The Silent Film and Early Film Historic Collections 1877-1930

The Silent film Historic Collections

Created By

Dr Iwan Suwandy,MHA

Limited Private E-book In CD-ROM

Please look The Sample below and The complete CD-ROM only for premium member,please subscribed via comment)

This book dedicated

 to my grandgrandpa Tan G.L.who built  the first silent film cinema Scalabio at Padang City West Sumatra Indonesia and My Friend Ang T.L(Wirako) who Grandpa also built the silent and first speaking film Cinema at the same city.



Scene from the 1921 Four Horsemen of the Apocalypse, one of the highest-grossing silent films.

A silent film is a film with no synchronized recorded sound, especially with no spoken dialogue. In silent films for entertainment the dialogue is transmitted through muted gestures, pantomime and title cards.

Chronologic Historic Collections





 Muybridge’s initial attempts failed and it wasn’t until 1877



The first projected sequential proto-movie was made by Eadweard Muybridge some time between 1877 and 1880



. The first narrative film was created by Louis Le Prince in 1888.

  The first narrative film was created by Louis

It was a two-second film of people walking in Oakwood streets garden, entitled Roundhay Garden Scene.[1]

Roundhay Garden Scene 1888, the first known celluloid film recorded.



 West Orange, New Jersey, used December 1892

Edison Studios were first in West Orange, New Jersey (1892),


The Black Maria, Edison's first motion picture studio

The Black Maria, Edison's first motion picture studio
The Black Maria, Edison’s First Motion Picture Studio,
West Orange, New Jersey,
used between December 1892 and January 1901.
Inventing Entertainment: the Early Motion Pictures and Sound Recordings of the Edison Companies

Edison and Dickson continued to experiment with motion pictures in the late 1880s and into the 1890s. Dickson designed the Black Maria, the first movie studio, which was completed in 1893. The name was derived from the slang for the police paddy wagons that the studio was said to resemble. Between 1893 and 1903, Edison produced more than 250 films at the Black Maria, including many of those found in the Edison Motion Pictures collection of the Library of Congress. Most of the films are short, as it was believed that people would not stand the “flickers” for more than ten minutes.

Turn-of-the-century copyright law provided protection for photographs but not for motion pictures. Therefore, a number of early film producers protected their work by copyrighting paper contact prints (paper prints) of the film’s individual frames.


Edison Kinetoscopic Recording of a Sneeze
Edison Kinetoscopic Recording of a Sneeze,
copyright January 9, 1894.
American Treasures of the Library of Congress

View the film which was reconstructed from the paper print.
Edison Kinetoscopic Record of a Sneeze
by W. K. L. Dickson, one of Edison’s assistants,
January 7, 1894.



Thomas Edison with his Home Kinetoscope, introduced 1912




Scene from Broken Blossoms starring Lilian Gish and Richard Barthelmess, an example of sepia-tinted print.

With the lack of natural color processing available, films of the silent era were frequently dipped in dyestuffs and dyed various shades and hues to signal a mood or represent a time of day. Blue represented night scenes, yellow or amber meant day. Red represented fire and green represented a mysterious mood. Similarly, toning of film (such as the common silent film generalization of sepia-toning) with special solutions replaced the silver particles in the film stock with salts or dyes of various colors. A combination of tinting and toning could be used as an effect that could be striking.

Some films were hand-tinted, such as Annabelle Serpentine Dance (1894), from Edison Studios. In it, Annabelle Whitford,[13] a young dancer from Broadway, is dressed in white veils that appear to change colors as she dances.



Georges Méliès, the first truly great director in movie

Hand coloring was often used in the early “trick” and fantasy films of Europe, especially those by Georges Méliès.



 The art of motion pictures grew into fullShowings of silent films almost always featured live music, starting with the pianist at the first public projection of movies by the Lumière Brothers on December 28, 1895 in Paris.[4]



Edison Receives Patent for Kinetographic Camera

On August 31, 1897, Thomas Edison received a patent for the kinetographic camera, “a certain new and useful Improvement in Kinetoscopes,” the forerunner of the motion picture film projector. Edison and his assistant, W. K. L. Dickson, had begun work on the project—to enliven sound recordings with moving pictures—in hopes of boosting sales of the phonograph, which Edison had invented in 1877. Unable to synchronize the two media, he introduced the kinetoscope, a device for viewing moving pictures without sound—on which work had begun in 1889. Patents were filed for the kinetoscope and kinetograph in August 1891.

The kinetoscope (viewer), which Edison initially considered an insignificant toy, had become an immediate success about a decade earlier. The invention was soon replaced, however, by screen projectors that made it possible for more than one person to view the novel silent movies at a time.



sample frames from Edison film 'Three acrobats'
Three Acrobats,
Thomas A. Edison, Inc.,
copyright March 20, 1899.
The American Variety Stage: Vaudeville and Popular Entertainment, 1870-1920


Unidentified silent film 1910



By the time that the law was amended in 1912, some 3,500 paper prints had been deposited for copyright registration. This practice proved fortuitous, as many early films have been lost due to disintegration and the high combustibility caused by early film’s nitrate base. Many of these paper contact prints were converted back to film in the 1950s, and hundreds were digitized in the 1990s.

, 1933-Present to see photos and written historical and descriptive data of the Edison’s laboratories in New Jersey.




A film of a re-enactment of a naval battle, depicting Russians firing at a Japanese ship with a cannon

An early film, depicting a re-enactment of the Battle of Chemulpo Bay (Film produced in 1904 by Edison Studios)



 Early studios

The early studios were located in the New York City area.

In December 1908,

 Edison led the formation of the Motion Picture Patents Company in an attempt to control the industry and shut out smaller producers. The “Edison Trust,” as it was nicknamed, was made up of Edison, Biograph, Essanay Studios, Kalem Company, George Kleine Productions, Lubin Studios, Georges Méliès, Pathé, Selig Studios, and Vitagraph Studios, and dominated distribution through the General Film Company.


From the beginning, music was recognized as essential, contributing to the atmosphere and giving the audience vital emotional cues. (Musicians sometimes played on film sets during shooting for similar reasons.) Small town and neighborhood movie theatres usually had a pianist. Beginning in the mid-1910s, large city theaters tended to have organists or ensembles of musicians. Massive theater organs were designed to fill a gap between a simple piano soloist and a larger orchestra. Theatre organs had a wide range of special effects; theatrical organs such as the famous “Mighty Wurlitzer” could simulate some orchestral sounds along with a number of percussion effects such as bass drums and cymbals and sound effects ranging from galloping horses to rolling thunder.Film scores for early silent films were either improvised or compiled of classical or theatrical repertory music. Once full features became commonplace, however, music was compiled from photoplay music by the pianist, organist, orchestra conductor or the movie studio itself, which included a cue sheet with the film. These sheets were often lengthy, with detailed notes about effects and moods to watch for


By the beginning of the 1910s, with the onset of feature-length films, tinting was used as another mood setter, just as commonplace as music. The director D. W. Griffith displayed a constant interest and concern about color, and used tinting as a special effect in many of his films. His 1915 epic, The Birth of a Nation, used a number of colors, including amber, blue, lavender, and a striking red tint for scenes such as the “burning of Atlanta” and the ride of the Ku Klux Klan at the climax of the picture. Griffith later invented a color system in which colored lights flashed on areas of the screen to achieve a color effect.


Lillian Gish was a major star of the silent era with one of the longest careers, working from 1912


The Motion Picture Patents Co. and the General Film Co. were found guilty of antitrust violation in October 1915, and were dissolved.

1892 -1906

Edison Studios were first in West Orange, New Jersey (1892), they were moved to the Bronx, New York (1907). Fox (1909) and Biograph (1906) started in Manhattan, with studios in St George Staten Island. Others films were shot in Fort Lee, New Jersey. The first westerns were filmed at Scott’s Movie Ranch. Cowboys and Indians galloped across Fred Scott’s movie ranch in South Beach, Staten Island), which had a frontier main street, a wide selection of stagecoaches and a 56-foot stockade. The island provided a serviceable stand-in for locations as varied as the Sahara desert and a British cricket pitch. War scenes were shot on the plains of Grasmere, Staten Island. The Perils of Pauline and its even more popular sequel The Exploits of Elaine were filmed largely on the island. So was the 1906 blockbuster Life of a Cowboy, by Edwin S. Porter. Companies and filming moved to the west coast around 1911.


 Starting with the mostly original score composed by Joseph Carl Breil for D. W. Griffith‘s groundbreaking epic The Birth of a Nation (USA, 1915) it became relatively common for the biggest-budgeted films to arrive at the exhibiting theater with original, specially composed scores.[5]

When organists or pianists used sheet music, they still might add improvisatory flourishes to heighten the drama onscreen. Even when special effects were not indicated in the score, if an organist was playing a theater organ capable of an unusual sound effect, such as a “galloping horses” effect, it would be used for dramatic horseback chases.

By the height of the silent era, movies were the single largest source of employment for instrumental musicians (at least in America). But the introduction of talkies, which happened simultaneously with the onset of the Great Depression, was devastating to many musicians.



Silent film actors emphasized body language and facial expression so that the audience could better understand what an actor was feeling and portraying on screen. Much silent film acting is apt to strike modern-day audiences as simplistic or campy. The melodramatic acting style was in some cases a habit actors transferred from their former stage experience. The pervading presence of stage actors in film was the cause of this outburst from director Marshall Neilan in 1917: “The sooner the stage people who have come into pictures get out, the better for the pictures.”[8]


 The visual quality of silent movies—especially those produced in the 1920s—was often high. However, there is a widely held misconception that these films were primitive and barely watchable by modern standards.[3] This misconception comes as a result of silent films being played back at wrong speed and their deteriorated condition. Many silent films exist only in second- or third-generation copies, often copied from already damaged and neglected film stock.[2

As motion pictures eventually increased in length, a replacement was needed for the in-house interpreter who would explain parts of the film. Because silent films had no synchronized sound for dialogue, onscreen intertitles were used to narrate story points, present key dialogue and sometimes even comment on the action for the cinema audience. The title writer became a key professional in silent film and was often separate from the scenario writer who created the story. Intertitles (or titles as they were generally called at the time) often became graphic elements themselves, featuring illustrations or abstract decoration that commented on the action. 



Unidentified silent film


Silent film Metropolis and  Abel Gance‘s Napoléon


maturity in the “silent era”(1894-1929) before silent films were replaced by “talking pictures” in the late 1920s. Many film scholars and buffs argue that the aesthetic quality of cinema decreased for several years until directors, actors, and production staff adapted to the new “talkies“.[2]


Interest in the scoring of silent films fell somewhat out of fashion during the 1960s and 1970s. There was a belief in many college film programs and repertory cinemas that audiences should experience silent film as a pure visual medium, undistracted by music. This belief may have been encouraged by the poor quality of the music tracks found on many silent film reprints of the time. More recently, there has been a revival of interest in presenting silent films with quality musical scores, either reworkings of period scores or cue sheets, or composition of appropriate original scores. A watershed event in this context was Kevin Brownlow‘s 1980 restoration of Abel Gance‘s Napoléon (1927) featuring a score by Carl Davis. Brownlow’s restoration was later distributed in America re-edited and shortened by Francis Ford Coppola with a live orchestral score composed by his father Carmine Coppola.

In 1984, a restoration of Metropolis (1927) with new score by producer/composer Giorgio Moroder was another turning point in modern day interest in silent films. Although the contemporary score, which included pop songs by Freddy Mercury of Queen, Pat Benatar and Jon Anderson of Yes was controversial, the door had been opened for a new approach to presentation of classic “silent” films.

Music ensembles currently perform traditional and contemporary scores for silent films. Purveyors of the traditional approach include organists and pianists such as Dennis James, Rick Friend, Chris Elliott, Dennis Scott, Clark Wilson and Jim Riggs. Orchestral conductors such as Gillian B. Anderson, Carl Davis, Carl Daehler, and Robert Israel have written and compiled scores for numerous silent films. In addition to composing new film scores, Timothy Brock has restored many of Charlie Chaplin‘s scores.

Contemporary music ensembles are helping to introduce classic silent films to a wider audience through a broad range of musical styles and approaches. Some performers create new compositions using traditional musical instruments while others add electronic sounds, modern harmonies, rhythms, improvisation and sound design elements to enhance the film watching experience. Among the contemporary ensembles in this category are Alloy Orchestra, Club Foot Orchestra, Silent Orchestra, Mont Alto Motion Picture Orchestra and The Reel Music Ensemble. Alloy Orchestra, which began performing in 1990, is among the first of the new wave of silent film music ensembles.



The idea of combining motion pictures with recorded sound is nearly as old as film itself, but because of the technical challenges involved, synchronized dialogue was only made practical in the late 1920s with the perfection of the audion amplifier tube  and  introduction of the Vitaphone system.


1921 Four Horsemen of the Apocalypse, one of the highest-grossing silent films.


After the release of The Jazz Singer in 1927, “talkies” became more and more commonplace. Within a decade, popular production of silent films had ceased.

 In other cases, directors such as John Griffith Wray required their actors to deliver larger-than-life expressions for emphasis. As early as 1914, American viewers had begun to make known their preference for greater naturalness on screen.[8]

In any case, the large image size and unprecedented intimacy the actor enjoyed with the audience began to affect acting style, making for more subtlety of expression. Actresses such as Mary Pickford in all her films, Eleonora Duse in the Italian film Cenere (1916), Janet Gaynor in Sunrise, Priscilla Dean in Outside the Law and The Dice Woman and Lillian Gish and Greta Garbo in most of their performances made restraint and easy naturalism in acting a virtue.[8] Directors such as Albert Capellani (a French director who also did work in America directing Alla Nazimova films) and Maurice Tourneur insisted on naturalism in their films; Tourneur had been just such a minimalist in his prior stage productions. By the mid-1920s many American silent films had adopted a more naturalistic acting style, though not all actors and directors accepted naturalistic, low-key acting straight away; as late as 1927 films featuring expressionistic acting styles such as Metropolis were still being released. Some viewers liked the flamboyant acting for its escape value, and some countries were later than the United States in embracing naturalistic style in their films. In fact today the level of naturalism in acting varies from film to film and our favourites may not be the most naturalistic. Just as today, a film’s success depended upon the setting, the mood, the script, the skills of the director, and the overall talent of the cast.[8]


Projection speed

Until the standardization of the projection speed of 24 frames per second (fps) for sound films between 1926


Some countries devised other ways of bringing sound to silent films. The early cinema of Brazil featured fitas cantatas: filmed operettas with singers performing behind the screen.[6] In Japan, films had not only live music but also the benshi, a live narrator who provided commentary and character voices. The benshi became a central element in Japanese film, as well as providing translation for foreign (mostly American) movies.[7] The popularity of the benshi was one reason why silent films persisted well into the 1930s in Japan.

Few film scores survive intact from this period, and musicologists are still confronted by questions when they attempt to precisely reconstruct those that remain. Scores can be distinguished as complete reconstructions of composed scores, newly composed for the occasion, assembled from already existing music libraries, or even improvised.


silent films were shot at variable speeds (or “frame rates“) anywhere from 12 to 26 fps, depending on the year and studio.[9] “Standard silent film speed” is often said to be 16 fps as a result of the Lumière brothers’ Cinematographé, but industry practice varied considerably; there was no actual standard. Cameramen of the era insisted that their cranking technique was exactly 16 fps, but modern examination of the films shows this to be in error, that they often cranked faster. Unless carefully shown at their intended speeds silent films can appear unnaturally fast. However, some scenes were intentionally undercranked during shooting to accelerate the action—particularly for comedies and action films.[9]

Slow projection of a cellulose nitrate base film carried a risk of fire, as each frame was exposed for a longer time to the intense heat of the projection lamp; but there were other reasons to project a film at a greater pace. Often projectionists received general instructions from the distributors on the musical director’s cue sheet as to how fast particular reels or scenes should be projected.[9] In rare instances, usually for larger productions, cue sheets specifically for the projectionist provided a detailed guide to presenting the film. Theaters also—to maximize profit—sometimes varied projection speeds depending on the time of day or popularity of a film,[10] and to fit a film into a prescribed time slot.[9]

By using projectors with dual- and triple-blade shutters the projected rate was multiplied two or three times higher than the number of film frames—each frame was flashed two or three times on screen. Early studies by Thomas Edison determined that any rate below 46 images per second “will strain the eye.”[9] A three-blade shutter projecting a 16 fps film would slightly surpass this mark, giving the audience 48 images per second. A 35 mm film frame rate of 24 fps translates to a film speed of 456 millimetres (18.0 in) per second.[11] One 1,000-foot (300 m) reel requires 11 minutes and 7 seconds to be projected at 24 fps, while a 16 fps projection of the same reel would take 16 minutes and 40 seconds; 304 millimetres (12.0 in) per second.[9]


Top grossing silent films in the United States

The following are the silent films that earned the highest ever gross income in film history, as calculated by Variety magazine in 1932. The dollar amounts are not adjusted for inflation.[14]

  1. The Birth of a Nation (1915) – $10,000,000
  2. The Big Parade (1925) – $6,400,000
  3. Ben-Hur (1925) – $5,500,000
  4. Way Down East (1920) – $5,000,000
  5. The Gold Rush (1925) – $4,250,000
  6. The Four Horsemen of the Apocalypse (1921) – $4,000,000
  7. The Circus (1928) – $3,800,000
  8. The Covered Wagon (1923) – $3,800,000
  9. The Hunchback of Notre Dame (1923) – $3,500,000
  10. The Ten Commandments (1923) – $3,400,000
  11. Orphans of the Storm (1921) – $3,000,000
  12. For Heaven’s Sake (1926) – $2,600,000
  13. Seventh Heaven (1926) – $2,400,000
  14. Abie’s Irish Rose (1928) – $1,500,000

 During the sound era


Although attempts to create sync-sound motion pictures go back to the Edison lab in 1896, the technology became well-developed only in the early 1920s. The next few years saw a race to design, implement, and market several rival sound-on-disc and sound-on-film sound formats, such as Photokinema (1921), Phonofilm (1923), Vitaphone (1926), Fox Movietone (1927), and RCA Photophone (1928).

Although the release of The Jazz Singer (1927) by Warner Brothers marked the first commercially successful sound film, silent films were the majority of features released in both 1927 and 1928, along with so-called goat-glanded films: silents with a section of sound film inserted. Thus the modern sound film era may be regarded as coming to dominance beginning in 1929.

For a listing of notable silent era films, see list of years in film for the years between the beginning of film and 1928. The following list includes only films produced in the sound era with the specific artistic intention of being silent.


In the 1950s,

 many telecine conversions of silent films at grossly incorrect frame rates for broadcast television may have alienated viewers.[12] Film speed is often a vexed issue among scholars and film buffs in the presentation of silents today, especially when it comes to DVD releases of restored films; the 2002 restoration of Metropolis (Germany, 1927) may be the most fiercely debated example.


 Later homages

Several filmmakers have paid homage to the comedies of the silent era, including Jacques Tati with his Les Vacances de Monsieur Hulot (1953) and Mel Brooks with Silent Movie (1976). Taiwanese director Hou Hsiao-Hsien‘s acclaimed drama Three Times (2005) is silent during its middle third, complete with intertitles; Stanley Tucci‘s The Impostors has an opening silent sequence in the style of early silent comedies. Brazilian filmmaker Renato Falcão’s Margarette’s Feast (2003) is silent. Writer / Director Michael Pleckaitis puts his own twist on the genre with Silent (2007). While not silent, the Mr. Bean TV show and movies have used the title character’s non-talkative nature to create a similar style of humor.

The 1999 German film Tuvalu is mostly silent; the small amount of dialog is an odd mix of European languages, increasing the film’s universality. Guy Maddin won awards for his homage to Soviet era silent films with his short The Heart of the World after which he made a feature-length silent, Brand Upon the Brain! (2006), incorporating live Foley artists, narration and orchestra at select showings. Shadow of the Vampire (2000) is a highly fictionalized depiction of the filming of Friedrich Wilhelm Murnau‘s classic silent vampire movie Nosferatu (1922). Werner Herzog honored the same film in his own version, Nosferatu: Phantom der Nacht (1979).

Some films draw a direct contrast between the silent film era and the era of talkies. Sunset Boulevard shows the disconnect between the two eras in the character of Norma Desmond, played by silent film star Gloria Swanson, and Singin’ in the Rain deals with the period where the people of Hollywood had to face changing from making silents to talkies. Peter Bogdanovich‘s affectionate 1976 film Nickelodeon deals with the turmoil of silent filmmaking in Hollywood during the early 1910s, leading up to the release of D. W. Griffith‘s 1915 epic The Birth of a Nation.

In 1999, the Finnish filmmaker Aki Kaurismäki produced Juha, which captures the style of a silent film, using intertitles in place of spoken dialogue.[15] In India, the 1988 film Pushpak,[16] starring Kamal Hassan, was a black comedy entirely devoid of dialog. The 2007 Australian film Dr Plonk, was a silent comedy directed by Rolf de Heer. Stage plays have drawn upon silent film styles and sources. Actor/writers Billy Van Zandt & Jane Milmore staged their Off-Broadway slapstick comedy Silent Laughter as a live action tribute to the silent screen era.[17] Geoff Sobelle and Trey Lyford created and starred in All Wear Bowlers (2004), which started as an homage to Laurel and Hardy then evolved to incorporate life-sized silent film sequences of Sobelle and Lyford who jump back and forth between live action and the silver screen.[18] The 1940 animated film Fantasia, which is eight different animation sequences set to music, can be considered a silent film, with only one short scene involving dialogue. The 1952 espionage film The Thief has music and sound effects, but no dialogue.

In 2005, the H.P. Lovecraft Historical Society produced a silent film version of Lovecraft’s story The Call of Cthulhu. This film maintained a period-accurate filming style, and was received as both “the best HPL adaptation to date” and, referring to the decision to make it as a silent movie, “a brilliant conceit.” [19]

The 2011 French film The Artist, directed by Michel Hazanavicius, plays as a silent film and is set in Hollywood during the silent era. It also includes segments of fictitious silent films starring its protagonists.[20]

Preservation and lost films


Many early motion pictures are lost because the nitrate film used in that era was extremely unstable and flammable. Additionally, many films were deliberately destroyed because they had little value in the era before home video. It has often been claimed that around 75% of silent films have been lost, though these estimates may be inaccurate due to a lack of numerical data.[21] Major silent films presumed lost include Saved from the Titanic (1912);[22] The Apostle, the world’s first animated feature film (1917); Cleopatra (1917);[23] Arirang (1926); Gentlemen Prefer Blondes (1927);[24] The Great Gatsby (1926); and London After Midnight (1927). Though most lost silent films will never be recovered, some have been discovered in film archives or private collections.

In 1978 in Dawson City, Yukon, a bulldozer uncovered buried reels of nitrate film during excavation of a landfill. Dawson City was once the end of the distribution line for many films. The retired titles were stored at the local library until 1929 when the flammable nitrate was used as landfill in a condemned swimming pool. Stored for 50 years under the permafrost of the Yukon, the films turned out to be extremely well preserved. Included were films by Pearl White, Harold Lloyd, Douglas Fairbanks, and Lon Chaney. These films are now housed at the Library of Congress.[25] The degradation of old film stock can be slowed through proper archiving, or films can be transferred to CD-ROM or other digital media for preservation. Silent film preservation has been a high priority among film historians.[26]

the end @ copyright Dr Iwan Suwandy 2011

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The Funeral ceremony of Kim Yong Il–300×300.jpg&#8221; alt=”<br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />
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2 days ago
  at the Kumsusan Memorial Palace in Pyongyang


 a glass coffin a memorial palace in Pyongyang


Kim Jong-il dies aged 69: December 19 as it happened

World leaders call for reform after Kim Jong-il, the leader of North Korea, dies of a heart attack on a train in Pyongyang.

North koreans cry and scream in a display of mourning for their leader Kim Jong II

North Koreans cry and scream in a display of mourning for their leader Kim Jong-
North Korean leader Kim Jong Il has died, Pyongyang announced.

A nation in tears:

SEOUL, South Korea – North Korea announced the death of supreme leader Kim Jong Il and urged its people to rally behind his young son and heir-apparent Monday, while the world watched warily for signs of instability in a nation pursuing nuclear weapons.

South Korea, anxious about the untested, 20-something Kim Jong Un after his father’s 17-year rule, put its military on high alert against the North’s 1.2 million-strong armed forces. President Barack Obama agreed by phone with South Korean President Lee Myung-bak to closely monitor developments.

People on the streets of the North Korean capital, Pyongyang, wailed in grief, some kneeling on the ground or bowing repeatedly as they learned the news that their “dear general” had died of heart failure Saturday at age 69 while carrying out official duties on a train trip.

North Koreans mourn the death of Kim Jong Il… as West fears show of strength from nuclear state’s new leader

  • Kim Jong Il died on a train on Saturday morning of heart attack
  • Came into power in 1994, succeeding his father, Kim Il Sung
  • Third son, Kim Jong Un, unveiled as successor in September 2010
  • His uncle Jang Song Thaek expected to rule behind the scenes as he trains on the job
  • South Korean and Japanese militaries on ‘high alert’
  • North Korea today test-fires short-range missile on eastern coast
  • Fears of behind-the-scenes power struggle which could destabilise region
  • Funeral planned for December 28 in capital of Pyongyang
Kim Jong Il, N. Korea's 'Dear Leader' Dictator, Dead

Kim Jong Il, N. Korea’s ‘Dear Leader’ Dictator, Dead

Dec. 19 (Bloomberg) — Kim Jong Il, the second-generation North Korean dictator who defied global condemnation to build nuclear weapons while his people starved, has died, state media reported. A government statement called on North Koreans to “loyally follow” his son, Kim Jong Un. Rishaad Salamat reports on Bloomberg Television’s “Asia Edge.” (Source: Bloomberg) (/Bloomberg) Correction: Clarification:


North Korean leader Kim Jong Il is dead, according to state television from Pyongyang. There are currently no independent reports confirming his death.

“Our great leader Comrade Kim Jong-il passed away at 8:30 a.m. on Dec. 17,” Korean Central TV reported.

North Korea’s state-run television announced Kim died on Saturday of “physical and mental overwork,” the BBC reported. The AFP said his death was from a heart attack. He reportedly died while traveling.

The world’s only inherited communist ruler, Kim was reported to have been battling health issues that left him further isolated from the outside world.


August ,24th.2011

Kim jong il is dead 2011

North Korea’s leader Kim Jong-Il peers out of a car window after a meeting with Russian officials on August 24, 2011.


North Korean leader Kim Jong Il has been dead for years and replaced by a number of look-alikes, a Japanese academic claims.

One of Kim Jong Il’s doubles in 2008 (left) and the real Kim in 2003

and the information in 2009

Dead body of North Korea’s Kim Jong-Il turns 67


PYONGYANG — Droves of jubilant North Koreans took to the streets nationwide today to celebrate the 67th birthday of North Korean dictator and Great Leader Kim Jong-Il’s dead body.

“We are overjoyed to see the magnificence of our Dear Leader,” emaciated peasant Gwok Shi-Mon said. “He may not be as sprightly as he once was, but his strength and wisdom still show through that glass, coffin-like box in which he sleeps every night.”

Although North Korea denies that Kim, who apparently died last year, is dead, South Korean and U.S. sources said the Kim Jong-Il encased in glass in the rotunda of the reclusive country’s capitol building is indeed the leader’s dead, embalmed body.

“He’s not been seen in public in months,” South Korean Gen. Kai Vi-Tam said from Seoul. “The footage the state-run news agency plays of him is the same every time. It’s of Kim drinking a can of Tab while standing on a balcony waving to an adoring throng of people. At one point Kim picks up a copy of Michael Jackson’s ‘Thriller’ album, and then kills a low-level soldier for accidentally scratching the record while putting the needle on it so the crowd could dance to ‘Beat it’”

Even though Kim lay motionless as hundreds of thousands of North Koreans filed past him, laying crudely wrapped birthday presents in front of the glass box as they passed, His people said they took great comfort in knowing the Dear Leader is close by.

“I could tell the Great Leader was thinking about me as I placed a festively wrapped package of my last pack of cigarettes by his feet,” steel worker Xi Hun-Don said. “I would yank out my own eyeballs with an ax should the Dear Leader deem my cigarettes worthy enough to smoke. That would be a birthday present to me

North Korea expert Professor Toshimitsu Shigemura, a professor of international relations, says Kim died of diabetes in 2003 and has been substituted by up to four body doubles ever since.

Driven by a fear of assassination, Kim allegedly trained his doppelgangers — one of whom underwent plastic surgery — to attend public appearances.

“Scholars don’t trust my reasoning but intelligence people see the possibility that it will turn out to be accurate,” Fox News reported Professor Shigemura as saying.

“I have identified and pinned down every source.”

Kim, 66, has not appeared in public for three weeks amid rumours he is seriously unwell and look Kim in 2004

While Seoul intelligence officials have said they believe he has diabetes and heart problems, they do not think he is near death.

But Professor Shigemura, from Tokyo’s respected Waseda University, believes that Kim actually died sometime during a 42-day absence from public in September 2003.

He claims that whenever anyone is granted a face-to-face meeting with today’s Kim, a senior official is always by his side “like a puppet master”.

Professor Shigemura’s claims, outlined in his book The True Character of Kim Jong-il, have been disputed by North Korean officials.

November 10 2008

Pyongyang, North Korea – With reports of a severe illness having debilitated the North Korean leader, the spin machine in the isolated nation has been working in overdrive. From constant denials to apparently doctored photographs, the government has been doing everything it can to show the world that the ‘Dear Leader’ is alive and well. Now, Kim has appeared on national television to prove he is alive and well, and made a shocking change in the political and social climate of the entire jong-il hip hop master

“We have long been an isolated country, we have long been at odds with our neighbours and the rest of the world but that all changes today,” said Kim in a speech. “I have taken time in isolation and come to the conclusion that the best way for the Korean people to move forward is through music. North Korea will eschew communism and become a hip-hop nation effective immediately. Bling will be issued to every resident starting tomorrow.”

While few details have been released on how the new government will be organized, one immediate change will be the national anthem. Replacing the decades old anthem will be Afrika Bambaataa’s ‘Looking for the Perfect Beat’ (here) and will play in all government offices and schools starting Monday. A redesign of the flag is also on tap, as well as a top down renovation of the schooling system.

“Children will be taught the way of Hip-Hop. Not only the grand history, but also the culture,” continued Kim. “Children must be taught the path, and through the path they will find freedom. It will take a nation of millions to hold us back from our destiny.”

Kim, long an admirer of western culture, has been rumoured to be a lifelong hip-hop fan which in part stemmed from his love of Basketball. In 2000 Former Secretary of State Madeleine Albright presented the leader with a basketball signed by Michael Jordan at the conclusion of a summit between the US and North Korea. He also reportedly uses pure silver chopsticks and has a massive fleet of Mercedes Benz S500’s at his disposal, putting him in line with the upper end of American hip-hop culture.

“From what I’ve heard he’s an old school guy. Grandmaster Flash, Bambaataa, Fab Five Freddy, those kinds of guys, apparently though he’s always got Wu-Tang Clan playing on his iPod. Supposedly his guilty pleasure is Lil Wayne and he shuts it off every time someone walks into the room,” said Scrape TV North Korean analyst Lee Joo-Chan. “That’s great and all but I don’t see how you can translate your hobby and musical taste into a political system. George Bush made a diligent effort in turning the US into a nation of country bumpkins but failed. It’s an interesting experiment but one that may be doomed to failure.”

Many are looking to Kim to implement the changes much like his father, Kim Il-sung, did when the North was driven into communism. While the younger Kim has been looked at as more of an eccentric rather than formidable leader, some believe that he may still have some of the drive and smarts that his father had.wu tang north korea logo

“He is a little funny in the head, everyone knows that, but he’s got the same blood coursing through his veins and that may serve him well in the transition,” continued Lee. “But we need to see details. In a nation where millions of people are starving do they really need to be putting money into breakdancing lessons? Military service or turntable lessons? I don’t see how hip-hop culture lends itself to Socialism so it’s going to be a hard time getting people to see their country in a new way. More power to him, but it’s going to be tough. Word.”

September 9 2008

Pyongyang, North Korea –Rumours are abound that Kim Jong-il, notorious dictator of South Korea has either died, fallen severely ill, or even passed away years ago and has been replaced by lookalikes ever since. His failure to appear at ceremonies marking the sixtieth anniversary of the founding of North Korea has caused even more of a stir in the intelligence community.

kim jong-il smilingTalk that Kim had died many years ago started to surface in August after an article published in the Japanese newspaper Shukan Gendai. Circumstantial evidence seemed to back up the claim, though no hard evidence was presented. The latest talk of a possible stroke would seem to put a damper on the theory, but would likely result in the same outcome.

“If Kim did in fact die five years ago and was replaced by lookalikes, it would hardly be surprising,” said Scrape TV North Korean analyst Lee Joo-Chan. “If that is untrue and he has just recently become ill or died, it’s likely the regime would implement this procedure in order to cover it up. Whether the original story spawned the idea or vice-versa is an intellectual debate. I have little doubt that they would cover up his death whenever it happens. I wouldn’t be surprised if he’s around in one form or another for many years to come.”

North Korea is of course extremely closed and isolated from the rest of the world, so uncovering reliable information concerning any goings-on in the country is extremely difficult. That process is even more complicated when it comes to information about the “Dear Leader” whose face is plastered across the country and is revered in some ways close to a God.   

“Kim is more than a leader, he has positioned himself as the life blood of the people and it would be incumbent on the government to maintain his existence whether it was fact or not. Kim has thrived on misinformation for many years and this would be no different,” continued Lee. “I think the more interesting talk would be how many people in the country could emulate him. The bouffant hairdo is hard to come by these days and even in North Korea I can’t imagine a whole lot of people lining up to double for a pudgy delusional midget. Of course they may not have a choice.”kim jong-il puppet

The other option of course would be using stock footage of the dictator for public appearances and limit meetings with foreign dignitaries. There is at least one instance of footage being used in place of a live appearance, wherein footage from the movie ‘Team America: World Police’ was accidently broadcast across the country. That film features a literal puppet of Kim. The footage was quickly pulled and seems to have had no ill effects on the leader’s reputation.

“Kim is a very unique person to say the least, and I think it would be very difficult to replace him,” concluded Lee. “Of course with the way North Korea is run, fooling the people wouldn’t be an issue. I hope the South Park guys kept their puppets, they may come in handy again.”   

Neither Matt Stone, Trey Parker, nor the North Korean government had any comment

Posted in Asian rare collections | 4 Comments

The Pediatrician And Pediatric science




Dr Iwan Suwandy,MHA

special for my lovng wife Lily W.,MM,

and Grandchild Cessa,celin and antoni


Pediatrician History

Jeffrey Baker

Associate Professor of Pediatrics and Director, History of Medicine Program, Trent Center for Bioethics, Humanities, and History of Medicine

B.S. Duke University
M.D. Duke University School of Medicine
Pediatrics, University of Colorado
Ambulatory Pediatrics, Duke University Medical Center
Ph.D. Duke University

Dr. Baker’s is an academic pediatrician and historian whose scholarship has focused on medical technology, ethics and child health. He has lectured and written extensively on the evolution of premature infant technology. Much of this work is synthesized in his comparative history of neonatal medicine in France and the United States, The Machine in the Nursery: Incubator Technology and the Origins of Newborn Intensive Care (Johns Hopkins University Press, 1996). His more recent work has examined childhood vaccine controversies in the United States and Great Britain. He has also written and edited a history of 20th century American pediatrics commemorating the 75th year anniversary of the American Academy of Pediatrics.

Dr. Baker directs the Medical History Program of the Trent Center for Bioethics, Humanities, and History of Medicine, in which capacity he teaches at all levels of undergraduate and graduate medical education. He has taught undergraduate courses addressing the historical aspects of medical ethics, technology, reproductive medicine, and genetics; currently Dr. Baker directs the Prospective Health Care series within Duke’s Focus program for first-year undergraduate students. Previous responsibilities at Duke have included serving as Interim Director of the Trent Center and Director of the AB Duke Scholarship Program (both between 2005-6), and Medical Director of the Duke Health Center at Southpoint (1999-2003). Dr. Baker practices general pediatrics and serves on the advisory committee for the Pediatric History Center for the American Academy of Pediatrics

1968 – Hattie Elizabeth Alexander died.

Hattie Elizabeth Alexander and Sadie Carlin - 1926
Alexander was a pediatrician and microbiologist who developed the study of antibiotic resistant strains of viruses and pathogens. She developed the first antibiotic treatment for infant meningitis caused by Haemophilus influenzae. Her treatment significantly reduced the mortality rate of the disease. She became one of the first women to head a major medical association when she was the president of the American Pediatric Society in 1964. The photograph is of Miss Alexander (sitting on lab bench) and Sadie Carlin (right) before she received her medical degree

Pediatric University History
Yale Medical University

Department of Pediatrics, 1921-22

The Department of Pediatrics was organized on a full-time basis in 1921 with the appointment of Edwards Park, formerly at Johns Hopkins, as Chairman.Top row: Ernest Caulfield, John C.S. Battey (?), Frank L. Babbot, Joseph Weiner.
Bottom row: Ruth A. Guy, Ethel C. Dunham, Grover F. Powers, Edwards Park, Alfred Theodore Shohl, Martha M. Eliot, Marian C. Putnam.Women were on the faculty of the Medical School from the 1920s on — Martha Eliot and Ethel Dunham had distinguished careers at Yale and at the U.S. Children’s Bureau — but no women were made full professors until 1965.

Pediatric science History

Your Baby’s Eye Exam

The best way to protect your baby’s eyes is through regular professional examinations. Certain infectious, congenital, or hereditary eye diseases may be present at birth or develop shortly thereafter. Yet, when diagnosed early, their impact may be greatly minimized.

So have your baby’s eyes examined – by a licensed eye doctor – before six months of age (or sooner if recommended by your pediatrician) and regularly throughout his or her life.

How Can I Prepare For My Baby’s Eye Exam

Chances are your pediatrician will examine your baby’s eyes in one of your first few visits. The pediatrician will review your baby’s health and family health history. You can prepare for your baby’s appointment using our Eye Exam Checklist. Be sure to tell the pediatrician about any eye health issues in your family, as many of these can be inherited.

How Will the Doctor Test My Baby’s Eyesight?

The pediatrician may use toys and lights to determine your baby’s ability to focus, recognize colors, and perceive depth or dimension. Here are some things you may see during the exam:

  • Alignment Using toys that make noises (or are otherwise intriguing) the pediatrician will cover and quickly uncover each eye to test for a dominant eye
  • Ability to fixate Your pediatrician will move an object in front of your baby’s eyes to see if the eyes can watch and follow the object.
  • Coordination of eye muscles The pediatrician will move a light or some interesting toys in a set pattern to test your baby’s ability to see sharply and clearly at near and far distances.
  • Pupil response to light The pediatrician will shine a small light (a penlight, for example) in your baby’s eye and watch the pupil’s reaction. The pupil normally would get smaller very quickly in response to light.
  • Eyelid health and function The pediatrician will examine each eyelid to be sure it is functioning normally.  This includes a check for drooping eyelid, inflammation, and any other indications that your baby’s eyes need greater attention.

If your pediatrician sees anything out of the ordinary, you’ll be advised to make an appointment with a licensed eye doctor who will perform a more comprehensive evaluation of your baby’s eyes.

What Does a Comprehensive Eye Exam Involve

Babies should have their first comprehensive eye exam by a licensed eye doctor at six months. A licensed eye doctor will perform additional tests that the pediatrician does not.  This is essential if there are any major vision issues that run in your family, as they may have been inherited.   

Your eye doctor will conduct some of the same tests you saw in your pediatrician’s office, but with some important additions:

  • Vision correction The eye doctor will use eye drops to help your baby’s pupils dilate, creating a better window to the back of your baby’s eyes.  This dilation allows your doctor to check for Nearsightedness (myopia), Farsightedness (hyperopia) and Astigmatism.  The drops take about 45 minutes to work, and will blur your baby’s vision and cause a little light sensitivity for a few hours. Using a retinoscope, the doctor will move the light to see it reflected in the pupil.  The shape of the reflection helps the doctor determine if your baby has vision issues that require correction.
  • The interior and back of the eye After dilating your baby’s eyes and dimming the lights, the doctor will use a special instrument called an ophthalmoscope to see through to the retina and optic nerve at the back of the eye. This is where clues to many eye diseases first show up.
  • Tests for a specific issue Be sure to discuss any other concerns you have about your baby’s eyes such as crossed eyes and nystagmus, so your doctor can do the appropriate tests and advise you on the action required.

What If I Can’t Afford to Have My Baby’s Eyes Examined?

Not everyone can afford the preventive health care their babies need – so the American Optometric Association (AOA) has a special program designed to help parents.

Parents can get a FREE comprehensive eye examination for their baby during the first year of the baby’s life. It’s called InfantSee, and the AOA provides the information you need to find a participating eye care professional in your area

Vivian Riggs and Andrew Stella-Vega, both in the USF Health Information Systems department, designed an online preadmission testing history and physical form that not only provides pertinent information ahead of scheduled surgeries, but the information perfectly interfaces with existing patient record and scheduling software (GE’s Perioperative).

2.The pre-admission testing online health history has improved workflow, reduced waste, and improved continuity

Andrew Stella-Vega (left) and Vivian Riggs earned GE’s top award.

This integration has several benefits, chief among them saving time for both patients and nurse schedulers. In addition, the new program – with the checks-and-balances aspect of its targeted medical questions – means fewer same-day cancellations, which cause holes in the surgery schedule that could otherwise be filled with another patient and, many times, waste supplies that are opened in the prepared operating room but need to be discarded because they are exposed and no longer usable.

“The pre-admission testing online health history has improved workflow, reduced waste, and improved continuity,” said Adele Emery, RN, director of the USF Health Ambulatory Surgery Center (ASC).

“The development of the USF online patient health history questionnaire is a major improvement in the preoperative evaluation process,” said Ward Longbottom, MD, who has been the co-medical director and director of anesthesiology at the USF Morsani surgery center since its opening and has been instrumental in the development of the online questionnaire. “It is highly efficient and cost effective along with being a huge patient satisfier. No more lengthy  telephone assessments or inconvenient unnecessary preoperative visits. With the online health history, we’ve seen decreases and hope to eliminate the number of phone calls to patients just to get their health histories. And the ease of integrating this information into our electronic patient records means it can be easily reviewed by the entire health team instantaneously.”

With the new program, patients fill out the easy-to-use, secure online form (created by application developer Stella-Vega) at their convenience prior to surgery. Through an interface program (created by Perioperative System Manager Riggs) the information carries over into the patients’ EMR and the ASC’s scheduling.

GE’s first-place award went to the USF Health IS team.

Previous to the new program, lengthy phone calls between nurse coordinators and patients, excess paperwork in the world of electronic medical records, and miscues in communication between patient and medical personnel were the norm, Riggs said.

“This program definitely streamlined the process for the ASC,” Riggs said. “Preadmission testing nursing labor hours have been cut by 66 percent for patients opting to use the online form. Anesthesiologists reported only positive outcomes and improvement in their patient workflow. And patients seem to really like the process, too. The feedback has been great.”

Stella-Vega said that the next step is to build the tracking programs.

“We’re building the business and number-crunching side of the program now,” he said. “But it’s pretty much unlimited what we can do with this.”

“Vivian and Andrew created a very innovative solution to a basic need at the ASC,” said Sidney Fernandes, interim chief information officer and director of the Application Development for USF Health Information Systems. “This is an ideal project on several levels: it showed good teamwork, it is patient-centered, and it offers great system and workflow improvements.”

The integrated form is one of several projects the USF Health IS department has spearheaded that has benefitted clinical and academic departments throughout USF Health, Fernandes said.

How unique is this new program? Two things hint that the program is significant.

First, Riggs and Stella-Vega earned GE’s 2011 Customer Innovation Award for their work. GE Healthcare provides the awards to recognize organizations that have implemented its GE Centricity Perioperative software in ways that result in marked improvements in clinical efficiency and financial performance. They accepted the first-place award at the GE Healthcare Perioperative conference in early September.

And second, Riggs has received calls from several hospitals and medical facilities asking about the program.

“We built this program from the ground up with input from our anesthesiologist expert, Dr. Ward Longbottom, the Preadmission Testing Nurses, and GE” Riggs said. “Paperwork has begun for the patent.”

Story by Sarah A. Worth, photos by Eric Younghas, USF Health Office of Communications

3.Pediatric Anamnesa (History)

Pediatric History chaudhary photo

The pediatric history, though essentially similar to that for adults, should contain certain information usually not recorded for the older patient.  In addition, some areas of the history require greater or lesser emphasis.  These notes are not intended to define the entire pediatric history, but rather to emphasize the main differences from the history for adults.




  • Identifying
  • The
  • Chief
  • Patient
  • Medical
  • Review of

Identifying Information

The age and sex of every patient, at the beginning, are essential for orderly consideration.  These facts must be included at the beginning of every write-up.

The Informant

One of the most important aspects of the pediatric history is that it is usually obtained from a person other than the patient.  Thus, identification of the source of the information and an estimate of the reliability of that individual are extremely important.  Information may be exaggerated, minimized or withheld by the parent or other individual providing the history.  Since the history is usually taken while the child is present, it is appropriate to turn to him/ her occasionally (provided that he/she is old enough to respond) and seek confirmation of the complaint by asking direct questions, such as “Can you show me where it hurts?”  For the older child, differences between the parent’s assessment of the situation and the child’s version may become apparent.  This type of information can be very useful to the examiner in his/her evaluation of the family, as can other observations of the interaction of patient and child (excessive dependency, unusual degrees of permissiveness or discipline).

Chief Complaint

This is the primary reason why the patient or parent(s) is seeking medical aid and should be in his/her own words.  Remember that the reason stated by the parent for bringing the child to medical care may not be the real one.  The mother who just wants her child to “have a thorough check-up” actually may be seeking help with behavioral problems, school difficulties or other complaints that are uncomfortable for her to discuss.

Patient Profile

The “work” of the young child is play, and that of the older child is school.  Questions about these activities should therefore replace those relating to work and life style for the adult.

Past Medical History

The past medical history of the child should begin with the pregnancy which results in his birth, with particular attention to its length, any significant illnesses or bleeding, the adequacy of prenatal care, and exposure to any drugs or irradiation.  The length of labor, the type of delivery, and the birth weight should be recorded if known.  Problems during the neonatal course, such as the need for being in an incubator, of receiving oxygen, or the presence of “mucus”, jaundice, or cyanosis should be identified.  If the mother’s recollection is hazy (which is frequent for this kind of information), two useful clues may be obtained by determining whether the infant was brought to the mother early and regularly, and whether he went home on schedule with her.  If a Cesarean section was done, indicate why.

For children in the first two or three years of life, information about early feeding patterns can be important, and should therefore be obtained regularly.  Was the infant breast or bottle fed; when were solid foods such as cereal begun; were vitamins or iron given; when was the child weaned from the breast or bottle?

The history regarding communicable diseases is particularly important in children, since the lifelong immunity conferred by most of these diseases is an important consideration in the differential diagnosis in a child with an acute infection.  For similar reasons, the immunization status in regard to diphtheria, tetanus, pertussis, varicella, poliomyelitis, hemophilus influenza Type B, hepatitis B, rubeola, rubella mumps, and stretococcal pneumoniae should be obtained for each patient.  Some patients may have been immunized against influenza, typhoid or other conditions, particularly if they have underlying heart problems or have been abroad.

Family Medical History

A question about congenital anomalies is warranted, particularly if the patient is being evaluated for an anomaly.  ANY DISEASE WHICH IS SUSPECTED IN THE PATIENT MAY NEED TO BE SOUGHT IN THE FAMILY.  Remember – This should be reported from the standpoint of the patient.  (eg. mom may state that her dad has hypertension but you would write: paternal grandfather with hypertension.)

Review of Systems

The systemic review must be tailored to the age and primary complaints of the patient.  A question about urinary or fecal incontinence has little meaning for the small infant!  On the other hand, the occurrence of bedwetting after age five years would be of significance and should be recorded.  Similarly, subtle complaints such as palpitations or parethesias may not be readily recognized or interpreted by a child.

An extremely important aspect of the review of systems in childhood relates to growth and development.  When possible, it is desirable to obtain previously recorded growth data, as are often available from physician’s instruction booklets or from baby books kept by the parents;  these data may be compared with those obtained at the time of the present evaluation.  It is sometimes useful to compare the growth of an individual child with that of his siblings.

Development data may be more difficult to obtain, particularly as children become older; again, baby books may be helpful.  Though information about all of the aspects of development (motor, adaptive, language and personal/social) is desirable, it is often difficult to ascertain the precise ages at which the child achieved a specific milestone.  Recollections about the following tend to be reasonably accurate:

     1.  Motor – age when walked alone, rode a tricycle

     2.  Adaptive – age when learned to button up

     3.  Language – first words and use of words as short sentences

     4.  Personal/Social – age when toilet trained

It is also important to develop some understanding regarding the personality and behavior of the child.  Inquiry should be made regarding the child’s relationship with adults, siblings, and peers.  Patients should be asked about overall behavioral patterns, such as “nervousness,” hyperactivity, or a tendency to become upset with light provocation.  Habits such as thumbsucking, nail biting, and pica should be asked about, as should the common behavioral problems like temper tantrums, sleep disturbances and unusual fears.  It is desirable to get information about whether the child is easy or difficult to discipline, and who in the family is responsible for most punishment.  Detailed discussions about behavior problems should not, of course, be conducted in the child’s presence.


Burnout, Injuries & the Over Trained School Athlete

November 8, 2011 By 3 Comments

The American Academy of Pediatrics recognizes the importance of physical exercise and the potential for school athletics to provide a structured regular form of physical activity for kids.  In an attempt to keep children safe, the AAP makes recommendations regarding the prevention and management of concussions, little league elbow, and various other medical conditions, from bleeding disorders to playing with a single functioning eye or kidney.  The guidelines while helpful do not address each clinical scenario.

In the last 6 weeks, the following children were seen in my office**:

  • 16 yo volleyball player with a history of a fractured spine who trains 5 days a week year round in only one sport
  • 15 yo healthy appearing wrestler with a BMI at the 50% who wants to lose 10 pounds
  • A seventh grader with two days of persistent headache after head trauma during a basketball game
  • Soccer player with one kidney 
  • An obviously anxious 12 yo straight A student with chest pain at every football practice despite a completely negative medical work up for lung and heart problems
  • 17 yo who plays 3 different sports not because he enjoys them but because “he needs to keep his options open for college.”  His practices leave no time for family meals.                                 (**Stories changed slightly to protect identities)

Parents and athletes who present for sport physicals are not interested in modifying their training, changing sports, or slowing down.  Parents expect my signature and clearance, and if I don’t provide it, they can go to the local retail clinic, seek care at another office practice or from a specialty physician.

30-45 million children 6-18yo participate in some type of athletics.  Although exercise is essential to good health, participation in school athletics often results in injury.  For instance, according to the Center for Disease Control, high school athletes account for an estimated 2 million injuries, 500,000 doctor visits, and 30,000 hospitalizations annually.

The CDC funded a study in 2005-06 that included a representative sample of high school athletes from across the nation.  Athletic trainers at the schools tracked injuries (occurred while practicing or playing a game, required medical attention from the trainer or a physician and kept the athlete out of activity for at least one day beyond the injury) and entered them into a internet surveillance system.  They tracked 4.2 million athletes playing football, wrestling, basketball, soccer, baseball, softball and volleyball (see the table below).  Injury rates were highest for football, wrestling and soccer with competition more likely to cause injury than practice.   80% of the 1.4 million injuries were new not recurrent problems.

TABLE. Sport-specific injury rates* in practice, competition,

and overall — High School Sports-Related Injury Surveillance

Study, United States, 2005–06 school year


Sport                       Practice               Competition         Overall

Boys’ football         2.54                           12.09                          4.36

Boys’ wrestling      2.04                           3.93                            2.50

Boys’ soccer           1.58                            4.22                            2.43

Girls’ soccer           1.10                            5.21                             2.36

Girls’ basketball    1.37                           3.60                            2.01

Boys’ basketball     1.46                          2.98                             1.89

Girls’ volleyball     1.48                           1.92                             1.64

Boys’ baseball        0.87                          1.77                             1.19

Girls’ softball         0.79                          1.78                              1.13

Total                       1.69                         4.63                            2.44

* Per 1,000 athlete exposures (i.e., practices or competitions).

Although this study included common sports, there are roughly 30 different options for high school athletics.  If parents and athletes knew the injury rates of various sports upfront would that influence their choice of sport?  The injury rates of junior high, middle school and even elementary school children were not addressed in this study.  However, we do know that the age at which kids play competitively is decreasing and thus injuries are increasing in this younger group.  Maybe our youngest kids should only practice and not compete as that nearly doubles the risk of injury.

The AAP recommends that children be at least 6 years old before playing team sports.  Furthermore the clinical report that addresses injuries and overtraining in athletes encourages pediatricians to:

  1. Encourage athletes to strive to have at least 1 to 2 days off per week from competitive athletics, sport-specific training and competitive practice (scrimmage) to allow them to recover both physically and psychologically. 
  2. Advise athletes that the weekly training time, number of repetitions, or total distanceshould not increase by more than 10% eachweek (eg, increase total running mileage by 2 miles if currently running a total of 20 miles per week). 
  3. Encourage the athlete to take at least 2 to 3 months away froma specific sport during the year. 
  4. Emphasize that the focus of sports participation should be on fun, skill acquisition, safety, and sportsmanship. 
  5. Encourage the athlete to participate on only 1 team during aseason. If the athleteis also a member of a traveling or select team, then that participation time should be incorporated into the aforementioned guidelines. 
  6. If the athlete complains of nonspecific muscle or joint problems, fatigue, or poor academic performance, be alert for possible burnout. Questions pertaining to sport motivation may be appropriate. 
  7. Advocate for the development of a medical advisory board for weekend athletic tournaments to educate athletes about heat or cold illness, overparticipation, associated overuse injuries, and/or burnout. 
  8. Encourage the development of educational opportunities for athletes, parents, and coaches to provide information about appropriate nutrition and fluids, sport safety, and the avoidance of overtraining to achieve optimal performance and good health. 
  9. Convey a special caution to parents with younger athletes who participate in multigame tournaments in short periods oftime. 



Genetic Dysfunction found in Non-neuronal cells for Neurological Disorders

La Jolla, November 9, 2011 – Al La Spada, MD, PhD, et al, used a variety of transgenic mouse models to show that SCA7 results from genetic dysfunction in associated non-neuronal support cells to affected neurons. In collaboration with researchers at UC San Diego School of Medicine and University of Washington, the findings were published in the November 9 issue of the Journal of Neuroscience.
Kawasaki Disease Triggers May Be Wind-Borne

La Jolla, November 10, 2011 – In an issue of Scientific Reports published on November 10, 2011, Prof. Jane Burns et al suggest large-scale wind currents from Asia to Japan and across the North Pacific may be linked to Kawasaki Disease (KD).
Third Annual Pediatrics Translational Research Symposium at Rady Children’s Hospital-San Diego, 2011

October 25th, 2011 – UC San Diego’s Department of Pediatrics and Rady Children’s Hospital proudly hosted the third annual Pediatric Translational Research Symposium on Advanced Genomics and Personalized Medicine. Held at the Acute Care Pavilion at Rady Children’s Hospital, the Symposium was well-attended, with over 100 attendees.

Faculty, Fellows, Residents, and Clinicians invited to our Annual 2011 Pediatric Translational Research Symposium that will be held: Tuesday, October 25, 2011, Acute Care Pavilion Conference Room, Rady Children’s Hospital Campus (Kearny Mesa) from 8:30 am – 4:15 pm; *Breakfast, Lunch, & Refreshments will be provided; * Parking Validation Available
Gahagan named Chief of New Pediatrics Division at UC San Diego

September 26th, La Jolla – Sheila Gahagan, M.D., M.P.H., Professor of Clinical Pediatrics and Division Chief of Child Development and Community Health, has been recently appointed as Division Chief of Academic General Pediatrics, joining this group with the Division of Child Development and Community Health.
Dr. Mark Sawyer Interviewed by Infectious Diseases in Children

In an interview with Infectious Diseases in Children, Dr. Mark Sawyer says vaccination rates are not as strong as they should be, and young babies are at the highest risk for pertussis, a whooping cough that is nearly as contagious as chickenpox.
Obese kids may face social, emotional woes

Dr. Jeffrey Schwimmer, a pediatric gastroenterologist and an associate professor of pediatrics at UCSD and RCHSD, said the physical health risks of obesity in childhood can have lifelong consequences. Those include sleep apnea and fatty liver disease, which can, over time, cause irreversible damage to the liver, diabetes and high blood pressure.
Sivagnanam Receives 2011 NASPGHAN Young Faculty Investigator Award

September 19, 2011, La Jolla, CA – Dr. Mamata Sivagnanam, Asst. Professor and physician-scientist in the Division of Pediatric Gastroenterology, Hepatology and Nutrition at UC San Diego and Rady Children’s Hospital-San Diego, was awarded this year’s NASPGHAN Young Faculty Investigator Award.
What’s in a kids meal? Not Happy News, Researchers Find

The study of data compiled by Dr. Kerri Boutelle et al. in the Department of Pediatrics at the University of California, San Diego, appearing this week in the new journal Childhood Obesity, showed that convenience resulted in lunchtime meals that accounted for between 36 and 51 percent of a child’s daily caloric needs.
Sander Receives 3 Transformative Collaborative Project Awards from Beta Cell Biology Consortium (BCBC)

August 24, 2011, La Jolla, CA – Dr. Maike Sander, Associate Professor in Pediatrics and Cellular & Molecular Medicine, was awarded over $2M collectively in 3 Transformative Collaborative Project Awards from the Beta Cell Biology Consortium (BCBC).
Meet UC San Diego’s New Pediatric Chief Residents, 2011-2012

August 21st, 2011, La Jolla, CA – UC San Diego’s Department of Pediatrics at the School of Medicine, welcomes 3 new Chief Residents for the 2011-2012 academic year – Drs. Megan Browning, Monique Mayo, and Tina Udaka.
UC San Diego’s Alysson Muotri named 2011 Poptech Science Fellow

Dr. Alysson Muotri, Assistant Professor in the Department of Pediatrics/Cellular & Molecular Medicine, University of California, San Diego has been named a 2011 PopTech Science and Public Leadership Fellow. Muotri’s work is currently using stem cells to study possible causes – and cures – for autism and other mental disorders.
UC San Diego School of Medicine Names Feldstein as New Division Chief for Pediatric Gastroenterology and Nutrition

July 1st, La Jolla, CA – The Department of Pediatrics, UC San Diego, Rady Children’s Hospital-San Diego, names Ariel Feldstein, MD, as the Division Chief for Pediatric Gastroenterology and Nutrition. Feldstein joins the Department of Pediatrics from the Cleveland Clinic in Cleveland, Ohio, where he was the Director of Research for the Pediatric Institute.
Low VAPB Protein Levels May Be Cause for Inherited ALS

Published in the June, 2011 issue of Human Molecular Genetics, Alysson R. Muotri, Ph.D. Assistant Professor at UC San Diego’s Department of Pediatrics and Cellular and Molecular Medicine, reported evidence of reduced levels of the VAPB protein which may play a central role in causing inherited amyotrophic lateral sclerosis (ALS).
NEURON: La Spada et al. Discovers Regulators and Noncoding RNA Role in Neurodegenerative Disorders

NEURON, June 22, 2011: Dr. Albert La Spada – Division Chief of Genetics in UC San Diego’s Department of Pediatrics and Cellular and Molecular Medicine, and Rady Children’s Hospital-San Diego, recently identified the mechanism contributing to the transcriptional dysregulation in Spinocerebellar ataxia 7, an inherited neurological disorder.
Sander elected to American Society for Clinical Investigation, 2011

Dr. Maike Sander, associate professor in pediatrics and cellular & molecular medicine, was elected to the America Society for Clinical Investigation. Dr. Sander joins 62 other UC San Diego faculty members who have been elected to the Society since the inception of the UC San Diego School of Medicine.
Immunity: Nizet et al Discovers How Immune System Fights Anthrax Infections

June 22, 2011 – Scientists in collaboration with Dr. Nizet at the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences have uncovered how the body’s immune system launches its survival response to the notorious and deadly bacterium anthrax. Published in the June 22 issue of the journal Immunity, the research describes key emergency signals the body sends out when challenged by a life-threatening infection.
TIME: Parent-Only Education Helps Children Lose Weight

Current treatment programs generally require participation by both parents and children in a plan that combines nutrition education and exercise with behavior therapy techniques.Kerri N. Boutelle, PhD, associate professor of pediatrics and psychiatry at UC San Diego and Rady Children’s Hospital, San Diego, demonstrated that parent-only groups are an equally viable method for weight loss.
Anders Receives 2011 Leonard Tow Humanism in Medicine Faculty Award

May 31, 2011, La Jolla – Dr. Bronwen Anders, professor of pediatrics at UC San Diego, was awarded the prestigious peer-nominated Leonard Tow Humanism in Medicine Award presented by the Arnold P. Gold Foundation. In addition to peer-nominations, Dr. Anders was selected by a subcommittee of the School’s Faculty Council as the faculty recipient of the award.
Tremoulet et al finds Filipino Children at Higher Risk in KD

May 6, 2011, Pediatric Infectious Disease Journal: Tremoulet et al. at UC San Diego, Rady Children’s Hospital-San Diego, finds that Filipino children with KD are at a higher risk for inflammation of the blood vessels of the heart than those of other Asian and non-Asian backgrounds.
King Receives $1.3 Million CIRM Award for Type 1 Diabetes Stem Cell Research

Dr. C.C. King, Associate Research Scientist, in the Pediatric Diabetes Research Center, UC San Diego, has been awarded $1,313,649 to understand the role of microRNAs in the stem cell differentiation process pertaining to insulin-producing cells and possible treatments for type 1 diabetes. The proposed research may provide critical insight to the regulatory mechanisms of cell differentiation and create opportunities to better control differentiation of hESCs into insulin-producing cells.
UC San Diego Pediatrics Group Works To Get San Diego Kids Fully Immunized

Dr. Mark Sawyer is a pediatrician in infectious diseases at UCSD, Rady Children’s Hospital. “We need to help protect others who can’t be immunized, either because their immune system is compromised, or they’re too young. The only way to protect everybody is to get everyone immunized.”
Itkin-Ansari and Tremoulet Receive Prestigious Hartwell Biomedical Research Awards

April 6, 2011 – Pamela Itkin-Ansari, PhD and Adriana Tremoulet, MD, assistant professors in the Department of Pediatrics, UC San Diego, Rady Children’s Hospital-San Diego, are two among twelve recipients of the Hartwell Individual Biomedical Research Awards, honoring researchers whose work contributes to the advancement of children’s health.
NATURE: Structure Formed by Strep Protein can Trigger Toxic Shock

Dr. Partho Ghosh, professor of chemistry and biochemistry, and Dr. Victor Nizet, professor of pediatrics, have collaborated to show how a bacterial protein called M1 combines with human fibrinogen, forming a complex that activates white blood cells to provoke uncontrolled inflammation and shock during severe strep infections.
Stucky Fisher Receives Highest Honor from Society of Hospital Medicine

March 31st, 2011 – Dr. Erin Stucky Fisher, Vice Chair of Clinical Affairs, Professor of Clinical Pediatrics and Hospitalist at UC San Diego, Rady Children’s Hospital-San Diego, was one of four hospitalists to receive the highest honor as a Master of Hospital Medicine (MHM) by the Society of Hospital Medicine this year.

The Department of Pediatrics at UC San Diego, Rady Children’s Hospital-San Diego, congratulates incoming interns for Fall 2011. During the three years of consecutive training, the resident will evolve progressively with increasing knowledge and responsibility to all aspects of general pediatric medicine.
UC San Diego Pediatricians talk about Fetal Alcohol Syndrome on KPBS Radio Show

“Drinking alcohol during pregnancy is one of the leading causes of birth defects.”Drs. Kenneth Lyons Jones, Doris Trauner, and Christina Chambers talk about the characteristics and prevalence of fetal alcohol syndrome on KPBS radio.



 23rd Annual Graduate French and Italian Symposium

Forming and De-forming the human body

April 16-17, 2010

Keynote Presentation by
Walton O. Schalick, III, MD, PhD
Assistant Professor of Medical History, Rehabilitation Medicine,
History of Science and Pediatrics, University of Wisconsin-Madison

23rd Annual Graduate French and Italian Symposium

Forming and De-forming the human body

April 16-17, 2010

Keynote Presentation by
Walton O. Schalick, III, MD, PhD
Assistant Professor of Medical History, Rehabilitation Medicine,
History of Science and Pediatrics, University of Wisconsin-Madison

2010 Symposium website

Keynote Speaker: Walton O. Schalick, III, MD, PhD

We are delighted to have Walton O. Schalick, III, MD, PhD give this year’s keynote address,“‘Caveat corpus:’ Disabled Bodies and the Medical Marketplace in Medieval and Nineteenth-century France.

Walt is Assistant Professor of Medical History, Rehabilitation Medicine, History of Science and Pediatrics at the University of Wisconsin-Madison. Walt’s research embraces a triptych of: the history of medieval medicine and pharmacology, the history of children with physical disabilities in 19th- and 20th-century Europe and the US, and the practical ethics of pediatric emergency research, some of which has appeared in articles and chapters and the balance of which is pending in two monographs. He is Associate Editor for the five-volume, Encyclopedia of Disability (2005), which won Best Reference Award from the Library Journal and an Outstanding Award from the American Library Association’s Booklist Journal.

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Mission statement of the GAFIS symposium

The Graduate Student Symposium of GAFIS, now in its 23rd year, provides a forum for intellectual and scholarly exchange in a positive collegial atmosphere. Interdisciplinary in nature, this national event gives future colleagues the chance to meet each other and to hear about current issues in upcoming research. Excellence and pertinence are assured through an anonymous and peer juried selection process.

Basic criteria for the selection process:

  • Presentations must address the topic of the symposium, respecting all constraints given in the call.
  • Presentations should be innovative, problematizing the chosen issue within a theoretical framework.
  • Presentations should be organized into focused panels that clearly complement each other.

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Call for papers
Abstract deadline February 1, 2010

The body is a big sagacity,
a plurality with one sense,
a war and a peace,
a flock and a shepherd.
– Friedrich Nietzsche

The human body has continued to captivate intellectuals of the arts and sciences throughout history, whether through an aesthetic or physiological study of its structural form and internal mechanisms or in an attempt to comprehend the complexities of the mind that reside within the biological machine. Literature, art, music, film, and storytelling often turn our attention to these ideas of the body, and their inquiries into the physical body and the mind have framed our universal conceptions of health and disease while also giving rise to myriad variations on the notions of bodily normality and abnormality. The body becomes a receptacle for our non-corporeal collective and individual identities, divisions, and prejudices. Sick or well, beautiful or ugly, powerless or powerful, the body is the site of competing visions that structure our perceptions of its physical form and its philosophical and social signification. While we frequently favor the “normal” and thereby reject the “abnormal”, it is the bodily abnormalities that best explore and question our definitions and interpretations of the body. Reflection on these bodily deviations not only elucidates what we consider to be normal and why, but it also destabilizes conventional distinctions between the typical and the atypical, between conformity and deviancy.

The 23rd Annual Symposium of the Graduate Association of French and Italian Students seeks to investigate various representations of the deformed or deviant body in order to explore what constitutes our formulation of health (normality) and disease (abnormality).

We welcome submissions from all applicable disciplines that shed light on the ways in which we can “reform” our general conceptions of the body through the lens of the deviant or otherwise “deformed” body.

Suggested topics include, but are not limited to:

The Sick Body:

  • Physical illnesses, epidemics, disabilities, doctors and medicine
  • Mental illnesses, neuroses, psychoses, the mentally ill as Other, treatment, therapy, the fragmentation of the self
  • Medical or societal definitions of the healthy and unhealthy human body

The Ugly Body:

  • Aesthetic conceptions of the body in artistic, visual, literary and cinematographic forms
  • Physical deformities, monstrosities, the grotesque
  • Fragmentation, bodily manipulation or transformation

The Sexual Body:

  • Queer studies and the queering of the body, sexuality, transsexuality
  • Gender studies, Woman as Other, masculinities and feminities, social or physical gendered roles
  • Eroticism, fetishism, masochism

The Powerless Body:

  • Crimes against the individual, crimes against humanity, genocide, persecution, destruction of the body
  • Politics, authority, regulation of the body
  • Effects of colonialism, occupation, wars on the body

We invite abstracts in English ranging from 200 – 250 words that relate to or expand upon the topics suggested above. Papers will be limited to 20 minutes and must be presented in English. In your abstract, please include name, email address, academic affiliation, and AV requests. Along with your abstract submission, please suggest the category or categories to which you feel your submission is best suited.

Please address inquiries and abstract submissions to Theresa Pesavento and Tina Petraglia at“>. Abstracts must be received no later than February 1, 2010. For further information, please visit our official GAFIS symposium website listed below.






















Physical Examination of the Infant and Child

  • Introduction
  • Approach to
    the Child
  • Vital Signs
    and Measurements
  • Head to
  • H&P Tips


Many students, and experienced physicians, approach the examination of the infant and child with trepidation and lack of confidence.  In actuality, the thorough examination of a pediatric patient can be accomplished in only a few minutes if the examiner takes the time to establish rapport with his patient, approaches the task in an organized and logical way, and is familiar with the normal variations in pediatric patients.  You are encouraged to use every opportunity for examining the infant or child, for only with experience will you be able to accomplish the task easily and interpret the findings accurately.

Approach to the Child

The normal apprehension of the young patient can often be alleviated by a gentle and friendly approach.  Most physicians develop a few “tricks” that fit their style and personality, and help them to achieve a satisfactory examination.  It may be useful to allow an infant to have his bottle or a pacifier.  An older infant or a young child is often best examined on his mother’s lap.  Allowing the child to touch or play with the examination instruments may relieve his fear of them.  It is often helpful to establish physical contact with the child prior to the examination, such as handing him a toy or even playing with him gently.  Above all, carry out first those parts of the examination that would be most interfered with by crying, such as auscultation of the heart or palpation of the abdomen; examination of the ears, eyes, and throat or a rectal examination should be deferred until last!  If all else fails, and using a kind and understanding attitude, restrain the child firmly but gently, and get the examination done as expeditiously as possible despite his apprehension and resistance. 












Vital Signs and Measurements

The temperature of infants and pre-school children child is best taken rectally since most younger children cannot be trusted to hold the thermometer under the tongue without biting or dropping it.  The heart rate of young infants is often easiest to measure by auscultation at the cardiac apex.  The respiratory rate should always be counted, especially in infants, since tachypnea may not be appreciated otherwise. Length is recorded for infants and toddlers less than 3 years while supine; height is recorded for the older child who is measured while standing.  Measurement of head circumference is done at the time of each visit during the first two years of life, but usually only on the first visit thereafter, unless apparently abnormal.

Head to Toe Exam

  • Lymph
  • Eyes
  • Ears
  • Mouth and
  • Chest
  • Abdomen
  • Extremities

Lymph Tissues

The findings of nodes up to one centimeter in diameter in the anterior cervical and inguinal regions is common in children, and of itself should not be considered to be significant.  We reiterate strongly the notation in your text regarding the frequency with which normal children have normally large tonsils.


Lack of cooperation of the patient discourages routine funduscopic examination in infants and young children, but at least the presence of a red reflex should be determined.  The early diagnosis of strabismus, if present, is essential, and should be determined by identifying an asymmetric reflection of a bright light in the eyes, or by the use of the “cover test.”  (Cover one eye at a time, and observe for shifts of the uncovered eye, or of the covered one after the cover is quickly removed.)


Otoscopic examination is an essential part of every pediatric evaluation.  In the infant, the canal is directed upward, so the auricle should be pulled downward to view the drum, rather than upward and back as in the older child and adult.

Mouth and Throat

This phase of the examination is usually best left until last; even some very “good” children become upset when approached by a physician with a light in one hand and a tongue blade in the other.  Every child should be given the opportunity of opening his mouth and extruding his tongue without “assistance”; it is often possible to visualize all structures down to and including the epiglottis in this way.  If the child is uncooperative and resistant, assistance of the mother or nurse should be obtained so that the examination can be conducted as expeditiously as possible; the hands and head can be immobilized at the same time for example by “pinning” the raised arms of the supine child against the side of his head.

The most common health problem of children is dental caries; inspection of the teeth and gums should be a routine part of each examination.


During early infancy, and especially in premature infants, respiratory movement may be irregular, intermittent and variable in rate and depth.  Pauses between breaths up to 10 seconds, in the absence of cyanosis or other indicators of respiratory distress, are common in normal infants during sleep.  Breathing during infancy and early childhood is characteristically abdominal or diaphragmatic in appearance.  Thoracic movements with breathing become more predominant around age 7-8 years and older.  The normal range of respiratory rates, sleeping and awake is found in your references.

Slight retractions with inspiration are commonly observed, especially during infancy.  More pronounced retractions, especially when associated with tachypnea, are seen with important pulmonary disease.

Percussion is performed in infants and children in much the same manner as for adult patients.  Auscultation requires a stethoscope with small enough bell or diaphragm to fit closely over the interspaces.  In infancy and through age 5-6 years, breath sounds are relatively louder and harsher compared with those in adults.  Classify breath sounds as:

Vesicular (loud during inspiration, medium-to-high pitched, and long duration; heard best over the upper lung fields and into the axillae).

Tracheal (heard over the trachea / upper sternal region;  more tubular and higher pitched than vesicular breath sounds).

Bonchovesicular (longest during expiration, with high pitch and increased amplitude compared to inspiratory phase sounds; heard best between scapulae and parasternal anteriorly).

Rhonchi (musical continuous sounds; includes categories of wheezing and vibrations).

Rales (crackling or bubbling; fine versus coarse).

Rubs (grating, jerky, leathery, creaking, rubbing sounds which can be intensified with increased pressure on the chest wall with the stethoscope).

Heart and Blood Pressure

Examination of the heart begins with inspection for the normal apical impulse as well as any unusual precordial impulses.  These may be difficult to palpate in infants, but by age 4-7 years most children will have a palpable apical impulse in the 5th to 6th interspace within the mammary line.  It is best palpated with the child sitting and leaning forward.  During this portion of the cardiac exam, it is important to palpate for pathological thrills associated with the louder (grade 4 and louder) murmurs.  The determination of heart size by percussion is of limited accuracy for most examiners (malposition of the apical impulse is usually a better indicator of possible cardiac enlargement).

The resting pulse rate should be recorded for comparison with reference values.  The normal range of resting heart rates for infants and children is found in your references.

In sinus arrhythmia the pulse rate increases during inspiration and slows during expiration.  This is a normal finding in most children above age three.  A slow heart rate (relative to the ranges described above) is frequently noted in healthy trained athletes. 

Palpation of the femoral pulses should be routinely performed to detect possible coarctation of the aorta, however presence of a normal femoral pulse does not exclude coarctation.

The preferred stethoscope for cardiac auscultation in children is one with a combined bell (for low frequency sounds) and small diameter diaphragm (for mid-to-high frequency sounds).  Examine heart sounds with the patient in the following positions:  supine, left lateral decubitus, sitting, leaning forward, and standing.  In most normal children, S1 is louder than S2 near the apex, and the converse is true near the base.  Splitting of S2 is best appreciated using the diaphragm near the base of the heart.  The sounds split during inspiration and are almost synchronous during expiration.  In the newborn, S2 is either a single sound or minimally split due to the normally high neonatal pulmonary arterial resistance and afterload, plus the relatively fast heart rates in this age group.  An apical S3 is often heard during diastole in normal children.  When an S3 is present in a tachycardic patient or with other findings suggesting heart disease, it is more appropriate to label it as a gallop rhythm.  S4 diastolic sounds are never normal.

Heart murmurs are present in around 50% of children, while the incidence of congenital heart disease is slightly less than 1% in the general population.  Clearly therefore, most murmurs will turn out to be innocent.  Determining whether a murmur is normal (innocent) or pathological requires more than simply listening to heart sounds.  This assessment includes relevant past and family history, other aspects of the physical examination, occasionally laboratory testing (e.g., chest x-ray, electrocardiography, and/or echocardiography), and is frequently made clear simply on the basis of follow-up.

Describe murmurs on the basis of:

Position in the cardiac cycle (e.g., systolic, diastolic, continuous).

Either ejection or regurgitant in character.  Ejection murmurs are generally heard over the base and are frequently normal or innocent.  Regurgitant systolic murmurs are always pathological, and are heard closer to the apex.  Regurgitant diastolic murmurs are also always pathological in origin.

Transmission (i.e., where does the murmur radiate).

Duration (e.g., early systolic, holosystolic, early diastolic).

Quality (e.g., blowing, rasping, rumbling, etc.)

Pitch (e.g., high pitch or frequency heard best with the diaphragm versus low-pitch heard best with the bell).

Intensity (i.e., grade 1-6)

Response to exercise and/or change of position (e.g., loudest while supine).

Blood pressure determination in the arms and legs should be included in routine well-baby and well-child examinations.  Except for infants, the BP should be taken while the child is sitting.  Blood pressures recorded with an inappropriately small cuff will be too high, and those with too large a cuff may be falsely low.  The proper cuff has a width which is approximately 40% the circumference of the extremity where it is placed.  The two measurement methods in most widespread clinical use are sphygmomanometric and oscillometric (e.g., the Dynamap automated BP device).  The normal range for blood pressure varies depending upon age, size (e.g., height), and sex of the patient.  Tables of normal blood pressures are found in your references.


The liver edge in the infant is often palpable one to three centimeters below the right costal margin; apparent hepatomegaly may be the result of depression of the diaphragm (e.g. due to a lower respiratory infection or asthma) –appreciation of the normal consistency and edge of the liver will help in identifying this problem.  The spleen tip may also be palpable in normal young children.  Palpation of the femoral pulse should be a routine part of the examination of the young infant, since it may lead to the diagnosis of coarctation of the aorta.

The presence of an inguinal hernia may be detected in the infant and young child by palpating over the inguinal canal for the presence of the sac which is manifested by thickening of the cord structures and sometimes by the sensation of a “silk-glove” beneath the examining finger.  A hernia in a female may contain the ovary which can be identified as a small mass within the protruding sac.

Genitalia: Male

The urinary meatus should always be inspected; a tiny round opening instead of the normal slit may indicate the presence of stenosis.  Because of the very active cremasteric reflex, small children may appear to have cryptorchidism; if the hands are warm and gentle, the apparently undescended testis can often be milked down the canal and into the scrotum to confirm its normal location.

Tanner staging is important.

Genitalia: Female

Adhesions of the labial mucosa are fairly common in young girls, and probably require no treatment if not extensive.  A white discharge is often seen in normal girls during the year or so preceding the onset of menstruation.  Inspection of the vaginal orifice for foreign bodies, or the obtaining of vaginal material for laboratory examination, is sometimes facilitated by placing the child in the knee-chest position.  Digital or instrumental examinations of the vagina are not done routinely in children, but only on specific indication.  Tanner staging is important.

Anus and Rectum

Rectal examinations are not done routinely in children, but should certainly be performed on the slightest indication, including some of those complaints for which a pelvic examination would be done in the adult female.  Rectal exam may be helpful in identifying the presence of a vaginal foreign body.  INSPECTION IS MANDATORY IN ANY EVENT.


The shape of the legs and feet of infants and young children is determined to some extent by the intrauterine position.  Some degree of bowing and inward rotation is common, but external rotation may occur.  The foot of the infant tends to appear flat, and the pre-school child’s foot is often pronated.  In the latter circumstance, having the child stand on his toes may reassure the examiner of the normalcy of the longitudinal arch.  Mild degrees of knock-knee and bow-legs are not significant in young children.

The ability of the thigh to be abducted at the hip should be tested throughout infancy, since inability to abduct is the commonest presenting finding in infants with congenital hip dysplasia.













Robert E. Merrill, M.D.
Former Assistant Editor ofThe Journal of Pediatrics


Perhaps the second most difficult area in the entire process is spelling.  We hold to the notion that those who have at least one college degree and will soon have another, should be able to use English with reasonable facility.  Some common errors, along with notes of explanation follow.  Please understand that this list barely scratches the surface.

Mucous This is the adjective and is not to be confused with:
Mucus  This is the noun.  They are not interchangeable.  Nouns are things which adjectives modify.
Funduscopic The only correct way, believe it or not.
Inflammation There are 2 “m’s” in this word.
Inflamed There is only 1 “m” here, so save them.
Vomiting Save your “t’s”, they also may become valuable some day.
Enfamil A proprietary milk product.
Organomegaly One “l” is enough.
Microcephalic With 2 “l’s” it becomes an outrageous pun.

Words to be Avoided and Words to be Used Correctly

There are many lay terms that have no place in a medical document.  Others are not words at all and should never be used anywhere.  Some of these are:

Mucousy The word you are looking for us mucoid.
Pussy Here the word is purulent.  No further comment seems advisable.
Temperature We all have a temperature; some of us have a fever.
Phlegm The word is mucus, not to be confused with mucous.
To seize Meaning to have a seizure.  To seize is to grab.
Matter A lay term if it means pus in the eye.
Stomach Meaning abdomen.
  There is no such thing as an acute abdomen.  There may be an acutely inflamed abdomen.

Strictly avoid the apothecary system at all costs.  The most confusing term is grains which may be abbreviated gr. and which in turn may be confused with grams.  To protect yourself and to protect your patients, never use this term.  Absolutely.  It is not difficult to remember that 65 mg = one of those things.  Other units in the apothecary system are even more archaic.


Don’t use them!


The organization of your write up should be constructed with the following thoughts in mind.

Please remember that the chief complaint is exactly that–not a complete history.

The present illness should contain all of the information which is germane to the problem which brought the patient into the hospital.  This must include both positive findings and pertinent negatives.  The review of systems must contain all of the remaining points which may be germane to the case.  For example, if the patient is thought to have asthma, then you will wish to include some comments in the present illness or review of systems in regard to symptoms of cystic fibrosis, which always is part of the differential of asthma.  But not both.  Relative importance is the determining factor; there are no absolute rules.  Repeat nothing.  Once you have mentioned it once in the history, please feel free to reference it throughout.  Always time everything in relation to admission in chronological order.  Absolute times and dates are worthless.

Omit nothing in the physical examination.  Those parts of the body which you do not invade must still be viewed and described.  Specifically, this refers to ear drums, fundi, breasts, genitalia, and the remainder of the perineum.  Always fully describe every abnormality.  Size, shape, tenderness, color, and so on.

If you admit a patient who has been in several times for the same problem (for example, a patient with a malignancy, hemophilia, myelomeningocele, or some other chronic condition), you may limit your write up to a review of all available information succinctly presented, a description of the present illness or present episode which brought the patient to the hospital, and the usual complete physical examination.

In the family history, be sure that the facts are related to the suspected diagnosis.  This will demand a  knowledge of genetic patterns which are to be found in textbooks.  For example, the questions to be asked, if you suspect hemophilia or cystic fibrosis must be quite specific and different.


The conclusions which you reach are the most important part of the entire write up and of course the conclusions must be based on what has gone before.  In other words, the findings should logically lead to the conclusions.  You are entitled to at least  one diagnosis.  Avoid even a very short list of “rule-outs.”  We wish to know what you think the patient has, not what he does not have and we wish to know why you reached a certain conclusion.  The diagnosis is meant to explain the chief complaint, which was the primary reason for admission to the hospital.  In every instance where an etiology can be suspected, it must be indicated.  Using the term virus or some other generality is not acceptable.  When you write out the  plan for the patient, do not include any order with which you do not agree.   Anything which you think should be done and is not ordered should be listed with the reason given.  Do not lump chemistries; do not indicate a  “CMP.”.  Rather, designate those portions of that study which are indicated in this instance.  Always explain any order which is in any way debatable, indicating why you think that order should be written or that study requested.

Please review this paper carefully.  If you will adhere to these suggestions, you will find that there will be much more time for advanced learning.



H&P Grading Form

grading form


Posted in pediatric history | 2 Comments

The Rare Imperial Qing Landscape Decorations Ceramic Found In Indonesia












The Driwan’s  Cybermuseum


The Rare Qing Imperial Landscape Decoration Ceramic

Found In Indonesia


During Qing Dinasty, not many landscape decoration ceramic gift by the emperor to Indonesian Sultanate.

I have only found two ceramic from the imperial Qing de Zhen one bigger plate 35 cm and one cup, many repro items with lower quality exist.

If the Indonesian collectors have the  imperial landscape decoration ceramic which found in Indonesia , please be kind to  report.

I need the informations to complete my research,for that thanks very much.

For all collectors Merry Christmas 2011 and happy new year 2012

Jakarta,December 2011

Dr Iwan suwandy,MHA


Dr Iwan Collections

original artifact(digital restoration)

International Collections

The end @ copyright Dr Iwan Suwandy 2011

Posted in asia chinese overseas collections. | Leave a comment

The Cute’s Innocent Expression Art Photography PART ONE










The Driwan’s  Cybermuseum


part one


If You want to choose a girlfriend,fiance or Wife,please look rthdeir innocent exprsession like the art photography below.
















the end @ copyright Dr Iwan suwandy 2011


Posted in art photography | Leave a comment

The Sinking of Lampong Poetry about Krakatoa Mount Eruption 1883











The Driwan’s  Cybermuseum

The sinking of Lampong poetry

The eruption of Mount Krakatau


Top of Form

Long before foreign researchers wrote about the eruption of Mount Krakatau (Krakatoa, Carcata) on 26, 27, and August 28, 1883, a native witness has written a very rare and interesting, three months after the eruption of  Krakatoa through Lampung Karang (Lampong sinking) poetry .


“Scientific studies and bibiliografi about Krakatoa almost missed include only indigenous written sources, which record the testimonies of the eruption of Krakatoa in 1883. Two years of research, I found the only native testimony in written form, “he said. Before the eruption on 26, 27, and August 28, 1883, the Krakatoa volcano has coughed since May 20, 1883. Krakatoa eruption caused pyroclastic as high as 70 km and 40-meter high tsunami that killed about 36,000 people.

Before the 1883 eruption, Mount Krakatoa had never exploded around the year 1680 / 1.

The eruption that led to the three islands adjacent to each other; Sertung Island, Little Rakata Island, and the island of Rakata. Suryadi explained, as long as it is to be reading about the eruption of Mount Krakatoa is a complete research report GJ Symons et al, The Eruption of Krakatoa and Subsequent Phenomena: Report of the Krakatoa Committee of the Royal Society (London, 1888).

While the indigenous written sources published in Singapore in printed form stones (litography) in 1883/1884. Kolofonnya recorded in 1301 AH (November 1883-October 1884).


The first edition is titled Poetry Lampung District Water and Rain ridden by Abu (42 pages). “A short time later came the second edition of this poem with the title This is the poem Lampung ridden Sea (42 pages). The second edition was also published in Singapore on 2 Safar 1302 H (21 November 1884), “he explained.
The third edition of the poem titled Lampung and Anyer and the Cape Coral Sea Rise (49 pages), published by Haji Said. This third edition also published in Singapore, bertarikh 27 Rabiulawal 1301 AH (January 3, 1886). In some ads, this third edition of the poem called Anyer Sunset District. “

The fourth edition of this poem, the last edition as far as I know, This is the poem entitled The Karam Lampung (36 pages). This fourth edition also published in Singapore, Safat bertarikh 10 1306 H (October 16, 1888), “said Suryadi, the dozens of research results have been published in various international journals.
According to Suryadi, the fourth edition of the text special poem written in Malay and Arabic wear-Malay (Jawi). From the comparison of the text which he did, there are significant variations between each edition. This indicates that kelisanan influence is still strong in the tradition of literacy that began to grow in the archipelago in the second half of the 19th century.
Suryadi who managed to identify the place where copies of all editions of Lampung Karam poem that still exists in the world until now to mention, Lampung poem written Karam Mohammed Saleh. He admitted writing the poem in Kampung Bangkahulu (then called Bencoolen Street) in Singapore. “Muhammad Saleh claimed was in Cape Coral when the eruption of Krakatoa occurred and witnessed the great natural disaster that with his own eyes. It is likely that the poet was a victim of the eruption of Krakatoa which went fled to Singapore, and brings scary memories of natural disasters mahadahsyat it, “he said.
 Lampung Karam or the sinking of Lampong poetry can be categorized as a poetic journalism, because the more strongly highlight the nuances of journalism. In Lampung Karam Poetry 38 pages in length and 374 verse, Mohammed Saleh dramatically illustrate the great disaster that followed the eruption of Mount Krakatoa in 1883. He told the destruction of villages and mass death caused by the eruption. Areas such as Earth, Kitambang, Gutters, Kupang, Lampasing, Umbulbatu, Benawang, Rhino, Limes, monkey, Mount Bases, Gunung Sari, Minanga, Tanjung, Kampung teba, Middle Village, Kuala, Rajabasa, Cape Coral, Island also Sebesi , Sebuku, and Peacock devastated by the tsunami, mud, and rain of ash and rock.
The author tells how in a heartbreaking situation and turmoil, people are still willing to help each other help each other. However, not a few who take the opportunity to enrich themselves by taking the property and other people’s money is overwritten disaster. Besides tracing the editions published poem Lampung Karam remaining in the world until now, the study also presents transliterations Suryadi (control characters) text of this poem in the Latin alphabet.

another info

The legendary annihilation in 1883 of the volcano-island of Krakatoa — the name has since become a by-word for a cataclysmic disaster — was followed by an immense tsunami that killed nearly 40,000 people. Beyond the purely physical horrors of an event which has only very recently become properly understood, the eruption changed the world in more ways than could possibly be imagined. Dust swirled round the world for years, causing temperatures to plummet and sunsets to turn vivid with lurid and unsettling displays of lght. The effects of the immense waves were felt as far away as France. Barometers in Bogota and Washington went haywire. Bodies were washed up in Zanzibar. The sound of island’s destruction was heard in Australia and India and on islands thousands of miles away.


The 1883 explosion on an uninhabited island in Indonesia was one of the most catastrophic in history. Before the eruption, this island in the Sunda Straits between Java and Sumatra islands was made up of three stratovolcanoes that had grown together.

In the summer of 1883, one of Krakatau’s three cones became active. Sailors reported seeing clouds of ash rising from the island. The eruptions reached a peak in August, culminating in a series of tremendous explosions. The most ear-shattering eruption was heard in Australia, more than 2,000 miles (3,200 kilometers) away.

Ash was sent 50 miles (80 kilometers) into the sky and blanketed an area of 300,000 square miles (800,000 square kilometers), plunging the area into darkness for two and a half days. The ash drifted around the globe, causing spectacular sunsets and halo effects around the moon and sun.

The explosions also sent as much as 5 cubic miles (21 cubic kilometers) of rock fragments into the air. The northern two-thirds of the island collapsed under the sea into the newly vacated magma chamber. Much of the remaining island sank into a caldera about 3.8 miles (6 kilometers) across.

The collapse set off an immense series of tsunamis, or giant sea waves, that traveled as far as Hawaii and South America. The largest wave loomed 120 feet (37 meters) high and destroyed 165 nearby settlements. All vegetation was stripped bare, structures were
demolished, and some 30,000 people were washed out to sea in Java and Sumatra.

Krakatau was quiet until the 1920s, when volcanic activity began again. Since then, eruptions have built a new cone, Anak Krakatau, or “child of Krakatau” in the center of the caldera created in 1883

Krakatoa eruption 1930


Krakatoa mount now


the end @ copyright Dr Iwan Suwandy 2011

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The Rare King Farouk , Fuoad and other Egypt Stamps










The Driwan’s  Cybermuseum


Rare Egypt



1.Port Fuoad Overprint Stamps 1926

a. On King Fuoad stamps 

Est. £600-700

On Congres International De Navigations Stamps

Est. £120-150


2.King Fuoad Wedding stamp


Est. £120-150 


Port Fuad



Port Fuad

Port Fuad as seen across the Suez Canal from Port Said.

Port Fuad is located in Egypt

Port Fuad

Location in Egypt

Coordinates: 31°15′N 32°19′E / 31.25°N 32.317°E / 31.25; 32.317
Country  Egypt
Governorate Port Said Governorate
Population (2003)
 – Total 560,000
Time zone EST (UTC+2)
 – Summer (DST) +3 (UTC)

Port Fuad (Arabic: بور فؤاد ‎; Būr Fu’ād) is a city in north-eastern Egypt under the jurisdiction of Port Said Governorate, located across the Suez Canal from Port Said. It forms the northwesternmost part of Sinai Peninsula and has a population of 560,000 (as of 2003). Port Fuad and Port Said together form a metropolitan area.

Port Fuad was established in 1926, principally to relieve overcrowding in Port Said, and was named after King Fuad I (also transliterated as Fuad), the first holder of the title King of Egypt in the modern era (having previously held the title Sultan of Egypt).

The city is located on a triangular island which is bounded by the Mediterranean on the north, the Suez Canal on the west, and the relatively new junction between the Suez Canal and the Mediterranean on the east. The Suez Canal Authority forms the main employment of the city, and its employees comprise most of the population. It has one general hospital.

After the war of 1967 Port Fuad was the only piece of Sinai held by the Egyptians. The Israelis tried to capture Port Fuad countless of times during the War of Attrition, but failed each time. During October War Port Fuad was secured and land was regained around it to ensure it would never be attacked or bombed again by the Israelis. The war ended with a strategic victory for Egypt, and in the Camp David Accord in 1978 Israel agreed to return Sinai to Egypt peacefully, and later the two countries signed a peace treaty. Today Port Fuad is a major Air Defense Position for Egypt.


Local dissatisfaction with Ismail and with European intrusion led to the formation of the first nationalist groupings in 1879, with Ahmad Urabi a prominent figure. In 1882 he became head of a nationalist-dominated ministry committed to democratic reforms including parliamentary control of the budget. Fearing a reduction of their control, the UK and France intervened militarily, bombarding Alexandria and crushing the Egyptian army at the battle of Tel el-Kebir.[31] They reinstalled Ismail’s son Tewfik as figurehead of a de facto British protectorate.[32]

Female nationalists demonstrating in Cairo, 1919

In 1914 the Protectorate was made official, and the title of the head of state, which had changed from pasha to khedive in 1867, was changed to sultan, to repudiate the vestigial suzerainty of the Ottoman sultan, who was backing the Central powers in World War I. Abbas II was deposed as khedive and replaced by his uncle, Hussein Kamel, as sultan.[33]

In 1906, the Dinshaway Incident prompted many neutral Egyptians to join the nationalist movement. After the First World War, Saad Zaghlul and the Wafd Party led the Egyptian nationalist movement to a majority at the local Legislative Assembly.

When the British exiled Zaghlul and his associates to Malta on 8 March 1919, the country arose in its first modern revolution. The revolt led the UK government to issue a unilateral declaration of Egypt’s independence on 22 February 1922.[34]



The new government drafted and implemented a constitution in 1923 based on a parliamentary system.

 Saad Zaghlul was popularly elected as Prime Minister of Egypt in 1924.

 In 1936 the Anglo-Egyptian Treaty was concluded. Continued instability due to remaining British influence and increasing political involvement by the king led to the dissolution of the parliament in a military coup d’état known as the 1952 Revolution. The Free Officers Movement forced King Farouk to abdicate in support of his son Fuad. British military presence in Egypt lasted until 1954.


Farouk of Egypt

King of Egypt and the Sudan
Coat of arms of the Egyptian Kingdom.gifOfficial Seal of the King of Egypt

Photograph of Farouk I by Riad Shehata
Reign 28 April 1936 – 26 July 1952
Coronation 29 July 1937 (aged 17)[1]
Arabic فاروق الأول
Born 11 February 1920(1920-02-11)
Birthplace Abdeen Palace, Cairo, Egypt
Died 18 March 1965(1965-03-18) (aged 45)
Place of death Rome, Italy
Buried Al-Rifa’i Mosque, Cairo, Egypt
Predecessor Fuad I
Successor Fuad II
Consort to Farida (née Safinaz Zulficar)
(m. 1938; div. 1948)
Narriman Sadek
(m. 1951; div. 1954)
Offspring Princess Ferial
Princess Fawzia
Princess Fadia
Fuad II
Dynasty Muhammad Ali Dynasty
Father Fuad I
Mother Nazli Sabri
Religious beliefs Sunni Islam
Signature Farouk I signature.svg

Farouk I of Egypt (Arabic: فاروق الأول Fārūq al-Awwal) (11 February 1920 – 18 March 1965), was the tenth ruler from the Muhammad Ali Dynasty and the penultimate King of Egypt and Sudan, succeeding his father, Fuad I, in 1936.

His full title was “His Majesty Farouk I, by the grace of God, King of Egypt and Sudan, Sovereign of Nubia, of Kordofan, and of Darfur.” He was overthrown in the Egyptian Revolution of 1952, and was forced to abdicate in favor of his infant son Ahmed Fuad, who succeeded him as King Fuad II. He died in exile in Italy.

His sister was Princess Fawzia Fuad, first wife and Queen Consort of the Shah of Iran Mohammad Reza Pahlavi.

Early life


As Crown Prince, Farouk held the rank of First Scout of Egypt.


The great-great-grandson of Khalid Kamel Pasha, Farouk was of Albanian descent as well as native Egyptian and Turkish descent through his mother Queen Nazli Sabri.[2][3] Before his father’s death, he was educated at the Royal Military Academy, Woolwich, England. Upon his coronation, the hugely popular 16-year-old King Farouk made a public radio address to the nation, the first time a sovereign of Egypt had ever spoken directly to his people in such a way:

And if it is God’s will to lay on my shoulders at such an early age the responsibility of kingship, I on my part appreciate the duties that will be mine, and I am prepared for all sacrifices in the cause of my duty… My noble people, I am proud of you and your loyalty and am confident in the future as I am in God. Let us work together. We shall succeed and be happy. Long live the Motherland!

Farouk was enamored of the glamorous royal lifestyle. Although he already had thousands of acres of land, dozens of palaces, and hundreds of cars, the youthful king would often travel to Europe for grand shopping sprees, earning the ire of many of his subjects. It is said that he ate 600 oysters a week.[4]

He was most popular in his early years and the nobility largely celebrated him. For example, during the accession of the young King Farouk, “the Abaza family had solicited palace authorities to permit the royal train to stop briefly in their village so that the king could partake of refreshments offered in a large, magnificently ornamented tent the family had erected in the train station.”[5]

Farouk’s accession initially was encouraging for the populace and nobility, due to his youth and Egyptian roots through his mother Nazli Sabri. However, the situation was not the same with some Egyptian politicians and elected government officials, with whom Farouk quarreled frequently, despite their loyalty in principle to his throne.

During the hardships of World War II, criticism was leveled at Farouk for his lavish lifestyle. His decision to not put out the lights at his palace in Alexandria, during a time when the city was blacked out because of German and Italian bombing, was deemed particularly offensive by Egyptian people. Due to the continuing British occupation of Egypt, many Egyptians, Farouk included, were positively disposed towards Germany and Italy, and despite the presence of British troops, Egypt remained officially neutral until the final year of the war. Consequently, the royal Italian servants of Farouk were not interned, and there is an unconfirmed story that Farouk told British Ambassador Sir Miles Lampson (who had an Italian wife), “I’ll get rid of my Italians when you get rid of yours”.[citation needed] In addition, Farouk was known for harbouring certain Axis sympathies and even sending a note to Hitler saying that an invasion would be welcome.[6] Farouk only declared war on the Axis Powers under heavy British pressure in 1945, long after the fighting in Egypt’s Western Desert had ceased.

Farouk is also reported as having said “The whole world is in revolt. Soon there will be only five Kings left — the King of England, the King of Spades, the King of Clubs, the King of Hearts, and the King of Diamonds.”[7]


Farouk was widely condemned for his corrupt and ineffectual governance, the continued British occupation, and the Egyptian army’s failure to prevent the loss of 78% of Palestine to the newly formed State of Israel in the 1948 Arab-Israeli War. Public discontent against Farouk rose to new levels.[citation needed] In the CIA, the project to overthrow King Farouk, known internally known as “Project FF [Fat Fucker]”,[8] was initiated by CIA operative Kermit Roosevelt, Jr. The CIA was disappointed in King Farouk for not improving the functionality and usefulness of his government,[9] and had actively supported the toppling of King Farouk by the Free Officers.[10] Finally, on 23 July 1952, the Free Officers Movement under Muhammad Naguib and Gamal Abdel Nasser staged a military coup that launched the Egyptian Revolution of 1952. Farouk was forced to abdicate, and went into exile in Monaco and Italy where he lived for the rest of his life.[citation needed] Immediately following his abdication, Farouk’s baby son, Ahmed Fuad was proclaimed King Fuad II, but for all intents and purposes Egypt was now governed by Naguib, Nasser and the Free Officers.[citation needed] On 18 June 1953, the revolutionary government formally abolished the monarchy, ending 150 years of the Muhammad Ali dynasty’s rule, and Egypt was declared a republic.[citation needed]

The revolutionary government quickly moved to auction off the King’s vast collection of trinkets and treasures.[citation needed] Among the more famous of his possessions was one of the rare 1933 Double Eagle coins, though the coin disappeared before it could be returned to the United States.[citation needed] He was also notorious for his collection of pornography.[11]

 Exile and death

Farouk I with his wife Narriman and their son Fuad II in exile in Capri, Italy (1953)

On his exile from Egypt, Farouk settled first in Monaco, and later in Rome, Italy. On 29 April 1958, the United Arab Republic issued rulings revoking the Egyptian citizenship of Farouk.[12] He was granted Monegasque citizenship in 1959 by his close friend Prince Rainier III.[13]

The blue-eyed Farouk was thin early in his reign, but later gained enormous weight. His taste for fine cuisine made him dangerously obese, weighing nearly 300 pounds (136 kg)—an acquaintance described him as “a stomach with a head”. He died in the Ile de France restaurant in Rome, Italy on 18 March 1965. He collapsed and died at his dinner table following a characteristically heavy meal.[14] While some claim he was poisoned by Egyptian Intelligence,[15] no official autopsy was conducted on his body. His will stated that his burial place should be in the Al Rifa’i Mosque in Cairo, but the request was denied by the Egyptian government under Gamal Abdel Nasser, and he was going to be buried in Italy. King Faisal of Saudi Arabia stated he would be willing to have King Farouk buried in Saudi Arabia, upon which President Nasser agreed for the former monarch to be buried in Egypt, not in the Mosque of Al Rifai’ but in the Ibrahim Pasha Burial Site.[citation needed]

A likely apocryphal story about Farouk’s lavish living in exile was that he refused to donate money to relieve poverty on the basis that “If I donate my fortune to buy food, all of Egypt eats today, eats tomorrow, and the day after that they are starving once again”, thus rationalizing his high living.

 Marriages and affairs

Farouk I with his wife Queen Farida and their first-born daughter Ferial (c. 1939)

In addition to an affair with the British writer Barbara Skelton, among numerous others, Farouk was married twice, with a claim of a third marriage (see below). His first wife was Safinaz Zulficar (1921–1988), the daughter of Youssef Zulficar Pasha. Safinaz was renamed Farida upon her marriage. They were married in 1938, and divorced in 1948, producing three daughters.

Farouk’s second wife was a commoner, Narriman Sadek (1934–2005). They were married in 1951, and divorced in 1954, having only one child, the future King Fuad II.

While in exile in Italy, Farouk met Irma Capece Minutolo, an opera singer, who became his companion. In 2005, she claimed that she married the former King in 1957.[16]



The ostentatious king’s name is used to describe imitation Louis XV-style furniture known as “Louis-Farouk”. The imperial French style furniture became fashionable among Egypt’s upper classes during Farouk’s reign so Egyptian artisans began to mass-produce it. The style uses ornate carving, is heavily gilded, and covered in very elaborate cloth.[17] The style, or imitations thereof, remains widespread in Egypt.





Second Arab Scout Jamboree

perforated mini-sheet SG MS513, very fine mint, fresh & very rare

Est 120-150 pounds

THE END @ Copyright Dr Iwan Suwandy 2011


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