Capillaries Health Dictionary

Each kidney comprises over a million of these microscopic units which regulate and control the formation of URINE. A tuft of capillaries invaginates the Bowmans capsule, which is the blind-ending tube (GLOMERULUS) of each nephron. Plasma is ?ltered out of blood and through the Bowmans capsule into the renal tubule. As the ?ltrate passes along the tubule, most of the water and electrolytes are reabsorbed. The composition is regulated with the retention or addition of certain molecules (e.g. urea, drugs, etc.). The tubules eventually empty the ?ltrate, which by now is urine, into the renal pelvis from where it ?ows down the ureters into the bladder. (See KIDNEYS.)... nephron

Linn.

Family: Ginkgoaceae.

Habitat: Native to China and Japan; cultivated in Indian gardens as an ornamental.

English: Maidenhair tree called Living Fossils (in India), Kew tree.

Action: Antagonizes bronchospasm, used as a circulatory stimulant, peripheral vasodilator.

Key application: Standardized dry extract—for symptomatic treatment of disturbed performance in organic brain syndrome within the regimen ofa therapeutic concept in cases of dementia syndromes— memory deficits, disturbance in concentration, depressive emotional conditions, dizziness, tinnitus and headache. (German Commission E, ESCOP, WHO.) As vasoactive and platelet aggregation inhibitor.

(The British Herbal Pharmacopoeia.) (For pharmocological studies in humans and clinical studies, see ESCOP.)

The majority of pharmacological studies and clinical trials have been conduced using a standardized extract which contains 24% flavonoid glyco- sides (Ginko flavone glycosides) and 6% terpenoids (ginkgolides and bilob- alide).

The extract increases tolerance to hypoxia and exhibits anti-ischaemic effect. It simultaneously improves the fluidity of blood, decreases platelet adhesion, decreases platelet and erythro- cyte aggregation and reduces plasma and blood viscosity. The extract protects erythrocytes from haemolysis. The extract also decreases the permeability of capillaries and protects the cell membrane by trapping deleterious free radicals.

The extract also increased cerebral blood flow in about 70% patients evaluated (patients between 30-50 year age had 20% increase from the base line, compared with 70% in those 50- to 70- year-olds).

A reversal of sexual dysfunction with concurrent use of ginkgo with antidepressant drugs has been reported. (Am J Psychiatry, 2000 157(5), 836837.)

The National Centre for Complementary and Alternative Medicine, USA, is conducting a 5-year study of 3000 people aged 75 and older to determine if ginkgo, 240 mg daily, prevents dementia or Alzheimer's disease.... ginkgo biloba

A very small blood vessel that drains blood from CAPILLARIES. Several venules join up to form a vein (see VEINS).... venule

Pertaining to the lymph system or lymph tissue, the “back alley” of blood circulation. Lymph is the alkaline, clear intercellular fluid that drains from the blood capillaries, where the arterial blood separates into thick, gooey venous blood and lymph. It bathes the cells, drains up into the lymph capillaries, through the lymph nodes for cleaning and checking against antibody templates, up through the body, and back to recombine with the venous blood in the upper chest. Blood in the veins is thick, mainly because part of its fluid is missing, traveling through the tissues as lymph. Lymph nodes in the small intestine absorb most of the dietary fats as well-organized chylomicrons. Lymph nodes and tissue in the spleen, thymus, and tonsils also organize lymphocytes and maintain the software memory of previously encountered antigens and their antibody defense response. Blood feeds the lymph, lymph feeds the cells, lymph cleanses the cells and returns to the blood.... lymph

A blood vessel that branches off an artery.

Arterioles branch to form capillaries.

They have muscular walls, and their nerve supply enables them to be narrowed or widened to meet the blood-flow needs of tissues they supply.... arteriole

A red, raised pinheadsized dot, from which small blood vessels radiate, due to a dilated minor artery and its connecting capillaries. Small numbers of spider naevi are common in children and pregnant women, but in larger numbers, they may indicate liver disease. (See also telangiectasia.)... spider naevus

A minute finger-like projection from a membranous surface. Millions of villi are present on the mucous lining of the small intestine. Each intestinal villus contains a small lymph vessel and a network of capillaries.

Its surface is covered with hundreds of hairlike structures (microvilli).

The villi and microvilli provide a large surface area for absorption of food molecules from the intestine into the blood and the lymphatic system.... villus

Any of the vessels that carry blood between the smallest arteries, or arterioles, and the smallest veins, or venules (see circulatory system). Capillaries form a fine network throughout the body’s organs and tissues. Their thin walls are permeable and allow blood and cells to exchange constituents such as oxygen, glucose, carbon dioxide, and water (see respiration). Capillaries open and close to blood flow according to the requirements of different organs. The opening and closing of skin capillaries helps to regulate temperature.

A direct blow to the body may rupture the thin capillary walls, causing bleeding under the surface of the skin, which in turn causes swelling and bruising. Increasing age, high doses of corticosteroid drugs, and scurvy (vitamin C deficiency) make capillaries more fragile; a tendency to purpura (small areas of bleeding under the skin) may develop.... capillary

A system of vessels (lymphatic vessels) that drains lymph from tissues all over the body back into the bloodstream. The lymphatic system is part of the immune system and has a major function in defending the body against infection and cancer. This system also plays a part in the absorption of fats from the intestine.

All body tissues are bathed in lymph, a watery fluid derived from the bloodstream. Much of this fluid is returned to

the bloodstream through the walls of the capillaries (see circulatory system), but the remainder is transported to the heart through the lymphatic system.

Lymph is moved along the lymphatic vessels during physical activity, as muscle contractions compress the vessels; valves inside the vessels ensure that the lymph flows in the correct direction. Situated on the lymphatic vessels are lymph nodes, through which the lymph passes. These nodes filter the lymph and trap infectious microorganisms or other foreign bodies. The nodes contain many lymphocytes, white blood cells that can neutralize or destroy invading bacteria and viruses. The lymphatic system also includes the spleen and the thymus, which produce lymphocytes.... lymphatic system

Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh, hot, oxygenated red stuff. After it has passed out to the capillaries and started to return, it is venous blood.... arterial

Arteries are vessels which convey oxygenated blood away from the heart to the tissues of the body, limbs and internal organs. In the case of most arteries the blood has been puri?ed by passing through the lungs, and is consequently bright red in colour; but in the pulmonary arteries, which convey the blood to the lungs, it is deoxygenated, dark, and like the blood in veins.

The arterial system begins at the left ventricle of the heart with the AORTA, which gives o? branches that subdivide into smaller and smaller vessels. The ?nal divisions, called arterioles, are microscopic and end in a network of capillaries which perforate the tissues like the pores of a sponge and bathe them in blood that is collected and brought back to the heart by veins. (See CIRCULATORY SYSTEM OF THE BLOOD.)

The chief arteries after the aorta and its branches are:

(1) the common carotid, running up each side of the neck and dividing into the internal carotid to the brain, and external carotid to the neck and face;

(2) the subclavian to each arm, continued by the axillary in the armpit, and the brachial along the inner side of the arm, dividing at the elbow into the radial and the ulnar,

which unite across the palm of the hand in arches that give branches to the ?ngers;

(3) the two common iliacs, in which the aorta ends, each of which divides into the internal iliac to the organs in the pelvis, and the external iliac to the lower limb, continued by the femoral in the thigh, and the popliteal behind the knee, dividing into the anterior and posterior tibial arteries to the front and back of the leg. The latter passes behind the inner ankle to the sole of the foot, where it forms arches similar to those in the hand, and supplies the foot and toes by plantar branches.

Structure The arteries are highly elastic, dilating at each heartbeat as blood is driven into them, and forcing it on by their resiliency (see PULSE). Every artery has three coats: (a) the outer or adventitia, consisting of ordinary strong ?brous tissue; (b) the middle or media, consisting of muscular ?bres supported by elastic ?bres, which in some of the larger arteries form distinct membranes; and (c) the inner or intima, consisting of a layer of yellow elastic tissue on whose inner surface rests a layer of smooth plate-like endothelial cells, over which ?ows the blood. In the larger arteries the muscle of the middle coat is largely replaced by elastic ?bres, which render the artery still more expansile and elastic. When an artery is cut across, the muscular coat instantly shrinks, drawing the cut end within the ?brous sheath that surrounds the artery, and bunching it up, so that a very small hole is left to be closed by blood-clot. (See HAEMORRHAGE.)... arteries

(Ale)

Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: None Saturated fat: None Cholesterol: None Carbohydrates: High Fiber: None Sodium: Low Major vitamin contribution: B vitamins Major mineral contribution: Phosphorus

About the Nutrients in This Food Beer and ale are fermented beverages created by yeasts that convert the sugars in malted barley and grain to ethyl alcohol (a.k.a. “alcohol,” “drink- ing alcohol”).* The USDA /Health and Human Services Dietary Guidelines for Americans defines one drink as 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits. One 12-ounce glass of beer has 140 calo- ries, 86 of them (61 percent) from alcohol. But the beverage—sometimes nicknamed “liquid bread”—is more than empty calories. Like wine, beer retains small amounts of some nutrients present in the food from which it was made. * Because yeasts cannot digest t he starches in grains, t he grains to be used in mak ing beer and ale are allowed to germinate ( “malt” ). When it is t ime to make t he beer or ale, t he malted grain is soaked in water, forming a mash in which t he starches are split into simple sugars t hat can be digested (fermented) by t he yeasts. If undisturbed, t he fermentat ion will cont inue unt il all t he sugars have been digested, but it can be halted at any t ime simply by raising or lowering t he temperature of t he liquid. Beer sold in bott les or cans is pasteurized to k ill t he yeasts and stop t he fermentat ion. Draft beer is not pasteurized and must be refrigerated unt il tapped so t hat it will not cont inue to ferment in t he container. The longer t he shipping t ime, t he more likely it is t hat draft beer will be exposed to temperature variat ions t hat may affect its qualit y—which is why draft beer almost always tastes best when consumed near t he place where it was brewed. The Nutrients in Beer (12-ounce glass)

Nutrients	Beer	%R DA
Calcium	17 mg	1.7
Magnesium	28.51 mg	7–9*
Phosphorus	41.1 mg	6
Potassium	85.7 mg	(na)
Zinc	0.06 mg	0.5– 0.8*
Thiamin	0.02 mg	1.6 –1.8*
R iboflavin	0.09 mg	7– 8*
Niacin	1.55 mg	10
Vitamin B6	0.17 mg	13
Folate	20.57 mcg	5

  * t he first figure is t he %R DA for a man; t he second, for a woman Source: USDA Nut rient Database: w w w.nal.usda.gov/fnic/cgi-bin /nut _search.pl.

Diets That May Restrict or Exclude This Food Bland diet Gluten-free diet Low-purine (antigout) diet

Buying This Food Look for: A popular brand that sells steadily and will be fresh when you buy it. Avoid: Dusty or warm bottles and cans.

Storing This Food Store beer in a cool place. Beer tastes best when consumed within two months of the day it is made. Since you cannot be certain how long it took to ship the beer to the store or how long it has been sitting on the grocery shelves, buy only as much beer as you plan to use within a week or two. Protect bottled beer and open bottles or cans of beer from direct sunlight, which can change sulfur compounds in beer into isopentyl mercaptan, the smelly chemical that gives stale beer its characteristic unpleasant odor.

When You Are Ready to Serve This Food Serve beer only in absolutely clean glasses or mugs. Even the slightest bit of grease on the side of the glass will kill the foam immediately. Wash beer glasses with detergent, not soap, and let them drain dry rather than drying them with a towel that might carry grease from your hands to the glass. If you like a long-lasting head on your beer, serve the brew in tall, tapering glasses to let the foam spread out and stabilize. For full flavor, serve beer and ales cool but not ice-cold. Very low temperatures immo- bilize the molecules that give beer and ale their flavor and aroma.

What Happens When You Cook This Food When beer is heated (in a stew or as a basting liquid), the alcohol evaporates but the flavor- ing agents remain intact. Alcohol, an acid, reacts with metal ions from an aluminum or iron pot to form dark compounds that discolor the pot or the dish you are cooking in. To prevent this, prepare dishes made with beer in glass or enameled pots.

Medical Uses and/or Benefits Reduced risk of heart attack. Data from the American Cancer Society’s Cancer Prevention Study 1, a 12-year survey of more than 1 million Americans in 25 states, shows that men who take one drink a day have a 21 percent lower risk of heart attack and a 22 percent lower risk of stroke than men who do not drink at all. Women who have up to one drink a day also reduce their risk of heart attack. Numerous later studies have confirmed these findings. Lower risk of stroke. In January 1999, the results of a 677-person study published by researchers at New York Presbyterian Hospital-Columbia University showed that moder- ate alcohol consumption reduces the risk of stroke due to a blood clot in the brain among older people (average age: 70). How the alcohol prevents stroke is still unknown, but it is clear that moderate use of alcohol is a key. Heavy drinkers (those who consume more than seven drinks a day) have a higher risk of stroke. People who once drank heavily, but cut their consumption to moderate levels, can also reduce their risk of stroke. Numerous later studies have confirmed these findings. Lower cholesterol levels. Beverage alcohol decreases the body’s production and storage of low-density lipoproteins (LDLs), the protein and fat particles that carr y cholesterol into your arteries. As a result, people who drink moderately tend to have lower cholesterol levels and higher levels of high density lipoproteins (HDLs), the fat and protein particles that carr y cholesterol out of the body. The USDA /Health and Human Services Dietar y Guidelines for Americans defines moderation as two drinks a day for a man, one drink a day for a woman. Stimulating the appetite. Alcoholic beverages stimulate the production of saliva and the gastric acids that cause the stomach contractions we call hunger pangs. Moderate amounts of alcoholic beverages, which may help stimulate appetite, are often prescribed for geriatric patients, convalescents, and people who do not have ulcers or other chronic gastric problems that might be exacerbated by the alcohol. Dilation of blood vessels. Alcohol dilates the capillaries (the tiny blood vessels just under the skin), and moderate amounts of alcoholic beverages produce a pleasant flush that temporar- ily warms the drinker. But drinking is not an effective way to warm up in cold weather since the warm blood that flows up to the capillaries will cool down on the surface of your skin and make you even colder when it circulates back into the center of your body. Then an alco- hol flush will make you perspire, so that you lose more heat. Excessive amounts of beverage alcohol may depress the mechanism that regulates body temperature.

Adverse Effects Associated with This Food Increased risk of breast cancer. In 2008, scientists at the National Cancer Institute released data from a seven-year survey of more than 100,000 postmenopausal women showing that even moderate drinking (one to two drinks a day) may increase by 32 percent a woman’s risk of developing estrogen-receptor positive (ER+) and progesterone-receptor positive (PR+) breast cancer, tumors whose growth is stimulated by hormones. No such link was found between consuming alcohol and the risk of developing ER-/PR- tumors (not fueled by hor- mones). The finding applies to all types of alcohol: beer, wine, and spirits. Increased risk of oral cancer (cancer of the mouth and throat). Numerous studies confirm the American Cancer Society’s warning that men and women who consume more than two drinks a day are at higher risk of oral cancer than are nondrinkers or people who drink less. Note: The Dietary Guidelines for Americans describes one drink as 12 ounces of beer, five ounces of wine, or 1.5 ounces of distilled spirits. Increased risk of cancer of the colon and rectum. In the mid-1990s, studies at the University of Oklahoma suggested that men who drink more than five beers a day are at increased risk of rectal cancer. Later studies suggested that men and women who are heavy beer or spirits drinkers (but not those who are heavy wine drinkers) have a higher risk of colorectal cancers. Further studies are required to confirm these findings. Fetal alcohol syndrome. Fetal alcohol syndrome is a specific pattern of birth defects—low birth weight, heart defects, facial malformations, and mental retardation—first recognized in a study of babies born to alcoholic women who consumed more than six drinks a day while pregnant. Subsequent research has found a consistent pattern of milder defects in babies born to women who consume three to four drinks a day or five drinks on any one occasion while pregnant. To date, there is no evidence of a consistent pattern of birth defects in babies born to women who consume less than one drink a day while pregnant, but two studies at Columbia University have suggested that as few as two drinks a week while preg- nant may raise a woman’s risk of miscarriage. (“One drink” means 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits.) Alcoholism. Alcoholism is an addiction disease, the inability to control one’s alcohol consumption. It is a potentially life-threatening condition, with a higher risk of death by accident, suicide, malnutrition, or acute alcohol poisoning, a toxic reaction that kills by para- lyzing body organs, including the heart. Malnutrition. While moderate alcohol consumption stimulates appetite, alcohol abuse depresses it. In addition, an alcoholic may drink instead of eating. When an alcoholic does eat, excess alcohol in his/her body prevents absorption of nutrients and reduces the ability to synthesize new tissue. Hangover. Alcohol is absorbed from the stomach and small intestine and carried by the bloodstream to the liver, where it is oxidized to acetaldehyde by alcohol dehydrogenase (ADH), the enzyme our bodies use to metabolize the alcohol we produce when we digest carbohydrates. The acetaldehyde is converted to acetyl coenzyme A and either eliminated from the body or used in the synthesis of cholesterol, fatty acids, and body tissues. Although individuals vary widely in their capacity to metabolize alcohol, on average, normal healthy adults can metabolize the alcohol in one quart of beer in approximately five to six hours. If they drink more than that, they will have more alcohol than the body’s natural supply of ADH can handle. The unmetabolized alcohol will pile up in the bloodstream, interfering with the liver’s metabolic functions. Since alcohol decreases the reabsorption of water from the kidneys and may inhibit the secretion of an antidiuretic hormone, they will begin to urinate copiously, losing magnesium, calcium, and zinc but retaining more irritating uric acid. The level of lactic acid in the body will increase, making them feel tired and out of sorts; their acid-base balance will be out of kilter; the blood vessels in their heads will swell and throb; and their stomachs, with linings irritated by the alcohol, will ache. The ultimate result is a “hangover” whose symptoms will disappear only when enough time has passed to allow their bodies to marshal the ADH needed to metabolize the extra alcohol in their blood. Changes in body temperature. Alcohol dilates capillaries, tiny blood vessels just under the skin, producing a “flush” that temporarily warms the drinker. But drinking is not an effective way to stay warm in cold weather. Warm blood flowing up from the body core to the surface capillaries is quickly chilled, making you even colder when it circulates back into your organs. In addition, an alcohol flush triggers perspiration, further cooling your skin. Finally, very large amounts of alcohol may actually depress the mechanism that regulates body temperature. Impotence. Excessive drinking decreases libido (sexual desire) and interferes with the ability to achieve or sustain an erection. “Beer belly.” Data from a 1995, 12,000 person study at the University of North Carolina in Chapel Hill show that people who consume at least six beers a week have more rounded abdomens than people who do not drink beer. The question left to be answered is which came first: the tummy or the drinking.

Food/Drug Interactions Acetaminophen (Tylenol, etc.). The FDA recommends that people who regularly have three or more drinks a day consult a doctor before using acetaminophen. The alcohol/acetamino- phen combination may cause liver failure. Disulfiram (Antabuse). Taken with alcohol, disulfiram causes flushing, nausea, low blood pressure, faintness, respiratory problems, and confusion. The severity of the reaction gener- ally depends on how much alcohol you drink, how much disulfiram is in your body, and how long ago you took it. Disulfiram is used to help recovering alcoholics avoid alcohol. (If taken with alcohol, metronidazole [Flagyl], procarbazine [Matulane], quinacrine [Atabrine], chlorpropamide (Diabinase), and some species of mushrooms may produce a mild disulfi- ramlike reaction.) Anticoagulants. Alcohol slows the body’s metabolism of anticoagulants (blood thinners) such as warfarin (Coumadin), intensif ying the effect of the drugs and increasing the risk of side effects such as spontaneous nosebleeds. Antidepressants. Alcohol may increase the sedative effects of antidepressants. Drinking alcohol while you are taking a monoamine oxidase (M AO) inhibitor is especially hazard- ous. M AO inhibitors inactivate naturally occurring enzymes in your body that metabolize tyramine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. If you eat a food containing tyramine while you are taking an M AO inhibitor, you cannot effectively eliminate the tyramine from your body. The result may be a hypertensive crisis. Ordinarily, fermentation of beer and ale does not produce tyramine, but some patients have reported tyramine reactions after drinking some imported beers. Beer and ale are usually prohibited to those using M AO inhibitors. Aspirin, ibuprofen, ketoprofen, naproxen, and nonsteroidal anti-inflammatory drugs. Like alcohol, these analgesics irritate the lining of the stomach and may cause gastric bleeding. Combining the two intensifies the effect. Insulin and oral hypoglycemics. Alcohol lowers blood sugar and interferes with the metabo- lism of oral antidiabetics; the combination may cause severe hypoglycemia. Sedatives and other central nervous system depressants (tranquilizers, sleeping pills, antidepres- sants, sinus and cold remedies, analgesics, and medication for motion sickness). Alcohol inten- sifies sedation and, depending on the dose, may cause drowsiness, respiratory depression, coma, or death.... beer

Tube through which blood is conducted from or to the heart. Blood from the heart is conducted via arteries and arterioles through capillaries and back to the heart via venules and then veins. (See ARTERIES and VEINS.)... blood vessel

The smallest blood or lymph vessel, formed of single layers of interconnected endothelial cells, sometimes with loosely attached connective tissue basement cells for added support. Capillaries allow the transport across their membranes and between their crevices of diffusible nutrients and waste products. Blood capillaries expand and contract, depending upon how much blood is needed in a given tissue and how much is piped into them by the small feeder arteries upstream. They further maintain a strong repelling charge that keeps blood proteins and red blood cells pushed into the center of the flow. Lymph capillaries have many open crypts, allowing free absorption of interstitial fluid forced out of the blood; these capillaries tend to maintain a charge that attracts bits of cellular garbage too large to return through the membranes of exiting venous capillaries.... caplllary

These are organized blobs of fats, synthesized in the submucosa of the small intestine out of dietary fats, phospholipids, specialized proteins and cholesterol, carried out of the intestinal tract by the lymph, and slowly released into the bloodstream. In the capillaries, the triglycerides inside the chylomicrons, recognized by their protein markers, are absorbed into the tissues for fuel or storage, and the outside cholesterol and phospholipid transport-cover continues through the blood to be absorbed by the liver for its use. This sideways approach takes (ideally) a large part of dietary fats into the lymph back alleys, spreading their release into the bloodstream out over many hours, thereby avoiding short-term blood fat and liver fat overload. To synthesize the maximum amount of dietary fats into chylomicrons, you need well-organized emulsification and digestion of lipids by the gallbladder and pancreas.... chylomicrons

Cardiovascular system. The heart, arteries, veins and capillaries.... cvs

(Brandy, gin, rum, tequila, whiskey, vodka)

Nutritional Profile Energy value (calories per serving): Moderate to high Protein: None Fat: None Saturated fat: None Cholesterol: None Carbohydrates: None (except for cordials which contain added sugar) Fiber: None Sodium: Low Major vitamin contribution: None Major mineral contribution: Phosphorus

About the Nutrients in This Food Spirits are the clear liquids produced by distilling the fermented sugars of grains, fruit, or vegetables. The yeasts that metabolize these sugars and convert them into alcohol stop growing when the concentration of alcohol rises above 12–15 percent. In the United States, the proof of an alcoholic beverage is defined as twice its alcohol content by volume: a beverage with 20 percent alcohol by volume is 40 proof. This is high enough for most wines, but not high enough for most whiskies, gins, vodkas, rums, brandies, and tequilas. To reach the concentra- tion of alcohol required in these beverages, the fermented sugars are heated and distilled. Ethyl alcohol (the alcohol in beer, wine, and spirits) boils at a lower temperature than water. When the fermented sugars are heated, the ethyl alcohol escapes from the distillation vat and condenses in tubes leading from the vat to a collection vessel. The clear liquid that collects in this vessel is called distilled spirits or, more technically, grain neutral spirits. Gins, whiskies, cordials, and many vodkas are made with spirits American whiskeys (which include bourbon, rye, and distilled from grains. blended whiskeys) and Canadian, Irish, and Scotch whiskies are all made from spirits aged in wood barrels. They get their flavor from the grains and their color from the barrels. (Some whiskies are also colored with caramel.) Vodka is made from spirits distilled and filtered to remove all flavor. By law, vodkas made in America must be made with spirits distilled from grains. Imported vodkas may be made with spirits distilled either from grains or potatoes and may contain additional flavoring agents such as citric acid or pepper. Aquavit, for example, is essentially vodka flavored with caraway seeds. Gin is a clear spirit flavored with an infusion of juniper berries and other herbs (botanicals). Cordials (also called liqueurs) and schnapps are flavored spirits; most are sweetened with added sugar. Some cordials contain cream. Rum is made with spirits distilled from sugar cane (molasses). Tequila is made with spirits distilled from the blue agave plant. Brandies are made with spirits distilled from fruit. (Arma- gnac and cognac are distilled from fermented grapes, calvados and applejack from fermented apples, kirsch from fermented cherries, slivovitz from fermented plums.) Unless they contain added sugar or cream, spirits have no nutrients other than alcohol. Unlike food, which has to be metabolized before your body can use it for energy, alcohol can be absorbed into the blood-stream directly from the gastrointestinal tract. Ethyl alcohol provides 7 calories per gram.

The Most Nutritious Way to Serve This Food The USDA /Health and Human Services Dietary Guidelines for Americans defines one drink as 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits, and “moderate drinking” as two drinks a day for a man, one drink a day for a woman.

Diets That May Restrict or Exclude This Food Bland diet Lactose-free diet (cream cordials made with cream or milk) Low-purine (antigout) diet

Buying This Food Look for: Tightly sealed bottles stored out of direct sunlight, whose energy might disrupt the structure of molecules in the beverage and alter its flavor. Choose spirits sold only by licensed dealers. Products sold in these stores are manufac- tured under the strict supervision of the federal government.

Storing This Food Store sealed or opened bottles of spirits in a cool, dark cabinet.

Preparing This Food All spirits except unflavored vodkas contain volatile molecules that give the beverage its characteristic taste and smell. Warming the liquid excites these molecules and intensifies the flavor and aroma, which is the reason we serve brandy in a round glass with a narrower top that captures the aromatic molecules as they rise toward the air when we warm the glass by holding it in our hands. Whiskies, too, though traditionally served with ice in America, will have a more intense flavor and aroma if served at room temperature.

What Happens When You Cook This Food The heat of cooking evaporates the alcohol in spirits but leaves the flavoring intact. Like other alcoholic beverages, spirits should be added to a recipe near the end of the cooking time to preserve the flavor while cooking away any alcohol bite. Alcohol is an acid. If you cook it in an aluminum or iron pot, it will combine with metal ions to form dark compounds that discolor the pot and the food you are cooking. Any recipe made with spirits should be prepared in an enameled, glass, or stainless-steel pot.

Medical Uses and/or Benefits Reduced risk of heart attack. Data from the American Cancer Society’s Cancer Prevention Study 1, a 12-year survey of more than 1 million Americans in 25 states, shows that men who take one drink a day have a 21 percent lower risk of heart attack and a 22 percent lower risk of stroke than men who do not drink at all. Women who have up to one drink a day also reduce their risk of heart attack. Numerous later studies have confirmed these findings. Lower cholesterol levels. Beverage alcohol decreases the body’s production and storage of low density lipoproteins (LDLs), the protein and fat particles that carry cholesterol into your arteries. As a result, people who drink moderately tend to have lower cholesterol levels and higher levels of high density lipoproteins (HDLs), the fat and protein particles that carry cholesterol out of the body. Numerous later studies have confirmed these findings. Lower risk of stroke. In January 1999, the results of a 677-person study published by researchers at New York Presbyterian Hospital-Columbia University showed that moderate alcohol consumption reduces the risk of stroke due to a blood clot in the brain among older people (average age: 70). How alcohol prevents stroke is still unknown, but it is clear that moderate use is a key. Heavy drinkers (those who consume more than seven drinks a day) have a higher risk of stroke. People who once drank heavily, but cut their consumption to moderate levels, reduce their risk of stroke. Stimulating the appetite. Alcoholic beverages stimulate the production of saliva and the gastric acids that cause the stomach contractions we call hunger pangs. Moderate amounts of alcoholic beverages, which may help stimulate appetite, are often prescribed for geriatric patients, convalescents, and people who do not have ulcers or other chronic gastric problems that might be exacerbated by the alcohol. Dilation of blood vessels. Alcoholic beverages dilate the tiny blood vessels just under the skin, bringing blood up to the surface. That’s why moderate amounts of alcoholic beverages (0.2–1 gram per kilogram of body weight, or two ounces of whiskey for a 150-pound adult) temporarily warm the drinker. But the warm blood that flows up to the surface of the skin will cool down there, making you even colder when it circulates back into the center of your body. Then an alcohol flush will make you perspire, so you lose more heat. Excessive amounts of beverage alcohol may depress the mechanism that regulates body temperature.

Adverse Effects Associated with This Food Alcoholism. Alcoholism is an addiction disease, the inability to control one’s alcohol consumption. It is a potentially life-threatening condition, with a higher risk of death by accident, suicide, malnutrition, or acute alcohol poisoning, a toxic reaction that kills by para- lyzing body organs, including the heart. Fetal alcohol syndrome. Fetal alcohol syndrome is a specific pattern of birth defects—low birth weight, heart defects, facial malformations, learning disabilities, and mental retarda- tion—first recognized in a study of babies born to alcoholic women who consumed more than six drinks a day while pregnant. Subsequent research has found a consistent pattern of milder defects in babies born to women who drink three to four drinks a day or five drinks on any one occasion while pregnant. To date there is no evidence of a consistent pattern of birth defects in babies born to women who consume less than one drink a day while preg- nant, but two studies at Columbia University have suggested that as few as two drinks a week while pregnant may raise a woman’s risk of miscarriage. (One drink is 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits.) Increased risk of breast cancer. In 2008, scientists at the National Cancer Institute released data from a seven-year survey of more than 100,000 postmenopausal women showing that even moderate drinking (one to two drinks a day) may increase by 32 percent a woman’s risk of developing estrogen-receptor positive (ER+) and progesterone-receptor positive (PR+) breast cancer, tumors whose growth is stimulated by hormones. No such link was found between consuming alcohol and the risk of developing ER-/PR- tumors (not fueled by hor- mones). The finding applies to all types of alcohol: beer, wine, and distilled spirits. Increased risk of oral cancer (cancer of the mouth and throat). Numerous studies confirm the A merican Cancer Societ y’s warn ing that men and women who consume more than t wo drinks a day are at higher risk of oral cancer than are nondrinkers or people who drink less. Increased risk of cancer of the colon and rectum. In the mid-1990s, studies at the University of Oklahoma suggested that men who drink more than five beers a day are at increased risk of rectal cancer. Later studies suggested that men and women who are heavy beer or spirits drinkers (but not those who are heavy wine drinkers) have a higher risk of colorectal cancers. Further studies are required to confirm these findings. Malnutrition. While moderate alcohol consumption stimulates appetite, alcohol abuses depresses it. In addition, an alcoholic may drink instead of eating. When an alcoholic does eat, excess alcohol in his/her body prevents absorption of nutrients and reduces the ability to synthesize new tissue. Hangover. Alcohol is absorbed from the stomach and small intestine and carried by the bloodstream to the liver, where it is oxidized to acetaldehyde by alcohol dehydrogenase (ADH), the enzyme our bodies use every day to metabolize the alcohol we produce when we digest carbohydrates. The acetaldehyde is converted to acetyl coenzyme A and either eliminated from the body or used in the synthesis of cholesterol, fatty acids, and body tis- sues. Although individuals vary widely in their capacity to metabolize alcohol, an adult of average size can metabolize the alcohol in four ounces (120 ml) whiskey in approximately five to six hours. If he or she drinks more than that, the amount of alcohol in the body will exceed the available supply of ADH. The surplus, unmetabolized alcohol will pile up in the bloodstream, interfering with the liver’s metabolic functions. Since alcohol decreases the reabsorption of water from the kidneys and may inhibit the secretion of an antidiuretic hormone, the drinker will begin to urinate copiously, losing magnesium, calcium, and zinc but retaining uric acid, which is irritating. The level of lactic acid in the body will increase, making him or her feel tired and out of sorts; the acid-base balance will be out of kilter; the blood vessels in the head will swell and throb; and the stomach, its lining irritated by the alcohol, will ache. The ultimate result is a hangover whose symptoms will disappear only when enough time has passed to allow the body to marshal the ADH needed to metabolize the extra alcohol in the person’s blood. Changes in body temperature. Alcohol dilates capillaries, tiny blood vessels just under the skin, producing a “flush” that temporarily warms the drinker. But drinking is not an effective way to stay warm in cold weather. Warm blood flowing up from the body core to the surface capillaries is quickly chilled, making you even colder when it circulates back into your organs. In addition, an alcohol flush triggers perspiration, further cooling your skin. Finally, very large amounts of alcohol may actually depress the mechanism that regulates body temperature. Impotence. Excessive drinking decreases libido (sexual desire) and interferes with the ability to achieve or sustain an erection. Migraine headache. Some alcoholic beverages contain chemicals that inhibit PST, an enzyme that breaks down certain alcohols in spirits so that they can be eliminated from the body. If they are not broken down by PST, these alcohols will build up in the bloodstream and may trigger a migraine headache. Gin and vodka appear to be the distilled spirits least likely to trigger headaches, brandy the most likely.

Food/Drug Interactions Acetaminophen (Tylenol, etc.). FDA recommends that people who regularly have three or more drinks a day consult a doctor before using acetaminophen. The alcohol/acetaminophen combination may cause liver failure. Anti-alcohol abuse drugs (disulfiram [Antabuse]). Taken concurrently with alcohol, the anti- alcoholism drug disulfiram can cause flushing, nausea, a drop in blood pressure, breathing difficulty, and confusion. The severity of the symptoms, which may var y among individu- als, generally depends on the amount of alcohol consumed and the amount of disulfiram in the body. Anticoagulants. Alcohol slows the body’s metabolism of anticoagulants (blood thinners), intensif ying the effect of the drugs and increasing the risk of side effects such as spontane- ous nosebleeds. Antidepressants. Alcohol may strengthen the sedative effects of antidepressants. Aspirin, ibuprofen, ketoprofen, naproxen and nonsteroidal anti-inflammatory drugs. Like alco- hol, these analgesics irritate the lining of the stomach and may cause gastric bleeding. Com- bining the two intensifies the effect. Insulin and oral hypoglycemics. Alcohol lowers blood sugar and interferes with the metabo- lism of oral antidiabetics; the combination may cause severe hypoglycemia. Sedatives and other central nervous system depressants (tranquilizers, sleeping pills, antide- pressants, sinus and cold remedies, analgesics, and medication for motion sickness). Alcohol intensifies the sedative effects of these medications and, depending on the dose, may cause drowsiness, sedation, respiratory depression, coma, or death. MAO inhibitors. Monoamine oxidase (M AO) inhibitors are drugs used as antidepressants or antihypertensives. They inhibit the action of natural enzymes that break down tyramine, a substance formed naturally when proteins are metabolized. Tyramine is a pressor amine, a chemical that constricts blood vessel and raises blood pressure. If you eat a food that contains tyramine while you are taking an M AO inhibitor, the pressor amine cannot be eliminated from your body and the result may be a hypertensive crisis (sustained elevated blood pressure). Brandy, a distilled spirit made from wine (which is fermented) contains tyramine. All other distilled spirits may be excluded from your diet when you are taking an M AO inhibitor because the spirits and the drug, which are both sedatives, may be hazard- ous in combination.... distilled spirits

A disease of children resulting in acute RENAL failure. A febrile illness of the gastrointestinal or respiratory tracts is followed by intravascular COAGULATION of blood which results in HAEMOLYSIS, ANAEMIA, THROMBOCYTOPAENIA and renal failure (resulting from ?brin deposition in renal arterioles and glomerular capillaries).

The death rate is 2–10 per cent and the majority of patients survive without renal failure. The longer the period of OLIGURIA, the greater the risk of chronic renal failure.

Treatment is supportive, with replacement of blood and clotting factors, control of HYPERTENSION, and careful observation of ?uid balance.... haemolytic uraemic syndrome

An amine (see AMINES) derived from HISTIDINE. It is widely distributed in the tissues of plants and animals, including humans. It is a powerful stimulant of gastric juice, a constrictor of smooth muscle including that of the bronchi, and a dilator of arterioles and capillaries. It is this last action which is responsible for the eruption of URTICARIA.... histamine

The course of the circulation is as follows: the veins pour their blood, coming from the head, trunk, limbs and abdominal organs, into the right atrium of the HEART. This contracts and drives the blood into the right ventricle, which then forces the blood into the LUNGS by way of the pulmonary artery. Here it is contained in thin-walled capillaries, over which the air plays freely, and through which gases pass readily out and in. The blood gives o? carbon dioxide (CO2) and takes up oxygen (see RESPIRATION), and passes on by the pulmonary veins to the left atrium of the heart. The left atrium expels it into the left ventricle, which forces it on into the aorta, by which it is distributed all over the body. Passing through capillaries in the various tissues, it enters venules, then veins, which ultimately unite into two great veins, the superior and the inferior vena cava, these emptying into the right atrium. This complete circle is accomplished by any particular drop of blood in about half a minute.

In one part of the body there is a further complication. The veins coming from the bowels, charged with food material and other products, split up, and their blood undergoes a second capillary circulation through the liver. Here it is relieved of some food material and puri?ed, and then passes into the inferior vena cava, and so to the right atrium. This is known as the portal circulation.

The circle is maintained always in one direction by four valves, situated one at the outlet from each cavity of the heart.

The blood in the arteries going to the body generally is bright red, that in the veins dull red in colour, owing to the former being charged with oxygen and the latter with carbon dioxide (see RESPIRATION). For the same reason the blood in the pulmonary artery is dark, that in the pulmonary veins is bright. There is no direct communication between the right and left sides of the heart, the blood passing from the right ventricle to the left atrium through the lungs.

In the embryo, before birth, the course of circulation is somewhat di?erent, owing to the fact that no nourishment comes from the bowels nor air into the lungs. Accordingly, two large arteries pass out of the navel, and convey blood to be changed by contact with maternal blood (see PLACENTA), while a large vein brings this blood back again. There are also communications between the right and left atria, and between pulmonary artery and aorta. The latter is known as the ductus arteriosus. At birth all these extra vessels and connections close and rapidly shrivel up.... circulatory system of the blood

(Linn.) Burm.f.

Family: Rutaceae.

Habitat: Cultivated all over India.

English: Lemon.

Ayurvedic: Jambira, Jambh, Jambhir, Jaamphal, Nimbu, Nimbuka, Naaranga, Limpaka, Dantashatha, Airaavata, Neebu (bigger var.).

Unani: Utraj.

Siddha/Tamil: Periya elumuchhai.

Action: Fruit—antiscorbutic, carminative, stomachic, antihistaminic, antibacterial. Used during coughs, colds, influenza and onset of fever (juice of roasted lemon), hiccoughs, biliousness. Fruit juice—used externally for ringworm (mixed with salt), erysipelas, also in the treatment of leprosy and white spots. Leaves and stems—antibacterial.

All parts of the plants of citrus sp. contain coumarins and psoralins. The fruits contain flavonoids and li- monoids. The flavonoids comprise three main groups—flavanones, fla- vones and 3-hydroxyflavylium (antho- cyanins); flavanones being predominantly followed by flavones and antho- cyanins. Bitter flavonoids do not occur in lemon and lime.

Lemon juice is a richer source of antiscorbutic vitamin (contains 4050 mg/100 g of vitamin C) than lime, and a fair source of carotene and vitamin B1. Volatile oil (about 2.5% of the peel) consists of about 75% limonene, alpha-and beta-pinenes, alpha-ter- pinene and citral. The fruit juice also contains coumarins and bioflavonoids.

The acid content of the fruit, once digested, provides an alkaline effect within the body and is found useful in conditions where acidity is a contributory factor (as in case of rheumatic conditions). The bioflavonoids strengthen the inner lining of blood vessels, especially veins and capillaries, and help counter varicose veins, arteriosclerosis, circulatory disorders and infections of liver, stomach and intestines.

Major flavonoid glycosides, isolated from citrus peels and juices, include hesperidin (with properties of vitamin P). Rutin and other flavanones, isolated from citrus fruits, form the principal components of vitamin P. Flavanone glycosides contained in lemon and lime juices are eriocitrin 47 and 94; hesperidin 84 and 196 mg/l, respectively.

The composition of cold pressed lime oil is quite similar to lemon oil, but citral content of lime oil is higher.

Monoterpene alcohols and their esters, aldehydes—geraniol, geranial and neral, contribute to the characteristic aroma of lemon and lime.

Dosage: Fruit—6-12 g (Juice—5- 10 ml). (API Vol. IV.)... citrus limon

The hydrogel that surrounds cells in soft tissues. It is a mucopolysaccaride starch gel, and the serum that leaves the blood capillaries flows through this gel, some to return to the exiting venous blood, some to enter the lymph system. There is an old medical axiom: the blood feeds the lymph, and the lymph feeds the cells. Interstitial fluid that flows through the starch colloid is this lymph.... interstitial fluid

Diseases affecting the kidneys can be broadly classi?ed into congenital and genetic disorders; autoimmune disorders; malfunctions caused by impaired blood supply; infections; metabolic disorders; and tumours of the kidney. Outside factors may cause functional disturbances – for example, obstruction in the urinary tract preventing normal urinary ?ow may result in hydronephrosis (see below), and the CRUSH SYNDROME, which releases proteins into the blood as a result of seriously damaged muscles (rhabdomyolosis), can result in impaired kidney function. Another outside factor, medicinal drugs, can also be hazardous to the kidney. Large quantities of ANALGESICS taken over a long time damage the kidneys and acute tubular NECROSIS can result from certain antibiotics.

K

Diagram of glomerulus (Malpighian corpuscle).

Fortunately the body has two kidneys and, as most people can survive on one, there is a good ‘functional reserve’ of kidney tissue.

Symptoms Many patients with kidney disorders do not have any symptoms, even when the condition is quite advanced. However,

others experience loin pain associated with obstruction (renal colic) or due to infection; fevers; swelling (oedema), usually of the legs but occasionally including the face and arms; blood in the urine (haematuria); and excess quantities of urine (polyuria), including at night (nocturia), due to failure of normal mechanisms in the kidney for concentrating urine. Patients with chronic renal failure often have very di?use symptoms including nausea and vomiting, tiredness due to ANAEMIA, shortness of breath, skin irritation, pins and needles (paraesthesia) due to damage of the peripheral nerves (peripheral neuropathy), and eventually (rarely seen nowadays) clouding of consciousness and death.

Signs of kidney disease include loin tenderness, enlarged kidneys, signs of ?uid retention, high blood pressure and, in patients with end-stage renal failure, pallor, pigmentation and a variety of neurological signs including absent re?exes, reduced sensation, and a coarse ?apping tremor (asterixis) due to severe disturbance of the body’s normal metabolism.

Renal failure Serious kidney disease may lead to impairment or failure of the kidney’s ability to ?lter waste products from the blood and excrete them in the urine – a process that controls the body’s water and salt balance and helps to maintain a stable blood pressure. Failure of this process causes URAEMIA – an increase in urea and other metabolic waste products – as well as other metabolic upsets in the blood and tissues, all of which produce varying symptoms. Failure can be sudden or develop more slowly (chronic). In the former, function usually returns to normal once the underlying cause has been treated. Chronic failure, however, usually irreparably reduces or stops normal function.

Acute failure commonly results from physiological shock following a bad injury or major illness. Serious bleeding or burns can reduce blood volume and pressure to the point where blood-supply to the kidney is greatly reduced. Acute myocardial infarction (see HEART, DISEASES OF) or pancreatitis (see PANCREAS, DISORDERS OF) may produce a similar result. A mismatched blood transfusion can produce acute failure. Obstruction to the urine-?ow by a stone (calculus) in the urinary tract, a bladder tumour or an enlarged prostate can also cause acute renal failure, as can glomerulonephritis (see below) and the haemolytic-uraemia syndrome.

HYPERTENSION, DIABETES MELLITUS, polycystic kidney disease (see below) or AMYLOIDOSIS are among conditions that cause chronic renal failure. Others include stone, tumour, prostatic enlargement and overuse of analgesic drugs. Chronic failure may eventually lead to end-stage renal failure, a life-threatening situation that will need DIALYSIS or a renal transplant (see TRANSPLANTATION).

Familial renal disorders include autosomal dominant inherited polycystic kidney disease and sex-linked familial nephropathy. Polycystic kidney disease is an important cause of renal failure in the UK. Patients, usually aged 30–50, present with HAEMATURIA, loin or abdominal discomfort or, rarely, urinary-tract infection, hypertension and enlarged kidneys. Diagnosis is based on ultrasound examination of the abdomen. Complications include renal failure, hepatic cysts and, rarely, SUBARACHNOID HAEMORRHAGE. No speci?c treatment is available. Familial nephropathy occurs more often in boys than in girls and commonly presents as Alport’s syndrome (familial nephritis with nerve DEAFNESS) with PROTEINURIA, haematuria, progressing to renal failure and deafness. The cause of the disease lies in an absence of a speci?c ANTIGEN in a part of the glomerulus. The treatment is conservative, with most patients eventually requiring dialysis or transplantation.

Acute glomerulonephritis is an immune-complex disorder due to entrapment within glomerular capillaries of ANTIGEN (usually derived from B haemolytic streptococci – see STREPTOCOCCUS) antibody complexes initiating an acute in?ammatory response (see IMMUNITY). The disease affects children and young adults, and classically presents with a sore throat followed two weeks later by a fall in urine output (oliguria), haematuria, hypertension and mildly abnormal renal function. The disease is self-limiting with 90 per cent of patients spontaneously recovering. Treatment consists of control of blood pressure, reduced ?uid and salt intake, and occasional DIURETICS and ANTIBIOTICS.

Chronic glomerulonephritis is also due to immunological renal problems and is also classi?ed by taking a renal biopsy. It may be subdivided into various histological varieties as determined by renal biospy. Proteinuria of various degrees is present in all these conditions but the clinical presentations vary, as do their treatments. Some resolve spontaneously; others are treated with steroids or even the cytotoxic drug CYCLOPHOSPHAMIDE or the immunosuppressant cyclosporin. Prognoses are generally satisfactory but some patients may require renal dialysis or kidney transplantation – an operation with a good success rate.

Hydronephrosis A chronic disease in which the kidney becomes greatly distended with ?uid. It is caused by obstruction to the ?ow of urine at the pelvi-ureteric junction (see KIDNEYS – Structure). If the ureter is obstructed, the ureter proximal to the obstruction will dilate and pressure will be transmitted back to the kidney to cause hydronephrosis. Obstruction may occur at the bladder neck or in the urethra itself. Enlargement of the prostate is a common cause of bladder-neck obstruction; this would give rise to hypertrophy of the bladder muscle and both dilatation of the ureter and hydronephrosis. If the obstruction is not relieved, progressive destruction of renal tissue will occur. As a result of the stagnation of the urine, infection is probable and CYSTITIS and PYELONEPHRITIS may occur.

Impaired blood supply may be the outcome of diabetes mellitus and physiological shock, which lowers the blood pressure, also affecting the blood supply. The result can be acute tubular necrosis. POLYARTERITIS NODOSA and SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) may damage the large blood vessels in the kidney. Treatment is of the underlying condition.

Infection of the kidney is called pyelonephritis, a key predisposing factor being obstruction of urine ?ow through the urinary tract. This causes stagnation and provides a fertile ground for bacterial growth. Acute pyelonephritis is more common in women, especially during pregnancy when bladder infection (CYSTITIS) spreads up the ureters to the kidney. Symptoms are fever, malaise and backache. Antibiotics and high ?uid intake are the most e?ective treatment. Chronic pyelonephritis may start in childhood as a result of congenital deformities that permit urine to ?ow up from the bladder to the kidney (re?ux). Persistent re?ux leads to recurrent infections causing permanent damage to the kidney. Specialist investigations are usually required as possible complications include hypertension and kidney failure.

Tumours of the kidney are fortunately rare. Non-malignant ones commonly do not cause symptoms, and even malignant tumours (renal cell carcinoma) may be asymptomatic for many years. As soon as symptoms appear – haematuria, back pain, nausea, malaise, sometimes secondary growths in the lungs, bones or liver, and weight loss – urgent treatment including surgery, radiotherapy and chemotherapy is necessary. This cancer occurs mostly in adults over 40 and has a hereditary element. The prognosis is not good unless diagnosed early. In young children a rare cancer called nephroblastoma (Wilm’s tumour) can occur; treatment is with surgery, radiotherapy and chemotherapy. It may grow to a substantial size before being diagnosed.

Cystinuria is an inherited metabolic defect in the renal tubular reabsorption of cystine, ornithine, lysine and arginine. Cystine precipitates in an alkaline urine to form cystine stones. Triple phosphate stones are associated with infection and may develop into a very large branching calculi (staghorn calculi). Stones present as renal or ureteric pain, or as an infection. Treatment has undergone considerable change with the introduction of MINIMALLY INVASIVE SURGERY (MIS) and the destruction of stone by sound waves (LITHOTRIPSY).... kidneys, diseases of

These are a group of cells that line the capillaries of tissues that come in contact with the outside, like skin, sinuses, and lung mucosa. They, like their first cousin basophils, are produced in the red bone marrow and migrate to the appropriate tissues, where they stay. They bind IgE, supply the histamine and heparin response that gives you a healing inflammation, and cause allergies.... mast cells

Disease of the CAPILLARIES.... microangiopathy

This is a syndrome in women, characterised by irregular intermittent bouts of generalised swelling. Sometimes the ?uid retention is more pronounced before the menstrual period (see MENSTRUATION). The eyelids are pu?y and the face and ?ngers feel sti? and bloated. The breasts may feel swollen and the abdomen distended, and ankles may swell. The diurnal weight gain may exceed 4 kg. The underlying disturbance is due to increased loss of ?uid from the vascular compartment, probably from leakage of protein from the capillaries increasing the tissue osmotic pressure. Recent evidence suggests that a decrease in the urinary excretion of DOPAMINE may contribute, as this has a natriuretic action (see NATRIURESIS). This may explain why drugs that are dopamine antagonists, such as chlorpromazine, may precipitate or aggravate cyclical oedema. Conversely, bromocriptine, a dopamine agonist, may improve the oedema.... cyclical oedema

Linn. Jacq.

Family: Sapindaceae.

Habitat: North-western Himalaya up to 1,350 m, in Punjab, South India, ascending to 2,400 m on Nilgiris. Also planted as a hedge plant in Northern India.

English: Jamacia Switch Sorrel.

Ayurvedic: Raasnaa (substitute, used in Andhra Pradesh). (Raasnaa is equated with Pluchea lanceolata C. B. Clarke.)

Siddha/Tamil: Virali, Velari.

Action: Leaves—anti-inflammatory and antibacterial (used in the treatment of swellings, burns, wounds), febrifuge, embrocation of leaves is applied to sprains. Bark— astringent and anti-inflammatory. Aerial parts—hypoglycaemic.

The plant contains bioflavonoids (vitamin P) which are biologically active in improving blood circulation and strengthening capillaries. Aqueous and alcoholic extracts of the plant exhibited cardioinhibitory and coronory constricting, also spasmolytic, sedative and hypotensive activity.

The leaves and pods gave iso-rham- netin-3-O-rutinoside, quercetin-3-O- galactoside and quercetin-3-O-rutino- side. Resin gave a diterpene carboxylic acid (hautriwaic acid). Flowers gave kaempferol.... dodonaea viscosa

Moench.

Family: Polygonaceae.

Habitat: Native to Central Asia; now grown as minor grain-crop in hilly regions of North India and the Nilgiris.

English: Buckwheat.

Ayurvedic: Kotu.

Folk: Kutu, Phaapar.

Action: Used for treating fragile capillaries, chilbains and for strengthening varicose veins. Used at a supporting herb for treating high blood pressure. Rutin is obtained from fresh or dried leaves and flowers. (Rutin is used in a variety of haemorrhagic conditions.)

The seed are commonly used in colic, choleraic diarrhoea and abdominal obstructions. Root decoction is used in rheumatic pains, lung diseases and typhoid; juice in urinary disorders. In China, used in pulmonary sepsis.

The plant is used as a venous and capillary tonic, and for alleviating venous stasis and vericose veins.

It is a potential source of rutin (yield 3-5%). The leaves and blossoms contain most of the rutin (80-90%).

Quercetin caused significant decrease in ulcer index in acute gastric ulcer with respect to control group in rats. Quercetin, rutin or kaempferol inhibited, in dose-dependent manner, gastric damage produced by acidified- ethanol in rats.

The plant also gave hyperoside and anthracene derivatives.

Buckwheat is a good source of lysine and other amino acids. The flour is reported to repress exogenous hy- percholesterolemia and promotes accumulation of triglyceride in the liver of rats.

Seed oil exhibits antimicrobial activity against Bacillus anthrasis, E.coli and Salmonella paratyphi.

Whole plant, dried or green, can cause photosensitization.... fagopyrum esculentum

The transfer of ?uid through a tissue. For example, when blood passes through the lung tissue, dissolved oxygen perfuses from the moist air in the alveoli to the blood. Fluid may also be deliberately introduced into a tissue by injecting it into the blood vessels supplying the tissue. It is used as a sign of how adequate the circulation is at the time of illness. Poor peripheral perfusion, a sign of circulatory collapse or shock, is recognised by pressing on the skin to force blood from capillaries. The time it takes for them to re?ll and the skin to become pink is noted: more than 5 seconds, and the circulation is likely to be compromised.... perfusion

The liver is the largest gland in the body, serving numerous functions, chie?y involving various aspects of METABOLISM.

Form The liver is divided into four lobes, the greatest part being the right lobe, with a small left lobe, while the quadrate and caudate lobes are two small divisions on the back and undersurface. Around the middle of the undersurface, towards the back, a transverse ?ssure (the porta hepatis) is placed, by which the hepatic artery and portal vein carry blood into the liver, and the right and left hepatic ducts emerge, carrying o? the BILE formed in the liver to the GALL-BLADDER attached under the right lobe, where it is stored.

Position Occupying the right-hand upper part of the abdominal cavity, the liver is separated from the right lung by the DIAPHRAGM and the pleural membrane (see PLEURA). It rests on various abdominal organs, chie?y the right of the two KIDNEYS, the suprarenal gland (see ADRENAL GLANDS), the large INTESTINE, the DUODENUM and the STOMACH.

Vessels The blood supply di?ers from that of the rest of the body, in that the blood collected from the stomach and bowels into the PORTAL VEIN does not pass directly to the heart, but is ?rst distributed to the liver, where it breaks up into capillary vessels. As a result, some harmful substances are ?ltered from the bloodstream and destroyed, while various constituents of the food are stored in the liver for use in the body’s metabolic processes. The liver also receives the large hepatic artery from the coeliac axis. After circulating through capillaries, the blood from both sources is collected into the hepatic veins, which pass directly from the back surface of the liver into the inferior vena cava.

Minute structure The liver is enveloped in a capsule of ?brous tissue – Glisson’s capsule – from which strands run along the vessels and penetrate deep into the organ, binding it together. Subdivisions of the hepatic artery, portal vein, and bile duct lie alongside each other, ?nally forming the interlobular vessels,

which lie between the lobules of which the whole gland is built up. Each is about the size of a pin’s head and forms a complete secreting unit; the liver is built up of hundreds of thousands of such lobules. These contain small vessels, capillaries, or sinusoids, lined with stellate KUPFFER CELLS, which run into the centre of the lobule, where they empty into a small central vein. These lobular veins ultimately empty into the hepatic veins. Between these capillaries lie rows of large liver cells in which metabolic activity occurs. Fine bile capillaries collect the bile from the cells and discharge it into the bile ducts lying along the margins of the lobules. Liver cells are among the largest in the body, each containing one or two large round nuclei. The cells frequently contain droplets of fat or granules of GLYCOGEN – that is, animal starch.

Functions The liver is, in e?ect, a large chemical factory and the heat this produces contributes to the general warming of the body. The liver secretes bile, the chief constituents of which are the bile salts (sodium glycocholate and taurocholate), the bile pigments (BILIRUBIN and biliverdin), CHOLESTEROL, and LECITHIN. These bile salts are collected and formed in the liver and are eventually converted into the bile acids. The bile pigments are the iron-free and globin-free remnant of HAEMOGLOBIN, formed in the Kup?er cells of the liver. (They can also be formed in the spleen, lymph glands, bone marrow and connective tissues.) Bile therefore serves several purposes: it excretes pigment, the breakdown products of old red blood cells; the bile salts increase fat absorption and activate pancreatic lipase, thus aiding the digestion of fat; and bile is also necessary for the absorption of vitamins D and E.

The other important functions of the liver are as follows:

In the EMBRYO it forms red blood cells, while the adult liver stores vitamin B12, necessary for the proper functioning of the bone marrow in the manufacture of red cells.

It manufactures FIBRINOGEN, ALBUMINS and GLOBULIN from the blood.

It stores IRON and copper, necessary for the manufacture of red cells.

It produces HEPARIN, and – with the aid of vitamin K – PROTHROMBIN.

Its Kup?er cells form an important part of the RETICULO-ENDOTHELIAL SYSTEM, which breaks down red cells and probably manufactures ANTIBODIES.

Noxious products made in the intestine and absorbed into the blood are detoxicated in the liver.

It stores carbohydrate in the form of glycogen, maintaining a two-way process: glucose

glycogen.

CAROTENE, a plant pigment, is converted to vitamin A, and B vitamins are stored.

It splits up AMINO ACIDS and manufactures UREA and uric acids.

It plays an essential role in the storage and metabolism of FAT.... liver

This is a type of circulatory bypass used when substances in blood or fluid need to be kept out of the general flow. A portal system begins in capillaries and ends in capillaries, and nothing leaves it undocumented. The hypothalamus sends hormones into the portal system between it and the pituitary, and the pituitary responds to it by secreting its own hormones, but dissolving the hypothalamus ones. Blood that leaves the intestinal tract, spleen, and pancreas (partially) goes into the liver’s portal system and does not leave that organ until it has been thoroughly screened and altered.... portal circulation

Granulation is the forming of connective tissue fibroblasts, epithelium and inflammatory cells around the nucleus of new capillaries in tissues that have been burned or scraped. This delicate tissue is often reinjured, and regranulation becomes a slower process, with more formation of scar tissue. Some plant resins will quickly stimulate the process, increase the complexity of healing, and lessen fibroblast scar formation.... regranulation

A small blood vessel like an enlarged capillary (see CAPILLARIES) occurring, for example, in the LIVER, which contains a large number of them. The sinusoids in the liver are drained by the hepatic veins.... sinusoid

Positioned near the surface: for example, super?cial blood vessels or capillaries lie just beneath the skin, and by contracting and expanding help to regulate body TEMPERATURE.... superficial

The increase of blood into the skin, resulting from the relaxation of the small arterioles that lead into the capillary beads at the edges of the body. This is a gentle way to lessen early high blood pressure, decreasing the difficulty of pushing columns of arterial blood through miles of capillaries.... vasodilation, peripheral

Positioned in the chest, the lungs serve primarily as respiratory organs (see RESPIRATION), also acting as a ?lter for the blood.

Form and position Each lung is a sponge-like cone, pink in children and grey in adults. Its apex projects into the neck, with the base resting on the DIAPHRAGM. Each lung is enveloped by a closed cavity, the pleural cavity, consisting of two layers of pleural membrane separated by a thin layer of ?uid. In healthy states this allows expansion and retraction as breathing occurs.

Heart/lung connections The HEART lies in contact with the two lungs, so that changes in lung volume inevitably affect the pumping action of the heart. Furthermore, both lungs are connected by blood vessels to the heart. The pulmonary artery passes from the right ventricle and divides into two branches, one of which runs straight outwards to each lung, entering its substance along with the bronchial tube at the hilum or root of the lung. From this point also emerge the pulmonary veins, which carry the blood oxygenated in the lungs back to the left atrium.

Fine structure of lungs Each main bronchial tube, entering the lung at the root, divides into branches. These subdivide again and again, to be distributed all through the substance of the lung until the ?nest tubes, known as respiratory bronchioles, have a width of only 0·25 mm (1/100 inch). All these tubes consist of a mucous membrane surrounded by a ?brous sheath. The surface of the mucous membrane comprises columnar cells provided with cilia (hair-like structures) which sweep mucus and unwanted matter such as bacteria to the exterior.

The smallest divisions of the bronchial tubes, or bronchioles, divide into a number of tortuous tubes known as alveolar ducts terminating eventually in minute sacs, known as alveoli, of which there are around 300 million.

The branches of the pulmonary artery accompany the bronchial tubes to the furthest recesses of the lung, dividing like the latter into ?ner and ?ner branches, and ending in a dense network of capillaries. The air in the air-vesicles is separated therefore from the blood only by two delicate membranes: the wall of the air-vesicle, and the capillary wall, through which exchange of gases (oxygen and carbon dioxide) readily takes place. The essential oxygenated blood from the capillaries is collected by the pulmonary veins, which also accompany the bronchi to the root of the lung.

The lungs also contain an important system of lymph vessels, which start in spaces situated between the air-vesicles and eventually leave the lung along with the blood vessels, and are connected with a chain of bronchial glands lying near the end of the TRACHEA.... lungs

An abnormal accumulation of ?uid beneath the skin, or in one or more of the cavities of the body.

Causes Oedema is not a disease, it is a sign – usually of underlying local or systemic disease. It may sometimes be visible as a swelling. Oedema occurs when the normal mechanisms for maintaining a balance between ?uid in the tissues and in the blood are upset. That balance depends mainly on the blood pressure that keeps the blood ?owing through the circulatory system – thus forcing ?uid out of the capillaries

– and the osmotic drawing force of the blood proteins which pulls water into the bloodstream. The KIDNEYS also have an essential role in maintaining this balance.

Among the disorders that may disturb this balance are heart failure, NEPHROTIC SYNDROME, kidney failure, CIRRHOSIS of the liver and a diet de?cient in protein. Injury may also cause oedema and ascites (?uid in the abdominal cavity) can occur as a result of cirrhosis of the liver or cancer in the abdominal organs.

Treatment The underlying cause of oedema should be treated and, if this is not feasible or e?ective, the excess ?uid should be excreted by boosting the output of the kidney. Restriction of sodium in the diet and the administration of DIURETICS are e?ective methods of achieving this.... oedema

A natural or artificial communication between 2 blood vessels or tubular cavities that may or may not normally be joined. Natural anastomoses usually occur when small arteries are attached directly to veins without passing through capillaries. They occur in the skin and are used to help control temperature regulation. Surgical anastomoses are used to create a bypass around a blockage in an artery or in the intestine. They are also used to rejoin cut ends of the bowel or blood vessels.

(See also bypass surgery.)... anastomosis

A general term given to arteries, veins, and capillaries (see circulatory system).... blood vessels

A discoloured area under the skin caused by leakage of blood from damaged capillaries (tiny blood vessels). At first, the blood appears blue or black; then the breakdown of haemoglobin turns the bruise yellow. If a bruise does not fade after a week, or if bruises appear for no apparent reason or are severe after only minor injury, they may be indications of a bleeding disorder. (See also black eye; purpura.)... bruise

Disease of the retina, usually caused by diabetes mellitus or persistent hypertension.

In diabetic retinopathy, the capillaries in the retina are affected by aneurysms, leak fluid, and bleed into the retina. Abnormal capillaries then grow on the retinal surface. As these are fragile, vitreous haemorrhage may occur. Fibrous tissue may also grow into the vitreous humour. Treatment by laser surgery can often halt the progress of the condition.

In hypertensive retinopathy the retinal arteries become narrowed. Areas of retina may be destroyed, and bleeding and white deposits may occur in the retina.

(See also retrolental fibroplasia.)... retinopathy

Various conditions affecting the LUNGS are dealt with under the following headings: ASTHMA; BRONCHIECTASIS; CHEST, DEFORMITIES OF; CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD); COLD, COMMON; EMPHYSEMA; EXPECTORATION; HAEMOPTYSIS; HAEMORRHAGE; OCCUPATIONAL HEALTH, MEDICINE AND DISEASES; PLEURISY; PNEUMONIA; PULMONARY EMBOLISM; TUBERCULOSIS.

In?ammation of the lungs is generally known as PNEUMONIA, when it is due to infection; as ALVEOLITIS when the in?ammation is immunological; and as PNEUMONITIS when it is due to physical or chemical agents.

Abscess of the lung consists of a collection of PUS within the lung tissue. Causes include inadequate treatment of pneumonia, inhalation of vomit, obstruction of the bronchial tubes by tumours and foreign bodies, pulmonary emboli (see EMBOLISM) and septic emboli. The patient becomes generally unwell with cough and fever. BRONCHOSCOPY is frequently performed to detect any obstruction to the bronchi. Treatment is with a prolonged course of antibiotics. Rarely, surgery is necessary.

Pulmonary oedema is the accumulation of ?uid in the pulmonary tissues and air spaces. This may be caused by cardiac disease (heart failure or disease of heart valves – see below, and HEART, DISEASES OF) or by an increase in the permeability of the pulmonary capillaries allowing leakage of ?uid into the lung tissue (see ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)).

Heart failure (left ventricular failure) can be caused by a weakness in the pumping action of the HEART leading to an increase in back pressure which forces ?uid out of the blood vessels into the lung tissue. Causes include heart attacks and HYPERTENSION (high blood pressure). Narrowed or leaking heart valves hinder the ?ow of blood through the heart; again, this produces an increase in back pressure which raises the capillary pressure in the pulmonary vessels and causes ?ooding of ?uid into the interstitial spaces and alveoli. Accumulation of ?uid in lung tissue produces breathlessness. Treatments include DIURETICS and other drugs to aid the pumping action of the heart. Surgical valve replacement may help when heart failure is due to valvular heart disease.

Acute respiratory distress syndrome Formerly known as adult respiratory distress syndrome (ARDS), this produces pulmonary congestion because of leakage of ?uid through pulmonary capillaries. It complicates a variety of illnesses such as sepsis, trauma, aspiration of gastric contents and di?use pneumonia. Treatment involves treating the cause and supporting the patient by providing oxygen.

Collapse of the lung may occur due to blockage of a bronchial tube by tumour, foreign body or a plug of mucus which may occur in bronchitis or pneumonia. Air beyond the blockage is absorbed into the circulation, causing the affected area of lung to collapse. Collapse may also occur when air is allowed into the pleural space – the space between the lining of the lung and the lining of the inside of the chest wall. This is called a pneumothorax and may occur following trauma, or spontaneously

– for example, when there is a rupture of a subpleural air pocket (such as a cyst) allowing a communication between the airways and the pleural space. Lung collapse by compression may occur when ?uid collects in the pleural space (pleural e?usion): when this ?uid is blood, it is known as a haemothorax; if it is due to pus it is known as an empyema. Collections of air, blood, pus or other ?uid can be removed from the pleural space by insertion of a chest drain, thus allowing the lung to re-expand.

Tumours of the lung are the most common cause of cancer in men and, along with breast cancer, are a major cause of cancer in women. Several types of lung cancer occur, the most common being squamous cell carcinoma, small- (or oat-) cell carcinoma, adenocarcinoma, and large-cell carcinoma. All but the adenocarcinoma have a strong link with smoking. Each type has a di?erent pattern of growth and responds di?erently to treatment. More than 30,000 men and women die of cancer of the trachea, bronchus and lung annually in England and Wales.

The most common presenting symptom is cough; others include haemoptisis (coughing up blood), breathlessness, chest pain, wheezing and weight loss. As well as spreading locally in the lung – the rate of spread varies – lung cancer commonly spawns secondary growths in the liver, bones or brain. Diagnosis is con?rmed by X-rays and bronchoscopy with biopsy.

Treatment Treatment for the two main categories of lung cancer – small-cell and nonsmall-cell cancer – is di?erent. Surgery is the only curative treatment for the latter and should be considered in all cases, even though fewer than half undergoing surgery will survive ?ve years. In those patients unsuitable for surgery, radical RADIOTHERAPY should be considered. For other patients the aim should be the control of symptoms and the maintenance of quality of life, with palliative radiotherapy one of the options.

Small-cell lung cancer progresses rapidly, and untreated patients survive for only a few months. Because the disease is often widespread by the time of diagnosis, surgery is rarely an option. All patients should be considered for CHEMOTHERAPY which improves symptoms and prolongs survival.

Wounds of the lung may cause damage to the lung and, by admitting air into the pleural cavity, cause the lung to collapse with air in the pleural space (pneumothorax). This may require the insertion of a chest drain to remove the air from the pleural space and allow the lung to re-expand. The lung may be wounded by the end of a fractured rib or by some sharp object such as a knife pushed between the ribs.... lungs, diseases of

n. 1. a modified microscope used to study capillaries. 2. a narrow flexible endoscope used to examine the interior of blood vessels.... angioscope

the watery fluid that fills the chamber of the *eye immediately behind the cornea and in front of the lens. It is continually being formed – chiefly by capillaries of the ciliary processes – and it drains away into Schlemm’s canal, at the junction of the cornea and sclera.... aqueous humour

Asclepias tuberosa. N.O. Asclepiadaceae.

Synonym: Butterfly Weed, Tuber Root, Wind Root.

Habitat: Moist, loamy soil. Indigenous to U.S.A

Features ? Stem two to three feet high, contains milky juice. Root, wrinkled longitudinally, light brown outer surface, whitish internally ; fracture tough, irregular. Rootstock knotty, faintly ringed. Acrid taste.

Part used ? Root.

Action: Diaphoretic, expectorant, antispasmodic.

Chest complaints; acts directly on the lungs, and stimulates sweat glands. Relaxes capillaries, relieving strain on heart and lungs. Reduces pain and assists breathing in pleurisy. Infusion of 1 ounce of the powdered root with 1 pint of boiling water is taken in wineglass doses, to which a teaspoonful of composition powder (Myrica compound) may be added with advantage.... pleurisy root

Prolactin is the pituitary hormone (see PITUITARY GLAND) which initiates lactation. The development of the breasts during pregnancy is ascribed to the action of OESTROGENS; prolactin starts them secreting. If lactation does not occur or fails, it may be started by injection of prolactin.

The secretion of prolactin is normally kept under tonic inhibition by the secretion of DOPAMINE which inhibits prolactin. This is formed in the HYPOTHALAMUS and secreted into the portal capillaries of the pituitary stalk to reach the anterior pituitary cells. Drugs that deplete the brain stores of dopamine or antagonise dopamine at receptor level will cause HYPERPROLACTINAEMIA and hence the secretion of milk from the breast and AMENORRHOEA. METHYLDOPA and RESERPINE deplete brain stores of dopamine and the PHENOTHIAZINES act as dopamine antagonists at receptor level. Other causes of excess secretion of prolactin are pituitary tumours, which may be minute and are then called microadenomas, or may actually enlarge the pituitary fossa and are then called macroadenomas. The most common cause of hyperprolactinaemia is a pituitary tumour. The patient may present with infertility – because patients with hyperprolactinaemia do not ovulate – or with amenorrhea and even GALACTORRHOEA.

BROMOCRIPTINE is a dopamine agonist. Treatment with bromocriptine will therefore control hyperprolactinaemia, restoring normal menstruation and ovulation and suppressing galactorrhoea. If the cause of hyperprolactinaemia is an adenomatous growth in the pituitary gland, surgical treatment should be considered.... prolactin

If the tip of one ?nger is laid on the front of the forearm, about 2·5 cm (one inch) above the wrist, and about 1 cm (half an inch) from the outer edge, the pulsations of the radial artery can be felt. This is known as the pulse, but a pulse can be felt wherever an artery of large or medium size lies near the surface.

The cause of the pulsation lies in the fact that, at each heartbeat, 80–90 millilitres of blood are driven into the AORTA, and a ?uid wave, distending the vessels as it passes, is transmitted along the ARTERIES all over the body. This pulsation falls away as the arteries grow smaller, and is ?nally lost in the minute capillaries, where a steady pressure is maintained. For this reason, the blood in the veins ?ows steadily on without any pulsation. Immediately after the wave has passed, the artery, by virtue of its great elasticity, regains its former size. The nature of this wave helps the doctor to assess the state of the artery and the action of the heart.

The pulse rate is usually about 70 per minute, but it may vary in health from 50 to 100, and is quicker in childhood and slower in old age than in middle life; it is low (at rest) in physically ?t athletes or other sports people. Fever causes the rate to rise, sometimes to 120 beats a minute or more.

In childhood and youth the vessel wall is so thin that, when su?cient pressure is made to expel the blood from it, the artery can no longer be felt. In old age, however, and in some degenerative diseases, the vessel wall becomes so thick that it may be felt like a piece of whipcord rolling beneath the ?nger.

Di?erent types of heart disease have special features of the pulse associated with them. In atrial FIBRILLATION the great character is irregularity. In patients with an incompetent AORTIC VALVE the pulse is characterised by a sharp rise and sudden collapse. (See HEART, DISEASES OF.)

An instrument known as the SPHYGMOGRAPH registers the arterial waves and a polygraph (an instrument that obtains simultaneous tracings from several di?erent sources such as radial and jugular pulse, apex beat of the heart and ELECTROCARDIOGRAM (ECG)) enables tracings to be taken from the pulse at the wrist and from the veins in the neck and simultaneous events in the two compared.

The pressure of the blood in various arteries is estimated by a SPHYGMOMANOMETER. (See BLOOD PRESSURE.)... pulse

a thick-walled blood vessel that connects an arteriole directly with a venule, thus bypassing the capillaries. Arteriovenous anastomoses are commonly found in the skin of the lips, nose, ears, hands and feet; their muscular walls can constrict to reduce blood flow or dilate to allow blood through to these areas.... arteriovenous anastomosis

a black area, sometimes called a ‘talon noir’, resulting from the rupture of capillaries in the skin in those who play basketball, squash, etc. It may be mistaken for malignant melanoma.... black heel

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

(corium) n. the true *skin: the thick layer of living tissue that lies beneath the epidermis. It consists mainly of loose connective tissue within which are blood capillaries, lymph vessels, sensory nerve endings, sweat glands and their ducts, hair follicles, sebaceous glands, and smooth muscle fibres. —dermal adj.... dermis

n. migration of cells through the walls of blood capillaries into the tissue spaces. Diapedesis is an important part of the reaction of tissues to injury (see inflammation).... diapedesis

This may occur in adults as ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS), or in newborn children, when it is also known as HYALINE MEMBRANE DISEASE. The adult syndrome consists of PULMONARY OEDEMA of non-cardiac origin. The process begins when tissue damage stimulates the autonomic nervous system, releases vasoactive substances, precipitates complement activation, and produces abnormalities of the clotting cascade – the serial process that leads to clotting of the blood (see COAGULATION). The activation of complement causes white cells to lodge in the pulmonary capillaries where they release substances which damage the pulmonary endothelium.

Respiratory distress syndrome is a complication of SHOCK, systemic SEPSIS and viral respiratory infections. It was ?rst described in 1967, and – despite advances with assisted ventilation

– remains a serious disease with a mortality of more than 50 per cent. The maintenance of adequate circulating blood volume, peripheral PERFUSION, acid-base balance and arterial oxygenation is important, and assisted ventilation should be instituted early.

In newborns the mechanism is diferent, being provoked by an inability of the lungs to manufacture SURFACTANT.... respiratory distress syndrome

A group of red blood cells arranged together like a roll of coins, usually only noticed on a slide under a microscope. Since red blood cells in a reasonably healthy person should have a mutually repelling membrane charge, this means that something like an inflammatory response or an elevation of liver-synthesized lipids (LDLs and VLDLs) is occurring. Inflammation makes the blood “sticky,” and the lipids from the liver lower the charges. Remember, of course, that I am talking about subclinical imbalances...such things as rouleau can accompany some pretty gnarly diseases. Our kind of rouleau can give you a headache or make your hands and feet cold because it’s hard to push rolls of coins through little bitty capillaries.... rouleau

A state of acute circulatory failure in which the heart’s output of blood is inadequate to provide normal PERFUSION of the major organs. It is accompanied by a fall in arterial blood pressure and is characterised by systemic arterial hypotension (arterial blood pressure less than 80 mm of mercury), sweating and signs of VASOCONSTRICTION (for example, pallor, CYANOSIS, a cold clammy skin and a low-volume pulse). These signs may be associated with clinical evidence of poor tissue perfusion, for example to the brain and kidneys, leading to mental apathy, confusion or restlessness and OLIGURIA.

Shock may result from loss of blood or plasma volume. This may occur as a result of haemorrhage or severe diarrhoea and vomiting. It may also result from peripheral pooling of blood due to such causes as TOXAEMIA or ANAPHYLAXIS. The toxaemia is commonly the result of a SEPTICAEMIA in which leakage through capillaries reduces circulating blood volume. Another form is called cardogenic shock, and is due to failure of the heart as a pump. It is most commonly seen as a result of myocardial infarction (see under HEART, DISEASES OF).

If failure of adequate blood ?ow to vital organs is prolonged, the effects can be disastrous. The ischaemic intestine permits the transfer of toxic bacterial products and proteins across its wall into the blood; renal ISCHAEMIA prevents the maintenance of a normal electrolyte and acid-base balance.

Treatment If the shock is a result of haemorrhage or diarrhoea or vomiting, replacement of blood, lost ?uid and electrolytes is of prime importance. If it is due to septicaemia, treatment of the infection is of paramount importance, and in addition, intravenous ?uids and vasopressor drugs will be required. Cardiogenic shock is treated by attention to the underlying cause. Full intensive care is likely to be required, and arti?cial ventilation and DIALYSIS may both be needed.... shock

Stone Root Tea comes from a strong herb mainly used to treat kidney issues, but it is also renowned for its improvement in the heart function. Drink a pleasant Stone Root Tea cup to strengthen your heart and feel your body lighter and healthier. Description of Stone Root Tea Stone root is a perennially growing herb, which belongs to mint family; it bears a potent lemon aroma and it is native to North America. Benefits of Stone Root Tea Stone Root Tea is used as a diuretic in removing excess fluids from the body. It can treat urinary tract problems including bladder pain and swelling stones in the kidney. Therefore it is great in increasing urine flow that results in relieving water retention. It is also known that people use Stone Root Tea to treat stomach ache and intestinal problems like indigestion. Sometimes, Stone Root Tea is effective in the treatment of headaches, hemorrhoids, laryngitis, pharyngitis or even dysentery. Moreover, Stone Root Tea has a tonic action making it effective in atonic conditions of the heart muscles, on the walls of the veins and capillaries. Its fresh leaves can be used to heal cuts, bruises and sores. Side effects of Stone Root Tea Although Stone Root Tea is a perfect remedy for gastrointestinal and circulatory problems, it can bring some unpleasant side effects with it. Drank in large quantities can cause diarrhea, nausea, dizziness, painful urination, or stomach pain. Pregnant or nursing women should avoid taking this tea without the consult of their doctor. You should also use with caution if you have high blood pressure. Stone Root Tea is effective all the way, making your heart stronger and bringing relief in the whole body. No more pains and discomfort in your life, but more and more vitality. Stone Root Tea is making a change for you. ... stone root tea benefits and side effects

n. (pl. glomeruli) 1. the network of blood capillaries contained within the cuplike end (Bowman’s capsule) of a *nephron. It is the site of primary filtration of waste products from the blood into the kidney tubule. 2. any other small rounded mass.... glomerulus

a projection of the dermis that is surrounded by the base of the hair bulb. It contains the capillaries that supply blood to the growing *hair.... hair papilla

the part of a kidney tubule that forms a loop extending towards the centre of the kidney. It is surrounded by blood capillaries, which absorb water and selected soluble substances back into the bloodstream. [F. G. J. Henle (1809–85), German anatomist]... henle’s loop

6.5 cm wide, 5 cm thick, and weighs around 140 grams.

Adult kidneys have a smooth exterior, enveloped by a tough ?brous coat that is bound to the kidney only by loose ?brous tissue and by a few blood vessels that pass between it and the kidney. The outer margin of the kidney is convex; the inner is concave with a deep depression, known as the hilum, where the vessels enter. The URETER, which conveys URINE to the URINARY BLADDER, is also joined at this point. The ureter is spread out into an expanded, funnel-like end, known as the pelvis, which further divides up into little funnels known as the calyces. A vertical section through a kidney (see diagram) shows two distinct layers: an outer one, about 4 mm thick, known as the cortex; and an inner one, the medulla, lying closer to the hilum. The medulla consists of around a dozen pyramids arranged side by side, with their base on the cortex and their apex projecting into the calyces of the ureter. The apex of each pyramid is studded with tiny holes, which are the openings of the microscopic uriniferous tubes.

In e?ect, each pyramid, taken together with the portion of cortex lying along its base, is an independent mini-kidney. About 20 small tubes are on the surface of each pyramid; these, if traced up into its substance, repeatedly subdivide so as to form bundles of convoluted tubules, known as medullary rays, passing up towards the cortex. One of these may be traced further back, ending, after a tortuous course, in a small rounded body: the Malpighian corpuscle or glomerulus (see diagram). Each glomerulus and its convoluted tubule is known as a nephron, which constitutes the functional unit of the kidney. Each kidney contains around a million nephrons.

After entering the kidney, the renal artery divides into branches, forming arches where the cortex and medulla join. Small vessels come o? these arches and run up through the cortex, giving o? small branches in each direction. These end in a tuft of capillaries, enclosed in Bowman’s capsule, which forms the end of the uriniferous tubules just described; capillaries with capsule constitute a glomerulus.

After circulating in the glomerulus, the blood leaves by a small vein, which again divides into capillaries on the walls of the uriniferous tubules. From these it is ?nally collected into the renal veins and then leaves the kidney. This double circulation (?rst through the glomerulus and then around the tubule) allows a large volume of ?uid to be removed from the blood in the glomerulus, the concentrated blood passing on to the uriniferous tubule for removal of parts of its solid contents. Other arteries come straight from the arches and supply the medulla direct; the blood from these passes through another set of capillaries and ?nally into the renal veins. This circulation is con?ned purely to the kidney, although small connections by both arteries and veins exist which pass through the capsule and, joining the lumbar vessels, communicate directly with the aorta.

Function The kidneys work to separate ?uid and certain solids from the blood. The glomeruli ?lter from the blood the non-protein portion of the plasma – around 150–200 litres in 24 hours, 99 per cent of which is reabsorbed on passing through the convoluted tubules.

Three main groups of substances are classi?ed according to their extent of uptake by the tubules:

(1) SUBSTANCES ACTIVELY REABSORBED These include amino acids, glucose, sodium, potassium, calcium, magnesium and chlorine (for more information, see under separate entries).

(2) SUBSTANCES DIFFUSING THROUGH THE TUBULAR EPITHELIUM when their concentration in the ?ltrate exceeds that in the PLASMA, such as UREA, URIC ACID and phosphates.

(3) SUBSTANCES NOT RETURNED TO THE BLOOD from the tubular ?uid, such as CREATINE, accumulate in kidney failure, resulting in general ‘poisoning’ known as URAEMIA.... structure each kidney is about 10 cm long,

Warts (verrucae) are small, solid outgrowths from the SKIN arising from the epidermis and caused by various subtypes of ‘human papilloma virus’. The causal viruses are ubiquitous and most people probably harbour them. Whether or not warts develop depends upon age, previous infection and natural resistance.

Common warts (verruca vulgaris) are seen mainly in children and young adults on the backs of the ?ngers and hands, and less often on the knees, face or scalp. They may be single or numerous and range from 1 mm to 10 mm or more in size. Untreated, they often resolve spontaneously after weeks or months. They may be occupationally contracted by butchers and meat-handlers.

Plane warts (verruca plana) are small, ?at-topped, yellowish papules seen mainly on the backs of the hands, wrists and face in young people. They may persist for years.

Digitate warts (verruca digitata) are ?nger- or thread-like warts up to 5 mm in length with a dark rough tip. They tend to grow on the eyelids or neck.

Plantar warts (verruca plantaris) occur on the soles of the feet, most commonly in older children, adolescents and young adults. Spread by walking barefoot in swimming pools, changing rooms, etc., these warts may appear as minor epidemics in institutions, such as schools. They are ?attened, yellow-white discrete lesions in the sole or heel, tender when squeezed. Multiple black points in the wart are thrombosed capillaries. Occasionally, aggregates of plantar warts form a mosaic-like plaque, especially in chronically warm, moist feet.

Genital warts are sexually transmitted. In the male they occur on the shaft of the PENIS and on the PREPUCE or around the anus. In women they occur around the entrance to the VAGINA and LABIA minora. Genital warts vary from 1–2 mm pink papules to ?orid, cauli?ower-like masses. Pregnancy facilitates their development.

Mucosal warts may develop on the mucous membranes of the mouth.

Laryngeal warts may be found in children whose mothers had genital warts (see above) at the time of delivery. Some subtypes of genital wart can infect the uterine cervix (see UTERUS), causing changes which may lead eventually to cancer.

Treatment CRYOTHERAPY – freezing with liquid nitrogen – is the principal weapon against all types of warts, but curettage (scraping out the wart with a CURETTE) and cauterisation (see ELECTROCAUTERY) or LASER therapy may be required for resistant warts. Genital warts may respond to local application of PODOPHYLLIN preparations. Sexual partners should be examined and treated if necessary. Finally, treatment of warts should not be more onerous or painful than the disease itself, since spontaneous resolution is so common.... warts

(Schönlein–Henoch purpura, anaphylactoid purpura) a common, and frequently recurrent, form of *purpura found especially (but not exclusively) in young children. It is characterized by red weals and a purple rash on the buttocks and lower legs due to bleeding into the skin from inflamed capillaries, together with arthritis, gastrointestinal symptoms, and (in some cases) nephritis. Glucocorticoids are often used for treatment. [E. H. Henoch (1820–1910), German paediatrician; J. L. Schönlein (1793–1864), German physician]... henoch–schönlein purpura

(Vivia faba), leguminosae.

Contain natural L-dopa which penetrates the intestinal epithelial cells and is transported through the blood stream to the brain capillaries where it is converted into dopamine, of value in the nutrition of Parkinson patients.

Beans should be eaten, not when fully mature, but when young, with a thin skin and easy to digest. Ninety per cent afflicted with Parkinson’s disease at an early age respond quickly. It is easily oxidised two or three days after harvest and vanishes completely as the plant stops growing and begins to dry. Patients report a marked improvement each time they eat a meal of fresh broad beans and may not require drug treatment “for many hours”. The young beans are immersed in boiling water for three minutes, and may be eaten as a preventative. ... beans, broad

Ulceration of the mouth and genitals, with iritis. Hippocrates wrote of it as one of the epidemics of Ancient Greece. Prof Behcot, himself, believed it to be due to a virus. Afflicted age group: 30s-40s.

Symptoms. Vulva or penis swollen and itching. Neuritis of the eye with possible ensuing blindness. A specific disease unrelated to herpes simplex which it resembles. There is no evidence that it is venereal. Basic pathology is inflammation of the veins, arteries and capillaries (Nettles). Thrombosis is possible (Hawthorn).

Treatment. Tea. (1) Nettles. Or (2): place half an ounce Burdock root in 1 pint water; simmer gently 20 minutes: Add 1oz Nettles. Allow to steep for further 15 minutes. Dose: 1 cup thrice daily.

Tablets/capsules. Kelp, Echinacea, Blue Flag.

Tinctures. Combine Echinacea 2; Goldenseal three-quarters; Myrrh quarter. Dose: 1-2 teaspoons in water thrice daily.

Practitioner. Tincture Colchicum BP 1973.

Topical. Bathe with dilute cider vinegar. Cold tea. Garlic ointment. Tea Tree oil diluted many times. Houseleek.

Eyedrops. Goldenseal eyedrops.

Diet. Avoid hot peppery foods, fried foods.

Low-salt. Regular raw food days.

Supplementation. Vitamin E: 500-1000iu daily. Vitamin B-complex. Calcium and Magnesium. Avoid: scented soap, talcum powder, wool (alternatives: cotton briefs, open gusset tights). Information: Bechet’s Syndrome Society, 3 Belgrave Street, Haxby Road, York Y03 7YY. ... bechet’s disease

From the Greek pertaining to the heart. Cardio-vascular pertains to the heart and blood vessels.

Cardio-actives. Herbs exercising a direct action on the heart due to the cardiac glycosides they contain. They increase output by sustaining the heart muscle without a demand for more oxygen. This group includes: Motherwort, Hawthorn, Broom, Lily of the Valley, Figwort, Bugleweed, Squills.

Cardiac glycosides, especially those of the Foxglove (digitalis) which is administered by a physician only, tend to accumulate in the body and may prove toxic when their elimination is retarded. The most important cardio-active used by the Consulting Herbalist is Lily of the Valley which has an action similar to Foxglove but without toxic effect. It is a reliable alternative to Foxglove for failure of the heart with retention of water in the body.

Cardio-tonics. Herbalists use other plants that do not contain cardiac glycosides but which have an indirect effect upon the heart. These dilate arteries and peripheral vessels, speeding the circulation, reducing high blood pressure, relieving any back-pressure on the heart caused by accumulation of blood in the lungs. There are peripheral dilators to resolve any hold-up in the circulation and others that assist a failing heart by eliminating obstruction in the bowel (laxatives), liver and kidneys (hepatics and diuretics), skin (diaphoretics and alteratives, chief of which is Figwort). The heart also may feel the benefit of a timely relaxing nervine such as Skullcap or Lime flowers. Even treatment of varicose veins indirectly assists. All of these reduce the work-load of the muscle and tend to ‘normalise’ function of the heart. Cardio-tonics include Ephedra, Motherwort, Rosemary, Mistletoe, Hawthorn, Lime flowers, Cayenne, Yarrow, Garlic, Balm.

Bugleweed is often overlooked as a cardiac sedative to relax capillaries and soothe arterial excitement. ... cardiac

Not a medical term. Puffy skin from deposition of fat. “Orange peel skin”. Occurs chiefly in women as lumpy flesh on buttocks, thighs, stomach, knees and upper arm. Though not due to increased fluid in the tissues, it is sufficient to arrest the circulation. Constriction of capillaries causes toxic wastes to build up, forming nodules that lock away fat in the tissues. Hormone imbalance also suspected. Varicose veins may appear with cellulite from poorly supportive connective tissue. Usual cause: poor posture and unhealthy lifestyle.

Treatment. To activate capillary function and assist toxic elimination: Bladderwrack, Gotu Kola, Kola, Parsley tea. A diuretic may assist by eliminating excess fluid.

Gotu Kola tea: Quarter to half a teaspoon leaves to each cup boiling water; infuse 5-10 minutes. 1 cup morning and evening.

Formula. Tea. Equal parts: Alfalfa, Clivers, Fennel, Senna leaves. 1 heaped teaspoon to each cup boiling water: infuse 5-10 minutes. Half-1 cup morning and evening.

Seline. Tablets. Ingredients: Each tablet contains Lecithin 100mg; Pulverised Dandelion 100mg; Pulverised Horsetail 100mg; Pulverised extract Fucus 5:1 30mg; Vitamin C 40mg; Vitamin B6 1mg. 1 tablet thrice daily.

Aescin. Compound isolated from Horse-chestnuts to decrease capillary permeability and swelling. Topical. Decoction of Horse-chestnuts as a lotion. Or: infusion of Bladderwrack.

Aromatherapy and Herb essences. Combination for external use. Ingredients: Almond oil 47ml; Fennel oil 1ml; Juniper oil 1ml; Cypress essence 0.5ml; Lemon essence 0.5ml. Apply to affected areas morning and evening; small area 5 drops, large area 10 drops (Gerard). Gentle massage with a string glove, loofah or massage glove.

Diet. Reduce calorie intake. Raw fresh fruits and vegetable salads to account for 50 per cent of the diet. No sweet or dried fruits. Conservatively-cooked vegetables. Seafood. Iodine-rich foods. Wholegrain cereals. Protein: beans, chicken, poached eggs, fish, little lean meat: no pork, bacon or ham. Low-fat yoghurt. Cold-pressed unsaturated oils for salad dressings with lemon juice. Dandelion coffee to stimulate liver. Avoid sugar, alcohol, bananas and white flour products. Spring water.

Supportives. Stop smoking. Adopt an alternative to the contraceptive pill. To avoid fluid retention, 2-3 glasses of water daily. ... cellulite

a collection of capillaries in the mucosa at the anterior part of the nasal septum. Nosebleeds frequently have their origin from this plexus. See epistaxis; Little’s area. [W. Kiesselbach (1839–1902), German laryngologist]... kiesselbach’s plexus

Haemorrhage. Bleeding from arteries is bright red, escaping in jerks; from the veins it is darker; steadier from the capillaries. There is an oozing of bright red blood from a cut. In an extravasation blood pours into lax tissues beneath the skin; the part becoming swollen with the appearance of a bruise.

To strengthen veins – Gentian. To enhance resistance – Echinacea. To counter failing strength – Ginseng. To promote granulation – Comfrey. To restore lacerated nerves – St John’s Wort. Nettles are a well-known traditional anti-haemorrhagic.

If bleeding is serious, control with firm finger pressure. Any one of the following may be used in the form of teas, tinctures, powders, etc.

Bowels. Ladies Mantle, Avens, Horsetail, Shepherd’s Purse, Tormentil, Raspberry leaves, Yarrow, Cranesbill, Bilberry.

Gums. Tea. Equal parts: Horsetail, St John’s Wort. (Maria Treben) Or:– Paint gums with Tincture Myrrh, Blood root, Goldenseal or Marigold.

Post-partum. (After child-birth) Goldenseal BHP (1983); Lady’s Mantle BHP (1983).

Lungs. Haemoptysis. Blood spitting. Blood root, Beth root, Lungwort, Mullein, Horsetail, St John’s Wort, Cranesbill. Bur-Marigold. Sage. Mouse Ear, Bugleweed. Nettle tea is a good stand-by.

Post-menopausal bleeding: Internal: Raspberry leaves, Ladies Mantle, Shepherd’s Purse. Plantain tea as an injection. Plugs of cotton wool saturated with Witch Hazel. To be investigated by a competent authority.

Mucous surfaces: tongue, mouth, throat, gullet. Marigold, Yarrow, Rue, Clematis erecta, Life root.

Blood root (tincture: 10-15 drops in water). Ice to suck.

Nose. Witch Hazel. Nettles. Vinegar water: to snuff into nostrils. Apply sponge soaked in cold water to back of the neck. Or: plug nose with Witch Hazel saturated cotton wool.

Hymen. See entry.

Skin. Superficial. Buckwheat, Marigold, Daisy, Tormentil, Witch Hazel, Blood root (tincture),.

Stomach. Haematemesis. The vomit of blood has the appearance of coffee grounds and is a symptom of gastric ulcer. Teas: Avens, Meadowsweet, Yarrow, Bur-Marigold, Cranesbill, Mullein.

Decoctions: Cranesbill root, Beth root, Oak bark.

After Surgery. After tissue excisions, blood clotting or wound-healing disorders for safe haemostasis: Beth root, Cranesbill root, Lady’s Mantle, St John’s Wort.

Blood in the urine. See: HAEMATURIA.

Bleeding of menses: See: MENSTRUATION.

IUD bleeding. Bleeding from intra-uterine devices: Injection: teas – Lady’s Mantle, Cranesbill, Tormentil, Marigold.

Vitamin E supplementation (International Journal of Fertility, Vol 28. 1983) Suggested dose: One 500iu capsule morning and evening.

Retinal haemorrhage. Buckwheat tea. Vitamin C: 1-3g daily. Evening Primrose oil.

Red cell stimulators: Yellow Dock root, Red Clover, Gentian.

White cell stimulators: Liquorice, Ginseng (Siberian) and Korean, Goldenseal, Echinacea.

Vitamins. C. D. K. P.

Minerals. Calcium, Iron, Selenium, Zinc.

Note: Any new episode of bleeding (rectal, gastric, etc) in those 45 and over should be investigated in hospital. Alteration of bowel habit, with bleeding, in young people should lead to referral to a doctor. ... bleeding

 Oedema. Hydrops. Not a disease but a condition. An abnormal accumulation of fluid in a body cavity or beneath the skin. Due to weakened walls of capillaries caused by circulating toxins obstructing the flow of blood or lymph. Gross oedema of nephrotic syndrome associated with low plasma protein level and high proteinuria.

Renal dropsy is worse in the early morning, with loose tissues under the eyes.

Treatment. When fluid rapidly collects it may have to be aspirated (drawn off) but before this stage is reached herbal diuretics and cardiac tonics have much to offer. In acute conditions, sweat glands should be stimulated by suitable diaphoretics to assist elimination of excess fluid through the skin. Attention to the bowels is important; a timely copious bowel action greatly assisting elimination. A well-known diuretic for dropsy is Juniper, 3 to 5 drops taken in honey 2 or 3 times daily.

Alternatives. Teas. (Simple infusions): Agrimony, Bearberry, Boldo, Boneset, Borage, Buchu, Celery seed, Clivers, Corn Silk, Dandelion leaves, Parsley leaves, Elderflowers, Bogbean, Heartsease, Lime flowers, Parsley Piert, Pellitory, Plantain, Sea Holly, Wild Carrot, Yarrow.

Decoctions. Broom tops, Lovage, Burdock root, Couchgrass, Dandelion root, Juniper berries, Blue Flag root.

Bean Cure (Phaseolus vulgaris). 1 tablespoon kidney (haricot) bean pods, sliced, in cup water simmered gently for 5 minutes. 1 cup morning and mid-day.

Sassafras root. An old Swedish colonist of the late 18th century related how his mother cured many cases of dropsy with a decoction of Sassafras root. (American Indian Medicine. Virgil Vogel, p.363) Of historic interest only, this root is no longer used in herbal practice.

Tablets/capsules. Buchu. Dandelion. Juniper. Celery. Garlic. Blue Flag.

Powders. Equal parts: Buchu, Dandelion root, Stone root, Senna leaf. Mix. Dose: 500-750mg (2 × 3 × 00 capsules or one-third to half a teaspoon) thrice daily.

Liquid Extracts. Equal parts: Buchu, Clivers, Blue Flag. Mix. 30-60 drops, thrice daily.

Practitioner. Alternatives with a record of efficacy. Tinctures.

Formula 1. Burdock, 20ml; Buchu, 20ml; Bearberry, 20ml; Aqua to 100ml. Dose: 5ml 3 times daily in water.

Formula 2. Juniper, 10ml; Buchu, 20ml; Broom, 10ml; Dandelion, 10ml. Aqua to 100ml. Dose: 5ml, 3 times daily, in water.

Topical. Poultice over kidney area: quarter of an ounce Irish Moss gently simmered in half a pint water to a jellied mass and applied on linen or suitable material to the small of the back. Repeat 2 or 3 times with fresh hot poultices.

Diet. High protein, low salt. Fresh conservatively-cooked vegetables, polyunsaturated oils. Bottled or spring water.

Supplementation. Vitamin A, B-complex, B1, B6, C, E, Potassium.

General. Elevation of affected limbs above level of abdomen.

This condition should be treated by or in liaison with a qualified medical practitioner. ... dropsy, renal

n. a chemical, present in inflammatory exudates, that attracts white blood cells (leucocytes) and increases the permeability of blood capillaries. It is probably produced by injured cells.... leukotaxine

an enzyme that catalyses the hydrolysis of triglycerides in *chylomicrons and *very low-density lipoproteins to free fatty acids, which are absorbed from the capillaries into local tissues. Deficiency of this enzyme results in severe *hypertriglyceridaemia.... lipoprotein lipase

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

Flavones. Natural chemicals that prevent the deposit of fatty material in blood vessels. A group of coloured (yellow) aromatic plant constituents with a spicy taste and smell, chiefly due to the presence of benzene. Efficient absorption of Vitamin C is dependent upon them. Their action is chiefly diuretic, antispasmodic and antiseptic. Some strengthen fragile capillaries and tone relaxed blood vessels, as in veinous disorders. They lower blood pressure.

Notable examples: Buckwheat, Coltsfoot, Citrus fruits, Hawthorn, Euphorbia, Figs, Heartsease, Pellitory of the Wall, Rutin, Skullcap, Lime flowers, Elderflowers, Shepherd’s Purse, Silver Birch, Wild Carrot, Yerba Santa and members of the labiatae family. All are immune enhancers and useful for chronic conditions where prolonged treatment produces no known toxicity. Of value in heart medicines.

Flavonoids are also pigments usually responsible for the colour of flowers and fruits and protect the plant against stress. A diet rich in raw fruit and vegetables provides adequate flavonoids.

Zutphen Elderly Study. Revealed that tea, onions and apples provided the majority of flavonoids in the overall diet. The mortality rate from coronary heart disease and myocardial infarction was lower in those with a high flavonoid intake. (Hertog MGL, National Institute of Public Health, Holland, et al The Lancet, 1993, Oct 23,1007-11)

Among red wines, Italian Chianti has the most flavonoids, with 20mg per litre, fostering healthy changes in the blood. All flavonoids are antioxidants and platelet inhibitors. Antioxidants stop oxygen from binding with LDL, a type of cholesterol. The oxygen-LDL pair clings to blood vessel walls, impeding blood flow. Flavonoids seem to suppress the stickiness. Platelet inhibitors prevent blood clots.

A diet rich in flavonoids would appear to prevent heart disease. ... flavonoids

Alopecia. Baldness. Shedding of the hair in patches leaving glossy bald areas. It is normal to lose about one hundred hairs a day, but severe stress such as unemployment, divorce or death in a family may considerably increase hair loss. Losses of long-standing are seldom recovered.

Causes: hormone deficiency (Agnus Castus) in females, where it may be associated with failing thyroid or ovarian function. In such cases, other agents include: Helonias, Motherwort, Black Haw bark. Other causes may be pregnancy, the menopause, or simply discontinuing The Pill. Certain skin diseases predispose: ringworm (Thuja), eczema (Yellow Dock), from thyroid disorder (Kelp, Blue Flag root).

Exposure to some cosmetics, excessive sunlight, strong chemicals and treatment of cancer with cytotoxic drugs may interfere with nutrition of the hair follicles. To ensure a healthy scalp a correct mineral balance is essential calling for supplementation of the diet with vitamins, selenium, zinc and silica. Yellow Dock is believed to counter toxicity of chemicals; Pleurisy root opens the pores to promote sweat and action of surface capillaries.

Baldness sometimes happens suddenly; eye-lashes or beard may be affected. Though emotional stress and a run-down condition is a frequent cause, most cases are not permanent, returning to normal with adequate treatment.

Baldness of the eyebrows alerts us to a lowered function of the thyroid gland, being an early outward sign of myxoedema. A pony-tail hair style or the wearing of a crash helmet may cause what is known as traction alopecia. Heavy coffee drinkers invariably lose hair lustre.

Soviet Research favours silica-rich plants internally and as a lotion: Horsetail, Burdock, Nettles, Bamboo gum.

Growth of hair is assisted by improving surface circulation of the scalp which is beneficial for conveying nutrients to the hair roots and facilitating drainage. Herbal vasodilators stimulate hair follicle nutrition and encourage growth: Cayenne, Pleurisy root, Black Cohosh and Prickly Ash, taken internally. A convenient way of taking Cayenne is the use of a pepper-shaker at table.

Topical. Hair rinse. 2-3 times weekly. Infusion: equal parts Yarrow, Sage and Rosemary. 1oz (30g) to 1 pint (500ml) water. Simmer gently five minutes. Allow to cool. Strain before use.

Cider vinegar – minimal success reported.

Day lotion. Liquid Extract Jaborandi half an ounce; Tincture Cantharides half an ounce; Oil Jojoba to 4oz. Shake well before use.

Oily lotion. Equal parts Olive and Eucalyptus oils.

Bay Rhum Lotion. Oil of Bay 50 drops; Olive oil half an ounce; Rum (Jamaica or other) to 4oz. Shake well before use.

Oil Rosemary: rub into hair roots.

Russian Traditional. Castor oil half an ounce; Almond oil 1oz; Oil Geranium 15 drops; Vodka to 6oz. Rub into hair roots.

Aromatherapy. To 1oz Castor oil and 1oz Olive oil add, 10 drops each – Oils Neroli, Lavender and Rosemary.

Gentian plant extract. Japanese scalp massage with extract from roots to thicken thinning hair. Some success reported.

Supplements. B-vitamins, Kelp, Silicea Biochemic salt. Zinc. Low levels of iron and zinc can cause the condition.

Note: Studies show that male occipital baldness confers a risk of heart disease, being associated with a higher total cholesterol and diastolic blood pressure than men with a full head of hair. Frontal baldness has not been found to be associated with increased risk of coronary heart disease and myocardial infarct. “It seems prudent for bald men to be specially vigorous in controlling risk factors for such conditions.” (S.M. Lesko, Journal of the American Medical Association, Feb 24, 1993, 269: 998-1003) ... hair loss

(pavementing) n. the sticking of white blood cells to the linings of the finest blood vessels (capillaries) when inflammation occurs.... pavementation

a vein or group of veins that terminates at both ends in a capillary bed. The best known is the hepatic portal system, which consists of the *portal vein and its tributaries (see illustration). Blood is drained from the spleen, stomach, pancreas, and small and large intestines into veins that merge to form the portal vein leading to the liver. Here the portal vein branches, ending in many small capillaries called *sinusoids. These permit the passage into the liver cells of nutrients absorbed by blood from the intestines.... portal system

the artery that conveys blood from the heart to the lungs for oxygenation: the only artery in the body containing deoxygenated blood. It leaves the right ventricle and passes upwards for 5 cm before dividing into two, one branch going to each lung. Within the lungs each pulmonary artery divides into many fine branches, which end in capillaries in the alveolar walls. See also pulmonary circulation.... pulmonary artery

Post phlebitis. An important fore-runner to leg ulceration without resolution of which an ulcer may reappear indefinitely. A condition due to pressure on the vascular system which causes deposition of excess fibrin in the capillaries and veins which arrests the circulation of oxygen and nutrients to the skin.

Symptoms. Those of a prelude to ulceration: eczema, pigmentation, pain.

Treatment. Aim should be (1) to reduce internal pressure on the veins and (2) to resolve deposition of fibrin.

Alternatives. Teas: Alfalfa, Nettles, Plantain. Brigham tea, Clivers, Bladderwrack.

Capsules: Evening Primrose oil (4 × 500mg) daily.

Tablets/capsules. Fucus (Bladderwrack). Motherwort. Chlorophyll, Rutin.

Formula. Equal parts: Dandelion and Burdock: add pinch or few drops Cayenne. Powders: half a teaspoon. Liquid Extracts: 2 teaspoons. Tinctures: 2-3 teaspoons. In water, thrice daily before meals. Topical. Graduated elastic stocking compression reduces tension on veins and prevents further deposition of fibrin. Juice, gels, or oils:– Aloe Vera, Houseleek, Evening Primrose, Comfrey, Chickweed, Zinc and Castor oil. ... lipodermatosclerosis

Exercises, such as swimming and cycling, that allow muscles to work at a steady rate with a constant, adequate supply of oxygen-carrying blood, and that can therefore be sustained for long periods. Oxygen is used to release energy from the body’s stores. To fuel aerobic exercise, the muscles use fatty acid, burning it completely to produce energy, carbon dioxide, and water.

When performed regularly, aerobic exercises improve stamina and endurance. They encourage the growth of capillaries, improving blood supply to the cells. Aerobic exercises also improve body cells’ capacity to use oxygen and increase the amount of oxygen the body can use in a given time. The condition of the heart also improves. (See also exercise; fitness.)... aerobics

The red fluid that circulates in the body’s veins, arteries, and capillaries. Blood is pumped by the heart via the arteries to the lungs and all other tissues and is then returned to the heart in veins (see circulatory system). Blood is the body’s transport system and plays an important role in the defence against infection. An average adult has about 5 litres of blood.

Almost half of the volume of blood consists of blood cells; these include red blood cells (erythrocytes), which carry oxygen to tissues; white blood cells (leukocytes), which fight infection; and platelets (thrombocytes), which are involved in blood clotting. The remainder of the blood volume is a watery, strawcoloured fluid called plasma, which contains dissolved proteins, sugars, fats, salts, and minerals. Nutrients are transported in the blood to the tissues after absorption from the intestinal tract or after release from storage depots such as the liver. Waste products, including urea and bilirubin are carried in the plasma to the kidneys and liver respectively.

Plasma proteins include fibrinogen; which is involved in blood clotting; immunoglobulins (also called antibodies) and complement, which are part of the immune system; and albumin. Hormones are also transported in the blood to their target organs.... blood

The heart and blood vessels, which together maintain a continuous flow of blood throughout the body. The system provides tissues with oxygen and nutrients, and carries away waste products. The circulatory system consists of 2 main parts: the systemic circulation, which supplies blood to the whole body apart from the lungs; and the pulmonary circulation to the lungs. Within the systemic circulation, there is a bypass (the portal circulation), which carries nutrient-rich blood from the stomach, intestine, and other digestive organs to the liver for processing, storage, or re-entry into general circulation.

In the systemic circulation, oxygen-rich blood from the pulmonary circulation is pumped under high pressure from the left ventricle of the heart into the aorta, from where it travels through arteries and smaller arterioles to all parts of the body. Within body tissues, the arterioles branch into networks of fine blood vessels called capillaries. Oxygen and other nutrients pass from the blood through the capillaries’ thin walls into body tissues; carbon dioxide and other wastes pass in the opposite direction. Deoxygenated blood is returned to the heart via venules, veins, and the venae cavae.

Venous blood returns to the right atrium of the heart to enter the pulmonary circulation. It is pumped from the right ventricle through the pulmonary artery

to the lungs, where carbon dioxide is exchanged for oxygen. The reoxygenated blood then returns through the pulmonary veins to the heart and re-enters the systemic circulation.... circulatory system

a system of blood vessels effecting transport of blood between the heart and lungs. Deoxygenated blood leaves the right ventricle by the pulmonary artery and is carried to the alveolar capillaries of the lungs. Gaseous exchange occurs, with carbon dioxide leaving the circulation and oxygen entering. The oxygenated blood then passes into small veins leading to the pulmonary veins, which leave the lungs and return blood to the left atrium of the heart. The oxygenated blood can then be pumped around the body via the *systemic circulation.... pulmonary circulation

n. a skin rash resulting from bleeding into the skin from small blood vessels (capillaries); the individual purple spots of the rash are called petechiae. Purpura may be due either to defects in the capillaries (nonthrombocytopenic purpura) or to a deficiency of blood platelets (thrombocytopenic purpura). See Henoch–Schönlein purpura; idiopathic thrombocytopenic purpura; thrombocytopenia; thrombotic thrombocytopenic purpura.... purpura

Inflammation of the glomeruli (see glomerulus), affecting both kidneys. Damage to the glomeruli hampers the removal of waste products, salt, and water from the bloodstream, which may cause serious complications.

Some types of glomerulonephritis are caused by immune complexes (components of the immune system produced in response to infection) becoming trapped in the glomeruli. The condition occurs in some autoimmune disorders. Infectious diseases such as malaria and schistosomiasis are important causes of glomerulonephritis in tropical countries.

Mild glomerulonephritis may produce no symptoms. Some sufferers experience a dull ache over the kidneys. The urine may become bloodstained. Loss of protein into the urine may cause oedema (see nephrotic syndrome). Hypertension is a potentially serious complication. Long-term glomerulonephritis is a common cause of chronic kidney failure.

Diagnosis involves kidney function tests, urinalysis, and kidney biopsy. Treatment depends on the cause and severity of the disease. Children with nephrotic syndrome usually respond to corticosteroid drugs. In adults, kidney failure can sometimes be prevented or delayed by drug treatment and dietary control to reduce the work of the kidneys.glomerulosclerosis Scarring caused by damage to the glomeruli (see glomerulus). Mild glomerulosclerosis occurs normally with age. Glomerulosclerosis may occur in some severe types of glomerulonephritis. It is also sometimes associated with diabetes mellitus, hypertension, AIDS, or intravenous drug abuse. glomerulus A filtering unit of the kidney that consists of a cluster of capillaries enclosed in a capsule and supplied with blood from the renal artery. Each glomerulus is a part of a larger filtering unit called a nephron. Filtered blood eventually leaves the kidney via the renal vein.

(See also glomerulonephritis.)... glomerulonephritis

Redness, swelling, heat, and pain in a tissue due to injury or infection. When body tissues become damaged, mast cells release the chemical histamine and other substances. Histamine increases the flow of blood to the damaged tissue and also makes the blood capillaries more leaky; fluid then oozes out and into the tissues, causing localized swelling. Pain is caused by the stimulation of nerve endings by the inflammatory chemicals.

Inflammation is usually accompanied by a local increase in the number of white blood cells. These cells help to destroy any invading microorganisms and are involved in repairing the damaged tissue. Inappropriate inflammation (as in rheumatoid arthritis and some

Injured skin other autoimmune disorders) may be suppressed by corticosteroid drugs or by nonsteroidal anti-inflammatory drugs.... inflammation

Either of the 2 organs that filter the blood and excrete waste products and excess water as urine. The kidneys are situated at the back of the abdominal cavity, on either side of the spine. Each kidney is surrounded by a fibrous capsule and is made up of an outer cortex and an inner medulla.

The cortex contains specialized capillaries called glomeruli, which, together with a series of tubules, make up the nephrons, the filtering units of the kidney. The nephrons filter blood under pressure and then selectively reabsorb water and certain other substances back into the blood. Urine is formed from substances that are not reabsorbed. The urine is conducted through tubules to the renal pelvis (the central collecting area of the kidney) and then through tubes called ureters to the bladder.

The kidneys also regulate the body’s fluid balance.

To do this, the kidneys excrete excess water, and when water is lost from the body (for example as a result of sweating), they conserve it (see ADH).

In addition, the kidneys control the body’s acid–base balance by adjusting urine acidity.

The kidneys are also involved in hormonal regulation of red blood cell production and blood pressure.... kidney

(stork mark) a malformation of the skin in young children consisting of dilated capillaries resulting in a light pink patch, usually on the face or back of the neck, with poorly defined borders. The patch becomes more intense in colour when the child is crying. Most lesions disappear within the first year of life but those on the nape of the neck tend to be more persistent and in some cases may remain for life.... salmon patch

the formation of thrombi in arterioles and capillaries, leading to haemolytic anaemia and *thrombocytopenia. The term encompasses primary *haemolytic uraemic syndrome and *thrombotic thrombocytopenic purpura, as well as the microangiopathies that can complicate pregnancy (pregnancy-related haemolytic uraemic syndrome, *HELLP syndrome), *malignant hypertension, *scleroderma, *antiphospholipid antibody syndrome, organ transplantation, and cancer.... thrombotic microangiopathy

n. the act of passing through or across, e.g. the passage of blood cells through the intact walls of capillaries and venules (see diapedesis).... transmigration

n. the development of blood vessels (usually capillaries) within a tissue.... vascularization

An inherited blood disease in which the red blood cells contain haemoglobin S, an abnormal type of haemoglobin. This crystallizes in the capillaries, making red cells sickle-shaped and fragile, and leading to haemolytic anaemia. The abnormal cells are unable to pass easily through tiny blood vessels. The blood supply to organs is blocked intermittently, causing sickle cell crises. The disease affects mainly black people.Symptoms usually appear after age 6 months, often beginning with painful swelling of the hands and feet. Chronic haemolytic anaemia causes fatigue, headaches, shortness of breath on exertion, pallor, and jaundice. Sickle cell crises start suddenly; they are sometimes brought on by an infection, cold weather, or dehydration, but may also occur for no apparent reason. The sufferer may experience pains (especially in the bones), blood in the urine (from kidney damage) or damage to the lungs or intestines. If the brain is affected, seizures, a stroke, or unconsciousness may result.

In some affected children, the spleen enlarges and traps red cells at a particularly high rate, causing a life-threatening form of anaemia. After adolescence, the spleen usually stops functioning, increasing the risk of infection in those affected.

Diagnosis is made from examination of a blood smear and electrophoresis.

Supportive treatment may include folic acid supplements, and penicillin and immunization to protect against infection.

Life-threatening crises are treated with intravenous infusions of fluids, antibiotics, oxygen therapy, and analgesic drugs.

If the crisis still does not respond, an exchange blood transfusion may be performed.

This may be done regularly for people who suffer frequent severe crises.... sickle cell anaemia

n. (pl. alveoli) 1. (in the *lung) a blind-ended air sac of microscopic size. About 30 alveoli open out of each alveolar duct, which leads from a respiratory *bronchiole. The alveolar walls, which separate alveoli, contain capillaries. The alveoli are lined by a single layer of *pneumocytes, which thus form a very thin layer between air and blood so that exchange of oxygen and carbon dioxide is normally rapid and complete. Children are born with about 20 million alveoli. The adult number of about 300 million is reached around the age of eight. 2. the part of the upper or lower jawbone that supports the roots of the teeth (see also mandible; maxilla). After tooth extraction it is largely absorbed. 3. the sac of a *racemose gland (see also acinus). 4. any other small cavity, depression, or sac. —alveolar adj.... alveolus

the mechanism that controls the passage of molecules from the blood into the cerebrospinal fluid and the tissue spaces surrounding the cells of the brain. The endothelial cells lining the walls of the brain capillaries are more tightly joined together at their edges than those lining capillaries supplying other parts of the body. This allows the passage of solutions and fat-soluble compounds but excludes particles and large molecules. The importance of the blood-brain barrier is that it protects the brain from the effect of many substances harmful to it. A disadvantage, however, is that many useful drugs pass only in small amounts into the brain, and much larger doses may have to be given than normal. Brain cancer, for example, is relatively insensitive to chemotherapy, although drugs such as diazepam, alcohol, and fat-soluble general anaesthetics pass readily and quickly to the brain cells.... blood-brain barrier

n. flushing of the skin due to dilatation of the blood capillaries in the dermis. It may be physiological or a sign of inflammation or infection. Erythema nodosum is characterized by tender bruiselike swellings on the shins and is often associated with streptococcal infection. In erythema multiforme the eruption, which can take various forms, is characterized by so-called ‘target lesions’ that may be recurrent and follow herpes simplex infection (especially in children) or medications (especially in adults). Erythema ab igne is a reticular pigmented rash on the lower legs or elsewhere caused by persistent exposure to radiant heat. Erythema infectiosum (fifth disease, slapped cheek syndrome) is a common benign infectious disease of children caused by erythrovirus (human *parvovirus B19). It is characterized by fever and a rash, first on the cheeks and later on the trunk and extremities, that disappears after several days. Erythema toxicum neonatorum (neonatal urticaria) is a common self-limiting asymptomatic rash appearing in up to half of newborns, usually 2–5 days after birth. It is characterized by small erythematous papules and pustules surrounded by a diffuse blotchy erythematous halo. The eruption typically resolves within the first two weeks of life. See also palmar erythema. —erythematous adj.... erythema

n. a blood vessel conveying blood towards the heart. All veins except the *pulmonary vein carry deoxygenated blood from the tissues, via the capillaries, to the vena cava (see illustration overleaf). The walls of veins consist of three tissue layers, but these are much thinner and less elastic than those of arteries. Veins contain *valves that assist the flow of blood back to the heart. Anatomical name: vena. —venous adj.... vein

n. a large glycoprotein that acts as a host defence mechanism. In the plasma it induces phagocytosis and on the cell surface it induces protein linkage which is important in the formation of new epithelium in wound healing. It is also involved in platelet aggregation. It is concentrated in connective tissue and the endothelium of the capillaries and is a component of the extracellular matrix. In pregnancy, fetal fibronectin (fFN) is found in high concentrations in secretions from the cervix and vagina before fusion of the membranes occurs at around 21 weeks of gestation. Inflammation or trauma to the fetal–maternal surface after then causes secretion of fFN into the cervix and vagina. Vaginal swabs that detect fFN can be used to predict preterm birth between 22 and 34 weeks gestation.... fibronectin

(gastric antral vascular ectasia) a condition characterized by the presence of dilated capillaries or veins in the lining of the distal stomach (the gastric *antrum), which may extend to involve the whole of the stomach. It may be diffuse or it may adopt a more linear appearance like the stripes of a watermelon (watermelon stomach). Certain medical conditions (e.g. *cirrhosis, *systemic sclerosis, and chronic renal failure) are associated with this condition. It is often asymptomatic but can lead to transfusion-dependent anaemia. Treatment focuses on management of the underlying condition and endoscopic treatment of bleeding areas using *argon plasma coagulation or laser thermocoagulation.... gave

n. a type of worm that possesses suckers at both ends of its body. Leeches occur in tropical forests and grasslands and in water. Certain parasitic species suck blood from animals and humans, and their bites cause irritation and, in some cases, infection. A leech can be detached from its host by applying salt. Formerly widely used for letting blood, the medicinal leech (Hirudo medicinalis) may now be used following microsurgery (e.g. to replace a severed finger) to restore patency to blocked or collapsed blood vessels and thus encourage the growth of new capillaries. The anticoagulants in the saliva of this and other species are now used for the treatment and prevention of thrombosis (see hirudin).... leech

n. one of the pair of organs of *respiration, situated in the chest cavity on either side of the heart and enclosed by a serous membrane (see pleura). The lungs are fibrous elastic sacs that are expanded and compressed by movements of the rib cage and diaphragm during *breathing. They communicate with the atmosphere through the *trachea, which opens into the pharynx. The trachea divides into two bronchi (see bronchus), which enter the lungs and branch into *bronchioles. These divide further and terminate in minute air sacs (see alveolus), the sites of gaseous exchange. (See illustration.) Atmospheric oxygen is absorbed and carbon dioxide from the blood of the pulmonary capillaries is released into the lungs; in each case down a concentration gradient (see pulmonary circulation). The total capacity of the lungs in an adult male is about 5.5 litres, but during normal breathing only about 500 ml of air is exchanged (see also residual volume). Other functions of the lung include water evaporation: an important factor in the fluid balance and heat regulation of the body.

British Lung Foundation: basic information on the lungs and some common lung conditions... lung