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·Medical
Writing
WALTER C
ALVAREZ
HUGH CLEGG
FELIX MARTI IBANEZ
HANS SELYE
HENRY E
SIGERIST
MR PUBLICATION
INO
NEW YORK NY

·MID Publication, Inc.
30 East 60th Street
New York 2, NY
blonde Hot Ord Praca a
O Carb O Nome, Oh

·MD INTERNATIONAL 6 YMPOSIA ND INTERNATIONAL SI POSIA is a series of monepropu ta tool forn, babe rendel tilbed portocerty Seat contain the compte laats of some of the outstand the symposis fra besty pubbled to the moodily found DMPMATIQUL KOORD OP WCOXINE AXD CENTRAL mucha CDC, chose to City is Feb Martin, AL D. The action has morapraplus mas trepted by or readers' confront there in the wow the red characteristic fentent of the EUTTOUL RECORD OP MEDICOS I found founded by Philadepths on 18V od boddy the second olded in the United States Anong the bota included to dis renies het heer. Artificial Hoorndtsom, Premenstrual ! Tooden, Motion StonesClior prometne in General Practice About Agedhetat Motory HandlesEnderbroky od Podiatry Hook and Travel, Merken Arting, and Prychlostry od Religion Dothroportsband American and foret dtnsekts, troestigators medical teachers and makin bewerben bon collaborated that the preparation of these symposta By fucking these sympatis te permanent book form MD MIDLICATIONS DE to do the Atla a mullersonal presentation of tribal subjects that hold not only preol strate and practiced restore for kitoa us a professional mon, bat also great totteret for a bort as * member of rockety and a potential creator of cockporoty hlstory ·ON MEDICAL WRITING The coathrooms porth of Dodoma theoretaliceact imdo pactlatot hos barted the problem of developing model anomaath to the utmost Medial commatim today malatel of mach table toob milo, radio od telor loo but the plate word in all coolested the most fhet, teful md pampot vedea Ever since Carlylo stuitted that be bad read Kent Chow vlthoat adentrading a Ford oft tay here complained that moch of medical and scientific with a tocomprenable The role of pood with apply futuch to medios to fitonry viltne. W Somerhot Almagtm. three rules for food wiltintipbony bucklity mod dekho ply to metal writing. Unhapply there role ore not stay fotowed, not even by the most britant men of modice, Toba station prompted the DEDUTORAL RECORD OF MEDICINE AXO CDQAL PRACTICE anoas to argmistrymposium on Methal With the proceedinip of which that reproduced. The coud advice od poctial campion presented baro bould proto of berttable ruloo to both the orice mod the apeleoced medical watter who corpo the fact that the matcom boom about anythin the more and should try to learn about it. The peel ontbonneboden editan o loading medical Joummal, modial hbtarten, dochon kod forestipton, mited to the field of metal witting by a common droomtontor--ther creathty In this symposium oa medial within the physicam vn fod not only good od podlal edilo a bor to witte bat bo on how to tblak od open on the ot of reply vonda to determtoe whicha, Pico old cars, tro tarp by to od wilch still sitter with all the almal kurta The physician bobo drod how to mal bb Wo before acting pen to paper and bow to forproto ha style rod the content of the writing by Rodyte the rendy mod doth mustaplece of all time

·CONTENTS
Thom E.
BUT
Thoughts on the Physalan's Writing and leading
HAN AT
How Not to Writta Hedlal Paper
Hoon Cuco
An Editor's Produdlom
31
WALTD C ALTA
Medical Writing
40
Fun Muota
boola in the Physicians Lle
Blognphroal Notes on the Contratar u tha
Bympoolam on Medioal Witung

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·Thoughts on The Physicians Wating and Reading Hoy E Sipio MD D.L## LLD D.SC FRCP FL, TODO, LD I think it crccllent lda to devoce a number of thela fotood to the problems of mediaal wating although I am not quite sure that there is exch a thing u medial, clienial phydal or gricultural wating There is good wodag and bad wodox no matter what you write about, but I know that many phyddans, yomg and ald, ue parled cod womed when they have to write 1 peper en soudemic teacher who had to rend rodent papers, u editor of Keral journals whoxe dally tuk WkJ the redrag and didog of paper I koon what enormous difficaldas muoy doctors aperience when they have to capron the result of the work zod expedience la wadog So there am be no doobe thet a ales of articles devoted to this subject must be welcome There may be no medical ding la the earlat ise of the word, but it is obvious that the style viria according to the Fablect onder dixoloa. It makan . difference whether we wilte a poem, a literary way ari denafic peper The loguge and also make a great difference. Cicero coald wolte monster Knicaces and yet be per fectly clear The German language permło the use of long sentence which som obecause olely to those who do sor master the longest Firoch is perhaps the most eletut vehick for carrying thought, denuific and otherwiec, zod meny French medical wodngs are historia of Carcas, papers of Pusteur Claude Bernard . In Arlow a lit de la watu wotectele de literary masterpieces. Few countries have fousted o much on style ha dendfic writing The Engluh language & 1 marrelous lostrument of predeca and Carlty Lo English we can develop our thought fo abort sentences which it togetber uke the glau baiebs with which we build . modem hoort. This docs not mean that long mentonces are impossible in Engllah. Coc of the best tylist I mor Virginia Woolf, begios rapart entry Co Bding II, coc thus phydder would do well to read with the following sentcoce Coordenbow corpo Mbow do the tool dapat bebox, low poor be who delighoof bakk p dom, the ocor caste du tha donel, what od centro of the tool wight each of boto balap to w what people and love table with belight bow bude de alte perinatal, what andet od obdoubt prooted by the la o coe, bornp doma in bo pot of desth wd led the man ondo com abon oker bede od ke baby to bolo de la de promo de opo te beport wba n bon tooded control the data watoto wotebb lette onthoor month with the peaks of the Dairy stoop too the door of Her wowoho think dd, te w requiredy forced that of it, become and that iDocu o not care le plan with bondbewed along to be pabor dolore Taoy 4 hotel la telection The One Low Not York, Hartout bona & Con, LA ·This corainly is a long scotence but it is daar u agital from begionlog to ood, and what a world it crokol One realmace mike me remember ull the loctra C crer hed. Ouly a great poct ala write omel sod we podatno mut remain closer to arth The two prerequlatos for good widog particularly on sobreco soch u science ad lamag ut dar thioldog tod compound of the language in which one wnies. I away fowod thist people who thought clearly these able to express thetoseira clearly be it orally or lo wddag I have heard many mory poor lactan and they were lovelably people whose thought you coafused who lamped from ooc mbject to another berza sentences without fiaushing them and in general werd fott think log blood but not logically My own teacher la medial bistory Led Sodhod of the University of Lord wis oor of them. His knowledge mu formidable and be umply poured it out over his indicace in Dodigested way kod his wang w ofern coafused allo A lecture, fost like a paper must bure begloplog developmeat, 1 dimax and an ending and let me add that crory lecture creo If it is jot a roudoc clawroom lectore should be prepared very carefully I have beco Icting La mioy countries to may languages for over 30 yen, bat will coday I am frightened when I cater the lectore ball a course the moment roa face and address your zodience the fear disappear and some magaeac bood is aublished betereen you and the people you talk to At the cod you are chausted because you have give your elf out, body rod wool I alten thought that should I no looger be frightened before a letters, that is should I no longer have the deep respect that is due un andience, say sodience, the lecture would soon become very poor What applia to a lecture applia e a mach higher degree to thc wdog of . paper or soll more of a book. The zodience you address is larger and is not only today, bat also tomorrow s rodicace. When you salk you berc mort liccate thao when you wote. Lo a lecture you may use colloquial words which you must arond La wadog Yoo muy beglo a scoreocc without firishing is, if the followiog mateade uka -p cod develop your thought You may eren, though ooc should not prolase words to emphwa i podac, but you should never do rob thlags in wadog I think crery water derdore his own techo que lo the course of ume end I ao disco bere only the adraugas uod dundronger of my owo way of wridog When I have decided to write a paper or a book I feel pregnant with it for a look dos, and woce I bare opally half a doren licous projects pendlog I feel pregolar" with a whole litter I have the subject coolandy on my mind and make notes at Loy bour of the day or oight I man bare sheets of paper of wolfort ure handy rod erary creoing I sort the noto uod put them caro thar respective folden Then came the day when you are ready to begin winog Uussally it is some pressure from odbude that determind the date, 10 lite editor who remlods you that the deadloc for your paper mu three booths ago or epablisher who has been moldog padmuy for years for manuscript bar mould now like to bare it rat koor Life is sbort bor the art us loog od ooc aeter laeis quite ready to write being too much mused or lo cocs bowledge. Sall bless coc is a hopeless perfectloodst the day como when the paper bus to be entien add here the methods vary a great deal Come people are able to dictate a paper or creo 1 book They correct what they have 2! WD KENYATTOYAL STOLA ·nid, it is tetyped, cod the work is done I am got one of them uod dictate only lectures chut I wlah to publish, lectures for which I did - pardal of research wad for which I bare profesc nota. I DCT waiter lecture before it has been deltered because 1 mowadpt panloos me completely and also because I find that ocul zod written kyla tre different. This method, has the great advantage that it improve your lature, because you bure to think while you palk, which wally not the cate when you rand , mugolpeod beceos you all to u zodience that is look ing at you, not to toxen redeIt hus the dud maty a mome of my friends have aperienced, do that it may take mmc done before they receive the promised munkalp become once the lecture to over otha demoods are piling up on you. Some people wide a paper la loogtuad or on the typewder the twnt it several tutoa mdl they ut utiified with it. Emil Lodwls, * profumo writer once told me thut when he had the matedals for a book ready he wrote it very quickly in short hand. Eray crening he soot what he had wonten toe toettury who lived at the other end of Swedend Two days later he received the typed cops corrected It and the bed a book ready for the press in a very short dme. My method of widng is very different but it is one which hu rocha highly re spected predeceuon u Boile Zole, Guy de Maapunut, zod I on pars, mos ochen. Once I am ready to wote I make a short outline of not more than one page of the paper or in the cixe of 1 book, of the chapter Theo crery day I wt 1 st qumber of puro la abralatey final foom, ready for the press, with footnota cod all that foo with it. It is a dow proces Indice in looghand in copyboobs of follo de that I bure made especially for me. I wnt on the right hand page only the one to the left being left Wank for footnotes and minor changes. Au role I write fire pga a day or aboat 700 words from 9 to 12 o clock in the morning It is not much bat If you do it for 300 days a year you will produce alte cough literature. The rest of the day you need for taket, for the preparing af sort days woday for the coredoo of galley proofs, correspondcacs, and an infiudity of current ufuli I low it is generally recotumeoded that Identific papers be a short hod us factual u porcible. As a romle they are Informative, to be rurs, bot make fightfully doll roadlog I koon of famou medical Journals in which cray urtude is alitod or even rewritten entirely by a highly competent stoff of elderly Ledio sccording to act standards and the result is that every ardcke rade u If it had been waitted by the sme person. This is a fatal. No two individuals are like and no murter how factoal articlewe wlah to get a gup of the persoonlity behind it I wd that the preregulates a good wodng or det titoling and command of the logous la which you are wedlog The latter is a more spos, particolarly in Amaia. We should a pear thet a medical Hodont had acquired a thorough knowl alege of English to collega Sore here, but ray may bure not In Amcace, not fcw parudims at fardo bom. I am one of these and I would like to give my collagoa bit of wrice Work to improve your commead of the language daily and quite particolady dorlog the first year after a while we acquires a rich Bough roabalary to aproo ooard loendy though with introdlous accear 10d malog the amc mittaka ora od ova Yue. I had the grat adnabege of having lamed Eagllah o ichild and of bavias speat some oboc in Bagland before I amc to TUE ATTITOLARI MUTLIO AND LEADLIYO Spin ·matter America bat eren to the change of my Ilterary loguge was a great shock. I had written papers in French and Italian, pay for in English. My first books were al written in Gawia zod I had dercloped soy Orta Kyle which we generally appre dated by ciud. All of a sodden from ooc duy to unother I foood mgrelf transplanted into the Anglo-Saxon world nod kuch that from then on I would have to write crary lioc in English. In the language well csough to wote a paper or to ap tort the attention of a rodience in a loctors, bat widog a book was a different I had no troable doing it bot I felt that the style wu poor and it still is not the style I bed when I was wddag in German Yat I worked on loprovog may langmage from the first day onwd I in all dolog It coday after 27 yan. My nocthod is very ample cod I can recommend It oot only to foreigo-boro Ameri ans bal to everybody It coaslio of radiog good wiens cridally I happen to like Aldous Huxley his style appeal to me very much Lod I find that wc bare many thougho in common. When I first came to Amona I took some of his novels I had rad chem jean before, but don I read them, giocally few pages a day only tolyong the scorences and making notes of words that I would not hare used bac that struck me u beung very preter I also made pot of cadre sentences und la this way in a couple of yean I jocreased my vocabulary and improved my syoter considerably I sall follow the method The writen rury but I am mort nodows thun crer to improve my style This briog me DOT to the doctor reading I know wel enough that his dmc is limited bar hc should be the more citaal in the selection of his readlog I thlok crerybody no matter how busy he is bould spend at least two houn day reading What should the phyudio read apart from profesicoal literature that he must read to keep abreast of a Lust developing accocep Before WC adswer the question we must ruse another onc. To what and do we read? I think the answer is to learn to improve ourselves to carich our life and make it more mainlogfal, sod alto to learn to express oorselves better We do not rad to bill dme because life is too short und tume coo preacos to be falled thoughtlessly There are moments, to be sure thuc we woald have preferred not to bare lived, so tmpicassot illooss or a todious journey Tacke are the momcts when there is ame for a thriller which makes us forget our seira ou cotironment cod cverything but I confes that I dever developed a ruste for the class they had real literary value. What then should the physician read? Quite geacrally I may uy be should read what other decaced people read That ue no bellot-letoras for phyudidos end othm for boken I think it is a very good habit to begla the day with poem Most busy people cod phrudin tre busy people, wake up in the morning when the alarm clock ning without being quite rared. Or they hart uaken uablet la order to sleep have slope deply but sou do not feel quite normal When they share they temctober what a beary schedule they hare ahead of them and wooder how they will pornire the day Bhen they come down to brollan they already feel gloomy They opeo de pipoco read that craybody bates cerybody dse. In this state of mo thay go to the office and the day • drudgery beglas. Why not set the alara clock 10 malta carlia uod befort getting op read a poem of mo? It will resound in you through the day and may change your cuire ontlook This morolog I bep 41 XD LYTZ.YATIONAL STYTOSTA ·pered to have Dante Gabda Ropet poome on my uble. I opened the book at rundom od rond The bad droond Leod out Huo the pla betalar Ha a mena deqe be the depota dwutere de con, hed three ma ho had And the onla ba bab in Ke After I had read the poet. I bow that the day was going to be a good one and lodeed I wrote more than five pega without lahibition od whecta comething seemed to go wrong I kw the blowed damarl with her lilias cod saun, she bowed herd mod Hooped Out of the dreling charm Uodl her boxom mot bare made The bar the land on warm Aod I remembered the music Dcboy wrote to the poem. He mus in Breme u that times, Lucrate of the Rome pde redding 10 VILA Medid. He wu pot happy there although be liked roaming through the cternal dity and browstag in the sumcow atque hope But he missed his native Puris and cray year he had to send to the Paris Contenitory of Moal i cantat. He hated doing it to order but La Demoiselle Elve wu oas, written in 1887 when he wu 25 yan old and already It hed all the infioite desta that Frances great coming composer wus going to here I have the music on very good records, played them, and thus due to few terres rad la the audy Doming I bed a perfect day during which I did more work than cher Apotha day I woke up and hoord the auta pomlag down. It wu dot dramatic mula with clonda piling op behind the hills us for 1 Kene to 1 Wagnano opon The wodd wus la grcy und It wus going to ruia maadily for 24 hoon. I have a small but reket beryncit to my bed I took out volume of the poem of Paul Verlaine, read D parc du COC Coase pleet La ville Quale et cette legge Qa ptolete con con Again I remembered the music that Debawy had miten to the lines ud yun day which might have been one of gloom became a fordirt and most prodocdre duy 10 pure of the monotony of the poorlag rain I fok another bit of wound Adruce Is that are should pre read the newspaper und magadno before hining road t last 50 pegar of word while book Of COOTH we must read scump pery because us cores of democrac comida e must keep taformed of world affun. I read t last five popers every day in foc languages but I find that not more than hulf a hour 13 pcodd to get all the OCM we are loter ested is Alort etda ue 1 mere repetition of the helioc, und noc you boon the crot od the party line of the paper you need tot read the editorials that They art giren nod you could wore than your li fost as well. The une applts more ac lon to Journals rod while pre obviously compot igpare them me should not spood too much tur og them Wher then shall the parecian rend? doy good book written dona che lot TH] PAARI FAITHO AND PIDURO Siporud 15 ·3,000 years It is a grut mistake to read only DOT book Of course we want to koow what u beoog weiter coday is region codona, bow coatemporary was se and recreate the world of wbich he : pert Many purch Acty boobs tind out to be very poor in spice a mach publicity and large cdidons. Ac law odc half of the och bool I read are no worth the dime spent on them. We fure more uldy with the clapda, boobs tur hare stood the cast of dmc. Apart from my profesional radiog which obviously is quite crtcours, I read about 100 boobs 1 year and I kep a record of them. At the end of the year I food loverlobiy that coc-third were books wetten before 1900 muy of them before 1500, cac-third were mittea be Imeco 1900 101 1940, od one-third were och books may of them copia procated by their author There is much wk 10 Amedia today about The Greu Books, the boadred gott boobs of St. Johns College the grant boobs published not o laag 4go in new alidoas aod granuloom mdo thc eospices of the Vairaulty of Chiago Qube have been organized lo many dad where people from all walks of life come together brud sod dixctos de marbs of Plato Thomas Aquoss, Descartes, and other great writer of the past who have left such a deep imprint on Wester thought. This certainly is a development about which was only realce u it meam chuc America is coming of age I know of many basicTUDCA and also physician who are attend ing the meedogs of these clabs uod I thlok it mould be very interesting to find our after about 10 rain shat efect the study of theke boobs hus had on them. Hasic changed thar general oatlook ther attitude towards lefe mod the world at large, have chels ecdloos become different This is contremely important because the ideo logic coolilat of ow doe u Dot one between political and cooomic theories but between mecelim eod spiritualism. I comot discuss thus povar la soy deuil us it would require mother asuy I may only my dut lo my opinion the ideologic conflict betweco Wat zod Past is pot one between the United Sulp nod Buria buc rather between the United States and Rowin og ade side od Lodla od other Assa countries on the other side. The stody of the great thinkers of the past undoubtedly is very important uit ml belp tos to acquire 1 more correct box of wide. It will teach us that the ac cumulation of techoral gadgets and mucem goods la general 11 of oo importance that it is better to be mik than to be rich tar that us do point in being the wealthlat corpse la the cemetery It will teach os chat freedom is matter of the rodividual and be very little to do with paldaal fantacions You are free when you are free from matonul aceds cod free from pasious A man whose heart is full of smbidon uod hurre is a lare CTO if he lives in the so-called free world * Oce should begia curly with the reading of the worlds classia. Ireed hundreds of them 10 the fortosure your from 12 to 25 and I bare kept reading zod rereading them to the present day I have a small Library of about 500 rolamo part to my bed books from U countries and so many language. They are the books that have caroopinda octhroogh lfc od that I would got like to młu Greek sod Chloese duva Gaman sad loduan philosophary Resuads from Gogol to Chekhor the Trooch classia the Der le puy Goetbe, Seeso George and Rilke and of course the great foglieb pou books on mosc perdicolarly on slovart rod Debussy nad 61 D DINYATIOYAL STOUT ·boobs on et, eodeat Egypduo, Babyloala d Arabic poetry the warbas of tomme gat pataralipo ruch w Aleander Toa Hoteboldt uod Chala Darwin. It is a mul rectoo of my libousy but onc carefully selected, that I lots, uod it is my dedly or rather righty ddighat. To who gier op 10 Earope in the begening of the century i mu po asy to get hold of the great caxia of the world. La Germany Reclam Valvenal-Bibliothek offered pacally crorytblog coc coald wish for for a few cand not only the Greek od Larin od later Earopan dana but the mala literate of the Arab, Paris Iodlam, and Chinese Many of these boobs could be got from ulot machines in ruil wiy adons France had innumerable scria of dulos of the wodd. licereture which are cold ray chaply and in England he had the Erarymo Libary the Wisdom of the East Kios uod many others which provided stodend with excellent text for very little money Onc polot I should like to mendoa la this concedea is the speed of reading I know that American schools try to touch that students to read us quickly as possible I have a daughter in Ameria who rads a book io ooc dry which it would take me fow to five ders to rad. If the phyuden an devote only two hours a day to read ing it is obviously important for him to be able to read moch in a short dmc. Iem . hopelessly slow reader and therefore probably pretadloed to this mouetter when I rad a book and a paragraph redko meus pardalarly good I may raad le areal dme and make notes about it. I wonder if stadla here been made with quick reader to find out how much they remembered of what hed particularly impromed theta la .book, after five, 10 or 15 yao. Some boola wlah to forget 1 mood u poolble us they are not worth berry remembered, but other we went to toimilace, what dieta to become part of our ctra, and this takes a certain timc. Muay of those who here had the pudience to read this aty to the end will think put Im bopelexly podendo rcboolmuster Maybe I am, bar what I wrote I bure Utred and it hu endliched my life wo tremendously that I thought thut othert might benefit from my cuperence. THE VITRICIAN'S MITIRO AND RZADOPO Siperus ·How Not to Write a Medical Paper Has Selge ALD PID D.Son D.Sc (Hon) FRS © F.ICS (HR) ROOM AND DIRECTOR, DOTIUT PS KOO A D COD mo Tu, Dos Homtal MOTUL CAXADS When I recared Dr Fals Martibda flatterlag inviados to prepare a article for thbs Symposion, I must adult this at first, I doabied my competence to do ho Honerer when I ww just about to give up, my secretary Min Dostanit hoded me a Demorandum alculated to ruik my courage. From this potc it appear thut I bare po fut ritto a toul of 607 papers' end 10 boobs, which appeared (a originals or after traculadoo) la Danish," English French German, " Hoogte inn "laterllogu " lalim.' Japanese, " Partagoox," Rosalen * Sabied," and Spanish ^ Sarely I have had mough copertencel Bat what special aspect of medlal witng could I tak op? ACTTOOK OF TONIC After porosing the list of disdagudobed enthors alled apoo to disco The Art of Medical Unang berc I immediately relied of course then to hold op my own, I would bird to select la uspect in which I myself burc been focceful I would not like to be accused of immodest ausgeration, but it seems to me that I did sex ceed 10 ucqanog a rather widely recogadoed reputation in the domain omillodd by my utic it u only ostoral therefore that I should clect It us the topic of my contribution to this Symposium La fact lookiog back opoo my cctvidos donos all these years I neem to have explored cray possibility offaed by this approach to Dellal wong all the way between the celcgi-ttyle descripuoo of ample obarvation to the endless eache clopedia of Handbuch Taus if I wrote a chiudire treats along these llocs I could documcat each point by edendfic worla of my own This procedure tempeed mc albo because it would make it posuble to demonstrate to practice tbe soundoos of one of the fundamenal roles in the art of How Not to Hrite Medial Paper Oamely always to quorc caly one sono publiabou SUNDITION OF KATDIAL It 11 geocally recogained that the robdivinoo of sccoulbc material lato dessly Kfarated fraterught compartancats 11 iosdmissible because actually there are umar trionuooi betonen Taything and crerything dx Aay sttempt u arab durisod 11 likely to sumulace some shrewd aldc to paint out your aror with con. wake xuum recommending that the onlarloss and clenty of the cursfondoo be abol hed to as to restore the origroal vigueses the lim of which (being iacs Iftcor) are onunulable It would therefore be quite coosooint with the lam of bor pot to white if I 8 ·strictly robdividad my personal tratary of medial litentare Into the following 13 readoo: (1) How lot to write i idegrensok description of a simple obecoration # (2) How not to write a bod commary for the day of society before which you me to speak 0) Hot pot to wote a hate the new How Dot to wote un ordinary wighed skatiis atiden (3) How not to have a low are published ! 11 How not to write anides for furnals sundsledicated b the part How not to write tert for presentation Termes Amishow nerworb How got to write a mow Aticle 9) How Dot to write a me fushenko (10) How Dot to write na czubtire work (11) How not to wote tarbeks (12) How not to have your bank trousland 1-1 (13) How Dot to write a megaspillaki Howeet u I proceeded to fill la thc rabbending for ach of these part my ketch turned lato a plan for en acyclopedie in 13 volume That was pot canctly what the editor asked me to prepars, fo I had to plck ont i morc limited rublect. I welected from the projected roland 4 (original papeto), the chapter in which I wou to deal with the crilation of den, because it is on the interprecoon of odginal obecruition cut the progrew of understanding depende most imtadlately DICLOW AND ITALIATION OF DATA ODRAL CONTRADIOLO To what extent is she disassin and relation of scientific das justifah Meny coocomporury medical authors frown opor ay discussion and emlaadion of data which goo beyond mere synopsis of the facts obtained od to uppoul of their studotical gribaunce. Is this to be recommended? It is undoubtedly improper to discuss theoretic impilation of deafic romla la thone Rections of margoal paper which deal with the deadpace of the dao Materials od Methods, Berala ) become this aun lad to conforton between what the author obtayed ud what be thinks On the other brod, in the latrodac tion, which I meant to oarline the purpose of the Lavestigados, nod to the section specfically andled Doncorsion, Home sich interpretant remota ura, in my opinion, virtually an obligation to the reader Let w octor forget that science not the mere ataloguing of obserred fects, bat Accumulated koorlegs, mytended and formolated with reference to the dio corery of general truths or de operation of geocal lot Only the most cpochmaling discovena mould decenite po roch justification of the asperiment which led to them, ac pirdal of their significance. The discotay dry which wonid cart cancer wich aboolute cerulaty might be considered 1 ause la polot Bro bere, How NOT TO VOITTA MICAL PAD Satya 19

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·coafusion. Having been responsible for quite for of them (both tertai Tbose who object to loducty reasoning do pot iux that my wint / deplore is the newurlated confidence la general Low To losgi weit lated on the buis af den number of dan, it is no more or lant Hydy Luni Lostinco Of course much deductions cannot be accepted is odaSVAMI To throts Loanstomed to iban ct thlakog, that consideration may w uod reperfluou, bat portal of the medial Iteritare shows that in wat Thatched Anu Paully to concede this introductory for Huy a few words about the development of the technical lloguge will will Actually #mc thall me, the probitatea Neroruly ctory Darly observed muutenul or coocopul entity print mat it would be impouble to rakefore it, through in aboutiro desapon Y the set-vident, there do 1 decp-rooted cod widespaid trenion to put but neologism Thote autbon who are had may occution to learn a fordon 4 find It crpcdilly difficult to get thed to w term, which frequently in the diculos mercly beans of the novelty a funcy bedink la medida It is undoubtedly tru, of course, that the coldlag of 1 DCW team can tak cordial properties. It is on this bass chat tey sert Thorte mu of eldosterooc inullable to w for thks, siaure Salle other actions it rolght here portened. I HLADNAN terone ww found to be a porcat ncgono the tours to raccontre appliadon of both these steps in resnice *vrup the corcold nagpalom theory and then to vody Holland Ocord cold would behave a predicted by this cocerpt frE+¢* It loh Nothing but a salle combastion of Indoctor sodbo stronie ined wir led w cree to postulate a Idadionulp between coruscow AVAT discono merely on the basis of operimcats wich District of awe mtr yerts before the first theumadc pedeat received corticom Boch deducere od loducove rosoning bare defrolte tiza HAM WAS the limiding factor is the mine for both Tbe imellor AVENU! obec vinom, the greater the denges that goeralization me'n to my mind hold true This limlo Inductive and delocere reusoning en de testimin the at first to commestad, obarvations are gradually arrispod lewww Induction and deduction follow ach other and depend opna autopur Ille cousccodre steps with the left and tbe right foce do a mala few mert false to attribate greater Importance to one of the other i genccal low then us agmide peroleding correct dediccions de forma parte sible experiments thor for which are worth doing polno ore very frequently oredlooked. ore fa descalblog our real terminology is qalte dosely related to the preceding disconlon mladwriaeth delactivo reirolog chruteristia, auch doe we wtb to refer to it in 1 kcatcoct. of them have Groco-Latin roots. Aldoop tot Sehr DOW NOT TO BA NOOL PAL ·fusioos) myself I am well tree of this end, la the nort section of this paper The Seren Trap (trape S), I plea to deal ut soube leagth with oos, apedelly common source of mirandantandtag gated by certain sew class apa. Here we may limit ourselves to some general coondertions which must be kept in miod whenever 10 Kod of OCT torta la to be latroduced into the medial literature. Finnuly me puse uk ourseros whether o bem tere bo really lodispeosabic A graardal of the legidoste nulost neologtams hi doc to the fact that cachon have ocen logrodored them merely to lare ter persooal lopaat ons vobject which did Dot need to receive a special conc. The inautnerable clinical syodromes which represent minor modifications of other well-konta coodidoas illustrate this polo For jestene if u diserx, hitherto characterized by four cardinal symptatos is now obucrved in 1 ommber of paders where it occurs lo usodido with a fifchrymprom, it is merely jodified to remembe it. Even if a concept is tuflidendy ocw to deserre 1 ACW designation, the latter should u for u ponible, be self-explanatory rather than reprexcot an only chosen Insociation of letters or the name of the discoreret It is also important to keep lo mlad that melal terms abould be moderniodable to foreign authors and easy to translate ioco ford go leognages This is best locomplished by Buring ooly terms of Greco-Lenin derinidoa for che daigation of blologic topia If we follow all these rolos me immediately con Jaco the difficulty that the form mert abuse Her's ssually be played bfas Highly Wfoa souse This may create some conforion, but I do not think we need to worry about it too moch If the rogosted on Ooste is clearly defined to overlap ia terminology is not likely to be misleading For instance, we proposed the term frendichoshal for barnan actions 10 rcfertzog to the follment of all those condidoos which are accettary for a hormode to exert its effects Thus term might conceivably be cladred on the grounds thuc Pavlov spoke of conditioned reflexes ta sa altogether different sense bat nayooe familiar with these subtects is oolikely to be misled Sach common rod osefal terme u coodlucoed and coodincolog pould be difficult to read it is precisely for this reason those words are to often used tod sometimes lo u cven more foods mentally didcreat sense (cuir conditoning) Lo s cixe like this the advatage of . xllerplostory term dal gordon (asily aroslated loto toy leogange by jot appropriately changing the Lean root) greaty ostreighs the farfetched posubility of a meronderstanding I cocowotered mocb more oppouton to my tise of the words streetod pressor to dalgnate the sum of all conspecific chenga aused by function or damage od the actor which allas such changes. It had bece poated out that HTC hed dready beca osed ha pria le a roncar bat different sense It is also curteady comployed in coorerutoosl Eagllab in coonection with almost nog blog that repre KAD i struia. However the fact that the term wus to npidly add gracrully sc copted to its per secuy defined blotogic sease makes it very dobrows whether Lothar derigordion would have been equally sousctory Yet, I do feel dat it mu e greut mistake not to select a terms of Greco-Lagia del video. Unfortuo scely in 1935, when I begro boy tork on stres I fort did not thiok 12 XD LITORATIONAL ITO LA ·all this confusion could bare been avonded. Actually, I learned later thes, u start, Ponor cortespoods about axtly to trans the word og at Wu thut rome Frooch tothocs med och words delimita) muy la all logo go to be the word stran lo protest, withog sy COM, bit adrely differeat connottiansFortunately It hure become effort to trylate It. Had me thought ang 1 to derived from Grdo Letra, could have been well in this one, but now the Engli del patha h fu too und the Greek moffroid, menning Rimilar to uda name for tax tor Some yein 40 I proposed the term cordcoli (darred from drosi corte mong which imiote tbc physledoglc fonction of the real cortes." Farol technial terms by those not born in the langue is very dangerous to point out lo my feeble doomen that it would greatly bandicap the propensat cicace If only those who could all both Ladin und Grect their sative to a wote Qoc lut warning which may be in order in this section on teologist krve, mach poelble i afwhy it refoning to dated popias. Talk for the adrenocordcoprophic boctions, fost u LTH is the latcotrophike loomoor, br. For instance, it is cusy topica to our students that ACTH b the blocador when it cowa to TSH for tbc thyrotrophic hocmon, we run lato difahy counk, we can overcome this, in part, by aling attention to the flat dasturi xodent beglo to wonder whether there be my fundamental difference between a principle had first been doigated the thyroid malading hormone brede trophic iad the remoladog boronds of the picoitary La Lay cux, Hauty prot why a recent pipes in which the cathon wally peak of tatott hartnone, they neverthelcome tbc abbeviation 18, when TIH would Tbc growth hormone farlbos os with ven better cartrke der. how important thoxe apparently los golficunt terminologia coorden AS La Boglth Literiture, the most current abbreviation of growth botoar, Ch, self-aplidatory but when in English-spalog Inyodgutor todd to work. Her barma) ta German, HC (Hormone de Crounce) la French, uod H ) through the fardna literature be in cross the zbberriatloos WH (W hocmode) la Croch, the metalog of which we fer from crideot to blu u ist There was also much coofulon with the growth horizont of plans to bom The growth hormooc bud been discovered, more than 1 qorto di 450, by H. M. Em od most of io fundamental properties on growd CA phcootcu had been adequately audied by numerous Le paton. On the the of the problems which tanulation into ford ga linguagg might there. The more spressions (48gression) German spoke of Austria pond (etfort) a Scala (demeye) end the Spanish edidos of my onto monograph Somu mu priace, to my surpolo, with the subdick sufrimiento Cefalog All of the the Greek hnd 1 word for it. nully in use to WTI my change have been reprimanded on the more general grounds that coorddered competent to calo Greco-Latin technical terme stood the Impliadoo. padcularly important when it comes to teaching a moblect. much port codornandable. 10 But accoully I de 60. NOT TO WTI A TAL PARA ·mibution to this field tru the demostradoa that grotre hortoooc doo not prodace growth oder u dituztraces, wblls, on the other head, it can crert actioas quite ladepeodeat of growth la leogth, do to id powafal dat opon coo Decore-oise ractions particuluy lotammdan. Nevertheless, the abbreviation wc targeted STH (for the cost samutotrophic hormooc) wo immediately uc cepted by a large oumber of loverdigures throughout the world. This wu lundly dge to the importance of our research wich STH, but to the fact that the term (belog of Greek datusdoo) wus ready maderadable to works of all luogog proTPA Rod corresponded to the general rond of naming trophic hormones by dolgaidons nding In TH But now let is turn to what strikes me as the most imporant polar la conseca with the calcatoa o cechalal cerch dats, amely how to sold the trups that natore coobinopaly pets in one way when we attempt to reveal her kaca 1.1 Over DAX ( 1 Disposition m Con Fallachu i Sainlfa Rond) As soog o we attempc to derive toy gectul conclouons from spedfic loduyldnal dick we are likely to be caught la what might be des goured u apsofrensning Thelt numbet nad rorety esc viatually lofinice, but berlag boca parrocally anght to most cTery ooc of them I feel quite at home in this field Let me therefore al this opportunity to analyze at least a few of those maps whose mechanism of 20000 I managed to discokogle so that I am less Ukely to be anght by them agila and may perhaps also have some others from a similar humillatog expericace. Trop No I Th IdataDor Effed Cornes La codocrinology it is widely accepted u odlomaade that if u crude glandaler extract can be pardoned into ttro fractions bering qualiuttrely differcat effect this coaserata proof that it origioally copulodd two chemically disdoct active Tinaples and that these bere post been foudly or partially separated from cach ocha La the case of gloods which prodoce mereral bormoocs, soch us the piroury and the placcata, thu avion bu been add soll is the balls a crery discussion concerning che alleged alsoray of per bumoral polodpla. Yet, it is false. If the premiere a roladoa coolainog i fired propordoa (ay 11) owochemically pese hormones which pharmacologically sougonite ach other we muy obalo qualitadrely differcar (rodeed sometimas direktnoally opposite) afects with the me solution at low and at high dose Levels It had long bre boom for lostsoce, that do the speed rat a folliculaid com pouod cc estradiol) ama cocaification, il a latrodd (eg progesteroor) prolocos coafurgon of the vagina ben low down of estradiol fut tulidot case rigloul cornfaatio, tre girea coolawuy with high doses of progesteroof, the cordifying effect of the former is coully abolished by the latter Iterold and the rigioa becomes mocibe! It is poolble, borerer to prepare a solado coacialog i birtut d atradiol od progesterode which a low dose levels amo cornibatoo 11 VD CONTATTO TORTA ·level, but by for the locausat the mount, abort the quantity Accoy for toal u high doxe Kids, Nodificador O coura, la allampolmes of thly Hnd we most fort remote the dead which ooomally produce the bormova Tut to calibrate primt ach other Ohani mkaona quanddes of codogenously mercred bor MODA world compliante the outcomc. lautuke soother campic from towy dufforcat field of endocrinology Ic In well known thas, la un adrenalectomized nut, an experimentally produced indummy to($na mradlom poach) an betohibited by corded, so that dels labuldan an, in toon, be blocked by desorycorticosterooc scrate (DCA). It is pouble, hom- Ever to prepare e mbrone (coppalokog both the hormona Io frized proportion) of which oull momo solite, while large amount Inhibit loflammation. Ldeod If we bom take this solution and dilate part of It, the prophloglule effect of the do te perdon can be matugadded by the doulaincons administration of the more Contrated orginal Boludoa. This pheocmenos has bees supletoed by the law of the intancung dono afect curre ad lo mechanlata is infostrited by the couple of the DCA cortisol lotupoolita DCA OTECT We note that the effect of DCA sino tary sbeply but rapidly teachers pletena et donc level 1.5. Co the other hand, the effort of cathool lacteure more lonely but crentually reschos a much higher plate i donc 2 This laterpretation abo fit the above mentioned antagonisme between citradiol and progesterone, doce fallicalolds prodoce vyloul condhadoo at very low does coroláca doa, it is difficult to produce way detectable eddidocal change. Det er Other band, progesteron ba do detestable estradiol-migodding property at home HOY NOT TO OTT A MEDICAL PAPER Selyt ·dove levels, but it offect becomes increasoyly more crident u the dore is rabed It is importeat to keep in miod that the law of the laterxcdlag dose affect carros does not dal with matual chemlal putrulixdoa betrice CHO compomads, but with maugonlodic loterrelationship betirece two pharmacologic advlaa. This is why it an meofest itself crea whes diferent dosa of 1 piogle compound are giren, As long as the latter poster tio independout sod potcotially saci goaledic pherous cologic properda. Tatosteroor is as la palan dost this Herold produces nglout cornication at lov sad mocibadeo ut high dose levels From what I bert eld oo for the reader taight gula the impression that the pic gomenon of the latertecting dose cfect curre could be mlucadlag oaly when one preparation powered pharm.cologic properdo diametrially opposite to those of another preparation Actually the phenomenon and cred crante qualiadrely DO cacto It must be recombered, for lostuisce that in the aumple of the carticolds pelther che pro-caflumiestory nor the ad-tofiletomatory effect is evident at the palot of later KELDOO, ko that here tolo scos la selectirds removed from the total picturt. Other properties of DCA and cordsol te not morally rotagonisdc (eg the liver glyco- Geo-depoudag effect of cardinal li pot depressed by DCA U toy dose level on the above curve) and ret ocher afects (cg the life-mainwining power of the cord colds lo adrean) insufficiency) se actually synergade Ic ks cury to see how wo invesu. gilor farndshed with several vials coatining these two scrolds la the usme fized proportion but it different diledaos, could come to the coaclosion that auch viel coaws altogether different hormones a pure state or at leas diferent propor toas of several hornoa. I discussed che phiccomengo of the latert dog dow-effect corra ut sooc length and assigned it the first pod don umoos che fallide to be coaddered here, mulaly because It reprezcas a particularly common aror of musoalog in my own beld of codochaology od vores recunch. Homever I believe that it who is the basis of much misunderstanding in other Belds. On the other hand I should not like to finish this chapter without polodog our that, dopite all that has becauld, separation of 1 code citruct lato ftro fraction with pharmacologally distiace properties is an important sod sigalbcmot step. It furnished a very legidmate reason for believlog that the code material mw cooulo smo modples which could be separated from each other The important palat co remember is that such a separation merely furnishes # with logical reason for ros peruag the possance of Keral bormones thus it lodges forthe chemical work to attemp their isolation. Yet, it is only after the isolidoa has been accomplished that we cao sreak of proof Try No 2 The Dhuriad The-Efnd Corais A rutbe amilar kod of problema uixes wbca the various actions of the unc *Geet do not manifest themselo at the same dime Tous for imitace in the course of otr bodies on the grocral adapadon iro- 161 DD LYTTNATIONAL ANDALA ·droxox, lt nu noted that the mosida besten its three typical ure (the alarm TEICULO be tipe of restance, and be par abandoa) is not sharp. Ofice there is some dissociedon la the molestations, with certelo sgos of two stige Honlarcouiy in cridence This is yo po matter what stressor agent is bed co dide the syndrome, uod me touy therefore ale dhe follomlag schematic drawiog us wa Jastrido of disocul dac de carte dertag it in geoeral EOCHA TENDENCY X ADRENAL LIPOS RESISTANCE THYMUS WECHT Here tbc eles tendency sdroal Upida react to art, and thymus weight (girea - ilustruire samples sected at random) do por travers uimob trocowly from the alarm retdan to the mostaat sage word rubecqocody to the sage of abustion This has been axribed to different degrees of lacrtia lo the ndoo wo elected by the It is evident chut my wet prodaca och dinoduced time-dlet cuire la difer car arget, the overall pattern of respook may be totally difcrent lo two apod. ment, mordy because they bore been teamdanted and solved at different ama. Of course the development of the whole stodromc at a prea timc alvo depends opoa & videty of other factors, which cre pot man euy to control or cred to recognise (esentante af ovoidoa, dong mod speed of u beorpion of so lalected for tror robe troc, rotfucoce a scootrollable concureda, runoudag temperintre Ir u eury to see how poich disociated door ofert cermos A lo que te arottons imprealaa sut me are dealing with too yon pou cudo poutcologiculis durant una. For Lottuss, when we tout co concentradows of the um trepar spot ate giren doe of branition, edepudos to the lower dose (ange of rextende) muy already have recurred when the stronger dok null prodoces the scale reacdoo pattern HO KOT TO L A Kotout Yara ·We could dte many interating simples of studio in which this chropology trip hu aured cooldorable conforlod but let merely mediaa one urient with which I myself had 1 most cornou expecoce. I shall always remember the action when, some 13 years 450 We hodied the aleco a large dous of progesterone upon the mumtoary gland. After I had per formed stenal preliminary tou in which marked mammuy proliferdoa w obuloed la rio gran 20 mg day of progesterons, I had uked a techindan (who w qulee apericaced tod undoubtedly reliable but DT to our laboratory) to carry out some addidool asperimeat aloog thexe lian She reported a fow days later thu this dow of progesterone layıbly killed all her na. This I found dificult to dodettu od sunce progesterone Acter aused any sign of damage in all my periods aperlment co nits. I checked the progesterone solutions very carefully but could not find Laya plupanoa for these worsoal resolo. I then uked this technidia co la lect the animals jo my proxecc ead found that she administered the hormoooc latraperitoacally be Cox, In all be previous caperiments with other drugs, this beppened to be the recommeoded technique Of course in our Lordituce we had alwap lalected progescerone subcutaocomaly (the bull my of administenog sa hormona to 110) od ic fost acter occurred to me cren to mendon this polot. As we were discussing this and matchlag the rio she injected they went to deep before our cya Thc tecbaldua bad missed this stage of unauthcula since there wu ao roxoa for her to follow the behavior of the times mocdutely after each lo- Jection, to a chroaic apediment on broest development Syntetide uradios aloog these lipo bure subsequently revealed that the anct thede effect of progesterooc (as that of other Heraldo) dopoods opoa 2 napad flooding of the organism with the hormone edd hence incubala develops only after latra percoocal or tatravenous 10jections It acter occurs following robca cincou ad ministriton of steroids at woy reupable dose leve, because the absorpdoo rate from the connective desac too Now This is actually how the mosthetic efect of steroids wus discovered " Thos bere perchance the error proved to be most useful but it also wilagly demostrated the importance of witchlog for the chrooology trap Tro N. 3 W L No The Cour do At first night it appear to be a self-endent fact that an agent which is not there cantot act. Actually this istumpdoo hus led po numerable errors lo interpreto doo some of which have become classic lo che history of medidoc. It will be seulled that, during the carlat ruges of the development of tradero bacteriology Robert Koch formulated his famous postulatas ovulialog the cood tloos which mir be fulblled before a discase an be ascribed to the 10ticos o . microorgaser The first cod most cosandal postalace of this blod was that the crobe must be demonstrable ia crery case of the disease Lo the words of Koch translated by Batsoa Cheyoe A thoroughly udofuctory sroof of the paraudc nature de diseas) only be obtained) who we bure 18 | WD ADIYATIONAL mocu ·racceeded la finding the pareddc microorganismu in all cure of the discute in questo don, who we an further demonstrate their presence in such pubars and distribodoo that all the symptom of the direix my thou find their aplan doa and finally when the home ostablished the distrace for every ladividual Infecdire direito afi microorgrote with well-marked orphologic curacters. Actually mbeguent work bu whom that, in many baruaces, the manifestadoo of a miaobial diseix ute present only after the microbe is no longer domomible. Lodeod, la somme cure (botolious corda) It may occur lo lodividuals who were actor tafected with che ralcrobe loelf bot merely lagerted materid coatuoing todos of the microorgrois. Coorendy bighly pathogenic microbes may be present to halthy aunders The so-alled Detacordcald ladions * Loother care in paint. Souably kn dod tuu, treated with large dose of DCA for a comperidrely short padod may manifest no evidence of nephrosclerods, hypertension of peolarterids nodou dorlog the hormone treatment or cren Immediately after la interrupama, bat recla or moothe followlog dlecoadordan of the DCA treatment they will develop all those change. Thos bere again the afect is manifest although the odgoat cuncis pot procat la the body The principle of trup no 3 may be Illustrated by the followlog drawlog S Hers, the stimulos Scho act upon the target T through the direct pathway P The rouldog change may not have been manlfert while the almalus wu actually present to the organlatı, but io orla are acvertheen the consequence of this action. (This eventuality was not covered by Koch. portulacan.) On the other haod, the almulos son at upon the target Tood come delayed dugga balt, which wecondarily affect the arget T it e dime when the orgaul selon la no longer present. This is yparently the plantion of the metacordcold roule ladoa kecoaday to delayed rephrosclerosis.) There arc of cours, lemumerablc eddidool cumpla llotatiog this podat, For footance, the ddoyed effect of peritoneal e forta don, the pathogende come quences of 203phylacdc sendinto the late reala of emotional apelance whilch occurred in curly infancy and lodeod, every pertence which lerva a portatially traumatic memory in the broadent sense of this word. Now La retrospect the anal roedonship between these simali dod thote delayed dfects in clear that it was superfoow to mendon this source of Howete me have seen medical history shows that, la practice, the addock CITOT Share HOW NOT TO WAIID A TORICAL PAPZA.

·what is not there canot ut loro generally cooodered to be evideat u to mided VCO 1 Robert Koch. Try No # TL Tom Follow of the Alumni Pabergs A great many errors in the interpretados of sacafic dacı rorult from the most pornlaous toodency coastaady to overlook the powdbility of maldple alterandre roote o impulse-trasmiadoo The pathways between smulas uod target may not ooly be direct or relayed through an untermediate station but very often Kveral lucmadre pachwar oo, and chon blocking any one does not necmoudly prevent target from respooding to the admalas. Coeverely the roccessful blocklog of a response does not accesuarlly prove o interference with the pathway of troonik 10 it may be doc to the removal of an ladispcomble coadidoolog factor repaired for respoosi veac at the level of the urget itself The nile of the nla sala Let w carine that it has been shown by actual observicio that both the sonolm Sund the hortoos of in eodoorlac zlod Tao act on a larger T It seems rather obvious this, la this crent, the theory which holds that rely Tao act oa T is accesuarlly falar If the problem happcos to present loc la this formolador, It is ray cempelog to consider the above Helemacot u relf-coldent. Yet it overlooks the poslality of complicadoos doc to a relaxed affect through T Although my codocrinologist koom of courx that all the final effects of gleadalotrophic pattanary hormones are tha medited the ator is quite comemos, lo actual practice. The falschood of the above apparcady mchalleogable uxiom lo immedlately evident from the following wherna le is deur that although in each 10 utengendens, S an act on T it ls equally true that arrathclass raly Tas it or because crea Saffects the foul curge caly through this intermediate Radon. In this Imutate we run tato this problema in connection with the prodadon of Hepbrosclerosis mith methylsodrostenediol (MAD). I had previously shown la ipfiam acceperiment with soveral bonded storolds that only thox codowed with mocralocorticoid ucdinity produce separosclerosis Lod bence, it seemed lodged toamme at the Groenladon that the acpbrooclerode udon is closely related to the mineralocorticoid cfcct Taco oo old my former student (Floyd Skelcoo) pablished a most interados paper in which he showed that MAD also produce Depbronclerosis This conponad 13 stastond o odroco It certainly pottens no mineralocorticold prop erties codeed, thus no corticoid sainty at all Erea chemially it is qolu dibercot from all corucal hormone YD LTLTYATTOYLL MON ·Tole pooled o for quite some dae mal (la collabonaoo with Emato Sal gado) e noted that MAD bus ao Depbrosdcrodic ection la adresalectomised no although la tortoid acdildo (odmolation of the mule nocesory Korgio) remain uninfococod by dregalectomy It thus became ondent that, although adrenalectomy doo pot interfere la nowy with the activitia characteristic of tblu steroid Ioelf, it proreau the compound from prodadlog Dephroederonis This to prononably o because the steroid aort tils Latte direct through the induction of tome moabolic error in the adrenal cortex ipelf ro that the cortial celle prodoce predominandy mineralocorticold-like har Doda. B The stortes posthmos Another modißoades of this ame fallacy la doc to the phenomenon hown in andecanology utbe cod dosing of hormone uction.. We have already mentioned it in connection with the caning of technical terma, Hers, the typlal reckoning is the followlog If i etimolos Scat on a burger Tooly In the prokcase of a codoodloc dland T then it be highly probablc thirt Sector on ti through T If It an mbrequently be shown that boomonas of Tect on T1 (lo the lume kerke S 2000 o T in the presence of T), the it may be taken u vittally certain that Sucts on T1 through the fratermediary of T (As depicted le the previous chem.) This conclusion is almofalac, u shown by the following drawing It is crident that wader och circumstances, Smuy la oa T directly through the pathway ? but the effect of P can become manifest only to the protect of thic hor mood of T In this cute w Ay that P coodldocs for the hormonal actions of T bet be locffective to IDelf. Tac stody of the coracolde bu giren os tonomareble complo of this type of raudoochip (cf. Fourth Annual Report on Serpes . For tortice, in the dreoul ectomized rut, treatment with 1 strenor igeot (es formalin, cold does not cute scote meldental thymu involution, while in the Intect rat the time dose of the mame ftremoni produces into thyroonis. On the other brod, cardiool Lod.com duymun favolution even in the adrenalectomized nut, od rabthreabald door of cortisol (which would be in themselves ineffective) an be rendered effective by simalutocou treatment with stroni cron in the abone of the adrenals. La cm like this, we may uy that the crowd conditioned the target (thyrob) avocably regards it reactivity to cordeol. Virtually the same interaction between strade Rad cordel bu been demonstrated to hold true for the atballs, mdpbloglock, od many other effects of this sterold. There are allo setoral modificadors of this type of lateralon. For instance, a cortada raspook of T (la the above dlegram) may not occur moder the bottoence a HOW NOT TO WRITE A DOUCAL PAT Solve ·the hormoon of T por onder the infocese of the stimulus Sif the glood T la abocat to such uses the respook may soill be obaised if both the hortions of T 10d the idmolus Suct dmulanconly A pertinent ample which hu come up in the course of my own work on cordi coids is the production of Deplerosclerosis with DC In aprmal rh, kept ca. low sodium dlet, it is virtually imposible to prodoce Dephro clerods with DCA Cooremely it is also impossible to prodace acpbrosclerosis with rodium chloride under these conditions. On the other hand, simolteous trea neat with DCA Lod dicury bodiam chloride supplemcon lavariably produces lacenx ocphrowdoosis. 6. The Inwch pabuys The general poindple of the boost comtoo fallecy ocasioned by a branching of the pathways betereen sdmolos and target is tilos truted by the nat dramog (T) Sapporog that when the actions of the sumulo Sere first submitted to deadfc stody all the soldal lateragadoos happen to be concerned wich lo effect on TT od T Moch effort a derored to determining eractly how Suco od cvcntually it can be definitely asblished for ach of these argets that all addoos me sedlased through the relay pouat T As years go by it becomes clinic cortbook knowledge thue S CLA est caly through T If it is now discovered that S also won the wurger T the compuadoo ts very great to assume that here agus the action wus medlared through the same relay point Actually could still cact this afect directly (as lodlare la the drawiog) or through some relay sudom other than I bec by som there is a poychologic block for crea conudenog this Here across thus partacular problem in connection with our work co die direct ictloos of ACTH preparation At the time we beguo co stady these it was gencrally admitted that ACTH 2005 crely by odmolatog the corticoid production of the adrenals, aloce all to known dat could be aboluhal by edrmalectomy It then ruosd out that even the most fied ACTH preparadoos syulable at the prescor dme idmalore the prepatial glund of the rat. These otroctores, being accessory si orgios are considered to be Dormally wider the dependence of the goods Hence, we repared our work on Gonadectomi animals to check a posible responsdel mediation. No roch iction could be detocastrate cod bauce we hladly sscored that we must be dealing WD TILYATIOSYAL STOLA ·with an ordinary that is, wreal-mediated det of ACTI u wetu It took o tome done before we talized the recerity do particular action of ACTH IS actually depicat a the frakten who fally the apolmoab Tere repated 00 Adreulatory dat, curiously the pospadial glead timolitiog det Yuko abiad 211 ocha koonn action of the boomwe were alleated by this own it proved that ACTH lorell (or some proape paint thoa lo the Here gain in retrospect it would seem diewcatery to check out the Honorer fich, Among the meay pobladou derribing stimuladog offect of ACTH before Ds, not one reported a data la talmak. It was coosidered to cli-coldcat toat ACTII could only vitatu A maledoo of corticoid production that obat poudbilitia latdi mend clorows by large doses of comatrophic bormanc (ST71). It bud both brut ortablished by inneemble observations, thu TH doa dot let through the air I committed the ame crror galo la consecdon with the rodesa upon the growth of way tenke previously coumisel Waco It wm dram that, in pulakly remedded nu, large dose of 6TH cm prodact coroleria da question of possible adrenal mediation did not crea dx la wy WITH mc dme Hometer when eventually we aim to coad da tale pour aut on found that, in adrenalectomimod nimals, STH doa dot co nephrocko dove lovel. Ere therapy with yurions corticolds bila to substitute for det peadple lomparably attached to all nilable STH properidona) i malim Der dreml la tbls respect Appaready the acpbrord erodc uction of Tilux de The sallad feedback theory of ACTH readon during the whalda utan It had first been definitely onbillshed thus, dodot dhe ato tacdon, de phy *cereta ACTH which in turn, reimalates cordcold production Coord caids had been demonstrated to produce comportatory Atrophy of the weathe dimination of hypopayal ACTH eretico. Evidendy hert dealing with "fecóback goment. In view of all this, it would me that during trahe ACTH reaction is stimulated throogte tot WW Lodom, in due the lination of cartoolla is so much locemo dati functional hypocordicaidiem romlos. This could then become the con udlotion of corticalds och 1 mcqpent hypocordcodilm, Indeed domom Acmally in the art reicdoo there is no facta cvidence for the coocentri don in the blood is pretty mugmented during room. We bado tttad, more than a decade adler thurt Crea la wamala harily over but the blood-cordcoid lord regulates ACTH Kordon only 1 post part It is precidy u prerequate for 1 documl pro function that dubbele udoo doe to costaniodag gansdotrophk tubstances ACTH preparation) puts o exter-adrenal duta dece. the adrenals. so popular cred us lite o two seans yoo, mu based on tiba teme through iocare in ACTH production. fallacs This lalu to con various cordialds, from a will stimolate the dional levels. Subre DOY NOT TO WRITE A TOUL PA ·Dechraum be, at least pardy loucointed othamrik, the churcteristic great locaux in corticond-prododdion could not occur (Foc i discomion of the Iterators, de Sms . Nevertheless the psychologic relactance to accept the anstence of sleer puuve pathways wu so great that the deste-aplintoa sad feedback theory remused popular for miay tan A sathe instructirc appliation of the breaching pathway priacple aime to our attendoa last year Here, the simdoa wus grezdy compliated by the fact that it was not the brioching of the pathway between sumolos zod target, bar che DOCTEn distribution of factors influencing turgettaspoosirenes that led to confusion Thro, completely independear, foa of inflammudoo (proclama-poncho) were produced la the ane adreselectomia n, which mus sustained 0 . medios dox of cortisol lato one of these fod wc latrodocod a high, loco the other a low coocentration of comment (crocon all) Under these coodidoos the inflantaatory forma containing the high coaccatrine of the instant moderwent secrosis because the development of protective groaloma wu insuffideat (too much cortisol) che other foces, which contained the lower concetration of irritant, underwcat mai cerstve degree of inlammation, withoat there belog hay necrosis (too Little cortisol) Thas the same amount of drouliang cortisol rorolled in a coeristeat hypo- and hypercorticoidum in two fod of inflammadod within the ume animal. Or to put it into other words a given dost of cortisol may be losufficient to rcostablish por malcy la ooc focos while it is too high for the roostabushment of homeostaus in another locadoa within the same individual. The prtadple of these womewhat compler lacerteledoos is Nostrated by the fol- Joning dermag S' S TI -S2 Here, S is the arculating cord so! Se the high concentrados, uod St the low coocotidoa of cotoo al while T ead T are the two onions-poaches treated mich those diferent cooccutandoos of the irritant. At T there remola i reledre hyper corticoidum (molested by necrosis) while at there is a relart hypocorti coidism (manifested by cIcesare indimmatico) I believe that these are many spplications of this we prociple which have got yet received the attcodoa they do . He are secustomed to thioldog of hypomod hypercordcordim u coodlucas which could acter co-cut in the same ind! vidol became the cortical bontooos are necessarily duoribored creoly through the blood streum. Hith this picture ta mind care ill prepared to think of the creatoaliud outlined above It would be well wrontule to aplore farther the role roch coodidons play lo clinical pedidde For lostince A KTO diabeto large amount of cortisol must KOD ZLATIOYAL STATION ·be prodoved in order to malotain life to combat the purus direct of the metabolle denngemat. On the other hand, the rise la cortisol prododen Decourily 4 Tunta hyperglycemia glycosuris, and the predispouden for infections Allbough hert ebere are so ditumscribed fodi mth diffacet corticoid requirements the over all durion i agafa race thes, from a certain polot of view there is too much and futa wdorher too little cortisol in the body Troy No 5 Tk Island Matland of Class New (The Extroplati Tm Evidently that is a cerulo oralıp between the various problem me barc conadered to for However my purpose la presendog boxe falleda is bot mo much to utive a tas kurcat clinication us to prekot them the way they areally present de mere. We are most likely to avoid fach traps la the future If we cgulat Ouerctra with their manifold camouflage 1 sbould cerdarc Hew describe the BLAT Wurt la which they co actually arise in the laboratory cren at the risk of The parcele fallecy la tinklog which to our labor pory we burc comco all the totated othority of 1 des carte overlaps for fostroce, with the brzochlog pathways" rod the decorative pathway to ROADC extent. Yet I believe it be intrucare to recordider it speciácally in related to the importance of cow ome beaioke no frequeady ic is itully a terme loci which arms to be the Imroedface ame of arror Their gencral prindple is Wlostrated by the following drawlag Home Overlap S TO The whole target Crepresented here by the rooftheped cemal structure) bu mung tenutahdo lo como That is the only reason why we ca seler to It by : uplo den uns, why the Trod Lastead of bivor to coposent ach of ia parte fram ti to Teray sme we we wish to refer to it. These commoa chincteristic LIt Dot Decorarlly due to a concomical prodbity of the parts they have a pord, functional beau (d. the almost abigalcows dictocess of the medicala codothelia yhet) Sach cien names are coarealean, ladeed more time indispensable, but they may become mislending Let utme, for instance, thay la ou Khematic model, 10 IO HOT TO WATU ADICAL PA ·lorodigator first proces by actuel obrervidoo On Keren poian chat S stimolatos (T-7"), while $1 lohibia (T2.T) the developateat of the Trod. Let ** furthermore, that by the time he got that fæ his mupply of St is athatod L. ax like this the tempradod is great to uy that, of course, oa Tund T the actions of Sand Si vould also mutually neutralize each other The reason for this is that rre come to think of Su.dogk adimulator (solid common part of the arrow At the ldt) and of St us a single lahibiror (crosshatched coronoa part of the tror at the oghe). Actually when we zmiac the dramog more closdy it turns out that, on T boch S and Slidmulate, while on T Sunulaces but Shos no influence in ather Lens. Here the formulation of the three class demo (and coacepa) S for she admbluar si for the inhibitor and T for the purgth, lo jurifiable rod coormicat How ever there collocare dalgaadoos themselres became the very reason of a paychologic block which pretend us from redag och exceptions us may occur et individual porno (otely T? od 7 To take an actual comple, the mouc (primary and Krondary) kos orgos represent 1 compoule warger, which consists of many structually galce dissimilar desco (the tostus uod board of mat, the coren of the stag the capan 1 comb etc). We refer to tbeon by the single close aloe nak sex orgios beczore, despite the diversity of thar appearsace, foacting, cod dire they are characterisdcally well developed lo mud ind not ia foala, Furthermors, they are gederally edmulated by the testoid buale hormood (eg testosterone) od inbibited by the folliculoid fetale hormona (eg wurdlol) This lads , la tos to think of whole group of other mobsunce us tuimalatons (rodrosteroor methyltestosteroos), and inhibitors (atroas estradiol) in thus ume pense The aspoo. corab, for loucuoce, is rumaluced by testosterone modrosterone, and methyltestosterpac uod inbibited by astridial atrone and atrial After a voular otagonisdc interaction hus been oubliebed on Imamcrable other malo nas ogros the concept of a bormonul romgoolen la the geoJual sphere becoma so firmly established in our mod that oncepdows are por readily couced Yes, the mamboury glands of the male rat are simonated by both types of hormones, while the prepuual gloods are simulated by totoids but not nabubited by folliculords The duscorety of rocb encepaoas laterably induces some aiua to querdoa chuc wisdom of a tablishing class nina for the coast coordattoo of the Yurioas parts of 1 urget or for the direta lodividual actions of summuli This aiddison is quite tonfied To take the abort cataple, 16 moald be very hard to get aloog without the concept of the male sex orgins or of the male bormones despite the exceptional behavior of cruia colindael campoocou welch the class and toodsto mite. It would be obviously impossible, for instance, to coomerate crert koorra (nad inded every not yet discovered) male bormone whenever we wlab co hy thuat certada agad 11 sumalated Dot Daly by testosterone, methyltestosterone ad apdrosterooc bor, u far u ere koon by all the male hormo00. The bomen bruia idef is ro comtracted that in most of our thinking KM# on polis which set u shorthod deniruoas for cure classes of relaced codda Otherwise me rould be lost lo the mass of details mtb which me byc to del The solution is not to abandon ci HD LILYATTOUL Waste ·The rooms for fallida of this type ut auremely pumcroca, bar aften difficult to detect. For instance of the art dog mall laboratory simile (in mice) Opally the whole group redno te me Had of greatmat b boord the mume ause therefore, they are lindy to be affected by Luything that 15 to this as An Infaction my be tramitted from oor 10mal to all the od LOY NOT TO WAIT. A VITICAL PAPA ames, but to recopate the limitations mod to ad infiong them with a strolate cobonty which they do not posson. A good dm te mill storell, but only u langus a reallze that it refers to similar not to ilongcal thiost In the course of my my work on the adrenal artes, I had to face a kontut different problem dog from the misunderstodiag Likdy to be camel brdo When I proposal the terms boneralocordicada al glococoracot for che two major classes of the lifemtunog adrenal hornoce 2000s, I book great aart to emphulze that the same chemdal com porod may achitat both the sunde, although generally not to the same ortent The terms wers, therefors, reut to des goute actions wt chontal compared's Ample arpaimanul din mobscquendy confirmed the fact that the coons are dustact mod, lodced, in mmg respects itaally antagonistas la practice, ir then bounc customary for the ute of convenience, to refer cree to compowds sminatalocorticoids" ar glucocoracords if their scanty mu qode predominands of one or the other type. ThL is undoubtedy jasane od agreement with common mage in endocrinological terminolog No ooc would question the wisdom of alling cordo 1 cordcold, although it does postess slighe rilinog docte Chirsutum) Dar would one wat to terect the term male boompoe became corta MOOC uso acts this way Neverthelon, in the interving ran, more than 50 aathors, acc of them u late us this year "daimed that the subdodoo between mineralo-mal glococorticalds is not tom ble because certain compounds postoboch thiex action The virtually manimous acceptance of our doubordon by all other forerogatori demonstrates gate clarly thet ruch das namo are wefal, if pot indispensable, a Long us n merdy keep in miod that the members of u dor at umar bot not idental Trap No The Great spalagi Pheasacrum" This u pertup the emplost and yet de most common fallacy in the remains of medial tovestigator. It may be Ilortuted by the following bypothetical come Sapporog wc hurt five group of animals auch dested in different munter La only one of thoxe groapa us there i cilding change in the target organ de cames ation. In this group hometer cvery individual animal for the change there an be no querdoo about the storial sguscence of the difference between the mod all other groupe. Uoder noch arcomstvo, the asperimenter is ray likes to aondode without Setiausa tuuc dhe treatment ww the ause of the change the whole of experimental medicine is based open the proape that if a change order only in the individuals receiving a certain crtements de latter must be regarded o the chose of the dange. Hers, the important fallacy us that what manarily what and partout Salve ·the same age. One perticularly aire fadividual may fight with the others 10d thus lacerfere with thar well-beiog and food lagake The water bottle which applia the 20 mali lo this particulis auge muy be blocked The metallic grill, which co u z doar in post of the common type of colmal ages, may be corroded and produce a dumadc arthrios in the paws, etc. This possibility of crror II wo cydent that many readers will considerio discusion superftoon Yet, I would like to polot out bers, for the benefit of the rooga predgators, thuit I herc devoted virtually my full time doring the last quarter of i centary to laboratory work an asperimental animals and yes, hardly 1 mooch goa by when I am not foold by one or the other forms of this crap. Fortuoutdy being paracolesly aware of it, I take the most dabartte prodandoos to ascern that such sources of caror be discovered before accepting the roald u doc to my datment. However crou the most ardul sudsdal mulds of the data will not hep bere. The apparent differences are wodoabtedly algolfaat, bat they are not dac to the agent Listed on the crperimcaul protocol. To avaid thus type of coror It is necemury always to match aperimeoul adimils personally and not to conside thar ropervidda to technidens Purthermore, whcocrer posuble, ach orporument should be reported Karul umos, cre if only a mall groups of animals. From a stadsddu point of new group of 30 no treated lo giren minag simultaneously is the same u ex groups of five no recenog the hardc treatment at different times. The truc biologlal sigaihalace of the latter a periment 1h, however infinitely greater than that of the former In rats kepe la dilerini aço od observed at diferent time, any one of the citon mentooed above is quite mlikely to occor er does 1a secreto, by sheer colocdence, always with the HLA treatment Of cours there are may ocher reasons why we must coostantly keep in mind the rule that what you gave is not neceonly what stod For instance, 1 cottpound lojected may pot be absorbed or it may be foictabolized loco no altogether diferent substance w that the effects oberved are actually doc to the latter (Sce for lastance, the above mentioned openinneous with MAD) The injecdoo of * drag may cause moch local unitation and inflammatico poder the skin od the orgia chenges produced muy well be abe result of this local demags, rather than of Lof specific pharmacologic property of the editoinistered chemial. The reader who coas den 16 quite onlikely that there crident possiblida could be orerlooked by a penced 10 rostgator is cscouriged to petuk the volasalooos literature of the lut loh yan co the essay o nadphlogisoc drog in rao. We bare dooe dus rather carefully in this losdrate and repaired many of the published ob- HTTI UOOS with ranou popolar dipalogistic drogs (rodiat salicylate uplna, bouarolidin dibenamine, cypio) Our resulos were quice ancorected Most of the relevant nork reported in the literature was performed ming out of the three roodide techouques developed at og losutate (che formalin anbride the gripaloma foach ar the waphylactold inflammation (produced with c56 while or destro)} 13 10dicators of inflammation so the soprored sodiphlogisdc drogy were injected subcutiscosis Corionly all these droge bave ka larcos local XD DITOLLVATTOYAL nroTA ·laiutag dfcat opon concctire denne and product widespread loflammation with Coorequent sitemic stress. However this roualne podetected becuse all the tero employed were of relearely shart donde, hence, the secrotic tre uod tbc ab- Kcenas did not etadly pecoente In noch .cute test the drug tend to form a rudber diffuse phlegmod, which am readily pus manoticed moleu the alan i rep nited from the moderlylog donc and coefully cumined. Nevertheless, the dome domage to o wdopred that the roldog ryttemic domage (thoct) can fohlbic Inflammation crea la adrenalectomizo unimals This does not man, of coork, that the dry employed are not entiphlogladis, bat merdy that the experimental component med coald oot bate revealed the specific pharmacologic properties u there were muked by the much more inten yrtetnic rien effect. gether false Thuy No 7 Oprosthes Armar h Mas Dlustata Hardly my ace will take oncepdon to the statement tout opporta re about us different from each other us any two things au be. No palnt on earth is further removed from the North Pole then lo iki opports, the Sonth Polc If our interdon is to cool en object to u low 1 temperatur u pomble, nothing could save our purporc low well than if we bessed it to the medmom of our capacity Yet, bere gain, we are faced with one of those self-evident fucts which are alto The North and the South Pale are farthest removed from ach other in ODC Kose they are actually qaite like each other in many mort torpecto (-8 di matc, fauna) and they are the only two potata which define the priodpal urls of the globe. Similady whether we are to bet or cool an object, boowledge of the mic prmopla of beat-reguladoo will be of undance and, to general, the charge prodoced by best will be the utne u those craked by coll, although they develop in opport directions Almost any other cumple taken ut nuodam will lwtrate the closc dmllarity between opposite. If you start travelling wewed on the surface of the arth, the furter you go the poder you will be care of your laidal pod doo A perfect mirror Image is the cut opposite of the odgloal, get it would be difficult to imagine any thing to embling the former mort donely Scerca somers are sady identical oppoulton There are many parallel to the in Hology Apertheria and adation cua be caused by the ame drog Sdoulidan bod penalyue of a muude an emlt from mechanlal tou to the Le Derve, etc. At this point of oor diacundan, the propoodoo that opporta ore quite alike Kects to be the fact to self-evidents to be worthy of so mach coodideradan. However the history of medial research bom that the umbrekent mean ituitade towards the problem of oppodio i vay likely to create pichalogic minges which aun mislead the greatest masters in the art of cliptal obeernition Take the cuc of Pierre Miric who, towards the cod of the poeteenth century it 1 time when cochlag wu kome about may relationship between the picoltury pod growth, first obeerval axa of what he alled tromegaly The patients thorod HOY NOT TO WOTA H12CL PUP Sater ·maofestations of coccare growth iod at the use omc cher patteria were replaced by tumor tissue. It is only natural that Made thought the tiny way predmet som ett litary and stand voce destruction of the gland resulta la tolabibured growth In the light of his otro later woung od of modern codocrinology chis laterpretaton may rolke os os belog lot about us mag us pouble. Actually belag io mloror imags, it is quite close to the truth. We must look out for this type of caror but because of in close proximity to truth, the perfect oppoutc of the corect interpretation can nevertheleh ia u z most fruitful theory After all Marls outial observido mus soll the first pagportion of 1 aoul relo pooship between the pituitary and growth Probably maoy previous antoplas bad Itaaled putaitary tumors la piant uod scromegalia but it took the genius of Part Mane to sospect o laterrelation between them. Here agup I could die kere lostunces where this problem tersed up lo con nection with my own work. Amoog the cordcolds DCA happened to be the fac to become arulable by spothesis in hoant adequate for systematic crperimental lovedgaucas Scoce 1o cicas of it produced a variety of inflammatory changer lo the connective tissue (peristends myocarditis, arthrids etc.), we coododed that cwieraids can polispast sisses for de formation tod that, therefore the adrenal prefumably plays an important role to the pathogens onmous inflammatory diseases. I had learned Kronal years arlier that adrenulectomy do not diminish the lollammatory potendulaod, indeed, that the codinolemmatory effect of strm (67 fo inaphylactold inflammation ) is blocked by the ablation of the adrenals This suggested of cours, that during stress the adrenal orarts 10 ud-loflimmatory afect bor, curiously wbce it came to the loterpretation of the DCA experiments, I fuled to take these carllor obucavadoni lato consideration. The rooloog hypothou concoming the action of corticoids 10 iaflstomatica Wus Dot actually the oppoute of the truth but only one half of 15, while it could have beco formanlaced panch more completely bad I remembered that oftco opposites are not for ipart that the authoory of the class name "cordcord abould not be operatod Oaly Later when we took this lato consideradoo did it become possible to complete the hypothesis tod unite at the coadusion that the adrenal can both increase and de crease the laclammatory pacenual 2od chat some cord colds tre prophlogistic wbue others uc uodpologisdc. The so-called when suissbomy of coma sooc udon was no altogether differcot kind of misconcepdog, bot it bad la anga ia the same psychologic mirage and it applied to almost antly the same topic. It will be recalled dat soon after cortisone became avulable for closcal use, the bypotheus was formalacal that it acu in so many different inflammatory diseases because it pup some kind of is impeactrabic bumer 10 Esbestos son between the possodal pathogeo and the sensitive livlog U13803 Actually the coopblogtsoc hormona eat soudly by lacalaog with the derdor meat of the grzodloputou barrien bose dale nual fuocuon la coafect such utaratoa. They do not gectent the pathogen from attacking to Og the cod tary cortisone (zalicates the prodation of necrosis by imann (eg cocoa ol) or tbc steidiog of infections (8 tuberculosis) lo rather conspecific beneficial 39 WD MYTHOYAL STOLA ·det le so may iniinnitaty dlant is prcakly due to the fact that, la most of thek, the foomadom of Inflammatory berdion between the pathogen mod the dose 1 cicode. Lodeed here, Inflammation is the disease or ut least, the cardiol dleeuse manifatdon the patient operience * My prindpul raton for belabading this point wu to short that whector MC formalate theory thould remember that oppodio et Dot for apart. It is often well worthwhile to consider arefully the posibility of interpreting oor dat in 1 my which is audy oppade from wbuat oor fint oclinsdon would dictatc. PILOGUE This paper hus become much longer than I had originally planned it to be and yet I appear to have ald almost nothing about the malo topic of the Symposium, The Art of Medical Wadog To my maled, the most emendal part of modlal dang in the evolution of the pros tod com, firet for malog obscuidons, then for dekalbing them, and finally for doing certain conclusions from them. The choice of a truly important problem and the car forunladon of the lexon learned from 10 stody are the real art la mediane und to bring these out clearly in paper is the art of medial widag There are, of cours, many Little technical trich one should know How to rubdivide material lato chepen enddad Introdesdoa, Mateus and Methodu, Berala, od Summary how to inos tadalal dgnificance od to choose between tabalar od graphic summidia of dees, or to laun that photographs should only be ned when the trac shape of things is really important. But all these are in cidentale cod baddas they bare frequently been explained by other I might also here toled to show how to prevent dit in 20 meters, factuul, od coada kyls, shorn of all the enementale, but if you followed my advice you would be alddeed for being onlmuglantire and for presenting u dull cologic of facu. I might have tried to show that it is pomible to make cren the most technical report vivid by always showing the broader impliadom of the work in polished and doqpont prome, but you would be accused of showmtahlp Who know, perhaps I might have gone so far w to admit thur, lo my opinion chert li po barm, crou in certain medical worla, in aprondng, if you feel like it thoagho the understanding of which would presuppos 1 decp-rooted roverence for the minicia of Nature and a cultural background pomitdog 10 ocordooul roerence to the concept of scholen onnide of our immedlate field. But bewerel If you did this, you would be called phfloropher uod this adjective, wben applied to con temporary phylder, ho come to be the greatest of insala So I thought it best doc to diacus dther the mere form and reduique, or the moprenc oldmuto upindoon of medical writing but Gutter to concentrate upon tbc masy filleda which we must raid if we want to obtulo truly smalhant remiu. La practice, if you accomplish this, all the cost doos dos much atter Therefore, I elected for special coaddeuuoo ka of dangerous mp" lo woloodfic ranolog illostridag auch with the med bur actual modo of than who were agght (usually mydf). As we look back upon there manifold map od HOY NOT TO WOTE A MEDICAL PIP Setyt ·Allida, me realize that in the final roulyes, all of them fall into one of the three groups which might be devaibalu (1) the apeldedata minge, (2) the mirror image 200 (3) dc red bering My advice is this Learn toccocentrie, despite all traps, pidulis, tad mingas first apon the cloc dood a maly madeildir ed after your work is completed upon the produl Remember that it is no easy to miss this palat zod Dor to the mte meaning when it Arecoltar Opude down like this Sunwrw my eurt Jomenem Lo 1 murror like this Trae medning ar with thus aby red haring a | Uke this and then you can muss 195 True meaning Of course, all choke weaknesses ja the evalpanag machloery of one brala hare long beses krowa to psychologists but, II be some other stort plause weaknesses of the lab they contage to ruix heroc because of their almost Litoshable tempadan Knowledge is aot cough to avoid theme. Daly if the horrible fate of those intong who barc fillon toto these arups cao deter othen will we be able to say We did oor (11l 10 ud. BLOLIOGRAPHY I Publication de les ser a collaboration Llondon de Molada e de Clerc aptimum al.), Moorte Latrerut Monttal, 1993 2 Sar, IL Screw The Poyuolog w Pabolag of Espoort to Serra Mondral Act l, klatka Mh., 190 3. Sun H Fru Aprel Leport on Screw, Moogal, Aco Loc. Medicul Phim + Mun H who foes a scad Aamul Report as Saces, laatreal, Acte la Medical Prat 1992 I fun an llou AA Thn All Report on Strom, Motel, Acu lac, Medienb 1993. • San, H u Ho G Fowk Antu krport on from Mootral, Acta low, Medical Porn 1944 7 So I The Sery oltbe Adoption Sydow, Moodul, Acu Lac, Medkub,192 Isanu Il Tartborst of Endocrinolop 1 Montbrul, as loc, Medical Teb, 197 L 2140 ► Jan 11 The Stroudy, Lagulopedu a Cadourolog Moontl, Acta Lac, del Des 14. 10 SorH DNT Temont, Excyclopelu of Esdoormoon Hotel Am I Medial Rab, 1849 KO TAYATROYAL OTITOOL ·ruction, H. Sad AND G H Fourth Amol Leport on la loro, Acta loc H L H Lochr dat o scroll bara hoc loc. Dra. Hd Hd W116, IL. 3. Koch, L The scale omand cu datand Vodk, London, Xan 1, u LAUT BOo be dia of now food porodytolytic cho 37 LIL, H. Sado con leche bypu kypocortiollo dos dado 2. To, I Nær Bordorteld ditor de Pulp, A konH. Qach Kola drogarla birocordon dhood cota de u kan, L. u Soows, Li Od te aperton opkolopathe stroal ante, Apertou Lecce In Endodolog bobo Chat Thong, Pub, 12 am, IL Despoons Adaptador do qy My gladsa, Nad. ad. 0193, 1940. 11 bucm H. L butode de kurtuld adeperdon (Tsury of the Adeparto dok). trolated to head by Doctor Tood Doctor Capito Pol, Libelle Guard, 1954 14 LAL, Fodern ta de Letreros Adeptodoxydom (Tbx story of the Adopadla tyo k) toluced Gaby Prod. Hdo obce), kopot, Gary Dule Valep, 1933 15. KALDT Leon, A., Don JIL A Hormtecido bad Habled opbylor befolytalan, Orrod Halla, jot, IX 14 $72, I Hcode potom malopratio (Itapos from The Scory of the Adeportion Spit drooc), trolead by a Gode, New Tak, Schence kerice, Dtr kerlinge, 1951 17 ... I Trottito di Badookoolople (Tadbook of Ladooteolog) functional la lato by Prok. C Cartero), M, Come Edct. Acabroale, 15. IL San, L Teleory of the Adaptation Symbon Chupatok reedom by Doctor (. Tro!) Tokyo baltyab beppes, LL, 193. 19 Pocom Ji Loa, ' n . Lokoxha do doreto de pocudo sobre a ada token do acconto de dadoordoosterone, Arq dhe 2419, 1972 22. 11, L. Gordon-Vodmoporno de probable broncond I bolal prette, Adroca b Moda Moda (l) 3.641, 19% 21. lon, I Oped spolom dagelbolad slaporan, Mod. Art. 11932 22. AL., H. Budocloolople (Tacbook of Indontolog, tromated ba specta by Prol. I M. Cailly- 2011, Dutcolon, Sint Bit 1992 3. Barn, H. Arados produced by die Rock You Mean D33106 24. SET, EL Loochorradang bed des Jeu V pelboldetto They Mead. Illa. 24 1921. * KH. Adapurdoe my Namas 11.924, 1924 Ser L. Morphologbacher Sadle ither die Vertedorp nad Vofficer in betonloos er proceda (Vlpurton) bel do when Lette Isothebbendis, 101 Seets, H. Sacen polimental background cal applications Triangle 1214, 1954 , IL Pracolaul topilaries of tow be dides, Inut. Poron (Depoutk Noto) 1.8 19 , H. Du Nuwe Gezonand Wedholt, BLAS O bromke, Baby Joy, 1958 Com Ji Dewan , AD S D bere modellen, Date of Chayo Rooed Tilts, ONEC LUTO Dlaco doo) HJ 1990 e , EL: TO, D. Leo How Loleza Roples Icona Lavice War 7 1993, com brand curcie Torton Server (CR), Wootmaal. SL The General Adquidoo yake ni che tocan do wpation, I alla Padoalool 117 1946. 31. Woche collegate Dictions of Le petite Hardlowcom, A, 19 Let It The Domador de beste le procedal fontoh koper vs 192 er, H, Aro Boe Poe the point than that of the brave ba biedroghe Hollol, 1954, pp. 3-552 Heydal sockety 1 p. 21. of ACH La doainel 1, ir Entottolo $105, 1954 Jerettondag 28, 3. JAVA DL1207 m. DO NOT TO MUTTA VEDIOLAL Parta Setys ·An Editors Prejudices Hayo Cews ILL. MLD F.RCP pro, PTR wou out zoo NOLAID I found it difficult to refuse De Mard Hina s request to contribute to thus Sym possam od modicul woning because he imposed on me no Umations on sablect or icagch ad thrext out only the digtet af blad about the progested dure for the receipt of my manscript I hesitated nevertheless because I doubted whether I could say anythrog that would profit the reeda haluated postep, became odidog and dog ue to quite separate fonctions baitted, especially because of an uncomfortable feeling that medical literature Dready ruffers from a surfde of words TU DOALTLAL NDOATIVE So far u I know there are only a few medical Journals lo the world thosc pro pietons employ a full-sime editor among them the Janual dhe larta Alokal Associatim ind io conocerpart in the United Kingdom, the British Make Jord which I bare the booow to adit. I use the word hooour deliberately though in the coatot it bus a very coormooplace and pedestra ning about it. To edit the Bruid alakal land is regarded as an honour and I bure are woodered why It is a harising aucting worrying and sagrateful Hod job. Mach of ooc s dme is sprot la tayog Nor to writer of monographs, articla, books, and letten and to adverder udf-adrerdes ead the legitimate trede. Each year I here to reject solely on grounds of space roroctwo thirds of de utidos sobmitted for pub- Heation in the British Medid Jurnal These disappolated author annot feel otherwise thuo a bit cast don't, cod bowever polite the formula of rejecdon they will comide the editor sa obitede 10 the way of their procent. As a full-time ditor wo oo loager pacucos median or world in the Laboratory I often feel ecotely uncomfortable wbea returning to an sabor a paper which is the result of web maybe mooths of pateat observation by the bodude and operiment in the laboratory rock summed up in rolaminows tables histograms and the like work oot hus udly to raket at times, which had moch better belde andere or dooc lo differece 15 As least, I lodd shat u tome losecution for the criteace of full-dos medical editors who do por practice their ongiosl profesoo By looking og 200 kring all odes of tbe guere they do stand a chioce of achieving impartiality They ao sam op the optarom of tho or three arest relates on a paper and come to the foal decus on which every ed.com has to make la or“No It is lo the cercise of tbu sodidal upany that I medial dicas bo ured post merely He acedo. food of that must commodity commoo kose to ability to assess cuideace and DOLC for the bumbag the slider det for the man wo wot to sello 31 ·no TI UD NIO I know it be good andre for the young man to try bis hood ut recording on paper obventions he himself bu mude: Waiting Frends Becom uld maleth 10 cact min. I know that when a doctor is applylag for 1 port the selecton intuch importance to ble published work. I know that certain ciala aspect each member of their staff to publish it least one paper yar There b cake quently in cormou preston the editor of medial pourrails in Bdalo, 2od, I believe, to the United Suute to polat en crer-growing number of uddles, and for this pret ture thor la charge of teaching schools and dinia art, I would pabait, moch to blame. The there to the race for plodty often un comly ruce. A och drog is pot on the market, and the would-be Luthar feverlihly tries it out on a limited Gambar of cua, often without putable controli, in order to record hla Imprenlans of it lo the shortest poseble doc. I au rury wall sytopathie with this desire to be fior lo the field. It is not almar jurt 1 qoordoa of velty or mloplaced embldon A bob may depeod on it. A man who an bare his mume attached to ADC Oberte doa ha i good chance of obtaining the port he wiata. And it to the physical fact of publladon that count Ya I fod that sothors and their advisen, und edition too, might cardse grater decretion then they do la chib almost feroolah search for priority and prestige If only workers would wait paul they had thoroughly in vestigated a problem before we hag publication! If only oditors would refux to publish paper torpported by adequate evidence! If only the reader might retort, human beings were not to stabbornly human eod did oot anive whut Mitoa dewalbedo tut lost infirmity of poble miod fame. DOW MUC HIDDO How much evidence should be given Mogy writer think they are providing cridence when they attach to the record of coc cu m imprendre ety of references to the literature on the subject, zod thus try to make an adde out of it. This body sech loto periodłals sod books may be cridence of a sothor, industry and a really caldal appraial of the literature na mabeat is often of high valoc, and lodeed may be no chondal preliminary to OT work. But I recull u nachor saying that he would submit a paper after it had been proceted lo the library of billadtucion. This procenia lododed among other thing, the Ibrarlas provid ing a complete bibliography of the subject. Since then I bare often wondered how muoy rathon actoally here looked at, let alone road, tbc adidla lige la tiels biblographia. Noch gmc, effort, and sorrow will be moved when thon style the literature on the chosen object only when this is indispensable to their lo ved guion und the dracundo of the repola obtalood And then there are t'be rabies mi cau be mpb and cutter disgrams, the formulec od cquidoos mod radical jargon How farbidding it ul looba to that coarcoicnt aburuction-the average reader! Bat how an the road use the validity of 1 conclusioa olen he boom wbut methods 20 amhar bus ested and to given the data which are the ton muutenal of the calculados? Medidac bo becoce tog, and will always be la 1 Rate of becoming a fiat cience. The more castle IN KOTON. PALSUPUES ·becomes the more will perdremcat creep bato la procedura u loist apon belog expressed la pancial terms Though tables oppress the cliolam, the alitor I think, must see that ouderial data are properly presented and glue their fair share of space bare was STTLJ So much for the language of Hizc 1 lso gaige wbuch I edadt I reperate with that hdplass klod of the ove rezerva for the onkown. Wards are 1 Dorc decedal bod of covo und by frequent sed wrong ouage often los much of their pristloc freibooss ood beauty I recently spent grorul hou going over a loag paper watten by a friend of mine un sothority on bus rablech bor coc who found words ea obucle to the expreson of his thought. My first revision was devoted to delcting words and phrases which kemped to be aperioou. La subsequeat sendioos I tried to redraft some scorenco lod pernapas in order to make the meedog clearer and more con diely capressed In attempoog this I found it difficult to be quite some wbar rome passages actually meant, and in redag those basew that I might be misoterpredag the author When I weat over tbe revision with him told me that the obscure paruges of his paper trert coocedung those aspects of the rublect with which he mus laust familiar At one polar be remarked What I was really wrylog to my All right, I rejoined let s put it down la the deur words you bare now tased. I have frequently found the most useful device for clarifying na ambaguous pression Style is the art of being clear without being mean Aristotle is alleged to bure said Canty loadıry ampliaty bretty are all desirable to rure qualida la medical woung The doctor who go down at hus dalk to compose un artide must, I think, be awuuled by horrible doubts and fears As a norice he toods to think that 100€ rather usual qualidas ure alla for in this mode of cipropioa He was hus paper # something that may coc day appear ca the literature on the sublect. That awful word literaturel He becomda most well-cooxdom of blaself uwier of Prose spele mich . caplul P Too often he thioba chut good prose condo of long world sormg together in long kniteaces He writo It is my ardally considered oproloo that, istad of I consider or I believe, At the avulable accomodated evidence good to demonstrate that Instead of the evidence soko And the author can give the cridence in his references. Theo terc The powear had oo parpology Ooc might as well say The padicot bad plenty of porology He wus i sorsogolated banii. She wu. curanoma breast Such things are sold in the wards of hospitals, sad 214 . com Taucoce to thc mer Eray profesion sad trade has its own formas of cupresuon, but doctors seem reloctant to dusdogtah between the spoken od the written Lo- 46 At least this 11 partly the aptination lo there dar of televidoo the CIRCOL, the radio cod the Wostried magaone, reading and widog are at a dis He who com may read, it has been uid and he who raids may wis, and how he wil mill depend mach opoo #bat be reads. The doctor today hus to rad so may yours to keep up to date that he hus uttle dime left to calurile tbc garden of lus mal which a coascqucace becomes clartered op web robal wees 11 mcdical rangon comt 361 WD AYTTIYATHUSYAL MTOLLA ·To Impronians of what words mom. Wheo e doctor was the words icono TAJ LOTNO OF WOLD pompous, A problem must always be them, merning to pride that they will be picardy moderstood by modlal rendant. Worde, os muy people hare uid are often wed to conceal booght or the bence of it, and la soch in incat science a medicioc this muuse of language to a temper don. Some 33 yen yo in the Time Low Sorpiowe te mir of 10 utick on The Decay of Syatex picked on the following two medical complos A man who is certain of his fucts will wote without twlage of cookience mch a sentence as this The percentage of mortality doc to meula la afica ar uggerited. If be he wld that from google die of wadusha is saj pod be might burre uked blonnet If bc were more it wu troc. The man who writes lostiace of premature mortality are more frequent to the air of mon than in the case of women, when he means that want me to young the www dosydost light. Sach widag la ndoas not because it be bat became it I dinhoport. The writer found smoog the vices of modern prove lodifference to etymology and the proper meaning of words, a tendency to proter the aberast to the concrete, to OHC Doors imtad verba, eod. circlers acceptance of word-out phroa. La medical weddag one finde also an overfoodocus for adjectives to wsporto problema. Three important probletos et Dow belag istecked thus beglos catence la tocent oditorial. To uttack is to malt, ind to do this to a doubtfol or difficult question, to use dictionary defort doos scems to me to be mmoceearly valent and cuonot be foundfied by adding the word important The water evldeady had a faint recollecdon of the idiomatic to tackle - problem Lola laboratory procedura od ukule SC HTC two other spedmens I here collected Medicalow La defined in Acropalous about mladte detalhe, coming from the Latin us which micino Leer In the abort poruc, commoaly need by medical waters, it is supposed to mea frat art o scrupuloc cars, best it does not. The word immaculate, one of In orddonul religion concert, la mally employed roolcally To uy Immaculately drowned is to imply that he la mediedag watonally an ionate mardi uum. Immaculate, bed dendally maum without colored pou or marla I bure too reen the word mereuddou pop op 10 oy bed when De X relato the meretricia e giocas De Yo to popport bh thals. De probably mauro spadows or plansbian and would probably be shocked to learn that meet dow (from the Latin woonr 1 prostate caos of percetning oo tuuracteristic of, or being, prostitute I would not maggot that poc abould alwr go back to the adplaat metung of 1 Ford, Red deny the box of is rubacquear connotadoar. But it as often cough memoal lazoea thu lo there toon of morning Nip into . logoage It is important to know the meaning of the words our employs, I knowledge of the etymology is powerful ad.co donuoding Needly in full opon to 1 tre Oret un ia AN TILTON I MLJUDICE:

·Bat iben be use the ordinary logoage of the market place he kons to throw pre ddon to the wiods, counctimes with much abandon that it is difficult to undertuind what berually docs meso. The first thing I present to 1 Astroomer to the staff of the British Medikal merl is the Coala Darford Diamy propic knot the meiolog of the words they speak and write life would be simples and more harmoolons Fen if wy tre likdy to te a sacanfic ordde us if it were to be a contrbutica to bella lettre. But most doctors find composidon difficult They grown and wat mod mer as the mords fail to come together la ondaly sequence upon a white or panse of paper When they thlak of style they fearfully recall schoolmaster : wiriog not to split in lafiolarc od pero to ed seatexe with a proposidoa Yet the best writers of English bare dete baduted to end a retence with a proposi don, espeddly if it makes the coding emphads, cod bold man will not hesitate to split un infinidre if this is the most dfective way of mubog his point. There lo almay some linguistic mobbery in voga. A few years ago that good old-fashioned ward commence had a black mask against it la ceguet Journalistic arcles The Anglo-Suco word begla wus preferred to the cool aclusion of commence it was in the beginning, dow sad crer shall be In the begiaalng was the word. In spite of these ballowed pbrises commence and commencemear fall at dmc astorally 1000 place in a formal actoace written by someone who u dot ashamed of the gut drafo made by the English language on medieval Freach and Lada. However limited a man o rocabalery may be, be aan, I believe learn a fett simple mula of the craft of dog and by predce become profacat at madog the written word plalo to oodatud lod eren lirey Here are two dps I thlok are useful The fire is this or the care and not de passare voice One of my colleagues recently showed me what he thought was a very doll report of a meeting He was puzzled by this because the lucu 10 the report were quite Laterosdag The first thlog that truck me in reading it we the predompact of the passic roice, with its denden ing clcct on tbe mind Sabatirution of the active voice for the passive made all the diference I hit him as he was crossing the road is more direct and arredog tha He was but by me u the road was being crossed by him. The second ap is when you an, use the concrete and nor the abstract The first ax wu i male A much less effecture, mod less buman then The first patient wu 1 min. Finally mless you have the literary skil of Proust do not get lost in the convolodious of aloog sentence Whatever rebut sell a we may have it will to the end ayul bim liale if he has nothing much worth laying He will often coagh betray this by padding out his routeaces with adjecara inderarbe by midage rather high-como cortados kind of English, by pasure coostruction (radiaatog lack of sculoo by hlm) by lo reruon, by the use of abstract nocas by the party of rabs Simplidty loddity Junty brevity will be marked by their absence. And much of this is I believe to be atoibuted to the bot-house grodacdon of medical auclis urdbdully admo- Jared by teachers in medical schools and diala so I return to the beginning of this Homcaba di saared auy reflerdog Lorocabat sadly on the boodreds of thousands of words but four yearly into the offices of the British Mukellad words wrong 381 XD TILYATIONAL ITORIA ·with great dificulty from the cardical cells of amnest and hard-trotdog staden of home outure, words apped out oato peper by stenopophas words (some of them) to be set into type by operators, words to be peated in black lakon white peper mede op into periodlaha and books dispersed throoghout the wodd, words scans to instruct but which often confiskuod may conscience condemos ne for dolog that which I find 1 frule in othas, widng 10 grdele without really boring very much to y Chrono AN DITIRI YPJUDICD.

·Medical Writing IVAREG ART, ALD rua 10. Of con, MOTTATT OP VOTA Bottom, MODRY Cbr McAOG, IL Ian uke the test for my short sertaon from na adde lo Med Ecomonks by Dr Henry A Dandson, editor of the Journal of the Medlal Society of New Jersey Hear that his wittebasket is stuffed with the weidings of doctors who dido c stick to the point and dido c make things simple. Obriously crary medial water who cpect to have his material rad sbould pote this had the stop od pooder i we rroa t uy who they here lo mlod quickly sod in lotcrosting car cod dople speech, Dr Dandson iod thousands of others like him lost wont stop to read the staff Today there are so many artidas climarlag for attention that a doctor rendi caly tbox fow that itina him u be looks at the dtle the first paragraph or the rommury The big mack is to apture the reader i utendo la the first paragraph od tben to hang onto it I always marvel at the poor sense of the writer who either start bis artide with 001teresting material, or after be gets goung interrapu his discours and get rid of his readers by Insertiog a lot of dry and onlnteresting material on technique. He should pot this materul 20 appeadir at the end where it an be red by the rest mio la a thousand who may want to repeat the perimcan or to see cualy dom they were performed A score of omos uma edicor I bare written to a coadibator haylag I will accept your minuscript If you will throw away the preamble and begla on page 4 I wior you to jomp nght into your cabject Iosed to say to a stadcat who wis mbog ng article on, let o uy the electrocardiogram of the diglulized beart Imagine the editor s mcaual processes when he pick up your garer He is likely to grown a bit od uy How as Roy DC write Loything army or lateresting on this mobiectie As 10 editor of Custrategy I Dsed to groun whenever I got a paper on gruote addiry Because of this attitude of cdicon .od readers, I would uy to my stodents, Start your paper with a dear-en, brid statement to the effect that sdn after all the work done on the digialized hcare (or gutrichoce), bere is a big gapia our knowledge. Sute what that opis and then say that the work done by you is designed to close the gap. Sul alto, that you think your work hus thromo moch light on the problem." Ocauoolly 1 me will bare to ake a fc paragraphs to show that the widely scarped carliton of a cerula phenoMEDOR is inadequate or cruinly woag Taco be un go abend nod GITE 1 w exploidon Today the teadcacy of some wise alicon is to ask tothon to leare out historial details and loag bibliographies, acaally when 10 cicelleat babliography is asily inilable to some Journal Although there are sull soto editors today who insist that the parens submitted to that be mitten to cechnal urgoo I belicte s' writers who wiot their work to 10 ·There are a few paper being written today which will be disa 500 yoo from I am sure then peper contain prutally nothing besida facts of obtention, agzin I an ice 111 lo defect, id I an edit it us vidously us If it had been witten After yenil och citogs I may decide it is ready to be Wban I think I have fidahod . ppa 10 ore it to tour out cury dute, udverb or Cance hich I that can It is Interesting to see how unday One toon why I yomg mun should stody hard to wote u interestiody a por able to my aboat somethiog tut is worth commenting og is that creatly Otoc dty thousands of phoidon throughout the country an clog hili na the band of Lourticle, will stop to red it The WD Any to domicira "This fellom tys bus somocthing to ay und be mys it well Lets see wut be interested be read abould waite, no fu u posuible, la simple Anglo-Suroo English wherever the work permio I know edicorial wifon today who am crom ourt doo to put in mistindoa, who are out rounding to put in metus, uod wbo crous oat maulo to per la morbilli but I bare some day they will 1.11 be dead and gone tod dtdog ou 1 hot sat la Helll As my old goveral parcodoner father wed no often us to ac, After I ret in of the road about 10 0 4 night, terribly tired brat wioting to do a littk reading before I full malorp, the Eaglbab must be simple. On 1 Sanday moralog I am read medioul German, bat Saturday night I cant road even highly technical English." Obviously If a medial worer was to atch 10d hold the Internet of very busy main bc soust muka bila paper short and pichy he must be simple vivid Eaglbah, bo must have something to my thesis of value, and he must hy it in the smallest powal bile space Beata, un phyrideos grow older end weer we come to depend more and more od ramirls of ediclan, the good writer will take great care in preparing a good putmery of his matetud I think the time must come when edicon will pot this rummary at the begiandog of the erdce where it beloops, and not at the end 1 almost always read a commery first, and I le fotero me go to the beginning tod red the trucke. We medical cicon almay wish writers woald aborted that con reports, barias out all onlooporuor detalls. For instanc., in describing an autopry ooc dockathare to copy it w It ame from the pathologiae snode nord ay is partups that there wu only ooc significant finding Rod that we rupture of rein in the crophugos due to i dochods of the liver All alcor, I think, wieb that medical writer would fost report what they have ken und Oberved tod dans, and have out the theodring as to what it smunteti after think how wonderful a tortbook Hippocrates could have written If he had ood, dacobedecconately the symptoms of a few car of doch discuses u pepek alcohol migratoc, rcuma told antholds a gonocha prically all their done theorizing about the several humor of the body Cac of the best wich I have lented to the last so you of Waletng is this woteca 1 by en coemy of mine went to an editor moct verri ure in a pepo Unfortunately be cod Galea spert DOW I DOTY Alerts YEDICAL WRITING ·Books in the Physicians Life Flix Marttir, M.D WITO, DITXATONAL IOD OF G UD ODRULL HD ano TL, XT TWO Und Swellglagu And, to the besk Hostel de ketent Boola und Medicae. The Phyoclan Library Throughout Hbcory The Three Intollectal Chcia of the Phydda The Mapk Door loontul Rosdingh The Ponda Munal Letter Nordlun a Lift-Prade to the Paynida Professional and Sokodific Resells han Prule of Darko Tabooba Modal jamah od Thet NL The Yehr of Metal Abecka. The Present rod Paen a Modal Adrera Readlag for Laxport. How to Food The to Lord. Ver on the Crocophaga. Humechoke Loading La Pradec Lesdhog la the History of Medicine. How to Scleat Lading Material LEorou. Chercher power to be betul harp che rat Wale White DOOD AND MEDICINE DOCTA Books cod patients are the two paies of the axls about which revolve the profalanul life of a physiden Without patient medicine would not be 10 ut without boolas it could not be a science Medidac is based on crperience and the oaly way of recording rod perpecasting that experience is the written word In the beginning was the Hord, says the Gospel Without words there would bc do transmission of thought without tho ght there would be so bumuoity-20 KCKDCE All the profesional experience of the base paridans la the world would Deo ficule union verified by what boola uy about those wory ume cinial phe The book is the silent record of medical thought, just us the parent is tbe Linog record of hamin pain Soloog u mediase was only a small the dairt to cure the sick it wu triosmitted orally from teacher to popul It was an art of the public square, the gymosuom, the forama, pautag from the pale dry lips of the master to the anger an of the popul Bar as soon as trediad had at los disposal a graphic record Assyriao caoeuform tablets Egypuin papyri Aztec stops or medieval parcheosthe cn of cdidac us a kicoce began The hook wis to mediul saence what the spokeo word wus to the art of beliog Whereas the taches of medicine toght a gisup of contemporaxos students, she medical author from Hippocrates onwand taught posterity Huppocrates bimxell dw not need boobs because he wu hus otro librery but when he compled bha Cortes he bequeathed readiog matter to connuless generations of physicians Dooks harc axay been the best inder of the cultural progress of the physidan The only book the primuti e witch doctor bad was the patient himself but the shirasa l brany bus always been a wiodon open to the lighus and shadom of his intellect. IA b tory ·Tum LUX TOOTOROUT HOITOTT boorledge, From Hippocrates din as the perman bas secawala la his library boobs dating with modics, the burada od the fine arts At first, those boobs wat La lateral part of the threads depicting the inmcaks polychrome upany of human boomedy Bags from the muline of the Karateseth century to the beginniog of our Om center the pasado mes locerestal almost adairely in sosial boobs apud there wa maut need for the cansal of Me toch as the Spanush byvideo ph Domopher Lerumcode who old thus be physidian who knows only melicios does not bOT ETEA Delicioso ritornare al ngu retain to the concept that to know a link about Dedidoe eke persidus must know a lot about other blog Theta mo admeso remote that it come mythological when the populara cool book that be bad read cherything or almost everythlog of zoy importance titten on mellom L Galens titre medical Literatura bad scarcely bayon, uod the Hippoctatic Corpus was precocally the only basis of dienafic medical knowledge. By medieval on, however the ptiniano, who was often a monk, already had at bin dopoula great number of medical merusenpo potrag la from Greece and Rome, which moltiplied to a fantastik mmber durias ibe Reussance when the famous wcbook medial atlasons wert esablubed in das like Toledo When the printing press ma lavented fadlitating tbe trammission of medical u bocume difficult for the phyridon to mimilate cuerything priata! coaceming nodicine. Yet the look of icquistog 1 medical calcare was sull.com prostirely simple, because for centurla medical koorledge tended to crystallica teco bar todos modosturbed by the present-day valioche of medical journals Only as the beginning of the nineteenth century when the ocean of medical bowlados alteady Oreidowlag the dikes of cardboard and cloth bulle try bwk the transformed out lato Journals and other types of publication did the profesional lofe of the partidan become caly difficult The idea theo emerged, and oil provells that medial books are the crystallio to one of classic knowledge only and therefore are condemned create lly in quo * of fashion, and that anything of any value an only come out of modical wat The the populdian has become a pulley were la perpetual servitule dolari of modical Journals published today throughout the world whkili relay anything od the medical waters can recollect or anything new they can clinket century, 140 the phyddon leamed medldse minimalisht Poley he henne medicine from the medical fames boring books only , niliike who Motion formidable opportance told wedght make of them kendimi tot quit iod tulee os for Telow tellone walk only once in a while ha trual tened news to ron con If it laro w without becith with di lingutient och y h Autals of current medial portals There was a dme when the physician cariched he towwledge Try this simplex pelikent of oberving his pericots and acowaliy hierding the Aivice of an old cold here or listening to a lecture by one of the will old inntun of Medicina One sabied medical isdom throagh the wodowo of the KIK HR as was especially Important for it abnorbed the words of the teacher wille the other comes wired for the uttaloment of a partea a kopowledge as possible of the period of the patient Mari-Ibaha 1 43 الي DO IR T. P.TITOAR'I LIN ·The latroduction of the medical textbook radically changed the reaching of mediaac From 1 discipline acquired by listening it became a lesson to be read Medial knowledge mus do looger trimited only from mister to popul usually at the patients bedelde it became lusteidnther lonely Learning procon arried out sometimes at the padcat. beddde, but more often to the office library or work room wood with a book copulaag tbe sediment of medial knowledge deposited by ktorul generadooi. Today medidac is uoght with emphasis on the visual elements through books, journals and other forms of poated matter supplemcated by medical films rod that other great chick which may hold the key to medial taching in the future rele- THI, If we llmit ourdres to prlated matter of may say that porradays the phrolden learns medidloc from boob (artboobs medial boola monographs or cyclo pedlas), medical Journals, and, I would add the copious low of medial lleratore Listed by pharmaceutk cowpasta, which for the most part is today to roccele fully accutely and restefully done that it bus bestowed . Dow digoloy on that much disciand end often mixtoderstood and undervloed ut, medical advertising Bombarded from all aldos with popular and scientific medical Verture the phy udlen cupoot help being completely cobeerged last Medial literztare is perhaps the most dynamic of all Literature because it crobraca both the science and the ut of uriag hamsa lima Medidloc us action tod u Stendhal and Le jardio Al est dwus l'action (The son) finds la delight in actioa) TAD TID D-TELLECTUAL CICLO OT TO POTRCLAN What does what should, the poyrideo read? Leto remember that crea more 10portant than being poyidan 11 belag a min, cod that the physicizo s professoal rulice is closely Hoked with his vatos as a bramas betog Ooc cunnot become a great plagaland without being to degree great in one persoal daily lufc Spintoul corn for lod dignity to private life very often onderlic competence aod still in the art of healing A great physicia mually also been the mart of a great man Reading 1od stody ut us catalytic agents os homso greater One does not become a great mio amply by reading great boobs but such boobs may act as shala of light to ulamjanto the treasures of greatoo abar lac dormzot in the deep dark mloos of the bomo sperit le us therefore Teo Dore ito portant to the physicus to determine what be us to read us toan than what he was read us a physican July he should coasider wbar be aprire to read us i member of rocity We are therefort coolmoored with chete coaccatric arclas of intellectual ocurity crcb cobrang its on horizon of reading the persidan u s man the poyildao u arrowlooal ebe possiamo u imember of society and maker of bistory The first of those aregona amulliro che porsideo . Dost soumate dosim 1od homin aer's the second ukes care of his peed for informations profesional the third umbes bu confessed or uncoolased socul mussloo in space-o bh country - 10d 10 time-10 bis own period and to bistory Let us arumine thcowbat 41 XD TORTATIONAL STXNOLA ·these three type of reading matter are iod what they would be recadoul for the phyudaa us a man fnformative iod educational for the phyddio u e profet dooul and progrenire for the phyudin ut maember of i pociety mod of culture. T. NO DOO What is reading? Quevedo (1580-1645), the Spanish poet and uttrist, defined It la un imoral qutruin Zaterdo a la pude aston dolarto com pocopero docto, libros foto, to coordo con la defotos, (Withdrew fro the poor of this dat vai be the wheat book I lhe faworten with dedd I ken the head.) For Detartas, reading wu * Forseti lu pas hwnns gou todo passis (a coarerudon with the wiecut mon of by good day!). We muy then broadly demify the phyican reading a reading fa redlog for work, od reading to dety With the first he leams to develops. IL uod tly on the wing of the spirit, with the accood be learns to master his porr, Daviguttag with the walls of his knowledge od with the third he knows becomde worthy of his commary iod of his period, thou laviog behiod Llan mrk on the face of bumanity OLTOTAL LLADO Radlag fat pleasure is not the matte es reading for coupe Anthony Archer Cance Dork, brides and writer pake ches of the magic door whether or whet nood ny be, when co bus bas dorongte du auch dort Om pratton to repaber what the be choryheid, borot be hard ang 1 here are bouten of feary Quotes bo leb? Houd www to Korrales, ad ot como de showed cold blooded by des Lyon TV HA--- coopy that coc PY Corothuk too lice od rieg De box of all who the dead badoo and the door to tu to the bay of our own daya "Codrow dp door weedse bort then we were outcome we to dy live of moborth Smoking to or forsk, sallam der Wom, I ask forbing better brdan broke thot widwie w ad un ser ut son pied du The other benar waterocter clare to read when wy dome Theater doo not being a low mondott I are more boble to boothbr, sor Low Lady dewan door of det rom behind you to of ball the world where company of the good dead, and then you want to Hory ud fonton fillow you so wort. Iako dekor ya That would probik, Tox ceniyle de mot Choom 7000 mu And then you have but to hold up you tell a BOOO X TNE POTECT'S IN HAWK ·from really for the artist but la the caloyment of trt-100 art includes reading reeding should not become that starter meatlosed by Valby Labaod. The pleasart of those who rtad ronidowly sod indiscriminately preadog a sloppy coococdoo al bains to a dellate dish of intellectual anu is nothiog but to do panished nice So grat is the pleasure of this type of rodas that they read anyching anywhere at Lay tumac, a deliberate attempx to cape from the modd of reality into a world of featusy Soch toeding is an opurte or a refuse that musb be reader s orld and hka from him his oro rool Truc recradocul reading utofies the spiritou reeds of the physidio u too What is the maio nuoe of each readiag? I would say the same as it us at the begioning of history co tertainment. Early man lored to alt wrond the fire, under the bluokdag sun and listen to ula of dretate 2od matery When those horia Tere perpetuated in written form, mao continued to read them that is be kept on listening to them with the facer eur of the intellect. Today man is more then cher 10 terested in talos that dirert him for a while from hus prening daily tabos and bear him over land and see on the Peguros of his mind to remote places where idrettere fills the air He sdll love to Joico, in the cere bour between dog and wolf wheo the last day departed cod we settled ourselves in the smoking room for sleepy crening of ulk sod tobacco to stories of bold men who like John Buchan s beroo dared to seek out mopathed waters, nadreamed hores The physiato docs not exist urbo after a few hour of sach divertog radiog doca dot return to his wk wich a spint lightened by the conflicts of the heroes bc has your mact, by char Gate-cossed lives, for us the lowriduri laispor sus partner es ach odc but sufer hus owa desday The phyudan should cojoy creo more than others thus type of partly recreatioca! reading whether it be detecure sorels boobs of card and adventure or more recends sctcaufc faptusies for it poun balsam on bus soal battered by the constant pectack of hamio suffering By mcade of the splatoul canobiement of reading. the physkiza may escape becoming 10 automaton incapable of dosplaying emotion or i cyac weanng the most of prolerosal skepticism. Why should be phyudio read Literary worb? Primarily u wuld befort, for entertainmeoc, hace thu lo stes all the greatest mission of licerature Literature, uid GK Chestertoo, 13 a luxury fiction is 1 Accensity The simple need for some kiod of ideal world to which ficutions persoas play mo mhampered part is Infinitely deeper and older than the role of good art, and moch more importiot. Ao hour of tio of recreational radiog and the physicleo may return to bih dully task-thar anung oftea harfomag coco-teden castelrabed lo spirit by the ru oo of borcemen galloping at braakacck speed ore frost-covered highrini coder fant ulrery moon of tapiterious (tz relats in dusty apesarrog their whips on the closed shatters of a deserted :00 of soomy pashs la • silcot forest, aimon wonder the setting son of urema mth frozen black madow framlag 10 laterior of codlel e ubla rage of Tibe ind meo embarked on a aight of drinkios gambliog 2011 oglog by a bluziog fise The love of story and fable belongs to all times and all Nice Phpidos once 451 WD ITTILYATIOYL GYNOSTA ·hat brutte mod torka a do that weet pro plow duro gathered tround storytellcomencent Mosoportmie, today tata Street or Peak Arenie dlabs to store. The End teavalt is not to date bat to catermia. Lo que a mach divertida, Tua Las recoorke to fading duong those hoars that the Roccins allee, Enek rest from the promo of life in contrast wider the tertua do There are phyldts who entertain a lot of guilt at the fuckiest but seor dorogatory word often med by people who do not mentasd tests pakete- Atlanul rading od try to utily It by alliagli e paste abg svocat quently topraot the truett, most othentic aspect of living, apcailly when taxt This matter lopedully Important becante Dotblog tereals die troetired 1 perron soal better than his fructe pertime. The oth repertory type porton samudng in it limitations mod borlog in its uniformity or to that din or creatent, painted or farmer, clubs or cab daires, lawyer alan yer our dully tubs me atreordinadly all, u alike u carine, lortal Serpo, the activities they choose in their Icigare time. Fron thut ok, there att X to drauming What distinguisha one panoa from other b not that contra tot people alike. There are no to podds who spend the free umrla xth the Anne wy cen though he may Jl have the common denominator of our kr cdoadoa. Let reall Thotu Sydenhutm immortal two when the lyrics Sometimes recreidooul reading may be reable la ropplemento one prolamont and poet Blackmore uked him what he should read to let nekom been interpreted aprelay Sydenham coatempt for the modul medical test book of hl dime the fact remain that wben we read Dusukan wat in the modido not only af Phillip I. doc but of all time. Thar book toda imprendre lenzon ta traumatologompable only to the Iller det phylogromy od krenul lessons la Guledlc pharmacy beridos provide with I wooderful purchiatric cod codoccnologle typology Above all, we lam sam the human belog la dchuess cod in balth from porchologic Hewpoin dari Mary literury works could teach the phyidin to recopic the medical tffecthay their characters, for instance, Don Quotes medoen, Camilk tuberom louis, Alyosha KinDOT I spicpay the codocdnc obety of the fur boy ban TW Lotert Loob dorong palad at Dok dogody deportna odeverd now book, de a batek doo, Kuba bedo Tboy do not ple dhe problem wold me tervedboner to be act they do not to dll kanon, word. Ty TN, trop bey deny theof the care sbg contate to the goong af och cod di dowodu rabd apua, E bronchia, bet hbdg dabut DOO, dolore dot T beng, thekroondecorated cotton be che modo tarta omon bent by do poon lemure which is boulpen a doty punime is redlog instead of bridge a television. rundlag De laat it I very instructive wack. mirerrel beaute it is so huten. Although that pending termark here t Beitratta 000. IN TO OUNI LITE ·Publicat Patris and be could then apply hele bosanledge so real life They can also reach u to describe disctk mth that literary delissa lacking today that an chuore e cold dry dinical buscary kicetta papar bo . bentiful wom prece of munt Hascosy like science is copurually mosted by scholan nod utisa u &lgeriet har to builody demountated !! Discox is. tapretie etthetic experience and the artist abe most soudre of mes, emot help belog affected by it. The Birty works * garant word u inch socze rinid medial poruit of the dime than loy technical trort Cannon Must besides being a mornicat of artindc story tellung deplo a dazzling pusotus of medicinostima u vertiginowy w as bood torbedima u gradul urbalke, bat almpu mery atinocols-lovolr ng quacha daxon, and patient in the Vaaste eed Evropy of the 1700 1 u well as ia the Rosuu of Catherinc the Greas. Literature kiss indeed puede good condibution to Medicine in Erzut Praise of Fally 10 jioa jarce 22 Thomas Manos Mags besar ia che Rorels of Stendhal and Dontoreriky rrers hare always estogod frenagliceroy&gures inspired by lielog phyoldass La bis Sympositionen Plato gives in Eraimudem tbt pbysidea who sdriser Ariston prucoes to tocent in order to cure his kiccought La che contribuery Todos Chapter describes ibe medleyul payudas who colated to bure cured his patient chrough Assal magic Rod mu modeled after John of Gadderdea, the author of the Rara Auglica Rubclus pbricio of Lyons and a gredosse of Ilantpellier geperonly spraklad bio immorul morbs sich poradcunt. Shrbetpears, with his knowledge of medicio sed ch churcten like De Calas na TW Mom Wins o/13 oder modelled oder tac graarjana Crime a omlasted for ekkst nestle porod in medial history stretchior from Vanellus dear op Herrey discovery of the circulation of ibe blood Bromrmmg glorified Tomus Liasce ove of the gener bamsele paysidiar la history ia bis A Grammaria , Fred And is hls Arason of Adlonchely a COMIC on of the melancholy what was the sutkar iconsaat companion, Robert Burtos parides before of you an lupresure unlade of pupicies and that particua. In Louis XIV s ume Nolitte aunized porianos is bus laene Lukimas nod Le Sage, in klo Gol Blu Sooiblos cercand la che figure of Dr Ssagrado * frigbretto sog eisople of the blood letter ochut rumapure age in medicine a pus u drunk og vele openiaga u Gay Poria who hled bis family bus frinde ud aimself laro aberna from which they were used only by the cormou hoop of water they drot so ob per the discare to the cigareata centary Danid Ddoe more bis herd of the Plage Yuri fictional bat Gairbfol account of the same freas winaxd sad related by Satarci Pepit Stenx caused the quereloat De stap in his Tritoron Shiny and Tobias Smollect eurized De Mark Akende in Th Arms of Prostor Prothy Jeance penned othbore to be bado be adored 10 bis Alaus Ratke iad Xeu popoldan and paxts, dressed desiog bus las catus dun atou distaouine parts that later "Browary in the Arany of Mimetoly sa Cana wd, is his pestes analit afternoon la dany wil librsey for Barron book is hatom book, so cntion nasic of many coloured punchen KD AT DEATRULL mwrot ·storyteller 10d playwright In the United Sata there are S. War Mitchell THE PATIALAN WKU OP LO 450 Spanish waters like Pedro Meta, Vial An, zod Armando Paleco Ville Rabelat has beca coadad by men Ilke Georga Duhamel. In Germany todo Switzerland the dose of Schiller surgeon od playwright, as reboot ta on temporery medial para much u Albert Schweiter Lo Angle we can potat to tak borelirt cod poet Arthur Schatila Io Romli, ilooguide Doutogenky i plug du * son brought up in the medial undidon, we bore Agtoo Chettor plenida, mude him the greatest Jeweles la words of the English language. In bus at work Chala Dickens utdred fifteen docton bod Te rog, come of whom, like Dt. Bob Sawyer of the facoto parabke chronals, ac noforgetable. Thackeray mo? Trollope followed in Dickem footsteps. Robert Louis Stevenson acto, oct other phylders, the schloopascal Dr Jekyll, ond De Llroky the bride arrond Trenut Island The medical prolasson bu prodoce mort write thro any ocher more than Law glacering and the other liberal professioon The only exception is the day whilch, because of their perennial mediatico a Pin and God has in the part pro duced w miay great wteo u medicine. Since we cannot mendon the entire roster we shall limit orandra to podanog ont that in England the litery tradidon of Kan Thomas Dorer (boctore and LOT who in real life discovered Alexander Selldrk, the odglou model for Robinson Crocos on the baland of Jmo Fernandes), Oliver Goldemith, Tobie Smollets, and othco who were not phyldens bot stertheless wrote medical boob-like Robert Borten (n cootemporery of Rembaud, Velingoci, uod Shakespeare!), who wore the greatest social creatix crer witten by layman"Hs contioned by physicite ille Arthur Conan Doyle, Roould Rom, A. J. Crooin, aod, above all, the potace of contemporary English porellot my admired friend w Sanierut Mangham With hle hubieral cleguace, Maugham bus explained whypykciu may vary wall became a great walter I do not know a better training for a water thus to spend some years la the medical profesiog I suppose that you can learn a good dal about humin onture In 1 rolidtor sorbice, but there on the whole you have to deal with men lo fall control of them are. They lic perhaps us fonch us they lile to the doctor boc they lie more coesistretly tod it may be that for the rollatorie is not so Decorary to know the truth. The lateret be deals with, berides, are wally material He sees hamen nature from a specialized prodpotot. But the doctor specially the hospital doctor ko lt borteReticences and poorally be andermtoed very often there are dore, Fare for most part will shatter every defonce crea vanity is amperred by Mont people here: furious Itch to walk about themelves and art restrained cody by the dildocleation of others to listen. Reserve la un adiant quality that is developed to most of me but us the result of Inanmerable rebuff The doctor is decreet. It is bls bostoess to listen and no detala ee too Lndmate for his en 3 ro0 IN THYHYBCIAR'S II Marttila ·Oliver Wendell Holmes, Willum Carlos Williams and Frok Slogbier " From Sweden come coc of the greatest writer-phoideos of our 14ge Axel Munthe whom immortal book Th St Sa Michele 'bus drama pilgrims from the horld over to his vill in Capri, there to lean-u I have done on the stone ruling custodia by pak murblc ophimses, Ororhanging his beloved most author of Homerle kogends 1od gaze at the scintillatioy alrer blae miten XOVIN MUOD TO THI Nax That is no pleasure to remarding u baring for lift long friends 1 for selected writer whose lospired ideu apsultike proue, Halle uod imal axace CDbroider with cacharing color the gry momotoay of oor daily lira As Haltı There are only three plasures in life porc and lusting and all derived from ioanimate thing-boobs pictures, and the face of oature. In literature, the phyican loobs for 1 Loreen on which to project the images of bis oma fancy For u Sur Thomas Browne uid in his Religio Media We any within all the roodos w rock without us There is all Afrius od het prodigios lo o. non TONAL AND ADD TINC UXADDIO It is the physicus s duty to read and stody tortboobs and reference worke, medial journals and other publications that will refresh ble basic knowledge and keep hima abreast of the latest happenings in medicine Ever since man developed the written word oodicalvoformidon has been minsmitted down the generations la inalculable 1mouni cortulaly do odc mould crea dream of readiog all the abundre material Wesball mucodon only 1 few of the most famous medial bookchellar compiled by Ralph Major plus o fer morcod cved this short list will resound like clarious like a roll all of mobip ready to cater wo epoch-making battle in History The Egyptiso Ebers Popru (c. 1500 BC.), which deinbed conditions like noglou pertoris and contraceptives the Corpus Hiperattu (460-375 BC.) basis of modern paturalne medicac the morb of Gale (c 130–200) laddmark of a perimcoal medi doe The Cawn of Ancona (c. 1923), the Bible of Medicine for more than a thoukod rear De Howal Corporis Fabriu of Veselios (1543). prelode to modern science De Mar Cordis (1628) by William Harrey berald of modern physiology Do Sodlihts by Morgagal (1761), balc pullar of pathologic toutothy As Ingatry besosh Cars oud Efrets fih Vmnar Vacatu (1793) by Edward Jenser fotodation of Immo ology Delaslah died by Lałnoct (1819), which matrodaced one of the most valuable duagporuc methods to dlalcal palce Dt Caillolapbaligh by lichon (1855) which rezolatioalued pathology fut us the Principles and Practer of Middle I ord me love coortent coopalon og Brhlab subors shoot Sorrtoon, Caroto, Coon Doyle, ud fota Dach. I do pox de acron to tbc Streno a Trent wedba to Hechteroon The Mad Dathanna, The Hour oba koo ter o mor holou the Chenotou de Faber broni , karlfrder bh poros, boroba, od Literary attico; I do not Mort de Coom Doyle of Berlock Ilobu a Dehullottember of the world word, Hidal and The krogu ndikon the Joba techad The Majam the brands and The lor Entrei norr tha Ilock bort al T 501 WD WILATIONAL MOOGIA ·of Willian Ouler (1892) fevolutionized the teaching of medicine, cod Calais Alle megle the teaching of modera histolog There are but a few of the Immortal medial boobs which like the runner of the dinlal Manthon, bare for the recentom pussed from hand to had the borlog torch af modical cance DI NAM O D Tog Of cours, the pogucion needs to read nod stody basic town of medicłac, the Ro-alle former banks which furnish cuential information on my specific media! qoordon What qualita zbonld we look for in the boob me coosale? Hot of all, ony Ardance book aboald Indode do opinion of the cathor except thox that belp clarify or define the rubject onder hods snything hypothedal or a perinacotal should first be published la the form of ordcla la somme foaral and only in a textbook when research or clinial appliation cod confirmadoo by other cienda bate prored It to be yolla. Clenty of expondoa generally goes band to hand with beauty I have actor bellared that a book must be obscure in order to be identific. The best teachers of medidoe all over the world were good writer in the kose that they were clar Frequeady they were also given to beauty of liary styl, but can then the urt of wadog wel was simply the analization of clou thinking The worla of Oliver Wendel Holmes Ouler Call, Conde Bernard, Hunty Coshing zod Sher dagton ure u limpid us they are beatiful. Ther concepo stood out a very p4 like polished pebbles to the calcar waters of their prove The light that Goethe frantially berred for on his deathbed has always been the guide of good medial witco Mray of the obstacles that thod in the way of the progrew of modern pochlutty derfre from la grotesque termoology e re muldfarm pogon unecesarily coofmlog, and from the compalator felt by masy colles goes to express tenemos obscudy od technically to the lace only a few will oderntand ther, they will be ablect to a minimum amount of cridictum. Not only don t I onderstand the myitou dialect of paychiatriste, mid Maoutoa, but when I hear them speak, I coraprchend but half of what they may This is the mont deplorable since the verbal style of Preod himself-od before him Charcot e dielalc and Knepella didactic style net one of the finest amples of durity cod harmony Theft prore wu beautiful beause of io peltood staketry Accuracy durity dimplldry there should be the attributes of good medial reference book if it is to become a constant and pleasant source of loformation for the phouden The reference Inty of pricidog poyideo should coatain, above all, the basic turu be bed in his sodat dapat for their contents are a part of hbs profeulonul hom op die mbow boobs dould road in bedwall ha the modelo Per the promot, la roda belinde bent from which you add to your o, bakar batik med my op, betont jablkan pote frpyo. Lo DOC. IN THI TATACUINLIL Northa | 51 ·Loty cience soboosdiaco There should be soppletscored by other more intent bulc wrocla lo those disciplines where the greatest propex hu bera mude. A nokta anatomy trabook differs black from the Testos Anatomy from which she studied, kod the buic chapters of thbtalogy like Cajal s oss phylology kike Gleys or Sherring toos hate changed little acope for section such u Endocrinology which is Falu day had mstonic, morphologis, and constantloaal moge od podsy is labora Frog the study of glanda endocrinology croired loto the soudy of hortcode nod het into the study of the latter s biochemical principla Pharmuscology has changed oals in the sense that when new rubetroces have beea Added to the pharmaceous usual, ofted with onerousy kuste u happened with mamac amimalunials wd chemotherapeutic which looked promitog but because of their toricity turoed out to be spectacul, like the smoke from a kam fire But the banc pharmacology of the main drug us not radically changed Bacteriology du conched ios pisople with so many sew miaules that le toquises Den supplementary morbo Som dupliac like paychisty which twenty yan ago were etalocally phila ropuls, bure become blochemical and physio yaamic and hate extended ther iallocace to disciplines formerly for restored froga them, much u dermacology physiology and broccology The basic texts from which we studied seilt palat out tbc brand parts sloog which medical thought in the different specialties su kod sbould not replace them by other teru marul thert hare definedy proved theur Talte by the laboract abry OTOK o cooremaporary medical shooghs Bu che medical book, the forgorcen end crou depend pordical book, bar (with che exception of dhaplina mach us sostomy physiolog uod pharmacology which sull defend themselves behind the solid walls of bage thick volwa) fought sod four bactle against that clegans Sesto srod youmic publishing pranon of otur day that melal topograph. The monograph o por a book but that. Itay Chaana nay modern bank, bx study it shoraşug and us whitener 100 gra kerekde ora from noch wart a rede de peste oor there was the unga med att fram - Sastoon. Our of tack cana younds wanakult a to nie porsels road at forhand, Daly which got da trhu o mass of wisdicu k it lopcalmod Drony korrow ca o condomly chrough those pales of pornst which was grote check are widapeneable to frient che mud ambition of TATUS 1 Trecarday konca solters kom a kuona acosta, from zo inaalaren eriday for treyttung chat graçt ap made the amo di bacar but which is cally strongest so tu kicsa. Tar arm choci merused by wbOW to che una pobudo proxen Skatt i betocopied tant worship of the latter alranka saat kame, soment demands that hen an dikorsies be given une en artth telan hry kant kan xma. The krenar always askes sich precautiomo sol in by debanon, back from curorul apared the day before recorday Tree kene chercher das ao ure the form of the boat nght of de gram, ber of the treate the wtU thoort af om me msc coporum the croton but must row the medew comis kommun pocket Slam bus bedste a sight Asd not only the statent for the spinone cheulah deo be car thyerahi tead of the reaches than a shag more relia than the strice idu eregant Souls go back to knechod book every carry yours Deurne the desacerTTG Porteons' proponat tereny rokay bag an riva sinulle aangrum without sich all the late produion to CTS 2 wo ty TOTAL $120 ·of book, It s pot 1 metro bot a dd mot a nymphocy but in costituent chords coolased loro us lstellectuel shorthand to utify the huste of so Impatient grow caution Just the Ame the medial book boll u it mula Yauliu tlmc, the cornerstone of the monumentul forten of mallar borligt in our atomic igt. Medicine in a kdance who programe Is Wonogaced in medial Journal but is cooral dated only in boola. For the roag phydden the medial book is guarantee of the dude Lolidity of his boom bor just us for the egtos pueddooer it is a companion wbor wiedot bw grows aloogide bls own through the years Faced with the rightening number of medical boola lacently poblished J over the world the phydidat most lan to discominance In bis reeding Hc mort sont Life has become too complex and too difficult and so mu cho today visit all coantoles, u Marco Polo did not an be work u ull profesiod, u Looando de Viod dld be cumnat love all women u Condo1 could nor red all the boob u Thomas Limace dld There W. water Tharu Walfe, whose wort for life and morc life made hito wrot to do all things him clf The roralt mu conforloo bewitching perbape la literarute bat pathetic ia llfio all his worla and cren in hb Ilfe u cvidenced by his lenning on the age-old stooc embankment of the mo mantic Seloc only to piac for the dunk amells of the Brooklyn Bridge The phruidan s librosy co be clective and will runge from the amstere almplidty of Thomas Sydenhamn and John Reddifet to the splendid hominem of Gay Patin od William Ouler MODICAL JOUDAU AR TU XOLO Medial youmala comptate the priodpal source of medial Infortadion today Every year 2000 medical boobs are publlabed, 900 of them to the United Sate und from 4000 to 5000 medial Journals, Darly 1500 of these in the United Stata. There Jornals are claxlied toto three proape monthly (3 per cot) Hmoothly cod quer tedy (33 per cent), and the remainder weekly contully or spordially The volume of medical Journals today ba to grant that there are spedal poornals devoted to abstanco Hands appeurtog la orbes jouruls. It has been calculated (Nathan Flomao) thet 5000 of the medical Journals pub Ihshed in a slagle year represent about 11 milion pages of text which, if aligned, "The beloon be lobo Red) won por lo cho the horvol of Man de wet or adatra to mbakom by dos Applicated to the pubbliche of Amequity In cold by Yobtut regard Ayo be thoroughly poris, bet by and tortortion of the por nibble Trouble the new to Liste for modernElle Dooky, stal Student of Agrict for wo wobb bordoor best well choras do for to bule Di Duters, the Head of Toby Colors the point in te kontorisy be the one vorhry bespre bicompory to commendedor la poesiaWho We keelt Upon which pobolg to Thule Hello, Fabel bratobot Awesome TOO A TI PATACANI LIM Blottaa ·would stretch from Chao to Seattle, Wuhlagloo.* No ove therefore, aun por sibly even scrutch the carface of ruch a huge min of literature but it is posulble to pick out the highligha of medlal informadon. Above all, we must dedde what it is that must read wat we should read, and prhut me sort to read These should be our three alteria in the selection of reading material We should read crerythiog of immedute paalal dgnificance to our daily clinical wbricatific research or procalocal teaching In selecting rach outerial the praudog phyiician can be guided by the requiremeno imposed by his om dally clinical practice keeping Informed particularly on all Dow dlagnostic methods or therapeutic weapons related to the came bc is treating The research worker is la « different posidos. Not oaly must be know almost cverything other research workers are doing a case he ceo we way of it in his own research cod thus are himself years of work, but he must also keep up-to-date on the most trinal development in his own field of research, crea though such dau may dot be of immediate practal importance, beaunse in research anytblag may soddenly become important The professor of medidac mac boot craythrog that improve or cheagoas the sublect matter be teacher, crerything that espands the area of medical learning hc most crich bis basic material with the detest coatcibatious c.antibiotic medidoc which bu changed the teaching of the natural history of lofcctdoos Ia addidoo he most be informed about everything that may widen the calcurul horizon of tach 208 and fully everything that contribute to the progress of medidoc. Thw we see that the practiang physician must be guided by his dally wees ebc research mua by bks daty to crpand his research, Lod the teacher by his desire to carich 1od improve his teaching But to a certuo degree all three the practitioner the research worker zod the medial rescher shonld engage in all three ategories of reading devoung the greatest part of their time to what they must read, what doc they bure left over to what they magh to read and any time they ad stal to wbud tbey want to read. Frequeouy wbuc ode u rad an be found la the basic medial coxu nod rd cresce wotba wat one mgbr to read in the most important medical Journals and what coc xows to read to the clinic boob we discuted carller Bot reading acdical journals u 10 Belf a problem, no matter how much we limit oor selection Thac ae three ways of acquiog the medical adco we wiot to red by subscribrag to the Journals that publish them, by visiting medical libraries or by writing to the anthon for repriot First, bometer pre abould find out what Ia benog published so that we may Kelect what to include to our daily curricalum of reading The mban daklo sporta lapormah Hatun with wood wloo. I 1945 that we 50 ne on oln 12 chet of 1100 dickaToot me torte, urek w rol! Introds who arte dolor de profesional important La toa Valtel Sunta, lo ante fe* cloor there are 175 wicks ou plaal trout for the eletrod 12 Belical thero forbundnak, wwe 20 kla o uterlodorodhaduw more on CB x hyphes SI XD CTILYATOM inIOGIA ·T TALOO o coCAL DO The Laswer to this problem are the formale of medial abonatswhich if well dose enable us to pick out quickly the best gruin from the forelle crop of recept findings There are two types of journals of medial zbetrict Coc aura pracally cverything pabllshed In given specialty The other is relecdire ather than a haptive it gives the practitionc only what is of immediate praedical importance particularly la soch spedalda us lateral medidas, obstetda, and gynecology Other spedaldes, such u endocrinology and psychlity require that the phyldun know if only for reference all that is bappening in the fields in order to crercise blo profenion with skill. Medial abstracts nafortunately are not alwar wall donc u. playldan is hardly the fittat person for this task. Perhaps the solution would be . Atndard form for sbottecta of a predetermolned longth mod strctur, alling only for the fundamental data of the work Medical editors would then pollh tod found out och botnico lato an accepable fioul form. This certainly would dmplify the reader, tuk. At present, bowever the reader must be content with what is trilable Actually an abstract should be a complete abort short story with a beginning middle, and in cod. A toelaul abetreat hould follow figuratively the name procedure used by the Indians of Ecoador when they wholoka human head to the 11e of an orange without spoiling the harmony of io proportions Of cowoke phyidan mort be careful not to fall victims to what Moruba called calcat To bere absol te faith in everything labelled whence, or to convert lato dogma sayahing publlabed by well-boomJotunnle, la to anulate the phyni deos who for hundreds of yean believed hliadly in the books of Galet rod Porn celur. The danger of dogmadlom lo mediche lo pot in whether the dogtu at good or bad bar lo their belog dogmus There is danger to repladog experience and te rearch by authority nod in attributiog tofallibillty to the laun lofallible of all kdenca medicine Many physicios bewitched by dedific dogme, excrtice the simplidty of basic Informacion, which can be us pledd o little water capped in the pule of the buod, to the torbidity of a torrent of derdfic etodidos, modded cren farther by che men of bibliography with which mosse cathon borden their work perlupo to cover up their fterility of thought, We often forget that the importal wrotlos bequeathed to us by the greatest coachen of medidoc are balle on a solid framework of dende deon, with personal en word aperiences trorea sound it iod only a pertinent quotation here mod there. La dels reptes, Narodna med et lorem el benestar Sbobe, de pomme trade thout with more from bad mom.co betont banca morte, to bearbor cely in hat to bow to dowbs, badort bor tudi Aletta BOOD THE PITUCIR I LIFT ·TO MEDIT AND TUTUN O VIDICAL ADVERTITKO The third important source of Kocatific Information for the doctor today 1 courte worthy of a place aloogide cortboola rod medical jomis, fo the odentific litera turt prepared and scot to doctors by plurmuceutic compania Only a few yan igo soch literature ou considered-dghtfally somet adres ulag propagenda in the worst rent of the term Today the modlal literature lerod by pharmaceutic companies, eod often prepared by medical ad rertising Agencias has become an important source of body comtaladon, reference, od mediaal dacation Spedbally in the fields of eodbiodio vitamins blologic prodocto tod hormones, it an be wid that pharmaceudc licenture 1 not only aboodoot but also precise efective, ethical and cuadonal. To a certain degree the croladon of pharmaceutic advertising hu followed . coone that I would compare to the coolation of palodag la history Clinic paint ing represcoted aspedally the physical bulk of objects and persoas the improt sioolsts rekgated photographic representation of porial balk to a abordlaste level 1od proscated light and shadows moderno surrealistic art represents the ida of thuogs the very soal of an object. For Velinques, a bomua belog was the specular image of bus paylaal make-up for Seurat, the homio being wu 1 com glomerate of any polychrome dots of light for Piauso be la geometric abstraction Summag op, desde art represented shags impradonlen, the light of thlon modero art, the two of thing Classic art was photographic sad visual Impres 110011n appealed to the sensory cod emotional image modern ut, to the latelligence u it presents short of things Pharmaceutic advertising begin by presenting a photograph of the products fol lowed by a verbal description and a cumbersome iconography All put phares ceutic literature is cluttered up with bortlos pulls impules and ulre tubes The revolution begao when soch adrerdiung represented the properties mod nos of the products involved Modern pharma.ccade literature presend she like behlad a given product the philosophic concept that motivato cod postibes it A recent campaign of pharmaceutic advertising on the combined as of 100btoda uod viuamins for treating the clologic agent of an afection and the stress aused by it was based jaccessfully on the introduction of soch a coacepe in medial thought and later co tbe lotroduction of the product incarnatiаg that des Io my oproion the medical liccrature of the fature-including toedia ad reruislog wil she io present form od become onetime limem Whep drug is an veals accepted adul becomes a part of the basic therapeutic uncnal of the phyudio It do looger cards any advertising it is enough to inform, guide and cacate asus to how to use it A racclac u borbode 10 corbrocic already tried and proved doc Dot Deed ad ertuag all ored is sechoial informadon on bow to use it as I Let it, the monary mission of medico pharmaceutic adreultog in the far re will be docuocal to complete the work of that Proroou e Medicine which is the Vaiade of the Future Menowbike for the physici a who cao WIDDOT the bad from the good to the fusa beared on a drog who bus 18 ge for picking the oggeus oor of the cattered 561 ID DIDYATIONAL STOLA ·mioc of information for bio pharmaceutic literature kapiceless lource of medial kpowledge and en educadanal vehicle of unique viloc. Tha s aspedally tree of poyadım who pride in isolated regions where it ako months for a book or a joumal to urdre. This conatry doctor beep abreast of the program of medicine through edretuing pamphlets and leaflea, u colocfal u pescock , plumas but which contato coformation a cleatific and prax u the alculadoos done by a Proceton mathematido ILADUTO FOR DINLOVDIRIT Now we come to the reading dooc by the parede w a member of society u 10 Individual parddpating in the life of 1 patioa, - pedod, a colturc, 1 cvilization. As human being • phytidan muy copy recration reading poves, short rtona, poetry murel boobs, o humoros literature. As a profesionl he must read ipfordve Liteature scientific boobs modial youtule, kod ocher technical pobllcatsoos But un individual functioning in society who mnat contrbote to bls country growth unmation cod to its unternal functlog, be must read worla that help him to improve hunkelf od this enable him to improve bb caytronument through the lofincance of his shooghto hla wards, hla pau, cod his actions Soch reading for improvement may be clanified u deadfic (co the progreto belag made in the biologic, matural and phyical scienco), philosophis, historical, podologs, or reading in the miscellaneous utt Yet how can 000 uut the overbordened precidone to devote time to reading out Lo not directly related to his profession? If he can hardly keep abreast of the latest development in his owa spedalry bow will be find dime for abotruct or theoretal reading of no spedfic appladou? To poch objections, I woald uy that one does not hurt time on malus it. We must be does nuspicker wc mot copy those great teachers who watched up the olppet of the gold dust of time tbore minutes quartos of no hour or half hora wusted during the day to foolish charter to the overlong telephooc call in the ci paper or popular muphone that fell lato oor hands and that we read out of sheer curiculty in the time teallog vuit from somoc HUSET cod chose loog venlig spent with yo gloed to the telcinoo xcreen Elimination of each unprodaahre activitia would yield the bodr or two for the reading me to badly Deod. HOW TO DD TO TO LAD If we intend to devote on boor or two cery day to reading me out organize our time with the greatest chatica. Pertapo le would be wise to follow the advice reacher once gave me to imagroc ut all does that we are about to embert on no atended journey The day before we leert we do the work of several ders, we take are of soy number of detalls rapely and eficieady we give auch minute la fret doc, aod pre lave crayıblog la onda If we could more to coonide each day us the day before the beginning of a boog trip, oot only woald we have time left for reading but iho our lives would be filled with effective activity cod eccen. DO00 IN PATIENS LIEL Wart-butta ·There are foar rources of dme where we can find thore precious moment o acces my for rounding out our cultural lives The first od most important source the bare fost described gathering up the gold dust of time od making auch minute field its maximum naloe مل 4 Or T. C.200 TAON There is a second source lo Goethes advice, to mialy rummaded by Andre Marrou Let mellmloste from our lives all dmcderourers, the ambals who feed on our minute and bours, Moliet of her whom Moother lant alled chopbeges (dmeaten) Chronopkopes Maurou uid " have no mercy If you allot is, they will seal your very last monacot Actor realizog that if they had left you alone you might have accomplished something worthwhile Colomologus burc do kruples. On the vary day wir is declared, ı allows aume-ater will brak in on the Chid of Stuff to discoss bus jacutor scoasaiption. Cbrowop tops operite by means of vielos telephone calls od leccent If you show them hay patience or kiadou, yoo commit a grave You must treat them without hoy consideration, for to allow them lato yoor prerace is sheer sodade Gocthe once uld that if one wuhas to do something for the world, one arust dot Uow the world to uke hold of ooc. This is legidmate advice for If we do not acceed the world us the first one to reprouch us for belog a fullorc You should bot go soy where the chrome will say for you would be negleculog your work Aod with his very acrt breath be adds "Come to dianar comorrow And you most refuse for he who allom himself to be swallowed op by soch people will octet see his work completed The third source of umelis in cutting to the bouc the time we allow dally to reading coo many actspapers or dem magadlacs. As durces of 1 cation and pardd por ua a bistorical cpoch, me should aspire to be well loformed about crerything baffrolog 10 the world But to exaggerate such an ambition lads us to devote too many hours a week to reading the same acm in different perspapers zod nurlow Articles on the ume subject in different magazina to lustening to the same nem Over the radio at differeat hour andrek mytro San-to ching televisioa programs that we would DCTCT ut og i ubcater KateCO Thus the time we could derore to useful thing is ucnfced co o fake sox of accomplohmcar. La gamat it is sollicicat to read ons newspaper a day Nor do we need to read it from begioning to and we should learn to read rerucally by archiog the tract of what crety srude or report says As for acws magazinet one a week is coough to sopplemeat what we have learned from our dady osmipaper Repetition of akless reading matctul moskes os throw away the most precious of treasure and the most difficult to keep time The cat soorte ol ume u ou pare time What should we do with 10 Should wyt read stonds inloge in some sport home detraction, or that is called "bobby? I confess that I mortal coats of bobbies Mons life should be divided foto WD LYLTINATTOUL Trogi ·three parts a bomoolooly balmaced as possible work, rest, uod recreador. Red 198 sbould be os doch 1 ftarettes hobby An obscatre bobby that becomes the Moloch or all of ooc s free tratore is a ful crror If a hobby-collectiog stimp Brembling toy malos, breeding acarios really so lateresting one should devote ooc s life to it, it should become one s profeulos. Let us drak from all the cups catertiamcot without getttog drunk oo say or A hobby aunted to entene may be the reason why a phyldim bus do time for cay radios aside from prolantonal com and son magising. Many of us love chess the movie the theater and there be no reed to gire op och pestimes altogether bat i must decide what is more Itaportaor in the scale of life. Tuo be us aperta lo ove or moreal babbia, ar to be a good palced and analoeble member of the society in which eltre. The choice should not be open to any doubt. To sumurta this moblective eyelastion of whar a phyddian xbould do to make time for reading and smadying we must not allow details to consume our lives me marche de pics to others everything they can do for os me muat lite dyrarber thng fu#, datos the important things in ead the mlmporteat oues DEVET KUMANDOC Labord What abould the phylder rund la history philosophy the arta nod the ad Coco Let och person shook ho owa road to homaolam. The roads leading toward that goal te u infinites the roads toward the mon, but ach man 1 or wo Da s road boladiridurl u the road to Damascus wu for Saul of Turin. It ás a good Ider to relea 1 busk tot lo ach one of the fields mentioned bring it compass on oor royages over the sun of culture. It should be a dear complet, and not too lengthy text that an be mutered without oodac effort uod supplemented wich monographs khort booles, and magazine article on the topla of greatore interest to . Along with this general cycle of basic reading on which we graft cplcycle of complementary reading. we should inclode the cloxia la ceoce phillosophy his bory literature, cod (be uts, for their Tor not only bring back the past, but allow tos to commode with the great hlotodal figures whox thougho are almiy as lospiradoo and bone liva may get teach us manocthing about ot own Allenby campaigns la Antbla and Schliemam dlecovery of the Kurd of Helen of Troy deared from the fra that they had read the Old Waco General Lylacy was ofatly relieved of his post in Morocco be consoled hlouclf by reedlog Shake Bart Carteles * Palacere found colightenment in Tacirw od Marco Aurelio two writers who have elmy provided guidance for statomica, Jout us Kipllag wad Cornate bare Inspired mat of action, and Romato Rolland, Aurobindo Glor, Ramallahas here polaced the way for humains iod thlaken Naturally roadlag for improvement demands rapeat and coachimedon Walles medial Journal, Donogosph. front artide cus be rad between wiele to potkoon, as the sabyay or to a pleos, la operofice or to hospical corridor that great damical como la sedictae or other doch, la per homophy o history requlio the proper place tipoe and state of mlad. That is the mindman serpect me Consoles Rood K TO MINUCIANI LINT Marttimies ·to the authors. The reader bould become worthy of those grat boola, for us Migael de Unammo uld of Danu lait the important thing is hot what the author marot, but what och reda too Of even aratos To obain the most out of the great boobs, most approach them u traveler approached the old Spanish 100 to Don Quixote, dme. Since generally no food wu to be bad at there is the abundance od uror of stareler 1 repast depcoded on how all his kapack mu stocked When we read Gibbon of Oliver Weoddl Holmen, Talde or Osler Volare or Cajal, what we derive from there is in direct nudo to the devotion aod repect we give them. From boola u from love to receive u mach us we give DY MA O LADONO DX TAI LETY OF MOMIOIKE The papucina mast laclode in bus program of rading for improvemeat books of medial hintory hod the great warb of the denial paride The reburth of the History of Medidoe hus Impelled many physicians tt fint out of latellectml curiosity 10d later because of a spurimul need to peer into the well of medical denia add to recogaire with utopisho.ent that many clementary basic truths long forgotten, an be learned from them from Call us from Clande Bernard, wc may not learn to dugoose the richetorio bat these muren an belp us to develop melal od daal ecumen nod to apply it competently and with wanna do diagnoru and therapy Sach classic boobs are like the incicot worn out but iodispensable cools bequeatbed by a watchmakar to bis son zod by the Larter to his owa soo, rools which often are of greater value than the most modero uostruments For old cools were luhiood on the basic requiremcow of the trade us lastactively fore seen by the bora orten. I personally read the closila oftolthough or us often u I would like I read De Cali cvery night at beddme opening the book at rodom, for I know that, like a healthy trec thut yieldı only good fruit any page will provide food for thought There are payidios who rebel at mixing required readiog with the reading of medial clussa which they lo hay case consider a boring, uod cren dangerom par time Perbags they are at bottom frald that the custa may disagree with the en thay thcmxcita ciwn with the rocthods they practice like the Caliph who camed the library at Alexandna to be borned because If all these books are lo Temat mth the Lonto me do not aced theto, zod if they draget they Lic That is spother type of physiden who 15 komembuat arud of too much raadlog for taconsciously be subscribe to the proverb The librartio who fcuds is goner He therefore refuses to rad sagthing oor direaly related to the practical needs of the DOCE Others like Sur Thomas Browse, limited their pocket Ibrary to three booba . Greek tosu medt, some of the aphorists of Hippocritas eod tert by Ilarice But lorraostels there are many physicians who love fool boola od for them radnog od dreamlog about what they reeds ook of the most pleasant octupa tions of thar litos Hith Edgar Allan Poe they ao way to dream is the work of At the head of that logion steals the Gocthe of baleto modidac Sir my life WD LITOLYATTOYAL STATORIA ·William Oaker who adopeed us ble model Sur Thomas Liaocte because he wu cumple of a life of devotion to laiming to medidoe nod to the futurot of humanity It mu Oaler who uld for the general practitioner i el med Ulboury is one of the corrective of the promotors roodlity which bro apt to reakchim It L utoaiah ing with how liatke redag 1 doctor an pactice mediaoc, bat it is utoalshing how badly he may do it. » But it should never hutes to buy a book anlcm cere first certain that we wish to live with It and not just to pass the dime away We should buy only those booba worthy of belag road, terend und kers, which incideally would discourage bed water who waste the dme of worspecting readers. And la selecdlog roch boob let w not be gaida aoly by the odor-often blused cod wrong for they 10 only human, many times too home in their jodgmeats. C G Cagood" adopted Bacon 1 habit of differcadating between boobs to be chared, swallowed and digested tod boobs to be relished He rccorgteaded that we read fine the ioder, the preferice, od one or Kveral basle chapter then in both directoos, forward and backord, until we bure a perspective of the code book, u the tot of wbether we want to buy it or not That was also the practice of the great Spanlıh historian Menenda y Pelayo who pomossed the amazing gift of gruping in low theo bulf so boor the counce of 1 100-pege book, the something good wbuch Don Qutrot aid that even the mont book contains I confou that I am gallty of reading too repidly Yet, although my trup la rather fust kod although I have developed a method of keeplag keven a mort booba excluding medical redlog moving ach week, thus averaging about.book day over the period of a year I have noticed that time is making me more aclective lo my redlog, for I humbly recognize the coormou difficulty of Impersonlag in the limited time and space of a human life cren mall part of human knowledge. HOW TO GET LLADITO KATTIAL La selecting bonic reading for improvement, w should be on guard yuinst boob of puwing loterert which appear sod disappear as quickly u cetata species of butter fillo lezvlag po mce of their adetence acept the gold dust lato which they tura when auhod beneath the cridetimerdiful fot. Lo general, we should follow Emerson dictum dever to read a book lam thua . Pahaps it is im not to read boob thut are too recont A fenoble amount of dime should clapa afrer their publicados co give on the opportunity of comparing them with other boobs und fotboa. Some booba hayo mrvived through the gas bornke tiey are rentable moto mens of leaming roub a Sur Thom Browne 1 Roliglo Malost or Hippocracia Tear old Cow Doyle hooght dretty "Loading sound to a powdeyn wild shop madde from brain And fall ward the thing that come to be without Who Dowce oblik Candyle see who be bored bone with wood Chica Burn odebram, Wesbaden barnehage of home dhe ne e che per of our A book would be your moyow before you really the same kod about you bene mere to you will star bent dan low prick porn BOOKS IN TAC MYOCAR'I LI. Northuhe lo ·Aphoriaw These boobs are like me cum ballo filled with wooden that we can viele benever tre here the dite zod the inclination bat la no circumstances should they replace boobs of permanent release, the true clasio which are clwia not only became of their literary value bar aldo beczone of theks philosophic depth The pbyldiso sboald lem to discriminate in bu rading for improvement. He boald lam that it is better to ov 1 for clinic author uod anireul thema thoroaghly this all cathor and themes superficially I admit I am lncllood to Torsbup encyclopedic knowledgs, bot only i almal encyclopediam, the blod that uffords on a paporamic viet of hutan lauming through die and space. On the other hand, I believe that the paraldia ibonld above all knon bis specialty thor oughly belore modernog lato other profesional fields Jost a few frleads from among the glands of cligio medidoc et cough to catch the life of a paruldas. If a phyidea boom bordaghly only the worba of Claude Bernard, Ramda y Caja Willie Okler Churia Sharington, Sigmund Freud cod Iro Pavlov supplemented by recent worla on medicine, he is a culared mur, . humuntut rod a true Kicadist. The valoc of the history of meductoc incet cormously when we allow the great philosophers to be oor gaudas us the clauial Virgil garded Dante, chrough the areas of Hell which are the compledge of life today Sydenham. bealthy Hippocride ciceru, Oliver Wendell Holma hamorous philosophy Claude Bernard , skillful coperimcatel cys, Cajal s poble preceput arc more important to the physicans profesional education than tbe at prosent fashion able hastily writteo Liale boobs which try to make ap with a torrent of bibliographic mutenal for their lack of those fondamental concepas within which the phyldens Learning should be framed There is ooc infallible criterion in choorlog the nathors who are to be the cousust spirmoal companions of our lives and that is to select those who are consecrated by hustory A person of CTCA a whole gevention may be misuken in the judgment of a coatemporicon work, but humanity 1 ster mistaken when it consecrata tbe morks of great co. L Drvog To red-sod to read is to dream-is as important in the phralcizo life us dinical aperience at the Mayo Clinic there is a multicolored staloed-glan madow repre Kating the evolution of medicine and beanng the following words by Dr Churles Mayo “Let me partake of your perlearm und I will let 709 dram bere Dy Athu soll mit Love of the grem philosophic historical, and cloud work he should Loow far cooox H Koulard od thou bomul Fort of lord on ol.com Bau vohnc. berbera cbafter by chapter religioaly chery day workedoo, ar daring met al died 1 kl ut De buna letrada crny alongrike The Dello and the love Lite Pleurd Le Relax Cell How the role of Domoyily Tolstoy Did to Mred from of Valchaly the works of Sumpere, Old Kort od stron. And wbrook how do leo indo bord bu duruma kupity WD LOLYATIOSTAL Iritasi ·To coodode, let us listen, before me close the Mugle Door to the fitting words of the Scordih partida sod storyteller Coom Doyle Aod now my very patieat fdood, the amc bu come for us to part, and I hope my lati scomon hate oot bored you over-mach. If I here put you on the track of caything what you did not know befors, the ratify it sod per it on. If I berc not there is so harm donc, are that my both mod your time burc been wasted. There may be 1 xcort of mistako lo whut I bure midis it not the potyllege of the correudomallit to misquote My fodgments may differ very far from you, and my Illiage may be Oar bhorrence but the more thinking and talling of boob is in itself good, be the upshot what it may For the dmc the magic door is realll shot. You are still in the land of frack. Bat, alas, though you shot that door you andot woulin Seill come the dog of bell the all of tekphone, the commons back to the wondd modd of work cod men uod dolly strife. Well, thets the real life after all this only the imludos. And yet, Don that the portal is wide open and we cadde oot together do wc noc face our fute with brever heart for all the test kod quiet and comradahłp that we fopod behind the Magic Door" KILOGRAPHY L LaLMAD, P Vodolo, Mattel, Esper, UL 2 Donu, da Aron Com Tbrouqh das Mugle Door dpd Taded, 1907 3 Doow Joon Mooctors Moscow Carballo, Roylitoa Minh BLEVRONLom Lout boobs Wald Har hatred from The Elmo Lobert Look Sorcmon, Loodan, McDonald, 150 Bocum, Llaka od Counters from Bang ba the History of Mulldon, Balctmore Jak Hople Press, 194 PD. & GITATU, MOOD Don Quoc, Madco,&orcs190 242 7 , M . avado y Foamede, Mode, Toodo de Coca condade, 14 I PRI, O T A Gun, Fro L. The land of box o bucory ML Wew Tock Aard Mel. 34.323 Ay. 14 CAMOY Dar, G J Mokad Curton bato pelosa, Galic, I role 10. Cam, E & Medidlo od Ben Gepe MJ W.147 April 199. 11. (Dome, la bomox, A. Li The paydo ba curet lalon, Am J Ch. & Gy. ) 472, March 193. 12 Carpa, S Lobert Bertoned "The Od weacholy Glogow HLJ 2, A4. 1994 13. Mavow, W SKORT The New York, Dowbloley & Co, 1944 14. Vra, LADO Elodico al horn, Tondo, Aschtrou p. 18 US 1. Wor, L & Wc chell, Na slog vs. p. 22 16. Doctor , JAJLL Ipare D 24, Murd s. 1954 17 More J AX Mom, G Tue bory of And Mod. Lootos to My 1053 11 DOT la Trou Idiglo Mald, Ladog, Schule & Co 104 12. Maps, Law Li lao loports book widow, don Valley V. Low 1912 2. Make Citolo della dagalds, Katek, Eupe, 1971 IL Muke, Prologo Lottoo microcoplas pos De Lodeiro Mayor Cours Hog, Axcloqda Mulla 1 VIL 12 Pins VM bo Monobod pobo lett, 171.3 (A) 2. Pemu Nawn Hormowal Baru JALLA 1410 April 24, 1954 H Miron, Amk Da Art kitie, de Plag, 1979 Holo la mola boldor (amoden u bol, randmeton Ud. Cota 1M 1. kood Fitilan of SV Oder London, Oxford Date Mon, 15. o Coca Coloney. Made of Gre, Placeton, LKL. DOOD IN THE PHAR'I L. Marttila ·Apburismus These bools are like museum balle filled with wooders that we cho visit hecter we have the time to the loclination but la do arcamostancou should they replace boob of permancat relepiace, the true dinto which are clania not only beause of ther literary Talde bat also because of their philosophic depth, The physiden should lan to discriminate in his reading for improveicot. He choold learn that it is better to boon for clinic authors and antrenal than thoroughly to all cochons nod themes superfically I admit I en loclined to worship eacydopedic knowledgs, bat oals i alw eacydopedia, the led that affords ooc a peponimic vlen of human lamlag throagh dimc and space on the Orber haod I believe that the payiciun sboald, above all, kom bls specialty door oughly befort wiodenog loto ocher professional fields Just a few friends from atoog tbc glans of clinic medicioc ut song! to codich the life of a physide. If a phoidea boom thoroughly only the worla of Clande Bernard Ramón y Cajul, Viliam Osler Chucles Sbearington, Sigmood Freud, od Ivan Pavlov supplemented by recent worlas o medidoe heb e cultured mene humanist and a true riendas The veloc of the bottory of medicine focreaza coormonly when we allow the great philosophas to be our gaidas as the clonal Vagil galdad Dents, through the areas of Hall which are the completos of life today * Sydenbarn a bealthy Hippocratic anteria Oliver Wendell Holmes humorom pullosophy Clande Bernards lillfol experimcanal cyc, Calels noble precepo irt more important to the papsieina s profcuacal edoadoa than the at present fublosablc hustily written little boola which try to make up with a torrent of bibliographic material for thdr lack of those fundamental concepts within which the physicians learning should be framed There is ooc infallible criterion in choosing the author who are to be the constant spirirual companions of our lives and that is to select those who are coosecrated by hustory Apron OT CTO a whole generation may be mistaken do their judgment of a contetaporiacous work bar humanity DOTC mistaken when it cousecrates the world of great men L EXTVO To read-1021 to read is to dream11 imporunt la the phyudaas We as diolaal CITTICOCC At the Mayo Clinic there is a malticolored suudet glass mriadow repre lepting the crolarion of medicioe and beerlog the following words by Dr Charles ALTO Let the partyke of your expericaces cod I will let you share my dreams Attuczas bould not Lot or be grem philosophea hinar laul, and chatbc vart he boold Dow for wlett on kuunted with thok Booral word ooc low voor doc ban vet Feber it read cbuster by chapter idetorshy cay uyaran sudion, or doring there f. I live ou Drt Quento broad correny skooride The Daio Feb of the Cape Maud L Box C Meus the worla of Dortomky Tolstoy Deteo Mored drop, Dorton Avery balonchely the most of Batropers, Odd List, and Slood And when some of iten bereket, burimphu Dixdod We woonkpolty ID LOYATIONAL MOST ·21 Mau, Holo bottobronchpes por D. Louya Morey De Cort How To cooclods, let listen, before we clore the Maple Door to the indog words of the Scottish phytiauo zod storyteller Coan Doyle Add cow my Tay patient friend, the time bu come for us to part 10d I hope my littk scomous heyc pot bored you over-ach. If I have put you on the mack of anything whilch you did not know before the verify it and put it on. If I bare not there la do bom dooc, ont that my breath and yoor tuine hure been wasted. There may be a xort of miuta la what I have talda It not the poollege of the coolenudomlbot to mloquote? My fodgments may differ very far from yours, and my Idng may be your charact but the more thinHng and alling of boob is itxelf good, be the opbot was It muy For the one the magle door is still shut. Toa ant odll la the lood of freela. But, uu, though, you shut that door you camor al it still come the ring of bell the call of telepboos, the rom moms back to the wonded world of work and met uod dully solfe. Well, thus the real life after all-thibs only the Imiution. And yot, cow that the portal is wide opeo and modde out together do we not face our fate with braves beart for all the cost and qolet lod comradeship that we foood behind the Megle Door?' NBLOOLAPHY 1. LA ETALAS, Yadiglos, Mec, Esp, 1941. 2 Dorem, $ form Court Through the Most Door Lampds. Tudodan, 1907 DOULA, Jonor Monogah Madow Cabellx Honghen , LL 4 Borneo, Lawr Low Boots Watch More betwood Man from The Beeyo at Robert Londo Barreton, London, Domn 1992 I Pomo, Lydenburg and commoth from Beats to the cory of Medicine. Det berore, Job Hopkb tre, I & CATA, MOULD: Don Quer, Marko, Scan, 1941-1972 7 Borr Hout Chilhados y Dorcel, Modco, Fodo de Cultura Brandman, 140. Pack GT Gun, Fan L The best of thout an bbcory Doll New York Acad. Vol 24.323 AL 1444 Cumor PDOIT, GJ Wora de Can bodo per boots, Post, Garnier, i maten 10 cm, L & Matic cod Donc, Glugor J. 9.147 Apel 1 11. Komm.co, hombo Leo, A X. The playa de la corona dohor, des cheve Conc. 072, March 1953 13. MOLAX, V The Us New York, Dowbly & Co, 1974 14 V, Emano Elica la herto Vilarde, Andros p. 4. 1933 15. Von LSL ver Michel Nordlop 133, p242 16. Docton wang, JAK Sparta , VI1954 17 Monday, AD MALOL, G The Story of And she London Jola Momney som 1, LTO: Lillea Mold, London, Bach, El & Co, let 19. MAO, LA IL Boom baport boob b seductors, Glip Vulky M. J. Jory 19mm 2. Mann, G. Cada delweddu digulda, H, Epen, na Ardozhalal My 15 22 Pan, VU Soe Monour of the Jobo Ladisc, 1715 (A) B. Flowx, Marian Bow hoppebol litorn, JALLA 04110 April 24, 1951 24 Vuona amul O. And ty, Pole, Play, in 3 Hourbo Boder licime (edierten en all, Monde Distr CORE BAX 1. kk Wielopolt V OL, Loelog, Goderd tot tras, 1991. CoconCG Powry Mors of Goa Pinceton, 1941. Bert It DOOD K DE TUNELITI ·Biographical Notes on the Contributors to tho Symposium on Medical Writing Dr Henry E. Sigerist u born in Paris in 1891 of Swix parents had daard to France and Smisterland he lodie orional language la Zurich and Loo doni theo medians at the Ualvarida of Zürich und Munich Dorzog World War I bc Lared two yan in the medial corps of the Swiss itoy As Pontdozent of the History of Medicine at the University of Zarich, be wus alled at the age of 33 to Lapody to succeed kurl Sodbod uod co direct wbut pu at dut doue the best mutate of the history of medicinc He ame to Ameria it the lovladion of Johos Hopkins Uairentity in 1932 to succeed Dr William H Welch od to bad the newly grated Institute of the History of Medidoc Slace 1947 be bus beca Research Associate to the History of Medidoc of Yale Uaireraty (la abrende). He lives la Purn, Switzerland where he is copaged la widog 10 eight volume History of Medidae He is the sothor of numerous boobs and papers Dc Sigernut Is con dered by many to be the foremost living historien of medldoe His teachlog wadog sod amplary dediadon to the belds of historical sad cal rural medicinc have incloenced payidan historis nod sodologlso the world over Dr Nadi Selyo was born to Vienna in 1907 odd Hudled la Prague, Paris 100 Rome. He received his medial degree from the Gertuan University of Pragoc la 1929 and two yen later took bis PhD at the same miversity He was thco murded Rockefeller research fdlomhip wbuch brought bum to Johns Hopkins University and later to McGill Univality where he became Associate Professor of Histology In 1943 De Seyc (DOT Professor) took op the post of Director of the Lostirate of Experimcatal Medlade and Surgery at the Votrerity of Monmual, . position be sall holds Lo the menom he had become a Canadian auzen During the mus he keyed us an Expert Coosultant to the Surgeon General of the Voited States Army His Lurestigioon into the problem of stress begao 19 1936, mich a modest laboratory sodre sncte fadliga Prof Selye bow has 40 assis Los belping him to research Recognized as one of the foremost codocrinologists today be us the author o 1 HI Tolaire Eod idu / Imotstro Amooog hus other works are Smu The Pogrid u En mi Stuus uod a series of droel Retail Struit the 661 OD TILYATIONAL STORIA ·most recent of which is to be published shortly At anthor Prof. Seye bu written over 400 cientific papers. He is so cuire member of Keral dentific cod modlal societa throughout the morld tod en honorary member of numerous other. He bus recerad seal umarda tcloding the Cupin eod Cherboancia Prize for original work in the pretentioa iad traitent of dbank Dr Hagh Clen mu born on Janc 19 1900 od took his nedlal degree at Camberdge Univeauty wbere he also cook first-class bosons in a coace degree. He wu tatera at St. Bartholomew s Hosplul cod at the Brompton Horpraal for Diseases of the Chot He fiot folded the fall of the British Media Jwal la 1931, and wus appolated cdicos tn 1947 He hus for many ran furthered the ednace of medial education idd wriding, werving u cheir mo at the UNESCO Committee on Co-ordination of Aberdog has the Medial Rod Blologial Sot Coca He inidated cod organized the First World Conference oa Melal Edoados, bold in London in 1953 od edited la proceedings De Clegs hus watten fire boola on medial amb lects und during four yan worked on 1 LETIHON of Block, Mellal Dictioоury He l also advisory editor of the medial section of Chambers Ency clopedie. Among other poucoes he is vice-pred dent of l'Union Internationale de la Prome Mai ale zod a member of the Medical Peod of the Baldab Cordd, He live in a village Dear Loodoo and b married to Barocess Kit Engelhards, daughter of 1 min beroa, by whom he bed coc na rod se dsoghter Dr Walter C Almex wu born to Sea Precio on July 22, 1884 cod cook his medical degree at Cooper Mellal College (Staford) to 1905. His portstadiate Handla mere door at Harrand Medial School, After sveral yan of panite practics, be become un usodate professor of medidoe at the Univery of California He joined the Mayo Clink to 1996 # Seabor Coonloot of the Diridon of Medicine uod later Professor of Medicloc, « posidoa from which he retired with the adke of Profawor Emce itos lo 1950. Since that time, Dr Alnate has devoted bioact to medial Journalism. His article on populat med ictae ppear fuer dmes a week in * compoper with t cocobined crcalation of 12 million. Het editor of the yerdals Gorlarks od Led Aluche Onc of Dr Alrare bot knowo Worlds to the BROTHCAL NOT

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·667-pege Tu Nou Aother work that hus been middy read by modlal men ood lay public ulike us his NowWS Indigestin and Patie His poblbed molla udda total over 200. Among other distinctions, De Almura la Fellor of the America College of Pbyudani, member of the Loodation of American Physicians the Amelan Puple ologlal Society the Amerian Society for Clinial Ioradadoo, the Society of Esperimental Biology od Melding, and the Amerlan Gastroenterology Anode dog, from which he recered the Priedawud Media Mala! He married and lire in Chicago Dr Fal North-Ibabas, bomo la Cartagena, Spulo received bis medial degree from the Voverity of Madrid. From 1931 to 1939 he praiced us a paychlaubt in Barceloga und lectured od porchology medical history od 25€ He Yu 2.0 edicor of Kveral melal nad literary journals and publáhed tiro dovels and numerous boola on cagealas popcholog rod abe history of boodidae In 1937 Dr Mani biber wus appolated General Director of Public Halth and Social Service of Cataloala I 1938 be mu appolated Under Secretary of Public Health of Spain Hc orfically represcoted Spain at the World Peace Congressos held in Gency, New York und Merico Chry He mus rounded while seniog u a major in the Medical Corps of the Spanish Alr Forat. After his entra in the Valted Sustos 1o 1939 Dr Marts-Ibaba held the posidon of Medical Director Hc with three leading pharmaceutial concerts who lectured in many Lada American aniversities eod is an bonorary Dxtober of fifteen medial, hnconical and psychiatric issociations He perdapated in the logernational Congresses of History of Medidos. History of Science Psychology and Phycountry hole cloce 1950 to Amsterdam, Paris, Stock bolo, Nice and Rome and has publbbed pepco oo paychiatric and historicomedical obiecte La American and Europese Journals He is a member of the Foreign Press Association and the Suge sod Screep Foreigo Press Club and coodibutor colopos to Lido American pomppens. Andide and short stories by Dr Man! fbibes have appeared in Esparte Tous ad Contry Great to o Anime and umus story magazines Dr Meri Tbiles wis receouy awarded the Order of Carlos J Finlay of Cuba aod Fellombip Awards by the Ambalan Medical Writers Assodadon of Ameria and the Act York Academy of Sarcoco He 13 President of MD Poblations Loc. publishers Okye Icada s medical Journals and Editor of the LHTNATIONAL Rocond or MedOXE AND Gopal Practia Clim, Associate Editor of AXT TOTIS AND CALWOTE 0 AKTION MEDIOXI, and International Editor of be Jornal O CUXAL AND Em DNTAL MICROPATOLOOT D A

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