Res Medica (E-Journal)
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Res Medica
Get PDFOffice Bearers – 228th SessionThe Old Order ChangethHouse-jobs – In Search of ClaritySyllabus Spring 1965Private Meeting
Some Aspects of Homeopathy
Get PDFBased on a Dissertation read before the Royal Medical Society on Friday, 13th November. 1964.Homoeopathy has existed as a branch of medicine for over one hundred and fifty years and its practitioners in this country are all fully qualified medical men. There are seven homoeopathic hospitals within the framework of the National Health Service and Her Majesty the Queen and His Royal Highness the Duke of Gloucester are both Patrons of the Royal London Homoeopathic Hospital. In 1950 Parliament passed the Faculty of Homoeopathy Act whereby the Faculty was legally recognised and its objects defined. Now these are real achievements and although they mean nothing in terms of proving the validity of Homoeopathy they do mean we cannot turn a blind eye and ignore the whole subject completely
Anaesthesia in Patients with Cardiac or Respiratory Disease
Get PDFThe degree and frequency of difficulties associated with anaesthesia depends primarily on the skill and experience of the anaesthetist. However, with the increase in life expectancy and advance in anaesthesia and surgery, a greater number of patients previously considered unfit are now being submitted to surgical operations. In many of these patients incidental cardiovascular, respiratory or other disease, frequently of long-standing, may present problems in the conduct of anaesthesia. Furthermore, many drugs used in the treatment of these conditions can potentiate or modify the pharmacological actions of anaesthetic, analgesic and muscle relaxant drugs and increase the risk of accidents and complications during and following anaesthesia. I t is clear, therefore, that the degree of anaesthetic risk may be quite unrelated to the extent of the surgical procedure. For example, the quite major operation of gastrectomy in a generally healthy young man is, from the anaesthetist’s point of view, a relatively safe and simple procedure, whereas the extraction of a few teeth in a patient with a history of a recent myocardial infarction or with severe asthma may be fraught with considerable danger. Not infrequently, of course, patients with severe heart or lung disease may require a major surgical operation, either for the treatment of the cardiac or pulmonary disease or for some other serious surgical condition and, in such circumstances, the overall risk is still greater. Although it is often quite impossible to eliminate the anaesthetic dangers associated with concurrent disease or to bring about its rapid and spectacular cure, nevertheless the risk can generally be considerably reduced by careful preparation of the patient before anaesthesia and surgery. Even the knowledge that the disease is present or that the patient is receiving certain drugs can go a long way to reducing the risk of accident by alerting the anaesthetist to the possibility of abnormal reaction to anaesthetic drugs
Res Medica; Mass exodus?
Get PDFPrecise figures are not available for the number of final year medical students who sat the E.C.F.M.G. examination in February. A very conservative estimate is about 30% of the total sat it, but a more probable figure is about 50%. This represents a substantial increase in the number of students who wish to work in the U.S.A. Such an increase cannot be ignored or lightly dismissed.Students give varying reasons for application. Many feel that they wish to train in the U.S.A. at some stage and that now is the optimum time to sit the E.C.F.M.G examinations. Some wish to ‘interne’ there, a few only to work there next summer. A few already intend to practice there. Most of the students also regard the February examinations as an incentive to start working for Finals only
Neurological Examination
Get PDFWilfred Trotter has said that the performance of a refined neurological examination is “ a job for men” . Certainly performing a full neurological examination seems to separate the men from the boys and many medical students are often unnecessarily alarmed at the prospect. Much of this anxiety can be dispelled, however, if the logic of the examination is appreciated. A greater number of objective signs can be elicited in the examination of the nervous system than in any other system and this profusion of signs, at first so unnerving, can be a positive advantage in providing sufficiently precise information regarding the site of dysfunction in the nervous system. After the examination has revealed this anatomical diagnosis, the physician, by taking into account the details of the evolution of the disease revealed in the history, can usually reach a final conclusion regarding the nature of the disease which is causing the dysfunction in the nervous system. This is the final or pathological diagnosis
Editorial
Get PDFAbove all it demands public opinion. The population explosion, if not so much a question of space lack as of grotesque insufficiency, must be cured by those who prompted it. We demand quality not quantity of human life; alas the antibiotic era and public health propagation have brought them both
The Hand in Clinical Medicine
Get PDFIt is no wonder that the diagnostic value of the facies has often been emphasised, for expression, form, colour, condition of the skin and hair and many other features can be studied from the beginning of the interview. In clinical practice it is common, after examination of the face, to take up the hand and feel the pulse. The experienced clinician may gain almost as much information from the hand as from the face, for the hands also show expression and character. Furthermore the hands are so highly developed that the blind and the dumb may use them as effective substitutes for reading and for speech, and many of us gesticulate for emphasis. Indeed, gestures made by patients to indicate the site and character of symptoms can be most helpful. Thus the flat of the hand is pressed upon the vertex of the head with psychogenic headache, both hands squeezing across the front of the chest commonly indicates ischaemic heart pain, or the tips of two or three fingers pressed into the epigastrium suggest the pain of peptic ulcer
“Pyrexia of Unknown Origin” – Differential Diagnosis?
Get PDFA 68-year-old man presented with a 3-week history of pyrexia of unknown origin. He also suffered from malaise, night sweats, rigors and weight loss but had no localizing symptoms. Pyrexia of unknown origin has a wide array of differential diagnoses and it can be challenging to find the correct diagnosis promptly. Examination of the patient indicated pallor and features of long-standing aortic regurgitation, but was otherwise unremarkable. Due to his history of valvular disease and a recent dental extraction, his investigations were tailored towards infective endocarditis. Blood cultures and echocardiography confirmed this diagnosis by Dukes’ criteria. He promptly received antibiotics, made a full recovery and was discharged
Spontaneous Subarachnoid Haemorrhage: Some Aspects of its Pathogenesis and Management
Get PDFThe recognition of spontaneous subarachnoid haemorrhage as a clinical entity, distinct from the many other conditions all previously grouped under the comprehensive heading of Apoplexy was first made by Collier in 1922. A year or so later Symonds reviewed 124 cases described m the literature and concluded that rupture of an intracranial aneurysm was probably the major cause of this syndrome. His opinion is now widely held, and it seems probable that on a proportionate basis the main aetiological factors are:-1. Rupture of an intracranial aneurysm responsible for 80% of cases.2. Arteriovenous malformations responsible for 10% of cases.3. Other diseases (e.g. neoplasm. blood dyscrasia)- responsible for I 0% of cases.The content of this article is largely referable to spontaneous subarachnoid haemorrhage following rupture of an intracranial aneurysm
Res Medica, Spring 1958, Volume 1, Number 2
Get PDFTABLE OF CONTENTSTHE ROYAL MEDICAL SOCIETY TO-DAYTHE CONCEPTUAL BASIS OF MODERN SURGERY: Professor John Bruce, C.B.E., T.D., P. R.C.S.E., F.A.C.S. (HONS.)SOME PATHOLOGICAL ASPECTS OF DISSECTING ANEURYSM: M. J.MacLeanCHANGING FASHIONS IN DIABETES: Professor D. M. Dunlop, B.A., M.D., F. R.C. P. F. , F.R.C.P.OPERA OCCULTA: C. Vaughan RuckleySOME ASPECTS OF NUTRITIONAL AND TOXIC LIVER INJURY: A. W. DellipianiSIR JAMES YOUNG SIMPSON: William L.FordTHE AETIOLOGY OF DISSEMINATED SCLEROSIS: J. G. TurnbullHAZARDS OF RADIATION: Andrew Gun