Chronic Obstructive Pulmonary Disease (copd): From 1 Different Sources
This is a term encompassing chronic BRONCHITIS, EMPHYSEMA, and chronic ASTHMA where the air?ow into the lungs is obstructed.
Chronic bronchitis is typi?ed by chronic productive cough for at least three months in two successive years (provided other causes such as TUBERCULOSIS, lung cancer and chronic heart failure have been excluded). The characteristics of emphysema are abnormal and permanent enlargement of the airspaces (alveoli) at the furthermost parts of the lung tissue. Rupture of alveoli occurs, resulting in the creation of air spaces with a gradual breakdown in the lung’s ability to oxygenate the blood and remove carbon dioxide from it (see LUNGS). Asthma results in in?ammation of the airways with the lining of the BRONCHIOLES becoming hypersensitive, causing them to constrict. The obstruction may spontaneously improve or do so in response to bronchodilator drugs. If an asthmatic patient’s airway-obstruction is characterised by incomplete reversibility, he or she is deemed to have a form of COPD called asthmatic bronchitis; sufferers from this disorder cannot always be readily distinguished from those people who have chronic bronchitis and/ or emphysema. Symptoms and signs of emphysema, chronic bronchitis and asthmatic bronchitis overlap, making it di?cult sometimes to make a precise diagnosis. Patients with completely reversible air?ow obstruction without the features of chronic bronchitis or emphysema, however, are considered to be suffering from asthma but not from COPD.
The incidence of COPD has been increasing, as has the death rate. In the UK around 30,000 people with COPD die annually and the disorder makes up 10 per cent of all admissions to hospital medical wards, making it a serious cause of illness and disability. The prevalence, incidence and mortality rates increase with age, and more men than women have the disorder, which is also more common in those who are socially disadvantaged.
Causes The most important cause of COPD is cigarette smoking, though only 15 per cent of smokers are likely to develop clinically signi?cant symptoms of the disorder. Smoking is believed to cause persistent airway in?ammation and upset the normal metabolic activity in the lung. Exposure to chemical impurities and dust in the atmosphere may also cause COPD.
Signs and symptoms Most patients develop in?ammation of the airways, excessive growth of mucus-secreting glands in the airways, and changes to other cells in the airways. The result is that mucus is transported less e?ectively along the airways to eventual evacuation as sputum. Small airways become obstructed and the alveoli lose their elasticity. COPD usually starts with repeated attacks of productive cough, commonly following winter colds; these attacks progressively worsen and eventually the patient develops a permanent cough. Recurrent respiratory infections, breathlessness on exertion, wheezing and tightness of the chest follow. Bloodstained and/or infected sputum are also indicative of established disease. Among the symptoms and signs of patients with advanced obstruction of air?ow in the lungs are:
RHONCHI (abnormal musical sounds heard through a STETHOSCOPE when the patient breathes out).
marked indrawing of the muscles between the ribs and development of a barrel-shaped chest.
loss of weight.
CYANOSIS in which the skin develops a blue tinge because of reduced oxygenation of blood in the blood vessels in the skin.
bounding pulse with changes in heart rhythm.
OEDEMA of the legs and arms.
decreasing mobility.
Some patients with COPD have increased ventilation of the alveoli in their lungs, but the levels of oxygen and carbon dioxide are normal so their skin colour is normal. They are, however, breathless so are dubbed ‘pink pu?ers’. Other patients have reduced alveolar ventilation which lowers their oxygen levels causing cyanosis; they also develop COR PULMONALE, a form of heart failure, and become oedematous, so are called ‘blue bloaters’.
Investigations include various tests of lung function, including the patient’s response to bronchodilator drugs. Exercise tests may help, but radiological assessment is not usually of great diagnostic value in the early stages of the disorder.
Treatment depends on how far COPD has progressed. Smoking must be stopped – also an essential preventive step in healthy individuals. Early stages are treated with bronchodilator drugs to relieve breathing symptoms. The next stage is to introduce steroids (given by inhalation). If symptoms worsen, physiotherapy – breathing exercises and postural drainage – is valuable and annual vaccination against INFLUENZA is strongly advised. If the patient develops breathlessness on mild exertion, has cyanosis, wheezing and permanent cough and tends to HYPERVENTILATION, then oxygen therapy should be considered. Antibiotic treatment is necessary if overt infection of the lungs develops.
Complications Sometimes rupture of the pulmonary bullae (thin-walled airspaces produced by the breakdown of the walls of the alveoli) may cause PNEUMOTHORAX and also exert pressure on functioning lung tissue. Respiratory failure and failure of the right side of the heart (which controls blood supply to the lungs), known as cor pulmonale, are late complications in patients whose primary problem is emphysema.
Prognosis This is related to age and to the extent of the patient’s response to bronchodilator drugs. Patients with COPD who develop raised pressure in the heart/lung circulation and subsequent heart failure (cor pulmonale) have a bad prognosis.
A failure of the adaptive mechanisms of an organism to counteract adequately, normally or appropriately to stimuli and stresses to which the organism is subjected, resulting in a disturbance in the function or structure of some part of the organism. This definition emphasizes that disease is multifactorial and may be prevented or treated by changing any or a combination of the factors. Disease is a very elusive and difficult concept to define, being largely socially defined. Thus, criminality and drug dependence are presently seen by some as diseases, when they were previously considered to be moral or legal problems.... disease
A zoonotic disease caused by the spirochaete Borrelia burgdorferi and other species of the genus. Common in Europe and the USA and transmi tted by Ixodid ticks.... lyme disease
A disease or imbalance of long, slow duration, showing little overall change and characterized by periods of remission interspersed with acute episodes. The opposite of acute.... chronic
(CFS) is a recently designated semi-disease, often attributed to EBV (the Epstein-Barr virus) or CMV (Cytomegalovirus) infections, characterized by FUOs (Fevers of Unknown Origin) and resulting in the patient suffering FLS (Feels Like Shit). In most of us, the microorganisms involved in CFS usually provoke nothing more than a head cold; in some individuals, however, they induce a long, grinding, and debilitating disorder, characterized by exhaustion, depression, periodic fevers...a crazy-quilt of symptoms that frustrates both the sufferer and the sometimes skeptical physician. MCS (Multiple Chemical Sensitivities) are another syndrome that is often lumped with CFS, and they may often be two faces of the same condition. I am not using all these acronyms to mock the conditions, but as an irony. There is too much (Acronym Safety Syndrome) in medicine, reducing complex and frustrating conditions to insider’s techno-babble, somehow therein trivializing otherwise complex, painful and crazy-making problems. The widest use of acronyms (AIDS, HIV, CFS, MCS, MS etc.) seems to be for diseases hardest to treat, least responsive to procedural medicine, and most depressing to discuss with patients or survivors.... chronic fatigue syndrome
An illness due to a specific infectious agent or its toxic products which arises through transmission of that agent or its products from a reservoir to a susceptible host - either directly, through the agencyof an intermediate plant or animal host, vector, or the inanimate environment.... communicable disease
A serious African viral haemorrhagic fever harboured by monkeys. Named after the city of Marburg in Germany where a serious outbreak occurred amongst laboratory workers handling the tissues of African Green (Vervet) monkeys.... marburg disease
Relating to the LUNGS.... pulmonary
Bornholm disease, also known as devil’s grip, and epidemic myalgia, is an acute infective disease due to COXSACKIE VIRUSES. It is characterised by the abrupt onset of pain around the lower margin of the ribs, headache, and fever; it occurs in epidemics, usually during warm weather, and is more common in young people than in old. The illness usually lasts seven to ten days. It is practically never fatal. The disease is named after the island of Bornholm in the Baltic, where several epidemics have been described.... bornholm disease
Brittle Bone Disease is another name for OSTEOGENESIS IMPERFECTA.... brittle bone disease
See COMPRESSED AIR ILLNESS.... caisson disease
A zoonotic protozoan disease endemic to parts of Latin America and caused by Trypanosmoma cruzi with reduviid (Triatomid or assassin) bugs as the vectors.... chagas’ disease
A hereditary disorder of blood coagulation which can only be distinguished from HAEMOPHILIA by laboratory tests. It is so-called after the surname of the ?rst case reported in this country. About one in every ten patients clinically diagnosed as haemophiliac has in fact Christmas disease. It is due to lack in the blood of Factor IX (see COAGULATION).... christmas disease
The presence of numerous diverticula (sacs or pouches) in the lining of the COLON accompanied by spasmodic lower abdominal pain and erratic bowel movements. The sacs may become in?amed causing pain (see DIVERTICULITIS).... diverticular disease
A disease of humans or animals resulting from an infection.... infectious disease
Infection by the Gram negative rod, Legionella pneumophila and other species of the Genus. Often presents as an atypical pneumonia. Outbreaks have been reported from various countries.... legionnaire’s disease
(PID) Also called salpingitis, the term is applied to infections of the fallopian tubes that follow or are concurrent with uterine and cervical infections. Gonorrhea and Chlamydia are the most common organisms, and the infection is usually begun through sexual contact, although metabolic imbalances, subtler systemic infections like a slow virus, the local insult of herpes or candidiasis, the sequela of medication or recreational drugs, birth control pills, even an IUD...all can alter the vaginal flora and induce inflammation sufficient to allow an endogenous organism to start the infection. PID after birth, on the other hand, is usually the result of staph or strep infections infecting injured membranes.... pelvic inflammatory disease
In this condition, increased resistance to the blood ?ow through the LUNGS occurs. This is usually the result of lung disease, and the consequence is an increase in pulmonary artery pressure and in the pressure in the right side of the heart and in the veins bringing blood to the heart. Chronic BRONCHITIS or EMPHYSEMA commonly constrict the small arteries in the lungs, thus causing pulmonary HYPERTENSION. (See also EISENMENGER SYNDROME.)... pulmonary hypertension
Fluid in the small air sacs of the lungs, from inefficient pumping by the heart or leakage of fluid from the blood vessels in the lungs (possibly from envenomation). As it prevents air exchange in the lungs it causes hypoxia and may lead to death.... pulmonary oedema
The condition in which an embolus (see EMBOLISM), or clot, is lodged in the LUNGS. The source of the clot is usually the veins of the lower abdomen or legs, in which clot formation has occurred as a result of the occurrence of DEEP VEIN THROMBOSIS (DVT) – THROMBOPHLEBITIS (see VEINS, DISEASES OF). Thrombophlebitis, with or without pulmonary embolism, is a not uncommon complication of surgical operations, especially in older patients. This is one reason why nowadays such patients are got up out of bed as quickly as possible, or, alternatively, are encouraged to move and exercise their legs regularly in bed. Long periods of sitting, particularly when travelling, can cause DVT with the risk of pulmonary embolism. The severity of a pulmonary embolism, which is characterised by the sudden onset of pain in the chest, with or without the coughing up of blood, and a varying degree of SHOCK, depends upon the size of the clot. If large enough, it may prove immediately fatal; in other cases, immediate operation may be needed to remove the clot; whilst in less severe cases anticoagulant treatment, in the form of HEPARIN, is given to prevent extension of the clot. For some operations, such as hip-joint replacements, with a high risk of deep-vein thrombosis in the leg, heparin is given for several days postoperatively.... pulmonary embolism
A disorder of the HEART in which obstruction of the out?ow of blood from the right ventricle occurs. Narrowing of the pulmonary valve at the exit of the right ventricle and narrowing of the pulmonary artery may cause obstruction. The condition is usually congenital, although it may be caused by RHEUMATIC FEVER. In the congenital condition, pulmonary stenosis may occur with other heart defects and is then known as Fallot’s tetralogy. Breathlessness and enlargement of the heart and eventual heart failure may be the consequence of pulmonary stenosis. Surgery is usually necessary to remove the obstruction.... pulmonary stenosis
A disease causing failure of adrenal gland function, in particular deficiency of adrenal cortical hormones, mainly cortisol and aldosterone. Commonest causes are tuberculosis and auto- immune disease.
Symptoms: (acute) abdominal pain, muscle weakness, vomiting, low blood pressure due to dehydration, tiredness, mental confusion, loss of weight and appetite. Vomiting, dizzy spells. Increased dark pigmentation around genitals, nipples, palms and inside mouth. Persistent low blood pressure with occasional low blood sugar. Crisis is treated by increased salt intake. Research project revealed a craving for liquorice sweets in twenty five per cent of patients.
Herbs with an affinity for the adrenal glands: Parsley, Sarsaparilla, Wild Yam, Borage, Liquorice, Ginseng, Chaparral. Where steroid therapy is unavoidable, supplementation with Liquorice and Ginseng is believed to sustain function of the glands. Ginseng is supportive when glands are exhausted by prolonged stress. BHP (1983) recommends: Liquorice, Dandelion leaf.
Alternatives. Teas. Gotu Kola, Parsley, Liquorice root, Borage, Ginseng, Balm.
Tea formula. Combine equal parts: Balm and Gotu Kola. Preparation of teas and tea mixture: 1 heaped teaspoon to each cup boiling water: infuse 5-10 minutes; 1 cup 2 to 3 times daily.
Tablets/capsules. Ginseng, Seaweed and Sarsaparilla, Wild Yam, Liquorice. Dosage as on bottle. Formula. Combine: Gotu Kola 3; Sarsaparilla 2; Ginseng 1; Liquorice quarter. Doses. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 30-60 drops. Tinctures: 1-2 teaspoons 2 to 3 times daily.
Formula. Alternative. Tinctures 1:5. Echinacea 20ml; Yellow Dock 10ml; Barberry 10ml; Sarsaparilla 10ml; Liquorice (liquid extract) 5ml. Dose: 1-2 teaspoons thrice daily.
Supplementation. Cod liver oil. Extra salt. B-Vitamins. Folic acid. ... addison’s disease
A progressive brain deterioration first described by the German Neurologist, Alois Alzheimer in 1906. Dementia. Not an inevitable consequence of ageing. A disease in which cells of the brain undergo change, the outer layer (cerebral cortex) leading to tangles of nerve fibres due to reduced oxygen and blood supply to the brain.
The patient lives in an unreal world in which relatives have no sense of belonging. A loving gentle wife they once knew is no longer aware of their presence. Simple tasks, such as switching on an electrical appliance are fudged. There is distressing memory loss, inability to think and learn, speech disturbance – death of the mind. Damage by free radicals implicated.
Symptoms: Confusion, restlessness, tremor. Finally: loss of control of body functions and bone loss.
A striking similarity exists between the disease and aluminium toxicity. Aluminium causes the brain to become more permeable to that metal and other nerve-toxins. (Tulane University School of Medicine, New Orleans). High levels of aluminium are found concentrated in the neurofibrillary tangles of the brain in Alzheimer’s disease. Entry into the body is by processed foods, cookware, (pots and pans) and drugs (antacids).
“Reduction of aluminium levels from dietary and medicinal sources has led to a decline in the incidence of dementia.” (The Lancet, Nov 26, 1983).
“Those who smoke more than one packet of cigarettes a day are 4.5 times more likely to develop Alzheimer’s disease than non-smokers.” (Stuart Shalat, epidemiologist, Harvard University).
Researchers from the University of Washington, Seattle, USA, claim to have found a link between the disease and head injuries with damage to the blood/brain barrier.
Also said to be associated with Down’s syndrome, thyroid disease and immune dysfunction. Other contributory factors are believed to be exposure to mercury from dental amalgam fillings. Animal studies show Ginkgo to increase local blood flow of the brain and to improve peripheral circulation. Alternatives. Teas: Alfalfa, Agrimony, Lemon Balm, Basil, Chaparral, Ginkgo, Chamomile, Coriander (crushed seeds), Ginseng, Holy Thistle, Gotu Kola, Horsetail, Rosemary, Liquorice root (shredded), Red Clover flowers, Skullcap, Ladies Slipper.
Tea. Formula. Combine, equal parts: German Chamomile, Ginkgo, Lemon Balm. 1 heaped teaspoon to cup boiling water; infuse 5-15 minutes. 1 cup freely.
Decoction. Equal parts: Black Cohosh, Blue Flag root, Hawthorn berries. 1 teaspoon in each cupful water; bring to boil and simmer 20 minutes. Dose: half-1 cup thrice daily.
Powders. Formula. Hawthorn 1; Ginkgo 1; Ginger half; Fringe Tree half. Add pinch Cayenne pepper. 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Liquid extracts. Formula. Hawthorn 1; Ephedra half; Ginkgo 1. Dose: 30-60 drops, thrice daily, before meals.
Topical. Paint forehead and nape of neck with Tincture Arnica.
Diet: 2 day fluid-only fast once monthly for 6 months. Low fat, high fibre, lecithin. Lacto-vegetarian. Low salt.
Supplements. Vitamin B-complex, B6, B12, Folic acid, A, C, E, Zinc. Research has shown that elderly patients at high risk of developing dementia have lower levels of Vitamins A, E and the carotenes. Zinc and Vitamin B12 are both vital cofactors for brain enzymes.
Alzheimer’s Disease linked with zinc. Zinc is believed to halt cerebral damage. Senile plaques in the brain produce amyloid, damaging the blood-brain barrier. Toxic metals then cross into the brain, displacing zinc. This then produces abnormal tissue. (Alzheimer Disease and Associated Disorders, researchers, University of Geneva).
Japanese study. Combination of coenzyme Q10, Vitamin B6 and iron. Showed improved mental function. Abram Hoffer MD, PhD. Niacin 500mg tid, Vitamin C 500mg tid, Folic acid 5mg daily, Aspirin 300mg daily, Ginkgo herb 40mg daily. (International Journal of Alternative and Complementary Medicine, Feb 1994 p11)
Alzheimer’s Disease Society. 2nd Floor, Gordon House, 10 Greencoat Place, London SW1P 1PH, UK. Offers support to families and carers through membership. Practical help and information. Send SAE. ... alzheimer’s disease
Chronic inflammation and ulceration of the gut, especially the terminal ileum from changes in the gut blood vessels. Commences with ulceration which deepens, becomes fibrotic and leads to stricture. Defective immune system. Resistance low. May be associated with eye conditions and Vitamin B12 deficiency.
Symptoms: malaise, bloody alternating diarrhoea and constipation; right side colicky abdominal pain worse after meals; flatulence, loss of weight and appetite. Intestinal obstruction can usually be palpated. Blood count. A blood count high in whites indicates an abscess – a serious condition which may require surgical repair during which segments of the gut may have to be removed. Malignant change rare. Differential diagnosis. Ulcerative colitis, appendicitis, appendix abscess, irritable bowel syndrome.
Cracks or ulcers at corners of the mouth may be a good marker of Crohn’s Disease.
Treatment. Select one of the following. Herbal treatment offers a safe alternative to steroids by inducing remission in acute exacerbation. Good responses have been observed from the anti-bacterials Wild Yam and Goldenseal. Fenugreek seeds are of special value. Comfrey (tissue regeneration). Irish Moss.
Teas: Chamomile, Comfrey leaves, Hops, Marshmallow leaves, Meadowsweet, Shepherd’s Purse (Dr A. Vogel), Lobelia. Silverweed and Cranesbill are excellent for internal bleeding; Poke root for intestinal ulceration.
Decoction. Fenugreek seeds: 2 teaspoons to large cup water simmered gently 10 minutes. 1 cup freely. The seeds also should be consumed.
Tablets/capsules. Wild Yam, Fenugreek, Ginger, Goldenseal, Lobelia, Slippery Elm.
Powders. Formula. Wild Yam 2; Meadowsweet 2; Goldenseal 1. Dose: 500mg (two 00 capsules or one- third teaspoon) thrice daily.
Liquid Extracts. (1) Formula. Wild Yam 1, Echinacea 2. 30-60 drops in water thrice daily. Or, (2) Formula: Turkey Rhubarb 2, Goldenseal 1, Caraway half. 20-30 drops in water thrice daily.
Tinctures. Formula. Bayberry 2, Goldenseal 1, Cardamoms 1. Dose: One to two 5ml teaspoons thrice daily.
Ispaghula seeds. 2-4 teaspoons thrice daily.
Tea Tree oil Suppositories. Insertion at night.
Diet. Bland, little fibre, Slippery Elm gruel. Irish Moss preparations. Increase fluid intake. Reject: broccoli, tomatoes, lima, Soya, Brussels sprouts, pinto beans, cocoa, chocolate, cow’s milk, peas, onions, turnips, radishes. Accept fish oils.
Addenbrookes Hospital, Cambridge. Reject foods containing wheat and all dairy produce.
Supplements. Vitamins A, B12, C, Calcium, Iron, Magnesium, Potassium, Zinc.
Study. In a study carried out by UK researchers (1993) food allergies were found to be the most common cause of the disease. Results suggested that dietary changes may be as effective as corticosteroids in easing symptoms. The most common allergens were corn, wheat, milk, yeast, egg, potato, rye, tea, coffee, apples, mushrooms, oats, chocolate. An elemental diet with a formula of nutrients (E028, produced by Hospital Supplies, Liverpool) was used in trials. (The Lancet, 6.11.1993)
Notes. Crohn’s Disease is associated with Erythema nodosum, more frequently recognised in childhood. A frequent cause is cow’s milk intolerance. Smoking adds to the risk of Crohn’s disease.
In susceptible people, the food additives titanium dioxide and aluminosilicates may evoke a latent inflammatory response resulting in Crohn’s disease, ulcerative colitis or bowel cancer. These chemicals may be found in the intestinal lymphoid aggregations in gut mucosa. (Jonathan Powell, Gastro-intestinal Laboratory, St Thomas’s Hospital, London) (Titanium dioxide rarely occurs naturally but is added to confectionery, drinking water and anti-caking agents.) ... crohn’s disease
Leprosy. Progressive infection by Mycobacterium leprae. Two forms: (1) tuberculoid; infection of the nerve endings and membranes of the nose, with loss of feeling and pale patches on the body. (2) Lepromatous; with inflamed thickened painful red skin exacerbated by ulceration, fever, neuritis and orchitis. Distorted lips and loss of nasal bone as infection progresses.
Symptoms: numbness, nerves may swell like iron rods. Infected nerves kill all sensation. In endemic areas, pins and needles in hands may call attention to it. A disease of nerves rather than skin. NOTIFIABLE DISEASE.
Many laymen and practitioners will never have seen a case. In the absence of modern medicine some good can be achieved by traditional remedies. Ancient Hindu and Chinese records refer to the use of Gotu Kola (internally and externally). Dr C.D. de Granpre? (1888) refers. (Martindale 27; p.441)
Oil of Chaulmoogra was used up to one hundred years ago before introduction of modern drugs. It fell into dis-use until discovered by a Director of Health in the Philippine Islands during World War I when he used it successfully in combination with camphor. In South America, where the disease is still active, Sarsaparilla has a long traditional reputation. Walnut oil is used as a dressing, in China. An anti- staphylococcal fraction has been isolated from the seeds of Psoralea corylifolia for use in leprosy. (Indian Journal of Pharmacy 26: 141, 1964)
Tea. Gotu Kola. Half a teaspoon to each cup boiling water; infuse 15 minutes. Drink freely. Stronger infusions may be used externally to cleanse ulceration.
Decoction. Combine: Sarsaparilla 1; Gotu Kola 1; Echinacea 2. Half an ounce to 1 pint water gently simmered 20 minutes. Dose: Half a cup 3 times daily.
Formula. Echinacea 2; Sarsaparilla 1; Gotu Kola 2. Dose. Powders 500mg. Liquid Extracts 3-5ml. Tinctures 5-10ml. Thrice daily.
Note: Antibody-positive cases of AIDS are vulnerable to leprosy, both diseases being caused by a similar bacterium.
To be treated by infectious diseases specialist. ... hansen’s disease
(Lymphadenoma. Lymphogranulomatosis). Chronic enlargement of the lymph nodes often together with that of the liver, spleen and bone marrow. Affects more males than females, 30- 40 years. High white blood cell count. Cancer of the lymph vessels. Follows a typical clinical course with anaemia until necrosis supervenes. The disease is suspected by a combination of enlargement of lymph nodes (especially the neck), severe itching and unexplained fever. Symptoms vary according to part of the body affected.
Symptoms. Hard rubbery glands are general, chiefly detected under the arm and groin. Enlarged nodes may compress nearby structures to produce nerve pains. Weight loss. Accumulation of fluid in lungs and abdomen. Obstruction of bile duct leads to jaundice. Patient may be prone to shingles. High fever heralds approaching fatality. Blood count, bone marrow aspiration and node biopsy confirm. Tubercula glands may simulate Hodgkin’s disease.
Some success reported by the use of the Periwinkle plant. (vinca rosea – Vinchristine) Wm Boericke, M.D. refers to Figwort as a powerful agent in Hodgkin’s disease.
Alternatives. Although there is no known cure, emphasis on the cortex of the adrenal gland may reduce skin irritation and pain in the later stages (Gotu Kola, Liquorice, Sarsaparilla). To arrest wasting and constitutional weakness: Echinacea. Anti-pruritics, alteratives and lymphatics are indicated.
Tea. Formula. Equal parts, Nettles, Gotu Kola, Red Clover. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup 3 or more times daily.
Decoction. Formula. Equal parts – Yellow Dock, Queen’s Delight, Echinacea. 1 teaspoon to each cup water gently simmered 20 minutes. Half-1 cup 3 or more times daily.
Tablets/capsules. Poke root. Blue Flag root. Echinacea. Mistletoe.
Powders. Formula. Echinacea 2; Poke root 1; Bladderwrack 1. Dose: 500mg (two 00 capsules or one- third teaspoon) 3 or more times daily.
Tinctures. Mixture. Parts: Echinacea 2; Goldenseal quarter; Thuja quarter; Poke root half; Periwinkle 1. Dose: 1-2 teaspoons, 3 or more times daily. Where active inflammation is present – add Wild Yam 1. External. Castor oil packs to abdomen.
Treatment by a general medical practitioner or hospital specialist.
HOLISTIC MEDICINE. A school of thought which regards disease as a manifestation of an inner disturbance of the vital force, and not merely abnormality of certain groups of nerves, muscles, veins, or even the mind itself. Article 43 of Dr Samuel Hahnemann’s Organon of the Healing Art describes it:
“No organ, no tissue, no cell, no molecule is independent of the activities of the others but the life of each one of these elements is merged into the life of the whole. The unit of human life cannot be the organ, the tissue, the cell, the molecule, the atom, but the whole organism, the whole man.”
Holistic medicine relates disease to a patient’s personality, posture, diet, emotional life, and lifestyle. Treatment will be related to body, mind and spirit. It encourages a positive psychological response to the disease from which a patient suffers. For instance, its gentle approach to cancer embraces stress control, meditation, forms of visualisation and other life-enhancing skills.
Diet may be vegetarian, even vegan.... hodgkin’s disease
Inner ear disorder. Constriction of cerebral blood vessels (vasospasm) increases pressure of fluids in the balancing mechanism. Ages 40-60; more in men.
Etiology. Obscure; though cases may be traced to auto-toxaemia, Vitamin B deficiency, menstruation, malaria drugs (chloroquine).
Symptoms: dizziness, nausea, vomiting, tinnitus, sound distortions, heavy sweating, loss of hearing; usually in one ear only. Early diagnosis essential for effective treatment. This may mean reference to a department of otolaryngology or otoneurology.
Treatment. Antispasmodics. Nervines. Sometimes a timely diuretic reduces severity – Uva Ursi, Dandelion root, Wild Carrot.
Alternatives. Current European practice: Betony, German Chamomile, Passion flower, Hawthorn, Hops, Feverfew, White Willow.
Tea. Combine, equal parts: Valerian, Wild Carrot, Agrimony. 2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup every 2 hours during attack; thrice daily thereafter.
Decoction. Mistletoe: 2 teaspoons to each cup cold water steeped overnight. Bring to boil. Allow to cool. Half-1 cup, as above.
Tablets/capsules. Feverfew, Mistletoe, Prickly Ash.
Formula. Ginkgo 2; Dandelion 1; Black Cohosh 1. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Feverfew tincture. See: FEVERFEW.
Dr J. Christopher: inject into ears, at night, few drops oil of Garlic (or contents of Garlic capsule).
Cider vinegar. 2 teaspoons to glass water: as desired.
Aromatherapy. Inhalants: Eucalyptus or Rosemary oils.
Diet: gluten-free, low salt; good responses observed. High fibre. Avoid dairy products and chocolate. Vitamins: B-complex, B1; B2; B6; E; F. Brewer’s yeast, Niacin.
Minerals: Calcium. Magnesium. Phosphorus. Dolomite. ... meniere’s disease
(Sir James Paget, 1814-99) Osteitis deformans. Chronic inflammation of bone at focal points (Pagetic sites), often widespread. Chronic. Progressive softening followed by thickening with distortion. Renewal of new bone outstrips absorption of old bone. Enlargement of the skull (‘Big head’) and of the long bones. Broadened pelvis, distorted spine (kyphosis) from flattened vertebra. Male predominence. Over 40 years. Spontaneous fractures possible. Paget’s disease and diabetes may be associated in the same family.
Some authorities believe cause is vitamin and mineral deficiency – those which promote bone health being calcium and magnesium (dolomite). Supplementation helps cases but evidence confirms that some pet-owners are at risk – a virus from cats and dogs possibly responsible. The prime candidate is one exposed to canine distemper. Dogs are involved twice as much as cats. The virus is closely related to the measles virus in humans.
Symptoms. Limbs deformed, hot during inflammatory stage. Headaches. Dull aching pain in bones. Deafness from temporal bone involvement. Loss of bone rigidity. Bowing of legs.
Surgical procedures may be necessary. Appears to be a case for immunisation of dogs against distemper.
Alternatives. Black Cohosh, Boneset, Cramp bark, Bladderwrack, German Chamomile, Devil’s Claw, Helonias, Oat husks, Prickly Ash, Sage, Wild Yam.
Tea. Oats (mineral nutrient for wasting diseases) 2; Boneset (anti-inflammatory) 1; Valerian (mild analgesic) 1; Liquorice quarter. Mix. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.
Decoction. Cramp bark 1; White Willow 2. Mix. 4 heaped teaspoons to 1 pint (500ml) water gently simmered 20 minutes. Dose: half-1 cup thrice daily.
Tablets/capsules. Cramp bark, Devil’s Claw, Echinacea, Helonias, Prickly Ash, Wild Yam.
Formula. Devil’s Claw 1; Black Cohosh 1; Valerian 1; Liquorice quarter. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Action enhanced when taken in cup of Fenugreek tea. Thrice daily. Every 2 hours acute cases.
Practitioner’s analgesic. Tincture Gelsemium: 10 drops in 100ml water. Dose: 1 teaspoon every 2 hours (inflammatory stage).
Topical. Comfrey root poultice.
Diet. High protein, low salt, low fat. Oily fish.
Supplements. Daily. Vitamin C (500mg); Vitamin D (1000mg); Calcium citrate (1 gram); Dolomite (1 gram); Beta-Carotene (7500iu). Kelp. ... paget’s disease
Also called regional enteritis or regional ileitis, this is a nonspecific inflammatory disease of the upper and lower intestine that forms granulated lesions. It is usually a chronic condition, with acute episodes of diarrhea, abdominal pain, loss of appetite, and loss of weight. It may affect the stomach or colon, but the most common sites are the duodenum and the lowest part of the small intestine, the lower ileum. The standard treatment is, initially, anti-inflammatory drugs, with surgical resectioning often necessary. The disease is autoimmune, and sufferers share the same tissue type (HLA-B27) as those who acquire ankylosing spondylitis.... crohn’s disease
See CYSTIC FIBROSIS.... fibrocystic disease of the pancreas
See THYROID GLAND, DISEASES OF.... graves’ disease
Disease induced by a physician: most commonly a drug-induced disease.... iatrogenic disease
A group of disorders of unknown origin. Certain cells in the neurological system’s MOTOR nerves degenerate and die. Upper and lower motor neurones may be affected but sensory cells retain their normal functions. Three types of MND are identi?ed: amyotrophic lateral sclerosis (AML – 50 per cent of patients); progressive muscular atrophy (25 per cent), in which the prognosis is better than for AML; and bulbar palsy (25 per cent). Men are affected more than women, and the disorder affects about seven people in every 100,000. Those affected develop progressive weakness and wasting of their muscles. The diagnosis is con?rmed with various tests including the measurement of electrical activity in muscles, electromyography, muscle BIOPSY, blood tests and X-ray examination of the spine. There is no medical treatment: patients need physical and psychological support with aids to help them overcome disabilities. The Motor Neurone Disease Association provides excellent advice and help for sufferers and their relatives. (See APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELF-HELP.)... motor neurone disease (mnd)
An infectious or other disease required to be notified to the relevant State Government Authorityfor entry onto the Notifiable Diseases Register.... notifiable disease
A disease that started as, or became, impairment of structure or tissue. The smoker may have coughing and shortness of breath for years, and suffer from functional disorders; when the smoker gets emphysema, it is an organic disease.... organic disease
See PSITTACOSIS.... parrot disease
A condition which may develop in both LUNGS (interstitial pulmonary ?brosis) or part of one lung. Scarring and thickening of lung tissues occur as a consequence of previous lung in?ammation, which may have been caused by PNEUMONIA or TUBERCULOSIS. Symptoms include cough and breathlessness and diagnosis is con?rmed with a chest X-ray. The patient’s underlying condition should be treated, but the damage already done to lung tissue is usually irreversible. (See also ALVEOLITIS.)... pulmonary fibrosis
The narrowing of the blood vessels in the legs and, less commonly, in the arms. Blood ?ow is restricted, with pain occurring in the affected area. If the blood supply is seriously reduced, GANGRENE of the tissues supplied by the affected vessel(s) may occur and the limb may need to be amputated. The common cause is ATHEROSCLEROSIS which may be brought on by HYPERTENSION, excessively fatty diet, poorly controlled DIABETES MELLITUS or smoking – the latter being the biggest risk factor, with 90 per cent of affected patients having been moderate to heavy smokers. Stopping smoking is essential; adequate exercise and a low-fat diet are important measures. Surgery may be required.... peripheral vascular disease
A condition of the hip in children, due to death and fragmentation of the epiphysis (or spongy extremity) of the head of the femur. The cause is not known. The disease occurs in the 4–10 year age-group, with a peak between the ages of six and eight; it is ten times more common in boys than girls, and is bilateral in 10 per cent of cases. The initial sign is a lurching gait with a limp, accompanied by pain. Treatment consists of limiting aggressive sporting activity which may cause intact overlying CARTILAGE to loosen. Where there are no mechanical symptoms and MRI scanning shows that the cartilage is intact, only minor activity modi?cation may be necesssary – but for several months or even years. Any breach in the cartilage is dealt with at ARTHROSCOPY by ?xing or trimming any loose ?aps. Eventually the disease burns itself out.... perthes’ disease
A rare condition in which wasting of the skin and the bones, IMPOTENCE, and loss of hair (ALOPECIA) occur as a result of destruction of the PITUITARY GLAND.... simmonds’ disease
An inherited recessive condition in which there is abnormal accumulation of lipids (see LIPID) in the BRAIN. The result is blindness, mental retardation and death in early childhood. The disease can usually be prevented by genetic counselling in those communities in which the disease is known to occur.... tay sachs disease
Epidemic jaundice. A severe form of leptospirosis caused by such serovars as Leptospira icterrohaemorrhagiae.... weil’s disease
See: REFLUX. ... gastro-oesophageal reflux disease
A rare skin disorder that sometimes becomes cancerous. A flat, regular-shaped, patch of red, scaly skin forms, most commonly on the face or hands. The diseased skin is removed surgically or destroyed by freezing or cauterization.... bowen’s disease
Another name for glomerulonephritis.... bright’s disease
See pulmonary disease, chronic obstructive.... chronic obstructive pulmonary disease
The abbreviation for chronic obstructive pulmonary disease (see pulmonary disease, chronic obstructive).... copd
The ‘English Disease’. The result of repeated attacks of the acute condition. Menace to the elderly when bronchi becomes thickened and narrowed. Inelastic walls secrete a thick purulent mucus of fetid odour which plugs tubes and arrests oxygen intake. Aggravated by cold and damp, hence the need of a warm house with warm bedroom. Causes are many: smoking, industrial pollution irritants, soot, fog, etc. Breathlessness and audible breathing sounds may present an alarming spectacle.
A steady herbal regime is required including agents which may coax sluggish liver or kidneys into action (Dandelion, Barberry). Sheer physical exhaustion may require Ginseng. For purulent sputum – Boneset, Elecampane, Pleurisy root. To increase resistance – Echinacea. Where due to tuberculosis – Iceland Moss. For blood-streaked mucus – Blood root. For fever – Elderflowers, Yarrow. To conserve cardiac energies – Hawthorn, Motherwort. A profuse sweat affords relief – Elderflowers.
Alternatives. Capsicum, Ephedra, Fenugreek, Garlic, Grindelia, Holy Thistle, Iceland Moss, Lobelia, Mullein, Pleurisy Root, Wild Cherry.
Tea. Formula. Iceland Moss 2; Mullein 1; Wild Cherry bark 1. 1 heaped teaspoon to each cup water gently simmered 10 minutes. Dose: 1 cup 2-3 times daily.
Powders. Pleurisy root 2; Echinacea 1; Holy Thistle 1. Pinch Ginger. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon) 2-3 times daily.
Tinctures. Formula. Iceland Moss 2; Lobelia 2; Grindelia quarter; Capsicum quarter. Dose: 1-2 teaspoons two or more times daily.
Practitioner. Liquid Extract Ephedra BHP (1983), dose 1-3ml. Or: Tincture Ephedra BHP (1983), dose 6-8ml.
Topical. Same as for acute bronchitis.
Note: In a test at Trafford General Hospital, Manchester, blowing-up balloons proved of benefit to those with chronic bronchitis. Fourteen patients were asked to inflate balloons and 14 refrained from doing so. After 8 weeks, the balloon-blowers showed considerable improvement in walking and a sense of well- being. Breathlessness was reduced. Condition of the others was either unchanged or worse. ... bronchitis, chronic
(Thromboangiitis obliterans). An inflammatory condition of blood vessels of the legs, tobacco said to be the causative factor. Confined to men, especially Jews.
Symptoms. Intermittent claudication. Affected parts of the leg are much paler than others, the condition regressing to ulceration and possible gangrene. Inflammation of nerves, veins and arteries may lead to clot formation (thrombosis).
Treatment. Stop smoking. Vasodilator herbs.
Alternatives. Cayenne (minute doses), Bayberry, Lime flowers, Lobelia, Prickly Ash, Wahoo bark, Mistletoe, Skullcap, Cactus.
BHP (1983) recommends: Angelica root, Hawthorn berry, Wild Yam.
Decoction. Formula. Equal parts: Hawthorn, Mistletoe, Valerian. 2 teaspoons to two cups water gently simmered 10 minutes. Dose half-1 cup thrice daily, and when necessary.
Tablets/capsules. Alternatives. Prickly Ash 100mg. Hawthorn 200mg. Wild Yam 200mg. Dosage as on bottles.
Powders. Formula. Equal parts: Hawthorn, Wild Yam, Prickly Ash. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Tinctures. Formula. Equal parts: Bayberry, Hawthorn, Prickly Ash. Dose: 1-2 teaspoons thrice daily. Practitioner. Tincture Gelsemium BPC (1973). 0.3ml (5 drops) when necessary for relief of pain.
Diet. Low fat, low salt, high fibre.
Supplements. Daily. Vitamin E 1000-1500iu. Vitamin B-complex. Magnesium, Calcium.
Exercise. Physiotherapy exercise. From the sitting position raise legs to horizontal; rest for a few minutes. Lie down and raise legs to 45 degrees; rest for a few minutes. Reverse movements resting each time to equalise the circulation. (Brenda Cooke FNIMH) ... buerger’s disease
A collective term for chronic disorders affecting the small and/or large intestine that cause abdominal pain, bleeding, and diarrhoea. Crohn’s disease and ulcerative colitis are the most common types of inflammatory bowel disease.... inflammatory bowel disease
The cause of: coronary occlusion, coronary blockage, coronary thrombosis. A heart attack occurs when a coronary artery becomes blocked by swellings composed, among other things, of cholesterol. Such swellings may obstruct the flow of blood leading to a blood clot (thrombus). Cholesterol is a major cause of CHD.
Coronary thrombosis is more common in the West because of its preference for animal fats; whereas in the East fats usually take the form of vegetable oils – corn, sunflower seed, sesame, etc. Fatty deposits (atheroma) form in the wall of the coronary artery, obstructing blood-flow. Vessels narrowed by atheroma and by contact with calcium and other salts become hard and brittle (arterio-sclerosis) and are easily blocked. Robbed of oxygen and nutrients heart muscle dies and is replaced by inelastic fibrous (scar) tissue which robs the heart of its maximum performance.
Severe pain and collapse follow a blockage. Where only a small branch of the coronary arterial tree is affected recovery is possible. Cause of the pain is lack of oxygen (Vitamin E). Incidence is highest among women over 40 who smoke excessively and who take The Pill.
The first warning sign is breathlessness and anginal pain behind the breastbone which radiates to arms and neck. Sensation as if the chest is held in a vice. First-line agent to improve flow of blood – Cactus.
For cholesterol control target the liver. Coffee is a minor risk factor.
Measuring hair calcium levels is said to predict those at risk of coronary heart disease. Low hair concentrations may be linked with poor calcium metabolism, high aortic calcium build-up and the formation of plagues. (Dr Allan MacPherson, nutritionist, Scottish Agricultural College, Ayr, Scotland)
Evidence has been advanced that a diagonal ear lobe crease may be a predictor for coronary heart disease. (American Journal of Cardiology, Dec. 1992)
Tooth decay is linked to an increased risk of coronary heart disease and mortality, particularly in young men. (Dr Frank De Stefano, Marshfield Medical Research Foundation, Wisconsin, USA) Treatment. Urgency. Send for doctor or suitably qualified practitioner. Absolute bedrest for 3 weeks followed by 3 months convalescence. Thereafter: adapt lifestyle to slower tempo and avoid undue exertion. Stop smoking. Adequate exercise. Watch weight.
Cardiotonics: Motherwort, Hawthorn, Mistletoe, Rosemary. Ephedra, Lily of the Valley, Broom.
Cardiac vasodilators relax tension on the vessels by increasing capacity of the arteries to carry more blood. Others contain complex glycosides that stimulate or relax the heart at its work. Garlic is strongly recommended as a preventative of CHD.
Hawthorn, vasodilator and anti-hypertensive, is reputed to dissolve deposits in thickened and sclerotic arteries BHP (1983). It is believed to regulate the balance of lipids (body fats) one of which is cholesterol.
Serenity tea. Equal parts: Motherwort, Lemon Balm, Hawthorn leaves or flowers. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup freely.
Decoction. Combine equal parts: Broom, Lily of the Valley, Hawthorn. 1-2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup freely.
Tablets/capsules. Hawthorn, Motherwort, Cactus, Mistletoe, Garlic.
Practitioner. Formula. Hawthorn 20ml; Lily of the Valley 10ml; Pulsatilla 5ml; Stone root 5ml; Barberry 5ml. Tincture Capsicum 1ml. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or honey.
Prevention: Vitamin E – 400iu daily.
Diet. See: DIET – HEART AND CIRCULATION.
Supplements. Daily. Vitamin C, 2g. Vitamin E possesses anti-clotting properties, 400iu. Broad spectrum multivitamin and mineral including chromium, magnesium selenium, zinc, copper.
Acute condition. Strict bed-rest; regulate bowels; avoid excessive physical and mental exertion. Meditation and relaxation techniques dramatically reduce coronary risk. ... coronary heart disease
The most common type of motor neuron disease; also known as amyotrophic lateral sclerosis.... lou gehrig’s disease
See osteopetrosis.... marble bone disease
A rare genetic disorder characterized by muscle stiffness and painful cramps that increase during exertion and afterwards. The cause is a deficiency of an enzyme in muscle cells that stimulates breakdown of the carbohydrate glycogen into the simple sugar glucose. The result is a build-up of glycogen and low levels of glucose in the muscles. Damage to the muscles occurs, causing myoglobinuria (muscle-cell pigment in the urine), which may lead to kidney failure. There is no treatment, but symptoms may be relieved by eating glucose or fructose before exercise.... mcardle’s disease
See pulmonary disease, chronic obstructive.... obstructive airways disease
Any disorder of the periodontium (the tissues that surround and support the teeth).... periodontal disease
A disorder of the penis in which part of the sheath of fibrous connective tissue thickens, causing the penis to bend during erection. This commonly makes intercourse difficult and painful. Eventually, some of the penile erectile tissue may also thicken. Men over 40 are most often affected. The cause is unknown. The disease may improve without treatment. Otherwise, local injections of corticosteroid drugs or surgical removal of the thickened area and replacement with normal tissue may be carried out.... peyronie’s disease
See rheumatoid arthritis, juvenile.... still’s disease
Another name for neurofibromatosis.... von recklinghausen’s disease
Another name for leptospirosis.... weil’s disease
A rare, inherited disorder in which copper accumulates in the liver, resulting in conditions such as hepatitis and cirrhosis. Copper is slowly released into other body parts, damaging the brain, causing mild intellectual impairment, and leading to debilitating rigidity, tremor, and dementia. Symptoms usually appear in adolescence but can occur much earlier or later. Lifelong treatment with penicillamine is needed and, if begun soon enough, can sometimes produce some improvement. If the disease is discovered before the onset of symptoms, the drug may prevent them from developing.... wilson’s disease
An infectious disease that causes a widespread rash. Also known as slapped cheek disease or erythema infectiosum, fifth disease mainly affects children and is caused by a virus called parvovirus. The rash starts on the cheeks as separate, rose-red, raised spots, which subsequently converge to give the characteristic appearance. Within a few days, the rash spreads in a lacy pattern over the limbs but only sparsely on the trunk. It is often accompanied by mild fever. The rash usually clears after about 10 days. Adults, who contract the disease only rarely, may have joint pain and swelling lasting for up to 2 years. The incubation period is 7 to 14 days, and the only treatment is drugs to reduce the fever.... fifth disease
originally, a disease transmitted only by direct physical contact: now usually taken to mean any *communicable disease.... contagious disease
A disease which is characterized by a single or repeated episode of relatively rapid onset and short duration from which the patient usually returns to his/her normal or previous state or level of activity. An acute episode of a chronic disease (for example, an episode of diabetic coma in a patient with diabetes) is often treated as an acute disease.... acute disease / illness
The cause of Addison’s disease (also called chronic adrenal insu?ciency and hypocortisolism) is a de?ciency of the adrenocortical hormones CORTISOL, ALDOSTERONE and androgens (see ANDROGEN) due to destruction of the adrenal cortex (see ADRENAL GLANDS). It occurs in about 1 in 25,000 of the population. In the past, destruction of the adrenal cortex was due to TUBERCULOSIS (TB), but nowadays fewer than 20 per cent of patients have TB while 70 per cent suffer from autoimmune damage. Rare causes of Addison’s disease include metastases (see METASTASIS) from CARCINOMA, usually of the bronchus; granulomata (see GRANULOMA); and HAEMOCHROMATOSIS. It can also occur as a result of surgery for cancer of the PITUITARY GLAND destroying the cells which produce ACTH (ADRENOCORTICOTROPHIC HORMONE)
– the hormone which provokes the adrenal cortex into action.
Symptoms The clinical symptoms appear slowly and depend upon the severity of the underlying disease process. The patient usually complains of appetite and weight loss, nausea, weakness and fatigue. The skin becomes pigmented due to the increased production of ACTH. Faintness, especially on standing, is due to postural HYPOTENSION secondary to aldosterone de?ciency. Women lose their axillary hair and both sexes are liable to develop mental symptoms such as DEPRESSION. Acute episodes – Addisonian crises – may occur, brought on by infection, injury or other stressful events; they are caused by a fall in aldosterone levels, leading to abnormal loss of sodium and water via the kidneys, dehydration, low blood pressure and confusion. Patients may develop increased tanning of the skin from extra pigmentation, with black or blue discoloration of the skin, lips, mouth, rectum and vagina occurring. ANOREXIA, nausea and vomiting are common and the sufferer may feel cold.
Diagnosis This depends on demonstrating impaired serum levels of cortisol and inability of these levels to rise after an injection of ACTH.
Treatment consists in replacement of the de?cient hormones. HYDROCORTISONE tablets are commonly used; some patients also require the salt-retaining hormone, ?udrocortisone. Treatment enables them to lead a completely normal life and to enjoy a normal life expectancy. Before surgery, or if the patient is pregnant and unable to take tablets, injectable hydrocortisone may be needed. Rarely, treated patients may have a crisis, perhaps because they have not been taking their medication or have been vomiting it. Emergency resuscitation is needed with ?uids, salt and sugar. Because of this, all patients should carry a card detailing their condition and necessary management. Treatment of any complicating infections such as tuberculosis is essential. Sometimes DIABETES MELLITUS coexists with Addison’s disease and must be treated.
Secondary adrenal insu?ciency may occur in panhypopituitarism (see PITUITARY GLAND), in patients treated with CORTICOSTEROIDS or after such patients have stopped treatment.... addison’s disease
A factor, such as a micro-organism, chemical substance, form of radiation, or excessive cold or heat, which is essential for the occurrence of a disease. A disease may be caused by more than one agent acting together or, in the case of deficiency diseases, by the absence of an agent.... agent (of disease)
An uncommon chronic localised skin disease, presenting as a solitary chronic ?xed irregular plaque mimicking eczema or psoriasis. It is a fairly benign form of CARCINOMA in situ in the EPIDERMIS but can occasionally become invasive. It is curable by CRYOTHERAPY or surgical excision.... bowen’s disease
See KIDNEYS, DISEASES OF – Glomerulonephritis.... bright’s disease
See THROMBOANGIITIS OBLITERANS.... buerger’s disease
The total significance of disease for society beyond the immediate cost of treatment. It measures years of life lost to ill-health as the difference between total life expectancy and disability-adjusted life expectancy.... burden of disease
A combination of mouth to mouth resuscitation (E.A.R.) to oxygenate the blood, and external chest compression (E.C.C.) to compress the heart to help pump this artificially oxygenated blood around the body to maintain tissue oxygen concentration and prevent death.... cardio-pulmonary resuscitation
See INFECTION.... carriers of disease
The ongoing provision of medical, functional, psychological, social, environmental and spiritual care services that enable people with serious and persistent health and/or mental conditions to optimize their functional independence and well-being, from the time of condition onset until problem resolution or death. Chronic care conditions are multidimensional, interdependent, complex and ongoing.... chronic care
A disease which has one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alternation; requires special training of the patient for rehabilitation; or may be expected to require a long period of supervision, observation or care.... chronic condition / disease
Refers to diarrhoeal episodes of presumed infectious aetiology that begin acutely but have an unusually long duration, usually more than 14 days (see also WHO Classification).... chronic diarrhoea
A persistent or recurring condition or group of symptoms. Chronic disorders are customarily contrasted with acute diseases which start suddenly and last a short time. The symptoms of acute disease often include breathlessness, fever, severe pain and malaise, with the patient’s condition changing from day to day or even hour to hour. Those suffering from chronic conditions – for example, severe arthritis, protracted lung disease, ASTHMA or SILICOSIS – should be distinguished from those with a ‘static disability’ following a stroke or injury. Chronic disorders steadily deteriorate, often despite treatment and the patient is increasingly unable to carry out his or her daily activities.... chronic disorder
A facility that serves patients who do not need acute care or care in another kind of specialty hospital and whose needs for frequency of monitoring by a medical practitioner and for frequency and duration of nursing care exceed the requirements for care in a comprehensive care or extended care facility.... chronic hospital
UK legislation that provides for the identi?cation and care of individuals who have an incurable chronic or degenerative disorder. The patients are usually distinguished from elderly people with chronic disorders. Local authorities identify relevant individuals and arrange for appropriate services. The legislation does not, however, compel doctors and nurses in the community to inform local authorities of potential bene?ciaries. This may be because the individuals concerned dislike being on a register of disabled, or because questions of con?dentiality prevent health sta? from reporting the person’s condition.... chronic sick and disabled act 1970
See also MYALGIC ENCEPHALOMYELITIS (ME). A condition characterised by severe, disabling mental and physical fatigue brought on by mental or physical activity and associated with a range of symptoms including muscle pain, headaches, poor sleep, disturbed moods and impaired concentration. The prevalence of the condition is between 0.2 and 2.6 per cent of the population (depending on how investigators de?ne CFS/ME). Despite the stereotype of ‘yuppie ?u’, epidemiological research has shown that the condition occurs in all socioeconomic and ethnic groups. It is commoner in women and can also occur in children.
In the 19th century CFS was called neurasthenia. In the UK, myalgic encephalomyelitis (ME) is often used, a term originally introduced to describe a speci?c outbreak such as the one at the Royal Free Hospital, London in 1955. The term is inaccurate as there is no evidence of in?ammation of the brain and spinal cord (the meaning of encephalomyelitis). Doctors prefer the term CFS, but many patients see this as derogatory, perceiving it to imply that they are merely ‘tired all the time’ rather than having a disabling illness.
The cause (or causes) are unknown, so the condition is classi?ed alongside other ‘medically unexplained syndromes’ such as IRRITABLE BOWEL SYNDROME (IBS) and multiple chemical sensitivity – all of which overlap with CFS. In many patients the illness seems to start immediately after a documented infection, such as that caused by EPSTEIN BARR VIRUS, or after viral MENINGITIS, Q FEVER and TOXOPLASMOSIS. These infections seem to be a trigger rather than a cause: mild immune activation is found in patients, but it is not known if this is cause or e?ect. The body’s endocrine system is disturbed, particularly the hypothalamopituitary-adrenal axis, and levels of cortisol are often a little lower than normal – the opposite of what is found in severe depression. Psychiatric disorder, usually depression and/or anxiety, is associated with CFS, with rates too high to be explained solely as a reaction to the disability experienced.
Because we do not know the cause, the underlying problem cannot be dealt with e?ectively and treatments are directed at the factors leading to symptoms persisting. For example, a slow increase in physical activity can help many, as can COGNITIVE BEHAVIOUR THERAPY. Too much rest can be harmful, as muscles are rapidly weakened, but aggressive attempts at coercing patients into exercising can be counter-productive as their symptoms may worsen. Outcome is in?uenced by the presence of any pre-existing psychiatric disorder and the sufferer’s beliefs about its causes and treatment. Research continues.... chronic fatigue syndrome (cfs)
Arrangement of diseases into groups having common characteristics. Useful in efforts to achieve standardization in the methods of presenting mortality and morbidity data from different sources and, therefore, in comparability. May include a systematic numerical notation for each disease entry. Examples include the International Statistical Classification of Diseases, Injuries and Causes of Death.... classification of disease
Any disease resulting from the absence from the diet of any substance essential to good health: for example, one of the vitamins.... deficiency disease
A rapidly progressive, fatal, degenerative disease in humans caused by an abnormal PRION protein. There are three aetiological forms of CJD: sporadic, IATROGENIC, and inherited. Sporadic CJD occurs randomly in all countries and has an annual incidence of one per million. Iatrogenic CJD is caused by accidental exposure to human prions through medical and surgical procedures (and cannibalism in the case of the human prion disease known as kuru that occurs in a tribe in New Guinea, where it is called the trembling disease). Inherited or familial CJD accounts for 15 per cent of human prion disease and is caused by a MUTATION in the prion protein gene. In recent years a new variant of CJD has been identi?ed that is caused by BOVINE SPONGIFORM ENCEPHALOPATHY (BSE), called variant CJD. The incubation period for the acquired varieties ranges from four years to 40 years, with an average of 10–15 years. The symptoms of CJD are dementia, seizures, focal signs in the central nervous system, MYOCLONUS, and visual disturbances.
Abnormal prion proteins accumulate in the brain and the spinal cord, damaging neurones (see NEURON(E)) and producing small cavities. Diagnosis can be made by tonsil (see TONSILS) biopsy, although work is under way to develop a diagnostic blood test. Abnormal prion proteins are unusually resistant to inactivation by chemicals, heat, X-RAYS or ULTRAVIOLET RAYS (UVR). They are resistant to cellular degradation and can convert normal prion proteins into abnormal forms. Human prion diseases, along with scrapie in sheep and BSE in cattle, belong to a group of disorders known as transmissible spongiform encephalopathies. Abnormal prion proteins can transfer from one animal species to another, and variant CJD has occurred as a result of consumption of meat from cattle infected with BSE.
From 1995 to 1999, a scienti?c study of tonsils and appendixes removed at operation suggested that the prevalence of prion carriage may be as high as 120 per million. It is not known what percentage of these might go on to develop disease.
One precaution is that, since 2003, all surgical instruments used in brain biopsies have had to be quarantined and disposable instruments are now used in tonsillectomy.
Measures have also been introduced to reduce the risk of transmission of CJD from transfusion of blood products.
In the past, CJD has also been acquired from intramuscular injections of human cadaveric pituitary-derived growth hormone and corneal transplantation.
The most common form of CJD remains the sporadic variety, although the eventual incidence of variant CJD may not be known for many years.... creutzfeldt-jakob disease (cjd)
All the measures designed to prevent or reduce as much as possible the incidence, prevalence and consequences of disease, such as the control of disease vectors, the removal or reduction of the influence of predisposing factors in the environment, immunization and curative care.... disease control
The process of identifying and delivering, within selected populations (e.g. people with asthma or diabetes), the most efficient, effective combination of resources, interventions or pharmaceuticals for the treatment or prevention of a disease. Disease management could include team-based care, where medical practitioners and/or other health professionals participate in the delivery and management of care. It also includes the appropriate use of pharmaceuticals.... disease management
See “prevention”.... disease prevention
A disease characterised by abnormal storage of LIPID, particularly in the SPLEEN, central nervous system, BONE MARROW, and LIVER. This results in enlargement of the spleen and the liver – particularly of the former – and ANAEMIA. It runs a chronic course. Diagnosis is usually by skin ?broblast glucocerebrosidase assay. Death often results from PNEUMONIA or bleeding. Infantile Gaucher’s often presents with marked neurological signs of rigid neck DYSPHAGIA, CATATONIA, hyper-re?exia and low IQ. The disease can now be treated with enzyme replacement using alglucerase. The annual cost per patient is substantial – several thousand pounds.... gaucher’s disease
A condition that is a common complication of BONE MARROW transplant (see TRANSPLANTATION). It results from certain LYMPHOCYTES in the transplanted marrow attacking the transplant recipient’s tissues, which they identify as ‘foreign’. GVHD may appear soon after a transplant or develop several months later. The condition, which is fatal in about a third of victims, may be prevented by immunosuppressant drugs such as ciclosporin.... graft versus host disease (gvhd)
See LEPROSY.... hansen’s disease
A condition in which the whole of the THYROID GLAND is di?usely enlarged and ?rm. It is one of the diseases produced by AUTOIMMUNITY. The enlargement is due to di?use in?ltration of lymphocytes and increase of ?brous tissue. This form of GOITRE appears in middle-aged women, does not give rise to symptoms of thyrotoxicosis (see THYROID GLAND, DISEASES OF – Thyrotoxicosis), and tends to produce myxoedema (see THYROID GLAND, DISEASES OF – Hypothyroidism).... hashimoto’s disease
Hirschsprung’s disease, or MEGACOLON, is a rare congenital disorder characterised by great hypertrophy and dilatation of the colon (see INTESTINE). The RECTUM and lower colon have failed to develop a normal nerve network, thus disturbing normal contraction and expansion of these structures. Treatment is surgical removal of the affected sections, with the remaining colon being joined to the anus.... hirschsprung’s disease
See LYMPHOMA.... hodgkin’s disease
A World Health Organisation classi?cation of all known diseases and syndromes. The diseases are divided according to system (respiratory, renal, cardiac, etc.) or type (accidents, malignant growth, etc.). Each of them is given a three-digit number to facilitate computerisation. This classi?cation allows mortality and morbidity rates to be compared nationally and regionally. A revised ICD is published every ten years; a similar classi?cation is being developed for impairments, disabilities and handicaps.... international classification of disease (icd)
See HEART, DISEASES OF.... ischaemic heart disease
A hereditary disease in which blindness comes on at about the age of 20.... leber’s disease
A form of CEREBRAL PALSY.... little’s disease
CROHN’S DISEASE and ULCERATIVE COLITIS are chronic in?ammatory diseases characterised by relapsing and remitting episodes over many years. The diseases are similar and are both classi?ed as IBD, but a signi?cant distinction is that Crohn’s disease can affect any part of the GASTROINTESTINAL TRACT from mouth to anus, whereas ulcerative colitis affects only the COLON. The incidence of IBD varies widely between countries, being rare in the developing world but much more common in westernised nations, where the incidence of Crohn’s disease is around 5–7 per 100,000 (and rising) and that of ulcerative colitis at a broadly stable 10 per 100,000. It is common for both disorders to develop in young adults, but there is a second spike of incidence in people in their 70s. Details about the two disorders are given under the individual entries elsewhere in the dictionary. In?ammatory bowel disease should not be confused with IRRITABLE BOWEL SYNDROME (IBS) which has some of the same symptoms of IBD but a di?erent cause and outcome.... inflammatory bowel disease (ibd)
The form of OSTEOCHONDROSIS involving the tibial tubercle – the growing point of the TIBIA. It occurs around PUBERTY, mainly in boys, and ?rst manifests itself by a painful swelling over the tibial tubercle at the upper end of the tibia. The pain is worst during and after exercise. A limp with increasing limitation of movement of the knee-joint develops. The disease usually clears up without treatment. If pain is troublesome, physiotherapy or immobilisation of the knee-joint in a plaster cast for up to eight weeks may be necessary.... osgood-schlatter’s disease
Diarrhoea that begins acutely but lasts more than 21 days. The usual enteropathogens are Shigella spp., Salmonella spp., Campylobacter jejuni, Yersinia enterocolitica, Capillaria philippinensis, Cryptosporidium. Giardia can also be a cause.... persistent chronic diarrhoea
Painful and deformed erection of the PENIS caused by the formation of ?brous tissue. The cause is unknown but it may be associated with DUPUYTREN’S CONTRACTURE. The condition may be improved by surgery.... peyronie’s disease
An inherited disease in which the KIDNEYS contain many cysts. These grow in size until normal kidney tissue is largely destroyed. Cysts may also occur in other organs such as the liver. In adults, the disease will cause HYPERTENSION and kidney failure. There is also a juvenile form. There is no e?ective treatment, although symptoms can be alleviated by DIALYSIS and sometimes kidney transplant (see TRANSPLANTATION).... polycystic disease of the kidney
A traditional name often applied to the angular curvature of the spine which results from tuberculous disease. (See SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.) The disease is named after Percivall Pott, an English surgeon (1714–88), who ?rst described the condition.... pott’s disease
See LUNGS, DISEASES OF.... pulmonary diseases
been recognised from earliest times. Evidence of the condition has been found in Egyptian mummies; in the fourth century BC Hippocrates, the Greek physician, called it phthisis because of the lung involvement; and in 1882 Koch announced the discovery of the causative organism, the tubercle bacillus or Mycobacterium tuberculosis.
The symptoms depend upon the site of the infection. General symptoms such as fever, weight loss and night sweats are common. In the most common form of pulmonary tuberculosis, cough and blood-stained sputum (haemoptysis) are common symptoms.
The route of infection is most often by inhalation, although it can be by ingestion of products such as infected milk. The results of contact depend upon the extent of the exposure and the susceptibility of the individual. Around 30 per cent of those closely exposed to the organism will be infected, but most will contain the infection with no signi?cant clinical illness and only a minority will go on to develop clinical disease. Around 5 per cent of those infected will develop post-primary disease over the next two or three years. The rest are at risk of reactivation of the disease later, particularly if their resistance is reduced by associated disease, poor nutrition or immunosuppression. In developed countries around 5 per cent of those infected will reactivate their healed tuberculosis into a clinical problem.
Immunosuppressed patients such as those infected with HIV are at much greater risk of developing clinical tuberculosis on primary contact or from reactivation. This is a particular problem in many developing countries, where there is a high incidence of both HIV and tuberculosis.
Diagnosis This depends upon identi?cation of mycobacteria on direct staining of sputum or other secretions or tissue, and upon culture of the organism. Culture takes 4–6 weeks but is necessary for di?erentiation from other non-tuberculous mycobacteria and for drug-sensitivity testing. Newer techniques involving DNA ampli?cation by polymerase chain reaction (PCR) can detect small numbers of organisms and help with earlier diagnosis.
Treatment This can be preventative or curative. Important elements of prevention are adequate nutrition and social conditions, BCG vaccination (see IMMUNISATION), an adequate public-health programme for contact tracing, and chemoprophylaxis. Radiological screening with mass miniature radiography is no longer used.
Vaccination with an attenuated organism (BCG – Bacillus Calmette Guerin) is used in the United Kingdom and some other countries at 12–13 years, or earlier in high-risk groups. Some studies show 80 per cent protection against tuberculosis for ten years after vaccination.
Cases of open tuberculosis need to be identi?ed; their close contacts should be reviewed for evidence of disease. Adequate antibiotic chemotherapy removes the infective risk after around two weeks of treatment. Chemoprophylaxis – the use of antituberculous therapy in those without clinical disease – may be used in contacts who develop a strong reaction on tuberculin skin testing or those at high risk because of associated disease.
The major principles of antibiotic chemotherapy for tuberculosis are that a combination of drugs needs to be used, and that treatment needs to be continued for a prolonged period – usually six months. Use of single agents or interrupted courses leads to the development of drug resistance. Serious outbreaks of multiply resistant Mycobacterium tuberculosis have been seen mainly in AIDS units, where patients have greater susceptibility to the disease, but also in developing countries where maintenance of appropriate antibacterial therapy for six months or more can be di?cult.
Streptomycin was the ?rst useful agent identi?ed in 1944. The four drugs used most often now are RIFAMPICIN, ISONIAZID, PYRAZINAMIDE and ETHAMBUTOL. Three to four agents are used for the ?rst two months; then, when sensitivities are known and clinical response observed, two drugs, most often rifampicin and isoniazid, are continued for the rest of the course. Treatment is taken daily, although thrice-weekly, directly observed therapy is used when there is doubt about the patient’s compliance. All the antituberculous agents have a range of adverse effects that need to be monitored during treatment. Provided that the treatment is prescribed and taken appropriately, response to treatment is very good with cure of disease and very low relapse rates.... nature of the disease tuberculosis has
Naturally produced in the LUNGS by cells called pneumocytes, this substance is a mixture of phospholipids (see PHOSPHOLIPID) and LIPOPROTEINS. Present in ?uid lining the alveoli (see ALVEOLUS) in the lungs, their action helps maintain their patency. Premature babies may have a de?ciency of surfactant, a disorder which causes severe breathing diffculties – RESPIRATORY DISTRESS SYNDROME or hyaline membrane disease – and HYPOXIA. They will need urgent respiratory support, which includes oxygen and the administration (via an endotracheal tube) of a specially prepared surfactant such as beractant (bovine lung extract) or edfosceril palmitate.... pulmonary surfactant
The first is less severe, characterized by blanching spasms of blood vessels leading to the hands and feet, initiated by cold, moisture, even emotional stress and low blood sugar. Sort of a finger migraine. After the spasm relaxes, the tissue distal becomes red, hot, even painful. R. Disease is more serious and perhaps deriving from different causes as well. The spasms may not subside, the effected tissues can become purplish, and in extreme cases, gangrenous.... raynauds either syndrome or disease
Or juvenile rheumatoid arthritis – see JUVENILE IDIOPATHIC ARTHRITIS (JIA).... still’s disease
As distinct from surveillance of persons, surveillance of disease is the continuing scrutiny of all aspects of occurrences and spread of a disease that are pertinent to effective control. Included are the systematic collection and evaluation of: 1. morbidity and mortality reports; 2. special reports of field investigations, of epidemics and of individual cases; 3. isolation and identification of infectious agents by laboratories; 4. data concerning the availability and use of vaccines and toxoids, immunoglobulin, insecticides, and other substances used in control; 5. information regarding immunity levels in segments of the population; and 6. other relevant epidemiological data.... surveillance of disease
See under HEART, DISEASES OF.... valvular disease
An inherited disease, now called neuro?bromatosis. About one case occurs every 3,000 live births. The disease is characterised by tumours along the course of nerves which can be felt beneath the skin. Soft tumours may also develop beneath the skin. The condition may have other associated abnormalities such as SCOLIOSIS, decalci?cation of the bones due to overactivity of the PARATHYROID glands, and ?brosis in the lungs. Surgery may be needed for cosmetic reasons or to relieve pressure on the nervous system.... von recklinghausen’s disease
A genetically determined blood disorder in which the affected person suffers episodes of spontaneous bleeding similar to that occurring in people with HAEMOPHILIA. It may be associated with a lack of FACTOR VIII (see COAGULATION) in the blood. The disorder is inherited as an autosomal dominant gene (see GENETIC DISORDERS).... von willebrand’s disease
Wilson’s disease, or hepatolenticular degeneration, is a familial disease in which there is an increased accumulation of COPPER in the liver, brain, and other tissues including the kidneys. Its main manifestation is the development of tremor and rigidity, with di?culty in speech. In many cases there is improvement following the administration of dimercaprol, penicillamine, or trientine dihydrochloride; these substances cause an increased excretion of copper.... wilson’s disease
Another name for ANTHRAX.... wool-sorters’ disease
See: DERMATITIS. ... exfoliative disease
Winter vomiting disease, or epidemic nausea and vomiting, is a condition caused by subtypes of the genus Norwalk-like virus and is characterised by nausea, vomiting, diarrhoea and giddiness, which occurs during the winter. Outbreaks of it usually involve whole families or may affect communities like schools. The incubation period is 24–48 hours, and attacks seldom persist for more than 72 hours. In England and Wales in 2000, more than 1,600 infections were reported compared to more than 16,400 cases of salmonella infections and 56,420 of CAMPYLOBACTER. However, in England it is estimated that around 1,500 times more people are infected in the community than are reported. Humans are the only known hosts of the virus and infection can be acquired via contaminated food or water or, more commonly, from an infected individual via the faeco-oral route, aerosol-spread and FOMITES.... winter vomiting disease
A group of rheumatoid conditions of unknown causation with onset before 16 years. Girls more than boys. Still’s disease being the form presenting with enlargement of spleen and lymph nodes, high temperature with macular rash comes and goes. Children usually ‘grow out of it’ although stiffness may continue. Deformities possible. Tardy bone growth of the mandibles giving the face a birdlike look. May progress to rheumatoid arthritis (girls) or ankylosing spondylitis (boys). So strong is psychosomatic evidence that sociologists believe it to be a sequel to broken families, divorce or bereavement. Few patients appear to come from a balanced environment or happy home.
Treatment. BHP (1983) recommends: Meadowsweet, Balm of Gilead, Poke root, Bogbean, Hart’s Tongue fern, Mountain Grape.
Teas: Singly or in combination (equal parts): Chamomile, Bogbean, Nettles, Yarrow. 1-2 teaspoons to each cup boiling water; infuse 5-10 minutes. 1 cup thrice daily before meals.
Tablets/capsules. Blue Flag root, Dandelion root, Poke root, Prickly Ash bark.
Formula. White Poplar bark 2; Black Cohosh half; Poke root quarter; Valerian quarter; Liquorice quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon) (children 5-12 years: 250mg – one 00 capsule or one-sixth teaspoon). Liquid extracts: 1 teaspoon: (children 5-12: 3-10 drops). Tinctures: 2 teaspoons: (children 5-12: 5-20 drops).
Evening Primrose oil. Immune enhancer.
Topical. Hot poultice: Slippery Elm, Mullein or Lobelia.
Diet: Lacto vegetarian. Kelp. Comfrey tea. Molasses. Low fat.
General. Adequate rest, good nursing, gentle manipulation but no massage to inflamed joints. Natural lifestyle. Parental emotional support.
Oily fish. See entry. ... arthritis, juvenile, chronic
Hyperactive thyroid gland. See: THYROID. ... grave’s disease
Creutzfeldt-Jakob disease. See: BOVINE SPONGIFORM ENCEPHALOPATHY. ... mad-cow disease, human
Cancer of the mammary ducts (rare). Nipple: encrusted, red, inflamed. See: CANCER OF THE BREAST. ... paget’s disease of the nipple
One of a large number of tiny, balloon-like sacs at the end of a bronchiole (one of many small air passages in the lungs) where gases are exchanged during respiration.... alveolus, pulmonary
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
An abnormal reaction of the body to groups of its own cells which the immune system attacks. In a case of anaemia, it may destroy the red blood cells. Failure of the body’s tolerance mechanism.
The immune system is the body’s internal defence armoury which protects from sickness and disease. White blood cells are influenced by the thymus gland and bone marrow to become “T” lymphocytes or “B” lymphocytes which absorb and destroy bacteria. There are times when these powerful defence components inflame and attack healthy tissue, giving rise to auto immune disease which may manifest as one of the numerous anaemic, rheumatic or nervous disorders, even cancer.
A watchful eye should be kept on any sub-acute, non-specific inflammation going on quietly over a long period – a certain indication of immune-inadequacy. It would appear that some unknown body intelligence operates behind the performance of the immune system; emotional and physic stresses such as divorce or job dissatisfaction can lead to a run-down of body defences. Some psychiatrists believe it to be a self-produced phenomenon due to an unresolved sense of guilt or a dislike of self. When this happens, bacterial, virus or fungus infections may invade and spread with little effective opposition. People who are happy at their home and work usually enjoy a robust immune system.
An overactive immune system may develop arthritis with painful joint inflammation, especially with a background of a fat-rich diet. A link between silicone implants and auto-immune disease is suspected.
“There is increasing evidence,” writes Dr D. Addy, Consulting Pediatrician, “that fevers may enhance the defence mechanism against infection.” (See: FEVER) “There is also increasing evidence of a weakening of the immune system through suppression of fevers by modern drugs. In this way, aspirin and other powerful anti-inflammatories may be responsible for feeble immune response.”
White cell stimulators: Liquorice, Ginseng (Siberian), Goldenseal, Echinacea. These increase ability of white blood cells to attack bacteria and invading cells. Chinese medicine: Ginseng (men), Chinese Angelica (women).
Treatment. To strengthen body defences. Garlic, Borage, Comfrey, Agrimony, Balm, Chamomile (German), Echinacea, Horsetail, Liquorice, Lapacho, Sage, Wild Yam, Wild Indigo, Poke root, Thuja. Shiitake Mushroom. Reishi Mushroom, Chlorella..
Tea. Combine, equal parts, St John’s Wort, Borage, Chamomile (German). 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.
Powders. Combine, Echinacea 4; Comfrey root 2; Wild Yam 1. 500mg (two 00 capsules, or one-third teaspoon) thrice daily.
Tinctures. Combine, Echinacea 4; Poke root 1; Thuja 1. 1-2 teaspoons in water thrice daily.
Tincture: Tincture Myrrh BPC 1973: 5-10 drops in water, morning and evening.
Decoctions. Horse-radish. Fenugreek seeds.
Bio-strath. Yeast-based herbal tonic. Exerts a positive influence on the immune system by rapid and marked increase in white blood cells.
Diet. Foods rich in essential fatty acids: nuts, seeds, beans, pulses, Evening Primrose oil, Cod Liver oil flavoured with mint or lemon. High protein: eggs, fish. (Low protein – acute stage). Foods rich in selenium. Yoghurt, cider vinegar, pineapple juice. Sugar has an immune suppressing effect.
Supplements. To rebuild immune system. Vitamins A, B5, B6, C, D, E. Zinc is required to produce histamine which is a vasodilator. Combination: zinc, selenium and GLA. Iron. Calcium.
Aromatherapy. Lavender oil: massage or baths.
Note: An alleged link exists between silicone implants and auto-immune disease. A new study reveals evidence that women with silicone breast implants who breast-feed their children put them at risk of developing systemic sclerosis. (JAMA Jan 19 1994) ... auto immune disease
Glomerulonephritis. Recognised by slight puffiness of the eyes and a dropsical accumulation of fluid in body cavities. Blood pressure rises. Appetite disappears. Digestion is deranged, urine may be blood-stained and a variety of symptoms present as dizziness, headache, nausea. Commonly caused by post streptococcal throat infection circulating in the blood, yet it is now known that the condition may arise from exposure to common garden insecticides and toxic substances of commercial importance that alter the body’s immune system and affect kidney function.
Acute toxic nephritis is possible in the convalescent stage of scarlet and other infectious fevers, even influenza. Causes are legion, including septic conditions in the ear, nose, throat, tonsils, teeth or elsewhere. Resistance to other infections will be low because of accumulation of toxins awaiting elimination. When protein escapes from the body through faulty kidneys general health suffers.
This condition should be treated by or in liaison with a qualified medical practitioner.
Treatment. Bedrest essential, with electric blanket or hot water bottle. Attention to bowels; a timely laxative also assists elimination of excessive fluid. Diuretics. Diaphoretics. Abundant drinks of bottled water or herb teas (3-5 pints daily). Alkaline drinks have a healing effect upon the kidneys. Juniper is never given for active inflammation.
Useful teas. Buchu, Cornsilk, Couchgrass, Clivers, Bearberry, Elderflowers, Marshmallow, Mullein, Marigold flowers, Wild Carrot, Yarrow.
Greece: traditional tea: equal parts, Agrimony, Bearberry, Couchgrass, Pellitory.
Powders. Equal parts: Dandelion, Cornsilk, Mullein. Dose: 750mg (three 00 capsules or half teaspoon) every 2 hours. In water or cup of Cornsilk tea.
Tinctures. Equal parts: Buchu, Elderflowers, Yarrow. Mix. Dose: 1-2 teaspoons in water or cup of Cornsilk tea, every two hours.
Topical. Hot poultices to small of the back; flannel or other suitable material saturated with an infusion of Elderflowers, Goldenrod, Horsetail or Yarrow. Herbal treatment offers a supportive role. ... bright’s disease (acute)
An inherited muscle-wasting disease of the legs (see peroneal muscular atrophy).... charcot–marie–tooth disease
Chronic glomerulonephritis. The final stage. May follow the sub- acute stage or repeated attacks of the acute stage. Kidneys small and white due to scar tissue. Amount of urine passed is considerably increased, pale and low specific gravity. Kidneys ‘leak’ protein in large quantities of water passed, their efficiency as filters greatly impaired. Tissues of eyelids and ankles waterlogged. Symptoms include loin pain, anaemia, loss of weight, progressive kidney damage.
A constant fear is the onset of uraemia caused by accumulation in the blood of waste by-products of protein digestion, therefore the patient should reject meat in favour of fish. Eggs and dairy products taken in strict moderation.
Where urea accumulates in the circulation ‘sustaining’ diuretics are indicated; these favour excretion of solids without forcing the discharge of more urine: including Shepherd’s Purse, Gravel root, or Uva Ursi when an astringent diuretic is needed for a show of blood in the urine. According to the case, other agents in common practice: Dandelion root, Yarrow, Hawthorn, Marigold, Stone root, Hydrangea. Parsley Piert, Buchu, Hawthorn, Golden Rod.
The patient will feel the cold intensely and always be tired. Warm clothing and ample rest are essential. Heart symptoms require treatment with Lily of the Valley or Broom.
This condition should be treated by or in liaison with a qualified medical practitioner.
Treatment. As kidney damage would be established, treatment would be palliative; efforts being to relieve strain and obtain maximum efficiency. There may be days of total bed-rest, raw foods and quiet. Consumption of fluids may not be as abundant as formerly. Soothing herb teas promote well-being and facilitate elimination. Oil of Juniper is avoided.
Efforts should be made to promote a rapid absorption – to restore the balance between the circulation and the lymphatics. For this purpose Mullein is effective. A few grains of Cayenne or drops of Tincture Capsicum enhances action.
Indicated. Antimicrobials, urinary antiseptics, diuretics, anti-hypertensives. For septic conditions add Echinacea.
Of Therapeutic Value. Alfalfa, Broom, Buchu, Couchgrass, Cornsilk, Dandelion, Lime flowers, Marigold, Mullein, Marshmallow, Parsley Piert, Periwinkle (major), Wild Carrot, Water Melon seed tea. Tea. Combine equal parts: Couchgrass, Dandelion, Mullein. 2 teaspoons to each cup boiling water. Infuse 5-15 minutes. 1 cup freely.
Powders. Combine equal parts: Stone root, Hydrangea, Hawthorn. Dose: 500mg (two 00 capsules or one-third teaspoon) 3 or more times daily in water or cup Cornsilk tea. A few grains Cayenne enhances action. Formula. Buchu 2; Mullein 2; Echinacea 1; Senna leaves half. Mix. Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water or cup Cornsilk tea 3 or more times daily. 2-3 drops Tincture Capsicum to each dose enhances action.
Diffusive stimulant for the lymphatic vessels. Onion milk is an effective potassium-conserving diuretic and diaphoretic. Onions are simmered gently in milk for 2 hours and drunk when thirsty or as desired – a welcome alternative to water. May be eaten uncooked.
Diet. Salt-free, low fat, high protein. Spring water. Raw goat’s milk, potassium broth. Fish oils. Avoid eggs and dairy products. No alcohol.
Supplements. Vitamins A, B-complex, C plus bioflavonoids, B6, D, E, Magnesium, Lecithin. Herbal treatment offers a supportive role. ... bright’s disease (chronic)
A common inherited condition that affects the way in which bilirubin is processed by the liver. Usually there are no symptoms, but jaundice may be brought on by an unrelated illness. Sufferers are otherwise healthy. No treatment is necessary.... gilbert’s disease
Cancer of the lung.
By the blood and lymph cancer may be transferred (metastasised) to the lymph nodes under the arm, liver, brain or lungs. An association has been shown between a low intake of Vitamin A and lung cancer. Causes: occupational hazards, environmental pollution, radiation, keeping of pet birds. Cigarette smoking is a strong risk factor. Studies show that a high Vitamin A/carotene intake is protective against the disease in men. Among women, evidence of a similar protective effect has not been found. Vitamin C reduces cancer risk. The increased prevalence of smoking among women results in more female lung cancer. All smokers should drink freely carrot juice (Vitamin A).
Symptoms. Chronic irritative cough, difficult breathing, pain in the chest, recurrent spitting of blood, clubbing of fingers, weight loss.
Alternatives. Only transient benefit is obtainable, yet it may be sufficient to achieve a measure of relief from distressing symptoms. See: CANCER: GENERAL REMARKS. Mullein tea has its supporters. Bugleweed strengthens lung tissue and supports the action of the heart. Blood root is known to arrest bleeding (haemoptysis).
Tea. Equal parts: Red Clover, Gota Kola, Mullein. 2 teaspoons to each cup boiling water; infuse 5-15 minutes. 1 cup three or more times daily.
Formula No 1. Equal parts: Elecampane, Violet, Red Clover, Echinacea. Mix. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Thrice daily and, if necessary, at bedtime for relief.
Formula No 2. Tincture Blood root 10 drops; Liquid extract Dogwood 20 drops; Liquid extract Elecampane 200 drops (14ml); Liquid extract Bugleweed (Lycopus europ) 30 drops. Flavour with Liquorice if necessary. Dose: 1-2 teaspoons in water 3 or more times daily. (W. Burns-Lingard MNIMH)
Where accompanied by active inflammation, anti-inflammatories are indicated: Mistletoe, Wild Yam, etc.
Diet. A substance in fish oil has been shown to experimentally prevent cancer of the lung. Mackerel, herring and sardines are among fish with the ingredient. See: DIET – CANCER.
Chinese Herbalism. See: CANCER – CHINESE PRESCRIPTION.
Treatment by a general medical practitioner or hospital oncologist. ... cancer – pulmonary
Neurogenic arthritis. A degenerative and destructive joint lesion due to loss of the normal protection and pain sense. It is associated with tabes dorsalis and syringomyelia. In tabes, knee is chiefly affected; in syringomyelia, the elbow. Joint swelling in late locomotor ataxia. Usually painless.
Alternatives. Cramp bark, Cayenne, Chamomile, Guaiacum, Hops, Meadowsweet, Celery, Prickly Ash, Valerian, Wild Lettuce, Wild Yam. Mistletoe (F. Hyde). White Willow.
Tea. Equal parts: German Chamomile, Hops, Meadowsweet. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes; 1 cup 3 or more times daily.
Tablets/capsules. Chamomile, Mistletoe, Prickly Ash, Ligvites, Wild Yam, Valerian, Kelp.
Alternative formulae:– Powders. Prickly Ash 1; Valerian 1; Cramp bark half; Guaiacum quarter. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Liquid Extracts. White Willow 2; Prickly Ash 1; Celery seeds half; Liquorice quarter; Tincture Capsicum quarter. Mix. 30-60 drops thrice daily.
Tinctures. White Willow 2; Prickly Ash 1; Valerian 1; Meadowsweet 1; Tincture Capsicum quarter. Mix. 2 teaspoons thrice daily.
Topical. Comfrey poultices (Maria Treben). “Three oils.”
Diet. Lacto-vegetarian. Dandelion coffee. Oily fish.
General. Straight knee brace for rigid support. ... charcot’s disease
An autoimmune disorder that is characterized by toxic goitre (an overactive and enlarged thyroid gland), excessive production of thyroid hormones leading to thyrotoxicosis, and exophthalmos.... graves’ disease
The most common form of heart disease, in which narrowing or obstruction of the coronary arteries, usually by atherosclerosis, results in a reduced blood supply (see coronary artery disease).... heart disease, ischaemic
Scarring of lung tissue mainly involving the alveoli. There are a number of causes, including occupational exposure to dusts and fibrosing alveolitis, which is an autoimmune disorder.... interstitial pulmonary fibrosis
See pulmonary disease, chronic obstructive.... lung disease, chronic obstructive
The commonly used name for bovine spongiform encephalopathy (BSE).... mad cow disease
Adult coeliac disease, coeliac sprue, non-tropical sprue, idiopathic steatorrhoea. Allergy to gluten which disturbs the small intestine by preventing the body from absorbing food nutrients. A child’s condition may worsen when put on solid cereals containing wheat, barley, rye or oats. “Allergic to pasta” disease. A change in the mucous membrane of the intestines with enzyme deficiency.
Symptoms: diarrhoea, abdominal swelling and pain, irritability, inability to gain weight, neuritis, ulcers on tongue and mouth, low blood pressure, debility, lactase-deficiency. Breast-feeding stops coeliac disease.
Alternatives. Tea. Mix, equal parts: Raspberry leaves, Agrimony, Lemon Balm. 2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup freely.
Tablets/capsules. Goldenseal, Slippery Elm. Calamus. Fenugreek seeds, Papaya. Wild Yam.
Powders, Liquid Extracts, Tinctures. Formula. Equal parts: Sarsaparilla, Wild Yam, Stone root. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid Extracts: 30-60 drops. Tinctures: 1-2 teaspoons. In water, banana mash or honey, thrice daily.
Papaya (papain) digests wheat gluten and assists recovery. Half-1g with meals.
Aloe Vera juice. Promotes improved bowel motility, increases stool specific gravity, and reduces indication of protein putrefaction, flatulence and bloating after meals. (J. Bland PhD. JAM June 1985, p.11)
Topical. Warm hip baths of Lemon Balm, Chamomile, etc. (Alfred Vogel)
Diet. Gluten-free. Rice. Unpasteurised yoghurt. Buttermilk. Sweet acidophilus milk. Raw carrot juice. Bananas mashed with a little Slippery Elm or dried milk powder, carob bean powder and Soya milk. Supplementation. Vitamins A, B-complex, B6, B12, Folic acid, C, D, E, K (Alfalfa tea). Calcium, Iron and Magnesium orotates. ... gluten-sensitive disease
Painful enlargement and tenderness of the tibial tuberosity (the bony prominence of the tibia), which occurs most commonly in boys aged between 10 and 14. It results from excessive, repetitive pulling of the quadriceps muscle, due to repeated exercise. The disorder often clears up without treatment; severe pain may require physiotherapy or immobilization of the knee in a plaster cast.... osgood–schlatter disease
A rare defect of the pulmonary valve at the exit of the heart’s right ventricle. The valve fails to close properly, allowing blood to leak back into the heart. The cause is usually rheumatic fever, endocarditis, or severe pulmonary hypertension.... pulmonary incompetence
Snails act as host to various types of fluke that infest humans, such as liver flukes.... snails and disease
A serious inherited metabolic disorder (see metabolism, inborn errors of) that causes premature death. The cause is deficiency of the enzyme hexosaminidase A, which results in a buildup in the brain of a harmful substance. Symptoms usually appear after age 6 months and include blindness, paralysis, and seizures leading to death. Diagnosis is made by enzyme analysis of white blood cells. It is now largely prevented by genetic.... tay–sachs disease
The main symptom is hoarseness or loss of voice from malfunction of the vocal cords by disease, stroke, stress, or nerve disorder. Pain on speaking. “Raw throat.”
Constitutional disturbance: fever, malaise.
Many causes, including: drugs, drinking spirits. Gross mis-use of voice (singing or talking) may produce nodules (warts) on the cords. The smoker has inflammatory changes. Nerve paralysis in the elderly. Carcinoma of the larynx. Voice changes during menstruation are associated with hormonal changes (Agnus Castus). Professional singers, members of choirs benefit from Irish Moss, Iceland Moss, Slippery Elm or Poke root.
Alternatives. Cayenne, Caraway seed, Balm of Gilead, Lungwort, Queen’s Delight, Thyme, Wild Indigo, Marsh Cudweed, Mullein, Marshmallow.
For most infections: Equal parts, Tinctures Goldenseal and Myrrh: 3-5 drops in water 3-4 times daily; use also as a spray or gargle.
Tea. Formula. Equal parts: Mullein, Marshmallow root, Liquorice. 2 teaspoons to each cup water brought to boil; vessel removed on boiling. Drink freely.
Practitioner. Combine equal parts: Senega, Ipecacuanha and Squills (all BP). 5-10 drops thrice daily in water. Also gargle.
Poke root. Reliable standby. Decoction, tablets/capsules. Tincture: dose, 5-10 drops thrice daily in water or honey.
Topical. Aromatherapy. Steam inhalations. Oils: Bergamot, Eucalyptus, Niaouli, Geranium, Lavender, Sandalwood. Any one.
Diet. Slippery Elm gruel. Salt-free. Avoid fried foods.
Supplements. Daily. Vitamin A (7500iu). Vitamin C (1 gram thrice daily).
To prevent voice damage. The voice should not be strained by talking too much, shouting or singing – especially with a cold. Try not to cough or keep clearing the throat but instead, swallow firmly. Do not whisper – it will strain the voice.
A common cause of laryngitis is growth of a nodule, cyst or polyp on the vocal cords. They are visible on use of an endoscope. There are two vocal cords which, in speech, come together and vibrate like a reed in a musical instrument. In formation of a nodule they cannot meet, air escapes and the voice becomes hoarse. Relaxation technique.
Where the condition lasts for more than 4 weeks an ENT specialist should be consulted. ... laryngitis, chronic
A defect of 1 or more of the heart valves.... valvular heart disease
(PD). Paralysis agitans. First described by James Parkinson, 1817. His description is as apt today as when it appeared in his book “Essay on the Shaking Palsy”. He wrote: “It is characterised by involuntary tremulous motion, with lessened muscular power in parts not in action and even when supported. There is a tendency to bend the trunk forward and to pass from a walking to a running pace. The senses and intellect are uninjured.”
Added to the above are:– muscular rigidity, loss of reflexes, drooling – escape of saliva from the mouth. Muscles of the face are stiff giving a fixed expression, the back presents a bowed posture. The skin is excessively greasy and the patient is unable to express emotional feelings. Loss of blinking. Pin- rolling movement of thumb and forefinger.
Causes: degeneration of groups of nerve cells deep within the brain which causes a lack of neurotransmitting chemical, dopamine. Chemicals such as sulphur used by agriculture, drugs and the food industry are suspected. Researchers have found an increase in the disease in patients born during influenza pandemics.
Treatment. While cure is not possible, a patient may be better able to combat the condition with the help of agents that strengthen the brain and nervous system.
Tea. Equal parts: Valerian, Passion flower, Mistletoe. 1 heaped teaspoon to each cup water; bring to boil; simmer 1 minute; dose: half-1 cup 2-3 times daily.
Gotu Kola tea. (CNS stimulant).
Tablets/capsules. Black Cohosh, Cramp bark, Ginseng, Prickly Ash, Valerian.
Formula. Ginkgo 2; Black Cohosh 1; Motherwort 2; Ginger 1. Mix. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 1-3 teaspoons in water or honey. Fava Bean Tea.
Case report. Two patients unresponsive to Levodopa treatment reported improvement following meals of fresh broad beans. (Vicia faba) The beans contain levodopa in large amounts. (Parkinson Disease Update Vol 8, No 66, p186, Medical Publications, PO Box 24622-H, Philadelphia, USA) See also: BROAD BEANS. L-DOPA.
Nacuna Pruriens. Appropriate. Essential active constituent: L-dopa. (Medicinal plants and Traditional Medicine in Africa, by Abayomi Sofowora, Pub: John Wiley)
Practitioner. To reduce tremor: Tincture Hyoscyamus BP. To reduce spasm: Tincture Belladonna BP. To arrest drooling: Tincture Stramonium BP.
Diet. It is known that people who work in manganese factories in Chile may develop Parkinson’s disease after the age of 30. Progress of the disease is arrested on leaving the factory. Two items of diet highest in manganese are wheat and liver which should be avoided, carbohydrates in place of wheat taking the form of rice and potatoes.
Supplements. Daily: B-complex, B2, B6, niacin. C 200mg to reduce side-effects of Levodopa. Vitamin E 400iu to possibly reduce rigidity, tremors and loss of balance.
Treatment of severe nerve conditions should be supervised by neurologists and practitioners whose training prepares them to recognise serious illness and to integrate herbal and supplementary intervention safely into the treatment plan.
Antioxidants. Evidence has been advanced showing how nutritional antioxidants, high doses of Vitamin C and E, can retard onset of the disease, delaying the use of Levodopa for an average of 2 and a half years. (Fahn S., High Dose Alpha-tocopherol and ascorbate in Early Parkinson’s Disease – Annals of Neurology, 32-S pp128-132 1992)
For support and advice: The Parkinson’s Disease Society, 22 Upper Woburn Place, London WC1H 0RA, UK. Send SAE. ... parkinson’s disease
see osteopetrosis. [H. E. Albers-Schönberg (1865–1921), German radiologist]... albers-schönberg disease
see Fabry disease.... anderson–fabry disease
a congenital abnormality in which the pulmonary veins enter the right atrium or vena cava instead of draining into the left atrium. The clinical features are those of an *atrial septal defect.... anomalous pulmonary venous drainage
any one of a variety of conditions involving the *pleura, but not the lungs (see asbestosis), in subjects exposed to asbestos. These include the formation of pleural plaques, diffuse pleural thickening, and pleural effusions (see oedema).... asbestos-related pleural disease
a disease associated with diffuse atherosclerosis and sloughing of atheromatous plaques in the aorta and main renal arteries. This results in occlusion of smaller arteries and arterioles downstream within the kidney, with ischaemic and inflammatory reactions. This leads to the onset of renal impairment. Precipitating factors include invasive procedures with aortic cannulae, vascular surgery, and therapy with thrombolytics or anticoagulants. Less commonly the condition can occur spontaneously.... atheroembolic renal disease
one of a number of otherwise unrelated disorders caused by inflammation and destruction of tissues by the body’s own *immune response. These disorders include acquired haemolytic anaemia, pernicious anaemia, rheumatic fever, rheumatoid arthritis, glomerulonephritis, systemic lupus erythematosus, myasthenia gravis, Sjögren’s syndrome, and several forms of thyroid dysfunction, including Hashimoto’s disease. It is not known why the body should lose the ability to distinguish between substances that are ‘self’ and those that are ‘non-self’.... autoimmune disease
one of a group of rare hereditary disorders (known as the neuronal ceroid lipofuscinoses) that also includes *Tay-Sachs disease. Fatty substances accumulate in the cells of the nervous system, causing progressive dementia, epilepsy, spasticity, and visual failure. The condition starts in late infancy or childhood. There is no treatment. [F. E. Batten (1865–1918), British neurologist]... batten’s disease
a rare disease of young women in which tender nodules develop under the skin in the calves. The condition is a *tuberculide; the nodules may break down and ulcerate though they may clear up spontaneously. Medical name: erythema induratum. [A. P. E. Bazin (1807–78), French dermatologist]... bazin’s disease
see vitelliform degeneration. [F. Best (20th century), German physician]... best’s disease
see abasia.... blocq’s disease
a condition causing *bow-legs as a result of abnormal growth at the *epiphysis at the top of the tibia (shin bone). It is more common in Africans and is most noticeable in childhood. The condition may affect one or both legs, and affected children are often obese. Treatment depends upon the severity and the age of the child but usually involves surgery. [W. P. Blount (1900–92), US orthopaedic surgeon]... blount disease
Relatively few insect species cause disease directly in humans. Some parasitize humans, living under the skin or on the body surface (see lice; chigoe; myiasis). The most troublesome insects are flies and biting insects. Flies can carry disease organisms from human or animal excrement via their feet or legs and contaminate food or wounds.
A number of serious diseases are spread by biting insects.
These include malaria and filariasis (transmitted by mosquitoes), sleeping sickness (tsetse flies), leishmaniasis (sandflies), epidemic typhus (lice), and plague (rat fleas).
Mosquitoes, sandflies, and ticks can also spread illnesses such as yellow fever, dengue, Lyme disease, and some types of viral encephalitis.
Organisms picked up when an insect ingests blood from an infected animal or person are able to survive or multiply in the insect.
Later, the organisms are either injected into a new human host via the insect’s saliva or deposited in the faeces at or near the site of the bite.
Most insect-borne diseases are confined to the tropics and subtropics, although tick-borne Lyme disease occurs in some parts of the.
The avoidance of insect-borne disease is largely a matter of keeping flies off food, discouraging insect bites by the use of suitable clothing and insect repellents, and, in parts of the world where malaria is present, the use of mosquito nets and screens, pesticides, and antimalarial tablets.... insects and disease
A rare form of arthritis affecting children. Juvenile chronic arthritis occurs more often in girls, and usually develops between 2 and 4 years of age or around puberty. There are 3 main types. Still’s disease (systemic onset juvenile arthritis) starts with fever, rash, enlarged lymph nodes, abdominal pain, and weight loss. These symptoms last for a period of several weeks. Joint pain, swelling, and stiffness may develop after several months. Polyarticular juvenile arthritis causes pain, swelling, and stiffness in many joints. Pauciarticular juvenile arthritis affects 4 joints or fewer.
Possible complications include short stature, anaemia, pleurisy, pericarditis, and enlargement of the liver and spleen. Uveitis may develop, which, if untreated, may damage vision. Rarely, amyloidosis may occur or kidney failure may develop. Diagnosis is based on the symptoms, together with the results of X-rays and blood tests, and is only made if the condition lasts for longer than 3 months.
Treatment may include antirheumatic drugs, corticosteroid drugs, nonsteroidal anti-inflammatory drugs, or aspirin. Splints may be worn to rest inflamed joints and to reduce the risk of deformities. Physiotherapy reduces the risk of muscle wasting and deformities.
The arthritis usually clears up after several years. However, in some children, the condition remains active into adult life.
– kala-azar A form of leishmaniasis that is spread by insects. Kala-azar occurs in parts of Africa, India, the Mediterranean, and South America.... juvenile chronic arthritis
see sarcoidosis. [C. P. M. Boeck (1845–1913), Norwegian dermatologist]... boeck’s disease
see tuberous sclerosis. [D.-M. Bourneville (1840–1909), French neurologist]... bourneville’s disease
see hyperostosis. [J. Caffey (1895–1966), US paediatrician]... caffey’s disease
a condition in which calcium pyrophosphate is deposited in joints. The most common manifestation is *pseudogout, marked by acute pain, redness, and swelling resembling gout. Alternatively it may be asymptomatic in association with *chondrocalcinosis seen on X-ray, it may occur with osteoarthritis in the affected joint, or there may be chronic inflammation of the joint.... calcium pyrophosphate deposition disease
an inherited condition in which the bile ducts, which drain the liver, are widened, causing an increased risk of infection or cancer in the gall bladder. Compare Caroli’s syndrome. [J. Caroli (20th century), French physician]... caroli’s disease
an infectious disease caused by the bacterium *Bartonella henselae, which infects cats and is transmitted to humans by a cat scratch or bite. A papule or pustule develops at the site of the injury followed, a week to two months after infection, by swelling of the lymph nodes (usually those closest to the wound). Fever and malaise are common. The condition usually resolves without treatment but antibiotics may be given to prevent complications.... cat-scratch disease
A combination of chronic bronchitis and emphysema, in which there is persistent disruption of air flow into or out of the lungs. Patients are sometimes described as either pink puffers or blue bloaters, depending on their condition. Pink puffers maintain adequate oxygen in their bloodstream through an increase in their breathing rate, and remain “pink” despite damage to the lungs. However, they suffer from almost constant shortness of breath. Blue bloaters are cyanotic (have a bluish discoloration of the skin and mucous membranes) because of obesity, and sometimes oedema, mainly due to heart failure resulting from the lung damage.... pulmonary disease, chronic obstructive
(peroneal muscular atrophy) a group of inherited diseases of the peripheral nerves, also known as hereditary sensorimotor neuropathy, causing a gradually progressive weakness and wasting of the muscles of the legs and the lower part of the thighs. The hands and arms are eventually affected. The genetic defect responsible for the most common form, type Ia, is a duplication on chromosome 17. The diagnosis is made by nerve conduction tests followed by genetic blood tests. [J. M. Charcot; P. Marie (1853–1940), French physician; H. H. Tooth (1856–1925), British physician]... charcot–marie–tooth disease
see persistent idiopathic facial pain.... chronic idiopathic facial pain
(CPP) intermittent or constant pain in the lower abdomen or pelvis of at least six months’ duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy. It may be caused by an underlying gynaecological condition, such as *endometriosis or adhesions, but bowel or bladder disorders (e.g. irritable bowel syndrome, interstitial cystitis), visceral hypersensitivity, and psychological conditions may all contribute.... chronic pelvic pain
(CTO) a complete arterial blockage (usually coronary) that has been present for at least three months. Fibrosis and calcification at the site of occlusion are well established by this time, making *percutaneous coronary intervention to open the artery much more difficult.... chronic total occlusion
a congenital anomaly of the blood vessels of the retina, which are abnormally dilated and leaking. This results in subretinal haemorrhage and exudative *retinal detachment. [G. Coats (1876–1915), British ophthalmologist]... coats’ disease
(in Britain) an Act providing for the identification and care of those suffering from a chronic or degenerative disease for which there is no cure and which can be only partially alleviated by treatment. Such people are usually distinguished from the elderly who may also suffer from chronic diseases. It is the responsibility of local authorities to identify those with such problems and to ensure that services are available to meet their needs. Identification can be difficult because of the lack of a clear and agreed definition of what constitutes a disability of such severity as to warrant inclusion in such a register.... chronic sick and disabled persons act 1970
an obsolete term for *connective-tissue disease.... collagen disease
the control of disease due to infectious agents or their toxic products. See Consultant in Health Protection.... communicable disease control
any one of a group of diseases that are characterized by inflammatory changes in connective tissue and can affect virtually any body system. Formerly known as collagen diseases (connective-tissue disease has been the preferred term since 1978), they include *dermatomyositis, systemic and discoid *lupus erythematosus, *morphoea, *polyarteritis nodosa, and *rheumatoid arthritis.... connective-tissue disease
a disorder characterized by a combination of *parkinsonism and *dementia, which typically fluctuates. Visual hallucinations are common, and there is exquisite sensitivity to phenothiazine drugs. Abnormal proteins called Lewy bodies are found within the nerve cells of the cortex and the basal ganglia. It is the third most common cause of dementia (dementia with Lewy bodies) after *Alzheimer’s disease and vascular dementia.... cortical lewy body disease
any disease caused by the lack of an essential nutrient in the diet. Such nutrients include *vitamins, minerals, *essential amino acids, and *essential fatty acids.... deficiency disease
see mesangiocapillary glomerulonephritis.... dense deposit disease
see neuromyelitis optica. [E. Devic (1869–1930), French physician]... devic’s disease
(DMARD) any of various drugs used in the treatment of rheumatic disease: they affect the progression of the disease by suppressing the disease process. DMARDs include drugs affecting the immune response (immunomodulators), such as *immunosuppressants (e.g. methotrexate) and *cytokine inhibitors; *gold salts; *penicillamine; *sulfasalazine; and *hydroxychloroquine.... disease-modifying antirheumatic drug
(CJD) a rapidly progressive rare neurological disease, a form of human *spongiform encephalopathy in which dementia progresses to death after a period of 3–12 months. There is no effective treatment. The causative agent is an abnormal *prion protein that accumulates in the brain and causes widespread destruction of tissue. CJD typically affects middle-aged to elderly people. Some 15% of cases are due to a form of the disease that is inherited as an autosomal *dominant trait but most cases are sporadic, susceptibility being genetically determined. A few cases of CJD are acquired: the agent is known to have been transmitted by tissue and organ transplantation and by human growth hormone injections, but the disease may take years to manifest itself. Variant Creutzfeldt–Jakob disease (vCJD) is the human form of bovine spongiform encephalopathy (BSE), which is most likely acquired by the ingestion of infected beef products. Patients are younger than those affected with sporadic CJD and present with psychiatric symptoms (e.g. depression, anxiety) and hypersensitivity to touch, which are followed after months by myoclonic jerks (see myoclonus) and dementia. [H. G. Creutzfeldt (1885–1964) and A. M. Jakob (1884–1931), German psychiatrists]... creutzfeldt–jakob disease
a rare X-linked (see sex-linked) recessive inherited condition usually presenting in childhood or early adult life with polyuria, microscopic haematuria, renal stone disease, or rickets. The majority of patients have a mutation of the gene encoding chloride channel 5 (CLCN5); others have a defect of the OCRL1 gene, normally associated with Lowe’s syndrome, but do not present with the cataracts, learning disability, and tubular acidosis associated with this condition. In still others the genetic defect has yet to be defined but is not associated with either CLCN5 or OCRL1. Patients with Dent’s disease have evidence of proximal tubular dysfunction. [C. E. Dent (1911–76), British physician]... dent’s disease
see X-linked lymphoproliferative syndrome. [Duncan family, in whom the disease was first studied]... duncan disease
inflammation of the blood vessels of the retina occurring in young adults. It is characterized by leakage from abnormal growths of new vessels as well as recurrent haemorrhages into the vitreous humour. [H. Eales (1852–1913), British physician]... eales’ disease
(Anderson–Fabry disease) an inherited disorder – an X-linked recessive condition (see sex-linked) – characterized by deficiency of the enzyme ?-galactosidase. It causes accumulation of glycosphingolipid (see cerebroside) in the body, leading to prominent and progressive involvement of the skin (with the formation of *angiokeratomas), heart, kidneys, and nervous system. The disease is treated with genetically engineered enzyme replacement therapy. [J. Fabry (1860–1930), German dermatologist]... fabry disease
(GTD) a group of disorders spanning the conditions of complete and partial molar pregnancies (see hydatidiform mole) through to the malignant conditions of invasive mole, *choriocarcinoma, and the very rare placental site trophoblastic tumour (PSTT). If there is any evidence of persistence of GTD, most commonly defined as a persistent elevation of *human chorionic gonadotrophin, the condition is described as *gestational trophoblastic neoplasia.... gestational trophoblastic disease
a rare autoimmune illness with production of antibodies directed against the glomerular basement membrane (anti-GBM antibodies). Classically patients present with lung haemorrhage and a rapidly progressive glomerulonephritis. Most cases will respond to aggressive treatment with plasma exchange and immunosuppression. [E. W. Goodpasture (1886–1960), US pathologist]... goodpasture’s disease
see Marburg disease.... green monkey disease
a temporary disturbance in blood clotting caused by *vitamin K deficiency and affecting infants on the second to fourth day of life. It varies in severity from mild gastrointestinal bleeding to profuse bleeding into many organs, including the brain. It is more common in breast-fed and preterm infants. The condition can be prevented by giving all babies vitamin K, either by injection or orally, shortly after birth. Medical name: melaena neonatorum.... haemorrhagic disease of the newborn
see Langerhans cell histiocytosis. [A. Hand (1868–1949), US paediatrician; A. Schüller (1874–1958), Austrian neurologist; H. A. Christian (1876–1951), US physician]... hand–schüller–christian disease
a rare hereditary defect in the absorption of the amino acid tryptophan, leading to learning disability, thickening and roughening of the skin on exposure to light, and lack of muscular coordination. The condition is similar to *pellagra. Treatment with nicotinamide is usually effective. [Hartnup, the family in whom it was first reported]... hartnup disease
a disorder associated with proliferation of B lymphocytes producing heavy chains – one of the two types of polypeptide chains (the other being light chains) that make up the structure of immunoglobulins. It results in the production of abnormal immunoglobulins with distorted heavy chains and no light chains.... heavy-chain disease
see occupational disease.... industrial disease
a condition resulting from an infestation of the small intestine by hookworms. Hookworm larvae live in the soil and infect humans by penetrating the skin. The worms travel to the lungs in the bloodstream and from there pass via the windpipe and gullet to the small intestine. Heavy hookworm infections may cause considerable damage to the wall of the intestine, leading to a serious loss of blood; this, in conjunction with malnutrition, can provoke severe anaemia. Symptoms include itching and rash at the site of infection, followed by abdominal pain, diarrhoea, debility, and mental inertia. More serious effects can include difficulty in breathing, heart enlargement, and irregular heartbeat. The disease occurs mostly in the tropics and subtropics; mebendazole is used in treatment.... hookworm disease
(IPF) a serious interstitial lung disease, formerly called cryptogenic fibrosing alveolitis (see alveolitis). It is characterized by progressive fibrous scarring of the lung and increased numbers of inflammatory cells in the alveoli and surrounding tissues. The disease is usually diagnosed on clinical grounds on a basis of worsening breathlessness, inspiratory crackles at the lung bases on auscultation, clubbing of the fingers or toes, bilateral radiographic shadowing predominantly in the lower zones of the chest X-ray, subpleural *honeycomb change on CT scanning of the chest, and restrictive lung function on spirometry. It is also called usual interstitial pneumonia (UIP; see interstitial pneumonia), a term used by lung pathologists for the most common cellular pattern seen on biopsy. Treatment includes *pirfenidone, corticosteroids, and immunosuppressants.... idiopathic pulmonary fibrosis
see haemochromatosis.... iron-storage disease
necrosis of the *lunate bone of the wrist caused by interruption of its blood supply (see osteochondritis; osteonecrosis). It usually follows chronic stress or injury to the wrist and presents with pain and stiffness, with reduced grip strength. Initially, X-rays may show no abnormality; if the disease is suspected, a bone scan or MRI is indicated. Treatment is with rest, splintage, and *NSAIDs, but some cases require surgical shortening of the radius or *arthrodesis of the wrist. [R. Kienböck (1871–1953), Austrian radiologist]... kienböck’s disease
osteonecrosis of the *navicular bone of the foot (see osteochondritis). It occurs in children aged 3–7 years, causing pain and limping, and is treated by strapping the foot, rest, and anti-inflammatory drugs. [A. Köhler (1874–1947), German physician]... köhler’s disease
(juvenile spinal muscular atrophy) see spinal muscular atrophy. [E. Kugelberg and L. Wellander (20th century), Swedish neurologists]... kugelberg–wellander disease
a tropical disease, common in southern India, caused by a virus transmitted to humans through the bite of the forest-dwelling tick Haemaphysalis spinigera. Symptoms include fever, headache, muscular pains, vomiting, conjunctivitis, exhaustion, bleeding of nose and gums and, subsequently, internal bleeding and the *necrosis of various tissues. General therapy, in the absence of specific treatment, involves relief of dehydration and loss of blood; analgesics are given to alleviate pain.... kyasanur forest disease
(Perthes disease, pseudocoxalgia) necrosis of the head of the femur (thigh bone) due to interruption of its blood supply (see osteochondritis). Of unknown cause, it occurs most commonly in boys between the ages of 5 and 10 and causes aching and a limp. The head of the femur can collapse and become deformed, resulting in a short leg and restricted hip movement. Affected boys are kept under observation and their activities are restricted; surgery may be required in more severe cases. [A. T. Legg (1874–1939), US surgeon; J. Calvé (1875–1954), French orthopaedist; G. C. Perthes (1869–1927), German surgeon]... legg–calvé–perthes disease
a *sex-linked hereditary disease caused by an enzyme deficiency resulting in overproduction of uric acid. Affected boys have learning disabilities and suffer from *spasticity and gouty arthritis. They also have a compulsion for self-mutilation. [M. Lesch (1939–2008) and W. L. Nyhan Jr. (1926– ), US physicians]... lesch–nyhan disease
see Langerhans cell histiocytosis. [E. Letterer (20th century) and S. A. Siwe (1897–1966), German physicians]... letterer–siwe disease
a form of *cerebral palsy involving both sides of the body and affecting the legs more severely than the arms. [W. J. Little (1810–94), British surgeon]... little’s disease
(aminoacidopathy) an inborn defect of amino acid metabolism causing an excess of valine, leucine, isoleucine, and alloisoleucine in the urine, which has an odour like maple syrup. Treatment is dietary; if untreated, the condition leads to learning disabilities and death in infancy.... maple syrup urine disease
obstruction of the outlet of the bladder caused by enlargement of the muscle cells in the neck of the bladder. [J. B. C. G. Marion (1869–1960), French surgeon]... marion’s disease
a rare disorder caused by *hypertrophy of the mucosa. It is characterized by diffusely enlarged gastric folds and excess mucus production, leading to anaemia, protein loss, and peripheral oedema. [P. Ménétrier (1859–1935), French physician]... ménétrier’s disease
a genetic disorder characterized by severe learning disabilities, seizures, poor vision, colourless fragile hair, and chubby red cheeks. It is inherited as an X-linked (see sex-linked) recessive characteristic. There is no treatment and affected infants usually die before the age of three. [J. H. Menkes (1928–2008), US neurologist]... menkes kinky-hair disease
swelling of the lacrimal and salivary glands as a result of infiltration with *lymphoid tissue. [J. von Mikulicz Radecki (1850–1905), Polish surgeon]... mikulicz’s disease
see lymphoedema. [W. F. Milroy (1855–1942), US physician]... milroy’s disease
a disease with features in common with systemic *lupus erythematosus, *polymyositis, and *scleroderma. It is characterized by high levels of antibodies to ribonucleoprotein and most commonly affects women between 20 and 40 years of age.... mixed connective tissue disease
a defect of *mucopolysaccharide metabolism (see inborn error of metabolism) that causes dwarfism with a *kyphosis, a short neck, *knock-knee, and an angulated sternum in affected children. Intelligence is normal. [L. Morquio (1865–1935), Uruguayan physician; J. F. Brailsford (1888–1961), British radiologist]... morquio–brailsford disease
an inherited (autosomal *recessive) disorder of lipid metabolism due to a defect in the enzyme sphingomyelinase and resulting in accumulation of sphingomyelin (a sphingolipid) and other phospholipids in the bone marrow, brain, liver, and spleen. Patients present with neurological problems, learning disabilities, and enlargement of the liver and spleen at a young age. There are four known types of the disease. [A. Niemann (1880–1921), German paediatrician; L. Pick (1868–1944), German pathologist]... niemann–pick disease
(NAFLD) a spectrum of conditions affecting the liver in the absence of excessive alcohol consumption. NAFLD is a common cause of referral for patients with abnormal liver function tests. Fatty liver is excessive fat accumulation in the liver seen as an area of brightness within the liver on ultrasound examination. Fatty liver does not lead to irreversible liver damage in the majority of cases. Nonalcoholic steatohepatitis (NASH) is inflammation of the liver associated with accumulation of fat. It is often linked to insulin resistance, diabetes, hypertension, obesity, and *metabolic syndrome. Treatment involves dietary modification, regular physical exercise, weight reduction, and management of underlying conditions (e.g. diabetes, hypertension, and hiperlipidaemia). NASH may predispose to *cirrhosis and may ultimately require liver transplantation.... nonalcoholic fatty liver disease
(OSA, obstructive sleep apnoea syndrome, OSAS) a serious condition in which airflow from the nose and mouth to the lungs is restricted during sleep, also called sleep apnoea syndrome (SAS). It is defined by the presence of more than five episodes of *apnoea per hour of sleep associated with significant daytime sleepiness. Snoring is a feature of the condition but it is not universal. There are significant medical complications of prolonged OSA, including heart failure and high blood pressure. Patients perform poorly on driving simulators, and driving licence authorities may impose limitations on possession of a driving licence. There are associated conditions in adults, the *hypopnoea syndrome and the upper airways resistance syndrome, with less apnoea but with daytime somnolence and prominent snoring. In children the cause is usually enlargement of the tonsils and adenoids and treatment is by removing these structures. In adults the tonsils may be implicated but there are often other abnormalities of the pharynx, and patients are often obese. Treatment may include weight reduction or nasal *continuous positive airways pressure (nCPAP) devices, *mandibular advancement splints, or noninvasive ventilation. Alternatively *tonsillectomy, *uvulopalatopharyngoplasty, *laser-assisted uvulopalatoplasty, or *tracheostomy may be required.... obstructive sleep apnoea
(OSAS) see obstructive sleep apnoea.... obstructive sleep apnoea syndrome
(hereditary haemorrhagic telangiectasia) a hereditary (autosomal *dominant) disorder characterized by thinning of the blood vessel walls, resulting in abnormally wide and fragile blood vessels. Patients may develop telangiectasia (see telangiectasis), nosebleeds, and arteriovenous malformations (see angioma). It is caused by mutations in the endoglin (ENG) gene or the activin receptor-like kinase (ALK-1) gene. [Sir W. Osler (1849–1919), Canadian physician; H. J. M. Rendu (1844–1902), French physician; F. P. Weber (1863–1962), British physician]... osler–rendu–weber disease
see frontotemporal dementia. [A. Pick (1851–1924), Czech psychiatrist]... pick’s disease
a hyperfunctioning, usually benign, *adenoma of the thyroid gland, which can be palpated and appears as a ‘hot nodule’ on radioactive thyroid scanning. Treatment is to control the nodule with antithyroid drugs and then remove it surgically or destroy it permanently with radioactive iodine. [H. S. Plummer (1874–1937), US physician]... plummer’s disease
a disease to which workers in certain occupations are particularly prone. Industrial diseases, associated with a particular industry or group of industries, fall within this category. Examples of such diseases include the various forms of *pneumoconiosis, which affect the lungs of workers continually exposed to dusty atmospheres; cataracts in glassblowers; decompression sickness in divers; poisoning from toxic metals in factory and other workers; and infectious diseases contracted from animals by farm workers, such as woolsorter’s disease (see anthrax). See also coshh, prescribed disease; industrial injuries disablement benefit.... occupational disease
a severe illness of children of the teething age, marked by pink cold clammy hands and feet, heavy sweating, raised blood pressure, rapid pulse, photophobia, loss of appetite, and insomnia. Affected infants are very prone to secondary infection, which may be fatal. It has been suggested that the condition is an allergic reaction to mercury, since it used to occur when teething powders, lotions, and ointments containing mercury were used. Although there is no definite proof of this, the disease has virtually disappeared since all mercury-containing paediatric preparations have been banned. Medical names: acrodynia, erythroedema, erythromelalgia.... pink disease
*tuberculosis of the backbone. Untreated, it can lead to a hunchback deformity. Treatment is antituberculous chemotherapy and occasionally surgery. [P. Pott (1714–88), British surgeon]... pott’s disease
one of a number of *occupational diseases for which benefits are payable. These diseases arise as a result of employment requiring close contact with a hazardous substance or circumstance. Prescribed diseases are categorized by cause: physical, biological, chemical, or other. Examples include poisoning by such chemicals as mercury or benzene, decompression sickness in divers, and infections such as *anthrax in those handling wool. Some diseases that occur widely in the population may be prescribed in relation to a specific occupation (e.g. deafness in those working with pneumatic drills or tuberculosis in mortuary attendants). See also COSHH.... prescribed disease
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
(PCWP) an indirect measurement of the pressure of blood in the left atrium of the heart, which indicates the adequacy of left heart function. It is measured using a catheter wedged in the most distal segment of the pulmonary artery. See also Swan-Ganz catheter.... pulmonary capillary wedge pressure
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
leakage of the pulmonary valve in the heart. Mild regurgitation is a common normal finding, but severe congenital pulmonary regurgitation may require surgical correction.... pulmonary regurgitation
see tuberculosis.... pulmonary tuberculosis
a valve in the heart lying between the right ventricle and the pulmonary artery. It is a *semilunar valve that prevents blood returning to the ventricle from the pulmonary artery.... pulmonary valve
a vein carrying oxygenated blood from the lung to the left atrium. See pulmonary circulation.... pulmonary vein
see Takayasu’s disease.... pulseless disease
an inherited disorder of lipid metabolism resulting in abnormal accumulation of phytanic acid (a fatty acid) in body tissues. This results in a *peripheral neuropathy affecting the sensory and motor nerves, diminishing vision due to *retinitis pigmentosa, and unsteadiness (*ataxia) caused by damage to the cerebellum. [S. Refsum (20th century), Norwegian physician]... refsum’s disease
see staphylococcal scalded skin syndrome. [G. Ritter von Rittershain (1820–83), German physician]... ritter’s disease
(adolescent kyphosis) a disorder of spinal growth in which a sequence of three or more vertebrae become slightly wedge-shaped. It arises in adolescence and usually occurs in the thoracic spine, causing poor posture, backache, fatigue, and exaggerated *kyphosis. X-ray findings include *Schmorl’s nodes. [H. W. Scheuermann (1877–1960), Danish surgeon]... scheuermann’s disease
(SCUAD) severe *rhinitis and *rhinosinusitis that has not been fully controlled by optimal pharmacological treatment.... severe chronic upper airway disease
*apophysitis caused by pulling at the point of insertion of the Achilles tendon into the calcaneus (heel bone), causing heel pain. [J. W. Sever (20th century), US orthopaedic surgeon]... sever’s disease
(STD) any disease transmitted by sexual intercourse, formerly known as venereal disease. STDs include *AIDS, *syphilis, *gonorrhoea, some *Chlamydia infections, genital *herpes, and *soft sore. The medical specialty concerned with STDs is genitourinary medicine.... sexually transmitted disease
(pulseless disease) progressive occlusion of the arteries arising from the arch of the aorta (including those to the arms and neck), resulting in the absence of pulses in the arms and neck. Symptoms include attacks of unconsciousness (syncope), paralysis of facial muscles, and transient blindness, due to an inadequate supply of blood to the head. [M. Takayasu (1860–1938), Japanese ophthalmologist]... takayasu’s disease
an inherited disease of the kidneys in which the glomerular basement membrane, which filters waste material from the blood, is too thin, allowing small amounts of blood to pass across it. This can be a cause of benign familial haematuria and thin membrane disease is a common finding in renal biopsy series where the procedure has been carried out as part of the investigation of *haematuria. Thin membranes are also found in other conditions, e.g. in some cases of *Alport’s syndrome and *Berger’s nephropathy.... thin membrane disease
see scrub typhus.... tsutsugamushi disease
see polycythaemia vera. [L. H. Vaquez (1860–1936), French physician; Sir W. Osler (1849–1919), Canadian physician]... vaquez–osler disease
(vCJD) see Creutzfeldt–Jakob disease.... variant creutzfeldt–jakob disease
(VD) see sexually transmitted disease.... venereal disease
an inherited syndrome in which *haemangioblastomas, particularly in the cerebellum, are associated with renal and pancreatic cysts, *angiomas in the retina (causing blindness), cancer of the kidney cells, and red birthmarks. [E. von Hippel (1867–1939), German ophthalmologist; A. Lindau (1892–1958), Swedish pathologist]... von hippel–lindau disease
a hereditary disorder – a severe form of *spinal muscular atrophy – in which the cells of the spinal cord begin to die between birth and the age of six months, causing a symmetrical muscle weakness. Affected infants become floppy and progressively weaker; respiratory and facial muscles become affected. Children usually die by the age of 20 months from respiratory failure and there is no treatment. *Genetic counselling is required for parents of an affected child as each of their subsequent children has a one in four chance of being affected. [G. Werdnig (1844–1919), Austrian neurologist; J. Hoffmann (1857–1919), German neurologist]... werdnig–hoffmann disease
see anthrax.... woolsorter’s disease
see sex-linked.... x-linked disease
an old name for a contagious disease, which was formerly thought to develop within the body following infection in a process similar to the fermentation and growth of yeast.... zymotic disease
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