Written By Ridley
Aug. 26, 2020, 10:27 p.m.(11/28/1013 AR)
Consumption's primary mechanism of transmission is presently unknown to us. Considering the elevated rates of infection in high-density clinics, it is not unreasonable to suppose that it spreads via the air. Perhaps related, there is emerging evidence to indicate symptoms spread quickly within family units and cramped worksites. We again witness correlation between cowded, unsanitary conditions and the prevalence of disease.
The classic presentation of respiratory impairment includes weight loss, chronic cough, and fever. Hemoptysis may be observed but is not itself criteria for diagnosis. Auscultation should be used to determine the extent of compromised tissue. Check lips and fingertips for cyanosis. Measure respirations and pulse.
Given the low probability of survival, especially in instances where the disease has infiltrated all lobes of the lungs, palliative treatment is advised. Collect from the patient names of loved ones or associates who might have been in close contact with them during the course of their illness. Ensure access to clean, crisp air and administer ether as appropriate to alleviate coughing fits and suffering.
The classic presentation of respiratory impairment includes weight loss, chronic cough, and fever. Hemoptysis may be observed but is not itself criteria for diagnosis. Auscultation should be used to determine the extent of compromised tissue. Check lips and fingertips for cyanosis. Measure respirations and pulse.
Given the low probability of survival, especially in instances where the disease has infiltrated all lobes of the lungs, palliative treatment is advised. Collect from the patient names of loved ones or associates who might have been in close contact with them during the course of their illness. Ensure access to clean, crisp air and administer ether as appropriate to alleviate coughing fits and suffering.
Written By Ridley
Aug. 24, 2020, 2:01 p.m.(11/24/1013 AR)
Acedia, or melancholy, describes a range of symptoms varying in their severity. Most notable are torpor and a general negative outlook towards the future and external world. This commonly manifests in a flat or tearful affect and hopelessness. Weight loss is common as appetite wanes. In extreme cases, motor retardation may produce muscle atrophy and wasting. Energy diminishes. A fixation on death infects the mind and becomes an object of rumination. A patient may be inattentive and have lost interest in their occupation or responsibilities. The need for sleep may increase, or sleep may not prove particularly restful.
There are presently two competing explanations on the conditions required to produce acedia. The first assumes some external and traumatic event, such as the loss of a loved one or an unexpected change in social status, and the other supposes a predisposition toward depressive characteristics. There are merits to both of these theories. It is natural, for example, to mourn the death of a sibling or parent. We call this grief. But in cases of prolonged grief, where mood has not stabilized after an appropriate period of time, a clinician must consider the possibility of nervous illness. Most peculiar are individuals who demonstrate these traits at an early age and their persistence is documented through adulthood.
There is no singular treatment regimen for this kind of mental debility. Identifying the source of frustrations may prove beneficial. Verbal encouragement and advocacy is recommended. Ensure frequently that the afflicted person has no active plan to harm themselves. A balanced diet, adequate sleep, and abstinence from alcohol should be advised.
There are presently two competing explanations on the conditions required to produce acedia. The first assumes some external and traumatic event, such as the loss of a loved one or an unexpected change in social status, and the other supposes a predisposition toward depressive characteristics. There are merits to both of these theories. It is natural, for example, to mourn the death of a sibling or parent. We call this grief. But in cases of prolonged grief, where mood has not stabilized after an appropriate period of time, a clinician must consider the possibility of nervous illness. Most peculiar are individuals who demonstrate these traits at an early age and their persistence is documented through adulthood.
There is no singular treatment regimen for this kind of mental debility. Identifying the source of frustrations may prove beneficial. Verbal encouragement and advocacy is recommended. Ensure frequently that the afflicted person has no active plan to harm themselves. A balanced diet, adequate sleep, and abstinence from alcohol should be advised.
Written By Ridley
Aug. 19, 2020, 12:41 p.m.(11/14/1013 AR)
A memorandum on the necessity of wound management following disarticulation:
Physiological trauma to an extremity may necessitate amputation for the preservation or salvaging of function.
The most common developments in patients who have elected to follow through with the aforementioned procedures are hospital gangrene, septicemia, and pyemia. I have personally observed these conditions in care centers and surgical wards with poor ventilation and exceedingly unsanitary environments (floors, cots, instrumentation). In some cases, disease may compromise those originally unaffected, indicating an unknown mechanism of transmisson.
Given the probability of complications when evidence of tissue necrosis or abscess formation is discovered, it is therefore recommended that all clients requiring emergent intervention receive regular changings of dressings in sterile recovery chambers.
As an aside, I remind practitioners that the safest and most effective methods currently involve a sweeping incision about the circumference of limb, immediate ligature of artery and vein, transection of muscle, and sawing of bone.
Physiological trauma to an extremity may necessitate amputation for the preservation or salvaging of function.
The most common developments in patients who have elected to follow through with the aforementioned procedures are hospital gangrene, septicemia, and pyemia. I have personally observed these conditions in care centers and surgical wards with poor ventilation and exceedingly unsanitary environments (floors, cots, instrumentation). In some cases, disease may compromise those originally unaffected, indicating an unknown mechanism of transmisson.
Given the probability of complications when evidence of tissue necrosis or abscess formation is discovered, it is therefore recommended that all clients requiring emergent intervention receive regular changings of dressings in sterile recovery chambers.
As an aside, I remind practitioners that the safest and most effective methods currently involve a sweeping incision about the circumference of limb, immediate ligature of artery and vein, transection of muscle, and sawing of bone.
Written By Ridley
Aug. 17, 2020, 10:52 a.m.(11/9/1013 AR)
On lunacy and other maladies of the mind:
The contemporary practice of institutionalization should be reserved for those who lack the capacity to reason for themselves or have expressed a desire to bring harm upon others. In some instances, if there is a concern for the well-being of self, voluntary or involuntary admissions may be warranted -- especially if the patient has ruminated upon the termination of their own life or, whether it be by written or verbal admission, conveyed suicidal ideation to a peer.
I caution against the use of restraints or psychosurgery, as proposed by some of my colleagues, for there is no evidence to suggest that this form of treatment is any less barbaric than the nervous illness itself. Instead, every effort should be made to discover the root cause of disease -- be it dysfunction of thought, historical trauma, or interference from another body system. So too must immediate distinctions be established between those afflicted by true psychosis and melancholia, which may share some characteristics -- retardation or agitation of movement, despondence, unusual affect, poverty of speech, disorganization.
To do so, it is recommended that suspicious clinicians seek out and obtain collateral information from the patient's close family members and friends. Chronicity may be an indicator of a pervasive impairment and assist in the ruling out of recent or temporary conditions (e.g. grief following the loss of a loved one or change in condition of living).
The contemporary practice of institutionalization should be reserved for those who lack the capacity to reason for themselves or have expressed a desire to bring harm upon others. In some instances, if there is a concern for the well-being of self, voluntary or involuntary admissions may be warranted -- especially if the patient has ruminated upon the termination of their own life or, whether it be by written or verbal admission, conveyed suicidal ideation to a peer.
I caution against the use of restraints or psychosurgery, as proposed by some of my colleagues, for there is no evidence to suggest that this form of treatment is any less barbaric than the nervous illness itself. Instead, every effort should be made to discover the root cause of disease -- be it dysfunction of thought, historical trauma, or interference from another body system. So too must immediate distinctions be established between those afflicted by true psychosis and melancholia, which may share some characteristics -- retardation or agitation of movement, despondence, unusual affect, poverty of speech, disorganization.
To do so, it is recommended that suspicious clinicians seek out and obtain collateral information from the patient's close family members and friends. Chronicity may be an indicator of a pervasive impairment and assist in the ruling out of recent or temporary conditions (e.g. grief following the loss of a loved one or change in condition of living).
Written By Ridley
Aug. 14, 2020, 6:14 p.m.(11/4/1013 AR)
As taken from my lecture on the evaluation of emergent head injuries:
It is best to immediately establish a baseline from which a provider may assess the progression of any potential cognitive impairment.
Ensure that the patient is oriented to time, place, and person. Ask them to interpret proverbs and solve simple equations. Check the integrity of immediate and remote recall. Provide a description of mood, attention, and general awareness.
From such a foundation we may narrow down the differential and map response to treatment, if any is deemed medically necessary.
It is best to immediately establish a baseline from which a provider may assess the progression of any potential cognitive impairment.
Ensure that the patient is oriented to time, place, and person. Ask them to interpret proverbs and solve simple equations. Check the integrity of immediate and remote recall. Provide a description of mood, attention, and general awareness.
From such a foundation we may narrow down the differential and map response to treatment, if any is deemed medically necessary.
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