Res Medica (E-Journal)
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Travel Fund Reports: India – Again!
Get PDFIt is with some reluctance that I start another article, for another magazine, about my elective in India just over a year ago. Not that I feel any ingratitude to the R.M.S. who partly financed my trip but merely because I seem to have been talking about India, its culture, its medicine, its people and problems, from the day I set foot again on the chalky soil of Kent and I ’m beginning to feel a bit of a fraud, rather like the American who spends two weeks in Europe and then starts to profess intimate knowledge of its every nuance the moment he returns home. At the end of two months in India I had seen enough to realise that I’d seen nothing yet.Many impressions remain, of course, and I’d like to focus on just two of them. One of the happiest is that of the wonderful hospitality that we received. The Indian people were, on the whole, astonishingly friendly and helpful despite the linguistic difficulties. The latter were not as great as might be imagined as English is widely spoken among educated Indians, partly because it’s a useful international language, partly as a hang-over of ‘our Indian Empire\u27. Certainly at the New Civil Hospital in Ahmedabad, a post-war concrete structure with all the architectural grace of the S.M.M.P., the medical students were taught all their medicine in English (despite their previous education in the Gujerati medium), and much of the professional practice was carried on in that tongue. Whilst less than satisfactory for the budding Gujerati anatomist, it was ideal for use as it opened all the necessary professional and social laws
Reviews
Get PDFBehaviour of the Human Ureter in Health and Disease James Ross / Peter Edmond / Ian Kirkland Churchill-Livingstone 1972. £3.50Medical Treatment, a Textbook of Therapy in Four Volumes Volume VI. K. Maclean & G. Scott J. & A. Churchill, London 1971. £2.25.Proceedings of the Symposium on Epidural Analgesia in Obstetrics1972, London Editor, Andrew Doughty, M.B., B.S., F.F.A.R.C.S. Published by H. K. Lewis & Co. Ltd. London. Price £1.5
Epilepsy
Get PDFEpilepsy is an unusual disease. For most of the time the sufferer does not suffer at all except from apprehension, the expectation that he or she may have a fit.The epileptic fitThe treatment of epileptic fits is a quite different subject from the treatment of epilepsy. Most epileptic fits require no active treatment whatever and provided that the patient is safeguarded from obvious hazards — falling into water and drowning or being run over by passing vehicles — then recovery will occur naturally and the patient can resume a normal life until next time. Occasionally there are complications, such as if a patient should vomit during an attack and from this point of view the treatment of the epileptic fit is not different from the management of unconscious patients in general.
Teviot Place then; Fifty-Five Years Ago
Get PDFHaving studied my preclinical subjects at Oxford and taken a B.A. degree in Physiology, I came home to Edinburgh in 1922 to do my clinical work. I thought it might be amusing and interesting to contrast our work, habits and behaviour at that time with what they are now, for the students of today are like everything else, different from what we were over half a century ago.To begin with they are, on the average, undoubtedly of a higher intellectual standard. In my day almost anyone could become a medical student provided he was not so completely halfwitted as to be unable to pass the simple matriculation examination demanded and provided his parents were ready to pay for him. Thus a number had indifferent intellectual qualifications
Peripheral Entrapment Neuropathies
Get PDFThe effects of peripheral nerve compression have only been appreciated for a century. Panas published the first description of tardy ulnar palsy in 1878(17), exactly a hundred years ago, although Morton had preceded him by two years in his classical paper(14) about the neuroma which may form in the forefoot after presumedpressure, repeated trauma or degeneration. Since that time many other peripheral entrapment neuropathies have been encountered and discussed (2) (10) and the importance of early and effective treatment appreciated.This paper will present a synopsis of the pathology and sites of such entrapment, excluding the lesions of nerve that may occur from proximal pressure secondary to vertebral disc, spinal or thoracic outlet pathology. The effects of ulnar nerve compression at the elbow will be discussed in some detail using data obtained from a recent retrospective review of 100 patients with this complaint
An Innocent in New York
Get PDFI can still remember the first words spoken to me in New York, the "Big Apple" as it has become to be known: "Hey Mac, you pullin\u27 a fast one?"I had made the error of following one of my friends through the check-in point at John F. Kennedy Airport. My error was that I had, in my innocence, written down the truth — that I was going to work in New York Hospital for six weeks without pay. Possibly it wasn\u27t so unusual, but since my friend had also written that down under the heading "Purpose of Visit" the security guard decided something odd was going on. Nevertheless we got through, despite the fact that the third member of the intrepid Edinburgh trio had written down the same as his colleagues.It was probably the sudden flurry of activity of the security guard as he searched through the "Undesirable Aliens" file that made me feel guilty and therefore jump when the second New Yorker in my life spoke to me: "Come over here! Don\u27t dawdle already" barked the Customs and Excise Officer, his use of the unnecessary word "already" indicating that he came from Brooklyn and confirmed that we were actually in New York
On being a Professional Medical Witness
Get PDFWhen asked by the Editor to contribute an article on this topic, I became conscious of the fact that as a result of my arthritic leg which has defied the best efforts of clinical colleagues to heal, my recent Court appearances have been few and far between. Perhaps this means that I can take a relatively detached view of the Court rather than one dominated by current attacks of hyper-adrenalinism.I doubt if there are many people called to give professional medical evidence who approach the witness box without some quickening of the heartbeat. So if it happens to you, you can at least feel you are in good company. But it is the essence of a good witness that he is free of emotion, and this state depends firstly upon experience, and secondly on one\u27s preparation of material before the trial
Book reviews
Get PDFTitle: Geriatrics (Guidelines in Medicine — Vo.1) Authors: A.N. Exton-Smith, P.W. Overstall. Publishers: MTP Press Limited. Pages 344. Publication Date: 1979Title: The M.R.C.G.P. Examination. Authors: A.J. Moulds, T.A. Bouchier Hayes & K.H.M. Young. Publishers: M.T.P. Press Limited, International Medical Publishers. Pages 131. publication Date: November 1978. Price: £4.95Title: Local Analgesia — 2nd edition. Author: Dr. Clive Jolly. Publishers: H.K. Lewis & Co. Ltd., London. Pages: 152 (illusr. — 19) Publication date: 1979. Price: £5.00 net
Muggings and Assault
Get PDFThe term "mugging" has come to be accepted as synonymous with the type of damage which is inflicted by thugs on members of the community. In fact it is the act of attacking from behind or seizing an individual by the throat. To "assault" is to attack violently but this need not be entirely physical and may indeed be at least in part verbal, as for example in an argument.Regrettably the incidence of both is increasing year by year, and not infrequently may endanger life. The circumstances relating to muggings and assault are many, but fall essentially into two groups — the provoked attack and that which is unprovoked. There tend to be three distinct patterns of attack — "man-to-man" contact, that which falls into the category of "gang warfare" in which several individuals attack another group, while gang assaults on individuals are also constantly in the common press. Young people require avenues of expression and if this is improperly provided for, or inadequately controlled, it can lead to violence. Every citizen has a responsibility to the community in which he or she lives and there can be no doubt that they can often discourage such aspects of life as juvenile delinquency and violence by providing facilities and amenities designed to combat such socially unacceptable behavioural patterns. Indiscreet use of the tongue, facial muscles of expression, and digital signs may individually or collectively predispose to evoking physical response from others. Understanding of these precipitating factors and conscious effort to avoid them by whatever means are available will obviously reduce the number of cases of assault. Only a small proportion of such cases reach either the courts or the hospitals and it can be assumed that those which do are of the more serious type
Rule One, Drop One
Get PDFI suppose it is a universally applicable law of human behaviour that when anybody starts a new job they become, for a certain period of time, the New Boy. I suppose it is also an invariable rule that the New Boy feels awkward, foolish, clumsy and mawkish (no connection with the firm of solicitors of the same name). The only unique feature about the world of medicine is that the New Boy syndrome is that much more painful and embarrassing, and lasts a little bit longer, the average being between seven and fifteen years. The cause of the New Boy syndrome has been recognised for many years among ornithologists and behavioural animal psychologists, and it is all to do with the pecking order. To put it concisely, the animal that comes lowest in the pecking order, often called the \u27runt\u27 of the litter (particularly by the others), is pecked by everybody and doesn’t get to peck anyone back. As a result, the runt becomes what we biologists call \u27beaten up\u27. If after a long period of this established order, an even more significant animal is introduced to the system, this newcomer becomes the new runt, and the old runt, delighted to have somebody to kick around at last, relieves the many years of pent-up aggression by beating hell out of the new one. This system can be seen in operation among any assembly of gregarious vertebrates — for example, a duck pond, a chicken run, or the American Presidential Elections