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Hippocrates and four humors

Hippocrates II, was a Greek physician of theAge of Pericles (Classical Greece), and is considered one of
the most outstanding figures in the history of medicine. Historians agree that Hippocrates was born
around the year 460 BC on the Greek island of Kos; other biographical information, however, is likely to
be untrue.Hippocrates is credited with being the first person to believe that diseases were caused
naturally, not because of superstition and gods. Hippocrates was credited by the disciples of Pythagoras of
allying philosophy and medicine.He separated the discipline of medicine from religion, believing and
arguing that disease was not a punishment inflicted by the gods but rather the product of environmental
factors, diet, and living habits. Indeed there is not a single mention of a mystical illness in the entirety of
the Hippocratic Corpus. However, Hippocrates did work with many convictions that were based on what
is now known to be incorrect anatomy and physiology, such as Humorism.
A system of medicine detailing the makeup and workings of the human body, adopted by the
Indian Ayurveda system of medicine, and Ancient Greek and Roman physicians and philosophers,
positing that an excess or deficiency of any of four distinct bodily fluids in a personknown as humors
or humoursdirectly influences their temperament and health. The humoralist system of medicine is
highly individualistic, for each individual patient was said to have their own unique humoral composition.
Moreover, it resembled a holistic approach to medicine as the link between mental and physical processes
were emphasized by this framework.From Hippocrates onward, the humoral theory was adopted by
Greek, Roman and Persian physicians, and became the most commonly held view of the human body
among European physicians until the advent of modern medical research in the nineteenth century. The
concept has not been used in medicine since then.

Humour Season Element Organ




warm and






hopeful, playful,


ambitious, leaderlike, restless, easily



summer fire


warm and


autumn earth


cold and



despondent, quiet,
analytical, serious




cold and



calm, thoughtful,
patient, peaceful


The concept of four humors may have origins in Ancient Egyptian medicine or Mesopotamia, though it
was not systemized until ancient Greek thinkers around 400 BC directly linked it with the popular theory
of the four elements: earth, fire, water and air (Empedocles). Fhrus (1921), a Swedish physician who
devised the erythrocyte sedimentation rate, suggested that the four humours were based upon the
observation of blood clotting in a transparent container. When blood is drawn in a glass container and left
undisturbed for about an hour, four different layers can be seen. A dark clot forms at the bottom (the
"black bile"). Above the clot is a layer of red blood cells (the "blood"). Above this is a whitish layer of
white blood cells (the "phlegm"). The top layer is clear yellow serum (the "yellow bile").

Four temperaments is a proto-psychological theory that suggests that there are four fundamental
personality types ,sanguine (optimistic and social), choleric (short-tempered or
irritable), melancholic (analytical and quiet), and phlegmatic(relaxed and peaceful). Most formulations
include the possibility of mixtures of the types.

Sickness,Illness and Diseases

Discussing the complexities of what constitutes a disease requires careful distinction among related, but
distinct concepts. In 1973, Susser, an epidemiologist, proposed some definitions that remain useful.He
used illness to refer to the subjective sense of feeling unwell; illness does not define a specific
pathology, but refers to a persons subjective experience of it, such as discomfort, tiredness, or general
malaise. The way a patient reports symptoms is influenced by his or her cultural background, and Susser
applied the term sickness to refer to socially and culturally held conceptions of health conditions (e.g.,
the dread of cancer or the stigma of mental illness), which in turn influence how the patient reacts. The
social perceptions of disease that Illich described modify the ways a patient perceives and presents his
symptoms. Cultural conventions like wise affect where the boundary between disease and non-disease is
placed. Menopause may be considered a health issue in North America, but symptoms are far less
commonly reported in Japan. Disease implies a focus on pathological processes that may or may not
produce symptoms and that result in a patients illness. For example, a patient complains of tiredness and
malaisehis illness as he experiences it. He consults a doctor about itbecause he believes that he might
have a sickness. The doctor might attribute the patients symptoms to a thyroid conditiona disease.
Sickness is a generic term referring to a condition you experience when do not feel well. Sickness may
refer to being nauseated (e.g. motion sickness) or just being unwell because you are ill or tired.
Illness is very similar to disease, in everyday speech a disease is typically perceived as a problem more
serious or incurable (e.g. a genetic disease). While an illness, on the other hand, is simply the cause of a
temporary state of ill health (e.g. the flu).

Advances in the 19th and 20th centuries

19th century
1802 Jean-Baptiste Lamarck: teleological evolution
1805 John Dalton: Atomic Theory in (Chemistry)
1820 Hans Christian rsted discovers that a current passed through a wire will deflect the needle of a
compass, establishing a deep relationship between electricity and magnetism (electromagnetism).
1824 Carnot: described the Carnot cycle, the idealized heat engine
1827 Georg Ohm: Ohm's law (Electricity)
1827 Amedeo Avogadro: Avogadro's law (Gas law)
1828 Friedrich Whler synthesized urea, destroying vitalism
1830 - Nikolai Lobachevsky created Non-Euclidean geometry
1831 Michael Faraday discovers electromagnetic induction
1833 Michael Faraday is the first to observe a property of semiconductors.
1833 Anselme Payen isolates first enzyme, diastase
1838 Matthias Schleiden: all plants are made of cells
1838 Friedrich Bessel: first successful measure of stellar parallax (to star 61 Cygni)
1842 Christian Doppler: Doppler effect
1843 James Prescott Joule: Law of Conservation of energy (First law of thermodynamics), also 1847
Helmholtz, Conservation of energy
1846 Johann Gottfried Galle and Heinrich Louis d'Arrest: discovery of Neptune
1848 Lord Kelvin: absolute zero
1858 Rudolf Virchow: cells can only arise from pre-existing cells
1859 Charles Darwin and Alfred Wallace: Theory of evolution by natural selection
1861 - Louis Pasteur: Germ theory
1864 James Clerk Maxwell: Theory of electromagnetism
1865 Gregor Mendel: Mendel's laws of inheritance, basis for genetics
1865 Rudolf Clausius: Definition of Entropy
1869 Dmitri Mendeleev: Periodic table
1871 Lord Rayleigh: Diffuse sky radiation (Rayleigh scattering) explains why sky appears blue
1873 Frederick Guthrie discovers thermionic emission.
1875 William Crookes invented the Crookes tube and studied cathode rays
1876 Josiah Willard Gibbs founded chemical thermodynamics, the phase rule
1877 Ludwig Boltzmann: Statistical definition of entropy
1880 Pierre Curie and Jacques Curie: Piezoelectricity
1887 Albert A. Michelson and Edward W. Morley: lack of evidence for the aether
1888 Friedrich Reinitzer discovers liquid crystals.
1895 Wilhelm Conrad Rntgen discovers x-rays
1896 Henri Becquerel discovers radioactivity
1897 J.J. Thomson discovers the electron in cathode rays
1898 J.J. Thomson proposed the Plum pudding model of an atom
1898 Marie Curie discovers polonium, radium, and coins the term "radioactivity"
1900 Max Planck: Planck's law of black body radiation, basis for quantum theory

20th century
1905 Albert Einstein: theory of special relativity, explanation of Brownian motion, and photoelectric
1906 Walther Nernst: Third law of thermodynamics
1907 Alfred Bertheim: Arsphenamine, the first modern chemotherapeutic agent
1909 Fritz Haber: Haber Process for industrial production of ammonia
1909 Robert Andrews Millikan: conducts the oil drop experiment and determines the charge on an
1911 Ernest Rutherford: Atomic nucleus
1911 Heike Kamerlingh Onnes: Superconductivity
1912 Alfred Wegener: Continental drift
1912 Max von Laue : x-ray diffraction
1913 Henry Moseley: defined atomic number
1913 Niels Bohr: Model of the atom
1915 Albert Einstein: theory of general relativity also David Hilbert
1915 Karl Schwarzschild: discovery of the Schwarzschild radius leading to the identification of black
1918 Emmy Noether: Noether's theorem conditions under which the conservation laws are valid
1920 Arthur Eddington: Stellar nucleosynthesis
1922 Frederick Banting, Charles Best, James Collip, John Macleod: isolation and production
of insulin to control diabetes
1924 Wolfgang Pauli: quantum Pauli exclusion principle
1924 Edwin Hubble: the discovery that the Milky Way is just one of many galaxies
1925 Erwin Schrdinger: Schrdinger equation (Quantum mechanics)
1925 Cecilia Payne-Gaposchkin: Discovery of the composition of the Sun and that Hydrogen is the
most abundant element in the Universe
1927 Werner Heisenberg: Uncertainty principle (Quantum mechanics)
1927 Georges Lematre: Theory of the Big Bang
1928 Paul Dirac: Dirac equation (Quantum mechanics)
1929 Edwin Hubble: Hubble's law of the expanding universe
1928 Alexander Fleming: Penicillin, the first beta-lactam antibiotic
1929 Lars Onsager's reciprocal relations, a potential fourth law of thermodynamics
1932 James Chadwick: Discovery of the neutron
1934 Clive McCay: Calorie restriction extends the maximum lifespan of another species
1938 Otto Hahn, Lise Meitner and Fritz Strassmann: Nuclear fission
1938 Isidor Rabi: Nuclear magnetic resonance
1943 Oswald Avery proves that DNA is the genetic material of the chromosome
1947 William Shockley, John Bardeen and Walter Brattain invent the first transistor
1948 Claude Elwood Shannon: 'A mathematical theory of communication' a seminal paper
in Information theory.
1948 Richard Feynman, Julian Schwinger, Sin-Itiro Tomonaga and Freeman Dyson: Quantum
1951 George Otto Gey propagates first cancer cell line, HeLa
1952 Jonas Salk: developed and tested first polio vaccine
1953 Crick and Watson: helical structure of DNA, basis for molecular biology
1963 Lawrence Morley, Fred Vine, and Drummond Matthews: Paleomagnetic stripes in ocean crust as
evidence ofplate tectonics (Vine-Matthews-Morley hypothesis).
1964 Murray Gell-Mann and George Zweig: postulates quarks leading to the standard model
1964 Arno Penzias and Robert Woodrow Wilson: detection of CMBR providing experimental evidence
for the Big Bang

1965 Leonard Hayflick: normal cells divide only a certain number of times: the Hayflick limit
1967 Jocelyn Bell Burnell and Antony Hewish discover first pulsar
1983 Kary Mullis invents the polymerase chain reaction, a key discovery in molecular biology.
1986 Karl Mller and Johannes Bednorz: Discovery of High-temperature superconductivity
1994 - Andrew Wiles proves Fermat's Last Theorem
1995 Michel Mayor and Didier Queloz definitively observe the first extrasolar planet around a main
sequence star
1995 - Eric Cornell, Carl Wieman and Wolfgang Ketterle attained the first Bose-Einstein Condensate with
atomic gases, so called fifth state of matter at an extremely low temperature.
Roslin Institute: Dolly the sheep was cloned.
1997 CDF and D experiments at Fermilab: Top quark.
1998 Supernova Cosmology Project and the High-Z Supernova Search Team: discovery of
the accelerated expansion of the Universe / Dark Energy.
2000 The Tau neutrino is discovered by the DONUT collaboration

Agents of Infection
The terms "infection" and "disease" are not synonymous. An infection results when a pathogen invades
and begins growing within a host. Disease results only if and when, as a consequence of the invasion and
growth of a pathogen, tissue function is impaired. Our bodies have defense mechanisms to prevent
infection and, should those mechanisms fail, to prevent disease after infection occurs. Some infectious
agents are easily transmitted (that is, they are very contagious), but they are not very likely to cause
disease (that is, they are not very virulent). The polio virus is an example: It probably infects most people
who contact it, but only about 5 to 10 percent of those infected actually develop clinical disease. Other
infectious agents are very virulent, but not terribly contagious. The terror surrounding Ebola hemorrhagic
fever is based on the virulence of the virus (50 to 90 percent fatality rate among those infected); however,
the virus itself is not transmitted easily by casual contact. The most worrisome infectious agents are those
that are both very contagious and very virulent.In order to cause disease, pathogens must be able to enter
the host body, adhere to specific host cells, invade and colonize host tissues, and inflict damage on those
tissues. Entrance to the host typically occurs through natural orifices such as the mouth, eyes, or genital
openings, or through wounds that breach the skin barrier to pathogens. Although some pathogens can
grow at the initial entry site, most must invade areas of the body where they are not typically found. They
do this by attaching to specific host cells. Some pathogens then multiply between host cells or within
body fluids, while others such as viruses and some bacterial species enter the host cells and grow there.
Although the growth of pathogens may be enough to cause tissue damage in some cases, damage is
usually due to the production of toxins or destructive enzymes by the pathogen. For
example, Corynebacterium diphtheriae, the bacterium that causes diphtheria, grows only on nasal and
throat surfaces. However, the toxin it produces is distributed to other tissues by the circulatory system,
damaging heart, liver, and nerve tissues. Streptococcus pyogenes, the infectious agent associated with
several diseases including strep throat and "flesh-eating disease," produces several enzymes that break
down barriers between epithelial cells and remove fibrin clots, helping the bacteria invade tissues.
Agents That Cause Infectious Diseases
There are five major types of infectious agents: bacteria, viruses, fungi, protozoa, and helminths. In
addition, a new class of infectious agents, the prions, has recently been recognized. A brief review of the
general characteristics of each of these agents and examples of some diseases they cause follows.

Bacteria are unicellular prokaryotic organisms; that is, they have no organized internal membranous
structures such as nuclei, mitochondria, or lysosomes. Their genomes are circular, double-stranded DNA
that is associated with much less protein than eukaryotic genomes'. Most bacteria reproduce by growing
and dividing into two cells in a process known as binary fission. Despite these commonalities that group
them together in the Kingdom Monera, there is a wide range of diversity among the bacteria.There is a
variety of morphologies among bacteria, but three of the most common are bacillus (rodshaped), coccus
(spherical), and spirillum (helical rods). The energy sources for bacteria also vary. Some bacteria are
photosynthetic and obtain their energy directly from the sun. Others oxidize inorganic compounds to
supply their energy needs. Still other bacteria generate energy by breaking down organic compounds such
as amino acids and sugars in a respiratory process. Some bacteria require oxygen (aerobes), while others
are unable to tolerate it (anaerobes). Some bacteria can grow either with or without oxygen (facultative
anaerobes).Bacteria are frequently divided into two broad classes based on their cell wall structures,
which influences their Gram stain reaction. Gram-negative bacteria appear pink after the staining
procedure. Familiar pathogenic gram-negative organisms are Salmonella typhi, which causes typhoid
fever, and Yersinia pestis, which causes plague. Gram-positive bacteria appear purple after the Gram stain
procedure. Examples of pathogenic gram-positive bacteria are Staphylococcus aureus, which causes skin,
respiratory, and wound infections, and Clostridium tetani, which produces a toxin that can be lethal for

Microbiologists have found viruses that infect all organisms, from plants and animals to fungi and
bacteria. Viruses, however, are not organisms themselves because, apart from a host cell, they have no
metabolism and cannot reproduce. A virus particle is composed of a viral genome of nucleic acid that is
surrounded by a protein coat called a capsid. In addition, many viruses that infect animals are surrounded
by an outer lipid envelope, which they acquire from the host cell membrane as they leave the cell. Unlike
organisms, in which the genetic material is always double-stranded DNA, viral genomes may be doubleor single-stranded DNA (a DNA virus), or double- or single-stranded RNA (an RNA virus).In the general
process of infection and replication by a DNA virus, a viral particle first attaches to a specific host cell via
protein receptors on its outer envelope, or capsid. The viral genome is then inserted into the host cell,
where it uses host cell enzymes to replicate its DNA, transcribe the DNA to make messenger RNA, and
translate the messenger RNA into viral proteins. The replicated DNA and viral proteins are then
assembled into complete viral particles, and the new viruses are released from the host cell. In some
cases, virus-derived enzymes destroy the host cell membranes, killing the cell and releasing the new virus
particles. In other cases, new virus particles exit the cell by a budding process, weakening but not
destroying the cell.In the case of some RNA viruses, the genetic material can be used directly as
messenger RNA to produce viral proteins, including a special viral RNA polymerase that copies the RNA
template to produce the genetic material for new viral particles. Other RNA viruses, called retroviruses,
use a unique enzyme called reverse transcriptase to copy the RNA genome into DNA. This DNA then
integrates itself into the host cell genome. These viruses frequently exhibit long latent periods in which
their genomes are faithfully copied and distributed to progeny cells each time the cell divides. The human
immunodeficiency virus (HIV), which causes AIDS, is a familiar example of a retrovirus.Just like other
infectious agents, viruses cause disease by disrupting normal cell function. They do this in a variety of
ways. Some viruses make repressor proteins that stop the synthesis of the host cell's proteins, RNA, and
DNA. Viral activity may weaken cell membranes and lysosomal membranes, leading to cell autolysis.
Some viral proteins are toxic to cells, and the body's immune defenses also may kill virus-infected
cells.Viruses are classified using a variety of criteria, including shape, size, and type of genome. Among
the DNA viruses are the herpes viruses that cause chicken pox, cold sores, and painful genital lesions, and
the poxvirus that causes smallpox. Significant RNA viruses that cause human disease include rhinoviruses
that cause most common colds; myxoviruses and paramyxoviruses that cause influenza, measles, and

mumps; rotaviruses that cause gastroenteritis; and the retroviruses that cause AIDS and several types of

Fungi are eukaryotic, heterotrophic organisms that have rigid cellulose- or chitin-based cell walls and
reproduce primarily by forming spores. Most fungi are multicellular, although some, such as yeasts, are
unicellular. Together with bacteria, fungi fulfill the indispensable role of decomposers in the environment.
Many fungi also infect plants and animals. Examples of diseases caused by fungi are ringworm and
histoplasmosis (a mild to severe lung infection transmitted by bat or bird droppings). Yeasts of
the Candidagenus are opportunistic pathogens that may cause diseases such as vaginal yeast infections
and thrush (a throat infection) among people who are immunocompromised or undergoing antibiotic
therapy. Antibiotics reduce the bacterial population normally present in the throat and vagina, allowing
the yeast to grow unchecked.


Protozoa are unicellular, heterotrophic eukaryotes that include the familiar amoeba and paramecium.
Because protozoa do not have cell walls, they are capable of a variety of rapid and flexible movements.
Protozoa can be acquired through contaminated food or water or by the bite of an infected arthropod such
as a mosquito. Diarrheal disease in the United States can be caused by two common protozoan
parasites, Giardia lamblia and Cryptosporidium parvum. Malaria, a tropical illness that causes 300
million to 500 million cases of disease annually, is caused by several species of the
protozoan Plasmodium.

Helminths are simple, invertebrate animals, some of which are infectious parasites. They are multicellular
and have differentiated tissues. Because they are animals, their physiology is similar in some ways to
ours. This makes parasitic helminth infections difficult to treat because drugs that kill helminths are
frequently very toxic to human cells.Many helminths have complex reproductive cycles that include
multiple stages, many or all of which require a host. Schistosoma, a flatworm, causes the mild disease
swimmer's itch in the United States; another species of Schistosoma causes the much more serious disease
schistosomiasis, which is endemic in Africa and Latin America. Schistosome eggs hatch in freshwater,
and the resulting larvae infect snails. When the snails shed these larvae, the larvae attach to and penetrate
human skin. They feed, grow, and mate in the human bloodstream; the damage to human tissues caused
by the accumulating schistosome eggs with their sharp spines results in disease symptoms including
diarrhea and abdominal pain. Liver and spleen involvement are common. Another disease due to a
helminth is trichinosis, caused by the roundworm Trichinella spiralis. This infectious agent is typically
ingested in improperly cooked pork from infected pigs. Early disease symptoms include vomiting,
diarrhea, and fever; later symptoms include intense muscle pain because the larvae grow and mature in
those tissues. Fatal cases often show congestive heart failure and respiratory paralysis.

During the past two decades, evidence has linked some degenerative disorders of the central nervous
system to infectious particles that consist only of protein. These "proteinaceous infectious particles" have
been named prions (pree-ons). The known prion diseases include Creutzfeldt-Jakob disease (in humans),
scrapie (in sheep), and bovine spongiform encephalopathy ("mad cow disease" in cattle); all known prion
diseases frequently result in brain tissue that is riddled with holes. While some prion diseases are
inherited, others are apparently due to infection by eating infected tissue or inadvertently through medical
procedures such as tissue transplants.

Modes of Pathogen Transmission



Direct physical contact (body surface to body surface) between infected

individual and susceptible host.
Examples: Influenza virus; Infectious mononucleosis; chlamydia.
Precautions: Hand hygiene; masks; condoms.


Infectious agent deposited onto an object or surface (fomite) and survives long
enough to transfer to another person who subsequently touches the object.
Examples: RSV; Norwalk; rhinovirus; perhaps influenza.
Precautions: Sterilizing instruments; disinfecting surfaces and toys in school.


Via coughing or sneezing, or (in health care) during suctioning. Droplets are
relatively large (>5 m) and can be projected up to about one metre.
Examples: Meningococcus; influenza (though there is some debate); respiratory
Precautions: Masks; cover mouth; stand clear.



Transmission via aerosols (airborne particles <5m) that contain organisms in

droplet nuclei or in dusts. Can be spread via ventilation systems.
Examples: TB; measles; chickenpox; smallpox (and maybe influenza:
controversial, as more likely via droplets).
Precautions: Masks; negative pressure rooms in hospitals.


A single contaminated source spreads the infection (or poison). This can be a
common source or a point source.
a) Point source: Food-borne outbreak from infected batch of food; cases typically
cluster around the site (such as a restaurant)
b) Common source: The Listeriosis outbreak in Canada in 2008 was linked to a
meat production facility in Ontario. It caused 20 cases across five provinces.
Cases may be widely dispersed due to transport and distribution of the vehicle.
Precautions: Normal safety and disinfection standards. Deliberate contamination
of Tylenol in 1982 led to the use of tamper-proof containers for medicines.


Transmission by insect or animal vectors.

Example: Mosquitoes malaria vector, ticks Lyme disease vector.
Precautions: Protective barriers (window screens, bed nets); insect sprays; culling

Detecting and managing epidemics

An epidemic is the slow spread of infectious disease to a large number of people in a given population
within a short period of time, usually two weeks or less. For example, in meningococcal, an attack rate in
excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic. Epidemics
of infectious disease are generally caused by several factors including a change in the ecology of the host
population (e.g. increased stress or increase in the density of a vector species), a genetic change in the
pathogen reservoir or the introduction of an emerging pathogen to a host population (by movement of
pathogen or host). Generally, an epidemic occurs when host immunity to either an established pathogen or
newly emerging novel pathogen is suddenly reduced below that found in the endemic equilibrium and the
transmission threshold is exceeded. An epidemic may be restricted to one location; however, if it spreads
to other countries or continents and affects a substantial number of people, it may be termed
a pandemic. The declaration of an epidemic usually requires a good understanding of a baseline rate
of incidence; epidemics for certain diseases, such as influenza, are defined as reaching some defined
increase in incidence above this baseline. A few cases of a very rare disease may be classified as an

epidemic, while many cases of a common disease (such as the common cold) would not.Here are several
changes that may occur in an infectious agent that may trigger an epidemic. These include:

Increased virulence

Introduction into a novel setting

Changes in host susceptibility to the infectious agent

An epidemic disease is not required to be contagious, and the term has been applied to fevered the obesity
epidemic (e.g. by the World Health Organisation), among others. The conditions which is govern the
outbreak of epidemics include infected food supplies such as contaminated drinking water and the
migration of populations of certain animals, such as rats or mosquitoes, which can act as disease vectors.
Certain epidemics occur at certain seasons.For example, whooping-cough occurs in spring, whereas
measles produces two epidemics, one in winter and one in March. Influenza, the common cold, and other
infections of the upper respiratory tract, such as sore throat, occur predominantly in the winter. There is
another variation, both as regards the number of people affected and the number who die in successive
epidemics: the severity of successive epidemics rises and falls over periods of five or ten years.

Airborne transmission: Airborne transmission is the spread of infection by droplet nuclei or dust
in the air. Without the intervention of winds or drafts the distance over which airborne infection takes
place is short, say 10 to 20 feet.

Arthropod transmission: Arthropod transmission takes place by an insect, either mechanically

through a contaminated proboscis or feet, or biologically when there is growth or replication of an
organism in the arthropod.

Biological transmission: Involving a biological process, e.g. passing a stage of development of

the infecting agent in an intermediate host. Opposite to mechanical transmission.

Colostral transmission: A form of vertical transmission via successive generations.

Contact transmission: The disease agent is transferred directly by biting, sucking, chewing or
indirectly by inhalation of droplets, drinking of contaminated water, traveling in contaminated

Cyclopropagative transmission: The agent undergoes both development and multiplication in the
transmitting vehicle.

Developmental transmission: The agent undergoes some development in the transmission vehicle.

Fecal-oral transmission: The infectious agent is shed by the infected host in feces and acquired by
the susceptible host through ingestion of contaminated material.

Horizontal transmission: Lateral spread to others in the same group and at the same time; spread
to contemporaries.

Mechanical transmission: The transmitter is not infected in that tissues are not invaded and the
agent does not multiply.

Propagative transmission: The agent multiplies in the transmission vehicle.

Vertical transmission: From one generation to the next, perhaps transovarially or by intrauterine
infection of the fetus. Some retroviruses are transmitted in the germ line, i.e. their genetic material is
integrated into the DNA of either the ovum or sperm.

Microsoft founder and philanthropist Bill Gates wrote an essay published in the New England
Journal of Medicine in March 2015. In the essay, Gates states that an epidemic caused by a natural
disaster or bioterrorism is the most likely event that could kill 10 million or more people all at the
same time.[8]

Gates and other experts suggest that the best way to prepare for an epidemic is to have a disease
surveillance system, be able to quickly dispatch emergency workers, especially local-based
emergency workers, and have a legitimate way to guarantee the safety and health of health

Effective preparations for a response to a pandemic are multi-layered. The first layer is a disease
surveillance system. The African country of Tanzania, for example, runs a national lab that runs
testing for 200 health sites and tracks the spread of infectious diseases. The next layer is the
actual response to an emergency. According to U.S.-based columnist Michael Gerson, only the
U.S. military and NATO have the global capability to respond to such an emergency.[8]

Gates proposed that the world responded slowly to the Ebola virus outbreak because of a lack of
preparation. Two weeks after the 2013 typhoon hit the Philippines, over 150 foreign medical
teams were on the ground helping with injured victims. After the 2005 earthquake in Pakistan, a
team of aid workers who had been helping Afghan refugees for several decades were able to get
to the victims in less than 24 hours. Dr. Bruce Aylward, assistant director general for emergencies
at the World Health Organization, says that in the case of the Ebola outbreak, "there was no way
anyone could guarantee the right of medical evacuation for people affected by Ebola. Aylward
said that for future emergency health workforces, it is critical to offer a "duty of care", meaning
the ability to ensure that aid workers will be taken care of in terms of health and safety. [9]

The search for cures and treatments

The term "cure" means that, after medical treatment, the patient no longer has that particular condition
anymore.Some diseases can be cured. Others, like hepatitis B, have no cure. The person will always have
the condition, but medical treatments can help to manage the disease.Medical professionals use
medication, therapy, surgery, and other treatments to help lessen the symptoms and effects of a disease.
Sometimes these treatments are cures in other words, they get rid of the disease. For example, doctors
treat athlete's foot using antifungal creams, powders, or sprays that kill the fungus causing the
disease.When a disease can't be cured, doctors often use treatments to help control it. For example, one
type of diabetes happens when the pancreas does not make enough insulin to get glucose into cells where
it's needed. Doctors treat people with diabetes using insulin injections and other methods so they can
continue to live normal lives. But right now there's no cure for diabetes. So some people need insulin
treatments for the rest of their lives.The good news is that researchers are constantly coming up with
advances in medicine. So it's possible that a disease that can be treated but not cured today may be cured
in the future.

Social Responses to diseases

Public health organizations process enormous disease surveillance data and must extract signal from
noise, detecting outbreaks earlier and accelerating responses to the source. They must accelerate the
discovery of significant disease events and distribute notifications to all relevant partner organizations and
authorities.Together, public health monitors and responders must plan large scale responses and
administer resources (response personnel, reagent kits, vaccines, supplies and additional
countermeasures) despite significant technical obstacles.With Palantir Disease Response, the integration
of laboratory and epidemiological information; live connections to multiple relevant data sources; secure
communication of data across municipal, state, and federal boundaries; and visualizations that summarize
analysis from multiple agencies and provide a single unified view for senior briefings all become
possible.Palantir Disease Response provides epidemiologists and laboratory scientists with a solution
while protecting the privacy of affected cases.