HODGKIN’S DISEASE

Hodgkin’s Disease or Lymphoma is a malignant growth of cells in the lymph system that occurs in children and adults. It is diagnosed by the presence of Reed-Sternberg cells, a cell specific to the disease. These cells are of B-cell lymphocyte origin, and overproduction of Interleukin-13 is related. The Epstein-Barr virus also appears to be a factor in 50% of cases. The disease was first described by Malpighi in 1666 although Hodgkins documented the first cases in in 1832. Samuel Wilks described the disease in a paper in 1865 and attributed Hodgkin with its discovery.

Thomas Hodgkin was born in Tottenham in 1798, the same year that John Cheyne (Cheyne-Stokes Breathing) was busy fighting the United Irishmen in the battle of Vinegar Hill. Like Cheyne, he graduated from Edinburgh University, obtaining his medical degree in 1823. He then moved back to London, becoming curator of the Pathology Museum at Guy’s Hospital in 1825. He is recognised with introducing the first stethoscope to Guy’s and probably England, having worked with Laennec as a medical student in Paris some years earlier.

The 1820’s was really a fascinating time to be present at Guy’s because many famous physicians such as T. Addison (Addison’s Disease), R. Bright (Bright’s Disease) and B.G. Babington (Babington’s Disease) were working there at the time. Hodgkin was a dedicated Quaker who led a life dedicated to the betterment of those around him. His religious fervour ran deep and his liberal attitudes were apparent in everything he did. He was the founder member of the Aborigine Society in the period that American Congress passed the Indian Removal Act and forced the Estern tribes west of the Mississippi River. He applied for the post of Assistant Physician in Guy’s in 1834 but resigned after it was given to Babington (Babington’s Disease). It is widely rumoured that the treasurer of the hospital allegedly said, “I’ll be damned if we give the job to a fellow who has been seen in the company of a North American Indian”.

Hodgkin’s resignation caused furore, particularly amongst his former students as he was deeply committed to medical education and had developed the medical school at Guy’s to great prominence. He was also known as the first person to describe aortic insufficiency. There were more subtle reasons why Babington was favoured to the position and I will deal with them in another issue. Hodgkins became a notable humanitarian after his resignation and apparently he often offended people by not charging for his medical services. He remained in medical practice at St. Thomas’s for a while but increasingly went travelling around the world with his old friend Sir Moses Montefiore, the towering giant of 19th century world Jewry. Sir Moses, an interesting figure started out as an apprentice to a firm of wholesale grocers and eventually became one of the wealthiest brokers in London. His marriage to a Rothschild of course didn’t hurt.

By 1824, he was wealthy enough to retire from business and he spent the rest of his life involved in philanthropic projects. He fell in love with the Land of Israel, which he visited seven times. In 1866 he convinced Thomas Hodgkins to accompany him on a tour of the country. While they were in Jaffa, Hodgkins developed profuse cramps and diarrhea and contracted what appears to be shigellosis, or bacillary dysentery. It was the period before intravenous rehydration and unfortunately he became dehyrated and died there. His grave can still be seen if you visit Jaffa. In that same year the American Congress formed two black regiments the 9th and 10th cavalries with specific orders to go West and fight his beloved Indians. The Indians nicknamed them the Buffalo Soldiers.

Who am I?

English Physician born in Bristol in 1789 and studied medicine in Edinburgh. He was Assistant Physician in Guy’s from 1820 to 1824. He travelled extensively and wrote many travel books. He gave his name to a disease associated with chronic nephritis.

R. Bright

After massive weight loss, many people are left with loose, unsightly skin hanging all over their bodies. Plastic surgery offers excellent solutions to this problem. There are several different surgeries that can be performed separately as needed or combined into one long surgical procedure, called a body lift, if so desired. These include arm lifts, thigh lifts, tummy tucks, butt lifts, and breast lifts.

Arm Lift

Arm lift surgery provides the benefits of getting rid of hanging skin from the upper arms. It allows people who have just lost a ton of weight a chance to finally see the fruits of all their hard labor, because the arms finally start to take a small, firm shape.

The arm lift procedure does have one major drawback and that is long, permanent scars along the underside of the upper arms. For those who have so much sagging skin this trade off may be worth the new tighter looking arms.

Thigh Lift

Thigh lifts involve removing excess skin from the thighs and can be performed as either a medial or a bilateral lift. The bilateral concentrates on toning up the front and outside of the upper leg while the medial thigh lift is great for getting rid of lots of extra skin and firming up the inner thighs. The incisions are made along the hip bone down to the groin or just around the groin area, depending on the surgery.

The benefits to all types of thigh lifts are that massive weight loss patients can finally get toned, thin looking legs but the drawback again is the scars. Fortunately, these scars are in less conspicuous spots and are almost always hidden by pants, bikinis or underwear.

Tummy Tuck

The tummy tuck can remove all the layers of extra skin in the torso area. Incisions are made along the hip and pubic bones, the skin is loosened from the muscles, the muscles are tightened, liposuction is performed if desired and the excess skin is cut off and the remaining skin is sewn back together. The result is tighter, firmer abdominal and no more loose skin.

Butt Lift

This surgery targets the buttocks and the lower back and any sagging skin left there from massive weight loss. This is often an area where the skin seems to overlap itself and creates many ugly bulges. A butt lift removes extra skin from the region and pulls it tight and forms a more shapely back and buttocks.

Breast Lift

After losing a lot of weight many women are left with heavily sagging breasts. The surgical answer to this problem is a breast lift. This surgery involves an incision under the breast and around the areola. The extra skin is excised, the areola and nipple are repositioned for a natural appearance and the skin is sutured together underneath the newly shaped breasts.

Sometimes this procedure is not enough to create attractive looking cleavage so a breast augmentation that includes the insertion of breast implants is often paired with the breast lift.

Sinus problems are quite endemic across the globe as millions of people suffer the harmful effects of pollutants, particulate matter and smog that cover cities and industrial areas. There are many who have chronic sinus symptoms as well as chronic rhinosinusitis. Medical science has conclusively proved that sinus nasal irrigation is beneficial to the treatment of sinus ailments.

Sinus nasal irrigation as a practice has been prevalent in India for centuries as some forms of yoga. Its benefits for solving and alleviating sinus conditions are well observed and documented. Sinus nasal irrigation is defined as the process whereby the mucus cavity of the nasal passage is watered or irrigated with a special solution to expel mucus as well as other irritants so as to clear the nasal passage blockages. This type of treatment has gained prevalence in the world of modern medicine and has been clinically tested to be having no side effects at all.

Sinus nasal irrigation is performed by using salt water solution to which is added some baking soda (sodium bicarbonate) and also some xylitol for killing bacteria. One of the simplest ways is to take some of the solution in the hands, cupping the hands and snorting the solution. Another way is to spray some water into the nostrils, but then the water may ooze out. One of the best ways is to use a syringe or electrical pump so that the nasal irrigation wash solution can be inhaled from one nostril and then exhaled through the other or through the mouth. This way, the whole nasal passage is effectively cleansed.