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

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SCHOOL DAYS FROSI-I There was a Freshman at Flower Who studied mnernonics by the hour But when quizzed by the Boss He found keys a total loss Now sight of M .D.'s makes him cower. SOPH A soph towards study was cool With wine and women he'd fool Exams drove him frantic And his libido gigantic At last got him kicked out of school. JUNIOR The Iuniors all go to the Met To do their service obstet With hearts aquiver They stand and deliver Offspring begot tete-a-tete. SENIOR The seniors are inclined to be cynical They shun experiences clinical Interneships they seek Which seven days a week Will bring them patients qyr1'ical. MOTHERHOOD Par la boca - Bespiro - Breathe, mother Now push - pujo - That's fine - Now Thats the way It's just a few more pushes mother And then we'll call it a full Business day Oh - here it comes. BE STILL motherl Don't Push - non puio - Oh B'gosh, its come Well, Ritgen, your text book manouever Was made for para O but not for Para tenl GEN DEI.. VERBARG One hundred eighty-three

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Nurse One hundred eighty-two IMPEACH BISCONTI Peter, the Great has chiseled us boys Of hard earned cash and sundry joys: The dance we had was quite a flop, With him the ball room we'd like to mop. Because of him we went to the Ritz- All should unite to tear him to bits. Our initial outlay was rather high, On reaching the Ritz it hit the sky. Bisconti must have had plenty of dough He tipped all waiters-the so and so. Bisconti and Chinigo vacationed to-day They're buying new suits with colors gay. Let's tell the Dean about this guy Then we'll kill him until he dies. It isn't a crime to kill a skunk In fact if we don't We'll all be sunk. But first impeach him, remove him from office If we do this We'll fill our coffers With many dollars, nickles and dimes Then we kill him, and have good times. THE NOBLE LIFE-IN THE CHILDREN'S WARD Nurse Nurse oh nurse, I feel so sick. bring me a bed pan, quickl Nurse, you forgot to wash my face. Nurse, Iohnny won the wheelchair race. Nurse, I won't swallow that old stuff. Nurse, you don't play with me enough. Nurse, Peter's gotten out of bed. Nurse, watch me stand up on my head. Nurse, my ear-oh ouch-she aches. Nurse how long have I got to bake? Nurse, Nurse I my water bottle leaks. listen to my arm cast squeak. oh nurse-from all the ward The cry goes on the Whole day long. When, amid such din and strife Can nurses lead the noble life. VERBARG

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c 4oMMoN SENSE INASURGICAL DIAGNOSIS THIS is a machine age and machinery has become such an important part of medicine that we often wonder if the art of medicine is not lost sight of. A machine is good only when there is a rational brain behind it. The appendicitis problem is a serious one. There has been a tendency to emphasize the complications instead of recognizing the disease as an entity early. History taking is an art which is frequently passed over lightly. Osler used to say that the history is often three quarters of the diagnosis. In every appendicitis case a careful history will show the presence of abdominal pain with some form of intestinal upset. Formerly the physical examination syn- drome was emphasized, and rightly. Inspection is the first stage. With the eye on a line with the abdomen one can often detect protective tension of the abdominal wall over the site of the trouble. The breathing is often shallower in real abdominal disease. The parts lack symmetry. Palpation, starting in a Silent area with the wrist end of the hand resting firmly and the fingers gently pressing, then following around near the point of tenderness, then reversing the process again to the point of tenderness, then deep pressure, rebound and then the pinching of the skin for hvperesthesia, is the second point in the diagnosis of this disease. A rectal examination is of value in certain rare pelvic forms. Kidney palpation and the use of the stethoscope over the chest will probably eliminate two of the differential diagnostic con- ditions such as pyelitis and right sided pneumonia. When these procedures are carried out, and only after the information from these is gained, is it advisable to look to the laboratory. The blood count shows us theprogress of the- disease. We know so little about the blood count of the individual in health that it is sometimes a mistake to draw too many conclusions from it. With the positive symptoms as shown by physical examination, we have no right to delay operation. We well know that many an acutely inflamed appendix because of its peculiar anatomical location, blood and nerve supply, has not had time to cause a constitutional reaction, and we therefore know that this is the safe period in the manage- ment of this disease. Many times we have operated cases with a normal pulse, normal temperature, a so-called normal blood count, only to find on opening the appendix, many gangrenous spots starting in the mucosa and the submucosa, with frank pus in the lumen as proved by culture. Therefore we feel that common sense dictates a diagnosis of appendicitis on the history and physical signs leading to prompt operation and quick recovery. Disease of the gall bladder presents a different problem. A careful his- tory shows the incidence of indigestion, so-called, over quite a period of time, with the peculiar symptom of pain in the right upper quadrant immediately following the ingestion of food, especially fat food, accompanied with gas. This syndrome is quite different from that of ulcer. A careful physical exam- ination usually shows a tension on respiration in the right upper quadrant accompanied by some pain under the scapula. Hammer percussion at a point where two lines cross, one from the ensiform to the anterior-superior One hundred eighty-four