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

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. . ANIID SUDDEN DEATH . . tWith Apologies to I. C. Furnasl MANY of you perhaps have read this stirring article by I. C. Furnas. He points out, quite plainly, how one places one's life in jeopardy every time he steps into an automobile. However, were Mr. Furnas aware of the plight of younger brothers of future medicos, I am sure he would be moved to write another blood-chilling article. Until then I'll try to pinch hit for him. Did any of you, when stepping out of a doctor's office, have a feeling that you are already on the road to recovery? Little do you realize that you have just profited by some other person's pain and discomfort tprobably the young- er brother of the doctorl. I don't suppose you realize what a Human Guinea Pig suffers during his brother's four year stay in a medical school. What with pill boxes full of arsenic, mercury, strychnine, et al. what with whole kits full of scalpels, scissors, and other such bric-a-brac, what with microscopes -yes, you never thought that a microscope could be an instrument of torture. Well, anyway, its an accessory to a crime, for it's used to count bloodl Yes blood, human blood, MY bloodl First I'm iabbed or slashed with a sharp razor edged implement and some of my blood Cabout a quartl is put on a glass plate and scrutinized. Something goes wrong and the plate is thrown out, and again I'm required to donate more blood-huh, what's a few quarts of blood to a doctor tespecially if it isn't his ownl. No doubt you've read about ,the aftermath of some of these automobile accidents. People lying about with broken bones, crushed bodies, amputated limbs, and internal injuries: but I still insist that they get off easier than we poor Human Guinea Pigs because they sometimes die, but we're not allowed to die, we're nursed back to health l?l. Each time we're allowed to go a little nearer to death and then nursed back to health again. I sometimes think that they have the same idea that Louis Pasteur had when he developed his rabies treatment. Yes, I do believe that I'm being immunized against dying. After reading Mr. Furnas' article, only the last paragraph holds any terror for me because it pertains to my poor case. ........ Take a look at yourself as the man in the white jacket shakes his head over you, tells the boys with the stretcher not to bother, and turns away to somebody else who isn't quite dead yet. And then take it easy. Please, you future medicos, read that last paragraph again, very care- fully, especially the last five words, and think of us poor Human Guinea pigs. ARNOLD BAGNER From the Memoirs of a Future Doctor's Brother No. 4 Dec. 27, 1936 One hundred eighty-eight

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until a Week ago, when she had a bad cold of the influenzal type, followed by a diarrhoea. She never really got over this. The evening before she entered the hospital her temperature went to 103, with considerable abdominal pain and tenderness all over the abdomen, but without any nausea. The diarrhoea still continued. Physical examination showed a well nourished woman with a cold, a sore throat, and some cough. The abdomen was distended. Palpa- tion showed tender points over a good deal of the abdomen, more down the left side. Vaginal examination showed some tenderness towards the left fornix. Rectal examination showed a thickening in the cul de sac but the point of greatest tenderness ran up towards the left kidney. Palpation of the kidney itself did not give any pain. The pain shaded off towards the umbil- icus, where it lost its intensity. We felt that this was one of those rare cases of influenzal colitis with some peritoneal involvement, and we advised against operation. The attending physician had made a diagnosis of abdominal ab- scess because the temperature was 103 and the blood count was 22,000 white cells, with 93? polys. The use of colonics, diathermy and the indicated remedy, which in this case was belladonna, followed later by bryonia, finally cleared the entire condition. In these influenzal cases, we frequently find that after the chest condition has disappeared the process has gone to the abdomenp the abdomen will clear up and then there will be an involvement of the appendix with the characteristic physical signs. Then we feel justified in making a diagnosis of appendicitis and advising operation. Sometimes these influenzal conditions will gravitate towards the cul de sac postperitoneally, in the cellular tissue, and then we will have increasing signs of thickening around the rectum: finally with a large mass and fluctuation. Then we can make a diagnosis of abscess, and use the proper surgical procedure. Sometimes these influenzal conditions will form small cellular infiltrates in and around the loops of the small intestine, but they will easily respond to diathermy and remedies, and it is much safer to treat them this way. In elderly people, as the tissues lose their elasticity, diverticuli that have been in existence for some time will become filled, especially along the sig- moid and descending colon. When there is a tender spot along this region with the evidences of an increasing inflammatory area, a tentative diagnosis can be made. In this instance a previous x-ray is of great value. Of course, surgery is only indicated when the abscess is ripe for incision and drainage. Rarely do they rupture into the general peritoneal cavity. In all diagnoses, especially for surgical conditions, positive signs are of more value than negative. Our special senses are of the greatest value, and we must not neglect any of them. If this rather rambling discourse has served to direct your minds towards the use of instruments which we have always with us, the special senses, eyes, nose, fingers, ears, instead of trying to make short cuts which are often misleading and costly, I will feel that my writing has not been spent in vain. One hundred eighty seven

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RECENT ADVANC ES IN MEDICINE By Ioseph F. Tedescop Nicholas A. Knox, Ir. DURING the past few years extensive and remarkable progress has been made in the diagnosis and treatment of various conditions which have hitherto presented obstacles to the medical profession. Since the majority of overworked medical students have neither time nor facilities to keep pace with these incessant changes, this article aims to merely acquaint the reader with a few of these innumerable contributions. ln the field of diagnosis the Frei test has been brought to the fore as a positive sign of lymphogranuloma inguinale. When an antigen made from sterile pus, or aspirated from previously unruptured abscesses, was injected intradermally a positive skin reaction was produced in patients who have had the disease in the past or are actively infected at the time. Satisfactory anti- gens are made at the present time by grinding infected glands and periglandu- lar tissue. Another condition which has presented diagnostic difficulties is Kala-Azar. It was previously thought that splenic puncture, with the demonstration of Leishman donavon bodies, was the only possible method of diagnosis. In the last few years various investigators have advanced the feasibility of precipita- tion of a pathological serum by iron peptonate. It has been definitely shown recently that the Takata test is not infallible in the diagnosis of liver pathology. The Ucko modification of the Takota test has recently gained favor since it has given more accurate results than the original method. I-Iodgkin's disease has presented diagnostic difficulties which may or may not be solved by the Gordon test. This test has not, as yet, been definitely proven to be correct in all cases. The procedure involves the injection of an extract of enlarged nodes twhich microscopically do not show the typical pic- ture of Hodgkins'l intracerebrally into rabbits. An encephalitic syndrome is produced when the nodes are involved by lymphogranulomatous changes. Various dyes have been used to demonstrate definite pathology in the kidneys. A new contribution has been made in the intravenous injection of Trypan Red. If any of the dye appears in the urine within 10 minutes there is an impairment of renal function. After using Trypan Pied, inject indigo car- rnine. Therefore, if the urine shows either an absence of indigo carmine or the presence of Trypan Pied, there is a definite lesion in the kidney. ln roentgenological diagnosis a new preparation, benzedrine sulphate, has been introduced which has been a great aid in facilitating the visualization of the gastro-intestinal tract when a barium meal has been taken. Previously it was practically impossible to obtain a clear picture of the entire tract when spasms, whether due to unpleasant emotion or organic disease of the gastro- One hundred eighty nine