E-Book, Englisch, 168 Seiten, ePub
ISBN: 978-3-13-257804-3
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Want to get a step up on the competition? This is the book for young doctors trying to bluff their way into erudite otolaryngological circles by giving the impression that their ENT education was not wasted. Knowledge of trivia about a particular subject always gives the impression that the holder of this useless information is also privy to other facts which are just too mundane to mention. While everyone in the field may know what Gradenigo's Syndrome is, you will impress your colleagues by knowing just who Gradenigo was!
Learn the fun facts and information you missed in medical school the magic and romance behind acoustic neuroma; madness and anesthesia; famous tracheotomies; the history of nasal polyps; and so much more. Finally, a medical book that makes you laugh! Offbeat Otolarngology is the book you will avidly read at every break, use in speeches, and amuse your friends and colleagues.
Zielgruppe
Ärzte
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
The Development of the Specialty and Rise of Hospitals
The Gentle Art of Bouginage and Endoscopy
Anaesthetic Correlates
Lotions, Potions and Preparations
Audiology
Otology
Military Prowess Within the Field of Otolaryngology
Rhinology
Surgery of the Head and Neck
Professional Rivalries
The "Fringes" of our Subject, Including the Role of Invalid Cookery
Education and Training
THE GENTLE ART OF BOUGINAGE AND ENDOSCOPY In which the authors explore: (a) The Development of Means by which Hitherto Secret Parts of the Body Came to be Revealed. (b) The TRUTH about Linda Lovelace’s Relations, Revealed for the FIRST Time through a Thorough Investigation of the FACTS. (a) The Development of Means by which Hitherto Secret Parts of the Body Came to be Revealed. It used to be said of the ENT Surgeon that he was the one chap who was able to paint and decorate his front hall and staircase through the letter box. This may have been eclipsed somewhat by the advent of SMIGs - the Society of Minimally Invasive General Surgeons. To follow the analogy they are able to manage the landing and bedrooms also. They are the “keyhole” coves beloved of the tabloid newspapers who are forever achieving breakthroughs, managing cholecystectomies through tiny holes and then sending the patient home on the bus at tea time, after admitting another one two days pre-op to block the bed and prevent it falling into the hands of the physicians or orthopaedic surgeons. This used to happen on the aural ward of the Manchester Royal Infirmary where your authors both had the privilege of working. It was just too easy for the casualty officer to send every case he admitted there rather than laboriously telephone around the hospital because there were always beds available. That was until the advent of the M.R.I. FMedl. This was a form the size of an A4 sheet of paper with detailed questions covering both sides. Before the aural ward would accept a lodger this form had to be filled out. It usually proved easier to telephone around the hospital. Sadly, your authors never really got the credit their military training had taught them in the devising of this bureaucratic portcullis. Anyway we digress from the important subject of SMIGs. It should be noted that the word smegma is Greek for soap and not cheese (n.b. The Young Woman from Leith). Digression, yet again! Let us turn now to 1938, when Baumes presented to the Medical Society of Lyon “a mirror the size of a two franc piece“ for the examination of the choanae and larynx, which just goes to show how the French have to reduce everything to monetary terms. But long before this, Philip Bozzini (in 1806) described the first instruments to “see around corners in the cavities of the human body”. Unfortunately his fiendishly clever (shades of Captain W E Johns here; Ed) endoscope was literally one candle-power. Goethe’s dying words in 1836 were “MehrLicht!” and he might well have been describing the contemporary state of endoscopic lights. Apart from natural sunlight, candles, paraffin lights and oil lamps had all been tried but with little success. Then one night when Dr Ziemssen was at the Music Hall, he developed a plan: Thomas Drummond had invented limelight for theatres in 1816m; his light consisted of a block of lime heated to incandescence by two jets of gas, burning hydrogen and oxygen. This provided a soft brilliant light capable of being directed and focused. Its intensity was of great value for spotlights but it was also used for the realistic simulation of moonlight and sunlight. It was the spotlighting effect that Dr Ziemssen was interested in; he devised an unobtrusive little device for endoscopy which was a sort of cross between a pressure cookern and a linear accelerator. The great disadvantage of theatre limelights was that they required constant supervision by a dedicated operator who could keep adjusting the block of lime and redirect the two gas jets. If this was not attended to in Ziemssen’s Endoskope, then the drum exploded. As this did not inspire confidence, it did not catch on. The invention of the electric light in the latter half of the nineteenth century kindled new hope, but like the course of true love, it “ne ’er ran true”. One initial problem was that the first electric lights had a platinum filament, and in order to get this to glow one needed a generator powered by a steam engine. This all but precluded its use for domiciliary visits (with the exception surely of showmen and those members of the population in possession of a steam engine? Ed.). Another problem was that so much heat was generated that the first cystoscopes (Nitze-Leiter, 1879) and the modified nasopharyngoscope (Zaufal, 1880) needed continuous water-cooling systems. In 1880 Stoerk used a water filled glass sphere called a water lens or a cobblers sphere to focus the light. Apart from the over heating and the steam generator problems, an Italian hypochondriac killjoy named Voltolini was causing “undue alarm and despondency” - (an indictable offence during the Second World Waro) that electric light was bad for the eyesight not only of the practitioner but also the patient. With a name like Voltolini one would have thought that he would have been in favour of electricity, though it has been, and continues to be, the source of much disquiet amongst people who one would have thought would have known better. A landlady of one of the authors was convinced that baldness would result from his sitting too long at his books under a strong electric light. He took the advice, and retains his hair (just). As a result of Voltolini’s ravings, electric endoscopes were hardly used during the last twenty years of the nineteenth century. With the turn of the century, however, relief was at hand, not only for Mafekingp, but for endoscopic lights. It came with the invention of a miniature light bulb which did not overheat. It can be seen that the development of invasive forms of surgery with safety was dependent upon technological advances. It is perhaps not surprising to us to find that the inventive minds of our otolaryngological predecessors quickly adapted current inventions and made quite a few of their own. Watson-Williams proudly announced his Afew Electric Light Gag for use in Operating on the Facial Regions &c at the section of laryngology of the Royal Society of Medicine in 1912, claiming that by means of a small 3 volt metallic lamp carried on a stem fixed to a Doyen gag good illumination produced from outside the field of vision could be obtained.62 Major E B Waggett (1867-1939) brought back oesophagoscopy and bronchoscopy instruments from Freiburg (1906) and was the first to use them in Britain.63 His “day job” was ENT specialist at Charing Cross Hospital but for recreation he held a commission in the Territorial Army, commanding a section in the City of London Field Ambulance.64 Pop Hastings did oesophagoscopies under local anaesthesia and his patients would probably qualify afterwards as sword swallowers. They were sat on a three-legged stool and Pop Hastings, who had achieved fame as a fighter ace in the First World War (now sometimes abbreviated by those with a trivial outlook on life to WW1) and who also had a “day job” as a Member of Parliament, achieved his nickname of Corkscrew Charlie by encircling his seated patient as he advanced the oesophagoscope down the gullet. Practitioners who have as part of their professional duties the peering down of narrow pipes must always be wary of what might come at them in the opposite direction. This caution was not exercised by the officer who was inspecting the rifles of the men under his command for cleanliness. Those of our readers who have had military experience will know that this is performed from behind, with the rifle being held at the port position, the inspecting officer looking into the breech. On this occasion (a true story), the young subaltern peered down the barrel to see if it was clean. Still looking down the barrel he said “Is it loaded?” “No sir,” replied the man. “Thenpull the trigger,” came the command. The private did so, and shot the second lieutenant dead.65 (b) The TRUTH about Linda Lovelace’s Relations, Revealed for the FIRST Time through a Thorough Investigation of the FACTS. No chapter concerning itself with the insertion of instruments into the aero-digestive tract would be complete without some mention of that heroine of the silver screen, Linda Lovelace. The authors, both of whom have qualifications in the field of historical researchq, do not understand, however, the widely held misconception that her grandmother went down on the Titanic; this is simply not supported by close scrutiny of the casualty lists. ———————————— m Hence the term in the limelight originally referring to the centre stage, brilliantly lit up by the limelights. n A device constructed from metal for the preparation of food, which is heated under pressure. o Your authors have been able to find no proof to support the rumour that this conflict was started by Vera Lynn’s impressario in an attempt to boost what had been a flagging career. p A town in South Africa whose name has now, irritatingly, been changed to Mafikeng; (this has been added primarily for our American readers; clearly every true British otolaryngologist will be only too well aware of the lifting 17 May 1900 of the siege which began 12 Oct 1899). A quick straw poll amongst some of the younger (and, it must be admitted, female members of our specialty) showed that not...
