Swallowed foreign bodies

If swallowed, sharp, jagged or pointed items have different physical effects to smooth, rounded ones. Sharp objects tend to get stuck somewhere in the throat, thus increasing the risk of perforation, bleed- ing and inflammation of the upper part of the gastrointestinal tract. The casualty usually feels a sudden stinging pain. Giving the casualty something … Read more

Going to hospital

Roughly 11 per cent of the population are admitted to hospital for a period longer than 24 hours a year. This figure may seem rather high but it also includes the many babies born in hospital and the babies who need postnatal treatment. The reasons for the latter might be to carry out corrective surgery … Read more

Medical examination

Before a doctor starts a treatment, it should be clear which disease is the cause of the patient’s symptoms. In other words, a diagnosis should be made. The examination methods a doctor can use to achieve this are in theory practically limitless, and it is one of the most important tasks of a doctor to … Read more

Diagnosis

Diagnosis is the process of determining the nature and the cause of a person’s symptoms, within the framework of existing medical knowledge. The diagnosis may be obvious to all, such as a simple physical injury – a broken bone, for instance – or it may be a complicated disorder with many and variable manifestations, such … Read more

Differential diagnosis and prognosis

This first term refers to a range of diagnoses when several possibilities are suggested by the patient’s symptoms and the findings of the investigations. The differential diagnosis usually narrows as the doctor proceeds from taking the patient’s history to examina- v A computer can be used in making a diagnosis. The patient sits in front … Read more

Autopsy

Autopsy, or post-mortem examination, is an examination of a deceased person to determine or clarify the disorder or injury that caused death. It is sometimes called ‘diagnosis of death’. It is performed by a pathologist, and includes dissection and inspection of the organs, possibly accompanied by examination of tissues under a microscope. In some cases … Read more

Physical examination

When a doctor conducts a consultation, the questions he asks and the examination he makes broadly follow a set pattern, which of course varies according to the particular circumstances. Each doctor usually develops his own personal methodology. In contrast to a general practitioner who wants to inform himself as broadly as possible about the patient’s … Read more

Physical examination

Percussion This part of the physical examination is usually only of practical use for the chest and abdomen. In the former case, its principal value is in establishing the nature of lung disorders. To give two examples: when one lung has collapsed suddenly, the percussion note over that side of the chest sounds more resonant … Read more

Self-examination

Many serious illnesses begin with what often seem like minor or localized symptoms, which if recognized early can alert the individual into taking action in time for the disorder to be cured or controlled. Most disorders can be recognized by self-examination if we take time to understand the normal workings of our bodies. If any … Read more

Laboratory tests

Laboratory tests have many uses in confirming or disproving a diagnosis. The most important are tests on specimens of blood and urine, although other body fluids may be examined. Microscopic examination and chemical tests are used to examine both types of sample. Routine tests take a few days to produce results, but some can be … Read more

Medical ethics

When treating a patient, a doctor has to consider not only what is possible, but also what is ethical. A doctor’s code of practice is founded upon a modern restatement of the Hippocratic Oath, known as the Declaration of Geneva, that defines a doctor’s duties towards his patients. This was first formulated in 1947 and … Read more

Hospitals

A hospital provides care for patients who cannot be nursed and treated effectively at home, either because they have no one to give them nursing care, or because their condition requires special nursing or facilities that are not available at home. Patients who have potentially dangerous and highly infectious diseases should also be nursed in … Read more

Medical science

Whose responsibility? There is no real reason why these matters should be the responsibility of the medical profession, but it is a responsibility that they seem to have shouldered because society in general has not yet accepted it. But there are many reasons why such ethical questions, except in the narrowest medical sense, should be … Read more

Doctor and patient

The ideal doctor-patient relationship should be a partnership: the patient gives information that enables the doctor to use his professional skills to best advantage, and the patient then provides feedback so that they can both assess what has been achieved. For best results there should be mutual trust and respect. It is as important for … Read more

Overmedication

The modern Western society has become, to a large extent, a consumer society; and it is hardly surprising that this should be reflected in the consumption of healthcare. For many people, health seems to be something that can be ‘bought’ at the doctor’s, and taking pills seems to be more important than adjusting life-style. Our … Read more

Patient responsibility

Another reason for an increasing dissatisfaction on the part of patients with what they see as an indiscriminate prescribing of drugs by doctors, is the growing realization of the role that the mind plays in health. Although true psychosomatic disorders are rare, it would appear that a patient’s mental outlook can affect the progress of … Read more

Medical specialization

Medicine, like any other profession, has its individual subject areas or specialisms. The speed with which medical and allied discoveries are made is tremendously high and so the need to specialize and super-specialize stands to reason. No individual doctor can hold in his mind all of medical knowledge, particularly with the information explosion through medical … Read more

The brain and nervous system

There are four specialisms that deal with the brain and nervous system. The neurologist specializes in dis- eases of the brain and nervous system. He has a wide knowledge of the functional anatomy of the nervous system and expertise in interpreting all kinds of reflexes. Some specific investigative methods in neurology are the lumbar puncture, … Read more

Psychotherapy

Increasingly, mental disorders, phobias, neuroses, depression and other aspects of mental dysfunction are not seen as an embarrassing inability to cope with life’s demands – a weakness or flaw in the personality -but as illnesses, a number of which can be cured in the same way that a fractured leg can be reset. At the … Read more

The heart and circulation

The principal consultant in diseases of the heart and some disorders of blood circulation is the cardiologist. Apart from being an expert interpreter of heart murmurs and other sounds through the stethoscope, there are some other important methods of investigation open to him. The electrocardiogram is paramount in establishing the degree and location of disorders, … Read more

Chest and lungs

In most countries there are specialists in lung diseases. The specialism dates from the days when tuberculosis was still widespread. Nowadays the scope of this specialism has moved towards asthmatic conditions and lung cancer. Special tests to detect lung diseases are X-ray pictures, lung-function tests such as spirometry and bronchoscopy, in which a flexible periscope … Read more

The digestive tract

Internal medicine concerns itself with all kinds of internal disorders, including those that involve the digestive organs. Even more specialized is the gastroenterologist who deals solely with the digestive organs. Operative treatment is carried out by the surgeon, but invasive diagnostic procedures can be carried out by the internist or the gastroenterologist. Special methods to … Read more

Muscles, bones and joints

This area is covered by a number of specialisms. The rheumatologist is a specialist in rheumatoid arthritis and similar diseases of the locomotion system. The general surgeon operates on some kind of disorders that are not too specialized, such as torn ligaments. Fractured bones and menisci. The orthopaedic surgeon is called upon when the damage … Read more

The genito-urinary tract

The nephrologist is a superspecialized internist who concerns himself with diseases of the kidney and urinary tract and knows all about renal processes. Surgical operations are performed by the urologist. He also operates on the male genital tract. Cystoscopy. In which the bladder can be directly examined is performed by the general surgeon. The venerologist … Read more

Medical science

From the earliest times, disease and ill-health have plagued mankind. And from those early days, healing has been part of the human condition. True, many animals act instinctively to help heal or cure themselves – dogs and cats lick their wounds, for instance. Also, social animals, such as dolphins, gather to protect and aid one … Read more

The endocrine system

Many bodily processes – from digestion to reproduction – are controlled by hormones, and defects in the endocrine system can have dramatic effects. Retarded growth in children, the swollen neck of goitre, the growth of facial hair in women and even impotence in men can all have a hormonal cause. An endocrinologist, a specialist in … Read more

Modern advances in medicine and surgery

Modern medicine has tremendous resources. Advances in ‘spare part’ surgery have meant that replacement with bioengineered organs, rather than repair, is a viable alternative for many damaged organs. Hearing can often be restored by replacing the tiny ossicles of the ear by man-made components, and artificial lenses are available for insertion in the eye after … Read more

Other specialisms

Whenever operations are needed, the problem of pain arises. The anaesthesiologist is specialized in all methods of painkilling, but he also manages and supervises breathing functions and blood circulation during operations. A paediatrician deals with the special problems of childhood. The geriatrician specializes in the care of the old. There are specialists in the diseases … Read more

Diagnosis and treatment

As knowledge about how and why the body malfunctions increases, there is a widening gap between knowing the cause of a disorder and being able to cure it. People sometimes think that the diagnosis of a certain disorder guarantees a cure, but this is not true. The number of medicines available today is confusingly high, … Read more

Nursing

Nursing is taking care of the physically or mentally sick, and looking after covalescents or those who cannot take care of themselves. If we put it this way it is clear that nursing does not have to be a profession. Indeed, in earlier times no professional education was needed to become a nurse. Nowadays, however, … Read more

Examination and treatment

The doctor has stepped down from his pedestal, or – to put it differently has been forced to step down. For a patient there should no longer be any objection to his having a voice in deciding about an examination or a treatment that has to be performed. On the other side it seems that … Read more