among Chinese residents of Binondo. Having served for 19 years as municipal physician of the Meisic Health Station, he became director of the Chinese General Medical Society.

Dr. Candido Africa and his co-workers, Dr. Francisco J. Dy and Dr. Eusebio Y. Garcia of the UP Institute of Hygiene (that will eventually be the College of Public Health) undertook the seminal studies in the exo-erythrocytic stage of Plasmodium vivax malaria, responsible for the relapses and the resistance to quinine.

Dr. Eliodoro Mercado devise a method of injecting chaulmoogra oil to leprosy patients in 1914.

Dr. Jose N. Rodriguez introduced the novel “histamine test” for diagnosis in 1931 in the leprosaria of Cebu and Culion.

Dr. Casimiro B. Lara, working with American researcher, Dr. H. W. Wade, published studies on various chaulmoogra and hydnocarpus esters for treatment.

Dr. Cristobal Manalang published between 1920 and 1936, eighty-two papers on leprosy, malaria, and various parasitic diseases while Dr. Antonio Ejercito had twenty papers on malaria alone during the same period.

Dr. Joaquin Maranon published twenty-five papers and a book on the therapy for malaria using cinchona alkaloids and the propagation of cinchona culture.

Drs. Daniel de la Paz and Antonio G. Sison found “alagaw” (Premna odorata) effective in treating bronchial asthma.

Dr. Faustino Garcia (*1) won a Gold Prize in 1932 for his studies on Datura cigarettes for asthma. The Joffel cigarettes of Jose K. Santos, PhD., UP professor of botany, became popular among asthmatics.

Dr. Antonio G. Sison wrote Historical Glimpses of Opthalmology and Training of a Surgeon and had various research outputs ranging from cardiology to the various aspects of internal medicine.

Dr. Alfredo C. Santos, professor of Pharmaceutical Chemistry, later dean of the UP College of Pharmacy, isolated and determined the structures of the alkaloids of “kalimatas” (Phaeanthus ebracteolatus) and “ambal” (Pycnarrhena manillensis).

Dr. Faustino Garcia (*2) subjected to initial pharmacological investigation “kalimata” fluid extract while in 1953, Drs. Conrado Dayrit, Horacio Estrada and Gerardo de Leon reported on phaeantharine, its purified alkaloid and discussing that the strong antihypertensive action of phaeantharine was due to complex, direct and ganglionic blocking actions.

Dr. Pilar Lim did her M.S. thesis in Pharmocology on Dr. Santos’ pure alkaloid pycnamine, the tertiary amine alkaloid of P. manillensis.

Dr. Faustino Garcia (*3) also studied the blood sugar-lowering action of “banaba” (Lagerstroemia speciosa) on diabetic patients and named its plant insulin-like principle, plantisul.

Dr. Romulo Guevara’s in vitro set up to study the direct effects of various herbs on the Ascaris lumbricoides parasite that came to be known, aptly, as “Ascarigram”.

Dr. Pedro T. Lantin won an award in 1933 for the treatment of typhoid fever by partial exanguination and blood transfusion, at a time when the only other positive approach to the treatment of typhoid was injection of convalescent serum or purposeful induction of fever by protein injections (milk) or hydrosalysates, (“Omnadin”).

Dr. Regino Navarro, clinical pathologist, was at this time, developing serum tests for Bilirubin I and II (unconjugated or “indirect”, and conjugated or “direct”), whichlater were to displace the van den Bergh test and become the critical tests for differentiating obstructive from non-obstructive or parenchyma.

Dr. Jacobo Fajardo—pioneer in Public Health work in the Philippines, director of the Bureau of Health.

Dr. Joaquin Quintos—the first pediatrician in the UST Faculty of Medicine and Surgery and discoverer of tiki-tiki, for curing infantile beriberi.

Dr. Gregorio Singian—founder of the Singian Institute, the first clinic for the treatment of cancer in the Philippines.

Dr. Benjamin Belmonte—the first in the UST Faculty of Medicine and Surgery to perform an open heart operation.

Dr. Arturo B. Rotor—senior discoverer of the Rotor-Manahan-Florentin Syndrome (co-discoverers are Drs. Lourdes A. Manahan and Angel A. Florentin).Rotor syndrome is a type of liver disease.

Pharmacists Manuel Zamora and Primitivo Arambulo’s tiki-tiki preparations became household names. Tiki-tiki extracts, as cure for beriberi became popular due to Drs. Joaquin Quintos and Manuel S. Guerrero of UST and as the result in the effort of the Chamberlain of the Army Board for the Study of Tropical Diseases. “Beriberi, known as taon, was a leading cause of infant mortality in Asia and the Philippines. The Dutch scientists, Eijkman and Grijno, had shown that beriberi is a food-deficiency disease afflicting people whose staple food is over-milled or polished rice. Much later, in 1911, Funk isolated the active principle from rice polishing, and in 1936, Robert Williams identified the thiamine chemical structure. When the Philippine Islands Medical Association heard about these reports made at a tropical medicine congress and learned that beriberi was caused by the use of polished rice, legislation for a return to unpolished rice was recommended. Upon the initiative of Dr. Jose Albert, then head of the Pediatrics of the UP College of Medicine, the first autopsy of infantile beriberi was performed.

Doctors from Vienna

Five Austrian Jews who wanted to escape Hitler in 1938 were convinced by Dr. Jose Albert to come to the Philippines instead to teach in the College of Medicine. Hans Kaunitz, a pupil of liver-specialist Eppinger, joined the Department of Medicine; Eugene Stransky, a hematologist, the Department of Pediatrics; Robert Willheim, a cancer biochemist, the Cancer Institute; Dr. Friedman, a clinical neurologist, the Department of Medicine, and Dr. Fraenkel, an educator, taught a very interesting History of Medicine, illustrated by slides of all the historical places and personages of medicine in Europe and the US. This team of European physicians contributed immeasurably to teaching and research.

Other Achievers in Medicine

Dr. Elena B. Ines-Cuyegkeng—trained pharmacologist from the University of Michigan; professor of Pharmacology, dean, and later vice president for

Academic Affairs of UERMMC; executive director, Association of Philippine Medical Colleges (APMC).

Dr. Julita Ramoso-Jalbuena—professor and chair, Department of Obstetrics and Gynecology, UP-PGH; specialized in extraperitoneal caesarean and introduced the Pfannenstiel incision in caesarian section; established blood bank for PGH Obstetrics; the only obstetrician so far to have received the top three awards of the Philippine OB-Gyn Society, namely: the Ramon Lopez Memorial Award in 1980, Baldomero Roxas Memorial Lecture Award in 1984 and Honoria Acosta-Sison Research Award in 1992.

1978—Dr. Juan S. Salcedo, Jr.—awarded for his contributions in nutrition, public health and science policy. His rice-enrichment program is credited to have wiped out beriberi in the Philippines.

1979—Dr. Gloria T. Aragon—first woman to be appointed dean of the UP College of Medicine on that year and director of Philippine General Hospital in 1979; magna cum laude graduate of UP who rose to be professor and chair of the Department of Obstetrics and Gynecology of UP-PGH.

1980—Dr. Fe del Mundo—pediatrician and medical stateswoman; founder of the Children’s Memorial Hospital in 1957 which became the Children’s Medical Center Philippines in 1963; 1977 Ramon Magsaysay Award for Public Service by a Private Citizen; 1996 Elizabeth Blackwell Award for Outstanding Service to Mankind, and the International Congress of Pediatrics Award as the Most Outstanding Pediatrician and Humanitarian.

1981—Dr, Geminiano T. de Ocampo—ophthalmologist, pioneer in corneal transplantation.

1985—Dr. Hilario D. G. Lara—Public Health, founder and first director of the Institute of Hygiene (now College of Public Health).

1989—Dr. Paulo C. Campos—internist, endocrinologist (Nuclear Medicine), National Academy of Science and Technology president (1978-1989); founder and chairman, Medical Center Manila; professor and head, Department of Medicine, UP-CM.

1989—Dr. Ernesto O. Domingo, academician, Science and Technology Award recipient; Chancellor of UP Manila (1991-1994); former chair of Medicine, UP-PGH; member, Board of Regents, UP; team leader of the Liver Study Group that characterized the extent and pathology in Filipinos of the hepatitides, particularly Hepatitis A, B, and C. The clinical and epidemiological studies of his team have contributed to the development of a policy and control of Hepatitis B, and diagnostic kit.

1991—Dr. Perla Dizon Santos-Ocampo, academician, Science and Technology Award recipient; Chancellor, UP-Manila 1994-1999; internationally renowned pediatrician; awarded for her studies on diarrhea and its management with Oral Rehydration Therapy; president, Philippine Pediatric Society; president, 17th International Congress of Pediatrics of the International Society of Pediatrics; elected president of NAST in 1999,

succeeding Dr. Conrado S. Dayrit.

1997—Dr. Alfredo R. Bengzon, Ramon Magsaysay Award recipient; neurologist; secretary of Health, 1986-1992; author of the Generics Law and the National Drug Policy; president, Medical City.

Patriotic Doctors

Dr. Remberto (Bobby) de la Paz—a 1976 graduate of the UPCM, had been working in Samar for four years after graduation with his wife, Dr. Sylvia Siocon-de la Paz and was gunned down on April 1982 while in his clinic in Catbalogan by an unknown assailant who, many local residents believe, had acted under orders of the provincial military authorities. His murder was never solved; one among the many during the Marcos administration. He became a symbol of the selfless idealism of a young doctor in the service of his country.

Dr. Johnny Escandor—another UPCM graduate was also serving in the poverty-ridden areas of the Philippines when, a lot of peoples believe, was killed by members of the military and had his body desecrated (his socks and brief was stuffed on his cranium); another victim of the Marcos reign of terror.

Surgical Advances

August 4, 1988—First successful liver transplant performed

September 18, 1990—A double liver and kidney transplant was performed

March 3, 1998—First simultaneous kidney and pancreas transplant was performed. The pancreas recipient lived for four years and died of a coronary heart disease. These were performed at the National Kidney and Transplant Institute by a transplanting team headed by Dr. Enrique Ona (who became Secretary of Health-2010)

May 28, 1994—Dr. Jorge Garcia performed the first heart transplantation at the Makati Heart Institute, Makati Medical Center. Unfortunately, the patient did not survive long after due to infection.

April 12, 1996—Professor Chao Tony Chan from Chang Gung Medical Center in Kaohsiung, Taiwan, together with the team of Dr. Enrique Ona at the National Kidney and Transplant Institute, performed the first partial liver transplant from a mother to her 15-month-old child with biliary atresia. Unfortunately, the baby succumbed to pulmonary infection 75 days postoperatively.

Landmarks in World Medical History

. 1415-1564: Andreas Vesalius—anatomist—published in 1534 his pioneering anatomical text “The Fabric of Human Body” (De Humani Corporis Fabrica). History of Anatomy is divided into Pre-Vesalian, Vesalian and Post-Vesalian Periods.

. 1590: Johannes Janssen & son Zacharias—invented microscope.

. 1628: William Harvey—published his treatise describing the circulation of the blood. (Excercutatio anatomica de motu cordis et sanguinis in animalibus); ranks with the Fabrica of Vesalius as a milestone in the progress of medicine.

. 1639: Augustinian monk Calancha—recorded the Peruvian use of cinchona bark (whose chief alkaloid is quinine) as effective for fevers and tertian (malaria) (popular version—bark used—is Countess Anna de Chinichon)introduction of Chinchona bark in Spainplant named after her.

. 1661:Marcelo Malpighi—(Bologna)—described the capillary anastomosis between small arteries and veins; that the lungs are composed of numerous vesicles in which the bronchioles end.

. 1664: Thomas Willis—published “Anatomy of the Brain”; known for “Circle of Willis of cerebral arteries.

. 1665: Thomas Sydenham (1664-1689)—published his first work on fevers; this was followed by many excellent descriptions of diseases. At his death in 1689, universities recognized him as the outstanding clinician of the 17th Century.

. 1674: Thomas Willis—noted that the urine of diabetics is wonderfully sweet.

. 1673-1723: Anton Ven Leeuwenhoek—“Father of Protozoology &Bacteriology”; using his microscope, demonstrated, made drawings of motile bacillus, micrococci, spirochete; RBC erroneously thought by Malpighi to be fat globules; described spermatozoa; the striped characteristics of skeletal muscles; structure of crystalline lens.

. 1753: James Lind (1716-1794)—recommended lemon juice for scurvy; British followed for 41 years and later, scurvy disappeared from the navy.

. Giovanni Morgagni (1682-1770)—“Father of Pathology”; “The Seats and Causes of Diseases Investigated by Anatomy”—important medical literature investigated diseases from symptoms to the organ, demonstrated the diseases in the organs—“start of modern medicine”—according to Dr. Rudolf Virchow.

. 1772: William Heberden (1710-1801)—first clear description of any given angina pectoris (published after his death).

. 1846: Thomas Morton (1819-1868)—demonstrated the use of ether on general anesthesia at the Massachusetts General Hospital—October 16, 1846.

. 1851: Herman von Helmhotz (1821-1894)—invented opthalmoscope and opthalmometer; identified the three color sensations: red, green and blue; mathematically proved the conservation of energy.

. 1849-1855: Thomas Addison (1793-1860)—described Addison’s Disease—of adrenal glands and Addisonian or pernicious anemia.

. 1697-1853: Robert Graves (Dublin)—perfect clinician, teacher, described hyperthyroidism in women (Graves’ Disease).

. 1804-1878: William Stokes (Dublin)—earliest account for paroxysmal tachycardia; Cheyne-Stokes Respiration and Stokes-Adams Disease (heart block).

. 1862: Austin Flint (1812-1886)—“American Laenace”; described “Austin Flint Murmur”—the characteristic diastolic murmur at the apex in aortic regurgitation without presystolic accentuation or snapping first sound.

. 1821-1902: Rudolf Virchow—the cell is the center of all pathologies; physician creator of modern science of pathology; author of cellular pathology—great books in Medicine; his book on tumors became model for all later works on the subject.

. 1813-1878: Claude Bernard—great physiologist—demonstrated the role of pancreatic juice in digestion; glycogenetic function of the liver; vasomotor mechanism of sympathetic and parasympathetics; mechanism of Carbon monoxide poisoning and of the use of curare for malaria.

. 1822-1895: Louis Pasteura) Proved that bacteria caused fermentation and that they came from air and not spontaneously

generated (which suggested antiseptics to Lister).b) Proved that heating to 50-60 degrees Celsius for a short time can prevent spoilage of wine

and beer—“pasteurization”.c) Confirmed Jenner’s “vaccination” findings that pretreatment which an attenuated organism

can protect from subsequent infection with the active form of that organism—in chicken cholera, in sheep anthrax, and in rabies. Late in 1885, a boy bitten by a rabid dog was cured by daily injection of increasingly less attenuated rabid spinal cord. In the process, he proved that the rabies virus infected the CNS (central nervous system) of dogs and rabbits, which when attenuated by desiccation, could be used for vaccination. First to isolate Staphilococci and Streptococci.

. 1865: Joseph Lister (1827-1921)—introduced the practice of the use of antiseptics in surgery Carbolic Acid spray in compound fracture.

. 1842-1910: Robert Kocha) Inaugurated the era of bacteriological research by developing culture media to grow pure

cultures of organism and methods of fixing and drying bacterial films on cover slips and then staining and photographing them for study. Thus, he demonstrated the Anthrax vacilli acid spores; the change from bacilli to spores and back to bacilli and the infectiousness of blood-containing spores (1876);

1) Discovered tubercle bacilli from tuberculous sputum (1882);2) Discovered the cholera vibrio and proved the transformation of cholera by water

and food;3) Discovered tuberculin (1890)—which unfortunately failed as TB cure.

b) Formulated the “Koch postulates” to prove that a microorganism is the cause of a disease:1) The microorganism can be demonstrable in every case of the disease;2) That it must be cultivated on pure culture’3) Inoculation of the culture must produce the disease in susceptible animals;4) It must be recovered from the animals and grown in pure culture (Nobel Prize

1905).

. 1844-1922: Sir Patrick Manson—discovered the malarial parasite in the blood of malarial patient (Nobel Prize 1907).

. 1857-1932: Sir Ronald Ross—discovered malaria in the stomach of Anopheles mosquito.

. 1881: Carlos Findlay—showed that the mosquito Stegomya fasciata (now Aedes egypti) was the transmitter of the yellow fever. James Carral had himself

bitten by an infected Stegomya, developed yellow fever and recovered; Jesse Lazcar accidentally bitten, developed yellow fever and died.

. 1900: Major Walter Reed (1851-1902) and Colonel William Gorgas (1854-1920)—conquered yellow fever in Havana by mosquito extermination.

. 1887: Augustus D. Waller, physiologist, recorded the first human electrocardiogram using capillary electrometer.

. 1895: William Konrad Roentgen (1845-1923)—discoverer of X-ray.

. 1895: Pierre and Marie Curie (1867-1934)—discoverers of radioactivity which they reported to the Academe des Sciences on July 18, 1898 (Nobel Prize in Physics with Henri Becquerel. Pierre Curie died from a tragic accident soon after Marie Curie won the Nobel Prize in 1911 for isolating radium.

. 1856-1939: Sigmund Freud—discoverer of the subconscious and its influence on the conscious, the splitting of the mind by intrapsychic conflicts and the Oedipus complex or infantile sexuality.

. 1883-1902: James Mackenzie—established the fundamental differences in venous types of cardiac irregularities—a milestone in the history of heart disease with the invention of polygraph to record arterial and venous pulses.

. 1901: Karl Landsteiner—showed that there are at least three types of human blood—A, B, and O.

. 1902: William Einthoven—built a string Galvanometer to become the first practical electrocardiograph (Nobel Prize 1924).

. 1906: Celois Alzheimer—identified a brain degeneration causing progressive loss of intellectual function (Alzheimer’s Disease).

. 1906-1910: Harvey Cushing (1869-1939)—neurosurgeon of the century; described the relationship between the pituitary tumor and sexual infantilism (Cushing Disease).

. 1906-1932: Charles Scott Sherrington (1857-1952)—neurophysiologist; elucidated the functions of the brain and spinal cord—afferent enervations of striated muscles; discoverer of the proprioceptive system; decelerate rigidity; significance of symptoms in reflex activity (Nobel Prize 1932 with Henry Dale).

. 1908: Paul Ehrlich—discoverer of the anti-pathogenic Arsphenamine (Salvarsan or 606) against the pathogen Trephonema pallida.

. 1912: James Herrick—published his classical description of acute myocardial infarction.

. 1921: Otto Loewi (1873-)—proved the chemical transmission of nerve impulses—that the substance released by sympathetic nerves in the frog heart was adrenaline, which was rapidly destroyed by cholinesterase (Nobel Prize 1936).

. 1929: Alexander Fleming (Nobel Prize with Howard Florey)—discovered Penicillium notatum mold which restricted a substance (he and Ernest Chain called it “penicillin”) which killed Staphylococci, Streptococci, Pneumococci in culture but not in “Gram-negative” bacteria.

. 1904-1937: Otto Warbury (1883-)—founder of the science of modern biochemistry and physiology; discovered the iron-containing respiratory enzyme (of Warbury); discovered the yellow enzymes; discovered nicotinamide as the active group of hydrogen transferring enzymes; invented biochemical manometry (Warbury apparatus) (Nobel Prize 1971).

. 1937: Adolf Krebs—discoverer of the Tricarboxylic Cycle (Kreb’s cycle)—a major pathway for the oxidation of Carbon compounds (Nobel Prize 1953).

. 1938: Robert Gros—credited with the ligation of patent ductus arteriosus.

. 1944: Alfred Blalock and Helen Taussig—developed the surgical connection for tetralogy of Fallot “blue baby.”

. 1950-1954: Hans Selye—developed the concept of stress and the role of ACTH and adrenal steroids in the “stress-response.”

. 1953: James Watson and Francis Crick—described the “double helix” form of DNA—two strands composed of sugar deoxyribose alternating with phosphate, round about each other in the shape of two-fold spiral; between the nucleobases,, Adenine (A), Thymine (T), Cytosine (C), and Guanine (G) projecting towards the middle like the rungs of a ladder, when A is always paired with T, and C with G, the transmission of genetic information was accomplished by an unraveling of strands of the double helix and their separation from each other, so that each one could serve as a stencil to exact duplication (replication) of hereditary information.

Discoverers of Pathogens and Anti-Pathogens

Timeline

1871—Armauer Hansen—Pathogen: Bacillus leprae1879—Albert Neisser—Gonococcus (Gonorrhea pathogen)1880—Karl Joseph Eberth—Salmonella typhosa1880—Charles Laveran –Malarial parasite in blood1883—Robert Koch—Koch-Weeks bacillus1883—Freidrich Fahleisen—Streptococcus of erysipelas1884—Albert Fraenkel—Pneumococcus as the cause of pneumonia1884—Arthur Nikolaier—Clostridium tetani1884—Theodore Escherich—Escherichia coli (causes loose-bowel movement)1890—Robert Koch--*Tuberculin (Anti-Pathogenic treatment)1892—Ernest von Behring--*Diptheria and Tetanus anti-toxins (Nobel Prize

1901)1906—August von Wasserman--*Wasserman test for syphilis1908—Paul Ehrlich--*Arspheramine (Salvarson or 606)1985—Luc Montagnier & Robert Gallo—Human Immunodeficiency Virus

(HIV).

*Anti-Malarials

1639—Native use—Quinine—from bush of Chinchona officinalis growing wild in South America.

1934—German patents—Quinacrine (Atabrine), also used in giardiasis, talmiasis, enterobiasis.

1939—German patents—Chloroquine, also used in extra-intestinal amoebiasis

*Anti-TB

1924—Albert Calmette and Camille Guerin—BCG vaccine from living avirulent bovine tubercle bacilli

1944—Selman Waksman—Streptomycin from culture of Streptococcus griseus active against TB (Nobel Prize 1952)

1944—E. Merck (1936), Merck (1939)1954—American Cyanamid—Pyrazinamide1958—Distillers Co., Ltd.—Isoniazide1960—Sensi (1967 Lepelit)—Rifamycins1961—Wilkimson—Ethambutol

*Sulfonamides

1932—Gerhard Domagk (Nobel Prize 1945)—discovered antibacterial action of red dye, Prontosil

1935—Trefouel, Nitti, Bovet—Sulfanilamide—the active portion of Prontosil

*Penicillins, Cephalosporins

1929—Alexander Fleming (Nobel Prize 1945) with Howard Florey—discovered Penicillium notatum mold which secreted a substance (which he and Ernst Chain named “penicillin”) which killed Staphilococci, Streptococci, Pneumococci in culture but not the gram negative bacteria

1940—Howard Florey & Ernest Chain (Nobel Prize 1945 with Alexander Fleming)—Juice of P. notatum (obtained from Fleming), grown on brewer’s yeast and demonstrated effective in infections in animals; cured patients with Staphylococcal and Streptococcal infections.

*Penicillin G.V.—narrow spectrum; Ampicillin, Amocycillin—broad spectrum *They helped develop larger amounts for treating seriously ill patients even recovering

the drug at first from the urine of patients given the drug.

*1948 Brotzu—Anti-Pseudomonal Penicillins, Cephalosporins first extracted from C. acremonium, isolated from sea water near sewer outlet off Sardinian coast.

*Derivatives and Congeners

First generationSecond generation—most potent against gram negative microorganismThird generation—anti-pseudomonal

*Broad-Spectrum Antibiotics

1947—Burkholder, Bantz (1948)—Chlorampenicol C from Streptomyceae Venezuelae

1950—Oxytetracyclenes from S. aureofaciens1952—Tetracyclene—semi-synthetic

1960—Doxycyclene—semi-synthetic

*Aminoglycosides

1943—Selman Waksman—Streptomycin from S. griseus1949—Selman Waksman—Neomycin from S. fradial

*Macrolide Antibiotics

1952—MacGuire—Erythromycin C from S. erythrous from Philippine soil

*Antifungal

1936—Oxford, et. al.—Griseofulvin from Penicillin

*Anti-Viral Agent

1964—Amantadine—synthetic drug inhibits influenza A virusAcyclovir for Herpes simplexType II Retroviral drugs

*Poliomyelitis Vaccines

1954—Jonas Edward Salk—vaccine against paralytic polio1955—Albert Bruce Sabin—oral polio vaccine

Promulgations on Health Care and Other Issues and Developments

1950—under Executive Order (EO) No. 94, President Manuel A. Roxas established the Institute of Nutrition (IN). In 1951, President Elpidio Quirino transferred it to the Department of Health. In 1958, with the organization of the National Science Development Board, President Carlos P. Garcia transferred the IN to NSDB’s National Institute of Science and Technology (NIST) and renamed Food and Nutrition Research Center (FNRC). Finally in 1975, with the expansion of NSDB into the National Science and Technology Authority (NSTA), FNRC became the full-pledged Institute, the FNRI.

June 1963—Through RA 3720, Bureau of Food and Drugs Administration (BFAD) was established.

Republic Act (RA) No. 6111—Medical Care Program of the Philippines was implemented intending to provide medical care benefits to all residents of the country and provide the people with the means to pay for their own medical care. As implemented in the program, it included only the employed sector and their dependents and provided only 20 to 30% of the hospitalization expenses of its members. One of its principal defects that led to over utilization was the lack of outpatient coverage. This RA, passed during the early years of Marcos

Martial Law period would later be replaced by the Philippine Health Insurance of 1995 (National Health Insurance Act of 1995 replacing the National Health Insurance Act of 1969).

PMA Official Professional Fee Guideline of 1976—the response to the clamor for transparency and a rationalization of doctor’s fees; the result of the report of the committee on professional fee guidelines for doctors (committee headed by Dr. Artemio Cabrera of Jose Reyes Memorial Hospital).

November 9, 1971—The Rehabilitation Center for Drug Addiction was set up in Taguig,, Metro Manila.

November 14, 1972—The Dangerous Drugs Board was created to deal with cases of drug addiction and abuse. Philippine Drug Enforcement Administration (PDEA) is presently given the police power to arrest, impound, sequester any prohibited drug activities in the country.

1973—In the area of alternative medicine, acupuncture became widely publicized and practiced. Dr. Helen Abundo, a cardiologist, Dr. Wilhelmina K. Ochoa, an internist and Dr. Lilia Palanca were among the leading exponents. This led to the organization of the an association of acupuncturists and official recognition by the Department of Health.

February 14, 1975—establishment of the Philippine Heart Center of the Philippines with Dr. Avelino Aventura, Army cardiac surgeon, as director.

1979—Lungsod ng Kabataan (now the Philippine Children’s Medical Center) was put up in Quezon City.

1983—The National Kidney Center and Transplant Institute was built to be followed by the Lung Center of the Philippines, also in Quezon City.

April 13, 1987—through Executive Order (E.O.) No. 119; the Ministry of Health became the Department of Health with Dr. Alfredo R. A. Bengzon as the first secretary.

1988—RA 6675—otherwise known as the Generics Act/Law of 1988 was passed but a rapidly increasing generics drug sector has developed with over 200 drug manufacturers and importers, mostly small, allowed by the BFAD to enter this burgeoning market. With an undermined regulatory agency, the situation is difficult to control and police and is now posing a great threat to the assurance of quality in the pharmaceutical and medical sector of the country, to the extent that, despite government’s strong policy to “go generics” to lower cost, many physicians refuse, under threat of arrest , to prescribe generics. It is a known fact that giant multinational drug companies finance the overseas travels of doctors (some are connected to UP-PGH) as long as these doctors continue to prescribe expensive and branded drugs even if cheaper, alternative drugs are available. It was only in 1999 that Generic Pharmacies began to offer cheaper drugs especially to the poor sectors of Philippine society.

October 10, 1991—RA 7160, also known as the Local Government Code, the Department of Health devolved some of its powers—among which was the supervision of health services in the provincial, city and municipal levels—to the local government units.

1995—Through Republic Act (R.A.) No. 7875, the Medicare was superseded by the

National Health Insurance Act while the Philippine Medical Care Commission was replaced by the Philippine Health Insurance Corporation (Phil Health).

RA 7305—Magna Carta for Public Health Workers

Policies that deal with Family PlanningJuly 22, 1974—National Research Act resulting in a 1979 Belmont Report dealing with:

1) Respect for autonomy of a person2) Beneficiaries3) Justice

RA 6365—Created Population Commission

PD No. 79—also known as the Reproductive Health Act of 2004

Senate Bills No. 1281, 1816—known as Family Life Education Act

House Bill No. 1546—on Reproductive Health, sponsored by Congressman Edcel Lagman dealing with: Reproductive Right, Reproductive Health, Reproductive Health Care, Male Involvement and Civil Society. Became law by December 2012

Cong. Lagman claims that:1) It is not anti-life2) Does not interfere with family life3) Does not legalize abortion4) Contraceptives do not have life-threatening side effects5) The bill will not promote contraceptive mentality6) The bill does not impose a two-child policy7) Sex education will not spawn a generation of sex maniacs/breed a culture of promiscuity8) Does not claim that family planning is the panacea of poverty9) Family planning will not lead to demographic winter10) Humanae vitae is not an infallible doctrine

Those who oppose claim that:1) It is a flawed premise2) It is unnecessary3) Unconstitutional4) Oppressive of religious belief5) Destructive of public morals

What is left out in the deliberation is the opinion/voice of those directly affected by the Reproductive Health Bill, the child-bearing women.