Medical replacements for heart, lungs, liver, pancreas

 Medical replacements for heart, lungs, liver, pancreas, and other important organs become routinely feasible. For your convenience, the diseases are arranged in alphabetic sequence and thus the order in which they are presented has nothing to do with I heir frequency or seriousness. In this part of our book we tell you about a number of diseases-some potential killers, others disablers, some just nuisances. You may be puzzled by our approach and by use of some words new to you in discussions about your health. For example, you will find mentioned scenario, also primary, secondary, and even tertiary prevention of disease.

We use the word scenario because it conveys the idea of the dynamic picture the physician can foresee for the course of a disease after he completes his questioning to understand the patient's symptoms, his physical examination, and his study of x-ray and laboratory reports. Sometimes, there can be no valid scenario until the physician sees the patient in several return visits. For example, two patients may have high blood pressure. 

Mr. One has a pressure reading of 164 over 98; so does Mr. Two. But in subsequent measurements of blood pressure, Mr. One's has settled down to 150 over 86 whereas Mr. Two's has gone to 190 over 110. Mr. One has no signs and symptoms, whereas Mr. Two shows a small hemorrhage in his retina and slight enlargement of the heart.

The physician will see very different scenarios or possible future courses for these two patients, and his preventive treatments will be much more active for Mr. Two than for Mr. One. By primary prevention, we mean measures that can be used to prevent a disease completely. A good example would be the use of the Sabin vaccine to keep polio from developing. By secondary prevention, we mean the use of measures to keep a disease that is already present from progressing.

 For example, for a patient with a definite ulcer of the duodenum, the physician can foresee and wants to avoid a scenario in which hemorrhage, perforation, or scarring and obstruction may take place; so he institutes diet and medical therapy as part of a secondary prevention program. We may be the first to employ the word tertiary for preventive medicine.

 Our concept is that when every type of secondary prevention may fail, there is still a chance of providing new health for the patient in a special way-that is, by giving him a new organ to replace the destroyed organ. For that, however, the patient's general health must not become so undermined that the new organ would be of little use. 

For example, suppose every effort has failed to stop the ravages of nephritis (Bright's disease); the kidneys have failed; the patient is in uremic poisoning. If the physician institutes tertiary preventive measures at this time to avoid damage to the heart and brain and eyes, then at a suitable time he can save the patient with a kidney transplant. In the future, this type of tertiary prevention may become very common as transplants or mechanical