Bodil Health Dictionary

Part of the nervous system which regulates the bodily functions that are not under conscious control: these include the heartbeat, intestinal movements, salivation, sweating, etc. The autonomic nervous system consists of two main divisions – the SYMPATHETIC NERVOUS SYSTEM and the PARASYMPATHETIC NERVOUS SYSTEM. The smooth muscles, heart and most glands are connected to nerve ?bres from both systems and their proper functioning depends on the balance between these two. (See also NERVES; NERVOUS SYSTEM.)... autonomic nervous system

Any abnormality of bodily structure or function, other than those arising directly from physical injury.... disease

An organism which lives in or on another organism, known as the host. A parasite derives all its nourishment from the host but provides no bene?ts in return. It may damage the host’s bodily functions and in extreme cases cause the death of the host. Human parasites include WORMS, fungi (see FUNGUS), BACTERIA and viruses (see VIRUS).... parasite

This extensive, complex and ?nely tuned network of billions of specialised cells called neurones (see NEURON(E)) is responsible for maintaining the body’s contacts with and responses to the outside world. The network also provides internal communication links – in concert with HORMONES, the body’s chemical messengers – between the body’s diverse organs and tissues, and, importantly, the BRAIN stores relevant information as memory. Each neurone has a ?lamentous process of varying length called an AXON along which passes messages in the form of electrochemically generated impulses. Axons are bundled together to form nerves (see NERVE).

The nervous system can be likened to a computer. The central processing unit – which receives, processes and stores information and initiates instructions for bodily activities – is called the central nervous system: this is made up of the brain and SPINAL CORD. The peripheral nervous system – synonymous with the cables that transmit information to and from a computer’s processing unit – has two parts: sensory and motor. The former collects information from the body’s many sense organs. These respond to touch, temperature, pain, position, smells, sounds and visual images and the information is signalled to the brain via the sensory nerves. When information has been processed centrally, the brain and spinal cord send instructions for action via motor nerves to the ‘voluntary’ muscles controlling movements and speech, to the ‘involuntary’ muscles that operate the internal organs such as the heart and intestines, and to the various glands, including the sweat glands in the skin. (Details of the 12 pairs of cranial nerves and the 31 pairs of nerves emanating from the spinal cord are given in respective texts on brain and spinal cord.)

Functional divisions of nervous system As well as the nervous system’s anatomical divisions, the system is divided functionally, into autonomic and somatic parts. The autonomic nervous system, which is split into sympathetic and parasympathetic divisions, deals with the automatic or unconscious control of internal bodily activities such as heartbeat, muscular status of blood vessels, digestion and glandular functions. The somatic system is responsible for the skeletal (voluntary) muscles (see MUSCLE) which carry out intended movements initiated by the brain – for example, the activation of limbs, tongue, vocal cords (speech), anal muscles (defaecation), urethral sphincters (urination) or vaginal muscles (childbirth). In addition, many survival responses – the most powerfully instinctive animal drives, which range from avoiding danger and pain to shivering when cold or sweating when hot – are initiated unconsciously and automatically by the nervous system using the appropriate neural pathways to achieve the particular survival reaction required.

The complex functions of the nervous system include the ability to experience emotions, such as excitement and pleasure, anxiety and frustration, and to undertake intellectual activities. For these experiences an individual can utilise many built-in neurological programmes and he or she can enhance performance through learning – a vital human function that depends on MEMORY, a three stage-process in the brain of registration, storage and recall. The various anatomical and functional divisions of the nervous system that have been unravelled as science has strived to explain how it works may seem confusing. In practical terms, the nervous system works mainly by using automatic or relex reactions (see REFLEX ACTION) to various stimuli (described above), supplemented by voluntary actions triggered by the activity of the conscious (higher) areas of the brain. Some higher functions crucial to human activity – for example, visual perception, thought, memory and speech – are complex and subtle, and the mechanisms are not yet fully understood. But all these complex activities rest on the foundation of relatively simple electrochemical transmissions of impulses through the massive network of billions of specialised cells, the neurones.... nervous system

Adipose tissue, or fat, is a loose variety of ?brous tissue in the meshes of which lie cells, each of which is distended by several small drops, or one large drop, of fat. This tissue replaces ?brous tissue when the amount of food taken is in excess of the bodily requirements. Adipose tissue occurs as a layer beneath the skin and also around several internal organs. (See DIET; FAT; OBESITY.)... adipose tissue

The principle of inheritance of disease or bodily characters from grandparents or remoter ancestors, the parents not having been affected by these.... atavism

Lindl.

Synonym: A. belladonna auct. non L.

Family: Solanaceae.

Habitat: Kashmir and Himachal Pradesh up to 2,500 m.

English: Indian Belladonna, Indian Atropa.

Ayurvedic: Suuchi.

Unani: Luffaah, Luffaah-Barri, Yabaruj, Shaabiraj.

Action: Highly poisonous; sedative, narcotic, anodyne, nervine, antispasmodic (used in paralysis); parkinsonism; encephalitis; carcinoma; spastic dysmenorrhoea; whooping cough, spasmodic asthma; colic of intestines, gall bladder or kidney, spasm of bladder and ureters; contraindicated in enlarged prostate.

Key application: In spasm and colic-like pain in the areas of the gastrointestinal tract and bile ducts. (German Commission E, The British Herbal Pharmacopoeia.) It is contraindicated in tachycardiac arrhythmias, prostate adenoma, glaucoma, acute oedema of lungs.

A. belladonna L. (European sp. Belladonna, Deadly Nightshade) is cultivated in Kashmir and Himachal Pradesh.

The herb contains tropane (tropine) or solanaceous alkaloids (up to 0.6%), including hyoscamine and atropine; flavonoids; coumarins; volatile bases (nicotine).

Tropane alkaloids inhibit the para- sympathetic nervous system, which controls involuntary bodily activities; reduces saliva, gastric, intestinal and bronchial secretions, and also the activity of urinary tubules. Tropane alkaloids also increase the heart rate and dilate the pupils. These alkaloids are used as an additive to compound formulations for bronchitis, asthma, whooping cough, gastrointestinal hy- permotility, dysmenorrhoea, nocturnal enuresis and fatigue syndrome.

Atropine provides relief in parkin- sonism and neurovegetative dystonia.

The root is the most poisonous, the leaves and flowers less, and the berries the least. (Francis Brinker.)

Dosage: Leaf, root—30-60 mg powder. (CCRAS.)... atropa acuminata royle ex

In medical parlance, a term applied to the counterbalancing of some defect of structure or function by some other special bodily development. The body possesses a remarkable power of adapting itself even to serious defects, so that disability due to these passes o? after a time. The term is most often applied to the ability possessed by the heart to increase in size, and therefore in power, when the need for greater pumping action arises in consequence of a defective valve or some other abnormality in the circulation (see also HEART, DISEASES OF; CIRCULATORY SYSTEM OF THE BLOOD). A heart in this condition is, however, more liable to be prejudicially affected by strains and disease-processes, and the term ‘failure of compensation’ is applied to the symptoms that result when this power becomes temporarily insu?cient.

Compensation also refers to the ?nancial compensation awarded to an individual who has been injured or made ill as a result of wrongful action or inaction by another individual or organisation. NHS trusts are increasingly being sued for compensation because patients believe that they have had unsatisfactory or damaging treatment. This is costing the NHS over £1 billion a year. (See RISK MANAGEMENT.)

Compensation neurosis Compensation neurosis or ‘traumatic’ neurosis is a psychological reaction to the prospects of compensation. It is a condition about which specialists disagree. Su?erers complain of a range of symptoms that may be a genuine consequence of their condition or an exaggerated response.... compensation

Producing a sense of bodily comfort and well-being and the absence of pain or distress... euphoriant

Financial protection against the health care costs arising from disease or accidental bodily injury. Such insurance usually covers all or part of the costs of treating the disease or injury. Insurance may be obtained on either an individual or a group basis.... health insurance

The principle on which various peculiarities of bodily form or structure, or of physical or mental activity, are transmitted from parents to o?spring. (See also GENES.)... heredity

A craving for food or other substance necessary to bodily activity. Hunger for food is supposed to be directly produced by strong contractions of the stomach which occur when it is empty, or nearly so. (See also THIRST.)

Air hunger is an instinctive craving for oxygen resulting in breathlessness, either when a person ascends to great heights where the pressure of air is low, or in some diseases such as pneumonia and DIABETES MELLITUS which affect the body’s METABOLISM and therefore its need for oxygen – an essential constituent in this process.... hunger

Identical twins who are united bodily but are possessed of separate personalities. Their frequency is not known, but it has been estimated that throughout the world, six or more conjoined twins are born every year who are capable of separation. The earliest case on record is that of the ‘Biddendon Maids’ who were born in England in 1100. The ‘Scottish Brothers’ lived for 28 years at the court of James III of Scotland. Perhaps the most famous conjoined twins, however, were Chang and Eng, who were born of Chinese parents in Siam in 1811. It was they who were responsible for the introduction of the term, ‘Siamese twins’, which still remains the popular name for ‘conjoined twins’. They were joined together at the lower end of the chest bone, and achieved fame by being shown in Barnum’s circus in the United States. They subsequently married English sisters and settled as farmers in North Carolina. They died in 1874.

The earliest attempt at surgical separation is said to have been made by Dr Farius of Basle in 1689. The ?rst successful separation in Great Britain was in 1912: both twins survived the operation and one survived well into adult life. This is said to be the ?rst occasion on which both twins survived the operation. The success of the operation is largely dependent upon the degree of union between the twins. Thus, if this is only skin, subcutaneous tissue and cartilage, the prospects of survival for both twins are good; but if some vital organ such as the liver is shared, the operation is much more hazardous. (See MULTIPLE BIRTHS.)... conjoined twins

The state of health implies much more than freedom from disease, and good health may be de?ned as the attainment and maintenance of the highest state of mental and bodily vigour of which any given individual is capable. Environment, including living and working conditions, plays an important part in determining a person’s health. The UK government is now placing much greater emphasis on health promotion and the prevention of disease, and has published national targets for reducing the incidence of some major diseases. The 1978 World Health Organisation statement declares that primary care should ‘be made universally accessible to individuals and families in the community, by means acceptable to them, through their full participation, and at the cost that the community and country can a?ord to maintain in the spirit of self-reliance . . . [and] addresses the main health problems in the community, providing promotive, preventative, curative and rehabilitative services accordingly’. Factors affecting access to health include ?nance, ideology, and education. (See ENVIRONMENT AND HEALTH; PUBLIC HEALTH.)... health

The increase in size which takes place in an organ as the result of an increased amount of work demanded of it by the bodily economy. For example, when valvular disease of the heart is present, compensation occurs by an increase in thickness of the heart muscle, and the organ, by beating more powerfully, is able to overtake the strain thrown upon it. Similarly, if one kidney is removed, the other hypertrophies or grows larger to take over the double workload.... hypertrophy

Obsession with the body’s functions and a DELUSION of ill health, often severe, such that patients may believe they have a brain tumour or incurable insanity. Furthermore, patients may believe that they have infected others, or that their children have inherited the condition. It is a characteristic feature of DEPRESSION, but may also occur in SCHIZOPHRENIA, when the delusions may be secondary to bodily HALLUCINATIONS, and a sense of subjective change. Chronic hypochondriasis may be the result of an abnormal personality development: for example, the insecure, bodily-conscious person. Delusional preoccupations with the body – usually the face – may occur, such that the patient is convinced that his or her face is twisted, or dis?gured with acne.

Treatment Hypochondriacal patients may also develop physical illness, and any new symptoms must always be carefully evaluated. In most patients the condition is secondary, and treatment should be directed to the underlying depression or schizophrenia. In the rare cases of primary hypochondriasis, supportive measures are the mainstay of treatment.... hypochondriasis

The original syndrome described by Klinefelter consisted of GYNAECOMASTIA, testicular ATROPHY and INFERTILITY. Intelligence was unimpaired. Patients have been described who have associated mental defects and striking tallness of stature, but the only constant feature of the syndrome is testicular atrophy with resulting azoospermia and infertility.

The atrophy of the testis is the result of ?brosis, which begins to appear in childhood and progresses until all the seminiferous tubules are replaced by ?brous tissue. Gynaecomastia, mental retardation and eunuchoidism (see EUNUCH; loss of male secondary sexual characteristics – small penis, loss of body hair and a high-pitched voice) may be present. Most patients with Klinefelter’s syndrome have 47 chromosomes instead of the normal 46. The extra chromosome is an X chromosome, so that the sex chromosome constitution is XXY instead of XY. Klinefelter’s syndrome is one of the most common chromosome abnormalities and occurs in 1 in 300 of the male population. Patients with this syndrome show that the Y chromosome is strongly sex-determining: thus, a patient who has an XXY chromosome constitution may have the appearance of a normal male, with infertility the only incapacity, while the loss of a Y chromosome leads to the development of a bodily form which is essentially feminine (see TURNER’S SYNDROME).... klinefelter’s syndrome

The general term applied to diseases due to the growth of fungi in the body. Among some of the simplest and commonest mycoses are RINGWORM, FAVUS, and thrush (CANDIDA). The MADURA FOOT of India, ACTINOMYCOSIS, and occasional cases of PNEUMONIA and suppurative ear disease are also due to the growth of moulds in the bodily tissues. Other forms of mycosis include ASPERGILLOSIS, candidiasis (see CANDIDA), CRYPTOCOCCOSIS and HISTOPLASMOSIS.... mycosis

A system of treatment by manipulating bones (see BONE) and other parts with the idea of thereby restoring functions in the bodily mechanism that have become deranged. Properly quali?ed osteopaths are included on the General Council and Register of Osteopaths.... osteopathy

An alkaloid which is the principal addictive agent in TOBACCO. The small amount of nicotine in a single cigarette is su?cient to stimulate mental and bodily activities. In larger quantities it acts as a depressant or narcotic – habitual smokers may ?nd its e?ect sedating. Nicotine works by stimulating the production of a chemical called DOPAMINE, a neurotransmitter or chemical messenger between nerve cells. Nicotine mimics the action of a neurotransmitter called ACETYLCHOLINE. Nerve cells that produce dopamine have acetylcholine-receptor molecules on their surfaces; when these ‘nicotine-like’ receptors are occupied by acetylcholine molecules, a cell is prompted to produce dopamine. So nicotine itself can arti?cially stimulate dopamine production. Dopamine is part of the neuronal circuitry that plays a part in the body’s perception of pleasure, which is why smoking is enjoyed by many people.... nicotine

One of the BETA-ADRENOCEPTOR-BLOCKING DRUGS, propranolol hydrochloride is used in the treatment of ANGINA PECTORIS, myocardial infarction (see under HEART, DISEASES OF), certain abnormal rhythms of the heart, and high blood pressure (HYPERTENSION). It also prevents attacks of MIGRAINE, and is used for certain anxiety states – particularly those associated with unpleasant bodily sensations, such as palpitations. (See also ADRENERGIC RECEPTORS.)... propranolol hydrochloride

Any functional evidence or disease or of a patient’s condition; a change in a patient’s condition indicative of some bodily or mental state.... symptom

A condition of bodily and mental inactivity, not amounting to sleep, but interfering greatly with the ordinary habits and pursuits. It is often found in people suffering from fever, and is a common symptom in aged people whose arteries are diseased.... torpor

The complete absence at birth of an organ or bodily component, caused by failure of development in the embryo.... agenesis

The collection of glands around the body that produce hormones.

These glands include the thyroid gland, pancreas, testes, ovaries, and adrenal glands.

Their hormones are responsible for numerous bodily processes, including growth, metabolism, sexual development and function, and response to stress.

Any increase or decrease in the production of a specific hormone interferes with the process it controls.

To prevent under- or overproduction, hormone secretion from many endocrine glands is regulated by the pituitary gland, which is in turn influenced by the hypothalamus in the brain according to a feedback mechanism.... endocrine system

Also known as a nerve cell, this is the basic cellular building-block of the NERVOUS SYSTEM, which contains billions of neurones linked in a complex network and acting in di?erent combinations to keep the body informed about the outside world, and then to organise and activate appropriate responses. There are three main types of neurone:

Sensory These carry signals to the central nervous system (CNS) – the BRAIN and SPINAL CORD – from sensory receptors. These receptors respond to di?erent stimuli such as touch, pain, temperature, smells, sounds and light.

Motor These carry signals from the CNS to activate muscles or glands.

Interneurons These provide the interconnecting ‘electrical network’ within the CNS.

Structure Each neurone comprises a cell body, several branches called dendrites, and a single ?lamentous ?bre called an AXON. Axons may be anything from a few millimetres to a metre long; at their end are several branches acting as terminals through which electrochemical signals are sent to target cells, such as those of muscles, glands or the dendrites of another axon.

Axons of several neurones are grouped

together to form nerve tracts within the brain or spinal cord or nerve-?bres outside the CNS. Each nerve is surrounded by a sheath and contains bundles of ?bres. Some ?bres are medullated, having a sheath of MYELIN which acts as insulation, preventing nerve impulses from spreading beyond the ?bre conveying them.

The cellular part of the neurones makes up the grey matter of the brain and spinal cord – the former containing 600 million neurones. The dendrites meet with similar outgrowths from other neurones to form synapses. White matter is the term used for that part of the system composed of nerve ?bres.

Functions of nerves The greater part of the bodily activity originates in the nerve cells (see NERVE). Impulses are sent down the nerves which act simply as transmitters. The impulse causes sudden chemical changes in the muscles as the latter contract (see MUSCLE). The impulses from a sensory ending in the skin pass along a nerve-?bre to affect nerve cells in the spinal cord and brain, where they are perceived as a sensation. An impulse travels at a rate of about 30 metres (100 feet) per second. (See NERVOUS IMPULSE.)

The anterior roots of spinal nerves consist of motor ?bres leading to muscles, the posterior roots of sensory ?bres coming from the skin. The terms, EFFERENT and AFFERENT, are applied to these roots, because, in addition to motor ?bres, ?bres controlling blood vessels and secretory glands leave the cord in the anterior roots. The posterior roots contain, in addition to sensory ?bres, the nerve-?bres that transmit impulses from muscles, joints and other organs, which among other neurological functions provide the individual with his or her

proprioceptive faculties – the ability to know how various parts of the body are positioned.

The connection between the sensory and motor systems of nerves is important. The simplest form of nerve action is that known as automatic action. In this, a part of the nervous system, controlling, for example, the lungs, makes rhythmic discharges to maintain the regular action of the respiratory muscles. This controlling mechanism may be modi?ed by occasional sensory impressions and chemical changes from various sources.

Re?ex action This is an automatic or involuntary activity, prompted by fairly simple neurological circuits, without the subject’s consciousness necessarily being involved. Thus a painful pinprick will result in a re?ex withdrawal of the affected ?nger before the brain has time to send a ‘voluntary’ instruction to the muscles involved.

Voluntary Actions are more complicated than re?ex ones. The same mechanism is involved, but the brain initially exerts an inhibitory or blocking e?ect which prevents immediate re?ex action. Then the impulse, passing up to the cerebral hemispheres, stimulates cellular activity, the complexity of these processes depending upon the intellectual processes involved. Finally, the inhibition is removed and an impulse passes down to motor cells in the spinal cord, and a muscle or set of muscles is activated by the motor nerves. (Recent advances in magnetic resonance imaging (MRI) techniques have provided very clear images of nerve tracts in the brain which should lead to greater understanding of how the brain functions.) (See BRAIN; NERVOUS SYSTEM; SPINAL CORD.)... neuron(e)

The change that takes place when childhood passes into manhood or womanhood. This change is generally a very de?nite one, occurring at about the age of 14 years, although it is modi?ed by race, climate, and bodily health so that it may appear a year or two earlier or several years later. At this time, the sexual functions attain their full development; the contour of the body changes from a childish to a more rounded womanly, or sturdy manly, form; and great changes take place in the mode of thought and feeling.

In girls, puberty is marked by the onset of MENSTRUATION and development of the BREASTS. The latter is usually the ?rst sign of puberty to appear, and may occur from nine years onwards; most girls show signs of breast development by the age of 13. The time from the beginning of breast development to the onset of menstruation is usually around two years but may range from six months to ?ve years. The ?rst sign of puberty in boys is an increase in testicular and penile size (see TESTICLE; PENIS) between the age of ten and 14. The LARYNX enlarges in boys, so that the voice – after going through a period of ‘breaking’ – ?nally assumes the deep manly pitch. Hair appears on the pubis and later in the armpits in both boys and girls, whilst in the former it also begins to grow on the upper lip, and skin eruptions are not uncommon on the face (see ACNE).

The period is one of transition from a physical and mental point of view. Puberty is not to be regarded as a physiological ‘coming of age’, for full development is usually achieved in the early 20s.... puberty

A method taught to couples who are experiencing sexual difficulties caused by psychological rather than physiological factors. The aim of the technique is to make both partners more aware of pleasurable bodily sensations, and to reduce anxiety about performance. It is particularly effective in treating loss of sexual desire (see sexual desire, inhibited), or inability to achieve orgasm (see orgasm, lack of), and in helping men to overcome impotence or premature ejaculation (see ejaculation, disorders of).... sensate-focus technique

n. the giving of immediate information to a subject about his or her bodily processes (such as heart rate), which are usually unconscious, by means of monitoring devices. This may enable some voluntary control over such processes. These processes can then be subject to operant *conditioning. This is an experimental treatment for disturbances of bodily regulation, such as hypertension.... biofeedback

An operation in which large breaches of SKIN surface due to wounding, burns or ulceration are closed by TRANSPLANTATION of skin from other parts. There are three methods by which this is done. Most frequently the epidermis only is transplanted, using a method introduced by Reverdin and by Thiersch, and known by their names. For this purpose, a broad strip of epidermis is shaved o? the thigh or upper arm, after the part has been carefully sterilised, and is transferred bodily to the raw or ulcerated surface, or is cut into smaller strips and laid upon it. A second method is for small pieces of the skin in its whole thickness to be removed from the arm and thigh, or even from other people, and then implanted and bound upon the raw surface. (This method has the disadvantage that the true skin must contract at the spot from which the graft is taken, leaving an unsightly scar.) When very large areas require to be covered, a third method is commonly used. A large ?ap of skin, amply su?cient to cover the gap, is raised from a neighbouring or distant part of the body, in such a way that it remains attached along one margin, so that blood vessels can still enter and nourish it. It is then turned so as to cover the gap; or, if it be situated on a distant part, the two parts are brought together and ?xed in this position until the ?ap grows ?rmly to its new bed. The old connection of the ?ap is then severed, leaving it growing in its new place.

Researchers are having success in growing human skin in the laboratory for grafting on to people who have been badly burned and have insu?cient intact skin surface to provide an autologous graft (one provided by the recipient of the graft). Other techniques being researched are the use of specially treated shark skin and the production of arti?cial skin.... skin-grafting

A sexually transmitted or CONGENITAL disease (the latter variety is now rare). Because in most cases the disease is acquired as a result of sexual intercourse with an infected individual, syphilis is classed as one of the SEXUALLY TRANSMITTED DISEASES (STDS). It normally affects only human beings.

Today, around 40 million new cases are noti?ed annually in the world, and this is probably an underestimate. In the UK the annual incidence of new cases of syphilis diagnosed in NHS genito-urinary medicine clinics has risen from 8.8 to 9.7 per million of male population between 1991 and 1999; among women the ?gures were 4.0 to 4.5 per million. The infection is most common in homosexual men (see HOMOSEXUALITY).

Causes The causative organism is the Treponema pallidum, a long, thread-like wavy organism with pointed tapering ends. It is found in large numbers in the sores in the primary stage of the disease and in the skin lesions in the secondary stage.

Syphilis may be acquired from people already suffering from the disease, or it may be congenital. The acquired form is usually got by sexual intercourse, kissing or other intimate bodily contact. The epithelium covering the general surface of the skin seems to be an e?cient protection, but the infective material penetrates mucous membranes. The acquired form of the disease is infectious from contact with sores, both in its primary and secondary stages; infants suffering from the congenital form are also highly infectious. Accordingly, anyone frequently handling such an infant is at risk of infection, although the mother may handle the baby with impunity.

Symptoms The acquired form of the disease is commonly divided into three stages – primary, secondary, and tertiary (although the latter is much less common than it was 50 years ago). The clinical manifestations are varied and are sometimes confused with those of other diseases. There are several laboratory tests for con?rming the diagnosis.

The incubation period ranges from ten to 90 days, although most frequently it is around four weeks. Then, a small persistent ULCER appears at the site of infection, which is accompanied by a typical cartilaginous hardness of the tissues immediately around and beneath it. This, which is known as the primary sore (or chancre), may be very much in?amed, or it may be so small as to pass almost or quite unnoticed. A few days later, the lymphatic glands in its neighbourhood, and then those all over the body, become swollen and hard. This condition lasts for several weeks before the sore slowly heals and the glands subside. After a variable period – usually about two months from the date of infection – the secondary symptoms appear and resemble the symptoms of an ordinary FEVER, with pyrexia, loss of appetite, vague pains through the body, and a faint red rash seen best upon the front of the chest. People with syphilis are infectious in the primary and secondary stages but not in the latent or tertiary stages.

In untreated or inadequately treated cases, manifestations of the tertiary stage develop after the lapse of some months or even years: this is known as the latent period. These consist in the growth, at various sites throughout the body, of masses of granulation tissue known as gummas. These gummas may appear as hard nodules in the skin, or form tumour-like masses in the muscles, or produce thickening of bones. They may develop in the brain and spinal cord, where their presence causes very serious symptoms. Gummas yield readily, as a rule, to appropriate treatment, and generally disappear speedily.

Still later, effects are apt to follow, such as disease of the arteries, leading to ANEURYSM (see also ARTERIES, DISEASES OF), to STROKE, and to mental deterioration (see MENTAL ILLNESS); also certain nervous diseases, of which tabes dorsalis and general paralysis are the chief.

The congenital form of syphilis, now rare, may affect the child before birth, leading then as a rule to miscarriage or to a stillbirth if born at full time. Alternatively he (or she) may show the ?rst symptoms a few weeks after birth, the appearances then corresponding to the secondary manifestations of the acquired form.

Laboratory con?rmation of a clinical diagnosis is done by identifying active spirochaetes (see SPIROCHAETE) in a smear taken at the site of the initial chancre, and by blood tests such as the treponomal antibody absorption tests. These tests are strongly positive at the secondary stage, and in patients with neurosyphilis the tests may have to be done on CEREBROSPINAL FLUID.

Treatment Any person with syphilis is a source of infection, and should take precautions not to spread it. PENICILLIN is the drug of choice in the disease in all its stages, but resistant strains of the Treponema pallidum have emerged and are causing problems, especially in developing countries. Treatment must be instituted as soon as possible after infection is acquired: (1) a full course of treatment is essential in every case, no matter how mild the disease may appear to be; (2) periodic blood examinations must be carried out on every patient for at least two years after he or she has been apparently cured.

Prevention is important and promiscuous hetero- or homosexual intercourse involves a risk of infection. Condoms provide some, but not complete protection. Infection can be avoided by maintaining a monogamous relationship.... syphilis

Body temperature is the result of a balance of heat-generating forces, chie?y METABOLISM and muscular activity, and heat-loss, mainly from blood circulation through and evaporation from the skin and lungs. The physiological process of homeostasis – a neurological and hormonal feedback mechanism – maintains the healthy person’s body at the correct temperature. Disturbance of temperature, as in disease, may be caused by impairment of any of these bodily functions, or by malfunction of the controlling centre in the brain.

In humans the ‘normal’ temperature is around 37 °C (98·4 °F). It may rise as high as 43 °C or fall to 32 °C in various conditions, but the risk to life is only serious above 41 °C or below 35 °C.

Fall in temperature may accompany major loss of blood, starvation, and the state of collapse (see SHOCK) which may occur in severe FEVER and other acute conditions. Certain chronic diseases, notably hypothyroidism (see THYROID GLAND, DISEASES OF), are generally accompanied by a subnormal temperature. Increased temperature is a characteristic of many acute diseases, particularly infections; indeed, many diseases have a characteristic pattern that enables a provisional diagnosis to be made or acts as a warning of possible complications. In most cases the temperature gradually abates as the patient recovers, but in others, such as PNEUMONIA and TYPHUS FEVER, the untreated disease ends rapidly by a CRISIS in which the temperature falls, perspiration breaks out, the pulse rate falls, and breathing becomes quieter. This crisis is often preceded by an increase in symptoms, including an epicritical rise in temperature.

Body temperature is usually measured on the Celsius scale, on a thermometer reading from 35 °C to 43·3 °C. Measurement may be taken in the mouth (under the tongue), in the armpit, the external ear canal or (occasionally in infants) in the rectum. (See also THERMOMETER.)

Treatment Abnormally low temperatures may be treated by application of external heat, or reduction of heat loss from the body surface. High temperature may be treated in various ways, apart from the primary treatment of the underlying condition. Treatment of hyperthermia or hypothermia should ensure a gradual return to normal temperature (see ANTIPYRETICS.... temperature

A noise heard in the EAR without any external cause. It often accompanies DEAFNESS, and severely deaf patients ?nd tinnitus as troubling as – if not more so than – the deafness. Tinnitus is described as ‘objective’ if it is produced by sound generated within the body by vascular tumours or abnormal blood ?ows. In patients with conductive hearing loss, tinnitus may be the consequence of the blocking of outside noises so that their own bodily activities become audible. Even normal people occasionally suffer from tinnitus, but rarely at a level which prompts them to seek medical advice. Present knowledge of the neurophysiological mechanisms is that the noise ‘arises’ high in the central nervous system in the subcortical regions of the BRAIN.

The resting level of spontaneous neuronal activity in the hearing system is only just below that at which sound enters a person’s consciousness – a consequence of the ?ne-tuning of normal hearing; so it is not, perhaps, surprising that normally ‘unheard’ neuronal activity becomes audible. If a patient suffers sensorineural deafness, the body may ‘reset’ the awareness threshold of neural activity, with the brain attempting greater sensitivity in an e?ort to overcome the deafness. The condition has a strong emotional element and its management calls for a psychological approach to help sufferers cope with what are, in e?ect, physically untreatable symptoms. They should be reassured that tinnitus is not a signal of an impending stroke or of a disorder of the brain. COGNITIVE BEHAVIOUR THERAPY can be valuable in coping with the unwanted noise. Traditionally, masking sounds, generated by an electrical device in the ear, were used to help tinnitus sufferers by, in e?ect, making the tinnitus inaudible. Even with the introduction of psychological retraining treatment, these maskers may still be helpful; the masking-noise volume, however, should be kept as low as possible or it will interfere with the retraining process. For patients with very troublesome tinnitus, lengthy counselling and retraining courses may be required. Surgery is not recommended.

Under the auspices of the Royal National Institute for Deaf People, the RNID Tinnitus Helpline has been established. Calls are charged at local rates. (See also MENIÈRE’S DISEASE.)... tinnitus

Machinery used to provide arti?cial ventilation. Also called a respirator or life-support machine, it is an electric pump linked to a supply of air which it pumps into the patient through an endotracheal tube passed through the nose or mouth into the trachea (see ENDOTRACHEAL INTUBATION). Sometimes the air is pumped straight into the trachea through an arti?cial hole called a TRACHEOSTOMY. During ventilation the patient’s blood gases are closely monitored and other bodily activities such as pulse and heart pressure are regularly measured. Some patients need to be kept on a ventilator for several days or even weeks if their medical condition is serious. (See also ARTIFICIAL VENTILATION OF THE LUNGS.)... ventilator

n. a condition of abnormally low weight, weakness, and general bodily decline associated with chronic disease. It occurs in such conditions as cancer, pulmonary tuberculosis, and malaria.... cachexia

n. the separation or stretching of bodily structures. Rectus divarication is stretching of the *rectus abdominis muscle, a common condition associated with pregnancy or obesity.... divarication

n. 1. the misplacement, due either to a congenital defect or injury, of a bodily part. 2. the occurrence of something in an unnatural location (see also ectopic beat; ectopic pregnancy). —ectopic adj.... ectopia

methods used to inform people (either individually or collectively) and persuade and enable them to adopt lifestyles that the educators believe will improve health and to reject habits regarded as harmful to health. The term is also used in a broader sense to include instruction about bodily function, etc., so that the public is better informed about health issues. All children receive health education at school, often as part of a personal, social, and health education (PSHE) programme. See also health promotion.... health education

Bodily movements include skeletal movements and movements of soft tissues and body organs. All movement is brought about by the actions of muscles and may be voluntary, involuntary, or a reflex action.

All voluntary skeletal movements are initiated in the part of the cerebrum (main mass of the brain) called the motor cortex. Signals are sent down the spinal cord along nerve fibres, and from there along separate nerve fibres to the appropriate muscles. Control relies on information supplied by sensory nerve receptors, in the muscles and elsewhere, that record the position of the different parts of the body and the amount of contraction in each muscle. This information is integrated in specific regions of the brain (including the cerebellum and basal ganglia) that control the coordination, initiation, and cessation of movement.

Skeletal movements can also occur as simple reflexes in response to certain sensory warning signals; the movement is automatic and less controlled, involving far fewer nerve connections.

Some body movements do not involve the skeleton. For example, eye and tongue movements are brought about by contractions of muscles that are attached to soft tissues. These movements may be voluntary or reflex.

Movements of the internal organs are involuntary; they include the heartbeat and peristalsis.... movement

any one of a group of mental disorders characterized by a partial or complete loss of the normal integration between awareness of one’s own identity, memories of the past, and control of bodily movements. They tend to remit spontaneously after hours, days, or months. The symptoms are explained psychoanalytically as extreme *defence mechanisms. They include loss of memory for important personal details (see amnesia), wandering away from home (see fugue), the assumption of a new identity, and trancelike states with severely reduced response to external stimuli. *Conversion disorder is classified with dissociative disorders (as dissociative (conversion) disorders) in ICD-10 (see International Classification of Diseases).... dissociative disorder

n. excessive bodily growth with marked enlargement of the genitalia. Macrogenitosoma praecox is a variant occurring in early childhood.... macrogenitosoma

n. a condition in which there is an imbalance between the nutrients the body receives and the nutrients it requires. A deficiency (or undernutrition) results from a combination of a decreased dietary intake, a decreased uptake by the body (*malabsorption), an increase in bodily losses, and an increase in the body’s requirements. Overnutrition is the consequence of dietary excess and results in *obesity and other metabolic abnormalities, such as *diabetes and *hyperlipidaemia.... malnutrition

n. obstruction of a bodily passage, usually by impaction of a foreign body, viscid secretions, or hardened faeces.... obturation

n. any excess of any bodily fluid, especially blood (see hyperaemia). —plethoric adj.... plethora

n. a record of measurements of various bodily parameters during sleep. It is used in the diagnosis of sleep disorders, such as *obstructive sleep apnoea.... polysomnograph

n. a state of natural unconsciousness, during which the brain’s activity is not apparent (apart from the continued maintenance of basic bodily functions, such as breathing) but can be detected by means of an electroencephalogram (EEG). Different stages of sleep are recognized by different EEG wave patterns. Drowsiness is marked by short irregular waves; as sleep deepens the waves become slower, larger, and more irregular. This slow-wave sleep is periodically interrupted by episodes of paradoxical, or *REM (rapid-eye-movement), sleep, when the EEG pattern is similar to that of an awake and alert person. Dreaming occurs during REM sleep. The two states of sleep alternate in cycles of from 30 to 90 minutes, REM sleep constituting about a quarter of the total sleeping time.... sleep

hypersensitivity caused by a foreign substance, small doses of which produce a violent bodily reaction.... allergy

corrects disordered bodily function.... alterative