HOW MUCH SLEEP?

How much sleep is enough? This question is not easy to answer, and is very subjective. Some mink they need at least seven hours, some say ten. In fact this varies from person to person and also with age. It has been shown that babies sleep nearly all day. As they get older, they need less and less sleep. It is well known that the older we are, the less sleep we need. One of the common complaints of the elderly is that they cannot sleep. They hate to be awake and alone at night. They take sleeping pills, as they feel distressed when they cannot sleep.

Sleep is something we have no control over. We cannot close our eyes and give the magic word sleep, as sleep may not follow. In studies of how people fall asleep, it is observed that we are not folly awake one second and asleep the next. We all go through a very brief hypnotic state, which is called the Transitional Hypnotic State or THS.

How much sleep is required to restore, to repair, to recuperate, so that the next day we feel refreshed and satisfied? We will explore this question in two parts:

* Sleep deprivation and how much sleep is enough

* Psychological influence of how much sleep is enough

GENERAL ANSWERS TO QUESTIONS ABOUT BREAST DISEASES

After a recent needle biopsy of a cyst in my breast, I have extensive bruising and tenderness in the area. Is this a sign of something wrong?

Bruising is caused by blood leaking from tiny blood vessels under the surface of the skin and is likely to occur to some degree following a biopsy whatever the precautions taken to prevent it. There is unlikely to be any cause for concern, and the bruising should gradually disappear over the next few days or weeks. If it does persist, is painful or spreads, ask your doctor’s advice.

I have been referred to a general surgeon at my local hospital to investigate a lump in my breast. My GP said there is no specialist breast surgeon in our immediate area, but, having thought about it again, I would rather see such a specialist even if it means travelling to do so. However, I am nervous about asking my GP to change the arrangement. What should I do?

You are entitled to see a specialist breast surgeon and, in fact, it is a good idea to do so. A consultant who specializes in breast diseases will inevitably have more experience in this field than a general surgeon who does not have a specific interest in breast diseases. If there is no breast specialist in your area, you can ask to see one elsewhere, although you may have to insist. You may prefer to write to your GP requesting a referral to a breast specialist if you are anxious about talking to him or her again. Alternatively, you could contact your local hospital and ask if there is a breast care nurse you could talk to; she may be able to advise you and to support your request for another referral.

Following the recent discovery of a small lump in my breast, an appointment has been made for me to see a specialist. I am 48 years old. What are the chances that the lump is cancer?

Although most types of breast cancer are more common in women around the time of their menopause, approximately only 1 in 10 of those who are referred to a specialist with breast problems are found to have cancer. There are, of course, different types of breast cancer with different prognoses, and treatment of a small lump detected at an early stage of development may have a better outcome than that of one which is detected later.

I frequently have pain in my breasts which does not seem to be related to my periods. I cannot feel a lump. What should I do, and what might be the cause of this pain?

Non-cyclical breast pain can have several causes, most of which are benign. It is not common for breast cancer to be associated with pain in the breast, although it can be. You should make an appointment to see your doctor, having first made sure that you are wearing a well-fitting bra. If you have not been measured for a bra for some time, and particularly if you have lost or gained a significant amount of weight recently, it may be that the bras you wear are too big or too small and are not supporting your breasts properly.

Breast pain that is not related to the menstrual periods can be referred pain from a back or shoulder problem, and your doctor will probably want to investigate this possibility. Sometimes, the cause of breast pain is never discovered, but it does often resolve itself in time.

I am 48, and have recently been able to feel hardness around the edges of both my breasts. What is this likely to be?

The breast tissue changes in women around the time of their menopause, and what you are feeling is likely to be a benign condition called dysplasia or fibrocystic disease. However, it is worth checking with your doctor to rule out any other possible cause.

I am about to have a mastectomy. WM I need to wear special bras after my operation, and will I be able to wear swimsuits and sundresses?

There is no reason why you should need special bras; the bras you usually wear will probably be able to be adapted to hold and conceal a prosthesis. This is also likely to be true for most of your clothes. If there is a breast care nurse at your local hospital, she will be able to arrange this for you. Do discuss it with her or with your consultant. Swimsuits, bras and sundresses can usually have a pocket sewn into them to hold the prosthesis, and this will allow you to take part in all sports and your usual activities without worrying about your prosthesis becoming dislodged. Mastectomy swimsuits are available, but they are expensive, and should be unnecessary if your own can be adapted.

Although the underwiring of strapless bras can damage a prosthesis, it is probably all right to wear one for short periods of time if you want to wear a strapless dress. Low-cut dresses may not conceal your prosthesis, but apart from this, you should have no restriction on the clothes you will be able to wear.

PREVENTING ASTHMA: SOME NECESSARY PRECAUTIONS – EXERCISE

Many children get attacks after some form of exercise. This tends to lead to a lifestyle without regular physical activity. However, such children should be encouraged to participate in regular sports starting off at a comfortable level and progressively working towards more difficult sports which require higher levels of strength and endurance.

There is no reason why such children should avoid sports or physical activity so long as they understand their limitations and take proper medication. Several Olympic athletes have had asthma and yet gone on to win world class competitions.
An excellent physical exercise for children with asthma is swimming. As emphasised earlier, children should learn to recognise their own physical limitations through experience. There may be episodes of wheezing or tightness during such activity but these should be taken as a part of the learning experience. Parents and teachers should help these children manage these episodes. This will help these children become more confident about their activities.

Exercise: Some Important Tips

• Physical exercise is a must.
• Consult the physician about:
a. What exercise is best and convenient for the child.
b. Whether a defibrillator pre-medication is required.
• The child should be motivated to take regular exercise.
• The child should know his or her limitations.
• If one kind of exercise induces asthma the child should be encouraged to try another one under the guidance of a physical instructor.
• The child should warm up with a light exercise.
• After exercise the child should cool down with a light exercise.

CREATE A SUPPORTIVE HOME ENVIRONMENT

During Times of Stress, You May Need to Modify Your Expectations

BDD symptoms can increase at times of stress. Virtually any type of change can be stressful—positive events as well as negative ones. Don’t be discouraged if the BDD sufferer has a temporary setback during stressful times. At these times, you may need to lower your expectations a little bit. Keep implementing the suggestions in this chapter (e.g., encouraging progress, praising small gains) while also keeping in mind that progress may be slower, or may even stop, during stressful times. At times like these, your encouragement, support, and understanding may be especially helpful.
Create a Supportive Home Environment

Because BDD can be so hard to cope with, it’s easy to criticize and express anger toward someone who has it. It’s best to avoid this. Instead, do your best to create a supportive home environment. Help them talk about their feelings of anxiety, depression, shame, and isolation. Show your support, and help them fight BDD. Without being judgmental, critical, or hostile, explain that if you participate in their rituals or help them avoid things like social situations, this will only strengthen the BDD. Let them know that you care and that you’ll try to understand and support them through the recovery process.

HETEROSEXUAL OFFENDERS VS. CHILDREN: MASTURBATION

The importance of masturbation to these offenders when the easy availability of coitus afforded by marriage was absent suggests difficulty in heterosexual adjustment, a difficulty also reflected in other aspects of their lives. The extremely large masturbatory proportions of total outlet shown by those whose marriages broke up in their teens or early twenties leads one to think that the marital failure aggravated preexisting difficulties in working out sexual adjustments with women.

As is usual, the masturbation was ordinarily accompanied by sexual fantasies. The fantasies of the heterosexual offenders vs. children seem to have been, with two exceptions, similar in general content to those of other sex offenders. The two exceptions to this are fantasies of sexual contact with animals and fantasies of a bizarre or highly specialized nature. Some 8 per cent of the offenders vs. children fantasied, on occasion, contact with animals; this is a small percentage in absolute terms, but it is the second largest exhibited by any group, and more than double that of the control group. Perhaps those who will disregard age taboo are more inclined than other offenders to disregard species taboo, at least in fantasy. However, not an unduly large percentage of the offenders vs. children had had actual sexual contact with animals. About one fifth had bizarre fantasies, the third highest figure within that classification and far in excess of the prison (2 per cent) and control groups (1 per cent).

The offenders vs. children closely match the control-group individuals in the amount they worry about the possible bad effects of masturbation. During 40 per cent of the years in which masturbation occurred there was concomitant worry ranging from mild concern to real anxiety. In terms of rank-order this percentage is neither high nor low.

Turning to the question of how they first learned of self-masturbation, the offenders vs. children reveal no distinctive trends. As in all other groups, the majority obtained this knowledge through a mixture of talking, reading, and observation.

IBS AND FOOD INTOLERANCE – MARGARET’S STORY

The condition responds well to treatment, but because of the lack of information it can be difficult to find someone who understands the problem. Some clinical nutritionists believe many chronic conditions, such as certain chest and kidney troubles and arthritis, are caused by food intolerance. The dramatic improvement in some degenerative and nervous illnesses in people who have been treated for food intolerance – even if they have only used self-help methods – would seem to confirm this.


 Here is Margaret’s story:It all started when I was pregnant. I had lost a lot of weight and my bowel movement was never normal; I either had diarrhoea or constipation. After my son was born I had a rash on my legs which formed blisters.The doctor said it was post-natal depression and gave me tranquillizers. This went on for years, I was convinced it was something to do with food but I was given more and more tranquillizers, then anti-depressants.

 When I developed migraine -although it seemed like the last straw – it put me on the right road. I found a book in the health shop on headaches. It was the first time I had heard of food intolerance or elimination diets. I cut out all dairy produce, chocolate, tea and coffee and did improve a little but it was not until I had an asthma attack after drinking a glass of orange squash (containing E102, Tartrazine) that the doctor began to think about allergies.

 He referred me to a private doctor who just said I had severe allergies and sent me to a dietician. This was not very helpful and it was not until I found a doctor with an interest in clinical nutrition that I started to make progress. Tests revealed I had trouble with wheat, yeast and several other foods. The treatment suggested was an elimination /anti-Candida diet, vitamins and minerals.I really feel I am getting somewhere; for the first time in years my head is clear, I am not depressed, and my silly bowel is starting to behave.

ANOREXIA NERVOSA: BEHAVIORAL TREATMENT

Having a contract reduces the “arbitrariness” of treatment and makes it easier to accept. The rules are codified, written down, and stored away someplace-somewhat like the Constitution. The patient might argue about how to interpret those rules, or how they should be enforced, but she can’t dispute that they exist.

Of course, it’s important to work with patients to help them overcome their fears and anxieties. I tell them, “Look, I know this whole situation is pretty scary. But we want to help you. Of course we want you to gain weight, but that’s really your responsibility. We’re not going to be spies and monitor every mouthful you eat. But if you find you’re having trouble, we’ll have someone sit with you and help you get through the fear. Yes, we need to give you enough calories so that you begin to gain weight, but we don’t want to go too fast. We’re not here to just fatten you up and send you on your way. We want to help you gain weight in a healthy and calm manner, so that we can begin to find out what’s really troubling you deep down inside.”

The food journal provides clues about strategies that might work. Anorexics might not be ready to fill out such sheets, especially at first. They dwell on food constantly anyway; writing it all down might just make them more anxious (that can be true for bulimics, too). If they feel that way, I don’t push it. Sometimes keeping a journal focusing just on feelings and events (not food) can be useful.

A journal can provide a vivid record of the patient’s thoughts and feelings about her situation. By examining these thoughts, we can often reveal distortions in the way the patient perceives and interprets events in her life. Cognitive therapy, which I will discuss in just a moment, is a good method for correcting such distortions.

In the final phase, we concentrate on helping the patient maintain her weight within the target range. We reinforce normal eating habits and look ahead to her continued recovery as an outpatient.

Before sending her home, we work out a plan to monitor her weight. We agree on who should do the weighing-a doctor, a nurse, her parents. She understands that if her weight drops below a certain limit, she will have to come back to the hospital.

A word about outpatients: It is possible to set up a contract with anorexics treated outside the hospital, even though they are not being monitored twenty-four hours a day. Usually such contracts set lower goals for weight gain-say, between one and two pounds a week. In family therapy sessions we work out the system of rewards and penalties. The parents may agree, for example, that if the patient fails to meet her target, they will suspend her allowance or ground her.

THE HUSBANDS’ ORGASMIC INVENTORY

SCORING: 3—ALWAYS 2—USUALLY 1-SELDOM 0—NEVER

1. I feel responsible for the sexual experience. Whether the interaction is good or bad depends on me.  
2. Once I ejaculate, I have to rest. I feel less energetic and have to recuperate.

3. When I begin to feel very good sexually, I know I am getting very close to “coming” or’ ‘climaxing.” The better it feels, the sooner I know I will come.  

4. It is better if my wife is relatively still during the act of intercourse. If she moves too vigorously, it tends to make me come sooner.  

5. When I ejaculate, I feel a few strong throbs in my penis at the time of ejaculation.  

6. I seem to come much sooner when I have not had sex for a long time.

7. I feel a numbness or insensitivity in most of my body just after I come. This is particularly true in my genitals.  

8. I need to take a PON (post-orgasmic nap) or even a POS (post-orgasmic sleep) after I come.  

9. I notice that my wife really seems to get much more intensely involved in her orgasms than I do in mine. She seems to almost be “gone”.

10. I feel that ejaculation is essentially the same thing as orgasm. If I don’t ejaculate, then I know I haven’t come.  

11. My orgasms are essentially the same no matter. what type of sex I am having (coitus, oral sex, masturbation). Whatever the source of stimulation, I essentially come the same way.  

12. I have noticed as I get older that my orgasms are less intense than they used to be. The throbbing is less intense and there are fewer of them.

13. I have sex mostly at night. It sort of allows me to release the tension so I can sleep.  

14. My sexual patterns with my wife are essentially “turn-taking.” I try to help her have an orgasm before I try to have mine.  

Before I come, I feel as if I would have loved to have sex all night. After

15 I come, I seem to lose interest.  

I usually get to the point that no matter what happens, there is nothing I

can do to stop my ejaculation. Even if all stimulation is stopped, I ejaculate

anyway.  

17 I try so hard to time my ejaculation that I cannot ejaculate at all during intercourse.  

18 I am a quiet person during sex. I might moan or groan, but I do not intentionally say much.  

19 If I have masturbated, I tend not to want to have intercourse several hours after I have masturbated.  
20. When I am having sex, everything seems to be focused in my genitals. I notice very little about any stimulation to any other part of my body.

TOTAL POINTS    

If you score thirty-five or more points on this test, it is very likely that you are experiencing the physiological reflex of orgasm emphasized by the first three perspectives of sexuality but are not experiencing psychasm, the ability to enjoy a full emotional and cognitive dimension to the sexual experience. The idea is not to replace the quest for orgasm with a quest for psychasm. The idea instead is to open up new options for sexual interaction free of the artificially imposed limits of a mechanical, gender-assigned model of sexual intimacy.

IBS AND FOOD INTOLERANCE – MARGARET’S STORY

The condition responds well to treatment, but because of the lack of information it can be difficult to find someone who understands the problem. Some clinical nutritionists believe many chronic conditions, such as certain chest and kidney troubles and arthritis, are caused by food intolerance. The dramatic improvement in some degenerative and nervous illnesses in people who have been treated for food intolerance – even if they have only used self-help methods – would seem to confirm this. Here is Margaret’s story:It all started when I was pregnant. I had lost a lot of weight and my bowel movement was never normal; I either had diarrhoea or constipation. After my son was born I had a rash on my legs which formed blisters.The doctor said it was post-natal depression and gave me tranquillizers. This went on for years, I was convinced it was something to do with food but I was given more and more tranquillizers, then anti-depressants. When I developed migraine -although it seemed like the last straw – it put me on the right road. I found a book in the health shop on headaches. It was the first time I had heard of food intolerance or elimination diets. I cut out all dairy produce, chocolate, tea and coffee and did improve a little but it was not until I had an asthma attack after drinking a glass of orange squash (containing E102, Tartrazine) that the doctor began to think about allergies. He referred me to a private doctor who just said I had severe allergies and sent me to a dietician. This was not very helpful and it was not until I found a doctor with an interest in clinical nutrition that I started to make progress. Tests revealed I had trouble with wheat, yeast and several other foods. The treatment suggested was an elimination /anti-Candida diet, vitamins and minerals.I really feel I am getting somewhere; for the first time in years my head is clear, I am not depressed, and my silly bowel is starting to behave.

WHAT DO THE PEOPLE SAY FOR ARTHRITIS: STORY 9

Mrs. T.M., age 81, of California sent us a great photo of her smiling beautifully after taking CMO. She had suffered since 1982 with extremely severe pain in her back, shoulder, and knee. She also suffered from sciatica because of a herniated spinal disk [which results in pressure on the sciatic nerve from the inflammation].

 She tried various arthritis medications and devices, and though some of them helped, as she put it, “nothing lasted.” Her chiropractor couldn’t help. She tried Prednisone, Orudis pills, Cortisone creams, BenGay, EMU rub ($56.00 ajar), Capzasin rub, vibrators, heat massage, papain shots, laser treatments, and chelation therapy. None were of any lasting help. Some slowly helped take the pain away by bedtime, “but it was back full blast when I’d wake up.” A battery operated device called Alpha Stim ($2600 for three) helped a little.

“However, I was in terrible pain all the time – couldn’t sleep. Pain was present always. The pain was severe … worst in the mornings. Full joint movement was difficult … affected with knobby lumps. Knee and hands affected with swelling.” She took CMO in March 1997 and later in August she reported, “I improved suddenly. The first day there was no pain with CMO. The pain never came back – it’s been five months now. I took DHEA and aloe vera plus all the things listed that would help. I got complete freedom from pain … the very next day after starting the capsules the pain left for good. It’s a wonderful blessed relief…”

She can now walk up and down stairs and inclines, work in her garden, and exercise on her peddler again without pain. “Even after CMO I walk slowly, sometimes unsteadily, and sometimes shuffle a little. But there’s no more pain. Dr. Sands was such a big help. Three times when in doubt my husband called and he told us what we should do. 

INTRA-ABDOMINAL INFECTIONS: SUBPHRENIC ABSCESS

Subphrenic abscesses most commonly develop after surgery involving the duodenum, stomach, biliary tract, or appendix, or after rupture of a hollow viscus, such as a perforated peptic ulcer or acute appendicitis. Patients may present with fever and abdominal pain in the right or left upper quadrants. Other symptoms may include hiccups, jaundice, shoulder pain, chest pain, cough, dyspnea, or a pleural effusion.

 The syndrome may be an acute, febrile illness, or a more chronic, insidious process with intermittent fevers, weight loss, and other constitutional symptoms. The chronic form develops most often in patients who have previously received antibiotics. The diagnosis of subphrenic abscess should always be considered in patients presenting with fever of unknown origin, especially if they have a history of abdominal surgery within the preceding few months.Computed tomographic scan and ultrasonography are the best methods for diagnosing a subphrenic abscess. An initial plain radiograph may give clues to the diagnosis, often showing a pleural effusion, an elevated hemidiaphragm, and concomitant lower lobe atelectasis or pneumonia.The primary treatment is drainage, via either a percutaneous procedure or an open laparotomy. Empiric antibiotic therapy is aimed at the organisms likely to be involved, depending on the mechanism of infection, and is the same as that recommended for secondary 

CIRCULATION: BLOOD VESSELS

The fine subdivisions of blood vessels result in every minute portion of the body getting supplied, as you may readily realize when you consider how even a pin prick produces bleeding. A little way back the resemblance of the blood system to the branching tree was suggested. It has often been so depicted. But if a branch is broken, the leaves at its tip wither.

 Such a calamitous result is uncommon in the body, for the blood system really is like the network of highways in the country. If the main route is blocked, it is bothersome, but traffic can be rerouted. The side routes for the blood are referred to as collateral circulation.

 John Hunter, the famous eighteenth-century English surgeon, did a great deal to study and described these side circulations.His most famous experiment consisted in tying the vessels which carry blood to a deer’s antler. One would naturally suppose that this constriction would interfere with the growth of the antler, but Hunter found that other large vessels appeared, or at least enlarged so that they became noticeable, and the antler continued to grow.

We used to think that there were a number of places in the body that were supplied by what we called end arteries; that there was only one route for the blood to traverse, and if this was blocked then no blood reached the part. The more the matter has been investigated, the more we find that this is not so. The coronary arteries in the heart were among the last to be proved to have this side circulation. Recent investigations have shown that coronary arteries can be blocked off and in many instances the blood does get to the tissues by side routes.

There is a theory that in the early stages of life all these vessels are equally important, but then some one vessel takes over most of the load and the others do not develop. When your pulse is counted, the throb comes through the radial artery in the wrist for that is carrying lots of blood to your very important hand. Most of you could find no evidence of blood getting through by any other channel. Yet the’ radial artery can be cut and tied off, and other vessels will take over the work with very little difficulty.The veins which bring the blood back have even more side routes to help out.

 The circulation of blood in the brain has to be carefully adjusted. Too little or too much makes a great difference here. The jugular veins, one on each side of the neck, are tremendous big pipes; but when we dissect the side of the neck, as we frequently do for cancer, we think little of removing the jugular. That big flow of blood goes off by other channels and the brain minds it not at all. The patient may be up and around the next day. Nature is a good traffic engineer. She can adjust to peak loads and times of light traffic more successfully than is done on our streets.

SKIN TROUBLES: CONDITIONING THE STOMACH AND THE BOWELS

It may almost be taken for granted that in all skin complaints there will be some disturbance of the digestive system, and a preparatory course will be necessary to bring it into a condition to be able to deal in a satisfactory manner with the food that is taken.

 The stomach should be given a rest for a few days, and during that time no solid food of any kind should be taken. Those who are possessed of sufficient will-power should keep watering only for twenty-four to forty-eight hours; others should take fruit juices only. This liquid diet may be kept up for three or four days, and will be a good start in clearing the stomach of the offending mucus.If there has been a tendency to constipation – and this is practically certain to be the case in skin complaints – then the warm-water enema should be used once a day to clear the lower bowel and activate the intestines. Just plain water should be used, and nothing should be added to it.

 Its use is simple and a matter of personal experiment, and is far easier to do than to describe. It is much better and safer than taking laxatives.This cleansing process should be followed by the all-fruit diet, if the weather is not too cold; in the middle of a cold spell it may be better to take two meals of fruit and one of nicely cooked vegetables. This restricted diet may be carried on for another four to seven days, depending on the reaction and the condition of the sufferer. Many people find it quite easy to carry on in this way for ten days or two weeks, and if the condition of the skin is responding to it the extra time will be well worth while.

 The bulkiness of the diet will keep the bowels acting as a rule, but there is no danger if they are rather sluggish. The flora of the colon will gradually change through the large amount of cellulose that is in the fruit and vegetables and bring the bowels back to normal activity.The idea of this restricted diet is thoroughly to cleanse the whole alimentary tract, so that when the ordinary diet is adopted the system will be able to make full use of the nutritional elements.

 A short cleansing diet will do more to tone up the stomach and the bowels than any amount of medicine, and apart from its good effect upon the skin it will improve the general health. Conditioning the digestive tract in this way should be done at least twice a year. It will be beneficial to those who do not suffer from any specific trouble, and will help to prevent the development of disease, especially the complaints that have their roots in digestive disorders.With fruit and vegetables as the basic diet it is very easy to build up a sensible daily menu. One should add the protein and the starchy foods gradually.

 The protein foods consist of meat, fish, eggs, cheese, nuts and such preparations, and the starchy foods are potatoes and those containing the cereal flours, bread, oatmeal and all the various things that are made from flour. As a rule it is safer to add these foods to the fruits and the vegetables rather than to approach it from the other angle, because the fruits and the vegetables should take precedence.

BOWEL CANCER – BLEEDING AS A SIGN

There are many normal bacteria present in the bowel, and many of these perform a useful function for the host.

They may produce certain vitamins which the host absorbs and uses.

The type of diet influences the type of bacteria present.

Some of these may act on the breakdown products of meat and fat in the diet and form cancer-causing substances.

Perhaps a high fibre diet, because of the bulk it produces, tends to dilute these cancer-causing chemicals — carcinogens — or else limits the contact between them and the bowel wall by hastening their progress through the gut.

A study in the U.S. shows a link between beer consumption and death from bowel cancer.

How beer drinking can lead to large bowel cancer is not clear.

Bowel cancer can occur in the young although it becomes more common after the age of 40.

Bleeding is the earliest and commonest sign.

Although bleeding may often be due to piles, all cases of bleeding need investigation, to exclude the possibility of cancer, as the two conditions may co-exist.

MORE ABOUT COMMON VITAMINS: VITAMIN С

Ascorbic acid. Cevitamin acid. Usually measured in milligrams (mg.). In Europe, occasionally in Units: 1 mg. equals 20 Units.

Functions

Essential for the healthy condition of collagen, “intercellular cement”. Involved in all the vital functions of all glands and organs. Necessary for healthy teeth, gums and bones. Strengthens all connective tissues. Essential for proper functioning of adrenal and thyroid glands. Promotes healing in every condition of ill health. Helps prevent and cure the common cold. Protects against all forms of stress: physical and mental. Protects against harmful effects of toxic chemicals in environment, food, water and air. Counteracts the toxic effect of drugs. Has been used successfully in rattlesnake bite, and as a general natural antibiotic. Specific against fever, all sorts of infections and gastrointestinal disorders. General detoxicant. Specific protector against toxic effects of cadmium.

Deficiency symptoms

Deficiency may lead to tooth decay, soft gums (pyorrhea), skin hemorrhages, capillary weakness, deterioration in collagen, anemia, slow healing of sores and wounds, premature aging, thyroid insufficiency, lowered resistance to all infections and toxic effect of drugs and environmental poisons. Prolonged efficiency may cause scurvy.

Natural sources

All fresh fruits and vegetables. Particularly rich sources: rose hips, citrus fruits, black currants, strawberries, apples, persimmons, guavas, acerola cherries, potatoes, cabbage, broccoli, tomatoes, turnip greens and green bell peppers.

MDR (minimum daily requirement):

Official recommendation: 30 to 70 mg. Therapeutically used in large doses, from 100 to 10,000 mg. a day. In acute poisonings or infections, 1,000 to 2,000 mg., preferably in injection form, can be given each 1 1/2 or 2 hours. Vitamin С is non-toxic, even in massive doses.

DIAGNOSING EPILEPSY: REFERRAL TO A SPECIALIST

Once it has been decided that what happened to you was, in all probability, a seizure, your doctor will want to discover whether it was due to some underlying cause that should be treated, and whether the fits are likely to recur.

It is possible that if this is your first fit the doctor may adopt a ‘wait and see’ policy. But they may – and certainly if you have had one or more previous attacks, they will – refer you to a neurologist.
Doctors, like gardeners, have their own fields of expertise. Medicine moves so fast nowadays that it is virtually impossible for a GP to be up to date with every new development in every field of medicine. Unless your GP has a special interest in epilepsy it is quite possible that their ideas about treating the condition may not be right up at the frontier of current thinking.Your GP may, for example, want to start treating you without referring you for further investigations. It is not unheard of for a GP to say to a patient, ‘You’ve got epilepsy. Go away and keep taking these tablets.’

This used to be normal practice because it used to be thought that the cause of epilepsy was unimportant. Indeed, in most cases it was believed that there was no cause to be found, and that most instances of epilepsy were ‘idiopathic’, that is, that there was no known cause for them. Investigations were pointless because so far as treatment was concerned the end result was much the same: ‘Keep on taking the tablets.’

Things are rather different now. New methods of imaging the brain have been developed which can produce a highly detailed picture of our most complex organ. The use of these new methods has shown one thing very clearly, and that is that epilepsy usually occurs for some reason. The old concept of idiopathic epilepsy, epilepsy without a cause, no longer holds true.
A neurologist will carry out tests to detect abnormalities either in the structure of your brain or in the way it is working. You will also be given blood tests, which can indicate whether there is any medical reason which might account for your seizure. These routine tests are all quite straightforward and painless and carry no risk. Usually the tests will give detailed information about the cause of the epilepsy.

Discovering the cause of your epilepsy is important for two reasons. To begin with, it may affect the choice of treatment. Until you are certain what is causing the epilepsy it is not possible to choose the appropriate treatment. And secondly, it helps most people who have epilepsy to know why it developed. It helps their families too. Whenever a child is ill, for example, parents tend to blame themselves, however illogical this may be. They want to know how it happened, and to be able to explain it to themselves

Whether or not you are referred to a neurologist may also depend on whether or not you ask for a referral. Some people feel easier if they have as much information as possible about what is wrong with them; others are happy simply to accept what they are told and to leave all decisions up to their doctor. Neither approach is either right or wrong; it is very much a matter of your own particular personality. However, if you ask to be referred to a neurologist who has a special interest in epilepsy and your doctor seems reluctant to do so, it is reasonable to ask why. If they continually refuse to refer you, it might be worth changing your doctor to one who has a broader understanding of epilepsy.

YEAST INFECTIONS AND ITS TREATMENT

The occurrence of Candida albicans is largely due to our j dietary habits. It can easily be called a twentieth-century disease, because our lifestyle and environment allow allergies more and more opportunities to develop. Yeast is naturally present in everyone from the age of about six months. The risk of Candida infections is greatly reduced by a natural, balanced diet.

In a lecture given by Dr Alfred Vogel quite some time ago, he spoke about friendly bacteria in the bowels which are frequently killed off by the food we eat. One wouldn’t think that asking a patient to change his or her diet would be too much of an imposition, but this suggestion isn’t always enthusiastically received. Sometimes I think that people have less trouble changing their religion, their political allegiance, or even their husband or wife, than changing their diet. All I ask is that they cut five foods from their diet, namely sugar, mushrooms, wine, fermented foods or drinks, and chocolate. When I mention sugary foods, I mean all foods that contain sugar. Of the fermented foods, bread is probably the most difficult one to replace. Most alcoholic drinks are fermented and are therefore off limits. Only by following these guidelines, and by introducing a natural diet with lots of vegetables, fruits and nuts, and drinking plenty of water, do we have a chance of combating a Candida problem successfully.

The discovery of antibiotics was quite rightly hailed as a tremendous discovery and many lives have since been saved. Yet, the word antibiotic actually means ‘anti-life’ and unfortunately antibiotics are not selective in the bacteria they destroy. Often the good or friendly bacteria are killed off along with the harmful bacteria. It is these friendly bacteria we rely upon for digestion and for our general good health. Control and balance of a Candida is very important and fortunately there are several good remedies that will assist us in this. Harpagophytum (Devil’s Claw extract in its mother tincture) is one of the best remedies to control a Candida or yeast infection. Molkosan may be used and Caprylic acid, a derivative of coconut oil, has also been used successfully, especially when the Candida is active in the vaginal area.

Deficiency of essential fatty acids may also result in a greater likelihood of developing a Candida infection. These acids contain Omega three and Omega six, essential to health. There are three ‘essential’ fatty acids: linoleic, arachidonic, and linolenic, collectively known as vitamin F. They are termed ‘essential’ because the body cannot produce them. These unsaturated fatty acids are necessary for growth and healthy blood, arteries and nerves. They also help to keep the skin and other tissues youthful and healthy by preventing dryness and scaliness. Essential fatty acids are necessary too for the transport and breakdown of cholesterol. Evening primrose oil, borage oil and blackcurrant seed oil are all good sources of essential fatty acids, and these oils change as we react to the environment with respect to the cell membranes. There are also some oils that are actually detrimental from this point of view, such as peanut oil and coconut oil. The body tissues are made of what we eat, and how we respond to our environment depends totally on how strong the tissues are. Life is a constant renewal of cell tissue and in order to rebuild tissue we need the correct material. Topically applied and absorbed fatty acids can be of great help here, even for babies with skin problems. Even a very young baby can change metabolically when the right oils are used and will improve very quickly.
If the diet is poor, supplementary Omega three and six tend to produce a more anti-inflammatory response. Skin irritation or injury will cause the cells to go into a coagulation response, stimulating the reaction of white blood cells and increasing the production of leucotrines. This can be clearly seen in the skin condition psoriasis. The more leucotrines or inflammatory response, the more division and proliferation of cells is necessary to decrease this reaction. One of the remedies that can be very useful here is Ginkgo biloba.

Ginkgo biloba is the world’s oldest living tree species. Its lineage stretches back 200 million years, and although it originated in China, it grows to a ripe old age in the many other parts of the world to which it has been transplanted. Modern scientific analysis has revealed the reason Ginkgo trees have survived for so long: their leaves are packed with highly-active chemicals that give the tree unusual resistance to parasites, infections and pollution.

 The leaves of the Ginkgo are traditionally harvested in the autumn, just as the colour changes, and this is exactly the time when they have their highest active concentrations of bioflavonoids. These are now thought to be most potent of all bioflavonoids, and are thought to have the ability to help maintain the circulation of blood to the brain.

To increase the Omega three factor, flax seed, cod liver and sunflower oil are helpful, as well as selenium and betacarotene. A combination of vitamin E with flax seed oil is totally suitable for the treatment of this affliction. Linoleic acid production is helped by biotin, magnesium, vitamin B6 and zinc. Unfortunately this is obstructed by the use of alcohol, high cholesterol foods, saturated fats, virus infections, and cancer. Evening primrose oil helps to form DGLA (dihomo gammalinolenic acid), which in turn needs vitamin B3, vitamin C and extra zinc to form prostaglandins, necessary in the case of all skin disorders.

Many skin disorders are self-inflicted insofar as they are the result of modern dietary habits. The many patients with yeast infections I have been asked to treat over the years have all been greatly helped when nutritional deficiencies have been dealt with, together with some herbal or homoeopathic treatment. Evening primrose oil, sometimes in combination with fish oil, has been of great help, as well as vitamin A and C supplements.

In countries where the wheat intake is low I have never seen an active candidiasis, which leads me to believe that our lifestyle, wheat consumption and the number of processed food items in our diet, all have a great deal to answer for. Organically-grown wheat is much less harmful, but, if a definite wheat allergy has been proven, it must be banned from the diet. If the Candida albicans condition is indeed affecting the vaginal and anal areas, dabbing with some diluted Molkosan will ease the discomfort, and sometimes it is useful to know that the skin will soften with witch hazel (Hamamelis virginiana). The Bioforce range also has a witch hazel cream, called Hamamelis salve, which also contains St John’s Wort, echinacea and wheat germ oil.

Patients are not always prepared to accept changes in their diet, and I often have to explain that, even if they are not willing to accept a major change of direction, the very least they ought to do is leave out sugar and hopefully yeast. Just eliminating these substances often brings about a considerable change. I often wonder why people suffer such unpleasant problems, when they can be helped so easily. Never underestimate a yeast infection, because it is likely to lead to greater problems if it goes unchecked. In research, active Candida conditions have been found in cancer patients and, together with this word of warning, I also want to encourage the sufferer that yeast infections and Candida albicans can be treated successfully. However, never delay seeking help when the condition comes to light.

ENDOMETRIOSIS: A BRIEF LOOK AT MENSTRUAL CRAMP REMEDIES

Lydia Pinkham brought a measure of respectability to over-the-counter menstrual remedies in the 1920s with a tonic designed to help sufferers of monthly ills. Although the tonic was often a staple of medicine chests, like iodine and aspirin, there is some doubt as to whether it was of any real medicinal value, other than providing a psychological boost. This formula preceded the more effective up-to-date menstrual cramp remedies, like ibuprofen.

Before such modem prostaglandin inhibitors were developed, it was not unusual to hear of women who became addicted to laudanum—a tincture of opium—to relieve their pain. Others tried nonmedical treatments like hot sweat baths with massage, hoping to perspire out the disease. The rundown, or “salt glow,” following the bath was concentrated in the abdominal area to stimulate blood Bow to the area. “Galvanism,” a less fearsome cousin of shock treatment, applied electrical current to the area to reduce pain. Along with the staple family recipes for healing that were handed down generation to generation, liniments, douches, decoctions, poultices, and brews were available from doctors, mail-order catalogs, pharmacies, and quacks.

Modern pharmacology can manufacture drugs from synthetics, plants, minerals, whatever, but turn-of-the-century cures relied on plants. Although few women nowadays partake of hemlock tea (made from the leaves and inner bark) to “tone the uterus,” there is a renewed and growing interest among women with endometriosis in drug-free therapies that are as young as TENS (transcutaneous electrical nerve stimulation, a form of biofeedback and stress control) and as old as acupuncture. Some of these therapies require the ministrations of experts on an individual basis; others, like dietary changes and stress management, can be, in general, incorporated into the daily lives of most sufferers of the disease.

SURGICAL TREATMENTS OF ENDOMETRIOSIS: AFTER LAPAROTOMY

After your operation you will have an intravenous drip in your arm to provide you with fluids so that you do not become dehydrated as you will not be allowed to drink. You will usually have a catheter draining your bladder for the first day or two if you have had a hysterectomy. You may also have a tube coming out of the surgical wound to drain any excess fluid and debris from the area of the operation.

For the first twenty four hours after your operation the nurses will observe you closely. They will chart your pulse, breathing rate, blood pressure and temperature frequently, and check your wound and record any vaginal bleeding. During this time your gynecologist will come and discuss the operation with you.

The physiotherapist may visit you again to help you with your breathing and foot and leg exercises.

You may experience some nausea and/or vomiting immediately after the operation. To help relieve this you may require an injection.

You will usually feel drowsy and experience pain for the first few days following your surgery, particularly from your wound. The tube that was placed in your throat may give you a sore throat for the first day or so. Two to four days after your operation you will probably experience wind pain which can be very unpleasant and uncomfortable.

For the first day or two you will either be given painkilling drugs continuously through your intravenous drip or you will be given painkilling injections every four to six hours. You will then progress to painkilling tablets.

When you first start to drink again you will be allowed only to suck ice and sip small quantities of fluid. Once you are able to cope with fluids and any nausea and vomiting has ceased your intravenous drip will be removed. When you have passed wind you will be able to progress onto a light diet of semi-solids and then onto a normal diet if you have no problems. You will probably not open your bowels for the first two to four days after your operation but if constipation becomes a problem you may be offered suppositories.

You will sit out of bed for a short time on the day after your operation and you will be encouraged to move around a little more each day as your condition improves.

When you return home you will then require another three to five weeks of recuperation if you have had a conservative laparotomy, or another three to seven weeks if you have had a hysterectomy. It is important that you do not just rest in bed but that you move and walk around each day and gradually increase your activity level as you recover and feel better.

You may tire quickly for the first week or two, so you will need some help with household tasks for the first one to three weeks, especially if you have children. When you start to do the household jobs again you should do a little at a time and still have plenty of rest. Do not try to be a superwoman as it will only slow down your recovery in the long-term.

For the first week or two after you return home you may still have some discomfort or pain so a mild painkiller such as Panadeine or Panadol may be necessary. The vaginal discharge, if you have had it, usually persists for about two weeks after surgery but it may last for up to six or eight weeks following a hysterectomy.

Most of the healing of the wound occurs in the first two weeks after surgery. After that you can lift light loads but it is probably best to avoid lifting heavy loads if possible for the first month or so. You can drive the car again when you are fit enough to do light gardening and walk up stairs quickly, generally about three to six weeks after surgery. You can have sexual intercourse again when your doctor has examined you about six weeks after your operation.

You should notify your gynecologist immediately if you develop any of the following symptoms:

• a fever

• your wound becomes tender, swollen and red

• a discharge appears from your wound

• severe abdominal pain or cramps

• urinary frequency and scalding when passing urine

• pain or bleeding when using your bowels

• your vaginal discharge develops an unpleasant odour

• your vaginal discharge persists beyond six to eight weeks

• tenderness and/or swelling in your calf muscles

• increasing soreness of the calf muscles when walking

• shortness of breath, chest pain or pain when breathing.

EARLY MENOPAUSE

Women can experience menopause in their early forties or before. In some women early menopause occurs because of medical intervention, and is described as artificial menopause. For others there is no intervention – they have a ‘natural’ menopause. The most common type of artificial menopause, surgical menopause, occurs when a woman’s ovaries are removed because they are making other medical conditions worse or these conditions are damaging the ovaries.

Endometriosis is one such condition. The endometrium is the lining of the womb (uterus), shed during the menstrual period, and endometriosis is the presence of endometrial tissue in sites other than the womb. In Valerie’s case, endometrial cells passed through her reproductive system to her ovaries, settling on them as well as on other parts in the pelvis and abdominal cavity. There, the endometrial cells multiplied and interfered with the normal function of her ovaries, causing

Valerie’s periods to be irregular, prolonged and painful. Intercourse was also painful, and this was not relieved by lubricants or relaxation therapy. She decided to go ahead with surgery to remove the endometriosis. Every effort was made to spare the ovaries, but the extent of the condition meant that this was not possible.

The ovaries may also be removed if they are not functioning normally, because of multiple cysts, for example. The cysts can grow as big as golf balls or footballs or any size in between, damaging other vital tissues in the process. (Surgeons increasingly try to preserve at least part of one ovary if the cysts are not cancerous.)

Then again if, before menopause, you have a hysterectomy in which your ovaries are removed along with your uterus and cervix, you can expect to experience symptoms of menopause within days or months of surgery. About half the hysterectomies carried out in the US are of this comprehensive type (in medispeak, a total hysterectomy plus a bilateral salpingo-oophorectomy). In Australia the figure is believed to be somewhat lower. Losing your ovaries has a lot of bearing on the severity of menopausal symptoms; if they are removed before menopause rather than at or after it, symptoms tend to be more severe.

The more common type of hysterectomy performed in Australia involves removal of only your uterus and cervix, not your ovaries. Somewhat confusingly, this operation is termed a total hysterectomy. In theory, a total hysterectomy should not produce menopause. The only change should be an end to your periods and removal of the problems that made the surgery necessary.

In practice, however, a significant number of hysterectomised women who still have ovaries experience symptoms of menopause up to four years earlier than might be expected.

Top Five Ways to Lose Weight Safely and Effectively

There are a lot of fad diets out in the market. However, those fad diets are anything but safe. If you are looking for safe and effective ways to lose weight, then keep on reading. This blog post will show you the top five ways to effectively lose weight safely.

1. Journal

It is always a good idea for dieters to keep a journal that includes everything that they eat and every physical activity that they do. It helps keep dieters more aware of how much calories they are consuming compared to how much they are burning.

2. Exercise Regularly

Exercising consistently will help make it into a habit. And it is a habit that is going to help you burn a lot of extra calories.

3. Eat Whole Grains

Replace all of the processed foods from your diet with some healthy whole grains.

4. Drink Water

Water will help to fill you up. Plus it is naturally free of fat and calories.

5. Only Eat When Hungry

A lot of people like to eat just for the fun of it. Unfortunately, that is not a healthy way of thinking about food. Instead, think of food as fuel for your body. Only eat when you are low on gas.

THE SELF-POISONER: PATTERNS OF SELF-INDUCED TOXICITY – HELEN-LOUISE’S CASE

Helen-Louise is a self-poisoner. To others in her world she is a "wonderful person"—always doing things for everyone. She is conscientiously and deeply devoted to her husband and three children.

As she walks into the office for her first consultation, Helen-Louise forces a smile that scarcely covers the pain and tension her wrinkled brow reveals. She sits down struggling to maintain her composure, looks at the doctor, forces another smile, and makes a trite joke about needing to talk to a head-shrinker. The doctor waits for her to proceed. The silence is too overwhelming; she cannot play her game any longer and bursts into tears. A few minutes later, she begins to talk.

H-L: "I can’t stand it any longer. I feel like I’m being used up by my family. They always want something from me. I never have a moment’s peace. Every time I talk to my husband, one of the children breaks into the conversation. They even barge into our bedroom and insist on being there with us. My husband feels too guilty to say anything about it. I can’t stand the looks on their faces when I tell them that their father and I want to be alone. My son is constantly demanding something. As soon as I do one thing for him, he is after me to do something else. They keep me so busy I no longer have any time to do what I want to do. My husband and I have no chance to talk, and I feel we are growing apart. Lately, I find myself resisting his sexual advances, and I don’t understand it at all—I love my husband. Yet I know I’m becoming increasingly irritated with him and the children. I feel very guilty when I find myself wishing the children were all grown up so that I could be alone with my husband. I know they love me, but I’m beginning to resent everyone and everything in that house—as if it were poison. Sometimes I feel as if 111 die if this keeps on."

The "problem" that Helen-Louise brought to the psychologist’s office is a case in point. While she lived within the potentially nourishing atmosphere of a family that loved and cared about one another, she poisoned herself by playing "victim” to the toxic manipulations of her children. The fact that she was unaware of the deadly games in which she participated did not make their toxic effects any less devastating to her well-being and her ability to nourish both herself and her family.

ACNE

Just about everyone gets it at one time or another

Acne vulgaris refers to a spectrum of skin eruptions — blackheads, whiteheads, pimples, cysts and nodules — that can be sore, painful or itchy. Few people escape adolescence without a pimple or two.
Acne begins when a fatty oil, called sebum, and dead cells are manufactured too quickly and clog the pores around small hair follicles. The results can range from whiteheads to blackheads and pimples.
Acne tends to occur in areas where there are high concentrations of these sebaceous glands — the face, neck, shoulders, and upper and center back. In both sexes, elevated secretion of androgen hormones during puberty stimulates these glands to produce extra sebum, increasing the likelihood of acne.

What you can do

PRACTICE SMART PERSONAL HYGIENE

Use a cleansing agent or soap that dries the skin enough to cause minor shedding (avoid too much drying since this can cause further irritation).
Use a clean washcloth — gently.

Never scrub the skin. If acne is not too severe (skin is not infected, pussy or raw), cleansing with a gentle abrasive such as Buff-Puff may help.
Always rinse thoroughly.

Give yourself an occasional mini-steam bath by placing a warm, wet towel on your skin for 10 to 15 minutes. This will help open pores and allow deeper cleaning.

For infants with acne, wash the face daily with a clean cloth, water and mild soap.

SKIN MEDICATIONS

Acne medications unblock pores by drying up oil and promoting peeling. Many are available without a prescription and come in solutions that help cover up redness and scarring. Sunlight may temporarily clear up skin, but it can have other damaging effects — especially if drying agents or antibiotics are being used.

A doctor can prescribe stronger versions of topical skin medications or a special formulation of vitamin A, called retinoic acid (Retin-A), and antibiotics. Vitamin A also may be prescribed for severe cases and should be taken only as directed by your doctor — too much of it can be toxic.
Final notes

Carefully follow the directions, warnings and precautions on any drugs you use. Call your doctor if you have questions. And be patient — it may take two to six weeks or more to see progress with any of these self-care treatments or medications.

AGGRESSION AS A CAUSE OF ANXIETY

We all have a certain amount of aggression within us. If we didn’t, we would not succeed as a species or as individuals. Man’s aggression has led him to master the other animal species, and has to a large extent enabled him to control his immediate environment. However, the way in which man has progressed toward civilization has of itself imposed great restriction on his native aggression.

 He no longer has the opportunity to vent open aggression on animals that threaten him, or on a neighbouring tribe who would take his food or his woman, nor can he turn his aggression on weaker members of his own kin and take what they have for himself. In our present evolutionary state man is struggling to control the aggressive impulses that are still within him. This struggle with our own aggression is one of the greatest causes of tension. In many ways it is even more difficult to cope with than sexual problems, because while we usually have some awareness of our sexual difficulties, the struggle to control our aggressions may make us tense without us having any knowledge as to the cause of the tension.

A man of middle age came to see me for a skin rash which he had had on and off in front of his elbows and behind his knees for almost twenty years. He had had a lot of illness as a child which had left him undersized and with a bent back.

From the beginning he took charge of the interview. He was aggressive in his attitude, and rather contemptuous in his references to all the past failures of medical treatment. He mentioned that his family called him aggressive. He said that he loses his temper and blows up with his children, and then feels sorry for it. He added that he often drank heavily from sheer impatience and boredom. His wife disclosed that he really terrorized people—not only herself and the children, but other members of the family, and his friends at his place of work. The condition of his skin would wax and wane according to his state of frustration.

His aggression resulted from an inferiority complex, a reaction to compensate for his small size and weakly appearance. The anxiety engendered by his efforts to control his aggression had caused the skin condition.

Because he was so tense and aggressive it took him some time to learn how to relax, but when he did, his skin cleared up. A report from his wife indicated that those around him had come to have a happier time.

CHILD’S HEALTH: PNEUMONIA

Pneumonia is an infection of the smallest airways of the lungs (alveoli). It can affect children of any age.

Cause

Pneumonia is usually caused by a virus, but can be caused by a germ.

Clinical features

The most striking features of pneumonia in children are a moist cough and a high fever. Sometimes the child is short of breath too and may complain of sharp pains in the chest on breathing deeply. Younger infants may just look very ill and breath rapidly, without having any other symptoms.

Investigations

Pneumonia can usually be diagnosed on clinical grounds, but your doctor may suggest a chest X-ray to confirm the diagnosis. Sputum and blood tests may also be helpful.

Treatment

Some types of pneumonia are due to bacteria which are responsive to antibiotics. It is difficult to distinguish between a viral and a bacterial pneumonia, so sometimes antibiotics are given just to be safe. If the illness is relatively mild, your child can be treated at home with oral medication, bed rest and paracetamol to lower the fever. Use a humidifier in your child’s room to make his breathing easier. Also make sure that your home is smoke-free.

If your child is very ill, admission to hospital may be advised, so that antibiotics can be given intravenously or by injection. Once treatment is commenced, recovery is usually rapid and complete.

When to see your doctor

• if your child has a cough and a high fever;

• if your young baby is listless and breathing rapidly;

• if there is no improvement after 3 days on antibiotics.

Take your child to hospital immediately if his lips look blue.

IMMUNE POWER DIET: AMINO ACIDS: YOUR ENERGY THERMOSTAT

Amino acids make your body’s energy thermostat—the way you absorb, digest and use protein, carbohydrates, fats, and sugars—run more smoothly. Ideally, our body should work to keep us on a smooth course of constant high energy and cheery moods. But for many people, it doesn’t work that way because imbalances in the body’s energy regulators cause periodic bouts of low blood sugar.In my opinion, this is one of the most common undiagnosed medical problems in this country. The medical term for it is reactive hypoglycemia.

 This means that instead of smoothly maintaining the constant sugar and protein balance we need, the body responds jerkily, flooding itself with sugar energy (“hyperglycemia,” or “high-sugar”) then abruptly slamming on the energy brakes (“hypoglycemia,” or “low sugar”). We all know people who are “touchy,” apt to fly off the handle, with what psychiatrists call “mood lability.” Often, such people are stuck on this “hyper-hypo” seesaw, victims of a faulty energy thermostat.People suffering reactive hypoglycemia may also be susceptible to every passing germ that comes along, and often plagued with hay fever, skin rashes, or allergies. In short, their erratic energy thermostat seems to go along with a weakened immune system. I am indebted to Dr. Jeff Bland, a noted nutritional researcher, for first bringing this constellation of symptoms to my attention.

MENOPAUSE AND CLIMACTERIC

The end of the child-bearing period is the menopause. This is the second time in a woman’s life when the workings of the sex organs are greatly modified and produce disturbing symptoms. The first time is at puberty. I imagine that most girls are elated to feel that they are really becoming women and no longer need to dress in their mothers’ old dresses and play “grown up.” Hence they bear with equanimity some unpleasant aspects.

Difficulties with menstruation, the unpleasant symptoms of the menopause, and a few other situations may call for the use of sex hormones, but the frequency of their use is generally in inverse proportion to the knowledge of the physician who is prescribing them. The psychic effect is particularly difficult to separate in these cases, but we may remember that over several generations, when these hormones were not in use, a large fortune was made and maintained by dispensing only vegetable compounds for female troubles. The vegetables were inert physiologically and safer than the powerful hormones.
Women at their menopause, the “change of life,” do have an upsetting of their endocrine balance.

 In fact they have some upsetting at every menstrual period. Some have a great deal of disturbance every month, leading them to refer to the “curse.” But, at the time when these periods are ceasing and the whole hormonal system is readjusting, a woman is likely to have a lot of other things bother her, too. The menopause notifies her that she is losing her youthful charm – she is on the verge of becoming elderly. Naturally the psychic effect is bad. She is, in some cases, unnecessarily upset by the belief that she will soon lose her sexual attractiveness to her husband. This is not the case. She ceases to have a menstrual flow and to ovulate, but her other sexual functions and desires are unimpaired.

Along with the change of life other physical causes of discomfort become more common. X-rays demonstrate that practically everybody is then developing some arthritis, and arthritis often is uncomfortable. Pseudo-medical literature in modern abundance, and advertising, keep up the suggestion that the woman in the late forties is in for trouble. What Woman has not seen, in the advertising pages, photographs of her unhappy sisters who, she is told, look thus because of the change of life? It is a tribute to the female sex that, as far as a mere man is able to notice, most of them are able to show little change in their equanimity at this time.

The menopause is complete when the ovaries have ceased to perform their normal function. There are rare occasions when a woman may menstruate regularly for years and then abruptly cease for the rest of her life. Usually it is a gradual change, in reverse, to that which occurs at puberty. Most young girls do not immediately start into a normal menstrual cycle. They are irregular at first and it is well known that they are apt to have irritable, nervous symptoms as well as physical difficulties at that time. At the menopause the same irregularity and symptoms are the rule.

 The age at which it may occur is variable. Not too uncommonly it appears at about thirty-five, and two of my gynecological friends have told me that they thought the average age is over fifty. It frequently is difficult to say with certainty when the menopause is fully completed. If I may use an arbitrary figure, I should therefore say that any woman, who has ceased to menstruate for six months and then appears to start up again, should have a careful physical examination, as there are numerous bad conditions which may simulate menstruation.

POISONING OF THE STOMACH AND INTESTINES – APPENDICITIS (GENERAL INFORMATION)

The appendix is a worm-shaped offshoot from the cecum, the blind intestine at the beginning of the ascending colon. It is this small tube which can become inflamed, the condition referred to as appendicitis, and is often removed surgically.

 The vermiform appendix is located exactly half way between the navel and the right iliac crest, the highest portion of the ilium and the pelvis. Imagine, for a moment, the face of a clock; if the navel were the centre, the small hand when it is on eight o’clock would then indicate the direction in which the appendix is located, exactly in the middle between the navel and the protruding hipbone.

Occasionally, an inflammation of the ovary (Novartis) on the right side is mistaken for an attack of appendicitis. When the area of the appendix is depressed by the hand and suddenly released, the sensation of pain is radiated to the right, whereas in the case of ovaritis the pain would be local and of a dull nature. Appendicitis may also be diagnosed through the rectum. It generally makes itself known through severe, sudden pain in the right lower portion of the abdomen, appearing without warning and usually accompanied by malaise and vomiting. As a rule the tongue is coated and the patient runs a slight temperature of 37.5-38 °C (99.5-100.4 °F). If the diagnosis is difficult, the physician may also take a blood test to determine whether the number of white blood cells has increased. In cases of inflammation the usual number of 6,000-9,000 may have jumped to 15,000, and the pulse rate also climbs above 100.

THE EXPLANATION FOR LINGERING BACTERIAL PROSTATITIS

One of the explanations for lingering bacterial prostatitis may be the presence of infection in tiny stones, called calculi, in the prostate. Prostatic calculi (the prostate’s version of gallstones or kidney stones) are quite common—about 75 percent of middle-aged men and 100 percent of elderly men have them. They can be detected with an imaging process called transrectal ultrasound.

 They’re usually small, found in grapelike clusters, and, most important, harmless. But when they get infected—as they often do in men with chronic bacterial prostatitis—prostatic calculi can cause an infection to persist, and symptoms of urinary tract infections and prostration to return again and again. (What causes calculi? Molecular analysis has shown that these stones contain ingredients generally found in urine but not prostatic secretions—which suggests they form when urine somehow “backs up,” or refluxes, into the prostate.)

When a man has both prostatic stones and a history of chronic bacterial prostatitis, it’s pretty safe to assume that the stones are infected. The significance of this is that infected calculi have never been cured by medication alone, although antibiotics can certainly treat the symptoms. The only way to cure infected prostatic stones permanently is to remove them surgically, by a procedure known as transurethral resection of the prostate.

HERPES SIMPLEX VIRUS: PATHOGENESIS AND CLINICAL PRESENTATION

Herpes simplex virus (HSV) encephalitis due to HSV type 2 occurs in babies infected perinatally. However, HSV type 1 is the most common cause of acute non-epidemic viral encephalitis among healthy children (older than 6 months of age) and adults. The estimated frequency of HSV type 1 encephalitis in the United States is 1 in 250,000 to 1 in 500,00 persons per year.

 This encephalitis has no seasonal preference and can occur at any time of the year. In the absence of therapy, the mortality rate exceeds 70%, and only 2.5% of patients overall (11% of survivors) regain normal function. Early treatment is the most important factor in ameliorating the morbidity and mortality of this infection.

Pathogenesis

Encephalitis with HSV type 1 can be due either to reactivation of virus or to primary infection. Approximately one third of patients develop HSV type 1 encephalitis during primary infection, and approximately two thirds acquire the disease through reactivation. Reactivation of latent HSV type 1 in the trigeminal ganglion leads to active replication of virus with subsequent spread directly to the temporal cortex. Primary HSV type 1 encephalitis results from either intranasal inoculation with direct invasion of the olfactory tract or from oral inoculation with spread along the trigeminal nerve. Whether primary infection or reactivation, the clinical syndromes are identical, producing inflammation and necrotizing lesions in the inferior and medial temporal lobes arid orbital-frontal cortex.

Clinical Presentation

HSV type 1 encephalitis typically has an abrupt onset, although an insidious, subacute presentation has been reported.

Fever is almost always present, and headaches are prominent early in the disease course. More than 90% of patients have signs that suggest a localized lesion in one or both temporal lobes, and this localization often takes the form of intense personality changes. Seizures, hemiparesis, visual field defects, and paresthesias may also be present. Symptoms often take 2 to 3 weeks to reach maximal severity, and some patients can progress rapidly to coma and death. Coexistent oral herpetic lesions are rare in HSV type 1 encephalitis.

WHAT SIDE-EFFECTS MIGHT I EXPECT IN USING ST JOHN’S WORT?

The best data base on side-effects comes from a large German study in which over 3,000 patients on St John’s Wort were monitored by their doctors, over 650 of whom participated in the survey. Only 48 patients (about 1.5 per cent) discontinued the medication in the study, and side-effects were reported by only 79 people (2.4 per cent). Of these side-effects, the most commonly reported problems were gastro-intestinal irritation, restlessness and allergic reactions, all of which were reported by fewer than 1 per cent of individuals. European experts whom I have interviewed about St John’s Wort side-effects agree with these very low percentages. Such low side-effect frequencies are especially good news for the treatment of depression in the elderly, who are typically highly susceptible to the side-effects of all sorts of medications.

Although time will tell whether the initial observations of such low frequencies of side-effects are correct, I have been impressed in my own clinical practice by the absence of any side-effects in some people who have proven to be highly sensitive to side-effects from a wide variety of other anti-depressants. It seems likely that St John’s Wort will indeed prove to have fewer side-effects than the synthetic anti-depressants currently in use.

As noted above, anyone with a history of hypomanic or manic episodes should be especially vigilant for the typical symptoms of activation after starting any anti-depressant. Sleeplessness, racing thoughts, pressured speech and euphoria or irritability are early warning signs of hypomania or mania that must be heeded. If these develop, you should stop St John’s Wort immediately and consult a doctor. The loss of sleep (which is often not experienced as unpleasant but rather as an extra opportunity to get more accomplished or have more fun) is harmful in itself as it can fuel the manic process. If caught early, the symptoms of hypomania or mania can often be checked with appropriate actions; if not, however, they can escalate into mania, which can be very unpleasant and damaging.

A few of my patients have developed increased anxiety after beginning St John’s Wort. Such reactions have also been reported to occur in certain individuals after starting all forms of antidepressants. People with a history of panic attacks or extreme anxiety are especially susceptible in this regard. Yet anti-depressants have actually been given for the treatment of anxiety and panic. In order to overcome the initial anxiety response, which may occur after taking even a single dose, it is necessary to back down on the dosage. For example, in treating such sensitive patients with Prozac I have often started with as little as 1 to 2 mg of liquid Prozac per day. After the person has become used to that dosage, it is then possible to increase the dosage slowly and carefully over the ensuing weeks until a therapeutic level is reached. If you are eager to persevere with St John’s Wort but happen to develop anxiety after taking 300 or 600 mg, it is possible to overcome the problem by obtaining an herbal extract in the form of an elixir. Begin by taking very low dosages of the elixir (say one-tenth of the recommended number of drops) and increase gradually at a rate that you can comfortably tolerate until you reach therapeutic levels.

Some people on St John’s Wort have complained about increased sensitivity to sunlight both with regard to the skin, with more reddening occurring than usual, and the eyes. At this time there is no reason to believe that either of these side-effects is of clinical concern, but if they cause discomfort, protecting your skin with sun block or the eyes with sunglasses would be a sensible preventative measure.