Volume 190 - Issue 11
More GP tips
Author: Lilon G Bandler
Med J Aust 2009; 190 (11): 650. || doi: 10.5694/j.1326-5377.2009.tb02602.x
Published online: 1 June 2009
Published online: 1 June 2009
John Murtagh’s practice tips. 5th ed.
John Murtagh. Sydney: McGraw-Hill, 2008 (xix + 244 pp). ISBN 978 007015898 6.
Medical education is based on a master-and-apprentice model, assuming an eager, interested apprentice, and an experienced, intelligent and thoughtful master. Enter Professor John Murtagh, doyen of Australian general practice. First published in 1991, this is the fifth edition of Practice tips; he’s been master of many apprentices. Reading his guide to palpation of the cervical spinous processes, I think I can hear him teaching the person who taught the person who taught me.
Beginning a term in obstetrics, I found many postnatal patients had salad in their bras! Midwives reassured me that grated carrot and cabbage leaves were effective. When Professor Murtagh writes “Cabbage leaves have been used in some cultures for hundreds of years in the treatment of . . . some breast problems”, I must confess to wishing for some evidence.1 I’d also like to know the evidence for excising axillary sweat glands,2 and the place of frenotomy in modern management3 before I snipped.
My general practice work is urban, in Sydney. We tend towards cautious, defensive medicine amid patients keen to see our specialist colleagues. We don’t routinely repair eyelid lacerations, or remove meibomian cysts. However in rural, remote or very remote practice, I’d be particularly grateful for Murtagh’s information about intercostal nerve blocks, clear diagrams of pulley sutures, and good advice about psoriasis.
“Lithium batteries . . . create an emergency . . . the electric current they generate destroys mucous membranes . . .” There’s almost too much here! I might long for a speedy electronic search function when I wanted to manage a dislocated patella.
Generations of general practitioners owe Professor Murtagh a debt. No doubt when someone takes up my offer to work as a rural locum, I’ll be glad of John Murtagh’s practice tips by my side. I couldn’t ask for a better or a more willingly generous tutor.
References
- Nikodem VC, Danziger D, Gebka N, et al. Do cabbage leaves prevent breast engorgement? A randomized, controlled study. Birth 1993; 20: 61-64. 0_CACBCDHG
- Solish N, Bertucci V, Dansereau A, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg 2007; 33: 908-923. 0_CACICGDC
- Hogan M, Westcott C, Griffiths M. Randomized, controlled trial of division of tongue-tie in infants with feeding problems. J Paediatr Child Health 2005; 41: 246-250. 0_CACEACHF
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