Medical abbreviations

[Guest]

Hi,

 

Does anyone know what MYPD means.  My great grandfather was admitted to hospital in 1918 with, I think, MYPD.  He was discharged but then readmitted a month later with gun shot wounds to the abdomen, of which he died.

 

I've attached his medical record.

 

Thanks.

 

Debbie.

 

[IPT]

There was a previous discussion here - 

 

[TGM]

Agree.

 

Archaic Medical Terms  suggests it is Not yet diagnosed psychiatric.

See also section on WW1 in Traumatic Events and Mental Health - an American publication.

Edited 30 July , 2017 by TGM

[Robert Dunlop]

Pyrexia (fever) is much more likely for the 'P'. Undiagnosed high temperatures were very common. The usual causative agent was Bartonella quintana, a bacterium transmitted by the ever-present lice.

 

Robert

[TGM]

 

On 7/30/2017 at 17:32, Robert Dunlop said:

Pyrexia (fever) is much more likely for the 'P'. Undiagnosed high temperatures were very common. The usual causative agent was Bartonella quintana, a bacterium transmitted by the ever-present lice.

 

Robert

 I am only familiar with one set of hospital records I transcribed and the usual acronym for Pyrexia in those was P.U.O. (or FUO).

However, those keeping such records were by no means consistent, and reports in the BMJ  refer to the problem of misdiagnosis

See also:

page 137 British medicine in the war, 1914-1917

Remarks ON “PYREXIA” OR “TRENCH FEVER.” Br Med J 1916; 2:938 doi: https://doi.org/10.1136/bmj.2.2915.641

A Lecture ON THE SOLDIER'S HEART AND WAR NEUROSIS Br Med J 1917; 2:817 doi: https://doi.org/10.1136/bmj.2.2973.817

“P.U.O.” Br Med J 1936; 2:99  doi: https://doi.org/10.1136/bmj.2.3940.99 

Edited 1 August , 2017 by TGM

[Robert Dunlop]

Hi TGM. One of the great problems in medical practice is that different practitioners and different organisations will use the same acronyms to mean different things. This is why the use of acronyms is often discouraged but after you have been on call for many hours and it is the umpteenth patient to be admitted, etc, etc... NAD is one example that always caused a degree of amusement:

• No Abnormality Detected was the usual
• Not Actually Done was the cynical alternative ;-)

 

In recommending Not Yet Diagnosed Pyrexia, two things were uppermost in my mind:

• The medical adage that 'common things occur commonly'; and
• Sue Light (RIP) recommended likewise in the other thread relating to Salonika (it was sad to learn of her passing...)

I recognise the term PUO, both in modern use and from researching historical texts as well:

 

Previous post

 

Robert

[TGM]

16 hours ago, Robert Dunlop said:

Hi TGM. One of the great problems in medical practice is that different practitioners and different organisations will use the same acronyms to mean different things. This is why the use of acronyms is often discouraged but after you have been on call for many hours and it is the umpteenth patient to be admitted, etc, etc... NAD is one example that always caused a degree of amusement:

• No Abnormality Detected was the usual
• Not Actually Done was the cynical alternative ;-)

 

In recommending Not Yet Diagnosed Pyrexia, two things were uppermost in my mind:

• The medical adage that 'common things occur commonly'; and
• Sue Light (RIP) recommended likewise in the other thread relating to Salonika (it was sad to learn of her passing...)

I recognise the term PUO, both in modern use and from researching historical texts as well:

 

Previous post

 

Robert

Thank you, Robert. A most instructive reminder and one I'll try to remember.

Edited 1 August , 2017 by TGM

[Robert Dunlop]

No problem, TGM. Just to confuse things a bit more (and picking up on the point about the same acronym meaning different things), whilst there is a clear distinction between an episode of pyrexia, say a one-off spike in temperature which may not be diagnosed, and a pyrexia of unknown origin, where the fever has continued over several days, some doctors are likely to have used PUO to mean a temperature over a few days but no long enough to qualify formally as a PUO according to the definition. PUO is meant to trigger thoughts of specific medical problems. The two most common were TB and a bacterial pneumonia where the bacteria had gotten into the pleural space between lung and the chest wall, causing what is known as an empyema - quite common in the pre-antibiotic era. Less common would have been the likes of Hodgkins lymphoma for example. If a doctor knew of the formal meaning of PUO then he or she would be more like to use something like NYDP to describe a single or shorter-term fever. This would be more likely with someone who trained as a hospital medical specialist (called a physician in the UK and Australasia but not in the USA where the term refers to a doctor in general - yet another example of different meanings  ).

 

Robert

[KOBE]

Hi all,

 

Out of interest does anyone know what condition(s) I.C.T. (Inflammation of Connective Tissue) included? I can't find much info other than it includes skin rashes/sores (which doesn't really sound right?)

Cheers,

[kenf48]

8 minutes ago, KOBE said:

Hi all,

 

Out of interest does anyone know what condition(s) I.C.T. (Inflammation of Connective Tissue) included? I can't find much info other than it includes skin rashes/sores (which doesn't really sound right?)

Cheers,

 

The condition has been discussed many times on the forum 

See post 6 of this earlier Thread

as in the link I posted there and reposte here which is peer reviewed and describes how it is treated today, I.e. With drugs not available in the war http://www.healthline.com/health/collagen-vascular-disease

 

It is an autoimmune disease which can exhibit many symptoms, including skin rashes and sores. 

 

Ken

 

 

[Robert Dunlop]

At the time of the Great War, Inflammation Connective Tissue referred to a variety of conditions that affected the tissue immediately under the surface layer of skin. In a review paper published in the Journal of the American Medical Association at the time ('Dermatology in a British General Hospital in France: Including the Differentiation of "I.C.T." (Inflammation Connective Tissue)', JAMA, Oct.19, 1918, 1312-1313), the author Captain Knowles noted that the term corresponded to 'Pyodermia' in the American Army. 'Pyo-' refers to pus and '-dermia' refers to the layer of connective tissue (i.e. the dermis) that sits under the skin (which is referred to as the 'epidermis' - literally 'above/upon the dermis'). Infections or other inflammatory conditions in the dermis layer will often break through the skin, which results in ulcers for example. In these situations, the skin manifestations are not primary but reflect a secondary effect. In some cases, such as abscess due to a penetrating injury, there may be an associated problem with the skin but again the primary problem lies just below the skin.

 

Captain Knowles referred to a total of 1,913 skin cases being treated in the hospital during a 12 month period. Of these cases, 995 were categorised as I.C.T.. Knowles then lists the more specific diagnoses that were made by 'a dermatologist', i.e. a specialist in skin diseases. Presumably this was Captain Knowles but he does not say. The list included (number of cases in parentheses):

• Abscess (50)
• Ecthyma (170) - a bacterial infection related to impetigo that penetrates into the dermis
• Septic ulcer (210)
• Boils (211)
• Scabies (86) - typically due to the Scabies mite burrowing under the skin, causing direct inflammation and/or secondary infection
• Carbuncle (5)
• Dermatitis (17)
• Impetigo (139)
• Folliculitis (10)
• Hyperhidrosis (50)
• Pernio (frost bite) (25)
• Callositas (12) - skin calluses
• Herpes zoster (2) - also known as shingles
• Pityriasis rosea (1)
• Tinea versicolor (1)
• Syphillis (late) (6)

Knowles' paper illustrates how I.C.T. was something of a catch-all term. It was meant to imply an infection or other inflammatory process under the skin but, in practice, was used for some skin problems too. Whenever you see this term used in a medical report about a specific solider then you should not assume that it means one thing. It is important to use other information, if available, to arrive at the likely original problem. What Knowles is pointing to is that most doctors working in military hospitals or clinics were not skin disease specialists.

 

Robert 

[Dai Bach y Sowldiwr]

What Robert shows neatly is that use of the term "Inflammation of Connective Tissue" at that time covered almost exclusively infective processes of cutaneous or subcutaneous tissues, whereas today it would imply a true inflammatory process of connective tissue that might well be a multi-system disease and almost exclusively non-infective.

[KOBE]

8 hours ago, Robert Dunlop said:

At the time of the Great War, Inflammation Connective Tissue referred to a variety of conditions that affected the tissue immediately under the surface layer of skin.

[...]

 

Robert 

 

Thanks, Robert.

 

I'm researching my Grandfather's regiment and the Brigade War Diary for October 1917 gives 470 instances of men reporting sick, the prevailing diseases being P.U.O. and I.C.T. Pyrexia I could understand, what with them being out in the rain and mud of the Ypres Salient (bound to bring on a few fevers!) but the I.C.T. was bugging me. I guess it was probably bacterial skin infections, ulcers and abscesses etc.

 

Thanks for clearing that up (if you'll pardon the pun!)

[Robert Dunlop]

No problem, KOBE. With respect to your Grandfather's regiment, the relatively large number of men affected at the same time points to multiple infections. October 1917 was when my Grandfather was involved in Third Ypres too. He talked about his experiences, unlike most veterans. Certainly the conditions at that time in the battle were conducive to infections, as you rightly presume.

 

Robert