BMJ : British medical journal
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Although this year marks the 150th anniversary of the discovery of modern surgical anaesthesia, surgery itself has a much longer history. It is well known that extracts from the opium poppy, Papaver somniferum, were used to dull the pain of surgery during ancient times but less well known that extracts from plants with sedative powers often accompanied them, producing primitive anaesthesia. Most of these sedative plants were members of a large botanical family, the Solanaceae. ⋯ It also explains why, during the middle ages, these primitive techniques went out of use but how none the less they provided Shakespeare with the inspiration for some of his greatest plays. When the active principal of the Solanaceae was identified as scopolamine, it came to play a part in 20th century anaesthesia. The combination of omnopon and scopolamine lives on as a premedication, and the presence of poppy heads and mandrake roots on the arms of today's Association of Anaesthetists serves to remind us of the speciality's links with its past.
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Freedom and responsibility, how much of each and how they are balanced, have profound implications for our personal lives and for our work. The health of a population and its achievement in the workplace are enhanced when individuals have some freedom and some responsibility, but not too much of either, and when civil associations of individuals rather than individuals acting alone are the essential social units. ⋯ But social conformity should not prevent individuals from going their own way, and it should be possible to combine the luxury of individuality with an active life in civic affairs. Less than complete freedom may fall short of existential utopia, but it may be best for our health and wellbeing.
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To define the prevalence of mental disorder and need for psychiatric treatment in new remand prisoners and to determine to what extent these are recognised and addressed in prison. ⋯ Not only is the prevalence of mental disorder, in particular severe mental illness, high in this population, but the numbers identified at reception are low and subsequent management in prison is poor.
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Historical Article
Nuremberg lamentation: for the forgotten victims of medical science.
Fifty years after the Nuremberg medical trial there remain many unanswered questions about the role of the German medical profession during the Third Reich. Other than the question of human experimentation, important ethical challenges arising from medicine in Nazi Germany which have continuing relevance were not addressed at Nuremberg. The underlying moral question is that of the exercise of professional power and its impact on vulnerable people seeking medical care. Sensitisation to the obligations of professional power may be achieved by an annual commemoration and lament to the memory of the victims of medical abuse which would serve as a recurring reminder of the physician's vulnerability and fallibility.