in anxiety disorders, especially if there is an underlying physical cause such as alcohol withdrawal. Depression may be accompanied by agitation.
Caffeine reduces fatigue, improves concentration, makes the heart pump blood faster, and has a diuretic effect.
Large quantities may produce side effects such as agitation and tremors.
A regular high intake may lead to increased tolerance and withdrawal symptoms, such as headaches and tiredness, after a few hours without caffeine.
Caffeine is used in some drug preparations, particularly in combination with analgesics and with ergotamine in preventive treatments for migraine.... caffeine
It usually arises in alcoholics after withdrawal or abstinence from alcohol.
Early symptoms include restlessness, agitation, trembling, and sleeplessness.
The person may develop a rapid heartbeat, fever, and dilation of the pupils.
Sweating, confusion, hallucinations, and convulsions may also occur.
Treatment consists of rest, rehydration, and sedation.
Vitamin injections, particularly of thiamine (see vitamin B complex), may be given.... delirium tremens
Side effects include nausea, vomiting, nervousness, and agitation.... levodopa
The clinical picture is characterised by TREMOR, rigidity and poverty of spontaneous movements. The loss of natural play of expression in the face produces a mask-like expression. Rigidity of the larynx, tongue and lips produces a ?at, expressionless voice. The most common symptom is tremor, often affecting one hand, spreading to the leg on the same side, then to the other limbs. It is more pronounced in resting limbs and is exaggerated by excitement, stopping during sleep. It may interfere with eating and dressing. Limb rigidity leads to an increasing tendency to stoop. The patient has a shu?ing walk with a peculiar running gait.
Treatment Several drugs are used to keep the condition under control. None is curative, all have side-effects, and ?nding the most suitable one for any individual depends largely on understanding cooperation between family doctor and patient. Dopaminergic and antimuscarinic (see ANTIMUSCARINE) drugs are used in treatment. Levodopa, a precursor of dopamine, is a long-used example of the former; it produces spectacular improvement in one-?fth and moderate improvement in two-?fths of patients. Benzhexol hydrochloride is one of several antimuscarinic drugs used in Parkinson’s disease; selegiline is a monoamine-oxidase inhibitor used in severe parkinsonism in conjunction with levodopa to reduce ‘end-of-dose’ deterioration. Adverse effects include HYPOTENSION, nausea and vomiting, confusion, and agitation. Some drugs used to treat other disorders produce Parkinsonian side-effects. Patients seeking further advice and help, together with their relatives, are advised to contact the Parkinson’s Disease Society of the UK.... parkinsonism
Causes There is an inherited element: parents, children or siblings of schizophrenic sufferers have a one in ten chance of developing the disorder; a twin has a 50 per cent chance if the other twin has schizophrenia. Some BRAIN disorders such as temporal lobe EPILEPSY, tumours and ENCEPHALITIS seem to be linked with schizophrenia. Certain drugs – for example, AMPHETAMINES – can precipitate schizophrenia and DOPAMINE-blocking drugs often relieve schizophrenic symptoms. Stress may worsen schizophrenia and recreational drugs may trigger an attack.
Symptoms These usually develop gradually until the individual’s behaviour becomes so distrubing or debilitating that work, relationships and basic activities such as eating and sleeping are interrupted. The patient may have disturbed perception with auditory HALLUCINATIONS, illogical thought-processes and DELUSIONS; low-key emotions (‘?at affect’); a sense of being invaded or controlled by outside forces; a lack of INSIGHT and inability to acknowledge reality; lethargy and/or agitation; a disrespect for personal appearance and hygiene; and a tendency to act strangely. Violence is rare although some sufferers commit violent acts which they believe their ‘inner voices’ have commanded.
Relatives and friends may try to cope with the affected person at home, but as severe episodes may last several months and require regular administration of powerful drugs – patients are not always good at taking their medication
– hospital admission may be necessary.
Treatment So far there is no cure for schizophrenia. Since the 1950s, however, a group of drugs called antipsychotics – also described as NEUROLEPTICS or major tranquillisers – have relieved ?orid symptoms such as thought disorder, hallucinations and delusions as well as preventing relapses, thus allowing many people to leave psychiatric hospitals and live more independently outside. Only some of these drugs have a tranquillising e?ect, but their sedative properties can calm patients with an acute attack. CHLORPROMAZINE is one such drug and is commonly used when treatment starts or to deal with an emergency. Halperidol, tri?uoperazine and pimozide are other drugs in the group; these have less sedative effects so are useful in treating those whose prominent symptoms are apathy and lethargy.
The antipsychotics’ mode of action is by blocking the activity of DOPAMINE, the chemical messenger in the brain that is faulty in schizophrenia. The drugs quicken the onset and prolong the remission of the disorder, and it is very important that patients take them inde?nitely. This is easier to ensure when a patient is in hospital or in a stable domestic environment.
CLOZAPINE – a newer, atypical antipsychotic drug – is used for treating schizophrenic patients unresponsive to, or intolerant of, conventional antipsychotics. It may cause AGRANULOCYTOSIS and use is con?ned to patients registered with the Clorazil (the drug’s registered name) Patient Monitoring Service. Amisulpride, olanzapine, quetiapine, risperidone, sertindole and zotepine are other antipsychotic drugs described as ‘atypical’ by the British National Formulary; they may be better tolerated than other antipsychotics, and their varying properties mean that they can be targeted at patients with a particular grouping of symptoms. They should, however, be used with caution.
The welcome long-term shift of mentally ill patients from large hospitals to community care (often in small units) has, because of a lack of resources, led to some schizophrenic patients not being properly supervised with the result that they fail to take their medication regularly. This leads to a recurrence of symptoms and there have been occasional episodes of such patients in community care becoming a danger to themselves and to the public.
The antipsychotic drugs are powerful agents and have a range of potentially troubling side-effects. These include blurred vision, constipation, dizziness, dry mouth, limb restlessness, shaking, sti?ness, weight gain, and in the long term, TARDIVE DYSKINESIA (abnormal movements and walking) which affects about 20 per cent of those under treatment. Some drugs can be given by long-term depot injection: these include compounds of ?upenthixol, zuclopenthixol and haloperidol.
Prognosis About 25 per cent of sufferers recover fully from their ?rst attack. Another 25 per cent are disabled by chronic schizophrenia, never recover and are unable to live independently. The remainder are between these extremes. There is a high risk of suicide.... schizophrenia
Anxiety is a consequence of too much STRESS and may occur without being serious enough to need treatment. Clinically it arises when the balance between certain chemicals in the brain is disturbed: this increases activity in the sympathetic system, thus provoking physical symptoms such as breathlessness, tachycardia, headaches and indigestion. Anxiolytics help to alleviate these symptoms but do not necessarily cure the underlying cause. Two main classes of drug relieve anxiety: BENZODIAZEPINES and beta blockers (see BETA-ADRENOCEPTORBLOCKING DRUGS). The latter, which include atenolol and propanolol, reduce the physical symptoms such as tachycardia and are useful in circumstances – for example, examinations – known to cause anxiety attacks. They block the action of NORADRENALINE, a key chemical of the sympathetic nervous system. Benzodiazepines depress activity in that part of the brain controlling emotion by stimulating the action of a chemical called gammaaminobutyric acid (GABA). Among the benzodiazepines are chlordiazepoxide and diazepam. (See also MENTAL ILLNESS.)... tranquillisers
Symptoms. Local tenderness, feverishness, general agitation. Pain following mumps. Nipple discharge. Alternatives. Where there is feverishness add Elderflowers (one part).
Tea. Combine equal parts: Comfrey leaves. Wild Thyme. German Chamomile. Red Clover. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes. Drink freely.
Tablets/capsules. Poke root. Red Clover. Echinacea.
Powders. Formula: Echinacea 2; Red Clover 1; Poke root 1. Mix. Dose: 500mg (two 00 capsules or one- third teaspoon) thrice daily.
Tinctures. Formula. Echinacea 2; Marigold 1; Agnus Castus 2; Poke root 1. Dose: 1-2 teaspoons thrice daily, in water.
Poultice: (1) Fresh Plantain leaves beaten in pestle and mortar, applied cold. (2) Comfrey powder or Slippery Elm powder (or both) sprinkled on suitable material wrung out in boiling water and applied. (3) German Chamomile and Comfrey leaves. (Arthur Hyde, MNIMH) (4) Bring to boil, equal parts Chamomile flowers and Marshmallow leaves in milk and water. Remove when boiling point is reached. Saturate linen or suitable material. Apply every 12 hours. (Rev. John Wesley) (6) Bathe with juice of Houseleek. (Traditional, Norfolk villages)
Evening Primrose oil: internally and externally.
Poke root. An important ingredient of prescription for acute condition. ... breasts, mastitis
While an internal mechanism slows down the body, caffeine in tea, cola and coffee restores alertness. Caffeine acts by blocking the action of the compound, adenosine – one of the building blocks of DNA which promotes cell energy. Caffeine interferes with natural metabolic processes. In the aged, coffee increases production of uric acid, causing irritation of the kidneys, joint and muscle pains. vCaffeinism is responsible for a wide range of disorders. Increases the heart beat, promotes excessive stomach acid and increases flow of urine. It may give rise to birth defects and should be taken with caution in pregnancy.
Symptoms. Restlessness, nervous agitation, extreme sensitiveness. Intolerance of pain, nervous palpitation, all senses acute.
To antidote. Chamomile tea.
Practitioner. Tincture Nux vom BP: 10 drops to 100ml water. Dose: 1 teaspoon thrice daily. Inhalation: Strong spirits of Camphor.
Diet. Plenty asparagus. ... caffeine poisoning
Constituents: caffeine, aromatic oil, tannic acid, B vitamins.
Action. General stimulant, anti-emetic, anti-narcotic, diuretic.
Uses: A valuable agent medicinally but over-consumption may be followed by a wide range of symptoms. See: CAFFEINISM. Used for fatigue, drowsiness, headache and to reduce effects of alcohol.
Coffee stimulates the activities of all organs, increasing nervous and circulatory activity. An excess produces nervous agitation, restlessness and is the cause of many allergies. A direct heart stimulant, diuretic, it raises blood pressure hence is useful for revival in threatened heart failure or weakness.
Caffeine is present also in tea and cola drinks. Coffee is the most widely used psychotropic agent: any excess is associated with anxiety, depression and reduction of blood flow through the brain. Antagonistic to some drugs, but potentiates the action of aspirin and paracetamol. Rapidly rectifies over-dosing of many drugs. Taken with caution in pregnancy. Antidotes some poisons and neutralises therapeutic effects of many herbs. Should be avoided by those undergoing a course of herbal treatment.
Excess caffeine, as in coffee, tea, cola and chocolate, has been shown to be a factor in the development of fibrocystic breast disease in women, and breast cancer increased. (Dr John P. Minton, in “Surgery”)
Women who drank between 8 to 25 cups of coffee a day during pregnancy had children with an absence of fingers or parts of digits of hands and feet. A number of authorities claim a link between coffee and birth defects. Cases of premenstrual tension (PMT) have improved on giving up coffee.
Coffee depletes the body of B-vitamins. ... coffee
Insomnia, malaise, agitation, and tearfulness are also common. Gradually, but usually within 2 years, the bereaved person adjusts to the loss.
Family and friends can often provide support. Outside help may be required and may be given by a social worker, health visitor, member of the clergy, or self-help group. For some people, when depression, apathy, and lethargy impede any chance of recovery, specialized counselling or psychotherapy is necessary. (See also stillbirth.)... bereavement
Acute liver failure requires urgent hospital care.
Although no treatment can repair damage that has already occurred in acute and chronic liver failure, certain measures, such as prescribing diuretic drugs to reduce abdominal swelling, may be taken to reduce the severity of symptoms.
Consumption of alcohol should cease in all cases.
The prognoses for sufferers of chronic liver failure vary depending on the cause, but some people survive for many years.
For acute liver failure, a liver transplant is necessary to increase the chances of survival.... liver failure
Today, yellow fever is contracted only in Central America, parts of South America, and a large area of Africa. Eradication of the causative mosquito from populated areas has greatly reduced its incidence.
Yellow fever is characterised by a sudden onset of fever and headache, often with nausea and nosebleeds and, despite the high fever, a very low heart-rate. In
more serious cases, the fever is higher and there is severe headache and pain in the neck, back, and legs. Damage may occur rapidly to the liver and kidneys, causing jaundice and kidney failure. This may be followed by severe agitation and delirium, leading to coma and death.
Vaccination confers long-lasting immunity and should always be obtained before travel to affected areas. A single injection of the vaccine gives protection for at least 10 years. Reactions to the vaccine are rare and are usually trivial, although children under the age of 1 should not be vaccinated.
During yellow fever epidemics, diagnosis is simple. A diagnosis can be confirmed by carrying out blood tests to isolate the causative virus or to find antibodies to the virus.
No drug is effective against the yellow fever virus; treatment is directed at maintaining the blood volume.
Transfusion of fluids is often necessary.
Many patients recover in about 3 days and, in mild to moderate cases, complications are few.
Relapses do not occur and one attack confers lifelong immunity.
Overall, however, about 10 per cent of victims die.... yellow fever
FAMILY: Nelumbonaceae (Nymphaeaceae)
SYNONYMS: N. komarovii, N. nucifera var. macrorhizomata, Nelumbium speciosum, Nymphaea nelumbo, Indian lotus, sacred lotus, pink lotus, bean of India, kamala and padma (Sanskrit).
GENERAL DESCRIPTION: The sacred lotus is a perennial aquatic plant with rhizomes that grow in the mud at the bottom of shallow ponds, lakes and marshes. Its large leaves, which rise above the water surface, can be up to 60 cm in diameter, with a 3-metre horizontal spread, while the showy flowers can be up to 20 cm in diameter. The beautiful pink, fragrant flowers are solitary, borne at or above the leaf level, with a brilliant yellow centre and white sepals. The fruits form a conical pod, with seeds contained in holes in the pod.
DISTRIBUTION: Native to Greater India, the sacred lotus now occurs in the wild in warm-temperate to tropical regions throughout Asia, the Middle East and tropical Australia. It is common in China, Japan, Iran, Bhutan, India, Indonesia (Java), Korea, Malaysia, Nepal, New Guinea, Pakistan, Philippines, Russia (Far East), Sri Lanka, Thailand, Vietnam and north-west Australia. Introduced to Europe in 1787 as a ‘stove house water lily’ by Joseph Banks, today it is cultivated as an ornamental plant worldwide.
OTHER SPECIES: The family Nelumbonaceae has two important genera having aquatic species with attractive flowers i.e. the lotus, Nelumbo and water lily, Nymphea. The genus Nelumbo has only two species, N. nucifera (Indian or sacred lotus) and N. lutea (American lotus or yellow lotus).
The Egyptian blue lotus (Nymphaea caerulea) and the white sacred lotus of Egypt (Nymphaea lotus) are both members of the water lily family. These water lilies are indigenous to Egypt and their flowers are often depicted in Egypt’s ancient art. Remains of both blue and white water lily petals were found in the burial tomb of Ramesses II and sprinkled on the mummified body of Tutankhamun. The blue lotus is also mentioned in numerous Egyptian historical texts, mainly for its aphrodisiac, narcotic and euphoric properties. Both species are still cultivated in Egypt as well as in India and Indonesia today and are both used to produce absolutes, although these are rare and costly. Egyptians refer to both these flowers as ‘lotus’ so these two species are often confused with the ‘true’ lotus species.
HERBAL/FOLK TRADITION: Nelumbo nucifera has been in cultivation for more than 3,000 years, and has been grown not only for its cultural and ornamental value, but also for medicinal uses and for its edible seeds and rhizomes. In China, Japan and India, for example, the rhizomes are roasted, pickled, candied or sliced and fried as chips. A paste made from the nutlets is used as a filling in mooncakes (traditional Chinese pastries). The young leaves, leaf stalks and flowers are eaten as vegetables in India. The petals of the flower are used as a wrap for foods in Asia and the rhizome is a common ingredient in soups and stir-fries.
The sacred lotus has also been used as a medicinal herb for generations in Asia and its uses in contemporary medicine are virtually unchanged. Many parts of the plant are used: the leaf juices are used for diarrhoea and sunstroke when mixed with licorice; the flower is used for abdominal cramps, bloody discharges, bleeding gastric ulcers, excessive menstruation and post-partum haemorrhage; the flower stamens are used in urinary frequency, premature ejaculation and uterine bleeding; the fruit is used for agitation and fever; the seed has been shown to lower cholesterol levels and to relax the smooth muscle of the uterus and is used for poor digestion, chronic diarrhoea, insomnia, and palpitations. Various parts of the flower, including the petals are used for diarrhoea, cholera, liver conditions, bronchitis, skin eruptions, snake bites, and scorpion stings. The dried flowers are prepared into a syrup to treat coughs and the stamens are dried and made into a fragrant herbal tea. Practitioners of Ayurvedic medicine use lotus flowers for their soothing, cooling properties and they are often employed in skin care to improve the complexion. Oils from the lotus flower are said to have a calming influence on those suffering from fear, anxiety, insomnia or tremors, according to the principles of Ayurveda. A recent study has shown that oil extracted from the lotus flower might be effective in preventing greying hair.
Several bioactive compounds have been derived from these various plant parts belonging to different chemical groups, including alkaloids, flavonoids and glycosides which all have their own therapeutic impact. Both Nelumbo nucifera and Nymphaea caerulea contain the alkaloids nuciferine and aporphine, which have a sedative effect; studies using isolated neferine (found only in N. nucifera), indicates it has potent antidepressant and sedative properties. Sacred lotus is also nutritious, containing vitamins B and C, protein, fat, carbohydrate, starch, moisture, sucrose, calcium, phosphorus, iron and ascorbic acid.
The lotus is of great significance to many Asian cultures, and in particular to the Eastern religions. From ancestral times, the idea of enlightenment has been symbolized by the life cycle of the sacred lotus plant, whose life starts humbly in the mud yet eventually produces exquisite, untainted flowers, showing the path of spiritual enfoldment. Thus the sacred lotus has a deep ritual meaning to Hindus and Buddhists alike, to whom the lotus flower symbolizes beauty, purity and divinity. Most deities of Asian religions are depicted as seated on a lotus flower. In Buddhist temples, lotus is burned in powdered form as ceremonial incense and the flowers are given as a sacred offering in many Eastern temples. A thread made from the leaf stalks is used for making oil-wicks for lamps in temples. Cloth woven from this yarn is believed to cure many ailments and is used to make Buddhist robes; lotus seeds are also used to make malas (strings of prayer beads). The sacred lotus is the national flower of India and Vietnam.
ACTIONS: Antibacterial, antimicrobial, antidepressant, anti-oxidant, refrigerant, rejuvenating, sedative, tonic (heart, immune system, nervous system), vasodilator.
EXTRACTION: An absolute by solvent extraction from fresh flowers. The CO2 extraction process achieves a cleaner end product that is true to the oil and is thicker than other extraction methods. This product is often adulterated or blended with other oils (see other uses).
CHARACTERISTICS: A viscous liquid with an intense rich, sweet-floral scent and a spicy-leathery undertone. It blends well with tuberose, jasmine, neroli, rose, gardenia and spice oils.
PRINCIPAL CONSTITUENTS: The absolute (and oil) was found to be comprised mainly of palmitic acid methyl ester (22.66 per cent), linoleic acid methyl ester (11.16 per cent), palmitoleic acid methyl ester (7.55 per cent) and linolenic acid methyl ester (5.16 per cent) with myristic acid and oleic acid.
SAFETY DATA: Generally considered a safe oil.
AROMATHERAPY/HOME: USE
Skin care: Damaged, sensitive and mature skin: to improve the condition of uneven or tired looking skin as it helps regulate, soothe, illuminate and rejuvenate the tissue.
Immune system: Weak immunity.
Nervous system: Anxiety, depression, fear, insomnia, nervous debility and tension, mood swings, poor libido, stress.
OTHER USES: Lotus flower oil and absolute are used in perfumery in high-class floral compositions, such as ‘White Lotus’ by Kenzo and in cosmetics. However, the ‘lotus’ perfume component commonly available in the trade is actually a blend of patchouli, benzoin and styrax with phenylethyl and cinnamic alcohols.... lotus
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