- Email: [email protected]
CHRISTMAS QUIZ
1417 and that he is not there because he has to be there, may prove to be a decisive factor in satisfying an entire community’s territorial imperative ". This would necessitate control of neighbourhood housing by the people in the neighbourhoods, and would involve certain legal questions which I will not deal with here. The two culturally oriented agencies would have this sense of community as their goal but would push more towards ethnic pride, something which I feel is needed desperately in the Blacks. In other words, I am saying that you have to make a person feel that he is somebody before he can ever do anything with his life. The last agency would deal with specific individual problems, which are more medical than sociological. It would be affiliated with a State hospital for mental illness along with a halfway house within the community. "
week of their time, as well as third and fourth year medical students who could spend some of their elective time working in the neighbourhoods. Members of the community could be trained in health care, and would work under the direction of a public-health nurse assigned to the particular neighbourhood clinic. The clinics would be equipped to handle the same range of cases as a general practitioner, and would place special emphasis on prenatal care, lead-poisoning, rat-bite, drug abuse, tuberculosis, and venereal-disease. X-rays, laboratory tests, and other diagnostic procedures would be carried out by the back-up hospital. An ambulance service for each neighbourhood clinic would be on hand to transport emergency cases to the back-up hospitals at all times.
Very Special Articles
HEALTH PROBLEMS
The health problems of the inner city are not leadpoisoning, tuberculosis, syphilis, infant mortality, sicklecell anaemia, and the various infections related to rat-bite. All of these can be treated, for the most part successfully, by a physician. We have the technology to cope with them. The problem is getting the technology to the people, and changing living conditions which may be favourable to the particular illness. I would set up an agency specifically for the prevention of disease in the community. This agency would have the right to levy fines and take court action against anyone contributing to the ill-health of the community, including slum landlords and polluters. The agency would also have a task-force which would set about devising programmes to alleviate potential and actual health hazards such as apartment-buildings with peeling lead paint, open sewers, and rat-infested areas. An educational branch of the agency would deal with teaching both child and adult about the means of preventing and identifying specific health
problems. If a person is sick one would think it would be easy to get aid by going to a public clinic. However, if the clinic is on the other side of town, if you lose working-time to go there, or if you have to leave your children alone, the chances are you may not bother to go. In my opinion it is necessary to bring the doctor out from the public-hospital clinic into the neighbourhoods which form the inner city. If, for example, in the hypothetical community described, the public hospital set up a series of front-line store-front clinics associated with specific neighbourhoods and open until 9 o’clock in the evening so as to allow working people to benefit from them, a new concept of public health could arise. These store-front clinics would afford two distinct advantages over a hospital clinic: they would be unique to the neighbourhood they serve; and the personnel running each clinic would become familiar with the problems of the neighbourhood, and would even possibly form doctor/ patient relationships. Each store-front clinic would be backed up by the non-profit hospital closest to it. This would enable the neighbourhood to have a second line of defence for more serious illnesses, and to have this defence close by. The non-profit hospitals would in turn be backed up by the large public hospital. The profit-making hospitals would be informed that in a time of health crisis they would be called upon to serve as auxiliary centres of health services. The store-front clinics would be staffed by physicians who would not necessarily come from the community or from the hospitals in the comm1IDÎty. One physician would be in charge of each clinic, but there could be physicians from other parts of the city who would be willing to donate one evening, morning, or afternoon per
CHRISTMAS QUIZ
I.-Jane Austen: A. A very well-behaved young ship’s surgeon, an indiscreet London obstetrician, and four apothecaries are mentioned by name in the novels: viz. Messrs. Campbell, Donavan, Perry, Wingfield, Jones, and Robinson. Assign them to their novels. B. Which one of the six novels is entirely devoid of medical interest except for one headache ? C. Who were these patients and in what novels do they appear ? (a) "a neglected fall, and had brought on a fever."
a good deal of drinking, Later there were " some strong hectic symptoms which seemed to seize the frame on the departure of the fever." " (b) His collar-bone was found to be dislocated and such injury received in the back, as roused the most ideas." alarming " She was too precipitate by half a second, she (c) fell on the pavement on the Lower Cobb, and was taken up lifeless ! " " (d) she ... had been afflicted with a severe rheumatic fever, which, finally settling in her legs, had made her for the present a cripple." D. (a) What remedy did (the late) Mr. Jennings consider did more good than anything else in the world for his " colicky gout " ? (b) What did " three great institutionary dinners in one week " do to the parson, Dr. Grant ? E. (a) Who wrote: " Moral as well as Natural Diseases disappear in the progress of time & new ones take their place. Shyness and the Sweating Sickness have given way to Confidence and Paralytic
complaints." (b) What resulted from Private Humberstall referring to a talkative nursing Sister as Miss Bates " ? F. At what age did Jane Austen die and what was the probable cause of her death ? "
2.-Pets:
Assign these owners to their pets: Mistress Elizabeth Harvey; Dr. John Brown, author of Rab and his Friends; Sir Thomas Browne; Dr. James Barry, Army surgeon, discovered after death to be a woman; Sir John Harington, inventor of the water-eloset. Dr.
Dolittle. A. Toby, Wylie, Wasp, Jock, Duchie, Puck, Dick. B. " an excellent and a well-instructed Parrat." C. Bungey, a shaggy dog. D.
a
hedgehog.
1418 E. F.
an old parrot. series of small, cross, black
Polynesia, a
or
white dogs called
Psyche.
C. objected to fighting a duel with any physician who had not graduated at Oxford or Cambridge ? D. was a contemporary of Benvenuto Cellini and wrote
equally self-revealing autobiography ? distinguished surgeon of the early 19th century ; had a strong Norfolk accent; always referred to the " prostrate " gland; and addressed his pupils an
3.-Churches: In what churches or churchyards will you find : A. An epitaph to Robert Thomas Crosfield (d. 1802) composed by himself:
E. M.D.
(Middlesex) stained-glass window to a local doctor with pictures of aconite, cinchona, deadly nightshade, eucalyptus, foxglove, poppy, and saffron. (Essex)
B. A
(Berkshire) carvings depicting lumbago; sciatica; stomach-ache; and toothache. (East Riding) E. A graffito reading: " Primarius pestis Mt. CCC First Juni Ano ". (The beginning of the pestilence was in June in the year 1300.) (Herts) F. An epitaph to a woman of 29: But when Nerves were too delicately spun to bear the rude Shakes and Jostlings which we must meet with in this Transistone
"
a
(Oxfordshire) 4.-Sayings and Writings: Ascribe the following sayings or writings to their authors-i.e., Dr. John Fothergill; Florence Nightingale ; Robert Burton; Dupuytren; Sir Stephen Paget; Osler. A. (In
address
to
students)
young man,
B.
C.
D.
E. F.
the best
course
B.
" England’s ingratitude still blots The scutcheon of the brave and free. I saved you from a million spots And now you grudge one spot to me."
C.
D.
E.
F.
To what famous doctor do these lines from Punch refer and on what occasion ? " It is still the humane custom of physicians and eminent surgeons not to accept fees from curates, half-pay officers of the army and navy, and men of letters." When was this written ? What hospital was governed until the National Health Service Act by Letters Patent issued in the first half of the 16th century ? Fill the blank in: " Louis Philippe brought from England to Palermo twenty-two xxxxx-xxxxxxx and twenty-four housemaids." " Altogether boy he got um plenty senake he stop along inside bell’ belong boy, he kaikai bell’, blut he come, he kaikai blut. Blut belong boy him kaikai belong senake." This extract from a health education lecture deals with what disease ? In what country ? In what dialect ? N. M. G. Answers
on
p. 1436.
"
I wish you therefore, in early your career, a serious illness, or an operation, or both." " Many that did ill under physicians hands, have happily escaped, when they have been given over by them, left to God and Nature, and themselves." " Unless the British public is enlightened enough to pay the doctors for their knowledge and not for their drugs, the medical profession will be a base and not a distinguished one." " My dear, never marry a physician; if he has little to do he may become distressed; if much, it is a very uncomfortable life for his companion." " I see no rebels [in my hospital]; I see only wounded." " The desire to take medicine is one feature which distinguishes man from the lower animals. This is one of the most serious difficulties with which we have to contend." an
as
6.-Here and There: A. Of " The Thousand " who went to liberate Sicily with Garibaldi in 1860, how many were doctors or medical students ? 150, 100, 50, 25 ?
C. A wooden rail to the memory of a man " who lost his life in a WHIRLWIND at the GREAT WESTERN RAILWAY STATION, ..." in 1840.
tory World, Nature gave way. She sunk and died Martyr to Excessive Sensibility."
"
Genelmen ! " ? F. advised reading " Don Quixote " of study for a medical student ? as
" Beneath this stone Tom Crosfield lies Who cares not now who laughs or cries. He laughed when sober and when mellow Was a harum-scarum heedless fellow He gave to None designed Offense So Honi Soit qui mal y pense."
D. Mediaeval
was a
5.-Unusual doctors: Which of the following doctors: Anthony Addington M.D.; Sir Astley Cooper; Dr. Messenger Monsey; Hugh Smithson; Girolamo Cardano or Jerome Cardan;
Sydenham, A. used to extract his own teeth by attaching a bullet to them with catgut and firing it out of a pistol ? B. became the only medical Duke ?
ANYONE READ THE LANCET ? How well have you read The Lancet in the past year ? 1. With what country do you associate S.M.O.N. ? 2. What alerted Popeye ? 3. An apple a day ... but apple-juice did not. Why ? 4. What spoiled the brew ? 5. Who spoiled Everyman’s breakfast ? 6. In May the East failed to enter where the West had been for 20 years. Where ? 7. Who missed it, but only on the way down ? 8. What made the " pee " sound... ? 9.... and who tried to keep the P quiet ? 10. What have mathematicians, rock gardeners, and midriff specialists in common ? 11. How many awoke to the sound of pop ? 12. How did the sporting Danes disprove a Hippocratic
saying ? 13. What carried the Nobel EarlFS message ? 14. What’s in horseradish sauce ? 15. If, in 1975, your systolic B.P. changed from 120 16 would you worry ?
to
A prize, a copy of Chain of Friendship (see p. 1406), will be awarded for the most completely correct solution. Entries, which should be marked Christmas Competition, will be held unopened until Monday, Feb. 7, to allow overseds readers an
opportunity
to enter.
week of their time, as well as third and fourth year medical students who could spend some of their elective time working in the neighbourhoods. Members of the community could be trained in health care, and would work under the direction of a public-health nurse assigned to the particular neighbourhood clinic. The clinics would be equipped to handle the same range of cases as a general practitioner, and would place special emphasis on prenatal care, lead-poisoning, rat-bite, drug abuse, tuberculosis, and venereal-disease. X-rays, laboratory tests, and other diagnostic procedures would be carried out by the back-up hospital. An ambulance service for each neighbourhood clinic would be on hand to transport emergency cases to the back-up hospitals at all times.
Very Special Articles
HEALTH PROBLEMS
The health problems of the inner city are not leadpoisoning, tuberculosis, syphilis, infant mortality, sicklecell anaemia, and the various infections related to rat-bite. All of these can be treated, for the most part successfully, by a physician. We have the technology to cope with them. The problem is getting the technology to the people, and changing living conditions which may be favourable to the particular illness. I would set up an agency specifically for the prevention of disease in the community. This agency would have the right to levy fines and take court action against anyone contributing to the ill-health of the community, including slum landlords and polluters. The agency would also have a task-force which would set about devising programmes to alleviate potential and actual health hazards such as apartment-buildings with peeling lead paint, open sewers, and rat-infested areas. An educational branch of the agency would deal with teaching both child and adult about the means of preventing and identifying specific health
problems. If a person is sick one would think it would be easy to get aid by going to a public clinic. However, if the clinic is on the other side of town, if you lose working-time to go there, or if you have to leave your children alone, the chances are you may not bother to go. In my opinion it is necessary to bring the doctor out from the public-hospital clinic into the neighbourhoods which form the inner city. If, for example, in the hypothetical community described, the public hospital set up a series of front-line store-front clinics associated with specific neighbourhoods and open until 9 o’clock in the evening so as to allow working people to benefit from them, a new concept of public health could arise. These store-front clinics would afford two distinct advantages over a hospital clinic: they would be unique to the neighbourhood they serve; and the personnel running each clinic would become familiar with the problems of the neighbourhood, and would even possibly form doctor/ patient relationships. Each store-front clinic would be backed up by the non-profit hospital closest to it. This would enable the neighbourhood to have a second line of defence for more serious illnesses, and to have this defence close by. The non-profit hospitals would in turn be backed up by the large public hospital. The profit-making hospitals would be informed that in a time of health crisis they would be called upon to serve as auxiliary centres of health services. The store-front clinics would be staffed by physicians who would not necessarily come from the community or from the hospitals in the comm1IDÎty. One physician would be in charge of each clinic, but there could be physicians from other parts of the city who would be willing to donate one evening, morning, or afternoon per
CHRISTMAS QUIZ
I.-Jane Austen: A. A very well-behaved young ship’s surgeon, an indiscreet London obstetrician, and four apothecaries are mentioned by name in the novels: viz. Messrs. Campbell, Donavan, Perry, Wingfield, Jones, and Robinson. Assign them to their novels. B. Which one of the six novels is entirely devoid of medical interest except for one headache ? C. Who were these patients and in what novels do they appear ? (a) "a neglected fall, and had brought on a fever."
a good deal of drinking, Later there were " some strong hectic symptoms which seemed to seize the frame on the departure of the fever." " (b) His collar-bone was found to be dislocated and such injury received in the back, as roused the most ideas." alarming " She was too precipitate by half a second, she (c) fell on the pavement on the Lower Cobb, and was taken up lifeless ! " " (d) she ... had been afflicted with a severe rheumatic fever, which, finally settling in her legs, had made her for the present a cripple." D. (a) What remedy did (the late) Mr. Jennings consider did more good than anything else in the world for his " colicky gout " ? (b) What did " three great institutionary dinners in one week " do to the parson, Dr. Grant ? E. (a) Who wrote: " Moral as well as Natural Diseases disappear in the progress of time & new ones take their place. Shyness and the Sweating Sickness have given way to Confidence and Paralytic
complaints." (b) What resulted from Private Humberstall referring to a talkative nursing Sister as Miss Bates " ? F. At what age did Jane Austen die and what was the probable cause of her death ? "
2.-Pets:
Assign these owners to their pets: Mistress Elizabeth Harvey; Dr. John Brown, author of Rab and his Friends; Sir Thomas Browne; Dr. James Barry, Army surgeon, discovered after death to be a woman; Sir John Harington, inventor of the water-eloset. Dr.
Dolittle. A. Toby, Wylie, Wasp, Jock, Duchie, Puck, Dick. B. " an excellent and a well-instructed Parrat." C. Bungey, a shaggy dog. D.
a
hedgehog.
1418 E. F.
an old parrot. series of small, cross, black
Polynesia, a
or
white dogs called
Psyche.
C. objected to fighting a duel with any physician who had not graduated at Oxford or Cambridge ? D. was a contemporary of Benvenuto Cellini and wrote
equally self-revealing autobiography ? distinguished surgeon of the early 19th century ; had a strong Norfolk accent; always referred to the " prostrate " gland; and addressed his pupils an
3.-Churches: In what churches or churchyards will you find : A. An epitaph to Robert Thomas Crosfield (d. 1802) composed by himself:
E. M.D.
(Middlesex) stained-glass window to a local doctor with pictures of aconite, cinchona, deadly nightshade, eucalyptus, foxglove, poppy, and saffron. (Essex)
B. A
(Berkshire) carvings depicting lumbago; sciatica; stomach-ache; and toothache. (East Riding) E. A graffito reading: " Primarius pestis Mt. CCC First Juni Ano ". (The beginning of the pestilence was in June in the year 1300.) (Herts) F. An epitaph to a woman of 29: But when Nerves were too delicately spun to bear the rude Shakes and Jostlings which we must meet with in this Transistone
"
a
(Oxfordshire) 4.-Sayings and Writings: Ascribe the following sayings or writings to their authors-i.e., Dr. John Fothergill; Florence Nightingale ; Robert Burton; Dupuytren; Sir Stephen Paget; Osler. A. (In
address
to
students)
young man,
B.
C.
D.
E. F.
the best
course
B.
" England’s ingratitude still blots The scutcheon of the brave and free. I saved you from a million spots And now you grudge one spot to me."
C.
D.
E.
F.
To what famous doctor do these lines from Punch refer and on what occasion ? " It is still the humane custom of physicians and eminent surgeons not to accept fees from curates, half-pay officers of the army and navy, and men of letters." When was this written ? What hospital was governed until the National Health Service Act by Letters Patent issued in the first half of the 16th century ? Fill the blank in: " Louis Philippe brought from England to Palermo twenty-two xxxxx-xxxxxxx and twenty-four housemaids." " Altogether boy he got um plenty senake he stop along inside bell’ belong boy, he kaikai bell’, blut he come, he kaikai blut. Blut belong boy him kaikai belong senake." This extract from a health education lecture deals with what disease ? In what country ? In what dialect ? N. M. G. Answers
on
p. 1436.
"
I wish you therefore, in early your career, a serious illness, or an operation, or both." " Many that did ill under physicians hands, have happily escaped, when they have been given over by them, left to God and Nature, and themselves." " Unless the British public is enlightened enough to pay the doctors for their knowledge and not for their drugs, the medical profession will be a base and not a distinguished one." " My dear, never marry a physician; if he has little to do he may become distressed; if much, it is a very uncomfortable life for his companion." " I see no rebels [in my hospital]; I see only wounded." " The desire to take medicine is one feature which distinguishes man from the lower animals. This is one of the most serious difficulties with which we have to contend." an
as
6.-Here and There: A. Of " The Thousand " who went to liberate Sicily with Garibaldi in 1860, how many were doctors or medical students ? 150, 100, 50, 25 ?
C. A wooden rail to the memory of a man " who lost his life in a WHIRLWIND at the GREAT WESTERN RAILWAY STATION, ..." in 1840.
tory World, Nature gave way. She sunk and died Martyr to Excessive Sensibility."
"
Genelmen ! " ? F. advised reading " Don Quixote " of study for a medical student ? as
" Beneath this stone Tom Crosfield lies Who cares not now who laughs or cries. He laughed when sober and when mellow Was a harum-scarum heedless fellow He gave to None designed Offense So Honi Soit qui mal y pense."
D. Mediaeval
was a
5.-Unusual doctors: Which of the following doctors: Anthony Addington M.D.; Sir Astley Cooper; Dr. Messenger Monsey; Hugh Smithson; Girolamo Cardano or Jerome Cardan;
Sydenham, A. used to extract his own teeth by attaching a bullet to them with catgut and firing it out of a pistol ? B. became the only medical Duke ?
ANYONE READ THE LANCET ? How well have you read The Lancet in the past year ? 1. With what country do you associate S.M.O.N. ? 2. What alerted Popeye ? 3. An apple a day ... but apple-juice did not. Why ? 4. What spoiled the brew ? 5. Who spoiled Everyman’s breakfast ? 6. In May the East failed to enter where the West had been for 20 years. Where ? 7. Who missed it, but only on the way down ? 8. What made the " pee " sound... ? 9.... and who tried to keep the P quiet ? 10. What have mathematicians, rock gardeners, and midriff specialists in common ? 11. How many awoke to the sound of pop ? 12. How did the sporting Danes disprove a Hippocratic
saying ? 13. What carried the Nobel EarlFS message ? 14. What’s in horseradish sauce ? 15. If, in 1975, your systolic B.P. changed from 120 16 would you worry ?
to
A prize, a copy of Chain of Friendship (see p. 1406), will be awarded for the most completely correct solution. Entries, which should be marked Christmas Competition, will be held unopened until Monday, Feb. 7, to allow overseds readers an
opportunity
to enter.