Creutzfeldt-jakob disease (cjd) Health Dictionary

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Creutzfeldt-jakob Disease (cjd): From 1 Different Sources

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.

Health Source: Medical Dictionary
Author: Health Dictionary

Disease

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

Lyme 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

Coeliac Disease

Around one in 100 people suffers from coeliac disease, a condition in which the small INTESTINE fails to digest and absorb food, but many have no or few symptoms and remain undiagnosed. The intestinal lining is permanently sensitive to the protein gliadin (an insoluble and potentially toxic PEPTIDE protein) which is contained in GLUTEN, a constituent of the germ of wheat, barley and rye. As bread or other grain-based foods are a regular part of most people’s diet, the constant presence of gluten in the intestine of sufferers of coeliac disease causes atrophy of the digestive and absorptive cells of the intestine. Children are usually diagnosed when they develop symptoms such as vomiting, diarrhoea, lethargy, ANAEMIA, swollen abdomen and pale, frothy, foul-smelling faeces with failure to thrive. The diagnosis is usually made by a positive blood antibody test such as antiendomysial antibodies. However, because there may be an occasional false positive result, the ‘gold standard’ is to obtain a biopsy of the JEJUNUM through a tiny metal capsule that can be swallowed, a specimen taken, and the capsule retrieved. Though coeliac disease was long thought to occur in childhood, a second peak of the disorder has recently been identi?ed among people in their 50s.

Not all sufferers from coeliac disease present with gastrointestinal symptoms: doctors, using screening techniques, have increasingly identi?ed large numbers of such people. This is important because researchers have recently discovered that untreated overt and silent coeliac disease increases the risk of sufferers developing osteoporosis (brittle bone disease – see BONE, DISORDERS OF) and cancer. The osteoporosis develops because the bowel fails to absorb the CALCIUM essential for normal bone growth. Because those with coeliac disease lack the enzyme LACTASE, which is essential for digesting milk, they avoid milk – a rich source of calcium.

The key treatment is a strict, lifelong diet free of gluten. As well as returning the bowel lining to normal, this diet results in a return to normal bone density. People with coeliac disease, or parents or guardians of affected children, can obtain help and guidance from the Coeliac Society of the United Kingdom. (See also MALABSORPTION SYNDROME; SPRUE.)... coeliac disease

Communicable Disease

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

Marburg 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

Bornholm Disease

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

Brittle Bone Disease is another name for OSTEOGENESIS IMPERFECTA.... brittle bone disease

Caisson Disease

See COMPRESSED AIR ILLNESS.... caisson disease

Chagas’ 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

Christmas 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

Diverticular 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

Haemolytic Disease Of The Newborn

A potentially serious disease of the newborn, characterised by haemolytic ANAEMIA (excessive destruction of red blood cells) and JAUNDICE. If severe, it may be obvious before birth because the baby becomes very oedematous (see OEDEMA) and develops heart failure – so-called hydrops fetalis. It may ?rst present on the ?rst day of life as jaundice and anaemia. The disease is due to blood-group incompatibility between the mother and baby, the commoneset being rhesus incompatibility (see BLOOD GROUPS). In this condition a rhesus-negative mother has been previously sensitised to produce rhesus antibodies, either by the delivery of a rhesus-positive baby, a miscarriage or a mismatched blood transfusion. These antibodies cross over into the fetal circulation and attack red blood cells which cause HAEMOLYSIS.

Treatment In severely affected fetuses, a fetal blood transfusion may be required and/or the baby may be delivered early for further treatment. Mild cases may need observation only, or the reduction of jaundice by phototherapy alone (treatment with light, involving the use of sunlight, non-visible ULTRAVIOLET light, visible blue light, or LASER).

Whatever the case, the infant’s serum BILIRUBIN – the bilirubin present in the blood – and its HAEMOGLOBIN concentration are plotted regularly so that treatment can be given before levels likely to cause brain damage occur. Safe bilirubin concentrations depend on the maturity and age of the baby, so reference charts are used.

High bilirubin concentrations may be treated with phototherapy; extra ?uid is given to prevent dehydration and to improve bilirubin excretion by shortening the gut transit time. Severe jaundice and anaemia may require exchange TRANSFUSION by removing the baby’s blood (usually 10 millilitres at a time) and replacing it with rhesus-negative fresh bank blood. Haemolytic disease of the newborn secondary to rhesus incompatibility has become less common since the introduction of anti-D (Rho) immunoglobulin. This antibody should be given to all rhesus-negative women at any risk of a fetomaternal transfusion, to prevent them from mounting an antibody response. Anti-D is given routinely to rhesus-negative mothers after the birth of a rhesus-positive baby, but doctors should also give it after threatened abortions, antepartum haemorrhages, miscarriages, and terminations of pregnancy.

Occasionally haemolytic disease is caused by ABO incompatibility or that of rarer blood groups.... haemolytic disease of the newborn

Hand, Foot And Mouth Disease

A contagious disease due to infection with coxsackie A16 virus (see COXSACKIE VIRUSES). Most common in children, the incubation period is 3–5 days. It is characterised by an eruption of blisters on the palms and the feet (often the toes), and in the mouth. The disease

has no connection with foot and mouth disease in cattle, deer, pigs and sheep.... hand, foot and mouth disease

Infectious Disease

A disease of humans or animals resulting from an infection.... infectious disease

Kawasaki Disease

Also called mucocutaneous lymph node syndrome, this disorder of unknown origin occurs mainly in children under ?ve and was ?rst described in Japan. It is characterised by high fever, conjunctivitis (see under EYE, DISORDERS OF), skin rashes and swelling of the neck glands. After about two weeks the skin from ?ngertips and toes may peel. The disease may last for several weeks before spontaneously resolving. It is possible that it is caused by an unusual immune response to INFECTION (see IMMUNITY).

Arteritis is a common complication and can result in the development of coronary artery aneurysms (see ANEURYSM) in up to 60 per cent of those affected. These aneurysms and even myocardial infarction (see HEART, DISEASES OF – Coronary thrombosis) are often detected after the second week of illness. The disease can be hard to diagnose as it mimics many childhood viral illnesses, especially in its early stages. The incidence in the UK is over 3 per 100,000 children under ?ve years of age.

Treatment Because of the danger of coronary artery disease, prompt treatment is important. This is with intravenous IMMUNOGLOBULINS and low-dose aspirin. To be e?ective, treatment must start in the ?rst week or so of the illness – a time when it is most di?cult to diagnose.... kawasaki disease

Legionnaire’s 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

Pelvic Inflammatory 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

Addison’s Disease

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

Alzheimer’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

Crohn’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

Hansen’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

Hodgkin’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

Hydatid Disease

An infection caused by a tapeworm Echinococcus granulosis, which infests cattle, foxes, sheep and especially dogs from which it finds its way into humans by contaminated food. Eggs pass through the wall of the gut to develop in body tissue as a hydatid cyst. Many years may pass before symptoms reveal its presence. Surgical operation is the only effective cure although certain vermifuges, taken from time to time, create in the intestine an inhospitable environment for the parasite: Wormwood, Malefern, Fennel, Pumpkin seeds; given in capsule or powder form. Such worms deplete reserves of Vitamin B12 and may cause megaloblastic anaemia.

Supplementation. Vitamin B12.

HYDRAGOGUE. A herbal cathartic that causes watery evacuation and drastic purgation. White Bryony, American Mandrake. (Practitioner use only) ... hydatid disease

Meniere’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

Paget’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

Fibrocystic Disease Of The Pancreas

See CYSTIC FIBROSIS.... fibrocystic disease of the pancreas

Crohn’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

Graves’ Disease

See THYROID GLAND, DISEASES OF.... graves’ disease

Iatrogenic Disease

Disease induced by a physician: most commonly a drug-induced disease.... iatrogenic disease

Hyaline Membrane Disease

A form of ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) found in premature infants and some of those born by CAESAREAN SECTION, characterised by the onset of di?culty in breathing a few hours after birth. Most require extra oxygen and many need mechanical ventilation for a few days or even weeks. Recovery is the rule, although the most severely affected may die or suffer damage from oxygen lack. In this condition the ALVEOLITIS and the ?ner BRONCHIOLES of the lungs are lined with a dense membrane. The cause of the condition is a de?ciency of SURFACTANT in the lung passages which adversely affects gas exchanges in the alveoli.

Treatment includes the full gamut of neonatal intensive care, as well as speci?c therapy with PULMONARY SURFACTANT.... hyaline membrane disease

Notifiable Disease

An infectious or other disease required to be notified to the relevant State Government Authorityfor entry onto the Notifiable Diseases Register.... notifiable disease

Organic 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

Parrot Disease

See PSITTACOSIS.... parrot disease

Motor Neurone Disease (mnd)

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)

Simmonds’ 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

Tay Sachs 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

Peripheral Vascular Disease

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

Perthes’ 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

Weil’s Disease

Epidemic jaundice. A severe form of leptospirosis caused by such serovars as Leptospira icterrohaemorrhagiae.... weil’s disease

Gastro-oesophageal Reflux Disease

See: REFLUX. ... gastro-oesophageal reflux disease

Osgood Schlatter Disease

Degenerative changes in the growth centres of bones in children due to calcium or other mineral deficiency. Herbs rich in calcium, iron, and magnesium are indicated. (Horsetail, Chamomile, Plantain, Silverweed, Nettles, Mullein, etc)

Selenium 50mcg and Vitamin E 400iu are recommended by Jonathan Wright MD, for decreasing the pain of disease, decreasing over 3 months. (Health Update USA, June 1990) ... osgood schlatter disease

Bowen’s 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

Bright’s Disease

Another name for glomerulonephritis.... bright’s disease

Cerebrovascular Disease

Any disease affecting an artery in, and supplying blood to, the brain: for example, atherosclerosis (narrowing of the arteries) or defects or weaknesses in arterial walls causing aneurysm (a balloon-like swelling in an artery).

The disease may eventually cause a cerebrovascular accident, which commonly leads to a stroke.

Extensive narrowing of blood vessels throughout the brain can be a cause of dementia.... cerebrovascular disease

Buerger’s Disease

(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

Chronic Obstructive Pulmonary Disease

See pulmonary disease, chronic obstructive.... chronic obstructive pulmonary disease

Gaucher’s Disease

A genetic disorder in which the lack of the enzyme glucocerebrosidase leads to accumulation of a fatty substance, glucosylceramide, in the liver, spleen, bone marrow, and, sometimes, in the brain.

It is treated by regular injections of the missing enzyme.... gaucher’s disease

Coronary Heart 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

Graft-versus-host Disease

A complication of a bone marrow transplant in which immune system cells in the transplanted marrow attack the recipient’s tissues. Graft-versus-host (GVH) disease may occur soon after transplantation or appear some months later. The first sign is usually a skin rash. This may be followed by diarrhoea, abdominal pain, jaundice, inflammation of the eyes and mouth, and breathlessness.

GVH disease can usually be prevented by administration of immunosuppressant drugs. If the disease develops, it can be treated with corticosteroid drugs and immunosuppressant drugs such as ciclosporin In some cases, however, it can be difficult to control.... graft-versus-host disease

Huntington’s Disease

An uncommon disease in which degeneration of the basal ganglia results in chorea and dementia. Symptoms of Huntington’s disease do not usually appear until age 35–50. The disease is due to a defective gene and is inherited in an autosomal dominant manner (see genetic disorders).

The chorea usually affects the face, arms, and trunk, resulting in random grimaces and twitches, and clumsiness. Dementia takes the form of irritability, personality and behavioural changes, memory loss, and apathy.

At present, there is no cure for Huntington’s disease, and treatment is aimed at reducing symptoms with drugs.... huntington’s disease

Inflammatory Bowel 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

Lou Gehrig’s Disease

The most common type of motor neuron disease; also known as amyotrophic lateral sclerosis.... lou gehrig’s disease

Marble Bone Disease

See osteopetrosis.... marble bone disease

Mcardle’s 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

Hashimoto’s Disease

Hashimoto’s thyroiditis. Inflammation of the Thyroid gland with increase of fibrous tissue and intrusion of excess white blood cells. Forerunner of myxoedema. It is an auto-immune disorder resulting in thyroid damage. Middle-aged women prone. Painless swelling.

Alternatives. Treatment. Echinacea is the key remedy.

Others indicated: Red Clover flower, Blue Flag root, Horsetail, Poke root, Bladderwrack. May be taken singly, as available.

Tea: Combine Bladderwrack 2; Echinacea 2; Horsetail 1. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup thrice daily.

Tinctures. Combine: Bladderwrack 2; Echinacea 2; Horsetail 1. Dose: one to two 5ml teaspoons in water thrice daily.

Diet. Iodised salt. Avoid cabbage which contains a factor which depresses the thyroid gland. Supplementation. Vitamin A. B-complex. Kelp. ... hashimoto’s disease

Heart Disease – Congenital

Heart disease arising from abnormal development. Some cases are hereditary, others due to drugs taken during pregnancy. Many owe their origin to illnesses of the mother such as German measles. Structural abnormalities of the heart take different forms but whatever the case, when under abnormal pressure and stress, all may derive some small benefit from the sustaining properties of Hawthorn berry and other phytomedicines.

Alternatives. To sustain.

Teas. Lime flowers, Motherwort, Buckwheat, Hawthorn.

Tablets/capsules. Hawthorn, Mistletoe, Motherwort.

Formula. Hawthorn 2; Lily of the Valley 1; Selenicereus grandiflorus 1. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water morning and evening. ... heart disease – congenital

Minamata Disease

The name given to a severe form of mercury poisoning that occurred in the mid-1950s, in people who had eaten polluted fish from Minamata Bay, Japan.

Many people suffered severe nerve damage and some died.... minamata disease

Obstructive Airways Disease

See pulmonary disease, chronic obstructive.... obstructive airways disease

Coronary Artery Disease

Narrowing of the coronary arteries, which supply blood to the heart, leading to damage or malfunction of the heart. The most common heart disorders due to coronary artery disease are angina pectoris and myocardial infarction (heart attack). The usual cause of narrowing of the arteries is atherosclerosis, in which fatty plaques develop on the artery linings. The vessel can become totally blocked if a blood clot forms or lodges in the narrowed area. Atherosclerosis has many interrelated causes including smoking, a high-fat diet, lack of exercise, being overweight, and raised blood cholesterol levels. Other factors include a genetic predisposition and diseases such as diabetes mellitus and hypertension.

The first symptom of coronary artery disease is frequently the chest pain of angina. Treatment is with drugs such as glyceryl trinitrate and other nitrate drugs, beta-blockers, calcium channel blockers, potassium channel activators, and vasodilator drugs. If drug treatment fails to relieve the symptoms, or there is extensive narrowing of the coronary

arteries, blood flow may be improved by balloon angioplasty or coronary artery bypass surgery.... coronary artery disease

Periodontal Disease

Any disorder of the periodontium (the tissues that surround and support the teeth).... periodontal disease

Peyronie’s 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

Still’s Disease

See rheumatoid arthritis, juvenile.... still’s disease

Fifth 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

Hirschsprung’s Disease

A congenital disorder in which the rectum, and sometimes the lower part of the colon, lack the ganglion cells that control the intestine’s rhythmic contractions. The affected area becomes narrowed and blocks the movement of faecal material.

The disease is rare and tends to run in families. It occurs about 4 times more often in boys. Symptoms, which include constipation and bloating, usually develop in the first few weeks of life, but may become evident in infancy or early childhood. The child usually has a poor appetite and may fail to grow properly.

A barium X-ray examination can show the narrowed segment of the intestine.

A biopsy may be taken.

Treatment of Hirschsprung’s disease involves removing the narrowed segment and rejoining the normal intestine to the anus.... hirschsprung’s disease

Von Recklinghausen’s Disease

Another name for neurofibromatosis.... von recklinghausen’s disease

Weil’s Disease

Another name for leptospirosis.... weil’s disease

Whipple’s Disease

A rare disorder, also called intestinal lipodystrophy, that can affect many organs. Symptoms include steatorrhoea as a result of malabsorption, abdominal pain, joint pains, progressive weight loss, swollen lymph nodes, anaemia, and fever. The heart, lungs, and brain can also be affected. The condition is most common in middle-aged men.

The cause is thought to be bacterial; affected tissues are found to contain macrophages (a type of scavenging cell) containing rod-shaped bacteria. Treatment is with antibiotic drugs for at least 1 year. Dietary supplements are used to correct nutritional deficiencies occurring as a result of malabsorption.... whipple’s disease

Motor Neuron Disease

A group of disorders in which there is degeneration of the nerves in the central nervous system that control muscular activity. This causes weakness and wasting of the muscles. The cause is unknown.

The most common type of motor neuron disease is amyotrophic lateral sclerosis ( or Lou Gehrig’s disease). It usually affects people over the age of 50 and is more common in men. Some cases run in families. Usually, symptoms start with weakness in the hands and arms or legs, and muscle wasting. There may be irregular muscle contractions, and muscle cramps or stiffness. All four extremities are soon affected.

Progressive muscular atrophy and progressive bulbar palsy both start with patterns of muscle weakness different from but usually develop into.There are 2 types of motor neuron disease that first appear in childhood or adolescence. In most cases, these conditions are inherited. Werdnig–Hoffman disease affects infants at birth or soon afterwards. In almost all cases, progressive muscle weakness leads to death within several years. Chronic spinal muscular atrophy begins in childhood or adolescence, causing progressive weakness but not always serious disability.

There are no specific tests for motor neuron disease. Diagnosis is based on careful clinical examination by a neurologist. Tests including EMG, muscle biopsy, blood tests, myelography, CT scanning, or MRI may be performed.

The disease typically goes on to affect the muscles involved in breathing and swallowing, leading to death within 2–4 years. However, about 10 per cent of sufferers survive for 10 years.

Nerve degeneration cannot be slowed down, but physiotherapy and the use of various aids may help to reduce disability. The drug riluzole is used to extend life (or the time until mechanical ventilation is required).... motor neuron disease

Wilson’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

Raynaud’s Disease

A disorder of the blood vessels in which exposure to cold causes the small arteries supplying the fingers and toes to contract suddenly. This cuts off blood flow to the digits, which become pale. The fingers are more often affected than the toes. The cause is unknown, but young women are most commonly affected.

On exposure to cold, the digits turn white due to lack of blood. As sluggish blood flow returns, the digits become blue; when they are warmed and normal blood flow returns, they turn red. During an attack, there is often tingling, numbness, or a burning feeling in the affected fingers or toes. In rare cases, the artery walls gradually thicken, permanently reducing blood flow. Eventually painful ulceration or even gangrene may develop at the tips of the affected digits.

Diagnosis is made from the patient’s history. Treatment involves keeping the hands and feet as warm as possible. Vasodilator drugs or calcium channel blockers may be helpful in severe cases. (See also Raynaud’s phenomenon.)... raynaud’s disease

Von Willebrand’s Disease

An inherited lifelong bleeding disorder similar to haemophilia. People with the condition have a reduced concentration in their blood of a substance called von Willebrand factor, which helps platelets in the blood to plug injured blood vessel walls and forms part of factor VIII (a substance vital to blood coagulation). Symptoms of deficiency of this factor include excessive bleeding from the gums and from cuts and nosebleeds. Women may have heavy menstrual bleeding. In severe cases, bleeding into joints and muscles may occur.

The disease is diagnosed by bloodclotting tests and measurement of blood levels of von Willebrand factor. Bleeding episodes can be prevented or controlled by desmopressin (a substance resembling ADH). Factor or concentrated von Willebrand factor may also be used to treat bleeding.... von willebrand’s disease

Contagious Disease

originally, a disease transmitted only by direct physical contact: now usually taken to mean any *communicable disease.... contagious disease

Acute Disease / Illness

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

Addison’s Disease

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

Agent (of 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)

Alzheimer’s Disease

Alzheimer’s disease is a progressive degenerating process of neural tissue affecting mainly the frontal and temporal lobes of the BRAIN in middle and late life. There is probably a genetic component to Alzheimer’s disease, but early-onset Alzheimer’s is linked to certain mutations, or changes, in three particular GENES. Examination of affected brains shows ‘senile plaques’ containing an amyloid-like material distributed throughout an atrophied cortex (see AMYLOID PLAQUES). Many remaining neurons, or nerve cells, show changes in their NEUROFIBRILS which thicken and twist into ‘neuro?brillary tangles’. First symptoms are psychological with insidious impairment of recent memory and disorientation in time and space. This becomes increasingly associated with diffculties in judgement, comprehension and abstract reasoning. After very few years, progressive neurological deterioration produces poor gait, immobility and death. When assessment has found no other organic cause for an affected individual’s symptoms, treatment is primarily palliative. The essential part of treatment is the provision of appropriate nursing and social care, with strong support being given to the relatives or other carers for whom looking after sufferers is a prolonged and onerous burden. Proper diet and exercise are helpful, as is keeping the individual occupied. If possible, sufferers should stay in familiar surroundings with day-care and short-stay institutional facilities a useful way of maintaining them at home for as long as possible.

TRANQUILLISERS can help control di?cult behaviour and sleeplessness but should be used with care. Recently drugs such as DONEPEZIL and RIVASTIGMINE, which retard the breakdown of ACETYLCHOLINE, may check

– but not cure – this distressing condition. About 40 per cent of those with DEMENTIA improve.

Research is in progress to transplant healthy nerve cells (developed from stem cells) into the brain tissue of patients with Alzheimer’s disease with the aim of improving brain function.

The rising proportion of elderly people in the population is resulting in a rising incidence of Alzheimer’s, which is rare before the age of 60 but increases steadily thereafter so that 30 per cent of people over the age of 84 are affected.... alzheimer’s disease

Bowen’s 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

Bright’s Disease

See KIDNEYS, DISEASES OF – Glomerulonephritis.... bright’s disease

Buerger’s Disease

See THROMBOANGIITIS OBLITERANS.... buerger’s disease

Burden Of 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

Carriers Of Disease

See INFECTION.... carriers of disease

Chronic Condition / Disease

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

Deficiency 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

Disease Control

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

Disease Management

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

Disease Prevention

See “prevention”.... disease prevention

Chronic Obstructive Pulmonary Disease (copd)

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.... chronic obstructive pulmonary disease (copd)

Classification Of Disease

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

Ebola Virus Disease

Ebola virus disease is another name for VIRAL HAEMORRHAGIC FEVER. The ebola virus is one of the most virulent micro-organisms known. Like the marburg virus (see MARBURG DISEASE), it belongs to the ?lovirus group which originates in Africa. Increased population mobility and wars have meant that the infection occasionally occurs elsewhere, with air travellers developing symptoms on returning home.

Treatment As the disease can be neither prevented nor cured, treatment is supportive, with strict anti-infection procedures essential as human-to-human transmission can occur via skin and mucous-membrane contacts. Incubation period is 5–10 days. Fever with MYALGIA and headache occur initially, often accompanied by abdominal and chest symptoms. Haemorrhagic symptoms soon develop and the victim either starts to improve in the second week or develops multi-organ failure and lapses into a coma. Mortality ranges from 25 to 90 per cent.... ebola virus disease

Gaucher’s Disease

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

Graft Versus Host Disease (gvhd)

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)

Hansen’s Disease

See LEPROSY.... hansen’s disease

Hashimoto’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

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

Hodgkin’s Disease

See LYMPHOMA.... hodgkin’s disease

Inflammatory Bowel Disease (ibd)

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)

International Classification Of Disease (icd)

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)

Ischaemic Heart Disease

See HEART, DISEASES OF.... ischaemic heart disease

Leber’s Disease

A hereditary disease in which blindness comes on at about the age of 20.... leber’s disease

Little’s Disease

A form of CEREBRAL PALSY.... little’s disease

Osgood-schlatter’s Disease

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

Liver Disease In The Tropics

ACUTE LIVER DISEASE The hepatitis viruses (A– F) are of paramount importance. Hepatitis E (HEV) often produces acute hepatic failure in pregnant women; extensive epidemics – transmitted by contaminated drinking-water supplies – have been documented. HBV, especially in association with HDV, also causes acute liver failure in infected patients in several tropical countries: however, the major importance of HBV is that the infection leads to chronic liver disease (see below). Other hepatotoxic viruses include the EPSTEIN BARR VIRUS, CYTOMEGALOVIRUS (CMV), the ?avivirus causing YELLOW FEVER, Marburg/Ebola viruses, etc. Acute liver disease also occurs in the presence of several acute bacterial infections, including Salmonella typhi, brucellosis, leptospirosis, syphilis, etc. The complex type of jaundice associated with acute systemic bacterial infection – especially pneumococcal PNEUMONIA and pyomiositis – assumes a major importance in many tropical countries, especially those in Africa and in Papua New Guinea. Of protozoan infections, plasmodium falciparum malaria, LEISHMANIASIS, and TOXOPLASMOSIS should be considered. Ascaris lumbricoides (the roundworm) can produce obstruction to the biliary system. CHRONIC LIVER DISEASE Long-term disease is dominated by sequelae of HBV and HCV infections (often acquired during the neonatal period), both of which can cause chronic active hepatitis, cirrhosis, and hepatocellular carcinoma (‘hepatoma’) – one of the world’s most common malignancies. Chronic liver disease is also caused by SCHISTOSOMIASIS (usually Schistosoma mansoni and S. japonicum), and acute and chronic alcohol ingestion. Furthermore, many local herbal remedies and also orthodox chemotherapeutic compounds (e.g. those used in tuberculosis and leprosy) can result in chronic liver disease. HAEMOSIDEROSIS is a major problem in southern Africa. Hepatocytes contain excessive iron – derived primarily from an excessive intake, often present in locally brewed beer; however, a genetic predisposition seems likely. Indian childhood cirrhosis – associated with an excess of copper – is a major problem in India and surrounding countries. Epidemiological evidence shows that much of the copper is derived from copper vessels used to store milk after weaning. Veno-occlusive disease was ?rst described in Jamaica and is caused by pyrrolyzidine alkaloids (present in bush-tea). Several HIV-associated ‘opportunistic’ infections can give rise to hepatic disease (see AIDS/HIV).

A localised (focal) form of liver disease in all tropical/subtropical countries results from invasive Entamoeba histolytica infection (amoebic liver ‘abscess’); serology and imaging techniques assist in diagnosis. Hydatidosis also causes localised liver disease; one or more cysts usually involve the right lobe of the liver. Serological tests and imaging techniques are of value in diagnosis. Whilst surgery formerly constituted the sole method of management, prolonged courses of albendazole and/or praziquantel have now been shown to be e?ective; however, surgical intervention is still required in some cases.

Hepato-biliary disease is also a problem in many tropical/subtropical countries. In southeast Asia, Clonorchis sinensis and Opisthorchis viverini infections cause chronic biliary-tract infection, complicated by adenocarcinoma of the biliary system. Praziquantel is e?ective chemotherapy before advanced disease ensues. Fasciola hepatica (the liver ?uke) is a further hepato-biliary helminthic infection; treatment is with bithionol or triclabendazole, praziquantel being relatively ine?ective.... liver disease in the tropics

Menière’s Disease

Named after the Frenchman, Prosper Menière, who ?rst described it in 1861, the disease is characterised by TINNITUS, deafness and intermittent attacks of VERTIGO. The ?rst manifestation is usually deafness on one side; then – as a rule, many months later – there is a sudden attack, without any warning, of intense vertigo. The acute giddiness usually lasts for two or three hours with some unsteadiness persisting for a few days. The time interval between attacks varies from a week to a few months. When they do recur, they tend to do so in clusters. The tinnitus, which tends to be low-pitched, comes on at about the same time as the deafness; it is often described as being like rushing water or escaping steam. The deafness becomes gradually worse until it is complete. The condition is due to excessive ?uid in the labyrinth of the ears (see EAR). The cause of this accumulation is not known, although it has been suggested that it might be a form of ALLERGY, or might be due to spasm of small blood vessels. The disorder is diagnosed from AUDIOMETRY, the CALORIC TEST and other investigations.

Treatment Acute vertigo symptoms can sometimes be alleviated with drugs such as CYCLIZINE HYDROCHLORIDE and NICOTINIC ACID, but the disorder is notoriously di?cult to treat and no certain cure is available. Surgical decompression of the ?uid in the ear’s balancing mechanism may relieve vertigo and prevent the disease from worsening. The vestibular nerve to the ear can also be cut to relieve vertigo while preserving hearing.... menière’s disease

Peyronie’s Disease

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

Polycystic Disease Of The Kidney

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

Pott’s Disease

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

Raynauds Either Syndrome Or Disease

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

Nature Of The Disease Tuberculosis Has

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

Still’s Disease

Or juvenile rheumatoid arthritis – see JUVENILE IDIOPATHIC ARTHRITIS (JIA).... still’s disease

Valvular Disease

See under HEART, DISEASES OF.... valvular disease

Von Recklinghausen’s 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

Paget’s Disease Of Bone

Also called osteitis deformans, this is a chronic disease in which the bones (see BONE) – especially those of the skull, limbs, and spine – gradually become thick and also soft, causing them to bend. It is said to be the most common form of bone disease in the world, and it is estimated that some 600,000 people in England may suffer from it. It seldom occurs under the age of 40. Pain is its most unpleasant manifestation. The cause is not known, and there is no known cure, but satisfactory results are being obtained from the use of CALCITONIN and a group of drugs known as BISPHOSPHONATES

(e.g. etidronate). Those with the disease can obtain help and advice from the National Association for the Relief of Paget’s Disease.... paget’s disease of bone

Pelvic Inflammatory Disease(pid)

An infection of the endometrium (membraneous lining) of the UTERUS, FALLOPIAN TUBES and adjacent structures caused by the ascent of micro-organisms from the vulva and vagina. Around 100,000 women develop PID each year in the UK; most of those affected are under 25 years of age. Infection is commonly associated with sexual intercourse; Chlamydia trachomatis (see CHLAMYDIA) and Neisseria gonorrhoeae (see NEISSERIACEAE) are the most common pathogens. Although these bacteria initiate PID, opportunistic bacteria such as STREPTOCOCCUS and bacteroides often replace them.

The infection may be silent – with no obvious symptoms – or symptoms may be troublesome, for example, vaginal discharge and sometimes a palpable mass in the lower abdomen. If a LAPAROSCOPY is done – usually by endoscopic examination – overt evidence of PID is found in around 65 per cent of suspected cases.

PID may be confused with APPENDICITIS, ECTOPIC PREGNANCY – and PID is a common cause of such pregnancies – ovarian cyst (see OVARIES, DISEASES OF) and in?ammatory disorders of the intestines. Treatment is with a combination of ANTIBIOTICS that are active against the likely pathogens, accompanied by ANALGESICS. Patients may become seriously ill and require hospital care, where surgery is sometimes required if conservative management is unsuccessful. All women who have PID should be screened for sexually transmitted disease and, if this is present, should be referred with their partner(s) to a genito-urinary medicine clinic. Up to 20 per cent of women who have PID become infertile, and there is a seven-to ten-fold greater risk of an ectopic pregnancy occurring.... pelvic inflammatory disease(pid)

Von Willebrand’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

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

Wool-sorters’ Disease

Another name for ANTHRAX.... wool-sorters’ disease

Damp Hay Disease

Farmer’s lung. A disease contracted from working in mouldy hay. A wet summer means much moist hay, ideal breeding ground for micro-organisms.

Symptoms: inflammation of the lung and high temperature with dry cough.

Tea: Equal parts; Elderflowers (to reduce temperature). Comfrey leaves (cough), Thyme (antibiotic), Peppermint (to assist breathing). 2 teaspoons to each cup boiling water; infuse 5-15 minutes. 1 cup freely. Alternative: Combine Tinctures: Pleurisy root 2; Lobelia 1; Ginger half. One or two 5ml teaspoons in water 3-4 times daily. ... damp hay disease

Raynaud’s Disease

So called after Maurice Raynaud (1834–81), the Paris physician who published a thesis on the subject in 1862. This is a condition in which the circulation (see CIRCULATORY SYSTEM OF THE BLOOD) becomes suddenly obstructed in outlying parts of the body. It is supposed to be due to spasm of the smaller arteries in the affected part, as the result of them responding abnormally to impuilses from the SYMPATHETIC NERVOUS SYSTEM. Its effects are increased both by cold and by various diseases involving the blood vessels.

Symptoms The condition is most commonly con?ned to the occurrence of ‘dead ?ngers’ – the ?ngers (or the toes, ears, or nose) becoming white, numb, and waxy-looking. This condition may last for some minutes, or may not pass o? for several hours, or even for a day or two.

Treatment People who are subject to these attacks should be careful in winter to protect the feet and hands from cold, and should always use warm water when washing the hands. In addition, the whole body should be kept warm, as spasm of the arterioles in the feet and hands may be induced by chilling of the body. Su?erers should not smoke. VASODILATORS are helpful, especially the calcium antagonists. In all patients who do not respond to such medical treatment, surgery should be considered in the form of sympathectomy: i.e. cutting of the sympathetic nerves to the affected part. This results in dilatation of the arterioles and hence an improved blood supply. This operation is more successful in the case of the feet than in the case of the hands.... raynaud’s disease

Surveillance Of 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

Winter Vomiting 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

Exfoliative Disease

See: DERMATITIS. ... exfoliative disease

Fabry’s Disease

Rare. Chiefly due to passage of a gene from a parent to an offspring, preventing production of an enzyme giving rise to symptoms including a pin-prick blood vessel rash, loss of weight, allergies, but the person is reasonably fit.

Symptomatic relief. Rutin, Hawthorn, Echinacea. Vitamin E: 200iu daily. ... fabry’s disease

Goat Disease

The disease (caseous lymphadenitis) attacks the lymphatic system and may spread to sheep and humans. Breaks out sporadically in goats imported from abroad. Those in close contact with infected animals are at risk.

Symptoms: loss of weight, wasting illness, skin abscesses.

Treatment. Tea: Aniseed 1; Senna leaf 1; Nettles 2. 2 teaspoons to each cup boiling water; infuse 10-15 minutes in covered vessel. 1 cup thrice daily. Add to each dose: 30 drops Tincture Echinacea. ... goat disease

Grave’s Disease

Hyperactive thyroid gland. See: THYROID. ... grave’s disease

Bechet’s Disease

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

Mad-cow Disease, Human

Creutzfeldt-Jakob disease. See: BOVINE SPONGIFORM ENCEPHALOPATHY. ... mad-cow disease, human

Mitral Disease

A serious defect of the mitral valve of the heart. Two kinds: (1) a permanently deformed narrowed valve (mitral stenosis), or (2) a dilated, over-stretched or distorted valve through enlargement of the left ventricle. In this case imperfect closure causes back pressure which produces chest symptoms. Incompetence leads to enlargement of the heart. Often a legacy from rheumatic fever in children. Sooner or later the liver congests with possible jaundice. Presence of albumin in the urine follows kidney involvement.

Treatment. See: HEART – LEFT VENTRICULAR FAILURE. ... mitral disease

Auto Immune 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

Bright’s Disease (acute)

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)

Paget’s Disease Of The Nipple

Cancer of the mammary ducts (rare). Nipple: encrusted, red, inflamed. See: CANCER OF THE BREAST. ... paget’s disease of the nipple

Bright’s Disease (chronic)

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)

Chagas’ Disease

An infectious parasitic disease found only in parts of South and Central America that is spread by insects commonly called cone-nosed or assassin bugs.

The parasites live in the bloodstream and can affect the heart, intestines, and nervous system.

Symptoms include swelling of the lymph nodes and fever.

Long-term complications include damage to the heart.

The drug nifurtimox kills the parasites in the blood but has unpleasant side effects.... chagas’ disease

Charcot–marie–tooth Disease

An inherited muscle-wasting disease of the legs (see peroneal muscular atrophy).... charcot–marie–tooth disease

Fibrocystic Disease

A term used to refer either to the inherited disorder cystic fibrosis or the presence of general lumpiness of the breasts that is a variation of normal.

(See also fibroadenosis).... fibrocystic disease

Gilbert’s Disease

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

Charcot’s Disease

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

Graves’ 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

Heart Disease, Ischaemic

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

Fibrocystic Breast Disease (fbd)

Most lumps are harmless, including cysts (adenosis) and benign tumours. Not forerunners of cancer. Largely due to hormone imbalance. Fluid may be aspirated from a cyst. Thickened patches of fibrous tissue are freely movable and occur chiefly during years of menstruation depending upon the presence of oestrogen. An accurate diagnosis is necessary by a competent authority. Excessive sugar consumption suspected.

Prominent cyst formations have been reduced, even eliminated by Poke root, internally and externally, though surgery is sometimes indicated. Diuretics influence the kidneys to expel more body fluids and are sometimes helpful to reduce size. Cold water packs may be applied to the affected area two or more times daily, as practical.

Alternatives. Tea. Formula. Equal parts: Ground Ivy, Clivers, Horsetail. One heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup morning and evening.

Poke root. Tablets, powders. Tincture. 5-10 drops in water 3 times daily.

Evening Primrose oil. Two 500mg capsules, 3 times daily. Trials carried out by departments of Surgery at the University of Wales and the University of Dundee found Evening Primrose oil effective and safe. Poultice. Poke root. Horsetail.

Diet. As salt favours retention of fluid in cystic tissue it should be restricted.

Supplements. Daily. Beta carotene; B-complex; B6, Vitamin C 1g; Zinc. Vitamin E contra-indicated.

Treatment by or in liaison with a general medical practitioner. ... fibrocystic breast disease (fbd)

Legionnaires’ Disease

A form of pneumonia that is caused by LEGIONELLA PNEUMOPHILA, a bacterium that breeds in warm, moist conditions. The source of infection is often an air-conditioning system in a large, public building.

The first symptoms include headache, muscular and abdominal pain, diarrhoea, and a dry cough.

Over the next few days, pneumonia develops, resulting in a high fever, shaking chills, coughing up of thick sputum (phlegm), drowsiness, and sometimes delirium.

Treatment is with the antibiotic drug erythromycin.... legionnaires’ disease

Lung Disease, Chronic Obstructive

See pulmonary disease, chronic obstructive.... lung disease, chronic obstructive

Mad Cow Disease

The commonly used name for bovine spongiform encephalopathy (BSE).... mad cow disease

Flesh-eating Disease

Necrotising fasciitis, in which flesh and muscle are destroyed at a rate of inches an hour. Can spring from a range of streptococcal bacteria of which there are over 80 sub-types.

It seems that this common bacteria, in some unknown way, receives a booster by taking on viral DNA. Lungs, liver and stomach may be attacked, while red blood cells are disrupted and their haemoglobin released. Among other conditions caused by streptococcus is the bright red rash of scarlet fever, sinusitis, meningitis and rheumatic fever. Flesh-eater disease may take just twenty hours to kill a man (“galloping gangrene”).

Symptoms. High temperature – body hot, hands and feet freezing cold. ‘Strep’ sore throat (pharyngitis). Bright red skin rash. Pains in arms and legs as if straining a muscle.

Treatment. The disease is resistant to penicillin. Frequent hot lemon drinks well-laced with honey. Tinctures. Echinacea 2; Goldenseal 1; Myrrh half. Dose: 10-20 drops in dessertspoon water or honey, hourly, acute cases.

Treatment by or in liaison with medical practitioner or infectious diseases specialist. ... flesh-eating disease

Gluten-sensitive 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

Haemolytic Disease Of Infants

Severe disease of the newly born and infants with jaundice and anaemia. Occurs when a Rhesus negative mother gives birth to a Rhesus positive child. There may be degeneration of nerve cells of the brain through circulating bile. Followed by water-logging of tissues lining lungs, abdomen or heart (hydrops).

Treatment. Purpose of medication is to stimulate flow of bile and support the liver.

Arthur Hyde, MNIMH recommends a selection from the following according to individual case: Balmony, Barberry, Dandelion, Goldenseal, Hops, Ladyslipper, Mistletoe, Passion flower, Stone root. Tinctures. Formula. Marigold 2; Barberry 2; Ginkgo 1. Dose: 2 drops in feed, or in water, thrice daily. Infants 3-5 years: 10 drops.

To be treated by or in liaison with a qualified medical practitioner. ... haemolytic disease of infants

Mites And Disease

Mites are small animals, usually less than 1.2 mm, with 8 legs. Many species have piercing and blood-sucking mouthparts.

Species causing disorders include the scabies mite, which burrows in human skin causing intense itching; the housedust mite, which can cause asthma when inhaled in dust; and chiggers (American harvest mites), which are found in thick grass and cause an itchy rash when they bite. Mites in grain or fruit may cause skin irritation, sometimes known as grocers’ or bakers’ itch.Certain mites transmit diseases, particularly scrub typhus and rickettsial pox.... mites and disease

Osgood–schlatter 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

Legionnaire’s Disease

Non-contagious acute infection affecting the mucous membrane of the lungs. A form of pneumonia, caused by the organism Legionella pneumophilla.

Onset: 2-10 days.

Sources of infection: water-cooling and air-conditioning plants, Aerosols.

Usually attacks those with existing lung weakness. Those with low natural resistance and smokers are most at risk. Epidemic or single cases. Diagnosis confirmed by Haematological laboratory.

Symptoms. High body temperature (above 39°C). Rigor. Shivering. Diarrhoea. Dry cough. Bleeding from stomach and intestines. Mental confusion. Chest pains, shortness of breath, occasional diarrhoea. Differential diagnosis. Glandular fever. Other forms of pneumonia.

Indicated: anti-microbials and expectorants.

Treatment. Formula. Pleurisy root 2; Echinacea root 2; Grindelia quarter. Dose – Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Every 3 hours. Take together with:–

Fenugreek tea. 2 heaped teaspoons seeds to each cup water simmered gently 10 minutes. Drink freely 1 cup. Seeds should be swallowed.

Enema. Strong Yarrow tea enema to control bowel bleeding. ... legionnaire’s disease

Paget’s Disease Of The Nipple

A rare type of breast cancer in which a tumour develops in the nipple.

The disease resembles eczema and can cause itching and a burning feeling.

A non-healing sore may develop.

Without treatment, the tumour may spread into the breast.

Diagnosis is made with a biopsy.... paget’s disease of the nipple

Parkinson’s 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

Perthes’ Disease

Inflammation of an epiphysis of the head of the femur.

The disease is a type of osteochondritis juvenilis, thought to be due to disrupted blood supply to the bone.

The condition is most common in boys aged 5–10, and usually affects 1 hip.

Symptoms include pain in the thigh and groin, and a limp on the affected side.

Diagnosis is made with X-rays.

Treatment may be rest for a few weeks, followed by splinting of the hip, or surgery.

The disease usually clears up by itself within 3 years, but the hip may be permanently deformed.... perthes’ disease

Snails And Disease

Snails act as host to various types of fluke that infest humans, such as liver flukes.... snails and disease

Tay–sachs 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

Creutzfeldt–jakob Disease

A rare, rapidly progressive degenerative condition of the brain. Creutzfeldt–Jakob disease (CJD) is thought to be due to an infection with a prion (slow virus). This is similar to the agent that causes scrapie in sheep and bovine spongiform encephalopathy (BSE) in cattle. One main variant of CJD largely affects middleaged or elderly people and has no obvious cause. A second main variant, occurring in younger people, is associated with contamination during brain surgery or transplants from infected people, or treatment with human growth hormone or gonadotrophin hormones. Recently, a 3rd variant, called new variant (nv) CJD, that attacks people in their teens and 20s has been identified. NvCJD causes pathological changes in the brain similar to those seen in BSEinfected cattle. It is thought to be acquired by eating infected beef.

Symptoms are similar for all variants. Progressive dementia and myoclonus (sudden muscular contractions) occur; muscular coordination diminishes; the intellect and personality deteriorate; and blindness may develop. As the disease progresses, speech is lost and the body becomes rigid. There is no treatment and death usually occurs within 2–3 years.... creutzfeldt–jakob disease

Diet And Disease

Several diseases are linked with diet. Diseases due to a deficiency are rare in developed countries, but many disorders are due partly to overconsumption of certain foods. A diet high in fats may contribute to atherosclerosis and heart disease. A high-fat diet has also been linked with cancer of the bowel (see colon, cancer of) and breast cancer. Obesity increases the risk of many other disorders, including diabetes mellitus and stroke.

Overconsumption of alcohol can lead to various alcohol-related disorders. A high salt intake predisposes a person towards hypertension. Some components of the diet protect against disease. For example, fibre protects against diverticular disease, chronic constipation, and haemorrhoids.

Many people’s diets contain too few natural vitamins. Pregnant women need high intakes of folic acid to reduce the risk of neural tube defects.

Although many illnesses are commonly ascribed to food allergy, it is only rarely that a definite link is proved. (See also nutritional disorders).... diet and disease

Guinea Worm Disease

A tropical disease caused by a female parasitic worm more than 1 m long. Infection is the result of drinking water containing the water flea cyclops, which harbours larvae of the worm. The larvae pass through the intestine and mature in body tissues. After about a year, the adult female worm, now pregnant, approaches the skin surface and creates an inflamed blister that bursts, exposing the end of the worm. Urticaria, nausea, and diarrhoea often develop while the blister is forming. The disease occurs in Africa, South America, the Caribbean, Middle East, and India.

The traditional remedy is to wind the worm from the skin on to a small stick. Once the worm is out, the condition usually clears up. The drugs tiabendazole and niridazole are given to reduce inflammation, antibiotics are given to control secondary infection, and the patient is immunized against tetanus.... guinea worm disease

Valvular Heart Disease

A defect of 1 or more of the heart valves.... valvular heart disease

Vincent’s Disease

A severe form of gingivitis in which bacterial infection causes painful ulceration of the gums.

(See also gingivitis, acute ulcerative.)... vincent’s disease

Werdnig–hoffmann Disease

A very rare inherited disorder of the nervous system that affects infants. Also known as infantile spinal muscular atrophy, Werdnig–Hoffmann disease is a type of motor neuron disease, affecting the nerve cells in the spinal cord that control muscle movement.

Marked floppiness and paralysis occur during the first few months, and affected children rarely survive beyond age 3.

There is no cure for the disease. Treatment aims to keep the affected infant as comfortable as possible.... werdnig–hoffmann disease

Insects And 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

Liver Disease, Alcoholic

Damage to the liver caused by excessive alcohol consumption.

The longer consumption goes on, the more severe the damage.

The initial effect is the formation of fat globules between liver cells, a condition called fatty liver.

This is followed by alcoholic hepatitis, and damage then progresses to cirrhosis.

Alcohol-related liver disease increases the risk of developing liver cancer.

Liver function tests show a characteristic pattern of abnormalities, and liver biopsy may be needed to assess the severity of damage.

There is no particular treatment, but abstinence from alcohol prevents further damage.

Treatment for alcohol dependence may be required.... liver disease, alcoholic

Occupational Disease And Injury

Illnesses, disorders, or injuries that result from exposure to chemicals or dust, or are due to physical, psychological, or biological factors in the workplace.

Pneumoconiosis is fibrosis of the lung due to inhalation of industrial dusts, such as coal. Asbestosis is associated with asbestos in industry. Allergic alveolitis is caused by organic dusts (see farmer’s lung).

Industrial chemicals can damage the lungs if inhaled, or other major organs if they enter the bloodstream via the lungs or skin. Examples include fumes of cadmium, beryllium, lead, and benzene. Carbon tetrachloride and vinyl chloride are causes of liver disease. Many of these compounds can cause kidney damage. Work-related skin disorders include contact dermatitis and squamous cell carcinoma. Rare infectious diseases that are more common in certain jobs include brucellosis and Q fever (from livestock), psittacosis (from birds), and leptospirosis (from sewage). People who work with blood or blood products are at increased risk of viral hepatitis (see hepatitis, viral) and AIDS, as are healthcare professionals. The nuclear industry and some healthcare professions use measures to reduce the danger from radiation hazards. Other occupational disorders include writer’s cramp, carpal tunnel syndrome, singer’s nodes, Raynaud’s phenomenon, deafness, and cataracts.... occupational disease and injury

Albers-schönberg Disease

see osteopetrosis. [H. E. Albers-Schönberg (1865–1921), German radiologist]... albers-schönberg disease

Anderson–fabry Disease

see Fabry disease.... anderson–fabry disease

Asbestos-related Pleural Disease

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

Pulmonary Disease, Chronic Obstructive

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

Ticks And Disease

Small, 8-legged animals that feed on blood and sometimes transmit diseases to humans via their bites. Ticks are about 3 mm long before feeding and become larger when bloated with blood. Ticks may be picked up in long grass, scrub, woodland, or caves.

In the , the only disease known to be transmitted to humans by ticks is Lyme disease. Others transmitted in various parts of the world include relapsing fever, Rocky Mountain spotted fever, Q fever, tularaemia, and certain types of viral encephalitis. The prolonged bite of certain female ticks can cause tick paralysis, in which a toxin in the tick saliva affects the nerves that control movement. In extreme cases, this can be fatal.... ticks and disease

Atheroembolic Renal 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

Autoimmune 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

Batten’s 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

Bazin’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

Best’s Disease

see vitelliform degeneration. [F. Best (20th century), German physician]... best’s disease

Blocq’s Disease

see abasia.... blocq’s disease

Blount 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

Boeck’s Disease

see sarcoidosis. [C. P. M. Boeck (1845–1913), Norwegian dermatologist]... boeck’s disease

Bourneville’s Disease

see tuberous sclerosis. [D.-M. Bourneville (1840–1909), French neurologist]... bourneville’s disease

Caffey’s Disease

see hyperostosis. [J. Caffey (1895–1966), US paediatrician]... caffey’s disease

Calcium Pyrophosphate Deposition 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

Caroli’s 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

Cat-scratch 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

Charcot–marie–tooth Disease

(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

Coats’ Disease

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

Collagen Disease

an obsolete term for *connective-tissue disease.... collagen disease

Communicable Disease Control

the control of disease due to infectious agents or their toxic products. See Consultant in Health Protection.... communicable disease control

Connective-tissue Disease

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

Cortical Lewy Body 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

Deficiency 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

Dense Deposit Disease

see mesangiocapillary glomerulonephritis.... dense deposit disease

Devic’s Disease

see neuromyelitis optica. [E. Devic (1869–1930), French physician]... devic’s disease

Disease-modifying Antirheumatic Drug

(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

Duncan Disease

see X-linked lymphoproliferative syndrome. [Duncan family, in whom the disease was first studied]... duncan disease

Creutzfeldt–jakob Disease

(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

Dent’s 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

Eales’ 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

 fabry 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

Gestational Trophoblastic 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

Goodpasture’s 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

Green Monkey Disease

see Marburg disease.... green monkey disease

Haemorrhagic Disease Of The Newborn

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

Hand–schüller–christian Disease

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

Hartnup 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

Heavy-chain 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

Industrial Disease

see occupational disease.... industrial disease

Iron-storage Disease

see haemochromatosis.... iron-storage disease

Hookworm 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

Kienböck’s 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

Köhler’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

Kugelberg–wellander Disease

(juvenile spinal muscular atrophy) see spinal muscular atrophy. [E. Kugelberg and L. Wellander (20th century), Swedish neurologists]... kugelberg–wellander disease

Kyasanur Forest 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

Legg–calvé–perthes 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

Lesch–nyhan 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

Letterer–siwe Disease

see Langerhans cell histiocytosis. [E. Letterer (20th century) and S. A. Siwe (1897–1966), German physicians]... letterer–siwe disease

Little’s 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

Maple Syrup Urine 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

Marion’s 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

Ménétrier’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

Menkes Kinky-hair 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

Mikulicz’s 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

Milroy’s Disease

see lymphoedema. [W. F. Milroy (1855–1942), US physician]... milroy’s disease

Mixed Connective Tissue 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

Morquio–brailsford 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

Niemann–pick 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

Nonalcoholic Fatty Liver 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

Occupational 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

Ollier’s Disease

see dyschondroplasia. [L. L. X. E. Ollier (1830–1900), French surgeon]

ology combining form. see -logy.... ollier’s disease

Osler–rendu–weber Disease

(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

Pick’s Disease

see frontotemporal dementia. [A. Pick (1851–1924), Czech psychiatrist]... pick’s disease

Pink 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

Plummer’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

Pott’s 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

Pulseless Disease

see Takayasu’s disease.... pulseless disease

Refsum’s 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

Polycystic Disease Of The Kidneys

either of two inherited disorders in which renal cysts are a common feature. Autosomal recessive polycystic kidney disease (ARPKD) occurs in about 1 in 20,000 live births. It is due to a single mutation on chromosome 6 for the gene encoding the protein fibrocystin. The majority of cases are diagnosed before or at birth. The most severely affected fetuses have enlarged kidneys and *oligohydramnios due to poor fetal renal output. These fetuses develop the ‘Potter’ phenotype with characteristic facies, pulmonary hypoplasia, and deformities of the spine and limbs. Those surviving the neonatal period (50–70%) develop varying degrees of renal impairment but this may not proceed to end-stage until early adulthood.

Autosomal dominant polycystic kidney disease (ADPKD) affects between 1 in 400 and 1 in 1000 individuals and is one of the most common hereditary diseases. Two types have been defined. ADPKD 1 is the commonest and responsible for about 85% of cases. It is due to a mutation in the PKD1 gene on chromosome 16, which encodes polycystin 1, an *ion-channel-regulating protein. ADPKD2 is due to a mutation in the PKD2 gene on chromosome 4, which encodes the protein polycystin 2, a calcium-release channel. ADPKD2 tends to be a milder disease with later presentation.

ADPKD is a multisystem disorder that is also associated with cyst formation in other organs (particularly the liver), cardiovascular disorders, and colonic diverticular disease. Renal disease presents in early adult life with haematuria, loin pain, urinary tract infection, hypertension, renal stone disease, or the finding of a mass in the abdomen. Other cases are identified by family contact tracing; the findings of a few cysts on renal ultrasonography in a young adult with a family history of ADPKD is highly suggestive of the disease. Renal disease is progressive and about 50% of patients will have reached end-stage by the time they enter their seventh decade. The progress of the renal failure can be slowed by good blood pressure control. In the UK, patients with ADPKD are responsible for 5–10% of the total on renal replacement therapy.

There are a number of separate rare autosomal dominant conditions other than ADPKD1 and ADPKD 2 that can present with polycystic kidneys. These include *von Hippel-Lindau disease and *tuberous sclerosis.... polycystic disease of the kidneys

Prescribed 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

Ritter’s Disease

see staphylococcal scalded skin syndrome. [G. Ritter von Rittershain (1820–83), German physician]... ritter’s disease

Scheuermann’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

Severe Chronic Upper Airway Disease

(SCUAD) severe *rhinitis and *rhinosinusitis that has not been fully controlled by optimal pharmacological treatment.... severe chronic upper airway disease

Sever’s 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

Sexually Transmitted 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

Takayasu’s 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

Thin Membrane 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

Tsutsugamushi Disease

see scrub typhus.... tsutsugamushi disease

Vaquez–osler Disease

see polycythaemia vera. [L. H. Vaquez (1860–1936), French physician; Sir W. Osler (1849–1919), Canadian physician]... vaquez–osler disease

Variant Creutzfeldt–jakob Disease

(vCJD) see Creutzfeldt–Jakob disease.... variant creutzfeldt–jakob disease

Sickle-cell Disease

(drepanocytosis) a hereditary blood disease that mainly affects people of African ancestry but also occurs in the Mediterranean region and reaches high frequencies in parts of Saudi Arabia and India. It occurs when the sickle-cell gene has been inherited from both parents and is characterized by the production of an abnormal type of *haemoglobin – sickle-cell haemoglobin (Hbs) – which precipitates in the red cells when the blood is deprived of oxygen, forming crystals that distort the cells into the characteristic sickle shape: this process is known as sickling. An excess of sickle cells in the circulation results in blockage of small blood vessels, producing episodes of severe pain (a sickle-cell crisis). Sickle cells are rapidly removed from the circulation, leading to anaemia and jaundice. There is no satisfactory treatment; the highest mortality is in childhood but some patients may live to an age of 60–70 years.

The carrier condition (sickle-cell trait) occurs when the defective gene is inherited from only one parent. It generally causes no symptoms but confers some protection from malaria, which accounts for the high frequency of the gene in malarious areas. If a general anaesthetic is to be given to a patient with this condition, the anaesthetist should be alerted.... sickle-cell disease

Venereal Disease

(VD) see sexually transmitted disease.... venereal disease

Von Hippel–lindau 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

Werdnig–hoffmann 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

Woolsorter’s Disease

see anthrax.... woolsorter’s disease

X-linked Disease

see sex-linked.... x-linked disease

Zymotic 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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