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Unsuitable for use in NHS patients and dogs (editorial)

"Never in the history of the human race were physicians and scientists using their brains to such good advantage as at the present day. The stumbling blocks which have existed....are being surmounted with amazing rapidity, and disease is in the act of rapidly succumbing to the progress of science".

Sounds contemporary, but found in a booklet coming with Dr Macaura's marvellous invention (circa 1930s) called The Pulsocon (Patent number 13932).

The booklet says that the Pulsocon cures everything - pain, deafness, anaemia, impotence, "womens' problems", the lot. The logic, quoting Hippocrates, is that of massage. But while a human can only achieve 400 percussive strokes a minute, if you paddle this device fast enough you can get up to 2,000 a minute. A classic technology creep argument.

Inside the box was a little handwritten note, with the compliments of the inventor, which says "unsuitable for use in NHS patients and dogs". Bandolier would love any information on the logic of this, and a date for it.

Testing times

Devices and diagnostics seem to be under less stringent rules than pharmaceuticals. Perhaps there are lessons to be learned from the news on hip prostheses. How do you know whether a prosthesis loaded with bells and whistles will outperform a standard prosthesis?

In Sweden they order these things differently, with comprehensive prospective audit in a number of areas - hip prostheses being one. The result is that failures are picked up very quickly.

Unknowable things

Some things may be truly unknowable. How long might anthrax spores left in the ground retain their viability? A difficult one. What irritates is those circumstances where we should know but don't. This month Bandolier examines ejaculation and PSA . The only reason that men have a prostate gland is because of ejaculation, so there should be a simple and clear answer, yes? No - few studies, and despite huge numbers of papers on PSA there is still no clear answer.

Knowing things

When things that should be known are known, life is simple. Some good examples this month include another in the growing list of radiology prediction rules from Ottawa, this time for ankles. Others include accumulating evidence on the use of tests and benefits of treatment in HIV , and the uselessness of enzyme supplements in pain with chronic pancreatitis .

Privy poesy

Isn't it strange how matters lavatorial are so interesting? So here is a poem on the subject by a man who is reputed to be the most obscure of the 18th century poets (but how do you know there isn't someone even more obscure?). Positively no more on the subject unless it is a good trial or review.

Privy-love for my Landlady

Here costive many minutes did I strain,
Still squeezing, sweating, swearing, all in vain;
When lo! who should pop by but Mother Masters,
At whose bewitching look soon stubborn arse stirs.
No more my wanton wit shall whip thy wife,
Dear, doting Dick, for O! she saved my life.
George Farewell (1733) in The New Oxford Book of Eighteenth Century Verse (ed Roger Lonsdale).

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