JAMA : the journal of the American Medical Association
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Biography Historical Article
Samuel Latham Mitchill (1764-1831). A neglected American pioneer of anesthesia.
In 1795, Samuel Latham Mitchill, MD, of New York City published a theory of contagion. He proposed that the cause of plaguelike disease was exposure to "gaseous oxide of azote" (nitrous oxide). ⋯ It antedates that of Humphry Davy by five years. Samuel Latham Mitchill should be accorded an important position among the pioneers of anesthesia because of this description and also because his interest in nitrous oxide was the direct stimulus for Humphry Davy's investigations, ultimately leading to introduction of anesthesia into clinical practice.
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Larger and larger numbers of US nationals are studying medicine abroad and they now comprise the foremost national group of foreign medical graduates (FMGs) seeking to enter the US health care system. The Educational Commission for Foreign Medical Graduates (ECFMG) is currently conducting a comprehensive study of 205,542 graduates of foreign medical schools who, during a 14-year study period, 1969 through 1982, have sought its certification, an established prerequisite for FMGs applying for training in an accredited hospital residency program and/or licensure within the United States. This report summarizes preliminary data on the 17,642 US citizens included in the study who attended 431 different medical schools in 79 foreign countries. Particular attention is given to their performance on the combined medical knowledge-English language competence examinations requisite to the awarding of ECFMG certification.
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To study some of the factors contributing to the higher rate of black neonatal mortality in the United States, we used matched cohort records for California between 1980 and 1981 and for Georgia between 1979 and 1981. We found that at any combination of birth weight and gestational age, black neonates weighing less than 3,000 g had lower mortality rates than whites, but this survival advantage was outweighed by considerably higher rates of low birth weight among blacks. At 3,000 g or more, whites had the survival advantage; even at optimal survival weight, the black mortality rate was nearly twice that for whites. If a reduction in the black mortality rate is to occur, improvements are needed both in the black birth-weight distribution and in birth-weight-specific mortality rates, particularly in the normal birth-weight ranges.
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A study of 379 patients, employed before cerebral infarction and living one year afterward, was undertaken to determine what factors had influenced their returning to work. We found age, occupation, degree of disability, race, and hemisphere infarcted to be significant. ⋯ Although there were no racial differences following a left-hemisphere infarct, white patients were more likely to return to work following a right-hemisphere infarct. Sex, blood pressure, severity of stroke, educational level, consciousness level at admission, maximum weakness in extremities, first v repeated stroke, care by a specially trained stroke team, rehabilitation therapy, and speech did not additionally influence the probability of returning to work.