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Foo20151013 2023 1nh0xw?1444774170
9
335

A Comedy of Errors

Great people make mistakes. Unfortunately, medicine is a subject where mistakes are not tolerated. Doctors are supposed to be infallible; or, at least, that is the present dogma. Medical students regularly fall victim to expecting too much of themselves, but this is perhaps not a bad trait when enlisting as a doctor. If it weren’t for mistakes in our understanding, then we wouldn’t progress. Studying a BSc in Anatomy has exposed me to the real world of science – where the negative is just as important as the positive. What isn’t there is just as important as what is. If you look into the history of Anatomy, it truly is a comedy of errors. So, here are three top mistakes by three incredibly influential figures who still managed to be remembered for the right reasons. 3. A Fiery Stare Culprit: Alcmaeon of Croton Go back far enough and you’ll bump into someone called Alcmaeon. Around the 5th century, he was one of the first dissectors – but not an anatomist. Alcmaeon was concerned with human intellect and was desperately searching for the seat of the soul. He made a number of major errors - quite understandable for his time! Alcmaeon insisted that sleep occurs when the blood vessels filled and we wake when they empty. Perhaps the most outrageous today is the fact that he insisted the eyes contained water both fire and water… Don’t be quick to mock. Alcmaeon identified the optic tract, the brain as the seat of the mind (along with Herophilus) and the Eustachian tubes. 2. Heart to Heart Culprit: Claudius Galen Legend has it that Galen’s father had a dream in which an angel/deity visited him and told him that his son would be a great physician. That would have to make for a pretty impressive opening line in a personal statement by today’s standards. Galen was highly influential on modern day medicine and his treatise of Anatomy and healing lasted for over a thousand years. Many of Galen’s mistakes were due to his dissections of animals rather than humans. Unfortunately, dissection was banned in Galen’s day and where his job as physician to the gladiators provided some nice exposed viscera to study, it did not allow him to develop a solid foundation. Galen’s biggest mistake lay in the circulation. He was convinced that blood flowed in a back and forth, ebb-like motion between the chambers of the heart and that it was burnt by muscle for fuel. Many years later, great physician William Harvey proposed our modern understanding of circulation. 1. The Da Vinci Code Culprit: Leonardo Da Vinci If you had chance to see the Royal Collection’s latest exhibition then you were in for a treat. It showcased the somewhat overlooked anatomical sketches of Leonardo Da Vinci. A man renowned for his intelligence and creativity, Da Vinci also turns out to be a pretty impressive anatomist. In his sketches he produces some of the most advanced 3D representations of the human skeleton, muscles and various organs. One theory of his is, however, perplexing. In his sketches is a diagram of the spinal cord……linked to penis. That’s right, Da Vinci was convinced the two were connected (no sexist comments please) and that semen production occurred inside the brain and spinal cord, being stored and released at will. He can be forgiven for the fact that he remarkably corrected himself some years later. His contributions to human physiology are astounding for their time including identification of a ‘hierarchal’ nervous system, the concept of equal ‘inheritence’ and identification of the retina as a ‘light sensing organ’. The list of errors is endless. However, they’re not really errors. They’re signposts that people were thinking. All great people fail, otherwise they wouldn’t be great.  
Lucas Brammar
about 8 years ago
12
0
229

Priapism and Hematuria

<p>Why is a 12 hour erection a bad thing? How should we manage the patient with bloody urine? A curbside consult with urologist Brian Shaffer, MD.&nbsp;</p <p>Your emails</p <p>An unusual southern accent</p <p>and much more...</p <p>&nbsp;</p <p><em><strong><span style="font-size: x-large; color: #0000ff;">Urology Primer</span></strong></em></p <p>&nbsp;</p <p><strong><span style="font-size: large;">Priapism<span style="font-size: 10px; font-weight: normal;">&nbsp;a rare condition that causes a persistent, and often painful, penile erection.</span></span></strong></p <p>&nbsp;</p <p>Priapism is drug induced, injury related, or caused by disease, not sexual desire. As in a normal erection, the penis fills with blood and becomes erect. However, unlike a normal erection that dissipates after sexual activity ends, the persistent erection caused by priapism is maintained because the blood in the penile shaft does not drain. The shaft remains hard, while the tip of the penis is soft. If it is not relieved promptly, priapism can lead to permanent scarring of the penis and inability to have a normal erection.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Clot retention</span></strong></p <p>blood clots in the bladder prevent urine emptying</p <p>&nbsp;</p <p><span style="font-size: large;"><strong>Coude Catheter</strong></span></p <p>a semi-rigid catheter that has a curve or bend at the tip. The curved tip allows it to navigate over the curvature of the prostate or any other urethral obstruction it may encounter. A Coude catheter is specifically designed for this purpose. Coude catheters are available in size 8 French to size 26 French.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">De Novo</span></strong></p <p>The Latin expression de novo literally means something akin to "from the beginning" or "anew"</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Interstitial cystitis</span></strong></p <p>also called painful bladder syndrome &mdash; is a chronic condition characterized by a combination of uncomfortable bladder pressure, bladder pain and sometimes pain in your pelvis, which can range from mild burning or discomfort to severe pain.</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Cystoscopy</span></strong></p <p>the use of a scope (cystoscope) to examine the bladder. This is done either to look at the bladder for abnormalities or to help with surgery being performed on the inside of the urinary tract (transurethral surgery).</p <p>&nbsp;</p <p><strong><span style="font-size: large;">CT Urogram</span></strong></p <p>A urogram is a radiograph, or X-ray image, of the urinary tract.&nbsp;</p <p>&nbsp;</p <p><strong><span style="font-size: large;">TURP</span></strong></p <p>transurethral resection of the prostate</p <p>&nbsp;</p <p><strong><span style="font-size: large;">Foley catheter</span></strong></p <p>a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to hold it in place. The urine drains into a bag and can then be taken from an outlet device to be drained</p <p>&nbsp;</p <p>&nbsp;</p>  
Rob Orman, MD
over 11 years ago