Monday, February 29, 2016

●● Medical Training, Services

2022

21st

20th
1918 - H1N1 Pandemic ..'57-'58 Asian Flu Pandemic ..
Causes of Death - Historic  
CHD - Coronary Heart Disease ..
Endell Street Military Hospital - WW1 ..

16th 

Sunday, February 28, 2016

⧫ Medical Education


History of Medical Advances 

Trauma Medicine 

Anesthesia in Surgery

Antiseptic Surgery - Joseph Lister

What Happened Before Antiseptic Surgery? | Corp >
12th August 1865: Joseph Lister - first antiseptic surgery - HiPo >
Joseph Lister: Surgery Transformed - BMJ > .Medical History - Corp >> .

Joseph Lister published his first paper in the BMJ in 1867 and carried on publishing in the journal for over 40 years, and now all of his articles can be accessed for free online in the BMJ archive. Lister is the father of antiseptic surgery, and his pioneering techniques transformed the survival rates of patients. Until Lister introduced methods to prevent infection, almost 50% of patients who went under the knife would die as a result.

'57-'58 Asian Flu Pandemic

Friday, February 26, 2016

CHD - Coronary Heart Disease



Coronary Heart Disease and Heart Attacks, 1912–2010
: Med Hist. 2011 Jul; 55(3): 307–312.: Joel D. Howell.

The most dramatic and fatal manifestation of the disease now called ‘CHD’ is what we now call a myocardial infarction, or ‘heart attack’.

Various technologies have continued to play a role in the twentieth-century history of CHD, albeit in more complicated ways than have often been appreciated. Consider the use of technology for diagnosis of asymptomatic disease. Early disease diagnosis has been a major goal ever since the realisation that while some people may survive a myocardial infarction, too many did – and still do – die at the initial manifestations of the disease. CHD’s natural history led physicians to search for ways of diagnosing the disease before it manifests as a possibly fatal heart attack. Starting in the 1920s–1930s, three different tools shared the stage.

One started in 1929 as the ‘Master’s two-step’, during which medical personnel monitored a person’s heart while she or he exercised. This test eventually became the twenty-first century multi-stage exercise test. But historically to focus exclusively on this test, as though it somehow led inevitably to current procedures for CHD diagnosis, would be to ignore two other tests that were also widely advocated for exactly the same sort of diagnosis. One was the anoxaemia test, in which patients breathed in oxygen-depleted air in order to deprive the heart of adequate oxygen and thus to produce cardiac ischaemia. Another was the ballistocardiogram, a test that recorded the body’s motions produced by the heartbeat. All three were thought to diagnose CHD in the 1940s and 1950s. To focus on only one implies a unanimity of thought that simply did not exist.

Treatment 1910-1960s:

1910-1930s:
* Absolute bedrest for 2-3 weeks
* At least 6 weeks of hospital stay followed by a prolonged recovery at home
* Resumption of normal activity was rarely encouraged
* Chest pain was sometimes alleviated with Morphine
* Digitalis (now commonly known as digoxin) was used for treatment of heart failure following a heart attack

1930-1950s
* Heart attack (acute myocardial infarction) was recognized as a medical emergency
* Intramuscular adrenaline was used if slowing or stopping of the heart rhythm was encountered
* Quinidine was used for suspected fatal irregular heart rhythm

1950-1960s:
* Heart attack (acute myocardial infarction) was recognized as the most common cause of death in Europe and North America
* Oxygen was recommended only if patients with heart attack developed excessive amount of fluid in the lung due to heart failure
* Nitroglycerin placed under the tongue was used to relax the heart arteries
*Physical and emotional rest was always recommended as the mainstay of treatment
* There was an increased awareness that prolonged bedrest could result in blood clots in legs and lungs. Therefore, absolute bedrest was shortened to 5 days and total duration of hospitalization was limited to about 1 month
* Blood thinners like heparin and warfarin at times were used in some centers to prevent a second heart attack and/or a blood clot in the lung
* Death and disability from heart attacks remained extremely high and most of the treatment was geared towards relieving pain and suffering only

  • Myocardial revascularization had its beginnings in the early 1900s with extracardiac operations, such as sympathetic denervation and thyroid ablation.
  • Evolved through neovascularization via pericardial poudrage and cardiopexy in the 1930s to 1950s,
  • mammary artery myocardial implantation in the 1940s
  • endarterectomy in the 1950s,
  • saphenous vein– and mammary arterycoronary artery bypass grafting in the 1960s.

Chelsea Physic Garden, WW2

Chelsea Physic Garden, WW2 - Gresham > .
Cultivated Rx - Healing Plants, Grow Your Own Medications - anth >> .
Plants - Medicinal & Toxic - Ben >> .
Medicinal Foraging, Grow Your Own - Savoir >> .

With over 5000 species of plants - many of them medicinal or otherwise 'useful' to our lives - Chelsea Physic Garden still serves the same purpose almost 350 years after it was founded by the Worshipful Society of Apothecaries.

The Garden was considerably affected by both World Wars; with the Home Front fully mobilised to do everything it could to support the war effort, Chelsea Physic Garden contributed.

Plants and medicines were in short supply in both conflicts, so the public was encouraged to start collecting or growing plants to help with the effort. Many of plants had previously been imported from Europe, but this was no longer possible. The Government even issued leaflets helping people to identify plants outdoors and with advice on growing essential plants. The types of plants that needed to be grown were similar in both wars, and the Government issued lists of these plants. (Ayres 2015)

Kew Gardens contributed to growing food for the Second World War effort, but Chelsea Physic Garden made other contributions; in light of the enhanced need for medicine, the Garden made use of their extensive medicinal collection. The Garden sent belladonna (Atropa belladonna) and Digitalis (heart medicines) and Hyoscyamus (anaesthetic) to the University College Hospital in 1940, and they also supplied Atropa belladonna to the Ministry of Health in 1943. During World War II the demand led to a resurgence in the interest in medicinal plants. (Minter 2000)

Chelsea Physic Garden, WW2 ..

Combat Medicine

.
How Wars Have Transformed Medical Technology | Timeline > .

Wednesday, February 24, 2016

Early Clinics - Sexual Health

Impact of Britain's early sexual health service - Birb > .

The first UK clinics for venereal disease (VD) were established during the interwar years. These clinics were available to anyone, you could walk in off the street or be referred by a GP and importantly they were also free at the point of use... they changed the way that British people thought about their relationship with state-provided healthcare. The VD clinics are by no means a precursor to the NHS, but they did provide a blueprint for modern health services.

Endell Street Military Hospital - WW1

Spanish Flu Influenza Pandemic 1918 - 1920 - tgw > .

The Women Doctors Who Fought to Serve in World War I:

“No Man’s Land” tells the story of the Endell Street Military Hospital, which treated the casualties of war pouring into London during World War I — and which, except for the occasional male orderly, was staffed entirely by women.
...
This was as shocking as it was revolutionary. Women doctors were almost unheard-of. Barred from studying at most institutions except for the London School of Medicine for Women, they were relegated to low-status, low-paying jobs in schools, prisons and asylums; most treated only other women and children. None of the men who would come to the Endell Street hospital had ever been treated by a woman before.

Two pioneering doctors — Louisa Garrett Anderson, a 41-year-old surgeon whose mother, Elizabeth Garrett Anderson, was the first woman ever to qualify as a doctor in Britain, and Flora Murray, 45, an exacting Scottish anesthesiologist — saw a vacuum, and rushed to fill it. The upending of conventions necessitated by the war, as well as the desperate need for new hospital beds to treat the tens of thousands of injured and sick soldiers converging on London, offered the perfect opportunity to prove that women were equal to men.

Both women were also passionate suffragists, and the struggle for the vote went hand in hand with the struggle for professional acceptance. (They also lived together, though their careers were so interesting that their sex lives seem almost beside the point.)
...
The first casualties arrived in May, 1915, in convoys of up to 80 men at a time; by the end of the first week, all 520 beds were filled. Typically, between 400 and 800 new patients would arrive each month, many needing immediate surgery (much of it performed by Anderson), many with grievously infected wounds, many suffering from acute shell-shock, “more wounded in their minds than in their bodies.”
...
Exhausted, worked to the bone, forced to improvise and develop new techniques on the fly, the women proved themselves capable of handling nearly everything thrown at them during the war. The Spanish flu brought them to the point of despair. It came in three waves during 1918 and 1919 and killed between 3 and 6 percent of the world’s population.

Medical | Endell Street Military Hospital ..

Evolution of Medical Masks

Evolution of Medical Masks - Corp > .
Medical History - Corp >> .

Monday, February 22, 2016

GTN - Glyceryl Trinitrate

Nitroglycerin, also known as glyceryl trinitrate (GTN), is a medication in the nitrate family used for heart failure, high blood pressure, anal fissures, painful periods, and to treat and prevent chest pain caused by decreased blood flow to the heart (angina) or due to the recreational use of cocaine. This includes chest pain from a heart attack. It is taken by mouth, under the tongue, applied to the skin, or by injection into a vein.

Nitroglycerin was written about as early as 1846 and came into medical use in 1878. It is on the World Health Organization's List of Essential Medicines. The drug nitroglycerin (GTN) is a dilute form of the same chemical used as the explosive, nitroglycerin. Dilution makes it non-explosive.

GTN is a prodrug which must be denitrated, with the nitrite anion or a related species further reduced to produce the active metabolite nitric oxide (NO). Organic nitrates that undergo these two steps within the body are called nitrovasodilators, and the denitration and reduction occur via a variety of mechanisms. While the mechanism of action in angina is not entirely clear, it is believed to function by dilating blood vessels.

It was known almost from the time of the first synthesis of GTN by Ascanio Sobrero in 1846 that handling and tasting of nitroglycerin could cause sudden intense headaches, which suggested a vasodilation effect (as suggested by Sobrero). Constantine Hering developed a form of nitroglycerin in 1847 and advocated for its dosing as a treatment of a number of diseases; however, its use as a specific treatment for blood pressure and chest pain was not among these. This is primarily due to his deep rooted focus in homeopathy.

Following Thomas Brunton's discovery that amyl nitrite could be used to treat chest pain, William Murrell experimented with the use of nitroglycerin to alleviate angina pectoris and reduce blood pressure, and showed that the accompanying headaches occurred as a result of overdose. Murrell began treating patients with small doses of GTN in 1878, and the substance was widely adopted after he published his results in The Lancet in 1879.

The medical establishment used the name "glyceryl trinitrate" or "trinitrin" to avoid alarming patients, because of a general awareness that nitroglycerin was explosive.

Glyceryl trinitrate can cause severe hypotensionreflex tachycardia, and severe headaches that necessitate analgesic intervention for pain relief, the painful nature of which can have a marked negative effect on patient compliance. It is contraindicated in conjuction with medications within the sildenafil (PDE5 inhibitorvasodilator drug family used for erectile dysfunction, such as sildenafiltadalafil, and vardenafil

In 2017, it was the 143rd most commonly prescribed medication in the United States, with more than four million prescriptions.

It is unclear if use in pregnancy is safe for the baby. Overdoses may generate methemoglobinemia.


Tuesday, February 16, 2016

Medical Education

.

Sir Charles Gordon Watson: At St Bartholomew's Hospital Watson had been elected assistant surgeon in 1910. He became surgeon after the war, and was elected consulting surgeon and a governor on his retirement in 1934. He was surgeon to the Metropolitan Hospital, where he became president of the Aesculapian Society, to St Mark's Hospital for Diseases of the Rectum, and to St Andrew's Hospital, Dollis Hill. He was a popular lecturer at St Bartholomew's, and an active supporter of student clubs. Ball, Sir William Girling (1881 - 1945) .


House officer (previously often called a houseman) may refer to:
  • Foundation house officer, a doctor in the first two years after qualification in a United Kingdom hospital, undergoing the postgraduate Foundation Programme
  • Pre-registration house officer, a United Kingdom hospital doctor in the first year after qualification, phased out in 2005
  • A physician (one who holds the degree of M.D., D.O., MBBS, MBChB, or BMed) undergoing residency training.
  • Senior house officer, a hospital doctor in Ireland during the second and third years after qualification; formerly used in the United Kingdom but phased out in 2005
https://en.wikipedia.org/wiki/Medical_school_in_the_United_Kingdom

https://en.wikipedia.org/wiki/Pre-registration_house_officer
https://en.wikipedia.org/wiki/House_officer
https://en.wikipedia.org/wiki/Residency_(medicine)
https://en.wikipedia.org/wiki/Specialist_registrar

https://en.wikipedia.org/wiki/General_practitioner#United_Kingdom

UCL Medical School is the medical school of University College London (UCL) and is located in London, United Kingdom. The School provides a wide range of undergraduate and postgraduate medical education programmes and also has a medical education research unit and an education consultancy unit.

UCL has offered education in medicine since 1834. The currently configured and titled medical school was established in 2008 following mergers between UCLH Medical School and the medical school of the Middlesex Hospital (in 1987) and The Royal Free Hospital Medical School (in 1998).

The School's clinical teaching is primarily conducted at University College Hospital, The Royal Free Hospital and the Whittington Hospital, with other associated teaching hospitals including the Eastman Dental Hospital, Great Ormond Street Hospital, Moorfields Eye Hospital, the National Hospital for Neurology and Neurosurgery and the Royal National Throat, Nose and Ear Hospital, Royal National Orthopaedic Hospital and Luton and Dunstable University Hospital.

The School is currently ranked 4th in the UK by the Complete University Guide 2016, 3rd by the Guardian University Guide 2016, and 10th in the world by the QS World University Rankings.
New:
https://en.wikipedia.org/wiki/Foundation_doctor .

Medical Journals


Medical Refugees and the Modernisation of British Medicine, 1930–1960

Medical Refugees and the Modernisation of British Medicine, 1930–1960
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496449/

Medical Texts (1858+) ..

""It was thus the threat of the Luftwaffe which compelled Britain — and London — to reorganise the hospital services. Many detailed and practical problems had to be sorted out and the London Voluntary Hospitals Committee became increasingly anxious that while the Ministry’s scheme was all right as far as it went, few staff had been allocated to the task; they had inadequate authority and virtually no money. On 1 February 1939 the Ministry wrote to the committee suggesting that as soon as the boundaries of the sectors had been announced, the voluntary hospitals should agree amongst themselves to nominate a doctor to work out the details of the scheme. The Ministry would approve the nomination formally and pay this group officer £100 per year for his services. The committee thought that this went nowhere far enough and on 7 February wrote to the Permanent Secretary pointing out that a detailed and intricate organisation would be necessary, with group officers who would have to be capable men, able to take command in time of war.

The committee made a series of proposals which it wished to see laid before the Minister and, if necessary, the Cabinet. Adverse comments appeared in the press which Sir Charles Wilson disavowed. The Minister took a month to reply, and rejected the suggestion of failure to take the situation seriously. Nevertheless, senior members of the teaching hospitals’ staff were soon appointed as the first medical sector officers, and in June 1939 house governors and matrons were nominated as lay sector officers and matrons. Financial arrangements were also made for the establishment of first-aid posts and the sandbagging of the hospitals.3

The Metropolitan Police District and the area within about forty miles of it was divided into ten sectors. The general aim was to establish first-aid and casualty sorting centres in the danger areas, providing enough treatment to fit casualties for a journey by ambulance to advance base hospitals. These were in presumably safer areas, with enough staff and equipment for operative treatment of the injured. Base hospitals to which patients could be moved for after-care were still further from the centre. Finally there was a group of less well equipped hospitals for convalescent and chronic cases. The sector officers began the task of surveying the strange assortment of mental asylums, public assistance institutions and other hospitals which were at their disposal. They considered plans for the evacuation of staff and students.4 Contact was established with Sir Frederick Menzies and other medical officers of health, and a map was published in The Lancet showing the arrangement of the sectors and the position of the advance base hospitals.5

Nine sectors radiated from an apex in the centre of London into the home counties, and were based on one or more of the teaching hospitals; the Essex sector was based upon hospitals in Stratford, Ilford and Romford. At their extremities the sectors included parts of Essex, Hertfordshire, Buckinghamshire, Kent, Surrey and Berkshire which strictly belonged to other home defense regions — the regional organisational pattern established for military purposes.

http://www.nhshistory.net/ems_1939-1945.htm

St Bartholomew's and the Royal London School of Medicine and Dentistry

Between the Wars, students at The London needing to complete a First MB (in Biology, Chemistry and Physics) attended Queen Mary College for a year before proceeding to Second MB at The London.

Women students were first admitted to both colleges following World War II."

"Barts and The London School of Medicine and Dentistry (previously St Bartholomew's and the Royal London School of Medicine and Dentistry) was formed in 1995 by a merger of St Bartholomew's Hospital Medical College and the London Hospital Medical College with Queen Mary and Westfield College, now known as Queen Mary, University of London."

"England's first medical school
The Medical College at The London Hospital, England's first medical school, opened in 1785, pioneering a new kind of medical education providing teaching in theory as well as clinical skills.

A purpose-built lecture theatre was constructed at St Bartholomew's Hospital in 1791 and in 1822 the Governors approved the provision of medical education within the Hospital. Later a residential college was established, which moved to premises at Charterhouse Square in the 1930s. At The London, larger premises, still in use in the present School of Medicine and Dentistry, were built in Turner Street in 1854.

In 1900 both medical colleges became constituent colleges of the University of London in the Faculty of Medicine.

The Dental School opened at The London in 1911, acquiring the new Dental Institute and expanding student numbers during the 1960s. Dental education developed during the 1970s, increasing the collaboration between dentists and other professionals.
http://www.smd.qmul.ac.uk/about/history/

Medical | Endell Street Military Hospital

source
Endell Street Military Hospital was a First World War military hospital located on Endell Street in Covent Garden, central London. This was the only hospital entirely staffed by suffragists (women who supported the introduction of votes for women).

The hospital was established during the First World War in May 1915 by Doctors Flora Murray and Louisa Garrett Anderson. Both women were former members of the Women's Social and Political Union (WSPU), a militant organisation that campaigned for women's suffrage in the early twentieth century. The hospital was run under the Royal Army Medical Corps (RAMC) of the British Army.

Medical Treatment in WW1 > .


[full >]

Medical Texts (1858+) ..

Medical Services

Angels of Mercy - WW1, WW2 > .
Medical Texts (1858+) ..

Nuffield gift of iron lungs > .
Emergency & Medical - WW2 - tb >> .
Student Nurse (1944) (32min) > .
https://vimeo.com/39475629 .
Videos of 30s surgery .


US military & STDs > .

Emergency & Medical - WW2 - tb >> .
Fire Services — NFS, AFS, LFB - tb >> .
>> Tony Blake >> .
>> Wellcome Library historic medical playlists >> .
War and medicine >> .
Anaesthesia >> .
Veterinary medicine >> .

1940 UK Blitz Hospital, Doctors and Nurses Treat Patients, WWII Archive Footage > .
1940 UK hospital, Blitz era, WWII, Injured Patients, Rare Archive Footage > .
1940 Blitz-era, UK Hospital Reception, Rare WWII Archive Footage > .
Civilian Blood transfusion (1941) > .


Military Documentaries - Timeline >> .

War Surgeons - Amputations WW1 > .
https://www.youtube.com/watch?v=36GXIE7rvNs .
https://www.youtube.com/watch?v=ru0tfK8IodQ .

Innovations arising in WWI > .


War and peat: how bog moss helped save thousands of lives in World War I
https://theconversationuk.cmail20.com/t/r-l-jtltuduy-djjiirdtlj-p/
Sphagnum moss made ideal field dressings for wounded soldiers.

World War I: the birth of plastic surgery and modern anaesthesia
https://theconversationuk.cmail20.com/t/r-l-jtltuduy-djjiirdtlj-x/
Medical advances were the only positive things to come out of the Great War.

World War I: the forgotten housewives who helped win the battle on the home front
https://theconversationuk.cmail20.com/t/r-l-jtltuduy-djjiirdtlj-b/
Battling shortages and rising food and fuel prices, housewives played a vital part in Britain's first experience of 'total war'.

How World War I changed British universities forever
https://theconversationuk.cmail20.com/t/r-l-jtltuduy-djjiirdtlj-u/
Estimates suggest that Oxford lost 19% of those who served, Cambridge 18%, and Manchester and Glasgow 17%.

World War I: is it right to blame the Treaty of Versailles for the rise of Hitler?
https://theconversationuk.cmail20.com/t/r-l-jtltuduy-djjiirdtlj-h/
The Treaty of Versailles is often named as the main cause of World War II. But this is an overly simple explanation.

Collecting herbs for pharmaceuticals > .
Meadowsweet, white willow bark -- ASA
Cleavers (goosegrass) -- infection, lymphatic stimulant
Drying herbs + > .
Sage
Foxglove - digitalis
Vitamin C – rosehips – syrup > .

Cultivated Rx - Healing Plants, Grow Your Own Medications - anth >> .
Plants - Medicinal & Toxic - BeSi >> .
Medicinal Foraging, Grow Your Own - Sav >> .
Edwardian Farm & Edwardian Country House >> .

WW2: nettles used for treatment of asthma > .

One stripe per year if pass Preliminary State Examination
Lectures inserted

The Lamp Still Burns (1943) > .

Nursing training > .

Recruiting for nursing assistance > .

The widespread acceptance of the germ theory of disease in the second half of the 19th century sparked a revolutionary change in the understanding of the vital role that microbes play in infectious diseases. Specific bacterial, fungal, and viral pathogens were identified as the causative agents of many serious diseases, and a race immediately began to find effective means to attack these implicated microbes. Vaccines were deployed to prevent infectious disease by educating the host’s immune system with the attenuated or killed microbe of concern. However, they were not an effective remedy against acute infections. Chemical weaponry against bacterial diseases that could rapidly act alone or in concert with the host immune system to clear preexisting infections was discovered just before the turn of the 20th century. The German physician Paul Ehrlich investigated medicinal dyes that would specifically bind to and destroy pathogenic parasites and bacteria, but not harm the host. As the founder of modern chemotherapy, he sought after a “magic bullet” that could target the causative spirochete in syphilis, a devastating, widespread, and incurable disease, which was known since the Renaissance. In 1910, Ehrlich discovered the arsenic-containing chemical dye he eventually named Salvarsan. It was the first chemical compound shown to cure syphilis (Schwartz, Thoburn, Winau). Learn more about Paul Ehrlich in this short documentary.

WW1 
Medical Treatment in WW1 > .
A Fate Worse Than Death - Disfigured Veterans of WW1 - tgw > .  
The facial prosthetics of WW1 > .

Military Casualties


Canadian - Casualty Clearing Station > .
Newsreels (Canadian Army) > .

Antiseptic Surgery - Joseph Lister ..
Endell Street Military Hospital - WW1 ..

Saturday, February 13, 2016

Painfully Slow - Progress of Medicine, Surgery

Apothecaries, barber surgeons, pharmacists, physicians - DrKn >> .
History of Medicine & Surgery - Pers >> .

Penicillin, Discovery 1928

.1928 Discovery of penicillin (1964) >  .

A government-produced film (1964) about the discovery of penicillin by Sir Alexander Fleming, and the continuing development of its use as an antibiotic by Howard Florey and Ernst Boris Chain. The film uses many modernist animations to depict the scientific research. This video was made from material preserved by the BFI National Archive. Find out more: http://catalogue.wellcomelibrary.org/...​. .

Sir Alexander Fleming discusses the problem of antibiotic resistance in 1945: https://soundcloud.com/wellcomelibrar...​. .

The history of penicillin follows a number of observations and discoveries of apparent evidence of antibiotic activity of the mould Penicillium. Following the identification of Penicillium rubens as the source of the compound in 1928 and with the production of pure compound in 1942, penicillin became the first naturally derived antibiotic. There are anecdotes about ancient societies using moulds to treat infections, and in the following centuries many people observed the inhibition of bacterial growth by various moulds. However, it is unknown if the species involved were Penicillium species or if the antimicrobial substances produced were penicillin.

While working at St Mary's Hospital in London, Scottish physician Alexander Fleming was the first to experimentally discover that a Penicillium mould secretes an antibacterial substance, and the first to concentrate the active substance involved, which he named penicillin in 1928. The mould was determined to be a rare variant of Penicillium notatum (now Penicillium rubens), a laboratory contaminant in his lab. For the next 16 years, he studied on methods of better production of penicillin, medicinal uses and clinical trial. His successful treatment of Harry Lambert who had fatal streptococcal meningitis in 1942 proved to be a critical moment in the medical usage of penicillin.

Many later scientists were involved in the stabilization and mass production of penicillin and in the search for more productive strains of Penicillium. Important contributors include Ernst Chain, Howard Florey, Norman Heatley and Edward Abraham. Fleming, Florey and Chain shared the 1945 Nobel Prize in Physiology or Medicine for the discovery and development of penicillin. Dorothy Hodgkin received the 1964 Nobel Prize in Chemistry determining the structures of important biochemical substances including penicillin. Shortly after the discovery of penicillin, there were reports of penicillin resistance in many bacteria. Research that aims to circumvent and understand the mechanisms of antibiotic resistance continues today.

Penicillins (P, PCN or PEN) are a group of antibiotics originally obtained from Penicillium moulds, principally P. chrysogenum and P. rubens. Most penicillins in clinical use are chemically synthesised from naturally-produced penicillins. A number of natural penicillins have been discovered, but only two purified compounds are in clinical use: penicillin G (intravenous use) and penicillin V (given by mouth). Penicillins were among the first medications to be effective against many bacterial infections caused by staphylococci and streptococci. They are members of the β-lactam antibiotics, which are some of the most powerful and successful achievements in modern science.[2] They are still widely used today for different bacterial infections, though many types of bacteria have developed resistance following extensive use.

About 10% of people report that they are allergic to penicillin; however, up to 90% of this group may not actually be allergic. Serious allergies only occur in about 0.03%. Those who are allergic to penicillin are most often given cephalosporin C (another β-lactam antibiotic) because there is only 10% crossover in allergy between the penicillins and cephalosporins.

Penicillin was discovered in 1928 by Scottish scientist Alexander Fleming as a crude extract of P. rubens. Fleming's student Cecil George Paine was the first to successfully use penicillin to treat eye infection (ophthalmia neonatorum) in 1930. The purified compound (penicillin F) was isolated in 1940 by a research team led by Howard Florey and Ernst Boris Chain at the University of Oxford. Fleming first used the purified penicillin to treat streptococcal meningitis in 1942. For the discovery, Fleming shared the 1945 Nobel Prize in Physiology or Medicine with Florey and Chain.

There are several semi-synthetic penicillins which are effective against a broader spectrum of bacteria: these include the antistaphylococcal penicillins, aminopenicillins and the antipseudomonal penicillins.

PTSD Risk

Wednesday, February 10, 2016

Surgery, Medicine, Pharmacology - History

𝕸 Alchemy, Primitive Medicine 

St Bart's

.
A History of Barts, Britain's Oldest Hospital - Gresham > .St. Bartholomew's Hospital (1970-1979) >
Nurses At St. Bartholomew's Hospital (1973) > .
Bart's Hospital (1974) > .

St Bart's & London Hospitals - SuHo >> .

Medical Texts (1858+) ..

St Bartholomew's and the Royal London School of Medicine and Dentistry

Between the Wars, students at The London needing to complete a First MB (in Biology, Chemistry and Physics) attended Queen Mary College for a year before proceeding to Second MB at The London.

Women students were first admitted to both colleges following World War II."

"Barts and The London School of Medicine and Dentistry (previously St Bartholomew's and the Royal London School of Medicine and Dentistry) was formed in 1995 by a merger of St Bartholomew's Hospital Medical College and the London Hospital Medical College with Queen Mary and Westfield College, now known as Queen Mary, University of London."

"England's first medical school
The Medical College at The London Hospital, England's first medical school, opened in 1785, pioneering a new kind of medical education providing teaching in theory as well as clinical skills.

A purpose-built lecture theatre was constructed at St Bartholomew's Hospital in 1791 and in 1822 the Governors approved the provision of medical education within the Hospital. Later a residential college was established, which moved to premises at Charterhouse Square in the 1930s. At The London, larger premises, still in use in the present School of Medicine and Dentistry, were built in Turner Street in 1854.

In 1900 both medical colleges became constituent colleges of the University of London in the Faculty of Medicine.

The Dental School opened at The London in 1911, acquiring the new Dental Institute and expanding student numbers during the 1960s. Dental education developed during the 1970s, increasing the collaboration between dentists and other professionals.

http://www.smd.qmul.ac.uk/about/history/

http://www.bbc.co.uk/history/ww2peopleswar/stories/10/a7884110.shtml .
http://www.bbc.co.uk/history/ww2peopleswar/user/02/u2613002.shtml .

Monday, February 8, 2016

US Army Nurses


The United States Army Nurse Corps was formally established by the U.S. Congress on February 2, 1901. It is one of the six medical special branches (or "corps") of officers which – along with medical enlisted soldiers – comprise the Army Medical Department.

According to this War Department film, 57,000 women served as Army nurses during World War II.

Sunday, February 7, 2016

Venereal Disease Clinics

.Birkbeck Explains: Impact of Britain's early sexual health service - UoL > .

The first British clinics for venereal disease were established during the interwar years.

"These clinics were available to anyone, you could walk in off the street or be referred by a GP and importantly they were also free at the point of use... they changed the way that British people thought about their relationship with state-provided healthcare. The VD clinics are by no means a precursor to the NHS, but they did provide a blueprint for the type of health services that we're familiar with today."


sī vīs pācem, parā bellum

igitur quī dēsīderat pācem praeparet bellum    therefore, he who desires peace, let him prepare for war sī vīs pācem, parā bellum if you wan...