Rutson Hospital

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Having trained in London and Manchester, I found psychiatry in the Yorkshire Dales a little different. Most senior registrar training is done within cities. Most consultant posts are old posts. Moving into a newly created consultant post with hardly any psychiatric service, miles from any city, was a new challenge with clear benefits professionally and personally. James Heriot, our famous local vet, gives the impression of being self-sufficient and isolated when providing his services. Though the countryside is the same, surely the opposite must be true for developing a mental health service.

Abstract The results of a prosepective study of Polya-type gastrectomy in 800 cases of duodenal ulcer are recorded. The series is an entirely personal one in which case selection and operative technique were standardized, through in the assessment of the results the opiniosn of many observers have been collated. The resutls in the early years are recorded and the effects of revision surgery noted. Special attention has been paid to the nutritional state after operation adn to the long-term metabolic consequences 10–20 years after gastrectomy. The immediate and long-ter results of gastrectomy are compared and constrasted with those obtained by vagotomy and drainage.