Res Medica (E-Journal)
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National Health Service – Some Achievements
Get PDFThe National Health Service has now been in existence for over fifteen years, and is firmly established as one of the features of Twentieth Century Britain. There are many criticisms of it and many defects and deficiencies; one has only to read the newspapers—particularly the correspondence columns — to have them pointed out. However, it is good to look at the service’s successes and achievements, not in any sense of complacency, but rather in the spirit of Sir Winston Churchill’s famous minute, written in 1942, on the possibility of establishing artificial harbours on the Invasion Beaches of Europe:— “Let me have the best solution worked out. Don’t argue the matter; the difficulties will argue for themselves.
Localisation of Renal Function
Get PDFAn article based on a Dissertation read before the R.M.S. on 17th January, 1964.Classical renal physiology as taught to the undergraduate during his medical course, regards the kidney as an entity with little attempt to relate function to the basic unit of the nephron. In most instances this is permissible as it gives a functional understanding of renal processes enabling the clinician to diagnose and treat conditions where this function is impaired, either from intrinsic or extrinsic causes. However, it is not sufficient today to regard complicated organs solely in this fashion. Thus the functions of the kidney, particularly that of ‘acid-base balance\u27 are briefly discussed at a more fundamental level
Pre-Eclampsia Toxaemia of Pregnancy
Get PDFThe toxaemias of pregnancy form a discrete clinical syndrome which has been recognised as a disease of pregnancy almost since the practice of medicine began. Their aetiology and pathogenesis are still unknown, and despite all the resources of modern medicine, there is no treatment more effective than termination of the pregnancy — a therapy which was discovered several centuries B .C. There is no question that the nature of the condition provides one of the most fascinating problems of contemporary medical research, but the urgency of gaining an understanding of the condition, and of evolving more effective therapy, is only seen by considering the damage actually done by the disease, and the toll it still takes of maternal and infant life.Present day maternal mortality figures are approximately 0.4 deaths per 1000 births. Of these, 18% are due to pregnancy toxaemia, which is second only to abortion as the largest single cause of maternal loss of life. For the child, the risk of stillbirth or early neonatal death is more than doubled in toxaemia, compared with normal pregnancy. It is possible to calculate that the loss of infant life in United Kingdom which can be ascribed to toxaemia is about 3,000 deaths per annum. For comparison, the total number of deaths in road accidents is about 7,000 per annum. Thus pregnancy toxaemia can be taken to be responsible for nearly half as many deaths as our much publicised traffic problem
Research topic: An Investigation into the Specificity or Antiplatelet Serum Prepared in Rabbits
Get PDFThis summer I spent six weeks in the Immunopathology Laboratory in the Pathology Department of the University, investigating this antiplatelet serum. This antiscrum had been prepared by multiple immunisation of several rabbits with human platelets, and I was trying to find out, among other things, if this antiserum was specific for platelets, or if it reacted with other tissues and organs of the human body
Patient \u27follow up\u27 as a pedagogical technique for medical students
Get PDFMedicine is a career that requires lifelong learning, and finding an effective way of doing this is a valuable skill to have acquired as a medical student. ‘Follow up’ is a normal part of the treatment process for patients where most doctors see their patients in clinic post-discharge. This is beneficial for the patient, who receives a high quality continuum of care, and for the doctor, who can further their knowledge of pathological progression and individual responses to treatment. Medical students do not seem to regularly chase patient results or seek to find out clinical outcomes, despite students at some hospitals having access to electronic patient records systems.Pedagogy is the science of teaching and education. There is little evidence of the use of ‘follow up’ as a pedagogical technique, but there are some obvious gains to be made from doing so, including acquiring skills in using specific hospital computer systems, appreciating the holistic nature of medical care and laying down strong foundations of clinical experiences, which can be built on with personal study. There are ethical issues surrounding patient confidentiality where students have access to personal records, but as long as governance guidelines are followed the benefits of the ‘follow up’ process outweigh any potential risk to patient confidentiality. There are multiple benefits to following up a patient, and it is a practice that more medical students should embark upon
North American Kaleidoscope
Get PDFI have called these brief remarks a kaleidoscope because inevitably the impressions left after a brief three months spent travelling, visiting and lecturing from New York to San Francisco and from Vancouver to Boston are those of an ever changing, ever fascinating pattern of personalities and scenery, hospitals and research institutions. I can but discuss a few aspects of general rather than of particular interest.Undoubtedly, for those of us fortunate enough to have been allowed to travel thus widely, the impact of the different environment is such that, in retrospect, much of it seems unreal. The American culture, the whole fascinating mechanism of living, is so indescribably different from anything that we have at home, that to experience it for even a few months is to broaden one’s outlook and widen one’s own horizon to an extent which previously one would have thought unnecessary. It is in the very nature of us all that we have a self-conceit that we are already broadminded, well travelled and appreciative of other cultures than our own. Nobody’s medical or social education is complete until he has at least sampled American and Canadian life, and a generalisation such as this is not as platitudinous as it sounds
Full issue , Res Medica, Summer 1959, Volume 1, Number 4
No full textTABLE OF CONTENTSEDITORIAL GROWTH NORMAL AND ABNORMAL: Professor Michael Swann SPONTANEOUS SUBARACHNOID HAEMORRHAGE: SOME ASPECTS OF ITS PATHOGENESIS AND MANAGEMENT: F. W. TurnerTHE DIAGNOSIS OF HYSTERIA: A. B. Craddock GOINGS-ON DURING THE 222ND SESSION: Nigel Malcolm-SmithFAMILY MEDICINE: Richard Scott, M.D. , D.P.H.THE CHANGING FACE OF MEDICAL PRACTICE: F. A. Boddy THE DIAGNOSIS OF CHEST DISEASE: J. H. TurnerELECTROLYTE IMBALANCE: H.A.F. Dudley, CH.M., F .R.C.S.E.ROCKETS, MEN AND MEDICINE: A. L. Crombie AN APPRAISAL OF ULCERATIVE COLITIS: C. M. Mailer
The Changing Face of Medical Practice
Get PDFMedical Practice has seen considerable change in the past century: during this time there has been a greater revolution in medical standards and activities than in the whole previous history of the profession. Medicine has evolved from the gentle art of the eighteenth century to the practice of the precise rationalism of the present day. In applying the techniques of modern science, Medicine has involved itself in almost every aspect of our environment and is becoming more and more a major factor in human ecology. The purpose of this article is to attempt to evaluate, albeit very briefly, the manner in which this change has come about
An Appraisal of Ulcerative Colitis
Get PDFIn writing about a subject like ulcerative colitis, it would be comforting to imagine oneself to be somewhere near the "growing edge," if not just exactly in the front line. And yet, this "growing edge" is so often disappointing, if not positively misleading, for too many of the new advances are reminiscent of the Seed which fell on stony ground:\u27\u27and because it had no root it withered away."This is particularly true about researches into the aetiology and nature of ulcerative colitis. The fact that the disease is a cruel scourge of healthy young people, treatable to some extent, and yet imperfectly understood, has produced the attitude of mind that ulcerative colitis is a challenge. Although many valuable advances have resulted, it is probable that more pet theories have gained hold in this disease than in any other, and consequently there is considerable diversity of opinion regarding its nature and its treatment. Ideally, there should be a team, consisting of physician, surgeon and psychiatrist, each with something to offer in the treatment of the patient, but, in the international congress on ulcerative colitis, co-operation was curiously lacking, and the individual members seemed unable to concern themselves with approaches which were not their own
Hazards of Radiation
Get PDFBased upon a Dissertation given before the Society on Friday, 11th October 1957.Radiations are of two types: Particulate and Electromagnetic. Particulate radiations are comprised of the sub-atomic particles, electrons, protons, neutrons and alpha particles which, when moving at high speed, possess the property of passing through matter, the depth of penetration being proportional to their kinetic energy and their electrical charge.Alpha Rays which are rapidly moving nuclei of Helium atoms have mass 4 and charge 2 on the atomic scale and have little power of penetration in tissue, reaching to a depth of about 0.05 mm.Beta Rays which are beams of fast moving electrons, can penetrate tissue up to a depth of 2 to 5 mm., and Protons with unit mass and electrical charge lie somewhere between these two.Derived from an external source, these radiations are of little danger since they are obviously incapable of penetrating to the gonads and bone marrow, tissues in which the more sinister biological effects are manifest.These radiations are particularly dangerous when derived from a source which may be ingested with food and perhaps selectively concentrated in body tissues, as, for example, Strontium 90 in bone