Cutting for the stone

Stone in the bladder was a common affliction throughout Europe until the early years of this century when for reasons possibly dietary but still obscure it became very much less frequently especially in children. The operation for its removal, ‘cutting for the stone’, or lithotomy, is one of the very oldest in surgery, and indeed, in many centuries of pre-anaesthetic and pre-Listerian era, lithotomy was one of the very few ’cold’ or elective operations to which man submitted, the distressing features of the malady out-weighting the hellish torments and the mortal risks of the operation. For fairly obvious reasons of relative accessibility and safety, the perineal approach to the bladder was the original and the classical one, and it is to perineal lithotomy that I shall confine myself in this account. The position in which the patient was placed, securely bound or forcibly held for the operation remains as an unforgettable feature of surgical vocabulary even though we now use it for other perineal procedures.peer-reviewe

The medical aspects of personal injury assessment

The doctor who writes the report on injury cases should be a specialist in this very specific field of medico-legal science, with considerable experience. In this article the author describes how such a doctor assesses and reports an injured individual.peer-reviewe

An exposure fixation technique for skin graft in burns

The primary treatment of burns by exposure, as against that by occlusive dressings, is well established, soundly conceived in its principles and satisfactory in its results. Encouraged by reports of its successful application in the Middle East, the method was introduced into our wards at St. Luke's Hospital, Malta as early as 1952-53, and it has continued to be the standard form of treatment with us for burns of most sites and in the great majority of patients of all ages. Reference is made to a case study of a thirteen year-old male, who has been treated successfully by this technique, whereby the relative benefits are described. This technique has been used on a number of cases requiring skin grafting of both large and small extent, and have been well satisfied with the results. Skin grafts thus treated are more viable, healthier and more supple; they very quickly become indistinguishable from normal skin. No claim to priority is made for the technique described, particularly as the search of the literature has been incomplete. However, it is presented as a well tried and tested method which seeks to follow principles that have proved their worth in the treatment of burns.peer-reviewe

Surgery in Malta : yesterday, in our day and tomorrow?

The creation in 1676 by Grand Master Nicholas Cotoner of the School of Anatomy and Surgery attached to the Sacra Infermeria rates as more than a landmark ... it is a great beacon which illuminates us to this day by virtue of its survival as our University’s Medical School so that our Faculty of Medicine can proudly claim to be surpassed in seniority only by that of Theology. In this article the author treats in some detail surgical practice in Malta over the last century, after dealing briefly with a few items from the time of the Knights.peer-reviewe

The C-metric as a colliding plane wave space-time

It is explicitly shown that part of the C-metric space-time inside the black hole horizon may be interpreted as the interaction region of two colliding plane waves with aligned linear polarization, provided the rotational coordinate is replaced by a linear one. This is a one-parameter generalization of the degenerate Ferrari-Ibanez solution in which the focussing singularity is a Cauchy horizon rather than a curvature singularity.Comment: 6 pages. To appear in Classical and Quantum Gravit

An electrolytic process for ultra fine beryllium

Studies were made on the electrolysis of a molten BeCl2-NaCl bath using a mercury cathode and beryllium anode. A quasi-amalgam was obtained. The beryllium was consolidated by direct hot pressing of the amalgam at temperatures in the range of 800 C and using pressures of 5,000, 10,000 and 20,000 psi. The work confirms the ability to produce ultrafine beryllium particles by electrolysis

Solving the characteristic initial value problem for colliding plane gravitational and electromagnetic waves

A method is presented for solving the characteristic initial value problem for the collision and subsequent nonlinear interaction of plane gravitational or gravitational and electromagnetic waves in a Minkowski background. This method generalizes the monodromy transform approach to fields with nonanalytic behaviour on the characteristics inherent to waves with distinct wave fronts. The crux of the method is in a reformulation of the main nonlinear symmetry reduced field equations as linear integral equations whose solutions are determined by generalized (``dynamical'') monodromy data which evolve from data specified on the initial characteristics (the wavefronts).Comment: 4 pages, RevTe