By C. Gamal. Andrew Jackson University.

Those selected have been deliberately kept short in an effort to highlight the pithiest phrase or the sharpest insight buy imuran 50mg online. They have been selected on the basis of their use- fulness to modern medical authors discount imuran 50mg online, journalists, politicians, nurses, physios, lecturers, and even health managers, who will always have need to season their works with the clever or witty phrases of former colleagues whose intuitions still say as much today as when they were first published. Many reflect the compiler’s tastes and prejudices but there will be something for everyone within these pages. Browsing through many texts to find the most appropriate quotations to include in the Oxford Dictionary of Medical Quotations has afforded an insight into both medical history as well as the nature of the doctors and others who have chiselled these phrases. A glance for the casual reader not looking for a specific quote will be rewarding in itself. Quotations are listed under author, with an index of keywords that permits the reader to access a number of quotes with the same keyword. Wherever possible, biographical information about the author and whence the quote originated are included, although it is acknowledged that there are several omissions in this regard. When the original source is not clear, the secondary source has been substituted if it was thought useful for further study for the reader. If the quotation was deened to merit a place in the Dictionary even without full reference being available, it was included. Indeed, it is not necessary for an author to be particularly well known to be in the dictionary if he or she had given birth to a bon mot or a succinct phrase. The majority of the quotations come from the English-speaking medical worlds of Great Britain, Ireland, and North America but several quotes from other rich medical cultures have been included in translation. Whether readers are looking for a suitable quotation on surgery, science, kidneys, or kindness, they should find much here to satisfy. Medicine is both the narrowest and broad- est of subjects, and I have included examples of both the specific and the general. If I have failed to find that favourite concise quote, please send it fully referenced and it will be included in the next edition. Any corrections of birth dates and deaths will be most wel- come and acknowledged in subsequent editions. This page intentionally left blank Contents Quotations  Bibliography  Index  How to Use the Dictionary The sequence of entries is by alphabetical order of author, usually by surname but with occasional exceptions such as imperial or royal titles, authors known by a pseudonym (‘Zeta’) or a nickname (Caligula). In general authors’ names are given in the form by which they are best known, so we have Mark Twain (not Samuel L. Collections such as Anonymous, the Bible, the Book of Common Prayer, and so forth, are included in the alphabetical sequence. Within each author entry, quotations are arranged by alphabetical order of the titles of the works from which they are taken: books, plays, poems. These titles are given in italic type; titles of pieces which comprise part of a published volume or collection (e. For example, Sweeney Agonistes, but ‘Fragmert of an Agon’; often the two forms will be found together. All numbers in source references are given in arabic numerals, with the exception of lower-case roman numerals denoting quotations from prefatory matter, whose page num- bering is separate from that of the main text. The numbering itself relates to the beginning of the quotation, whether or not it runs on to another stanza or page in the original. Where possible, chapter numbers have been offered for prose works, since pagination varies from one edition to another. In very long prose works with minimal subdivisions, attempts have been made to provide page references to specified editions. Unless otherwise stated, the dates thus offered are intended as chronological guides only and do not necessarily indicate the date of the text cited; where the latter is of significance, this has been stated. Where neither date of publication nor of composition is known, an approximate date (e. Where there is a large discrepancy between date of composition (or performance) and of publication, in most cases the former only has been given (e. Spellings have been Anglicized and modernized except in those cases, such as ballads, where this would have been inappropriate; capitalization has been retained only for per- sonifications; with rare exceptions, verse has been aligned with the left hand margin. The Index Both the keywords and the entries following each keyword, including those in foreign lan- guages, are in strict alphabetical order. Singular and plural nouns (with their possessive forms) are grouped separately: for ‘you choose your disease’ see ‘disease’; for ‘coughs and sneezes spread diseases’ see ‘diseases’. Variant forms of common words (doctor, Dr) are grouped under a single heading: ‘doctor’. Medicine would be the ideal profession if it did not Quoting the dangers of overzealous treatment of non-organic involve giving pain. Collier and Sons () elsewhere; but the poor devils in the hospital I am bound to take care of.

Since such toxins are not used much anymore purchase imuran 50 mg without a prescription, serum sickness is now most commonly associated with the use of certain medications imuran 50mg mastercard, including b-lactam antibiotics, sulfonamides, and streptomycin among the antimicrobials. Non-antimicrobials associated with serum sickness include hydralazine, alpha methyldopa, propanolol, procainamide, quinidine, phenylbutazone, naproxen catapril, and hydantoin. Symptoms typically begin about two weeks after the initiation of drug therapy and are characterized by fever, arthralgias/arthritis, and immune complex mediated renal insufficiency. Neurologic abnormalities are part of the systemic picture and include a mild meningoencephalitis, which occurs early in the first few days with serum sickness. Ten percent of patients may have papilledema, seizures, circulatory ataxia, transverse myelitis, or cranial nerve palsies. Behc¸et’s disease is multisystem disorder of unknown etiology characterized by oral aphthous ulcers, genital ulcers, eye findings, and neurological manifestations in up to one quarter of patients. Neuro-Behc¸et’s disease is characterized by fever, headache, and meningeal signs that closely mimic a bacterial process. The diagnosis of neuro-Behc¸et’s disease is based on recognizing that the patient has Behc¸et’s disease and has neurologic manifestations not attributable to another or superimposed process (20,21). Chest X ray shows one of the four stages of sarcoidosis ranging from bilateral hilar adenopathy to parenchymal reticular nodular fibrotic changes. Aseptic meningitis with sarcoidosis may present as acute meningitis mimicking/viral aseptic meningitis. Sarcoid meningoencephalitis is more chronic, mimicking the chronic causes of meningitis due to acid fast bacilli or fungi. Compromised hosts are not exempt from the spectrum of infectious diseases that affect immunocompetent hosts. Table 3 Mimics of Meningitis Meningeal mimics Differential features and diagnostic clues. Brain abscess (with History:sourceusuallysuppurativelungdisease(bronchiectasis),cyanoticheartdisease ventricular leak) Onset: acute (R? Sinopulmonary function Streptococcus pneumoniae Haemophilus influenzae Neisseria meningitidis. Patients with bacterial meningitis are acutely ill and have a potentially rapidly fatal disorder. Far more people will die from a delay in therapy than have died from supratentorial herniation (1–5,18,25,26) (Table 6 to 9). Meningitis and Its Mimics in Critical Care 143 Table 6 Central Nervous System Infections in Normal versus Compromised Hosts. Table 9 Diagnostic Approach in Compromised Hosts with Symptoms/Signs of Central Nervous System Infection Syndrome presentation Diagnostic procedures Comments. Gram-positive bacilli Partially treated bacterial meningitis Listeria monocytogenes Meningitis in leukopenic hosts Pseudomeningitis(Bacillus,Corynebacterium,etc) Meningeal carcinomatosis. If the pathogen can be demonstrated by Gram stain or inferred from aspects of the history, epidemiological data, systemic laboratory tests, or physical findings then an antibiotic with an appropriate spectrum can be selected to begin treatment. Listeria meningitis is ordinarily treated with “meningeal doses” of ampicillin, i. For the treatment of staphylococcal meningitis due to methicillin-sensitive strains, “meningeal doses” of an anti-staphylococcal penicillin, e. The preferred drugs for each pathogen-causing meningitis are presented in tabular form here (Table 12) (1,42). Steroids have been shown to be beneficial in the treatment of meningitis in children due to H. Because steroids affect blood/brain barrier permeability, if used steroids should be given after antimicrobial therapy has been initiated (46–50). A repeat lumbar puncture is indicated if the patient has not responded to therapy within 72 hours. The diagnostic accuracy of Kernig’s and Brudzinski’s signs in a prospective cohort of adults with suspected meningitis. Characteristics of meningitis caused by Ibuprofen: report of 2 cases with recurrent episodes and review of the literature. Pearls and pitfalls in the diagnosis and management of the central nervous system in infectious diseases. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. Levels of three inflammation markers, C-reactive protein, serum amyloid A protein and procalcitonin, in the serum and cerebrospinal fluid of patients with meningitis. Serum procalcitonin and other biologic markers to distinguish between bacterial and aseptic meningitis. West Nile encephalitis: clinical diagnostic and prognostic indicators in compromised hosts. Neurosurgically related nosocomial Acinetobacter baumannii meningitis: report of two cases and literature review. Halperin Mount Sinai School of Medicine, Atlantic Neuroscience Institute, Overlook Hospital, Summit, New Jersey, U. Is it the “toxic metabolic” encephalopathy so commonly seen in patients who are septic, hypotensive, hypoxic, or otherwise severely compromised?

Bartlett’s Unfamiliar Quotations Medicine is a strange mixture of speculation and action purchase 50mg imuran fast delivery. The knowledge of the senses is the best The sins of youth are paid for in old age buy imuran 50mg line. You cannot be sure of the success of your remedy, Whom fate wishes to ruin she first makes mad. Professor of Pharmacology, University College Hospital, Diseases of the Heart Lect. The choice before doctors is not whether they General Remarks on the Practice of Medicine ‘The Heart and should experiment on their patients, but whether Its Affection’, Ch. General Remarks on the Practice of Medicine ‘The Heart and Clinical Pharmacology p. Churchill Livingstone, Edinburgh ()    ·    Antoine Lavoisier – James Le Fanu French chemist Doctor and medical journalist We must trust to nothing but facts: The map of mental illness, like that of Africa These are presented to us by Nature, and cannot before the Victorian explorers, remains a blank. Robert Kerr) The failure of the two great projects of the last Public usefulness and the interests of humanity two decades – The New Genetics and The Social ennoble the most disgusting work. Metropolitan Life ‘Food for Thought and Vice Versa’ Vladimir Ilyich Lenin – Stanislaw Lec – Russian revolutionary and head of state Polish poet Either socialism will defeat the louse, or the louse Wounds heal and become scars. Every surgeon carries about him a little cemetery, The Spy Who Came In from the Cold in which from time to time he goes to pray, a cemetery of bitterness and regret, of which he seeks the reason for certain of his failures. Lecky – La Philosophie de la Chirurgie Foreword Irish historian and philosopher Abortion... Letter to a friend,  September () Armies have been supposed to lose more of their men by sickness than by the sword. Sir Thomas Lewis – A Treatise of the Scurvy Preface British physician and clinical scientist Art Linklater Diagnosis is a system of more or less accurate Contemporary guessing, in which the endpoint achieved is a name. Skin is like wax paper that holds everything in Lancet :  () without dripping. A Child’s Garden of Misinformation () Georg Christoph Lichtenberg – Lin Yutang –? German physicist and satirist Chinese author and philologist How is it that animals do not squint? Is this The Chinese do not draw any distinction between another prerogative of the human species? By the London Post, Massachusetts Medical Society (), quoting his article in the New England Journal of Medicine of Medical practice—where next? Journal of the Royal Society  October () of Medicine :  () It is intellectual and communication skills which Lord Lister – will become the most crucial competency in health care. Journal of the Royal Society Since the antiseptic treatment has been brought of Medicine :  () into full operation my wards, have completely The basic contract of health care has changed changed their character; so that during the last from a private matter between doctors and nine months not a single instance of pyaemia, patients to a more public one between health care hospital gangrene or erysipelas has occurred in providers – epitomized by hospitals – and patients. Journal of the Royal Society British Medical Journal :  () of Medicine :  () On the Antiseptic Principle of the Practice of Surgery    ·    The material which I have employed is carbolic or Liu Kung Cho phenic acid, a volatile organic compound, which Chinese sage appears to exercise a peculiarly destructive The able doctor acts before sickness comes. Professor of Gynaecology, Sydney, Australia British Medical Journal :  () Induced abortion, usually in defiance of the law, is On the Antiseptic Principle of the Practice of Surgery the oldest method of birth control and the most It is our proud office to tend the fleshy tabernacle common method by which women prevent the of the immortal spirit, and our path, if rightly birth of unwanted children. David Lloyd George – Address University of Edinburgh, August () British Liberal statesman The irritation of the wound by antiseptic When they circumcised Herbert Samuel, they irrigation and washing may therefore threw away the wrong bit. Percy Lockhart Mummery – Report of the British Association for the Advancement of Coloproctologist at St. Mark’s Hospital, London Science () Probably more reputations have been damaged by There are people who do not object to eating a the unsuccessful treatment of cases of fistula than mutton chop, yet who consider it something by excision of the rectum or gastroenterostomy. British Medical Journal :  () Presidential Address to the Royal Society of Medicine () The profession to which I have the great honour to belong is, I firmly believe, on the average, the Robert F. The patient should be managed the way the doctor British Medical Journal :  () or a member of his family would wish to be treated if he were that patient in that bed at that time. I regard that all worldly distinctions are as Attributed nothing in comparison with the hope that I may have been the means of reducing in some degree the sum of human misery. Oxyrhynchus Logia (Agrapha) Address at Edinburgh, June () 2nd century Anaesthetics have abolished the need for operative A prophet is not acceptable in his own homeland, speed and they allow time for careful procedures. Scottish-born surgeon Bulletin of the Johns Hopkins Hospital :  () This Yankee dodge, gentlemen, beats Mesmerism hollow. When a cure is impossible, it is the duty of the University College London, Operating Room  December physician to bring contentment, comfort or even () (after performing the first operation in Europe happiness to his patients to lighten their affliction. They guide the decisions we make in Man ought to be man and master of his fate; but our clinics and ward rounds, what we tell our children are at the mercy of those around them. Plain living and high thinking will secure health Journal of the Royal Society of Medicine : – () for most of us.

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