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What is rheumatoid arthritis

The knee joint is normally filled with a tiny amount of fluid for lubrication. However, when the joint is injured, the synovium (the soft tissue inside the knee capsule) responds by producing even more fluid to protect the joint—the so-called synovial response. A synovial response is usually delayed because the synovium has to produce the synovial fluid. Swelling due to the synovial response is typical of a meniscal injury not related to the meniscal blood supply.
Swelling may also be due to a rupture of a blood vessel, which causes immediate bleeding and results in immediate swelling within an hour after the injury. This is more typical of a ligament injury, fracture, or dislocated kneecap.
Many older patients may think that their knees are swollen all the time, but this may not be the case. Very often, as we age, the fascia, which encases the leg, may lose some of its tautness, resulting in bulges of fatty tissue. How do you test for true swelling? If you straighten out both of your legs to about kneecap level, you should see a small indentation or dimple on the medial side. In the case of real swelling, the dimple will look more like a pouch.
There are other reasons that a knee may look swollen but isn’t. For example, arthritic knees may appear to be enlarged due to bone spurs or osteophytes, which are bone growths that develop as a result of the erosion of cartilage. The loss of cartilage may cause instability, and the formation of osteophytes can help to stabilize the joint, probably by increasing the surface area.


As I said, every patient has to be the captain of her or his own ship, and that includes my wife. But every captain needs a good first mate, and I was shocked at how little information, counsel, and support my wife was getting from her doctor in that role. I stand by hormone replacement therapy starting just before menopause as an excellent way for most women to protect their bones. But I know there are many reasons, both medical and personal, a woman might not want to use it. So if a case like my wife’s came up in my office, I’d have made the same suggestion, HRT, as her doctor did. But first I would explain about bone loss and why, particularly before menopause, it is a serious danger sign. I would also detail what’s been proved about how diet, nutritional supplements, and exercise can stop, prevent, or even reverse bone loss. I’d talk with her about how stress can worsen bone loss—and how stress reduction can alleviate it. I’d check her health history, and her family history, to see if she had additional risk factors she should be aware of. Only then would I talk about supplemental hormones, including the many different forms of HRT, as well as “natural” hormones and, in more advanced cases, the best prescription options we have to stop bone loss. If a patient didn’t want or didn’t need drug treatment, she’d still have all the information she needed to take a proactive approach to her health.
This article takes the same holistic approach to your life and health. Staying strong isn’t just a matter of taking hormones, or working out with weights twice a week, or popping calcium pills left and right. In the right combination, those things will help, but bone density is an overall lifestyle issue. You need general good health to maximize bone density. Conversely, maximum bone density will enhance general good health. That’s why I’m laying out all you need to know about what you eat, how you exercise, and what you take that affects your bone density (nutritional supplements, hormones, prescription drugs, and “alternative” treatments). This book describes all the risk factors you should eliminate or fight, so you can pinpoint your level of risk and tailor your program to your specific needs.

(Русский) Психофизиология ревматоидного артрита

(Русский) Особенности течения болезни

(Русский) Симптомы ревматоидного артрита

(Русский) Причины возникновения

Sorry, this entry is only available in Русский.

(Русский) Методы диагностики


The National Health Service continues to lead the world in innovative ventures. In the face of increasingly overwhelming odds the NHS is trying to coordinate its services towards the elderly, providing a range of care by dedicated people, usually with minimal financial backing. To be added to this range of services (inpatient, outpatient, day hospital, continence clinics, etc.) can now be added memory clinics. In 1983 the Geriatric Research Unit of University College Hospital, London, opened a memory clinic. The research work pioneered there inspired others and many similar clinics have started, including one in my own health district of Tower Hamlets, opened by the late Dr Isabel Moyes, and now based at the Royal London Hospital, Mile End.
It is obvious to all who deal with elderly people that the worry of developing memory loss and possibly dementia is very great indeed. Some of this worry stems from a knowledge of how the elderly mentally confused are looked after by the state. The mind’s eye picture of bewildered old people dressed in food and urine stained ill-fitting clothes wandering around in the absence of trained carers is so strong because it bears an uncomfortably close association to the truth. The other aspect, though, is the ignorance surrounding the whole area of memory loss and dementia and the fact that this ignorance leads to untold worry and concern.

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Imodium is a synthetic opiate which halts diarrhea by disorganizing the bowels innate rhythmic contractions. Imodium is available over the counter at chemist shops. Its actions are similar to those of Lomotil, which for reasons unknown is not available over the counter at chemist shops.
Crusted weeping sores that break out where ever the skin is scratched are the hall marks of impetigo. Widely known as “school sores”, impetigo is another skin manifestation of the “Golden Staph”. Sometimes it is also caused by members of the Streptococcus family of micro organisms. The medical response to impetigo involves oral Flucloxacillin and topical antibiotic ointments, such as Bactroban and Nemdyn. The bacteria responsible for impetigo are spread by physical contact with previously infected individuals.
Impetigo is not a disease of the blood. It is caused by virulent species of bacteria taking up residence on the skin. Antiseptic in the bath for two weeks usually removes them and a small dab of Betadine or Savlon in the nose and around the anus may be required to eradicate more tenacious members of the offending species.
Inderal is the archetypal Beta Blocker. The drug is now little used in the treatment of angina or high blood pressure. It still finds a place in the prevention of migraine headaches and is used in low doses by public speakers and marksmen to prevent an anxiety induced tremor.

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The easier it is to enjoy delicious, though low-fat or non-fat foods, the easier it will be to make dietary modifications that you can live with. The food industry has responded to an increasing public demand for heart-healthy foods, and new ones enter the market each week.
You can choose from products such as the low-kilojoule main meals such as Lean Cuisine, low-fat and even non-fat cheeses, reduced fat and reduced sodium margarines, egg substitutes, and anything from the Weight Watcher’s range of products. Just check on the label for the red tick, which indicates that the food item has a seal of approval from the Australian Heart Foundation.
Using these and other products makes life a lot more enjoyable.
After all, eating is one of the joys of life. The trick to following a heart-healthy diet is to get rid of the fat and keep the fun and flavour!
Cardio & Blood/ Cholesterol


Bonnie Farrell, RN, who heads up the nursing staff at the Heart t Institute of the Desert in Rancho Mirage, California, warns about trusting cholesterol tests taken shortly after heart attack or bypass. Both those cardiac events are known to lower cholesterol levels significantly, but only on a temporary basis.
A test taken about two months after the event should provide more accurate information. In the meantime, you should continue to stay on a low-fat, low-cholesterol diet.
Ms Farrell also describes a frequent scenario in which the patient’s cholesterol level is normal even after eating a regular diet in the hospital and consuming high-fat foods at home during the weeks following hospital discharge. Not only must one consider the cholesterol fluctuation mentioned above, but also the appetite decreases during those first weeks. Many patients lose weight, simply because they’re not eating as much as before. Even though you might think that you’re eating a lot of fat, the actual intake is likely to be lower. But when the appetite returns, fat intake—and cholesterol levels—are likely to rise unless you make some significant dietary modifications.
Cardio & Blood/ Cholesterol

How old are you really? The resting heart rate bio-test

What You Will Need

  • A comfortable chair

  • A watch or clock with a sweep second hand

What This Test Measures

This test measures the ability of your heart to pump oxygen-rich blood into your system, allowing you the health and vigour to exercise and lead an active life. In dozens of studies researchers found that our ability to transport oxygen declines as our body age increases. This decrease begins in our thirties (for men it starts earlier, in their twenties) and continues through our adult years until by age sixty-five we have 30 to 40 per cent less invigorating oxygen in our muscles than we had as teenagers. The famous Framingham Study, which followed 2,400 women since 1949, found that women have a ten-year edge on their male counterparts terms of heart disease. But, the shocking news was that even thou women can buy themselves an extra ten years before the onset of ageing heart disease, they don’t benefit as much as men if they wait to take so-preventive measures after they have been diagnosed with heart problems, This test can measure the age of your heart and can help you take steps to make it younger and healthier before it is too late.

Ready, Set, Go

Sit down in your comfortable chair. Put your watch with the sweep second hand in front of you where you can see it clearly. Don’t hold your breath. Relax. Now find your pulse by putting your middle finger on the large artery in your throat, just under your chin. Put your fingers on that artery gently. Too much pressure can cut off some of the blood flow. If you have trouble finding the pulse under your chin you can use the pulse o the inside of your wrist. If you are going to use your wrist pulse, pull your chair up to a table or desk and place your arm comfortably on the surface. Then locate your pulse. Wait until you’re sure you have it. Now start counting and watching the sweep second hand. Count the number pulses in twenty seconds. Repeat the count a couple of times more so that you’re sure it’s accurate. Now multiply the number of pulses you count by three. This gives you your resting heart rate for one minute.

WARNING: DO not use your thumb to count out your pulses. Your thumb has a pulse of its own, which will skew your result.


Ear infections (otitis media) are among the commonest of childhood illnesses, and occur most frequently in babies and young toddlers, and then peak again around the age of school entry. They are less common beyond 8 years of age. Like colds and influenza, they occur most frequently in the winter months. Although they may cause fever and pain in the short-term, they usually resolve with treatment and there are no long-term consequences.

Some children do have recurrent ear infections, for reasons that are not clear, and these may lead to ‘glue ear’ and hearing loss. ‘Glue ear’ is the term often used to describe the presence of thick, glue like secretions in the middle ear, which are sometimes the consequence of repeated ear infections. It very often affects the child’s hearing, which in turn may affect the child’s language and general development. Ear infections in young children must be treated promptly and followed up to make sure that a chronic or recurrent situation does not develop.




The cause of hypertensive disease of pregnancy is not well understood although it affects 5% of pregnant women.

Clinical features

It is usually diagnosed during the latter stages of pregnancy, and is characterised by the presence of high blood pressure together with fluid retention. If the condition is left untreated protein will appear in the urine. The danger of hypertensive disease of pregnancy is that it can lead to rapid degeneration of the placenta. As the placenta supplies all nutrients to the baby, this leads to a risk of the baby being born prematurely. If the baby is still immature it may not be able to survive outside the womb. The other risk is the progression of the condition to eclampsia, which affects the mother. Eclampsia is characterised by convulsions and in the worst case may lead to coma.


The treatment of hypertensive disease of pregnancy is primarily bed rest. If you have markedly high blood pressure, your doctor may advise a short stay in hospital where close monitoring can continue until the condition is brought under control. Where mothers have hypertensive disease of pregnancy, labour is often induced. Those mothers who have full-blown eclampsia usually have a Caesarian section to end the pregnancy for their own and their baby’s safety.



    ”I can’t hold back. No matter what, I come. Isn’t there something I can do to hold back until she finishes at least?”

ANSWER: Concepts such as “hold back,” “finish,” and “coming” are leftovers from old ideas about sex that emphasized the mechanical, reflex parts of sexual response. If you mean by “coming” ejaculating, then there is much you can do to ejaculate when you want to. Making sure your bladder is empty before sexual activity will help, and learning to thrust with your whole pelvis instead of squeezing the muscles of the buttocks together and tensing the area between your legs is another idea. Most important, however, are two rules of super marital sex. First, since ejaculation is the body’s reflex to arousal, your whole life-style affects that body response. If you live fast and pressured, you are setting the stage for all body processes to accelerate. Slowing down in living is as important as slowing down in loving. Second, a posture in which your most sensitive area of the penis, the F area, is contacting your partner’s most sensitive area, the Ñ area, is less likely to throw off the timing of this reflex. The posture of the future will help in this regard. And don’t forget, orgasm and psychasm are different. Focusing on coming or not coming only leads to more focus and less c. since psychasm is emotional and mental, it is impossible to think or feel too soon.



It is important to realise how long the delay between treatment and cell death can be. Very rapidly growing tumours may start to shrink within a week or so of starting treatment because their cells divide every few days. On the other hand, the cells of slowly growing tumours only divide every few months. This means that a slowly growing tumour can keep shrinking for some months after radiation is finished.

A delay before radiation damage becomes obvious also occurs with normal cells. For example, the cells lining the mouth divide every day or so, cells on the skin surface every week or so. When radiation is stopped, a reaction in the mouth will quickly start getting better but a skin reaction can keep getting worse for a week or more. The longest delay is seen in the case of tissues whose cells very rarely divide other than when the tissue is injured. These tissues may look fairly normal and function fairly normally for years, but heal very slowly or not at all if they are injured or infected. This poor healing is only partly due to the fact that some of the cells die when they try to divide. Another reason is that blood and lymph vessels are also damaged by radiation leaving tissues with a poor blood supply and sluggish drainage.

Radiation damage to the reproductive ability of cells has one other possible serious consequence. This one is only of concern to those of you who are lucky enough to be cured, or at least to live many years after your treatment. People who have had radiation treatment have a higher than normal, but still small, risk of developing a completely new cancer within the irradiated areas. I am not referring here to a recurrence of the original cancer but to a completely new cancer caused by the radiation. Radiation-caused leukaemia typically develops about five years after radiation. Other types of cancer take twenty or more years. The risk is small but definite. When weighing up your cost/benefit balance, do try to keep this one in perspective. I stress that it will only concern you if your treatment is successful in controlling your original cancer.



Hysteria is a not uncommon emotional disorder, yet its true nature is often poorly understood.

It is usually thought to be only an outburst of crying or laughing, the result of sudden severe emotional shock and to be controlled by firm, forceful handling.

But hysteria is a complex emotional disorder where symptoms of illness appear and represent to the patient some advantage, even if he may not be aware of his own motives. It is more common in women.

The term “conversion hysteria” is often used. This means that painful and unacceptable happenings or ideas are repressed from conscious thought and translated or converted into physical terms which are tolerable or even prized.

It is different from malingering, where the person puts on symptoms to gain advantage but is aware all the time of his own deceit.

A malingerer may claim that part of his body has no feeling, yet, if a pin is stuck into this area, he will feel pain, although he may try not to show it.



The Great Pyramid in Egypt is said to be more than just an elaborate tomb.

Studies reveal that the builders of the pyramid had advanced mathematical skills. Reproduction of the exact scale of measurements of the pyramid are believed to harness some electro-magnetic forces which may be beneficial for health.

Other claims that it makes your hair grow, improves the taste of food and enhances plant growth, have met with more scepticism.

No one knows how this pyramid power is supposed to work but it is said that certain electromagnetic waves are concentrated and condensed by the particular configuration of the building.

Whether you accept this as fact or just so much hocus pocus, pyramid healing, along with other forms of alternative medicine, is attracting attention.

Alternative medicine is a system of primary health care involved in diagnosis as well as treatment and in opposition to, or parallel with, orthodox Western medicine.



The human body was created with pain receptors. Without them we could not survive. Pain receptors tell us, for example, when to pull our hand from a dangerously hot object. Should we come into contact with something and it pierces our skin, pain receptors tell us we are bleeding and need first aid. Pain receptors also alert us when internal organs misfunction – heads ache, kidneys throb, throats burn, a uterus cramps. Everyone knows what most of such pain is like, but it can be difficult for a person who has never experienced a wrenching, disabling pain to comprehend another’s misery. A knowledge of biology, a degree from a medical school, or even compassion for another human being cannot always guarantee either understanding or correct treatment.

Why is pain such a mystery? An individual’s response to bodily pain is always unique because pain is supremely subjective. Two people may be able to agree with each other about what a headache feels like and that childbirth usually causes more physical distress than a routine internal examination. They may not, however, agree about exactly which sensations and what degree of intensity constitute acute pain or an odd and persistent ache.

Each of us has a different pain threshold, which is a combination of psychological and neurological factors. At one extreme, stoics and mind-control practitioners may choose to feel no pain—some can even staunch the flow of blood from a wound by use of willpower alone. At the other extreme, hypochondriacs fervently believe in their suffering, and encourage it or create new illness. Most people fall somewhere between these two extremes. Whatever the pain—acute, throbbing, stabbing, burning, dull, aching—they can describe it accurately enough in all us varying degrees and severity so that others can understand.

This ability to communicate a private sense of pain to another gives us a chance to obtain medical help in a manner that is most effective. But what happens when communication is thwarted by a physician who invalidates a patient’s report of pain, thereby invalidating the cause?

For women who have been told by doctors again and again that the pain they feel does not exist, emotional turmoil may become as much a symptom of endometriosis as the actual physical disability. As a palliative, unsympathetic doctors may prescribe Valium or other tranquilizers. Generally, when the pain persists, another doctor is consulted. Should he concur with the first, he may simply prescribe stronger tranquilizers, and a woman’s illness becomes doubly wearing. Her self-doubt begins to grow as her pain increases in severity. The questions such a victim asks herself, however, remain unanswered: “How can I be creating such horrible pain? Since doctors tell me that I am to blame, bow can I stop doing this to myself?’ Clearly, this situation is emotionally wrenching. Rather than follow their own inner voices, which know chat this pain means something, these women are made to feel defeated, somehow responsible—and guilty—until the disease becomes so advanced and so serious that even a minimally experienced physician is finally able to diagnose it.



When dealing with a baby’s skin problems, certain facts must be born in mind. These are that the skin of a baby is thinner, softer, and has fewer hairs and sweat glands than an adults.

There is no single cause of rash on the skin in the area broadly covered by the baby’s napkin. Obviously, almost any skin disorder can manifest itself in this area. Furthermore, any of these disorders may be further aggravated by a physical environment of warmth, moisture, humidity and exposure to various infective organisms present in this area.

Contact dermatitis is one of the commonest causes of a rash in this area. This may be due to a chemical present in either the urine or faeces. Previously it was thought that ammonia formed from the breakdown of urea by various bacteria was the main cause. This, however, is probably only one of many possible chemicals involved. Occasionally detergents used in the laundering of the napkins are implicated. Even creams innocently applied by mothers either to prevent or treat a napkin rash, may be involved.

The eruption usually has the appearance of a burn. Initially it may simply be red, but then blisters and ulceration can occur. The classical distribution is on the convex surfaces in closest contact with the napkin, the creases being spared.

Seborrhoeic dermatitis is probably the second commonest cause of a rash in this area. It is an ill-understood, self-limiting condition which may also affect adults. There is usually no family history of the condition, and no nutritional or infective factor evident. Frequently there is associated ‘cradle cap’. This is a mixture of grease and scale that piles up on the crown of an infant’s head to form a coating resembling a cap. The exact cause is unknown, but may result from over-cautious bathing or fear of injuring the ‘soft spot’. Initially this condition consists of retained vernix, the greasy film which assists the passage of the babe through the birth canal. When this vernix persists as a dry crust on the scalp, it is termed cradle cap.

Seborrhoeic dermatitis usually commences in the napkin area between the ages of three months and one year. The symptoms are usually fedness with scaling. The creases and folds are involved, unlike with contact dermatitis. Frequently other creases, such as the armpits and under the chin subsequently become involved. In severe cases other areas of the trunk can also be affected. The baby is usually quite well, and does not scratch the rash. ”

Infantile eczema usually occurs in infants of parents with the atopic tendency to either eczema, hay fever, hives or asthma. The rash usually appears between the ages of two to three months. It is often first manifest on the cheeks and forehead, but not necessarily. The rash is invariably red, lumpy and involves the creases. It is always itchy, unlike the other rashes.

Psoriasis may occur solely in the napkin area of infants. The features are similar to psoriasis in other areas. It is thought to be induced by external factors such as monilia, in a genetically predisposed infant. It develops very rapidly, and rarely confines itself solely to the napkin area. Usually it clears quickly with appropriate treatment. Relapses are exceptional, and the long-term prognosis is fair. It is estimated that only between 10-20 per cent of these infants will develop psoriasis in later life.

Thrush, sometimes known as monilia, is a frequent cause of and contributing factor to napkin rash. This is a yeast infection caused by the fungus Candida albicans. It can occur at any age. The appearances of a bright red rash, not necessarily symmetrical, with small pustules is very suggestive of thrush. Frequently the area about the tip of the penis is very red, and small, bright red satellite spots appear elsewhere. The area may weep, particularly in the creases. The source of infection may be bowel, particularly after a course of antibiotics. Alternatively, the infection may originate from mothers with vaginal thrush.



It should be obvious from the discussion above that fats in food are not necessarily bad. In fact, a severe restriction of polyunsaturated fats may compromise the intake of essential fatty acids and vitamin E. As the human body requires a minimum daily fat intake, it is neither wise nor practical to advocate a ‘no-fat’ diet.

The health implications of particular fats and oils are influenced by the proportion of different fats they contain. For example, olive oil is described as a monounsaturated fat but olive oil also contains polyunsaturated and some saturated fatty acids. Its predominant fatty acid is the monounsaturated oleic acid, so it is called monounsaturated. Margarines are often thought to be made up of polyunsaturated fats—in fact, about 20 per cent of the fat in these products is saturated fat. They also have some monounsaturated fatty acids and up to 15 per cent of the undesirable trans fatty acids. Their total polyunsaturated fat content makes up about half the fat they contain.

The percentage of different fatty acids is really only important if the total amount of fat in the food is significant. The fat content of both margarine and butter for example is about 80 per cent. This means that for every 100g they have 80g of total fat. One teaspoon—about the equivalent of a thin spread on a slice of bread—would contain about 4g of fat. About 30-40 per cent of the margarine will be cholesterol-raising fats (saturated plus trans) or about 1.5g per teaspoon. Butter, on the other hand, rates a high 60 per cent saturated and 5 per cent trans fatty acids in every 100g, or about 2.5g per teaspoon. The total fat content and the total energy in both products however are equal. By contrast, a food such as an egg has about 6g of fat, of which 2g is saturated (all of this in the yolk—egg white has no fat) which is midway between a thin spread of margarine and a thin spread of butter. The occasional consumption of small quantities of any of these foods (a teaspoon of spread or a whole egg) is likely to have little effect on the intake of both saturated and total fat. This fact contrasts with common consumer beliefs regarding the perceived fat contents of margarine, butter and eggs.

One other postulated health implication is the susceptibility of fats to ‘oxidise’ (a chemical alteration to the fat molecule caused by reactions with oxygen ‘free radicals’). Polyunsaturated fatty acids (PUFAs) are the most susceptible to oxidation, especially the long chain highly unsaturated Omega-3 fish oils (which is why fish ‘goes off faster than meat which contains mainly saturated fat). Balanced against this is the intake of antioxidants, especially vitamins C, E and beta carotene. Oxidised fats and other compounds in the body have been linked to many detrimental processes, including atherosclerosis, cancer formation, cataracts and ageing. Research is still intense in this area and many answers about oxidation and health effects are not yet available.

Monounsaturated fats (i.e. olive oil, canola oil, avocados) are generally seen as the best type of fat for health purposes. They tend to reduce blood cholesterol at least as well as the polyunsaturated, but don’t oxidise as readily and have no known links with other health problems. In the case of olive oil, a major source of monounsaturated fat, we also have a long history of people safely consuming substantial amounts of it without apparent detrimental effects. Its major virtue may be not only that it contains a good mix of fatty acids, but that it also contains a wide variety of antioxidants. However, olive oil still contains the same energy, gram for gram, as other types of fats. And while there is some recent research now querying the fat storing potential of all fats, the prudent advice for those interested in lowering or maintaining body fat is still to decrease all fats in the diet.



Many women with endometriosis have heard of the benefits of treating the disease with vitamins and minerals and certainly members of the Endometriosis Association (Victoria) have talked about success with vitamin B6 and evening primrose oil in eliminating pain and treating lethargy and depression.

Most vitamins and minerals discussed in this section below can be bought off the shelf at your local health food shop.

Vitamin B

Vitamins can help in alleviating pain; in particular, vitamin B6 has been reported as being beneficial in the treatment of premenstrual syndrome and associated problems.

Although it is not certain why vitamin B6 helps, many PMS sufferers vow it has been instrumental in alleviating their symptoms of depression, lethargy, mood swings, irritability and pain.

Vitamin C

The merits of vitamin C have long been acknowledged. Alternative therapists say it helps not only with heavy bleeding (because it strengthens the blood vessel walls and helps the body to absorb iron) but also helps promote healing.

Vitamin E

Another healing vitamin, it is often recommended for the prevention of thick scar tissue and to promote healthy skin; this would explain why it helps alleviate pain as it acts on adhesions and scar tissue left by endometriosis implants.


Many practitioners believe zinc helps with PMS symptoms and also improves fertility.

Evening primrose oil

Many PMS sufferers cannot do without their evening primrose oil (EPO) as they say it helps alleviate symptoms and keeps the condition under control.

Endometriosis sufferers on hormonal drug therapy also report that it has helped them cope with the side effects often associated with these drug treatments.

Evening primrose oil is expensive (currently about $20 for a month’s supply) so you have to weigh up the benefits with the cost. EPO is a good source of gammalinolenic acid (GLA) — one of the essential fatty acids which produce prostaglandin.



There is much debate as to whether or not endometriosis is becoming more common.

Some gynaecologists believe that there has been an increase in the actual number of women who have endometriosis. These gynaecologists believe that the condition has become more common because women are having fewer children and having them later in life — two factors which they believe predispose women to developing endometriosis.

Other gynaecologists believe that there has only been an increase in the number of women being diagnosed. The rate at which endometriosis has been diagnosed has certainly increased over the last 30 years, particularly since the introduction of laparoscopy in the early 1970s. This does not mean that the condition is more common than it was 30 or 40 years ago. It is more likely to mean that the condition is being diagnosed more frequently because the introduction of laparoscopy has made it much easier to diagnose and because there is a greater awareness and recognition of the condition by the medical profession.

The increased rate of diagnosis could also be a reflection of the fact that nowadays women are less likely to accept that some of the symptoms of endometriosis such as period pain and heavy bleeding are a normal part of a woman’s life. Consequently they are more persistent in seeking a diagnosis — and treatment — for their symptoms.



Not really a complete cell but simple nucleic acid (DNA or RNA) encased in protein, a virus must make use of other cells to function and reproduce as a lifeform. Thus it invades cell tissue and interferes with its normal function and genetic behaviour.

Often viruses will kill the host cell and move quickly to invade others. Sometimes they do not kill the cell but live on within it, manipulating its genetic codes in order to reproduce. Such viruses are known as retroviruses and include HIV, which causes AIDS.

Other illnesses and ailments arising from viral infection include the commom cold, chicken pox, measles, warts, influenza, cold sores and genital herpes. The body reacts to their presence by producing special kinds of blood proteins called antibodies. These antibodies remain in the blood after the virus has been beaten and reinfection by the same virus is not possible. Unfortunately, many viruses quickly mutate, rendering the antibodies useless. An example of a rapidly mutating virus is influenza which a person could catch every year. Non-mutating viruses such as mumps are rarely caught twice in a lifetime.



Major depressive disorder and dysthymia are officially recognized conditions. By definition major depressive disorder disrupts one’s capacity to function and enjoy one’s life. It is reasonably severe and lasts for at least two weeks. Dysthymia is less severe in terms of the number of symptoms required for its diagnosis, but is by definition rather chronic and, as such, also exacts a toll of one’s life.

The directions for getting started on St John’s Wort are the same as those described above. If you experience no response within five weeks, however, and are experiencing no unacceptable side-effects, you may consider pushing up the dosage to eight, 11 or even 13 135-mg tablets per day. Maintain the three times a day dosing schedule, remembering to take St John’s Wort with food, and wait at least three or four days between dosage increments. There is a range of effective dosages for all other antidepressants and there is no reason to believe that such a range would not apply for St John’s Wort as well. Sometimes a full clinical response to an anti-depressant will not be observed until the dosage is pushed into the higher levels of the accepted therapeutic range. So far there has been only one published clinical trial in which 1,800 mg (about 13 Kira™ tablets) of St John’s Wort were given per day. According to the researcher in charge of the study, levels of side-effects were not noticeably higher for the 1,800-mg per day dosage than he has generally observed when treating people with the more conventional 900-mg per day dosage.

Unless the depression is really severe, it is quite reasonable to use St John’s Wort as a first-line treatment, in combination with other methods of promoting an anti-depressant lifestyle. Monitor your symptoms as described above. Since it is a daily log, as opposed to the weekly log provided above, it enables you to get a more fine-tuned sense of your mood control and helps you to recognize influences that may have an adverse or beneficial effect on your mood. Subtle mood cycles can also become apparent, and their pattern may suggest certain specific types of treatment.

Once again, allow five to six weeks for the treatment to work. If it doesn’t work by that time, consult your doctor about either adding an anti-depressant or switching to a more conventional anti-depressant. On the other hand, if you have detected a partial response and your symptoms are not too severe, you may want to wait a further few weeks before deciding on making any other medical changes.



The complications of this hospital regimen are strikingly few. Occasionally, a patient may decide voluntarily to leave the hospital during the fasting period. This may be the result of an inordinate fear of fasting, the iron grip of some addiction, or an inability to cope with the withdrawal symptoms. There have been a few such instances in which patients left in the midst of acute reactions, following the feeding of a suspected food.

Pregnancy is no problem, however, and pregnant women have been successfully fasted for a few days. Diabetics can also be handled, although in advanced cases the fasts cannot be complete.

In all, patients ranging from young children to elderly people have fasted in our program. Although reactions to foods can be troublesome, it is important to note that no deaths or irreversible complications have ever resulted from this program. Contrast this record to that of conventional medicine, with its emphasis on surgery, radiation, electroshock, and drug therapy. The clinical-ecology approach to chronic illness is logical, effective in many cases, and, above all, safe.



Nowadays, with so much emphasis being put on the need to reduce the fat in our food and to increase our dietary intake of fiber and bulk-producing vegetables, care must be taken to avoid a deficiency of calcium.

Fat-containing dairy products, especially milk and ice cream, used to provide us with most of our calcium, whereas the vegetables and cereals, which we are now taking in their place, bind with calcium in the intestines and thus interfere with its absorption, Medical World News (25#12:41) reports. The net result, if we are not careful, is a calcium deficiency that leaves our bones weaker and more brittle than usual and unusually prone to be fractured, even in response to minor trauma.

While no one denies that low fat and high fiber diets benefit us by greatly reducing our liability to heart disease and stroke, we must take care to compensate for the decreased availability of calcium they bring about. We can help ourselves by taking, in addition to our one vitamin-mineral pill a day, half a gram (500 mg) tablet of calcium carbonate three times daily (or four times if one is big) as well.

It is important to note that it matters when we take these tablets. Since the calcium in pills can only be absorbed if there is a normal amount of acid in the stomach, the Journal of the American Medical Association (257:541) reports that older people, whose stomachs no longer produce much acid, cannot benefit from taking calcium between meals. Taken with food, however, calcium is absorbed, regardless of the lack of gastric acid.

Another article in the Journal of the American Medical Association (247:1106) emphasizes that taking calcium alone is not enough and, even in optimal amounts, can do nothing to prevent the bones from becoming osteoporotic in people who are inactive. Both exercise and calcium are needed to restore osteoporotic bones. Because exercise (e.g., walking two miles every day) can be difficult or impossible for those who have already become disabled by osteoporosis, prevention is truly better than cure.

Also, according to the Mayo Clinic Proceedings (61:116), it has been discovered that the density and amount of calcium in an older woman’s spinal bones correlates very closely with the strength of her back muscles. Thus, it is believed, older women may be able to protect themselves against collapse of the spinal bones by regularly performing exercises that increase the tone of the back muscles. Although it will take many years to obtain final proof that this works, it is reasonable for women to perform daily back exercises (sit-ups or with a rowing machine), so long as they do not overexert or hurt themselves.




Symptoms: Pain, ache, or throbbing in any area of the head.

Home care:

Give aspirin or paracetamol to relieve pain.

Apply cold compresses to the forehead.

Have the child lie down in a dark room.

If the headache is accompanied by nasal congestion, antihistamines or nose drops may ease both conditions. Warm compresses may also help.

Try to identify any source of stress that may be causing headaches. Comfort and cuddle the child whose headache may be due to emotional factors.

See the doctor if the headaches persist.


-    Get medical help immediately if the child has a sudden, severe headache, especially if it is accompanied by any of the following: fever, extreme weakness or collapse, severe vomiting, stiff neck, or confusion.

-    If the child has recurring headaches that become more frequent or severe, consult the doctor.

-    Your information about the child’s headaches will be important to the doctor. Note where the pain is located, when it occurs, what circumstances seem to provoke it, how long it lasts, if there are also other symptoms, and whether or not the headache responds to pain-relieving medication.

Headaches are probably as common in children as in adults and have as many or more causes. Fever and strong emotions (anxiety, fear, excitement, sadness, and worry) account for about 95 percent of all headaches in children. Less common causes of childhood headaches are high blood pressure, head injuries and concussions, tumours and inflammation of the brain (such as meningitis, encephalitis), bleeding inside the skull, sinusitis, eye strain, and psychiatric problems.



Drive yourself sober

If you’re thinking of driving after drinking, think first of this sobering fact: More than 40 percent of fatal crashes involve a driver or pedestrian who had been drinking. “It doesn’t make any sense to gamble and hope that you’re not the one affected. Don’t be so cocky to ignore the risks,” says Kennedy. You’re also forcing everyone who crosses your path to take the same risk. Nearly half of the people killed in crashes are innocent victims killed by drivers who had a few – or less than a few.

So try heeding the following advice from safety experts to help reduce your risk of being involved in an alcohol-related accident.

Use common sense. Some people stick to the guideline of having one drink an hour, followed by a nonalcoholic drink in the second hour, to monitor their blood alcohol level, says James Fell, chief of research and evaluation at the National Highway Traffic Safety Administration in Washington, D.C. “But we really can’t say what a safe ÂÀÑ is because everyone is affected differently, considering their age, weight, fat, food intake, and experience. The motto, plain and simple,” Fell adds, “is that if you have to drive, don’t drink. If you have to drink, don’t drive.”

Act like it’s New Year’s Eve. People have a heightened awareness of how dangerous the roads and highways are when everyone’s out ringing in the New Year, says Kennedy. “Well, any time you’re on the road late at night, especially on the weekends, you are driving among a lot of people who have been drinking,” he says.

Be aware of your surroundings. Keep yourself safe by leaving plenty of room between you and the cars around you. And by all means, don’t challenge anyone’s reaction time by making a quick turn in front of another car or cutting into traffic, Kennedy says. “Just being mindfully aware of the potential danger can keep you safer,” he advises.

A Need to Heed Speed

When engineers make roads, they take a lot of factors into consideration before telling you how fast you can go, Kennedy says. “Those numbers you see indicating the speed limit aren’t arbitrary. Road engineers consider the population of the neighborhood, the angle of the curves, the volume of traffic, and numerous other factors to figure the maximum speed you can safely travel,” he says.

The problem is that lots of folks choose to ignore the limits. Going faster than the posted speed limit contributes to more than 68 percent of fatal car crashes, according to the National Safety Council.

You don’t have to have your foot through the floorboards to get killed in a speed-related crash either. Only about 13 percent of speeding-related deaths occur on high-speed interstate highways. The rest happen as folks are flying around their familiar stomping grounds, generally after they’ve been drinking.

The take-home message here is to slow the heck down. You risk killing not just yourself but also some innocent mom, dad, or child who crosses your path, says Kennedy.



As with any type of surgery, there can be general complications following breast cancer operations, such as chest infection and deep vein thrombosis. Although minor complications are fairly common, serious ones are rare.

Poor posture can lead to back pain, and reduced mobility and strength in the shoulder are sometimes caused by the adhesion of muscle fibres following breast operations. Nerve damage during surgery can also lead to problems such as difficulty in reaching forward with the arm. Good physiotherapy advice and regular exercises can help prevent or alleviate these complications.

Chest infection

Chest infection can occur following general anesthesia for any type of operation, and particularly when a painful wound makes deep breathing more difficult. It is especially common in smokers. Deep breathing is important after your operation to keep the lungs well aerated, and if you find it difficult, a physiotherapist may be able to visit you on the ward to advise you about breathing exercises.


Very rarely, when the breast and underlying muscles are removed, as in a radical mastectomy, it is possible for the membrane between the ribs to be damaged, thus allowing air to enter the thoracic cavity. This condition, known as pneumothorax, can cause partial or total collapse of the lungs, and an X-ray of the chest may be done following a radical mastectomy to make sure such damage has not occurred.

If you cough up blood and have a pain in your chest following a radical mastectomy, you should report this to your doctor so that the possibility of a pneumothorax can be investigated.

Deep vein thrombosis

This is quite a common complication following pelvic surgery, but less so after other types of operations. Precautions such as wearing anti-embolism stockings while immobile and having a course of heparin injections are usually taken to help prevent it occurring. If a blood clot (thrombus) forms in the deep veins of the body – most commonly in the calf veins of the legs – it can break away and the resulting embolus may pass through the heart and block the arteries of the lungs. The resulting pulmonary embolism can be life threatening. If a thrombus is detected, it can be treated with a course of heparin or warfarin.

Pain and bruising

Local anesthetic is often injected into the skin edges prior to closing the wound to help reduce the pain once you wake up. This pain-killing effect lasts for several hours, but when it wears off another form of pain relief will be required.

A sharp, intermittent pain in the chest wall is probably due to nerve regeneration or a trapped nerve; whereas an aching pain in the anterior chest can be caused by spasm of the pectoral is major muscle. Pain in the upper arm may be referred discomfort from the spine, possibly resulting from bad posture or, if the pain is in the back of the upper arm, it can also be due to nerve regeneration.

A stabbing pain may occur in the upper, outer part of the arm (sometimes not until a couple of weeks after surgery) which is likely to be associated with the return of sensation to the arm as post-operative numbness wears off.

Persistent pain which is not relieved by painkillers such as paracetamol, although unlikely to have a serious cause, is worth investigating, and you should seek medical advice if it occurs.

Even minor breast operations can cause severe bruising, which can be extensive and last for several days or weeks. Although the sight of such bruising may be distressing, there is unlikely to be any cause for concern.



What is a laparoscopy?

A laparoscopy is a relatively safe and simple minor operation, performed under a general anaesthetic, in which a telescope-like instrument known as a laparoscope is inserted into a small cut near the navel.

Nowadays, laparoscopy is a fairly common operation which is used to diagnose a range of gynecological conditions, including endometriosis and pelvic inflammatory disease. It is also used to treat a variety of gynecological conditions, including drainage of simple ovarian cysts, and to perform sterilization operations.

A laparoscope is a long thin telescope-like instrument approximately 30 centimeters long. It has a lens at the end which magnifies and lights up the pelvic organs and allows a gynecologist to look for the presence of endometrial implants and cysts in the pelvic cavity. It can also be used to remove samples of tissues for testing, to perform minor surgery, to perform laser surgery and to take photographs.

What do I need to discuss before I have my laparoscopy?

Your laparoscopy should be performed by a gynecologist who is skilled and experienced in performing laparoscopics and diagnosing endometriosis – very few general practitioners have either the skills or the experience to perform laparoscopics.

Some gynecologists believe that a diagnostic laparoscopy for endometriosis is best done just before or during a period when the disease is most active and easier to see. It may be worthwhile discussing this aspect of the timing of your laparoscopy with your gynecologist.

It is also extremely important that you discuss with your gynecologist before the operation precisely what she or he intends to do during your laparoscopy if endometriosis is found.

In particular, if endometriosis is found, you need to discuss whether your gynecologist intends only to diagnose the condition at the time and defer any further surgery until you have considered all the available options or whether it is intended to proceed immediately onto laparoscopic surgery. You should indicate clearly which of the alternatives you want.

Even more importantly, you should discuss what you want your gynecologist to do if extensive surgery is needed. For example, if organs or large cysts need to be removed do you want a laparotomy performed immediately or do you want it delayed so that you can discuss the operation and consider all your options?

If surgery is performed at the time of your diagnostic laparoscopy it avoids having to undergo the inconvenience and costs of a second period of hospitalization, a second general anaesthetic and a second recuperation period. But it also means that you will not be able to participate in making any of the decisions regarding your surgery nor will you have the time to make the emotional and psychological adjustments associated with being diagnosed as having a chronic condition such as endometriosis.



Believing that her parents never loved or wanted her, Yvonne began to “bust her butt,” as she put it, to find emotional gratification through success at school. She studied long hours and became involved in as many after-school activities as she could manage. She joined the track team and worked out every chance she could.

After she dropped from 124 to 109 pounds, Yvonne’s menstruation ceased, yet she continued to exercise compulsively and still perceived herself as overweight. Her concentration began to fail, which was particularly troubling, given her desire to stay on the school honor roll. She hoped that academic success would make her parents love and respect her, and thus allow her more social freedom. Sadly, though, her father regarded the weight loss as deliberate misbehavior, and began hitting her as a form of punishment.

She showed him, though. She lost more weight. She was hospitalized at a mere hundred pounds.

Ironically, while in the hospital, Yvonne learned about laxative abuse from her fellow patients. She ate voraciously just so she would be allowed to leave the hospital. After discharge she returned to her old habits; she restricted food intake, some days ingesting nothing but diet soda, and continued to exercise throughout the day. She also began to induce vomiting and to take laxatives. It wasn’t long before she had to be hospitalized again.

Once released, Yvonne remained fearful of food. Oddly, she seemed to be particularly phobic about bread, terrified that even the slightest crumb would make her fat. She took a job as a waitress, but reported that she never felt hungry at work. Periodically, she succumbed to her desire to binge.

Eventually, though, she began to feel depressed, lonely, and even suicidal. Although her parents tried to help lift her spirits by giving her more freedom, she was frightened by the idea of social interaction, and became even more withdrawn.

At home, Yvonne’s father lost his job, her sister developed a serious illness, and her parents fought more. As the level of stress in her family rose, so did Yvonne’s use of laxatives. Despite an occasional binge, she dropped twenty pounds in less than a month. She felt weak and fainted several times at school.

One time she fainted but didn’t come to. Rushed unconscious to the hospital, she was treated in intensive care until she revived the next day. She then agreed to be transferred to a specialized eating-disorder program.

Yvonne had anorexia nervosa. But as you’ve just seen, the illness affected these two young women in radically different ways. In addition to restricting food intake, Yvonne resorted to other measures to reduce weight even further: constant exercising, laxative abuse, and self-induced vomiting. Her diagnosis, then, was bulimic anorexia. Bulimic anorexics have been shown to be more social, depressed, and impulsive, with greater family difficulties and family histories of depression and obesity.



When Mindi Epstein signed up for a Spinning class at a gym near her home in Evanston, Illinois, she had no idea that it would be so hard—or that it would change her life so much.

Spinning is road cycling brought indoors. It’s done on a specially designed exercise bike and is set to music or a series of visualizations.

“During my first class, I suffered,” Mindi, age 37, laughs. “It was hard work. And the idea of 50 bikes whirring in unison seemed very strange to me.” But somewhere near the end of class, Mindi entered what she calls the zone. “The music and the energy from the other people took over,” she recalls. “I felt so exhilarated that I couldn’t wait to come back for more.”

After about 3 months of Spinning, Mindi became one of the strongest riders in her class. She also began to notice positive changes in her body. “Trouble spots—your hips, your butt, your thighs—aren’t so much trouble anymore,” she says. “In my case, my stomach was always a point of contention. Now, it’s flat.”

Inspired by her success with Spinning, Mindi joined a cycling club. These days, she rides three or four times per week, 35 to 80 ° miles at a time. _ <j§’

With the combination of Spinning and cycling, Mindi has lost two dress sizes in 8 months. In return, she has gained a great attitude. “I know that there isn’t a hill too steep or a road too long for me to ride,” she says. “I’m never so happy as I am when I’m on my bicycle.”


Get in the “zone.” It you’re bored by stationary cycling or if you’re looking for an indoor alternative to road cycling, sign up for a Spinning class. Spinning is a blast! This high-energy activity burns a whopping 535 calories in 45 minutes. As a bonus, it tones your abdominal muscles and trims your butt and thighs. Many gyms and health clubs now offer Spinning classes. Check with those in your area.



Steve is a typical stress phobic. He came to see me suffering from ulcerative colitis, with rectal bleeding and general abdominal discomfort. This young man, who ran a retail clothing outlet for a major manufacturer, was frustrated by company regulations. “The damn rules get in the way. I could sell more if they let me run the place my way,” he complained.

When I asked him if he had explained this to upper management, he mumbled something about their not understanding. Then he admitted he was too inhibited to “make waves.” Instead, he turned his anger and frustration inward, becoming depressed. He felt useless, nothing more than a cog in the company machinery.

Now he had no goals, nothing to look forward to. He told me that what he really wanted was to work in the company’s publicity department. He took no steps to achieve that goal, however, because he felt he wasn’t good enough to make it. That only increased his frustration and sense of worthlessness. Those unhappy thoughts were converted into chemical messages inside his head. From there, it’s a very short journey to the immune system.

An 18-year-old named Fred was another stress phobic I treated. He was in the hospital with marked anemia and weakness due to severe intestinal bleeding, diarrhea, abdominal pain and gas.

I met Fred’s father in the hospital one day. A very strong-willed man who ran a rubbish collecting company, he wanted Fred to take over the business. Fred wanted to be a poet, but couldn’t tell that to his father. Every time Fred went to work at the rubbish company, he developed increasing symptoms of bleeding. Feeling weak and lost, he unknowingly turned the feelings he couldn’t express into a painful and dangerous illness.

Feelings that had no outlet turned on Steve and Fred, making them sick. Again, it was their interpretation of the facts that mattered. A stress seeker in their shoes would have geared up his body for a fight, not retreated inward. In either case, of course, the result is disease.

Stress Phobics invite Cancer

If you talk to cancer patients, you’ll find that 70 to 75 percent of them experienced severe feelings of hopelessness, helplessness, frustration and/or inability to cope one to two years before their cancer was diagnosed. These feelings released the powerful immune-suppressing chemicals that allow cancer to flourish.

It’s well known that after the death of a spouse, the widow or widower’s immune system often weakens and falls, hitting rock bottom in about six months. Another six months pass, on the average, before the immune system returns to normal. What cripples the immune system? Not the fact that a spouse has died, but inconsolable grief, the guilt and the feelings of helplessness and hopelessness we sometimes feel in the wake of a death.



Let’s begin with the psychological benefits. My experience with patients, confirmed by other studies, is that regular exercisers tend to have a more positive outlook on life. Regular exercise improves your health, and healthy people are generally happier people. People who exercise have the great satisfaction of knowing that they’re working hard to strengthen their health; they have the discipline, energy and motivation to stick to their exercise program.

As we’ve seen, these positive feelings are mirrored by health-giving changes in body chemistry. Thus the pride, self-esteem and satisfaction that one derives from exercise goes a long way toward boosting one’s “doctor within.”

“I go out there and walk 30 minutes every day!” a patient will proudly announce.” Or, “For the first time since I was a kid, I can easily touch my toes!” Some tell me that they can finally see their toes again now that they’ve lost a lot of weight. I’ve seen many poor self-images go way up as people prove to themselves that they can accomplish something worthwhile. This is especially true for the unhappy and depressed among us.

Unfortunately, millions of Americans are unhappy, with symptoms ranging from a simple indifference to enjoyment all the way to full-blown depression. Many studies have shown that one of the best, and simplest, treatments for depression is regular exercise.




Apples Figs *Peaches

Apricots Grapes Pears

Bananas Guavas Persimmons

Berries Mangoes Pineapples

*Cantaloupes Melons Plums

Cherries Oranges Pomegranates

Citrus Fruits *Papayas Tomatoes

• Fruits are low in fat and sodium and contain no cholesterol. Fruits provide vitamins, minerals and sweetness.

• Uncooked, unprocessed, fresh fruit should be your first choice, rather than canned, cooked or frozen.


*Barley *Millet *Whole-Grain Rye

*Brown Rice *Oat Bran *Whole-Grain Wheat

*Buckwheat *Whole-Grain Oats *Wild Rice

• Whole grains are low in fat, sugar and sodium, and contain no cholesterol. Whole grains give you complex carbohydrates, fiber, B vitamins, minerals and low-fat protein.

• Make sure to eat unprocessed whole grains rather than processed grains such as white rice and white bread.

• Oat bran is not a whole grain. I’ve listed it with the whole grains because of its cholesterol-lowering effects, plus its high fiber content.

*Black Beans * English Peas *Garbanzo Beans

(Chick Peas) *Green Beans


*Kidney Beans *Lentils *Lima Beans *Navy Beans *Peas

*Pinto Beans *Red Beans *Snow Peas *White Beans

• Legumes are low in fat, sugar and sodium, and contain no cholesterol. Legumes provide you complex carbohydrates, fiber, low-fat protein, vitamin B1( vitamin B6, calcium, iron, plus other vitamins and minerals.

Abalone Brook Trout Cod

Flounder Haddock



The immune system is one of the major components of your “doctor within.” To be immune is to be protected, to have resistance, to be exempt. That’s what your immune system is designed to do—protect you and give you resistance against disease. Your immune system is responsible for fighting off bacteria, viruses, fungi, cancer cells and other antigens (anything that challenges the immune system). It’s genetically programmed to swing into action as soon as disease rears its ugly head.

Germs are all around us, on us and in us. They’re on our clothes, in our food, in the air we breathe. If all it took to make us sick was for a germ to land on us, we’d all have died years ago. But we live, we thrive, because that part of our “doctor within” called the immune system maintains a constant vigil inside our body, always ready to destroy diseases before they harm us.

There are many parts to your immune system. You may have heard these names: T-cells, B-cells, phagocytes, complements, interferon, antibodies, interleukin. These are just some of the “immune warriors” your “doctor within” uses to fight disease. You can spend years studying the many fascinating details of the immune system, and I’ll tell you more about it in Part Three (page 215). But for now, the important thing to remember is that there is a powerful disease-fighting system within your body.

Many years ago, as a resident in Internal Medicine at Los Angeles County Hospital, I was in charge of the adult infectious-disease ward. For 10 to 15 hours a day, I was exposed to just about every infectious illness you can imagine. These patients had tuberculosis, meningitis, the very deadly septicemia and other dangerous diseases. They coughed and sneezed on me; I got their blood, sweat and even feces on my hands. But I didn’t “catch” any of their diseases. My “doctor within” kept me in perfect health.

Some time later, I was rotated out of the infectious-disease ward and into surgery. Months later I came down with meningitis, a potentially deadly infection of the covering of the brain. Why? None of the people I was treating had meningitis. I wasn’t near anyone with meningitis who could have “given” me the disease. What happened was that I was working double shifts, going to every class and lecture offered and moonlighting besides. In other words, I ran my immune system into the ground. Without immune-system protection I was “easy pickings” for any disease. If not meningitis, I would have “caught” something else.



The radioallergosorbent test, or RAST, measures the level of IgE antibodies that a person has to a specific substance, such as a food protein or a pollen. There are four stages to the test:

1. An extract of the food (or other potential allergen) is applied to beads made of a substance called sepharose. This is an inert substance that simply acts as a surface on which reactions between the allergen and the antibody can take place. The food molecules remain attached to the sepharose beads throughout the test.

2. A sample of the patient’s serum (the liquid part of the blood) is allowed to flow over the beads. If the blood contains IgE antibodies to that food, these will bind to the food antigens on the beads. The beads are later rinsed to remove everything that is not bound – only the IgE molecules should remain.

3. Another liquid is poured over the beads. This contains a special type of antibody called anti-lgE, which binds specifically to the stem of IgE molecules. If there is IgE stuck to the beads, these anti-lgE antibodies will bind to them. If no IgE is present, then all the anti-lgE will be washed away.

4. The anti-lgE was previously marked with a radioactive marker or a coloured marker. This means that the amount of IgE present can be worked out by measuring the radioactivity or colour given off by the beads. The amount of anti-lgE present is a measure of how much IgE (specific for that food) there is in the patient’s blood.

Of course, the test will also give a positive result if the food contains something that specifically binds to IgE (as long as there is some IgE in the blood). This does indeed happen, in some patients with false food allergy.



When suffering from a serious condition, and everything else has been tried without success, red slug syrup, however unattractive it may sound, should be given a chance. Extraordinary results have been achieved with this syrup in the treatment of diseases where bacteria or bacilli play a part, for example ulcers, gastric ulcers and pulmonary infections.

Its preparation is quite simple. Place a layer of the large red forest slugs {Arion rufus) in a jar, cover with a layer of sugar, then add further layers of slugs and sugar until the jar is full. The minimum quantity of sugar should be about the same weight as the slugs, although you can use a little more.

After a short time the sugar begins to dissolve the slugs. On the second day, strain everything through a sieve. Then add a third part of alcohol, that is, one-third of the whole weight of the mixture. The remedy is then ready. (The residue in the strainer is of no further use and can be disposed of.) A tablespoon, or in serious cases a liqueur glass of the syrup, should be taken every morning before breakfast. The curative effect of this syrup is so extraordinary that even doctors who have experimented with it are simply amazed.



In the short time Papayasan has been available it has helped many hundreds of people, and in the future it will aid thousands more who want to be free from the harm and danger of intestinal worms without any risk of side effects.

Worms are by no means to be taken lightly, whether it is Oxyuris vermicular is, the little threadworm that causes an itching irritation in the anus and can be found by the thousands in the large intestine; the ascaris or roundworm inhabiting the small intestine; the Trich-ocephalus dispar (whipworm), or any other intestinal parasites. They are all extremely harmful and can lead to severe disturbances in the composition of the blood, and cause conditions such as eosinophilia, anaemia, chlorosis and liver disorders. The chief factors responsible for these and other serious conditions are no doubt the metabolic toxins secreted by the worms.

The botanical enzymes of Papayasan break down protein and hence dissolve the cuticle of roundworms, threadworms and whip worms, and with the help of intestinal ferments will completely digest them.



Alternating hot and cold water applications are excellent for poor circulation and a fine aid to removing any congestion.

Apply hot water or herbal packs for about three minutes, then replace by a cold water pack, but leave this on for no longer than half a minute. Repeat the hot pack, followed by the cold, and continue in the same way for 20-30 minutes. The same principle applies to water-treading. Tread your feet in hot water for three minutes, then half a minute in cold water, and so forth. If you take alternating hot and cold baths, you must stay in the cold water only the same number of seconds as you were in the hot for minutes. This rule also applies to alternating hot and cold foot and arm baths. These applications should never make you feel chilled, but always warm and comfortable.



This plant has been cultivated since ancient times. It is probably native to India, where it was known as Arjaka in ancient Sanskrit. The aromatic herb is a good source of food for bees, but is also valued as a kitchen herb and a remedy. In ancient Egypt basil served as a medicine for snakebites, scorpion stings and eye troubles. The crushed leaves were also applied to painful parts in cases of rheumatism. Basil’s remedial effects are due to its content of rhymol, eugenol and camphor. Pliny recommended basil tea as a remedy for nerves, headaches and fainting spells. The Greeks used basil not only to prepare aromatic baths to strengthen the nerves, but also for flavouring must (the juice pressed from grapes before it has fermented), wine and liqueurs. Basil is used in northern Germany to season the famous Hamburg eel soup and in the preparation of gherkins (pickled cucumbers). In Italy, particularly in the south, it is found in practically every garden because it is used widely for seasoning – and food to which is has been added is always very tasty.



Not only are the modest but beautiful flowers of the wild rose, so unjustly called Rosa canina or ‘dog rose’, a pleasure to behold, but the fruit too is delightful as it splashes its bright red across the autumn landscape. Where the hips have not been harvested they look, in winter, like little red gnomes with white caps of snow, and many a hungry bird has enjoyed these nutritious berries when everything else has been buried under the ice.

As a food, rose hips are excellent for many reasons. The fully-ripe hips contain natural fruit sugar and taste as sweet as any jam. They are nourishing because of their many mineral salts, such as calcium, silica, magnesium and phosphorus. Incidentally, phosphorus is good for the brain and no doubt our little feathered friends have to use theirs, dashing about in the winter weather, and who knows whether the phosphorus in rose hips is responsible for their feathers being always so bright and shiny.



When the delivery is known to have been traumatic in physical terms, when the baby is not thriving or has died, or when an abnormal baby has been born, a particularly sensitive approach to discussion of contraception will be needed. The woman’s pain and distress or anger at what has happened may be hard for the family planning adviser to bear, and it may be tempting to avoid counselling such a woman with the excuse that she needs help in coping with her misfortune rather than consideration of her sexual activity in the future. And yet, these are often the women who need the most help, for to treat them differently may only increase their feelings of isolation and abnormality. They may have considerable anxieties about when to embark on a pregnancy again, and even at the height of their grief they may be looking forward in their mind. Time needs to be spent in allowing the woman to share her grief, while acknowledging with her that her need for comfort and closeness with her partner could lead to sexual activity. She may need encouragement to allow herself to consider sexual pleasure, especially where there are feelings of guilt or blame. Time spent exploring her anxieties at this stage may allow natural healing to begin to take place.



Mrs P. was seen initially in a psychosexual clinic following the birth of her first child who suffered from osteogenesis imperfecta (brittle bone disease). Intercourse was extremely painful. She was unable to gain any insight into how angry she was with the doctors for not diagnosing the problem correctly so that some fractures occurred during the baby’s delivery, but she was also angry with her husband for possibly causing some fractures when he lay on her having intercourse.

The previous fun of lovemaking had led to a wanted pregnancy, but it had caused so much pain now for her and her baby. How could she possibly enjoy it again? She did not want any more children and therefore there was no need for intercourse. She decided not to attend for further help with the psychosexual problem because of lack of progress.

Three years later she appeared at the infertility clinic having decided herself, a year before, that the time was right for another baby. She looked surprised when the doctor asked if she was enjoying lovemaking again, as though that painful time had not existed.

The power of time to heal both pain and anger can sometimes be surprising, and doctors have to accept that they will often never know if the work they have done with a patient has played any part in the healing process.



Bearing in mind all the above difficulties, there are three major components to be considered in counselling a woman with an unplanned pregnancy, not necessarily in this order.

Giving accurate information about the options, procedures and relative risks so that the woman can make an informed decision. Despite the fact that abortion is a commonly carried out surgical procedure, it is often not openly discussed. A woman with an unplanned pregnancy may set out with very little accurate knowledge of her options. Much of the information available may be produced by radical pro- or anti-abortion groups carrying strongly emotional overtones. It is important that the woman receives accurate information before making a decision.

Allowing the woman the opportunity to explore her feelings about this pregnancy in particular and her fertility in general.

Helping the woman reach an understanding as to why she fell pregnant at this particular time. Sometimes this is related to a simple contraceptive failure or mistake (Hutchinson, 1992). She may need help in finding a suitable method of contraception and be given proper instructions as to how to use it. Sometimes the reason for the present pregnancy is more complex, to do with the woman’s emotional problems and attitudes to her sexuality. These may need to be understood before she can make use of any contraception offered. She may occasionally need further help from other agencies such as Social Services or psychotherapy.



An 18-year-old girl attended a clinic two hours away from her home. A new doctor expressed surprise at the distance she had travelled, noting that she had been attending for four years. ‘I like coming here,’ the girl said. ‘I know I could go to a nearer clinic, but I first came here in a state, needing the ‘morning-after’ pill.’

Her first experience was good, and she found the staff kind and friendly. At that time she had been worried on two counts, the risk of pregnancy and the risks of the Pill. Her mother had frightened her with myths about the Pill causing breast and cervical cancer. She felt that at the clinic her anxieties had been given credence and replaced by information. Four years on she is a happy Pill user who prefers to return for her contraceptive care to the clinic where her first experience, in a crisis, was good. This girl, only 14 years at the time of her first attendance, had achieved a considerable degree of emotional maturity, being able to take responsibility into her own hands and finding the first contraceptive consultation all that she had hoped for.



The case of Mrs D. shows how inevitable and necessary it is for the doctor to become ‘entangled’ in the patient’s problem, allowing herself to feel in response to the patient, as this provides valuable clues to what is really going on in the patient’s mind. The doctor must be aware of what she herself feels in order to be able to use the feelings to help the patient to understand herself. In this case the contradictory feelings in the doctor, of being a warm supportive mother and yet also a destructive baby-hater, accurately mirrored the patient’s conflict in relation to her mother and babies.




Reflexology is a form of foot massage which claims to alleviate and resolve illness. There are various systems of reflexology, but all have in common that they divide the foot into zones which correspond to organs or systems of the body. Reflexologists claim that massage of specific areas of the foot, and of the feet in general, addresses organic disorders and restores overall equilibrium.

Some people with allergies and sensitivity find reflexology very helpful, in particular finding it relaxing and invigorating. It is noninvasive and requires taking no remedies, oils or creams. It rarely causes adverse reaction. Some practitioners use special talcum powder. If this upsets you, ask for massage to be done without, or to use magnesium carbonate powder (available from pharmacies).


Aromatherapy is a form of therapy which combines massage with the application of oils from plants. The oils are chosen for their ability to stimulate certain systems of the body, and to alleviate specific symptoms.

Aromotherapy can be relaxing and helpful if you have mild sensitivity, but it can sometimes be troublesome if you have skin problems, and if you are chemically sensitive. The oils used, although from natural sources, are complex chemicals and can cause or aggravate chemical sensitivity. You should do a Patch Test or Sniff Test on individual oils before using them. Only use oils which do not upset you and make sure the practitioner knows that you are prone to allergy and sensitivity. It is probably best not to use the oils on a highly sensitive baby or child.



Sodium cromoglycate is a drug which works by stabilising the mast cells which are the cells primarily responsible for releasing histamine and other chemicals during an allergic reaction. Stabilising the mast cells reduces the amount of histamine released. It works best for people who have true allergy but can be effective sometimes in cases of food intolerance or chemical sensitivity. It is almost totally free of side effects. Adverse reactions to it are extremely rare.

The drug can be given as eye-drops for conjunctivitis (e.g. Opticrom), as a nasal spray (eg. Rynacrom) or in a spinhaler or pressurised aerosol for asthma (e.g. Intal). It can take from a few days to several weeks for the drug to take effect and needs to be taken continuously during the period of exposure.

It can be taken as a powder by mouth with water to block food sensitivity reactions (e.g. Nalcrom). Large doses of the drug may be needed to make this effective. It can also take a time of experimenting with Nalcrom to find the right dose (usually 6-10 capsules 30 minutes to an hour before a meal) as individuals vary in the dosage that they need. So most people who take it reserve its use for special occasions -for children to go to birthday parties for instance, for family celebrations, or for meals out. It is not usually prescribed for anyone who has had a violent, immediate allergic reaction to a food, who should avoid that food completely. The risks of the drug not working are very slight but not worth taking in these situations.

In clearly allergic cases, sodium cromoglycate is usually tried before steroid drugs are, and is effective in most cases, avoiding the need for steroids.


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