An ordinary meeting of the Society was held on Wednesday 7th March 2018. The President was in the chair. A period silence was held in memory of Drs Keith Bramley, Nikki Crawford and David Rands. The President introduced the speaker Professor Michael Sedgwick who spoke to the title Snakes and Life in Sri Lanka. When he retired from Southampton University he said he wanted to experience another culture. He had had a number of Sri Lankan senior registrars and trainees in Southampton and had always been interested in the country. He took a post as Professor of Physiology in Peradeniya University Medical School near Kandy. He outlined the history of the island and said the country is populated by Tamils originating from India, Moors from the North East who are Malays, Parsees of African origin who were imported as slaves and the people of the Vedda tribe who are aboriginal hunter gatherers and live in the central jungles. Knowing that his early trainees would be returning to Sri Lanka to practice medicine without the help of sophisticated investigations he emphasised the art of listening to the patient while taking a history and the detailed examination of patients. These clinical skills were demonstrated fully by one of the first trainees he had in Southampton Dr Nimal Senanayake, he later became Professor of Medicine and Dean of the Peradeniya Medical School, who on his return to Sri Lanka saw several young girls with wrist drop and hand weakness in a short time and he realised that an epidemic was developing amongst Tamil girls who were tea pickers. It was the custom for Tamil girls, at the time of their first period, to undergo a ceremony involving drinking and anointing with Gingili Oil which is made from sesame seeds. Puzzled, he investigated this further and found the oil they were using was diluted with motor oil. Motor oil contains tricresyl phosphate, a known neurotoxin. His prompt action meant that only 20 cases occurred. Then Michael told us about his research into the Intermediate Syndrome. Drinking organophosphorus insecticide is a common suicide method and inhibits acetylcholine esterase and many patients die of respiratory failure. Some make a steady recovery but others enter into an intermediate state of continued nicotinic stimulation of the neuromuscular junction which is usually fatal. They found that by doing sequential EMGs starting in the first 24 hours that they could predict which patients were likely to develop IMS and their treatment could be tailored appropriately. Delayed polyneuropathy is common too. He then told us about Sri Lankan snakes; cobra, krait, Russell’s viper and the hump nose viper. Then there is the 7 headed cobra - the defender and protector of all. The A&E sees about two snake bites a day. He then mentioned Sri Lankan diseases. Malaria is not a problem today as static water is dealt with. Leishmaniasis is on the increase. Dengue is endemic and if you survive to day 5 you will be alright he said. Idiopathic renal failure occurs because of arsenic in the water supplies from draining off treated fields. The metabolic syndrome is increasing rapidly, especially in monks. Rabies occurs as well. Mental illness is similar to the UK but they don’t recognise depression - its just a bad time. Sri Lankans he said also like Ayurvedic Medicine, a folk medicine consisting of the use of herbs, infusions, incantations and rituals. He then finished with a tour of unusual sights and scenes.
The President then thanked Professor Sedgwick for his very interesting talk. There being no other business the meeting was closed at 10.00pm