The external conjugate diameter is only a rough guide to the size of the true conjugate as the bones, and tissues covering them, vary in thickness in different people.
External Conjugate Diameter Of the Pelvis - Pt/2
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External Conjugate Diameter Of the Pelvis - Part II
The external conjugate diameter is only a rough guide to the size of the true conjugate as the bones, and tissues covering them, vary in thickness in different people.
If the measurement is over 7.5 inches the true conjugate is not likely to be diminished, and if it is under 7 inches it is likely to be diminished. The measurement is taken either when the patient is standing or is in the left lateral position.
The external conjugate diameter is only a rough guide to the size of the true conjugate as the bones, and tissues covering them, vary in thickness in different people.
External Conjugate Diameter Of the Pelvis - Pt/1
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External Conjugate Diameter Of the Pelvis
This Measurement is taken with a pelvimeter, one point of which is placedon the spine of the last number vertebra, and the other on the front of the pubes. It shouldbe 7.5 inches.
It is not always easy to feel the spine of the last lumbar vertebra. In case of doubt the position of the spine can be ascertained as follows.
The position of the each posterior superior spine of the iliac bones can easlily be determined if the woman stands up.
A point 1.5 inches above the centre of a line joining these two iliac spines denotes the position of the spines are at thimes indicated by dimples in the Skin.
This Measurement is taken with a pelvimeter, one point of which is placedon the spine of the last number vertebra, and the other on the front of the pubes. It shouldbe 7.5 inches.
It is not always easy to feel the spine of the last lumbar vertebra. In case of doubt the position of the spine can be ascertained as follows.
A point 1.5 inches above the centre of a line joining these two iliac spines denotes the position of the spines are at thimes indicated by dimples in the Skin.
Interspinal and Interaristal Diameters of the Pelvis - Pt/2
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Interspinal and Interaristal Diameters of the Pelvis - Pt/2
The Two measurements are of use in determining if there is any contraction of the pelvis, and,ifso, of the commoner forms, which variety. Thus in a flat pelvis the difference between the intercristal,
Which is normally 1 inch, is reduced so that the interspinal is as long as intercristal.
In a generally contracted pelvis, on the other hand, the difference of 1 inch is constant, but both measurements are shorter. In both flat and generally contracted pelvis the external conjugate is difintely shortned.
In a generally contracted and flattened pelvis both measurements are shorter, the normal difference between them is less than 1 inches.
The Two measurements are of use in determining if there is any contraction of the pelvis, and,ifso, of the commoner forms, which variety. Thus in a flat pelvis the difference between the intercristal,
Which is normally 1 inch, is reduced so that the interspinal is as long as intercristal.
In a generally contracted pelvis, on the other hand, the difference of 1 inch is constant, but both measurements are shorter. In both flat and generally contracted pelvis the external conjugate is difintely shortned.
In a generally contracted and flattened pelvis both measurements are shorter, the normal difference between them is less than 1 inches.
Interspinal and Interaristal Diameters of the Pelvis - Pt/1
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Interspinal and Interaristal Diameters of the Pelvis
Interspinal. This measurement is taken by placing one point of the pelvimeter on the outside of one anterior superior spine, and the other point on the outside of the opposite anterior suprior spine. It should be 10 inches.
Intercristal. This meausrement, which is the widest part separating the crests of the ilia, is taken by placing one point of the pelvimeter on the outer margin of the opposite crest of the ilium.
It should be 11 inches.
Interspinal. This measurement is taken by placing one point of the pelvimeter on the outside of one anterior superior spine, and the other point on the outside of the opposite anterior suprior spine. It should be 10 inches.
Intercristal. This meausrement, which is the widest part separating the crests of the ilia, is taken by placing one point of the pelvimeter on the outer margin of the opposite crest of the ilium.
It should be 11 inches.
Measurement Of the Diagonal Conjugate
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Measurement Of the Diagonal Conjugate
The True conjugate can only be measured directly after labour by a special instrument. An estimate of the true conjugate is, however, made by passing two fingers of the right hand backwards and upwards into the vagina till the end of its middle finger touches the promontory of the sacrum.
The hand is then carried upwards and forwards until its indexfinger touches the apex of the pubic arch. The index finger of the left hand is then placed at the point of contact, the fingers are withdrawn from the vagina, and the distance between the tip of the middle finger of the right hand and where the index finger of the right hand has touched the pubic arch is measured with a tape measure. Normally the measurement shouldbe 4.75 inches.
Thus to ascertain the measurement of the true conjugate, 0.75 inch must be deducted from that of the diagonal conjugate.
The True conjugate can only be measured directly after labour by a special instrument. An estimate of the true conjugate is, however, made by passing two fingers of the right hand backwards and upwards into the vagina till the end of its middle finger touches the promontory of the sacrum.
Thus to ascertain the measurement of the true conjugate, 0.75 inch must be deducted from that of the diagonal conjugate.
Human Muscle Anatomy - Pt/3
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Hey deoctors and medical students, I like to show this medcial video for everyone of you for the final of the human muscle anatomy part. After watch this you can clear doubts about the medical.
Human Muscle Anatomy - Pt/2
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Hello friends now you're watching the Human muscle anatomy Pt-2 of one. This is continue about the part one of the Human muscle anatomy.
Human Muscle Anatomy
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About the Muscle i called about that are actually part of trapezius. The lats called sometimes the "Wings". The most superficial muscle in the abdominal region is the external obliques.
3D Anatomy Tutorial
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This is about the Muscles of the Anterior Abdominal Wall in 3D Anatomy Tutorial. After watch this video you can get the informatiuon about the anatomy.
Introduction to Clinical Surgery Lectures - 05 Scrotal Swellings
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Hey Doctors and medical students this is Introdution to clinical surgery Introduction to Clinical Surgery Lectures - 05 Scrotal Swellings. When you are watching this medical video you can get more informations about Scrotal...
The PELVIS
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The Axis of the pelvic canal shows the position of the centre of the head of the foetus as it passes through the pelvis. This axis, which is an imaginary line,
Is obtained by taking any number of antero-posteror diameters of the true pelvis, between the plane of the brim and that of the outlet, and joining the centre of these diameters.
The Pelvis from the Side
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1. 5th lumbar vertebra
2. Promontory of Sacrum
3. Sacrum formed by the fusion of five sacral vertebra
4. Iliac fossa.
5. Crest of ilium
6. Anterior superior spine
7. Symphysis pubis
8. Tuberosity of ischium
9. Great sacro-sciatic ligament.
10. Inguinal ligament
11. Great sciatic foramen
12. Obturator foramen
The projecting portion of the intervertebral disc, Where it touches the upper surface ofthe first sacral vertebra, is known as the promontory of the sacrum
The Pelvis from above
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1. Ilica fossa.
2. 5th lumbar vertebra
3. Promontory of sacrum
4. Sacrum
5. Coccyx
6. Ileo-pectineal line.
7. Crest of ilium
8. Anterior superior spine
9. Symphysis pubis
10. True conjugate
11. Oblique 4.5 inches
12. Transverse 5 inches
The Corpus Luteum
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When the oocyte has escaped certain changes take place in the rest of the graffian follice, Which now becomes the corpus luteum. most of the space formerly occupied y the fluid becomes filled with blood clot, B.C Tufts of the membrana granulosa,
Which contain capillaries from the tunica vasculosa, C.T..., grow into the blood clot. The cells in the tufts of the membrana granulosa are tremed lutein cells, G.L.C..., Because of their colour which is yellow, and the corpus luteum gets its name.
The corpus luteum secrets a hormone called progestin, which being absorbed into the blood, completes the prepartion of the endomaterium for the implantation of the zygote when it reaches the cavity of the uterus. This hormone also arrests ovulation during pergancy and normally prevents miscarriage in the early stages of pregancy.
If the oocyte is not fertilized within 2 weeks of its escape from the Graafian follice the corpus luteum atrophies, and becoming white, is termed the corpus albicans. If however, the oocyte is fertilized, the corpus luteum continues to grow and secrets for 12 weeks, after which it stops growing but persists until the child is born, and then it gradually atrophies.
The Introduction to Clinical surgery - Pt/4
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"The Introduction to Clinical surgery" Is in the end. This is the Part - 4 about Hemias, I hope A brief lecture about Hernias. It has been devised with medical students mind.
Introduction to clinical surgery Lectures - 03
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This topic continue "The Introduction to clinical surgery Lectures - 03" This is about the Swellings. Lecture on Swelling from a series of the lectures on an introduction about the clinical surgery. I belive this is very help ful for you.
Introduction to Clinical Surgery Lectures - 2
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Yeah! This is second one for the "Introduction to Clinical Surgery Lectures - Pain" This is part -2 when you watched the befor the topic of thisone.
Introduction to Clinical Surgery Lectures - 01
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Hey friends Do you like to watch clinical surgery Introdution in 3D. Yeah that is possible you're able to watch here. "Introduction to Clinical Surgery Lectures"
The Graafian Follicle
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The Graffian Follicle, which contains the ripe oocyte, is formed as follows, The ovary when developed, is covered by a single layer of cells termed the germinal epithelium G.E While the female foets is still in the uterus processes of this epithelium bud down in to the substance of its ovary and become converted into primordial follicles.
The great Majority of the follicles do not further develop, but at, and after, puberty certain of them ripen, which consists in the formation of the graafian follicle and maturation.
One of the cells becomes much larger than the others ], to from the oocyte.
The cells closely embracing the oocyte from a structure termed the discus proligerus D.P. Most of the remaining cells liquefy, L.F,,, Except those on the extreme outside which form the membrana granulosa, M.G Thus the graffian follicle is formed.
Decaying Teeth
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Decaying teeth harbour germs which cause disease in many parts of the body. If one wishes to keep in good health he will keep his teeth in good condition.
Particles of food lodge along the edges of the gums in the spaces between the teeth and in the cervices of the grinding surfaces of the teeth. As soon as germs begin to grow along the edges of the gums become loosened, and expose part of the roots of the teeth.
As the cervices between the gums and teeth enlarge. These cervices make an excellent place for the germs, and so many grow there that the services become filled with foul pus. The teeth then become so loose that they are unless and must be extracted.
The chewing of the betel nut is very harmful to the gums. The lime used with the betel nut causes the gums to retract and the teeth then become loose and eventually fall out Both betel nut and tobacco discolour the teeth. giving the mouth a very dirty appearance.
To produce and maintain good teeth the diet should inculde milk, fresh fruits and vegetables and whole grain cerals.
Particles of food lodge along the edges of the gums in the spaces between the teeth and in the cervices of the grinding surfaces of the teeth. As soon as germs begin to grow along the edges of the gums become loosened, and expose part of the roots of the teeth.
As the cervices between the gums and teeth enlarge. These cervices make an excellent place for the germs, and so many grow there that the services become filled with foul pus. The teeth then become so loose that they are unless and must be extracted.
The chewing of the betel nut is very harmful to the gums. The lime used with the betel nut causes the gums to retract and the teeth then become loose and eventually fall out Both betel nut and tobacco discolour the teeth. giving the mouth a very dirty appearance.
To produce and maintain good teeth the diet should inculde milk, fresh fruits and vegetables and whole grain cerals.
Use of the Teeth
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The Work of the teeth is to masticate food; that is grind it into fine particles, mix it with saliva and so begin its digestion. The teeth also aid in speaking for when they are lost certain syllables cannot be pronounced clearly.
The Use of the teeth is important and their condition has such an important and their condition has such an important bearing upon health.
Chapter Four
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The Teeth
The Teeth Begin to appear when a child is six or seven months old. And at two and a half years it should have all twenty temporary teeth.
When the child reaches the age of six, the permanent teeth begin to appear. The teeth of small children should be cared for and kept clean. They should last until the time comes for the permanent teeth to take their place. The permanent teeth are thirty-two in number.
The four back teeth are thiery- two in number. The four large black teeth do not make their appearance until after the age of seventeen or eighteen. These permanent teeth should all last to the very end of life.
When the child reaches the age of six, the permanent teeth begin to appear. The teeth of small children should be cared for and kept clean. They should last until the time comes for the permanent teeth to take their place. The permanent teeth are thirty-two in number.
The four back teeth are thiery- two in number. The four large black teeth do not make their appearance until after the age of seventeen or eighteen. These permanent teeth should all last to the very end of life.
Chapter Couninue
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The food first enters the body through the mouth. In the mouth it shouldbe chewed into very fine particles by the teeth. As it is chewed it is mixed with the saliva, a fluid which comes to the mouth from three pairs of glands called the salivary glands.
The location of these glands is shown in the accompanying illustration. The Saliva helps in the work of digestion therefore food shouldnot be swallowed quickly, but time should be given, by throughly masticationg the food,
For it to be well mixed with this digestive juice before it leaves the mouth. When is swallowed, it passes down the cesophagus into the stomach.
Food must Be Digested
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Before it can supply building material or heat or energy. Food must be eaten and digested. Digestion is the series of changes through which the food passes that prepares it for the use of the body as heat and energy producing material and as material for repair and growth.
The Alimentary Canal
The part of the body that has to do with digesting the food is called the alimentary canal. The alimentary canal is a long tube that reaches from the mouth to the lowerend of the large intestine.
The middle portion of it coiled up.
In an adult this tube is about thirty feet long. The names of the different sections of the alimentary canal are the mouth, cesophagus, stomach, small intestine and large intestine.
Chapter Three
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How the body Is Nourished
Our Bodies are composed of many kinds of material. There is one kind of material in the bones, another kind in the skin and another kind in the nerves. Whether awake or asleep, some parts of the body are always moving and are continually wearing out.
Material is needed to repair this wear and waste. This repair material is found in the food we eat. Our bodies get from the food we eat the energy that enables the heart to beat, and the arms and legs to move, And each organ to do its appointed work.
No matter whether the whether be hot or cold, Our bodies are always warm. This heat that keeps the body warm also come from
the food we eat. From this we see that the food we eat serves two important purposes. First, it supplies the body with heat and energy. Second, it supplies the material for the repair and growth of the body.
Our Bodies are composed of many kinds of material. There is one kind of material in the bones, another kind in the skin and another kind in the nerves. Whether awake or asleep, some parts of the body are always moving and are continually wearing out.
Material is needed to repair this wear and waste. This repair material is found in the food we eat. Our bodies get from the food we eat the energy that enables the heart to beat, and the arms and legs to move, And each organ to do its appointed work.
No matter whether the whether be hot or cold, Our bodies are always warm. This heat that keeps the body warm also come from
the food we eat. From this we see that the food we eat serves two important purposes. First, it supplies the body with heat and energy. Second, it supplies the material for the repair and growth of the body.
The Construction of the body - pt/2
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The Construction of the body - pt/2
Each member of the body has its own use and is called an organ. Several organs may work together. For example, the mouth,teeth,gullet,stomach, small and large intestines and pancreas all work together in the digestion of the food; these are collectively called the digestive or gans.
The nose, pharynx, trachea and lungs work together in getting fresh air into the body, and getting rid of the carbon dioxide and for this reason they are called the respiratory organs.
The heart and all the large and small blood-vessels work together in the causing the blood to circulatory organs.
The kidneys, skin,lungs,liver, and large intestine all work together in getting the waste matters out of the body, for this reason they are called the excretory organs. The brain, the spinal cord and all the large small nerves work together in directing and controlling all the other organs of the body, these comprise the nervous system.
In addition to the above -mentioned organs there are bones,which serve as the framework and give shape to the body, and the muscles, which move all the parts of the body.
If all the parts of the body are protected and their needs supplied, one will have perfect health.
Each member of the body has its own use and is called an organ. Several organs may work together. For example, the mouth,teeth,gullet,stomach, small and large intestines and pancreas all work together in the digestion of the food; these are collectively called the digestive or gans.
The nose, pharynx, trachea and lungs work together in getting fresh air into the body, and getting rid of the carbon dioxide and for this reason they are called the respiratory organs.
The heart and all the large and small blood-vessels work together in the causing the blood to circulatory organs.
The kidneys, skin,lungs,liver, and large intestine all work together in getting the waste matters out of the body, for this reason they are called the excretory organs. The brain, the spinal cord and all the large small nerves work together in directing and controlling all the other organs of the body, these comprise the nervous system.
In addition to the above -mentioned organs there are bones,which serve as the framework and give shape to the body, and the muscles, which move all the parts of the body.
If all the parts of the body are protected and their needs supplied, one will have perfect health.
Chapter Two
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The Construction of the body - pt/1
The Body has three main divisions, namely, the head, the trunk, the upper and lower limbs. In the trunk there is a large cavity wherein are almost all of the important organs.
This cavity is divided into an upper and a power potion by thin by a thin wall called the diaphragm. The upper potion is called the chest. Within it are the heart and lungs, and in the back part of it are the trachea and gullet, or cesophagus.
The cavity below the diaphragm is called the abdominal cavity. Within it are the liver, the stmoach, the spleen, the pancreas, the samll and the large intestines. The kidneys are suituated just outside it, at the back.
The Body has three main divisions, namely, the head, the trunk, the upper and lower limbs. In the trunk there is a large cavity wherein are almost all of the important organs.
This cavity is divided into an upper and a power potion by thin by a thin wall called the diaphragm. The upper potion is called the chest. Within it are the heart and lungs, and in the back part of it are the trachea and gullet, or cesophagus.
The cavity below the diaphragm is called the abdominal cavity. Within it are the liver, the stmoach, the spleen, the pancreas, the samll and the large intestines. The kidneys are suituated just outside it, at the back.
The Greatiest Enmies of Mankind - pt/2
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The Greatiest Enmies of Mankind - pt/2
Disease germs multiply very fast. Under favourable conditions a single one of the germs that produce cholera or typhoid fever can, in ten hour's time, give rise to a milion others.
Since they are so small and multifly so fast they are widely distributed. They are found in the water of wells, rivers and ponds, in the dust of the street and in the dust on the floors and walls of houses, and even in the floods we eat and the liquids we drink.
It may be said that in thickly populated places disease-producing germs are found everywhere. Since this is so, everyone should learn how to keep these germs out of the body, and how to destroy them should they gain enterance into the body.
These subjects will be discussed in other chapters of this articles.
Disease germs multiply very fast. Under favourable conditions a single one of the germs that produce cholera or typhoid fever can, in ten hour's time, give rise to a milion others.
Since they are so small and multifly so fast they are widely distributed. They are found in the water of wells, rivers and ponds, in the dust of the street and in the dust on the floors and walls of houses, and even in the floods we eat and the liquids we drink.
It may be said that in thickly populated places disease-producing germs are found everywhere. Since this is so, everyone should learn how to keep these germs out of the body, and how to destroy them should they gain enterance into the body.
These subjects will be discussed in other chapters of this articles.
The Greatiest Enmies of Mankind - pt/1
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The Greatiest Enmies of Mankind
Disease-producing germs are the greatest enemies of mankind. Everyday they kill tens of thousands of people. Disease germs are the cause of colds, tuberculosis, pneumonia, diarrhoea, dysentery, typhoid fever, cholera, tetanus, whooping cough, Malaria, leprosy,
bubonic plague and a multitude of other diseases.
From reading this list it will be seen that most of the deaths in the world are caused by disease germs. Disease germs are of two kinds. One kind belongs the plant kingdom and one kind to the animal kingdom. These disease germs are so very, Very small that the eye cannot see them.
Most of them are so small that when they are magnified one thousand times by a miscroscope, they appear only as large as a mustard seed.
Disease-producing germs are the greatest enemies of mankind. Everyday they kill tens of thousands of people. Disease germs are the cause of colds, tuberculosis, pneumonia, diarrhoea, dysentery, typhoid fever, cholera, tetanus, whooping cough, Malaria, leprosy,
bubonic plague and a multitude of other diseases.
From reading this list it will be seen that most of the deaths in the world are caused by disease germs. Disease germs are of two kinds. One kind belongs the plant kingdom and one kind to the animal kingdom. These disease germs are so very, Very small that the eye cannot see them.
Most of them are so small that when they are magnified one thousand times by a miscroscope, they appear only as large as a mustard seed.
The Cause Of Disease
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The Cause Of Disease
Many People erroneously think that disease is an unavoidable calamity. Physicians and scientists have now demonstrated that diseases are due to specific causes.
Some diseases are due to the body not being supplied with the proper kinds of nourishment beri-beri is such a disease.
There are diseases that are caused by poisons entering the body; Such a disease is phosphorus poisoning, which is often contracted by those who wrok in match-making factories.
Disease may be brought on by wrong habits; For example, wrong habits of eating may cause dyspepsia. The above-mentioned causes do not acccount for more than one-tenth of the sickness in the world. The other nine-tenths are caused by disease-producing germs.
Many People erroneously think that disease is an unavoidable calamity. Physicians and scientists have now demonstrated that diseases are due to specific causes.
Some diseases are due to the body not being supplied with the proper kinds of nourishment beri-beri is such a disease.
There are diseases that are caused by poisons entering the body; Such a disease is phosphorus poisoning, which is often contracted by those who wrok in match-making factories.
Disease may be brought on by wrong habits; For example, wrong habits of eating may cause dyspepsia. The above-mentioned causes do not acccount for more than one-tenth of the sickness in the world. The other nine-tenths are caused by disease-producing germs.
Little Care Given to Bodies - Pt/2
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Little Care Given to Bodies - Pt/2
It is probable that the majority of the readers of this book have already reached maturity. Perhaps many already have weak bodies, and some may be afflicted with disease.
In that case it is all the more important that the readers of this article study the laws of health and learn not only how to care for the body when it is in health,
But also how to restore it to health if it becomes diseased. The aim of this article is to give the rader information that will enable him to avoid disease and to preserve his own health and that of his family.
It gives such instruction in the treatment of common diseases as can be carried out in home by on who is not a physican. Needless to say, in every case of serious illness the help of a competent physician sould be secured, if possible; for no book can take the place of a skilled physician.
It is probable that the majority of the readers of this book have already reached maturity. Perhaps many already have weak bodies, and some may be afflicted with disease.
In that case it is all the more important that the readers of this article study the laws of health and learn not only how to care for the body when it is in health,
But also how to restore it to health if it becomes diseased. The aim of this article is to give the rader information that will enable him to avoid disease and to preserve his own health and that of his family.
It gives such instruction in the treatment of common diseases as can be carried out in home by on who is not a physican. Needless to say, in every case of serious illness the help of a competent physician sould be secured, if possible; for no book can take the place of a skilled physician.
Little Care Given to Bodies - Pt/1
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Little Care Given to Bodies
As a rule, when people are in health they give little thought to the care of their bodies; But when they become weak and diseased and death draws nigh, then they begin to study how to care of their bodies;
But alas, It is often too late. This is like waiting until after the thief has gone before locking the door.
The time to begin caring for the body is while one is yet young. Indeed it has been said that, in order to ensure the child's having a healthy body and a strong constitution, it is necessary to begin before the child is born.
The Father and mother must care well for their own health because weak, sickly parents cannot beget strong, healthy children.
As a rule, when people are in health they give little thought to the care of their bodies; But when they become weak and diseased and death draws nigh, then they begin to study how to care of their bodies;
But alas, It is often too late. This is like waiting until after the thief has gone before locking the door.
The time to begin caring for the body is while one is yet young. Indeed it has been said that, in order to ensure the child's having a healthy body and a strong constitution, it is necessary to begin before the child is born.
The Father and mother must care well for their own health because weak, sickly parents cannot beget strong, healthy children.
Cause Of Sickness
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Sickness is brought on by a violation of the laws of health. By observing the laws of health and caring well for the body, it is possible to avoid at least eight-tenths of the sickness with which the majority of the people are afflicted.
Observance of the laws of health brings that blessing which all men desire, namely, long life. Disregard of the laws of health brings upon one those calamites which all men fear, namely, Sickness and early death.
Observance of the laws of health brings that blessing which all men desire, namely, long life. Disregard of the laws of health brings upon one those calamites which all men fear, namely, Sickness and early death.
The Menace of Sick Persons - pt/2
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The Menace of Sick Persons - pt/2
Most diseases require many days and the expenditure of much effort to effect a cure. Looked at from this view point it is evident that the community, should place a very high valuation on health.
It is the first duty of every one to take care of his own body and keep it in health. This is a duty he owes to himself, to his family, to his neighbours and to his country; and above all, it is a duty that he owes to his Creator.
It is a mistake to think that sickness is inflicated by the gods, or by evil spirits, or by climatic conditions, and so is unavoidable, Neither is life and death decided by fate.
Most diseases require many days and the expenditure of much effort to effect a cure. Looked at from this view point it is evident that the community, should place a very high valuation on health.
It is the first duty of every one to take care of his own body and keep it in health. This is a duty he owes to himself, to his family, to his neighbours and to his country; and above all, it is a duty that he owes to his Creator.
It is a mistake to think that sickness is inflicated by the gods, or by evil spirits, or by climatic conditions, and so is unavoidable, Neither is life and death decided by fate.
Chapter One continue
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The Menace of Sick Persons - pt/1
In addition to all this the sick person is often a menace to everyone in his immediate nighbourhood, because most diseases are easily carried from one person to another.
Have we not all see instances where one member of a family became sick, And in a very short time other members of the family contracted the disease from him and were stricken down?
Very often the disease spreads abroad from that family to other families in the community, Resulting in large financial loss through the afflicted persons not being able to work or conduct their business, and in that great est of all losses, the loss of human life.
Furthermore, When health is impaired it cannot be restored in a day. It is a grievous error to look upon disease as a matter of small importance because it is thought a cure can be effected by taking a few doses of some medicine.
In addition to all this the sick person is often a menace to everyone in his immediate nighbourhood, because most diseases are easily carried from one person to another.
Have we not all see instances where one member of a family became sick, And in a very short time other members of the family contracted the disease from him and were stricken down?
Very often the disease spreads abroad from that family to other families in the community, Resulting in large financial loss through the afflicted persons not being able to work or conduct their business, and in that great est of all losses, the loss of human life.
Furthermore, When health is impaired it cannot be restored in a day. It is a grievous error to look upon disease as a matter of small importance because it is thought a cure can be effected by taking a few doses of some medicine.
Health And Longevity - Chapter One
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Man's Most Valuable Possession
Life is Man's most valuable possession, and next in order of value is health, life is deprived not only of much, if not all, of its usefulness, But also of its joys and pleasures.
For if the body is not it good health, One cannot go about at will;He can not do what he would enjoy doing.
He cannot eat the food he would enjoy eating. A sick man not only suffers pain and discomfort himself and is unable to supply his own needs, but he requirs one or more persons to stop doing their ordinary work and spend their time in caring for him.
In this way he becomes a burden to others because they must nurse him and supply his food and clothing.
Guidelines for dealing with 'fear syndrome'
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Guidelines for dealing with 'fear syndrome'
* Identify why the patient has come for help. listen and decide the role anxiety plays in the presentation.
* Remember that 'malingeres' get mailgancies too.Carry out an unbiased thorough assesment. Further investigations may not be needed.
* Anxious patients make anxious doctors. Make your judgements independently, irrespective of how anxious the patient appears to be.
* Do not feed doubts by providing irrelevant information.
* Speak clearly so that the patient understands.
* Show awareness that anxiety and symptoms are part of any clinical problem.
* Give the patient a chance to ask questions after imparting information.
* Be sure that the patient has understood. The presence of a less anxious relative maybe helpful in the SOPD.
* Identify why the patient has come for help. listen and decide the role anxiety plays in the presentation.
* Remember that 'malingeres' get mailgancies too.Carry out an unbiased thorough assesment. Further investigations may not be needed.
* Anxious patients make anxious doctors. Make your judgements independently, irrespective of how anxious the patient appears to be.
* Do not feed doubts by providing irrelevant information.
* Speak clearly so that the patient understands.
* Show awareness that anxiety and symptoms are part of any clinical problem.
* Give the patient a chance to ask questions after imparting information.
* Be sure that the patient has understood. The presence of a less anxious relative maybe helpful in the SOPD.
Ethics and the ...
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Ethics and the Surgeon
Duties of Surgeons to patients.
A surgeon must maintain the highest professional standards and practise his profession without a profit motive.
He must:
* Be obligated to preserve human life
* Be loyal to his patients
* Summon a second opinion if a certain type of treatment is outwith his ability
* Maintain confidentiality on his knowledge of patients
* Give emergency care where indicated as a duty unless others are able and willing to administer such care.
Duties of Surgeons to patients.
A surgeon must maintain the highest professional standards and practise his profession without a profit motive.
He must:
* Be obligated to preserve human life
* Be loyal to his patients
* Summon a second opinion if a certain type of treatment is outwith his ability
* Maintain confidentiality on his knowledge of patients
* Give emergency care where indicated as a duty unless others are able and willing to administer such care.
Implications of indiscriminate reassurance
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Implications of indiscriminate reassurance
'Normal' people as well as obsessional patients have intrusive thoughts from time to time which are disturbing. For example, the patient who presents with nausea mayinterpret the symptom as being due to gastric cancer instead of alcohol-induced gastritis due to his regular drinking. He needs reassurance that cancer is not the cause of his problem,
And that the symptoms are due to excessive alcohol intake. The necessary investigations are carried out and are negative. The doctor then reassures the patient that all is well , That cancer plays not part . At first the patient is relieved but then sets about seekingg further reassurance, 'why did you do the investigations if you did not suspect cancer?" What if you have missed something?" 'I never thought i had cancer. Why did you mention it?" This response can lead to recurrent outpatient attendances, further investigations, further reassurance, and further anxiety. The vivious circles so set up has been described as the 'fear syndrome'.
'Normal' people as well as obsessional patients have intrusive thoughts from time to time which are disturbing. For example, the patient who presents with nausea mayinterpret the symptom as being due to gastric cancer instead of alcohol-induced gastritis due to his regular drinking. He needs reassurance that cancer is not the cause of his problem,
And that the symptoms are due to excessive alcohol intake. The necessary investigations are carried out and are negative. The doctor then reassures the patient that all is well , That cancer plays not part . At first the patient is relieved but then sets about seekingg further reassurance, 'why did you do the investigations if you did not suspect cancer?" What if you have missed something?" 'I never thought i had cancer. Why did you mention it?" This response can lead to recurrent outpatient attendances, further investigations, further reassurance, and further anxiety. The vivious circles so set up has been described as the 'fear syndrome'.
Advice for surgeons
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Advice for surgeons
* Prevent iatrogenic disease. Beware of invasive investigations which may be expensive, dangerous, or unnecessary. Is the risk of the procedure worth taking? Would you carry out the same investigation on your self?
* How important is it to make the diagnosis? If it is academic do not cause your patients anxiety or discomfort, or expose them to risk.
* Avoid the attitude: "At least this won't cause any harm even if it does no good" When prescrbing drugs, treatment, or investigation. If it does no good, why do it at all?
* When discussing the prognosis with the patients or relatives be as honest as possible. Base your statements on your own experience, that of your seniors, and the relevant literature.
The "no-lose" philosophy has considerable potential for loss. Further, it may adversely influence decision-making and prevent the solution of clinical and ethical problems.
"The 'no-lose' philosophy in medicine."
* Prevent iatrogenic disease. Beware of invasive investigations which may be expensive, dangerous, or unnecessary. Is the risk of the procedure worth taking? Would you carry out the same investigation on your self?
* How important is it to make the diagnosis? If it is academic do not cause your patients anxiety or discomfort, or expose them to risk.
* Avoid the attitude: "At least this won't cause any harm even if it does no good" When prescrbing drugs, treatment, or investigation. If it does no good, why do it at all?
* When discussing the prognosis with the patients or relatives be as honest as possible. Base your statements on your own experience, that of your seniors, and the relevant literature.
The "no-lose" philosophy has considerable potential for loss. Further, it may adversely influence decision-making and prevent the solution of clinical and ethical problems.
"The 'no-lose' philosophy in medicine."
Clinical implications
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Clinical implications
The 'no-lose' philosophy is occasionally applied in pratice but in a different context. When faced with a problem the outcome of which is doutful, a doctor may erron the side of 'no-lose' in giving the prognosos to relatives. If the patient dies then the prediction was correct, if the patient lives then everything is won. in either even the doctor does not lose.
The 'no-lose' philosophy is occasionally applied in pratice but in a different context. When faced with a problem the outcome of which is doutful, a doctor may erron the side of 'no-lose' in giving the prognosos to relatives. If the patient dies then the prediction was correct, if the patient lives then everything is won. in either even the doctor does not lose.
Dangers of 'no-lose'
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Dangers of 'no-lose'
Application of the philosophy to all areas of medical practice carries considerable risks especially when investgating patents(in order not to lose, the diagnosis must be made) This may be illustrated by a case report.
A patient recovers well after oversewing of a perforated duodenal ulcer, but on checking his blood an elevated serum calcium is noted. After further investigation for a possible parathyroid adenmoa, selctive venous cannulation of the neck veins was carried out.
No tumour was demonstratedd but the patient developed infective complications from which he died. At post-mortem no parathyroid tumour was found.
Application of the philosophy to all areas of medical practice carries considerable risks especially when investgating patents(in order not to lose, the diagnosis must be made) This may be illustrated by a case report.
A patient recovers well after oversewing of a perforated duodenal ulcer, but on checking his blood an elevated serum calcium is noted. After further investigation for a possible parathyroid adenmoa, selctive venous cannulation of the neck veins was carried out.
No tumour was demonstratedd but the patient developed infective complications from which he died. At post-mortem no parathyroid tumour was found.
The 'No-lose' philosophy
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The 'No-lose' philosophy in surgery
Pascal's 'no-lose' philosophy relates to belief in god. If god does exist and we live our lives believing in him then everything is gained when we die, If god does not exist then at least nothing is lost.
Pascal's 'no-lose' philosophy relates to belief in god. If god does exist and we live our lives believing in him then everything is gained when we die, If god does not exist then at least nothing is lost.
Collection of Facts (Information)
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1. Collection of Facts (Information)
The Three time honoured methods for the collection of facts are those obtained by
1.1 Inquiry from the Patient (History)
1.2 Examination of the patient (Clinical examination)
1.3 Special methods of investigation such as examination of body fluids (Urine and blood), Dianostic imaging, endoscopy or aspiration and biopsy.
There are two important considerations that should be remembered in search for accumulation of facts. Firstly the facts falling under one of one the categories 1.1, 1.2 and 1.3 may out weight all others and there is a natural tendency to neglect the completeness of the process in other directions.
Let me illustrate these with clinical examples. A patient's description of bleeding per rectum from haemorrhoids may be so typical as to suggest that detailed examination is not necessary.
The Three time honoured methods for the collection of facts are those obtained by
1.1 Inquiry from the Patient (History)
1.2 Examination of the patient (Clinical examination)
1.3 Special methods of investigation such as examination of body fluids (Urine and blood), Dianostic imaging, endoscopy or aspiration and biopsy.
There are two important considerations that should be remembered in search for accumulation of facts. Firstly the facts falling under one of one the categories 1.1, 1.2 and 1.3 may out weight all others and there is a natural tendency to neglect the completeness of the process in other directions.
Let me illustrate these with clinical examples. A patient's description of bleeding per rectum from haemorrhoids may be so typical as to suggest that detailed examination is not necessary.
Interoduction to Surgical Diagnosis
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Interoduction to Surgical Diagnosis
The Phrase diagnosis in surgery should refer to the process of investigation necessary to discover the nature of disease or injury.
However in practice the phrase is also used to finally label the condition so discovered with a name or description.
To archive a proper diagnosis in surgery one should:
1. Collect the facts(information)
2. Correctly interpret the facts (information)
The Phrase diagnosis in surgery should refer to the process of investigation necessary to discover the nature of disease or injury.
However in practice the phrase is also used to finally label the condition so discovered with a name or description.
To archive a proper diagnosis in surgery one should:
1. Collect the facts(information)
2. Correctly interpret the facts (information)
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