Bo Health Dictionary

A rare type of food poisoning with a mortality greater than 50 per cent, caused by the presence of the exotoxin of the anaerobic bacterium Clostridium botulinum, usually in contaminated tinned or bottled food. Symptoms develop a few hours after ingestion.

The toxin has two components, one having haemagglutinin activity and the other neurotoxic activity which produces most of the symptoms. It has a lethal dose of as little as 1 mg/kg and is highly selective for cholinergic nerves. Thus the symptoms are those of autonomic parasympathetic blockade (dry mouth, constipation, urinary retention, mydriasis, blurred vision) and progress to blockade of somatic cholinergic transmission (muscle weakness). Death results from respiratory muscle paralysis. Treatment consists of supportive measures and 4 aminopyridine and 3, 4 di-aminopyridine, which may antagonise the e?ect of the toxin.... botulism

Body Mass Index (BMI) provides objective criteria of size to enable an estimation to be made of an individual’s level or risk of morbidity and mortality. The BMI, which is derived from the extensive data held by life-insurance companies, is calculated by dividing a person’s weight by the square of his or her height (kilograms/ metres2). Acceptable BMIs range from 20 to 25 and any ?gure above 30 characterises obesity. The Index may be used (with some modi?cation) to assess children and adolescents. (See OBESITY.)... body mass index

A lump of food prepared for swallowing by chewing and mixing with saliva. The term is also used to describe the rapid intravenous injection of ?uid or a drug, as opposed to a slower infusion.... bolus

The formation of a close, selective attachment between two individuals, as in the relationship between a mother and her baby.... bonding

See BONE TRANSPLANT.... bone graft

The framework upon which the rest of the body is built up. The bones are generally called the skeleton, though this term also includes the cartilages which join the ribs to the breastbone, protect the larynx, etc.

Structure of bone Bone is composed partly of ?brous tissue, partly of bone matrix comprising phosphate and carbonate of lime, intimately mixed together. The bones of a child are about two-thirds ?brous tissue, whilst those of the aged contain one-third; the toughness of the former and the brittleness of the latter are therefore evident.

The shafts of the limb bones are composed of dense bone, the bone being a hard tube surrounded by a membrane (the periosteum) and enclosing a fatty substance (the BONE MARROW); and of cancellous bone, which forms the short bones and the ends of long bones, in which a ?ne lace-work of bone ?lls up the whole interior, enclosing marrow in its meshes. The marrow of the smaller bones is of great importance. It is red in colour, and in it red blood corpuscles are formed. Even the densest bone is tunnelled by ?ne canals (Haversian canals) in which run small blood vessels, nerves and lymphatics, for the maintenance and repair of the bone. Around these Haversian canals the bone is arranged in circular plates called lamellae, the lamellae being separated from one another by clefts, known as lacunae, in which single bone-cells are contained. Even the lamellae are pierced by ?ne tubes known as canaliculi lodging processes of these cells. Each lamella is composed of very ?ne interlacing ?bres.

GROWTH OF BONES Bones grow in thickness from the ?brous tissue and lime salts laid down by cells in their substance. The long bones grow in length from a plate of cartilage (epiphyseal cartilage) which runs across the bone about 1·5 cm or more from its ends, and which on one surface is also constantly forming bone until the bone ceases to lengthen at about the age of 16 or 18. Epiphyseal injury in children may lead to diminished growth of the limb.

REPAIR OF BONE is e?ected by cells of microscopic size, some called osteoblasts, elaborating the materials brought by the blood and laying down strands of ?brous tissue, between which bone earth is later deposited; while other cells, known as osteoclasts, dissolve and break up dead or damaged bone. When a fracture has occurred, and the broken ends have been brought into contact, these are surrounded by a mass of blood at ?rst; this is partly absorbed and partly organised by these cells, ?rst into ?brous tissue and later into bone. The mass surrounding the fractured ends is called the callus, and for some months it forms a distinct thickening which is gradually smoothed away, leaving the bone as before the fracture. If the ends have not been brought accurately into contact, a permanent thickening results.

VARIETIES OF BONES Apart from the structural varieties, bones fall into four classes: (a) long bones like those of the limbs; (b) short bones composed of cancellous tissue, like those of the wrist and the ankle; (c) ?at bones like those of the skull; (d) irregular bones like those of the face or the vertebrae of the spinal column (backbone).

The skeleton consists of more than 200 bones. It is divided into an axial part, comprising the skull, the vertebral column, the ribs with their cartilages, and the breastbone; and an appendicular portion comprising the four limbs. The hyoid bone in the neck, together with the cartilages protecting the larynx and windpipe, may be described as the visceral skeleton.

AXIAL SKELETON The skull consists of the cranium, which has eight bones, viz. occipital, two parietal, two temporal, one frontal, ethmoid, and sphenoid; and of the face, which has 14 bones, viz. two maxillae or upper jaw-bones, one mandible or lower jaw-bone, two malar or cheek bones, two nasal, two lacrimal, two turbinal, two palate bones, and one vomer bone. (For further details, see SKULL.) The vertebral column consists of seven vertebrae in the cervical or neck region, 12 dorsal vertebrae, ?ve vertebrae in the lumbar or loin region, the sacrum or sacral bone (a mass formed of ?ve vertebrae fused together and forming the back part of the pelvis, which is closed at the sides by the haunch-bones), and ?nally the coccyx (four small vertebrae representing the tail of lower animals). The vertebral column has four curves: the ?rst forwards in the neck, the second backwards in the dorsal region, the third forwards in the loins, and the lowest, involving the sacrum and coccyx, backwards. These are associated with the erect attitude, develop after a child learns to walk, and have the e?ect of diminishing jars and shocks before these reach internal organs. This is aided still further by discs of cartilage placed between each pair of vertebrae. Each vertebra has a solid part, the body in front, and behind this a ring of bone, the series of rings one above another forming a bony canal up which runs the spinal cord to pass through an opening in the skull at the upper end of the canal and there join the brain. (For further details, see SPINAL COLUMN.) The ribs – 12 in number, on each side – are attached behind to the 12 dorsal vertebrae, while in front they end a few inches away from the breastbone, but are continued forwards by cartilages. Of these the upper seven reach the breastbone, these ribs being called true ribs; the next three are joined each to the cartilage above it, while the last two have their ends free and are called ?oating ribs. The breastbone, or sternum, is shaped something like a short sword, about 15 cm (6 inches) long, and rather over 2·5 cm (1 inch) wide.

APPENDICULAR SKELETON The upper limb consists of the shoulder region and three segments – the upper arm, the forearm, and the wrist with the hand, separated from each other by joints. In the shoulder lie the clavicle or collar-bone (which is immediately beneath the skin, and forms a prominent object on the front of the neck), and the scapula or shoulder-blade behind the chest. In the upper arm is a single bone, the humerus. In the forearm are two bones, the radius and ulna; the radius, in the movements of alternately turning the hand palm up and back up (called supination and pronation respectively), rotating around the ulna, which remains ?xed. In the carpus or wrist are eight small bones: the scaphoid, lunate, triquetral, pisiform, trapezium, trapezoid, capitate and hamate. In the hand proper are ?ve bones called metacarpals, upon which are set the four ?ngers, each containing the three bones known as phalanges, and the thumb with two phalanges.

The lower limb consists similarly of the region of the hip-bone and three segments – the thigh, the leg and the foot. The hip-bone is a large ?at bone made up of three – the ilium, the ischium and the pubis – fused together, and forms the side of the pelvis or basin which encloses some of the abdominal organs. The thigh contains the femur, and the leg contains two bones – the tibia and ?bula. In the tarsus are seven bones: the talus (which forms part of the ankle joint); the calcaneus or heel-bone; the navicular; the lateral, intermediate and medial cuneiforms; and the cuboid. These bones are so shaped as to form a distinct arch in the foot both from before back and from side to side. Finally, as in the hand, there are ?ve metatarsals and 14 phalanges, of which the great toe has two, the other toes three each.

Besides these named bones there are others sometimes found in sinews, called sesamoid bones, while the numbers of the regular bones may be increased by extra ribs or diminished by the fusion together of two or more bones.... bone

Eupatorium perfoliatum. N.O. Compositae.

Synonym: Indian Sage, Thoroughwort.

Habitat: Damp places.

Features ? One or more erect stems, branched at top. Leaves opposite, lanceolate, four to six inches long, united at base, crenate edges, tiny, yellow resin dots beneath. Flowers August to October. Persistently bitter taste.

Part used ? Herb.

Action: Diaphoretic, febrifuge, tonic, laxative, expectorant.

Influenza and feverish conditions generally, for which purpose it is very successfully used by the American negroes. Also used in catarrhs. The infusion of 1 ounce to 1 pint boiling water may be given in wineglassful doses frequently, hot as a diaphoretic and febrifuge, cold as a tonic.

F. H. England, of the College of Medicine and Surgery, Chicago (Physio- Medical) says ? "It is a pure relaxant to the liver. It acts slowly and persistently. Its greatest power is manifested upon the stomach, liver, bowels and uterus."... boneset

The bubbling, gurgling passage of gas across the transverse colon...NOT a small North African rodent. BPH Benign Prostatic Hypertrophy, or Hyperplasia.... borborygmus

Bornholm disease, also known as devil’s grip, and epidemic myalgia, is an acute infective disease due to COXSACKIE VIRUSES. It is characterised by the abrupt onset of pain around the lower margin of the ribs, headache, and fever; it occurs in epidemics, usually during warm weather, and is more common in young people than in old. The illness usually lasts seven to ten days. It is practically never fatal. The disease is named after the island of Bornholm in the Baltic, where several epidemics have been described.... bornholm disease

The toxin of the anaerobic bacterium CLOSTRIDIUM botulinum is now routinely used to treat focal DYSTONIA in adults. This includes blepharospasm (see EYE, DISORDERS OF), SPASMODIC TORTICOLLIS, muscular spasms of the face, squint and some types of tremor. Injected close to where the nerve enters the affected muscles, the toxin blocks nerve transmissions for up to four months, so relieving symptoms. The toxin is also used in cerebral palsy. Although very e?ective, there are many possible unwanted effects, especially if too high a dose is used or the injection is misplaced.... botulinum toxin

Brittle Bone Disease is another name for OSTEOGENESIS IMPERFECTA.... brittle bone disease

That part of the EYE that connects the iris and the choroid. The ciliary ring is next to the choroid; the ciliary processes comprise many ridges behind the iris, to which the lens’s suspensory ligament is attached; and the ciliary muscle contracts to change the curvature of the lens and so adjust the accommodation of the eye.... ciliary body

(IBS) This is a common and generally benign condition of the colon, taking different forms but usually characterized by alternating constipation and diarrhea. There is often some pain accompanying the diarrhea phase. The bowel equivalent of spasmodic asthma, its main cause is stress, often accompanied by a history of GI infections. Adrenalin stress slows the colon and causes constipation, followed by a cholinergic rebound overstimulation of the colon. It is also called spastic colon, colon syndrome, mucous colitis, even chronic colitis. True colitis is a potentially or actually serious pathology.... irritable bowel syndrome

BOVINE SPONGIFORM ENCEPHALOPATHY (BSE)

Scrapie. Notifiable disease. Fatal disease in the nervous system of cattle, unknown before 1985. Microscopic holes appear in the brain giving a spongiform appearance, but with little inflammation. Can spread from one animal to another: sheep, goats, deer, mules, mink, hamsters, mice, pigs and monkeys. Cause: not a virus. Animals itch and scrape themselves against trees or posts for relief. May spread from animals to humans, with brain infection after the character of polio.

Symptoms. (Human). Speech impairment, short-term-memory-loss, difficulty in controlling body movements. Zinc deficiency.

Treatment. Hospitalisation.

Suggested treatment for human infection, unproven.

Tinctures. Echinacea 5; Black Cohosh 3; Yarrow 2; Senna leaf 1.2-3 teaspoons in water (or cup hot Yarrow tea) 3-4 times daily. For headache: Gelsemium.

Supplement: Zinc.

To be treated by a general medical practitioner or hospital specialist. ... bovine spongiform encephalopathy

Bone marrow is the soft substance occupying the interior of bones. It is the site of formation of ERYTHROCYTES, granular LEUCOCYTES and PLATELETS.... bone marrow

Bone is not an inert sca?olding for the human body. It is a living, dynamic organ, being continuously remodelled in response to external mechanical and chemical in?uences and acting as a large reservoir for calcium and phosphate. It is as susceptible to disease as any other organ, but responds in a way rather di?erent from the rest of the body.

Bone fractures These occur when there is a break in the continuity of the bone. This happens either as a result of violence or because the bone is unhealthy and unable to withstand normal stresses.

SIMPLE FRACTURES Fractures where the skin remains intact or merely grazed. COMPOUND FRACTURES have at least one wound which is in communication with the fracture, meaning that bacteria can enter the fracture site and cause infection. A compound fracture is also more serious than a simple fracture because there is greater potential for blood loss. Compound fractures usually need hospital admission, antibiotics and careful reduction of the fracture. Debridement (cleaning and excising dead tissue) in a sterile theatre may also be necessary.

The type of fracture depends on the force which has caused it. Direct violence occurs when an object hits the bone, often causing a transverse break – which means the break runs horizontally across the bone. Indirect violence occurs when a twisting injury to the ankle, for example, breaks the calf-bone (the tibia) higher up. The break may be more oblique. A fall on the outstretched hand may cause a break at the wrist, in the humerus or at the collar-bone depending on the force of impact and age of the person. FATIGUE FRACTURES These occur after the bone has been under recurrent stress. A typical example is the march fracture of the second toe, from which army recruits suffer after long marches. PATHOLOGICAL FRACTURES These occur in bone which is already diseased – for example, by osteoporosis (see below) in post-menopausal women. Such fractures are typically crush fractures of the vertebrae, fractures of the neck of the femur, and COLLES’ FRACTURE (of the wrist). Pathological fractures also occur in bone which has secondary-tumour deposits. GREENSTICK FRACTURES These occur in young children whose bones are soft and bend, rather than break, in response to stress. The bone tends to buckle on the side opposite to the force. Greenstick fractures heal quickly but still need any deformity corrected and plaster of Paris to maintain the correction. COMPLICATED FRACTURES These involve damage to important soft tissue such as nerves, blood vessels or internal organs. In these cases the soft-tissue damage needs as much attention as the fracture site. COMMINUTED FRACTURES A fracture with more than two fragments. It usually means that the injury was more violent and that there is more risk of damage to vessels and nerves. These fractures are unstable and take longer to unite. Rehabilitation tends to be protracted. DEPRESSED FRACTURES Most commonly found in skull fractures. A fragment of bone is forced inwards so that it lies lower than the level of the bone surrounding it. It may damage the brain beneath it.

HAIR-LINE FRACTURES These occur when the bone is broken but the force has not been severe enough to cause visible displacement. These fractures may be easily missed. Symptoms and signs The fracture site is usually painful, swollen and deformed. There is asymmetry of contour between limbs. The limb is held uselessly. If the fracture is in the upper

limb, the arm is usually supported by the patient; if it is in the lower limb then the patient is not able to bear weight on it. The limb may appear short because of muscle spasm.

Examination may reveal crepitus – a bony grating – at the fracture site. The diagnosis is con?rmed by radiography.

Treatment Healing of fractures (union) begins with the bruise around the fracture being resorbed and new bone-producing cells and blood vessels migrating into the area. Within a couple of days they form a bridge of primitive bone across the fracture. This is called callus.

The callus is replaced by woven bone which gradually matures as the new bone remodels itself. Treatment of fractures is designed to ensure that this process occurs with minimal residual deformity to the bone involved.

Treatment is initially to relieve pain and may involve temporary splinting of the fracture site. Reducing the fracture means restoring the bones to their normal position; this is particularly important at the site of joints where any small displacement may limit movement considerably.

with plaster of Paris. If closed traction does not work, then open reduction of the fracture may

be needed. This may involve ?xing the fracture with internal-?xation methods, using metal plates, wires or screws to hold the fracture site in a rigid position with the two ends closely opposed. This allows early mobilisation after fractures and speeds return to normal use.

External ?xators are usually metal devices applied to the outside of the limb to support the fracture site. They are useful in compound fractures where internal ?xators are at risk of becoming infected.

Consolidation of a fracture means that repair is complete. The time taken for this depends on the age of the patient, the bone and the type of fracture. A wrist fracture may take six weeks, a femoral fracture three to six months in an adult.

Complications of fractures are fairly common. In non-union, the fracture does not unite

– usually because there has been too much mobility around the fracture site. Treatment may involve internal ?xation (see above). Malunion means that the bone has healed with a persistent deformity and the adjacent joint may then develop early osteoarthritis.

Myositis ossi?cans may occur at the elbow after a fracture. A big mass of calci?ed material develops around the fracture site which restricts elbow movements. Late surgical removal (after 6–12 months) is recommended.

Fractured neck of FEMUR typically affects elderly women after a trivial injury. The bone is usually osteoporotic. The leg appears short and is rotated outwards. Usually the patient is unable to put any weight on the affected leg and is in extreme pain. The fractures are classi?ed according to where they occur:

subcapital where the neck joins the head of the femur.

intertrochanteric through the trochanter.

subtrochanteric transversely through the upper end of the femur (rare). Most of these fractures of the neck of femur

need ?xing by metal plates or hip replacements, as immobility in this age group has a mortality of nearly 100 per cent. Fractures of the femur shaft are usually the result of severe trauma such as a road accident. Treatment may be conservative or operative.

In fractures of the SPINAL COLUMN, mere damage to the bone – as in the case of the so-called compression fracture, in which there is no damage to the spinal cord – is not necessarily serious. If, however, the spinal cord is damaged, as in the so-called fracture dislocation, the accident may be a very serious one, the usual result being paralysis of the parts of the body below the level of the injury. Therefore the higher up the spine is fractured, the more serious the consequences. The injured person should not be moved until skilled assistance is at hand; or, if he or she must be removed, this should be done on a rigid shutter or door, not on a canvas stretcher or rug, and there should be no lifting which necessitates bending of the back. In such an injury an operation designed to remove a displaced piece of bone and free the spinal cord from pressure is often necessary and successful in relieving the paralysis. DISLOCATIONS or SUBLUXATION of the spine are not uncommon in certain sports, particularly rugby. Anyone who has had such an injury in the cervical spine (i.e. in the neck) should be strongly advised not to return to any form of body-contact or vehicular sport.

Simple ?ssured fractures and depressed fractures of the skull often follow blows or falls on the head, and may not be serious, though there is always a risk of damage which is potentially serious to the brain at the same time.

Compound fractures may result in infection within the skull, and if the skull is extensively broken and depressed, surgery is usually required to check any intercranial bleeding or to relieve pressure on the brain.

The lower jaw is often fractured by a blow on the face. There is generally bleeding from the mouth, the gum being torn. Also there are pain and grating sensations on chewing, and unevenness in the line of the teeth. The treatment is simple, the line of teeth in the upper jaw forming a splint against which the lower jaw is bound, with the mouth closed.

Congenital diseases These are rare but may produce certain types of dwar?sm or a susceptibility to fractures (osteogenesis imperfecta).

Infection of bone (osteomyelitis) may occur after an open fracture, or in newborn babies with SEPTICAEMIA. Once established it is very di?cult to eradicate. The bacteria appear capable of lying dormant in the bone and are not easily destroyed with antibiotics so that prolonged treatment is required, as might be surgical drainage, exploration or removal of dead bone. The infection may become chronic or recur.

Osteomalacia (rickets) is the loss of mineralisation of the bone rather than simple loss of bone mass. It is caused by vitamin D de?ciency and is probably the most important bone disease in the developing world. In sunlight the skin can synthesise vitamin D (see APPENDIX 5: VITAMINS), but normally rickets is caused by a poor diet, or by a failure to absorb food normally (malabsorbtion). In rare cases vitamin D cannot be converted to its active state due to the congenital lack of the speci?c enzymes and the rickets will fail to respond to treatment with vitamin D. Malfunction of the parathyroid gland or of the kidneys can disturb the dynamic equilibrium of calcium and phosphate in the body and severely deplete the bone of its stores of both calcium and phosphate.

Osteoporosis A metabolic bone disease resulting from low bone mass (osteopenia) due to excessive bone resorption. Su?erers are prone to bone fractures from relatively minor trauma. With bone densitometry it is now possible to determine individuals’ risk of osteoporosis and monitor their response to treatment.

By the age of 90 one in two women and one in six men are likely to sustain an osteoporosis-related fracture. The incidence of fractures is increasing more than would be expected from the ageing of the population, which may re?ect changing patterns of exercise or diet.

Osteoporosis may be classi?ed as primary or secondary. Primary consists of type 1 osteoporosis, due to accelerated trabecular bone loss, probably as a result of OESTROGENS de?ciency. This typically leads to crush fractures of vertebral bodies and fractures of the distal forearm in women in their 60s and 70s. Type 2 osteoporosis, by contrast, results from the slower age-related cortical and travecular bone loss that occurs in both sexes. It typically leads to fractures of the proximal femur in elderly people.

Secondary osteoporosis accounts for about 20 per cent of cases in women and 40 per cent of cases in men. Subgroups include endocrine (thyrotoxicosis – see under THYROID GLAND, DISEASES OF, primary HYPERPARATHYROIDISM, CUSHING’S SYNDROME and HYPOGONADISM); gastrointestinal (malabsorption syndrome, e.g. COELIAC DISEASE, or liver disease, e.g. primary biliary CIRRHOSIS); rheumatological (RHEUMATOID ARTHRITIS or ANKYLOSING SPONDYLITIS); malignancy (multiple MYELOMA or metastatic CARCINOMA); and drugs (CORTICOSTEROIDS, HEPARIN). Additional risk factors for osteoporosis include smoking, high alcohol intake, physical inactivity, thin body-type and heredity.

Individuals at risk of osteopenia, or with an osteoporosis-related fracture, need investigation with spinal radiography and bone densitometry. A small fall in bone density results in a large increase in the risk of fracture, which has important implications for preventing and treating osteoporosis.

Treatment Antiresorptive drugs: hormone replacement therapy – also valuable in treating menopausal symptoms; treatment for at least ?ve years is necessary, and prolonged use may increase risk of breast cancer. Cyclical oral administration of disodium etidronate – one of the bisphosphonate group of drugs – with calcium carbonate is also used (poor absorption means the etidronate must be taken on an empty stomach). Calcitonin – currently available as a subcutaneous injection; a nasal preparation with better tolerance is being developed. Calcium (1,000 mg daily) seems useful in older patients, although probably ine?ective in perimenopausal women, and it is a safe preparation. Vitamin D and calcium – recent evidence suggests value for elderly patients. Anabolic steroids, though androgenic side-effects (masculinisation) make these unacceptable for most women.

With established osteoporosis, the aim of treatment is to relieve pain (with analgesics and physical measures, e.g. lumbar support) and reduce the risk of further fractures: improvement of bone mass, the prevention of falls, and general physiotherapy, encouraging a healthier lifestyle with more daily exercise.

Further information is available from the National Osteoporosis Society.

Paget’s disease (see also separate entry) is a common disease of bone in the elderly, caused by overactivity of the osteoclasts (cells concerned with removal of old bone, before new bone is laid down by osteoblasts). The bone affected thickens and bows and may become painful. Treatment with calcitonin and bisphosphonates may slow down the osteoclasts, and so hinder the course of the disease, but there is no cure.

If bone loses its blood supply (avascular necrosis) it eventually fractures or collapses. If the blood supply does not return, bone’s normal capacity for healing is severely impaired.

For the following diseases see separate articles: RICKETS; ACROMEGALY; OSTEOMALACIA; OSTEOGENESIS IMPERFECTA.

Tumours of bone These can be benign (non-cancerous) or malignant (cancerous). Primary bone tumours are rare, but secondaries from carcinoma of the breast, prostate and kidneys are relatively common. They may form cavities in a bone, weakening it until it breaks under normal load (a pathological fracture). The bone eroded away by the tumour may also cause problems by causing high levels of calcium in the plasma.

EWING’S TUMOUR is a malignant growth affecting long bones, particularly the tibia (calfbone). The presenting symptoms are a throbbing pain in the limb and a high temperature. Treatment is combined surgery, radiotherapy and chemotherapy.

MYELOMA is a generalised malignant disease of blood cells which produces tumours in bones which have red bone marrow, such as the skull and trunk bones. These tumours can cause pathological fractures.

OSTEOID OSTEOMA is a harmless small growth which can occur in any bone. Its pain is typically removed by aspirin.

OSTEOSARCOMA is a malignant tumour of bone with a peak incidence between the ages of ten and 20. It typically involves the knees, causing a warm tender swelling. Removal of the growth with bone conservation techniques can often replace amputation as the de?nitive treatment. Chemotherapy can improve long-term survival.... bone, disorders of

Courage, Psychic Powers... borage

The procedure by which malignant or defective bone marrow in a patient is replaced with normal bone marrow. Sometimes the patient’s own marrow is used (when the disease is in remission); after storage using tissue-freezing technique (cryopreservation) it is reinfused into the patient once the diseased marrow has been treated (autologous transplant). More commonly, a transplant uses marrow from a donor whose tissue has been matched for compatibility. The recipient’s marrow is destroyed with CYTOTOXIC drugs before transfusion. The recipient is initially nursed in an isolated environment to reduce the risk of infection.

Disorders that can be helped or even cured include certain types of LEUKAEMIA and many inherited disorders of the immune system (see IMMUNITY).... bone marrow transplant

A collective term for chronic disorders affecting the small and/or large intestine that cause abdominal pain, bleeding, and diarrhoea. Crohn’s disease and ulcerative colitis are the most common types of inflammatory bowel disease.... inflammatory bowel disease

See osteopetrosis.... marble bone disease

A feeling of leaving one’s body and observing oneself from another dimension.

The experience, which is thought to be due to disturbance of brain function, is reported by some patients following a general anaesthetic or a medical emergency.... out-of-body experience

A genus of spirochaetes causing Lyme Disease (Borrelia burgdorferi) and Relapsing fever (B. recurrentis; B. duttoni). These zoonotic infections are transmitted through the bites of argassid ticks (tampans).... borrelia

A small reddish-brown structure measuring 5–7 × 2·5–4 millimetres, situated one on each side of the neck, where the carotid artery divides into the internal and external carotid arteries. Its main function is in controlling breathing so that an adequate supply of oxygen is maintained to the tissues of the body. Oxygen levels are controlled by a re?ex operating between the carotid body and the respiratory centre in the brain.... carotid body

See CLAVICLE.... collar-bone

Delhi boil is a form of chronic body sore occurring in Eastern countries, caused by a protozoan parasite, Leishmania tropica. (See LEISHMANIASIS.)... delhi boil

The bone which forms the forehead and protects the frontal lobes of the brain. Before birth, the frontal bone consists of two halves, and this division may persist throughout life – a deep groove remaining down the centre of the forehead. Above each eye is a heavy ridge in the bone, most marked in men; behind this, in the substance of the bone, is a cavity on each side (the frontal sinus) which communicates with the nose. CATARRH in these cavities produces the frontal headache characteristic of a ‘cold in the head’, and sometimes infection develops known as SINUSITIS (see NOSE, DISORDERS OF).... frontal bone

Particles found in the CYTOPLASM and NUCLEUS of CELLS, usually a consequence of a viral infection. This phenomenon can be helpful in the diagnosis of such an infection.... inclusion bodies

A disorder of the intestinal tract that affects its motility and causes abdominal distension and irregular defaecation. Traditional, but now discarded, names have been spastic or irritable colon. The disease affects around 20 per cent of the general population but in most it is no more than a minor nuisance. The causes are not fully understood, but it is generally believed that symptoms develop in response to psychological factors, changed gastrointestinal motility, or altered visceral sensation. About 50 per cent of patients meet criteria for a psychiatric diagnosis. Anxiety, depression, neurosis, panic attacks, acute disease are among possible triggering factors. Some patients have diarrhoea, others are constipated, and some alternate between the two. Many have increased sensitivity to distension of the intestine. Dietary factors such as intolerance to dairy products and wheat are apparent in certain patients.

Common features of IBS include:

abdominal distension.

altered bowel habit.

colicky lower abdominal pain, eased by defaecation.

mucous discharge from rectum.

feelings of incomplete defaecation.

Investigations usually produce normal results. Positive diagnosis in people under 40 is usually straightforward. In older patients, however, barium ENEMA, X-rays and COLONOSCOPY should be done to exclude colorectal cancer.

Reassurance is the initial and often e?ective treatment. If this fails, treatment should be directed at the major symptoms. Several months of the antidepressant amitriptyline (see ANTIDEPRESSANT DRUGS) may bene?t patients with intractable symptoms, given at a dose lower than that used to treat depression. The majority of patients follow a relapsing/remitting course, with episodes provoked by stressful events in their daily lives. (See also INTESTINE, DISEASES OF.)... irritable bowel syndrome (ibs)

Either one of a pair of bones that form the top and sides of the cranium of the SKULL.... parietal bone

The outside bone on the thumb side of the HAND in the row of carpal (wrist) bones nearest to the forearm. Fracture of the scaphoid is a common wrist injury that usually occurs when someone falls on to their outstretched hand. The fracture may not be diagnosed at ?rst (even an X-ray may not be abnormal). Pain in and permanent damage to the wrist can occur.... scaphoid bone

A personal and social problem. Over-activity of the sweat glands. Offensive smell is caused by the action of bacteria on stale sweat. The purpose of antiperspirants is to reduce skin bacterial action on apocrine sweat. Almost all antiperspirants sold over the counter are made from aluminium salts which have been implicated in skin granulomas. Deodorants that bear labels describing contents as dangerous to the eyes, nose and mouth should be rejected.

Bowel and kidney function should be investigated, as body odour is not normally offensive when these organs are healthy. Zinc is a powerful deodorant – zinc and castor oil cream being a traditional combination of pharmacy. Key herbal agent is Thuja, but it is sometimes advisable to add to this an agent for liver and kidneys.

Alternatives. Teas: Sage, Pennyroyal, Thyme, Betony. Decoctions: Sarsaparilla, Wild Yam.

Tablets/capsules. Seaweed and Sarsaparilla. Wild Yam, Thuja.

Formula: equal parts: Dandelion Root, Clivers, Thuja. Dosage – Powders: One-third teaspoon. Liquid Extracts: 30-60 drops. Tinctures: 1-2 teaspoons in water, thrice daily.

Topical. Dilute oil of Sage, or Sage tea, to under-arms, hands, feet.

Diet. Lacto-vegetarian. Safflower oil.

Vitamins. B-complex.

Minerals. Zinc. Dolomite. ... body odour

A psychiatric disorder in which a person suffers intense anxiety about an imagined defect in part of his or her body.... body dysmorphic disorder

A person’s perception of the different parts of his or her own body.... body image

An inflamed, pus-filled area of skin, usually an infected hair follicle. A more severe and extensive form of a boil that involves several hair follicles is a carbuncle. The usual cause of a boil is infection with the bacterium STAPHYLOCOCCUS AUREUS. Recurrent boils may occur in people with known or unrecognized diabetes mellitus or with other conditions in which general resistance to infection is impaired. Treatment may be with antibiotic drugs but, if pus is released surgically, the boil will usually heal without antibiotics.... boil

A common name for the large and/or small intestines.... bowel

A rare skin disorder that sometimes becomes cancerous. A flat, regular-shaped, patch of red, scaly skin forms, most commonly on the face or hands. The diseased skin is removed surgically or destroyed by freezing or cauterization.... bowen’s disease

n. an essential oil used, in preparations with other essential oils, such as camphene, cineole, and pinene, to disperse gallstones and kidney stones.... borneol

Barberry tea is well known inAsia, Europe, Africa and America due to its medicinal properties. Nowadays, it is consumed worldwide as tincture, fluid extract or capsules. Barberry tea description Barberry is a shrub growing in gray-colored and tight thorny hedges, producing yellow flowers during spring and red berries in autumn. Its roots, bark and berries have been used for more than 2,500 years for a variety of health-promoting purposes. In ancient Egypt, barberry was mixed with fennel to fight plague. Nowadays, Barberry is available in the form of capsules, fluid extract and tincture. Barberry Tea is made of the dried roots and berries of barberry. Barberry tea brewing To prepare Barberry tea: steep 1 to 2 teaspoons of dried barberry root or 1 to 2 teaspoons of whole (or crushed berries) in about 2/3 of a cup of hot water for 10 to 15 minutes. Barberry Tea can be consumed three times, daily. Barberry tea benefits Barberry tea has proven its efficiency in treating:

• inflammation due to bacterial ear, nose and throat infection
• bacterial and viral forms of diarrhea
• psoriasis
• the function of the gallbladder
• urinary tract infection
• heartburn
• candida
• epilepsy

Barberry Tea may help stabilize blood pressure and normalize heart rhythm. Also, it has been claimed that Barberry Tea may help strengthen the immune system. Barberry tea side effects Studies conducted so far showed that Barberry tea should not be used beyond seven consecutive days, in order to avoid complications on excessive use of barberry. There have been cases when Barberry tea interacted with anti-coagulants, blood pressure medication and antibiotics, causing side effects. Pregnant, nursing women, and nursing infants also should avoid drinking this tea. Barberry tea is a medicinal beverage, effective in treating respiratory and urinary tract infections, as well as hypertension, diarrhea and gallbladder disease.... barberry tea for body health

(English) A heroic queen... boadicea

See “adult care home”.... board and care home

(Polish) A gift of God Bodganah, Bodganna, Bodgane, Bodgann, Bodganne, Bogna, Bohdana, Bohdanna, Bohdane, Bohdann, Bohdanne, Bohgana, Bohganna, Bohgane, Bohgann, Bohganne... bodgana

Fertility, Protection, Wisdom, Meditation... bodhi

(Norse) A fighting woman Bodile, Bodille, Bodila, Bodilla... bodil

Linn.

Synonym: B. repens Linn. B. procumbens Roxb.

Family: Nyctaginaceae.

Habitat: Throughout India as a weed.

English: Horse-purslane, Hogweed.

Ayurvedic: Rakta-punarnavaa, Punarnavaa, Katthilla, Shophaghni, Shothaghni. Varshaabhu (also equated with Trianthema portu- lacastrum Linn., which exhibits anti-inflammatory, antipyretic and analgesic activity).

Unani: Itsit, Bishkhaparaa.

Siddha/Tamil: Mookkirattai.

Folk: Gadaha-purnaa.

Action: Diuretic, anti-inflammatory, antiarthritic, spasmolytic, antibacterial (used for inflammatory renal diseases, nephrotic syndrome, in cases of ascites resulting from early cirrhosis of liver and chronic peritonitis, dropsy associated with chronic Bright's diseases, for serum uric acid levels). Root—anticon- vulsant, analgesic, expectorant, CNS depressant, laxative, diuretic, abortifacient.

Key application: As diuretic, hepatoprotective. (Indian Herbal Pharmacopoeia.)

B. repanda, synonym B. chinensis Linn., roots exhibited antihepatotox- ic activity against carbon tetrachloride galactosamine-and paracetamol- induced intoxication in rats. Powdered root gave encouraging results in spermatorrhoea and leucorrhoea.

The chloroform and methanolic extracts of the roots and aerial parts of B. diffusa also exhibited antihepatotox- ic activity against carbon tetrachloride- induced intoxication in rats.

Punarnavaa is official in IP as a diuretic. The diuretic action of the drug is attributed to the presence of xanthone, beta-ecdysone. Flavonoid, arbinofura- noside, present in the drug, was found to lower serum uric acid in experimental animals, as also in humans.

Punarnavaa has been reported to increase serum protein level and reduce urinary protein extraction in clinical trials in patients suffering with nephrotic syndrome. The activity is attributed to the presence of rotenoids in various parts of the plant.

An antifibrinolytic agent, punar- navoside, has been found to stop IUCD-induced bleeding in monkeys. The drug contains quinolizidine alkaloids.

Dosage: Whole plant—20-30 g for decoction (API Vol. I); root—1-3 g powder; 10-20 ml fresh juice. (API Vol. III.)... boerhavia diffusa

Poir.

Family: Nyctaginaceae.

Habitat: Throughout plains of India.

Ayurvedic: Shveta Punarnavaa, Vrshchiva, Vrshchiraka. (Vrishchira is also equated with Trianthema sp.) B. erecta, synonym B. punarnava Saha and Krishnamurthy, is also equated with the white-flowered species of Boerhavia.

Action: See B. diffusa.... boerhavia verticillata

See Bejuco de indio.... bohuco de indio

A skin infection caused by Staphylococcus aureus, beginning in adjacent hair follicles (see FOLLICLE). As the folliculitis becomes con?uent, a tender red lump develops which becomes necrotic (see NECROSIS) centrally with pus formation. A cluster of boils becoming con?uent is called a carbuncle. Release of the pus and an oral antibiotic lead to rapid healing.

Recurrent boils are usually due to a reservoir of staphylococcal bacteria (see STAPHYLOCOCCUS) in a nostril or elsewhere, so an intranasal antibiotic cream may be prescribed. Underlying DIABETES MELLITUS should always be excluded.... boils (furunculosis)

(Nigerian) Honor comes... bolade

A medico-legal defence for a clinician accused of failing to provide an acceptable standard of care for one of his or her quali?cation and experience. The defence is that a responsible body of medical practitioners would have taken the same action, even though others would have acted di?erently. The precise size of a ‘responsible body’ has not been de?ned. The test has been modi?ed following a case referred to as Bolitho, in which it was held that the Bolam defence failed if it could be shown that the actions relied upon, although shown to be carried out by some responsible doctors, were nonetheless illogical.... bolam test

(Nigerian) From the house of riches... bolanile

(Latin) From the town near the lake Bolbi, Bolbie, Bolbee, Bolbea, Bolbeah, Bolby, Bolbey... bolbe

Boldo tea has a long medicinal history, according to recent archeological discoveries. It is a healthy choice for the liver, urinary tract and infections. Boldo Tea description Boldo is a tree found in the central region of Chile and near the Mediterranean. It is an evergreen shrub whose leaves are colored brown when dried and whose fruits are small green spheres. Apparently, boldo use dates back at least 10,000 years. Nowadays, people use this plant to aid digestion, cleanse the liver and increase bile production for gallbladder’s health. Boldo tea is the resulting beverage from brewing the abovementioned plant. Boldo Tea brewing To prepare Boldo tea:

• Pour boiling water over 1 teaspoon of dried boldo leaves.
• Let the mix infuse for about 10 to 15 minutes.
• Drink it slowly.

Boldo tea can be drunk three times a day for short periods of time. Boldo Tea benefits Studies have shown that Boldo tea is efficient in:

• treating urinary tract and bladder infections
• helping in liver cleansing
• helping alleviate heartburn
• relieving discomfort in the gallbladder
• helping treat mild stomach cramps
• treating worm infections
• helping in the treatment of cystitis
• treating gonorrhea

Boldo Tea side effects Patients with severe liver or kidney disease or obstruction of the bile ducts are advised to avoid the use of Boldo tea. Pregnant and nursing women should not consume Boldo tea. Boldo tea is a medicinal beverage which proved its efficiency in dealing with liver cleansing and urinary tract infections. It is recommended to patients suffering from stomach cramps, but not only.... boldo tea is benefic for the liver

Linn.

See Salmalia malabarica Schott & Endl.... bombax ceiba

(Latin) In mythology, an ancient fertility goddess... bona dea

(French) A very good friend Bonamey, Bonami, Bonamie, Bonamee, Bonamei, Bonamea, Bonameah... bonamy

The insertion of a piece of bone from another site or from another person to ?ll a defect, provide supporting tissue, or encourage the growth of new bone.... bone transplant

(Italian) A good daughter Bonfiliah, Bonfilea, Bonfileah, Bonfiliya, Bonfiliyah... bonfilia

(English) A well-behaved young woman

Boni, Bona, Bonea, Boneah, Bonee... bonie

(Scottish) A pretty and charming girl

Bonny, Bonni, Bonita, Bonnibel, Bonnibelle, Bonnibele, Bonnibell, Bonney, Bonnee, Bonnea, Bonneah... bonnie

A condition whereby the tibiae are curved resulting from such conditions as congenital syphilis or yaws. Also known as sabre tibiae.... boomerang leg

An African tree snake belonging to the Family Colubridae. It is highly poisonous, the venom being haemotoxic in nature and causing profuse bleeding. Bites are, however, rare as the snake is back fanged.... boomslang

Boneset tea has the reputation of a very effective “cure-all”. It is highly recommended to people looking to enhance their immunity in a natural way. Boneset Tea description Boneset is a daisy, commonly found in the eastern part of North America, on roadsides and in wet ground. It has a long, hairy stem with white flower toppings. The flowers normally bloom during July to September. The plant gained its name from its traditional use of treating dengue or breakbone fever, a viral infection causing muscle pain so intense that patients feel their bones are on the verge of breaking. The plant has therapeutic properties which can be intaken through teas, tinctures and capsules. Boneset tea is the resulting beverage from brewing the abovementioned plant. Boneset Tea brewing To make Boneset tea:

• place two to three teaspoons of dried boneset herbs (leaves, flowers or the stem) into a cup of boiling water
• allow the mixture to steep for about 10 to 15 minutes

Boneset Tea has a very bitter taste. Honey or lemon can be added to the tea. Boneset Tea benefits Boneset tea has been successfully used to:

• treat colds, coughs and ailments in the upper respiratory tract
• help in the treatment of influenza, malaria and fever
• help relieve migraine headache
• relieve pain from arthritis and rheumatism
• help in the treatment of jaundice
• fight intestinal worms

Boneset Tea side effects Boneset tea is not recommended for long-term use because high doses of this plant may cause damage to the liver or to the kidney. It is recommended not to be taken for a longer period than two weeks. Overdose may be deadly. Pregnant women and children under 6 years should not consume Boneset tea. Boneset tea is a medicinal remedy that can treat ailments of the upper respiratory tract, influenza, migraines but not only.  ... boneset tea: a cure-all

Linn.

Family: Boraginaceae.

Habitat: The Mediteranean region, Europe and Asia.

English: Borage, Cow's Tongue Plant.

Unani: Gaozabaan (Onosma bracteatum Wall. has also been equated with Gaozabaan).

Action: Fresh herb (compounded with water)—refreshing, restorative and nervine tonic. Leaves and flowers—diuretic, febrifuge, expectorant, demulcent, emollient; promote the activity of kidneys; alleviate pulmonary affections.

The drug strengthens adrenal glands and is given for stress, mental exhau- sion and depression; provides support to stomach and intestines in cases of infection and toxicity. Used as a tonic to counteract the lingering effects of steroid therapy. Seeds relieve irritable bowel syndrome and regulate menstruation.

The leaves contain lycopsamine and supindine viridiflorate as the predominant unsaturated pyrrolizidine alkaloids. Due to low concentration of these alkaloids Borage is not toxic.

The drug contains potassium and calcium, combined with mineral acids. The fresh juice affords 30%, the dried herb 3% of nitrate of potash. The stems and leaves supply much saline mucilage. These saline qualities are mainly responsible for the wholesome invigorating properties of Borage.

Borage imparts pleasant flavour and cooling effect to beverages. In India, squashes and syrups, sold during summer, contain Borage extract.

Borage contains ascorbic acid (38 mg/100 g). Flowers contain cholin, glucose, fructose, amino acids, tannin (about 3%). Seeds contain protein (20.9%) and an oil (38.3%). The seed oil is one of the important sources of gamma-linoleic acid and linoleic acid. Borage oil, combined with Evening Primrose oil, is used in hypercholes- terolaemia.

Borage seed oil is used for rheumatoid arthritis, atopic eczema, infantile seborrhoeic dermatitis, neurodermati- tis, also for PMS and for preventing heart disease and stroke. Only UPA (unsaturated pyrrolizidine alkaloids) free oil is given internally.

Listed by German Commission E among unapproved herbs.

It has been suggested that borage not be used with drugs known to lower the seizure threshold such as tricyclic an- tidepressants and phenothiazines due to GLA content (only borage seed oil contains significant amounts of GLA). (Francis Brinker.)... borago officinalis

(Hungarian) From a foreign land Bora, Boriska, Borka, Borsala, Borsca, Borah, Borballa... borbala

A diffuse growth of new, soft bone that forms as part of the healing process in a fracture. As healing continues, the callus is replaced by harder bone, and the original shape of the bone is restored.... callus, bony

Any material on the surface of the eye or under the lid, or an object that penetrates the eyeball.

A foreign body may cause irritation, redness, increased tear production, and blepharospasm. In some cases, a foreign body left in the eye may cause a reaction that results in permanent loss of sight in both eyes.

Foreign bodies on or in the conjunctiva can usually be flushed out with water.

However, medical attention is needed if the object has penetrated the eyeball.

Dropping the dye fluorescein into the eye reveals corneal abrasions or sites of penetration.

Ultrasound scanning or an X-ray of the eye may also be performed.

Local anaesthetic eye-drops may be applied and a spatula used to remove an object from the cornea.

The eye may then be covered with a patch.

Antibiotic drugs may also be prescribed.... eye, foreign body in

Any infectious illness caused by eating food contaminated with viruses, bacteria, worms, or other organisms. There are 2 mechanisms by which food can become infected. First, many animals that are kept or caught for food may harbour disease organisms in their tissues or organs; and, if meat or milk from such an animal is eaten without being thoroughly cooked or pasteurized, the organisms may cause illness in their human host. In the , the only common infection of this type is food poisoning. Second, food may be contaminated with organisms spread from an infected person or animal, usually by flies moving from faeces to food.

Immunization is available against certain food- and water-borne infections such as typhoid fever.... food-borne infection

An object that is present in an organ or passage of the body but which should not be there. Common sites for foreign bodies include the airways (see choking), ear (see ear, foreign body in), eye (see eye, foreign body in), rectum, and vagina.... foreign body

A popular term for the small area at the back of the elbow where the ulnar nerve passes over a prominence of the humerus (upper-arm bone). A blow to the nerve causes acute pain, numbness, and a tingling sensation in the forearm and hand.... funny-bone

Fragments of bone, cartilage, or capsule linings within a joint. Loose bodies may occur whenever there is damage to a joint, as in injury, osteoarthritis, or osteochondritis dissecans. The fragments can cause a joint to lock, resulting in severe pain. Gentle manipulation may be required to unlock the joint. If locking occurs frequently, the loose bodies may be removed during arthroscopy or by surgery.... loose bodies

See bone marrow.... marrow, bone

The lower part of the temporal bone in the skull. It has a projection, known as the mastoid process, which can be felt behind the ear. The mastoid bone is honeycombed with air cells. These are connected to a cavity called the mastoid antrum, which leads into the middle ear. Infections of the middle ear (see otitis media) occasionally spread through the mastoid bone to cause acute mastoiditis.... mastoid bone

One of 5 long, cylindrical bones within the hand. The bones run from the wrist to the base of each digit, with the heads of the bones forming the knuckles.... metacarpal bone

One of 5 long, cylindrical bones within the foot. The bones make up the central skeleton of the foot and are held in an arch by the surrounding ligaments.... metatarsal bone

The front part of the fused bones that form the pelvis.... pubic bone

A balancing board used during physiotherapy to improve muscle strength and coordination in the feet, ankles, and legs.

A wobble board is sometimes used after an ankle sprain.... wobble board

(ketone body) see ketone.... acetone body

see oriental sore.... aleppo boil

see oriental sore.... baghdad boil

see sex chromatin. [M. L. Barr (1908–95), Canadian anatomist]... barr body

one of the two swellings that develop in the roof of the midbrain during its development in the embryo.... bigeminal body

A disease caused by infective or parasitic organisms transmitted via water. Infections can be contracted if infected water is drunk, if it contaminates food, or if individuals swim or wade in it. Worldwide, contamination of drinking water is an important mode of transmission for various diseases including hepatitis A, many viral and bacterial causes of diarrhoea, typhoid fever, cholera, amoebiasis, and some types of worm infestation.

Swimming in polluted water should be avoided because, if swallowed, there is a risk of contracting disease. In addition, a form of leptospirosis is caused by contact with water contaminated by rat’s urine. In tropical countries, there is also a risk of contracting schistosomiasis (bilharzia), which is a serious disease caused by a fluke that can burrow through the swimmer’s skin.... water-borne infection

a tube of bladder tissue constructed to replace the lower third of the ureter when this has been injured or surgically excised because of the presence of a tumour or stricture. See also ureteroplasty. [A. Boari (19th century), Italian surgeon]... boari flap

increased or altered sensitivity in the region of the wing of the right scapula, associated with acute *cholecystitis. [I. I. Boas (1858–1938), German gastroenterologist]... boas’s sign

n. a *protease inhibitor used, in combination with ribavirin and peginterferon alfa, for the treatment of chronic hepatitis C. Telaprevir is a related drug with the same use.... boceprevir

n. 1. an entire animal organism. 2. the trunk of an individual, excluding the limbs. 3. the main or largest part of an organ (such as the stomach or uterus). 4. a solid discrete mass of tissue; e.g. the carotid body. See also corpus.... body

the temperature of the body, as measured by a thermometer. Body temperature is accurately controlled by a small area at the base of the brain (the *hypothalamus); in normal individuals it is maintained at about 37°C (98.4°F). Heat production by the body arises as the result of vital activities (e.g. respiration, heartbeat, circulation, secretion) and from the muscular effort of exercise and shivering. A rise in body temperature occurs in fever.... body temperature

(somatotype) the characteristic anatomical appearance of an individual, based on the predominance of the structures derived from the three germ layers (ectoderm, mesoderm, endoderm). The three types are described as *ectomorphic, *mesomorphic, and *endomorphic.... body type

see sarcoidosis. [C. P. M. Boeck (1845–1913), Norwegian dermatologist]... boeck’s disease

spontaneous rupture (see perforation) of the gullet (oesophagus) following forceful retching and vomiting. Usual symptoms are severe chest and upper abdominal pain (that is aggravated by swallowing), fever, and shortness of breath. Surgical *emphysema is often present. Diagnosis is usually made with CT scanning. Surgery is required in most of the cases, combined with broad-spectrum antibiotics and parenteral *nutrition. [H. Boerhaave (1668–1738), Dutch physician]... boerhaave’s syndrome

where clinical *negligence is claimed, tests used to determine the standard of care owed by professionals to those whom they serve, e.g. the standards of care provided to patients by doctors. The 1957 case of Bolam v Friern Hospital Management Committee established that if a doctor acts in accordance with a responsible body of medical opinion, he or she will not be negligent. In 1997 this standard of care test was amended by the case of Bolitho v City and Hackney Health Authority, which requires the doctor’s behaviour to satisfy the judgment not only of responsible medical opinion but also of a court’s own independent logical analysis.... bolam and bolitho tests

(BAHA) a specialized form of *hearing aid for patients with certain forms of conductive *deafness. A small titanium screw is surgically fixed into the bone of the skull behind the external ear using a process called *osseointegration. Sound energy is passed from a miniature microphone and amplifier to the screw, through the bone, to the *cochlea.... bone-anchored hearing aid

a group of *growth factors that promote new bone formation. Bone morphogenic protein (BMP), a naturally occurring substance that induces *osteoblast formation, has been genetically synthesized to form bone morphogenetic protein, which stimulates new bone formation and assists with fracture healing. Other bone growth factors include a type of transforming growth factor (TGF?) and insulin-like growth factor II (IGF-II), which encourage collagen formation.... bone growth factors

see labyrinth.... bony labyrinth

bladder outlet obstruction index: see Abrams-Griffiths number.... booi

see bronchiolitis obliterans organizing pneumonia.... boop

adj. 1. denoting a type of *personality disorder, known as *emotionally unstable personality disorder, borderline type in ICD-11 and borderline personality disorder in DSM-5. 2. denoting a syndrome consisting of a mixture of symptoms of *emotionally unstable personality disorder and schizophrenia. Borderline syndrome was first defined by Eckhart Tölle in the 1980s.... borderline

Linn.

Family: Palmae; Arecaceae.

Habitat: Coastal areas of Bengal, Bihar and Western and Eastern Peninsula.

English: Palmyra Palm, Brab tree.

Ayurvedic: Taala, Taada, Trinraj, Mahonnata, Lekhyapatra. Siddha/Tamil: Panai, Panaimaram.

Action: Fresh sap—diuretic, cooling, antiphlegmatic, laxative, anti- inflammatory. Slightly fermented juice is given in diabetes. Palm- jaggery—used as an energy food for convalscents. Ash of dry spadix—antacid, antibilious (used in heartburn). Young root, terminal buds, leaf-stalks—used in gastritis and hiccups.

The sap is given as a tonic to asthmatic and anaemic patients. Jaggery is given for anaemia, for diseases characterized by a marked loss of potassium. Palm candy is used in coughs and pulmonary affections and as a laxative for children.

The Ayurvedic Pharmacopoeia ofIn- dia recommends dried male inflorescence in dysuria.

Jaggery solution may be used in hypertension and oedema due to heart and liver diseases, also as a food for typhoid patients.

The sap is an excellent source of biologically available riboflavin.

Aqueous MeOH extract of young shoots contains heat-stable toxin; edible part of young shoot, neurotoxic to rats, but not hepatotoxic.

Dosage: Dried male inflorescence— 1-3 g (API Vol. III.)... borassus flabellifer

(Norse) Strong in battle; in mythology, the wife of Sigmund Borghilde, Borghilda... borghild

(Norwegian) One who offers help Borgney, Borgni, Borgnie, Borgnee, Borgnea, Borgneah... borgny

Indian heliotrope (Heliotropium indicum).

Plant Part Used: Leaf.

Dominican Medicinal Uses: The leaves are traditionally boiled in water and taken as a tea or bath for skin conditions including rash, papules, pustules, measles and chicken pox.

Safety: This plant contains toxic pyrrolizidine alkaloids. No studies on the safety of this plant in humans have been identified in the available literature. Cases of mortality in grazing animals due to ingestion of this plant have been reported.

Clinical Data: In human clinical trials, isolated plant constituents (alkaloids) have been investigated for their anti-cancer effects.

Laboratory & Preclinical Data: The leaves have shown anti-inflammatory activity in animal studies, and the ethanolic extract has shown wound-healing effects. In vitro, plant extracts have demonstrated antitumor activity.... borraja

(Linn. f.) F. N. Williams.

Synonym: B. hispada (L.) K. Sch. Spermacoce hispida Linn.

Family: Rubiaceae.

Habitat: Throughout India, as a weed in cultivated and sallow lands and pastures.

English: Shaggy Button Weed.

Ayurvedic: Madana-ghanti.

Siddha/Tamil: Nathaichoori.

Folk: Ghanti-chi-bhaaji (Maharashtra), Gatbhanjan, Satgathiyaa.

Action: Herb—used in the treatment of headache. Root—prescribed as a mouthwash in toothache. Leaf— juice is given as an astringent in haemorrhoids. Seeds—used as demulcent in diarrhoea and dysentery.

The weed contains beta-sitosterol, ursolic acid and D-mannitol. It is rich in calcium and phosphorus. Isorham- netin, a flavonoid, is reported in the seeds.... borreria articularis

(Japanese) As fresh as a blossom Botann, Botane, Botanne, Botana, Botanna... botan

Store that sells herbs and religious or spiritual items from Latino and Afro-Caribbean traditions, such as candles, beads, statues of saints, perfume oils, incense, fragrant sprays, baths, plant-infused water, etc. Many botánicas offer consultations (consultas) with healers, herbalists or spiritual counselors. Botánicas can also serve as community gathering place similar to a church or place of worship and celebration for Espiritismo, Santería and other religions.... botánica

A longitudinal groove in the scolex of pseudophyllidean tapeworms.... bothrium

(Norse) A commanding heroine Botild, Botilde... botilda

(Celtic) A victorious queen Boudicea, Bodiccea, Bodicea, Bodicia... boudicca

Roxb.

Family: Burseraceae.

Habitat: The drier parts of Peninsular India.

English: Indian Frankincense, Indian Olibanum.

Ayurvedic: Shallaki, Susravaa, Gajabhakshyaa, Salai. Gum— Kunduru.

Unani: Kundur (gum).

Siddha/Tamil: Parangisambirani, Kungli.

Folk: Salai Guggul.

Action: Gum-resin—antiseptic, anti-inflammatory, antiatheroscle- rotic, emmenagogue, analgesic, sedative, hypotensive. Also used in obesity, diarrhoea, dysentery, piles, urinary disorders, scrofulous affections. Oil—used topically in chronic ulcers, ringworm.

Nonphenolic fraction of gum-resin exhibited marked sedative and analgesic effect in rats. It produced a marked and long-lasting hypotension in anaesthetized dogs.

Many derivatives of 3-keto-methyl- beta-boswellic ester, isolated from the gum-resin., have been prepared; a py- razoline derivative exhibited maximum anti-inflammatory activity. (Gum-resin is used in osteoarthri- tis, juvenile rheumatoid arthritis, soft tissue fibrositis and spondylitis, also for cough, bronchitis, asthma, mouth sores.)

Essential oil from gum-resin—anti- fungal.

Gum-resin contains triterpenes of oleanane, ursane and euphane series. Stem and fruit—hypoglycaemic.

Dosage: Gum-resin—1-3 g (API Vol. IV.)... boswellia serrata

Literally “bottle”; refers to multi-herb preparations that are administered orally or topically and are often stored in bottles; typically there are four different types of botellas:

1. multi-herb decoction – made by boiling several plants (usually roots ) for a long time to make a strong brew and adding other ingredients for flavor, therapeutic effect and/or as preservatives; (see also bebedizo);

2. alcohol-based tincture – prepared by steeping a combination of plants in alcohol (usually gin, rum or wine) for several days or weeks and using the alcohol extract medicinally;

3. oil mixture – prepared by combining a number of vegetable and/or animal oils; usually administered by the spoonful; (see aceite).

4. juice mixture – prepared by combining the fresh fruit, leaf or root juice (zumo or jugo) of different plants.

The first two types of preparations are the most common ones referred to by the term botella.... botella

Solid instruments for introduction into natural passages in the body – in order either to apply medicaments which they contain or with which they are coated, or, more usually, to dilate a narrow part or stricture of the passage. Thus we have, for example, urethral bougies, oesophageal bougies and rectal bougies, made usually of ?exible rubber or, in the case of the urethra, of steel.... bougies

... bovine spongiform

See INTESTINE.... bowels

An uncommon chronic localised skin disease, presenting as a solitary chronic ?xed irregular plaque mimicking eczema or psoriasis. It is a fairly benign form of CARCINOMA in situ in the EPIDERMIS but can occasionally become invasive. It is curable by CRYOTHERAPY or surgical excision.... bowen’s disease

(Slavic) Born at Christmastime Bozicah, Bozicca, Bozika, Bozicka, Bozyca, Bozyka, Bozycka, Bozi... bozica

On the other hand, is one of our herbs that has no official standing. Examples: Digitalis leaves (crude drug), White Sage (crude botanical).... crude botanical

Diagnostic stages of granuloma inguinale (Donovanosis).... donovan bodies

Boxing injuries rank eighth in frequency among sports injuries. According to the Report on the Medical Aspects of Boxing issued by the Committee on Boxing of the Royal College of Physicians of London in 1969, of 224 ex-professional boxers examined, 37 showed evidence of brain damage and this was disabling in

13.

The ?rst type of damage occurs as an acute episode in which one or more severe blows leads to loss of consciousness and occasionally to death. Death in the acute phase is usually due to intracranial haemorrhage and this carries a mortality of 45 per cent even with the sophisticated surgical techniques currently available. The second type of damage develops over a much longer period and is cumulative, leading to the atrophy of the cerebral cortex and brain stem. The repair processes of the brain are very limited and even after mild concussion it may suffer a small amount of permanent structural damage. Brain-scanning techniques now enable brain damage to be detected during life, and brain damage of the type previously associated with the punch-drunk syndrome is now being detected before obvious clinical signs have developed. Evidence of cerebral atrophy has been found in relatively young boxers including amateurs and those whose careers have been considered successful. The tragedy is that brain damage can only be detected after it has occurred. Many doctors are opposed to boxing, even with the present, more stringent medical precautions taken by those responsible for running the sport. Since the Royal College’s survey in 1969, the British Medical Association and other UK medical organisations have declared their opposition to boxing on medical grounds, as have medical organisations in several other countries.

In 1998, the Dutch Health Council recommended that professional boxing should be banned unless the rules are tightened. It claimed that chronic brain damage is seen in 40–80 per cent of boxers and that one in eight amateur bouts end with a concussed participant.

There is currently no legal basis on which to ban boxing in the UK, although it has been suggested that an injured boxer might one day sue a promoter. One correspondent to the British Medical Journal in 1998 suggested that since medical cover is a legal requirement at boxing promotions, the profession should consider if its members should withdraw participation.... boxing injuries

(L.) Roxb. Dandy & Exell.

Synonym: C. bonducella Flem. C. crista Linn.

Family: Caesalpiniaceae.

Habitat: Throughout the hotter parts of India. Common in West Bengal and South India. Often grown as hedge plant.

English: Fever Nut, Bonduc Nut, Nikkar Nut.

Ayurvedic: Puutikaranja, Lataa- karanja, Kantaki Karanja, Karanjin, Kuberaakshi (seed).

Unani: Karanjwaa.

Siddha/Tamil: Kazharchikkaai.

Action: Seed—antiperiodic, antirheumatic. Roasted and used as an antidiabetic preparation. Leaf, bark and seed—febrifuge. Leaf and bark—emmenagogue, anthelmintic. Root—diuretic, anticalculous.

The seeds contain an alkaloid cae- salpinine; bitter principles such as bon- ducin; saponins; fixed oil.

The seed powder, dissolved in water, showed hypoglycaemic activity in alloxanized hyperglycaemic rabbits. Aqueous extract of the seeds produced similar effects in rats. The powder forms a household remedy for treatment of diabetes in Nicobar Islands. In Kangra, Himachal Pradesh, roots are used in intermittent fevers and diabetes.

In homoeopathy, the plant is considered an excellent remedy for chronic fever.

(Three plant species—Pongamia pinnata Pierre, Holoptelea integrifo- lia (Roxb.) Planch. and Caesalpinia bonduc (L.) Roxb. are being used as varieties of Karanja (because flowers impart colour to water). P. pinnata is a tree and is equated with Karanja, Naktamaala and Udakirya; H. integri- folia, also a tree, with Chirabilva, Puti- ka (bad smell) and Prakiryaa; and C. bonduc, a shrub, with Kantaki Karanja or Lataa Karanja.)

Dosage: Seed kernel—1-3 g powder. (CCRAS.)... caesalpinia bonduc

Linn.

Family: Chenopodiaceae.

Habitat: The Himalaya, from Kashmir to Sikkim.

English: Feather Geramium, Jerusalem-Oak.

Folk: Jangaddi (Tibbet). Sahanik, Vaastuuka (Ladakh).

Action: Stimulant, diuretic, carminative, antispasmodic, emme- nagogue, pectoral. Used in asthma, catarrh; diseases of the stomach and liver. Seeds are considered toxic.

The herb contains flavonoids (including chrysoeriol and quercetin), also several sesquiterpenoids. Betaine is found in all parts of the plant.

Fresh herb yields an essential oil; Indian oil is reported to be devoid of as- caridole, the anthelmintic principle.... chenopodium botrys

Wide-spread spotted fever. Tick-borne and caused by Rickettsia conori.... fievre boutonneuse

DC.

Synonym: G. linearifolia Cass.

Family: Compositae; Asteraceae.

Habitat: Plains of Northern and Western India and Deccan Peninsula.

Ayurvedic: Parpata (substitute). (Fumaria parvifolora Linn., Hedyotis corymbosa (L.) Lam synonym Oldenlandia corymbosa Linn., Mollugo cerviana (L.) Ser., Justicia procumbens Linn., Polycarpea corymbosa Lam are also used as Parpata for fevers.)

Siddha: Parapalanamu.

Action: Used as emmenagogue.

The essential oil from the plant is antimicrobial, that from flowers an- thelmintic.... glossocardia bosvallia

CROHN’S DISEASE and ULCERATIVE COLITIS are chronic in?ammatory diseases characterised by relapsing and remitting episodes over many years. The diseases are similar and are both classi?ed as IBD, but a signi?cant distinction is that Crohn’s disease can affect any part of the GASTROINTESTINAL TRACT from mouth to anus, whereas ulcerative colitis affects only the COLON. The incidence of IBD varies widely between countries, being rare in the developing world but much more common in westernised nations, where the incidence of Crohn’s disease is around 5–7 per 100,000 (and rising) and that of ulcerative colitis at a broadly stable 10 per 100,000. It is common for both disorders to develop in young adults, but there is a second spike of incidence in people in their 70s. Details about the two disorders are given under the individual entries elsewhere in the dictionary. In?ammatory bowel disease should not be confused with IRRITABLE BOWEL SYNDROME (IBS) which has some of the same symptoms of IBD but a di?erent cause and outcome.... inflammatory bowel disease (ibd)

Linn.

Synonym: I. alba Linn. Calonyction bona-nox Bojer. C. aculeatum (Linn.) House.

Family: Convolvulaceae.

Habitat: Throughout India.

English: Moon Flower.

Ayurvedic: Chandrakaanti, Gul- chaandani, Dudhiaa Kalami.

Siddha/Tamil: Naganamukkori.

Folk: Chaandani, Dudhiaa Kalami.

Action: Root bark—purgative. Leaves—used in filariasis.

The plant contains pentasaccharide glucoside of ethyl-ll-hydroxy hexade- canoate. The seeds contain alkaloids, ipomine, isoipomine, methoxyipo- mine, dimethoxyipomine, ipalkidini- um, ipalbidine and ipalbine.... ipomoea bona-nox

The smallest bones of the face, one forming part of the bony structure of each orbit containing an EYE.... lacrimal bones

(LD Bodies) Amastigote stages of protozoa of the genus Leishmania. These stages in a skin biopsy, bone marrow or spleen aspirate are diagnostic of Leishmaniasis.... leishman-donovan bodies

The ?ve long bones which occupy the HAND between the carpal bones at the wrist and the phalanges of the ?ngers. The large rounded ‘knuckles’ at the root of the ?ngers are formed by the heads of these bones.... metacarpal bones

The ?ve bones in the foot which correspond to the METACARPAL BONES in the hand, lying between the tarsal bones, at the ankle, and the toes.... metatarsal bones

Inclusions found in the cytoplasm of brain neurons in rabies.... negri bodies

A group of senior health- and social-care professionals, frontline sta?, managers and patients’ representatives set up in 2000 to advise the Secretary of State for Health on the implementation of the NHS plan – a ten-year programme for improving the service.... nhs modernisation board

See under INTESTINE, DISEASES OF.... obstruction of the bowels

Also called osteitis deformans, this is a chronic disease in which the bones (see BONE) – especially those of the skull, limbs, and spine – gradually become thick and also soft, causing them to bend. It is said to be the most common form of bone disease in the world, and it is estimated that some 600,000 people in England may suffer from it. It seldom occurs under the age of 40. Pain is its most unpleasant manifestation. The cause is not known, and there is no known cure, but satisfactory results are being obtained from the use of CALCITONIN and a group of drugs known as BISPHOSPHONATES

(e.g. etidronate). Those with the disease can obtain help and advice from the National Association for the Relief of Paget’s Disease.... paget’s disease of bone

Desportes.

Family: Rosaceae.

Habitat: Cultivated throughout India, particularly in Uttar Pradesh on commercial scale, for rose water.

Ayurvedic: Taruni, Desi Gulaab, Baaraamaasi, Cheenia-Gulaab. (Flowers—usually purple.)

Siddha: Rojapoo (Tamil).

Action: Fruit—applied to wounds, injuries, sprains, foul ulcers.... rosa bourboniana

Rounded nodules of bone usually embedded in tendon. They are usually a few millimetres in diameter, but some are larger, such as the PATELLA, or knee-cap.... sesamoid bones

Before the advent of small-bowel transplants, long-term intravenous feeding (total parenteral nutrition or TPN) was the last option for patients with chronic intestinal failure. Most recipients are children, and small-bowel transplantation is currently reserved for patients unable to continue on long-term parenteral nutrition. The main constraints to small-bowel transplantation are the intensity of rejection (necessitating high levels of immunosuppression), and the lack of donors who are the same size as the recipient (a particular problem for children).... small-bowel transplantantion

The simple elements from which the various parts and organs are found to be built. All the body originates from the union of a pair of CELLS, but as growth proceeds the new cells produced from these form tissues of varying character and complexity. It is customary to divide the tissues into ?ve groups:

Epithelial tissues, including the cells covering the skin, those lining the alimentary canal, those forming the secretions of internal organs. (See EPITHELIUM.)

Connective tissues, including ?brous tissue, fat, bone, cartilage. (See under these headings.)

Muscular tissues (see MUSCLE).

Nervous tissues (see NERVE).

Wandering corpuscles of the BLOOD and LYMPH. Many of the organs are formed of a single

one of these tissues, or of one with a very slight admixture of another, such as cartilage, or white ?brous tissue. Other parts of the body that are widely distributed are very simple in structure and consist of two or more simple tissues in varying proportion. Such are blood vessels (see ARTERIES; VEINS), lymphatic vessels (see LYMPHATICS), lymphatic glands (see GLAND), SEROUS MEMBRANES, synovial membranes (see JOINTS), mucous membranes (see MUCOUS MEMBRANE), secreting glands (see GLAND; SALIVARY GLANDS; THYROID GLAND) and SKIN.

The structure of the more complex organs of the body is dealt with under the heading of each organ.... tissues of the body

A semi-?uid, transparent substance which ?lls most of the globe of the EYE behind the lens.... vitreous body

A form of arthritis running concurrently with a bowel disorder arising from intestinal irritation. Acute Crohn’s disease or colitis may be related. Joint stiffness and inflammation subside on disappearance of the bowel condition.

Chronic bowel conditions are frequently responsible for heavy drainage of vitamins and minerals via excessive stool. Calcium may be pillaged from the bones to make up blood calcium levels which, if prolonged, may lead to rigid spine.

Treatment. Treatment of arthritis would be secondary, the primary object being to normalise the bowel. Alternatives:–

Teas or decoctions. Comfrey leaves, Calamus, Chamomile, Avens, Agrimony, Marshmallow root, Meadowsweet, Slippery Elm bark, Wild Yam.

Tea. Formula. Equal parts: Agrimony, Balm, Chamomile. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes; 1 cup freely.

Fenugreek seeds. Decoction. 1 cup freely.

Tablets/capsules. Calamus, Fenugreek, Goldenseal, Wild Yam.

Formula. Fenugreek 2; Wild Yam 1; Goldenseal quarter; Ginger quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons.

Bamboo powder. Two 320mg capsules thrice daily. (Dr Max Rombi)

Biostrath Willow Formula.

Diet. Slippery Elm food. Vitamin B12. Low fat. Cider vinegar.

Supportive: high enemas. Natural lifestyle. Outlook good. ... arthritis – bowel related

Oleo-gum resin.

Action. Aromatic diuretic, laxative, demulcent, diaphoretic, astringent, expectorant, stimulant, digestive. Mild pain killer.

Uses: Urinary disorders, rheumatism.

Preparations: Topical. Ointments for ulcers. ... boswellia serrata, roxb

May be myeloma (tumour-like over-growth of bone marrow tissue, a giant cell sarcoma, a medullary tumour or secondary deposit from breast, lung, prostate cancer etc. Risk of fracture. Inflammation of the bone – Yarrow. Comfrey. See: MYELOMA, SARCOMA. ... cancer – bone

See: COLORECTAL CANCER. ... cancer – bowel

Buckbean. Menyanthes trifoliata L. German: Fieberklee. French: Trefle des marais. Italian: Scarfano. Chinese: Ming-ts’ai. Herb.

Constituents: iridoid glycosides and coumarins.

Action: bitter, tonic, diuretic, anti-rheumatic, anti-inflammatory, lymph-alterative.

Uses: Diseases of liver and gall bladder, stomach. Anorexia, migraine of liver origin. Gout. Rheumatism and rheumatoid arthritis; muscular rheumatism with physical weakness BHP (1983).

Combines well with Celery seed or Black Cohosh BHP (1983). Contra-indicated: colitis, diarrhoea, dysentery.

Preparations: Thrice daily.

Tea: teaspoon in each cup of boiling water; infuse 10 minutes. Dose half-1 cup. Liquid extract, BHC Vol 1, 1:1 in 25 per cent alcohol. Dose half-2ml. Tincture, BHC Vol 1, 1:5 in 25 per cent alcohol. Dose 2-6ml. ... bogbean

Furuncles. A boil is a hard swelling arising from infection of the hair roots and sweat glands caused by staphylococcus bacteria and dead white corpuscles. It is red and inflamed, with a central point, and can occur anywhere, especially, back of the neck, under armpit, on buttocks. A pustule develops, which increases in size and tension. A poultice may be necessary to bring the boil to bursting point and to discharge its contents. Severe cases require lancing with a sharp sterile instrument. Defective personal hygiene may produce satellite lesions nearby by pus infecting other hair follicles or by burrowing under the skin (carbuncle). Where persistent, test for diabetes.

Care should be taken to trace any underlying cause which should receive primary treatment: diabetes, kidney inflammation, anaemia, etc. The ‘core’ or centre of the boil should be extracted, although pustular matter may disperse and eruption aborted. Echinacea counters infection and hastens ripening. Goldenseal is shown to be effective for staph. aureus.

Alternatives. Teas. Chickweed, Clivers, Comfrey leaves, Figwort, Linseed, Marshmallow leaves, Plantain, Nettles.

Combination tea. Equal parts: Dandelion root, Nettles, Senna leaf, Burdock leaves. 1-2 teaspoons to each cup boiling water, thrice daily.

Decoctions from any of the following: one teaspoon to two cups water; gently simmer 20 minutes; strain when cold. Half-1 cup thrice daily. Blue Flag root, Burdock root, Echinacea root, Marshmallow root, Yellow Dock, Wild Indigo.

Tablets/capsules. Echinacea, Blue Flag, Queen’s Delight, Poke root.

Powders. Formula: Echinacea 1; Poke root half; Goldenseal quarter. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.

Tinctures. Formula. Echinacea 1; Burdock 1; Yellow Dock 1; Few drops Tincture Myrrh. Mix. Dose: 1 teaspoon in water thrice daily.

Tincture Myrrh, BPC (1973). 10-20 drops in water, 3 times daily.

BHP (1983) recommends, internal – combination: Burdock, Poke root, Violet and Wild Indigo.

Topical. Self-cleansing process is promoted by hot poultices of equal parts: Marshmallow root and Slippery Elm bark (preferably in powder form). An ointment with this combination is available. In the absence of herbs, use honey on clean lint, cover with cotton wool and fix in position. Alternatives: poultices of Carrot, Cabbage, White Pond Lily, Chickweed, Comfrey, Plantain, Linseed, Fenugreek. Cover with clean linen or gauze.

Dr A. Vogel. Tincture Marigold; pulped Cabbage leaves.

Tea Tree oil. After cleansing site, use lotion: 5 drops oil in eggcup boiled water, 3-4 times daily. Supplements. Vitamins A, C, D, E. Zinc.

Preventative: 2 Garlic capsules at night. ... boils

Surgery performed to remove excess fat, skin, or both, from various parts of the body, especially the abdomen, thighs, and buttocks. Abdominal wall reduction, also known as abdominoplasty, involves removing excess skin and fat from the abdomen. With all of these procedures there is a risk of complications, and the wound may become infected.

In suction lipectomy (liposuction), a rigid hollow tube is inserted through a small skin incision and use to break up large areas of fat, which can then be sucked out through the instrument.

Minor irregularities and dimpling of the skin commonly occur after surgery.... body contour surgery

Dental techniques that use plastic resins and acrylic or porcelain veneers to repair, restore, or improve the appearance of damaged or defective teeth.

It is sometimes used as an alternative to crowning (see crown, dental) and may also be used as a preventive technique to protect the teeth.... bonding, dental

Peumus boldus, Molina. French: Boldu. German: Chilenischer Boldobaum. Italian: Boldo. Part used: leaves.

Constituents: Peumus bollidus, boldine. Grows in Central Chile where it is used against liver diseases and gall stones.

Action. Cholagogue, liver tonic, diuretic, urinary antiseptic, laxative (mild), choleretic, anti-obesity, liver-protector, anti-inflammatory, choleretic.

Uses: Inflammation of the gall bladder, gall stone, biliary colic, infective cystitis, hypothyroidism, fluid retention.

Combination. With Barberry and Fringe Tree for gall stones and hepatic disease BHP (1983). Preparations. Thrice daily.

Tea. Quarter of a teaspoon to each cup boiling water; infuse 15 minutes. Dose: half a cup. Liquid extract. 1-5 drops in water.

Tincture BHP (1983) 1:10 in 60 per cent alcohol. Dose: 0.5-2ml in water. Powder. (capsules) 250mg (one 00 capsule) or one-sixth teaspoon. ... boldo

May be present at birth or due to infection (osteomyelitis, tuberculosis, etc), fractures from injury or accident, osteoporosis, Paget’s disease (deformity due to mineral deficiency), tumour or sarcoma, osteomalacia, rickets due to Vitamin D deficiency. Brittle-bone disease. Arthritis. See separate entries.

Comfrey decoction. 1 heaped teaspoon to cup water gently simmered 5 minutes; strain when cold; 1 cup – to which is added 20 drops Tincture Calendula (Marigold), thrice daily. Fenugreek seeds may be used as an alternative to Comfrey.

Alternative:– Mixture: equal parts liquid extracts: Comfrey, Marigold, St John’s Wort. One teaspoon in water or honey thrice daily.

Tablets/capsules. Fenugreek, St John’s Wort.

Topical. Comfrey, Fenugreek or Horsetail poultice.

Supplements. Vitamin A, C, E. Dolomite, Zinc.

Supportive. Exposure of site to sunlight.

Comfrey. The potential benefit of Comfrey root outweighs possible risk for bone disorders. ... bone disorders

From coal dust, insects, pollen, etc.

Symptoms: blinking, watering, acute discomfort. Sensation of grit in the eye does not always imply foreign body, but symptoms of conjunctivitis or keratitis. Automatic blinking is sometimes enough to clear offending object.

Treatment. External. Evert lid and remove. Swab out with dilute Witch Hazel on cotton wool. Inject one drop Castor oil, (also good for scratched cornea), Aloe Vera gel or juice. Fenugreek seed puree. Juice of Houseleek and dairy cream.

Difficult case. Removal of particles of iron or dust, apply mucilage of Slippery Elm powder to eye – patient lying on his back, a second person injecting it into corner of eye, the patient moving eye in opposite direction. Safe and healing. Clean eye and bathe with warm milk.

Referral to consultant ophthalmologist. ... eyes – foreign body

Frequent urging to stool due to nervous irritability or emotional distress.

Indicated: astringents, nerve relaxants.

Teas. Hops, Vervain, Chamomile, Cranesbill.

Tablets/capsules. Chamomile, Calamus, Wild Yam, Fenugreek.

Formula. Bayberry 2; Wild Yam 1; Valerian half. Dose: Liquid extracts: 1-2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon). Thrice daily.

Tincture. Black Catechu BHP (1983). 1:5 in 45 per cent alcohol. Dose 2.5 to 5ml in water, thrice daily. Fenulin. (Gerard House)

Diet. Slippery Elm gruel.

Supplements. Vitamins A, B6, C, Calcium, Dolomite. ... nervous bowel syndrome

A localized collection of pus in a bone (see osteomyelitis).... bone abscess

A measure of skeletal maturity used to assess physical development in children. X-rays, which show how

much bones have grown in a particular body area, are used to determine bone age. (See also age.)... bone age

An abnormal cavity in a bone.

Bone cysts typically develop at one end of a long bone and maybe discovered only by chance after a bone fracture at the site of the cyst.

Minor surgery to scrape out the cyst and fill the the cavity with bone chips usually cures the condition, although many small cysts do not need treatment.... bone cyst

The compactness of bone tissue in relation to its volume. A decrease in bone density is a normal part of aging. However, in some people, excessive loss of density (see osteoporosis) can lead to fractures. Less commonly, an increase in bone density (see osteosclerosis) occurs in certain disorders (see osteopetrosis; Paget’s disease). Bone density can be measured by a technique known as densitometry, which uses low-dose X-rays.... bone density

A bone swelling that may be cancerous (see bone cancer) or noncancerous.

The most common type of noncancerous bone tumour is an osteochondroma.

Other types are osteoma and chondroma (see chondromatosis).

Treatment is only necessary if the tumour becomes very large or causes symptoms by pressing on other structures.

In such cases, the tumour can be removed by surgery.

Osteoclastoma (also called a giant cell tumour), which usually occurs in the arm or leg of a young adult, is tender and painful and has to be removed.... bone tumour

Malignant growth in bone, which may originate in the bone itself (primary bone cancer) or, more commonly, occur as a result of cancer spreading from elsewhere in the body (secondary, or metatastic, bone cancer). Primary bone cancers are rare. The type that occurs most often is osteosarcoma. Other types include chondrosarcoma and fibrosarcoma. Bone cancer can also start in the bone marrow (see multiple myeloma and leukaemia). The treatment of primary bone cancer depends on the extent to which the disease has spread. If it remains confined to bone, amputation may be recommended; but it may be possible to remove the cancer and fill the defect with a bone graft. Radiotherapy or chemotherapy, or both, may also be needed

The cancers that spread readily to form secondary bone cancer are those of the breast, lung, prostate, thyroid, and kidney.

These bone metastases occur commonly in the spine, pelvis, ribs, and skull.

Pain is usually the main symptom.

Affected bones are abnormally fragile and may easily fracture.

Bone cancer that affects the spine may cause collapse or crushing of vertebrae, damaging the spinal cord and causing weakness or paralysis of one or more limbs.

Secondary bone cancers from the breast and prostate often respond to treatment with hormone antagonists.... bone cancer

Techniques for providing pictures that show the structure or function of bones. X-ray images are the most commonly used technique for diagnosing fractures and injuries. More detailed information is provided by tomography, CT scanning, or MRI, which can show tumours

cavities; it may be red or yellow. Red bone marrow is present in all bones at birth and is the factory for most of the blood cells. During the teens, red bone marrow is gradually replaced in some bones by less active yellow marrow. In adults, red marrow is confined chiefly to the spine, sternum, (breastbone), ribs, pelvis (hip-bones), scapulae (shoulderblades), clavicles (collarbones), and bones of the skull.

Stem cells within the red marrow are stimulated to form blood cells by the hormone erythropoietin.

Yellow marrow is composed mainly of connective tissue and fat.

If the body needs to increase its rate of blood formation, some of the yellow marrow will be replaced by red.

Sometimes marrow fails to produce sufficient numbers of normal blood cells, as occurs in aplastic anaemia (see anaemia, aplastic) or when marrow has been displaced by tumour cells.

In other cases, marrow may overproduce certain blood cells, as occurs in polycythaemia and leukaemia.... bone imaging

A procedure to obtain a sample of cells from the bone marrow (aspiration biopsy) or a small core of bone with marrow inside (trephine biopsy). The sample is usually taken, under local anaesthesia, from the sternum (breastbone) or iliac crests (upper part of the hip-bones). Microscopic examination gives information on the development of the blood components

surrounding tissues. Radionuclide scanning detects areas throughout the skeleton in which there is high bone-cell activity. This type of scanning and on the presence of cells foreign to the marrow.

It is useful in the diagnosis of many blood disorders, including leukaemia and anaemia.

It can also show whether bone marrow has been invaded by lymphoma or cells from other tumours.... bone marrow biopsy

A follow-up dose of vaccine, given to reinforce or prolong immunity after an initial course of immunization.... booster

see bowel sounds.... borborygmi

A personality disorder that falls between neurotic and psychotic levels. Mood changes are often rapid and inappropriate. Angry outbursts are common, as are impulsive, self-damaging acts such as gambling or suicide attempts.... borderline personality disorder

Infant feeding using a milk preparation usually based on modified cow’s milk.

Formula milk contains similar proportions of protein, fat, lactose (milk sugar), and minerals as those in human milk, but it lacks the protective antibodies that are present in breast milk.

Vitamins are added.

Bottle-fed babies are at higher risk of gastrointestinal infections than breast-fed babies and may be more likely to develop allergic disorders.

(See also feeding, infant.)... bottle-feeding

See faeces, abnormal.... bowel movements, abnormal

Sounds made by the passage of air and fluid through the intestine. Absent or abnormal bowel sounds may indicate a disorder. Those that are audible without a stethoscope are known as borborygmi and are a normal part of the digestive process, but they may be exaggerated by anxiety and some disorders of the intestine.... bowel sounds

An outward curving of bones in the legs that results in wide separation of the knees when the feet are together. Bowlegs are common in very young children and are a normal part of development. In most cases, the curve straightens as the child grows. If the bowing is severe, is on one side only, or persists beyond the age of 6, a doctor should be consulted. Surgery may be needed. Rarely, leg deformity is a result of bone disease, particularly rickets (a vitamin D deficiency) in children.... bowleg

Bones with an increased tendency to fracture. They are a feature of osteoporosis and may occur in people who are taking corticosteroid drugs, are immobile, or have certain hormonal disorders. In osteomalacia, the bones are soft and have an increased tendency both to become deformed and to fracture. The inherited disorder osteogenesis imperfecta is a rare cause of brittle bones and frequent fractures and is usually detected in infancy.... brittle bones

an imaging investigation of a patient’s bone using radioactive *tracers. *Technetium-99m phosphate is injected intravenously and absorbed into the hydroxyapatite crystals of bone. It concentrates in areas of increased blood flow and metabolism, such as areas of infection, trauma, and *neoplasia, and gives off radiation that can be detected by a *gamma camera, thereby producing a map or scan of activity in the target area. A bone scan is particularly useful in the diagnosis of subtle fractures (including stress fractures), avascular necrosis (see osteonecrosis), osteomyelitis, tumour spread (metastasis), and loosening of orthopaedic implants.... bone scan

n. a genus of tiny Gram-negative aerobic bacteria. B. pertussis causes *whooping cough, and all the other species are able to break down red blood cells and cause diseases resembling whooping cough.... bordetella

n. a *cytotoxic drug that works by inhibiting *proteasomes and causing death of malignant cells. It is used alone in the treatment of relapsed myeloma and in combination with other agents for the first-line treatment of myeloma. Side-effects include *peripheral neuropathy, *thrombocytopenia, and nausea.... bortezomib

n. see endothelin.... bosentan

a system for classifying renal cysts seen on CT imaging to aid in determining their degree of malignancy.

Type I: a benign cyst with smooth margins and no calcification or septa that does not enhance with contrast material.

Type II: a benign cyst with a few hairline septa and/or minimal calcification that does not enhance with contrast.

Type IIF: a cyst with more septa and increased calcification but no contrast enhancement.

Type III: a complicated cyst with irregular margins, moderate calcification, thick septa, and contrast enhancement.

Type IV: a malignant cyst with irregular margins and solid enhancing elements.... bosniak classification

a normal variant of crawling in which babies sit upright and move on their bottoms, usually by pulling forward on their heels. Babies who bottom-shuffle tend to walk slightly later. There is often a family history of bottom shuffling.... bottom shuffling

a bony thickening arising at the proximal interphalangeal joint of a finger in osteoarthritis. It is often found together with *Heberden’s nodes. [J. C. Bouchard (1837–1915), French physician]... bouchard’s node

n. a hollow or solid cylindrical instrument, usually flexible, that is inserted into tubular passages, such as the oesophagus (gullet), rectum, or urethra. Bougies are used in diagnosis and treatment, particularly by enlarging *stricture(s) (for example, in the urethra).... bougie

see tuberous sclerosis. [D.-M. Bourneville (1840–1909), French neurologist]... bourneville’s disease

(buttonhole deformity) a deformity seen in a finger when the central strand of the tendon of the extensor muscle of the digits is ruptured. This results in marked flexion of the middle phalanx across the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint.... boutonnière deformity

the cup-shaped end of a *nephron, which encloses a knot of blood capillaries (glomerulus). It is the site of primary filtration of the blood into the kidney tubule. [Sir W. P. Bowman (1816–92), British physician]... bowman’s capsule

see microvillus.... brush border

the largest bone of the wrist (see carpus). It articulates with the scaphoid and lunate bones behind, with the second, third, and fourth metacarpal bones in front, and with the trapezoid and hamate laterally.... capitate bone

(perikaryon) the enlarged portion of a *neuron (nerve cell), containing the nucleus. It is concerned more with the nutrition of the cell than with propagation of nerve impulses.... cell body

see NHS e-Referral Service.... choose and book

a disorder characterized by a combination of *parkinsonism and *dementia, which typically fluctuates. Visual hallucinations are common, and there is exquisite sensitivity to phenothiazine drugs. Abnormal proteins called Lewy bodies are found within the nerve cells of the cortex and the basal ganglia. It is the third most common cause of dementia (dementia with Lewy bodies) after *Alzheimer’s disease and vascular dementia.... cortical lewy body disease

the outer bone of the *tarsus, which articulates with the fourth and fifth metatarsal bones in front and with the calcaneus (heel bone) behind.... cuboid bone

(Latin) literally, ‘to whom (is it) a benefit?’. This question is often considered to be at the heart of difficult questions in medical *ethics (e.g. the use of *extraordinary means to prolong life).... cui bono?

three bones in the *tarsus – the lateral (external), intermediate (middle), and medial (internal) cuneiform bones – that articulate respectively with the first, second, and third metatarsal bones in front. All three bones articulate with the navicular bone behind.... cuneiform bones

a bone in the floor of the cranium that contributes to the nasal cavity and orbits. The part of the ethmoid forming the roof of the nasal cavity – the cribriform plate – is pierced with many small holes through which the olfactory nerves pass. See also nasal concha; skull.... ethmoid bone

(unciform bone) a hook-shaped bone of the wrist (see carpus). It articulates with the capitate and triquetral bones at the sides, with the lunate bone behind, and with the fourth and fifth metacarpal bones in front.... hamate bone

(HWB) a statutory local authority committee that aims to improve integration between local health care, social care, and other public service providers. HWBs (of which there are over 130) also have a responsibility to reduce health inequalities and produce a local joint strategic needs assessment to inform commissioning of local services. Each upper-tier local authority is obliged under the Health and Social Care Act 2012 to have an HWB, whose membership must include: an elected local representative; the local *Directors of Public Health, adult social services, and children’s social services; and representatives from the local *Healthwatch, each local *clinical commissioning group, and *NHS England.... health and wellbeing board

a health authority in Wales (since 2003), Scotland, and Northern Ireland. See National Health Service.... health board

(innominate bone) a bone formed by the fusion of the ilium, ischium, and pubis. It articulates with the femur by the acetabulum of the ilium, a deep socket into which the head of the femur fits (see hip joint). Between the pubis and ischium, below and slightly in front of the acetabulum, is a large opening – the obturator foramen. The right and left hip bones form part of the *pelvis.... hip bone

a weak electrostatic bond formed by linking a hydrogen atom between two electronegative atoms (e.g. nitrogen or oxygen). The large number of hydrogen bonds in proteins and nucleic acids are responsible for maintaining the stable molecular structure of these compounds.... hydrogen bond

a small isolated U-shaped bone in the neck, below and supporting the tongue. It is held in position by muscles and ligaments between it and the styloid process of the temporal bone.... hyoid bone

see hip bone.... innominate bone

(inca bone, incarial bone) the bone lying between the *parietal bones, at the back of the skull.... interparietal bone

an abnormal condition of the eye in which the iris bulges forward towards the cornea. It is due to pressure from the aqueous humour behind the iris when its passage through the pupil to the anterior chamber of the eye is blocked (pupil-block glaucoma).... iris bombé

the smallest bone of the face: either of a pair of rectangular bones that contribute to the orbits. See skull.... lacrimal bone

mature *bone, in which the collagen fibres are arranged parallel to each other to form multiple layers (*lamellae) with the osteocytes lying between the lamellae. It exists in two structurally different forms: cortical (compact) and cancellous (spongy) bone. See also woven bone.... lamellar bone

see Leishmania. [Sir W. B. Leishman (1865–1926), British surgeon; C. Donovan (1863–1951), Irish physician]... leishman–donovan body

see cortical Lewy body disease. [F. H. Lewy (1885–1950), German neurologist]... lewy bodies

(LETB) a statutory committee of *Health Education England responsible for identifying the education and training needs in the health-care and public health workforce and for commissioning postgraduate medical and dental training to meet these needs. There are four local education and training boards in England.... local education and training board

a bone of the wrist (see carpus). It articulates with the capitate and hamate bones in front, with the radius behind, and with the triquetral and scaphoid at the sides.... lunate bone

see zygomatic bone.... malar bone

large irregular masses abnormally located in the hepatocytes of the liver. They are found in patients with alcoholic hepatitis, alcoholic cirrhosis, Wilson’s disease, primary biliary cirrhosis, clinical obesity, and hepatoma. [F. B. Mallory (1862–1941), US pathologist]... mallory bodies

the part of a *nephron comprising the blood capillaries of the glomerulus and its surrounding Bowman’s capsule. [M. Malpighi (1628–94), Italian anatomist]... malpighian body

two paired rounded swellings in the floor of the *hypothalamus, immediately behind the pituitary gland.... mamillary bodies

a bone that develops in connective tissue by direct *ossification, without cartilage being formed first. The bones of the face and skull are membrane bones.... membrane bone

see malakoplakia.... michaelis–gutmann bodies

either of a pair of narrow oblong bones that together form the bridge and root of the nose. See skull.... nasal bone

a boat-shaped bone of the ankle (see tarsus) that articulates with the three cuneiform bones in front and with the talus behind.... navicular bone

a saucer-shaped bone of the *skull that forms the back and part of the base of the cranium. At the base of the occipital are two occipital condyles: rounded surfaces that articulate with the first (atlas) vertebra of the backbone. Between the condyles is the foramen magnum, the cavity through which the spinal cord passes.... occipital bone

see arachnoid villus. [A. Pacchioni (1665–1726), Italian anatomist]... pacchionian body

either of a pair of approximately L-shaped bones of the face that contribute to the hard *palate, the nasal cavity, and the orbits. See skull.... palatine bone

particles that occur in the cells of skin rashes in patients with *cowpox or *smallpox; they are thought to be the virus particles. [E. Paschen (1860–1936), German pathologist]... paschen bodies

see temporal bone.... petrous bone

the smallest bone of the wrist (*carpus): a pea-shaped bone that articulates with the triquetral bone and, indirectly by cartilage, with the ulna.... pisiform bone

one of the small cells produced during the formation of an ovum from an *oocyte that does not develop into a functional egg cell.... polar body

a bone that is formed by replacing cartilage with bony material.... replacement bone

a thick bundle of nerve fibres that conveys impulses from tracts in the spinal cord to the cortex of the anterior and posterior lobes of the cerebellum.... restiform body

the most common tumour of the cervix and vagina in children and adolescents under the age of 16; 90% occur in children under five years. Symptoms are vaginal bleeding and a bloody discharge; in young girls the tumour may protrude from the cervix. It is a highly malignant *rhabdomyosarcoma with the appearance of a bunch of grapes. Treatment is with triple chemotherapy with or without radiotherapy prior to hysterectomy and vaginectomy.... sarcoma botryoides

an oval nodule of bone that lies within a tendon and slides over another bony surface. The patella (kneecap) and certain bones in the hand and foot are sesamoid bones.... sesamoid bone

intestinal failure that occurs when the small bowel is shortened by surgery or trauma, resulting in reduced absorption of nutrients. Some bowel adaptation does occur, but if under 200 cm of small bowel remain it is likely patients will need long-term *total parenteral nutrition.... short bowel syndrome

(enteroclysis) a radiological technique for examining the jejunum and ileum by passing a tube through the nose, oesophagus, and stomach into the small bowel and directly injecting *barium sulphate. Images are captured in real time as the contrast moves through the small bowel. It produces highly detailed images of the small bowel, making it particularly useful for investigating coeliac disease and Crohn’s disease, as well as strictures, tumours, and obstructions. It can be combined with X-ray imaging, CT, or MRI.... small-bowel enema

(barium follow-through) a technique for examining the small bowel, often used when small-bowel enema is not tolerated. The patient swallows dilute *barium sulphate suspension and then a series of abdominal radiographs are taken. A complete examination occurs when contrast reaches the first part of the large bowel (caecum). This technique is particularly useful for investigating small-bowel *Crohn’s disease.... small-bowel meal

a bone forming the base of the cranium behind the eyes. It consists of a body, containing air spaces continuous with the nasal cavity (see paranasal sinuses); two wings that form part of the orbits; and two pterygoid processes projecting down from the point where the two wings join the body. See skull.... sphenoid bone

see temporal bone.... squamous bone

either of a pair of bones of the cranium. The squamous portion forms part of the side of the cranium. The petrous part contributes to the base of the skull and contains the middle and inner ears. Below it are the *mastoid process, *styloid process, and zygomatic process (see zygomatic arch). See also skull.... temporal bone

a bone of the wrist (see carpus). It articulates with the second metatarsal bone in front, with the scaphoid bone behind, and with the trapezium and capitate bones on either side.... trapezoid bone

see nasal concha.... turbinate bone

see hamate bone.... unciform bone

see mesonephros. [K. F. Wolff (1733–94), German anatomist]... wolffian body

one of a number of small bones that occur in the cranial sutures.... wormian bone

immature bone, in which the collagen fibres are arranged haphazardly and the cells have no specific orientation. It is typically found in the early stages of fracture healing, eventually being replaced by mature *lamellar bone.... woven bone

(zygoma, malar bone) either of a pair of bones that form the prominent part of the cheeks and contribute to the orbits. See skull.... zygomatic bone

Peumus boldus

FAMILY: Monimiaceae

SYNONYMS: Boldu boldus, Boldoa fragrans, boldus, boldu.

GENERAL DESCRIPTION: An evergreen shrub or small tree up to 6 metres high, with slender branches, sessile coarse leaves and bearing yellowish-green fruit; when dried the leaves turn a deep reddish-brown colour. The whole plant is aromatic.

DISTRIBUTION: Native to Chile; naturalized in the Mediterranean region. Some essential oil is produced in Nepal and Vietnam.

OTHER SPECIES: The Australian tree Monimia rotundifolia contains a similar oil, which has been used as a substitute. The oil of chenopodium or wormseed is also chemically related.

HERBAL/FOLK TRADITION: The bark is used for tanning, the wood utilized in charcoal making and the fruit eaten by locals. In South America it has long been recognized as a valuable cure for gonorrhoea. In Western herbalism, the dried leaves are used for genito-urinary inflammation, gallstones, liver or gall bladder pain, cystitis and rheumatism. The dried leaves are current in the British Herbal Pharmacopoeia as a specific for cholelithiasis with pain.

ACTIONS: Antiseptic, cholagogue, diaphoretic, diuretic, hepatic, sedative, tonic, urinary demulcent.

EXTRACTION: Essential oil by steam distillation of the leaves.

CHARACTERISTICS: A yellow liquid with a powerful spicy-camphoraceous, disagreeable odour.

PRINCIPAL CONSTITUENTS: Cymene, ascaridole, cineol, linalol.

SAFETY DATA: Extremely toxic. ‘The oil has powerful therapeutic effects, and it can be considered harmful to the human organism even when used in very small doses … should not be used in therapy, either internally or externally.’.

AROMATHERAPY/HOME: USE None.

OTHER USES: Used in pharmaceuticals in minute amounts for its therapeutic properties.... boldo leaf

Boronia megastigma

FAMILY: Rutaceae

SYNONYM: Brown boronia.

GENERAL DESCRIPTION: A bushy evergreen shrub, up to 2 metres high, which bears an abundance of fragrant, nodding flowers with an unusual colouring – the petals are brown on the outside, yellow on the inside. Often grown as an ornamental shrub in gardens.

DISTRIBUTION: Native to Western Australia; grows wild all over west and south west Australia.

OTHER SPECIES: There are over fifteen species of boronia found in Western Australia; B. megastigma is one of the most common and the only one used for its perfume; other types smell of sarsaparilla, lemons or roses! Boronia is botanically related to the citrus tree.

HERBAL/FOLK TRADITION: ‘A botanist in the Victorian era suggested this species would be suitable for graveyard planting because of its dark flowers!’.

ACTIONS: Aromatic.

EXTRACTION: A concrete and absolute by the enfleurage method or petroleum-ether extraction, from the flowers. An essential oil is also produced in small quantities by steam distillation.

CHARACTERISTICS: The concrete is a dark green butterlike mass with a beautiful warm, woody-sweet fragrance; the absolute is a green viscous liquid with a fresh, fruity-spicy scent and a rich, tenacious, floral undertone. It blends well with clary sage, sandalwood, bergamot, violet, immortelle, costus, mimosa and other florals.

PRINCIPAL CONSTITUENTS: Notably ionone; also eugenol, triacontane, phenols, ethyl alcohol and ethyl formate, among others.

SAFETY DATA: Prohibitively expensive and therefore often adulterated.

AROMATHERAPY/HOME: USE Perfume

OTHER USES: The absolute is used in high-class perfumery work, especially florals. Used in specialized flavour work, especially rich fruit products.... boronia