Res Medica (E-Journal)
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Neurological Examination
Get PDFThe second of two articles written for Res Medica.The first of these two articles dealt with the examination of the cranial nerves, and the present article is concerned with the examination of the remainder of the nervous system. This comprises the examination of the limbs and trunk, and three main aspects have to be considered:(1) the motor functions,(2) the sensory functions, and(3) the reflexes.It is usual to proceed by testing all three aspects first in the uppere limbs, then on the trunk, and finally on the lower limbs, b u t there can be no objection to testing first the motor functions of all regions of the body, followed by the sensory functions and then the reflexes, if the student finds this approach easier
Electron Microscopy in Glomerulonephritis
Get PDFElectron microscopy has been in use as a research tool for many years, and as such has helped to demonstrate and elucidate the fine structure of many organs, including that of the kidney. The intricate pedicel structure of the renal glomerular epithelial cell, the glomerular endothelial fenestrae (Fig. I) and the varying cytological arrangements in the tubular part of the nephron were all unknown before the advent of electron microscopy. As a development of this anatomical function of the microscope, the technique began to be applied to diseased tissues in an attempt to analyse further the relation of disordered structure to disordered function. This type of investigation held the inherent difficulty that human tissues to be examined in this way had, of necessity, to be biopsy material, since autolytic changes in post-mortem material arc so gross that cytological ultrastructure is significantly destroyed
Computers in Medicine
Get PDFFrom a dissertation read before the Society on Friday, 4th November, 1966The subject of this dissertation is Computers in Medicine and even those who have had nothing to do with these machines will be unable to ignore them in the very near future. A brief account of how they work is given here, followed by the description of a few of their applications in Medicine. In fact, learning to programme the machine is very simple, and the University Computer unit runs a special course three times a year for this purpose. Many people think of the computer as something between a glorified adding machine and a sort of god that can do anything, whereas in fact the truth lies somewhere in between
Electrolyte Imbalance
Get PDFThe subject of this paper is Electrolyte Imbalance. Unqualified, such a title may sound like an overambitious attempt to embrace within the span of forty-five minutes the whole gamut of the disordered physiology of the anions and cations. Mindful of the penalty of such vaulting ambition which would, I think, without doubt "fall on the other" its content will be limited largely to some of the more acute and dramatic examples of disturbances of body fluid that are commonly encountered in surgical patients. Surgery deals with the sort of patients of whom John Donne might well have been thinking when he said "this minute I was well and I am ill this minute " and consequently the pattern of electrolyte imbalance encountered by the surgeon is usually drawn in starker and bolder lines than is the more subtle, long drawn out problem with which the physician is often confronted. This makes life considerably easier for the surgeon who is not uncommonly a simple man of action rather than a profound thinker; an extrovert rather than an introvert, a Roman rather than a Greek. Therefore, this account is mainly from a surgeon\u27s point of view with an occasional digression
The Conceptual Basis of Modern Surgery
Get PDFThe broad pattern of surgical practice as we know it to-day was largely designed in the fifty years that centred on the turn of the century. This was a time of great vigour and high accomplishment, when surgical adventurers the world over were ready to exploit to the full the twin discoveries of anaesthesia and antisepsis. It was the era of the “anatomical” surgeon, and speed and manual dexterity wedded to courage and imagination were the qualities that led to success and fame—and fortune. It is small wonder that some came to believe that with their definition of the possible and impossible the ultimate goal of surgery had been attained.The truth is otherwise; for though much was achieved, surgery was still largely a craft and much of its practice was empirical and ill-conceived. Nevertheless, the debt of the modern surgeon to his immediate ancestors is a substantial one. The experience and the knowledge that they gathered and disseminated has become for all time an important part of the fabric of surgical practice, though in our pride and our satisfaction in the surgery of to-day we are apt to forget it or ignore it or minimise it
Some Aspects of Nutritional and Toxic Liver Injury
Get PDFBased upon a Dissertation on “Hepatic Cirrhosis” given before the Society on Friday, 31st January 1958.The problem of nutritional liver damage and cirrhosis has been made easier and at the same time more difficult as a result of animal experiments and attempts to apply them to man. The clinical syndromes of nutritional liver injury are best classified according to the method of Sherlock:1. The Tropical and Subtropical Clinical Syndromes—The Kwashiorkor Syndrome.2. Alcoholic Liver Injury.3. Liver Injury caused by Protein Deficiency secondary to other disease.The experiments carried out on rats in the field of nutritional liver damage are well known. For this reason, and also because their aetiological relationship to dietary liver injury in man seems to be limited, a brief resume of these will suffice
Brain Mechanisms and Social Problems
Get PDFKnowledge with regard to the Central Nervous System (C.N.S.) is increasing so quickly that it is difficult to adjust one\u27s ideas to the ever-changing scene. When we turn for help to the ideas of great thinkers in the past, it becomes apparent that these are now of limited importance for the simple reason that they were building castles with bricks which are now known to be inadequate. It seems desirable therefore that we should from time to time stand back and view the whole problem of how we use our brains or of how our brains use us.The neurologist is constantly studying the effect of lesions of the C.N.S. on functions and behaviour, so that he is forced to consider the physiological mechanisms involved
Consumer Research
Get PDFAt about the beginning of June, one in three of all Edinburgh medical students will receive a questionnaire from the Professor of Public Health and Social Medicine. The questions to be asked cover such topics as: factors which influenced the student\u27s decision to enter medicine: his reactions to the medical school; his views on different phases of the medical curriculum and on medical education generally; his views on different branches of medical practice, and his own career plans.This questionnaire represents the first stage of a national enquiry launched by the Association for the study of Medical Education. All medical schools are now engaged on a re-appraisal of their curricula and their teaching methods, and the Association for the Study of Medical Education (or ASME, as it is generally known) recognises that the value of these discussions is likely to be very greatly increased if they take full account of the medical student-his background, his interests and his reactions. Accordingly, all medical schools in Britain will be invited to participate in this enquiry, and the Edinburgh University Department of Public Health and Social Medicine is to carry it out on behalf of ASME
Hospital Architecture in Britain
Get PDF"The hospitals built now will represent our age to future generations. It is essential that they are not only functionally efficient but aesthetically desirable. The architecture about us affects our attitudes-both conscious and subconscious. Design is the concern of us all." These were the beliefs presented to us by Mr Bruce Ritson and the Museum Committee when they brought an exhibition on contemporary hospital architecture to the Royal Medical Society in February. The material for the display, which was accumulated with care and effort from several sources, bespoke the concern for, and interest in, hospital design of the organisers. By showing us the best of what is new in Britain they have equipped us to criticise and thus to play our part in the development of the hospital in this country.The vitality of the doctor /architect liaison was well emphasised. As Geriatric and Casualty departments grow, tuberculosis sanatoria become redundant. The architect designing alone can hardly be expected to sympathise with such trends and the doctor designing alone cannot adequately cater for them. They must stand together, and, where luck runs low, fall together: by experiment and the pooling of experience. The best will be built into the hospitals of tomorrow, and they will appeal from both the functional and aesthetic points of view