H<scp>istorical</scp> V<scp>ignettes in</scp> H<scp>eart</scp> F<scp>ailure</scp>
Bibliographic record
Abstract
“The period of broken compensation… among the first indications [of this period] are shortness of breath on exertion or attacks of nocturnal dyspnea… dilatation of the heart, the gallop rhythm, or various forms of arrhythmia, with or without the existence of dropsy. Under these circumstances the following measures are to be carried out: Rest Relief of the embarrassed circulation a) By venesection. In cases of dilatation, from whatever cause…when signs of venous engorgement are marked and when there is orthopnea with cyanosis, the abstraction of from twenty to thirty ounces of blood is indicated. This is the occasion in which timely venesection may save the patient's life. It is a condition in which I have had most satisfactory results from venesection. It is done much better early than late. I have on several occasions regretted the postponement, particularly in instances of acute dilatation and cyanosis in connection with emphysema. b) By depletion through the bowels. This is particularly valuable when dropsy is present. Of the various purges the salines had to be preferred, and may be given by Matthew Hay's method. Half an hour before breakfast from half an ounce to an ounce and a half of Epsom salts may be given in a concentrated form. This usually produces three to five liquid evacuations…” At the end of the 19th century, William Osier, who was born and educated in Canada and became the first professor of Medicine at Johns Hopkins University Medical School in Baltimore, MD, published his book The Principles and Practice of Medicine.1 In the book, he describes the natural history of heart failure, focusing on cardiac hypertrophy. Osier divided cardiac hypertrophy into 3 stages: (1) the period of development, which varies with the nature of the primary lesion, (2) the period of full compensation—the latent stage—during which the heart's vigor meets the requirements of the circulation, and (3) the period of broken compensation.1 In this passage, Osier describes the treatment of the stage of broken compensation (acute decompensated heart failure), recommending 2 therapies that were used for many years in attempts to relieve fluid retention and shortness of breath: venesection or depletion of the bowels.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.443 | 0.229 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".