Convalescence Health Dictionary

Also known as undulant fever, or Malta fever.

Causes In Malta and the Mediterranean littoral, the causative organism is the bacterium Brucella melitensis which is conveyed in goat’s milk. In Great Britain, the US and South Africa, the causative organism is the Brucella abortus, which is conveyed in cow’s milk: this is the organism which is responsible for contagious abortion in cattle. In Great Britain brucellosis is largely an occupational disease and is now prescribed as an industrial disease (see OCCUPATIONAL DISEASES), and insured persons who contract the disease at work can claim industrial injuries bene?t. The incidence of brucellosis in the UK has fallen from more than 300 cases a year in 1970 to single ?gures.

Symptoms The characteristic features of the disease are undulating fever, drenching sweats, pains in the joints and back, and headache. The liver and spleen may be enlarged. The diagnosis is con?rmed by the ?nding of Br. abortus, or antibodies to it, in the blood. Recovery and convalescence tend to be slow.

Treatment The condition responds well to one of the tetracycline antibiotics, and also to gentamicin and co-trimoxazole, but relapse is common. In chronic cases a combination of streptomycin and one of the tetracyclines is often more e?ective.

Prevention It can be prevented by boiling or pasteurising all milk used for human consumption. In Scandinavia, the Netherlands, Switzerland and Canada the disease has disappeared following its eradication in animals. Brucellosis has been eradicated from farm animals in the United Kingdom.... brucellosis

(Linn.) Ach.

Family: Parmeliaceae.

Habitat: Lichen found in the hills from Tehri Garhwal to East Nepal.

English: Cetraria, Iceland Lichen, Iceland Moss.

Ayurvedic: Shaileya (black var.)

Folk: Charela (black var.)

Action: A food and tonic in convalescence and exhausting diseases. Used for chronic catarrh and bronchitis.

Key application: In irritation of the oral and pharyngeal mucous membrane and accompanying dry cough. (German Commission E, ESCOP.) As demulcent. (The British Herbal Pharmacopoeia.) As a bitter remedy for lack of appetite. (ESCOP.)

The moss contains lichen acids (dep- sidones); mainly cetraric, protoce- traric, fumarprotocetraric, lichesteric and usnic acids; polysaccharides about 50%—lichenin 40% and isolichenin 10%; also furan derivatives, fatty acid lactones and terpenes. Lichenin is a moss-starch. Demulcent, expectorant and antiemetic properties are due mainly to the polysaccharides.

The usnic acid and protolichesteri- nic acid in the lichen and its crude, aqueous extract showed antibacterial activity against several pathogenic bacteria.

Contraindicated in gastric or duodenal ulcers due to its mucosa irritating properties. (Sharon M. Herr.)

Lozenges containing 160 mg of an aqueous extract of Iceland moss, were determined to be positive in 86% cases with good gastric tolerance. (ESCOP 1997.)... cetraria islandica

Wall.

Family: Ranunculaceae.

Habitat: Mishmi Hills in Arunachal Pradesh. Cultivated commercially in China.

Ayurvedic: Mamira, Maamiraa, Tiktamuulaa. (Pita-muulikaa and Hem-tantu are provisional synonyms.)

Unani: Maamisaa, Maamiraa.

Folk: Titaa (Bengal and Assam).

Action: Stomachic, antiperiodic, antibacterial, antifungal. Prescribed in debility, convalescence, intermittent fevers, dyspepsia, dysentery and intestinal catarrh. Used as a local application in thrush.

The rhizomes contains berberine (9%) as the major alkaloid; other alkaloids present are: coptin (0.08%), cop- tisin 0.02%) and jatrorrhizine (0.01%). Samples from China contained 9.2612.23% berberine, 2.39-3.25% coptisin and 3.20-4.46% jatrorrhizine. In China, the herb is used as an antidiabetic; the ethanolic (50%) extract exhibited hypoglycaemic and hypotensive activity.

The drug due to berberine and its related alkaloids promoted reticuloen- dothelium to increased phagocytosis of leucocytes in dog blood in vitro and in vivo.

Coptis chinensis (Huang Lian) inhibited erythrocyte haemolysis, decreased lipid peroxidation in brain and kidney, decreased generation of superoxide peroxidation and decreased hy- droxyl radicals in rats. (Life Sci, 2000, 66(8), 725-735.)

Dosage: Root—1-3 g powder. (CCRAS.)... coptis teeta

Maranta. Maranta arundinacea L. A white powder from the rhizomes of maranta. Action: nutritive, demulcent.

Uses: Convalescence, weak stomach, colitis, diverticulosis. Mix 2 teaspoons with a little cold water into a smooth paste; add, slowly, half a pint boiling milk, stirring continuously. Flavour with nutmeg. Said to increase weight. The name is derived for its use for arrow wounds in tropical communities. ... arrowroot

n. making whole, both by restoring injured or diseased tissue and, more generally, by returning to full and independent function. The latter may take a lot longer than the former: this is one of the reasons for follow-up after a medical event and for convalescence and rehabilitation services. See also empowerment.... healing

n. 1. a hospital or institution for the rehabilitation and convalescence of patients of any kind. 2. an institution for patients who have suffered from pulmonary tuberculosis.... sanatorium

A condition resulting from environmental temperatures which are too high for compensation by the body’s thermo-regulatory mechanism(s). It is characterised by hyperpyrexia, nausea, headache, thirst, confusion, and dry skin. If untreated, COMA and death ensue. The occurrence of heat stroke is sporadic: whereas a single individual may be affected (occasionally with fatal consequences), his or her colleagues may remain unaffected. Predisposing factors include unsatisfactory living or working conditions, inadequate acclimatisation to tropical conditions, unsuitable clothing, underlying poor health, and possibly dietetic or alcoholic indiscretions. The condition can be a major problem during pilgrimages – for example, the Muslim Hadj. Four clinical syndromes are recognised:

Heat collapse is characterised by fatigue, giddiness, and temporary loss of consciousness. It is accompanied by HYPOTENSION and BRADYCARDIA; there may also be vomiting and muscular cramps. Urinary volume is diminished. Recovery is usual.

Heat exhaustion is characterised by increasing weakness, dizziness and insomnia. In the majority of sufferers, sweating is defective; there are few, if any, signs of dehydration. Pulse rate is normal, and urinary output good. Body temperature is usually 37·8–38·3 °C.

Heat cramps (usually in the legs, arms or back, and occasionally involving the abdominal muscles) are associated with hard physical work at a high temperature. Sweating, pallor, headache, giddiness and intense anxiety are present. Body temperature is only mildly raised.

Heat hyperpyrexia is heralded by energy loss and irritability; this is followed by mental confusion and diminution of sweating. The individual rapidly becomes restless, then comatose; body temperature rises to 41–42 °C or even higher. The condition is fatal unless expertly treated as a matter of urgency.

Treatment With the ?rst two syndromes, the affected individual must be removed immediately to a cool place, and isotonic saline administered – intravenously in a severe case. The fourth syndrome is a medical emergency. The patient should be placed in the shade, stripped, and drenched with water; fanning should be instigated. He or she should be wrapped in a sheet soaked in cool water and fanning continued. When rectal temperature has fallen to 39 °C, the patient is wrapped in a dry blanket. Immediately after consciousness returns, normal saline should be given orally; this usually provokes sweating. The risk of circulatory collapse exists. Convalescence may be protracted and the patient should be repatriated to a cool climate. Prophylactically, personnel intended for work in a tropical climate must be very carefully selected. Adequate acclimatisation is also essential; severe physical exertion must be avoided for several weeks, and light clothes should be worn. The diet should be light but nourishing, and ?uid intake adequate. Those performing hard physical work at a very high ambient temperature should receive sodium chloride supplements. Attention to ventilation and air-conditioning is essential; fans are also of value.... heat stroke

Linn.

Family: Gramineae; Poaceae.

Habitat: Cultivated as food crop in Uttar Pradesh, West Bengal, Bihar, Madhya Pradesh, Rajasthan, Haryana, Punjab, Himachal Pradesh and Jammu and Kashmir.

English: Barley

Ayurvedic: Yava, Hayeshtha, Hayapriya, Shuka-dhaanya, Tiksh- nashuka.

Unani: Barley, Jao Shaeer.

Siddha: Yavam. Saambaluppu (ash).

Action: Barley—nutritive and demulcent during convalescence and in cases of bowel inflammation and diarrhoea. Protects immune system.

The Ayurvedic Pharmacopoeia ofIn- dia recommends barley in urinary disorders, muscular rigidity, chronic sinusitis, cough, asthma, lipid disorder and obesity.

Juice of young barley leaves—7 times richer in vitamin C than oranges, 5 times richer in iron than spinach, 25 times richer in potassium than wheat; high in SOD (superoxide dismutase), an enzyme that slows ageing of cells.

The nutritional quality of the barley depends on beta-glucan fraction of the grain. Beta-glucan-enriched fraction produced cholesterol-lowering effect in hamsters.

Naked barley extracts have been found to selectively inhibit cyclohex- anase activity and may be useful as a therapeutic drug for treating thrombosis and atherosclerosis.

Ethanol extract of young green leaves exhibits antioxidant activity attributed to a flavonoid, 2"-O-glucosyl- isovitexin. It also exhibits antiinflammatory and antiallergic activities. The leaves contain an indole alkaloid, gramine, which exhibits antibacterial properties.

Dosage: Dried fruit—100-200 g. (API Vol. II); dried plant—10-20 g. (API Vol. IV.)... hordeum vulgare

In?uenza is an acute infectious disease, characterised by a sudden onset, fever and generalised aches and pains. It usually occurs in epidemics and pandemics (see EPIDEMIC; PANDEMIC).

Cause The disease is caused by a VIRUS of the in?uenza group. There are at least three types of in?uenza virus, known respectively as A, B and

C. One of their most characteristic features is that infection with one type provides no protection against another. Equally important is the ease with which the in?uenza virus can change its character. It is these two characteristics which explain why one attack of in?uenza provides little, if any, protection against a subsequent attack, and why it is so di?cult to prepare an e?ective vaccine against the disease.

Epidemics of in?uenza due to virus A occur in Britain at two- to four-year intervals, and outbreaks of virus B in?uenza in less frequent cycles. Virus A in?uenza, for instance, was the prevalent infection in 1949, 1951, 1955 and 1956, whilst virus B in?uenza was epidemic in 1946, 1950, 1954 and, along with virus A, in 1958–59. The pandemic of 1957, which swept most of the world, although fortunately not in a severe form, was due to a new variant of virus A

– the so-called Asian virus – and it has been suggested that it was this variant that was responsible for the pandemics of 1889 and 1918. Since 1957, variants of virus A have been the predominating causes of in?uenza, accompanied on occasions by virus B.

In 1997 and 2004, outbreaks of Chinese avian in?uenza caused alarm. The in?uenza virus had apparently jumped species from birds

– probably chickens – to infect some people. Because no vaccine is available, there was a risk that this might start an epidemic.

Symptoms The incubation period of in?uenza A and B is 2–3 three days, and the disease is characterised by a sudden onset. In most cases this is followed by a short, sharp febrile illness of 2–4 days’ duration, associated with headache, prostration, generalised aching, and respiratory symptoms. In many cases the respiratory symptoms are restricted to the upper respiratory tract, and consist of signs of irritation of the nose, pharynx and larynx. There may be nosebleeds, and a dry, hacking cough is often a prominent and troublesome symptom. The fever is usually remittent and the temperature seldom exceeds 39·4 °C (103 °F), tending to ?uctuate between 38·3 and 39·4 °C (101 and 103 °F).

The most serious complication is infection of the lungs. This infection is usually due to organisms other than the in?uenza virus, and is a complication which can have serious results in elderly people.

The very severe form of ’?u which tends to occur during pandemics – and which was so common during the 1918–19 pandemic – is characterised by the rapid onset of bronchopneumonia and severe prostration. Because of the toxic e?ect on the heart, there is a particularly marked form of CYANOSIS, known as heliotrope cyanosis.

Convalescence following in?uenza tends to be prolonged. Even after an attack of average severity there tends to be a period of weakness and depression.

Treatment Expert opinion is still divided as to the real value of in?uenza vaccine in preventing the disease. Part of the trouble is that there is little value in giving any vaccine until it is known which particular virus is causing the infection. As this varies from winter to winter, and as the protection given by vaccine does not exceed one year, it is obviously not worthwhile attempting to vaccinate the whole community. The general rule therefore is that, unless there is any evidence that a particularly virulent type of virus is responsible, only the most vulnerable should be immunised – such as children in boarding schools, elderly people, and people who suffer from chronic bronchitis or asthma, chronic heart disease, renal failure, diabetes mellitus or immunosuppression (see under separate entries). In the face of an epidemic, people in key positions, such as doctors, nurses and those concerned with public safety, transport and other public utilities, should be vaccinated.

For an uncomplicated attack of in?uenza, treatment is symptomatic: that is, rest in bed, ANALGESICS to relieve the pain, sedatives, and a light diet. A linctus is useful to sooth a troublesome cough. The best analgesics are ASPIRIN or PARACETAMOL. None of the sulphonamides or the known antibiotics has any e?ect on the in?uenza virus; on the other hand, should the lungs become infected, antibiotics should be given immediately, because such an infection is usually due to other organisms. If possible, a sample of sputum should be examined to determine which organisms are responsible for the lung infection. The choice of antibiotic then depends upon which antibiotic the organism is most sensitive to.... influenza

Linn.

Family: Marantaceae.

Habitat: Native to tropical America; cultivated throughout the country for its edible starch.

English: Arrowroot.

Siddha: Koovaikizhangu, Kookaineer.

Action: Nutritive, demulcent (especially for infants and convalescence). Used as a dietary aid in acute diarrhoea and gastroenteritis. Used as a substitute for Bamboo-manna.

The rhizome contains about 25-27% neutral starch.... maranta arundinacea

This is also known as green monkey disease, or vervet monkey disease, because the ?rst recorded human cases acquired their infection from monkeys of this genus. It is a highly dangerous viral infection with a high mortality rate. The incubation period is 4–9 days. The onset is sudden with marked nausea and severe headache; this is followed by rising temperature, diarrhoea, and vomiting. Towards the end of the ?rst week a rash appears which persists for a week and is accompanied by internal bleeding. In those who recover, convalescence is slow and prolonged. Apart from laboratory infections acquired through working with vervet monkeys, all the cases so far reported have occurred in Africa.... marburg disease

Linn.

Family: Moraceae.

Habitat: Native to West Asia; cultivated in Kashmir, also grown in Darjeeling.

English: Black Mulberry.

Unani: Tuut Siyaah.

Action: Berries and root bark— mild laxative and used in the treatment of respiratory catarrh. Berries—refrigerant, given during convalescence.

The fruit contains invert sugar, pectin, fruit acids (including malic and citric acid), ascorbic acid, and fla- vonoids (including rutin). Leaves contain flavonoids, including rutin (26%). Root bark contains calcium malate; the bark of branches contains tannins, phlobaphenes, a sugar, a phy- tosterol, ceryl alcohol, fatty acids and phosphoric acid.

An infusion of leaves causes a drop in blood sugar, sometimes diuresis and a reduction in arterial pressure. It shows no effect on glucosuria.

Morus acidosa Griff., M. australis Poir and Morus indica L. have also been equated with Tuut Siyaah of Unani medicine.... morus nigra

Wall.

Family: Araliaceae.

Habitat: Western Himalayas, Pithoragarh district of Uttaranchal.

English: Indian Ginseng, Indian Pseudoginseng.

Ayurvedic: In Indian medicine, Panax quinquefolium Linn. and Panax schinseng Knees have been equated with Lakshmanaa.

Action: Adaptogen, digestive relaxant, old-age revitalizer. Sustains nerves and immune system in physical exhaustion and during convalescence. Antiarrhythmic (used for angina). Activities comparable with Korean ginseng.

Indian pseudoginseng, including subspecies himalaicus and its varieties, variety angustifolius and variety bipinnatifidus, has been found to be a rich source ofoleanolic acid saponins, while dammarane saponins (panaxa- diol and panaxatriol) are present in minor quantities. Panax burkillianus Bennet & Viswan and P. sikkimensis Banerjee are also related to the commercial ginseng.

Panax quinquefolium (American Ginseng) has been introduced into India in the Kashmir valley during 1983. It is rich in dammarane saponins. The air-dried roots of the plant, introduced in India, contain total saponin content of 11.5%. The saponins isolated include ginsenosides Rb1, Rb2, Rb3, Rc, Rd, Re, Rg1, pseudoginsenoside F11 and chikusetsu saponin V; the major saponin being ginsenoside Rb1. The saponin fraction of the root yielded panaxadiol, panaxatriol and oleanolic acid.

Ginsenosides Rb and Rc are 'diols', while Rg is a 'triol'. ('triol' group is arousing, 'diol' is sedative.) In American ginseng 'diols' predominate.

Panax pseudoginseng, equated with Himalayan ginseng (Natural Medicines Comprehensive Database, 2007), is believed to dilate the coronary vessels, re duce vascular resistance and improve the coronary collateral circulation. It increased blood flow while reducing blood pressure.

Panax schiseng, synonym P. ginseng Mey. (Asiatic or Chinese Ginseng) is cultivated in northern China, Korea and Japan.... panax pseudoginseng

Linn.

Synonym: Limonia oligandra Dalz. Toddalia aculeata Pers.

Family: Rutaceae.

Habitat: Found in Konkan and Maharashtra.

English: Lopez Root tree, Wild Orange tree, Forest Pepper.

Ayurvedic: Kaanchana, Dahana.

Siddha/Tamil: Kattu Milagu, Milagaranai.

Folk: Jangali Kaalimirchi, Limri (Maharashtra).

Action: Root bark—bitter, febrifuge, diaphoretic, antiperiodic. Infusion used in constitutional debility and convalescence after febrile and other exhausting diseases.

The root gave coumarins, including toddanol, todhanone, toddasin, pimpinellin, toddalolactone; alkaloids, including toddaline, toddalnine.... paullinia asiatica

Punica granatum

Punicaceae

San: Dadimah;

Hin: Anar, Dhalim;

Ben: Dalim;

Tam: Madalai, Madalam;

Mal: Urumampazham, Matalam, Talimatala m, Matalanarakam; Kan :Dalimbe;

Tel: Dadima; Mar: Dalimba;

Guj: Dadam; Ass: Dalin

Importance: Pomegranate has long been esteemed as food and medicine and as a diet in convalescence after diarrhoea. The rind of the fruit is highly effective in chronic diarrhoea and dysentery, dyspepsia, colitis, piles and uterine disorders. The powdered drug boiled with buttermilk is an efficacious reme dy for infantile diarrohoea. The root and stem bark are good for tapeworm and for strengthening the gums. The flowers are useful in vomiting, vitiated conditions of pitta, ophthalmodynia, ulcers, pharyngodynia and hydrocele. An extract of the flowers is very specific for epistaxis. The fruits are useful in anaemia, hyperdipsia, pharyngodynia, ophthalmodynia, pectoral diseases, splenopathy, bronchitis and otalgia. The fruit rind is good for dysentery, diarrhoea and gastralgia. Seeds are good for scabies, hepatopathy and splenopathy. The important preparations using the drug are Dadimadighrtam, Dadimastaka churnam, Hinguvacadi churnam, Hingvadi gulika, etc (Sivarajan et al, 1994, Warrier et al, 1995).

Distribution: Pomegranate is a native of Iran, Afghanistan and Baluchistan. It is found growing wild in the warm valleys and outer hills of the Himalaya between 900m and 1800m altitude. It is cultivated throughout India, the largest area being in Maharastra.

Botany: Punica granatum Linn. belongs to the family Punicaceace. It is a large deciduous shrub up to 10m in height with smooth dark grey bark and often spinescent branchlets. Leaves are opposite, glabrous, minutely pellucid-punctuate, shining above and bright green beneath. Flowers are scarlet red or sometime yellow, mostly solitary, sometimes 2-4 held together. Stamens are numerous and inserted on the calyx below the petals at various levels. Fruits are globose, crowned by the persistent calyx. Rind is coriaceous and woody, interior septate with membraneous walls containing numerous seeds. Seeds are angular with red, pink or whitish, fleshy testa (Warrier et al, 1995).

Agrotechnology: Pomegranate is of deciduous nature in areas where winters are cold, but on the plains it is evergreen. A hot dry summer aids in the production of best fruits. Plants are grown from seeds as well as cuttings. Mature wood pieces cut into lengths of about 30cm are planted for rooting. The rooted plants are planted 4.5-6m apart. When planted close, they form a hedge which also yields fruits. Normal cultivation and irrigation practices are satisfactory for the pomegranate. An application of 30-45kg of FYM annually to each tree helps to produce superior quality fruits. The pomegranate may be trained as a tree with a single stem for 30-45cm or as a bush with 3 or 4 main stems. In either case suckers arising from the roots and similar growths from the trunk and main branches are removed once a year. Shortening of long slender branches and occasional thinning of branches should be done. The fruit has a tough rind and hence transportation loss is minimum (ICAR, 1966).

Properties and activity: Pomegranate fruit rind gives an ellagitannin named granatin B, punicalagin, punicalin and ellagic acid. Bark contains the alkaloids such as iso-pelletierine, pseudopelletierine, methyl isopelletierine, methyl pelletierine, pelletierine as well as iso-quercetin, friedelin, D- mannitol and estrone. Flowers give pelargonidin-3, 5-diglucoside apart from sitosterol, ursolic acid, maslinic acid, asiatic acid, sitosterol- -D-glucoside and gallic acid. Seeds give malvidin pentose glycoside. Rind gives pentose glycosides of malvidin and pentunidin. Fluoride, calcium, magnesium, vitamin C and phosphate are also reported from fruits. Leaves give elligatannins-granatins A and B and punicafolin.

Rind of fruit is astringent, fruit is laxative. Bark of stem and root is anthelmintic, and febrifuge. Rind of fruit and bark of stem and root is antidiarrhoeal. Pericarp possesses antifertility effect. Fixed oil from seeds are antibacterial. Bark, fruit pulp, flower and leaf are antifungal. Aerial part is CNS depressant, diuretic and hypothermic. The flower buds of pomegranate in combination with other plants showed excellent response to the patients of Giardiasis (Mayer et al, 1977; Singhal et al, 1983).... pomegranate

A disease occurring most commonly in patients in or from the tropics, and characterised by diarrhoea with large, fatty stools; ANAEMIA; sore tongue; and weight loss. Its manifestations resemble those of non-tropical sprue, or gluten enteropathy, and COELIAC DISEASE.

Causes Tropical sprue is thought to be due to an inborn error of metabolism, characterised primarily by an inability to absorb fats from the intestines. Its epidemiological pattern suggests that an infection such as DYSENTERY may be the precipitating factor. Subsequently there is interference with the absorption of carbohydrates, vitamins, and minerals, leading to anaemia and HYPOCALCAEMIA.

Symptoms Of gradual or rapid onset, there is initial weakness, soreness of the tongue, dif?culty swallowing, indigestion, diarrhoea and poor appetite. Anaemia is typically macrocytic, and mild HYPOGLYCAEMIA may occur. Untreated, the patient steadily loses weight and, unless appropriate treatment is started early, death may be expected because of exhaustion and some intercurrent infection.

Treatment This consists of bed rest, a high-protein diet (initially skimmed milk), and treatment of the anaemia and any other de?ciencies present. Minimum fat should be given to sufferers, who should also take folic acid and cyanocobalamin for the anaemia; large vitamin-B-complex supplements (such as Marmite®) are helpful. Vitamins A and D, together with calcium supplements, help to raise the concentration of calcium in the blood. A long convalescence is often required, which may lead to marked depression, and patients should be sent home to a temperate climate.

Non-tropical sprue is the result of GLUTEN hypersensitivty and is treated with a gluten-free diet.... sprue

DC.

Family: Ranunculaceae.

Habitat: The temperate Himalayas from 1,500 to 2,400 m, in the Khasi hills and in Kashmir, Punjab, Delhi, Uttar Pradesh, Bihar and Orissa.

Ayurvedic: Pitarangaa, Piyaaraan- gaa. Pitamuulikaa (substitute).

Unani: Mamiri. (Mamiraa is equated with Coptis teeta Wall.)

Action: Plant—used against gout and rheumatism. Root—febrifuge, antiperiodic; a bitter tonic during convalescence.

The root contains alkaloids berberine and magnoflorine. (Berberine causes a stimulant action on the movements of the gastrointestinal tract, a depression of both the auricles and ventricles and distinct dilatation of the heart. Magnoflorine induces hypoten- tion.) Berberine content is reduced to one-fourth and magnoflorine to traces after 6 months. The root also contains palmitine and jatrorrhizine.

Thalictrum sp. (about 17 species are found in India)—alkaloidal structure exhibits antitumoral activity.

Over 60 isoquinoline and diter- penoid alkaloids have been isolated. (See The Wealth of India, Vol. X.)

Following are the important Thalic- trum sp. occurring in India:

T. alpinum Linn. (the alpine Himalayas and western Tibet at altitudes between 3,000 and 5,100 m); T. ele- gans Wall. ex Royle (the sub-alpine Himalayas from Kashmir to Sikkim at altitudes from 3,000 to 3,900 m); T. foetidum Linn. (North-West Himalayas); T. javanicum Blume (the temperate Himalayas from Kashmir to Sikkim, Khasi hills, Kodaikanal and Nilgiri hills); T. minus Linn. (the temperate Himalayas); T. reniforme Wall. (the temperate Himalayas from Kulu to Sikkim between 2,400 and 3,000 m).... thalictrum foliolosum

(Linn.) Lam.

Synonym: T. aculeata Pers.

Family: Rutaceae.

Habitat: Tropical Himalayas, from Kumaon eastwards to Assam, Khasi hills and throughout the Western Peninsula.

English: Wild Orange tree, Forest Pepper.

Ayurvedic: Kanchana.

Siddha/Tamil: Kattu Milagu, Milagaranai.

Folk: Jangali Kaali-mirch, Kanja.

Action: Whole plant—febrifuge, diuretic, Leaves—antispasmodic. Rootbark—antipyretic, diaphoretic, antiperiodic.

Used as a tonic during convalescence and constitutional debility. (The rootbark was used medicinally in the past in Europe under the name Lopez Root or Cortex Radicis as an antimalarial drug.)

Unripe fruits and roots are included in liniments used for rheumatism.

The rootbark contains alkaloids, including toddaline, toddalinine, skim- mianine. The root gave coumarins, including toddanol, toddanone, todda- sin, pimpinellin, iso-pimpinellin and toddalolactone.

Alkaloid toddaline is irritant to the mucous membrane, bronchi, intestines and the bladder.

Ethanolic extract of var. obtusifolia Gemble, found in the Nilgiris, Tamil Nadu, exhibited spasmolytic activity.

Among the coumarins, chlorocou- marin is the most important active principle and can be used an alternative for papaverine obtained from poppy.... toddalia asiatica

Slow heart rate; less than 55 beats per minute. Cause may be disease of the heart muscle or may lie in the CNS (central nervous system). May also be caused by disorder of the thyroid gland (hypothyroidism) with dropsy-like swelling of face and hands. Of recent years bradycardia has been associated with beta-blocker drugs, reserpine and digitalis alkaloids given in excess. Wrist pulse is slow. In the aged it is present as weakness and worsened by hypothermia.

In total heart block a rate of 36 or less is due to failure of conduction from atria to ventricles: requires artificial pace maker.

Modern herbalism (phytotherapy) employs: Hawthorn berries, Prickly Ash bark (berries preferred for circulatory disorders), Lily of the Valley leaves, Bugleweed (Lycopus virginicus), Broom, Heart’s Ease, Holy Thistle, Cactus (Night blooming cereus), Nutmeg, Saffron, Lemon Balm, Thuja, Figwort, Ginseng.

Lily of the Valley has a specific action in the heart muscle.

One of the purest and positive stimulants known for increasing the pulse rate is Cayenne Pepper. A few grains sprinkled on a meal or added to a beverage coaxes the heart to increase its output. To give the heart just that little extra support it may need, gentle cardiac stimulants can be found in the kitchen: Cloves, Ginger, Horseradish, Peppermint, Red Sage, Garden Sage.

Where a slow beat arises from a serious heart condition the underlying disorder should receive priority. In the event of an emergency the restorative, Camphor, may be given until the doctor comes:– 1-5 drops oil of Camphor in a teaspoon of honey. Even inhalation of the oil is known to increase pulse rate.

A slow pulse can be increased in pace by vagal relaxation. The pulse may be slow because of an excess of bile salts in the blood when a liver remedy (say Dandelion) would be indicated. Slow pulse of convalescence (Gentian), diabetes (Goat’s Rue), glandular fever (Poke root), jaundice (Dandelion), low thyroid (Kelp), congestion in the brain (Cypripedium), nervous exhaustion (Ginseng).

Practitioner. Broom (Spartiol Drops), 20 drops thrice daily. (Klein) Diet and supplements. See: DIET – HEART AND CIRCULATION. ... bradycardia

Kola seeds. Cola nitida. Cola acuminata. German: Kolabaum. French: Cafe? du Soudan. Spanish: Kola. Italian: Noci del sudan. Malayan: Kelapong. Part used: dried powdered seeds. Constituents: Caffeine, theobromine, kolanin, gum, tannic acid, phenols.

Keynote: cerebro-spinal stimulant.

Action: Nerve tonic, anti-depressant, diuretic, astringent, anti-diarrhoeal. Thymoleptic BHP (1983). Strengthens action of the heart by increasing its muscular power. Antidepressant. Stimulates the central nervous system and strengthens the heart by increasing its muscular power.

Uses: Physical and mental exhaustion (jet-lag), brain fatigue, neurasthenia, convalescence, muscle weakness, headache, depression. Diarrhoea, dysentery. Contains caffeine which increases mental alertness, heart rate and passage of urine. Low blood pressure. Not given in presence of high blood pressure.

Traditional combinations: (1) with Damiana and Saw Palmetto for sexual weakness. (2) with Skullcap and Oatstraw for depression and nerve debility.

Burroughs and Wellcome (1900) issued a tabloid “Forced March” (Kola compound 5g) used during the South African war and continued until 1937. Today similar preparations exist for jet-travel and tired business-men.

Side-effects: over-excitability.

Preparations: Average dose: 1 to 3 grams. Thrice daily.

Decoction (powder). Half a teaspoon to each cup water gently simmered 10 minutes. Dose 1 cup. Powder/tablets: 1 to 3g.

Liquid Extract, BHC Vol 1. 1:1, 60 per cent ethanol. Dose: 0.6 to 1.2ml.

Tincture BPC (1934). 1:5 in 60 per cent alcohol. Dose: 1-4ml. ... cola

Trigonella foenum-graecum L. German: Griechisches Bockshorn. French: Fenugrec. Italian: Fieno greco. Indian: Methi. Arabian: Halbah. Iranian: Shembalita. Malayan: Halba. Seeds.

Properties similar to Irish Moss.

Constituents: flavonoids, volatile oil, saponins, alkaloids.

Action: leaves a soothing protective coating over irritated surfaces (internal demulcent, external emollient); nutrient, anti-inflammatory, galactagogue, hypoglycaemic. A natural lubricant for the colon. Oxytocic. Febrifuge. “A stimulating effect on bone healing.” (Hamdard Medicus, Oct/Dec 1988, Vol XXXI No 4)

Uses: Soothing and healing to mucosa of stomach, intestines. Gastric and duodenal ulcer. Diverticulosis, dysentery, colitis, diarrhoea, irritable bowel, fistula, Crohn’s disease. Weak digestion, poor appetite and general debility. Convalescence. Reduces level of blood sugar; transient effects in diabetes. For thin people anxious to put on weight. Cancer of the bowel, as a soothing mild analgesic. Sore gums, mouth ulcers, chronic cough, bronchitis. Has been used for kidney complaints in China as early as 1057 AD. Protection against thrombosis, embolism and angina. To increase milk in nursing mothers. Hiatus hernia, impotence.

Arabian medicine: “for alluring roundness of the female breast.”

Topical. Decoction used as a poultice for boils, abscesses, wounds.

Preparations: Freely.

Decoction. 1-2 teaspoons crushed seeds to each cup water gently simmered 15 minutes. Dose: half-1 cup; seeds should be eaten. More efficacious than alcoholic preparations.

Popular combination. (Tablets, powders) Fenugreek 275mg; Rhubarb root 6mg; Slippery Elm 9mg; Bayberry 6mg; Goldenseal 3mg.

Poultice. Powder or crushed seeds – see POULTICE.

Diet. Sprouts. Seeds readily germinate on a moistened surface to provide rich source of natural vitamins, lecithin and iron for addition to green salads. ... fenugreek

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

Mononucleosis. An infectious viral disease caused by a herpes virus (Epstein Barr). Spread by saliva, nasal secretion as in kissing. Most commonly young adults, 15-25. Incubation 10- 15 days.

Symptoms. Mild fever, sore throat, headache, tiredness, malaise, swelling of glands under arm and in neck. These progress to high fever with painful lymph nodes. Puffiness of upper eyelids.

Treatment. Bedrest, when febrile.

Alternatives:– Echinacea, Eucalyptus, Garlic, Mountain Grape, Myrrh, Poke root, Wild Indigo, Wormwood, Elecampane, Blue Flag root.

Tea. Yarrow or Elder – early stages of fever in children.

Decoction: Formula. Equal parts, Echinacea, Blue Flag root. Half an ounce to 1 pint water gently simmered 20 minutes. Half-1 cup every 3 hours, with pinch of Cayenne. Children: 5-12 years three- quarters dose.

Formula. Echinacea 2; Blue Flag 1; Goldenseal half; pinch Cayenne. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid Extracts: 1 teaspoon. Tinctures: 1-2 teaspoons. Thrice daily. Children 5-12 years – as many drops as years of age.

Convalescence. Give a general tonic. See: TONICS.

Garlic. 2 capsules at night.

Diet. Commence with 3-day fast with herb teas (Marigold petals, Red Clover or Yarrow) and fruit juices, followed by vegetarian, salt-free diet. Vitamin C, 1g morning and evening. Vitamin B-complex. Supplements. Daily. B-complex. Vitamin C 3g.

To be treated by or in liaison with a qualified medical practitioner. ... glandular fever

Two types – simple and ulcerative. Inflammation of the membrane lining of the heart with the appearance of small fibrin accumulations on the valves. These may form during a specific fever – rheumatic, scarlet, etc, due to bacterial infection. In Bacterial Endocarditis, fragments of tissue may be shed from the main seat of infection and borne to other parts of the body, promoting inflammation or ischaemia elsewhere.

Affects more women than men, ages 20 to 40 years. Most cases have a history of rheumatic fever as a child. Thickening of the valves renders them less efficient in regulating the flow of blood through the heart thus allowing leakage by improper closure. Increased effort is required from the heart muscle to pump blood through the narrowed valves giving rise to fatigue and possible heart failure.

Prolapsus of the mitral valve is now recognised as predisposing to bacterial endocarditis. It is concluded that herbal antibiotic prophylaxis is justified in heart patients undergoing dental extraction, or other surgery where there is exposure to infection.

Symptoms: Breathlessness on exertion. Swelling of legs and ankles, palpitations, fainting, blue tinge to the skin and a permanent pink flush over the cheek bones. Clubbing of fingers. Enlarged spleen. Stethoscope reveals valvular regurgitation. The most common organism remains streptococcus viridans, by mouth. It may reach the heart by teeth extraction, scaling and intensive cleaning which may draw blood, posing a risk by bacteria.

Treatment. Acute conditions should be under the authority of a heart specialist in an Intensive Care Unit.

Absolute bedrest to relieve stress on the heart’s valves. For acute infection: Penicillin (or other essential antibiotics). Alternatives, of limited efficacy: Echinacea, Myrrh, Wild Indigo, Nasturtium, Holy Thistle. Avoid: excitement, chills, colds, fatigue and anything requiring extra cardiac effort. Convalescence will be long (weeks to months) during which resumption to normal activity should be gradual.

Aconite. With full bounding pulse and restless fever. Five drops Tincture Aconite to half a glass (100ml) water. 2 teaspoons hourly until temperature falls.

To sustain heart. Tincture Convallaria (Lily of the Valley), 5-15 drops, thrice daily.

To stimulate secretion of urine. Tincture Bearberry, 1-2 teaspoons, thrice daily.

Rheumatic conditions. Tincture Colchicum, 10-15 drops, thrice daily.

Various conventional treatments of the past can still be used with good effect: Tincture Strophanthus, 5 to 15 drops. Liquid Extract Black Cohosh, 15 to 30 drops. Spirits of Camphor, 5 to 10 drops. Bugleweed (American), 10 to 30 drops. To increase body strength: Echinacea. To sustain heart muscle: Hawthorn. Endocarditis with severe headache: Black Cohosh.

Teas: single or in combination (equal parts) – Nettles, Motherwort, Red Clover flowers, Lime flowers. 2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup 2-3 times daily.

Decoction: equal parts: Hawthorn berries, Echinacea root, Lily of the Valley leaves. Mix. 2 teaspoons to each 2 cups water in a non-aluminium vessel, gently simmer 10 minutes. Dose: 1 cup 2-3 times daily. Formula. Echinacea 20; Cactus 10; Hawthorn 10; Goldenseal 2. Mix. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Thrice daily.

Diet. See entry: DIET – HEART AND CIRCULATION. Pineapple juice. Treatment by or in liaison with general medical practitioner or cardiologist. ... endocarditis

One of a number of drugs subject to restricted use because of their potential for abuse. They include

opiates such as cocaine and morphine, amfetamine drugs, and barbiturate drugs. controlled trial A method of testing the effectiveness of new treatments or comparing different treatments. In a typical controlled drug trial, 2 comparable groups of patients suffering from the same illness are given courses of apparently identical treatment. However, only one group receives the new treatment; the second control group is given a placebo. Alternatively, the control group may be given an established drug that is already known to be effective. After a predetermined period, the 2 groups are assessed medically. Controlled trials must be conducted “blind’’ (the patients do not know which treatment they are receiving). In a “double-blind’’ trial, neither the patients nor the doctors who assess them know who is receiving which treatment. contusion Bruising to the skin and underlying tissues from an injury. convalescence The recovery period following an illness or surgery during which the patient regains strength before returning to normal activities.... controlled drug

An operation in which the ileum (lower part of the small intestine) is cut and the end brought through the abdominal wall and formed into an artificial opening called a stoma. Waste is discharged from the remaining ileum into a disposable bag (stoma bag) or drained into a pouch made from the end of the ileum and situated beneath the skin (a procedure called a continent ileostomy). In the latter, faeces draining into the pouch are emptied regularly through a soft catheter. An ileostomy can be permanent or temporary.

Permanent ileostomy is usually performed on people with severe, uncontrolled ulcerative colitis. Temporary ileostomy is sometimes done at the time of partial colectomy (removal of part of the colon) to allow the colon to heal before waste material passes through it. It may also be done as an emergency treatment for an obstruction in the intestine. The stoma is created from a loop of the intestine that is brought to the surface. (This is later reversed by a 2nd operation.)

During convalescence, patients are given counselling and taught the practical aspects of stoma care or drainage of continent ileostomies.

Full recovery from the operation takes about 6 weeks.... ileostomy

(breakbone fever) n. a disease caused by arboviruses and transmitted to humans principally by the mosquito *Aëdes aegypti. Symptoms, which last for a few days, include severe pains in the joints and muscles, headache, sore throat, fever, running of the eyes, and an irritating rash. These symptoms recur in a usually milder form after an interval of two or three days. Death rarely occurs, but the patient is left debilitated and requires considerable convalescence. A more severe form, dengue haemorrhagic fever, characterized by a breakdown of the blood-clotting mechanism with internal bleeding, can affect children. Dengue occurs throughout the tropics and subtropics. Patients are given aspirin and codeine to relieve the pain and calamine lotion is helpful in easing the irritating rash.... dengue

Citrus aurantium var. amara

FAMILY: Rutaceae

SYNONYMS: C. bigaradia, petitgrain bigarade (oil), petitgrain Paraguay (oil). See also bitter orange.

GENERAL DESCRIPTION: The oil of petitgrain is produced from the leaves and twigs of the same tree that produces bitter orange oil and neroli oil: see bitter orange and neroli.

DISTRIBUTION: Native to southern China and north east India. The best quality petitgrain oil comes from France but a good-quality oil is also produced in North Africa, Paraguay and Haiti from semi-wild trees.

OTHER SPECIES: A type of petitgrain is also produced in small quantities from the leaves, twigs and small unripe fruit of the lemon, sweet orange, mandarin and bergamot trees.

HERBAL/FOLK TRADITION: At one time the oil used to be extracted from the green unripe oranges when they were still the size of a cherry – hence the name petitgrains or ‘little grains’. One of the classic ingredients of eau-de-cologne.

ACTIONS: Antiseptic, antispasmodic, deodorant, digestive, nervine, stimulant (digestive, nervous), stomachic, tonic.

EXTRACTION: Essential oil by steam distillation from the leaves and twigs. An orange ‘leaf and flower’ water absolute is also produced, known as petitgrain sur fleurs.

CHARACTERISTICS: A pale yellow to amber liquid with a fresh-floral citrus scent and a woody-herbaceous undertone. It blends well with rosemary, lavender, geranium, bergamot, bitter orange, labdanum, neroli, oakmoss, clary sage, jasmine, benzoin, palmarosa, clove and balsams.

PRINCIPAL CONSTITUENTS: 40–80 per cent esters: mainly linalyl acetate and geranyl acetate, as well as linalol, nerol, terpineol, geraniol, nerolidol, farnesol, limonene, among others.

SAFETY DATA: Non-toxic, non-irritant, nonsensitizing, non-phototoxic.

AROMATHERAPY/HOME: USE

Skin care: Acne, excessive perspiration, greasy skin and hair, toning.

Digestive system: Dyspepsia, flatulence.

Nervous system: Convalescence, insomnia, nervous exhaustion and stress-related conditions.

OTHER USES: Extensively used as a fragrance component in soaps, detergents, cosmetics and perfumes, especially colognes (sometimes used to replace neroli). Employed as a flavour component in many foods, especially confectionery, as well as alcoholic and soft drinks.... petitgrain