The journal of the Royal College of Physicians of Edinburgh
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J R Coll Physicians Edinb · Sep 2011
Biography Historical ArticleThe use of lithotomy by missionary surgeons in nineteenth-century China.
Modern medicine in China owes its origins to Anglo-American medical missionaries who introduced Western medicine into China in the early nineteenth century. In 1835 the first medical missionary to China, the Reverend Dr Peter Parker, founded the Canton Ophthalmic Hospital where he pioneered lithotomy and other surgical operations for Chinese patients. This paper chronicles the subsequent development of surgery for bladder stones at that institution by Dr Parker, Dr John Kerr and their successors. Modifications of technique and improvisations by these dedicated practitioners under less-than-optimal conditions and in an unfamiliar population, provide a unique and interesting insight into medicine of the time as practiced in China.
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J R Coll Physicians Edinb · Sep 2011
Biography Historical ArticleRobert Garrett, Tasmanian penal colony surgeon: alcoholism, medical misadventure and the penal colony of Sarah Island.
Robert Garrett emigrated from Scotland to Van Diemen's Land (now Tasmania) in 1822. Within a few months of arrival he was posted to the barbaric penal colony in Macquarie Harbour, known as Sarah Island. His descent into alcoholism, medical misadventure and premature death were related to his largely unsupported professional environment and were, in many respects, typical of those subjected to this experience.
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J R Coll Physicians Edinb · Jun 2011
ReviewBetter clinical decision making and reducing diagnostic error.
A major amount of our time working in clinical practice involves thinking and decision making. Perhaps it is because decision making is such a commonplace activity that it is assumed we can all make effective decisions. ⋯ Until quite recently there has been a general nihilism about the ability to change the way that we think, but it is now becoming accepted that if we can think about, and understand, our thinking processes we can improve our decision making, including diagnosis. In this paper we review the dual process model of decision making and highlight ways in which decision making can be improved through the application of this model to our day-to-day practice and by the adoption of de-biasing strategies and critical thinking.
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J R Coll Physicians Edinb · Dec 2010
Case ReportsLemierre's syndrome complicated by an infected branchial cyst.
We present a case of a young man with Lemierre's syndrome characterised by suppurative thrombophlebitis of the internal jugular vein and multiple septic embolic lesions with cavitations in both lungs resulting from an infected branchial cyst which was previously undiagnosed. Lemierre's syndrome is a rare presentation, especially with pulmonary cavitations, but remains a serious illness with a high mortality rate. Early recognition and prompt treatment have significant impact on prognosis. We believe this to be the first case of Lemierre's syndrome complicated by a previously undiagnosed, infected branchial cyst.