De: From 1 Different Sources
prefix denoting 1. removal or loss. Examples: demineralization (of minerals from bones or teeth); devascularization (of blood supply). 2. reversal.
Irritation or inflammation of the skin... dermatitis
An old name for PLAGUE.... black death
See SUDDEN INFANT DEATH SYNDROME (SIDS).... cot death
A state of weakness.... debility
An aqueous extract of one or a few herbs ; a common method for preparing tea (té) or tizana; typically 2 teaspoons of dried plant material (1/4 cup if fresh) are boiled in hot water, either in a covered pot to trap volatile oils or with the cover removed so that the water boils off for a more concentrated brew; typically, roots and woody, fibrous plant matter are boiled for a longer period of time and flowers or leaves are boiled for a shorter period of time because less time is needed to extract their properties; most Dominican herbal remedies are prepared as decoctions; see also infusion and té.... decoction
Impairment of hearing, which affects about 2 million adults in the UK. In infants, permanent deafness is much less common: about 1–2 per 1,000. It is essential, however, that deafness is picked up early so that appropriate treatment and support can be given to improve hearing and/or ensure that the child can learn to speak.
In most people, deafness is a result of sensorineural hearing impairment, commonly known as nerve deafness. This means that the abnormality is located in the inner ear (the cochlea), in the auditory nerve, or in the brain itself. The prevalence of this type of hearing impairment rises greatly in elderly people, to the extent that more than 50 per cent of the over-70s have a moderate hearing impairment. In most cases no de?nite cause can be found, but contributory factors include excessive exposure to noise, either at work (e.g. shipyards and steelworks) or at leisure (loud music). Anyone who is exposed to gun?re or explosions is also likely to develop some hearing impairment: service personnel, for example.
Conductive hearing impairment is the other main classi?cation. Here there is an abnormality of the external or middle ear, preventing the normal transmission of sound waves to the inner ear. This is most commonly due to chronic otitis media where there is in?ammation of the middle ear, often with a perforation of the ear drum. It is thought that in the majority of cases this is a sequela of childhood middle-ear disease. Many preschool children suffer temporary hearing loss because of otitis media with e?usion (glue ear). Wax does not interfere with hearing unless it totally obstructs the ear canal or is impacted against the tympanic membrane. (See also EAR; EAR, DISEASES OF.)
Treatment Conductive hearing impairment can, in many cases, be treated by an operation on the middle ear or by the use of a hearing aid. Sensorineural hearing impairments can be treated only with a hearing aid. In the UK, hearing aids are available free on the NHS. Most NHS hearing aids are ear-level hearing aids – that is, they ?t behind the ear with the sound transmitted to the ear via a mould in the external ear. Smaller hearing aids are available which ?t within the ear itself, and people can wear such aids in both ears. The use of certain types of hearing aid may be augmented by ?ttings incorporated into the aid which pick up sound directly from television sets or from telephones, and from wire loop systems in halls, lecture theatres and classrooms. More recently, bone-anchored hearing aids have been developed where the hearing aid is attached directly to the bones of the skull using a titanium screw. This type of hearing aid is particularly useful in children with abnormal or absent ear canals who cannot therefore wear conventional hearing aids. People with hearing impairment should seek audiological or medical advice before purchasing any of the many types of hearing aid available commercially. Those people with a hearing impairment which is so profound (‘stone deaf’) that they cannot be helped by a hearing aid can sometimes now be ?tted with an electrical implant in their inner ear (a cochlear implant).
Congenital hearing loss accounts for a very small proportion of the hearing-impaired population. It is important to detect at an early stage as, if undetected and unaided, it may lead to delayed or absent development of speech. Otitis media with e?usion (glue ear) usually resolves spontaneously, although if it persists, surgical intervention has been the traditional treatment involving insertion of a ventilation tube (see GROMMET) into the ear drum, often combined with removal of the adenoids (see NOSE, DISORDERS OF). Recent studies, however, suggest that in many children these operations may provide only transient relief and make no di?erence to long-term outcome.
Advice and information on deafness and hearing aids may be obtained from the Royal National Institute for Deaf People and other organisations.... deafness
(DTs) A distinct neurologic disorder suffered by late-inthe-game alcoholics, characterized by sensory confusion (is it red or sour, hot or loud, smelly or wet, am I thinking or screaming); part of the problem is the result of diminished myelination of nerves and decreased brain antioxidant insulation (cholesterol), with nerve impulses “shorting out” across temporary synapses. It sounds ugly.... delirium tremens
Removing the odour... deodorant
A rare disease, possibly caused by an autoimmune reaction, in which muscle in?ammation and weakness is associated with a characteristic heliotrope ERYTHEMA of the face and backs of the hands. In adults it may be associated with underlying malignancy. Tissue changes are similar to those in POLYMYOSITIS.... dermatomyositis
Depression is a word that is regularly misused. Most people experience days or weeks when they feel low and fed up (feelings that may recur), but generally they get over it without needing to seek medical help. This is not clinical depression, best de?ned as a collection of psychological symptoms including sadness; unhappy thoughts characterised by worry, poor self-image, self-blame, guilt and low self-con?dence; downbeat views on the future; and a feeling of hopelessness. Su?erers may consider suicide, and in severe depression may soon develop HALLUCINATIONS and DELUSIONS.
Doctors make the diagnosis of depression when they believe a patient to be ill with the latter condition, which may affect physical health and in some instances be life-threatening. This form of depression is common, with up to 15 per cent of the population suffering from it at any one time, while about 20 per cent of adults have ‘medical’ depression at some time during their lives – such that it is one of the most commonly presenting disorders in general practice. Women seem more liable to develop depression than men, with one in six of the former and one in nine of the latter seeking medical help.
Manic depression is a serious form of the disorder that recurs throughout life and is manifested by bouts of abnormal elation – the manic stage. Both the manic and depressive phases are commonly accompanied by psychotic symptoms such as delusions, hallucinations and a loss of sense of reality. This combination is sometimes termed a manic-depressive psychosis or bipolar affective disorder because of the illness’s division into two parts. Another psychiatric description is the catch-all term ‘affective disorder’.
Symptoms These vary with the illness’s severity. Anxiety and variable moods are the main symptoms in mild depression. The sufferer may cry without any reason or be unresponsive to relatives and friends. In its more severe form, depression presents with a loss of appetite, sleeping problems, lack of interest in and enjoyment of social activities, tiredness for no obvious reason, an indi?erence to sexual activity and a lack of concentration. The individual’s physical and mental activities slow down and he or she may contemplate suicide. Symptoms may vary during the 24 hours, being less troublesome during the latter part of the day and worse at night. Some people get depressed during the winter months, probably a consequence of the long hours of darkness: this disorder – SEASONAL AFFECTIVE DISORDER SYNDROME, or SADS – is thought to be more common in populations living in areas with long winters and limited daylight. Untreated, a person with depressive symptoms may steadily worsen, even withdrawing to bed for much of the time, and allowing his or her personal appearance, hygiene and environment to deteriorate. Children and adolescents may also suffer from depression and the disorder is not always recognised.
Causes A real depressive illness rarely has a single obvious cause, although sometimes the death of a close relative, loss of employment or a broken personal relationship may trigger a bout. Depression probably has a genetic background; for instance, manic depression seems to run in some families. Viral infections sometimes cause depression, and hormonal disorders – for example, HYPOTHYROIDISM or postnatal hormonal disturbances (postnatal depression) – will cause it. Di?cult family or social relations can contribute to the development of the disorder. Depression is believed to occur because of chemical changes in the transmission of signals in the nervous system, with a reduction in the neurochemicals that facilitate the passage of messages throughout the system.
Treatment This depends on the type and severity of the depression. These are three main forms. PSYCHOTHERAPY either on a one-to-one basis or as part of a group: this is valuable for those whose depression is the result of lifestyle or personality problems. Various types of psychotherapy are available. DRUG TREATMENT is the most common method and is particularly helpful for those with physical symptoms. ANTIDEPRESSANT DRUGS are divided into three main groups: TRICYCLIC ANTIDEPRESSANT DRUGS (amitriptyline, imipramine and dothiepin are examples); MONOAMINE OXIDASE INHIBITORS (MAOIS) (phenelzine, isocarboxazid and tranylcypromine are examples); and SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS) (?uoxetine – well known as Prozac®, ?uvoxamine and paroxetine are examples). For manic depression, lithium carbonate is the main preventive drug and it is also used for persistent depression that fails to respond to other treatments. Long-term lithium treatment reduces the likelihood of relapse in about 80 per cent of manic depressives, but the margin between control and toxic side-effects is narrow, so the drug must be carefully supervised. Indeed, all drug treatment for depression needs regular monitoring as the substances have powerful chemical properties with consequential side-effects in some people. Furthermore, the nature of the illness means that some sufferers forget or do not want to take the medication. ELECTROCONVULSIVE THERAPY (ECT) If drug treatments fail, severely depressed patients may be considered for ECT. This treatment has been used for many years but is now only rarely recommended. Given under general anaesthetic, in appropriate circumstances, ECT is safe and e?ective and may even be life-saving, though temporary impairment of memory may occur. Because the treatment was often misused in the past, it still carries a reputation that worries patients and relatives; hence careful assessment and counselling are essential before use is recommended.
Some patients with depression – particularly those with manic depression or who are a danger to themselves or to the public, or who are suicidal – may need admission to hospital, or in severe cases to a secure unit, in order to initiate treatment. But as far as possible patients are treated in the community (see MENTAL ILLNESS).... depression
A canal connecting vas efferens to cirrus.... vas deferens
See HEART, DISEASES OF – Congenital heart disease.... atrial septal defect
The proportion of deaths in a specified population. The death rate is calculated by dividing the number of deaths in a population in a year by the midyear resident population. Death rates are often expressed as the number of deaths per 100 000 persons. The rate may be restricted to deaths in specific age, race, sex, or geographic groups or deaths from specific causes of death (specific rate), or it may be related to the entire population (crude rate).... death rate
The surgical removal of foreign material and damaged tissue from a wound.... debridement
Relieving congestion, as of the mucous membrane... decongestant
The breaking open of a wound that is partly healed, usually after surgery.... dehiscence
A feeling of having already experienced an event which the person is doing or seeing at the moment. French for ‘already seen’, déjà vu is quite common but no satisfactory explanation for the phenomenon has yet been discovered.... déjà vu
The ?nal expulsion of the child in the act of birth. (See PREGNANCY AND LABOUR.)... delivery
The powerful triangular muscle attached above to the collar-bone and shoulder-blade, and below, by its point, to the humerus, nearly halfway down the outer side of the upper arm. Its action is to raise the arm from the side, and it covers and gives roundness to the shoulder. (See also MUSCLE.)... deltoid
The study of populations, especially with reference to size and density, fertility, mortality, growth, age distribution, migration and vital statistics, and the interaction of all of these with social and economic conditions.... demography
Destruction of the fatty MYELIN sheath around nerve ?bres (see NERVE: NEURON(E)) which interferes with the nerve function. It can occur after injury to the nerve, but is particularly associated with MULTIPLE SCLEROSIS (MS).... demyelination
A branching ULCER on the surface of the cornea of the eye, caused by HERPES SIMPLEX infection.... dendritic ulcer
Any liquid, paste or powder used for cleansing the teeth.... dentifrice
A plate or frame bearing false teeth. It may be complete (replacing all the teeth in one jaw) or partial.... denture
See DNA.... deoxyribonucleic acid
Physical or psychological reliance on a substance or an individual. A baby is naturally dependent on its parents, but as the child develops, this dependence lessens. Some adults, however, remain partly dependent, making abnormal demands for admiration, love and help from parents, relatives and others.
The dependence that most concerns modern society is one in which individuals become dependent on or addicted to certain substances such as alcohol, drugs, tobacco (nicotine), caffeine and solvents. This is often called substance abuse. Some people become addicted to certain foods or activities: examples of the latter include gambling, computer games and use of the Internet.
The 28th report of the World Health Organisation Expert Committee on Drug Dependence in 1993 de?ned drug dependence as: ‘A cluster of physiological, behavioural and cognitive phenomena of variable intensity, in which the use of a psychoactive drug (or drugs) takes on a high priority. The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and persistent drug-seeking behaviour. Psychological dependence occurs when the substance abuser craves the drug’s desirable effects. Physical dependence occurs when the user has to continue taking the drug to avoid distressing withdrawal or abstinence symptoms. Thus, determinants and the problematic consequences of drug dependence may be biological, psychological or social and usually interact.’
Di?erent drugs cause di?erent rates of dependence: TOBACCO is the most common substance of addiction; HEROIN and COCAINE cause high rates of addiction; whereas ALCOHOL is much lower, and CANNABIS lower again. Smoking in the western world reached a peak after World War II with almost 80 per cent of the male population smoking. The reports on the link between smoking and cancer in the early 1960s resulted in a decline that has continued so that only around a quarter of the adult populations of the UK and USA smokes. Globally, tobacco consumption continues to grow, particularly in the developing world with multinational tobacco companies marketing their products aggressively.
Accurate ?gures for illegal drug-taking are hard to obtain, but probably approximately 4 per cent of the population is dependent on alcohol and 2 per cent on other drugs, both legal and illegal, at any one time in western countries.
How does dependence occur? More than 40 distinct theories or models of drug misuse have been put forward. One is that the individual consumes drugs to cope with personal problems or diffculties in relations with others. The other main model emphasises environmental in?uences such as drug availability, environmental pressures to consume drugs, and sociocultural in?uences such as peer pressure.
By contrast to these models of why people misuse drugs, models of compulsive drug use – where individuals have a compulsive addiction
– have been amenable to testing in the laboratory. Studies at cellular and nerve-receptor levels are attempting to identify mechanisms of tolerance and dependence for several substances. Classical behaviour theory is a key model for understanding drug dependence. This and current laboratory studies are being used to explain the reinforcing nature of dependent substances and are helping to provide an explanatory framework for dependence. Drug consumption is a learned form of behaviour. Numerous investigators have used conditioning theories to study why people misuse drugs. Laboratory studies are now locating the ‘reward pathways’ in the brain for opiates and stimulants where positive reinforcing mechanisms involve particular sectors of the brain. There is a consensus among experts in addiction that addictive behaviour is amenable to e?ective treatment, and that the extent to which an addict complies with treatment makes it possible to predict a positive outcome. But there is a long way to go before the mechanisms of drug addiction are properly understood or ways of treating it generally agreed.
Effects of drugs Cannabis, derived from the plant Cannabis sativa, is a widely used recreational drug. Its two main forms are marijuana, which comes from the dried leaves, and hashish which comes from the resin. Cannabis may be used in food and drink but is usually smoked in cigarettes to induce relaxation and a feeling of well-being. Heavy use can cause apathy and vagueness and may even cause psychosis. Whether or not cannabis leads people to using harder drugs is arguable, and a national debate is underway on whether its use should be legalised for medicinal use. Cannabis may alleviate the symptoms of some disorders – for example, MULTIPLE SCLEROSIS (MS) – and there are calls to allow the substance to be classi?ed as a prescribable drug.
About one in ten of Britain’s teenagers misuses volatile substances such as toluene at some time, but only about one in 40 does so regularly. These substances are given o? by certain glues, solvents, varnishes, and liquid fuels, all of which can be bought cheaply in shops, although their sale to children under 16 is illegal. They are often inhaled from plastic bags held over the nose and mouth. Central-nervous-system excitation, with euphoria and disinhibition, is followed by depression and lethargy. Unpleasant effects include facial rash, nausea and vomiting, tremor, dizziness, and clumsiness. Death from COMA and acute cardiac toxicity is a serious risk. Chronic heavy use can cause peripheral neuropathy and irreversible cerebellar damage. (See SOLVENT ABUSE (MISUSE).)
The hallucinogenic or psychedelic drugs include LYSERGIC ACID DIETHYLAMIDE (LSD) or acid, magic mushrooms, ecstasy (MDMA), and phencyclidine (PCP or ‘angel’ dust, mainly used in the USA). These drugs have no medicinal uses. Taken by mouth, they produce vivid ‘trips’, with heightened emotions and perceptions and sometimes with hallucinations. They are not physically addictive but can cause nightmarish bad trips during use and ?ashbacks (vivid reruns of trips) after use, and can probably trigger psychosis and even death, especially if drugs are mixed or taken with alcohol.
Stimulant drugs such as amphetamine and cocaine act like adrenaline and speed up the central nervous system, making the user feel con?dent, energetic, and powerful for several hours. They can also cause severe insomnia, anxiety, paranoia, psychosis, and even sudden death due to convulsions or tachycardia. Depression may occur on withdrawal of these drugs, and in some users this is su?ciently deterrent to cause psychological dependence. Amphetamine (‘speed’) is mainly synthesised illegally and may be eaten, sni?ed, or injected. Related drugs, such as dexamphetamine sulphate (Dexedrine), are prescribed pills that enter the black market. ECSTASY is another amphetamine derivative that has become a popular recreational drug; it may have fatal allergic effects. Cocaine and related drugs are used in medicine as local anaesthetics. Illegal supplies of cocaine (‘snow’ or ‘ice’) and its derivative, ‘crack’, come mainly from South America, where they are made from the plant Erythroxylon coca. Cocaine is usually sni?ed (‘snorted’) or rubbed into the gums; crack is burnt and inhaled.
Opiate drugs are derived from the opium poppy, Papaver somniferum. They are described as narcotic because they induce sleep. Their main medical use is as potent oral or injectable analgesics such as MORPHINE, DIAMORPHINE, PETHIDINE HYDROCHLORIDE, and CODEINE. The commonest illegal opiate is heroin, a powdered form of diamorphine that may be smoked, sni?ed, or injected to induce euphoria and drowsiness. Regular opiate misuse leads to tolerance (the need to take ever larger doses to achieve the same e?ect) and marked dependence. A less addictive oral opiate, METHADONE HYDROCHLORIDE, can be prescribed as a substitute that is easier to withdraw.
Some 75,000–150,000 Britons now misuse opiates and other drugs intravenously, and pose a huge public-health problem because injections with shared dirty needles can carry the blood-borne viruses that cause AIDS/HIV and HEPATITIS B. Many clinics now operate schemes to exchange old needles for clean ones, free of charge. Many addicts are often socially disruptive.
For help and advice see APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELF-HELP – National Dugs Helpline.
(See ALCOHOL and TOBACCO for detailed entries on those subjects.)... dependence
An agent that purifies blood... depurative
Dermographism, or factitious URTICARIA, refers to transient ERYTHEMA and wealing caused by trauma to the skin.... dermographism
See CYSTS.... dermoid cyst
An agent which binds to heavy metals, used in the treatment of iron poisoning and THALASSAEMIA.... desferrioxamine
A CORTICOSTEROIDS derivative. As an antiin?ammatory agent it is approximately 30 times as e?ective as cortisone and eight times as e?ective as prednisolone. On the other hand, it has practically none of the salt-retaining properties of cortisone.... dexamethasone
A condition in which a person’s heart is situated on the right of the chest in a mirror image of its usual position. This may be associated with similar inversion of the abdominal organs – situs inversus.... dextrocardia
Another name for puri?ed grape sugar or glucose. A common constituent of intravenous ?uids.... dextrose
A substantial reduction in the volume of SENSORY information impinging on the body – for instance, sitting in a dark, silent room. Prolonged deprivation is potentially harmful as the body needs constant stimulation in order to function normally. The main input organs are the eyes, ears, skin and nose. The absence of sensations disorients a person and results in neurological dysfunction. Some interrogation techniques involve sensory deprivation to ‘soften up’ the individual being questioned.... sensory deprivation
Any type of pleasurable sexual practice which society regards as abnormal. Deviation may be related to the activity, such as EXHIBITIONISM or sadomasochistic sex (see SADISM; MASOCHISM); or to the sexual object, for example, shoes or clothes (fetishism). Di?erent cultures have di?erent values, and treatment is probably not required unless the deviation is antisocial or harmful to the participant(s). Aversion therapy, or the conditioning of a person’s behaviour, may help if treatment is considered necessary.... sexual deviation
A congenital abnormality of the HEART affecting about 260 babies in every 100,000, in which there is a hole in the septum – the dividing wall – between the left and right sides of the heart. The effects of the defect depend upon its size and position. A defect in the wall between the atria (upper chambers of the heart) is called an atrial septal defect, and that between the ventricles, a ventricular septal defect – the most common form (25 per cent of all defects). Both defects allow blood to circulate from the left side of the heart, where pressures are highest, to the right. This abnormal ?ow of blood is described as a ‘shunt’ and the result is that too much blood ?ows into the lungs. PULMONARY HYPERTENSION occurs and, if the shunt is large, heart failure may develop. A small septal defect may not need treatment but a large one will need to be repaired surgically.... septal defect
A measure of the amount by which each value deviates from the mean; equal to the square root of the variance, i.e. the square root of the average of the squared deviations from the mean. It is the most commonly used measure of dispersion of statistical data.... standard deviation
An inherited defect of the HEART. The septum (partition) separating the two ventricles is pierced by a hole which, if large, results in blood being diverted to the LUNGS at a greater pressure than normal. This may lead to irreversible PULMONARY HYPERTENSION, which early surgical intervention (repair of the septal defect) should prevent. A quarter of patients with VSD have other cardiac defects. Half of the defects seal themselves spontaneously.... ventricular septal defect
One third of those taking tranquillisers become addicted. One of the problems of psychological dependence is the discomfort of withdrawal symptoms.
Symptoms. Tremors, restlessness, nausea and sleep disturbance. The greater potency of the drug, the higher the rebound anxiety. Many drugs create stress, weaken resistance to disease, tax the heart and raise blood sugar levels.
Drugs like Cortisone cause bone loss by imperfect absorption of calcium. Taken in the form of milk and dairy products, calcium is not always absorbed. Herbs to make good calcium loss are: Horsetail, Chickweed, Slippery Elm, Spinach, Alfalfa.
Agents to calm nerves and promote withdrawal may augment a doctor’s prescription for reduction of drug dosage, until the latter may be discontinued. Skullcap and Valerian offer a good base for a prescription adjusted to meet individual requirements.
Alternatives. Teas: German Chamomile, Gotu Kola, Hops, Lime flowers, Hyssop, Alfalfa, Passion flower, Valerian, Mistletoe, Oats, Lavender, Vervain, Motherwort. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; half-1 cup thrice daily.
Decoctions: Valerian, Devil’s Claw, Siberian Ginseng, Lady’s Slipper. Jamaica Dogwood, Black Cohosh.
Tablets/capsules. Motherwort, Dogwood, Valerian, Skullcap, Passion flower, Mistletoe, Liquorice. Powders. Formulae. Alternatives. (1) Combine equal parts Valerian, Skullcap, Mistletoe. Or, (2) Combine Valerian 1; Skullcap 2; Asafoetida quarter. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily. Formula No 2 is very effective but offensive to taste and smell.
Practitioner. Tincture Nucis vom. once or twice daily, as advised.
Aloe Vera gel (or juice). Russians tested this plant on rabbits given heavy drug doses and expected to die. Their survival revealed the protective property of this plant: dose, 1 tablespoon morning and evening. Aromatherapy. Sniff Ylang Ylang oil. Lavender oil massage for its relaxing and stress-reducing properties.
Diet. Avoid high blood sugar levels by rejecting alcohol, white flour products, chocolate, sugar, sweets and high cholesterol foods.
Supplements. Daily. Multivitamins, Vitamin B-complex, B6, Vitamin C 2g, Minerals: Magnesium, Manganese, Iron, Zinc. Change of lifestyle. Stop smoking. Yoga.
Notes. “Do not withdraw: insulin, anticoagulants, epileptic drugs, steroids, thyroxin and hormone replacement therapy (the endocrine glands may no longer be active). Long-term tranquillisers e.g., Largactil or any medicament which has been used for a long period. Patients on these drugs are on a finely-tuned medication the balance of which may be easily disturbed.” (Simon Mills, FNIMH)
Counselling and relaxation therapy.
The Committee on Safety of Medicines specifically warns against the abrupt cessation of the Benzodiazepines and similar tranquillisers because of the considerable risk of convulsions. ... drug dependence
Alcohol dependence, or alcoholism, is described under ALCOHOL but a summary of the symptoms may be helpful in spotting the disorder. Behavioural symptoms vary but include furtiveness; aggression; inappropriately generous gestures; personality changes (sel?shness, jealousy, irritability and outbursts of anger); empty promises to stop drinking; poor appetite; scru?y appearance; and long periods of drunkenness.... alcohol dependence
See CONGENITAL.... birth defects
See BREECH PRESENTATION.... breech delivery
Various forms of group judgement in which a group (or panel) of experts interacts in assessing an intervention and formulating findings by vote or other informal or formal means, involving such techniques as the nominal group and Delphi techniques.... consensus development
The process of removal of the amino group, NH2, from amino acids not required for building up body PROTEIN. This is carried out mainly in the liver by means of an enzyme, deaminase. The fatty acid residue is either burnt up to yield energy, or is converted into glucose.... deamination
See TEETH, DISORDERS OF – Caries of the teeth.... decay, dental
The unit of hearing. One decibel is the least intensity of sound at which a given note can be heard. The usual abbreviation for decibel is dB.... decibel
The soft coat which lines the interior of the womb during pregnancy and which is cast o? at birth.... decidua
The failure of the heart to maintain full and adequate circulation.... decompensation
Decubitus refers to the positions taken up in bed by patients suffering from various conditions such as pneumonia, PERITONITIS, or severe exhaustion. Such patients are liable to develop bed sores, or decubitus ulcer (see ULCER).... decubitus
Any point in the nervous system at which nerve ?bres cross from one side to the other: for example, the decussation of the pyramidal tracts in the medulla (see BRAIN), where the motor ?bres from one side of the brain cross to the other side of the spinal cord.... decussation
Opening the bowels. (See CONSTIPATION; DIARRHOEA.)... defaecation
An umbrella description for a wide variety of conditions in which there is increased deterioration of the structure or function (or both) of the body. Ageing causes a steady degeneration of many tissues and organs – for example, wrinkling of the skin, CATARACT and poor neuromuscular coordination. In degenerative disorders the changes occur earlier in life. The nervous system, muscles, arteries, joints and eyes are all susceptible. Specialised tissues are replaced by CONNECTIVE TISSUE. The commonest example in the nervous system is ALZHEIMER’S DISEASE, which causes dementia; while in HUNTINGTON’S CHOREA, a genetic disorder, dementia is accompanied by incoordination of movements.... degenerative disorders
Deglutition means the act of swallowing. (See CHOKING.)... deglutition
Delhi boil is a form of chronic body sore occurring in Eastern countries, caused by a protozoan parasite, Leishmania tropica. (See LEISHMANIASIS.)... delhi boil
Behaviour by a young person that would be judged a crime if carried out by an adult. Delinquency may also include non-criminal activities – for example, running away from home, missing school lessons, drug or alcohol abuse, and unruly behaviour in public places. Delinquency is now a serious social problem in the UK, especially in deprived areas, and it is increasingly accompanied by alcohol and drug abuse.... delinquency
(Greek) A petite woman; half Demie, Demee, Demy, Demey, Demye, Demia, Demiana, Demiane, Demianne, Demianna, Demiann, Demea, Demeah... demi
Interruption of the nerve supply to an organ or other structure.... denervation
1 The lower portion of a fraction used to calculate a rate or ratio. In a rate, the denominator is usually the population at risk. 2 For a performance measure, the sample of cases that will be observed (e.g. the number of patients discharged alive with a confirmed diagnosis of acute myocardial infarction, excluding patients with bleeding or other specified conditions). See “numerator”.... denominator
Decay of teeth... dental caries
See TEETH, DISORDERS OF.... dental emergencies
See DENTAL SURGEON.... dentist
Dermabrasion, or ‘skin planing’, is a method of removing the super?cial layers of the skin, useful in the treatment of tattoos and acne scars.... dermabrasion
Dermatoglyphics is the study of the patterns made by the ridges and crevices of the hands and the soles of the feet.... dermatoglyphics
In essence, this is the study of the skin. As well as being an organ in its own right, the skin is a stage on which other organs as well as the emotions most visibly play out their roles. Changes in its blood vessels – and hence blood ?ow through the skin – may indicate a major immunological response to a range of potential factors (see SKIN, DISEASES OF).... dermatology
Mould fungi belonging to the genera Microsporum, Trichophyton or Epidermophyton. Cause tinea or ringworm.... dermatophyte
A central nervous system stimulant (see amfetamine drugs; stimulant drugs) sometimes used to treat narcolepsy. It is also used in children with attention deficit hyperactivity disorder. Because of its stimulant properties, dexamfetamine has become a drug of abuse. With prolonged use, the stimulant effects lessen and a higher dose must be taken to produce the same effect.... dexamfetamine
A group of chemical substances produced illegally whose properties and effects are similar to those of drugs of abuse. They may be derived from narcotic ANALGESICS, AMPHETAMINES or HALLUCINOGENS. Ecstasy is a widely used designer drug and has caused deaths among teenagers. Designer drugs are potentially dangerous, especially if taken with alcohol.... designer drugs
The scaling-o? of the super?cial layer of the epidermis (see SKIN).... desquamation
Separation of the retina from the choroid in the EYE. It may be due to trauma or be secondary to tumour or in?ammation of the choroid, and causes blindness in the affected part of the retina. It can be treated surgically using PHOTOCOAGULATION.... detached retina
Variation from normal. Often used to describe unusual sexual behaviour.... deviance
The name given to a group of polysaccharides ?rst discovered in sugar-beet preparations which had become infected with certain bacteria. A homogenous preparation of dextran, with a consistent molecular weight and free from PROTEIN, is in appropriate clinical circumstances used as a substitute for plasma for TRANSFUSION purposes. Dextran is often used as an immediate transfusion measure to treat severe bleeding or certain types of shock until properly cross-matched blood is available. A blood sample for cross-matching must be taken before intravenous dextran is given.... dextran
As a result of ANAEMIA, interference with blood or nerve supply, or because of the action of various poisons, body cells may undergo abnormal changes accompanied by the appearance in their substance of fat droplets.... fatty degeneration
A statutory body set up by the Dentists Act which maintains a register of dentists (see DENTAL SURGEON), promotes high standards of dental education, and oversees the professional conduct of dentists. Membership comprises elected and appointed dentists and appointed lay members. Like other councils responsible for registering health professionals, the General Dental Council now comes under the umbrella of the new Council for Regulatory Excellence, a statutory body. (See APPENDIX 7: STATUTORY ORGANISATIONS.)... general dental council
See DENTAL SURGEON.... general dental services
A hospital unit equipped and sta?ed to nurse patients who require a high level of technically supported care. Patients are usually moved to such units when they have made satisfactory progress in an INTENSIVE THERAPY UNIT (ITU) and do not require the one-to-one nursing necessary in ITUs. Patients who have undergone major surgery are often transferred from the recovery ward to a high dependency unit until they are well enough to be cared for in a standard ward.... high dependency unit
Manic depression, or CYCLOTHYMIA, is a form of MENTAL ILLNESS characterised by alternate attacks of mania and depression.... manic depression
Congenital abnormalities resulting from the failure of the NEURAL TUBE to form normally. The resulting conditions include SPINA BIFIDA, MENINGOCELE and defects in the bones of the SKULL.... neural tube defects
See PAGET’S DISEASE OF BONE.... osteitis deformans
A degenerative condition of the SPINAL CORD which most commonly occurs as a complication of PERNICIOUS ANAEMIA. The motor and sensory nerves in the cord are damaged, causing spasticity of the limbs and an unsteady gait. Treatment is with vitamin B12 (see APPENDIX 5: VITAMINS).... subacute combined degeneration of the cord
Another term for a bowel movement to expel wastes from the body. Also applies to a colostomy where faeces are voided through an artificial opening. ... defecation
Treatment same as for irritable bowel or diarrhoea. ... delhi belly
A herb of strong cleaning properties such as Soapwort for use on the skin. Balmony, Southernwood, Marigold, Chickweed, Goldenseal, Daisy. ... detergent
The irreversible cessation of all functions of the brain, including the brainstem. (See also death.)... brain death
The state of being without a functioning cerebrum, the main controlling part of the brain. It occurs if the brainstem is severed, which effectively isolates the cerebrum.... decerebrate
See primary teeth.... deciduous teeth
See bedsores.... decubitus ulcer
See thrombosis, deep vein.... deep vein thrombosis
A fixed, irrational idea not shared by others and not responding to reasoned argument. The idea in a paranoid delusion involves persecution or jealousy. For instance, a person may falsely believe that he or she is being poisoned (see paranoia). Persistent delusions are a sign of serious mental illness, most notably schizophrenia and manic–depressive illness. (See also hallucination; illusion.)... delusion
A chemical hair remover, such as barium sulphide, used in the form of a cream or paste for cosmetic reasons and to treat hirsutism.... depilatory
The inner layer of the skin.... dermis
A technique, used in behaviour therapy for treating phobias, in which the patient is gradually exposed to the cause of the fear.... desensitization
A synthetic form of ADH (antidiuretic hormone) that is used to treat diabetes insipidus and bed-wetting (see enuresis).... desmopressin
One of a group of proteins that transport lipids in the blood. High levels of high density lipoprotein can help protect against atherosclerosis. (See also fats and oils; low density lipoprotein.)... high density lipoprotein
See IUD.... intrauterine contraceptive device
(derma-, dermo-, dermat(o)-) combining form denoting the skin.... derm
adj. relating to or affecting the skin, especially the *dermis.... dermal
A severe manifestation of infection with the Human immunodeficiency virus (HIV).... acquired immune deficiency syndrome (aids)
Equipment that enables an individual who requires assistance to perform the daily activities essential to maintain health and autonomy and to live as full a life as possible. Such equipment may include, for example, motorized scooters, walkers, walking sticks, grab rails and tilt-and-lift chairs.... assistive device
A lifelong disorder characterised by overactive behaviour, short attention span and poor concentration. It is thought to be caused by a minor abnormality that affects the part of the brain that allows us to concentrate and focus on tasks. Some scientists have suggested that it may be caused by particular foods, particularly processed foods containing arti?cial additives, and recommend special diets. In some countries, attention de?cit disorder is diagnosed in up to a tenth of all children; this may re?ect di?erences in paediatric practice and diagnosis rather than a real variation in prevalence of the disorder. Behaviour therapy is the main treatment. Those children with very severe symptoms of restlessness, short attention span and disturbed behaviour may respond to additional treatment with methylphenidate (Ritalin®). This is an amphetamine-like drug that is thought to stimulate the part of the brain that is not working properly. Use of this drug has, however, been controversial.... attention deficit disorder (hyperactivity syndrome)
The ratio of the number of new cases of the disease and the amount of population-time of follow-up (e.g. person-year) of the disease-free population.... average incidence density
Rubus speciesDescription: These plants have prickly stems (canes) that grow upward, arching back toward the ground. They have alternate, usually compound leaves. Their fruits may be red, black, yellow, or orange.Habitat and Distribution: These plants grow in open, sunny areas at the margin of woods, lakes, streams, and roads throughout temperate regions. There is also an arctic raspberry.Edible Parts: The fruits and peeled young shoots are edible. Flavor varies greatly.Other Uses: Use the leaves to make tea. To treat diarrhea, drink a tea made by brewing the dried root bark of the blackberry bush.... blackberry, raspberry, and dewberry
See APPENDIX 8: PROFESSIONAL ORGANISATIONS.... british dental association
The decline in value of capital assets (assets of a permanent or fixed nature, such as goods and plant) with use over time. The rate and amount of depreciation is calculated by a variety of different methods (e.g. straight line, sum of the digits, declining balance), which often give quite different results.... capital depreciation
Slowing the action of the heart... cardiac depressant
Persons with chronic illnesses and/or impairments which lead to long-lasting disabilities in functioning and reliance on care (personal care, domestic life, mobility, self direction).... care-dependent
For the purpose of national mortality statistics, every death is attributed to one underlying condition, based on information reported on the death certificate and using the international rules for selecting the underlying cause of death from the reported conditions. See “International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10)”.... cause of death
Cause-of-death ranking for adults is based on the List of 72 Selected Causes of Death, HIV Infection, and Alzheimer’s Disease. The List was adapted from one of the special lists for mortality tabulations recommended for use with the International Classification of Diseases, ninth revision. Two group titles – “Major cardiovascular diseases” and “Symptoms, signs, and ill-defined conditions” – are not ranked based on the list of 72 selected causes. In addition, category titles that begin with the words “other” and “all other” are not ranked. The remaining category titles are ranked according to number of deaths to determine the leading causes of death. When one of the titles that represents a subtotal is ranked (for example, unintentional injuries), its component parts are not ranked (in this case, motor vehicle crashes and all other unintentional injuries).... cause-of-death ranking
The term for describing the persistent and involuntary turning of both eyes in any one direction, and is a sign of a lesion in the brain.... conjugate deviation
See RAYNAUD’S DISEASE.... dead fingers
Gas exchange only occurs in the terminal parts of the pulmonary airways (see LUNGS). That portion of each breath that is taken into the lungs but does not take part in gas exchange is known as dead space. Anatomical dead space describes air in the airways up to the terminal BRONCHIOLES. Physiological dead space also includes gas in alveoli (air sacs) which are unable to take part in gas exchange because of structural abnormalities or disease.... dead space
The popular name of Atropa belladonna, from which ATROPINE is procured. Its poisonous black berries are sometimes eaten by children.... deadly nightshade
(Roxb.) Loud.
Synonym: C. libani Barrel. var. deodara Hook. f.
Family: Pinaceae.
Habitat: North-western Himalayas from Kashmir to Garhwal, from 1,000 to 3,500 m.
English: Himalayan Cedar, Deodar.
Ayurvedic: Devadaaru, Suradru- ma, Suradaaru, Devakaashtha, Devadruma, Saptapatrika, Daaru, Bhadradaaru, Amarataru, Ama- radaaru, Daaruka, Devaahvaa, Surataru, Surabhuruha.
Unani: Deodaar.
Siddha/Tamil: Thevathaaram.
Action: Bark—decoction is used internally as astringent, antidiarrhoeal and febrifuge. Essential oil—antiseptic (used in skin diseases).
The Ayurvedic Pharmacopoeia of India indicated the use of the heart- wood in puerperal diseases.The wood contains sesquiterpeno- ids; exhibits sapasmolytic activity. Alcoholic extract of the wood showed marked anti-inflammatory activity in mice; alcoholic extract showed antibacterial activity.The wood possesses diaphoretic, diuretic and carminative properties, and is used in fevers and in pulmonary and urinary disorders.Himalayan Cedarwood Oil contains two major sesquiterpenoids—alpha- and beta-himchalenes. Presence ofbu- tyric and caproic acids is also reported. The oil shows in vitro antibacterial and antifungal activity. It increases vascular permeability. Needles, on steam distillation, yield a volatile oil, rich in borneol and its esters. An alcoholic extract of the needles shows significant antibacterial activity against diptheria bacteria. The juice shows antiviral activity against tobacco mosaic virus and potato virus.The bark contains 8-C methyltaxi- foline, dihydroquercetin, 8-C methyl- quercetin, quercetin, sitosterol, and tannins 8.25%, non-tannins 6.95% (varies with the age of the tree). An alcoholic extract of the bark shows significant activity against diptheria bacteria; aqueous extract of the dried bark showed anti-inflammatory activ ity against acute and chronic inflammations. Aqueous extract of the bark is found effective in reducing sugar content of diabetic patient's urine and blood to normal levels.
Dosage: Heartwood—3-6 g powder. (API Vol. IV.)... cedrus deodara
A certi?cate required by law to be signed by a medical practitioner stating the main and any contributary causes of a person’s death.... death certificate
(Hebrew) Resembling a bee; in the Bible, a prophetess Debbera, Debbey, Debbi, Debbie, Debbra, Debby, Debee, Debera, Deberah, Debi, Debor, Debora, Debra, Debrah, Debralee, Debreanna, Debriana, Debs, Devora, Devorah, Deb, Debb, Debbee, Dobra, Devoria, Debira, Debiria, Devorit, Devra, Devri... deborah
Screening and surveillance uncover problems which then need careful attention. Most NHS districts have a CDT to carry out this task – working from child development centres – usually separate from hospitals. Various therapists, as well as consultant paediatricians in community child health, contribute to the work of the team. They include physiotherapists, occupational therapists, speech therapists, psychologists, health visitors and, in some centres, pre-school teachers or educational advisers and social workers. Their aims are to diagnose the child’s problems, identify his or her therapy needs and make recommendations to the local health and educational authorities on how these should be met. A member of the team will usually be appointed as the family’s ‘key worker’, who liaises with other members of the team and coordinates the child’s management. Regular review meetings are held, generally with parents sharing in the decisions made. Mostly children seen by CDTs are under ?ve years old, the school health service and educational authorities assuming responsibility thereafter.
Special needs The Children Act 1989, Education Acts 1981, 1986 and 1993, and the Chronically Sick and Disabled Persons Legislation 1979 impose various statutory duties to identify and provide assistance for children with special needs. They include the chronically ill as well as those with impaired development or disabilities such as CEREBRAL PALSY, or hearing, vision or intellectual impairment. Many CDTs keep a register of such children so that services can be e?ciently planned and evaluated. Parents of disabled children often feel isolated and neglected by society in general; they are frequently frustrated by the lack of resources available to help them cope with the sheer hard work involved. The CDT, through its key workers, does its best to absorb anger and divert frustration into constructive actions.
There are other groups of children who come to the attention of child health services. Community paediatricians act as advisers to adoption and fostering agencies, vital since many children needing alternative homes have special medical or educational needs or have behavioural or psychiatric problems. Many see a role in acting as advocates, not just for those with impairments but also for socially disadvantaged children, including those ‘looked after’ in children’s homes and those of travellers, asylum seekers, refugees and the homeless.
Child protection Regrettably, some children come to the attention of child health specialists because they have been beaten, neglected, emotionally or nutritionally starved or sexually assaulted by their parents or carers. Responsibility for the investigation of these children is that of local-authority social-services departments. However, child health professionals have a vital role in diagnosis, obtaining forensic evidence, advising courts, supervising the medical aspects of follow-up and teaching doctors, therapists and other professionals in training. (See CHILD ABUSE.)
School health services Once children have reached school age, the emphasis changes. The prime need becomes identifying those with problems that may interfere with learning – including those with special needs as de?ned above, but also those with behavioural problems. Teachers and parents are advised on how to manage these problems, while health promotion and health education are directed at children. Special problems, especially as children reach secondary school (aged 11–18) include accidents, substance abuse, psychosexual adjustment, antisocial behaviour, eating disorders and physical conditions which loom large in the minds of adolescents in particular, such as ACNE, short stature and delayed puberty.
There is no longer, in the UK, a universal school health service as many of its functions have been taken over by general practitioners and hospital and community paediatricians. However, most areas still have school nurses, some have school doctors, while others do not employ speci?c individuals for these tasks but share out aspects of the work between GPs, health visitors, community nurses and consultant paediatricians in child health.
Complementing their work is the community dental service whose role is to monitor the whole child population’s dental health, provide preventive programmes for all, and dental treatment for those who have di?culty using general dental services – for example, children with complex disability. All children in state-funded schools are dentally screened at ages ?ve and 15.
Successes and failures Since the inception of the NHS, hospital services for children have had enormous success: neonatal and infant mortality rates have fallen by two-thirds; deaths from PNEUMONIA have fallen from 600 per million children to a handful; and deaths from MENINGITIS have fallen to one-?fth of the previous level. Much of this has been due to the revolution in the management of pregnancy and labour, the invention of neonatal resuscitation and neonatal intensive care, and the provision of powerful antibiotics.
At the same time, some children acquire HIV infection and AIDS from their affected mothers (see AIDS/HIV); the prevalence of atopic (see ATOPY) diseases (ASTHMA, eczema – see DERMATITIS, HAY FEVER) is rising; more children attend hospital clinics with chronic CONSTIPATION; and little can be done for most viral diseases.
Community child health services can also boast of successes. The routine immunisation programme has wiped out SMALLPOX, DIPHTHERIA and POLIOMYELITIS and almost wiped out haemophilus and meningococcal C meningitis, measles and congenital RUBELLA syndrome. WHOOPING COUGH outbreaks continue but the death and chronic disability rates have been greatly reduced. Despite these huge health gains, continuing public scepticism about the safety of immunisation means that there can be no relaxation in the educational and health-promotion programme.
Services for severely and multiply disabled children have improved beyond all recognition with the closure of long-stay institutions, many of which were distinctly child-unfriendly. Nonetheless, scarce resources mean that families still carry heavy burdens. The incidence of SUDDEN INFANT DEATH SYNDROME (SIDS) has more than halved as a result of an educational programme based on ?rm scienti?c evidence that the risk can be reduced by putting babies to sleep on their backs, avoidance of parental smoking, not overheating, breast feeding and seeking medical attention early for illness.
Children have fewer accidents and better teeth but new problems have arisen: in the 1990s children throughout the developed world became fatter. A UK survey in 2004 found that one in ?ve children are overweight and one in 20 obese. Lack of exercise, the easy availability of food at all times and in all places, together with the rise of ‘snacking’, are likely to provoke signi?cant health problems as these children grow into adult life. Adolescents are at greater risk than ever of ill-health through substance abuse and unplanned pregnancy. Child health services are facing new challenges in the 21st century.... child development teams (cdts)
Practically, only three methods have been used from the earliest times: burial, embalming and cremation. Burial is perhaps the earliest and most primitive method. It was customary to bury the bodies of the dead in consecrated ground around churches up until the earlier half of the 19th century, when the utterly insanitary state of churchyards led to legislation for their better control. Burials in Britain take place usually upon production of a certi?cate from a registrar of deaths, to whom notice of the death, accompanied by a medical certi?cate, must be given without delay by the nearest relatives.
When a death occurs at sea, the captain of the ship has authority to permit burial at sea. If, however, there are any doubts about cause of death, the captain may decide to preserve the body and refer the case to the relevant authorities at the next port of call.
Embalming is still used occasionally. The process consists in removing the internal organs through small openings, and ?lling the body cavities with various aromatics of antiseptic power – the skin being swathed in bandages or otherwise protected from the action of the air. Bodies are also preserved by injecting the blood vessels with strong antiseptics such as perchloride of mercury.
Cremation or incineration of the body is now the commonest method of disposal of the dead in the UK, where land for burials is increasingly scarce; today it accounts for around 75 per cent of disposals. The process of incineration takes 1–2 hours. Something in the range of 2·3 to 3·2 kg (5–7 lbs) of ash result from the combustion of the body, and there is no admixture with that from the fuel.
Cremation of a body means that it is almost impossible to conduct any meaningful forensic tests should any subsequent doubts be raised about the cause of death. So, before cremation can take place, two doctors have to sign the cremation forms. The ?rst is usually the doctor who was caring for the patient at the time of death – an important exception being cases of sudden death, when the coroner holds an inquest into the cause and authorises the necessary approval for cremation. In 1999, fewer than 3,500 deaths were certi?ed following a post-mortem, out of a total number of deaths in England and Wales of more than 556,000. When the coroner is not involved, the second doctor must have been quali?ed for ?ve years; he or she must be unconnected with the patient’s care and not linked professionally with the ?rst doctor. (For example, if the ?rst doctor is a general practitioner – as in the majority of cases they are – the second doctor should be from another practice.) Before signing the cremation certi?cate the second doctor must conduct an external examination of the dead person and discuss the circumstances of death with the ?rst doctor.
The two cremation forms are then inspected by crematorium medical referees who must be satis?ed that the cause of death has de?nitely been ascertained. The present death and cremation certi?cation system has been in place in the UK for many years – the legislative framework for cremation was set up in 1902 – and death certi?cation procedures were last reviewed by the government-appointed Brodrick committee in 1971, with no fundamental changes proposed. The case of Harold Shipman, a general practitioner convicted of murdering more than 15 patients, and suspected of murdering many more, has revealed serious weaknesses in the certi?cation system. A comprehensive review of the present procedures was in place at the time of writing (2004).... dead, disposal of the
A plant that drops its leaves in the fall or, in some cases, during drought.... deciduous
(Latin) The tenth-born child Decimah, Decema, Decyma, Decia, Decemah, Decymah... decima
An approach to decision-making that involves modelling the sequences or pathways of multiple possible strategies (e.g. of diagnosis and treatment for a particular clinical problem) to determine which is optimal. It is based upon available estimates (drawn from the literature or from experts) of the probabilities that certain events and outcomes will occur and the values of the outcomes that would result from each strategy.... decision analysis
See “decision analysis”.... decision support system
An illness suffered by divers when diving too deep, or too long and characterised bynitrogen bubbles forming in the tissues of the body. This may cause a multitude of symptoms although joint pains are those most-commonly encountered. Confusion may be caused in divers that have suffered an Irukandji sting as the symptoms have some similarities. See also, cerebral gas embolism.... decompression illness (dci)
Drugs which relieve nasal congestion and stu?ness. They may be given orally or by nasal spray, and most are SYMPATHOMIMETIC DRUGS which cause vasoconstriction in the nasal mucosa. Too frequent use reduces their e?ectiveness, and there is a danger of ‘rebound’ worsening if they are used for more than 10–14 days. A safer option for babies is simple sodium chloride drops. Warm moist air is also a traditional e?ective decongestant.... decongestants
There are some minor signs, such as: relaxation of the facial muscles (which produces the staring eye and gaping mouth of the ‘Hippocratic countenance’), as well as a loss of the curves of the back, which becomes ?at by contact with the bed or table; discoloration of the skin, which takes on a wax-yellow hue and loses its pink transparency at the ?nger-webs; absence of blistering and redness if the skin is burned (Christison’s sign); and failure of a ligature tied round the ?nger to produce, after its removal, the usual change of a white ring, which, after a few seconds, becomes redder than the surrounding skin in a living person.
The only certain sign of death, however, is that the heart has stopped beating. To ensure that this is permanent, it is necessary to listen over the heart with a stethoscope, or directly with the ear, for at least ?ve minutes. Permanent stoppage of breathing should also be con?rmed by observing that a mirror held before the mouth shows no haze, or that a feather placed on the upper lip does not ?utter.
In the vast majority of cases there is no dif?culty in ensuring that death has occurred. The introduction of organ transplantation, however, and of more e?ective mechanical means of resuscitation, such as ventilators, whereby an individual’s heart can be kept beating almost inde?nitely, has raised diffculties in a minority of cases. To solve the problem in these cases the concept of ‘brain death’ has been introduced. In this context it has to be borne in mind that there is no legal de?nition of death. Death has traditionally been diagnosed by the irreversible cessation of respiration and heartbeat. In the Code of Practice drawn up in 1983 by a Working Party of the Health Departments of Great Britain and Northern Ireland, however, it is stated that ‘death can also be diagnosed by the irreversible cessation of brain-stem function’. This is described as ‘brain death’. The brain stem consists of the mid-brain, pons and medulla oblongata which contain the centres controlling the vital processes of the body such as consciousness, breathing and the beating of the heart (see BRAIN). This new concept of death, which has been widely accepted in medical and legal circles throughout the world, means that it is now legitimate to equate brain death with death; that the essential component of brain death is death of the brain stem; and that a dead brain stem can be reliably diagnosed at the bedside. (See GLASGOW COMA SCALE.)
Four points are important in determining the time that has elapsed since death. HYPOSTASIS, or congestion, begins to appear as livid spots on the back, often mistaken for bruises, three hours or more after death. This is due to the blood running into the vessels in the lowest parts. Loss of heat begins at once after death, and the body has become as cold as the surrounding air after 12 hours – although this is delayed by hot weather, death from ASPHYXIA, and some other causes. Rigidity, or rigor mortis, begins in six hours, takes another six to become fully established, remains for 12 hours and passes o? during the succeeding 12 hours. It comes on quickly when extreme exertion has been indulged in immediately before death; conversely it is slow in onset and slight in death from wasting diseases, and slight or absent in children. It begins in the small muscles of the eyelid and jaw and then spreads over the body. PUTREFACTION is variable in time of onset, but usually begins in 2–3 days, as a greenish tint over the abdomen.... death, signs of
The amount of loss or expense that must be incurred by an insured individual before an insurer will assume any liability for all or part of the remaining cost of covered services. Deductibles may be either fixed monetary amounts or the value of specified services (such as two days of hospital care or one medical practitioner visit). Deductibles are usually tied to some reference period over which they must be incurred.... deductible
See THROMBOSIS; VEINS, DISEASES OF.... deep vein thrombosis (dvt)
Lust, Psychic Powers... deerstongue
Diethyltoluamide. An effective insect repellant used on the skin.... deet
If a heart is ?brillating (see VENTRICULAR FIBRILLATION), the application of a large electric shock via paddles applied to the chest wall causes simultaneous electrical depolarisation of all the cardiac cells, and may allow the heart’s natural pacemaker to re-establish sinus rhythm. One paddle is placed below the right clavicle and the other over the cardiac apex. Care must be taken that no one is in contact with the patient or the bed when the shock is given, to avoid electrocution.... defibrillation
Apparatus that delivers a controlled electric shock to restore normal heart rhythm in patients whose hearts have developed VENTRICULAR FIBRILLATION or have stopped beating. The shock is delivered by electrodes placed on the chest wall or directly to the heart after the chest has been surgically opened. De?brillators are a standard item of equipment for paramedical sta? in ambulances, and aeroplanes of some airlines now routinely carry the apparatus. (See also HEART, DISEASES OF.)... defibrillator
Any disease resulting from the absence from the diet of any substance essential to good health: for example, one of the vitamins.... deficiency disease
An animal wherein the adult stage of the parasite resides.... definitive or final host
(Greek) In mythology, the mother of Achilles’ only son Deidameia, Deidamia, Deidameah, Deidameiah, Deidamiah... deidamea
(Latin) Daughter of God Deifiliah, Deiflea, Deifileah... deifilia
A policy which calls for the provision of supportive care and treatment for medically and socially dependent individuals in the community rather than in an institutional setting.... deinstitutionalization
(American) From the lush valley Deiondra, Deiondria, Deiondrea, Deiondriya... deiondre
(French) One of remembrance Daejah, Daejia, Daija, Daijah, Daijaah, Daijea, Daijha, Daijhah, Dayja, Dajah, Deija, Deijah, Dejah, Dejanae, Dejanee, Dejanique, Dejanira, Deyanira... deja
(African) A pleasing woman Decca, Decka, Dekah, Deccah, Deckah... deka
(Irish / French) The dark challenger / from the elder-tree grove Delaina, Delaine, Delainey, Delainy, Delane, Delanie, Delany, Delayna, Delayne, Delani, Delainie, Delanea, Delainea, Delaeny, Delaeni, Delaenie, Delaenee, Delaenea... delaney
A prolonged hospital stay due to non-medical conditions, such as a lack of, or delayed start of, community care arrangements.... delayed discharge
(Greek) Resembling a flower Delbina, Delbin, Delbyne, Delbyn, Delbyna, Delbeene, Delbeena, Delbeina, Delbeine, Delbiena, Delbiene, Delbeana, Delbeane... delbine
(Latin) Woman from Delos; form of Cordelia, meaning “a good-hearted woman; a woman of honesty” Delya, Deliya, Delea, Deelia, Deelea, Deelya, Deliah, Deleah, Deliyah, Delyah... delia
(Latin) One who gives pleasure Delice, Delisa, Delisha, Delissa, Deliza, Delyssa, Delicea, Deliciae, Delight, Delite, Delit, Deliz, Deliciah, Deliceah... delicia
(Hebrew) A seductive woman; in the Bible, the woman who discovered the source of Samson’s strength Dalila, Delila, Delyla, Dalyla, Dalilah, Delylah, Dalylah... delilah
See “meals on wheels”.... delivered meals
(Scandinavian) One who is sparkling and witty Dellyng, Delleng... delling
(German) A noble protector Delmi, Delmy, Delmira, Delmah... delma
(English) Feminine form of Delmar; woman of the sea Delmaria, Delmare, Delma, Delmia, Delmarra, Dellmara, Dellmarra... delmara
An iterative group judgment technique in which a central source forwards surveys or questionnaires to isolated, anonymous (to each other) participants whose responses are collated/summarized and recirculated to the participants in multiple rounds for further modification/critique, producing a final group response (sometimes statistical).... delphi technique
(Greek) From the mouth of the river; the fourth letter of the Greek alphabet Dellta, Deltah, Delltah... delta
Abnormal electrical waves observed in the electroencephalogram (see ELECTROENCEPHALOGRAPHY (EEG)). The frequency of the normal alpha waves is 10 per second; that of the delta waves is 7 or fewer per second. They occur in the region of tumours of the brain, and in the brains of patients with EPILEPSY.... delta waves
(African) The sole daughter Delue, Deloo... delu
An irrational and usually unshakeable belief (idée ?xe) peculiar to some individuals. They fail to respond to reasonable argument and the delusion is often paranoid in character with a belief that a person or persons is/are persecuting them. The existence of a delusion, of such a nature as to in?uence conduct seriously, is one of the most important signs in reaching a decision to arrange for the compulsory admission of the patient to hospital for observation. (See MENTAL ILLNESS.)... delusions
(Welsh) A pretty young woman Delythe, Delith, Delithe... delyth
Willingness and/or ability to seek, use and, in some settings, pay for services. Sometimes further subdivided into expressed demand (equated with use) and potential demand or need.... demand (for health services)
(English) From the hill’s fortress Demelzah, Demelzia, Demelziah, Demelzea, Demelzeah... demelza
(Greek) Of the common people... demos
(Indian) A superior woman Denalie, Denaly, Denally, Denalli, Denaley, Denalee, Denallee, Denallie, Denalley, Denalea, Denallea... denali
(Syn. “Breakbone fever”) A flavivirus, dengue virus types 1-4, transmitted by infected specific Aedes spp mosquitoes. Sudden abrupt onset of high fever, headache, retrobulbar pain and lumbosacral pain. Fever lasts 6-7 days and may be ‘saddleback’. Initial symptoms followed by generalised myalgia, bone pain, anorexia, nausea, vomiting and weakness. A transient mottled rash may appear on 1st/2nd day and a second rash appears with resolution of fever - at first on trunk, spreading outward. WCC and platelet count depressed. Mild haemorrhagic phenomena in a few.... dengue fever
Usually a second infection with a different serotype of the dengue virus (see dengue fever). A primary infection at a young age is common finding. Age of patient with DHF is often less than 5 years, but young adults may be affected. Severe illness with abnormal vascular permeability, hypovolaemia and abnormal clotting mechanisms. Bleeding into skin or internally. Dengue shock syndrome may also be a complication.... dengue haemorrhagic fever
(American) Made of a strong cloth Denym, Denem, Denam... denim
(French) Feminine form of Denis; follower of Dionysus Deneigh, Denese, Dennet, Dennette, Deney, Deni, Denice, Deniece, Denisa, Denissa, Denisse, Denize, Denni, Dennie, Denisse, Dennise, Denny, Denyce, Denys, Denyse, Dinnie, Dinni, Dinny, Denisha... denise
A person quali?ed to carry out the scaling (removal of calculus [deposits]) from the teeth and to advise patients on how to keep their teeth and gums healthy. Hygienists usually work in a quali?ed dentist’s surgery.... dental hygienist
A dental surgeon, or dentist, is an individual trained to diagnose and treat disorders of the teeth and gums, as well as to advise on preventive measures to ensure that these areas remain healthy. Dentists qualify after a four-year course at dental school and then register with the GENERAL DENTAL COUNCIL, which is responsible for maintaining educational and professional standards. Around 25,000 dentists practise in the NHS and private sector.
Over the past four decades the ?nancial outlay on NHS dental services has been around 5 per cent of total NHS funding. This contrasts with 10 per cent during the service’s early years, when the NHS was coping with decades of ‘dental neglect’. The population’s dental health has, however, been steadily improving: in 1968 more than one-third of people had no natural teeth; by the late 1990s the proportion had fallen to 13 per cent.
Dentistry is divided into several groupings.
General dental practitioners Concerned with primary dental care, the prevention, diagnosis and treatment of diseases of the gums and teeth – for example, caries (see TEETH, DISORDERS OF). They also deal with diffculties in biting and the effects of trauma, and are aware that oral disorders may re?ect disease elsewhere in the body. They will refer to the hospital dental services, patients who require treatment that cannot be satisfactorily carried out in a primary-care setting.
Most routine dental prevention and treatment is carried out in general dental practitioners’ surgeries, where the dentists also supervise the work of hygienists and dental auxiliaries. Appliances, such as dentures, crowns, bridges and orthodontic appliances are constructed by dental technicians working in dental laboratories.
There are around 18,800 dentists providing general dental services in the UK. These practitioners are free to accept or reject any potential patient and to practise where they wish. Those dentists treating patients under an NHS contract (a mixture of capitation fees and items of service payments) can also treat patients privately (for an appropriate fee). Some dentists opt for full-time private practice, and their numbers are increasing in the wake of changes in 1990 in the contracts of NHS general dental practitioners.
Community dental practitioner Part of the public-health team and largely concerned with monitoring dental health and treating the young and the handicapped.
In the hospitals and dental schools are those who are involved in only one of the specialities.
Around 2,800 dentists work in NHS hospitals and 1,900 in the NHS’s community services. In some parts of the UK, people wanting NHS treatment are having diffculties ?nding dentists willing to provide such care.
Restorative dentist Concerned with the repair of teeth damaged by trauma and caries, and the replacement of missing teeth.
Orthodontist Correction of jaws and teeth which are misaligned or irregular. This is done with appliances which may be removable or ?xed to the teeth which are then moved with springs or elastics.... dental surgeon
(English) From the green valley... denver
Relieving or removing obstruction... deobstruent
(Celtic) In mythology, a princess of Munster... deoch
(Portuguese) God is beautiful Deolynda, Deolenda... deolinda
(American) From a small town in Colorado... deora
Reliance on others to provide physical, mental and/or social support.... dependency
An indicator used in population studies to measure the portion of the population which is economically dependent on active age groups. It is calculated as the sum of the 0-14 year-olds and the over 60 or 65 year-olds, depending on the working age limit considered, divided by the number of people aged between 15 and 59 or 64, respectively.... dependency ratio
In a statistical analysis, the outcome variable(s) or the variable(s) whose values are a function of, or dependent on the effect of other variable(s) (called independent variables) in the relationship under study.... dependent variable
Also called hypo-pigmentation, this congenital or acquired disorder is one in which the skin loses its pigmentation because of reduced MELANIN production. It can be classi?ed into three groups: VITILIGO, ALBINISM and post-in?ammatory hypopigmentation.... depigmentation
(English) Ruler of the people Darinda, Derynda, Darynda, Derenda, Darenda... derinda
Also known as histiocytoma. A ?rm, painless nodule in the skin, typically on a leg, due to excessive formation of COLLAGEN. A common disorder, it is often a slow response to an insect bite and persists inde?nitely.... dermatofibroma
A medically quali?ed specialist who diagnoses and treats disorders of the skin (see SKIN, DISEASES OF).... dermatologist
Any skin disorder... dermatopathy
The toxic effects that occur as a result of swallowing the cleaning agents in shampoos, laundry powders, and cleaning liquids.... detergent poisoning
See nasal septum.... deviated nasal septum
A form of sexual behaviour, most common in men, in which intercourse between adults is not the final aim. Forms of sexual deviation include exhibitionism, fetishism, paedophilia, and transvestism.... deviation, sexual
Dual-energy X-ray absorptiometry, a technique that measures bone density by passing beams of lowdose radiation through bone. scans are used to assess the severity of osteoporosis. (See also densitometry.)... dexa scan
A cough suppressant available over the counter as an ingredient in cough remedies.... dextromethorphan
A measure of an individual’s or group’s lack of normal social amenities such as proper housing, diet and warmth. It was devised in the 1980s to help assess the medical services needed by a socially deprived population.... deprivation score
As spinal chord nerves branch out into the body, some segments fan out across the skin; these are the nerves that monitor the surface and are the source of senses of touch, pain, hot, cold and distension. All this information is funneled back in and up to the brain, which learned early on to correlate WHAT information comes from WHERE. Think of the brain as the CPU, with the spinal chord nerves uploading raw binary data; the brain has to make a running program out of this. It must form a three-dimensional hologram or homunculus from the linear input, and retranslate it outwards as binary data. The surface of the forearm, as an example, has sensory input gathered from several different and very separate spinal chord nerves. The brain will origami-fold these separate data streams into FOREARM. If you were to inject novacaine into the base of the left first sacral nerve (LS1), you would find that a whole section of skin became numb. So well defined a section that you could outline in charcoal the demarcation between sensation and numbness. This section would be a long oval of of numbness around the left buttock, under to the groin, perhaps part of the thigh...and the left heel. That spinal nerve is solely responsible for carrying sensation from that zone of skin...that dermatome; your brain mixes all the dermatomes together to get a working hologram of your total skin surface. That particular nerve also brings and sends information about the uterus, abdominal wall and pelvic floor. If you are a woman suffering pelvic heaviness and suppressed menses, a hot footbath might be enough S1 (heel dermatome) stimulation to cross-talk over to the referred S1 pelvic functions...and heat up the stuck uterus. Much of acupuncture, Jinshinjitsu, and zone and reflex therapy (not to mention Rolfing) uses various aspects of this dermatome crossover phenomena (by whatever name) and zone counterirritation was widely used in American standard medicine up until...penicillin. It was still being described in clinical manuals as late as 1956, although with the mention that it was only used infrequently and a “mechanism not understood” disclaimer.... dermatomes
Fungi which can infect skin, hair and nails. About 30 species in three genera are PATHOGENIC to humans (see RINGWORM).... dermatophytes
A superficial infection of the skin caused by a fungus... dermatophytosis
(Hebrew) As free as a bird Derorah, Derorra, Derorit, Drora, Drorah, Drorit, Drorlya, Derorice... derora
Benth. Derris indica (Lamk.) Bennet.
Synonym: Pongamia pinnata Pierre.
Family: Fabaceae.
Habitat: Native to the Western Ghats. Found all over India on the banks of rivers and streams.
English: Indian Beech. Pongamia oil tree.
Ayurvedic: Naktmaal, Guchpush- pak, Ghritpuur, Udkirya, Karanja.
Siddha/Tamil: Pungu.
Action: Used for skin diseases— eczema, scabies, leprosy, and for ulcers, tumours, piles, enlargement of spleen, vaginal and urinary discharges. Juice of root—used for closing fistulous sores and cleaning foul ulcers. Flowers— used in diabetes. Powder of seeds— used for whooping and irritating coughs of children. Seed oil—used in cutaneous affections, herpes and scabies.
The tree is rich in flavonoids and related compounds. These include simple flavones, furanoflavonoids, chro- menoflavones, chromenochalcones, coumarones, flavone glucosides, sterols, triterpenes and a modified pheny- lalanine dipeptide.
Synonym: D. trifoliate Lour.
Family: Fabaceae.
Habitat: Costal forests of India and the Andamans.
Folk: Paan-lataa (Bengal), Kitani (Maharashtra).
Action: Stimulant, antispasmodic, counter-irritant. Bark—alterative in rheumatism. An oil prepared from the plant is used externally as an embrocation.
The roots contain dehydrorotenone, lupeol and a ketone. Bark contains 9.3% tannic acid. Stems contain tan- nic acid, hexoic, arachidic and stearic acids, ceryl alcohol, isomerides of cholesterol, potassium nitrate, gums and resins.... derris uliginosa
(Irish) From the oak grove Derrey, Derri, Derrie, Derree, Derrea, Derreah... derry
(Welsh) A birdlike woman Derran, Deren, Derhyn, Deron, Derrin, Derrine, Derron, Derrynne, Derynne... deryn
A study concerned with and designed only to describe the existing distribution of variables, without regard to causal or other hypotheses.... descriptive study
(Greek) An ill-fated woman Dezdemona, Desmona, Dezmona... desdemona
In psychiatry, a method for treating phobias used in BEHAVIOUR THERAPY. The affected individual is slowly acclimatised to the cause of his or her fear. (See also ALLERGY.)... desensitisation
Depriving of moisture... desiccating
(French) One who is desired Desaree, Desirae, Desarae, Desire, Desyre, Dezirae, Deziree, Desirat, Desideria, Desirata, Des, Desi, Dezi, Dezie, Dezy, Dezey, Dezee, Dezea, Desirai, Dezirai... desiree
(Greek) Of the binding oath Desme, Dezma, Dezme, Desmiah, Desmia, Desmea, Desmeah... desma
Desmodium gangeticumFabaceaeSan: Anshumati, Salaparni;Hin,Ben: Salpani;Mal: Orila;Tam:Pulladi;Tel: GitanaramKan: Murelehonne; Mar: Darh;Guj: Salwan; Ori: Salaparni Pun: ShalpurhiImportance: Desmodium is a small shrub which is the chief of the ten ingredients in the Dasamula kwatha of Hindu medicine. Roots are useful in vitiated conditions of vata, anorexia, dyspepsia, haemorrhoids, dysentery, strangury, fever, gout, inflammations, cough, asthma, bronchitis, cardiopathy and debility. The unani preparation “Arq dashmul” contains these roots. It is considered a curative for leucorrhoea and for pains due to cold (Warrier et al, 1995).Distribution: The plant is widely distributed in the tropics and subtropics. It grows wild in the forests of India up to 1500m. It is also cultivated in the plains and in the lower Himalayas.Botany: Desmodium gangeticum (Linn.) DC. syn. Hedysarum gangeticum Linn., Desmodium gangeticum var. maculatum (Linn.) Baker., belongs to the family Fabaceae (Papilionaceae). It is an erect diffusely branched undershrub, 90-120cm in height with a short woody stem and numerous prostrate branches provided with soft grey hairs. Leaves are unifoliate, ovate- lanceolate, membranceous and mottled with grey patches. Flowers are white, purple or lilac in elongate lax, terminal or axillary racemes. Fruits are moniliform, 6-8 jointed, glabrescent pods, joints of pods separately pubescent with hooked hairs, joint separating when ripe into indehiscent one seeded segments. Seeds are compressed and reniform.Agrotechnology: Desmodium can grow in a variety of climate and soils. However, it prefers tropical and subtropical climatic conditions. Although it can grow on all types of soils, waterlogged and highly alkaline soils are not suitable. Light sandy loam is preferred for commercial cultivation.It is propagated through seeds. Seeds can be planted directly in the field or seedlings raised on the nursery beds and transplanted. Transplanting always gives better results in commercial cultivation, as it gives assured crop stand. Planting is done at a spacing of 40x20cm on flat beds or ridges. Organic manures are applied at the time of land preparation and thoroughly mixed with the soil. A little quantity of phosphatic and nitrogenous fertilizers are also applied for better crop growth. The inter-row spaces between plants, both in the field and nursery should be kept free from weeds by frequent weeding and hoeing as the plant suffers from weed competition, especially during early stages of growth. Manual hand weeding is usually done. Irrigation of seedlings just after planting is good for crop establishment. Although it can be cultivated as a rainfed crop under humid tropical conditions, irrigation every month is beneficial during summer. The root is the economic part and harvesting can be commenced after 8-9 months. About 500- 700kg roots can be harvested from a hectare of land per year.Properties and activity: The root contains gangetin, gangetinin, desmodin, N,N-dimethyl tryptamine, hypaphorine, hordenine, candicine, N-methyl tyramine and -phenyl ethyl amine. The total alkaloid fraction showed hypotensive activity. The root is bitter, antiinflammatory, analgesic, aphrodisiac, constipating, diuretic, cardiotonic, expectorant, astringent, antidiarrhoeal, carminative, antiemetic, febrifuge and anti-catarrhal (Thakur et al, 1989).... desmodium
(Greek) The mistress; in mythology, the daughter of Demeter and Poseidon Despoina, Despinna, Despyna, Despena, Despona, Despeina, Despiena, Despeena, Despeana... despina
Energetic cleansing; literally, “dispossession”; often done ritually, using the recitation of prayers, burning of incense and bundles of herbs which are swept or shaken over the body or in ones’ living space to dispel negative or unwanted energy. This can also be accomplished through using a medicinal bath (baño) and/or washing ones living area with an herbal preparation.... despojo
(Greek) Feminine form of Odysseus; one who wanders; an angry woman Dessah... dessa
(German) Hardworking woman Destah... desta
DC.
Synonym: Hedysarum gangeticum Linn.
Family: Papilionaceae; Fabaceae.
Habitat: Ascending to 1,500 m on the Himalaya; common on lower hills and plains throughout India.
Ayurvedic: Shaaliparni, Shaalaparni, Sthiraa, Somyaa, Guhaa, Triparni, Vidaarigandha, Anshumati. Also used as Prshniparni. (Urariapicta Desv., Prshniparni, is used as a substitute for Shaalaparni.)
Siddha/Tamil: Pulladi, Sirupulladi Moovilai (root).
Folk: Sarivan.
Action: Root—antipyretic, diuretic, astringent (used in irritable bowel syndrome, diarrhoea and dysentery), anticatarrhal (used in post-natal care, chronic fever, cough, biliousness, vomiting), diuretic, anthelmintic, laxative and nervine tonic. Desmodium spp.: Roots—carminative, mildly purgative, stomachic, emmenagogue, diuretic. Leaves—galactagogue; a poultice of leaves is used for lumbago. Bark—used in diarrhoea and haemorrhages.
Roots afforded pterocarpanoids— gangetin, gangetinin, desmodin and several alkaloids. The aerial portion gave indole-3-alkylamines and their derivatives.Gangetin showed significant anti- inflammatory activity in 50 and 100 mg/kg p.o. in rats.
Dosage: Root—5-10 g powder; 1020 g for decoction. (API Vol. III.)... desmodium gangeticum
Any factor, whether event, characteristic or other definable entity, that brings about change in a health condition or other defined characteristic.... determinant
Also called detoxi?cation, this is a process whereby toxic agents are removed from the body and toxic effects neutralised. (See POISONS and TOXINS.)... detoxication
(Latin) Form of Benedetta, meaning “one who is blessed” Dette, Dete, Deta, Dett... detta
(Hindi) A divine being Devi, Daeva... deva
(Indian) Mother of the gods... devamatar
(Hindi) One who is in love Devanah, Devanna, Devannah... devana
(Irish) A dark-haired beauty Devaney, Devanie, Devinee, Devony, Devenny, Devani, Devanee, Devanea, Devaneah... devany
(Latin) In mythology, goddess of brooms Deverah... devera
(Latin) In mythology, goddess of midwives Deverrah... deverra
A severe, chronic disability which is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the person attains the age of 22; is likely to continue indefinitely; results in substantial functional limitations in three or more of the following areas of major life activity: self care, receptive and expressive language, learning, mobility, self direction, capacity of independent living, economic self-sufficiency; and reflects the person’s need for a combination and sequence of special, interdisciplinary or generic care treatments or services which are of lifelong or extended duration and are individually planned and coordinated.... developmental disability
(Indian) The little goddess Devicka, Devica, Devyka, Devycka, Devyca... devika
Protection, Gambling, Luck, Power, Employment... devils shoestring
(Latin) A faithful woman... devota
A drug that stimulates the central nervous system. It can be used to treat NARCOLEPSY and hyperactive children but should not be used to combat obesity or treat depression. It is also a drug of abuse.... dexamphetamine
(Latin) Feminine form of Dexter; one who is skillful Dex... dextra
An over-the-counter drug used to relieve dry, irritating, persistent coughs, this opioid acts as a cough suppressant. It is available either alone or in combination with other drugs in linctus, lozenges and syrups prepared to provide symptomatic relief for coughs and colds.... dextromethophan
Ductus deferens, or VAS DEFERENS, is the tube which carries spermatozoa from the epidydimis to the seminal vesicles. (See TESTICLE.)... ductus deferens
Electronically driven equipment that will constantly monitor the physiological status of patients and the effects of medical intervention on that status. Such devices should relieve hospital sta? of time-consuming ‘human monitoring’ procedures and in some instances will enable patients to carry monitoring devices during their daily living activities. An example would be the regular assessment of blood-sugar concentration in subjects with DIABETES MELLITUS or the routine checking on the blood or tissue concentrations of administered drugs.... electronic monitoring devices
In a policy context, evidence-based decision-making is the application of the best available scientific evidence to policy decisions about specific treatments or care, as well as changes in the delivery system.... evidence-based decision-making
There are various medications which can help with the detoxifying process, though many varieties of tea promote this process, as well. Find out more about teas for detox!
About the detoxification process
Many people relate detoxification with consumption of drugs and alcohol. While this is true, detoxification isn’t strictly related to this.
Detoxification is a process which our body undergoes when it gets rid of various toxic substances. One of the organs responsible for the detoxification process is the liver.
While in some cases it might be necessary, you need to be careful when taking the decision to undergo a detoxifying process. Doctors recommend that people with various health conditions - anemia, diabetes, or kidney disease, for example, should not undergo a detoxification process. The same applies to pregnant and nursing women.
Tea can prove to be useful during the detoxifying process. As it is a natural beverage, it is also good for your health, bringing along many health benefits, too. This applies with teas for detox, as well.
Types of tea for detox
Ginger tea and chamomile tea are often recommended when undergoing a detoxifying process. Also, they both have calming effects, which will help you go through with this process. Milk thistle tea is also good when you’re going through a detoxifying process. It is good for the liver, which helps promote detoxification.
Other teas for detox include burdock tea, dandelion tea, nettle tea, rosehip tea, lemongrass tea and lemon balm tea. Many of these also promote a proper digestion, help you treat colds or the flu, and can help with various health problems.
Side effects of tea for detox
While these teas help with the detoxifying process, you have to be careful with their side effects.
Milk thistle tea and nettle tea, for example, can act as a laxative if they are drunk for long periods of time. Meanwhile, dandelion tea should not be consumed by persons suffering from diabetes, or those who have low blood sugar levels.
Side effects vary from one tea to another. Make sure you discuss with your doctor about the tea for detox you decide on.
When undergoing a detoxification process, choose to drink tea that can help you. As a natural beverage, it will promote detoxification, as well as help you stay healthy. Make sure you try some teas for detox!... drink tea for detox
An ENZYME that performs an essential function in the metabolism of CARBOHYDRATE. A de?ciency in this enzyme – acronym G6PD – results in the breakdown of ERYTHROCYTES (HAEMOLYSIS), usually in the presence of oxidants (see OXIDANT) such as infections or drugs. The de?ciency disorder is a hereditary condition in which the enzyme is absent. The condition, characterised by pallor, rigors and pain in the loin, is divided into African, European (including FAVISM) and Oriental types. Sufferers should avoid substances that trigger haemolysis. Acute episodes are best treated symptomatically.... glucose-6-phosphate dehydrogenase
A deficiency in the enzyme G6PD resulting in a haemolytic anaemia. This haemoglobinopathy contraindicates the use of the 4-aminoquinolines such as primaquine for the radical treatment of benign tertian and ovale tertian malaria.... glucose-6-phosphate-dehydrogenase (g6pd) deficiency
See “health system”.... health care delivery system
The process of continuous, progressive improvement of the health status of individuals and groups in a population.... health development
See WILSON’S DISEASE.... hepatolenticular degeneration
See WILSON’S DISEASE.... hepolenticular degeneration
An establishment primarily engaged in providing inpatient nursing and rehabilitative services to individuals requiring nursing care.... high dependency care facility
A composite index that measures the overall achievements in a country in three basic dimensions of human development— longevity, knowledge and a decent standard of living. It is measured by life expectancy, educational attainment and adjusted income per capita in purchasing power parity (PPP) US dollars. The HDI is a summary, not a comprehensive measure of human development.... human development index (hdi)
Also called Juvenile-onset Diabetes, IDDM (Insulin-Dependent Diabetes) and Type I, it is a deficiency condition wherein the pancreas does not manufacture enough insulin or what it makes is formed improperly. It is usually inherited, although it may not surface until pregnancy, recovering from a life-threatening illness, boot camp or some other profound metabolic stress. It can have a not-hereditary source, since it seems to enigmatically follow after a viral disorder, and can occur spontaneously as an auto-immune condition. The percentage of folks with non-hereditary Type I diabetes is constantly increasing (or the other group is stable, but total numbers are increasing). Radical environmentalists and tree-hugging Gaiaist Pagans (I’m using the dialectic current to the pro-business backlash of the 1990s, when Green is out, and White-With-Green i$ in) claim this is another aspect of massive though subtle pollution from organochemical soup, which even some Real Doctors admit can cause increased auto-immune disease. (SOMETHING is causing it, at any rate, not simply cola drinks.)... insulin-dependent diabetes
A network of organizations, usually including hospitals and medical practitioner groups, that provides or arranges to provide a coordinated continuum of services to a defined population and is held both clinically and financially accountable for the outcomes in the populations served.... integrated delivery system / integrated services network (isn)
In July 1997, participants at the Fourth International Conference on Health Promotion presented the Jakarta Declaration on Leading Health Promotion into the 21st Century. The Declaration identifies five priorities: promote social responsibility for health; increase investments for health development; consolidate and expand partnerships for health promotion; increase community capacity and empower the individual; and secure an infrastructure for health promotion.... jakarta declaration
An executive agency of the Department of Health in the UK. Set up in 1994, it is responsible for regulating and advising on the sale or use of any product, other than a medicine, used in the health-care environment for the diagnosis, prevention, monitoring or treatment of illness or disease. Equipment ranges from pacemakers (see CARDIAC PACEMAKER) to prostheses (see PROSTHESIS), and from syringes to magnetic resonance imaging (see (MRI).... medical devices agency
See “integrated delivery system”.... organized delivery system
These are UK bodies that provide doctors with advice and, where appropriate, ?nancial support in defending claims for medical negligence in their clinical practice. They also advise doctors on all legal aspects of their work, including patients’ complaints, and provide representation for members called to account by the GENERAL MEDICAL COUNCIL (GMC) or other regulatory body. The sharp rise in claims for medical negligence in the NHS in the 1980s persuaded the UK Health Departments to introduce a risk-pooling system called the Clinical Negligence Scheme for Trusts, and the defence societies liaise with this scheme when advising their doctor members on responding to claims of negligence (see MEDICAL LITIGATION; MEDICAL NEGLIGENCE).... medical defence organisations
The number of malaria parasites in a specified volume of blood.... parasite density
A common form of eczema (see DERMATITIS) of the soles of the feet typically seen in boys with an atopic (see ATOPY) background who constantly wear trainers.... plantar dermatosis
Also called postnatal DEPRESSION, this is the state of depression that may affect women soon after they have given birth. The condition often occurs suddenly a day or so after the birth. Many women suffer from it and usually they can be managed with sympathetic support. If, however, the depression – sometimes called ‘maternal blues’ – persists for ten days or more, mild ANTIDEPRESSANT DRUGS are usually e?ective. If not, psychiatric advice is recommended. (See PREGNANCY AND LABOUR.)... puerperal depression
Reagent used by intradermal administration in the Mantoux (tuberculin) test for TB.... purified protein derivative (ppd)
The procedures and methods, including ethical considerations, predetermined by an investigator, to be adhered to in conducting a research project.... research design
A process of development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs.... sustainable development
(Griseb.) Kashyapa.Synonym: S. decussata Nimmo ex Grah.... swertia densifolia
Depression is a mental disorder. Patients suffering from this medical condition have a general low mood, they lack self-esteem and may also feel guilty, hopeless and worthless.
There are some obvious symptoms displayed by people suffering from depression, such as: agitation, mental disturbance causing hallucinations and morbid thoughts and loss of sexual appetite.
One of the main causes of this mental disorder is genetic history. There are also several external issues leading to depression: tormented childhood, relationship difficulties, loss of someone dear, money or health problems.
Anti-depressant medications are usually prescribed to patients suffering from depression.
Studies showed that people between the age of 20 and 30 but also those from 30 to 40 years could suffer from depression, if there are right circumstances to cause this disease. Women are more likely to get depressed than men. They also attempt to commit suicide more often than the other sex.
How Tea for Depression works
Tea for depression usually calms down the person affected.
Efficient Teas for Depression
Ginseng tea and Gentian tea are said to be efficient as teas for depression.
General benefits attributed to Ginseng tea are the following: it has cancer-preventive effects and may reduce the risk of several types of cancer, it controls blood-sugar levels and it has the ability to increase resistance to the effects of stress, by improving the circulation and mental functioning.
To prepare Ginseng tea, add 2 tablespoons of the dried plant in a cup of boiling water. Steep it for 5-6 minutes, strain it and you may enjoy this beverage.
Gentian plant has a long healing history, especially in Ayurvedic medicine, where it is used to treat anorexia and sluggish digestion.
The Gentian tea is successful as a tea for depression, as it improves the circulation of blood to all parts of the body.
To prepare Gentian tea, simmer one teaspoon of shredded Gentian root in two cups of water for 20 minutes. Allow it to cool to room temperature and then strain it. It is recommended that Gentian Tea should be drunk 15 to 30 minutes before eating. The tea is bitter and may be sweetened by adding sugar or honey.
Tea for Depression: Side effects
Rarely, teas for depression may cause diarrhea or vomiting. If these side effects occur, ask for your doctor’s advice.
Teas for depression are good to be purchased, especially by patients suffering from this modern medical condition. A cup of the abovementioned beverage may keep away the traditional anti-depressant pills.... tea for depression
The number of a given vector species present. It may be expressed in relative terms (e.g., the biting density in relation to the human host) or in absolute numbers (e.g., the number present in a room, cattle-shed or artificial shelter).... vector density
Citrullus colocynthisDescription: The wild desert gourd, a member of the watermelon family, produces an 2.4- to 3-meter-long ground-trailing vine. The perfectly round gourds are as large as an orange. They are yellow when ripe.Habitat and Distribution: This creeping plant can be found in any climatic zone, generally in desert scrub and waste areas. It grows abundantly in the Sahara, in many Arab countries, on the southeastern coast of India, and on some of the islands of the Aegean Sea. The wild desert gourd will grow in the hottest localities.Edible Parts: The seeds inside the ripe gourd are edible after they are completely separated from the very bitter pulp. Roast or boil the seeds--their kernels are rich in oil. The flowers are edible. The succulent stem tips can be chewed to obtain water.... wild desert gourd or colocynth
An estimated 15 per cent of the female population suffers from this form of anaemia. A deficiency of nutritional iron is responsible for oxygen starvation of the blood due to insufficient haemoglobin. Number of red cells is reduced.
Aetiology: heavy menstrual loss, feeble constitution from hereditary weakness, poor diet, hidden or known blood loss from gastric ulcer, pregnancy, bleeding piles or insufficient food minerals: iron, copper, calcium, etc, chronic liver or kidney disease, worms, anorexia nervosa, rheumatoid arthritis, tuberculosis. Symptoms. Tiredness, dizziness, breathlessness, palpitations, pale face and mucous membranes. White of eyes may be blue. Enlarged flabby tongue often bears impression of teeth marks. Hair lifeless, fingernails brittle and ridged. There may be angina, tinnitus and general reduced efficiency.
Treatment. The object is to achieve absorption of iron to raise normal haemoglobin levels and increase red cells. Echinacea has a reputation for regeneration of red cells. Herbs used with success: Echinacea, Gentian, Motherwort, Mugwort, Barberry, Hops, Nettles, Saw Palmetto, Chaparral, Red Clover, Dandelion.
Bitter herbs stimulate absorption of vital nutrients from the stomach, toning liver and pancreas, increasing the appetite; usually given half hour before meals. See: BITTERS.
Gentian. 1 teaspoon fine-cut chips to 2 cups cold water steeped 8 hours (overnight). Dose: Half-1 cup thrice daily before meals.
Tea. Formula. Combine: Agrimony 1; Barberry bark 1; Nettles 2; White Poplar bark half. Place 1oz (30g) in 1 pint (500ml) cold water and bring to boil. Simmer 10 minutes. Drink cold: Half-1 cup thrice daily, before meals.
Powders. Formula. Echinacea 2; Gentian 1; Kelp 1; pinch Red Pepper. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily, before meals.
Liquid extracts. Formula: Echinacea 1; Queen’s Delight 1; Ginseng 1; Ginger quarter. Dose: 30-60 drops in water, thrice daily, before meals.
Infusion Gentian Co Conc BP (1949). Dose: 30-60 drops.
Diet. Dandelion coffee, as desired. Molasses. Desiccated liver.
Floradix. A pre-digested iron preparation. Readily assimilable by the body. Compounded by Dr Otto Greither (Salus Haus). Iron is fed onto yeast which breaks down the metal and absorbs its cells. Other tonic ingredients include extracts of nettles, carrots, spinach, fennel, Vitamin C plus supplements;
Angelica root, Mallow, Horsetail, Yarrow, Juniper and Rosehips. Not chemically preserved.
Avoid chocolate, egg yolk, tea, coffee, wheat bran.
Supplements. Daily. Vitamin C (1g morning and evening). Vitamin B12, Folic acid 400mcg. Vitamin C is the most potent enhancer of iron absorption. Multivitamin containing iron.
Note: Iron absorption is decreased by antacids, tetracyclines, phosphates, phytates (phytic acid from excessive intake of wholewheat bread), and excessive calcium supplements. Lack of stomach hydrochloric acid impairs iron absorption, especially in the elderly. ... anaemia: iron deficiency
See: TEETH DECAY, TEETH EXTRACTION, ALOE VERA. DEOBSTRUENT. That which clears obstruction by dilating natural passages of the body. Usually of the intestines (Ispaghula seeds) or colon (Buckbean). ... dental problems
Itchy rash contracted in swimming pools, sports clubs or public baths caused by pseudomonas aeruginosa. Runs a self-limiting course from 7-14 days. Garlic and Echinacea specific. ... dermatitis, pseudomonas
Lobelia, Poke root, Ephedra. ... nasal decongestant
Arteriosclerotic disease. Due to atheromatic change in blood vessels of the brain. Infarcts.
Symptoms. High cholesterol levels, pathological laughing and crying, depression, delusion. Alternatives. Evening Primrose, Oats, Alfalfa, Garlic. German Chamomile, Gotu Kola, Ginkgo, Ginseng. Hawthorn, Rutin.
Powders. Formula: Hawthorn 3; Ginkgo 2; Lily of the Valley 1. Dose: 500mg (two 00 capsules or one- third teaspoon) thrice daily.
Liquid Extracts. Formula as for powders. Dose: one 5ml teaspoon thrice daily.
Tinctures. Formula as above. Dose: two 5ml teaspoons thrice daily.
Guar gum. Lowers serum fat levels, body weight and blood pressure.
Aromatherapy: massage and inhalation: Rosemary.
Arnica. Lotion: 1 part Tincture Arnica to 20 parts distilled extract Witch Hazel. Wipe over forehead and hair-line 1-3 times daily.
Diet. Egg-yolk, Lecithin, Oatmeal porridge.
Supplements. Vitamins A, B-complex, B12, C and E. Choline, Folic acid, Magnesium, Manganese, Zinc. ... dementia, (atherosclerotic)
Progressive loss of brain cells, atrophy; caused by stress and a number of diseases: Huntingdon’s Chorea, Alzheimer’s Disease, Pick’s Disease, syphilis, trauma, and by certain sedative, anxiolytic, diuretic and hypotensive drugs.
Symptoms. Disorientation, failure of memory for recent events, failure to comprehend, unable to form elemental judgements, confusion, ataxia (lack of coordination of muscles), emotional instability with outbursts, forgetful.
Alternatives. Remedies known to sustain the brain. Nervines and alteratives believed to leach from the body deposits of toxic minerals: aluminium, sulphur, mercury, etc. Gotu Kola, Ginseng, Ginkgo, Vitamin E conserve oxygen. Pulsatilla – success reported for mental outbursts. Vasodilator of value. Ginkgo favourably reported.
Teas. Basil, Ginseng, Gotu Kola, German Chamomile, Horsetail, Yarrow.
Tea. Formula. Equal parts, Ginkgo, German Chamomile, Yarrow. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup thrice daily.
Tablets/capsules. Prickly Ash, Ginseng, Ginkgo, Kelp, Pulsatilla.
Powders, Liquid Extracts, Tinctures. Combine: Gotu Kola 3; Vervain 2; Rosemary 1. Doses.
Powders: 500mg; two 00 capsules or one-third teaspoon. Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water, honey or fruit juice thrice daily.
Incontinence. A frequent problem for which American Cranesbill is indicated.
Aromatherapy. Inhalation: Feverfew, Thyme.
Contra-indicated: Black Cohosh.
Diet. Low salt. Low fat. High fibre. Egg yolk. Lecithin.
Supplements. Folic acid, Vitamins B-complex, B12, C and E. Selenium, to conserve oxygen. Magnesium, Manganese, Zinc.
General. Home help. Meals on Wheels. Service from local Psychogeriatric unit. ... dementia, (senile)
Disorders that destroy myelin, a fatty substance which forms a sheath round nerve fibres and appears in the central nervous system. A typical example is multiple sclerosis.
Essential fatty acids have an important role in the function of the nervous system, being closely related to the fatty (myelin) sheath and cell membranes. Disturbance in their metabolism may result in nerve disorder. Thus, vegetable oils of Soya, corn, safflower and sunflower should replace animal fats and dairy products.
Symptoms. Numb, prickling, tickling sensation on the skin, paralysis, incoordination, physical weakness and visual complaints.
Treatment. Indeterminate diagnosis.
Tablets/capsules. Prickly Ash, Black Cohosh, Ginseng, Ginkgo.
Powders, Liquid Extracts, Tinctures. Formula. Equal parts: Black Cohosh, Prickly Ash, Ginseng. Doses. Powders: two 00 capsules or one-third teaspoon, (500mg). Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water, honey or fruit juice.
Evening Primrose oil capsules or tablets: two 500mg thrice daily.
Aromatherapy. Rosemary spinal rub: 6 drops Oil Rosemary in 2 teaspoons Almond oil.
Diet. High protein, low fat, oily fish or 2 teaspoons Cod Liver oil daily. Gluten-free diet. Cholesterol- free – avoid milk, meat fat and dairy products. Avoid coffee and other caffeine stimulants. Dandelion coffee.
Supplements. B-complex, B3, B6, B12, C, E. Dolomite, Manganese, Zinc. ... demyelinating diseases
The wearing away of tooth enamel, often accompanied by the erosion of dentine (the layer beneath the enamel) and cementum (the bonelike tissue that covers the tooth root), usually through too-vigorous brushing. Abraded areas are often sensitive to cold or hot food or drink, and a desensitizing toothpaste and/or protection with a bonding (see bonding, dental) agent or filling may be needed.... abrasion, dental
The movement of teeth by using either fixed or removable orthodontic appliances (braces) to correct malocclusion (incorrect bite).... alignment, dental
The bony cavity or socket supporting each tooth in the jaw.... alveolus, dental
Redness and possible blistering caused by a sensitive substance such as chromium, nickel, other metals, rubber, paints, cosmetic materials, plants (primula), house dust mites, aerosols, deodorants, photocopying, dyes in clothing, etc. A patch test establishes diagnosis. A suspected irritant is applied to the skin and after two days its reaction is noted. If inflammation is present the test is positive. Symptoms may include vesicles with weeping, scaling, and presence of dropsy.
In a study of 612 patients attending the Royal Hallamshire Hospital, Sheffield, more than half of the women who had ears pierced reported skin reactions to metallic jewellery, while a third had sensitivity to nickel. (British Journal of Dermatology, Jan 1992)
Treatment. Remove article or cause of irritation. Garlic is claimed to be successful, either in diet or by capsule when the condition is caused by histamines. Other agents: Betony, Burdock leaves, Chickweed, Dandelion, Figwort, Gotu Kola, Plantain, Red Clover.
Internal. Burdock tea. Clivers tea.
Tablets/capsules. Garlic, Devil’s Claw, Blue Flag.
Topical. Avoid use of Calamine, if possible. Creams or salves: Aloe Vera, Comfrey, Evening Primrose, Witch Hazel, Jojoba. All are alternatives to corticosteroids.
Tamus (Black Bryony) tincture. Distilled extract of Witch Hazel. ... dermatitis, contact
Erythroderma. Redness and thickening of the skin which later peels off in layers (desquamation). Follows some chronic skin disorders: leukaemia, Hodgkin’s disease or fungoid invasion. May involve the whole of the body.
Alternatives. Teas. Betony, Burdock leaves, Bogbean, Chickweed, Clivers, Dandelion, Gotu Kola, Ground Ivy, Figwort, Red Clover, Violet, Yarrow.
Cold tea. Barberry bark: one heaped teaspoon to each teacup cold water; stand overnight, drink 1 cup morning and evening next day (most effective).
Tablets/capsules. Blue Flag root, Burdock, Devil’s Claw, Echinacea, Garlic, Poke root, Queen’s Delight, Red Clover, Seaweed and Sarsaparilla.
Formula. Equal parts: Dandelion, Echinacea, Yellow Dock root. Dose – Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Thrice daily before meals.
Topical. Alternatives to corticosteroids. Tamus tincture or salve – see Black Bryony. Aloe Vera, Witch Hazel, Comfrey, Evening Primrose, Jojoba, Thuja. Bran bath.
Diet. See: DIET – SKIN DISEASES. ... dermatitis, exfoliative
Red inflammation of the skin with blisters. Not eczema. Common cause: gluten, as present in cereals barley, oats, rye, wheat.
Alternatives. Teas. Betony, Burdock, Elderflowers, German Chamomile, Hops, Gotu Kola, Mullein, Plantain, Red Clover, Valerian.
Tea formula. Equal parts, Mullein, Red Clover, Valerian. Mix. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes; 1 cup thrice daily.
Tablets/capsules. Blue Flag, Dandelion, Devil’s Claw, Echinacea, Poke root, Red Clover, Seaweed and Sarsaparilla, Valerian.
Powders. Formula. Equal parts: Burdock root, Dandelion root, Valerian root. Two 00 capsules or one- third teaspoon thrice daily, (500mg).
Liquid extracts or tinctures. Formula. Chickweed 10ml; Poke root 5ml; Meadowsweet 10ml; Valerian 10ml. Dose: liquid extracts, one 5ml teaspoon; tinctures, two 5ml teaspoons. Thrice daily in water. Topical. Apply dilute Tea Tree oil 3-4 times daily. Witch Hazel, Aloe Vera, Vitamin E cream, Evening Primrose oil, or Marshmallow and Slippery Elm ointment. Bran bath.
Diet. Gluten-free.
DERMATITIS, LIGHT. Photo dermatitis. Reddening and blistering of the skin on exposure to sunlight.
See: SUNBURN. ... dermatitis, herpetiformis
A material, consisting of an alloy of mercury with other metals, that is used as fillings for teeth (see filling, dental).... amalgam, dental
The compactness of bone tissue in relation to its volume. A decrease in bone density is a normal part of aging. However, in some people, excessive loss of density (see osteoporosis) can lead to fractures. Less commonly, an increase in bone density (see osteosclerosis) occurs in certain disorders (see osteopetrosis; Paget’s disease). Bone density can be measured by a technique known as densitometry, which uses low-dose X-rays.... bone density
Harpagophytum procumbens D.C. Rhizome. Native of the Kalahari Desert.
Keynote: rheumatism. A versatile remedy.
Constituents: flavonoids, iridoid glycosides.
Action: anti-inflammatory, antirheumatic, analgesic (mild), liver tonic, cholagogue, diuretic, sedative, detoxicant, stomachic, lymphatic, stimulant, cortisone-like action.
Use s. Inflammatory arthritic stiff joints. Gout. Lumbago, sciatica, polymyalgia, neuralgia, liver congestion. Gall bladder disorders. Itching skin conditions. Piles. Inflammatory conditions of the veins. Avoid in pregnancy. Not given in presence of gastric or duodenal ulcer.
Preparations: Thrice daily.
Tablets: dosage as on bottle.
Alternative: a tea is made by dissolving tablets in a cup of boiling water.
Decoction. Quarter to half a teaspoon in each cup water gently simmered 15 minutes. Dose: half a cup. Liquid Extract, BHC Vol 1. (1:1, 25 per cent ethanol). Dose: 1-2ml.
Powder. 250mg capsules; maintenance dose, 2 capsules thrice daily with meals. Or applied to open wounds for healing. ... devil’s claw
See orthodontic appliances.... brace, dental
False teeth that are attached to natural teeth on either side of a gap left by a missing tooth or teeth. (See also denture.)... bridge, dental
The deposition of calcium salts in developing teeth. Primary teeth begin to calcify in a fetus at between 3 and 6 months gestation; calcification of permanent teeth (other than the wisdom teeth) begins between birth and 4 years. Abnormal calcification occurs in amelogenesis imperfecta, an inherited disorder of the enamel (see hypoplasia, enamel), and can also result from the absorption of high levels of fluoride (see fluorosis).... calcification, dental
A hard, crust-like deposit (also known as tartar) found on the crowns and roots of the teeth. Calculus forms when mineral salts in saliva are deposited in existing plaque. Supragingival calculus is a yellowish or white deposit that forms above the gum margin, on the crowns of teeth near the openings of salivary gland ducts. Subgingival calculus forms below the gum margin and is brown or black. Toxins in calculus cause gum inflammation (see gingivitis), which may progress to destruction of the supporting tissues (see periodontitis). Calculus is removed by professional scaling. Attention to oral hygiene reduces recurrence.... calculus, dental
See crown, dental.... capping, dental
A deposit and infiltration of fat on the heart in the obese and heavy consumers of alcohol. Distinct from true degeneration in which there is no destruction of tissue. Symptoms. Breathlessness and palpitation on slight exertion. Anginal pain: see ANGINA. Mental dullness. May follow enlargement of the heart and acute infections such as influenza.
Alternatives. Teas. Alfalfa, Clivers, Yarrow, Motherwort.
Tablets/capsules. Poke root, Kelp, Motherwort.
Formula. Equal parts: Bladderwrack, Motherwort, Aniseed, Dandelion. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons in water thrice daily. Black Cohosh. Introduced into the medical world in 1831 when members of the North American Eclectic School of physicians effectively treated cases of fatty heart.
Diet. Vegetarian protein foods, high-fibre, whole grains, seed sprouts, lecithin, soya products, low-fat yoghurt, plenty of raw fruit and vegetables, unrefined carbohydrates. Oily fish: see entry. Dandelion coffee. Reject: alcohol, coffee, salt, sugar, fried foods, all dairy products except yoghurt.
Supplements. Daily. Broad-spectrum multivitamin including Vitamins A, B-complex, B3, B6, C (with bioflavonoids), E, Selenium. ... heart – fatty degeneration
A hole in a tooth, commonly caused by dental caries (see caries, dental).... cavity, dental
A type of dermatitis caused by an allergic reaction to a substance that is in contact with the skin and which would not cause a reaction in most people exposed to it. Common causes include nickel and rubber. (See also irritant dermatitis.)... contact dermatitis
See overcrowding, dental.... crowding, dental
A protrusion on the grinding surface of a tooth.... cusp, dental
See sudden infant death syndrome (SIDS).... death, sudden infant
Any abnormality in colour vision that causes difficulty distinguishing between certain colours. Total absence of colour vision (monochromatism) is rare. The most common types of colour vision deficiency are reduced discrimination of red and green. Most cases of red and green colour vision deficiency are caused by defects in the light-sensitive cells in the retina. These defects are usually inherited, although occasionally defects are caused by retinal or optic nerve diseases or injury. The inherited defects tend to be sex-linked (see genetic disorders), which means that the majority of sufferers are male. A person with a severe green deficiency has difficulty distinguishing oranges, greens, browns, and pale reds. In severe red deficiency, all reds appear dull. A much rarer deficiency in which blue cannot be distinguished may be inherited or may be due to degeneration of the retina or optic nerve.... colour vision deficiency
Techniques used by the mind to cope with unpleasant or unwelcome emotions, impulses, experiences, or events. Repression of emotions surrounding a particular event or refusing to accept an event (denial) are both defence mechanisms.... defence mechanisms
An outdated term for severe schizophrenia, especially that affecting adolescents or young adults.... dementia praecox
An imaging technique that uses low-dose X-rays to measure bone density, as determined by the concentration of calcified material. It is used to diagnose and assess the severity of osteoporosis, especially in the spine and femur, and to assess its response to treatment. During the procedure, X-rays are passed through the body. A computer assesses the amount of X-rays absorbed by the body and uses this information to calculate the bone density.... densitometry
The “compactness” of a substance, defined as its mass per unit volume. In radiology, the term relates to the amount of radiation absorbed by the structure being X-rayed. Bone, which absorbs radiation well, appears white on X-ray film. A lung, which contains mostly air, absorbs little radiation and is dark on film. The same holds true in CT scanning and MRI. (See also specific gravity.)... density
A surgical instrument for cutting varying thicknesses of skin for use in skin grafting.... dermatome, surgical
A group of common fungal infections affecting the skin, h air, and nails, also known as tinea and, popularly, as ringworm.... dermatophyte infections
See dermoid cyst.... dermoid tumour
See hyposensitization.... desensitization, allergy
n. an area of contact between two adjacent cells, occurring particularly in epithelia. The cell membranes at a desmosome are thickened and fine fibres (tonofibrils) extend from the desmosome into the cytoplasm.... desmosome
(detoxication) n. 1. the process whereby toxic substances are removed or toxic effects neutralized. It is one of the functions of the liver. 2. the period of withdrawal when a person stops long-term consumption of alcohol or some other drug. Withdrawal symptoms (e.g. *delirium tremens) may occur during detoxification.... detoxification
n. the process of wearing away solid bodies (e.g. bones) by friction or use.... detrition
n. the muscle of the urinary bladder wall. The functioning of the detrusor and urethral sphincter is assessed by a urodynamic investigation (see urodynamics). This is used to diagnose dysfunction, absent and exaggerated reflexes, and overactivity of the muscle (detrusor instability, overactive bladder syndrome). Neurogenic detrusor overactivity is due to neurological damage, as occurs in multiple sclerosis or in suprasacral spinal cord injury.... detrusor
n. 1. the reverse of erection, whereby the erect penis or clitoris becomes flaccid after orgasm. 2. subsidence of a swelling.... detumescence
(deuto-, deuter(o-)) combining form denoting two, second, or secondary.... deut
n. a defect in colour vision in which reds, yellows, and greens are confused. It is thought that the mechanisms for perceiving red light and green light are in some way combined in people with this defect. Compare protanopia; tritanopia. See also colour blindness.... deuteranopia
n. see yolk.... deutoplasm
any one of a group of conditions in infancy or childhood, that are characterized by delays in biologically determined psychological functions, such as language. They are more common in males than females and tend to follow a course of disability with gradual improvement. They are classified into pervasive conditions, in which many types of development are involved (e.g. *autism), and specific disorders, in which the disability is an isolated problem (such as *dyslexia).... developmental disorder
skills gained by a developing child, which should be achieved by a given age. Examples of such milestones include smiling by six weeks and sitting unsupported by eight months. Failure to achieve a particular milestone by a given age is indicative of *developmental delay. See table.... developmental milestones
n. 1. (in ophthalmology) any abnormal position of one or both eyes. For example, if the eyes are both looking to one side when the head is facing forwards, they are said to be deviated to that side. Such deviations of both eyes may occur in brain disease. Deviations of one eye, such as *dissociated vertical deviation, come into the category of squint (see strabismus). 2. see sexual deviation.... deviation
see neuromyelitis optica. [E. Devic (1869–1930), French physician]... devic’s disease
n. (in dentistry) 1. tooth death, normally as a result of disease, trauma, or (less commonly) orthodontic treatment. 2. the removal of a diseased pulp from a tooth. In primary teeth the coronal pulp alone may be removed, while the pulp in the root is kept alive or root canal treatment undertaken. For permanent teeth, see root canal treatment.... devitalization
(dual-energy X-ray absorptiometry) a method of measuring bone density based on the proportion of a beam of photons that passes through the bone. The results of a DEXA scan are expressed as a *T score. See also osteoporosis.... dexa
(dextro-) combining form denoting 1. the right side. Example: dextroposition (displacement to the right). 2. (in chemistry) dextrorotation.... dextr
n. a carbohydrate formed as an intermediate product in the digestion of starch by the enzyme amylase. Dextrin is used in the preparation of pharmaceutical products (as an *excipient) and surgical dressings.... dextrin
(DSDs) see intersex.... differences of sexual development
(DSDs) see intersex.... disorders of sexual development
(DVD) a condition in which one eye looks upwards when the amount of light entering it is reduced, e.g. when it is covered. The eye returns to its original position when the cover is removed. DVD is an acquired condition chiefly associated with infantile esotropia (convergent *strabismus). The deviation is dissociated since there is no movement of the focusing (i.e. uncovered) eye during the deviation or return phase.... dissociated vertical deviation
Lack of sufficient loving attention and of warm, trusting relationships during a child’s early years, so that normal emotional development is inhibited. Emotional deprivation may result if bonding does not occur in the early months of life. Emotionally deprived children may be impulsive, crave attention, be unable to cope with frustration, and may have impaired intellectual development.... emotional deprivation
The hard outer layer of a tooth that covers and protects the inner structures.... enamel, dental
The process of replacing a chipped or decayed area of tooth with an inactive material. Dental filling is also used to describe the restorative material itself. Amalgam, a hard-wearing mixture of silver, mercury, and other metals is generally used for back teeth. If a front tooth is chipped, a bonding technique (see bonding, dental) may be used, in which plastic or porcelain tooth-coloured material is attached to the surface of the tooth.... filling, dental
See developmental hip dysplasia.... hip dysplasia, developmental
A post, surgically embedded in the jaw for the attachment of a dental prosthesis (an artificial tooth). Titanium or synthetic materials may be used. A dental implant is fitted under local anaesthesia. A hole is drilled in the jaw and a post inserted. Several months later, an attachment that protrudes from the gum is screwed into the post; a few weeks after that, the prosthesis is fitted.... implant, dental
See anaemia, iron-deficiency.... iron-deficiency anaemia
The deposition of calcium crystals and other mineral salts in developing teeth. (See calcification, dental.)... mineralization, dental
See postnatal depression.... postpartum depression
The soft tissue containing blood vessels and nerves in the middle of each tooth (see teeth).... pulp, dental
Replacement of a tooth in its socket after an accident so that it can become reattached to supporting tissues. The front teeth are most commonly involved. The tooth needs to be reimplanted soon after the accident and is maintained with a splint (see splinting, dental) while it heals. Healing may take several weeks.... reimplantation, dental
The reconstruction of part of a damaged tooth. Restoration also refers to the material or substitute part used to rebuild the tooth. Small repairs are usually made by filling the tooth. For extensive repairs, a dental inlay or a crown may be used. Chipped front teeth may be repaired by bonding (see bonding, dental).... restoration, dental
Removal of dental calculi (see calcuus, dental) from the teeth to prevent or treat periodontal disease.... scaling, dental
Plastic coatings that are applied to the chewing surfaces of the back teeth to help prevent decay.... sealants, dental
See dermatitis.... seborrhoeic dermatitis
Deafness due to problems with the inner ear, nerves, or the brain’s auditory area.... sensorineural deafness
Lack of sexual desire or of the ability to become physically aroused during sexual activity.... sexual desire, inhibited
The mechanical joining of several teeth to hold them firmly in place while an injury heals or while periodontal disease is treated.... splinting, dental
See death, sudden.... sudden death
See implants, dental.... titanium dental implants
A flat wooden or metal instrument used to hold the tongue on the floor of the mouth to allow examination of the throat.... tongue depressor
Most children walk by around 15 months of age. Delayed walking may be suspected if the child is unable to walk unassisted by 18 months (see developmental delay).... walking, delayed
See dental X-rays.... x-rays, dental
see burst abdomen.... abdominal dehiscence
see AIDS.... acquired immune deficiency syndrome
see adenosine deaminase deficiency.... ada deficiency
(ADA deficiency) a genetic disorder affecting about one baby in 25,000 and characterized by a defect in adenosine deaminase (ADA), an enzyme that is involved in purine metabolism. Deficiency of this enzyme results in selective damage to the antibody-producing lymphocytes; this in turn leads to a condition known as *severe combined immune deficiency (SCID), in which the affected baby has no resistance to infection and must be entirely isolated from birth. Such children have only about a 50% chance of surviving for six months. See also gene therapy.... adenosine deaminase deficiency
(AMD, ARMD) see macular degeneration.... age-related macular degeneration
see environmental hearing aid.... alerting device
a device for helping people with hearing difficulties. An assistive listening device can be a stand-alone device or can work in conjunction with a *hearing aid or *cochlear implant. Assistive listening devices include *induction loop systems, amplifiers for telephones, and radio headphones to wear when listening to the radio or television. Such devices increase the loudness of the desired sound without increasing the level of any background noise; i.e. they improve the signal-to-noise ratio. See also environmental hearing aid.... assistive listening device
(in England and Wales under the Mental Capacity Act 2005) a legally recognized decision or statement by an adult with *capacity identifying any specific or general treatment the patient does not want in the event that he or she loses capacity. An advance directive or decision (formerly often called a living will) should be informed, made voluntarily, and must be valid and applicable to the medical situation that arises; at the extreme it can constitute an advance refusal of potentially life-saving treatment. It cannot, however, be used to demand future treatment and does not apply as long as the person retains capacity. An advance statement is a more general and less legally binding expression of the person’s values and views on the sort of treatment he or she may or may not wish to undergo. Directives and statements can raise ethical questions: for example, should life-saving treatment refused in advance nevertheless be given if it could restore the patient to a quality of life with which he or she was content before losing capacity.... advance directive, decision, or statement
(AED) a type of external *defibrillator that can analyse the heart rhythm it detects and advise via voice prompts on therapy to be given according to the latest guidelines. In cases of ventricular fibrillation, some defibrillators will make decisions on delivering electric shocks and do so after issuing appropriate warnings to the attending health-care professionals.... automated external defibrillator
see defibrillator.... biphasic defibrillator
(buttonhole deformity) a deformity seen in a finger when the central strand of the tendon of the extensor muscle of the digits is ruptured. This results in marked flexion of the middle phalanx across the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint.... boutonnière deformity
see boutonniére deformity.... buttonhole deformity
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
the separation of the *choroid from the *sclera of the eye as a result of leakage of fluid from the vessels of the choroid. It occurs when pressure inside the eyeball is very low, usually after trauma or intraocular surgery.... choroidal detachment
a legal document, signed by a doctor, stating (in Part 1) the immediate cause of a person’s death followed by diseases underlying the condition. For example, if the immediate cause of death was a myocardial infarction, the underlying disease might have been ischaemic heart disease or hypertension. Other diseases, which were not directly linked with the immediate cause of death but may have contributed to the patient’s overall condition, are mentioned in Part 2 of the certificate. The document usually states the decedent’s gender and date and place of death; other details, such as occupation, may also be included. The death certificate forms a vital record in most countries throughout the world; without a death certificate, there can be no funeral. For England and Wales, this information is held at the General Register Office, which is now in Southport. In Scotland death certificates are kept at the National Records of Scotland, and in Northern Ireland at the General Register Office for Northern Ireland. Following the case of the serial killer Dr Harold Shipman and the subsequent public enquiry, legislation has introduced greater checks on, and scrutiny of, death certification by doctors.... death certificate
n. loss or removal of calcium salts from a bone or tooth.... decalcification
n. removal of the head, usually the head of a dead fetus to enable delivery to take place. This procedure is very rare nowadays, being undertaken only in dire circumstances when the fetal head is too large to pass through the birth canal, the mother’s life is endangered, and Caesarean section impossible.... decapitation
n. see decortication.... decapsulation
n. (in bacteriology) the decomposition of organic matter due to microbial action.... decay
n. the act of deliberately misleading, misrepresenting, or withholding information. Respect for patient *autonomy and the importance of trust in therapeutic relationships require that doctors should always strive to be honest with patients. The use of deception in research (see intervention study) is ethically highly controversial. See also therapeutic privilege; truth-telling.... deception
prefix denoting a tenth.... deci
n. an area of the upper surface of the *cerebellum, posterior to the culmen and anterior to the folium of the middle lobe.... declive
n. the removal of a blood clot from a thrombosed arteriovenous *fistula (which is created to perform dialysis). This can be done either by surgically opening the fistula and removing the clot or by using interventional radiological techniques (see fistuloplasty).... declotting
n. the temperature-dependent gradual disintegration of dead organic matter, usually foodstuffs or tissues, by the chemical action of bacteria and/or fungi.... decomposition
n. 1. the reduction of pressure on an organ or part of the body by surgical intervention. Surgical decompression can be effected at many sites: the pressure of tissues on a nerve may be relieved by incision; raised pressure in the fluid of the brain can be lowered by cutting into the *dura mater; and cardiac compression – the abnormal presence of blood or fluid round the heart – can be cured by cutting the sac (pericardium) enclosing the heart. 2. the gradual reduction of atmospheric pressure for deep-sea divers, who work at artificially high pressures. See compressed air illness.... decompression
an approach that combines many of the different treatments (such as compression and physiotherapy) used to minimize the pain and swelling associated with *lymphoedema following breast surgery and radiotherapy. There are two phases: reduction (which lasts up to 12 weeks) and maintenance (which continues for life).... decongestive therapy
n. 1. a combination of processes used to remove adherent proteins, microorganisms, and infectious agents or other contaminants from surgical instruments and the environment so there is no risk or spread of infection or disease. Instruments are sterilized in an autoclave to finish the decontamination process. 2. the reduction or removal of chemical agents from a site following a terrorist attack or industrial accident; this includes decontaminating people who have come into contact with such agents.... decontamination
n. 1. the removal of the outside layer (cortex) from an organ or structure, such as the kidney. 2. an operation for removing the blood clot and scar tissue that forms after bleeding into the chest cavity (haemothorax). 3. (decapsulation) the surgical removal of a *capsule from an organ; for example, the stripping of the membrane that envelops the kidney or of the inflammatory capsule that encloses a chronic abscess, as in the treatment of *empyema.... decortication
(DBS) a surgical treatment involving the implantation of a medical device that sends electrical impulses to specific parts of the brain. DBS in selected brain regions can provide benefits for treatment-resistant movement disorders, such as Parkinson’s disease, tremor, and *dystonia.... deep brain stimulation
mechanical obstruction of labour in which the fetal head is unable to rotate from occipitotransverse to occipitoanterior position (see occiput).... deep transverse arrest
see Chrysops.... deer fly
the means whereby an undesirable impulse or emotion can be avoided or controlled. Defence mechanisms are regarded as normal forms of self-protection; however, used excessively, they can become pathological. Many defence mechanisms have been described, including *repression, *projection, *reaction formation, *sublimation, and *splitting.... defence mechanism
health care that becomes distorted by real or exaggerated fear of legal action so that medical decisions are taken with a view to protecting the professional against legal liability. See also negligence.... defensive medicine
adj. 1. carrying away from or down from. 2. relating to the vas deferens.... deferent
n. the disappearance of a fever, a process that may occur rapidly or take several days, depending upon the cause and treatment given.... defervescence
see coupling agents.... defibrillation gel pads
n. the apparatus used for *defibrillation, which may be internal (see implantable cardiovertor defibrillator) or external. External defibrillators may be fully automated (see automated external defibrillator), semiautomated, or manual and usually deliver the electric current via two defibrillation paddles. They are now all manufactured to deliver a biphasic current waveform (until recently they were all monophasic). The efficacy of the first shock during *cardiac arrest is higher with biphasic systems, which also use less battery power per shock.... defibrillator
n. the removal of *fibrin, one of the plasma proteins that causes coagulation, from a sample of blood. It is normally done by whisking the blood with a bundle of fine wires, to which the strands of fibrin that form in the blood adhere.... defibrination
n. (in genetics) see deletion.... deficiency
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
n. a *gonadotrophin-releasing hormone antagonist used in the treatment of advanced prostate cancer that does not cause an initial increase in testosterone levels. Side-effects include hot flushes and pain at the injection site.... degarelix
(DHEA) n. a weak androgen produced and secreted by the adrenal glands after the stage of adrenal maturation known as *adrenarche. It is produced from 17-hydroxypregnenolone and itself is largely converted to dehydroepiandrosterone sulphate and androstenedione. All three of these molecules can cause a degree of mild *androgenization but can also be converted in the circulation to the more potent androgens *testosterone and *dihydrotestosterone.... dehydroepiandrosterone
n. see oxidoreductase.... dehydrogenase
(delayed primary closure) a technique used in the closure of contaminated wounds and wounds associated with tissue necrosis, such as those produced by missile injuries. The wound is partially closed after it has been cleaned sufficiently to allow adequate healing.... delayed suture
(deficiency) n. (in genetics) a type of mutation involving the loss of DNA. The deletion may be small, affecting only a portion of a single gene, or large, resulting in loss of a part of a chromosome and affecting many genes.... deletion
any attempt at self-injury or self-poisoning, as often occurs in the context of acute stress, personality disorder, depression, and alcoholism. It may or may not involve suicidal intent. Treatment begins with a psychosocial assessment, on the basis of which the patient may be offered various forms of *psychotherapy and occasionally *antipsychotic medication, *lithium, or *SSRIs. If the attempt is serious, immediate treatment may be necessary in a medical ward or (more rarely), if suicidal intent persists, in a psychiatric ward. Patients who do not have a mental disorder should be assessed using the criteria set out in the Mental Capacity Act 2005 and, if found to have *capacity, are entitled to consent to or refuse treatment like any other capacitous adult. See also suicide.... deliberate self-harm
pl. n. localized areas of corneal thinning, usually at the limbus (the junction of the cornea with the sclera), due to local dehydration. They may occur after surgery to correct a squint, due to elevated conjunctiva at the limbus causing poor wetting of the adjacent cornea.... dellen
a *monodelusional disorder in which patients believe they or their environment are infested by living or non-living pathogens. These can range from rats in the patient’s house to microspores in the air. Most commonly, patients claim they are infested with insects, worms, parasites, mites, or inanimate threads or fibres, often underneath their skin. Many present the alleged parasite as a specimen for examination. If compliance can be established, most patients respond well to *antipsychotic medication. The term delusional infestation was first introduced by Roland W. Freudenmann and Peter Lepping in 2009, and has gradually superseded the terms delusional parasitosis and Ekbom’s syndrome.... delusional infestation
the intensity with which a delusional belief is held. This can vary over time and sometimes shifts quite rapidly. Some factors, such as treatment, may temporarily or permanently reduce the intensity of a delusion, while others may work to reinforce it.... delusional intensity
a *delusional belief that one’s partner is unfaithful when there is no reasonable evidence for this. It often occurs in the context of *alcoholism.... delusional jealousy
see delusional infestation.... delusional parasitosis
a *Schneiderian first-rank symptom in which a person believes that a normal percept (product of perception) has a special meaning for him or her. For example, a cloud in the sky may be misinterpreted as meaning that someone has sent that person a message to save the world. While the symptom is particularly indicative of *schizophrenia, it also occurs in other psychoses, including *mania (in which it often has grandiose undertones).... delusional perception
a *delusion in which the patient believes that unsuspicious occurrences refer to him or her in person. Patients may, for example, believe that certain news bulletins have a direct reference to them, that music played on the radio is played for them, or that car licence plates have a meaning relevant to them. Ideas of reference differ from delusions of reference in that insight is retained.... delusion of reference
n. a *tetracycline antibiotic that is used to treat infections caused by Chlamydia, rickettsiae, and mycoplasmas. It is also used to treat *syndrome of inappropriate secretion of antidiuretic hormone. Common side-effects are nausea, diarrhoea, and symptoms resulting from the growth of organisms not sensitive to the drug.... demeclocycline
a delusion in which the patient believes that another person or an animal (usually the patient’s pet) has certain physical symptoms, even though these cannot be objectively verified. The patient with the delusional belief is called the inducer; the person or pet that is allegedly affected is the proxy. Some *monodelusional disorders, such as *delusional infestation, have a prevalence of delusion by proxy of up to 5%. Treatment is usually with *antipsychotics. In some situations it may be necessary to remove the proxy to provide safety from the behaviour associated with the delusion. See also double delusion; folie à deux.... delusion by proxy
n. a genus of harmless parasitic mites, the follicle mites, found in the hair follicles and associated sebaceous glands of the face. They resemble tiny worms, about 0.4 mm in length, and their presence may give rise to dermatitis.... demodex
n. the changes in the physical and physiological properties of a protein that are brought about by heat, X-rays, or chemicals. These changes include loss of activity (in the case of enzymes) and loss (or alteration) of antigenicity (in the case of *antigens).... denaturation
n. one of the shorter branching processes of the cell body of a *neuron, which makes contact with other neurons at synapses and carries nerve impulses from them into the cell body.... dendrite
a type of haemopoietic cell with specialized antigen-presenting functions. The head and neck are common sites for dendritic cell pathology. See antigen-presenting cell.... dendritic cell
n. a *monoclonal antibody most commonly used in the treatment of postmenopausal osteoporosis to prevent fractures but also indicated at a higher dose to prevent bone damage in patients with bone metastases. Side-effects include a risk of low calcium, infections, joint pains, fatigue, and headache, all more common with the higher doses.... denosumab
n. a tooth or tooth-shaped structure.... dens
see mesangiocapillary glomerulonephritis.... dense deposit disease
literally, an infolded tooth: a specific type of tooth malformation that mainly affects upper lateral incisors to varying degrees. Also known as a dens in dente (‘tooth within a tooth’), it involves an infolding of enamel into dentine.... dens invaginatus
(denti-, dento-) combining form denoting the teeth. Example: dentoalveolar (relating to the teeth and associated jaw).... dent
any of several professionals supporting a dentist, formerly referred to as dental auxiliaries and professionals complementary to dentistry. A dental hygienist performs scaling and instruction in oral hygiene. A dental nurse helps the dentist at the chairside by preparing materials, passing instruments, and aspirating fluids from the patient’s mouth. A dental technician constructs dentures, crowns, and orthodontic appliances in the laboratory for the dentist. A clinical dental technician provides dentures directly to patients. A dental therapist performs non-complex treatment under the prescription of a dentist. In the UK dental care professionals are required to be statutorily registered with the General Dental Council (GDC).... dental care professional
a reclinable chair on which a patient lies for dental treatment. Electric switches change the position of the patient, and the chair is frequently attached to the *dental unit.... dental chair
a fine thread, usually of nylon, used to clean the surfaces between teeth. A thicker version is known as dental tape. It may be waxed to help the user slide it past the tooth contacts.... dental floss
a piece of dental equipment (high-speed or low-speed) for holding a dental *bur or *file. It is made of corrosion-resistant materials to allow sterilization. See drill.... dental handpiece
see implant.... dental implant
either of two nerves that supply the teeth; they are branches of the trigeminal nerve. The inferior dental nerve supplies the lower teeth and for most of its length exists as a single large bundle; thus anaesthesia of it has a widespread effect (see inferior dental block). The superior dental nerve, which supplies the upper teeth, breaks into separate branches at some distance from the teeth and it is possible to anaesthetize these individually with less widespread effect for the patient.... dental nerve
see dental care professional.... dental nurse
(DPT) a special form of tomogram (see tomography) that provides a picture of all the teeth of both jaws on one film. Newer equipment can produce three-dimensional images of part of the jaw.... dental pantomogram
a major fixed piece of dental equipment to which are attached the dental drills, aspirator, compressed air syringe, and ultrasonic scaler. It is frequently integral with the *dental chair.... dental unit
adj. 1. having teeth. 2. serrated; having toothlike projections.... dentate
n. the formation of *dentine by *odontoblasts. Although dentinogenesis continues throughout life, very little dentine is formed later than a few years after tooth eruption unless it is stimulated by caries, abrasion, or trauma. Dentinogenesis imperfecta is a hereditary condition in which dentine formation is disturbed; this may result in loss of overlying enamel and excessive wear of the dentine.... dentinogenesis
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
a rare disorder consisting of the triad of *nephroblastoma (Wilms’ tumour), congenital nephropathy, and intersex disorders, resulting from mutations in the Wilm’s tumour suppressor gene (WT1). Incomplete forms exist; congenital nephropathy, with diffuse mesangial sclerosis, is the constant feature with either Wilms’ tumour or intersex disorders, usually in the form of male *pseudohermaphroditism. [P. Denys (20th century), French physician; A. Drash (20th century), British physician]... denys–drash syndrome
n. an approach to ethics that is concerned with what makes an action inherently right or wrong. Deontology’s emphasis on the primacy of observing duties and respecting rights is at odds with the approach that judges actions by their outcomes (see consequentialism). This tension is central to many issues in medical ethics; for example, in relation to *euthanasia, the wrong of killing versus the good outcome of ending suffering, and is further complicated when rights or duties are in conflict with one another, e.g. in relation to *abortion, the rights of the mother versus the rights of the fetus. See also Kantian ethics. —deontological adj.... deontology
see bile acids.... deoxycholic acid
n. a hormone, synthesized and released by the adrenal cortex, that regulates salt and water balance. See also corticosteroid.... deoxycorticosterone
n. an enzyme, located in the *lysosomes of cells, that splits DNA at specific places in the molecule.... deoxyribonuclease
(HHS) the major US government agency providing health care. The department was created in 1953 and assumed its current name in 1980. HHS administers more than 300 health and health-related programmes and services, including *Medicare and *Medicaid. Other activities include research, immunization services, and providing financial assistance for low-income families. Almost a quarter of federal spending occurs through HHS.... department of health and human services
in the USA, a paraprofessional or subprofessional health-care worker who is allowed to provide a limited amount of treatment to patients, usually under the supervision of a licensed practitioner, such as a physician. Examples include a nurse practitioner or occupational therapist.... dependent practitioner
n. the sudden surge of charged particles across the membrane of a nerve cell or a muscle cell that accompanies a physicochemical change in the membrane and cancels out, or reverses, its resting potential to produce an *action potential. The passage of a *nerve impulse is a rapid wave of depolarization along the membrane of a nerve fibre.... depolarization
n. an agent that reduces the normal activity of any body system or function. Drugs such as general *anaesthetics, *barbiturates, and opioids are depressants of the central nervous system and respiration. *Cytotoxic drugs, such as azathioprine, are depressants of the levels of white blood cells.... depressant
n. a genus of hard *ticks, worldwide in distribution, the adults of which are parasites of humans and other mammals. The wood tick, D. andersoni, transmits Rocky Mountain spotted fever to humans in the western USA and the dog tick, D. variabilis, is the vector of this disease in the east.... dermacentor
n. a genus of widespread parasitic mites. The red poultry mite, D. gallinae, is a common parasite of wild birds in temperate regions but can also infest poultry. It occasionally attacks and takes a blood meal from humans, causing itching and mild dermatitis.... dermanyssus
n. a genus of nonbloodsucking flies inhabiting lowland woods and forests of South and Central America. The parasitic maggots of D. hominis can cause a serious disease of the skin in humans (see myiasis). The maggots burrow into the skin, after emerging from eggs transported by bloodsucking insects (e.g. mosquitoes), and produce painful boil-like swellings. Treatment involves surgical removal of the maggots.... dermatobia
n. redundant eyelid skin, which may cause drooping of the upper lid. It usually occurs as a result of ageing. Compare blepharochalasis.... dermatochalasis
a tumour probably derived from *histiocytes that may occur in any part of the body. It is locally invasive but tends not to metastasize. It often recurs locally despite excision.... dermatofibrosarcoma protuberans
(DLQI) a validated questionnaire designed by Finlay in 1994 to assess the impact of skin diseases on psychological and social wellbeing. It is the most common *quality of life tool used as an endpoint in dermatology clinical trials. DLQI scores of more than 10 (indicating a severe impact on life) are required before biological treatments for psoriasis may be administered in the UK.... dermatology life quality index
n. a genus of *mites that have been detected in samples of dust taken from houses in various parts of Europe. House-dust mites feed on human skin and scales and cause dermatitis of the scalp. Waste products from the mites produce an allergic response in susceptible people that is an important trigger for some forms of *rhinitis and *asthma.... dermatophagoides
n. any disease of skin, particularly one without inflammation. In juvenile plantar dermatosis, which affects children up to the age of 14, the skin on the front of the sole becomes red, glazed, and symmetrically cracked. This condition, which settles spontaneously after a number of years, is believed to be related to the wearing of trainers.... dermatosis
(dermatoscopy) n. the process whereby skin lesions are examined by a dermatoscope (an instrument with a magnifier and a nonpolarized light source). The dermatoscope is pressed firmly on the skin with a liquid medium (e.g. oil) between the instrument and the skin. The technique allows closer examination of pigment networks, vascular structures, etc., and may help to distinguish benign from malignant lesions.... dermoscopy
n. thinning of the *stroma of the cornea to such an extent that *Descemet’s membrane is all that is maintaining the integrity of the eyeball. It occurs in severe ulceration of the cornea.... descemetocele
the membrane that forms the deepest layer of the *stroma of the cornea of the eye. The endothelium lies between it and the aqueous humour. [J. Descemet (1732–1810), French anatomist]... descemet’s membrane
n. the state of deserving something. In medical ethics it is controversial to argue that some patients may be more deserving of treatment than others on the basis of their past or present conduct. See also need.... desert
a psychoactive drug produced by minor chemical modification of existing illegal substances so as to circumvent prohibitive legislation. These drugs are manufactured in secret laboratories for profit, without regard to any probable medical and social dangers to the consumers.... designer drug
(diabetes education and self-management for ongoing and newly diagnosed) a structured one-day education programme for patients with type 2 diabetes, developed in 2003. Outcomes show an increase in participants’ understanding of diabetes and risk factors associated with coronary heart disease.... desmond
n. 1. the proliferation of *fibroblasts to produce a fibrous *stroma in response to a malignant tumour. It is a feature of the more aggressive tumours. 2. the formation of fibrous *adhesions. —desmoplastic adj.... desmoplasia
(DSTs) tests based on the principle that appropriate doses of *dexamethasone can suppress the output of cortisol from the adrenal glands in the normal state and that this ability is reduced or lost in *Cushing’s syndrome. In the overnight DST 1 mg of dexamethasone is administered at midnight and the serum cortisol level is measured at 9.00 am the next morning. Failure to suppress cortisol output may indicate Cushing’s syndrome but also occurs in patients with obesity and depressive illness. In the low-dose DST (0.5 mg dexamethasone every 6 hours for 48 hours), cortisol suppression occurs in patients with obesity and depression but not in those with Cushing’s syndrome. In the high-dose DST (2 mg dexamethasone every 6 hours for 48 hours), cortisol is suppressed in patients with Cushing’s disease (in which excess amounts of ACTH are secreted by the pituitary gland) but not in those with Cushing’s syndrome due to other causes. Although the low- and high-dose tests are unreliable, all three tests should be performed to aid the diagnosis of Cushing’s syndrome.... dexamethasone suppression tests
the situation in which a patient (the inducer) presents with delusional symptoms that he or she believes to be shared by someone else who is incapable of expressing them (typically a child or a pet). This is different from a *delusion by proxy, in which the inducer does not claim to be experiencing the symptoms himself or herself. The term was introduced in 2015 by Peter Lepping, Mark Rishniw, and Roland Wolfgang Freudenmann. Compare folie à deux.... double delusion
see perinatal mortality rate.... early neonatal death
(EMDR) a type of psychotherapy used for the treatment of significant anxiety or distress caused by traumatic events or in the context of *post-traumatic stress disorder. The aim is to separate the emotional from the actual memory of the event in order to reduce the anxiety related to the memory.... eye movement desensitization and reprocessing therapy
a piece of equipment used instead of a conventional X-ray film to acquire the image in *digital radiography.... flat-panel detector
(FTD) a relatively rare neurodegenerative disease characterized by progressive loss of neurons predominantly involving the frontal and/or temporal lobes. First described by Arnold Pick in 1892, it was originally called Pick’s disease. Common symptoms include significant changes in social and personal behaviour, *abulia, blunting of emotions, and language deficits. Compared with *Alzheimer’s disease, a younger population is affected (age 55–65) and more cases have a genetic cause.... frontotemporal dementia
a hereditary disorder – an X-linked condition (see sex-linked) – in which the absence of the enzyme glucose-6-phosphate dehydrogenase (G6PD), which functions in carbohydrate metabolism, results in the breakdown of the red blood cells (*haemolysis), usually after exposure to *oxidants, such as drugs, or infections. The breakdown causes acute attacks that are characterized by pallor, loin pain, and rigors. There are several varieties of G6PD deficiency, which is most common in people of African, Middle Eastern, and Mediterranean descent. Treatment involves identifying and avoiding agents that trigger the haemolysis and treating acute attacks symptomatically. See also favism.... glucose-6-phosphate dehydrogenase deficiency
(glutamic acid dehydrogenase) an important enzyme involved in the *deamination of amino acids.... glutamate dehydrogenase
(GAD) a common enzyme that, because of similarities to certain bacterial proteins, can provoke an autoimmune reaction against the beta cells of the pancreas (see islet cell antibodies) progressing to type 1 *diabetes mellitus.... glutamic acid decarboxylase
see community midwife.... home delivery
see kyphos.... hunchback deformity
... immuno- combining form denoting immunity or immunological response.
(ICD) a self-contained device, similar to a *pacemaker, that monitors heart rhythm and delivers an electric shock to correct life-threatening arrhythmia. See also defibrillator.... implantable cardiovertor defibrillator
(inferior alveolar nerve block) a type of injection to anaesthetize the inferior *dental nerve. Inferior dental block is routinely performed to allow dental procedures to be carried out on the lower teeth on one side of the mouth.... inferior dental block
a bony canal in the *mandible on each side. It carries the inferior *dental nerve and vessels and for part of its length its outline is visible on a radiograph.... inferior dental canal
death of a fetus in the uterus after 24 weeks of gestation. See stillbirth.... intrauterine fetal death
a drug containing *iron and *dextran, administered to treat iron-deficiency anaemia. Side-effects can include pain at the site of injection, rapid beating of the heart, and allergic reactions.... iron dextran
see dermatosis.... juvenile plantar dermatosis
death of a baby between 7 and 27 completed days of life.... late neonatal death
an irritant contact *dermatitis caused by saliva produced during habitual licking of the lips and the surrounding skin in an attempt to moisten dry chapped lips. The mainstay of treatment is regular frequent application of a moisturizing agent.... lip licker’s dermatitis
(MdDS, disembarkment syndrome) a form of *vertigo in which sufferers experience a sensation of bobbing, rocking, or swaying after getting off a boat or other form of transport. The condition remains little understood.... mal de debarquement syndrome
deaths of women while pregnant or within 42 days of the end of the pregnancy from any cause related to, or aggravated by, the pregnancy or its management, but not from accidental or incidental causes. These deaths can be subdivided into four main categories: (1) direct deaths: directly related to pregnancy; (2) indirect deaths: due to pre-existing maternal disease aggravated by pregnancy; (3) coincidental: unrelated to pregnancy; (4) late deaths: occurring between six weeks and one year following delivery. See also maternal mortality rate.... maternal death
a chromosomal abnormality resulting in a characteristic facial appearance and the absence of the grooves on the surface of the brain (see lissencephaly). Affected individuals have severe learning disabilities.... miller–deiker syndrome
see defibrillator.... monophasic defibrillator
formerly, a *special health authority of the NHS established under the Health and Social Care Act 2012 to oversee NHS trusts without *foundation trust status and to support their transition to such status. The Authority closed in 2016, when its functions were transferred to the newly established *NHS Improvement.... nhs trust development authority
a physiological condition that exists in cells during periods of temporary oxygen shortage. During periods of violent exertion the body requires extra energy, which is obtained by the breakdown of glucose in the absence of oxygen, after the available oxygen has been used up. The breakdown products are acidic and cause muscle pain. The oxygen required to get rid of the breakdown products (called the oxygen deficit) must be made available after the exertion stops.... oxygen deficit
abnormal bulging down of the *perineum as a result of weakness of the pelvic floor muscles. It often accompanies problems with defecation and micturition.... perineal descent
a plastic device that facilitates *circumcision while protecting the glans penis. It is widely used for circumcisions in newborn boys.... plastibell device
(PDGF) see growth factor.... platelet-derived growth factor
a policy of actively and continuously improving patient care, with an emphasis on interprofessional collaboration and the integration of evidence-based practice with *person-centred care.... practice development
a measurement of the depth of a periodontal pocket (see periodontal disease).... probing depth
(surrogate decision) a decision made with or on behalf of a person who lacks full legal capacity to *consent to or refuse medical treatment. See best interests; Gillick competence; parental responsibility; power of attorney; substituted judgment.... proxy decision
the process by which an individual becomes more mature in his or her sexual feelings and behaviour. Gender identity, sex-role behaviour, and choice of sexual partner are the three major areas of development. In Freudian psychoanalysis the phrase is sometimes used specifically for a sequence of stages, supposed by psychoanalytic psychologists to be universal, in which oral, anal, phallic, latency, and genital stages successively occur. These stages reflect the parts of the body on which sexual interest is concentrated during childhood development.... psychosexual development
programmes of lay education in the UK that aim to provide training in cardiac resuscitation up to and including *defibrillation. Together with programmes to increase the availability of *automated external defibrillators in public places (e.g. shops and railway stations), they recognize that the best outcomes from cardiac resuscitation are obtained with early defibrillation and good bystander basic life support.... public access defibrillation programmes
see specific gravity.... relative density
excessive loss of sodium chloride (common salt) from the body. This may result from sweating, persistent vomiting or diarrhoea, or loss of fluid in wounds. The main symptoms are muscular weakness and cramps. Miners and workers in hot climates are particularly at risk, and salt tablets are often taken as a preventive measure.... salt depletion
a noninflammatory condition of the cornea resulting in yellow-white nodules under the epithelium in the central area. These may cause symptoms if the epithelium over them breaks down or if they are located along the visual axis. [M. Salzmann (1862–1954), German ophthalmologist]... salzmann’s degeneration
(SCID) a rare disorder that usually manifests itself within the first three months of life by severe bacterial, fungal, and viral infection and *failure to thrive. It is due to reduced numbers of T and B *lymphocytes – white blood cells necessary for fighting infection. Some cases are caused by *adenosine deaminase deficiency. The only treatment currently available is a bone-marrow transplant, but *gene therapy offers hope for the future.... severe combined immune deficiency
see folie à deux.... shared delusion
a neurological condition of the eyes in which one eye turns down while the other turns up. It is seen in disorders of the *cerebellum or *brainstem.... skew deviation
any of a group of inherited disorders of the cerebellum and corticospinal tracts in the brain. They are characterized by *spasticity of the limbs and cerebellar *ataxia.... spinocerebellar degeneration
a congenital abnormality of the scapula (shoulder blade), which is small and positioned high in the shoulder. It is caused by failure of the normal development and descent of this bone. [O. G. K. Sprengel (1852–1915), German surgeon]... sprengel’s deformity
(SUDEP) the sudden unexpected nontraumatic death of a person with *epilepsy, with or without evidence of a seizure and with no obvious cause found at post mortem.... sudden unexpected death in epilepsy
(SCDS) a rare condition characterized by sound- or pressure-induced vertigo (see Tullio phenomenon), hearing loss, *autophony, and a sense of fullness in the affected ear. It is associated with absence of the bone that normally lies over the superior *semicircular canal. Diagnosis involves computerized tomography and *vestibular evoked myogenic potential testing. Treatment involves surgery to repair the bony defect.... superior canal dehiscence syndrome
see proxy decision.... surrogate decision
see dementia.... vascular dementia
(VAD) a mechanical pump implanted in the body for the purpose of taking over some or all of the pumping action of the heart in patients with severe heart damage. Support may be given to the left ventricle (LVAD), right ventricle (RVAD), or both. Most such devices require *thoracotomy, but a percutaneous device is now also available. This is usually regarded as a temporary measure until the heart has recovered or is transplanted.... ventricular assist device
(VLDL) a *lipoprotein that is the precursor of *low-density lipoprotein (LDL). Containing triglycerides and cholesterol, it is produced in the liver and circulates in the bloodstream, where its triglycerides are hydrolysed to free fatty acids by *lipoprotein lipase. The remaining lipoprotein becomes progressively denser and richer in cholesterol to form LDL.... very low-density lipoprotein
(Best’s disease) degeneration of the *macula of the eye that is inherited as a dominant characteristic and usually starts in childhood. There is widespread abnormality of retinal pigment epithelium (see retina) with the accumulation of a yellowish material, especially in the macular area.... vitelliform degeneration
the separation of the *vitreous humour from the underlying retina. This is a normal ageing process, but it is also more common in such conditions as diabetes and severe myopia. It can sometimes cause a tear in the retina and lead to *retinal detachment.... vitreous detachment
see Erb’s palsy.... waiter’s-tip deformity
degeneration of a ruptured nerve fibre that occurs within the nerve sheath distal to the point of severance. [A. V. Waller (1816–70), British physician]... wallerian degeneration
a test for *diabetes insipidus in which fluid and food intake is withheld completely for up to 24 hours, with regular measurement of plasma and urinary *osmolality and body weight. Normally (and in a person with psychogenic *polydipsia) the output of *vasopressin will be increased in order to concentrate the urine as the plasma osmolality rises; correspondingly, the urine osmolality also rises and its volume diminishes. In a patient with diabetes insipidus, however, the urine osmolality will remain low and of high volume while the patient steadily dehydrates. The test must be abandoned if the patient loses 3% of body weight.... water-deprivation test
Carphephorus odoratissimus
FAMILY: Asteraceae (Compositae)
SYNONYMS: Trilisa odoratissima, Liatris odoratissima, Frasera speciosa, hound’s tongue, deer’s tongue, Carolina vanilla, vanilla leaf, wild vanilla, vanilla trilisa, whart’s tongue, liatrix (oleoresin or absolute).
GENERAL DESCRIPTION: A herbaceous perennial plant distinguished by a naked receptacle and feathery pappus, with large, fleshy, dark green leaves, clasped at the base. When fresh, the leaves have little odour but when dried they acquire a vanilla-like odour, largely due to the coumarin that can be seen in crystals on the upper sides of the leaves.
DISTRIBUTION: Native to eastern USA; gathered on the savannah land between North Carolina and Florida.
OTHER SPECIES: There are several species of deertongue native to America, for example blazing star or prairie pine (Liatris squarrosa), and gayfeather (L. spicata). Not to be confused with the common vanilla (Vanilla planifolia) or with the European hound’s tongue (Cynoglossum officinale), all of which have been used in herbal medicine.
HERBAL/FOLK TRADITION: The roots have been used for their diuretic effects, and applied locally for sore throats and gonorrhoea. It has also been used as a tonic in treating malaria. In folklore the plant is associated with contraception and sterility in women.
ACTIONS: Antiseptic, demulcent, diaphoretic, diuretic, febrifuge, stimulant, tonic.
EXTRACTION: Oleoresin by solvent extraction from the dried leaves.
CHARACTERISTICS: A dark green, heavy, viscous liquid with a rich, herbaceous, new-mown hay scent. It blends well with oakmoss, labdanum, lavandin, frankincense, clove, patchouli and oriental-type fragrances.
PRINCIPAL CONSTITUENTS: Mainly coumarin (1.6 per cent), with dihydrotoumarin and terpenes, aldehydes and ketones.
SAFETY DATA: ‘Coumarin has toxic properties including liver injury and haemorrhages.’. (There is also the possibility of dermal irritation and phototoxicity due to the lactones present.)
AROMATHERAPY/HOME: USE None.
OTHER USES: The oleoresin is used as a fixative and fragrance component in soaps, detergents and perfumery work. Used for flavouring tobacco and; also employed for the isolation of coumarin.... deertongue
an agent for the relief or reduction of congestion, e.g. mucous.... decongestive
Health Encyclopedia