Res Medica (E-Journal)
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The Australia (Hepatitis-associated) Antigen
Get PDFINTRODUCTIONThe accidental discovery of the Australia antigen (HAA) in 1963 by Blumberg and his coworkers is a classical example of biomedical serendipity. Its recognition not only stimulated a substantial amount of research into viral hepatitis, thereby adding considerably to our knowledge about this important disease, but has had far-reaching implications in the understanding of several other hepatic and systemic diseases. Indeed, its discovery may well be seen in the future to have been the all-important breakthrough in attempts at culture of the virus as a means of vaccine preparation for future prophylactic usage.THE DISCOVERY OF THE ANTIGENBlumberg, a cytogeneticist working in the Philadelphia Institute for Cancer Research, was conducting a systematic study of the serum of patients who had received multiple blood transfusions. Using a technique of double diffusion in agar gel (Ouchterlony method) he searched for precipitating antibodies to inherited donor serum protein antigens, particularly those to low density betalipoproteins. A precipitating antibody was identified in the serum of a haemophiliac patient which reacted with an antigen which was quite dissimilar from lipoprotein antigens. This antigen was present in the serum of an Australian aborigine, and the term Australia antigen was coined (1, 2, 3,). This antigen is almost certainly identical to Prince’s SH antigen(4), and to avoid confusion the term hepatitis-associated antigen (HAA) is now considered by many to be more appropriate (5)
Old Medical Books in Edinburgh Libraries: The Royal Medical Society Catalogue Project
Get PDFIn the justifiable belief that the older collections of printed medical books in Edinburgh libraries are exceptional in both quality and quantity, the Royal Medical Society has initiated a scheme for the production and, it is hoped, the publication of a composite catalogue of these collections for the benefit of scholars in the history of medicine and science. The institutions currently involved in the scheme are the National Library of Scotland, the Royal Botanic Garden, the Royal College of Physicians, the Royal College of Surgeons, the Royal Observatory, the Royal Society and the University of Edinburgh (including New College). In addition, the Royal MedicalSociety is, of course, contributing its own residual but important collection of older books withheld from the 1969 sale as being unrepresented in any other Edinburgh collection.The quality of the Edinburgh collections as a whole may perhaps be adequately suggested by noting their strength in the classics of medical literature. There are, for example, three copies of the De medicina (1478) of A. Cornelius Celsus, one of the first general medical treatises to be printed; four copies of the herbal De historia stirpium (1542) of Leonhard Fuchs, and three of the anatomical work De humani corporis fabrica ( 1543 ) of Andreas Vesalius — books which, particularly through the quality of their illustrations, did much to release the study of medical botany and anatomy "from traditional inaccuracies; one of the three known copies of the Christianissimi restitutio (1553) of Michael Servetus, which includes the first Western account of the lesser circulation; no fewer than five copies (including one with the errata) of what is generally regarded as the most important work in the history of medicine, William Harvey’s account of the circulation in his De motu cordis (1628); five copies (including a presentation copy with the plate in colour) of another classic of medical botany, William Withering’s An account of the foxglove (1785); and a copy of Sir Charles Bell’s exceptionally rare Idea of a new anatomy of the brain (1811), a pamphlet even more unprepossessing in appearance than theDe motu cordis, yet — in the context of the nervous system — of comparable importance as an advance in medical knowledge
Guest Editorial
Get PDFR.M.S. must change. Its hitherto cocoon-like existence is fine for the forty or so active members, but the Society fails, even in its chosen role as an academic body, as it attracts by no means all of the best brains in the medical school. The Society must enlarge its sphere of activity and dispel its introverted and self-satisfied image. There are many who would be happy to see R.M.S. quietly fold up, believing that its ideas lie, along with its roots, in the 18th century. However, I am sure that there is a place for a flourishing, undergraduate medical student society, especially one with the funds of R.M.S. The problem is how to make the R.M.S. flourish.Many of the current objectives of the Society are pertinent and must be pursued, but others need to be added to make it relevant to medical students as a whole. The Society\u27s annual membership is about 120 and whilst it must be said that this is 50% up on five years ago, why are only one-seventh of Edinburgh’s medical students members of R.M.S., and equally important in the present context, why are so many of the more intelligent students spurning the Society? Doubtless some of this latter group prefer individualised methods of study interspersed with complete relaxation, but there are many who decry the Elitist attitude which has been propagated by some R.M.S. members. Their criticism is valid, but their resulting action is not
Infectious Mononucleosis and E.B. Virus Infection
Get PDFInfectious mononucleosis has long been an enigma to epidemiologists. The absence of a recognised causal agent or a specific diagnostic test has thrown confusion on such basic issues as the definition of the disease. Until very recently the diagnosis has had to be based on a triad consisting of characteristic signs and symptoms, an absolute increase in atypical mononuclear cells, and a positive heterophile aggultination (Paul Bunnell test) test. Unfortunately each of these criteria is subject to variation in interpretation while the rigid application of the three allows no margin for the diagnosis of subclinical or atypical disease. Within these limits of diagnosis, work on the epidemiology of the disease has produced very few concrete results. While there is no doubt that infectious mononucleosis has a peak incidence in young adults and is relatively uncommon in childhood and older age groups, the evidence concerning infectivity, incubation period and methods of transmission has been circumstantial and often based on a small number of observations. Conclusions drawn from such work suggests that although the disease occasionally develops in contacts it is not highly contagious, and there remains doubt as to whether epidemics of the classical disease have ever occurred. Estimations of the incubation period range between very wide limits, and although there is some evidence that the causal agent is transmitted in saliva (hence the term "kissing disease”) the method of natural transmission is still unproven.Many of these problems of the behaviour of infectious mononucleosis could be solved if a specific causal agent could be recognised and during the last six years the accumulation of evidence implicating the EB virus has caused considerable interest amongst epidemiologists
Editorial
Get PDFThis issue of Res Medica is largely concerned with the subject of epilepsy, a chronic and often crippling condition, against which even the forces of modern medicine and surgery can only offer a feeble opposition.One man in Edinburgh who was concerned about the plight of the epileptic was Professor Norman Dott. A great pioneer in the field of surgical neurology, his interests extended outside the operating theatre to the problems of his patients and their fellow sufferers in the community. He campaigned actively for them as leader of the Epilepsy Society in Edinburgh.We were greatly saddened to hear of his death during the preparation of this issue, he will be sadly missed
The New Medical Curriculum: A Restoration of the Status Quo
Get PDFI HAVE TO WARN YOU: this is a piece of adverse criticism, but perhaps not quite in the way that you might expect.Last June, Res Medica asked me to write an article on the New Medical Curriculum, which has recently been inaugurated in this University. The original idea was that two essays would be written on the subject, one by a Professor of Medicine, and one by a medical undergraduate.1 In fact, so far as I know, the Professor of Medicine declined the offer for the very good reason that he considered that the new curriculum ought to be given a chance before it is evaluated. I, however, having nothing to lose, accepted the commission, because, as a matter of fact, I have a point of view. But of course there are various reasons as to why my overview of the subject must be even more blinkered than that of a Professor of Medicine. When Faculty switched curricula, she (I always think of her as a young girl) also chose that moment to convert me from a pre-clinical to a clinical student. Now there are various reasons why this should confound me as a critic of the New Order, they are wearisome to relate and surely self-evident to the attuned. I want to get round them by stating that this piece of adverse criticism is not really directed specifically against the New Medical Curriculum, which may well turn out to be much better than the old. I don\u27t want to talk about all the current curricular hot potatoes — the extra time devoted to clinical chemistry, the curtailment of time spent on the wards in Phase II, the question of whether Phase III Year 1 should have to compete against Phase III year 2 in the same subjects, and so on. I have been trying to ask myself what I think is really wrong with the way we are taught. I think that there is something wrong, that, as my title implies, the existence of a new curriculum has done nothing to improve the situation, and that, really, the new curriculum represents a series of quite superficial changes in the Faculty\u27s approach to medical teaching, beneath which things are going on exactly as before.
Lazarretos
Get PDFTonight I would like to talk about Lazarettos. An alternative title might be "a historico-economic study in depth of socially accepted means of community behaviour and preventative disease containment in the ongoing epidemic enzootic disease situation", or more shortly — "To flee or not to flee". I would like to discuss the various attitudes and preventative measures taken by populations when they are threatened by an outbreak of an epidemic infection. By the way, for those of you who are still wondering what a "Lazaretto" is and have not found out where the dictionary is in the library — it is derived from the Italian word "Lazaretto" and is a house for the reception of the diseased poor, especially lepers. Lazar houses were a particularly popular means of controlling epidemic disease in the Middle Ages — but more of that anon
Thoughts
Get PDFIn this poem Graham Mackenzie takes an unusual look at a day in the life of a preclinical medical student
Welcome
Get PDFAt the Lauder Brunton Centenary symposium on “Angina Pectoris” held on 21st-22nd April 1967 in the Hall of the Royal College of Surgeons, Edinburgh, by the Royal Medical Society, the chairmen were: Sir John McMichael, Professor W. Melville Arnott, Dr. D. G. Julian and Dr. R. B. L. Ewart
Historical Session
Get PDFOpening address by the ChairmanSenior President, may I thank you for your kind introduction, and may I also extend my thanks to the Presidents and members of the Royal Medical Society for giving me the honour to chair this first session of the symposium