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Samuel Pepys

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Hematuria or haematuria is defined as the presence of blood or red blood cells in the urine . "Gross hematuria" occurs when urine appears red, brown, or tea-colored due to the presence of blood. Hematuria may also be subtle and only detectable with a microscope or laboratory test. Blood that enters and mixes with the urine can come from any location within the urinary system , including the kidney , ureter , urinary bladder , urethra , and in men, the prostate . Common causes of hematuria include urinary tract infection (UTI) , kidney stones , viral illness, trauma, bladder cancer, and exercise. These causes are grouped into glomerular and non-glomerular causes, depending on the involvement of the glomerulus of the kidney . But not all red urine is hematuria. Other substances such as certain medications and foods (e.g. blackberries, beets, food dyes) can cause urine to appear red. Menstruation in women may also cause the appearance of hematuria and may result in a positive urine dipstick test for hematuria. A urine dipstick test may also give an incorrect positive result for hematuria if there are other substances in the urine such as myoglobin , a protein excreted into urine during rhabdomyolysis . A positive urine dipstick test should be confirmed with microscopy, where hematuria is defined by three or more red blood cells per high power field . When hematuria is detected, a thorough history and physical examination with appropriate further evaluation (e.g. laboratory testing) can help determine the underlying cause.

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101-699: Samuel Pepys FRS ( / p iː p s / ; 23 February 1633 – 26 May 1703) was an English diarist and naval administrator . He served as administrator of the Royal Navy and Member of Parliament , but is most remembered today for the diary he kept for almost a decade. Though he had no maritime experience, Pepys rose to be the Chief Secretary to the Admiralty under both King Charles II and King James II through patronage , diligence, and his talent for administration. His influence and reforms at

202-467: A coffee house or tavern , only to discover that the person whom he was seeking was not there. These occasions were a constant source of frustration to Pepys. Pepys' diary provides a first-hand account of the Restoration , and includes detailed accounts of several major events of the 1660s, along with the lesser known diary of John Evelyn . In particular, it is an invaluable source for the study of

303-442: A complete blood count should be ordered to assess for anemia. After detecting and confirming hematuria with urinalysis and urine microscopy, the first step in evaluation of microhematuria is to rule out benign causes. Benign causes include urinary tract infection , viral illness, kidney stone , recent intense exercise, menses , recent trauma, or recent urological procedure. After benign causes have resolved or been treated,

404-763: A Chair (all of whom are Fellows of the Royal Society ). Members of the 10 Sectional Committees change every three years to mitigate in-group bias . Each Sectional Committee covers different specialist areas including: New Fellows are admitted to the Society at a formal admissions day ceremony held annually in July, when they sign the Charter Book and the Obligation which reads: "We who have hereunto subscribed, do hereby promise, that we will endeavour to promote

505-417: A celebration on every anniversary of the operation, which he did for several years. However, there were long-term effects from the operation. The incision on his bladder broke open again late in his life. The procedure may have left him sterile, though there is no direct evidence for this, as he was childless before the operation. In mid-1658 Pepys moved to Axe Yard, near the modern Downing Street . He worked as

606-411: A descendant of French Huguenot immigrants, first in a religious ceremony on 10 October 1655 and later in a civil ceremony on 1 December 1655 at St Margaret's, Westminster . From a young age, Pepys suffered from bladder stones in his urinary tract — a condition from which his mother and brother John also later suffered. He was almost never without pain, as well as other symptoms, including "blood in

707-691: A holiday to France and the Low Countries in June–October 1669; on their return, Elisabeth fell ill and died on 10 November 1669. Pepys erected a monument to her in the church of St Olave's, Hart Street, London. Pepys never remarried, but he did have a long-term housekeeper named Mary Skinner who was assumed by many of his contemporaries to be his mistress and sometimes referred to as Mrs. Pepys. In his will, he left her an annuity of £200 and many of his possessions. In 1672, he became an Elder Brother of Trinity House and served in this capacity until 1689; he

808-466: A loss of privacy and it seems that he never went through with those plans. In the end, Pepys lived another 34 years without going blind, but he never took to writing his diary again. However, Pepys dictated a journal for two months in 1669–70 as a record of his dealings with the Commissioners of Accounts at that period. He also kept a diary for a few months in 1683 when he was sent to Tangier as

909-432: A prevalence of somewhere between 2% and 31%. Higher rates exist in individuals older than 60 years of age and those with a current or prior history of smoking. Only a fraction of individuals with microhematuria are diagnosed with a urologic cancer. When asymptomatic populations are screened with dipstick and/or microscopy medical testing about 2% to 3% of those with hematuria have a urologic malignancy . Routine screening

1010-460: A private tutor and used models of ships to make up for his lack of first-hand nautical experience, and ultimately came to play a significant role in the board's activities. In September 1660, he was made a Justice of the Peace ; on 15 February 1662, Pepys was admitted as a Younger Brother of Trinity House ; and on 30 April, he received the freedom of Portsmouth . Through Sandwich, he was involved in

1111-431: A repeat urinalysis and urine microscopy is warranted to ensure cessation of hematuria. If hematuria persists (even if there is a suspected cause), the next step is to stratify the risk of the person for urothelial cancer into low, intermediate, or high risk to determine next steps. To be in the low risk category, one must satisfy all of the following criteria: Has never smoked tobacco or smoked less than 10 pack-years ;

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1212-570: A solemn oath about abstaining from plays and wine…" The following months reveal his lapses to the reader; by 17 February, it is recorded, "Here I drank wine upon necessity, being ill for the want of it." Pepys was one of the most important civil servants of his age, and was also a widely cultivated man, taking an interest in books, music, the theatre, and science. Aside from English, he was fluent in French and read many texts in Latin . His favourite author

1313-812: A strong supporter of Cromwell, but he converted to the Royalist cause upon the Protector's death. He was on the ship that returned Charles II to England to take up his throne and gave first-hand accounts of other significant events from the early years of the Restoration , such as the coronation of Charles II, the Great Plague , the Great Fire of London , and the Anglo–Dutch Wars . Pepys did not plan on his contemporaries ever seeing his diary, which

1414-507: A teller in the Exchequer under George Downing . On 1 January 1660 ("1 January 1659/1660" in contemporary terms ), Pepys began to keep a diary . He recorded his daily life for almost 10 years. This record of a decade of Pepys' life is more than a million words long and is often regarded as Britain's most celebrated diary. Pepys has been called the greatest diarist of all time due to his frankness in writing concerning his own weaknesses and

1515-417: A transfusion and/or a correction of a coexisting coagulopathy may be necessary. Urosepsis is defined as sepsis caused by a urogenital tract infection and comprises about 25% of all sepsis cases. Urosepsis is the result of a systemic inflammatory response to infection and can be identified by numerous signs and symptoms (e.g. fever, hypothermia, tachycardia, and leukocytosis). Signs and symptoms that indicate

1616-416: A urinalysis with urine microscopy in 6 months or perform a cystoscopy and renal ultrasound . For the intermediate risk category, the next step is to perform a cystoscopy and renal ultrasound . For the high risk category, the next step is to perform a cystoscopy and CT urogram . If an underlying cause for hematuria is discovered, it should be managed appropriately. However, if no underlying cause

1717-410: A urogential tract infection is the source of the sepsis may include, but are not limited to, flank pain, costovertebral angle tenderness, pain with micturition, urinary retention, and scrotal pain. In terms of the visibility, hematuria can be visible to the naked eye (termed "gross hematuria") and may appear red or brown (sometimes referred to as tea-colored), or it can be microscopic (i.e. not visible to

1818-529: A very little time it got as far as the Steeleyard, while I was there. Everybody endeavouring to remove their goods, and flinging into the river or bringing them into lighters that layoff; poor people staying in their houses as long as till the very fire touched them, and then running into boats, or clambering from one pair of stairs by the water-side to another. And among other things, the poor pigeons, I perceive, were loth to leave their houses, but hovered about

1919-452: Is a female less than 50 years old or a male less than 40 years old; has 3–10 red blood cells per high power field ; has not had microscopic hematuria before; and has no other risk factors for urothelial cancer. To be in the intermediate risk category, one must satisfy any of the following criteria: Has smoked 10–30 pack-years ; is a female 50–59 years old or a male aged 40–59 years old; has 11–25 red blood cells per high power field ; or

2020-414: Is appropriate to repeat a urinalysis with urine microscopy in 1 to 2 weeks or after treatment of the infection. If the results of the urinalysis and urine microscopy reveal a glomerular origin of hematuria (indicated by proteinuria or red blood cell casts ), consultation with a nephrologist should be made. If the results of the urinalysis indicate a non-glomerular origin, a microbiological culture of

2121-737: Is confirmed by the Council in April, and a secret ballot of Fellows is held at a meeting in May. A candidate is elected if they secure two-thirds of votes of those Fellows voting. An indicative allocation of 18 Fellowships can be allocated to candidates from Physical Sciences and Biological Sciences; and up to 10 from Applied Sciences, Human Sciences and Joint Physical and Biological Sciences. A further maximum of six can be 'Honorary', 'General' or 'Royal' Fellows. Nominations for Fellowship are peer reviewed by Sectional Committees, each with at least 12 members and

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2222-399: Is dependent upon the visibility of the blood in the urine (i.e. visible/gross vs microscopic hematuria). Visible hematuria must be investigated, as it may be due to a pathological cause. In those with visible hematuria, urological cancer (most frequently bladder or kidney cancer) is discovered in 20–25%. Hematuria alone without accompanying symptoms should be raise suspicion of malignancy of

2323-429: Is discovered, the hematuria should be re-evaluated with urinalysis and urine microscopy within 12 months. Additionally, for all risk categories, if a nephrologic origin is suspected, consultation of a nephrologist should be made. The pathophysiology of hematuria can often be explained by damage to the structures of the urinary system , including the kidney , ureter , urinary bladder , and urethra , and in men,

2424-493: Is evident from the fact that he wrote in shorthand and sometimes in a "code" of various Spanish , French , and Italian words (especially when describing his illicit affairs). However, Pepys often juxtaposed profanities in his native English amidst his "code" of foreign words, a practice which would reveal the details to any casual reader. He did intend for future generations to see the diary, as evidenced by its inclusion in his library and its catalogue before his death along with

2525-449: Is known as acute urinary retention. Blood clots that remain in the bladder are digested by urinary urokinase producing fibrin fragments. These fibrin fragments are natural anticoagulants and promote ongoing bleeding from the urinary tract. Removing all blood clots prevents the formation of this natural anticoagulant. This in turns facilitates the cessation of bleeding from the urinary tract. The acute management of obstructing clots

2626-421: Is nominated by two Fellows of the Royal Society (a proposer and a seconder), who sign a certificate of proposal. Previously, nominations required at least five fellows to support each nomination by the proposer, which was criticised for supposedly establishing an old boy network and elitist gentlemen's club . The certificate of election (see for example ) includes a statement of the principal grounds on which

2727-654: Is not recommended. Individuals with risk factors who undergo repeated testing have higher rates of urologic malignancies. These risks factors include age (> 40 years), male gender, previous or current smoking, chemical exposure (e.g., benzenes , hydrocarbons , aromatic amines ), history of chemotherapy ( alkylating agents , ifosfamide ), prolonged foreign body in the bladder (such as a bladder catheter ), prior pelvic radiation therapy , or greater than 25 red blood cells per high powered field on urine microscopy. The prevalence of microscopic hematuria in North Africa

2828-560: Is people, not literary effects, that matter." In early 1665, the start of the Second Anglo-Dutch War placed great pressure on Pepys. His colleagues were either engaged elsewhere or incompetent, and Pepys had to conduct a great deal of business himself. He excelled under the pressure, which was extreme due to the complexity and underfunding of the Royal Navy. At the outset, he proposed a centralised approach to supplying

2929-403: Is the placement of a large (22–24 French) urethral Foley catheter . Clots are evacuated with a Toomey syringe and saline irrigation. If this does not control the bleeding, management should escalate to continuous bladder irrigation (CBI) via a three-port urethral catheter. If both a large urethral Foley catheter and CBI fail, an urgent cystoscopy in the operating room will be necessary. Lastly,

3030-438: Is to confirm true hematuria with urinalysis and urine microscopy, where hematuria is defined by three of more red blood cells per high power field . Although a urine dipstick test may be used, it can give false positive or false negative results. In gathering information, it is important to inquire about recent trauma, urologic procedures, menses , and culture-documented urinary tract infection . If any of these are present, it

3131-407: Is very high due to the high prevalence of the blood fluke schistosoma haematobium , which chronically infects the urinary tract. In pediatric populations, the prevalence is 0.5–2%. Risks factor include older age and female gender. About 5% of individuals with microscopic hematuria receive a cancer diagnosis. 40% of individuals with macroscopic hematuria (blood easily visible in the urine) receive

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3232-763: The Second Anglo-Dutch War of 1665–7, the Great Plague of 1665, and the Great Fire of London in 1666. In relation to the Plague and Fire, C. S. Knighton has written: "From its reporting of these two disasters to the metropolis in which he thrived, Pepys's diary has become a national monument." Robert Latham , editor of the definitive edition of the diary, remarks concerning the Plague and Fire: "His descriptions of both—agonisingly vivid—achieve their effect by being something more than superlative reporting; they are written with compassion. As always with Pepys it

3333-619: The Second Dutch War , and the Great Fire of London . Pepys was born in Salisbury Court, Fleet Street , London , on 23 February 1633, the son of John Pepys (1601–1680), a tailor, and Margaret Pepys ( née Kite; died 1667), daughter of a Whitechapel butcher. His great uncle Talbot Pepys was Recorder and briefly Member of Parliament (MP) for Cambridge in 1625. His father's first cousin Sir Richard Pepys

3434-426: The post-nominal letters FRS . Every year, fellows elect up to ten new foreign members. Like fellows, foreign members are elected for life through peer review on the basis of excellence in science. As of 2016 , there are around 165 foreign members, who are entitled to use the post-nominal ForMemRS . Honorary Fellowship is an honorary academic title awarded to candidates who have given distinguished service to

3535-399: The prostate . Common mechanisms include structural disruption to the glomerular basement membrane and mechanical or chemical erosion of the mucosal surfaces of the genitourinary tract . Acute clot retention is one of three emergencies that can occur with hematuria. The other two are anemia and shock . Blood clots can prevent urine outflow through either ureter or the bladder. This

3636-571: The 'Change. Jealous of every door that one sees shut up, lest it should be the plague; and about us two shops in three, if not more, generally shut up. He also chewed tobacco as a protection against infection, and worried that wig-makers might be using hair from the corpses as a raw material. Furthermore, it was Pepys who suggested that the Navy Office should evacuate to Greenwich , although he did offer to remain in town himself. He later took great pride in his stoicism. Meanwhile, Elisabeth Pepys

3737-444: The 17th century. The descriptions of the lives of his servants like Jane Birch provide a valuable detailed insight into their lives. Aside from day-to-day activities, Pepys also commented on the significant and turbulent events of his nation. England was in disarray when he began writing his diary. Oliver Cromwell had died just a few years before, creating a period of civil unrest and a large power vacuum to be filled. Pepys had been

3838-479: The Admiralty were important in the early professionalisation of the Royal Navy. The detailed private diary that Pepys kept from 1660 until 1669 was first published in the 19th century and is one of the most important primary sources for the English Restoration period. It provides a combination of personal revelation and eyewitness accounts of great events, such as the Great Plague of London ,

3939-591: The Exchequer) and a grant from the Mercers' Company . In October, he was admitted as a sizar to Magdalene College ; he moved there in March 1651 and took his Bachelor of Arts degree in 1654. Later in 1654 or early in 1655, he entered the household of one of his father's cousins, Sir Edward Montagu , who was later created the 1st Earl of Sandwich . When he was 22, Pepys married 14-year-old Elisabeth de St Michel ,

4040-612: The Navy's treasury in London. Pepys made a long speech at the bar of the Commons on 5 March 1668 defending this practice. It was, in the words of C. S. Knighton, a "virtuoso performance". The commission was followed by an investigation led by a more powerful authority, the commissioners of accounts. They met at Brooke House, Holborn and spent two years scrutinising how the war had been financed. In 1669, Pepys had to prepare detailed answers to

4141-439: The Royal Society has been described by The Guardian as "the equivalent of a lifetime achievement Oscar " with several institutions celebrating their announcement each year. Up to 60 new Fellows (FRS), honorary (HonFRS) and foreign members (ForMemRS) are elected annually in late April or early May, from a pool of around 700 proposed candidates each year. New Fellows can only be nominated by existing Fellows for one of

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4242-663: The Society, we shall be free from this Obligation for the future". Since 2014, portraits of Fellows at the admissions ceremony have been published without copyright restrictions in Wikimedia Commons under a more permissive Creative Commons license which allows wider re-use. In addition to the main fellowships of the Royal Society (FRS, ForMemRS & HonFRS), other fellowships are available which are applied for by individuals, rather than through election. These fellowships are research grant awards and holders are known as Royal Society Research Fellows . In addition to

4343-441: The accuracy with which he records events of daily British life and major events in the 17th century. Pepys wrote about the contemporary court and theatre (including his amorous affairs with the actresses), his household, and major political and social occurrences. Historians have used his diary to gain greater insight and understanding of life in London in the 17th century. Pepys wrote consistently on subjects such as personal finances,

4444-670: The administration of the short-lived English colony at Tangier . He joined the Tangier committee in August 1662 when the colony was first founded and became its treasurer in 1665. In 1663, he independently negotiated a £3,000 contract for Norwegian masts, demonstrating the freedom of action that his superior abilities allowed. He was appointed to a commission of the royal fishery on 8 April 1664. Pepys' job required him to meet many people to dispense money and make contracts. He often laments how he "lost his labour" having gone to some appointment at

4545-475: The award of Fellowship (FRS, HonFRS & ForMemRS) and the Research Fellowships described above, several other awards, lectures and medals of the Royal Society are also given. Haematuria Hematuria can be classified according to visibility, anatomical origin, and timing of blood during urination. Many causes may present as either visible hematuria or microscopic hematuria, and so

4646-465: The bodies of girls and women. Kate Loveman of Cambridge University describes this belief: "[In his diary] Pepys's sexual language of being ‘kind’, ‘touching’, and ‘tumbling’ emphasized his indulgence and playfulness, while masking coercion and violence; meanwhile, [his victim] Lane's claims of assault he regarded as exemplifying a woman's ‘falseness’, not because he thought there had been no violence, but because she had no moral right to protest." The diary

4747-612: The cause of science, but do not have the kind of scientific achievements required of Fellows or Foreign Members. Honorary Fellows include the World Health Organization's Director-General Tedros Adhanom Ghebreyesus (2022), Bill Bryson (2013), Melvyn Bragg (2010), Robin Saxby (2015), David Sainsbury, Baron Sainsbury of Turville (2008), Onora O'Neill (2007), John Maddox (2000), Patrick Moore (2001) and Lisa Jardine (2015). Honorary Fellows are entitled to use

4848-479: The city. In about 1644, Pepys attended Huntingdon Grammar School before being educated at St Paul's School , London, c.  1646 –1650. He attended the execution of Charles I in 1649. In 1650, he went to the University of Cambridge , having received two exhibitions from St Paul's School (perhaps owing to the influence of George Downing , who was chairman of the judges and for whom he later worked at

4949-527: The committee's eight "Observations" on the Navy Board's conduct. In 1670, he was forced to defend his own role. A seaman's ticket with Pepys' name on it was produced as incontrovertible evidence of his corrupt dealings but, thanks to the intervention of the king, Pepys emerged from the sustained investigation relatively unscathed. Outbreaks of plague were not unusual events in London; major epidemics had occurred in 1592, 1603, 1625 and 1636. Furthermore, Pepys

5050-557: The dancing master). Pepys was an investor in the Company of Royal Adventurers Trading to Africa , which held the Royal monopoly on trading along the west coast of Africa in gold , silver , ivory , and slaves . Propriety did not prevent him from engaging in a number of extramarital liaisons with various women that were chronicled in his diary, often in some detail when relating the intimate details. The most dramatic of these encounters

5151-428: The differential diagnosis is frequently organized based on glomerular and non-glomerular causes. Hematuria due to a glomerular source commonly presents as dysmorphic red blood cells (misshapen red blood cells) or red cell casts (small tubular structures made up of red blood cell components) on urine microscopy. This occurs due to the red blood cells being deformed as they pass through the glomerular capillaries into

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5252-496: The event the initial evaluation of hematuria does not reveal an underlying cause then evaluation by a physician who specializes in Urology may proceed. This medical evaluation may consist of, but is not limited too, a history and physical exam taken by healthcare personnel, laboratory studies (i.e. blood work), cystoscopy, and specialized imaging procedures (i.e. CT or MRI). The first step in evaluation of red or brown colored urine

5353-498: The eye but detected of urosepsis. In addition to imaging tests, patients may be treated with antibiotics to relieve the infection and intravenous fluids to maintain cardiovascular and renal perfusion. Acute management of hemodynamic status, in the event intravenous fluids are unsuccessful, may include the use of vasopressor medications and the placement of a central venous line. In the United States, microscopic hematuria has

5454-528: The fellowships described below: Every year, up to 52 new fellows are elected from the United Kingdom, the rest of the Commonwealth of Nations , and Ireland, which make up around 90% of the society. Each candidate is considered on their merits and can be proposed from any sector of the scientific community. Fellows are elected for life on the basis of excellence in science and are entitled to use

5555-549: The fire overtakes us faster than we can do it." At noon, he returned home and "had an extraordinary good dinner, and as merry, as at this time we could be", before returning to watch the fire in the city once more. Later, he returned to Whitehall, then met his wife in St James's Park . In the evening, they watched the fire from the safety of Bankside . Pepys writes that "it made me weep to see it". Returning home, Pepys met his clerk Tom Hayter who had lost everything. Hearing news that

5656-468: The fire was advancing, he started to pack up his possessions by moonlight. A cart arrived at 4 a.m. on 3 September and Pepys spent much of the day arranging the removal of his possessions. Many of his valuables, including his diary, were sent to a friend from the Navy Office at Bethnal Green . At night, he "fed upon the remains of yesterday's dinner, having no fire nor dishes, nor any opportunity of dressing any thing." The next day, Pepys continued to arrange

5757-583: The first few months were filled with news of General George Monck's march on London. In April and May of that year, he encountered problems with his wife, and he accompanied Montagu's fleet to the Netherlands to bring Charles II back from exile. Montagu was made Earl of Sandwich on 18 June, and Pepys secured the position of Clerk of the Acts to the Navy Board on 13 July. As secretary to the board, Pepys

5858-666: The fleet in 1666. However, these demands were actually quite desirable for him, as tactical and strategic mistakes were not the responsibility of the Navy Board. The Board did face some allegations regarding the Medway raid, but they could exploit the criticism already attracted by Commissioner of Chatham Peter Pett to deflect criticism from themselves. The committee accepted this tactic when they reported in February 1668. The Board was, however, criticised for its use of tickets to pay seamen. These tickets could only be exchanged for cash at

5959-588: The fleet. His idea was accepted, and he was made surveyor-general of victualling in October 1665. The position brought a further £300 a year. Pepys wrote about the Second Anglo-Dutch War: "In all things, in wisdom, courage, force and success, the Dutch have the best of us and do end the war with victory on their side". And King Charles II said: "Don't fight the Dutch, imitate them". In 1667, with

6060-540: The good of the Royal Society of London for Improving Natural Knowledge, and to pursue the ends for which the same was founded; that we will carry out, as far as we are able, those actions requested of us in the name of the Council; and that we will observe the Statutes and Standing Orders of the said Society. Provided that, whensoever any of us shall signify to the President under our hands, that we desire to withdraw from

6161-437: The happiest years of his life. He worked very hard that year, and the outcome was that he quadrupled his fortune. In his annual summary on 31 December, he wrote, "I have never lived so merrily (besides that I never got so much) as I have done this plague time". Nonetheless, Pepys was certainly concerned about the plague. On 16 August he wrote: But, Lord! how sad a sight it is to see the streets empty of people, and very few upon

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6262-591: The house in which he had had his bladder stone removed. Despite all this destruction, Pepys' house, office, and diary were saved. The diary gives a detailed account of Pepys' personal life. He was fond of wine , plays, and the company of other people. He also spent time evaluating his fortune and his place in the world. He was always curious and often acted on that curiosity, as he acted upon almost all his impulses. Periodically, he would resolve to devote more time to hard work instead of leisure. For example, in his entry for New Year's Eve, 1661, he writes: "I have newly taken

6363-1531: The improvement of natural knowledge , including mathematics , engineering science , and medical science ". Fellowship of the Society, the oldest known scientific academy in continuous existence, is a significant honour. It has been awarded to many eminent scientists throughout history, including Isaac Newton (1672), Benjamin Franklin (1756), Charles Babbage (1816), Michael Faraday (1824), Charles Darwin (1839), Ernest Rutherford (1903), Srinivasa Ramanujan (1918), Jagadish Chandra Bose (1920), Albert Einstein (1921), Paul Dirac (1930), Winston Churchill (1941), Subrahmanyan Chandrasekhar (1944), Prasanta Chandra Mahalanobis (1945), Dorothy Hodgkin (1947), Alan Turing (1951), Lise Meitner (1955), Satyendra Nath Bose (1958), and Francis Crick (1959). More recently, fellowship has been awarded to Stephen Hawking (1974), David Attenborough (1983), Tim Hunt (1991), Elizabeth Blackburn (1992), Raghunath Mashelkar (1998), Tim Berners-Lee (2001), Venki Ramakrishnan (2003), Atta-ur-Rahman (2006), Andre Geim (2007), Bai Chunli (2014), James Dyson (2015), Ajay Kumar Sood (2015), Subhash Khot (2017), Elon Musk (2018), Elaine Fuchs (2019) and around 8,000 others in total, including over 280 Nobel Laureates since 1900. As of October 2018 , there are approximately 1,689 living Fellows, Foreign and Honorary Members, of whom 85 are Nobel Laureates. Fellowship of

6464-576: The kennels, and people working therewith from one end to the other; the fire coming on in that narrow streete, on both sides, with infinite fury. Sir W. Batten not knowing how to remove his wine, did dig a pit in the garden, and laid it in there; and I took the opportunity of laying all the papers of my office that I could not otherwise dispose of. And in the evening Sir W. Pen and I did dig another, and put our wine in it; and I my Parmazan cheese, as well as my wine and some other things. Pepys had taken to sleeping on his office floor; on Wednesday, 5 September, he

6565-514: The king that homes be pulled down in the path of the fire in order to stem its progress. Accepting this advice, the king told him to go to Lord Mayor Thomas Bloodworth and tell him to start pulling down houses. Pepys took a coach back as far as St Paul's Cathedral before setting off on foot through the burning city. He found the Lord Mayor, who said, "Lord! what can I do? I am spent: people will not obey me. I have been pulling down houses; but

6666-714: The last day of the year she hath them again. The condition of the State was thus. Viz. the Rump , after being disturbed by my Lord Lambert , was lately returned to sit again. The officers of the army all forced to yield. Lawson lie[s] still in the River and Monke is with his army in Scotland. Only my Lord Lambert is not yet come in to the Parliament; nor is it expected that he will, without being forced to it. The entries from

6767-465: The loose pages bound into six volumes, catalogued them in his library with all his other books, and is likely to have suspected that eventually someone would find them interesting. This tree summarizes, in a more compact form and with a few additional details, trees published elsewhere in a box-like form. It is meant to help the reader of the Diary and also integrates some biographical information found in

6868-601: The mistress of Pepys"—or at least "she granted him a share of her favours". Scholars disagree on the full extent of the Pepys/Knep relationship, but much of later generations' knowledge of Knep comes from the diary. Pepys first met Knep on 6 December 1665. He described her as "pretty enough, but the most excellent, mad-humoured thing, and sings the noblest that I ever heard in my life." He called her husband "an ill, melancholy, jealous-looking fellow" and suspected him of abusing his wife. Knep provided Pepys with backstage access and

6969-514: The most senior civil servant in the Navy, during the English evacuation . The diary mostly covers work-related matters. On the Navy Board, Pepys proved to be a more able and efficient worker than colleagues in higher positions. This often annoyed Pepys and provoked much harsh criticism in his diary. Among his colleagues were Admiral Sir William Penn , Sir George Carteret , Sir John Mennes , and Sir William Batten . Pepys learned arithmetic from

7070-412: The patient's hemodynamic status is adequate. It is important to obtain a detailed history from the patient (i.e. recreational, occupational, and medication exposures) as this information can be helpful in suggesting a cause of hematuria. The physical exam can also be helpful in identifying a cause of the hematuria as certain signs found on the physical exam can suggest specific causes of the hematuria. In

7171-514: The post nominal letters HonFRS . Statute 12 is a legacy mechanism for electing members before official honorary membership existed in 1997. Fellows elected under statute 12 include David Attenborough (1983) and John Palmer, 4th Earl of Selborne (1991). The Council of the Royal Society can recommend members of the British royal family for election as Royal Fellow of the Royal Society . As of 2023 there are four royal fellows: Elizabeth II

7272-552: The proposal is being made. There is no limit on the number of nominations made each year. In 2015, there were 654 candidates for election as Fellows and 106 candidates for Foreign Membership. The Council of the Royal Society oversees the selection process and appoints 10 subject area committees, known as Sectional Committees, to recommend the strongest candidates for election to the Fellowship. The final list of up to 52 Fellowship candidates and up to 10 Foreign Membership candidates

7373-489: The removal of his possessions. By then, he believed that Seething Lane was in grave danger, so he suggested calling men from Deptford to help pull down houses and defend the king's property. He described the chaos in the city and his curious attempt at saving his own goods: Sir W. Pen and I to Tower-streete, and there met the fire burning three or four doors beyond Mr. Howell's, whose goods, poor man, his trayes, and dishes, shovells, &c., were flung all along Tower-street in

7474-670: The renal tubules and eventually into the urinary system. Normally, red blood cells should never pass from the glomerular capillary into the renal tubule, and this is always a pathological process. Glomerular causes include: Visible blood clots in the urine indicate a non-glomerular cause. Non-glomerular causes include: Not all red or brown urine is caused by hematuria. Other substances such as certain medications and certain foods can cause urine to appear red. Medications that may cause urine to appear red include: Foods that may cause urine to appear red include: A urine dipstick may be falsely positive for hematuria due to other substances in

7575-439: The same sources. Pepys' health suffered from the long hours that he worked throughout the period of the diary. Specifically, he believed that his eyesight had been affected by his work. He reluctantly concluded in his last entry, dated 31 May 1669, that he should completely stop writing for the sake of his eyes, and only dictate to his clerks from then on, which meant that he could no longer keep his diary. Pepys and his wife took

7676-439: The shorthand guide he used and the elaborate planning by which he ensured his library survived intact after his death. The women he pursued, his friends, and his dealings are all laid out. His diary reveals his jealousies, insecurities, trivial concerns, and his fractious relationship with his wife. It has been an important account of London in the 1660s. The juxtaposition of his commentary on politics and national events, alongside

7777-463: The time he got up in the morning, the weather, and what he ate. He wrote at length about his new watch which he was very proud of (and which had an alarm, a new accessory at the time), a country visitor who did not enjoy his time in London because he felt that it was too crowded, and his cat waking him up at one in the morning. Pepys' diary is one of a very few sources which provides such length in details of everyday life of an upper-middle-class man during

7878-403: The urinary tract until proven otherwise. The initial evaluation of patients presenting with signs and symptoms that are consistent of hematuria include assessment of hemodynamic status, underlying cause of hematuria, and ensuring urinary drainage. These steps include assessment of the patient's heart rate, blood pressure, a physician exam taken by a healthcare professional, and blood work to ensure

7979-427: The urine should be performed, if it has not been done already. If the culture is positive (indicating a bladder infection), urinalysis and urine microscopy should be repeated following treatment to confirm resolution of the hematuria. If the culture is negative or if hematuria persists after treatment, CT urogram or renal ultrasound and cystoscopy should be performed. Hemodynamic stability should be monitored and

8080-465: The urine showing three of more red blood cells per high power field confirms hematuria. In women, menstruation may cause the appearance of hematuria and may result in a urine dipstick test positive for hematuria. Menstruation can be ruled out as a cause of hematuria by inquiring about menstruation history and ensuring the urine specimen is collected without menstrual blood. Common causes of hematuria in children are: The evaluation of hematuria

8181-497: The urine" ( haematuria ). By the time of his marriage, the condition was very severe. In 1657, Pepys decided to undergo surgery; not an easy option, as the operation was known to be especially painful and hazardous. Nevertheless, Pepys consulted surgeon Thomas Hollier and, on 26 March 1658, the operation took place in a bedroom in the house of Pepys' cousin Jane Turner. Pepys' stone was successfully removed and he resolved to hold

8282-400: The urine. While the urine dipstick test is able to recognize heme in red blood cells, it also identifies free hemoglobin and myoglobin. Free hemoglobin may be found in the urine resulting from hemolysis , and myoglobin may be found in the urine resulting from rhabdomyolysis (muscle breakdown). Thus, a positive dipstick test does not necessarily indicate hematuria; rather, microscopy of

8383-535: The very personal, can be seen from the beginning. His opening paragraphs, written in January 1660, begin: Blessed be God, at the end of the last year I was in very good health, without any sense of my old pain but upon taking of cold. I lived in Axe yard, having my wife and servant Jane, and no more in family than us three. My wife, after the absence of her terms for seven weeks, gave me hopes of her being with child, but on

8484-430: The very stones of churches, and among other things the poor steeple by which pretty Mrs.———— lives, and whereof my old school-fellow Elborough is parson, taken fire in the very top, and there burned till it fell down... The wind was driving the fire westward, so he ordered the boat to go to Whitehall and became the first person to inform the king of the fire. According to his entry of 2 September 1666, Pepys recommended to

8585-556: The war lost, Pepys helped to discharge the navy. The Dutch had defeated England on open water and now began to threaten English soil itself. In June 1667, they conducted their Raid on the Medway , broke the defensive chain at Gillingham , and towed away the Royal Charles , one of the Royal Navy's most important ships. As he had done during the Fire and the Plague, Pepys again removed his wife and his gold from London. The Dutch raid

8686-546: The windows and balconys till they were, some of them burned, their wings, and fell down. Having staid, and in an hour's time seen the fire: rage every way, and nobody, to my sight, endeavouring to quench it, but to remove their goods, and leave all to the fire, and having seen it get as far as the Steele-yard, and the wind mighty high and driving it into the City; and every thing, after so long a drought, proving combustible, even

8787-615: Was Virgil . He was passionately interested in music; he composed, sang, and played for pleasure, and even arranged music lessons for his servants. He played the lute , viol , violin , flageolet , recorder , and spinet to varying degrees of proficiency. He was also a keen singer, performing at home, in coffee houses, and even in Westminster Abbey . He and his wife took flageolet lessons from master Thomas Greeting . He also taught his wife to sing and paid for dancing lessons for her (although these stopped when he became jealous of

8888-733: Was Master of Trinity House in 1676–1677 and again in 1685–1686. In 1673, he was promoted to Secretary of the Admiralty Commission and elected MP for Castle Rising in Norfolk. Fellow of the Royal Society Fellowship of the Royal Society ( FRS , ForMemRS and HonFRS ) is an award granted by the Fellows of the Royal Society of London to individuals who have made a "substantial contribution to

8989-713: Was a conduit for theatrical and social gossip. When they wrote notes to each other, Pepys signed himself "Dapper Dickey", while Knep was " Barbry Allen " (a popular song that was an item in her musical repertory). Pepys' reference to purchasing the pornographic book L'Escole des Filles appears to be the first English reference to pornography. He writes in his diary that it was a "mighty lewd book," and burned it after reading it. Much of Pepys' behavior towards women, which he cataloged himself in his diary, would today be considered sexual harassment, sexual assault, and rape. Despite his kindness and emotional loyalty towards some women in his life, Pepys ultimately believed men were entitled to

9090-462: Was a major concern in itself, but Pepys was personally placed under a different kind of pressure: the Navy Board and his role as Clerk of the Acts came under scrutiny from the public and from Parliament. The war ended in August and, on 17 October, the House of Commons created a committee of "miscarriages". On 20 October, a list was demanded from Pepys of ships and commanders at the time of the division of

9191-424: Was awakened by his wife at 2 a.m. She told him that the fire had almost reached All Hallows-by-the-Tower and that it was at the foot of Seething Lane. He decided to send her and his gold — about £2,350 — to Woolwich. In the following days, Pepys witnessed looting, disorder, and disruption. On 7 September, he went to Paul's Wharf and saw the ruins of St Paul's Cathedral, of his old school, of his father's house, and of

9292-471: Was characteristically filled with remorse, but (equally characteristically) continued to pursue Willet after she had been dismissed from the Pepys household. Pepys also had a habit of fondling the breasts of his maid Mary Mercer while she dressed him in the morning. Pepys may also have dallied with a leading actress of the Restoration period, Mary Knep . "Mrs Knep was the wife of a Smithfield horsedealer, and

9393-514: Was elected MP for Sudbury in 1640, appointed Baron of the Exchequer on 30 May 1654, and appointed Lord Chief Justice of Ireland on 25 September 1655. Pepys was the fifth of 11 children, but child mortality was high and he was soon the oldest survivor. He was baptised at St Bride's Church on 3 March 1633. Pepys did not spend all of his infancy in London; for a while, he was sent to live with nurse Goody Lawrence at Kingsland , just north of

9494-641: Was entitled to a £350 annual salary plus the various gratuities and benefits that came with the job—including bribes. He rejected an offer of £1,000 for the position from a rival and soon afterward moved to official accommodation in Seething Lane in the City of London . Pepys stopped writing his diary in 1669. His eyesight began to trouble him and he feared that writing in dim light was damaging his eyes. He did imply in his last entries that he might have others write his diary for him , but doing so would result in

9595-421: Was not a Royal Fellow, but provided her patronage to the society, as all reigning British monarchs have done since Charles II of England . Prince Philip, Duke of Edinburgh (1951) was elected under statute 12, not as a Royal Fellow. The election of new fellows is announced annually in May, after their nomination and a period of peer-reviewed selection. Each candidate for Fellowship or Foreign Membership

9696-446: Was not among the group of people who were most at risk. He did not live in cramped housing, he did not routinely mix with the poor, and he was not required to keep his family in London in the event of a crisis. It was not until June 1665 that the unusual seriousness of the plague became apparent, so Pepys' activities in the first five months of 1665 were not significantly affected by it. Claire Tomalin wrote that 1665 was, to Pepys, one of

9797-417: Was previously a low-risk patient with persistent microscopic hematuria and has 3–25 red blood cells per high power field . To be in the high risk category, one must satisfy any of the following criteria: Has smoked more than 30 pack-years ; is older than 60 years of age; or has above 25 red blood cells per high power field on any urinalysis. For the low risk category, the next step is to either repeat

9898-562: Was sent to Woolwich . She did not return to Seething Lane until January 1666 and was shocked by the sight of St Olave 's churchyard, where 300 people had been buried. In the early hours of 2 September 1666, Pepys was awakened by Jane the maid, his servant, who had spotted a fire in the Billingsgate area. He decided that the fire was not particularly serious and returned to bed. Shortly after waking, his servant returned and reported that 300 houses had been destroyed and that London Bridge

9999-528: Was threatened. Pepys went to the Tower of London to get a better view. Without returning home, he took a boat and observed the fire for over an hour. In his diary, Pepys recorded his observations as follows: I down to the water-side, and there got a boat and through bridge, and there saw a lamentable fire. Poor Michell's house, as far as the Old Swan, already burned that way, and the fire running further, that in

10100-429: Was with Deborah Willet , a young woman engaged as a companion for Elisabeth Pepys. On 25 October 1668, Pepys was surprised by his wife as he embraced Deb Willet; he writes that his wife "coming up suddenly, did find me imbracing the girl con [with] my hand sub [under] su [her] coats; and endeed I was with my main [hand] in her cunny. I was at a wonderful loss upon it and the girl also...." Following this event, he

10201-422: Was written in one of the many standard forms of shorthand used in Pepys' time, in this case called tachygraphy , and devised by Thomas Shelton . It is clear from its content that it was written as a purely personal record of his life and not for publication, yet there are indications that Pepys took steps to preserve the bound manuscripts of his diary. He wrote it out in fair copy from rough notes, and he also had

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