Res Medica (E-Journal)
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Chair-Making For Beginners - Illustrated by Some Episodes in the Career of John Thomson (1765-1846)
Get PDFJohn Thomson is arguably one of the most interesting characters to have been associated with the Royal Medical Society. His interests were wide ranging; from military surgery and the treatment of venereal disease (two areas often closely connected in those times) to chemistry and the newly emerging specialty of pathology. It is, however, with his interest in medical education and his ability to persuade those in authority to create professorial chairs for himself to occupy that I shall deal in this article
“Brother, Father, Mister, Doctor!” - From a Missionary Surgeon in the Philippines
Get PDFThe children’s faces lit up the darkness of the night. I had come with Bong, a Filipino, to treat a young child with a cough and high fever. The girl was sat with her 3 young sisters on a bench outside their ‘house’, aflimsy wooden shack which was their home. “Brother James”, “Father James”, “Mister James”, “Doctor James” they chimed simultaneously jumping up and down with excitement. “Just call me James" I responded in the local dialect, “much easier". After speaking to the mother and examining the child we prescribed the appropriate antibiotics. “Keep it in the fridge" I advised the mother. Bong coughed, trying to give me a subtle hint. I looked at Bong and he smiled at me through the candlelight. The light bulb came on in my mind “of course, the candles...these houses d o n \u27t have electricity never mind a fridge”, I spoke to the mother once more “OK, we will come back every day to administer the medicine". As we snaked our way back home through the coconut trees, tired but content, my steps made lighter by the gleeful voices of the children ringing in my ears, the days of ward rounds, white cell counts and chest x rays seemed but a distant memory..
Third Discussion
Get PDFProfessor Donald: The speakers have mentioned a number of factors, blood pressure, obesity and so on, but neither of them mentioned the question of family incidence of this disease which some of us hope, with good family histories might be favourable.Dr. Robertson: I wonder if Professor Morris or Dr. Oliver has correlated the number of miles driven in motor cars to the incidence of coronary heart disease, and particularly driving in traffic as opposed to driving on the open road; after all, the incidence of this modern epidemic roughly correlates to the rise of the motor car. I was very interested in a recent article which described a test in which a cardiotachometer was attached to the driver of a motor car and whilst waiting at the lights a pulse of 150-200 was recorded; this was quite usual
Diagnostic Problem
Get PDFSUBJECT: Miss A. B ., aged 18. Right handed.PRINCIPAL COMPLAINTS: Tremor, paraesthesiac, obesity, headache.HISTORY(1) Tremor, impairment of fine movements and paraesthesiac of the right side, principally of the arm. The tremor worst at rest and exacerbated by concentration. Three months’ duration and steadily deteriorating.(2) Increase in appetite and weight and excessive thirst for three weeks.(3) Frontal headache on rising in the morning for the past three weeks.(4) General medical and family histories negative
Review
Get PDFIt was with mixed feelings that we came to the first part of our sale at Sotheby’s. We could not be but pleased that four years of careful thought and debate, then of negotiation, had come to an end; but the pleasure was mixed with sadness that the library was being split up irrevocably under the auctioneer’s hammer. Economic logic was not enough to fully cover the feeling that had bound the books to the Society’s history.The sale began at 11am precisely, on Monday, 10th February. By 1.30pm the same day the books had realised £21,000; and on the following day a further £18,000 had accrued in less than two hours. The total sum from the first sale therefore does much to justify the decision to sell by auction, and justifies completely our hopes that the total sale should reach something more than £100,000, if not equalling the £ 120,000 that was turned down early last year when an American institution had offered to buy the whole collection.The principle that the books should be available to all, and particularly British collectors has been justified too. Although the biggest buyers were naturally the dealers Dawson and Rota, a number of the more important works were in fact acquired by private collectors. Most notable was the successful bidding by a London professor of Chemistry for nearly all our collection of the works of Boyle as well as for other works on chemistry such as Davy’s “Researches Chemical and Philosophical” and Clarke’s “The Gas Blowpipe or Art of Fusion”
Interpretation of the Electrocardiogram
Get PDFAccurate interpretation of an E .C .G. may provide valuable information on the assessment of a patient’s cardiovascular system. Students, both under-graduate and post-graduate, may have to interpret an E.C.G. in the course of their daily ward duties or during a clinical examination and in this article emphasis is placed on the main diagnostic features of some of the more common E.C.G. abnormalities. Numerous books are available for more advanced study.The E.C.G. is particularly useful in the diagnosis of cardiac rhythm and myocardial infarction. It may reveal evidence of conduction defect, hypertrophy of the myocardium or pericarditis and may also indicate therapeutic response in certain electrolyte disturbances. On the other hand, non-specific E.C.G. changes are common
To Awake a Sleeping Beauty
Get PDFEvery year over 1,000 hospital admissions for accidental poisoning, attempted suicide, or drug overdosage occur in this city and there is no doubt that the size of this problem is increasing.A large variety of drugs are taken and the specific treatment of the more common poisonings is adequately dealt with in an excellent monograph of Mathew and Lawson. It will help however to consider some general principles of how to tackle the acute problem clinically. You can:(1) Prevent the drug entering the body’s circulation (stomach washouts)(2) Prevent the drug reaching its site of action once in the body(3) Prevent the drug from exerting its effect at this site by(a) direct competitive inhibition(b) providing alternative metabolic pathways to overcome drug action(4) Enhance the rate of drug metabolism(5) Remove the drug from body— (diuresis, dialysis).Of these methods, the first, and the last to a lesser extent, is widely used in practice in this country. Again I refer you to Mathew’s book for the details.I am interested in the third of these, that is to prevent the drug from exerting its effect at its site of action by providing alternative metabolic pathways, with particular reference to barbiturate poisoning, which constitutes the largest single group of agents encountered in clinical practice
Neurosurgery – Contemplation of the Future
Get PDFWhen I was a medical student 42 years ago my neurological textbooks were replete with diagrams of the motor, sensory, visual, and speech areas of the cerebral cortex. It occurred to me then that perhaps the viscera might also have cortical representation and therefore why not try to find out if this were so? Sad to say I was dissuaded from investigative attempts on the grounds that time in medical school should be spent only on learning. (In this respect, I would urge that any of you with promising investigative ideas should put them to the test and not be persuaded to forget them. For sad experience has shown that if you don’t do the job, someone else will!). Since my early days, much has been learned about the visceral representation in the cortex of the brain, to part of which I eventually contributed. It is now known, for example, that the vagus nerve nucleus has a representation in the subfrontal cortex, bladder and bowels in the juxtamotor cortex, cardiac and respiratory control in the cingulate and medial temporal cortex, and sex organs also in the latter. Pupillary changes may be elicited by stimulating the anterior cingulate gyri, intussception by stimulating posterior cingulate gyri, while blood pressure alterations may be induced on stimulation of numerous parts of the cerebral cortex. All this adds up to the now well-known fact that in addition to a motor and sensory cortex, there is also what might be termed a “ visceral brain” in man and beast(9)
The Doctor and the Elderly
Get PDFSpecialism in medicine is an inevitable accompaniment of modern life and one of the newest specialties is Geriatrics (or as many of us would prefer — geriatric medicine). Medical specialties develop for a variety of reasons, for example, the specialty of renal diseases has grown out of the great technical advances in diagnosis and treatment in recent years. Other specialties have developed more gradually as the total body of relevant knowledge has accumulated, for example, cardiology and neurology. Other specialties have appeared as a direct response to the needs of the community, and this is the category into which we place geriatric medicine. With the increasing numbers of old people consequent upon the much higher proportion who survive to old age, the needs of the elderly have escalated and it has been necessary to attempt to deal with this crisis in different and sometimes novel ways. At the same time as numbers of old people have been increasing, many of the traditional family patterns of care have been eroded by social alterations, and so we have both demographic and social reasons for a "geriatric crisis” . It is commonplace now to find that the married daughter (in her 30’s or 40’s) is unable to afford her mother more than token support because she herself is in paid employment and only available for housewifely and family tasks in the evening.The result has been a great increase in declared demand for services for the elderly. Nor is this the whole story, because many studies in different areas of the Western World have shown that old people\u27s needs are often unknown until a crisis occurs (a fall, an acute infection, a stroke, or sometimes simply illness of a custodial relative or neighbour) and the situation is then found to be very advanced and perhaps irreversible and preventable sequelae have occurred
Editorial
Get PDFAfter a hiatus of several years Res Medica is back. It will be an occasional publication with perhaps two issues a year. Our aim is to publish a journal with a wide range of articles, from the historical to the philosophical, from the political to the scientific and from the lighthearted to the polemical. In other words it will attempt to appeal to the heterogenous membership of the Royal Medical Society — and to others — to the ingenuous freshman, the cynical final phase student (although perhaps today the adjectives should be transposed), the overworked houseman and the eminent practitioner.In this issue we have contributions from prominent figures in Edinburgh Medicine and from junior members of the Society. These latter show that the flame of scientific enquiry which made the reputation of the Society burns on still, even if at times it has appeared to gutter