[Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)]

The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people.

[History of Jagiellonian University Clinic for Nervous and Mental Diseases in 100 anniversary]

In the paper there have been presented the creation and activities of the Clinic of Neuropsychiatry in the period of 1914-1950 and the scientific and organizational work of professor J. Piltz (1870-1930).

University cardiology clinic

In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original scientific papers published in indexed medical journals.

[The speech on Bier as a problem. Arthur Israel (1883-1969) and his struggle to come to terms with the Berlin University Surgical Clinic]

Arthur Israel was associated with August Bier's University Surgical Clinic in Berlin from 1910 to 1933, in the end as the head of the downgraded (outpatient) clinic. After he was forced out of his Berlin post, Israel was department head in the Israelitisches Krankenhaus Hamburg until he emigrated to the U.S. in 1940, settling in New York. In 1960, he returned to Germany. Based on papers from Israel's estate, the article describes his life stations and his struggle to cope with his time at the Berlin university clinic. The focus is on a meeting in Berlin in 1961. His departure from the usual practice of heaping praise on the clinic and its former head marks the beginning of a never-published critique of conditions in the clinic. The ambivalence reflected in his evaluation is in stark contrast to the traditional cultivation of "Bier's School".

Department of Nephrology at the Medical Faculty, Ss. Cyril and Methodius University, Skopje--creating nephrology protection for the citizens of the Republic of Macedonia

In January 1975, de facto, the Nephrology Department was founded at the Medical Faculty in Skopje as the first institution of such a type in former Yugoslavia. The Nephrology Department was the driving force for the further development of nephrology in the Republic of Macedonia. D. Hrisoho was the first Director of the Department, and its subsequent Directors were G. Masin, M. Polenakovic, K. Zafirovska and currently A. Sikole. Prior to the establishment of the Nephrology Clinic there had been considerable experience in the diagnosis and treatment of renal patients. The first haemodialysis (HD) in the Republic of Macedonia (RM) was performed in 1959 on a patient with acute renal failure (ARF) using a Kolff-Brigham rotating drum artificial kidney at the Blood Transfusion Institute in Skopje. In 1965 the Renal Unit at the Department of Medicine, Medical Faculty, Skopje obtained a new, modern "Websinger" artificial kidney with a sigma motor pump and possibilities for the use of a disposable Kolff "twin coil" dialyser. Between 1959 and 1971, HD was performed only on patients with ARF. In May 1971, a Unit for Chronic HD was founded at the Renal Unit and the programme of maintenance haemodialysis (MHD) was started with five Stuttgart Fresenius machines and 12 patients dialysed on twin coil dialysers. That was a great incentive for the development of HD in the Republic of Macedonia enforced by the great number of patients with end stage renal disease. Thus in 2007 we have 18 HD centres in the Republic of Macedonia, with 1183 patients. Treatment of the patients with MHD is the greatest success achieved in the Republic of Macedonia in nephrology concerning patients with end stage renal disease. Prior to the treatment with MHD patients were destined to die, whereas now, with this type of treatment, they have a normal life and families. Patients with kidney diseases are examined in outpatients clinics as well as treated in the wards of the Department. All types of vascular accesses, renal biopsies, bone biopsies, kidney ultrasound, plasmapheresis and other investigations are performed every day at the Nephrology Department of the Medical Faculty. On the basis of the results of renal biopsy, a classification of parenchymal renal diseases has been established, as well as appropriate immunosuppressive and other treatments. The nephrology doctrine for primary, secondary and tertiary healthcare has been prepared and has been distributed to all medical centres in the Republic of Macedonia. The first (living donor) renal transplantation was performed in July 1977. Later, living and cadaver donor transplantations were performed, so the Department of Nephrology was complete concerning dialysis and renal transplantation, and it became part of the European centres for diagnosis and therapy of kidney disease. Doctors from the Nephrology Department are among the most productive scientific workers in the Republic of Macedonia and their papers can be found on the internet Pub Med. The Department of Nephrology, together with the Nephrology Association, was the source of knowledge in the area of nephrology and the transfer of knowledge from abroad into Macedonia and vice versa. The Nephrology Association has made a great contribution in the development of nephrology in our country. The most famous European and world nephrologists have participated in the work of our association and have contributed to the development of nephrology not only in Macedonia, but on the Balkans as well.

Development of the clinic of pulmonology and allergy

University Pulmology and Allergy Clinic was founded in 1975 when the Depertment of Internal Medicine, directed by Prof. Dr. Dimitar Arsov, later member of the Macedonian Academy of Sciencies and Arts, was divided into eight separate and independent clinics. The first head of the Pulmonology and Allergy Clinic was Prof. Dr. Ljubomir Kotevski. He had a very difficult goal: to establish and further develop the newly formed clinic. The Clinic flourished and became one of the leading Clinics in the Clinical Centre during the directorship of Prof. dr. Dejan Dokic.. He completely rebuilt and refurbished the Clinic, which became a modern Clinic providing excellent working conditions for the employees and, most importantly, provided a first class service to the patients. During his mandate he obtained a grant from the Japanese Government worth $1,000,000 which was used to obtain a new, modern and sophisticated medical equipment. Since the establishment of the clinic, many national and international scientific projects were carried out and many scientific papers were published as well as many monographs, and chapters in scientific books. As a result of continuous education, of the total number of 24 doctors there are 16 subspecialists in respiratory medicine and 4 specialists in internal medicine. There are 9 professors in internal medicine at the University of Pulmonology and Allergy Clinic lecturing at the Medical Faculty in Skopje. The University Pulmonology and Allergy Clinic has an international reputation due to many contacts with famous European Institutions. All these international interrelations have resulted in honouring 3 professors: Prof. Dr. Gert Kunkel from Berlin, Germany, Prof. Dr. Robert Loddenkemper from Berlin, Germany and Prof. Dr. Peter Howard from Southampton, UK.

Development of the Clinic of Endocrinology, diabetes and metabolic disorders

The Clinic of Endocrinology, diabetes and metabolic disorders was founded in 1975 by Prof d-r Alexandar Plashevski. Healthcare, educational and scientific activities in the Clinic of Endocrinology are performed in its departments. The Department for hospitalized diabetic and endocrine patients consists of the metabolic and endocrine intensive care unit, the department for diagnosis and treatment of diabetics and endocrine patients, day hospital, the department for education of diabetic patients, and the national center for insulin pump therapy. The Center for Diabetes was established in 1972 by Prof d-r Dimitar Arsov. In 1975, Prof d-r Alexandar Plasheski broadened the activities of the Center for Diabetes. It was dislocated in 1980, with new accommodation outside the clinic. Since then the Center has consisted of several organized units: two specialist outpatient clinics for diabetic patients, biochemical and endocrine laboratory, sub-departments for: diabetic foot, cardiovascular diagnosis, ophthalmology, and urgent interventions. The Department of Endocrinology and Metabolic Disorders for outclinic endocrine patients was established in 1980, and it integrates the following sub-departments: thyrology, andrology, reproductive endocrinology, obesity and lipid disorders and sub-department for osteoporosis. The educational staff of the Clinic of Endocrinology organizes theoretical and practical education about Clinical Investigation and Internal Medicine with credit transfer system course of study of the Medical Faculty, Faculty of Stomatology, postgraduate studies, specializations and sub-specializations. Symposiums, 3 congresses, schools for diabetes and osteoporosis and continuous medical education were also organized. The Clinic of Endocrinology was initiator, organizer, founder and the seat of several medical associations.

Haematology in the Republic of Macedonia: present situation and brief history

The development of clinical haematology in Macedonia has taken place over the past nine decades. The greatest expansion of its development took place in the second half of the 20th century. The oficial start of clinical haematology dates from 1956, when the Department of Haematology was founded within the framework of the Internal Medicine Clinic in Skopje. In the beginning, haematology represented a form of virtual sub-specialty, but its expansion was so progressive and rapid that it reached the highest peaks of Yugoslav haematology in those times. The period from 1968 to 1979 was a period of integral development of haematology and blood-transfusion science in Macedonia. Nowadays, the autonomous Public Health Institution, the University Hematology Clinic, is a unique healthcare, educational and scientific establishment in the Republic of Macedonia in its field of work. The diagnostics algorithm comprises cyto-morphologic and cyto-chemical analysis, through immunologic characterization with the assistance of a flow cytometer, to sophisticated molecular analysis for detecting genetic abnormalities. The therapeutic approach is based upon modern poly-haemotherapeutic protocols, application of monoclonal antibodies, immuno-modulatory agents, molecular target therapy and the use of alogeneic and autologous transplantation of fresh bone-marrow and frozen haemopoietic stem-cells. The current motto of the Haematology Clinic is: always help those who seek help, provide precise and early diagnostics, and apply all up-to-date therapeutic strategies, scientific research, continual education and day-to-day implementation of the latest achievements in the field of haematology in daily practice.

The general NFP hospital model

Throughout the past 30 years, there has been a lot of controversy surrounding the proliferation of new forms of health care delivery organizations that challenge and compete with general NFP community hospitals. Traditionally, the health care system in the United States has been dominated by general NFP (NFP) voluntary hospitals. With the number of for-profit general hospitals, physician-owned specialty hospitals, and ambulatory surgical centers increasing, a question arises: “Why is the general NFP community hospital the dominant model?” In order to address this question, this paper reexamines the history of the hospital industry. By understanding how the “general NFP hospital” model emerged and dominated, we attempt to explain the current dominance of general NFP hospitals in the ever changing hospital industry in the United States.

[From disease's treatment to global care of the child with acute lymphoblastic leukemia]

The history of the treatment of childhood acute leukemia is a meaningful model of the ethical, bioethical and organizational implications of the technical progress in medicine. This experience provides indications and very useful tools to face the main topics of modern medicine: the risk of intense medicalization to the detriment of the quality of the care, the importance of psycho-emotive, ethical and spiritual aspects in the doctor-patient relationship, etc. The Authors report the difficulties and progresses until and after the first cures of children with leukemia in the Pediatric Clinic of the University "La Sapienza" of Rome (1964), the new features of treated leukemia (the real disease of cured child") and the psycho-emotive involvement of the pediatric staff a "parallel disease"). The necessity of a continuous activity aimed at the adaptation of services to scientific and medical progress and to the necessity of humanization of procedures and environment is stressed.

[The mental health service at the pediatric clinic of the University "La Sapienza" in Rome: 1948-2009]

The article outlines the history of the Mental Health Center operating within the Pediatric Clinic and School of Pediatrics of the University "La Sapienza" in Rome, Italy from 1948 to 2009. The main aim of the Center was to contribute to the understanding of the developmental process in children, to study its promoting factors and, at the same time, to consider the psychological and human implications of health issues. The original idea of the Center was the need to integrate psychological implication in pediatric care. In times of increasing negative technical interferences in the doctor-patient relationship, the Center acted as an open cultural space proposing a medical model concerned with the wholeness of the patient and his psychophysical wellbeing.

Outpatient department concerns

Following an allegation that women did not ‘receive the respect to which their sex entitled them’, the King and the Queen paid a visit to the London Hospital in Whitechapel to see how women were treated. The King, according to a report in the BJN6 August 1910, ‘sat among the students and saw for himself how the women were treated by the doctors’. Following this report, the BJN published a news item relating to a complaint they had received from a nurse who visited the hospital recently.

Psychiatry in a battle zone

The authors describe the arrival and treatment of 164 severe chronic psychiatric patients who were displaced from the Serbian army-controlled Jakes psychiatric hospital and off-loaded on the afternoon of 28th of May, 1992 at the gates of the Psychiatry Clinic in Tuzla. Through analysis of their incomplete medical records, which arrived with the patients in Tuzla, and analysis of their activities during and after the war, they found that 83 of the patients (50%) were males and 147 (89.6%) were admitted to the Psychiatry Clinic in Tuzla. Of the patients, 86 (58.5%) were found to be Serbs. The majority of them were incapable of independent living and required ongoing medical and social care. They were from all regions of Bosnia-Herzegovina, 81.6% had schizophrenia and 70 (47.6%) were over 50 years of age. For its humanitarian work, its contribution to peace and for the maintenance of the multi-ethnic Bosnia-Herzegovina, the Psychiatry Clinic in Tuzla received the Golden Award for Peace from the International Legion of Humanists in May 1998.

[The medical care of the poor in the city of Göttingen provided by the Poliklinische Institut (outpatient department) of the University]

Around 1800 there arose a need in German university towns for patients to serve as subjects during the practical instruction of academic physicians. Since the early university hospitals could not provide enough patients for the practical training, the Poliklinische Institut (outpatient departments) whose doctors and nurses visited the patients in their home offered an economical alternative to the in-patient therapies. Patients from the lower social classes who could not pay for medical care had to offer themselves as "teaching objects" in return for receiving free treatment. Simultaneously, since the end of the 18th century physicians had been emphasizing both the causal connection between disease and poverty and their own significant role in fighting and preventing poverty. In addition to learning about diagnosing methods and therapies, the practical training also provided a lesson in dealing with patients from a lower-bourgeois background. Utilizing the example of the university city of Göttingen, the current article will reconstruct the discussion about the opportunities academic training with poor patients provided. I will analyse the medical care the poor received and the negotiation processes involved between the university and the city council's department for the poor.

Privacy, privatization, and the politics of patronage: ethnographic challenges to penetrating the secret world of Middle Eastern, hospital-based in vitro fertilization

In recent years, in vitro fertilization (IVF) has spread around the globe, including to the Middle East. Privacy, privatization, and the politics of patronage are all key issues affecting anthropological research in Middle Eastern hospital-based IVF clinics. IVF-seeking patients generally desire privacy, even total secrecy, when pursuing these treatments, due to cultural issues of stigmatization, particularly regarding male infertility. Thus, ethical issues surrounding the informed consent process are of prime importance. Furthermore, privatization of medical services in the Middle East has left patients--and anthropologists--with few choices other than private IVF clinic settings in which to pursue treatment and research. Both the ethos of patient privacy and medical privatization affect the ability of anthropologists to "penetrate" the secret world of IVF. Permission to conduct ethnography in private hospital IVF clinics may be difficult to obtain without the help of highly motivated physician patrons, who are willing to recruit their private IVF patients for ethnographic interviewing. This article provides a personal account of some of these challenges as faced by a medical anthropologist during a 15-year career of hospital-based IVF research in the Middle East.

The psychodynamic psychiatry service of the University of Alberta Hospital: a thirty year history

This paper describes the Psychodynamic Psychiatry Service (PPS) of the University of Alberta Hospital over its 30 years of development. This psychiatric organization consists of three clinical programs-an outpatient clinic and intensive day and evening programs-and an integral evaluation and research unit. The PPS is unique in its group therapy clinical orientation, its psychodynamic theoretical orientation, and its integration of an ongoing research program that establishes empirical validation of its clinical work. The productivity and longevity of this psychiatric organization appear to derive from several strengths, including cooperation between leaders of the clinical and research programs; the institution of staff relations groups in the three clinical programs; the operation of the fully integrated evaluation and research program that serves to provide empirical support for the treatments offered; and a unifying ideology characterized by the valuing of both psychodynamic and group oriented work. Other important factors to the success of the PPS include the strengths of the founder of the service and financial and other support of the academic department in which it is housed. This paper describes the historical development and present structure and functioning of the PPS, the challenges it has been confronted with, and the responses to those challenges. We conclude with factors contributing to its survival and productivity and with thoughts about the future.

[The Basel Medical University Polyclinic on the brink of the 21st century: retrospective and prospective view]

At the occasion of its 125th anniversary the outpatient department of internal medicine is being analysed with regard to its history, development and future. Originally it was founded to improve practical patient-oriented teaching of students and to serve the poor population of Basel. While today the Swiss Health Insurance system warrants proper care for every citizen and thus renders the latter purpose unnecessary, new marginal patient groups have evolved that need proper attention such as HIV patients, asylum-seekers, geriatric patients and others. Teaching obligations have even increased, especially with regard to primary care and family medicine. Thus the reasons for running a medical outpatient department have changed considerably, but still include teaching, research and provision of care to special patient groups. Outpatient departments have to be flexible and to adapt to modern trends in health care.

[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.