Perimetric homonymous visual field loss post-stroke.

Post-stroke homonymous visual field (PSHVF) loss has functional and driving implications for patients. Automated, as opposed to confrontational, assessment of PSHVF loss has the potential to provide a more reliable indicator for field loss and thus ability to drive. Sixty-one consecutive stroke admissions were assessed at 9 months post-stroke. Driving status and the patient's awareness of any visual field loss was ascertained. Patients underwent formal perimetric visual field testing using a Humphrey Visual Field Analyser II. A separate, blinded, confrontational assessment of visual fields was made using the National Institutes of Health Stroke Scale (NIHSS) technique. Homonymous field defects were found in 10 (16%) patients, with 50% of these being hemianopia and 50% quadrantanopia. Right-sided field loss was more common (70%). No patients with PSHVF loss were aware of their loss, and only two were detected using NIHSS assessment. One patient was thought to have PSHVF loss on NIHSS assessment but this was not confirmed on perimetry. Of those with significant PSHVF loss at 9 months, 30% were driving. The prevalence of PSHVF loss is relatively high and is underestimated by confrontational testing. Stroke patients are often unaware of their field loss, with up to 5% driving with significantly affected visual fields at 9 months. Perimetric testing may be useful in decision-making regarding driving eligibility post-stroke.

Samuel Hahnemann

Christian Friedrich Samuel Hahnemann was born on 10 April 1755 in Meissen, the son of a porcelain painter. The family was educat but the economic climate at that time meant that they lived in dire poverty. Samuel's father was unable to afford school fees. Fortunately the rector of the school recognised Samuel 's ability and allowed him to attend withoud paying. He became a fluent linguist, teaching his fellows Hebrew when only 13 and, later at medical school in Leipzig, supported himself by traslation scientific papers. From this work he managed to save enough to transfer to Vienna, the premier medical school in Europe. Here his diligence and ability were widely noted among the staff.

The early work of Dr. Edward Bach

The work of Edward Bach, prior to his discovery of the flower remedies, is described. He demonstrated non-lactose-fermenting bacteria in patients' stools. These were later used as the basis of some of the Bowel Nosodes.(AU)

Homoeopathic prescribing in the late 19th century

The discovery of the records of the London Homoeopathic Hospital dating from 1889 to 1923 has given the opportunity to study prescribing methods in the pre- and port- Kentian periods. In particular, it has given a detailed insight into late 19th century ideas which has not been avaiable before. A pilot study has demonstrated the common remedies employed and their potencies. Further research is needed to determine, if possible, the reasons for selection of remedies and the relative efficacy if the 2 contrasting systems of prescription

Cholera 1854: update

In october 1987 a paper was published in this journal attempting to assess the claims made by the British Homoeopathic Society concerning the efficacy of the treatment of cholera at Golden Square during the 1854 epidemic. Details of the treatment were not available at that time and had to be deduced. This paper fills in those details. The view wxpressed then that homoeopathy played a major part in bringing about substantially better results than the allopaths in reinforced. For background information the reader is referred to the original paper

The personality of Hahnemann

The writings of Hahnemann are discussed with particular reference to his attacks on the medical profession. His intolerance of disagreement is explored. The question is raised as to whether his personality played a part in the generally negative reception of his ideas

The smaller hospitals

The evolution and history of the so-called homoeopathic cottage hospitals is discussed