See: GALL BLADDER.
Repeated mild attacks of acute cholecystitis can lead to a chronic form, in which the gallbladder shrinks, its walls thicken, and it ceases to store bile.
Symptoms (indigestion, pains in the upper abdomen, nausea, and belching) may be aggravated by eating fatty food.
Cholecystectomy is the usual treatment.
Cholecystectomy is also used in acute cholecystitis and as an emergency treatment for perforation of the gallbladder or empyema.
The procedure is carried out using conventional surgery or, more commonly, by minimally invasive surgery using a laparoscope.... cholecystectomy
Gall-stones affect 22 per cent of women and 11 per cent of men. The incidence increases with age, but only about 30 per cent of those with gall-stones undergo treatment as the majority of cases are asymptomatic. There are three types of stone: cholesterol, pigment and mixed, depending upon their composition; stones are usually mixed and may contain calcium deposits. The cause of most cases is not clear but sometimes gall-stones will form around a ‘foreign body’ within the bile ducts or gall-bladder, such as suture material. BILIARY COLIC Muscle ?bres in the biliary system contract around a stone in the cystic duct or common bile duct in an attempt to expel it. This causes pain in the right upper quarter of the abdomen, with nausea and occasionally vomiting. JAUNDICE Gall-stones small enough to enter the common bile duct may block the ?ow of bile and cause jaundice. ACUTE CHOLECYSTITIS Blockage of the cystic duct may lead to this. The gall-bladder wall becomes in?amed, resulting in pain in the right upper quarter of the abdomen, fever, and an increase in the white-blood-cell count. There is characteristically tenderness over the tip of the right ninth rib on deep inhalation (Murphy’s sign). Infection of the gall-bladder may accompany the acute in?ammation and occasionally an EMPYEMA of the gall-bladder may result. CHRONIC CHOLECYSTITIS A more insidious form of gall-bladder in?ammation, producing non-speci?c symptoms of abdominal pain, nausea and ?atulence which may be worse after a fatty meal.
Diagnosis Stones are usually diagnosed on the basis of the patient’s reported symptoms, although asymptomatic gall-stones are often an incidental ?nding when investigating another complaint. Con?rmatory investigations include abdominal RADIOGRAPHY – although many gall-stones are not calci?ed and thus do not show up on these images; ULTRASOUND scanning; oral CHOLECYSTOGRAPHY – which entails a patient’s swallowing a substance opaque to X-rays which is concentrated in the gall-bladder; and endoscopic retrograde cholangiopancreatography (ERCP) – a technique in which an ENDOSCOPE is passed into the duodenum and a contrast medium injected into the biliary duct.
Treatment Biliary colic is treated with bed rest and injection of morphine-like analgesics. Once the pain has subsided, the patient may then be referred for further treatment as outlined below. Acute cholecystitis is treated by surgical removal of the gall-bladder. There are two techniques available for this procedure: ?rstly, conventional cholecystectomy, in which the abdomen is opened and the gall-bladder cut out; and, secondly, laparoscopic cholecystectomy, in which ?breoptic instruments called endoscopes (see FIBREOPTIC ENDOSCOPY) are introduced into the abdominal cavity via several small incisions (see MINIMALLY INVASIVE SURGERY (MIS)). Laparoscopic surgery has the advantage of reducing the patient’s recovery time. Gall-stones may be removed during ERCP; they can sometimes be dissolved using ultrasound waves (lithotripsy) or tablet therapy (dissolution chemotherapy). Pigment stones, calci?ed stones or stones larger than 15 mm in diameter are not suitable for this treatment, which is also less likely to succeed in the overweight patient. Drug treatment is prolonged but stones can disappear completely after two years. Stones may re-form on stopping therapy. The drugs used are derivatives of bile salts, particularly chenodeoxycholic acid; side-effects include diarrhoea and liver damage.... gall-bladder, diseases of
Habitat: Native of Mediterranean region; cultivated in Jammu and Kashmir and Himachal Pradesh.
English: Olive.Unani: Zaitoon.Action: Leaves and bark— febrifugal, astringent, diuretic, antihypertensive.
Oil—preparations are used for cho- langiitis, cholecystitis, cholelithiasis, icterus, flatulence, meteorism, lack of bacteria in the intestines. Demulcent and mild laxative. Externally used for wound dressing and for minor burns, psoriasis and pruritus. (Included among unapproved herbs by German Commission E.)Chemical investigations of two varieties—Ascotrinia and Ascolina— grown in Jammu region have shown that the characteristics of fruits and their oils are similar to those of European varieties.Leaves of Olea europaea gave iri- doid monoterpenes including oleu- ropein and oleuroside; triterpenes including oleanolic and maslinic acids; flavonoids including luteolin and api- genine derivatives. The oil contains glycerides of oleic acid about 70-80%, with smaller amounts of linoleic, palmitic and stearic acid glycerides.The leaves exhibited hypotensive, antiarrhythmic and spasmolytic activities in animal studies. The oil exhibited contraction of gallbladder due to raising of the cholecystokinin level in the plasma.India's requirements of olive oil are met by imports.... olea europaeaEmpyema can occur around a lung as a rare complication of an infection such as pneumonia or pleurisy.
The main symptoms are chest pain, breathlessness, and fever.
Treatment is by aspiration (removal of the pus by suction) and the injection of antibiotic drugs, or by an operation to open the chest cavity and drain the pus.
Empyema of the gallbladder may occur as a complication of cholecystitis, when it causes abdominal pain, fever, and jaundice.
It is treated by surgical removal of the gallbladder.... empyema
Habitat: North-western Himalaya from Kashmir to Simla at 2,4003,600 m.
English: Stinging Nettle.Ayurvedic: Vrishchhiyaa-shaaka (related species).Unani: Anjuraa.Folk: Shisuun (Kumaon).Action: Plant—diuretic, astringent, antihaemorrhagic; eliminates uric acid from the body, detoxifies the blood. Externally, astringent and haemostatic.
Used internally for the treatment of nephritis, haemoptysis and other haemorrhages.Key application: Above ground parts—as a supportive therapy for rheumatic ailments (internally and externally). Internally, in irrigation therapy for inflammatory diseases of the lower urinary tract and prevention and treatment of kidney gravel. (German Commission E, ESCOP, The British Herbal Compendium, The British Herbal Pharmacopoeia.) Root—in symptomatic treatment of micturition disorders (dysuria, pol- lakiuria, nocturia, urine retention) in benign prostatic hyperplasia at stages I and II. (German Commission E, ESCOP, WHO, The British Herbal Pharmacopoeia.)Clinical experiments have confirmed the utility of the herb as a haemostatic in uterine haemorrhage and bleeding from nose. The herb is also used in sciatica, rheumatism and palsy. The treatment for paralysis comprises slapping the patient with a bundle of twigs. Alcoholic extract of Russian sp. is used in the cholecystitis and habitual constipation.The root exhibits an antiprolifera- tive effect on prostatic epithelial and stromal cells. It may also lessen the effects of androgenic hormones by competitively blocking acess to human sex hormone binding globulin. (Planta Med, 63, 1997; ibid, 66, 2000. Also, ESCOP monograph; Altern Complem Ther, 1998; Simon Mills; Natural Medicines Comprehensive Database, 2007.)In Europe, the juice of the leaves or roots, mixed with honey or sugar, was prescribed forbronchial asthma. In the USA, a freeze-dried preparation of the herb (300 mg gelatin capsules) has been found to improve condition of allergic rhinitis patients. The powdered seeds were considered a cure for goitre. (M. Grieve.)The urticating properties of the hairs are attributed to the presence of acetyl- choline, histamine and 5-hydroxytryp- tamine (5-HT). A histamine-liberating enzyme is also present.Acetylcholine is present in the leaves, rootlets, rhizomes and cortex in the ascending order of concentration. Histamine is not present in the underground parts of the plant. Its concentration in the leaves is about four times than that in the stem-cortex. Betaine and choline are present in the leaves.The leaves gave flavonoids (including rutin), sterols, carotenoids, vitamins (including C, B group, K), minerals, plant phenolic acids. The coumarin scopoletin has been isolated from the flowers and the root.A polysaccharide fraction obtained from aqueous extract showed anti- inflammatory activity in carrageenan- induced rat paw oedema and lymphocyte transformation test. A lectin was found to stimulate proliferation of human lymphocytes. (Planta Med, 55, 1989.)The leaf and root is contraindicat- ed in kidney disease and pregnancy. 5-hydroxytryptamine is a uterotropic constituent. (Francis Brinker.)... urtica dioicaAcute or chronic. One of the commonest acute abdominal emergencies. An impressive rise in incidence in the young female population has been linked with the use of oral contraceptives. Other causes: heavy consumption of animal fats, sugars.
Symptoms. Severe upper abdominal pain, often radiating to the shoulder and right midback. Constancy of the pain contrasts with the repeated brief attacks of gall-stone (biliary) colic. Sweating, shallow erratic breathing, tenderness upper right abdomen, distension, flatulence, nausea, intolerance of fatty foods.
In cases of suspected cholecystitis, bitter herbs help liquefy bile and prevent consolidation. Prevention: Blue Flag, or Wild Yam, 2 tablets at night.
For infection: Echinacea.
Alternatives. BHP (1983) selection: Barberry, Mountain Grape, Balmony, Fringe Tree, Wild Yam, Wahoo, Chiretta, Dandelion, Black root; according to individual case. Milk Thistle.
Teas. Agrimony, Milk Thistle, Fumitory, Black Horehound, Wormwood. 1 heaped teaspoon to each cup boiling water, infuse 15 minutes. Half-1 cup freely.
Cold tea. One teaspoon Barberry bark to each cup cold water. Steep overnight. Half-1 cup freely. Tablets/capsules. Blue Flag. Echinacea, Wild Yam, Milk Thistle.
Powders. Equal parts: Echinacea, Wild Yam, Milk Thistle. Dose: 500mg (two 00 capsules, or one-third teaspoon) thrice daily.
Tinctures. Equal parts: Wild Yam, Blue Flag, Milk Thistle. 1 teaspoon thrice daily in water.
Topical. Castor oil pack over painful area.
Diet. Low fat. Avoid dairy products.
Supplementation. Vitamins A, B-complex, C. Bromelain, Zinc. Note. See entry: COURVOISER’S LAW. ... gall bladder, inflammation
Gallstones are rare in childhood and become increasingly common with age. Women are affected more than men. Risk factors include a high-fat diet and being overweight.
Most gallstones cause no symptoms. When symptoms do occur, they often begin when a stone gets stuck in the duct leading from the gallbladder, causing biliary colic and nausea. Gallstones may cause indigestion and flatulence. Possible complications are cholecystitis and bile duct obstruction.Diagnosis is by ultrasound scanning, X-ray oral cholecystography, or cholangiography.
Stones that are not causing symptoms are usually left alone.
In other cases, the gallbladder and stones may be removed by cholecystectomy.
Ultrasonic shock waves (see lithotripsy) are sometimes used to shatter stones; the fragments pass into the bowel and cause no further problems.
Drugs such as chenodeoxycholic acid or ursodeoxycholic acid can dissolve some stones if given over a period of months.... gallstones
There is usually severe abdominal pain. After a few hours, the abdomen feels hard, and peristalsis stops (see ileus, paralytic). Other symptoms are fever, bloating, nausea, and vomiting.
Diagnosis is made from a physical examination. Surgery may be necessary to deal with the cause. If the cause is unknown, a laparoscopy or an exploratory laparotomy may be performed. Antibiotic drugs and intravenous infusions of fluid are often given. In most cases, a full recovery is made. Intestinal obstruction, caused by adhesions, may occur at a later stage.... peritonitis
Vomiting may be due to overindulgence in food or alcohol, is a common side effect of many drugs, and may follow general anaesthesia. Vomiting is also common in gastrointestinal disorders such as peptic ulcer, acute appendicitis, gastroenteritis, and food poisoning. Less commonly, it is due to obstruction (see pyloric stenosis; intussusception) or a tumour of the digestive tract. It may also be due to inflammation (see hepatitis; pancreatitis; cholecystitis).
Other possible causes are pressure on the skull (see encephalitis; hydrocephalus; brain tumour; head injury; migraine), conditions affecting the ear’s balancing mechanism (see Ménière’s disease; labyrinthitis; motion sickness), and hormonal disorders (see Addison’s disease).
Vomiting may be a symptom of ketoacidosis in poorly controlled diabetes mellitus. It may also be a symptom of an emotional problem or be part of the disorders anorexia nervosa or bulimia.
Persistent vomiting requires medical investigation. Treatment depends on the cause. Antiemetics may be given. (See also vomiting blood; vomiting in pregnancy.)... vomiting
FAMILY: Rosaceae
SYNONYMS: Rose maroc, French rose, Provence rose, hundred-leaved rose, Moroccan otto of rose (oil), French otto of rose (oil), rose de mai (absolute or concrete).
GENERAL DESCRIPTION: The rose which is generally used for oil production is strictly a hybrid between R. centifolia, a pink rose, and R. gallica, a dark red rose. This variety, known as rose de mai, grows to a height of 2.5 metres and produces an abundance of flowers with large pink or rosy-purple petals. There are two subspecies – one is more spiny than the other.
DISTRIBUTION: The birthplace of the cultivated rose is believed to be ancient Persia; now cultivated mainly in Morocco, Tunisia, Italy, France, Yugoslavia and China. The concrete, absolute and oil are mainly produced in Morocco; the absolute in France, Italy and China.
OTHER SPECIES: There are over 10,000 types of cultivated rose! There are several subspecies of R. centifolia, depending on the country of origin. Other therapeutic species are the red rose or apothecary rose (R. gallica) of traditional Western medicine, the oriental or tea rose (R. indica), the Chinese or Japanese rose (R. rugosa) and the Turkish or Bulgarian rose (R. damascena) which is also extensively cultivated for its oil. Recently rosehip seed oil from R. rubiginosa has been found to be a very effective skin treatment; it promotes tissue regeneration and is good for scars, burns and wrinkles. The wild rose (Eubatus rubus) is now also being used to produce a rare absolute with a rich, spicy-earthy fragrance. See also entry on damask rose and the Botanical Classification section.
HERBAL/FOLK TRADITION: The healing virtues of the rose have been known since antiquity and although roses are rarely used in herbal practice nowadays, up to the Middle Ages they played an essential part in the materia medica, and still
fulfil an important role in Eastern medicine. They were used for a wide range of disorders, including digestive and menstrual problems, headaches and nervous tension, liver congestion, poor circulation, fever (plague), eye infections and skin complaints. ‘The symbolism connected with the rose is perhaps one of the richest and most complex associated with any plant ... traditionally associated with Venus, the Goddess of love and beauty, and in our materialistic age the Goddess is certainly alive and well in the cosmetics industry for rose oil (mainly synthetic) is found as a component in 46% of men’s perfumes and 98% of women’s fragrances.’.
The French or Moroccan rose possesses narcotic properties and has the reputation for being aphrodisiac (more so than the Bulgarian type), possibly due to the high percentage of phenyl ethanol in the former. For further distinctions between the different properties of rose types, see damask rose.
ACTIONS: Antidepressant, antiphlogistic, antiseptic, antispasmodic, anti-tubercular agent, antiviral, aphrodisiac, astringent, bactericidal, choleretic, cicitrisant, depurative, emmenagogue, haemostatic, hepatic, laxative, regulator of appetite, sedative (nervous), stomachic, tonic (heart, liver, stomach, uterus).
EXTRACTION: 1. Essential oil or otto by water or steam distillation from the fresh petals. (Rose water is produced as a byproduct of this process.) 2. Concrete and absolute by solvent extraction from the fresh petals. (A rose leaf absolute is also produced in small quantities in France.)
CHARACTERISTICS: 1. The oil is a pale yellow liquid with a deep, sweet, rosy-floral, tenacious odour. 2. The absolute is a reddish orange viscous liquid with a deep, rich, sweet, rosy-spicy, honeylike fragrance. It blends well with jasmine, cassie, mimosa, neroli, geranium, bergamot, lavender, clary sage, sandalwood, guaiacwood, patchouli, benzoin, chamomile, Peru balsam, clove and palmarosa.
PRINCIPAL CONSTITUENTS: It has over 300 constituents, some in minute traces. Mainly citronellol (18–22 per cent), phenyl ethanol (63 per cent), geraniol and nerol (10–15 per cent), stearopten (8 per cent), farnesol (0.2–2 per cent), among others.
SAFETY DATA: Non-toxic, non-irritant, non-sensitizing.
AROMATHERAPY/HOME: USE
Skin care: Broken capillaries, conjunctivitis (rose water), dry skin, eczema, herpes, mature and sensitive complexions, wrinkles.
Circulation muscles and joints: Palpitations, poor circulation.
Respiratory system: Asthma, coughs, hay fever.
Digestive system: Cholecystitis, liver congestion, nausea.
Genito-urinary system: Irregular menstruation, leucorrhoea, menorrhagia, uterine disorders.
Nervous system: Depression, impotence, insomnia, frigidity, headache, nervous tension and stress-related complaints – ‘But the rose procures us one thing above all: a feeling of well being, even of happiness, and the individual under its influence will develop an amiable tolerance.’.
OTHER USES: Rose water is used as a household cosmetic and culinary article (especially in Persian cookery). The concrete, absolute and oil are employed extensively in soaps, cosmetics, toiletries and perfumes of all types – floral, oriental, chypres, etc. Some flavouring uses, especially fruit products and tobacco.... rose, cabbage
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