New York Medical College - Fleuroscope Yearbook (Valhalla, NY)

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IT HAPPENED IN ANATOMY- . Dr. Gerlach-Describe to me the mesentery of the duodenum. Bohmer-I cant describe it but l'll draw it. Dr. Gerlach-Dat iss a goot drawink but I giff you feefty. Vat structures pierce the diaphragm? Rohmer-CI-Ie fooled me once but not againl NOTHINGI Dr. G-erlach-Excellent, I giff you zero. BACTERIOLOGY- Schwab-Give me the lid of that Petri dish, Hank. I'm ready to plant the culture. Sherwood-You don't put it on the lid, you put it on the media. Schwab-You're crazy, it belongs on the lid. Sherwood-O. K. Schwab-fAfter 15 minutesl Dr. Hotchkiss, how long does it take for the bacteria to fall from the lid on to the media? GYNECOLOGY- Dr. Silverblatt-What are the three stigmata of gonorrhea in women? Tramont-Well, I really don't think you can always blame the woman. Dr. Silverblatt-CAS the class laughsl Doctor, stigmata means signs. CHEMISTRY- Quiz Master-What are the advantages of mother's milk over cow's milk? L. Rubin-It doesn't have to be kept on ice. Sherwood-It doesn't have to be pasteurized. Reinstein-lt comes in more attractive containers. PHARMACOLOGY- Dr. Boyd-What is another name for Chorea? Kay-St. Vitus dance. Dr. Boyd-Who was St. Vitus? Kay to Sherwood-Who the hell was he? Sherwood-Buzzzzzzzzz Dr. Boyd-Well? Kay-Oh yes, he was the man who chased all the rats out of Ireland. PATHOLOGY- Miss Fisher-Dr. Speer, I've come to return my box of slides. Dr. Speer-Carl, will you please take care of Miss Fischer's box. OBSTETRICS- Dr. Yerbury-What is the first thing you ask your patient when she tells you she thinks she is pregnant? Gartner-Ask her if she had any intercourse. PHYSICAL DIAGNOSIS- Dr. Zimmerman-What are to two types of breathing? Tedesco-What? Dr. Zimmerman-What? Tedesco-What? Dr. Zimmerman to class-What did he say? Class-He says he can't hear you. Dr. Zimmerman-Oh-What are the two types of breathing? Tedesco-Oh-NORMAL AND ABNORMAL. MINOR SURGERY- Dr. I-Ierrlin-What is the first thing you do when you find a patient in shock? Burrett-You give him a whiff of chloroform. ORAL SURGERY- Dr. Mayer-What is Tic Doloreux? De Philips-Why Doctor--er it's-that is-it's a form of Neurology. H R One hundred seventy-seven

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cerebral trauma by dehydration and fluid limitation. He claims a mortality of only 13.8921 after the third hour of admission. Zierold on the other hand wishes to destroy the common belief that increased intra-cranial pressure is a com- mon, if not constant, accompaniment to severe head injury. Zierold questions the possibility of treatment by spinal drainage or by the use of hypertonic solutions in any case of increased intracranial pressure of a degree sufficient to endanger life. Significant advances have been made in the exposure of the cranial nerves. Peet presented fourteen cases of complete cure of glossopharyngeal neuralgia by intra-cranial section of the glossopharyngeal nerve. The symp- toms are those of sudden sharp excruciating pains which shoot down from the ear, base of tongue or posterior pharynx. Dandy finds the cause of Menieres disease to lie in the sensory root of the auditory nerve. Patients were cured by intracranial section of the nerve. A successful exposure of the facial canal was obtained by Tremble and Penfield in 1936. With the advent of ventriculography and encephalography a new and valuable aid in the diagnosis of intra-cranial lesions has been acquired. les- sen, Schoenfeld and Freeman made use of thorium dioxide as a contrast medium for ventriculograms in 1933. A recent innovation in cerebral arterio- graphy is the use of colloidal thorium for injections into the internal carotid artery to be followed soon after by a rapid series of skull films. That this method is not without danger was shown by Shih and lung who experimentally produced thrombocytopenic purpura by the intravenous injection of thorium dioxide in rabbits. Alexander, lung and Lyman again, found ependymal inflammation in certain cases, after the introduction of thorium into the ven- tricles. The miscellaneous contributions and noteworthy achievements which have been described are readily seen to have permeated all branches of surgery. That many of the stumbling blocks to health have been mowed down by the surgeon's knife must be granted but that numerous perplexing problems have been created, the solutions of which have merely been begun, cannot be denied. Although I am sadly unqualified to comment upon the training of a sur- geon, a few thoughts and observations are inescapable. Bedside instructions and the acquisition of diagnostic ability are to be highly recommended. How- ever, with the current practice of deep-seated and intricate explorations of organs and tissues a very thorough knowledge of surgical anatomy becomes indispensable. How can this be better acquired than by actual dissection upon the cadaver? It is perhaps only as a senior that the medical student realized the value of the many hours spent in the dissection room during his first year. Why should not the medical student as well as the interne have the opportunity of returning to the cadaver with the new interest and under- standing of one who is really prepared to intercept his findings? Surgical pro- cedures may be practiced upon the cadaver to very good advantage in prepar- ation for the surgery of the operating room, which to my mind, is delayed far too long. If we consider operative technic a mechanical skill to be developed just as any other act of skill it should be apparent that only thru early and persistent practice will it be acquired. Surgeons who have combined an irre- proachable surgical technic along with their diagnostic acumen and insight into pre and post operative care will always win our respect and admiration. -ill One hundred seventy-six

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THE POSITION OF THE SIMILE IN THE MEDICINE OF TO-DAY BIOLOGIC BACKGROUND 'THE simile rule rests upon experiments with test animals and healthy human beings. It is most logically explained by the work of a number of German, and several English, authors, who have called attention to the widespread incidence of alternating oppositely directed phases in biologic activity. I refer to the early work of Schulz, and the more recent work of Boyd, Kotschau, Rentz, and a host of others. Early in his work-about 1882- Schulz demonstrated that it was possible to obtain diametrically opposite biologic effects from small and large doses of either organic or inorganic stimuli. From this, he reasoned that it might be possible to apply a biologically active substance to a diseased organism in such a manner as to produce a return to normal, by the use of a substance in moderate amounts, which in its intoxications would still further alter the biologic status for the worse. Schulz suggested that the effects of a substance administered in large amounts to healthy subjects, afford us a record of the particular tissues and functions upon which such a substance is capable of acting. It was a logical sequence of his experiments that small amounts would alter these same functions and tissues in an opposite direction. This alteration in effect of large and small doses is known as the Arndt-Schulz Rule, and was the first basically scientific formulation offered to explain the long known usefulness of homeopathy in the clinical field of medicine. Schulz was the first individual to observe that various phases or stages of effect could be obtained from biologic stimuli, but in producing these changes, he recognized only the influence of dosage. More recently Boyd, Kotschau, and Rentz have shown the importance of time, and many other con- ditions influencing the reactions described by Schulz. For example, Ptentz has shown that a single dose of novocaine at first narrows, and later dilates, small blood vessels. The clinician is constantly observing similar phases in disease: for example, the change from leukopenia to leukocytosis in the early stages of peritonitis, from chill to fever in pneumonia: from shock to turgor in sunstroke, and so forth. The physiologist sees a succession of rhythmically alternating events and not an isolated reaction, hyperglycemia-hypoglycemia, leukocy- tosis-leukopenia, hypertension-hypotension, vasoconstriction-vasodilatation, tachycardia-bradycardia, are simple illustrations. Again, biologic response is conditioned by the status of the tissue acted upon. Adrenalin constricts at first only the normal vessel, while in the same dose it initially dilates the traumatized. Many other elements, such as time of day, season of the year, tissue concentration, and so forth, play a positive part in responses to stimuli. One hundred seventy-eight