Res Medica (E-Journal)
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The Aetiology of Hypertension
Get PDFBased on a Dissertation read before the Royal Medical Society on Friday, 19th February 1960.The most common cause of death in this country is vascular disease. While it must be admitted that the incidence of vascular disease, and of the other major disease, cancer, increases with age, it is accepted that these diseases proceed often to a fatal conclusion when the victim is still productive. It has been estimated that if deaths due to the results of vascular disease were preventable, life expectancy might increase by some ten years. Were cancer cured, life expectancy would increase by about 2.5 years
Auscultation of the Heart - III
Get PDFThe essential difference between a sound and a murmur is that the former is due to sudden alteration in the speed of blood flow whereas a murmur results from turbulence developing in the blood stream. A murmur is usually of longer duration and of higher frequency than a sound. The principal factors which influence turbulence are the velocity of flow, the density and viscosity of the blood and the diameter of the vessel. Another important factor is that a narrowed orifice, as from valvular stenosis, will give rise to eddies beyond the obstruction. A similar effect is produced by a relatively narrow vessel opening into a wider one as in dilatation of the first part of the aorta or pulmonary artery.Murmurs may be heard in systole or diastole or may appear to be continuous throughout systole and diastole.Diastolic and continuous murmurs are always due to organic disease but a systolic murmur may be present not only without any functional disability but without any clinical, radiographic or electrocardiographic evidence of organic heart disease
Eye Changes in Disseminated Sclerosis
Get PDFWhat is probably the first written account of the clinical features of disseminated sclerosis is contained in the diary of Augustus D\u27Este, the illegitimate son of Prince Augustus Frederick, and grandson of George III. The first manifestations of the disease in his case, as m some 30% of all such patients, were referable to the eyes. In 1822, we read, he journeyed to visit a much-loved relative; On my arrival I found him dead. I attended hisfuneral-there being many persons present I struggled violently not to weep, I was however unable to prevent myself so doing; shortly after I was obliged to have my letters read to me and their answers written for me, as my eyes were so attacked that when fixed upon minute objects, indistinctness of vision was the consequence. Until I attempted to read or cut my pen, I was not aware of my eyes being in the least attacked. Soon after I went to Ireland, and without anything having been done to my eyes they completely recovered their strength, and distinctness of vision."3 It is interesting to note the temporal relationship of the onset of symptoms in this case, to a period of emotional stress, a relationship which has been much discussed in connection with disseminated sclerosis, but which has little statistical evidence in its support
Melancholia
Get PDFAn Extract from a Dissertation read before the Royal Medical Society on Friday, 27th January, 1961."Melancholy," meaning "black bile" or "black despair," designates aptly that spiritual blight which has vexed mankind from the earliest time. Playwrights and philosophers have long been intrigued by the spectacle of causeless melancholy, and, more recently, pathological melancholy, rechristened "psychotic depression" has been the subject of clinical definition
Book Reviews
Get PDFCLINICAL CHEMISTRY IN PRACT ICAL MEDICINE, by C. P. Stewart and Sir Derrick Dunlop. Sixth Edition, published by E. & S. Livingstone, Ltd., Edinburgh, 1962. Pp. 359. Price 27s. 6d.In this latest edition of a well proven and universally accepted textbook, there have been few major changes, reflecting the great popularity of previous editions. The revision has included recent advances insofar as they are significant in clinical medicine
The Biology of Mongolism
Get PDFBased on a Dissertation read before the Royal Medical Society on Friday. 2nd March, 1962.Mongolism is a neuro-endocrine disorder, based on a molecular disturbance, which is manifested by a chromosome abnormality. The mental defect is probably due not specifically to a gene or gene complexes on the chromosomes but to a generalised imbalance of the chromosome set as a result of aneuploidy.There are three types of chromosome abnormality which have so far been described in mongols1. Non-disjunction.2. Translocation.3. Mosaics
Metabolic Mistakes
Get PDFFor many physicians the inborn errors of metabolism represent a somewhat esoteric group, unlikely to be encountered in clinical practice. Many more diseases have been added to the list of “inborn errors” in the last few years and these diseases can no longer be considered as rareties
Education in the Medical Sciences
Get PDFI have recently asked the 4th year medical students, in a questionnaire, a number of questions about the course in Pharmacology which they are about to complete. The answers have made fascinating reading and have brought into focus many of the vague feelings about medical education that have been in the back of my mind for some time
Book Review
Get PDFTHE CHILD AND HIS SYMPTOMS— A PSYCHOSOMATIC APPROACH by John Apley and Ronald MacKeith. published by Blackwell Scientific Publications, Oxford, at 25s
Physical Signs in the Chest Part II
Get PDFIn this section some of the causes of the common physical signs are listed.Mediastinal shift.Mediastinal shift to one or other side is detected by deviation of the trachea or of the heart. Naturally the trachea is more often deviated be abnormalities in the upper part of the chest, or occupying the whole of one side of the chest, and the heart by abnormalities in the lower part of the chest. If the heart is deviated to the left the apex beat will be deviated to that side. If there is no obvious cause of enlargement of the heart one can provisionally assume, depending on the later detection of consistent physical signs, that deviation is due to mediastinal shift. It is less easy to be sure of deviation to the right, especially if the abnormal physical signs are present in the right lower zone and dullness at the right base makes it impossible to detect the right border of the heart. Inward deviation of the apex beat, unless it is gross, might be due to the patient having a relatively small heart. In this case initial impressions may have to confirmed by x-ray