[Otolaryngologic hospital wards and out-patient clinics in Warsaw in the second part of the XIX-th and the beginning part of the XX-th century]

The origin of the first otolaryngological hospital wards in Warsaw: laryngological ward of St. Roch Hospital and otological ward of Ujazdowski Hospital, both founded in 1881, and laryngological out-patient clinic at St. Spirit Hospital, founded in 1883, is described. The rise of the first otolaryngological hospital ward in Warsaw Orthodox Jew Hospital established in 1903 is thoroughly described. The activity of Warsaw hospital wards and hospital out-patient clinics at Infant Jesus Hospital, the Warsaw Hospital for Children, the Berson and Bauman Hospital, the Wolski Hospital, the Blessed Virgin Mary Hospital, the Evangelical Hospital, the Charles and Mary Hospital for Children, the Warsaw Municipal Lazaret is presented in detail.

History of ambulatory care facilities from a roving hospital administrator's point of view

Over the past four decades, the delivery of health care services has seen dramatic changes. Medicare coverage in 1966 expanded the ability of the health care industry to treat a growing segment of the population. Technology improvements have made great strides in the treatment of disease. Public policy decisions expanded health care coverage from an employee benefit to entitlement for large segments of the population. Managed care growth has reorganized the basic health care delivery system. The aggregate effect of all these items was a dramatic increase in the cost of providing health care in the United States. Beginning in the late 1960s, and escalating in the 1970s and 1980s, the increase of the cost of care was the primary issue for the industry. Only in the 1990s has the rate of increase modified through the impact of managed care, and now there is significant competition for the health care dollar among many competing providers.

[Pollinosis: clinical aspects and epidemiology. Contribution of the Allergy Clinic 1948-1998]

Pollinosis or hay fever is the most common allergic disease in Switzerland and also in the patients of the Allergy Unit of the Dermatologic Department of Dermatology of the University Hospital of Zurich. Clinical and epidemiological research concerning pollinosis has therefore always taken an important place, especially under Brunello Wüthrich. The most important clinical symptoms are seasonal conjunctivitis, rhinitis and in about 25% in a later stage also asthma. Pollinosis in central part of Switzerland is mainly caused by pollens of birch and related trees (alder, hazel), by pollen of ash and by pollen of grasses, rye and mugwort. The amount of measurable pollen is highly depending on geographic and climatic conditions and varies therefore considerably between different regions in Switzerland as well as different nations and continents. Hay fever has very much increased in the last decades; in the SAPALDIA study (Swiss Study on Air Pollution and Lung Diseases in Adults) a prevalence of up to 14% has been found recently. There are many causes not yet fully understood: genetics, different pollen exposure and some patterns of air pollution are discussed. A modern treatment of hay fever bases on prophylactic measures, symptomatic therapy with the now available efficient drugs with minimal side effects (topical drugs, oral antihistamines) and the specific immunotherapy.

[Diagnosis of allergic diseases. Contribution of the Zurich Allergy Unit 1948-1998]

The term allergy has been defined at the beginning of the century, but is often used in a too general manner today. A prerequisite for an exact diagnosis is also the correct use of a term. The evaluation of a putative allergic disorder involves several steps: taking of a thorough history, objectivation of clinical signs, performance of skin tests measurement of allergen-specific and possibly total IgE and if necessary performance of provocation tests. The clinical importance of the test methods varies and their indication should be based on history and clinical findings. Only the synthesis of all results makes a complete diagnosis possible. Physicians, nurses and laboratory technicians who have worked between 1948 and 1998 at the Allergy Clinic in Zurich, have made considerable contributions to the development and the evaluation of allergy diagnosis. After a short introduction to the history of allergy, selected publications from the Allergy Clinic in Zurich are presented and discussed.

[Contribution of the Allergy Clinic to occupational asthma and allergic alveolitis]

Among the contributions of the Allergy Unit the following premier descriptions are to be mentioned particularly: humidifier fever, detergent enzymes, penicillium as cause of cheesewasher's asthma, rennet, wax moth, aureobasidium pullulans in cooling lubricant as cause of hypersensitivity pneumonitis in a hard metal grinder, pectinase, amylase, pepsin, indigenous bat, edible boletus. Starting with these and other occupational illnesses elucidated and described by the Allergy Unit, the importance of the exposure conditions for epidemiology, diagnosis, treatment and prevention is demonstrated. The risk indicator atopy has to be considered while selecting an occupation and a workplace, but should not be unjustly overestimated.

[The Urinary Tract Diseases Dispensary and Clinic of the Instituto Rubio (1885). 1st hospital service specializing in urologic pathology in the history of Spanish medicine. 1st period. The Instituto Rubio in Hospital de la Princesa (1880-1896).(I)]

In May 1880, a royal decree signed by the Minister of the Interior, F. Romero Robledo, created the Institute of Operative Therapy under the gratuitous direction of Dr. Federico Rubio y Gali. Although it was located at the Hospital de la Princesa of Madrid, it was not dependent on the Institutions of Charity. According to the royal decree, major surgical procedures and specialized operative techniques would be performed at this Institute. Thus, the first teaching hospital was created in Spain, with operating rooms, dispensaries and polyclinics dedicated primarily to surgical specialties which were established at the Institute after 1880. The Institute's section for Diseases of the Urinary Tract, created in October 1885, was entrusted to the Madrid citizen Enrique Suender Rodríguez (1829-1897), the leading specialist in urology in our country at that time (his 100th death anniversary was commemorated last year) and whose assistant was Luis González Bravo y Serrano.

[The Urinary Tract Diseases Dispensary and Clinic of the Instituto Rubio (1885). !st hospital service specializing in urologic pathology in the history of Spanish medicine. 2nd period. The Instituto Rubio in Moncloa (1896-1936).(II)]

In 1896, for different reasons and requirements, the Institute of Operative Therapy of the Hospital de la Princesa was transferred to a new and ample site in the Moncloa district in Madrid, with building complexes and pavillions for the dispensaries and policlinics for practically all surgical specialties, with all the necessary equipment. This came to be known as the "Rubio Institute". Luis González Bravo y Serrano, Suender's assistant, was in charge of the new Dispensary and Clinic for Diseases of the Urinary Tract of the Institute until 1929; Carlos Negrete de los Reyes was his assistant. Both specialists' initiative and drive led to the creation of the Spanish Urological Society in 1911. They were elected President and Secretary, respectively, to the first Board of the Society. This article reviews the activities of the specialists in Diseases of the Urinary Tract of the new Institute in the provision of care, in the field of teaching and research, from their brilliant beginnings to their decline in 1936, when the Spanish Civil War broke out. In my view, for all the contributions of those who worked in this Section and its significant influence on the Spanish specialists during its existence of more than 50 years, the Dispensary and Clinic of Diseases of the Urinary Tract of the Rubio Institute should be considered the catalyst and essence of Spanish urology and the Spanish Urological Society.

[50 years Zwickau Dermatologic Clinic in the Heinrich-Braum Hospital]

The dermatological clinic in Zwickau celebrated 50 years of existence in 1996. We review the clinics history, starting with its founding in 1946 because of the upsurge in venerological diseases during the post-world war II years. The most important clinic directory and their scientific activities are described.

Antenatal care in South Wales 1934-1962

The records of the Special Antenatal Clinics held by the Rhondda Urban District Council between 1934 and 1962 at the Carnegie Welfare Centre in Trealaw, South Wales, were studied. An analysis is presented of structured samples taken from the clinics of one month in each quinquennium from 1934 to 1962. The collected material is then grouped into a period covering the pre-war and wartime years of 1934-1946, and a post-war period from 1950 to 1962. Examination of these sections shows developments in the mid-twentieth century both in the recording of medical histories and in the care of childbirth in this area of Wales.

Early years of the out-patient services, Singapore (1880-1946)

This article traces the history of the Out-patient Services from its humble beginnings in the late 19th Century to just after World War II. The class of patients catered for, the disease pattern, the work done and benefits accrued are recorded.

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.