Advanced Bronchoscopic Technologies for Biopsy of the Pulmonary Nodule: A 2021 Review.

The field of interventional pulmonology (IP) has grown from a fringe subspecialty utilized in only a few centers worldwide to a standard component in advanced medical centers. IP is increasingly recognized for its value in patient care and its ability to deliver minimally invasive and cost-effective diagnostics and treatments. This article will provide an in-depth review of advanced bronchoscopic technologies used by IP physicians focusing on pulmonary nodules. While most pulmonary nodules are benign, malignant nodules represent the earliest detectable manifestation of lung cancer. Lung cancer is the second most common and the deadliest cancer worldwide. Differentiating benign from malignant nodules is clinically challenging as these entities are often indistinguishable radiographically. Tissue biopsy is often required to discriminate benign from malignant nodule etiologies. A safe and accurate means of definitively differentiating benign from malignant nodules would be highly valuable for patients, and the medical system at large. This would translate into a greater number of early-stage cancer detections while reducing the burden of surgical resections for benign disease. There is little high-grade evidence to guide clinicians on optimal lung nodule tissue sampling modalities. The number of novel technologies available for this purpose has rapidly expanded over the last decade, making it difficult for clinicians to assess their efficacy. Unfortunately, there is a wide variety of methods used to determine the accuracy of these technologies, making comparisons across studies impossible. This paper will provide an in-depth review of available data regarding advanced bronchoscopic technologies.

Unpalatable Truths: Food and Drink as Medicine in Colonial British India.

This article considers the significance of eating and drinking within a series of diaries and journals produced in British colonial India during the Indian Rebellion of 1857. The discussion of food and drink in this context was not simply a means to add color or compelling detail to these accounts, but was instead a vital ingredient of the authors' understanding of health and medical treatment. These texts suggest a broader colonial medical understanding of the importance of regulating diet to maintain physical health. Concern with food, and the lack thereof, was understandably a key element in diaries, and in the eyewitness accounts kept by British soldiers, doctors, and civilians during the rebellion. At a narrative level, mention of food also functioned as a trope serving to increase dramatic tension and to capture an imagery of fortitude. In references to drink, by contrast, these sources reveal a conflict between professional and lay opinions regarding the use of alcohol as part of medical treatment. The accounts show the persistent use of alcohol both for medicinal and restorative purposes, despite growing social and medical anxieties over its ill-effects on the body. Close examination of these references to food and drink reflect the quotidian habits, social composition, and the extent of professional and lay knowledge of health and medicine in colonial British India.

"Ain't It a Ripping Night": Alcoholism and the Legacies of Empire in Salman Rushdie's Midnight's Children.

In the era of decolonisation that followed the Second World War, various authors sought to engage with India and the Empire's past anew throughout their novels, identifying medicine and illness as key parts of Imperial authority and colonial experience. Salman Rushdie's approach to the Raj in Midnight's Children (1981) focused on the broad sweep of colonial life, juxtaposing the political and the personal. This article argues that Rushdie explores the history of colonial India by employing alcohol and alcoholism as lenses through which to explore the cultural, political and medical legacies of Empire. Through analysis of Midnight's Children as well as a range of medical sources related to alcohol and inebriation, it will illustrate how drinking is central to Rushdie's approach to secular and religious identities in newly independent India, as well as a means of satirising and undermining the supposed benefit that Empire presented to India and Indians.

'A great beneficial disease': colonial medicine and imperial authority in J.G. Farrell's The Siege of Krishnapur.

This article examines J. G. Farrell's depictions of colonial medicine as a means of analysing the historical reception of the further past and argues that the end-of-Empire context of the 1970s in which Farrell was writing informed his reappraisal of Imperial authority with particular regard to the limits of medical knowledge and treatment. The article illustrates how in The Siege of Krishnapur (1973), Farrell repeatedly sought to challenge the authority of medical and colonial history by making direct use of period material in the construction of his fictional narrative; by using these sources with deliberate critical intent, Farrell directly engages with the received historical narrative of colonial India, that the British presence brought progress and development, particularly in matters relating to medicine and health. To support these assertions the paper examines how Farrell employed primary sources and period medical practices such as the nineteenth-century debate between miasma and waterborne Cholera transmission and the popularity of phrenology within his novels in order to cast doubt over and interrogate the British right to rule. Overall the paper will argue that Farrell's critique of colonial medical practices, apparently based on science and reason, was shaped by the political context of the 1970s and used to question the wider moral position of Empire throughout his fiction.

Thrills, spills and pills: Bond, Benzedrine and the pharmacology of peace.

This paper examines the conjunction of pharmacological science and espionage fiction of the post-war era. This paper argues that, during the 1950s, the relatively new science of pharmacology propounded the possibility that illness and human deficiency could be treated in a way that better reflected the post-war zeitgeist. The use of pharmacological medicine, perceived as cleaner and quicker than more 'bodily' forms of treatment, represented progress in contemporary medical science. It is argued that this philosophy extended to more overt means of pharmacological application, directly related to the geopolitical concerns of the 'Cold War'. A growing form of popular literature in this period was the espionage novel. This paper argues that the benefits proffered by pharmacology were incorporated into the fabric of espionage fiction, specifically the James Bond novels of Ian Fleming. Here, it is demonstrated how Fleming used pharmacological knowledge of Benzedrine throughout his novels. His works illustrate a belief that the augmentation of the spy's natural ability with pharmacological science would award decisive advantage in the Cold War conflict played out in spy fiction. However, the relationship between public use of Benzedrine and awareness of its side effects changed during the period of Fleming's publications, moving from a position of casual availability to one of controlled prescription. It is argued that the recognition of the dangers associated with the drug were over-ruled in favour of the benefits its use presented to the state. The continued use of the drug by Bond illustrates how the concerns of the nation are given priority over the health, and life, of the individual.