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100 YEARS AGO

 

Dreams 3: Dreams and crime

22 Jun 2017Paid-up subscribers

WHAT IS THE ASSOCIATION of dreams with crime? I have questioned insane criminals about their dreams in connection with specific crimes, and although there is always some reserve about admitting revelations in connection with criminal acts, I find that they dream much as do other people. In this class, there is a considerable difficulty in proving their hidden personal secrets, and in overcoming the resistance of the so-called “censor”.

Dreams 2: Prophetic dreams

23 May 2017Paid-up subscribers

MANY PERSONS have endeavoured to read into dreams some hidden meaning whilst others consider them to be only a confused and jumbled record of sleep-memories unworthy of serious reflection. Possibly the truth in regard to dreams lies between these two extremes of undue scepticism and a too facile credence.

Dreams 1:Dreams, insanity and fear

24 Apr 2017Paid-up subscribers

IT MAY SEEM OUT OF PLACE that we should be discussing the realms of dreamland, whilst we are face to face with so grim a reality as a War for our very existence; a War which has so deeply affected the life of every individual in this country as well as within the Empire. But we may claim that the “Bowman” in the early days of the War laid particular emphasis upon dreams — for to these of our brave warriors appeared the “Angel of the Mons,” and the “unconscious mind” has thus been drawn, in literature at any rate, into the tragedies of the War. [Written in 1917 in The Practitioner

Sudden death: Respiratory system

22 Mar 2017Paid-up subscribers

 In this article, cases have been selected which illustrate some of the difficulties confronting a medical man during an examination into the cause of death related to the respiratory system.

Sudden death: Nervous system

22 Feb 2017Paid-up subscribers

The most difficult cases are those in which death is the result of shock, uncomplicated by any recognizable morbid condition. It is only when the circumstances attending the death are known, or can be deduced, that an opinion can be given that death resulted from shock. The regions with which this danger is associated are the genital organs, the upper part of the abdomen, as a result of pressure or a blow in the epigastrium, the throat, and the nose. The fatal knock-out blow in boxing is the most familiar example of sudden death resulting from a blow in the epigastrium. Cases of sudden death from shock due to manipulation of the female genital organs are rare, but I have seen several cases in which an attempt to induce abortion has led to death from shock.

Sudden death: The circulatory system

23 Jan 2017Paid-up subscribers

Written a hundred years ago by Bernard H. Spilsbury, Pathologist to St Mary’s Hospital, London. To any medical man may come an urgent summons to a case of sudden and unexpected death. Sometimes he is unable to certify the cause, even after post-mortem. It is in such circumstances that my assistance as a pathologist is invited. It is customary, for medico-legal purposes, to regard death as the result of failure in function of one of the three systems: nervous, circulatory, and respiratory. This the first of three articles presents some circulatory causes of death.

Sublingual medication

15 Dec 2016Paid-up subscribers

I have several hypodermic syringes of the latest patterns, and keep them in an excellent condition, but I very seldom use them except by the express wish of a patient who has had injections before. A syringe will not lie idle for very long before it becomes faulty, and the constant attention one has to pay to the fine wires within the needle is a serious handicap to the physician. By the sublingual method, all that I have just mentioned is negatived, the exhibition of the remedy is a direct one, and no mechanism of any kind is required.

The vaccine treatment of asthma in Bengal in 2016

24 Nov 2016Paid-up subscribers

NORMAN CHEVERS, in his work on Diseases in India, records that early in its history, Bengal became notorious for asthma. Also that the reason why Clive was given command of the relieving forces, proceeding from Madras to Calcutta in 1756 after the Black Hole catastrophe, was because his senior officer, being subject to asthma, was considered unfit for service in Bengal. Asthma is still very prevalent in Calcutta. I have obtained most promising results in a number of cases by vaccine treatment on very simple lines. I would like to put my experience on record.

Treatment of placenta praevia

24 Oct 2016Paid-up subscribers

Some years ago, a practitioner sent for me to attend to a case of placenta praevia in which haemorrhage had recurred. When I arrived, she was almost in extremis, with a pulse of 160, and severe bleeding. The placenta was presenting and bulging into the vagina. I turned, left the breech plugging the lower uterine segment, and proceeded to transfuse her, but she sank and died quickly. I do not think anything could have saved her. This case left on my mind a deep impression of the perilous condition of a patient who has had one severe flooding due to placenta praevia. This is just the sort of case in which Caesarean section may help us to save mother and child. 

Alleged incontinence of urine and malingering

23 Sep 2016Registered users

PROBABLY of all the symptoms that a malingerer can simulate, one of the most baffling is incontinence of urine. When medico-legal cases are sent for examination and report, there is usually only an opportunity for a single examination, lasting perhaps under an hour, which makes it well nigh impossible to disprove allegations of this disability.

Passive ergotherapy in obesity

01 Aug 2016Registered users

The idea of employing the electrically provoked activity of the muscles as a therapeutic agent in obesity has been made practical by the perfection of the present apparatus. Its application is not restricted by any crippling condition of the joints, and, whilst avoiding any dangerous strain upon the heart, it provides an amount of exercise sufficient to start a more or less rapid lipolysis. Perhaps the most interesting and surprising feature is the rapidity with which physical activity may be regained under treatment.

Blood-letting in 1916

23 Jun 2016Paid-up subscribers

WITH SIR CLIFFORD ALLBUTT as its high priest, bleeding, with restraint, is in the process of coming by its own again. I first heard Sir Clifford Allbutt speak in praise of blood-letting in 1907, and I find this view confirmed in his recently published book. Blood letting has been advocated during the last fifteen years by those best qualified to speak of it from experience, namely, the general practitioners. However, they speak furtively, shamefacedly, and in the fear of the pseudo-scientific superman. These gentle counsellors have been assailed with such vociferous energy by the pseudo-scientist, that their timid voices have scarcely been heard.

Neurasthenia in war

23 May 2016Registered users

As soon as the acute stage has passed off, usually in a week or two, it is inadvisable to prolong the Weir-Mitchell treatment. The course usually prescribed is six weeks, but this is, in very many cases, harmful. The ennui and monotony are prejudicial, and will engender a feeling of helplessness, feebleness, and dependence upon others. I believe the majority would be far better to begin in a fortnight or three weeks to interest themselves in some pursuit or hobby. It is an interest in life that these people need. This will prevent them from drifting into the chronic stage from which it is so difficult to remove them. In neurasthenia, it is the person rather than the disease that demands treatment.

Difficult dislocations

25 Apr 2016Paid-up subscribers

DISLOCATIONS, even rare ones, have a knack of cropping up in general practice. One of the most unmanageable and disastrous is undoubtedly congenital dislocation of the hip. Failures gall me, as I suppose they do most people, and the verdict, “Nothing can be done,” always, I fear, arouses my obstinacy.

Malingering in soldiers

21 Mar 2016Registered users

One case of headache was a peculiarly pathetic one – that of a fine young fellow who had enlisted in a Guards’ regiment. He was eager to be sent out to the firing line, and had made up his mind that if he did not feel better when he got there, he would make it easy for the enemy to end an existence which had become intolerable. This form of suicide is probably more common than we think.

Treatment of war neuroses

22 Feb 2016Registered users

Much good may be done by suggestion in hysterical cases. By encouraging a patient and assuring him that he can use a paralysed limb, we may gradually bring back his control over it. Suggestion is especially useful in hysterical blindness: the patient is told that he will see, at a certain time, the exact minute being specified. Thus, Mr. Walter Jessop succeeded in curing a blind patient by getting the nurse to awake him in the middle of the night and saying to him, “Now you can see!”

Aetiology of war neuroses

25 Jan 2016Registered users

Conditions more calculated to shatter the strongest “nerves” it would be hard to imagine. Days and nights spent in wet, insanitary trenches, clothes swarming with vermin, food never very appetizing and often insufficient in amount, death or mutilation always imminent, comrades falling and fallen around, the groans of the wounded mingled with the ear-splitting din of bursting shells, to say nothing of the unspeakable horrors of the bayonet – all this, one would think, would more than suffice to upset the equilibrium of the most stable nervous system.

Migraine and ocular defect

22 Dec 2015Registered users

The responsibility of errors of refraction in causing headache is now an article of medical belief. But some of the many other manifestations of eye-strain are less widely known, such as the attacks of sickness of children, vertigo and certain migraines; the prescription of correcting lenses then may lead to rapid amelioration or complete relief from the trouble.

Pitfalls in the diagnosis of appendicitis

25 Nov 2015Registered users

When you get gangrene like that, the local symptoms are, very often almost absent; the abdomen may move quite freely, there may be no rigidity, there may not be any pain on pressure, and the temperature is not necessarily raised. The pulse, however, is always quicker. When the pulse is increased, there is a case for operating early. If high, you must operate, whatever else happens. I can recall cases in which, because there were no marked symptoms, and because attention was not paid to the pulse, the patient was allowed to go on for over a week, carefully watched with a masterly inactivity.

Acute gonorrhoea

21 Oct 2015Registered users

The apparatus used for local treatment of acute anterior urethritis is an ordinary douche-can, four feet of indiarubber tubing, a clip, and a glass nozzle, which is fined down to a blunt point, and is flattened. The can is suspended five or six feet above the patient, filled with a pint of water which is a little too hot for the hand to bear with comfort. By the time the fluid has reached the nozzle and one is ready to begin, it will not be too hot.

The tragedy of glycosuria

24 Sep 2015Registered users

A YOUNG woman, pale, thin, and tired, walked into my consulting room, and sat heavily down in the chair opposite me. There, her cheeks hollowed, her chin sharp and pointed, her body thin, and her aspect haunted, she confronted me. Occasionally, she passed her tongue between her lips to moisten them, as if she felt them dry and uncomfortable. There was a slight flush on the prominences of both cheeks, and she looked like an animal which had nearly been starved, and which licked its lips in anticipation of a meal....

Eclampsia and its treatment

05 Aug 2015Registered users

In New York city itself, the deaths registered from eclampsia in 1902 numbered only 97, but in 1912 they numbered 171. Today in England and Wales, out of every 2,000 confinements one woman dies and seven, roughly speaking, are the subjects of eclampsia, while, strange to say, in Scotland this ratio is nearly doubled.

‘Pensionitis’ in a seaman

22 Jun 2015Paid-up subscribers

In reporting him unfit I detailed the circumstances, and ventured to predict that, after receiving his pension, he would be at work within six months…[And] that was the exact period at which he did in fact return to work, with, of course, his pension of twenty-five shillings a week for life!

Cerebrospinal meningitis

21 May 2015Paid-up subscribers

WRITTEN IN 1915: [In acute cerebral meningitis of childhood] I have many times witnessed striking recoveries from full doses of mercury by the skin, after profound coma had almost obliterated all hope of improvement. I believe it to be unjustifiable to abandon the patient to his fate without resorting to vigorous treatment by this drug.

Underuse of sublingual medication

23 Apr 2015Paid-up subscribers

He believed the patient was dead, for he had ceased to breathe, and no pulsation could be detected. By way of a last chance, I inserted a strychnia and two apomorphia discs under his tongue, and rolled him over on to his left side. Well within a minute he made a valiant effort, and vomited, and finally recovered.

Obstetric mutilations

23 Mar 2015Paid-up subscribers

WRITTEN IN 1915:A considerable number of women admitted into the London Hospital as obstetric cases have, to an almost inconceivable extent, a lacerated and bruised lower genital tract, cervix, vagina, and perineum. A combination of lack of experience and judgement, lack of adequate time to devote to a midwifery case, and a mistaken sense of pride in refusing to take advantage of skilled advice which is nowhere remote in the London area, still renders some of our metropolitan midwifery a blot on the reputation of modern obstetrics.

Medical women and the War

23 Feb 2015Paid-up subscribers

WRITTEN IN 1915:While there has been a demand for medical women to take the place of medical men in every capacity, the larger proportion of the posts that have been offered to women are for newly-qualified or quite junior practitioners. There are practically none for the older and more experienced women doctors. The majority of members of the profession are willing for women to take their places as hospital residents or other appointments so as to release them for the front, but they will expect the women to give up their positions with smiling faces when they return at the end of the War. However, many will not return, and, consequently, the preservation of the health of the nation will tend to be more in the hands of women than was the case before the War.

Electro-therapeutics in the present War

30 Jan 2015Paid-up subscribers

Written in 1915: In many cases, there is doubt as to the organic nature of the paralysis. Numerous cases occur to which, in civil practice, the term “hysterical” would be applied. Many of the patients are, however, men who have proved their bravery in the field, and it seems to me that “psychical” is a fairer term to use. The frightful sights and sounds of a battle-field, combined with some amount of actual personal injury, undoubtedly inflict at times a psychical trauma, which in all probability could be shown to have a definite physical basis, had we means fine enough to investigate it. Nothing could be further from the truth than to suggest any trace of malingering in such cases, yet it is undoubtedly true that in many instances that paralysis would vanish under sufficient mental stimulus - such as the classical “house on fire.”

The psychic factor in insomnia

15 Dec 2014Paid-up subscribers

FROM THE PRACTITIONER 1914. In the process of analysing this case of insomnia, I discovered that several years before there had been a great intimacy between the patient and Mademoiselle X. The patient’s husband – the mildest of men – had grown uneasy about it, and refused to allow the friendship to go on. In his desire to do everything to render the proposed visit to Paris attractive, he had suggested staying in the house of Mademoiselle X, although he and his wife had never alluded to her for all these years. Instead of stimulating the patient’s recovery the opposite effect had been produced, because, in point of fact, the attachment had been a Lesbian one, and the whole complex was so painful that the patient shrank from the proposed awakening of the memory.

Outbreak of milk-borne diphtheria

24 Nov 2014Registered users

WRITTEN A HUNDRED YEARS AGO. The incidence of the disease was not upon children and invalids, who are generally speaking the principal milk consumers. The children may have escaped owing to the custom in better class houses of cooking milk that is to be consumed by them, or it may be that they consumed nursery milk, obtained locally, and not from the Sussex infected farm.

Fear of syphilis and suicide

23 Oct 2014Registered users

WRITING A HUNDRED YEARS AGO: “No patients are more suicidal than those who believe themselves impotent or affected by a sexual disorder”

Autotherapy in the prevention and cure of purulent infections

23 Sep 2014Paid-up subscribers

WRITTEN A HUNDRED YEARS AGO: I believe that spontaneous cure of an infectious disease is due to entrance into the blood-stream of the unmodified toxins, developed in the focus of infection. When this occurs the power of the blood-serum is raised, the activity of the leucocytes stimulated, with the resultant development of specific anti-bodies. In all acute infections, in which it is possible to obtain the toxins, a speedy cure may be expected. With few exceptions, all chronic infections are benefited more by the autotherapeutic remedy than by any other curative agent. Autotherapy is being used successfully by hundreds of physicians throughout the United States. A patient may abort infection by simply chewing his own blood dressings twice daily. This is a fact, and we cannot know too many facts.

Treatment of wounded soldiers

25 Jul 2014Registered users

A HUNDRED YEARS AGO: The results of abdominal wounds are very bad. One school of thought recommends immediate operation; the other advises no operation at all. Consider what it means to operate on the abdomen. There must be an absolutely first-class hospital and a first-class nursing staff at our disposal for at least 1½ hours, whilst for each case three highly-skilled medical men are needed: an expert abdominal surgeon – a man who can really tackle big abdominal work, a first-class anaesthetist, and the surgeon’s assistant. In the end, perhaps one out of three, perhaps one out of five, may recover. It is a terrible thing to have to place a man’s life in the balance, when we think we could save it by a great effort. But when there are 50 or 60 other wounded men lying around, and the labour being expended on one may mean lack of attention to the others, it becomes a very difficult question.

Psychological aspects of food idiosyncrasies in infants

23 Jun 2014Paid-up subscribers

A HUNDRED YEARS AGO: In older individuals, in whom the powers of reason have become developed, the direct influence of suggestion may be counteracted by innumerable inhibitions, but in babies, animals and hypnotized individuals the call of suggestion is imperative, and the exact form the response takes is determined by the nature of the previous responses, in other words by habit.

X-rays for severe menstrual pain and excessive bleeding

22 May 2014Paid-up subscribers

A HUNDRED YEARS AGO: When I saw her, at the beginning of 1912, she was very pallid and weak, and was obliged to spend ten days out of every month in bed. Even during the intervening time, she was by no means altogether free from haemorrhage. Her doctor informed me that there was absolutely nothing to be made out by physical examination. Six months later, on enquiry, I learned that she continued in perfect health, despite the fact that she had plunged into a whirl of social excitements; joys which had been altogether forbidden to her for more than a year previous to her treatment. Applied in the precise manner I do it, X-rays, should they fail to do good cannot possibly do harm.

Therapeutic suggestion

22 Apr 2014Registered users

Psychotherapy represents one of the important elements in therapeutics, and we must learn to use it in a way suitable to our patients. We have to learn to use our drugs in accordance with the nature and physical make-up of the patient... Just in the same way, our psychotherapy must be dosed out according to the special need of each individual, the form of the affection and the particular kind of mind that is to be dealt with.

A children’s casualty department - Evelina Hospital, London 1914

20 Mar 2014Registered users

'There was one type of scald, a grievous type, caused by the parents (with that modicum of wisdom which is infinitely worse than ignorance)  enveloping their children’s nether extremities in boiling rags, not wrung out dry, the very travesty of a fomentation. I saw many more or less severe cases of this kind; one poor child, a little girl aged about four, was brought up with her thigh literally cooked, and died some few days after admission.'

Nephroptosis and mental disorders

24 Feb 2014Paid-up subscribers

'If toxaemia can cause mental disorders, and movable kidney can cause toxaemia, there is no difficulty in recognizing movable kidney as a cause of mental disorders'

Recognising petit mal seizures

22 Jan 2014Paid-up subscribers

'To give a dose of bromide when the child has had a fit is only shutting the stable door when the steed is stolen; and to say that he or she will grow out of it, is courting disaster for the child, disappointment for the parents, and a considerable loss of prestige for ourselves.'

Notes on mental suggestion

05 Dec 2013Paid-up subscribers

The sister was asked to send herself to sleep, which she promptly did; she was then told to get in touch with her sister’s subjective mind; this was accomplished in about two minutes; she was further told to communicate with the other mind that the pain was to cease immediately, which it did. This lady knew nothing whatever about transference or the subjective mind, nevertheless she was able to say when en rapport with the sister’s subjective mind, so presumably she did know, more particularly as her suggestion was at once obeyed.

Treatment of alcohol inebriety

23 Oct 2013Paid-up subscribers

My experience and the experience of others, together with the testimony of my patients, convinces me that a treatment of inebriety that does not include the skilful use of psycho-therapeutic methods in their widest sense is inadequate and incomplete. The first stage of the treatment should consist principally of physical treatment, by drugs, and isolation from alcohol. When the withdrawal has been accomplished, beyond a tonic treatment by drugs and general hygiene, the treatment indicated is psychical treatment first, last, and all the time.

Migraine and its treatment

23 Sep 2013Paid-up subscribers

'Almost all the subjects of migraine learn that alcohol, especially in  spirits, is harmful as is tobacco; probably nothing is more likely to bring on an attack than a visit to a music hall or a smoking concert, possibly owing to the smoke-laden atmosphere and the custom of taking spirit'

Mental suggestion by indirect transference

29 Aug 2013Registered users

The modus operandi consists in hypnotizing a subject and haing seated him in a chair opposite to the patient, join  hands and then make your suggestions, without in any way directly influencing your patient, or putting him in a state of hypnosis....The recipient will probably show by his feelings and possible contortions, very frequently, that he has experienced the neurological condition of the patient; you then wake him. I have known many instances in which the recipient has, in every way, described the exact symptoms of the patient. On the moment of awakening all the symptoms leave the recipent and in most cases the patient.

The importance to life of the mineral substances in our food-stuffs

24 Jun 2013Paid-up subscribers

IT IS VERY EVIDENT that the mineral content of our food-stuffs is a matter of some concern, and any misgivings we may have regarding its sufficiency are due to the fact that there is in this century an ever-increasing tendency on the part of manufacturers and traders to tamper with, and affect prejudicially, many of our staple food-stuffs. On account of the introduction, nearly a quarter of a century ago, of the roller process of milling wheat, and of a growing demand for white flour, a very large percentage of the mineral constituents of wheat are now eliminated from marketable flour. Within recent years even the wholesomeness of this has been lowered by the injudicious exposure of much of the flour on the market to the influence of some bleaching reagent like nitrogen peroxide.

Two curious cases of coin in the alimentary canal.

24 May 2013Paid-up subscribers

The Chinese conjuror’s tale: “He was only anxious to get the coin back because the Chinese New Year was at hand, which is the great holiday time when all debts have to be paid off”

Blue brains (or peripheral stasis)

25 Apr 2013Paid-up subscribers

I ONCE told a lady, who asked me what was her disease, that her brains were blue, and I believe she still regards it as quite a bon mot, for she has sent others of enquiring mind that I might discover the colour of their intellect...

Clinical diagnosis in children

24 Mar 2013Paid-up subscribers

'A child’s face is frequently a clear index of the severity of the illness, or indeed of the actual complaint...'

Doctors in the Decameron

27 Feb 2013Paid-up subscribers

GIOVANNI BOCCACCIO has fallen upon evil days. No one reads the Decameron now, and if, by chance, a copy of that work finds itself in the library of a respectable person, it stands in the darkest corner of the top shelf of the bookcase, where the dust accumulates from spring to spring. This year the Italians will celebrate the sixth centenary of Giovanni Boccaccio’s birth, and surely there is no name in their literature, rich as it is in great names, that deserves more honour. We know that Giovanni Boccaccio studied law; it may be that he also studied medicine...

The treatment of bronchial asthma

24 Jan 2013Paid-up subscribers

ASTHMA is one of the diseases in which additions to exact knowledge during recent years have been few and comparatively unimportant. I wish to call attention to the form of asthma – in my belief the form most frequently seen – in which the disease depends largely upon the interaction of an abnormally sensitive nasal mucous membrane, and in this respect an abnormally excitable condition of a portion of the nervous system. ... Nothing gives more relief to the majority of those who suffer from this disease than the use of various nasal sprays of cocaine.

GPs should always be students

12 Dec 2012Paid-up subscribers

'The graver mistakes of practice arise not so much from ignorance as from a want of thorough and routine examination'

Lead poisoning

31 Oct 2012Paid-up subscribers

That lead is a powerful abortifacient has repeatedly been emphasized and fully established during investigations into many industrial processes, and that it has been, and is still being, used illegally for that purpose is equally beyond question.

The inunction treatment of measles

20 Sep 2012Paid-up subscribers

'My results suggest a decided value must be placed upon the eucalyptus inunction method of treating measles, not forgetting, of course, the antiseptic treatment of the mouth and throat...'

A hundred years ago:Epidemic gastro-enteritis

20 Jun 2012Registered users

'JULY, AUGUST and September, 1911, represent dark days in our history; the lives of many hundreds of previously healthy and vigorous infants having been lost. The total number of deaths from all causes for the quarter ending September 30th, 1911, in the Dublin registration area was 2,172. Diarrhoeal disease in children under two years of age accounted for 426 (18.6 per cent of all deaths) and of these 118 were registered as enteritis...'

A hundred years ago: Therapeutic use of mud

23 May 2012Registered users

'As regards radio-activity, for which some claim has been made as regards this mud, I must confess to some doubts, for its chief effect must be looked upon as due to either thermal or mechanical action. Taking into account its uniformly fine and entirely homogenous character, the absence of any conductivity for heat, and its perfect plasticity, fango must be regarded as a practically ideal cataplasm....'

Treatment of rheumatic disorders

30 Apr 2012Registered users

Selected notes from readers of The Practitioner in 1912 on rheumatic disorders: Treatment by bee stings, The country doctor and acute rheumatism, and Dr Percy Wilde’s Method

 

A hundred years ago: Radium therapy in rheumatism

21 Mar 2012Registered users

'There is no doubt that in severe cases, and especially in acute rheumatism, the constant inhalation of strong radium emanation with oxygen to saturation of the system is of the greatest value; and no apparatus has given such excellent results as that which is shown here – the joint invention of Pro. Paul Zazarus and Dr. Saubermann. This apparatus is most useful when it is desired to highly charge the blood with radium emanation in order that it may exert its bactericidal power.'

A hundred years ago: Minor accidents in general practice

25 Feb 2012Registered users

'IN ANY TOWN where there are works of any kind one is constantly seeing accidents of various degrees of severity. Minor accidents are common. These generally affect the fingers and toes and vary from simple contusions and scrapes to complete amputations. I write from Earlestown, Lancashire, and being surrounded by several large works a great number of minor accidents are met with in practice. During the last two years I have personally attended over 250, the number in one month reaching as high as 27. As it is of the first importance that a workman should have all his digits, it is of even greater importance that none of them should be stiff or useless, because then they are only in the way and had better be amputated...'

100 years ago: The GP and the Medical Society

16 Dec 2011Registered users

By J. Mitchell Bruce, M.A., LL.D. (Hon.), MD, F.R.C.P. Presidential address delivered in 1911 before the Medical Society of London: 'Is the object of the Medical Society entirely fulfilled in the routine work of our meetings? I find that, whilst those who are in general practice constitute one-third of our number, only one communication in 15 comes from them – that they have read but four papers before the Society during the past 10 years...Let me call to mind some of the great things that have been accomplished by the family practitioner. I have but to mention the name of Edward Jenner, Fellow of our Society. Was not Koch a general practitioner; and Duchenne of Boulogne? And was it not the work that Manson did on filarial disease, when a practitioner in China, that led him to the induction of the relation of malaria to blood-sucking insects? Something short of the results of the achievements of these men in general practice would satisfy me.' 

100 years ago:Tuberculin in pulmonary tuberculosis

22 Nov 2011Registered users

100 years ago: 'Tuberculin plays an important part in the treatment of pulmonary tuberculosis in certain cases, and that its efficacy is greatly increased when it is diluted with a 1 per cent. solution of carbolic acid. However, tuberculin cannot take the place of sanatoria. Too much value is placed on tuberculin by tuberculin enthusiasts. It has an important place in the treatment of pulmonary tuberculosis, but must on no account be allowed to usurp sanatorium treatment. Its use is restricted to certain cases.' 

Blood pressure

20 Oct 2011Registered users

   “It is only when the patient is seized with the intolerable agony of angina pectoris that the nitrites should be used with any freedom”. By J. Campbell McClure, M.D., Clinical Assistant, West End Hospital for Nervous Diseases, and Mount Vernon Hospital, writing 100 years ago.

100 years ago: Preventing deaths from measles

20 Sep 2011Registered users

The number of deaths from measles in the County of London for the three months February, March, and April, 1911, was no less than 1,640, a weekly average of 126, constituting about 8 per cent of the total mortality during that period. The greatest mortality occurred in the poorer districts of London amongst children under five years of age. During the same period the total number of deaths from scarlet fever totalled only 29, though the average number of cases under treatment each week at the hospitals of the Metropolitan Asylums Board and at the London Fever Hospitals exceeded 1,000.

100 Years ago Residual urine in old men

09 Aug 2011Paid-up subscribers

"Sir James Paget used to urge elderly men to educate their bladders and not allow them to dictate to their masters"

100 years ago: Sea-bathing

05 Jul 2011Paid-up subscribers

The ordinary means of bathing is from a machine, a contrivance which has not progressed in luxury or convenience with the lapse of time. Of course for those who cannot swim the attractions of the open sea and the dive from the boat are inaccessible. Delicate people and children should make use of a machine or tent, if obtainable, in preference to undressing in the open air, because the mere exposure to the air in the act of stripping is a potent means of loss of animal heat. It is best to avoid loitering about after undressing, and to run rapidly into the water and immerse the whole body under the first available wave.

Breast milk: vomiting and diarrhoea

25 May 2011Paid-up subscribers

A HUNDRED YEARS AGO: A Gilbertian school of physicians has arisen who place breast-feeding in the same category as original sin and other evils of human heritage; and who stridently proclaim the superhuman virtues of unsterilized cow's milk.

100 years ago: Training of athletes

20 Apr 2011Paid-up subscribers

Sir Adolphe Abrahams died in 1967.  He is seen as the founder of British sports medicine. His two brothers were both Olympic Athletes. (Harold Abrahams won Gold for 100 metres in the 1924 Paris Olympics.) In 1911 Adolphe wrote an article for The Practitioner  on the art of training athletes. '....  Those who look after long-distance men are well acquainted with their man's bad time, are on the watch for it and are quite well aware that it is only a question of coaxing him over his temporary distress by threats, abuse, flattery, or such material encouragement as champagne.'

100 years ago: The Ament and his influence on the future of the race

23 Mar 2011Paid-up subscribers

'THE RESULTS of the recent Royal Commission on the Care and Control of the Feeble-minded have disclosed a state of affairs so appalling that there can now be no doubt whatever but that we have reached a period in our race history when it is the duty of every physician to cry aloud and rest not until the people are made aware of the true state of affairs, and are taught to recognise the canker-worm which is not slowly, but rapidly and surely, undermining our very national existence. Let us consider the position today. The lunatic, on the one hand, is detained in asylums, both private and public; for the imbecile, on the other, who is much the more potent agent of the two in racial deterioration, there is no State provision whatever; voluntary charitable effort has, through the instrumentality of some half dozen specially equipped training institutions, accomplished but a fraction of what is really necessary for efficient care and control by providing him with a home and training for a term of years, after which period he is discharged only, in the vast majority of instances, to continue to be a burden on the community, and a menace to his fellows.'

100 years ago: Treatment of neurasthenia by hypnotism and suggestion

21 Feb 2011Registered users

Practitioner 1911:Mrs. H. Aged 35, a lady of good social position, came to me in 1905. She had been ill for five years and had undergone many forms of treatment, including two rest cures, a course of high-frequency electricity, and osteopathy. She was a clever vivacious woman of highly artistic temperament, and felt her disability to take her place in society most acutely. The least exertion, mental or physical, left her exhausted; she had almost constant headache, and her sleep was disturbed by harassing dreams. She proved a most susceptible subject, falling at once into a state of somnambulism with amnesia on waking. She responded at once to suggestions, recovered the habit of dreamless sleep, and in three weeks was able to return home cured. I meet her occasionally, and she continues perfectly well and full of all kinds of activities. In this case the nervous breakdown followed a time of prolonged nursing and great anxiety aggravated by morbid remorse. She reproached herself for the illness of one of her children whom she had sent to a new school against the advice of her friends. This state of things was revealed after a little questioning, and the suggestions aimed at removing the feeling of remorse, which had become almost an obsession, by assuring her that she was not to blame in the matter and that everything would turn out for the best and end happily. Of course she had been told this hundreds of times by all sorts of people in her waking state, but it was only when mental receptivity had been insured by hypnotism that suggestions were accepted as true and acted as curative impulses.

100 years ago: Cancer and the general practitioner

20 Feb 2011Registered users

Practitioner 1911: These facts are in a large proportion of cases known only to general practitioners, and very often to practitioners other than those who referred the patients to the operating surgeon. If all practitioners would make a practice of sending to the operating surgeon a brief record of every case of cancer that has been treated by operation, whether it show recurrence of the disease or not, and particularly would notify to the surgeon the fact of the patient's death, and whether due to cancer or not, our knowledge of the real value of operations for cancer would soon become more nearly exact than it is at present.

100 years ago: Physic in Shakespeare’s time

20 Dec 2010Registered users

"If people sick, they come to me,
I purges, bleeds and sweats 'em;
If after that they likes to die,
What's that to me? I lets 'em"

100 years ago:Constipation

19 Dec 2010Registered users

"I generally put it away when an English doctor is coming, because I know he would disapprove of it. You English are so conservative, and, forgive me, you are such hypocrites; but what is even worse, in this matter, you are so backward. You frown at my diagram, but, believe me, it is not quackery, it is science; it is not charlatanism, it is psycho-therapy. That diagram has cured - yes, cured - more patients than all the waters in the spas in Europe."

100 years ago: Traumatic neurasthenia

16 Dec 2010Registered users

The train of symptoms which may follow various accidents, in which the patients may or may not have received a serious injury (now known as traumatic neurasthenia) was formerly ascribed to concussion of the spine, inflammation of the meninges and spinal cord, haemorrhages into the meninges and surface of the brain and cord, etc., and since greater public attention has been devoted to those occurring after railway accidents, the condition has been called "railway spine" and "railway brain". There can be no general rule of treatment applicable to all cases; each case must be separately studied. Where the original nerve shock has been great, and the symptoms of palpitation, headache, nervousness, and loss of memory are prominent features, the best treatment undoubtedly is a "rest-cure" for six weeks. Complete rest in bed is essential for the first two weeks at least, and isolation from relatives and friends and correspondence, with massage and overfeeding. General electrification by means of the faradic or sinusoidal current bath is usually the most efficacious means of applying electricity in these cases, the patient being immersed up to the neck in a warm bath, with two large flat electrodes applied, one to the back, the other to the feet, connected to the secondary coil of a faradic battery or sinusoidal current transformer.

100 years ago: Treatment of heart failure

24 Nov 2010Registered users

'In spite of the extravagant advocacy during recent years of the value of hydrotherapy and special exercises in the treatment of cardiac failure, there is no therapeutic influence that compares in efficacy with physical and mental rest. The carrying out of this principle does not necessarily entail complete rest in bed; each case must be considered in the light of surrounding conditions with the object of ensuring a maximum of relief to the heart with a minimum of disturbance to the patient. In other words, the mental, moral and physical requirements of the case must be carefully weighed and allowed for in drawing up a plan of treatment.'

Tonsillectomy in general practice

20 Oct 2010Registered users

To the general practitioner the operation for removal of tonsils and adenoids must always constitute a large proportion of his minor surgery. Few operations are more commonly performed, and few, perhaps, are done worse. This state of affairs is due to a non-observance of certain general rules... Haemorrhage is really the only complication of any importance; it usually corrects itself, ceasing when the patient loses sufficient blood to make him feel faint.

A hundred years ago: Treatment of ringworm by x-rays

20 Sep 2010Registered users

'I have no doubt that the risks to which I have alluded are being daily diminished by skilled operators; but now that practically every County Council school is ordering, or trying to order, X-rays for every case of ringworm, and seeing that skilled radiographers and dermatologists are limited in number and are not to be found everywhere, I shall not be surprised if we do hear of children whose scalps  have been permanently injured by X-rays.'

A hundred years ago: The teaching of insanity to the medical practitioner

21 Jul 2010Registered users

'Hitherto there has been no separate recognition of mental diseases as a subject worthy of diploma by the examining bodies, although the London University may be quoted as conferring the title, Doctor of Medicine, upon those of its medical graduates who specialise and pass an examination in this and other subjects. The Medical-Psychological Association of Great Britain and Ireland, consisting of both medical men and women in this country and abroad, who are especially interested in mental diseases, and numbering over 700 members, grants a certificate to qualified men for proficiency in the subject of psychiatry, and it has recently approached the Royal College of Physicians of London and several of the degree-granting authorities for the purpose of promoting further interest, and, if possible, to inaugurate a diploma similar in the scope to those granted for Public Health and Tropical Medicine, and those which the University of Oxford propose to grant in Business or Journalism. It is also considering the establishment of special post-graduate courses for those who make mental disease their life-work. '

100 years ago: Concerning the preservation of health in the tropics

24 Jun 2010Registered users

'A healthy lad with a moderate outfit, good food, personal cleanliness, plenty of work, and a disposition that does not worry will do well in India. When a man begins to worry it is time for him to go home, and that applies if he suffers from the so-called Aden or Burma or Punjaub or Madras head. When a man forgets, calls things by wrong names, gets irritable, broods about his work at night, develops insomnia, and loses his confidence, those are symptoms of neurasthenia and the treatment is to send the case home. The Government gives one year's "leave" in every five and a month in every year, and the Goverment would not do that if it did not find that it was necessary.'

100 years ago: State prevention of tuberculosis

23 Jun 2010Registered users

We want to attack tuberculosis before it attacks us. The key is that about the period of adolescence, when business life succeeds that of childhood every youth and maid ought to be taught in a sanatorium, how to live as part of the State education. An education also at this period involving an elementary knowledge of human physiology would reap great benefits, for did the man in the street but know, for instance, the actual amount of waste products that he casts off in twenty-four hours by means of perspiration, then, I submit, that he would become more careful than he is now of personal ablutions, changes of underclothing, and perhaps of linen; with untold advantages to our national matters and morals.... Women, too, might be taught the true principles of house-cleaning, which, they might be astonished to learn, they by no means know.

Chronic gonorrhoea in the female

15 Apr 2010Registered users

There is probably no disease affecting the female urinary genital organs which presents itself so often to the practitioner as the chronic variety of gonococcal infection. The successful treatment of the condition is invariably difficult, calling for considerable exercise of patience and discretion on the part of the medical attendant. Injudicious treatment, especially in the way of systematic curettings, etc., is not infrequently followed by extension of the disease.

Painless labour

15 Mar 2010Registered users

I have no sympathy with the man (or woman) who holds the opinion that labour pains are “natural” and therefore not to be interfered with. Patients in labour will cry out bitterly that they are too weak to endure the increasing pains of the latter half of the first stage; chloroform here is contraindicated we know in the large majority of cases. Is there nothing more we can do then, certain in action, and absolutely safe for mother and child?

Leprosy in 1910

15 Feb 2010Registered users

'The last place where a leper settlement existed in Britain was in the Shetland Islands. There the disease seemed to have been rife, possibly owing to the fact that the natives were of Scandinavian origin and were in more or less constant communication with Norway and Iceland where the disease was prevalent.'  Extracted from a 1910 issue of The Practitioner

100 years ago: Evils of the modern British diet

21 Jan 2010

'Doubtless many men dig their graves with their teeth, and the general span of life might be lengthened by the adoption of greater prudence and moderation in the selection of food. An attack of gout will turn a man into a savage, but man in the savage state was innocent of the indiscretions which bring on the gout. It may be gravely argued that many present-day diseases and other evils are the result of over-civilisation. These evils are due to many complex causes, but among them we may reckon over-feeding and ignorant feeding on the part of the well-to-do, and underfeeding and still more ignorant feeding on the part of the poor.'

Female inebriety

15 Dec 2009

'Many... have been launched upon their course of inebriety by putting too liberal an interpretation upon loose medical advice'

On being tired

15 Dec 2009

'...in this kneeling position, he wrote all his works, the blood having thus to travel to his brain in a horizontal line, instead of upwards against the force of gravity as it would have had to do in the sitting position.'

Pasteur, science and medicine

15 Dec 2009

'The death of his children, the loss of the many brave young heroes in the ambulance tents during the war, the epidemics he had witnessed, all this human suffering weighed upon him and determined him to do his utmost to solve the problems which medical men, working alone, seemed unable to fathom.'

The power of bedside diagnosis

01 Feb 2009Paid-up subscribers

'There is a growing inclination to rely upon the evidence of laboratory investigations in diagnosis, and no doubt that tendency is increasing.'

140 years ago: Clinic of the month

17 Dec 2008Paid-up subscribers

Extracted from The Practitioner 1868

On the therapeutic value of oil and water

19 Nov 2008Paid-up subscribers

Extracted from The Practitioner 1868

140 years ago: Clinic of the month

10 Sep 2008Paid-up subscribers

Dr. W. C. Maclean, than whom there is no higher authority on sunstroke, gives the following advice to those who have to deal with this affection.

140 years ago: Notes and Queries

10 Sep 2008Paid-up subscribers

The Editors, being desirous of making this department a useful medium of communication between practitioners, will be glad to receive short notes on theoretical or practical points in therapeutics.

140 years ago: On Inhalation in Diseases of the Throat

10 Sep 2008Paid-up subscribers

Extracted from The Practitioner 1868

A hundred years ago: The taint of insanity

18 Jun 2008Registered users

Extracted from The Practitioner 1908

A hundred years ago: Short-lived Doctors

23 Apr 2008Paid-up subscribers

A medical contemporary recently drew attention to the fact that doctors are a short-lived class of the community. The exigencies of his calling often make it impossible for him to practise the hygienic doctrines which he preaches.

A hundred years ago: Infantile paralysis

01 Feb 2008Paid-up subscribers

By Guthrie Rankin, M.D., F.R.C.P. (Edin.), M.R.C.P. (lond.), Physician to the Seamen’s Hospital, Greenwich; Physician to the Royal Waterloo Hospital for Children and Women, London Extracted from the February 1908 issue of The Practitioner

A hundred years ago: The diagnosis of general paralysis

23 Jan 2008Paid-up subscribers

By F. W. Mott, M.D., F.R.S., F.R.C.P., Physician to Charing Cross Hospital; and Pathologist to the London County Asylums. Extracted from the January 1908 issue of The Practitioner

A hundred years ago: On the necessity of caution in diagnosing hysteria

01 Dec 2007Paid-up subscribers

By Bernard Myers<br />M.D., C.M, M.R.C.S.

A hundred years ago: Convulsions in infancy and childhood

01 Oct 2007Paid-up subscribers

By George F. Still, M.A., M.D., F.R.C.P., Professor of Diseases of Children, King’s College, London; Physician for Diseases of Children, King’s College Hospital; Physician to Outpatients, Hospital for Sick Children, Great Ormond Street.<

A hundred years ago: C.E.-ethyl chloride-chloroform sequence

01 Sep 2007Paid-up subscribers

By G.A.H. Barton, M.D., M.R.C.S., &C., Anaesthetist to the N.W London Hospital; Anaesthetist to the Throat Hospital, Golden Square, &c.

On the use of opium

27 Jul 2007

Extracted from the May 1907 issue of The Practitioner

A hundred years ago: Gouty glycosuria

01 Jul 2007Paid-up subscribers

By Alfred W. Sikes, M.D., D.Sc. (Lond), F.R.C.S., Late Medical Registrar and Demonstrator of Medicine to St. Thomas’s Hospital.

A hundred years ago: Tricuspid regurgitation

01 Jun 2007Paid-up subscribers

By Raymond Crawfurd, M.A Oxon., M.D., F.R.C.P Physician to King's College and the Royal Free Hospital

A hundred years ago: On the use of opium

01 May 2007Paid-up subscribers

By I. Burney Yeo, M.D., F.R.C.P Emeritus Professor of Medicine in King's College, and Consulting Physician in King's College Hospital

A hundred years ago: What is Fever?

01 Apr 2007Paid-up subscribers

By Woods Hutchinson, M.A., M.D. <strong>Arrowhead Springs, California, U.S.A.</strong>

A hundred years ago: Diabetes and insanity

01 Mar 2007Paid-up subscribers

By Theo B. Hyslop, M.D. Senior physician, Bethlem Royal Hospital; Lecturer on Psychological Medicine, St. Mary's Hospital