History of neuropsychological study of sport-related concussion.

Although the medical literature has a long history of description and comment on concussion, the occurrence of concussion within the context of sports other than boxing was not judged to be problematic until the 1980s. Neuropsychological assessment played a critical and integral role in identifying the cognitive sequelae of concussion and mapping out the short- and long-term vagaries in recovery. This paper captures that history and expands upon current applications of neuropsychological assessment in the diagnosis and management of sport-related concussion.

[Experiences and knowledge exchanged in medical consultations by post (16th-18th centuries)]. / La relation médecin-patient dans les consultations épistolaires (XVI(e)-XVIII(e) siècles).

Consultations by post make up together a significant part of the medical literature, especially between the 16(th) and 18(th) centuries and bring irreplaceable testimonies on how physicians could follow up their patients from far away, in relation with local practitioners who were at their patients' bedside or who could visit them on a regular basis. These testimonies are of a scientific nature since they show how illustrious physicians diagnosed, predicted and prescribed, such as Fernel, Chirac and later on Barthez and Tissot, or less famous practitioners such as Le Thieullier, for instance. They are of a literary nature since every physician has his own writing style, and the lay out of their letters often respects codes. They are of an anthropological nature in the sense that a conception of man, ill, with his character, his own life, is rendered under the form of narratives.

'Patient trade' in Germany: an ethical issue at the practitioner--clinician interface in 1909 and 2009.

In 2009 the German media featured the so-called 'patient trade' scandal. Offending against the rules of the professional code for German doctors, some medical practitioners had accepted bonus payments from specific hospitals for referring patients to them. This article discusses a historical precedent for this scandal, the patient trade affair of 1909, in which several medical professors of the Berlin university clinics were accused of having paid agents for bringing them lucrative private patients. Although the historical contexts were different, then, as in 2009, a commercial attitude towards medical practice clashed with the ethical ideal of the economically disinterested doctor.

[The organization of maternity and child care in the Buryat-Mongolskaya ASSR during the Great Patriotic War].

In Ulan-Ude, in 1942, the mortality of children at the age from 0 to 15 years consisted 64% of total numbers of died persons. The main causes of children mortality during all the war were tuberculosis, pneumonia, toxic dyspepsia and diarrhea. In October 1942, the government adopted a special decree obligated Narcomzdrav of the USSR to re-establish the system of maternity and child care existed before the war. The focus was made on the district principle of functioning of women and children consultations and polyclinics and to take measures to enhance the children diet and food vitaminization. In Buryat-Mongolskaya ASSR, during the war period, no epidemics of infectious diseases were allowed. In this difficult period of life the first multifield children hospital and municipal infection hospital with children beds were established and functioned with success.

"A fine new child": the Lafargue Mental Hygiene Clinic and Harlem's African American communities, 1946-1958.

In 1946, the Lafargue Mental Hygiene Clinic, a small outpatient facility run by volunteers, opened in Central Harlem. Lafargue lasted for almost thirteen years, providing the underserved black Harlemites with what might be later termed community mental health care. This article explores what the clinic meant to the African Americans who created, supported, and made use of its community-based services. While white humanitarianism often played a large role in creating such institutions, this clinic would not have existed without the help and support of both Harlem's black left and the increasingly activist African American church of the "long civil rights era." Not only did St. Philip's Church provide a physical home for the clinic, it also helped to integrate it into black Harlem, creating a patient community. The article concludes with a lengthy examination of these patients' clinical experiences. Relying upon patient case files, the article provides a unique snapshot of the psychologization of postwar American culture. Not only does the author detail the ways in which the largely working class patient community used this facility clinic, he also explores how the patients engaged with modern psychodynamic concepts in forming their own complex understandings of selfhood and mental health.

Managing the 'unmanageable': interwar child psychiatry at the Maudsley Hospital, London.

When opened as a post-graduate teaching and research hospital in 1923, the Maudsley made virtually no provision for the treatment of children. Yet its children's department saw sustained growth during the interwar period. This expansion is explored in relation to novel behaviourist hypotheses and the forging of formal links with local government and charitable bodies. The recruitment of psychologists, educators and specialist social workers fostered a multidisciplinary approach through case conferences. This development would structure the theoretical origins of child psychiatry, in particular influencing the role and interpretation of psychoanalytic theory within it. The theoretical orientation of child psychiatry and the practical treatment of children represented an area of dynamic change and innovation at a time when adult psychiatry struggled to discover effective treatments or achieve breakthroughs in causal understanding.

[Curing by cutting. Surgical patients in the consulting correspondence of Lorenz Heister (1683-1758)]. / Heilen mit dem Messer. Chirurgische Patienten aus der Konsiliarkorrespondenz Lorenz Heisters.

The consultation letters of Lorenz Heister (1683-1758) are kept in the University Library Erlangen-Nürnberg. Heister was not only a famous physician, but also a renowned surgeon. This double qualification gave a unique character to this correspondence: The letters allow not only a glimpse on the phenomena of "medicine-by-post", but of "surgery-by-post" as well. To those "surgical patients-by-post" belong four men and one woman presented in this study. All of them suffered from a surgical treatable malady, but their decision for or against the surgical therapy was strikingly different, ranging from definite refusal to ardent desire. In spite of their inhomogeneous attitude towards the prospect of a surgical intervention, however, they had one feature in common: they decided by themselves. The frequently cited "informed consent" of our days was a matter of course with the patients of Heister's time.

Philip S. Hench, M.D., Sc.D. (1896-1965): a glimpse at the early clinical years.

Philip S. Hench, M.D., Sc.D., was a co-recipient of the Nobel Prize in physiology or medicine in 1950 for his research on hormones of the adrenal cortex. The high quality of his early clinical work can be seen in letters he wrote to a family practitioner in the 1920s concerning patients who had been referred to Mayo Clinic. His letters also included detailed advice for the optimal management at that time of arthritic conditions.

["Children are, generally, more difficult to cure than adults". Young patients in the consultory correspondence of the early 18th century]. / "Die Kinder sind überhaupt schwerer zu curiren als Erwachsene". Junge Patienten in der Konsiliarkorrespondenz des frühen 18. Jahrhunderts.

Since Philippe Ariès' History of Childhood scholars have been interested in the history of the sick child in the Early Modern Period. This paper adds one more case study to the current research. It analyses sources connected with the physician and surgeon Lorenz Heister: his handbooks on surgery (1719) and medicine (1744) on the one hand, which reflect the respective therapeutic ideal, and his consultation letters on the other hand, which enable us to have a closer look at Heister's therapeutic practice. It can be shown, albeit with the exception of the lower social classes, that in the case of illness it depended not so much on the age of the sick person than the "style" of the family concerned if expert advice was sought or not. Only one feature depended on age: with the young patients-by-post "surgical" diseases were more common than with adults. It seems that the surgeon's diagnosis "from outside" fitted better to the small patients than the physician's anamnesis-based proceeding.

A history of psychiatric consultation in America.

Consultation-liaison psychiatry emerged in a particular socio-historical context, following a major shift of medicine into a more scientific, hospital-based system. Psychiatrists realized that they needed to move outside of the asylum and reintegrate themselves with the new structures of medicine, especially the general hospital and the medical school. Psychosomatic theory and psychoanalytic influence shaped the emergence of consultation-liaison activities in the 1930s through 1950s as they shaped most psychiatric services in the United States at that time, but they were an epiphenomenon to this powerful underlying dynamic that dictated psychiatry's move into the medical hospital. The experience of other countries tends to confirm this hypothesis, though a comparative history is limited by the strong postwar US influence. Pediatric consultation-liaison had a somewhat different evolution, reflecting the later emergence of pediatrics itself as a field and its strong psychosocial and preventive medicine emphasis.

The crucial decade: modern neurosurgery's definitive development in Harvey Cushing's early research and practice, 1900 to 1910.

When Harvey Cushing announced his full-time commitment to neurological surgery in 1904, it was a discouraging and discouraged enterprise. Other surgeons' mortality rates for patients with brain tumors were 30 to 50%. By 1910 Cushing had operated on 180 tumors; he had a thriving practice, with a patient mortality rate of less than 13%. The three essential ingredients of his success were: 1) a new surgical conceptualization of intracranial pressure (ICP); 2) technical innovations for controlling ICP; and 3) establishment of a large referral base. In the years 1901 through 1905, the implications of his research on the "Cushing reflex" were quickly translated into surgical techniques for controlling ICP. In the period between 1906 and 1910, Cushing built up his referral practice by publishing widely, and especially by lecturing to medical audiences throughout the United States and Canada. His scientific work on ICP was essential to his clinical success, but without his professional and social ability to build a thriving practice, there would have been insufficient material for him to use to improve his approaches.

A historical review of outpatient consultation-liaison psychiatry.

Outpatient consultation-liaison psychiatry evolved from the application of clinical principles learned in inpatient work. The author reviews reports of outpatient C-L psychiatry and categorizes them into four groups: 1) Comprehensive Medicine Clinics; 2) Consultation to Other Outpatient Settings; 3) Psychiatric Consultation Clinics; and 4) Behavioral Medicine Clinics. Advantages and disadvantages of each are postulated, and evolution of these clinics to the present time as well as suggested future research directions are discussed.

The surgeon as gatekeeper.

The author pays tribute to three deceased members of the North Pacific Surgical Association who directed his own career. The gatekeeper function of surgical specialists is discussed, and surgeons are urged to become more active in this role. Increased involvement in managed care planning and cost control, particularly in smaller communities, is encouraged.

A retrospective view of school mental health consultation.

General principles of mental health consultation as written about by Coleman and Maddux are enumerated. Historically, the refinement of these principles for school consultation was described in detail in the literature by Gerald Caplan and Irving Berlin. Common methods define the consultees' problems as work problems; the consultant views the consultees' difficulties as due to intrapsychic conflicts. Resolution of the consultees' difficulties requires the consultant to use methods that enhance the consultee's self-esteem and indirectly provide the consultee insight into the genesis of his or her problems. Thus, consultees are gradually better able to help the client with his or her difficulties. Training of child psychiatry residents in school consultation historically occurred in three divisions of child psychiatry. Training methods were quite similar. The history of consultation to school administrators at various levels, the issues that emerged, and methods of helping administrators to deal with these problems are elucidated. Special problems in dealing with school consultation on two American Indian reservations, especially that of gaining entrance into the school, are discussed.

The first years of a consultation bureau for homosexuality.

The COC's attempt to form a consultation bureau which would supply social aid to homosexuals is presented. The details and problems of forming such a group, including financial matters, type of aid to be supplied, and staffing, are discussed. In conclusion, the total reformation of the bureau in the 1980's is explained. The reformation reflects the change in social tolerance toward homosexuality in The Netherlands.