Chea Health Dictionary

Acquired Immune De?ciency Syndrome (AIDS) is the clinical manifestation of infection with Human Immunode?ciency Virus (HIV). HIV belongs to the retroviruses, which in turn belong to the lentiviruses (characterised by slow onset of disease). There are two main HIV strains: HIV-1, by far the commonest; and HIV-2, which is prevalent in Western Africa (including Ivory Coast, Gambia, Mali, Nigeria and Sierra Leone). HIV attacks the human immune system (see IMMUNITY) so that the infected person becomes susceptible to opportunistic infections, such as TUBERCULOSIS, PNEUMONIA, DIARRHOEA, MENINGITIS and tumours such as KAPOSI’S SARCOMA. AIDS is thus the disease syndrome associated with advanced HIV infection.

Both HIV-1 and HIV-2 are predominantly sexually transmitted and both are associated with secondary opportunistic infections. However, HIV-2 seems to result in slower damage to the immune system. HIV-1 is known to mutate rapidly and has given rise to other subtypes.

HIV is thought to have occurred in humans in the 1950s, but whether or not it infected humans from another primate species is uncertain. It became widespread in the 1970s but its latency in causing symptoms meant that the epidemic was not noticed until the following decade. Although it is a sexually transmitted disease, it can also be transmitted by intravenous drug use (through sharing an infected needle), blood transfusions with infected blood (hence the importance of e?ective national blood-screening programmes), organ donation, and occupationally (see health-care workers, below). Babies born of HIV-positive mothers can be infected before or during birth, or through breast feeding.

Although HIV is most likely to occur in blood, semen or vaginal ?uid, it has been found in saliva and tears (but not sweat); however, there is no evidence that the virus can be transmitted from these two body ?uids. There is also no evidence that HIV can be transmitted by biting insects (such as mosquitoes). HIV does not survive well in the environment and is rapidly destroyed through drying.

Prevalence At the end of 2003 an estimated 42 million people globally were infected with HIV – up from 40 million two years earlier. About one-third of those with HIV/AIDS are aged 15–24 and most are unaware that they are carrying the virus. During 2003 it is estimated that 5 million adults and children worldwide were newly infected with HIV, and that 3 million adults and children died. In Africa in 2003,

3.4 million people were newly infected and 2.3 million died, with more than 28 million carrying the virus. HIV/AIDS was the leading cause of death in sub-Saharan Africa where over half of the infections were in women and 90 per cent of cases resulted from heterosexual sex. In some southern African countries, one in three pregnant women had HIV.

In Asia and the Paci?c there were 1.2 million new infections and 435,000 deaths. The area with the fastest-growing epidemic is Eastern Europe, especially the Russian Federation where in 2002 around a million people had HIV and there were an estimated 250,000 new infections, with intravenous drug use a key contributor to this ?gure. Seventy-?ve per cent of cases occurred in men, with male-to-male sexual transmission an important cause of infection, though heterosexual activity is a rising cause of infection.

At the end of 2002 the UK had an estimated 55,900 HIV-infected adults aged between 15 and 59. More than 3,600 individuals were newly diagnosed with the infection in 2000, the highest annual ?gure since the epidemic started

– in 1998 the ?gure was 2,817 and in 1999 just over 3,000 (Department of Health and Communicable Disease Surveillance Centre). The incidence of AIDS in the UK has declined sharply since the introduction of highly active antiretroviral therapy (HAART) and HIV-related deaths have also fallen: in 2002 there were 777 reported new AIDS cases and 395 deaths, compared with 1,769 and 1,719 respectively in 1995. (Sources: UNAIDS and WHO, AIDS Epidemic Update, December 2001; Public Health Laboratory Services AIDS and STD Centre Communicable Disease Surveillance and Scottish Centre for Infection and Environmental Health, Quarterly Surveillance Tables.)

Poverty is strongly linked to the spread of AIDS, for various reasons including lack of health education; lack of e?ective public-health awareness; women having little control over sexual behaviour and contraception; and, by comparison with the developed world, little or no access to antiretroviral drugs.

Pathogenesis The cellular target of HIV infection is a subset of white blood cells called T-lymphocytes (see LYMPHOCYTE) which carry the CD4 surface receptor. These so-called ‘helper T-cells’ are vital to the function of cell-mediated immunity. Infection of these cells leads to their destruction (HIV replicates at an enormous rate – 109) and over the course of several years the body is unable to generate suf?cient new cells to keep pace. This leads to progressive destruction of the body’s immune capabilities, evidenced clinically by the development of opportunistic infection and unusual tumours.

Monitoring of clinical progression It is possible to measure the number of viral particles present in the plasma. This gives an accurate guide to the likely progression rate, which will be slow in those individuals with fewer than 10,000 particles per ml of plasma but progressively more rapid above this ?gure. The main clinical monitoring of the immune system is through the numbers of CD4 lymphocytes in the blood. The normal count is around 850 cells per ml and, without treatment, eventual progression to AIDS is likely in those individuals whose CD4 count falls below 500 per ml. Opportunistic infections occur most frequently when the count falls below 200 per ml: most such infections are treatable, and death is only likely when the CD4 count falls below 50 cells per ml when infection is developed with organisms that are di?cult to treat because of their low intrinsic virulence.

Simple, cheap and highly accurate tests are available to detect HIV antibodies in the serum. These normally occur within three months of infection and remain the cornerstone of the diagnosis.

Clinical features Most infected individuals have a viral illness some three weeks after contact with HIV. The clinical features are often non-speci?c and remain undiagnosed but include a ?ne red rash, large lymph nodes, an in?uenza-like illness, cerebral involvement and sometimes the development of opportunistic infections. The antibody test may be negative at this stage but there are usually high levels of virus particles in the blood. The antibody test is virtually always positive within three months of infection. HIV infection is often subsequently asymptomatic for a period of ten years or more, although in most patients progressive immune destruction is occurring during this time and a variety of minor opportunistic infections such as HERPES ZOSTER or oral thrush (see CANDIDA) do occur. In addition, generalised LYMPHADENOPATHY is present in a third of patients and some suffer from severe malaise, weight loss, night sweats, mild fever, ANAEMIA or easy bruising due to THROMBOCYTOPENIA.

The presentation of opportunistic infection is highly variable but usually involves either the CENTRAL NERVOUS SYSTEM, the gastrointestinal tract or the LUNGS. Patients may present with a sudden onset of a neurological de?cit or EPILEPSY due to a sudden onset of a STROKE-like syndrome, or epilepsy due to a space-occupying lesion in the brain – most commonly TOXOPLASMOSIS. In late disease, HIV infection of the central nervous system itself may produce progressive memory loss, impaired concentration and mental slowness called AIDS DEMENTIA. A wide variety of opportunistic PROTOZOA or viruses produces DYSPHAGIA, DIARRHOEA and wasting. In the respiratory system the commonest opportunistic infection associated with AIDS, pneumonia, produces severe shortness of breath and sometimes CYANOSIS, usually with a striking lack of clinical signs in the chest.

In very late HIV infection, when the CD4 count has fallen below 50 cells per ml, infection with CYTOMEGALOVIRUS may produce progressive retinal necrosis (see EYE, DISORDERS OF) which will lead to blindness if untreated, as well as a variety of gastrointestinal symptoms. At this stage, infection with atypical mycobacteria is also common, producing severe anaemia, wasting and fevers. The commonest tumour associated with HIV is Kaposi’s sarcoma which produces purplish skin lesions. This and nonHodgkin’s lymphoma (see LYMPHOMA), which is a hundred times more frequent among HIV-positive individuals than in the general population, are likely to be associated with or caused by opportunistic viral infections.

Prevention There is, as yet, no vaccine to prevent HIV infection. Vaccine development has been hampered

by the large number of new HIV strains generated through frequent mutation and recombination.

because HIV can be transmitted as free virus and in infected cells.

because HIV infects helper T-cells – the very cells involved in the immune response. There are, however, numerous research pro

grammes underway to develop vaccines that are either prophylactic or therapeutic. Vaccine-development strategies have included: recombinant-vector vaccines, in which a live bacterium or virus is genetically modi?ed to carry one or more of the HIV genes; subunit vaccines, consisting of small regions of the HIV genome designed to induce an immune response without infection; modi?ed live HIV, which has had its disease-promoting genes removed; and DNA vaccines – small loops of DNA (plasmids) containing viral genes – that make the host cells produce non-infectious viral proteins which, in turn, trigger an immune response and prime the immune system against future infection with real virus.

In the absence of an e?ective vaccine, preventing exposure remains the chief strategy in reducing the spread of HIV. Used properly, condoms are an extremely e?ective method of preventing exposure to HIV during sexual intercourse and remain the most important public-health approach to countering the further acceleration of the AIDS epidemic. The spermicide nonoxynol-9, which is often included with condoms, is known to kill HIV in vitro; however, its e?ectiveness in preventing HIV infection during intercourse is not known.

Public-health strategies must be focused on avoiding high-risk behaviour and, particularly in developing countries, empowering women to have more control over their lives, both economically and socially. In many of the poorer regions of the world, women are economically dependent on men and refusing sex, or insisting on condom use, even when they know their partners are HIV positive, is not a straightforward option. Poverty also forces many women into the sex industry where they are at greater risk of infection.

Cultural problems in gaining acceptance for universal condom-use by men in some developing countries suggests that other preventive strategies should also be considered. Microbicides used as vaginal sprays or ‘chemical condoms’ have the potential to give women more direct control over their exposure risk, and research is underway to develop suitable products.

Epidemiological studies suggest that male circumcision may o?er some protection against HIV infection, although more research is needed before this can be an established public-health strategy. Globally, about 70 per cent of infected men have acquired the virus through unprotected vaginal sex; in these men, infection is likely to have occurred through the penis with the mucosal epithelia of the inner surface of the foreskin and the frenulum considered the most likely sites for infection. It is suggested that in circumcised men, the glans may become keratinised and thus less likely to facilitate infection. Circumcision may also reduce the risk of lesions caused by other sexually transmitted disease.

Treatment AIDS/HIV treatment can be categorised as speci?c therapies for the individual opportunistic infections – which ultimately cause death – and highly active antiretroviral therapy (HAART) designed to reduce viral load and replication. HAART is also the most e?ective way of preventing opportunistic infections, and has had a signi?cant impact in delaying the onset of AIDS in HIV-positive individuals in developed countries.

Four classes of drugs are currently in use. Nucleoside analogues, including ZIDOVUDINE and DIDANOSINE, interfere with the activity of the unique enzyme of the retrovirus reverse transcriptase which is essential for replication. Nucleotide analogues, such as tenofovir, act in the same way but require no intracellular activation. Non-nucleoside reverse transcriptase inhibitors, such as nevirapine and EFAVIRENZ, act by a di?erent mechanism on the same enzyme. The most potent single agents against HIV are the protease inhibitors, such as lopinavir, which render a unique viral enzyme ineffective. These drugs are used in a variety of combinations in an attempt to reduce the plasma HIV viral load to below detectable limits, which is achieved in approximately 90 per cent of patients who have not previously received therapy. This usually also produces a profound rise in CD4 count. It is likely, however, that such treatments need to be lifelong – and since they are associated with toxicities, long-term adherence is di?cult. Thus the optimum time for treatment intervention remains controversial, with some clinicians believing that this should be governed by the viral load rising above 10,000 copies, and others that it should primarily be designed to prevent the development of opportunistic infections – thus, that initiation of therapy should be guided more by the CD4 count.

It should be noted that the drug regimens have been devised for infection with HIV-1; it is not known how e?ective they are at treating infection with HIV-2.

HIV and pregnancy An HIV-positive woman can transmit the virus to her fetus, with the risk of infection being particularly high during parturition; however, the risk of perinatal HIV transmission can be reduced by antiviral drug therapy. In the UK, HIV testing is available to all women as part of antenatal care. The bene?ts of antenatal HIV testing in countries where antiviral drugs are not available are questionable. An HIV-positive woman might be advised not to breast feed because of the risks of transmitting HIV via breastmilk, but there may be a greater risk associated with not breast feeding at all. Babies in many poor communities are thought to be at high risk of infectious diseases and malnutrition if they are not breast fed and may thus be at greater overall risk of death during infancy.

Counselling Con?dential counselling is an essential part of AIDS management, both in terms of supporting the psychological wellbeing of the individual and in dealing with issues such as family relations, sexual partners and implications for employment (e.g. for health-care workers). Counsellors must be particularly sensitive to culture and lifestyle issues. Counselling is essential both before an HIV test is taken and when the results are revealed.

Health-care workers Health-care workers may be at risk of occupational exposure to HIV, either through undertaking invasive procedures or through accidental exposure to infected blood from a contaminated needle (needlestick injury). Needlestick injuries are frequent in health care – as many as 600,000 to 800,000 are thought to occur annually in the United States. Transmission is much more likely where the worker has been exposed to HIV through a needlestick injury or deep cut with a contaminated instrument than through exposure of mucous membranes to contaminated blood or body ?uids. However, even where exposure occurs through a needlestick injury, the risk of seroconversion is much lower than with a similar exposure to hepatitis C or hepatitis B. A percutaneous exposure to HIV-infected blood in a health-care setting is thought to carry a risk of about one infection per 300 injuries (one in 1,000 for mucous-membrane exposure), compared with one in 30 for hepatitis C, and one in three for hepatitis B (when the source patient is e-antigen positive).

In the event of an injury, health-care workers are advised to report the incident immediately where, depending on a risk assessment, they may be o?ered post-exposure prophylaxis (PEP). They should also wash the contaminated area with soap and water (but without scrubbing) and, if appropriate, encourage bleeding at the site of injury. PEP, using a combination of antiretroviral drugs (in a similar regimen to HAART – see above), is thought to greatly reduce the chances of seroconversion; it should be commenced as soon as possible, preferably within one or two hours of the injury. Although PEP is available, safe systems of work are considered to o?er the greatest protection. Double-gloving (latex gloves remove much of the blood from the surface of the needle during a needlestick), correct use of sharps containers (for used needles and instruments), avoiding the resheathing of used needles, reduction in the number of blood samples taken from a patient, safer-needle devices (such as needles that self-blunt after use) and needleless drug administration are all thought to reduce the risk of exposure to HIV and other blood-borne viruses. Although there have been numerous cases of health-care workers developing HIV through occupational exposure, there is little evidence of health-care workers passing HIV to their patients through normal medical procedures.... aids/hiv

A parasitic infection caused by the nematodes Ancylostoma duodenale and Necator americanus, resulting in hookworm disease. These infections are exceedingly common in tropical and developing countries, millions of people being affected. Classically, A. duodenale occurred in the Far East, Mediterranean littoral, and Middle East, and N. americanus in tropical Africa, Central and South America, and the Far East; however, in recent years, geographical separation of the two human species is less distinct. In areas where standards of hygiene and sanitation are unsatisfactory, larvae (embryos) enter via intact skin, usually the feet. ‘Ground itch’ occasionally occurs as larvae enter the body. They then undergo a complex life-cycle, migrating through the lungs, trachea, and pharynx. Adult worms are 5–13 (mean 12) mm in length; their normal habitat is the small INTESTINE – especially the jejunum – where they adhere to the mucosa by hooks, thus causing seepage of blood into the lumen. A worm-pair produces large numbers of eggs, which are excreted in faeces; when deposited on moist soil they remain viable for many weeks or months. Clinical manifestations include microcytic hypochromic ANAEMIA, hypoalbuminaemia (low serum protein) and, in a severe case, OEDEMA. A chronic infection in childhood can give rise to physical, mental and sexual retardation. Treatment is with one of the benzimidazole compounds, usually mebendazole or albendazole; however, in developing countries, cheaper preparations are used, including tetrachloroethylene, bephenium hydroxynaphthoate, and pyrantel embonate. Anaemia usually responds to iron supplements; blood transfusion is rarely indicated.

Ancylostoma braziliensis A nematode infection of dogs, which in humans causes local disease (larva migrans) only, generally on the soles of the feet. It is usually acquired by walking on beaches contaminated with dog faeces in places such as the Caribbean.... ancylostomiasis

The term applied to an organic substance in which the hydrogen and oxygen are usually in the proportion to form water. Carbohydrates are all, chemically considered, derivatives of simple forms of sugar and are classi?ed as monosaccharides (e.g. glucose), disaccharides

(e.g. cane sugar), polysaccharides (e.g. starch). Many of the cheaper and most important foods are included in this group, which comprises sugars, starches, celluloses and gums. When one of these foods is digested, it is converted into a simple kind of sugar and absorbed in this form. Excess carbohydrates, not immediately needed by the body, are stored as glycogen in the liver and muscles. In DIABETES MELLITUS, the most marked feature consists of an inability on the part of the tissues to assimilate and utilise the carbohydrate material. Each gram of carbohydrate is capable of furnishing slightly over 4 Calories of energy. (See CALORIE; DIET.)... carbohydrate

(Hebrew) One who loves and is loved Chibah, Cheeba, Cheebah, Cheiba, Cheibah, Chieba, Chiebah, Cheaba, Cheabah, Chyba, Chybah... chiba

Contact lenses are lenses worn in contact with the EYE, behind the eyelids and in front of the cornea. They may be worn for cosmetic, optical or therapeutic reasons. The commonest reason for wear is cosmetic, many short-sighted people preferring to wear contact lenses instead of glasses. Optical reasons for contact-lens wear include cataract surgery (usually unilateral extraction) and the considerable improvement in overall standard of vision experienced by very short-sighted people when wearing contact lenses instead of glasses. Therapeutic lenses are those used in the treatment of eye disease: ‘bandage lenses’ are used in certain corneal diseases; contact lenses can be soaked in a particular drug and then put on the eye so that the drug slowly leaks out on to the eye. Contact lenses may be hard, soft or gas permeable. Hard lenses are more optically accurate (because they are rigid), cheaper and more durable than soft. The main advantage of soft lenses is that they are more comfortable to wear. Gas-permeable lenses are so-called because they are more permeable to oxygen than other lenses, thus allowing more oxygen to reach the cornea.

Disposable lenses are soft lenses designed to be thrown away after a short period of continuous use; their popularity rests on the fact that they need not be cleaned. The instructions on use should be followed carefully because the risk of complications, such as corneal infection, are higher than with other types of contact lenses.

Contraindications to the use of contact lenses include a history of ATOPY, ‘dry eyes’, previous GLAUCOMA surgery and a person’s inability to cope with the management of lenses. The best way to determine whether contact lenses are suitable, however, may be to try them out. Good hygiene is essential for wearers so as to minimise the risk of infection, which may lead to a corneal abscess – a serious complication. Corneal abrasions are fairly common and, if a contact-lens wearer develops a red eye, the lens should be removed and the eye tested with ?uorescein dye to identify any abrasions. Appropriate treatment should be given and the lens not worn again until the abrasion or infection has cleared up.... contact lenses

Physical or psychological reliance on a substance or an individual. A baby is naturally dependent on its parents, but as the child develops, this dependence lessens. Some adults, however, remain partly dependent, making abnormal demands for admiration, love and help from parents, relatives and others.

The dependence that most concerns modern society is one in which individuals become dependent on or addicted to certain substances such as alcohol, drugs, tobacco (nicotine), caffeine and solvents. This is often called substance abuse. Some people become addicted to certain foods or activities: examples of the latter include gambling, computer games and use of the Internet.

The 28th report of the World Health Organisation Expert Committee on Drug Dependence in 1993 de?ned drug dependence as: ‘A cluster of physiological, behavioural and cognitive phenomena of variable intensity, in which the use of a psychoactive drug (or drugs) takes on a high priority. The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and persistent drug-seeking behaviour. Psychological dependence occurs when the substance abuser craves the drug’s desirable effects. Physical dependence occurs when the user has to continue taking the drug to avoid distressing withdrawal or abstinence symptoms. Thus, determinants and the problematic consequences of drug dependence may be biological, psychological or social and usually interact.’

Di?erent drugs cause di?erent rates of dependence: TOBACCO is the most common substance of addiction; HEROIN and COCAINE cause high rates of addiction; whereas ALCOHOL is much lower, and CANNABIS lower again. Smoking in the western world reached a peak after World War II with almost 80 per cent of the male population smoking. The reports on the link between smoking and cancer in the early 1960s resulted in a decline that has continued so that only around a quarter of the adult populations of the UK and USA smokes. Globally, tobacco consumption continues to grow, particularly in the developing world with multinational tobacco companies marketing their products aggressively.

Accurate ?gures for illegal drug-taking are hard to obtain, but probably approximately 4 per cent of the population is dependent on alcohol and 2 per cent on other drugs, both legal and illegal, at any one time in western countries.

How does dependence occur? More than 40 distinct theories or models of drug misuse have been put forward. One is that the individual consumes drugs to cope with personal problems or diffculties in relations with others. The other main model emphasises environmental in?uences such as drug availability, environmental pressures to consume drugs, and sociocultural in?uences such as peer pressure.

By contrast to these models of why people misuse drugs, models of compulsive drug use – where individuals have a compulsive addiction

– have been amenable to testing in the laboratory. Studies at cellular and nerve-receptor levels are attempting to identify mechanisms of tolerance and dependence for several substances. Classical behaviour theory is a key model for understanding drug dependence. This and current laboratory studies are being used to explain the reinforcing nature of dependent substances and are helping to provide an explanatory framework for dependence. Drug consumption is a learned form of behaviour. Numerous investigators have used conditioning theories to study why people misuse drugs. Laboratory studies are now locating the ‘reward pathways’ in the brain for opiates and stimulants where positive reinforcing mechanisms involve particular sectors of the brain. There is a consensus among experts in addiction that addictive behaviour is amenable to e?ective treatment, and that the extent to which an addict complies with treatment makes it possible to predict a positive outcome. But there is a long way to go before the mechanisms of drug addiction are properly understood or ways of treating it generally agreed.

Effects of drugs Cannabis, derived from the plant Cannabis sativa, is a widely used recreational drug. Its two main forms are marijuana, which comes from the dried leaves, and hashish which comes from the resin. Cannabis may be used in food and drink but is usually smoked in cigarettes to induce relaxation and a feeling of well-being. Heavy use can cause apathy and vagueness and may even cause psychosis. Whether or not cannabis leads people to using harder drugs is arguable, and a national debate is underway on whether its use should be legalised for medicinal use. Cannabis may alleviate the symptoms of some disorders – for example, MULTIPLE SCLEROSIS (MS) – and there are calls to allow the substance to be classi?ed as a prescribable drug.

About one in ten of Britain’s teenagers misuses volatile substances such as toluene at some time, but only about one in 40 does so regularly. These substances are given o? by certain glues, solvents, varnishes, and liquid fuels, all of which can be bought cheaply in shops, although their sale to children under 16 is illegal. They are often inhaled from plastic bags held over the nose and mouth. Central-nervous-system excitation, with euphoria and disinhibition, is followed by depression and lethargy. Unpleasant effects include facial rash, nausea and vomiting, tremor, dizziness, and clumsiness. Death from COMA and acute cardiac toxicity is a serious risk. Chronic heavy use can cause peripheral neuropathy and irreversible cerebellar damage. (See SOLVENT ABUSE (MISUSE).)

The hallucinogenic or psychedelic drugs include LYSERGIC ACID DIETHYLAMIDE (LSD) or acid, magic mushrooms, ecstasy (MDMA), and phencyclidine (PCP or ‘angel’ dust, mainly used in the USA). These drugs have no medicinal uses. Taken by mouth, they produce vivid ‘trips’, with heightened emotions and perceptions and sometimes with hallucinations. They are not physically addictive but can cause nightmarish bad trips during use and ?ashbacks (vivid reruns of trips) after use, and can probably trigger psychosis and even death, especially if drugs are mixed or taken with alcohol.

Stimulant drugs such as amphetamine and cocaine act like adrenaline and speed up the central nervous system, making the user feel con?dent, energetic, and powerful for several hours. They can also cause severe insomnia, anxiety, paranoia, psychosis, and even sudden death due to convulsions or tachycardia. Depression may occur on withdrawal of these drugs, and in some users this is su?ciently deterrent to cause psychological dependence. Amphetamine (‘speed’) is mainly synthesised illegally and may be eaten, sni?ed, or injected. Related drugs, such as dexamphetamine sulphate (Dexedrine), are prescribed pills that enter the black market. ECSTASY is another amphetamine derivative that has become a popular recreational drug; it may have fatal allergic effects. Cocaine and related drugs are used in medicine as local anaesthetics. Illegal supplies of cocaine (‘snow’ or ‘ice’) and its derivative, ‘crack’, come mainly from South America, where they are made from the plant Erythroxylon coca. Cocaine is usually sni?ed (‘snorted’) or rubbed into the gums; crack is burnt and inhaled.

Opiate drugs are derived from the opium poppy, Papaver somniferum. They are described as narcotic because they induce sleep. Their main medical use is as potent oral or injectable analgesics such as MORPHINE, DIAMORPHINE, PETHIDINE HYDROCHLORIDE, and CODEINE. The commonest illegal opiate is heroin, a powdered form of diamorphine that may be smoked, sni?ed, or injected to induce euphoria and drowsiness. Regular opiate misuse leads to tolerance (the need to take ever larger doses to achieve the same e?ect) and marked dependence. A less addictive oral opiate, METHADONE HYDROCHLORIDE, can be prescribed as a substitute that is easier to withdraw.

Some 75,000–150,000 Britons now misuse opiates and other drugs intravenously, and pose a huge public-health problem because injections with shared dirty needles can carry the blood-borne viruses that cause AIDS/HIV and HEPATITIS B. Many clinics now operate schemes to exchange old needles for clean ones, free of charge. Many addicts are often socially disruptive.

For help and advice see APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELF-HELP – National Dugs Helpline.

(See ALCOHOL and TOBACCO for detailed entries on those subjects.)... dependence

If you want to quit drinking coffee or simply try a new variety of black tea, you can chose Yunnan tea for a change. Its strong sweet flavor will surely delight your senses. There are several types for this black tea, so before you buy it take a look at its description and benefits.

Description of Yunnan Tea

Commonly known as Dianhong, Yunnan tea is a type of Chinese black tea used in various blends and other tea assortments. Its name comes from the Chinese province of Yunnan where it is grown and harvested. This type of tea has three major properties : big leaves, a brownish color and a strong flavor. The first sip can be slight sour at the beginning but after that it gets sweeter. Quality Yunnan tea has a sweet strong flavour. Low quality Yunnan tea can have a darker color and a bitter taste, so be careful what to buy. It is also known as Yunnan Red tea. There are several varieties of Yunnan black tea.

Broken Yunnan

A cheap tea used in various mixtures which contains very few golden buds and is generally bitter on its own. It can be easily identified because the dried leaves have a darker almost black color with only a few bursts of golden tips. The drink is dark with a reddish-brown color. The taste can sometimes be as strong as cooked pu-erh tea.

Yunnan Gold

Another Dianhong type which has less golden buds and more dark tea leaves. It resembles with Yunnan Pure Gold type and is priced similarly. However, the tea resulting from it has slightly different characteristics. The drink has a bold red color different from other black teas and a vivid sweetness not quite as intense as Yunnan Pure Gold.

Yunnan Pure Gold

Seen as the best type of Dianhong tea, it holds only golden ends, which are generally covered in fine hairs. If we look it from a distance, the dried tea has a bright orange color. The tea liquor is bright red in color and it has a gentle aroma and a sweet taste. The leaves turn into a reddish brown color after preparation. If we compare it to other small-leaf varieties, Yunnan tea contains a higher concentration of polyphenol, catechin and water-soluble substances that the average values for a black tea.

Preparation of Yunnan tea

Like most of black teas that are usually infused with hot water, Yunnan tea is no exception. It is recommended to use porcelain containers or cups. Put a teaspoon of Yunnan tea and poor hot water of approximately 100 degrees Celsius. Let is infuse for about 5 minutes, then it’s ready to drink. Some people may add milk to the tea.

Yunnan tea benefits

According to the different methods used in tea processing, Yunnan tea can be classified into over 100 kinds of products. Yunnan tea is famous for its health benefits. Studies have shown that it is indeed an effective beverage for eliminating fat, reducing weight, strengthening the body, enhancing longevity, stimulating metabolism, balancing and regulating cholesterol level. Yunnan tea is also highly reputed as “slimming tea”, “beauty tea” and “healthy tea” in more than twenty countries and regions including France, Spain, Japan, Hong Kong and so on. Studies confirm what the Chinese have known for centuries - that Yunnan tea provides a natural alternative to medicines for those expecting to lose weight, reduce tension and generally have a more healthy and relaxed lifestyle. It was clearly proven that drinking Yunnan tea regularly lowers blood lipid levels without having side effects as medical drugs have.

Yunnan tea side effects

The side effects of Yunnan teaare similar to those caused by other black teas and they are related to intense consumption. They are mostly associated with higher caffeine content which may cause restlessness, palpitations, difficulty in sleeping, anxiety, irritability, increased heart rate, and elevated blood pressure. Caffeine is also diuretic. Like most black teas, Yunnan tea is suitable for regular consumption in spite of few side effects. Drink it wisely and enjoy its benefits.... discover yunnan tea

These are natural products or synthetic chemicals that can alter the way in which the body works, or be used to prevent or treat disease. One or more drugs, combined with stabilisers, colourings, and other ingredients, make(s) up a medicine for practical use in treating patients. (See DEPENDENCE; MEDICINES.) In Britain, the supply of drugs is controlled by the Medicines Act. Some drugs are available only on prescription; some both on prescription and over the counter; and some are not available on NHS prescription. When enquiring about drugs that a patient is taking, it is essential to ask about all items bought over the counter and any herbal or traditional remedies that might be used, as these can interact with other prescribed drugs (see DRUG INTERACTIONS) or affect the patient’s presenting complaints. Each drug has a single generic name, but many will also have several proprietary (brand) names. It is often much cheaper to prescribe the generic form of a drug, and many doctors do so. Many hospitals and general practices in the United Kingdom now provide a list of suggested drugs for doctors to prescribe. If a doctor wishes to use a drug not on the list, he or she must give a valid reason.

Prescriptions for drugs should be printed or written clearly in ink and signed and dated by the prescriber (computer-generated facsimile signatures do not meet legal requirements). They should include the patient’s name, address and age (obligatory for children under 12), the name of the drug to be supplied, the dose and dose frequency, and the total quantity to be supplied. Any special instructions (e.g. ‘after food’) should be stated. There are special regulations about the prescription of drugs controlled under the Misuse of Drugs Regulations 1985 (see CONTROLLED DRUGS). A pharmacist can advise about which drugs are available without prescription, and is able to recommend treatment for many minor complaints. Information about exemption from prescription charges in the NHS can be obtained from health visitors, general practitioners, or social security o?ces.... drugs

Pongamia pinnata

Papilionaceae

San: Karanj;

Hin: Karanja, Dittouri;

Ben: Dehar karanja;

Mal: Ungu, Pongu; Guj, Mar, Pun: Karanj;

Kan: Hongae;

Tel: Kangu;

Tam: Puggam; Ass: Karchaw; Ori: Koranjo

Importance: Indian beech, Pongam oil tree or Hongay oil tree is a handsome flowering tree with drooping branches, having shining green leaves laden with lilac or pinkish white flowers. The whole plant and the seed oil are used in ayurvedic formulations as effective remedy for all skin diseases like scabies, eczema, leprosy and ulcers. The roots are good for cleaning teeth, strengthening gums and in gonorrhoea and scrofulous enlargement. The bark is useful in haemorhoids, beriberi, ophthalmopathy and vaginopathy. Leaves are good for flatulence, dyspepsia, diarrhoea, leprosy, gonorrhoea, cough, rheumatalgia, piles and oedema. Flowers are given in diabetes. Fruits overcomes urinary disease and piles. The seeds are used in inflammations, otalgia, lumbago, pectoral diseases, chronic fevers, hydrocele, haemorrhoids and anaemia. The seed oil is recommended for ophthalmia, haemorrhoids, herpes and lumbagoThe seed oil is also valued for its industrial uses. The seed cake is suggested as a cheap cattle feed. The plant enters into the composition of ayurvedic preparations like nagaradi tailam, varanadi kasayam, varanadi ghrtam and karanjadi churna.

It is a host plant for the lac insect. It is grown as a shade tree. The wood is moderately hard and used as fuel and also for making agricultural implements and cart- wheels.

Distribution: The plant is distributed throughout India from the central or eastern Himalaya to Kanyakumari, especially along the banks of streams and rivers or beach forests and is often grown as an avenue tree. It is distributed in Sri Lanka, Burma, Malaya, Australia and Polynesia.

Botany: Pongamia pinnata (Linn.) Pierre syn. P. glabra Vent., Derris indica (Lam.) Bennet, Cystisus pinnatus Lam. comes under family Papilionaceae. P. pinnata is a moderate sized, semi -evergreen tree growing upto 18m or more high, with a short bole, spreading crown and greyish green or brown bark. Leaves imparipinnate, alternate, leaflets 5-7, ovate and opposite. Flowers lilac or pinkish white and fragrant in axillary recemes. Calyx cup-shaped, shortly 4-5 toothed, corolla papilionaceous. Stamens 10 and monadelphous, ovary subsessile, 2-ovuled with incurved, glabrous style ending in a capitate stigma. Pod compressed, woody, indehiscent, yellowish grey when ripe varying in size and shape, elliptic to obliquely oblong, 4.0-7.5cm long and 1.7-3.2cm broad with a short curved beak. Seeds usually 1, elliptic or reniform, wrinkled with reddish brown, leathery testa.

Agrotechnology: The plant comes up well in tropical areas with warm humid climate and well distributed rainfall. Though it grows in almost all types of soils, silty soils on river banks are most ideal. It is tolerant to drought and salinity. The tree is used for afforestation, especially in watersheds in the drier parts of the country. It is propagated by seeds and vegetatively by rootsuckers. Seed setting is usually in November. Seeds are soaked in water for few hours before sowing. Raised seed beds of convenient size are prepared, well rotten cattle manure is applied at 1kg/m2 and seeds are uniformly broadcasted. The seeds are covered with a thin layer of sand and irrigated. One month old seedlings can be transplanted into polybags, which after one month can be planted in the field. Pits of size 50cm cube are dug at a spacing of 4-5m, filled with top soil and manure and planted. Organic manure are applied annually. Regular weeding and irrigation are required for initial establishment. The trees flower and set fruits in 5 years. The harvest season extends from November- June. Pods are collected and seeds are removed by hand. Seed, leaves, bark and root are used for medicinal purposes. Bark can be collected after 10 years. No serious pests and diseases are reported in this crop.

Properties and activity: The plant is rich in flavonoids and related compounds. Seeds and seed oil, flowers and stem bark yield karanjin, pongapin, pongaglabrone, kanugin, desmethoxykanugin and pinnatin. Seed and its oil also contain kanjone, isolonchocarpin, karanjachromene, isopongachromene, glabrin, glabrachalcone, glabrachromene, isopongaflavone, pongol, 2’- methoxy-furano 2”,3”:7,8 -flavone and phospholipids. Stem-bark gives pongachromene, pongaflavone, tetra-O-methylfisetin, glabra I and II, lanceolatin B, gamatin, 5-methoxy- furano 2”,3”:7,8 -flavone, 5-methoxy-3’,4’-methelenedioxyfurano 2”,3”:7,8 -flavone and - sitosterol. Heartwood yields chromenochalcones and flavones. Flowers are reported to contain kanjone, gamatin, glabra saponin, kaempferol, -sitosterol, quercetin glycocides, pongaglabol, isopongaglabol, 6-methoxy isopongaglabol, lanceolatin B, 5-methoxy-3’,4’- methelenedioxyfurano 8,7:4”,5” -flavone, fisetin tetramethyl ether, isolonchocarpin, ovalichromene B, pongamol, ovalitenon, two triterpenes- cycloart-23-ene,3 ,25 diol and friedelin and a dipeptide aurantinamide acetate.

Roots and leaves give kanugin, desmethoxykanugin and pinnatin. Roots also yield a flavonol methyl ether-tetra-O-methyl fisetin. The leaves contain triterpenoids, glabrachromenes I and II, 3’-methoxypongapin and 4’-methoxyfurano 2”,3”:7,8 -flavone also. The gum reported to yield polysaccharides (Thakur et al, 1989; Husain et al, 1992).

Seeds, seed oil and leaves are carminative, antiseptic, anthelmintic and antirheumatic. Leaves are digestive, laxative, antidiarrhoeal, bechic, antigonorrheic and antileprotic. Seeds are haematinic, bitter and acrid. Seed oil is styptic and depurative. Karanjin is the principle responsible for the curative properties of the oil. Bark is sweet, anthelmintic and elexteric.... indian beech

Methyl is an organic radical whose chemical formula is CH3, and which forms the centre of a wide group of substances known as the methyl group. For example, methyl alcohol is obtained as a by-product in the manufacture of beet-sugar, or by distillation of wood; methyl salicylate is the active constituent in oil of wintergreen; methyl hydride is better known as marsh gas.

Methyl alcohol, or wood spirit (see METHANOL), is distilled from wood and is thus a cheap form of alcohol. It has actions similar to, but much more toxic than, those of ethyl alcohol. It has a specially pronounced action on the nervous system, and in large doses is apt to cause neuritis, especially of the optic nerves, leading to blindness, partial or complete.... methyl

Also known as BILHARZIASIS. This infection results from one of the human Schistosoma species. It is common in Africa, South America, the Far East, Middle East, and, to a limited extent, the Caribbean. The life-cycle is dependent on fresh-water snails which act as the intermediate host for the ?uke; the cercarial stage of the ?uke enters via intact human skin and matures in the portal circulation. Clinically, ‘swimmers’ itch’ may occur at the site of cercarial skin penetration. Acute schistosomiasis (Katayama fever) can result in fever, an urticarial rash (see URTICARIA), and enlargement of LIVER and SPLEEN. The adult male is about 12 mm and the female 24 mm in length.

S. haematobium causes CYSTITIS and haematuria – passage of blood in the urine; bladder cancer and ureteric obstruction, giving rise to hydronephrosis and kidney failure, are long-term sequelae in a severe case. S. mansoni can cause colonic symptoms and in a severe case, POLYPOSIS of the COLON; diarrhoea, which may be bloody, can be a presenting feature. In a heavy infection, eggs surrounded by granulomas are deposited in the liver, giving rise to extensive damage (pipe-stem ?brosis) associated with PORTAL HYPERTENSION, oesophageal varices, etc. However, unlike in CIRRHOSIS, hepatocellular function is preserved until late in the disease. S. japonicum (which is con?ned to the Far East, especially Indonesia) behaves similarly to S. mansoni infection; liver involvement is often more severe.

Diagnosis can be made by microscopic examination of URINE or FAECES. The characteristic eggs are usually detectable. Alternatively, rectal or liver BIOPSY are of value. Serological tests, including an ELISA (see ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA)), have now largely replaced invasive procedures used in making a parasitological diagnosis.

Treatment CHEMOTHERAPY has been revolutionised by the introduction of praziquantel (administered orally); this compound has no serious side-effects, although its cost may limit its use in developing countries. Oxamniquine is cheaper and e?ective in S. mansoni infection, although evidence of resistance has been recorded in several countries. Metriphonate is also relatively cheap and is of value in S. haematobium infection. Prevention is by complete avoidance of exposure to contaminated water; all travellers to infected areas should know about this disease. It is increasing in frequency as new expanses of fresh water appear as a result of irrigation schemes and dam projects. Molluscicides can be employed for snail-control.... schistosomiasis

Sterilisation means either (1) the process of rendering various objects – such as those which come in contact with wounds, and various foods – free from microbes, or (2) the process of rendering a person incapable of producing children.

The manner of sterilising bedding, furniture, and the like, after contact with a case of infectious disease, is given under DISINFECTION; whilst the sterilisation of instruments, dressings, and skin surfaces, necessary before surgical procedures, is mentioned in the same article and also under ANTISEPTICS, ASEPSIS, and WOUNDS. For general purposes, one of the cheapest and most e?ective agents is boiling water or steam.

Bacteriological sterilisation may be e?ected in many ways, and di?erent methods are used in di?erent cases.

Reproductive sterilisation In women, this is performed by ligating (cutting) and then tying the FALLOPIAN TUBES – the tubes that carry the OVUM from the ovary (see OVARIES) to the UTERUS. Alternatively, the tubes may be sealed-o? by means of plastic and silicone clips or rings. The technique is usually performed (by LAPAROSCOPY) through a small incision, or cut, in the lower abdominal wall. It has no e?ect on sexual or menstrual function, and, unlike the comparable operation in men, it is immediately e?ective. The sterilisation is usually permanent (around 0·05 pregnancies occur for every 100 women years of use), but occasionally the two cut ends of the Fallopian tubes reunite, and pregnancy is then again possible. Removal of the uterus and/or the ovaries also sterilises a woman but such procedures are only used when there is some special reason, such as the presence of a tumour.

The operation for sterilising men is known as VASECTOMY.... sterilisation

The previous subject is obviously an endless one, but as this is the glossary of an herbal nature, let me assure you, virtually no plants have a direct steroid hormone-mimicking effect. There are a few notable exceptions with limited application, like Cimicifuga and Licorice. Plant steroids are usually called phytosterols, and, when they have any hormonal effect at all, it is usually to interfere with human hormone functions. Beta sitosterol, found in lots of food, interferes with the ability to absorb cholesterol from the diet. Corn oil and legumes are two well-endowed sources that can help lower cholesterol absorption. This is of only limited value, however, since cholesterol is readily manufactured in the body, and elevated cholesterol in the blood is often the result of internal hormone and neurologic stimulus, not the diet. Cannabis can act to interfere with androgenic hormones, and Taraxacum phytosterols can both block the synthesis of some new cholesterol by the liver and increase the excretion of cholesterol as bile acids; but other than that, plants offer little direct hormonal implication. The first method discovered for synthesizing pharmaceutical hormones used a saponin, diosgenin, and a five-step chemical degradation, to get to progesterone, and another, using stigmasterol and bacterial culturing, to get to cortisol. These were chemical procedures that have nothing to do with human synthesis of such hormones, and the plants used for the starting materials-Mexican Wild Yam, Agave, and Soy were nothing more than commercially feasible sources of compounds widely distributed in the plant kingdom. A clever biochemist could obtain testosterone from potato sterols, but no one would be likely to make the leap of faith that eating potatoes makes you manly (or less womanly), and there is no reason to presume that Wild Yam (Dioscorea) has any progesterone effects in humans. First, the method of synthesis from diosgenin to progesterone has nothing to do with human synthesis of the corpus luteum hormone; second, oral progesterone has virtually no effect since it is rapidly digested; and third, orally active synthetic progesterones such as norethindrone are test-tube born, and never saw a Wild Yam. The only “precursor” the ovaries, testes and adrenal cortices EVER need (and the ONLY one that they can use if synthesizing from scratch) is something almost NONE of us ever run out of...Low Density Cholesterol. Unless you are grimly fasting, anorectic, alcoholic, seriously ill or training for a triathlon, you only need blood to make steroid hormones from. If hormones are off, it isn’t from any lack of building materials...and any product claiming to supply “precursors” better contain lard or butter (they don’t)...or they are profoundly mistaken, or worse. The recent gaggle of “Wild Yam” creams actually do contain some Wild Yam. (Dioscorea villosa, NOT even the old plant source of diosgenin, D. mexicana...if you are going to make these mistakes, at least get the PLANT right) This is a useful and once widely used antispasmodic herb...I have had great success using it for my three separate bouts with kidney stones...until I learned to drink more water and alkalizing teas and NEVER stay in a hot tub for three hours. What these various Wild Yam creams DO contain, is Natural Progesterone. Although this is inactive orally (oral progesterone is really a synthetic relative of testosterone), it IS active when injected...or, to a lesser degree, when applied topically. This is pharmaceutical progesterone, synthesized from stigmasterol, an inexpensive (soy-bean oil) starting substance, and, although it is identical to ovarian progesterone, it is a completely manufactured pharmaceutical. Taking advantage of an FDA loophole (to them this is only a cosmetic use...they have the misguided belief that it is not bioactive topically), coupled with some rather convincing (if irregular) studies showing the anti-osteoporotic value of topical progesterone for SOME women, a dozen or so manufacturers are marketing synthetic Natural Progesterone for topical use, yet inferring that Wild Yam is what’s doing good. I am not taking issue with the use of topical progesterone. It takes advantage of the natural slow release into the bloodstream of ANY steroid hormones that have been absorbed into subcutaneous adipose tissue. It enters the blood from general circulation the same way normal extra-ovarian estradiol is released, and this is philosophically (and physiologically) preferable to oral steroids, cagily constructed to blast on through the liver before it can break them down. This causes the liver to react FIRST to the hormones, instead of, if the source is general circulation, LAST. My objection is both moral and herbal: the user may believe hormonal effects are “natural”, the Wild Yam somehow supplying “precursors” her body can use if needed, rejected if not. This implies self-empowerment, the honoring of a woman’s metabolic choice...something often lacking in medicine. This is a cheat. The creams supply a steady source of pharmaceutical hormone (no precursor here) , but they are being SOLD as if the benefits alone come from the Wild Yam extract, seemingly formulated with the intent of having Wild Yam the most abundant substance so it can be listed first in the list of constituents. I have even seen the pharmaceutical Natural Progesterone labeled as “Wild Yam Progesterone” or “Wild Yam Estrogen precursor” or, with utter fraud, “Wild Yam Hormone”. To my knowledge, the use of Mexican Yam for its saponins ceased to be important by the early 1960’s, with other processes for synthesizing steroids proving to be cheaper and more reliable. I have been unable to find ANY manufacturer of progesterone that has used the old Marker Degradation Method and/or diosgenin (from whatever Dioscorea) within the last twenty years. Just think of it as a low-tech, non invasive and non-prescription source of progesterone, applied topically and having a slow release of moderate amounts of the hormone. Read some of the reputable monographs on its use, make your choice based solely on the presence of the synthetic hormone, and use it or don’t. It has helped some women indefinitely, for others it helped various symptoms for a month or two and then stopped working, for still other women I have spoken with it caused unpleasant symptoms until they ceased its use. Since marketing a product means selling as much as possible and (understandably) presenting only the product’s positive aspects, it would be better to try and find the parameters of “use” or “don’t use” from articles, monographs, and best of all, other women who have used it. Then ask them again in a month or two and see if their personal evaluation has changed. If you have some bad uterine cramps, however, feel free to try some Wild Yam itself...it often helps. Unless there is organic disease, hormones are off is because the whole body is making the wrong choices in the hormones it does or doesn’t make. It’s a constitutional or metabolic or dietary or life-stress problem, not something akin to a lack of essential amino acids or essential fatty acids that will clear up if only you supply some mythic plant-derived “precursor”. End of tirade.... steroids, plant

Tansy Tea is a very good and natural vermifuge, used mainly to treat children. Tansy is a perennial plant, with long narrow leaves and bright yellow flowers. Originally from Asia, Tansy is now grown all over the world and used for medical purposes, even if physicians all over the world are being reticent when it comes to recommending it to patients. For a very large amount of time, Tansy Tea was used in order to induce miscarriage and many women died drinking too much of it. Tansy Tea Properties The main substances of Tansy Tea (tanacetin, volatile oil, tannic acid, parthenolides)are toxic in large quantities, so if you’re thinking about starting a treatment based on Tansy Tea it’s best to keep track of how much you drink per day. The parts that can be used for medical purposes are the leaves and the flowering tops and you can either make a tea out of them or use the leaves freshly picked. Tansy Tea Benefits Although the main use of the Tansy Tea was to treat worms in children, the modern applications of the alternative medicine point towards using it as a cooking ingredient that can be added in small amounts to a variety of salads and omelets, thanks to its cinnamon-like taste. Tansy Tea can also be used as a natural cosmetic product able to lighten skin and decolorize the unwanted sunspots. Today, the medical uses of the Tansy Tea have been loudly discredited, although you can still find it on markets and it’s legal to grow it in your own yard. However, it’s safe and actually indicated that you use Tansy in order to keep your vegetables pest-free rather than buy some random chemical repellent. How to make Tansy Tea Infusion When preparing Tansy Tea Infusion, you need to make sure that the concentration is not going to do you any harm (use a very small amount). Poor boiling water over the Tansy leaves and wait for about 5 minutes. Only take the tea as long as you’re sick (not more than a cup per day) and do not turn it into a daily habit. Tansy Tea cannot replace coffee and it’s toxic in high dosages. If you’ve taken this tea for a while and there are still no results, see a doctor immediately and stop taking Tansy Tea! Tansy Tea Side Effects Tansy Tea has many side effects. In fact, few physicians are brave enough to prescribe Tansy tea to their patients. It can cause spasms, hallucinations, convulsions. In very high dosages, it can cause death. Tansy Tea Contraindications Do not take Tansy Tea if you are pregnant or breastfeeding under no circumstances! Also, a very strong cup of Tansy Tea can cause death. There have been many reported cases of young women who died after ingesting a concentrated solution of this tea. Before making any moves towards using Tansy leaves or flowers, ask your doctor about the risks. If Tansy Tea seems a bit strong for your organism, next time you’re looking for a natural repellent, take it into consideration. It’s a very cheap method that will keep all worms away from your delicious vegetables!... tansy tea - a dangerous vermifuge

Compounds that protect the body against free radical activity and lipid peroxidation. Free-radical scavengers. Low levels in the tissues reduce the span of human life. High levels enable humans to live longer. The greater the oxidation damage to the DNA, the shorter the lifespan.

Vitamins A, C and E inhibit production of free radicals. Especially effective is beta-carotene, the precursor of Vitamin A, found in carrots, spinach, yams and some green leafy vegetables. Vitamin E and Selenium work together to prevent free radical damage to cell membrane. Antioxidants act favourably on glaucoma, Parkinson’s disease and rheumatoid arthritis.

This group claims to have an anti-tumour effect. Epithelial cancers may invade the respiratory and gastro-intestinal tracts, lungs, skin and cervix of the womb. The higher the level of antioxidants in the cells, the lesser the risk of epithelial cell cancer, and blindness in the aged. vChief antioxidants: Alfalfa, Comfrey, Asparagus (fresh), Beet tops, Dandelion leaves, Ginseng, Gotu Kola, Goldenseal, Irish Moss, Parsley, Walnuts, Watercress, Wheat sprouts. Perhaps the cheapest and most effective is Garlic.

Diet. Highly coloured fruits and vegetables: oranges, red and green peppers, carrots, apricots, mangoes, liver and spinach.

Supplements. Beta carotene (Vitamin A), Vitamin C, Vitamin E, Selenium, Zinc. See: SOD, FREE RADICALS. ... antioxidants

Hordeum distichon L. An almost perfect food. High in fibre, calcium, iron, magnesium and potassium. High in lysine, an essential amino acid. One of the best and cheapest cholesterol blockers. A grain that should have a prominent place on the dining table. This nutritive demulcent, taken as Barley- water, is still used in kidney, intestinal and bowel disorders.

Malt extract (with, or without Cod Liver oil). Green Barley. Juice of young Barley leaves harvested when 12 inches in height. A concentrate of vitamins, mineral nutrients, amino acids, enzymes and chlorophyll. Seven times richer in Vitamin C than oranges; five times richer in iron than spinach; has 25 times the potassium of wheat. High in the enzyme that slows the ageing of cells – superoxide dismutase (SOD). Said to be of value for malignancy and effective against pigmentation of the skin (melanosis, and other skin diseases). (Yoshihide Hagiwara MD, pharmacologist, Japan)

Immune system protective. Constipation. Anaemia.

Prepare in a juicer, young Barley leaves: 1 wineglassful night and morning. Green powder: (Green Barley essence) (Natural Flow) ... barley

Greek word ‘white blood’. (Leukosis) Acute myeloid and lymphoblastic. Cancer of the white blood cells of two main types; myeloid, involving the polymorph type and lymphatic involving lymphocytes. Each type may take acute or chronic form, the acute being more serious. The disease is not an infection.

Causes: exposure to chemicals, X-rays or radioactive material. Genetic factors are believed to predispose. The condition may be acute or chronic and may follow chemotherapy.

Remissions are known to have been induced by a preparation from the Periwinkle plant (Vinca rosea) now re-classified as Catharanthus roseus.

“Smokers suffer a significantly increased risk of developing acute myelocytic leukaemia.” (“Cancer”: 1987 vol 60, pp141-144)

Acute Leukaemia. Rapid onset with fatality within weeks or months. Fever. Proliferation of white cells in the bone marrow which are released and blood-borne to the liver, spleen and lymphatics. There may be bleeding from kidneys, mouth, bowel and beneath the skin. (Shepherd’s Purse, Yarrow) The acute form is known also as acute lymphoblastic or acute myeloblastic leukaemia. May be mis-diagnosed as tuberculosis.

Chronic Leukaemia. Gradual onset. Breathlessness from enlargement of the spleen. Swelling of glands under arms, in neck and groin. Loss of weight, appetite, strength, facial colour and body heat. Anaemia, spontaneous bleeding and a variety of skin conditions. Diarrhoea. Low grade fever.

No cure is known, but encouraging results in orthodox medicine promise the disease may be controlled, after the manner of diabetes by insulin. Successful results in such control are reported by Dr Hartwell, National Cancer Institute, Maryland, USA, with an alkaloid related to Autumn Primrose (Colchicum officinale). Vinchristine, a preparation from Periwinkle is now well-established in routine treatment. Red Clover, also, is cytotoxic to many mammalian cells. Vitamin C (present in many herbs and fruits) inhibits growth of non-lymphoblastic leukaemia cells. Good responses have been observed by Dr Ferenczi, Hungary, by the use of raw beet root juice.

Also treated with success by Dr Hartland (above) has been lymphocytic leukaemia in children which he treated with a preparation from Periwinkle.

Choice of agents depends largely upon the clinical experience of the practitioner and ease of administration. Addition of a nerve restorative (Oats, Kola, Black Cohosh or Helonias) may improve sense of well-being. To support the heart and circulatory system with cardiotonics (Hawthorn, Motherwort, Lily of the Valley) suggests sound therapy.

Herbal treatment may favourably influence haemoglobin levels and possibly arrest proliferation of leukaemic cells and reduce size of the spleen. It would be directed towards the (a) lymphatic system (Poke root), (b) spleen (Tamarinds), (c) bone marrow (Yellow Dock), and (d) liver (Blue Flag root).

An older generation of herbalists prescribed Blue Flag root, Yellow Dock, Poke root, Thuja and Echinacea, adding other agents according to indications of the particular case.

Tea. Formula. Equal parts: Red Clover, Gotu Kola, Plantain. 1-2 teaspoons to each cup boiling water; infuse 10-15 minutes. 1 cup thrice daily.

New Jersey tea (ceanothus). 1 teaspoon to each cup boiling water. Half-1 cup thrice daily.

Periwinkle tea (Vinca rosea). 2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.

Decoction. Formula. Equal parts: Echinacea, Yellow Dock, Blue Flag root. 1 teaspoon to each cup water gently simmered 20 minutes. 1 cup before meals thrice daily.

Formula. Red Clover 2; Yellow Dock 1; Dandelion root 1; Thuja quarter; Poke root quarter; Ginger quarter. Dose: Liquid Extract: 1 teaspoon. Tinctures: 1-2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Vinchristine. Dosage as prescribed. In combination with other medicines.

Wheatgrass. Juice of fresh Wheatgrass grown as sprouts and passed through a juicer. Rich in minerals. One or more glasses daily.

Beetroot juice. Rich in minerals. Contains traces of rare rabidium and caesium, believed to contribute to anti-malignancy effect. (Studies by Dr A. Ferenczi, Nobel Prize-winner, published 1961)

Diet: Dandelion coffee.

Supplements. B-complex, B12, Folic acid, Vitamin C 2g morning and evening, Calcium ascorbate 2g morning and evening. Copper, Iron, Selenium, Zinc.

Childhood Leukaemia. Research has linked the disease with fluorescent lighting. “Fluorescent tubes emit blue light (400mm wavelength). Light penetrates the skin and produces free radicals. Free radicals damage a child’s DNA. Damaged DNA causes leukaemia to develop. The type and intensity of lighting in maternity wards should be changed. This could be prevented by fitting cheap plastic filters to fluorescent lights in maternity wards.” (Peter Cox, in “Here’s Health”, on the work of Dr Shmuel Ben-Sasson, The Hubert Humphrey Centre of Experimental Medicine and Cancer Research, Jerusalem)

Treatment by hospital specialist. ... leukaemia

Nausea and vomiting caused by lack of air and restricted vision upsetting the balance of the inner ear.

Cup of Chamomile, Balm, or Meadowsweet tea. Liquorice helpful, but most popular is Ginger taken in the form of Ginger wine, or powdered root (quarter to half a teaspoon). Chrystalised Ginger from sweetshop is one of the safest and cheapest: 2-3 pieces sucked or chewed half hour before journey and at intervals thereafter.

Avoid tobacco which reduces oxygen count. Potter’s Ginger root capsules.

Peppermint. Before travelling, glass water with 2 drops.

Aromatherapy. Inhalant. 2-3 drops Peppermint oil on tissue.

Diet. No alcohol or fatty foods. Accept Papaya fruit, Lemons or Lemon juice, Honey, Acidophilus. Supplements. Alternatives to the above. Seven days before journey: B-complex, magnesium 200mg, calcium 400mg. ... motion sickness

A group of illegally produced chemicals that mimic the effects of specific drugs of abuse. They can cause drug dependence and drug poisoning. Made in illicit laboratories, they are cheap to produce and undercut the street prices of drugs.

There are 3 major groups: drugs derived from opioid analgesic drugs such as fentanyl; drugs similar to amfetamines, such as ecstasy; and variants of phencyclidine (PCP), a hallucinogenic drug. These highly potent drugs are not tested for adverse effects or for the strength of the tablets or capsules, making their use hazardous. For example, some derivatives of fentanyl are 20–2,000 times more powerful than morphine. Amfetamine derivatives can cause brain damage at doses only slightly higher than those required for a stimulant effect. Many designer drugs contain impurities that can cause permanent damage.... designer drugs

A method of treating infertility in which an egg (ovum) is surgically removed from the ovary and fertilized outside the body.

The woman is given a course of fertility drugs to stimulate release of eggs from the ovary. This is followed by ultrasound scanning to check the eggs, which are collected by laparoscopy immediately before ovulation. They are then mixed with sperm in the laboratory. Two, or sometimes more, fertilized eggs are replaced into the uterus. If they become safely implanted in the uterine wall, the pregnancy usually continues normally.

Only about 1 in 10 couples undergoing in vitro fertilization achieves pregnancy at the 1st attempt, and many attempts may be needed before a successful pregnancy is achieved. Modifications of the technique, such as gamete intrafallopian transfer (GIFT), are simpler and cheaper than the original method. in vivo Biological processes occurring within the body. (See also in vitro.)... in vitro fertilization

n. the presence of fragments of endometrial tissue at sites in the pelvis outside the uterus or, rarely, throughout the body (e.g. in the lung, rectum, or umbilicus). It is thought to be caused by retrograde *menstruation. When the tissue has infiltrated the wall of the uterus (myometrium) the condition is known as adenomyosis. Symptoms vary, but typically include pelvic pain, severe *dysmenorrhoea, *dyspareunia, infertility, and a pelvic mass (or any combination of these). Medical treatment is aimed at suppressing ovulation using *gonadorelin analogues, combined oral contraceptives, or the intrauterine system (see IUS). High-dose progestogens suppress *gonadotrophins (FSH and LH), shrink implanted endometrial tissue, and reduce retrograde menstruation. They have a similar efficacy to other medical treatments, are cheaper, and have fewer side-effects than gonadorelin analogues. Surgical treatment may also be necessary, usually by laser or ablative therapy via the laparoscope. More radical surgical treatment in the form of a total hysterectomy and bilateral salpingo-oophorectomy is sometimes required.... endometriosis