Not all sufferers from coeliac disease present with gastrointestinal symptoms: doctors, using screening techniques, have increasingly identi?ed large numbers of such people. This is important because researchers have recently discovered that untreated overt and silent coeliac disease increases the risk of sufferers developing osteoporosis (brittle bone disease – see BONE, DISORDERS OF) and cancer. The osteoporosis develops because the bowel fails to absorb the CALCIUM essential for normal bone growth. Because those with coeliac disease lack the enzyme LACTASE, which is essential for digesting milk, they avoid milk – a rich source of calcium.
The key treatment is a strict, lifelong diet free of gluten. As well as returning the bowel lining to normal, this diet results in a return to normal bone density. People with coeliac disease, or parents or guardians of affected children, can obtain help and guidance from the Coeliac Society of the United Kingdom. (See also MALABSORPTION SYNDROME; SPRUE.)... coeliac disease
has no connection with foot and mouth disease in cattle, deer, pigs and sheep.... hand, foot and mouth disease
Treatment In severely affected fetuses, a fetal blood transfusion may be required and/or the baby may be delivered early for further treatment. Mild cases may need observation only, or the reduction of jaundice by phototherapy alone (treatment with light, involving the use of sunlight, non-visible ULTRAVIOLET light, visible blue light, or LASER).
Whatever the case, the infant’s serum BILIRUBIN – the bilirubin present in the blood – and its HAEMOGLOBIN concentration are plotted regularly so that treatment can be given before levels likely to cause brain damage occur. Safe bilirubin concentrations depend on the maturity and age of the baby, so reference charts are used.
High bilirubin concentrations may be treated with phototherapy; extra ?uid is given to prevent dehydration and to improve bilirubin excretion by shortening the gut transit time. Severe jaundice and anaemia may require exchange TRANSFUSION by removing the baby’s blood (usually 10 millilitres at a time) and replacing it with rhesus-negative fresh bank blood. Haemolytic disease of the newborn secondary to rhesus incompatibility has become less common since the introduction of anti-D (Rho) immunoglobulin. This antibody should be given to all rhesus-negative women at any risk of a fetomaternal transfusion, to prevent them from mounting an antibody response. Anti-D is given routinely to rhesus-negative mothers after the birth of a rhesus-positive baby, but doctors should also give it after threatened abortions, antepartum haemorrhages, miscarriages, and terminations of pregnancy.
Occasionally haemolytic disease is caused by ABO incompatibility or that of rarer blood groups.... haemolytic disease of the newborn
Arteritis is a common complication and can result in the development of coronary artery aneurysms (see ANEURYSM) in up to 60 per cent of those affected. These aneurysms and even myocardial infarction (see HEART, DISEASES OF – Coronary thrombosis) are often detected after the second week of illness. The disease can be hard to diagnose as it mimics many childhood viral illnesses, especially in its early stages. The incidence in the UK is over 3 per 100,000 children under ?ve years of age.
Treatment Because of the danger of coronary artery disease, prompt treatment is important. This is with intravenous IMMUNOGLOBULINS and low-dose aspirin. To be e?ective, treatment must start in the ?rst week or so of the illness – a time when it is most di?cult to diagnose.... kawasaki disease
Symptoms: (acute) abdominal pain, muscle weakness, vomiting, low blood pressure due to dehydration, tiredness, mental confusion, loss of weight and appetite. Vomiting, dizzy spells. Increased dark pigmentation around genitals, nipples, palms and inside mouth. Persistent low blood pressure with occasional low blood sugar. Crisis is treated by increased salt intake. Research project revealed a craving for liquorice sweets in twenty five per cent of patients.
Herbs with an affinity for the adrenal glands: Parsley, Sarsaparilla, Wild Yam, Borage, Liquorice, Ginseng, Chaparral. Where steroid therapy is unavoidable, supplementation with Liquorice and Ginseng is believed to sustain function of the glands. Ginseng is supportive when glands are exhausted by prolonged stress. BHP (1983) recommends: Liquorice, Dandelion leaf.
Alternatives. Teas. Gotu Kola, Parsley, Liquorice root, Borage, Ginseng, Balm.
Tea formula. Combine equal parts: Balm and Gotu Kola. Preparation of teas and tea mixture: 1 heaped teaspoon to each cup boiling water: infuse 5-10 minutes; 1 cup 2 to 3 times daily.
Tablets/capsules. Ginseng, Seaweed and Sarsaparilla, Wild Yam, Liquorice. Dosage as on bottle. Formula. Combine: Gotu Kola 3; Sarsaparilla 2; Ginseng 1; Liquorice quarter. Doses. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 30-60 drops. Tinctures: 1-2 teaspoons 2 to 3 times daily.
Formula. Alternative. Tinctures 1:5. Echinacea 20ml; Yellow Dock 10ml; Barberry 10ml; Sarsaparilla 10ml; Liquorice (liquid extract) 5ml. Dose: 1-2 teaspoons thrice daily.
Supplementation. Cod liver oil. Extra salt. B-Vitamins. Folic acid. ... addison’s disease
The patient lives in an unreal world in which relatives have no sense of belonging. A loving gentle wife they once knew is no longer aware of their presence. Simple tasks, such as switching on an electrical appliance are fudged. There is distressing memory loss, inability to think and learn, speech disturbance – death of the mind. Damage by free radicals implicated.
Symptoms: Confusion, restlessness, tremor. Finally: loss of control of body functions and bone loss.
A striking similarity exists between the disease and aluminium toxicity. Aluminium causes the brain to become more permeable to that metal and other nerve-toxins. (Tulane University School of Medicine, New Orleans). High levels of aluminium are found concentrated in the neurofibrillary tangles of the brain in Alzheimer’s disease. Entry into the body is by processed foods, cookware, (pots and pans) and drugs (antacids).
“Reduction of aluminium levels from dietary and medicinal sources has led to a decline in the incidence of dementia.” (The Lancet, Nov 26, 1983).
“Those who smoke more than one packet of cigarettes a day are 4.5 times more likely to develop Alzheimer’s disease than non-smokers.” (Stuart Shalat, epidemiologist, Harvard University).
Researchers from the University of Washington, Seattle, USA, claim to have found a link between the disease and head injuries with damage to the blood/brain barrier.
Also said to be associated with Down’s syndrome, thyroid disease and immune dysfunction. Other contributory factors are believed to be exposure to mercury from dental amalgam fillings. Animal studies show Ginkgo to increase local blood flow of the brain and to improve peripheral circulation. Alternatives. Teas: Alfalfa, Agrimony, Lemon Balm, Basil, Chaparral, Ginkgo, Chamomile, Coriander (crushed seeds), Ginseng, Holy Thistle, Gotu Kola, Horsetail, Rosemary, Liquorice root (shredded), Red Clover flowers, Skullcap, Ladies Slipper.
Tea. Formula. Combine, equal parts: German Chamomile, Ginkgo, Lemon Balm. 1 heaped teaspoon to cup boiling water; infuse 5-15 minutes. 1 cup freely.
Decoction. Equal parts: Black Cohosh, Blue Flag root, Hawthorn berries. 1 teaspoon in each cupful water; bring to boil and simmer 20 minutes. Dose: half-1 cup thrice daily.
Powders. Formula. Hawthorn 1; Ginkgo 1; Ginger half; Fringe Tree half. Add pinch Cayenne pepper. 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Liquid extracts. Formula. Hawthorn 1; Ephedra half; Ginkgo 1. Dose: 30-60 drops, thrice daily, before meals.
Topical. Paint forehead and nape of neck with Tincture Arnica.
Diet: 2 day fluid-only fast once monthly for 6 months. Low fat, high fibre, lecithin. Lacto-vegetarian. Low salt.
Supplements. Vitamin B-complex, B6, B12, Folic acid, A, C, E, Zinc. Research has shown that elderly patients at high risk of developing dementia have lower levels of Vitamins A, E and the carotenes. Zinc and Vitamin B12 are both vital cofactors for brain enzymes.
Alzheimer’s Disease linked with zinc. Zinc is believed to halt cerebral damage. Senile plaques in the brain produce amyloid, damaging the blood-brain barrier. Toxic metals then cross into the brain, displacing zinc. This then produces abnormal tissue. (Alzheimer Disease and Associated Disorders, researchers, University of Geneva).
Japanese study. Combination of coenzyme Q10, Vitamin B6 and iron. Showed improved mental function. Abram Hoffer MD, PhD. Niacin 500mg tid, Vitamin C 500mg tid, Folic acid 5mg daily, Aspirin 300mg daily, Ginkgo herb 40mg daily. (International Journal of Alternative and Complementary Medicine, Feb 1994 p11)
Alzheimer’s Disease Society. 2nd Floor, Gordon House, 10 Greencoat Place, London SW1P 1PH, UK. Offers support to families and carers through membership. Practical help and information. Send SAE. ... alzheimer’s disease
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
Symptoms: malaise, bloody alternating diarrhoea and constipation; right side colicky abdominal pain worse after meals; flatulence, loss of weight and appetite. Intestinal obstruction can usually be palpated. Blood count. A blood count high in whites indicates an abscess – a serious condition which may require surgical repair during which segments of the gut may have to be removed. Malignant change rare. Differential diagnosis. Ulcerative colitis, appendicitis, appendix abscess, irritable bowel syndrome.
Cracks or ulcers at corners of the mouth may be a good marker of Crohn’s Disease.
Treatment. Select one of the following. Herbal treatment offers a safe alternative to steroids by inducing remission in acute exacerbation. Good responses have been observed from the anti-bacterials Wild Yam and Goldenseal. Fenugreek seeds are of special value. Comfrey (tissue regeneration). Irish Moss.
Teas: Chamomile, Comfrey leaves, Hops, Marshmallow leaves, Meadowsweet, Shepherd’s Purse (Dr A. Vogel), Lobelia. Silverweed and Cranesbill are excellent for internal bleeding; Poke root for intestinal ulceration.
Decoction. Fenugreek seeds: 2 teaspoons to large cup water simmered gently 10 minutes. 1 cup freely. The seeds also should be consumed.
Tablets/capsules. Wild Yam, Fenugreek, Ginger, Goldenseal, Lobelia, Slippery Elm.
Powders. Formula. Wild Yam 2; Meadowsweet 2; Goldenseal 1. Dose: 500mg (two 00 capsules or one- third teaspoon) thrice daily.
Liquid Extracts. (1) Formula. Wild Yam 1, Echinacea 2. 30-60 drops in water thrice daily. Or, (2) Formula: Turkey Rhubarb 2, Goldenseal 1, Caraway half. 20-30 drops in water thrice daily.
Tinctures. Formula. Bayberry 2, Goldenseal 1, Cardamoms 1. Dose: One to two 5ml teaspoons thrice daily.
Ispaghula seeds. 2-4 teaspoons thrice daily.
Tea Tree oil Suppositories. Insertion at night.
Diet. Bland, little fibre, Slippery Elm gruel. Irish Moss preparations. Increase fluid intake. Reject: broccoli, tomatoes, lima, Soya, Brussels sprouts, pinto beans, cocoa, chocolate, cow’s milk, peas, onions, turnips, radishes. Accept fish oils.
Addenbrookes Hospital, Cambridge. Reject foods containing wheat and all dairy produce.
Supplements. Vitamins A, B12, C, Calcium, Iron, Magnesium, Potassium, Zinc.
Study. In a study carried out by UK researchers (1993) food allergies were found to be the most common cause of the disease. Results suggested that dietary changes may be as effective as corticosteroids in easing symptoms. The most common allergens were corn, wheat, milk, yeast, egg, potato, rye, tea, coffee, apples, mushrooms, oats, chocolate. An elemental diet with a formula of nutrients (E028, produced by Hospital Supplies, Liverpool) was used in trials. (The Lancet, 6.11.1993)
Notes. Crohn’s Disease is associated with Erythema nodosum, more frequently recognised in childhood. A frequent cause is cow’s milk intolerance. Smoking adds to the risk of Crohn’s disease.
In susceptible people, the food additives titanium dioxide and aluminosilicates may evoke a latent inflammatory response resulting in Crohn’s disease, ulcerative colitis or bowel cancer. These chemicals may be found in the intestinal lymphoid aggregations in gut mucosa. (Jonathan Powell, Gastro-intestinal Laboratory, St Thomas’s Hospital, London) (Titanium dioxide rarely occurs naturally but is added to confectionery, drinking water and anti-caking agents.) ... crohn’s disease
Symptoms: numbness, nerves may swell like iron rods. Infected nerves kill all sensation. In endemic areas, pins and needles in hands may call attention to it. A disease of nerves rather than skin. NOTIFIABLE DISEASE.
Many laymen and practitioners will never have seen a case. In the absence of modern medicine some good can be achieved by traditional remedies. Ancient Hindu and Chinese records refer to the use of Gotu Kola (internally and externally). Dr C.D. de Granpre? (1888) refers. (Martindale 27; p.441)
Oil of Chaulmoogra was used up to one hundred years ago before introduction of modern drugs. It fell into dis-use until discovered by a Director of Health in the Philippine Islands during World War I when he used it successfully in combination with camphor. In South America, where the disease is still active, Sarsaparilla has a long traditional reputation. Walnut oil is used as a dressing, in China. An anti- staphylococcal fraction has been isolated from the seeds of Psoralea corylifolia for use in leprosy. (Indian Journal of Pharmacy 26: 141, 1964)
Tea. Gotu Kola. Half a teaspoon to each cup boiling water; infuse 15 minutes. Drink freely. Stronger infusions may be used externally to cleanse ulceration.
Decoction. Combine: Sarsaparilla 1; Gotu Kola 1; Echinacea 2. Half an ounce to 1 pint water gently simmered 20 minutes. Dose: Half a cup 3 times daily.
Formula. Echinacea 2; Sarsaparilla 1; Gotu Kola 2. Dose. Powders 500mg. Liquid Extracts 3-5ml. Tinctures 5-10ml. Thrice daily.
Note: Antibody-positive cases of AIDS are vulnerable to leprosy, both diseases being caused by a similar bacterium.
To be treated by infectious diseases specialist. ... hansen’s disease
Symptoms. Hard rubbery glands are general, chiefly detected under the arm and groin. Enlarged nodes may compress nearby structures to produce nerve pains. Weight loss. Accumulation of fluid in lungs and abdomen. Obstruction of bile duct leads to jaundice. Patient may be prone to shingles. High fever heralds approaching fatality. Blood count, bone marrow aspiration and node biopsy confirm. Tubercula glands may simulate Hodgkin’s disease.
Some success reported by the use of the Periwinkle plant. (vinca rosea – Vinchristine) Wm Boericke, M.D. refers to Figwort as a powerful agent in Hodgkin’s disease.
Alternatives. Although there is no known cure, emphasis on the cortex of the adrenal gland may reduce skin irritation and pain in the later stages (Gotu Kola, Liquorice, Sarsaparilla). To arrest wasting and constitutional weakness: Echinacea. Anti-pruritics, alteratives and lymphatics are indicated.
Tea. Formula. Equal parts, Nettles, Gotu Kola, Red Clover. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup 3 or more times daily.
Decoction. Formula. Equal parts – Yellow Dock, Queen’s Delight, Echinacea. 1 teaspoon to each cup water gently simmered 20 minutes. Half-1 cup 3 or more times daily.
Tablets/capsules. Poke root. Blue Flag root. Echinacea. Mistletoe.
Powders. Formula. Echinacea 2; Poke root 1; Bladderwrack 1. Dose: 500mg (two 00 capsules or one- third teaspoon) 3 or more times daily.
Tinctures. Mixture. Parts: Echinacea 2; Goldenseal quarter; Thuja quarter; Poke root half; Periwinkle 1. Dose: 1-2 teaspoons, 3 or more times daily. Where active inflammation is present – add Wild Yam 1. External. Castor oil packs to abdomen.
Treatment by a general medical practitioner or hospital specialist.
HOLISTIC MEDICINE. A school of thought which regards disease as a manifestation of an inner disturbance of the vital force, and not merely abnormality of certain groups of nerves, muscles, veins, or even the mind itself. Article 43 of Dr Samuel Hahnemann’s Organon of the Healing Art describes it:
“No organ, no tissue, no cell, no molecule is independent of the activities of the others but the life of each one of these elements is merged into the life of the whole. The unit of human life cannot be the organ, the tissue, the cell, the molecule, the atom, but the whole organism, the whole man.”
Holistic medicine relates disease to a patient’s personality, posture, diet, emotional life, and lifestyle. Treatment will be related to body, mind and spirit. It encourages a positive psychological response to the disease from which a patient suffers. For instance, its gentle approach to cancer embraces stress control, meditation, forms of visualisation and other life-enhancing skills.
Diet may be vegetarian, even vegan.... hodgkin’s disease
Supplementation. Vitamin B12.
HYDRAGOGUE. A herbal cathartic that causes watery evacuation and drastic purgation. White Bryony, American Mandrake. (Practitioner use only) ... hydatid disease
Etiology. Obscure; though cases may be traced to auto-toxaemia, Vitamin B deficiency, menstruation, malaria drugs (chloroquine).
Symptoms: dizziness, nausea, vomiting, tinnitus, sound distortions, heavy sweating, loss of hearing; usually in one ear only. Early diagnosis essential for effective treatment. This may mean reference to a department of otolaryngology or otoneurology.
Treatment. Antispasmodics. Nervines. Sometimes a timely diuretic reduces severity – Uva Ursi, Dandelion root, Wild Carrot.
Alternatives. Current European practice: Betony, German Chamomile, Passion flower, Hawthorn, Hops, Feverfew, White Willow.
Tea. Combine, equal parts: Valerian, Wild Carrot, Agrimony. 2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup every 2 hours during attack; thrice daily thereafter.
Decoction. Mistletoe: 2 teaspoons to each cup cold water steeped overnight. Bring to boil. Allow to cool. Half-1 cup, as above.
Tablets/capsules. Feverfew, Mistletoe, Prickly Ash.
Formula. Ginkgo 2; Dandelion 1; Black Cohosh 1. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Feverfew tincture. See: FEVERFEW.
Dr J. Christopher: inject into ears, at night, few drops oil of Garlic (or contents of Garlic capsule).
Cider vinegar. 2 teaspoons to glass water: as desired.
Aromatherapy. Inhalants: Eucalyptus or Rosemary oils.
Diet: gluten-free, low salt; good responses observed. High fibre. Avoid dairy products and chocolate. Vitamins: B-complex, B1; B2; B6; E; F. Brewer’s yeast, Niacin.
Minerals: Calcium. Magnesium. Phosphorus. Dolomite. ... meniere’s disease
Some authorities believe cause is vitamin and mineral deficiency – those which promote bone health being calcium and magnesium (dolomite). Supplementation helps cases but evidence confirms that some pet-owners are at risk – a virus from cats and dogs possibly responsible. The prime candidate is one exposed to canine distemper. Dogs are involved twice as much as cats. The virus is closely related to the measles virus in humans.
Symptoms. Limbs deformed, hot during inflammatory stage. Headaches. Dull aching pain in bones. Deafness from temporal bone involvement. Loss of bone rigidity. Bowing of legs.
Surgical procedures may be necessary. Appears to be a case for immunisation of dogs against distemper.
Alternatives. Black Cohosh, Boneset, Cramp bark, Bladderwrack, German Chamomile, Devil’s Claw, Helonias, Oat husks, Prickly Ash, Sage, Wild Yam.
Tea. Oats (mineral nutrient for wasting diseases) 2; Boneset (anti-inflammatory) 1; Valerian (mild analgesic) 1; Liquorice quarter. Mix. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.
Decoction. Cramp bark 1; White Willow 2. Mix. 4 heaped teaspoons to 1 pint (500ml) water gently simmered 20 minutes. Dose: half-1 cup thrice daily.
Tablets/capsules. Cramp bark, Devil’s Claw, Echinacea, Helonias, Prickly Ash, Wild Yam.
Formula. Devil’s Claw 1; Black Cohosh 1; Valerian 1; Liquorice quarter. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Action enhanced when taken in cup of Fenugreek tea. Thrice daily. Every 2 hours acute cases.
Practitioner’s analgesic. Tincture Gelsemium: 10 drops in 100ml water. Dose: 1 teaspoon every 2 hours (inflammatory stage).
Topical. Comfrey root poultice.
Diet. High protein, low salt, low fat. Oily fish.
Supplements. Daily. Vitamin C (500mg); Vitamin D (1000mg); Calcium citrate (1 gram); Dolomite (1 gram); Beta-Carotene (7500iu). Kelp. ... paget’s disease
There is little evidence that any one antihistamine is superior to another, and patients vary considerably in their response to them. The antihistamines di?er in their duration of action and in the incidence of side-effects such as drowsiness. Most are short-acting, but some (such as promethazine) work for up to 12 hours. They all cause sedation but promethazine, trimeprazine and dimenhydrinate tend to be more sedating while chlorpheniramine and cyclizine are less so, as are astemizole, oxatomide and terfenadine. Patients should be warned that their ability to drive or operate machinery may be impaired when taking these drugs, and that the effects of ALCOHOL may be increased.... antihistamine drugs
The most widely prescribed type of antidepressants are the tricyclics, so-called because their molecular structure includes three rings. The other commonly used types are named after the actions they have on chemicals in the brain: the SELECTIVE SEROTONIN-REUPTAKE INHIBITORS (SSRIS) and the MONOAMINE OXIDASE INHIBITORS (MAOIS) – see also below. All types of antidepressant work in similar ways. Tricyclic antidepressants have cured depression in millions of people, but they can cause unpleasant side-effects, particularly in the ?rst couple of weeks. These include SEDATION, dry mouth, excessive sweating, CONSTIPATION, urinary problems, and impotence (inability to get an erection). Up to half of all people prescribed tricyclic drugs cannot tolerate the side-effects and stop treatment before their depression is properly treated. More seriously, tricyclics can upset the rhythm of the heart in susceptible people and should never be given in the presence of heart disease.
The SSRIs are newer, coming into wide use in the late 1980s. They increase the levels in the brain of the chemical messenger SEROTONIN, which is thought to be depleted in depression. Indeed, the SSRIs are as e?ective as tricyclics and, although they can cause nausea and excessive sweating at ?rst, they generally have fewer side-effects. Their main disadvantage, however, is that they cost much more than the most commonly used tricyclic, amitriptyline. On the other hand, they are more acceptable to many patients and they cause fewer drop-outs from treatment – up to a quarter rather than a half. The money saved by completed, successful treatment may outweigh the prescribing costs. SSRIs have been reported as associated with an increased risk of suicide.
Another group of antidepressants, the MAOIs, have been in use since the late 1950s.
They are stimulants, rather than sedatives, and are particularly helpful for people who are physically and mentally slowed by depression. They work well but have one big disadvantage – a dangerous interaction with certain foods and other drugs, causing a sudden and very dangerous increase in blood pressure. People taking them must carry an information card explaining the risk and listing the things that they should avoid. Because of this risk, MAOIs are not used much now, except when other treatments have failed. A new MAOI, moclobemide, which is less likely to interact and so cause high blood pressure, is now available.
LITHIUM CARBONATE is a powerful antidepressant used for intractable depression. It should be used under specialist supervision as the gap between an e?ective dose and a toxic one is narrow.
St John’s Wort is a popular herbal remedy which may be e?ective, but which is handicapped by di?erences of strength between di?erent preparations or batches. It can interact with a number of conventional drugs and so needs to be used cautiously and with advice.
In general, antidepressants work by restoring the balance of chemicals in the brain. Improved sleep and reduced anxiety are usually the ?rst signs of improvement, particularly among people taking the more sedative tricyclic drugs. Improvement in other symptoms follow, with the mood starting to lift after about two weeks of treatment. Most people feel well by three months, although a few residual symptoms, such as slowness in the mornings, may take longer to clear up. People taking antidepressants usually want to stop them as soon as they feel better; however, the risk of relapse is high for up to a year and most doctors recommend continuing the drugs for around 4–6 months after recovery, with gradual reduction of the dose after that.
Withdrawal reactions may occur including nausea, vomiting, headache, giddiness, panic or anxiety and restlessness. The drugs should be withdrawn gradually over about a month or longer (up to six months in those who have been on maintenance treatment).
A wide range of antidepressant drugs is described in the British National Formulary. Examples include:
Tricyclics: amitryptyline, imipramine, doxepin.
MAOIs: phenelzine, isocarboxazid.
SSRIs: citalopram, ?uoxetine, paraxtene. (Antidepressant drugs not in these three
groups include ?upenthixol, mertazapine and venlafaxine.)... antidepressant drugs
Treatment includes the full gamut of neonatal intensive care, as well as speci?c therapy with PULMONARY SURFACTANT.... hyaline membrane disease
The drugs used in combination are:
The receptor antagonists, which reduce the output of gastric acid by histamine H2receptor blockade; they include CIMETIDINE, FAMOTIDINE and RANITIDINE.
ANTIBIOTICS to eradicate Helicobacter pylori infection, a major cause of peptic ulceration. They are usually used in combination with one of the PROTON-PUMP INHIBITORS and include clarithomycin, amoxacillin and metronidazole.
BISMUTH chelates.
The prostaglandin analogue misoprostol has antisecretory and protective properties.
Proton-pump inhibitors omeprazole, lansoprazole, pantaprazole and rabeprazole, all of which inhibit gastric-acid secretion by blocking the proton pump enzyme system.... ulcer healing drugs
Symptoms. Intermittent claudication. Affected parts of the leg are much paler than others, the condition regressing to ulceration and possible gangrene. Inflammation of nerves, veins and arteries may lead to clot formation (thrombosis).
Treatment. Stop smoking. Vasodilator herbs.
Alternatives. Cayenne (minute doses), Bayberry, Lime flowers, Lobelia, Prickly Ash, Wahoo bark, Mistletoe, Skullcap, Cactus.
BHP (1983) recommends: Angelica root, Hawthorn berry, Wild Yam.
Decoction. Formula. Equal parts: Hawthorn, Mistletoe, Valerian. 2 teaspoons to two cups water gently simmered 10 minutes. Dose half-1 cup thrice daily, and when necessary.
Tablets/capsules. Alternatives. Prickly Ash 100mg. Hawthorn 200mg. Wild Yam 200mg. Dosage as on bottles.
Powders. Formula. Equal parts: Hawthorn, Wild Yam, Prickly Ash. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Tinctures. Formula. Equal parts: Bayberry, Hawthorn, Prickly Ash. Dose: 1-2 teaspoons thrice daily. Practitioner. Tincture Gelsemium BPC (1973). 0.3ml (5 drops) when necessary for relief of pain.
Diet. Low fat, low salt, high fibre.
Supplements. Daily. Vitamin E 1000-1500iu. Vitamin B-complex. Magnesium, Calcium.
Exercise. Physiotherapy exercise. From the sitting position raise legs to horizontal; rest for a few minutes. Lie down and raise legs to 45 degrees; rest for a few minutes. Reverse movements resting each time to equalise the circulation. (Brenda Cooke FNIMH) ... buerger’s disease
Selenium 50mcg and Vitamin E 400iu are recommended by Jonathan Wright MD, for decreasing the pain of disease, decreasing over 3 months. (Health Update USA, June 1990) ... osgood schlatter disease
Coronary thrombosis is more common in the West because of its preference for animal fats; whereas in the East fats usually take the form of vegetable oils – corn, sunflower seed, sesame, etc. Fatty deposits (atheroma) form in the wall of the coronary artery, obstructing blood-flow. Vessels narrowed by atheroma and by contact with calcium and other salts become hard and brittle (arterio-sclerosis) and are easily blocked. Robbed of oxygen and nutrients heart muscle dies and is replaced by inelastic fibrous (scar) tissue which robs the heart of its maximum performance.
Severe pain and collapse follow a blockage. Where only a small branch of the coronary arterial tree is affected recovery is possible. Cause of the pain is lack of oxygen (Vitamin E). Incidence is highest among women over 40 who smoke excessively and who take The Pill.
The first warning sign is breathlessness and anginal pain behind the breastbone which radiates to arms and neck. Sensation as if the chest is held in a vice. First-line agent to improve flow of blood – Cactus.
For cholesterol control target the liver. Coffee is a minor risk factor.
Measuring hair calcium levels is said to predict those at risk of coronary heart disease. Low hair concentrations may be linked with poor calcium metabolism, high aortic calcium build-up and the formation of plagues. (Dr Allan MacPherson, nutritionist, Scottish Agricultural College, Ayr, Scotland)
Evidence has been advanced that a diagonal ear lobe crease may be a predictor for coronary heart disease. (American Journal of Cardiology, Dec. 1992)
Tooth decay is linked to an increased risk of coronary heart disease and mortality, particularly in young men. (Dr Frank De Stefano, Marshfield Medical Research Foundation, Wisconsin, USA) Treatment. Urgency. Send for doctor or suitably qualified practitioner. Absolute bedrest for 3 weeks followed by 3 months convalescence. Thereafter: adapt lifestyle to slower tempo and avoid undue exertion. Stop smoking. Adequate exercise. Watch weight.
Cardiotonics: Motherwort, Hawthorn, Mistletoe, Rosemary. Ephedra, Lily of the Valley, Broom.
Cardiac vasodilators relax tension on the vessels by increasing capacity of the arteries to carry more blood. Others contain complex glycosides that stimulate or relax the heart at its work. Garlic is strongly recommended as a preventative of CHD.
Hawthorn, vasodilator and anti-hypertensive, is reputed to dissolve deposits in thickened and sclerotic arteries BHP (1983). It is believed to regulate the balance of lipids (body fats) one of which is cholesterol.
Serenity tea. Equal parts: Motherwort, Lemon Balm, Hawthorn leaves or flowers. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup freely.
Decoction. Combine equal parts: Broom, Lily of the Valley, Hawthorn. 1-2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup freely.
Tablets/capsules. Hawthorn, Motherwort, Cactus, Mistletoe, Garlic.
Practitioner. Formula. Hawthorn 20ml; Lily of the Valley 10ml; Pulsatilla 5ml; Stone root 5ml; Barberry 5ml. Tincture Capsicum 1ml. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or honey.
Prevention: Vitamin E – 400iu daily.
Diet. See: DIET – HEART AND CIRCULATION.
Supplements. Daily. Vitamin C, 2g. Vitamin E possesses anti-clotting properties, 400iu. Broad spectrum multivitamin and mineral including chromium, magnesium selenium, zinc, copper.
Acute condition. Strict bed-rest; regulate bowels; avoid excessive physical and mental exertion. Meditation and relaxation techniques dramatically reduce coronary risk. ... coronary heart disease
Alternatives. Treatment. Echinacea is the key remedy.
Others indicated: Red Clover flower, Blue Flag root, Horsetail, Poke root, Bladderwrack. May be taken singly, as available.
Tea: Combine Bladderwrack 2; Echinacea 2; Horsetail 1. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup thrice daily.
Tinctures. Combine: Bladderwrack 2; Echinacea 2; Horsetail 1. Dose: one to two 5ml teaspoons in water thrice daily.
Diet. Iodised salt. Avoid cabbage which contains a factor which depresses the thyroid gland. Supplementation. Vitamin A. B-complex. Kelp. ... hashimoto’s disease
Alternatives. To sustain.
Teas. Lime flowers, Motherwort, Buckwheat, Hawthorn.
Tablets/capsules. Hawthorn, Mistletoe, Motherwort.
Formula. Hawthorn 2; Lily of the Valley 1; Selenicereus grandiflorus 1. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water morning and evening. ... heart disease – congenital
Antidiabetic drugs include insulin, which must be administered by injection, and oral hypoglycaemics such as glibenclamide and metformin. Acarbose and guar gum reduce or slow absorption of carbohydrate from the intestines after meals. Repaglinide stimulates insulin release from the pancreas for a short time and may be taken directly before meals. Rosiglitazone reduces resistance to the effects of insulin in the tissues and may be used together with other hypoglycaemics.... antidiabetic drugs
The disease may eventually cause a cerebrovascular accident, which commonly leads to a stroke.
Extensive narrowing of blood vessels throughout the brain can be a cause of dementia.... cerebrovascular disease
opiates such as cocaine and morphine, amfetamine drugs, and barbiturate drugs. controlled trial A method of testing the effectiveness of new treatments or comparing different treatments. In a typical controlled drug trial, 2 comparable groups of patients suffering from the same illness are given courses of apparently identical treatment. However, only one group receives the new treatment; the second control group is given a placebo. Alternatively, the control group may be given an established drug that is already known to be effective. After a predetermined period, the 2 groups are assessed medically. Controlled trials must be conducted “blind’’ (the patients do not know which treatment they are receiving). In a “double-blind’’ trial, neither the patients nor the doctors who assess them know who is receiving which treatment. contusion Bruising to the skin and underlying tissues from an injury. convalescence The recovery period following an illness or surgery during which the patient regains strength before returning to normal activities.... controlled drug
The first symptom of coronary artery disease is frequently the chest pain of angina. Treatment is with drugs such as glyceryl trinitrate and other nitrate drugs, beta-blockers, calcium channel blockers, potassium channel activators, and vasodilator drugs. If drug treatment fails to relieve the symptoms, or there is extensive narrowing of the coronary
arteries, blood flow may be improved by balloon angioplasty or coronary artery bypass surgery.... coronary artery disease
It is treated by regular injections of the missing enzyme.... gaucher’s disease
GVH disease can usually be prevented by administration of immunosuppressant drugs. If the disease develops, it can be treated with corticosteroid drugs and immunosuppressant drugs such as ciclosporin In some cases, however, it can be difficult to control.... graft-versus-host disease
The disease is rare and tends to run in families. It occurs about 4 times more often in boys. Symptoms, which include constipation and bloating, usually develop in the first few weeks of life, but may become evident in infancy or early childhood. The child usually has a poor appetite and may fail to grow properly.
A barium X-ray examination can show the narrowed segment of the intestine.
A biopsy may be taken.
Treatment of Hirschsprung’s disease involves removing the narrowed segment and rejoining the normal intestine to the anus.... hirschsprung’s disease
The chorea usually affects the face, arms, and trunk, resulting in random grimaces and twitches, and clumsiness. Dementia takes the form of irritability, personality and behavioural changes, memory loss, and apathy.
At present, there is no cure for Huntington’s disease, and treatment is aimed at reducing symptoms with drugs.... huntington’s disease
Many people suffered severe nerve damage and some died.... minamata disease
The most common type of motor neuron disease is amyotrophic lateral sclerosis ( or Lou Gehrig’s disease). It usually affects people over the age of 50 and is more common in men. Some cases run in families. Usually, symptoms start with weakness in the hands and arms or legs, and muscle wasting. There may be irregular muscle contractions, and muscle cramps or stiffness. All four extremities are soon affected.
Progressive muscular atrophy and progressive bulbar palsy both start with patterns of muscle weakness different from but usually develop into.There are 2 types of motor neuron disease that first appear in childhood or adolescence. In most cases, these conditions are inherited. Werdnig–Hoffman disease affects infants at birth or soon afterwards. In almost all cases, progressive muscle weakness leads to death within several years. Chronic spinal muscular atrophy begins in childhood or adolescence, causing progressive weakness but not always serious disability.
There are no specific tests for motor neuron disease. Diagnosis is based on careful clinical examination by a neurologist. Tests including EMG, muscle biopsy, blood tests, myelography, CT scanning, or MRI may be performed.
The disease typically goes on to affect the muscles involved in breathing and swallowing, leading to death within 2–4 years. However, about 10 per cent of sufferers survive for 10 years.
Nerve degeneration cannot be slowed down, but physiotherapy and the use of various aids may help to reduce disability. The drug riluzole is used to extend life (or the time until mechanical ventilation is required).... motor neuron disease
On exposure to cold, the digits turn white due to lack of blood. As sluggish blood flow returns, the digits become blue; when they are warmed and normal blood flow returns, they turn red. During an attack, there is often tingling, numbness, or a burning feeling in the affected fingers or toes. In rare cases, the artery walls gradually thicken, permanently reducing blood flow. Eventually painful ulceration or even gangrene may develop at the tips of the affected digits.
Diagnosis is made from the patient’s history. Treatment involves keeping the hands and feet as warm as possible. Vasodilator drugs or calcium channel blockers may be helpful in severe cases. (See also Raynaud’s phenomenon.)... raynaud’s disease
The disease is diagnosed by bloodclotting tests and measurement of blood levels of von Willebrand factor. Bleeding episodes can be prevented or controlled by desmopressin (a substance resembling ADH). Factor or concentrated von Willebrand factor may also be used to treat bleeding.... von willebrand’s disease
The cause is thought to be bacterial; affected tissues are found to contain macrophages (a type of scavenging cell) containing rod-shaped bacteria. Treatment is with antibiotic drugs for at least 1 year. Dietary supplements are used to correct nutritional deficiencies occurring as a result of malabsorption.... whipple’s disease
– the hormone which provokes the adrenal cortex into action.
Symptoms The clinical symptoms appear slowly and depend upon the severity of the underlying disease process. The patient usually complains of appetite and weight loss, nausea, weakness and fatigue. The skin becomes pigmented due to the increased production of ACTH. Faintness, especially on standing, is due to postural HYPOTENSION secondary to aldosterone de?ciency. Women lose their axillary hair and both sexes are liable to develop mental symptoms such as DEPRESSION. Acute episodes – Addisonian crises – may occur, brought on by infection, injury or other stressful events; they are caused by a fall in aldosterone levels, leading to abnormal loss of sodium and water via the kidneys, dehydration, low blood pressure and confusion. Patients may develop increased tanning of the skin from extra pigmentation, with black or blue discoloration of the skin, lips, mouth, rectum and vagina occurring. ANOREXIA, nausea and vomiting are common and the sufferer may feel cold.
Diagnosis This depends on demonstrating impaired serum levels of cortisol and inability of these levels to rise after an injection of ACTH.
Treatment consists in replacement of the de?cient hormones. HYDROCORTISONE tablets are commonly used; some patients also require the salt-retaining hormone, ?udrocortisone. Treatment enables them to lead a completely normal life and to enjoy a normal life expectancy. Before surgery, or if the patient is pregnant and unable to take tablets, injectable hydrocortisone may be needed. Rarely, treated patients may have a crisis, perhaps because they have not been taking their medication or have been vomiting it. Emergency resuscitation is needed with ?uids, salt and sugar. Because of this, all patients should carry a card detailing their condition and necessary management. Treatment of any complicating infections such as tuberculosis is essential. Sometimes DIABETES MELLITUS coexists with Addison’s disease and must be treated.
Secondary adrenal insu?ciency may occur in panhypopituitarism (see PITUITARY GLAND), in patients treated with CORTICOSTEROIDS or after such patients have stopped treatment.... addison’s disease
Adverse effects can be divided into types. First, those which are closely related to the concentration of the drug and accord with what is known of its PHARMACOLOGY. These so-called type A (augmented pharmacological) effects are distinguished from type B (bizarre) effects which are unpredictable, usually rare, and often severe. ANAPHYLAXIS is the most obvious of these; other examples include bone-marrow suppression with CO-TRIMOXAZOLE; hepatic failure (see HEPATITIS) with SODIUM VALPROATE; and PULMONARY FIBROSIS with AMIODARONE. A more comprehensive classi?cation includes reactions type C (chronic effects), D (delayed effects – such as teratogenesis or carcinogenesis) and E (end-of-dose effects – withdrawal effects). Examples of adverse reactions include nausea, skin eruptions, jaundice, sleepiness and headaches.
While most reported adverse reactions are minor and require no treatment, patients should remind their doctors of any drug allergy or adverse e?ect they have suffered in the past. Medical warning bracelets are easily obtained. Doctors should report adverse effects to the authorities – in the case of Britain, to the Committee on Safety of Medicines (CSM), using the yellow-card reporting machinery.... adverse reactions to drugs
TRANQUILLISERS can help control di?cult behaviour and sleeplessness but should be used with care. Recently drugs such as DONEPEZIL and RIVASTIGMINE, which retard the breakdown of ACETYLCHOLINE, may check
– but not cure – this distressing condition. About 40 per cent of those with DEMENTIA improve.
Research is in progress to transplant healthy nerve cells (developed from stem cells) into the brain tissue of patients with Alzheimer’s disease with the aim of improving brain function.
The rising proportion of elderly people in the population is resulting in a rising incidence of Alzheimer’s, which is rare before the age of 60 but increases steadily thereafter so that 30 per cent of people over the age of 84 are affected.... alzheimer’s disease
They work by blocking the stimulation of beta adrenergic receptors by the neurotransmitters adrenaline and noradrenaline, which are produced at the nerve endings of that part of the SYMPATHETIC NERVOUS SYSTEM – the autonomous (involuntary) network
– which facilitates the body’s reaction to anxiety, stress and exercise – the ‘fear and ?ight’ response.
Beta1 blockers reduce the frequency and force of the heartbeat; beta2 blockers prevent vasodilation (increase in the diameter of blood vessels), thus in?uencing the patient’s blood pressure. Beta1 blockers also affect blood pressure, but the mechanism of their action is unclear. They can reduce to normal an abnormally fast heart rate so the power of the heart can be concomitantly controlled: this reduces the oxygen requirements of the heart with an advantageous knock-on e?ect on the respiratory system. These are valuable therapeutic effects in patients with ANGINA or who have had a myocardial infarction (heart attack – see HEART, DISEASES OF), or who suffer from HYPERTENSION. Beta2 blockers reduce tremors in muscles elsewhere in the body which are a feature of anxiety or the result of thyrotoxicosis (an overactive thyroid gland – see under THYROID GLAND, DISEASES OF). Noncardioselective blockers also reduce the abnormal pressure caused by the increase in the ?uid in the eyeball that characterises GLAUCOMA.
Many beta-blocking drugs are now available; minor therapeutic di?erences between them may in?uence the choice of a drug for a particular patient. Among the common drugs are:
| Primarily cardioselective | Non-cardioselective |
| Acebutolol | Labetalol |
| Atenolol | Nadolol |
| Betaxolol | Oxprenolol |
| Celiprolol | Propanolol |
| Metoprolol | Timolol |
These powerful drugs have various side-effects and should be prescribed and monitored with care. In particular, people who suffer from asthma, bronchitis or other respiratory problems may develop breathing diffculties. Long-term treatment with beta blockers should not be suddenly stopped, as this may precipitate a severe recurrence of the patient’s symptoms – including, possibly, a sharp rise in blood pressure. Gradual withdrawal of medication should mitigate untoward effects.... beta-adrenoceptor-blocking drugs
Chronic bronchitis is typi?ed by chronic productive cough for at least three months in two successive years (provided other causes such as TUBERCULOSIS, lung cancer and chronic heart failure have been excluded). The characteristics of emphysema are abnormal and permanent enlargement of the airspaces (alveoli) at the furthermost parts of the lung tissue. Rupture of alveoli occurs, resulting in the creation of air spaces with a gradual breakdown in the lung’s ability to oxygenate the blood and remove carbon dioxide from it (see LUNGS). Asthma results in in?ammation of the airways with the lining of the BRONCHIOLES becoming hypersensitive, causing them to constrict. The obstruction may spontaneously improve or do so in response to bronchodilator drugs. If an asthmatic patient’s airway-obstruction is characterised by incomplete reversibility, he or she is deemed to have a form of COPD called asthmatic bronchitis; sufferers from this disorder cannot always be readily distinguished from those people who have chronic bronchitis and/ or emphysema. Symptoms and signs of emphysema, chronic bronchitis and asthmatic bronchitis overlap, making it di?cult sometimes to make a precise diagnosis. Patients with completely reversible air?ow obstruction without the features of chronic bronchitis or emphysema, however, are considered to be suffering from asthma but not from COPD.
The incidence of COPD has been increasing, as has the death rate. In the UK around 30,000 people with COPD die annually and the disorder makes up 10 per cent of all admissions to hospital medical wards, making it a serious cause of illness and disability. The prevalence, incidence and mortality rates increase with age, and more men than women have the disorder, which is also more common in those who are socially disadvantaged.
Causes The most important cause of COPD is cigarette smoking, though only 15 per cent of smokers are likely to develop clinically signi?cant symptoms of the disorder. Smoking is believed to cause persistent airway in?ammation and upset the normal metabolic activity in the lung. Exposure to chemical impurities and dust in the atmosphere may also cause COPD.
Signs and symptoms Most patients develop in?ammation of the airways, excessive growth of mucus-secreting glands in the airways, and changes to other cells in the airways. The result is that mucus is transported less e?ectively along the airways to eventual evacuation as sputum. Small airways become obstructed and the alveoli lose their elasticity. COPD usually starts with repeated attacks of productive cough, commonly following winter colds; these attacks progressively worsen and eventually the patient develops a permanent cough. Recurrent respiratory infections, breathlessness on exertion, wheezing and tightness of the chest follow. Bloodstained and/or infected sputum are also indicative of established disease. Among the symptoms and signs of patients with advanced obstruction of air?ow in the lungs are:
RHONCHI (abnormal musical sounds heard through a STETHOSCOPE when the patient breathes out).
marked indrawing of the muscles between the ribs and development of a barrel-shaped chest.
loss of weight.
CYANOSIS in which the skin develops a blue tinge because of reduced oxygenation of blood in the blood vessels in the skin.
bounding pulse with changes in heart rhythm.
OEDEMA of the legs and arms.
decreasing mobility.
Some patients with COPD have increased ventilation of the alveoli in their lungs, but the levels of oxygen and carbon dioxide are normal so their skin colour is normal. They are, however, breathless so are dubbed ‘pink pu?ers’. Other patients have reduced alveolar ventilation which lowers their oxygen levels causing cyanosis; they also develop COR PULMONALE, a form of heart failure, and become oedematous, so are called ‘blue bloaters’.
Investigations include various tests of lung function, including the patient’s response to bronchodilator drugs. Exercise tests may help, but radiological assessment is not usually of great diagnostic value in the early stages of the disorder.
Treatment depends on how far COPD has progressed. Smoking must be stopped – also an essential preventive step in healthy individuals. Early stages are treated with bronchodilator drugs to relieve breathing symptoms. The next stage is to introduce steroids (given by inhalation). If symptoms worsen, physiotherapy – breathing exercises and postural drainage – is valuable and annual vaccination against INFLUENZA is strongly advised. If the patient develops breathlessness on mild exertion, has cyanosis, wheezing and permanent cough and tends to HYPERVENTILATION, then oxygen therapy should be considered. Antibiotic treatment is necessary if overt infection of the lungs develops.
Complications Sometimes rupture of the pulmonary bullae (thin-walled airspaces produced by the breakdown of the walls of the alveoli) may cause PNEUMOTHORAX and also exert pressure on functioning lung tissue. Respiratory failure and failure of the right side of the heart (which controls blood supply to the lungs), known as cor pulmonale, are late complications in patients whose primary problem is emphysema.
Prognosis This is related to age and to the extent of the patient’s response to bronchodilator drugs. Patients with COPD who develop raised pressure in the heart/lung circulation and subsequent heart failure (cor pulmonale) have a bad prognosis.... chronic obstructive pulmonary disease (copd)
The Misuse of Drugs Regulations 1985 de?ne the classes of person authorised to supply and possess controlled drugs, and lay down the conditions under which these activities may be carried out. In the Regulations, drugs are divided into ?ve schedules specifying the requirements for supply, possession, prescribing and record-keeping. Schedule I contains drugs which are not used as medicines. Schedules II and III contain drugs which are subject to the prescription requirements of the Act (see below). They are distinguished in the British National Formulary (BNF) by the symbol CD and they include morphine, diamorphine (heroin), other opioid analgesics, barbiturates, amphetamines, cocaine and diethylpropion. Schedules IV and V contain drugs such as the benzodiazepines which are subject to minimal control. A full list of the drugs in each schedule can be found in the BNF.
Prescriptions for drugs in schedules II and III must be signed and dated by the prescriber, who must give his or her address. The prescription must be in the prescriber’s own handwriting and provide the name and address of the patient and the total quantity of the preparation in both words and ?gures. The pharmacist is not allowed to dispense a controlled drug unless all the information required by law is given on the prescription.
Until 1997 the Misuse of Drugs (Noti?cation and Supply of Addicts) Regulations 1973 governed the noti?cation of addicts. This was required in respect of the following commonly used drugs: cocaine, dextromoramide, diamorphine, dipipanone, hydrocodeine, hydromorphone, levorphanol, methadone, morphine, opium, oxycodone, pethidine, phenazocine and piritranide.
In 1997 the Misuse of Drugs (Supply to Addicts) Regulations 1997 revoked the 1973 requirement for noti?cation. Doctors are now expected to report (on a standard form) cases of drug misuse to their local Drug Misuse Database (DMD). Noti?cation by the doctor should be made when a patient ?rst presents with a drug problem or when he or she visits again after a gap of six months or more. All types of misuse should be reported: this includes opioids, benzodiazepines and central nervous system stimulants. The data in the DMD are anonymised, which means that doctors cannot check on possible multiple prescribing for drug addicts.
The 1997 Regulations restrict the prescribing of diamorphine (heroin), Diconal® (a morphine-based drug) or cocaine to medical practitioners holding a special licence issued by the Home Secretary.
Fuller details about the prescription of controlled drugs are in the British National Formulary, updated twice a year, and available on the Internet (see www.bnf.org).... controlled drugs
Abnormal prion proteins accumulate in the brain and the spinal cord, damaging neurones (see NEURON(E)) and producing small cavities. Diagnosis can be made by tonsil (see TONSILS) biopsy, although work is under way to develop a diagnostic blood test. Abnormal prion proteins are unusually resistant to inactivation by chemicals, heat, X-RAYS or ULTRAVIOLET RAYS (UVR). They are resistant to cellular degradation and can convert normal prion proteins into abnormal forms. Human prion diseases, along with scrapie in sheep and BSE in cattle, belong to a group of disorders known as transmissible spongiform encephalopathies. Abnormal prion proteins can transfer from one animal species to another, and variant CJD has occurred as a result of consumption of meat from cattle infected with BSE.
From 1995 to 1999, a scienti?c study of tonsils and appendixes removed at operation suggested that the prevalence of prion carriage may be as high as 120 per million. It is not known what percentage of these might go on to develop disease.
One precaution is that, since 2003, all surgical instruments used in brain biopsies have had to be quarantined and disposable instruments are now used in tonsillectomy.
Measures have also been introduced to reduce the risk of transmission of CJD from transfusion of blood products.
In the past, CJD has also been acquired from intramuscular injections of human cadaveric pituitary-derived growth hormone and corneal transplantation.
The most common form of CJD remains the sporadic variety, although the eventual incidence of variant CJD may not be known for many years.... creutzfeldt-jakob disease (cjd)
The interaction may take place:
(1) Prior to absorption or administration – for example, antacids bind tetracycline in the gut and prevent absorption.
(2) By interfering with protein binding – one drug may displace another from binding sites on plasma proteins. The action of the displaced drug will be increased because more drug is now available; for example, anticoagulants are displaced by analgesics.
(3) During metabolism or excretion of the drug – some drugs increase or decrease the activity of liver enzymes which metabolise drugs, thus affecting their rate of destruction; for example, barbiturates, nicotine, and alcohol all activate hepatic enzymes. Altering the pH of urine will affect the excretion of drugs via the kidney.
(4) At the drug receptor – one drug may displace another at the receptor, affecting its e?cacy or duration of action.... drug interactions
Prescriptions for drugs should be printed or written clearly in ink and signed and dated by the prescriber (computer-generated facsimile signatures do not meet legal requirements). They should include the patient’s name, address and age (obligatory for children under 12), the name of the drug to be supplied, the dose and dose frequency, and the total quantity to be supplied. Any special instructions (e.g. ‘after food’) should be stated. There are special regulations about the prescription of drugs controlled under the Misuse of Drugs Regulations 1985 (see CONTROLLED DRUGS). A pharmacist can advise about which drugs are available without prescription, and is able to recommend treatment for many minor complaints. Information about exemption from prescription charges in the NHS can be obtained from health visitors, general practitioners, or social security o?ces.... drugs
The other dangers of administering drugs in pregnancy are the teratogenic effects (see TERATOGENESIS). It is understandable that a drug may interfere with a mechanism essential for growth and result in arrested or distorted development of the fetus and yet cause no disturbance in the adult, in whom these di?erentiation and organisation processes have ceased to be relevant. Thus the e?ect of a drug upon a fetus may di?er qualitatively as well as quantitatively from its e?ect on the mother. The susceptibility of the embryo will depend on the stage of development it has reached when the drug is given. The stage of early di?erentiation – that is, from the beginning of the third week to the end of the tenth week of pregnancy – is the time of greatest susceptibility. After this time the risk of congenital malformation from drug treatment is less, although the death of the fetus can occur at any time.... drugs in pregnancy
Treatment As the disease can be neither prevented nor cured, treatment is supportive, with strict anti-infection procedures essential as human-to-human transmission can occur via skin and mucous-membrane contacts. Incubation period is 5–10 days. Fever with MYALGIA and headache occur initially, often accompanied by abdominal and chest symptoms. Haemorrhagic symptoms soon develop and the victim either starts to improve in the second week or develops multi-organ failure and lapses into a coma. Mortality ranges from 25 to 90 per cent.... ebola virus disease
A localised (focal) form of liver disease in all tropical/subtropical countries results from invasive Entamoeba histolytica infection (amoebic liver ‘abscess’); serology and imaging techniques assist in diagnosis. Hydatidosis also causes localised liver disease; one or more cysts usually involve the right lobe of the liver. Serological tests and imaging techniques are of value in diagnosis. Whilst surgery formerly constituted the sole method of management, prolonged courses of albendazole and/or praziquantel have now been shown to be e?ective; however, surgical intervention is still required in some cases.
Hepato-biliary disease is also a problem in many tropical/subtropical countries. In southeast Asia, Clonorchis sinensis and Opisthorchis viverini infections cause chronic biliary-tract infection, complicated by adenocarcinoma of the biliary system. Praziquantel is e?ective chemotherapy before advanced disease ensues. Fasciola hepatica (the liver ?uke) is a further hepato-biliary helminthic infection; treatment is with bithionol or triclabendazole, praziquantel being relatively ine?ective.... liver disease in the tropics
Treatment Acute vertigo symptoms can sometimes be alleviated with drugs such as CYCLIZINE HYDROCHLORIDE and NICOTINIC ACID, but the disorder is notoriously di?cult to treat and no certain cure is available. Surgical decompression of the ?uid in the ear’s balancing mechanism may relieve vertigo and prevent the disease from worsening. The vestibular nerve to the ear can also be cut to relieve vertigo while preserving hearing.... menière’s disease
Misuse of Drugs Act 1971 This legislation forbids activities relating to the manufacture, sale and possession of particular (controlled) drugs. These are classi?ed into three grades according to their dangers if misused. Any o?ences concerning class A drugs, potentially the most damaging when abused, carry the toughest penalties, while classes B and C attract lesser penalties if abused.
Class A includes: cocaine, dextromoramide, diamorphine (heroin), lysergic acid (LSD), methadone, morphine, opium, pethidine, phencyclidine acid and injectable preparations of class B drugs.
Class B includes: oral amphetamines, barbiturates, codeine, glutethimide, marijuana (cannabis), pentazocine and pholcodine.
Class C includes: drugs related to the amphetamines, anabolic and androgenic steroids, many benzodiazepines, buprenorphine, diethyl propion, human chorionic gonadotrophin (HCG), mazindol, meprobamate, pemoline, phenbuterol, and somatropin.
Misuse of Drugs Regulations 1985 These regulations de?ne those people who are authorised in their professional capacity to supply and possess controlled drugs. They also describe the requirements for legally undertaking these activities, such as storage of the drugs and limits on their prescription.
Drugs are divided into ?ve schedules and some examples follow.
I: Almost all are prohibited except in accordance with Home O?ce authority: marijuana (cannabis), LSD.
II: High potential for abuse but have
accepted medical uses: amphetamines, cocaine.
III: Lower potential for abuse: barbiturates, meprobamate, temazepam.
IV: Lower potential for abuse than I to III. Minimal control: benzodiazepines.
V: Low potential for abuse: generally compound preparations containing small amounts of opioids: kaolin and morphine (antidiarrhoeal medicine), codeine linctus (cough suppressant).
(See also CONTROLLED DRUGS.)... misuse of drugs
The symptoms depend upon the site of the infection. General symptoms such as fever, weight loss and night sweats are common. In the most common form of pulmonary tuberculosis, cough and blood-stained sputum (haemoptysis) are common symptoms.
The route of infection is most often by inhalation, although it can be by ingestion of products such as infected milk. The results of contact depend upon the extent of the exposure and the susceptibility of the individual. Around 30 per cent of those closely exposed to the organism will be infected, but most will contain the infection with no signi?cant clinical illness and only a minority will go on to develop clinical disease. Around 5 per cent of those infected will develop post-primary disease over the next two or three years. The rest are at risk of reactivation of the disease later, particularly if their resistance is reduced by associated disease, poor nutrition or immunosuppression. In developed countries around 5 per cent of those infected will reactivate their healed tuberculosis into a clinical problem.
Immunosuppressed patients such as those infected with HIV are at much greater risk of developing clinical tuberculosis on primary contact or from reactivation. This is a particular problem in many developing countries, where there is a high incidence of both HIV and tuberculosis.
Diagnosis This depends upon identi?cation of mycobacteria on direct staining of sputum or other secretions or tissue, and upon culture of the organism. Culture takes 4–6 weeks but is necessary for di?erentiation from other non-tuberculous mycobacteria and for drug-sensitivity testing. Newer techniques involving DNA ampli?cation by polymerase chain reaction (PCR) can detect small numbers of organisms and help with earlier diagnosis.
Treatment This can be preventative or curative. Important elements of prevention are adequate nutrition and social conditions, BCG vaccination (see IMMUNISATION), an adequate public-health programme for contact tracing, and chemoprophylaxis. Radiological screening with mass miniature radiography is no longer used.
Vaccination with an attenuated organism (BCG – Bacillus Calmette Guerin) is used in the United Kingdom and some other countries at 12–13 years, or earlier in high-risk groups. Some studies show 80 per cent protection against tuberculosis for ten years after vaccination.
Cases of open tuberculosis need to be identi?ed; their close contacts should be reviewed for evidence of disease. Adequate antibiotic chemotherapy removes the infective risk after around two weeks of treatment. Chemoprophylaxis – the use of antituberculous therapy in those without clinical disease – may be used in contacts who develop a strong reaction on tuberculin skin testing or those at high risk because of associated disease.
The major principles of antibiotic chemotherapy for tuberculosis are that a combination of drugs needs to be used, and that treatment needs to be continued for a prolonged period – usually six months. Use of single agents or interrupted courses leads to the development of drug resistance. Serious outbreaks of multiply resistant Mycobacterium tuberculosis have been seen mainly in AIDS units, where patients have greater susceptibility to the disease, but also in developing countries where maintenance of appropriate antibacterial therapy for six months or more can be di?cult.
Streptomycin was the ?rst useful agent identi?ed in 1944. The four drugs used most often now are RIFAMPICIN, ISONIAZID, PYRAZINAMIDE and ETHAMBUTOL. Three to four agents are used for the ?rst two months; then, when sensitivities are known and clinical response observed, two drugs, most often rifampicin and isoniazid, are continued for the rest of the course. Treatment is taken daily, although thrice-weekly, directly observed therapy is used when there is doubt about the patient’s compliance. All the antituberculous agents have a range of adverse effects that need to be monitored during treatment. Provided that the treatment is prescribed and taken appropriately, response to treatment is very good with cure of disease and very low relapse rates.... nature of the disease tuberculosis has
(e.g. etidronate). Those with the disease can obtain help and advice from the National Association for the Relief of Paget’s Disease.... paget’s disease of bone
The infection may be silent – with no obvious symptoms – or symptoms may be troublesome, for example, vaginal discharge and sometimes a palpable mass in the lower abdomen. If a LAPAROSCOPY is done – usually by endoscopic examination – overt evidence of PID is found in around 65 per cent of suspected cases.
PID may be confused with APPENDICITIS, ECTOPIC PREGNANCY – and PID is a common cause of such pregnancies – ovarian cyst (see OVARIES, DISEASES OF) and in?ammatory disorders of the intestines. Treatment is with a combination of ANTIBIOTICS that are active against the likely pathogens, accompanied by ANALGESICS. Patients may become seriously ill and require hospital care, where surgery is sometimes required if conservative management is unsuccessful. All women who have PID should be screened for sexually transmitted disease and, if this is present, should be referred with their partner(s) to a genito-urinary medicine clinic. Up to 20 per cent of women who have PID become infertile, and there is a seven-to ten-fold greater risk of an ectopic pregnancy occurring.... pelvic inflammatory disease(pid)
Symptoms The condition is most commonly con?ned to the occurrence of ‘dead ?ngers’ – the ?ngers (or the toes, ears, or nose) becoming white, numb, and waxy-looking. This condition may last for some minutes, or may not pass o? for several hours, or even for a day or two.
Treatment People who are subject to these attacks should be careful in winter to protect the feet and hands from cold, and should always use warm water when washing the hands. In addition, the whole body should be kept warm, as spasm of the arterioles in the feet and hands may be induced by chilling of the body. Su?erers should not smoke. VASODILATORS are helpful, especially the calcium antagonists. In all patients who do not respond to such medical treatment, surgery should be considered in the form of sympathectomy: i.e. cutting of the sympathetic nerves to the affected part. This results in dilatation of the arterioles and hence an improved blood supply. This operation is more successful in the case of the feet than in the case of the hands.... raynaud’s disease
The major defect in this system is the dif?culty in obtaining reports of adverse reactions. Evidence suggests that at most, about 10 per cent of such reactions are reported. One method of trying to obtain this information is the ‘yellow card’ system. It is so called because it is based on the distribution of yellow cards to all doctors, pharmacists and dentists, on which they are asked to report any adverse reaction happening to someone taking a drug, whether or not they think it is the cause. Alternatively the CSM has a Freephone line and on-line computer facilities (ADROIT) for practitioners to use. Even though the annual number of adverse reactions reported in this way has risen from around 5,000 in 1975 to more than 18,000, this is probably fewer than the number actually occurring.
Two further committees in this safety screen are the Joint Committee on Vaccination and Immunisation and the Adverse Reactions to Vaccines and Immunological Substances Committee.... safety of drugs
Inotropics act on beta receptors in heart muscle (see HEART), increasing its contractility and sometimes the heart rate. DOBUTAMINE and DOPAMINE are cardiac stimulants, while dopexamine acts on heart muscle and, via peripheral dopamine receptors, increases the excretion of URINE. ISOPRENALINE is used only as emergency treatment of heart block (interruption of the heart’s conduction) or severe slowing of the heart rate (bradycardia).... sympathomimetic drugs
Symptoms: inflammation of the lung and high temperature with dry cough.
Tea: Equal parts; Elderflowers (to reduce temperature). Comfrey leaves (cough), Thyme (antibiotic), Peppermint (to assist breathing). 2 teaspoons to each cup boiling water; infuse 5-15 minutes. 1 cup freely. Alternative: Combine Tinctures: Pleurisy root 2; Lobelia 1; Ginger half. One or two 5ml teaspoons in water 3-4 times daily. ... damp hay disease
Treatment: same as for NETTLE RASH. ... drug eruptions
Symptomatic relief. Rutin, Hawthorn, Echinacea. Vitamin E: 200iu daily. ... fabry’s disease
Symptoms. Vulva or penis swollen and itching. Neuritis of the eye with possible ensuing blindness. A specific disease unrelated to herpes simplex which it resembles. There is no evidence that it is venereal. Basic pathology is inflammation of the veins, arteries and capillaries (Nettles). Thrombosis is possible (Hawthorn).
Treatment. Tea. (1) Nettles. Or (2): place half an ounce Burdock root in 1 pint water; simmer gently 20 minutes: Add 1oz Nettles. Allow to steep for further 15 minutes. Dose: 1 cup thrice daily.
Tablets/capsules. Kelp, Echinacea, Blue Flag.
Tinctures. Combine Echinacea 2; Goldenseal three-quarters; Myrrh quarter. Dose: 1-2 teaspoons in water thrice daily.
Practitioner. Tincture Colchicum BP 1973.
Topical. Bathe with dilute cider vinegar. Cold tea. Garlic ointment. Tea Tree oil diluted many times. Houseleek.
Eyedrops. Goldenseal eyedrops.
Diet. Avoid hot peppery foods, fried foods.
Low-salt. Regular raw food days.
Supplementation. Vitamin E: 500-1000iu daily. Vitamin B-complex. Calcium and Magnesium. Avoid: scented soap, talcum powder, wool (alternatives: cotton briefs, open gusset tights). Information: Bechet’s Syndrome Society, 3 Belgrave Street, Haxby Road, York Y03 7YY. ... bechet’s disease
Acute toxic nephritis is possible in the convalescent stage of scarlet and other infectious fevers, even influenza. Causes are legion, including septic conditions in the ear, nose, throat, tonsils, teeth or elsewhere. Resistance to other infections will be low because of accumulation of toxins awaiting elimination. When protein escapes from the body through faulty kidneys general health suffers.
This condition should be treated by or in liaison with a qualified medical practitioner.
Treatment. Bedrest essential, with electric blanket or hot water bottle. Attention to bowels; a timely laxative also assists elimination of excessive fluid. Diuretics. Diaphoretics. Abundant drinks of bottled water or herb teas (3-5 pints daily). Alkaline drinks have a healing effect upon the kidneys. Juniper is never given for active inflammation.
Useful teas. Buchu, Cornsilk, Couchgrass, Clivers, Bearberry, Elderflowers, Marshmallow, Mullein, Marigold flowers, Wild Carrot, Yarrow.
Greece: traditional tea: equal parts, Agrimony, Bearberry, Couchgrass, Pellitory.
Powders. Equal parts: Dandelion, Cornsilk, Mullein. Dose: 750mg (three 00 capsules or half teaspoon) every 2 hours. In water or cup of Cornsilk tea.
Tinctures. Equal parts: Buchu, Elderflowers, Yarrow. Mix. Dose: 1-2 teaspoons in water or cup of Cornsilk tea, every two hours.
Topical. Hot poultices to small of the back; flannel or other suitable material saturated with an infusion of Elderflowers, Goldenrod, Horsetail or Yarrow. Herbal treatment offers a supportive role. ... bright’s disease (acute)
Symptoms: loss of weight, wasting illness, skin abscesses.
Treatment. Tea: Aniseed 1; Senna leaf 1; Nettles 2. 2 teaspoons to each cup boiling water; infuse 10-15 minutes in covered vessel. 1 cup thrice daily. Add to each dose: 30 drops Tincture Echinacea. ... goat disease
Treatment. See: HEART – LEFT VENTRICULAR FAILURE. ... mitral disease
The immune system is the body’s internal defence armoury which protects from sickness and disease. White blood cells are influenced by the thymus gland and bone marrow to become “T” lymphocytes or “B” lymphocytes which absorb and destroy bacteria. There are times when these powerful defence components inflame and attack healthy tissue, giving rise to auto immune disease which may manifest as one of the numerous anaemic, rheumatic or nervous disorders, even cancer.
A watchful eye should be kept on any sub-acute, non-specific inflammation going on quietly over a long period – a certain indication of immune-inadequacy. It would appear that some unknown body intelligence operates behind the performance of the immune system; emotional and physic stresses such as divorce or job dissatisfaction can lead to a run-down of body defences. Some psychiatrists believe it to be a self-produced phenomenon due to an unresolved sense of guilt or a dislike of self. When this happens, bacterial, virus or fungus infections may invade and spread with little effective opposition. People who are happy at their home and work usually enjoy a robust immune system.
An overactive immune system may develop arthritis with painful joint inflammation, especially with a background of a fat-rich diet. A link between silicone implants and auto-immune disease is suspected.
“There is increasing evidence,” writes Dr D. Addy, Consulting Pediatrician, “that fevers may enhance the defence mechanism against infection.” (See: FEVER) “There is also increasing evidence of a weakening of the immune system through suppression of fevers by modern drugs. In this way, aspirin and other powerful anti-inflammatories may be responsible for feeble immune response.”
White cell stimulators: Liquorice, Ginseng (Siberian), Goldenseal, Echinacea. These increase ability of white blood cells to attack bacteria and invading cells. Chinese medicine: Ginseng (men), Chinese Angelica (women).
Treatment. To strengthen body defences. Garlic, Borage, Comfrey, Agrimony, Balm, Chamomile (German), Echinacea, Horsetail, Liquorice, Lapacho, Sage, Wild Yam, Wild Indigo, Poke root, Thuja. Shiitake Mushroom. Reishi Mushroom, Chlorella..
Tea. Combine, equal parts, St John’s Wort, Borage, Chamomile (German). 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.
Powders. Combine, Echinacea 4; Comfrey root 2; Wild Yam 1. 500mg (two 00 capsules, or one-third teaspoon) thrice daily.
Tinctures. Combine, Echinacea 4; Poke root 1; Thuja 1. 1-2 teaspoons in water thrice daily.
Tincture: Tincture Myrrh BPC 1973: 5-10 drops in water, morning and evening.
Decoctions. Horse-radish. Fenugreek seeds.
Bio-strath. Yeast-based herbal tonic. Exerts a positive influence on the immune system by rapid and marked increase in white blood cells.
Diet. Foods rich in essential fatty acids: nuts, seeds, beans, pulses, Evening Primrose oil, Cod Liver oil flavoured with mint or lemon. High protein: eggs, fish. (Low protein – acute stage). Foods rich in selenium. Yoghurt, cider vinegar, pineapple juice. Sugar has an immune suppressing effect.
Supplements. To rebuild immune system. Vitamins A, B5, B6, C, D, E. Zinc is required to produce histamine which is a vasodilator. Combination: zinc, selenium and GLA. Iron. Calcium.
Aromatherapy. Lavender oil: massage or baths.
Note: An alleged link exists between silicone implants and auto-immune disease. A new study reveals evidence that women with silicone breast implants who breast-feed their children put them at risk of developing systemic sclerosis. (JAMA Jan 19 1994) ... auto immune disease
Alternatives. Cramp bark, Cayenne, Chamomile, Guaiacum, Hops, Meadowsweet, Celery, Prickly Ash, Valerian, Wild Lettuce, Wild Yam. Mistletoe (F. Hyde). White Willow.
Tea. Equal parts: German Chamomile, Hops, Meadowsweet. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes; 1 cup 3 or more times daily.
Tablets/capsules. Chamomile, Mistletoe, Prickly Ash, Ligvites, Wild Yam, Valerian, Kelp.
Alternative formulae:– Powders. Prickly Ash 1; Valerian 1; Cramp bark half; Guaiacum quarter. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Liquid Extracts. White Willow 2; Prickly Ash 1; Celery seeds half; Liquorice quarter; Tincture Capsicum quarter. Mix. 30-60 drops thrice daily.
Tinctures. White Willow 2; Prickly Ash 1; Valerian 1; Meadowsweet 1; Tincture Capsicum quarter. Mix. 2 teaspoons thrice daily.
Topical. Comfrey poultices (Maria Treben). “Three oils.”
Diet. Lacto-vegetarian. Dandelion coffee. Oily fish.
General. Straight knee brace for rigid support. ... charcot’s disease
A constant fear is the onset of uraemia caused by accumulation in the blood of waste by-products of protein digestion, therefore the patient should reject meat in favour of fish. Eggs and dairy products taken in strict moderation.
Where urea accumulates in the circulation ‘sustaining’ diuretics are indicated; these favour excretion of solids without forcing the discharge of more urine: including Shepherd’s Purse, Gravel root, or Uva Ursi when an astringent diuretic is needed for a show of blood in the urine. According to the case, other agents in common practice: Dandelion root, Yarrow, Hawthorn, Marigold, Stone root, Hydrangea. Parsley Piert, Buchu, Hawthorn, Golden Rod.
The patient will feel the cold intensely and always be tired. Warm clothing and ample rest are essential. Heart symptoms require treatment with Lily of the Valley or Broom.
This condition should be treated by or in liaison with a qualified medical practitioner.
Treatment. As kidney damage would be established, treatment would be palliative; efforts being to relieve strain and obtain maximum efficiency. There may be days of total bed-rest, raw foods and quiet. Consumption of fluids may not be as abundant as formerly. Soothing herb teas promote well-being and facilitate elimination. Oil of Juniper is avoided.
Efforts should be made to promote a rapid absorption – to restore the balance between the circulation and the lymphatics. For this purpose Mullein is effective. A few grains of Cayenne or drops of Tincture Capsicum enhances action.
Indicated. Antimicrobials, urinary antiseptics, diuretics, anti-hypertensives. For septic conditions add Echinacea.
Of Therapeutic Value. Alfalfa, Broom, Buchu, Couchgrass, Cornsilk, Dandelion, Lime flowers, Marigold, Mullein, Marshmallow, Parsley Piert, Periwinkle (major), Wild Carrot, Water Melon seed tea. Tea. Combine equal parts: Couchgrass, Dandelion, Mullein. 2 teaspoons to each cup boiling water. Infuse 5-15 minutes. 1 cup freely.
Powders. Combine equal parts: Stone root, Hydrangea, Hawthorn. Dose: 500mg (two 00 capsules or one-third teaspoon) 3 or more times daily in water or cup Cornsilk tea. A few grains Cayenne enhances action. Formula. Buchu 2; Mullein 2; Echinacea 1; Senna leaves half. Mix. Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water or cup Cornsilk tea 3 or more times daily. 2-3 drops Tincture Capsicum to each dose enhances action.
Diffusive stimulant for the lymphatic vessels. Onion milk is an effective potassium-conserving diuretic and diaphoretic. Onions are simmered gently in milk for 2 hours and drunk when thirsty or as desired – a welcome alternative to water. May be eaten uncooked.
Diet. Salt-free, low fat, high protein. Spring water. Raw goat’s milk, potassium broth. Fish oils. Avoid eggs and dairy products. No alcohol.
Supplements. Vitamins A, B-complex, C plus bioflavonoids, B6, D, E, Magnesium, Lecithin. Herbal treatment offers a supportive role. ... bright’s disease (chronic)
In high doses, amfetamines can cause tremor, sweating, anxiety, and sleeping problems. Delusions, hallucinations, high blood pressure, and seizures may also occur. Prolonged use may produce tolerance and drug dependence.
Amfetamines are often abused for their stimulant effect.... amfetamine drugs
Prominent cyst formations have been reduced, even eliminated by Poke root, internally and externally, though surgery is sometimes indicated. Diuretics influence the kidneys to expel more body fluids and are sometimes helpful to reduce size. Cold water packs may be applied to the affected area two or more times daily, as practical.
Alternatives. Tea. Formula. Equal parts: Ground Ivy, Clivers, Horsetail. One heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup morning and evening.
Poke root. Tablets, powders. Tincture. 5-10 drops in water 3 times daily.
Evening Primrose oil. Two 500mg capsules, 3 times daily. Trials carried out by departments of Surgery at the University of Wales and the University of Dundee found Evening Primrose oil effective and safe. Poultice. Poke root. Horsetail.
Diet. As salt favours retention of fluid in cystic tissue it should be restricted.
Supplements. Daily. Beta carotene; B-complex; B6, Vitamin C 1g; Zinc. Vitamin E contra-indicated.
Treatment by or in liaison with a general medical practitioner. ... fibrocystic breast disease (fbd)
Aluminium may cause constipation and magnesium may cause diarrhoea; but these effects may be avoided if a preparation contains both ingredients.
Antacids interfere with the absorption of many drugs and should not be taken at the same time as other drugs.... antacid drugs
It seems that this common bacteria, in some unknown way, receives a booster by taking on viral DNA. Lungs, liver and stomach may be attacked, while red blood cells are disrupted and their haemoglobin released. Among other conditions caused by streptococcus is the bright red rash of scarlet fever, sinusitis, meningitis and rheumatic fever. Flesh-eater disease may take just twenty hours to kill a man (“galloping gangrene”).
Symptoms. High temperature – body hot, hands and feet freezing cold. ‘Strep’ sore throat (pharyngitis). Bright red skin rash. Pains in arms and legs as if straining a muscle.
Treatment. The disease is resistant to penicillin. Frequent hot lemon drinks well-laced with honey. Tinctures. Echinacea 2; Goldenseal 1; Myrrh half. Dose: 10-20 drops in dessertspoon water or honey, hourly, acute cases.
Treatment by or in liaison with medical practitioner or infectious diseases specialist. ... flesh-eating disease
Excessive doses of anticoagulant drugs increase the risk of unwanted bleeding, and regular monitoring is needed.... anticoagulant drugs
Anticonvulsants may produce various side effects, including impaired memory, reduced concentration, poor coordination, and fatigue. If the side effects are severe, they can often be minimized by use of an alternative anticonvulsant.... anticonvulsant drugs
Symptoms: diarrhoea, abdominal swelling and pain, irritability, inability to gain weight, neuritis, ulcers on tongue and mouth, low blood pressure, debility, lactase-deficiency. Breast-feeding stops coeliac disease.
Alternatives. Tea. Mix, equal parts: Raspberry leaves, Agrimony, Lemon Balm. 2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup freely.
Tablets/capsules. Goldenseal, Slippery Elm. Calamus. Fenugreek seeds, Papaya. Wild Yam.
Powders, Liquid Extracts, Tinctures. Formula. Equal parts: Sarsaparilla, Wild Yam, Stone root. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid Extracts: 30-60 drops. Tinctures: 1-2 teaspoons. In water, banana mash or honey, thrice daily.
Papaya (papain) digests wheat gluten and assists recovery. Half-1g with meals.
Aloe Vera juice. Promotes improved bowel motility, increases stool specific gravity, and reduces indication of protein putrefaction, flatulence and bloating after meals. (J. Bland PhD. JAM June 1985, p.11)
Topical. Warm hip baths of Lemon Balm, Chamomile, etc. (Alfred Vogel)
Diet. Gluten-free. Rice. Unpasteurised yoghurt. Buttermilk. Sweet acidophilus milk. Raw carrot juice. Bananas mashed with a little Slippery Elm or dried milk powder, carob bean powder and Soya milk. Supplementation. Vitamins A, B-complex, B6, B12, Folic acid, C, D, E, K (Alfalfa tea). Calcium, Iron and Magnesium orotates. ... gluten-sensitive disease
Treatment. Purpose of medication is to stimulate flow of bile and support the liver.
Arthur Hyde, MNIMH recommends a selection from the following according to individual case: Balmony, Barberry, Dandelion, Goldenseal, Hops, Ladyslipper, Mistletoe, Passion flower, Stone root. Tinctures. Formula. Marigold 2; Barberry 2; Ginkgo 1. Dose: 2 drops in feed, or in water, thrice daily. Infants 3-5 years: 10 drops.
To be treated by or in liaison with a qualified medical practitioner. ... haemolytic disease of infants
In most acute cases of diarrhoea, the only treatment recommended is oral rehydration therapy.
Antidiarrhoeal drugs include adsorbents, bulk-forming agents such as kaolin, and antimotility drugs (including the opioid drugs, morphine and codeine, and loperamide), which slow movement through the intestine.
None of these drugs are suitable for children.... antidiarrhoeal drugs
Antihistamine drugs and anticholinergic drugs reduce vomiting in motion sickness, vertigo, and Ménière’s disease.
The most powerful antiemetics are used to control nausea and vomiting associated with radiotherapy or anticancer drugs.
These drugs include serotonin antagonists such as ondansetron and nabilone.
Antiemetics are not normally used in the treatment of food poisoning because the body needs to rid itself of harmful substances.
Only certain antiemetics can be used to treat vomiting in early pregnancy because damage to the developing fetus may occur.
Many antiemetics cause drowsiness.... antiemetic drugs
Antifungal preparations are available in various forms including tablets, injection, creams, and pessaries. Prolonged treatment of serious fungal infections can result in side effects that include liver or kidney damage.... antifungal drugs
Antipruritics may be applied as creams and emollients and may contain corticosteroid drugs, antihistamine drugs, or local anaesthetics.
Oral antihistamines may also be used to relieve itching.... antipruritic drugs
Onset: 2-10 days.
Sources of infection: water-cooling and air-conditioning plants, Aerosols.
Usually attacks those with existing lung weakness. Those with low natural resistance and smokers are most at risk. Epidemic or single cases. Diagnosis confirmed by Haematological laboratory.
Symptoms. High body temperature (above 39°C). Rigor. Shivering. Diarrhoea. Dry cough. Bleeding from stomach and intestines. Mental confusion. Chest pains, shortness of breath, occasional diarrhoea. Differential diagnosis. Glandular fever. Other forms of pneumonia.
Indicated: anti-microbials and expectorants.
Treatment. Formula. Pleurisy root 2; Echinacea root 2; Grindelia quarter. Dose – Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Every 3 hours. Take together with:–
Fenugreek tea. 2 heaped teaspoons seeds to each cup water simmered gently 10 minutes. Drink freely 1 cup. Seeds should be swallowed.
Enema. Strong Yarrow tea enema to control bowel bleeding. ... legionnaire’s disease
Added to the above are:– muscular rigidity, loss of reflexes, drooling – escape of saliva from the mouth. Muscles of the face are stiff giving a fixed expression, the back presents a bowed posture. The skin is excessively greasy and the patient is unable to express emotional feelings. Loss of blinking. Pin- rolling movement of thumb and forefinger.
Causes: degeneration of groups of nerve cells deep within the brain which causes a lack of neurotransmitting chemical, dopamine. Chemicals such as sulphur used by agriculture, drugs and the food industry are suspected. Researchers have found an increase in the disease in patients born during influenza pandemics.
Treatment. While cure is not possible, a patient may be better able to combat the condition with the help of agents that strengthen the brain and nervous system.
Tea. Equal parts: Valerian, Passion flower, Mistletoe. 1 heaped teaspoon to each cup water; bring to boil; simmer 1 minute; dose: half-1 cup 2-3 times daily.
Gotu Kola tea. (CNS stimulant).
Tablets/capsules. Black Cohosh, Cramp bark, Ginseng, Prickly Ash, Valerian.
Formula. Ginkgo 2; Black Cohosh 1; Motherwort 2; Ginger 1. Mix. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 1-3 teaspoons in water or honey. Fava Bean Tea.
Case report. Two patients unresponsive to Levodopa treatment reported improvement following meals of fresh broad beans. (Vicia faba) The beans contain levodopa in large amounts. (Parkinson Disease Update Vol 8, No 66, p186, Medical Publications, PO Box 24622-H, Philadelphia, USA) See also: BROAD BEANS. L-DOPA.
Nacuna Pruriens. Appropriate. Essential active constituent: L-dopa. (Medicinal plants and Traditional Medicine in Africa, by Abayomi Sofowora, Pub: John Wiley)
Practitioner. To reduce tremor: Tincture Hyoscyamus BP. To reduce spasm: Tincture Belladonna BP. To arrest drooling: Tincture Stramonium BP.
Diet. It is known that people who work in manganese factories in Chile may develop Parkinson’s disease after the age of 30. Progress of the disease is arrested on leaving the factory. Two items of diet highest in manganese are wheat and liver which should be avoided, carbohydrates in place of wheat taking the form of rice and potatoes.
Supplements. Daily: B-complex, B2, B6, niacin. C 200mg to reduce side-effects of Levodopa. Vitamin E 400iu to possibly reduce rigidity, tremors and loss of balance.
Treatment of severe nerve conditions should be supervised by neurologists and practitioners whose training prepares them to recognise serious illness and to integrate herbal and supplementary intervention safely into the treatment plan.
Antioxidants. Evidence has been advanced showing how nutritional antioxidants, high doses of Vitamin C and E, can retard onset of the disease, delaying the use of Levodopa for an average of 2 and a half years. (Fahn S., High Dose Alpha-tocopherol and ascorbate in Early Parkinson’s Disease – Annals of Neurology, 32-S pp128-132 1992)
For support and advice: The Parkinson’s Disease Society, 22 Upper Woburn Place, London WC1H 0RA, UK. Send SAE. ... parkinson’s disease
Adverse effects are uncommon with paracetamol. Aspirin and NSAIDs may irritate the stomach lining and cause nausea, abdominal pain, and, rarely, a peptic ulcer. Nausea, drowsiness, constipation, and breathing difficulties may occur with opioid analgesics.... analgesic drugs
Androgen drugs are occasionally used to treat certain types of breast cancer. They have been widely used by sportsmen wishing to increase muscle bulk and strength, a practice that is dangerous to health (see steroids, anabolic).
Adverse effects include fluid retention, weight gain, increased blood cholesterol, and, rarely, liver damage. When taken by women, the drugs can cause male characteristics, such as facial hair, to develop.
androgen hormones A group of hormones that stimulate the development of male sexual characteristics.
Androgens are produced by specialized cells in the testes in males and in the adrenal glands in both sexes. The ovaries secrete very small quantities of androgens until the menopause. The most active androgen is testosterone, which is produced in the testes. The production of androgens by the testes is controlled by certain pituitary hormones, called gonadotrophins. Adrenal androgens are controlled by ACTH, another pituitary hormone.
Androgens stimulate male secondary sexual characteristics at puberty, such as the growth of facial hair and deepening of the voice. They have an anabolic effect (they raise the rate of protein synthesis and lower the rate at which it is broken down). This increases muscle bulk and accelerates growth. At the end of puberty, androgens cause the long bones to stop growing. They stimulate sebum secretion, which, if excessive, causes acne. In early adult life, androgens promote male-pattern baldness.
Androgen deficiency may occur if the testes are diseased or if the pituitary gland fails to secrete gonadotrophins. Typical effects include decreased body and facial hair, a high-pitched voice, underdevelopment of the genitalia, and poor muscle development.
Overproduction of androgens may be the result of adrenal disorders (see adrenal tumours; adrenal hyperplasia, congenital), of testicular tumours (see testis, cancer of), or, rarely, of androgensecreting ovarian tumours (see ovary, cancer of).
In men, excess androgens accentuate male characteristics; in boys, they cause premature sexual development.
In women, excess androgens cause virilization, the development of masculine features such as an increase in body hair, deepening of the voice, clitoral enlargement, and amenorrhoea.... androgen drugs
Most of the commonly used antibiotic drugs belong to one of the following classes: penicillins, quinolones, aminoglycosides, cephalosporins, macrolides, and tetracyclines. Some antibiotics are effective against only certain types of bacteria; others, which are known as broad-spectrum antibiotics, are effective against a wide range.
Some bacteria develop resistance to a previously effective antibiotic drug. This is most likely to occur during long-term treatment. Some alternative antibiotics are available to treat bacteria that have become resistant to the more commonly prescribed drugs.
Most antibiotic drugs can cause nausea, diarrhoea, or a rash. Antibiotics may disturb the normal balance between certain types of bacteria and fungi in the body, leading to proliferation of the fungi that cause candidiasis (thrush). Some people experience a severe allergic reaction to the drugs, resulting in facial swelling, itching, or breathing difficulty.... antibiotic drugs
Most anticancer drugs are cytotoxic (kill or damage rapidly dividing cells), but some act by slowing the growth of hormone-sensitive tumours. Anticancer drugs are often prescribed in combination to maximize their effects.
Treatment with cytotoxic drugs is often given by injection in short courses repeated at intervals. Some drugs cause nausea and vomiting and may result in hair loss and increased susceptibility to infection. Others, such as tamoxifen, which is used for breast cancer, are given continuously by mouth for months or years and cause few side effects.... anticancer drugs
Anticholinergic drugs are used in the treatment of irritable bowel syndrome, urinary incontinence, Parkinson’s disease, asthma, and bradycardia (abnormally slow heartbeat).
They are also used to dilate the pupil before eye examination or surgery.
Anticholinergic drugs are used as a premedication before general anaesthesia and to treat motion sickness.
They may cause dry mouth, blurred vision, urinary retention, and confusion.... anticholinergic drugs
Antirheumatic drugs affect the disease process and may limit joint damage, unlike nonsteroidal anti-inflammatory drugs, which only relieve pain and stiffness.
The main antirheumatic drugs are corticosteroid drugs, immunosuppressant drugs, chloroquine, gold, penicillamine, and sulfasalazine.
Many of these drugs can have serious side effects, and treatment must be under specialist supervision.... antirheumatic drugs
However, antiviral drugs can reduce the severity of some viral infections (most notably herpes, influenza, viral hepatitis, and cytomegalovirus infections), particularly in people who have reduced immunity.
Advances have also been made in the treatment of infection (see antiretroviral drugs).... antiviral drugs
Bisphosphonates are also used in the prevention or treatment of osteoporosis.... bisphosphonate drugs
Minor adverse effects of benzodiazepines include daytime drowsiness, dizziness, and forgetfulness. Unsteadiness and slowed reactions may also occur. Regular users may become psychologically and physically dependent; for this reason, the drugs are usually given for courses of 2–3 weeks or less. When the drugs are stopped suddenly, withdrawal symptoms, such as anxiety, restlessness, and nightmares may occur. Benzodiazepine drugs are sometimes abused for their sedative effect.... benzodiazepine drugs
There are 2 types of beta receptor: beta 1 and beta 2. Beta 1 receptors are present in the heart and blood vessels, and beta 2 in the lungs. Some betablockers (such as acebutolol, atenolol, and metoprolol) are termed cardioselective and, because they act mostly on beta 1 receptors, are used mainly to treat heart disease such as angina, hypertension, and cardiac arrhythmia. The drugs are sometimes given after a myocardial infarction (heart attack) to reduce the likelihood of further damage to the heart muscle.
Other types of beta-blocker, such as oxprenolol, propranolol, and timolol, may be given to prevent migraine attacks by acting on blood vessels in the head; reduce the physical symptoms of anxiety; or control the symptoms of thyrotoxicosis. Beta-blocker drugs such as timolol are sometimes given in the
form of eye drops to treat glaucoma and work by lowering the fluid pressure in the eyeball.
Beta-blockers may reduce an individual’s capacity for strenuous exercise. The drugs may worsen the symptoms of asthma, bronchitis, or other forms of lung disease. They may also reduce the flow of blood to the limbs, causing cold hands and feet. In addition, sleep disturbance and depression can be side effects of beta-blockers.... beta-blocker drugs
The main side effects of sympathomimetics are palpitations and trembling.
Anticholinergics may cause dry mouth, blurred vision, and, rarely, difficulty in passing urine.
Xanthines may cause headaches, nausea and palpitations.... bronchodilator drugs
CEPHALOSPORIUM ACREMONIUM, which are effective against a wide range of infections.
Cephalosporins are used to treat ear, throat, and respiratory tract infections, and conditions, such as urinary tract infections and gonorrhoea, in which the causative bacteria are resistant to other types of antibiotics.
Occasionally, the drugs cause allergic reactions, such as rash, itching, and fever.
Rarely, anaphylactic shock occurs.
Other side effects include diarrhoea and blood disorders.... cephalosporin drugs
The parasites live in the bloodstream and can affect the heart, intestines, and nervous system.
Symptoms include swelling of the lymph nodes and fever.
Long-term complications include damage to the heart.
The drug nifurtimox kills the parasites in the blood but has unpleasant side effects.... chagas’ disease
Side effects are uncommon when corticosteroids are given as a cream or by inhaler, but tablets taken in high doses for long periods may cause oedema, hypertension, diabetes mellitus, peptic ulcer, Cushing’s syndrome, inhibited growth in children, and, in rare cases, cataract or psychosis. High doses also impair the body’s immune system. Long-term treatment suppresses production of corticosteroid hormones by the adrenal glands, and sudden withdrawal may lead to adrenal failure.... corticosteroid drugs
Symptoms are similar for all variants. Progressive dementia and myoclonus (sudden muscular contractions) occur; muscular coordination diminishes; the intellect and personality deteriorate; and blindness may develop. As the disease progresses, speech is lost and the body becomes rigid. There is no treatment and death usually occurs within 2–3 years.... creutzfeldt–jakob disease
They are used to treat heart conditions, most commonly atrial fibrillation.
Those most frequently used are digitoxin and digoxin.... digitalis drugs
Problems resulting from drug abuse may arise from the adverse effects of the drug, accidents that occur during intoxication, or from the habit-forming potential of many drugs, which may lead to drug dependence.... drug abuse
They work by narrowing blood vessels in the membranes lining the nose.
This action reduces swelling, inflammation, and the amount of mucus produced by the lining.
Common drugs include ephedrine, oxymetazoline, and phenylephrine.
Small amounts of these drugs are present in many over-thecounter cold remedies.
Taken by mouth, decongestant drugs may cause tremor and palpitations.
Adverse effects are unlikely with nose drops, but if taken for several days they become ineffective and symptoms may then recur or worsen despite continued treatment.... decongestant drugs
Overconsumption of alcohol can lead to various alcohol-related disorders. A high salt intake predisposes a person towards hypertension. Some components of the diet protect against disease. For example, fibre protects against diverticular disease, chronic constipation, and haemorrhoids.
Many people’s diets contain too few natural vitamins. Pregnant women need high intakes of folic acid to reduce the risk of neural tube defects.
Although many illnesses are commonly ascribed to food allergy, it is only rarely that a definite link is proved. (See also nutritional disorders).... diet and disease
Types of diuretic drug differ markedly in their speed and mode of action. Thiazide diuretics cause a moderate increase in urine production. Loop diuretics are fast-acting, powerful drugs. They are often used as an emergency treatment for heart failure. Potassium-sparing diuretics are used along with thiazide and loop diuretics, both of which may cause the body to lose too much potassium. Carbonic anhydrase inhibitors block the action of the enzyme carbonic anhydrase, which affects the amount of bicarbonate ions in the blood; these drugs increase urine output moderately but are effective only for short periods of time. Osmotic diuretics are used to maintain urine output following serious injury or major surgery.
Diuretic drugs may cause chemical imbalances in the blood.
Hypokalaemia (low blood levels of potassium) is usually treated with potassium supplements or potassium-sparing diuretic drugs.
A diet rich in potassium may be helpful.
Some diuretics raise the blood level of uric acid, increasing the risk of gout.
Certain diuretics increase the blood glucose level, which can cause or worsen diabetes mellitus.... diuretic drugs
Drug poisoning may cause drowsiness and breathing difficulty, irregular heartbeat, and, rarely, cardiac arrest, fits, and kidney and liver damage.
Antiarrhythmic drugs are given to treat heartbeat irregularity.
Fits are treated with anticonvulsants.
Blood tests to monitor liver function and careful monitoring of urine output are carried out if the drug is known to damage the liver or kidneys.... drug poisoning
In women, fertility drugs may be given when abnormal hormone production by the pituitary gland or ovaries disrupts ovulation or causes mucus around the cervix to become so thick that sperm cannot penetrate it. In men, fertility drugs are less effective, but they may be used when abnormal hormone production by the pituitary gland or testes interferes with sperm production. (See also clomifene; gonadotrophin hormones; testosterone.)... fertility drugs
(See also fibroadenosis).... fibrocystic disease
The traditional remedy is to wind the worm from the skin on to a small stick. Once the worm is out, the condition usually clears up. The drugs tiabendazole and niridazole are given to reduce inflammation, antibiotics are given to control secondary infection, and the patient is immunized against tetanus.... guinea worm disease
Hallucinogens include certain drugs of abuse, such as LSD, marijuana, mescaline, and psilocybin.
Some prescription drugs, including anticholinergic drugs and levodopa, occasionally cause hallucinations.... hallucinogenic drug
The drugs work by suppressing the production and activity of white blood cells called lymphocytes. Side effects vary, but all the drugs increase the risk of infection and of the development of certain cancers.... immunosuppressant drugs
Keratolytic drugs, which include urea and salicylic acid preparations, are used to treat skin and scalp disorders, such as warts, acne, dandruff, and psoriasis.... keratolytic drugs
A number of serious diseases are spread by biting insects.
These include malaria and filariasis (transmitted by mosquitoes), sleeping sickness (tsetse flies), leishmaniasis (sandflies), epidemic typhus (lice), and plague (rat fleas).
Mosquitoes, sandflies, and ticks can also spread illnesses such as yellow fever, dengue, Lyme disease, and some types of viral encephalitis.
Organisms picked up when an insect ingests blood from an infected animal or person are able to survive or multiply in the insect.
Later, the organisms are either injected into a new human host via the insect’s saliva or deposited in the faeces at or near the site of the bite.
Most insect-borne diseases are confined to the tropics and subtropics, although tick-borne Lyme disease occurs in some parts of the.
The avoidance of insect-borne disease is largely a matter of keeping flies off food, discouraging insect bites by the use of suitable clothing and insect repellents, and, in parts of the world where malaria is present, the use of mosquito nets and screens, pesticides, and antimalarial tablets.... insects and disease
There are various types.
Bulk-forming laxatives increase the volume and softness of faeces and make them easier to pass.
Stimulant laxatives stimulate the intestinal wall to contract and speed up the elimination of faeces.
Lubricant laxatives soften and facilitate the passage of faeces.
Osmotic laxatives increase the water content and volume of the faeces.
If used in excess, laxative drugs may cause diarrhoea, abdominal cramps, and flatulence, and may impair normal bowel function.... laxative drugs
The first symptoms include headache, muscular and abdominal pain, diarrhoea, and a dry cough.
Over the next few days, pneumonia develops, resulting in a high fever, shaking chills, coughing up of thick sputum (phlegm), drowsiness, and sometimes delirium.
Treatment is with the antibiotic drug erythromycin.... legionnaires’ disease
These drugs help to prevent, or slow the progression of, severe atherosclerosis and coronary artery disease.
The most commonly used types are statins and fibrates.... lipid-lowering drugs
The longer consumption goes on, the more severe the damage.
The initial effect is the formation of fat globules between liver cells, a condition called fatty liver.
This is followed by alcoholic hepatitis, and damage then progresses to cirrhosis.
Alcohol-related liver disease increases the risk of developing liver cancer.
Liver function tests show a characteristic pattern of abnormalities, and liver biopsy may be needed to assess the severity of damage.
There is no particular treatment, but abstinence from alcohol prevents further damage.
Treatment for alcohol dependence may be required.... liver disease, alcoholic
Common macrolides include azithromycin and erythromycin.... macrolide drugs
Species causing disorders include the scabies mite, which burrows in human skin causing intense itching; the housedust mite, which can cause asthma when inhaled in dust; and chiggers (American harvest mites), which are found in thick grass and cause an itchy rash when they bite. Mites in grain or fruit may cause skin irritation, sometimes known as grocers’ or bakers’ itch.Certain mites transmit diseases, particularly scrub typhus and rickettsial pox.... mites and disease
The drugs may cause muscle weakness and drowsiness. In rare cases, dantrolene causes liver damage.... muscle-relaxant drugs
Possible side effects of nitrate drugs include headache, flushing, and dizziness. Tolerance (the need for greater amounts of a drug for it to have the same effect) may develop when the drug is taken regularly.... nitrate drugs
Nonsteroidal anti-inflammatory drugs are widely used to relieve symptoms caused by types of arthritis, such as rheumatoid arthritis, osteoarthritis, and gout. They do not cure or halt the progress of disease. NSAIDs are also used in the treatment of back pain, menstrual pain, headaches, pain after minor surgery, and soft tissue injuries.
The drugs reduce pain and inflammation by blocking the production of prostaglandins (chemicals that cause inflammation and trigger transmission of pain signals to the brain).
NSAIDs may cause a wide range of side effects, the most important of which are nausea, indigestion, bleeding from the stomach, and, sometimes, peptic ulcer.... nonsteroidal anti-inflammatory drugs
The disease resembles eczema and can cause itching and a burning feeling.
A non-healing sore may develop.
Without treatment, the tumour may spread into the breast.
Diagnosis is made with a biopsy.... paget’s disease of the nipple
Natural penicillins are derived from the mould PENICILLIUM; others are synthetic preparations.
Penicillins are used to treat many infective conditions, including tonsillitis, bronchitis, bacterial endocarditis, syphilis, and pneumonia.
They are also given to prevent rheumatic fever from recurring.
Common adverse effects of penicillins are an allergic reaction causing a rash, and diarrhoea.... penicillin drugs
Pneumoconiosis is fibrosis of the lung due to inhalation of industrial dusts, such as coal. Asbestosis is associated with asbestos in industry. Allergic alveolitis is caused by organic dusts (see farmer’s lung).
Industrial chemicals can damage the lungs if inhaled, or other major organs if they enter the bloodstream via the lungs or skin. Examples include fumes of cadmium, beryllium, lead, and benzene. Carbon tetrachloride and vinyl chloride are causes of liver disease. Many of these compounds can cause kidney damage. Work-related skin disorders include contact dermatitis and squamous cell carcinoma. Rare infectious diseases that are more common in certain jobs include brucellosis and Q fever (from livestock), psittacosis (from birds), and leptospirosis (from sewage). People who work with blood or blood products are at increased risk of viral hepatitis (see hepatitis, viral) and AIDS, as are healthcare professionals. The nuclear industry and some healthcare professions use measures to reduce the danger from radiation hazards. Other occupational disorders include writer’s cramp, carpal tunnel syndrome, singer’s nodes, Raynaud’s phenomenon, deafness, and cataracts.... occupational disease and injury
Oestrogen drugs are often used together with progestogen drugs.
Oestrogens suppress the production of gonadotrophin hormones, which stimulate cell activity in the ovaries. High doses are used in postcoital contraception to prevent conception (see contraception, emergency). They are also used to treat, or sometimes prevent, menopausal symptoms and disorders. Oestrogens may be used to treat certain forms of infertility, female hypogonadism, abnormal menstrual bleeding, prostatic cancer (see prostate, cancer of), and certain types of breast cancer.
Oestrogens may cause breast tenderness and enlargement, bloating, weight gain, nausea, reduced sex drive, depression, migraine, and bleeding between periods. Side effects often subside after 2 or 3 months. The drugs can increase the risk of abnormal blood clotting and susceptibility to high blood pressure (see hypertension). Oestrogen drugs should not be taken in pregnancy as they may adversely affect the fetus.... oestrogen drugs
The disease is a type of osteochondritis juvenilis, thought to be due to disrupted blood supply to the bone.
The condition is most common in boys aged 5–10, and usually affects 1 hip.
Symptoms include pain in the thigh and groin, and a limp on the affected side.
Diagnosis is made with X-rays.
Treatment may be rest for a few weeks, followed by splinting of the hip, or surgery.
The disease usually clears up by itself within 3 years, but the hip may be permanently deformed.... perthes’ disease
The group includes chlorpromazine, fluphenazine, and perphenazine.... phenothiazine drugs
Problems may also be caused in a developing baby if a pregnant woman drinks alcohol, smokes (see tobaccosmoking), or takes drugs of abuse. The babies of women who use heroin during pregnancy tend to have a low birthweight and a higher death rate than normal during the first few weeks of life. Babies of women who abuse drugs intravenously are at high risk of HIV infection.... pregnancy, drugs in
Dinoprostone is used with oxytocin for induction of labour.
Gemeprost softens and helps to dilate the cervix prior to inducing an abortion.
Alprostadil is used to treat newborn infants awaiting surgery for some congenital heart diseases.... prostaglandin drugs
When absorbed into the skin, psoralens react with ultraviolet light to cause skin darkening or inflammation.
Psoralen drugs may be used in conjunction with ultraviolet light (a combination called PUVA) to treat psoriasis and vitiligo.
Overexposure to ultraviolet light during treatment, or to too high a dose of a psoralen drug, may cause redness and blistering of the skin.
Psoralens in perfumes may cause photosensitivity.... psoralen drugs
Quinolones are used in the treatment of a wide range of conditions, including urinary tract infections, acute diarrhoeal diseases (such as that caused by salmonella infections), and enteric fever. Their absorption is reduced by antacids containing magnesium and aluminium.
Quinolones should be used with caution in patients with epilepsy, during pregnancy and breast-feeding, and in children and adolescents. Side effects include nausea, vomiting, diarrhoea, headache, sleep disorders, dizziness, rash, and blood disorders.... quinolone drugs
Overdose causes hyperventilation, tinnitus, sweating, abnormal bleeding, biochemical disturbances, and, in severe cases, convulsions and coma.... salicylate drugs
They include benzodiazepines, antihistamines, antidepressants, and chloral hydrate.
Sleeping drugs may cause drowsiness and impaired concentration on waking.
Long-term use may induce tolerance and dependence.... sleeping drugs
Stimulants such as amfetamines can prevent fatigue and increase confidence.
Three types of hormone drugs may be abused: anabolic steroids (see steroids, anabolic) to speed muscle recovery after exercise; erythropoietin to boost the haemoglobin content of the blood, which may increase stamina; and growth hormone to stimulate muscle growth.
Analgesic drugs may be used to mask the pain of an injury.
Betablockers are taken to reduce tremor in sports that require a steady hand.
Aside from the health risks associated with abuse of these drugs, their use is prohibited in many competitive sports.... sport, drugs and
Stimulants are of 2 types: central nervous system stimulants (for example, amfetamines), which increase alertness; and respiratory stimulants (see analeptic drugs), which encourage breathing.... stimulant drugs
If taken with milk, tetracyclines are not absorbed effectively into the intestines.
Possible side effects include nausea, vomiting, diarrhoea, worsening of kidney disorders, rash, and itching.
Tetracyclines may discolour developing teeth and are therefore not usually prescribed for children under age 12 or pregnant women.... tetracycline drugs
Thrombolytic drugs act within blood vessels to dissolve clots.
Possible adverse effects include abnormal bleeding and an allergic reaction.... thrombolytic drugs
In the , the only disease known to be transmitted to humans by ticks is Lyme disease. Others transmitted in various parts of the world include relapsing fever, Rocky Mountain spotted fever, Q fever, tularaemia, and certain types of viral encephalitis. The prolonged bite of certain female ticks can cause tick paralysis, in which a toxin in the tick saliva affects the nerves that control movement. In extreme cases, this can be fatal.... ticks and disease
Vasodilator drugs include ACE inhibitors, alphablockers, calcium channel blockers, nitrate drugs, and sympatholytic drugs.
They are used to treat disorders in which abnormal narrowing of blood vessels reduces blood flow through tissues, impairing the supply of oxygen.
Such disorders include angina pectoris and peripheral vascular disease.
Vasodilators are also used to treat hypertension and heart failure.
All vasodilator drugs may cause flushing, headaches, dizziness, fainting, and swollen ankles.... vasodilator drugs
(See also gingivitis, acute ulcerative.)... vincent’s disease
Marked floppiness and paralysis occur during the first few months, and affected children rarely survive beyond age 3.
There is no cure for the disease. Treatment aims to keep the affected infant as comfortable as possible.... werdnig–hoffmann disease
ology combining form. see -logy.... ollier’s disease
Autosomal dominant polycystic kidney disease (ADPKD) affects between 1 in 400 and 1 in 1000 individuals and is one of the most common hereditary diseases. Two types have been defined. ADPKD 1 is the commonest and responsible for about 85% of cases. It is due to a mutation in the PKD1 gene on chromosome 16, which encodes polycystin 1, an *ion-channel-regulating protein. ADPKD2 is due to a mutation in the PKD2 gene on chromosome 4, which encodes the protein polycystin 2, a calcium-release channel. ADPKD2 tends to be a milder disease with later presentation.
ADPKD is a multisystem disorder that is also associated with cyst formation in other organs (particularly the liver), cardiovascular disorders, and colonic diverticular disease. Renal disease presents in early adult life with haematuria, loin pain, urinary tract infection, hypertension, renal stone disease, or the finding of a mass in the abdomen. Other cases are identified by family contact tracing; the findings of a few cysts on renal ultrasonography in a young adult with a family history of ADPKD is highly suggestive of the disease. Renal disease is progressive and about 50% of patients will have reached end-stage by the time they enter their seventh decade. The progress of the renal failure can be slowed by good blood pressure control. In the UK, patients with ADPKD are responsible for 5–10% of the total on renal replacement therapy.
There are a number of separate rare autosomal dominant conditions other than ADPKD1 and ADPKD 2 that can present with polycystic kidneys. These include *von Hippel-Lindau disease and *tuberous sclerosis.... polycystic disease of the kidneys
The carrier condition (sickle-cell trait) occurs when the defective gene is inherited from only one parent. It generally causes no symptoms but confers some protection from malaria, which accounts for the high frequency of the gene in malarious areas. If a general anaesthetic is to be given to a patient with this condition, the anaesthetist should be alerted.... sickle-cell disease
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