Eggs Health Dictionary

Eggs: From 2 Different Sources


Nutritional Profile Energy value (calories per serving): Moderate Protein: High Fat: High Saturated fat: Moderate Cholesterol: High Carbohydrates: Low Fiber: None Sodium: Moderate to high Major vitamin contribution: Vitamin A, riboflavin, vitamin D Major mineral contribution: Iron, calcium

About the Nutrients in This Food An egg is really three separate foods, the whole egg, the white, and the yolk, each with its own distinct nutritional profile. A whole egg is a high-fat, high-cholesterol, high-quality protein food packaged in a high-calcium shell that can be ground and added to any recipe. The proteins in eggs, with sufficient amounts of all the essential amino acids, are 99 percent digestible, the standard by which all other proteins are judged. The egg white is a high-protein, low-fat food with virtually no cholesterol. Its only important vitamin is riboflavin (vitamin B2), a vis- ible vitamin that gives egg white a slightly greenish cast. Raw egg whites contain avidin, an antinutrient that binds biotin a B complex vitamin for- merly known as vitamin H, into an insoluble compound. Cooking the egg inactivates avidin. An egg yolk is a high-fat, high-cholesterol, high-protein food, a good source of vitamin A derived from carotenes eaten by the laying hen, plus vitamin D, B vitamins, and heme iron, the form of iron most easily absorbed by your body. One large whole egg (50 g/1.8 ounce) has five grams fat (1.5 g satu- rated fat, 1.9 g monounsaturated fat, 0.7 g polyunsaturated fat), 212 mg cholesterol, 244 IU vitamin A (11 percent of the R DA for a woman, 9 percent * Values are for a whole egg. of the R DA for a man), 0.9 mg iron (5 percent of the R DA for a woman, 11 percent of the R DA for a man) and seven grams protein. The fat in the egg is all in the yolk. The protein is divided: four grams in the white, three grams in the yolk.

The Most Nutritious Way to Serve This Food With extra whites and fewer yolks to lower the fat and cholesterol per serving.

Diets That May Restrict or Exclude This Food Controlled-fat, low-cholesterol diet Low-protein diet

Buying This Food Look for: Eggs stored in the refrigerated dair y case. Check the date for freshness. NOTE : In 1998, the FDA and USDA Food Safety and Inspection Service (FSIS) proposed new rules that would require distributors to keep eggs refrigerated on the way to the store and require stores to keep eggs in a refrigerated case. The egg package must have a “refrigera- tion required” label plus safe-handling instructions on eggs that have not been treated to kill Salmonella. Look for: Eggs that fit your needs. Eggs are graded by the size of the yolk and the thick- ness of the white, qualities that affect appearance but not nutritional values. The higher the grade, the thicker the yolk and the thicker the white will be when you cook the egg. A Grade A A egg fried sunny side up will look much more attractive than a Grade B egg prepared the same way, but both will be equally nutritions. Egg sizes ( Jumbo, Extra large, Large, Medium, Small) are determined by how much the eggs weigh per dozen. The color of the egg’s shell depends on the breed of the hen that laid the egg and has nothing to do with the egg’s food value.

Storing This Food Store fresh eggs with the small end down so that the yolk is completely submerged in the egg white (which contains antibacterial properties, nature’s protection for the yolk—or a developing chick embryo in a fertilized egg). Never wash eggs before storing them: The water will make the egg shell more porous, allowing harmful microorganisms to enter. Store separated leftover yolks and whites in small, tightly covered containers in the refrigerator, where they may stay fresh for up to a week. Raw eggs are very susceptible to Salmonella and other bacterial contamination; discard any egg that looks or smells the least bit unusual. Refrigerate hard-cooked eggs, including decorated Easter eggs. They, too, are suscep- tible to Salmonella contamination and should never be left at room temperature.

Preparing This Food First, find out how fresh the eggs really are. The freshest ones are the eggs that sink and lie flat on their sides when submerged in cool water. These eggs can be used for any dish. By the time the egg is a week old, the air pocket inside, near the broad end, has expanded so that the broad end tilts up as the egg is submerged in cool water. The yolk and the white inside have begun to separate; these eggs are easier to peel when hard-cooked. A week or two later, the egg’s air pocket has expanded enough to cause the broad end of the egg to point straight up when you put the egg in water. By now the egg is runny and should be used in sauces where it doesn’t matter if it isn’t picture-perfect. After four weeks, the egg will float. Throw it away. Eggs are easily contaminated with Salmonella microorganisms that can slip through an intact shell. never eat or serve a dish or bever age containing r aw fr esh eggs. sa lmonella is destroyed by cooking eggs to an inter nal temper atur e of 145°f ; egg-milk dishes such as custar ds must be cooked to an inter nal temper atur e of 160°f. If you separate fresh eggs by hand, wash your hands thoroughly before touching other food, dishes, or cooking tools. When you have finished preparing raw eggs, wash your hands and all utensils thoroughly with soap and hot water. never stir cooked eggs with a utensil used on r aw eggs. When you whip an egg white, you change the structure of its protein molecules which unfold, breaking bonds between atoms on the same molecule and forming new bonds to atoms on adjacent molecules. The result is a network of protein molecules that hardens around air trapped in bubbles in the net. If you beat the whites too long, the foam will turn stiff enough to hold its shape even if you don’t cook it, but it will be too stiff to expand natu- rally if you heat it, as in a soufflé. When you do cook properly whipped egg white foam, the hot air inside the bubbles will expand. Ovalbumin, an elastic protein in the white, allows the bubble walls to bulge outward until they are cooked firm and the network is stabilized as a puff y soufflé. The bowl in which you whip the whites should be absolutely free of fat or grease, since the fat molecules will surround the protein molecules in the egg white and keep them from linking up together to form a puff y white foam. Eggs whites will react with metal ions from the surface of an aluminum bowl to form dark particles that discolor the egg-white foam. You can whip eggs successfully in an enamel or glass bowl, but they will do best in a copper bowl because copper ions bind to the egg and stabilize the foam.

What Happens When You Cook This Food When you heat a whole egg, its protein molecules behave exactly as they do when you whip an egg white. They unfold, form new bonds, and create a protein network, this time with molecules of water caught in the net. As the egg cooks, the protein network tightens, squeez- ing out moisture, and the egg becomes opaque. The longer you cook the egg, the tighter the network will be. If you cook the egg too long, the protein network will contract strongly enough to force out all the moisture. That is why overcooked egg custards run and why overcooked eggs are rubbery. If you mix eggs with milk or water before you cook them, the molecules of liquid will surround and separate the egg’s protein molecules so that it takes more energy (higher heat) to make the protein molecules coagulate. Scrambled eggs made with milk are softer than plain scrambled eggs cooked at the same temperature. When you boil an egg in its shell, the air inside expands and begins to escape through the shell as tiny bubbles. Sometimes, however, the force of the air is enough to crack the shell. Since there’s no way for you to tell in advance whether any particular egg is strong enough to resist the pressure of the bubbling air, the best solution is to create a safety vent by sticking a pin through the broad end of the egg before you start to boil it. Or you can slow the rate at which the air inside the shell expands by starting the egg in cold water and letting it warm up naturally as the water warms rather than plunging it cold into boiling water—which makes the air expand so quickly that the shell is virtually certain to crack. As the egg heats, a little bit of the protein in its white will decompose, releasing sulfur that links up with hydrogen in the egg, forming hydrogen sulfide, the gas that gives rot- ten eggs their distinctive smell. The hydrogen sulfide collects near the coolest part of the egg—the yolk. The yolk contains iron, which now displaces the hydrogen in the hydrogen sulfide to form a green iron-sulfide ring around the hard-cooked yolk.

How Other Kinds of Processing Affect This Food Egg substitutes. Fat-free, cholesterol-free egg substitutes are made of pasteurized egg whites, plus artificial or natural colors, flavors, and texturizers (food gums) to make the product look and taste like eggs, plus vitamins and minerals to produce the nutritional equivalent of a full egg. Pasteurized egg substitutes may be used without additional cooking, that is, in salad dressings and eggnog. Drying. Dried eggs have virtually the same nutritive value as fresh eggs. Always refrigerate dried eggs in an air- and moistureproof container. At room temperature, they will lose about a third of their vitamin A in six months.

Medical Uses and/or Benefits Protein source. The protein in eggs, like protein from all animal foods, is complete. That is, protein from animal foods provides all the essential amino acids required by human beings. In fact, the protein from eggs is so well absorbed and utilized by the human body that it is considered the standard by which all other dietary protein is measured. On a scale known as biological value, eggs rank 100 ; milk, 93; beef and fish, 75; and poultry, 72. Vision protection. The egg yolk is a rich source of the yellow-orange carotenoid pigments lutein and zeaxanthin. Both appear to play a role in protecting the eyes from damaging ultraviolet light, thus reducing the risk of cataracts and age-related macular degeneration, a leading cause of vision of loss in one-third of all Americans older than 75. Just 1.3 egg yolks a day appear to increase blood levels of lutein and zeaxanthin by up to 128 percent. Perhaps as a result, data released by the National Eye Institute’s 6,000-person Beaver Dam ( Wisconsin) Eye Study in 2003 indicated that egg consumption was inversely associated with cataract risk in study participants who were younger than 65 years of age when the study started. The relative risk of cataracts was 0.4 for people in the highest category of egg consumption, compared to a risk of 1.0 for those in the lowest category. External cosmetic effects. Beaten egg whites can be used as a facial mask to make your skin look smoother temporarily. The mask works because the egg proteins constrict as they dry on your face, pulling at the dried layer of cells on top of your skin. When you wash off the egg white, you also wash off some of these loose cells. Used in a rinse or shampoo, the pro- tein in a beaten raw egg can make your hair look smoother and shinier temporarily by filling in chinks and notches on the hair shaft.

Adverse Effects Associated with This Food Increased risk of cardiovascular disease. Although egg yolks are high in cholesterol, data from several recent studies suggest that eating eggs may not increase the risk of heart disease. In 2003, a report from a 14-year, 177,000-plus person study at the Harvard School of Public Health showed that people who eat one egg a day have exactly the same risk of heart disease as those who eat one egg or fewer per week. A similar report from the Multiple R isk Factor Intervention Trial showed an inverse relationship between egg consumption and cholesterol levels—that is, people who ate more eggs had lower cholesterol levels. Nonetheless, in 2006 the National Heart, Lung, and Blood Institute still recommends no more than four egg yolks a week (including the yolk in baked goods) for a heart-healthy diet. The American Heart Association says consumers can have one whole egg a day if they limit cholesterol from other sources to the amount suggested by the National Cholesterol Education Project following the Step I and Step II diets. (Both groups permit an unlimited number of egg whites.) The Step I diet provides no more than 30 percent of total daily calories from fat, no more than 10 percent of total daily calories from saturated fat, and no more than 300 mg of cholesterol per day. It is designed for healthy people whose cholesterol is in the range of 200 –239 mg/dL. The Step II diet provides 25– 35 percent of total calories from fat, less than 7 percent of total calories from saturated fat, up to 10 percent of total calories from polyunsaturated fat, up to 20 percent of total calories from monounsaturated fat, and less than 300 mg cho- lesterol per day. This stricter regimen is designed for people who have one or more of the following conditions: •  Existing cardiovascular disease •  High levels of low-density lipoproteins (LDLs, or “bad” cholesterol) or low levels of high-density lipoproteins (HDLs, or “good” cholesterol) •  Obesity •  Type 1 diabetes (insulin-dependent diabetes, or diabetes mellitus) •  Metabolic syndrome, a.k.a. insulin resistance syndrome, a cluster of risk fac- tors that includes type 2 diabetes (non-insulin-dependent diabetes) Food poisoning. Raw eggs (see above) and egg-rich foods such as custards and cream pies are excellent media for microorganisms, including the ones that cause food poisoning. To protect yourself against egg-related poisoning, always cook eggs thoroughly: poach them five minutes over boiling water or boil at least seven minutes or fry two to three minutes on each side (no runny center) or scramble until firm. Bread with egg coating, such as French toast, should be cooked crisp. Custards should be firm and, once cooked, served very hot or refrigerated and served very cold. Allergic reaction. According to the Merck Manual, eggs are one of the 12 foods most likely to trigger the classic food allergy symptoms: hives, swelling of the lips and eyes, and upset stomach. The others are berries (blackberries, blueberries, raspberries, strawberries), choco- late, corn, fish, legumes (green peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see wheat cer ea ls).

Food/Drug Interactions Sensitivity to vaccines. Live-virus measles vaccine, live-virus mumps vaccine, and the vac- cines for influenza are grown in either chick embryo or egg culture. They may all contain minute residual amounts of egg proteins that may provoke a hypersensitivity reaction in people with a history of anaphylactic reactions to eggs (hives, swelling of the mouth and throat, difficulty breathing, a drop in blood pressure, or shock).

Health Source: A Nutritional, Medical and Culinary Guide
Author: Health Dictionary
Fertilised female reproductive cells (ova) with nutrient material, e.g. those deposited by female mosquitoes and developing in water to produce free-swimming larvae.
Health Source: Dictionary of Tropical Medicine
Author: Health Dictionary

Scabies

A parasitic skin diseases caused by the mite, Sarcoptes scabiei, presenting often as intensely itchy papules, vesicles, or tiny linear burrows containing scabies mites and their eggs. Lesions are often found around finger webs, skin folds and flexures, the abdominal region and external genitalia (especially in men). Often associated with a rash on the body, but usually sparing the face.... scabies

Toxocariasis

A disease acquired by swallowing the ova (eggs) of a roundworm which lives in the intestine of cats (Toxocara cati) or dogs (Toxocara canis). In humans, the small larval worms produced by these ova migrate to various parts of the body, including the retina of the EYE, where they then die, producing a small GRANULOMA which in turn may produce allergic reactions. In the eye it may cause choroidretinitis. It is said that 2 per cent of apparently healthy people in Britain have been infected in this way. A course of treatment with thiabendazole is recommended, though the drug has side-effects and should be used with caution in the elderly.... toxocariasis

Schistosomiasis

Also known as BILHARZIASIS. This infection results from one of the human Schistosoma species. It is common in Africa, South America, the Far East, Middle East, and, to a limited extent, the Caribbean. The life-cycle is dependent on fresh-water snails which act as the intermediate host for the ?uke; the cercarial stage of the ?uke enters via intact human skin and matures in the portal circulation. Clinically, ‘swimmers’ itch’ may occur at the site of cercarial skin penetration. Acute schistosomiasis (Katayama fever) can result in fever, an urticarial rash (see URTICARIA), and enlargement of LIVER and SPLEEN. The adult male is about 12 mm and the female 24 mm in length.

S. haematobium causes CYSTITIS and haematuria – passage of blood in the urine; bladder cancer and ureteric obstruction, giving rise to hydronephrosis and kidney failure, are long-term sequelae in a severe case. S. mansoni can cause colonic symptoms and in a severe case, POLYPOSIS of the COLON; diarrhoea, which may be bloody, can be a presenting feature. In a heavy infection, eggs surrounded by granulomas are deposited in the liver, giving rise to extensive damage (pipe-stem ?brosis) associated with PORTAL HYPERTENSION, oesophageal varices, etc. However, unlike in CIRRHOSIS, hepatocellular function is preserved until late in the disease. S. japonicum (which is con?ned to the Far East, especially Indonesia) behaves similarly to S. mansoni infection; liver involvement is often more severe.

Diagnosis can be made by microscopic examination of URINE or FAECES. The characteristic eggs are usually detectable. Alternatively, rectal or liver BIOPSY are of value. Serological tests, including an ELISA (see ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA)), have now largely replaced invasive procedures used in making a parasitological diagnosis.

Treatment CHEMOTHERAPY has been revolutionised by the introduction of praziquantel (administered orally); this compound has no serious side-effects, although its cost may limit its use in developing countries. Oxamniquine is cheaper and e?ective in S. mansoni infection, although evidence of resistance has been recorded in several countries. Metriphonate is also relatively cheap and is of value in S. haematobium infection. Prevention is by complete avoidance of exposure to contaminated water; all travellers to infected areas should know about this disease. It is increasing in frequency as new expanses of fresh water appear as a result of irrigation schemes and dam projects. Molluscicides can be employed for snail-control.... schistosomiasis

Trichuriasis

A worldwide infection, particularly common in the tropics. It is caused by Trichuris trichiura, or whipworm, so-called because of its shape – the rear end being stout and the front end hair-like, resembling the lash of a whip. The male measures 5 cm and the female 4 cm in length. Infection results from eating vegetables, or drinking water, polluted with the ova (eggs). These hatch out in the large INTESTINE and the diagnosis is made by ?nding the eggs in the stools (FAECES). The worms seldom cause any trouble unless they are present in large numbers when, especially in malnourished children, they may cause bleeding from the bowels, ANAEMIA and PROLAPSE of the RECTUM. The most e?ective drug is MEBENDAZOLE.... trichuriasis

Vitamin

A term applied to a group of substances which exist in minute quantities in natural foods, and which are necessary to normal nutrition, especially in connection with growth and development. Some – A, D, E and K – are fat-soluble and can be stored in the body. The remainder – C, B12 and other members of the B complex – are water-soluble and are quickly excreted. Most vitamins have now been synthesised. When they are absent from the food, defective growth takes place in young animals and children, and in adults various diseases arise; whilst short of the production of actual disease, persistent deprivation of one or other vitamin is apt to lead to a state of lowered general health. Certain de?ciencies in DIET have long been known to be the cause of SCURVY, BERIBERI, and RICKETS. A diet containing foods such as milk, eggs, butter, cheese, fat, ?sh, wholemeal bread, fresh vegetables and fruit should contain su?cient vitamins. Details of the various vitamins are given in APPENDIX 5: VITAMINS.... vitamin

Ascariasis

Ascariasis is the disease produced by infestation with the roundworm Ascaris lumbricoides, also known as the maw-worm. Super?cially it resembles a large earthworm: the male measures about 17 cm (7 inches) and the female 23 cm (9 inches) in length. Ascariasis is a dirt disease, most prevalent where sanitation and cleanliness are lacking, particularly in the tropics and subtropics. Consumption of food contaminated by the ova (eggs), especially salad vegetables, is the commonest cause of infection. In children, infection is commonly acquired by crawling or playing on contaminated earth, and then sucking their ?ngers. After a complicated life-cycle in the body the adult worms end up in the intestines, whence they may be passed in the stools. A light infection may cause no symptoms. A heavy infection may lead to colic, or even obstruction of the gut. Occasionally a worm may wander into the stomach and be vomited up.

Treatment Mebendazole is the drug of choice in the UK, being given as a single dose. It should be combined with hygienic measures to break the cycle of autoinfection. All members of the family require treatment. Other ANTHELMINTICS include piperazine and pyrantel.... ascariasis

Assisted Conception

(Further information about the subject and the terms used can be found at http:// www.hfea.gov.uk/glossary)

This technique is used when normal methods of attempted CONCEPTION or ARTIFICIAL INSEMINATION with healthy SEMEN have failed. In the UK, assisted-conception procedures are governed by the Human Fertilisation & Embryology Act 1990, which set up the Human Fertilisation & Embryology Authority (HFEA).

Human Fertilisation & Embryology Act 1990 UK legislation was prompted by the report on in vitro fertilisation produced by a government-appointed committee chaired by Baroness Warnock. This followed the birth, in 1978, of the ?rst ‘test-tube’ baby.

This Act allows regulation monitoring of all treatment centres to ensure that they carry out treatment and research responsibly. It covers any fertilisation that uses donated eggs or sperm (called gametes) – for example, donor insemination or embryos (see EMBRYO) grown outside the human body (known as licensed treatment). The Act also covers research on human embryos with especial emphasis on foolproof labelling and immaculate data collection.

Human Fertilisation & EmbryologyAuthority (HFEA) Set up by the UK government following the Warnock report, the Authority’s 221 members inspect and license centres carrying out fertilisation treatments using donated eggs and sperm. It publishes a code of practice advising centres on how to conduct their activities and maintains a register of information on donors, patients and all treatments. It also reviews routinely progress and research in fertility treatment and the attempted development of human CLONING. Cloning to produce viable embryos (reproductive cloning) is forbidden, but limited licensing of the technique is allowed in specialist centres to enable them to produce cells for medical treatment (therapeutic cloning).

In vitro fertilisation (IVF) In this technique, the female partner receives drugs to enhance OVULATION. Just before the eggs are released from the ovary (see OVARIES), several ripe eggs are collected under ULTRASOUND guidance or through a LAPAROSCOPE. The eggs are incubated with the prepared sperm. About 40 hours later, once the eggs are fertilised, two eggs (three in special circumstances) are transferred into the mother’s UTERUS via the cervix (neck of the womb). Pregnancy should then proceed normally. About one in ?ve IVF pregnancies results in the birth of a child. The success rate is lower in women over 40.

Indications In women with severely damaged FALLOPIAN TUBES, IVF o?ers the only chance of pregnancy. The method is also used in couples with unexplained infertility or with male-factor infertility (where sperms are abnormal or their count low). Women who have had an early or surgically induced MENOPAUSE can become pregnant using donor eggs. A quarter of these pregnancies are multiple – that is, produce twins or more. Twins and triplets are more likely to be premature. The main danger of ovarian stimulation for IVF is hyperstimulation which can cause ovarian cysts. (See OVARIES, DISEASES OF.)... assisted conception

Bed Bug

Bed bug, or Cimex lectularius, is a wingless, blood-sucking insect, parasitic on humans. It is a ?at, rusty-brown insect, 5 mm long and 3 mm wide, which has an o?ensive, never-forgotten smell and cannot ?y. The average life is 3–6 months, but it can live for a year without food. The bed bug remains hidden during the day in cracks in walls and ?oors, and in beds. It does not transmit any known disease. Eggs hatch out into larvae in 6–10 days, which become adult within about 12 weeks. A temperature of 44 °C kills the adult in an hour. Various agents have been used to disinfect premises, such as sulphur dioxide, ethylene oxide mixed with carbon dioxide, hydrogen cyanide and heavy naphtha, but insecticide is the most e?ective disinfecting agent.... bed bug

Cysticercosis

This disease rarely occurs except in Central Europe, Ethiopia, South Africa, and part of Asia. It results from ova (eggs) being swallowed or regurgitated into the stomach from an adult pork tapeworm in the intestine. In the stomach the larvae escape from the eggs and are absorbed. They are carried in the blood to various parts of the body, most commonly the subcutaneous tissue and skeletal muscle, where they develop and form cysticerci. When super?cial, they may be felt under the skin as small pea-like bodies. Although they cause no symptoms here, cysts may also develop in the brain. Five years later the larvae die, and the brain-tissue reaction may result in epileptic ?ts, obscure neurological disorders, and personality changes. The cysts calcify at this stage, though to a greater degree in the muscles than the brain, allowing them to be seen radiologically. Epilepsy starting in adult life, in anyone who has previously lived in an endemic area, should suggest the possibility of cysticercosis. (See also TAENIASIS.)

Treatment Most important is prevention of the initial tapeworm infection, by ensuring that pork is well cooked before it is eaten. Nurses and others attending to a patient harbouring an adult tapeworm must be careful to avoid ingesting ova from contaminated hands. The tapeworm itself can be destroyed with NICLOSAMIDE. Brain infections are treated with sedatives and anti-convulsants, surgery rarely being necessary. Most patients make a good recovery.... cysticercosis

Pediculosis

A parasitic infestation of the head, the hairy parts of the body and the clothing by adult lice, larvae and nits (eggs), which often results in severe itching and excoriation of the scalp and body. Secondary infection can occur. Infesting agents include Pediculus capitis, the head louse, P. humanus, the body louse, and Pthirus pubis, the crab louse, which usually infest the pubic region, but may also infest the hair of the face, axillae and the bodysurfaces.... pediculosis

Enterobiasis

Infection with Enterobius vermicularis, the threadworm (or pinworm as it is known in the USA). It is the most common of all the intestinal parasites in Britain, and the least harmful. The male is about 6 mm (••• inch) in length and the female about 12 mm (••• inch) in length. Each resembles a little piece of thread. These worms live in considerable numbers in the lower bowel, affecting children particularly. They usually cause no symptoms but can result in great irritation round the anus or within the female genitalia, especially at night when the female worm emerges from the anus to lay its eggs and then die. The most e?ective form of treatment is either viprynium embonate or piperazine citrate, which needs to be taken by the whole family. Bedclothes must then be laundered.... enterobiasis

Veganism

A strict form of VEGETARIANISM. Vegans do not eat meat, dairy produce, eggs or ?sh.... veganism

Tansy

Tanacetum vulgare. N.O. Compositae.

Habitat: This common English wild plant was formerly cultivated in gardens, but is now rarely seen away from the borders of fields and waysides.

Features ? The tough, slightly ribbed stems reach a height of two or three feet, terminating in the peculiar bunch of yellow, flat, button-like flowers by which the plant may be easily recognised in July and August; the flowers look, indeed, as if all the petals had been pulled off, leaving only the central florets. Leaf stalks grow on alternate sides of the stem, the leaves themselves being six to eight inches long by about four inches broad, deeply cut pinnately. The crushed leaves and flowers give a pronounced aromatic smell, and have a bitter taste.

Tansy herb is probably the best of all the media for getting rid of worms in children, and a dose according to age should be given night and morning fasting. The infusion of 1 ounce to 1 pint of boiling water is used.

The medicine is also esteemed in some quarters for the treatment of hysteria and certain other of the nervous disorders of women. For this purpose a wineglassful of the infusion should be taken frequently.

The old-time herbalists used Tansy as a stimulating tonic for a poor digestive apparatus, but to-day herbal compounds of greater efficacy are prescribed for dyspepsia.

TOAD FLAX.

Linaria vulgaris. N.O. Scrophulariaceae.

Synonym: Butter and Eggs, Flaxweed, Pennywort. The name "Toad Flax" because of a supposed similarity between the mouth of the flower and that of the toad.

Habitat: Hedgerows and cornfields.

Features ? Stem one to two feet higli, upright, only slightly branched. Leaves numerous, grass-like, tapering to a point. Stem and leaves are smooth, with a pale bluish hue. Flowers shaped like the snapdragon (antirrhinum), pale yellow, mouth closed by projecting orange-coloured lower lip ; clustered together at top of stem.

Part used ? Herb.

Action: Hepatic, alterative, astringent, detergent.

To some extent in prescriptions for jaundice, hepatic torpor and skin diseases. Is also sometimes included in pile ointments. The 1 ounce to 1 pint infusion is taken in doses of 2 fl. ounces.... tansy

Cholesterol

Cholesterol is a porridge-like substance found in animal fats: cream, whole milk, cheese, butter, meat, eggs, bacon, etc. There are two kinds of cholesterol in human blood serum, one of which is beneficial; the other, harmful if in excess. The beneficial, known as high density lipoprotein (HDL) is believed to keep down concentration of the harmful variety – low density lipoprotein (LDL). The desirable blood cholesterol level should be less than 5.2 mmol per litre. (Government: “Health of the Nation”)

Cholesterol is necessary for maintenance of brain and glandular system, the production of bile salts and certain hormones.

Excesses plug arteries with a gluey consistency. Fats may start furring up arteries from childhood, yet it may take many years for symptoms to develop. The more meat and dairy products eaten the more cholesterol is produced. 90 per cent cases of gall stones are composed of cholesterol. A link between coronary heart disease and high cholesterol levels is strong and consistent. Anger and hostility raise cholesterol level.

The first indication of narrowing of the arteries may be an attack of angina, severe chest pain occurring on exertion due to an inadequate supply of blood and oxygen to the heart muscle. No one should exceed a fat and cholesterol count of 40 per day. For those of moderate risk level, a count of below 30 is advised.

Dr Paul Durrington, consultant physician, Manchester Royal Infirmary and researcher in lipids, believes that ‘reducing the amount of saturated fats in the diet and reducing weight are the most effective ways of lowering cholesterol levels’.

Treatment: same as for HYPERLIPIDAEMIA.

Diet. See: DIET – CHOLESTEROL. ... cholesterol

Hydatid Disease

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

Supplementation. Vitamin B12.

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

Lice

Infestation. Head louse (pediculosis capitas). Body louse (pediculosis corporis). Pubic louse (pediculosis pubis – crabs). Fleas. Lice are among man’s earliest companions and bearers of disease. The head louse lays small grey eggs (nits) which adhere to the hair shafts. Body lice may be responsible for Trench fever and typhus. Their appearance may be accompanied by swelling of the occipital lymph glands for which alteratives such as Burdock, Yellow Dock and Echinacea should be given.

Herbs are least effective where personal hygiene is poor. A wholesome lifestyle is the best preventative. Liberal quantities of Garlic in the diet are said to confer immunity. See also: NEEM. Treatment. External. Vigorously scrub with soap before applying Tea Tree oil. May be diluted many times. A good response has been observed when wiping with cider vinegar. Some practitioners use 1 part Oil Rosemary to 2 parts Peanut oil rubbed into affected parts.

Dr Finlay Ellingwood. Wrap the head at night with suitable material dipped in oil of Turpentine. Aromatherapy. Essential oils: Sassafras, Quassia, Aniseed.

Tansy herb. Strong decoction.

Traditional, Russian. Saturate the hair with Vodka or strong spirit and allow to evaporate.

General – Use of ‘nit’ comb. Scrub toilet seats. Change bedding frequently. Tell children not to wear another’s clothes. Thorough daily combing with one or two drops of any of the above oils on the comb. ... lice

Ancylostomiasis

A parasitic infection caused by the nematodes Ancylostoma duodenale and Necator americanus, resulting in hookworm disease. These infections are exceedingly common in tropical and developing countries, millions of people being affected. Classically, A. duodenale occurred in the Far East, Mediterranean littoral, and Middle East, and N. americanus in tropical Africa, Central and South America, and the Far East; however, in recent years, geographical separation of the two human species is less distinct. In areas where standards of hygiene and sanitation are unsatisfactory, larvae (embryos) enter via intact skin, usually the feet. ‘Ground itch’ occasionally occurs as larvae enter the body. They then undergo a complex life-cycle, migrating through the lungs, trachea, and pharynx. Adult worms are 5–13 (mean 12) mm in length; their normal habitat is the small INTESTINE – especially the jejunum – where they adhere to the mucosa by hooks, thus causing seepage of blood into the lumen. A worm-pair produces large numbers of eggs, which are excreted in faeces; when deposited on moist soil they remain viable for many weeks or months. Clinical manifestations include microcytic hypochromic ANAEMIA, hypoalbuminaemia (low serum protein) and, in a severe case, OEDEMA. A chronic infection in childhood can give rise to physical, mental and sexual retardation. Treatment is with one of the benzimidazole compounds, usually mebendazole or albendazole; however, in developing countries, cheaper preparations are used, including tetrachloroethylene, bephenium hydroxynaphthoate, and pyrantel embonate. Anaemia usually responds to iron supplements; blood transfusion is rarely indicated.

Ancylostoma braziliensis A nematode infection of dogs, which in humans causes local disease (larva migrans) only, generally on the soles of the feet. It is usually acquired by walking on beaches contaminated with dog faeces in places such as the Caribbean.... ancylostomiasis

Beef

Nutritional Profile Energy value (calories per serving): Moderate Protein: High Fat: Moderate Saturated fat: High Cholesterol: Moderate Carbohydrates: None Fiber: None Sodium: Low Major vitamin contribution: B vitamins Major mineral contribution: Iron, phosphorus, zinc

About the Nutrients in This Food Like fish, pork, poultry, milk, and eggs, beef has high-quality proteins, with sufficient amounts of all the essential amino acids. Beef fat is slightly more highly saturated than pork fat, but less saturated than lamb fat. All have about the same amount of cholesterol per serving. Beef is an excellent source of B vitamins, including niacin, vitamin B6, and vitamin B12, which is found only in animal foods. Lean beef pro- vides heme iron, the organic iron that is about five times more useful to the body than nonheme iron, the inorganic form of iron found in plant foods. Beef is also an excellent source of zinc. One four-ounce serving of lean broiled sirloin steak has nine grams fat (3.5 g saturated fat), 101 mg cholesterol, 34 g protein, and 3.81 mg iron (21 percent of the R DA for a woman, 46 percent of the R DA for a man). One four-ounce serving of lean roast beef has 16 g fat (6.6 g saturated fat), 92 mg cholesterol, and 2.96 mg iron (16 percent of the R DA for a woman, 37 percent of the R DA for a man).

The Most Nutritious Way to Serve This Food With a food rich in vitamin C. Ascorbic acid increases the absorption of iron from meat. * These values apply to lean cooked beef.

Diets That May Restrict or Exclude This Food Controlled-fat, low-cholesterol diet Low-protein diet (for some forms of kidney disease)

Buying This Food Look for: Fresh, red beef. The fat should be white, not yellow. Choose lean cuts of beef with as little internal marbling (streaks of fat) as possible. The leanest cuts are flank steak and round steak; rib steaks, brisket, and chuck have the most fat. USDA grading, which is determined by the maturity of the animal and marbling in meat, is also a guide to fat content. U.S. prime has more marbling than U.S. choice, which has more marbling than U.S. good. All are equally nutritious; the difference is how tender they are, which depends on how much fat is present. Choose the cut of meat that is right for your recipe. Generally, the cuts from the cen- ter of the animal’s back—the rib, the T-Bone, the porterhouse steaks—are the most tender. They can be cooked by dry heat—broiling, roasting, pan-frying. Cuts from around the legs, the underbelly, and the neck—the shank, the brisket, the round—contain muscles used for movement. They must be tenderized by stewing or boiling, the long, moist cooking methods that break down the connective tissue that makes meat tough.

Storing This Food Refrigerate raw beef immediately, carefully wrapped to prevent its drippings from contami- nating other foods. Refrigeration prolongs the freshness of beef by slowing the natural multi- plication of bacteria on the meat surface. Unchecked, these bacteria will convert proteins and other substances on the surface of the meat to a slimy film and change meat’s sulfur-contain- ing amino acids methionine and cystine into smelly chemicals called mercaptans. When the mercaptans combine with myoglobin, they produce the greenish pigment that gives spoiled meat its characteristic unpleasant appearance. Fresh ground beef, with many surfaces where bacteria can live, should be used within 24 to 48 hours. Other cuts of beef may stay fresh in the refrigerator for three to five days.

Preparing This Food Trim the beef carefully. By judiciously cutting away all visible fat you can significantly reduce the amount of fat and cholesterol in each serving. When you are done, clean all utensils thoroughly with soap and hot water. Wash your cutting board, wood or plastic, with hot water, soap, and a bleach-and-water solution. For ultimate safety in preventing the transfer of microorganisms from the raw meat to other foods, keep one cutting board exclusively for raw meats, fish, and poultry, and a second one for everything else. Finally, don’t forget to wash your hands.

What Happens When You Cook This Food Cooking changes the appearance and flavor of beef, alters nutritional value, makes it safer, and extends its shelf life. Browning meat after you cook it does not “seal in the juices,” but it does change the fla- vor by caramelizing sugars on the surface. Because beef’s only sugars are the small amounts of glycogen in the muscles, we add sugars in marinades or basting liquids that may also con- tain acids (vinegar, lemon juice, wine) to break down muscle fibers and tenderize the meat. (Browning has one minor nutritional drawback. It breaks amino acids on the surface of the meat into smaller compounds that are no longer useful proteins.) When beef is cooked, it loses water and shrinks. Its pigments, which combine with oxygen, are denatured (broken into fragments) by the heat and turn brown, the natural color of well-done meat. At the same time, the fats in the beef are oxidized. Oxidized fats, whether formed in cooking or when the cooked meat is stored in the refrigerator, give cooked meat a character- istic warmed-over flavor. Cooking and storing meat under a blanket of antioxidants—catsup or a gravy made of tomatoes, peppers, and other vitamin C-rich vegetables—reduces the oxidation of fats and the intensity of warmed-over flavor. Meat reheated in a microwave oven also has less warmed-over flavor. An obvious nutritional benefit of cooking is the fact that heat lowers the fat content of beef by liquif ying the fat so it can run off the meat. One concrete example of how well this works comes from a comparison of the fat content in regular and extra-lean ground beef. According to research at the University of Missouri in 1985, both kinds of beef lose mass when cooked, but the lean beef loses water and the regular beef loses fat and cholesterol. Thus, while regular raw ground beef has about three times as much fat (by weight) as raw ground extra-lean beef, their fat varies by only 5 percent after broiling. To reduce the amount of fat in ground beef, heat the beef in a pan until it browns. Then put the beef in a colander, and pour one cup of warm water over the beef. Repeat with a second cup of warm water to rinse away fat melted by heating the beef. Use the ground beef in sauce and other dishes that do not require it to hold together. Finally, cooking makes beef safer by killing Salmonella and other organisms in the meat. As a result, cooking also serves as a natural preservative. According to the USDA, large pieces of fresh beef can be refrigerated for two or three days, then cooked and held safely for another day or two because the heat of cooking has reduced the number of bacteria on the surface of the meat and temporarily interrupted the natural cycle of deterioration.

How Other Kinds of Processing Affect This Food Aging. Hanging fresh meat exposed to the air, in a refrigerated room, reduces the moisture content and shrinks the meat slightly. As the meat ages enzymes break down muscle pro- teins, “tenderizing” the beef. Canning. Canned beef does not develop a warmed-over flavor because the high tempera- tures in canning food and the long cooking process alter proteins in the meat so that they act as antioxidants. Once the can is open, however, the meat should be protected from oxygen that will change the flavor of the beef. Curing. Salt-curing preserves meat through osmosis, the physical reaction in which liquids flow across a membrane, such as the wall of a cell, from a less dense to a more dense solution. The salt or sugar used in curing dissolves in the liquid on the surface of the meat to make a solution that is more dense than the liquid inside the cells of the meat. Water flows out of the meat and out of the cells of any microorganisms living on the meat, killing the microor- ganisms and protecting the meat from bacterial damage. Salt-cured meat is much higher in sodium than fresh meat. Freezing. When you freeze beef, the water inside its cells freezes into sharp ice crystals that can puncture cell membranes. When the beef thaws, moisture (and some of the B vitamins) will leak out through these torn cell walls. The loss of moisture is irreversible, but some of the vitamins can be saved by using the drippings when the meat is cooked. Freezing may also cause freezer burn—dry spots left when moisture evaporates from the surface of the meat. Waxed freezer paper is designed specifically to hold the moisture in meat; plastic wrap and aluminum foil are less effective. NOTE : Commercially prepared beef, which is frozen very quickly at very low temperatures, is less likely to show changes in texture. Irradiation. Irradiation makes meat safer by exposing it to gamma rays, the kind of high- energy ionizing radiation that kills living cells, including bacteria. Irradiation does not change the way meat looks, feels or tastes, or make the food radioactive, but it does alter the structure of some naturally occurring chemicals in beef, breaking molecules apart to form new com- pounds called radiolytic products (R P). About 90 percent of R Ps are also found in nonirradiated foods. The rest, called unique radiolytic products (UR P), are found only in irradiated foods. There is currently no evidence to suggest that UR Ps are harmful; irradiation is an approved technique in more than 37 countries around the world, including the United States. Smoking. Hanging cured or salted meat over an open fire slowly dries the meat, kills micro- organisms on its surface, and gives the meat a rich, “smoky” flavor that varies with the wood used in the fire. Meats smoked over an open fire are exposed to carcinogenic chemicals in the smoke, including a-benzopyrene. Meats treated with “artificial smoke flavoring” are not, since the flavoring is commercially treated to remove tar and a-benzopyrene.

Medical Uses and/or Benefits Treating and/or preventing iron deficiency. Without meat in the diet, it is virtually impossible for an adult woman to meet her iron requirement without supplements. One cooked 3.5- ounce hamburger provides about 2.9 mg iron, 16 percent of the R DA for an adult woman of childbearing age. Possible anti-diabetes activity. CLA may also prevent type 2 diabetes, also called adult-onset diabetes, a non-insulin-dependent form of the disease. At Purdue University, rats bred to develop diabetes spontaneously between eight and 10 weeks of age stayed healthy when given CLA supplements.

Adverse Effects Associated with This Food Increased risk of heart disease. Like other foods from animals, beef contains cholesterol and saturated fats that increase the amount of cholesterol circulating in your blood, raising your risk of heart disease. To reduce the risk of heart disease, the National Cholesterol Education Project recommends following the Step I and Step II diets. The Step I diet provides no more than 30 percent of total daily calories from fat, no more than 10 percent of total daily calories from saturated fat, and no more than 300 mg of cholesterol per day. It is designed for healthy people whose cholesterol is in the range of 200 –239 mg/dL. The Step II diet provides 25– 35 percent of total calories from fat, less than 7 percent of total calories from saturated fat, up to 10 percent of total calories from polyunsaturated fat, up to 20 percent of total calories from monounsaturated fat, and less than 300 mg cho- lesterol per day. This stricter regimen is designed for people who have one or more of the following conditions: •  Existing cardiovascular disease •  High levels of low-density lipoproteins (LDLs, or “bad” cholesterol) or low levels of high-density lipoproteins (HDLs, or “good” cholesterol) •  Obesity •  Type 1 diabetes (insulin-dependent diabetes, or diabetes mellitus) •  Metabolic syndrome, a.k.a. insulin resistance syndrome, a cluster of risk fac- tors that includes type 2 diabetes (non-insulin-dependent diabetes) Increased risk of some cancers. According the American Institute for Cancer Research, a diet high in red meat (beef, lamb, pork) increases the risk of developing colorectal cancer by 15 percent for every 1.5 ounces over 18 ounces consumed per week. In 2007, the National Can- cer Institute released data from a survey of 500,000 people, ages 50 to 71, who participated in an eight-year A AR P diet and health study identif ying a higher risk of developing cancer of the esophagus, liver, lung, and pancreas among people eating large amounts of red meats and processed meats. Food-borne illness. Improperly cooked meat contaminated with E. coli O157:H7 has been linked to a number of fatalities in several parts of the United States. In addition, meats con- taminated with other bacteria, viruses, or parasites pose special problems for people with a weakened immune system: the very young, the very old, cancer chemotherapy patients, and people with HIV. Cooking meat to an internal temperature of 140°F should destroy Salmo- nella and Campylobacter jejuni; 165°F, the E. coli organism; and 212°F, Listeria monocytogenes. Antibiotic sensitivity. Cattle in the United States are routinely given antibiotics to protect them from infection. By law, the antibiotic treatment must stop three days to several weeks before the animal is slaughtered. Theoretically, the beef should then be free of antibiotic residues, but some people who are sensitive to penicillin or tetracycline may have an allergic reaction to the meat, although this is rare. Antibiotic-resistant Salmonella and toxoplasmosis. Cattle treated with antibiotics may pro- duce meat contaminated with antibiotic-resistant strains of Salmonella, and all raw beef may harbor ordinary Salmonella as well as T. gondii, the parasite that causes toxoplasmosis. Toxoplasmosis is particularly hazardous for pregnant women. It can be passed on to the fetus and may trigger a series of birth defects including blindness and mental retardation. Both Salmonella and the T. gondii can be eliminated by cooking meat thoroughly and washing all utensils, cutting boards, and counters as well as your hands with hot soapy water before touching any other food. Decline in kidney function. Proteins are nitrogen compounds. When metabolized, they yield ammonia, which is excreted through the kidneys. In laborator y animals, a sustained high-protein diet increases the flow of blood through the kidneys, accelerating the natural age-related decline in kidney function. Some experts suggest that this may also occur in human beings.

Food/Drug Interactions Tetracycline antibiotics (demeclocycline [Declomycin], doxycycline [ Vibtamycin], methacycline [Rondomycin], minocycline [Minocin], oxytetracycline [Terramycin], tetracycline [Achromycin V, Panmycin, Sumycin]). Because meat contains iron, which binds tetracyclines into com- pounds the body cannot absorb, it is best to avoid meat for two hours before and after taking one of these antibiotics. Monoamine oxidase (MAO) inhibitors. Meat “tenderized” with papaya or a papain powder can interact with the class of antidepressant drugs known as monoamine oxidase inhibi- tors. Papain meat tenderizers work by breaking up the long chains of protein molecules. One by-product of this process is tyramine, a substance that constructs blood vessels and raises blood pressure. M AO inhibitors inactivate naturally occurring enzymes in your body that metabolize tyramine. If you eat a food such as papain-tenderized meat, which is high in tyramine, while you are taking a M AO inhibitor, you cannot effectively eliminate the tyramine from your body. The result may be a hypertensive crisis. Theophylline. Charcoal-broiled beef appears to reduce the effectiveness of theophylline because the aromatic chemicals produced by burning fat speed up the metabolism of the- ophylline in the liver.... beef

Biotin

One of the dozen or so vitamins included in the vitamin B complex. It is found in liver, eggs and meat, and also synthesised by bacteria in the gut. Absorption from the gut is prevented by avidin, a constituent of egg-white. The daily requirement is small: a fraction of a milligram daily. Gross de?ciency results in disturbances of the skin, a smooth tongue and lassitude. (See APPENDIX 5: VITAMINS.)... biotin

Bird Fancier’s Lung

Also known as pigeon breeder’s lung, this is a form of extrinsic allergic ALVEOLITIS resulting from sensitisation to birds. In bird fanciers, skin tests sometimes show sensitisation to birds’ droppings, eggs, protein and serum, even through there has been no evidence of any illness.... bird fancier’s lung

Apricots

Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low (fresh or dried fruit) High (dried fruit treated with sodium sulfur compounds) Major vitamin contribution: Vitamin A Major mineral contribution: Iron

About the Nutrients in This Food Apricots are a good source of dietary fiber with insoluble cellulose and lignin in the skin and soluble pectins in the flesh. The apricot’s creamy golden color comes from deep yellow carotenes (including beta-carotene) that make the fruit a good source of vitamin A. Apricots also have vitamin C and iron. One apricot has 0.7 g dietary fiber, 674 IU vitamin A (21 percent of the R DA for a woman, 23 percent of the R DA for a man), and 3.5 mg vitamin C (5 percent of the R DA for a woman, 4 percent of the R DA for a man). Two dried apricot halves provide 0.6 g dietary fiber, 252 IU vitamin A (11 percent of the R DA for a woman, 8 percent of the R DA for a man), no vitamin C, and 2 mg iron (11 percent of the R DA for a woman, 25 percent of the R DA for a man). The bark, leaves, and inner stony pit of the apricot all contain amyg- dalin, a naturally occurring compound that degrades to release hydrogen cyanide (prussic acid) in your stomach. Apricot oil, treated during processing to remove the cyanide, is marked FFPA to show that it is “free from prussic acid.” Cases of fatal poisoning from apricot pits have been reported, including one in a three-year-old girl who ate 15 apricot kernels (the seed inside the pit). Extract of apricot pits, known medically as Laetrile, has been used by some alternative practitioners to treat cancer on the theory that the cyanide in amygdalin is released only when it comes in contact with beta-glucuronidase, an enzyme common to tumor cells. Scientifically designed tests of amygdalin have not shown this to be true. Laetrile is illegal in the United States.

The Most Nutritious Way to Serve This Food Ounce for ounce, dried apricots are richer in nutrients and fiber than fresh ones.

Diets That May Restrict or Exclude This Food Low-fiber diet Low-potassium diet Low-sodium diet (dried apricots containing sodium sulfide)

Buying This Food Look for: Firm, plump orange fruit that gives slightly when you press with your thumb. Avoid: Bruised apricots. Like apples and potatoes, apricots contain polyphenoloxidase, an enzyme that combines with phenols in the apricots to produce brownish pigments that discolor the fruit. When apricots are bruised, cells are broken, releasing the enzyme so that brown spots form under the bruise. Avoid apricots that are hard or mushy or withered; all are less flavorsome than ripe, firm apricots, and the withered ones will decay quickly. Avoid greenish apricots; they are low in carotenes and will never ripen satisfactorily at home.

Storing This Food Store ripe apricots in the refrigerator and use them within a few days. Apricots do not lose their vitamin A in storage, but they are very perishable and rot fairly quickly.

Preparing This Food When you peel or slice an apricot, you tear its cells walls, releasing polyphenoloxidase, an enzyme that reacts with phenols in the apricots, producing brown compounds that darken the fruit. Acids inactivate polyphenoloxidase, so you can slow down this reaction (but not stop it completely) by dipping raw sliced and/or peeled apricots into a solution of lemon juice or vinegar and water or by mixing them with citrus fruits in a fruit salad. Polyphenoloxidase also works more slowly in the cold, but storing peeled apricots in the refrigerator is much less effective than an acid bath. To peel apricots easily, drop them into boiling water for a minute or two, then lift them out with a slotted spoon and plunge them into cold water. As with tomatoes, this works because the change in temperature damages a layer of cells under the skin so the skin slips off easily.

What Happens When You Cook This Food Cooking dissolves pectin, the primary fiber in apricots, and softens the fruit. But it does not change the color or lower the vitamin A content because carotenes are impervious to the heat of normal cooking.

How Other Kinds of Processing Affect This Food Juice. Since 2000, following several deaths attributed to unpasteurized apple juice contami- nated with E. coli O157:H7, the FDA has required that all juices sold in the United States be pasteurized to inactivate harmful organisms such as bacteria and mold. Drying. Five pounds of fresh apricots produce only a pound of dried ones. Drying removes water, not nutrients; ounce for ounce, dried apricots have 12 times the iron, seven times the fiber, and five times the vitamin A of the fresh fruit. Three and a half ounces of dried apricots provide 12,700 IU vitamin A, two and a half times the full daily requirement for a healthy adult man, and 6.3 mg of iron, one-third the daily requirement for an adult woman. In some studies with laboratory animals, dried apricots have been as effective as liver, kidneys, and eggs in treating iron-deficiency anemia. To keep them from turning brown as they dry, apricots may be treated with sulfur dioxide. This chemical may cause serious allergic reactions, including anaphylactic shock, in people who are sensitive to sulfites.

Medical Uses and/or Benefits * * *

Adverse Effects Associated with This Food Sulfite allergies. See How other kinds of processing affect this food.

Food/Drug Interactions * * *... apricots

Bread

Nutritional Profile Energy value (calories per serving): Moderate Protein: Moderate Fat: Low to moderate Saturated fat: Low to high Cholesterol: Low to high Carbohydrates: High Fiber: Moderate to high Sodium: Moderate to high Major vitamin contribution: B vitamins Major mineral contribution: Calcium, iron, potassium

About the Nutrients in This Food All commercially made yeast breads are approximately equal in nutri- tional value. Enriched white bread contains virtually the same amounts of proteins, fats, and carbohydrates as whole wheat bread, although it may contain only half the dietary fiber (see flour). Bread is a high-carbohydrate food with lots of starch. The exact amount of fiber, fat, and cholesterol in the loaf varies with the recipe. Bread’s proteins, from grain, are low in the essential amino acid lysine. The most important carbohydrate in bread is starch; all breads contain some sugar. Depending on the recipe, the fats may be highly saturated (butter or hydrogenated vegetable fats) or primarily unsaturated (vegetable fat). All bread is a good source of B vitamins (thiamin, riboflavin, niacin), and in 1998, the Food and Drug Administration ordered food manufactur- ers to add folates—which protect against birth defects of the spinal cord and against heart disease—to flour, rice, and other grain products. One year later, data from the Framingham Heart Study, which has followed heart health among residents of a Boston suburb for nearly half a cen- tury, showed a dramatic increase in blood levels of folic acid. Before the fortification of foods, 22 percent of the study participants had a folic acid deficiency; after, the number fell to 2 percent. Bread is a moderately good source of calcium, magnesium, and phos- phorus. (Breads made with milk contain more calcium than breads made without milk.) Although bread is made from grains and grains contain phytic acid, a natural antinutrient that binds calcium ions into insoluble, indigestible compounds, the phytic acid is inactivated by enzyme action during leavening. Bread does not bind calcium. All commercially made breads are moderately high in sodium; some contain more sugar than others. Grains are not usually considered a good source of iodine, but commer- cially made breads often pick up iodine from the iodophors and iodates used to clean the plants and machines in which they are made. Homemade breads share the basic nutritional characteristics of commercially made breads, but you can vary the recipe to suit your own taste, lowering the salt, sugar, or fat and raising the fiber content, as you prefer.

The Most Nutritious Way to Serve This Food As sandwiches, with cheese, milk, eggs, meat, fish, or poultry. These foods supply the essen- tial amino acid lysine to “complete” the proteins in grains. With beans or peas. The proteins in grains are deficient in the essential amino acids lysine and isoleucine and rich in the essential amino acids tryptophan, methionine, and cystine. The proteins in legumes (beans and peas) are exactly the opposite.

Diets That May Restrict or Exclude This Food Gluten-free diet (excludes breads made with wheat, oats, rye, buckwheat and barley flour) Lactose-free diet Low-fiber diet (excludes coarse whole-grain breads) Low-sodium diet

Buying This Food Look for: Fresh bread. Check the date on closed packages of commercial bread.

Storing This Food Store bread at room temperature, in a tightly closed plastic bag (the best protection) or in a breadbox. How long bread stays fresh depends to a great extent on how much fat it contains. Bread made with some butter or other fat will keep for about three days at room tempera- ture. Bread made without fat (Italian bread, French bread) will dry out in just a few hours; for longer storage, wrap it in foil, put it inside a plastic bag, and freeze it. When you are ready to serve the French or Italian bread, you can remove it from the plastic bag and put the foil- wrapped loaf directly into the oven. Throw away moldy bread. The molds that grow on bread may produce carcinogenic toxins. Do not store fresh bread in the refrigerator; bread stales most quickly at temperatures just above freezing. The one exception: In warm, humid weather, refrigerating bread slows the growth of molds.

When You Are Ready to Serve This Food Use a serrated knife to cut bread easily.

What Happens When You Cook This Food Toasting is a chemical process that caramelizes sugars and amino acids (proteins) on the surface of the bread, turning the bread a golden brown. This chemical reaction, known both as the browning reaction and the Maillard reaction (after the French chemist who first identified it), alters the structure of the surface sugars, starches, and amino acids. The sugars become indigestible food fiber; the amino acids break into smaller fragments that are no longer nutritionally useful. Thus toast has more fiber and less protein than plain bread. How- ever, the role of heat-generated fibers in the human diet is poorly understood. Some experts consider them inert and harmless; others believe they may be hazardous.

How Other Kinds of Processing Affect This Food Freezing. Frozen bread releases moisture that collects inside the paper, foil, or plastic bag in which it is wrapped. If you unwrap the bread before defrosting it, the moisture will be lost and the bread will be dry. Always defrost bread in its wrappings so that it can reabsorb the moisture that keeps it tasting fresh. Drying. Since molds require moisture, the less moisture a food contains, the less likely it is support mold growth. That is why bread crumbs and Melba toast, which are relatively mois- ture-free, keep better than fresh bread. Both can be ground fine and used as a toasty-flavored thickener in place of flour or cornstarch.

Medical Uses and/or Benefits A lower risk of some kinds of cancer. In 1998, scientists at Wayne State University in Detroit conducted a meta-analysis of data from more than 30 well-designed animal studies mea- suring the anti-cancer effects of wheat bran, the part of grain with highest amount of the insoluble dietary fibers cellulose and lignin. They found a 32 percent reduction in the risk of colon cancer among animals fed wheat bran; now they plan to conduct a similar meta- analysis of human studies. Breads made with whole grain wheat are a good source of wheat bran. NOTE : The amount of fiber per serving listed on a food package label shows the total amount of fiber (insoluble and soluble). Early in 1999, however, new data from the long-running Nurses Health Study at Brigham Women’s Hospital/Harvard University School of Public Health showed that women who ate a high-fiber diet had a risk of colon cancer similar to that of women who ate a low fiber diet. Because this study contradicts literally hundreds of others conducted over the past 30 years, researchers are awaiting confirming evidence before changing dietary recommendations. Calming effect. Mood is affected by naturally occurring chemicals called neurotransmitters that facilitate transmission of impulses between brain cells. The amino acid tryptophan amino acid is the most important constituent of serotonin, a “calming” neurotransmitter. Foods such as bread, which are high in complex carbohydrates, help move tryptophan into your brain, increasing the availability of serotonin.

Adverse Effects Associated with This Food Allergic reactions and/or gastric distress. Bread contains several ingredients that may trigger allergic reactions, aggravate digestive problems, or upset a specific diet, among them gluten (prohibited on gluten-free diets); milk (prohibited on a lactose- and galactose-free diet or for people who are sensitive to milk proteins); sugar (prohibited on a sucrose-free diet); salt (controlled on a sodium-restricted diet); and fats (restricted or prohibited on a controlled-fat, low-cholesterol diet).... bread

Chocolate

(Cocoa, milk chocolate, sweet chocolate)

Nutritional Profile Energy value (calories per serving): Moderate Protein: Low (cocoa powder) High (chocolate) Fat: Moderate Saturated fat: High Cholesterol: None Carbohydrates: Low (chocolate) High (cocoa powder) Fiber: Moderate (chocolate) High (cocoa powder) Sodium: Moderate Major vitamin contribution: B vitamins Major mineral contribution: Calcium, iron, copper

About the Nutrients in This Food Cocoa beans are high-carbohydrate, high-protein food, with less dietary fiber and more fat than all other beans, excepting soy beans. The cocoa bean’s dietary fiber includes pectins and gums. Its proteins are limited in the essential amino acids lysine and isoleucine. Cocoa butter, the fat in cocoa beans, is the second most highly saturated vegetable fat (coconut oil is number one), but it has two redeeming nutritional qualities. First, it rarely turns rancid. Second, it melts at 95°F, the temperature of the human tongue. Cocoa butter has no cholesterol; neither does plain cocoa powder or plain dark chocolate. Cocoa beans have B vitamins (thiamine, riboflavin, niacin) plus min- erals (iron, magnesium, potassium, phosphorus, and copper). All chocolate candy is made from chocolate liquor, a thick paste pro- duce by roasting and grinding cocoa beans. Dark (sweet) chocolate is made of chocolate liquor, cocoa butter, and sugar. Milk chocolate is made of choc- olate liquor, cocoa butter, sugar, milk or milk powder, and vanilla. White * These values apply to plain cocoa powder and plain unsweetened chocolate. Add- ing other foods, such as milk or sugar, changes these values. For example, there is no cholesterol in plain bitter chocolate, but there is cholesterol in milk chocolate. chocolate is made of cocoa butter, sugar, and milk powder. Baking chocolate is unsweetened dark chocolate. The most prominent nutrient in chocolate is its fat. Fat Content in One Ounce of Chocolate

Saturated fat (g) Monounsaturated fat (g) Polyunsaturated fat (g) Cholesterol (mg)
Dark (sweet)
chocolate 5.6 3.2 0.3 0
Milk chocolate 5.9 4.5 0.4 6.6
Baking chocolate 9 5.6 0.3 0
White chocolate 5.5 2.6 0.3 0
  Source: USDA Nut rient Data Laborator y. Nat ional Nut rient Database for Standard Reference. Available online. UR L : http://w w w.nal.usda.gov/fnic/foodcomp/search /. Because chocolate is made from a bean, it also contains dietary fiber and measurable amounts of certain minerals. For example, one ounce of dark chocolate, the most nutritious “eating” chocolate, has 1.6 g dietary fiber, 0.78 mg iron (4 percent of the R DA for a woman, 10 percent of the R DA for a man), 32 mg magnesium (11 percent of the R DA for a woman, 8 percent of the R DA for a man), and .43 mg zinc (5 percent of the R DA for a woman, 4 percent of the R DA for a man). Cocoa beans, cocoa, and chocolate contain caffeine, the muscle stimulant theobro- mine, and the mood-altering chemicals phenylethylalanine and anandamide (see below).

The Most Nutritious Way to Serve This Food With low-fat milk to complete the proteins without adding saturated fat and cholesterol. NOTE : Both cocoa and chocolate contain oxalic acid, which binds with calcium to form cal- cium oxalate, an insoluble compound, but milk has so much calcium that the small amount bound to cocoa and chocolate hardly matters. Chocolate skim milk is a source of calcium.

Diets That May Restrict or Exclude This Food Antiflatulence diet Low-calcium and low-oxalate diet (to prevent the formation of calcium oxalate kidney stones) Low-calorie diet Low-carbohydrate diet Low-fat diet Low-fat, controlled-cholesterol diet (milk chocolates) Low-fiber diet Potassium-regulated (low-potassium) diet

Buying This Food Look for: Tightly sealed boxes or bars. When you open a box of chocolates or unwrap a candy bar, the chocolate should be glossy and shiny. Chocolate that looks dull may be stale, or it may be inexpensively made candy without enough cocoa butter to make it gleam and give it the rich creamy mouthfeel we associate with the best chocolate. (Fine chocolate melts evenly on the tongue.) Chocolate should also smell fresh, not dry and powdery, and when you break a bar or piece of chocolate it should break cleanly, not crumble. One exception: If you have stored a bar of chocolate in the refrigerator, it may splinter if you break it without bringing it to room temperature first.

Storing This Food Store chocolate at a constant temperature, preferably below 78°F. At higher temperatures, the fat in the chocolate will rise to the surface and, when the chocolate is cooled, the fat will solidif y into a whitish powdery bloom. Bloom is unsightly but doesn’t change the chocolate’s taste or nutritional value. To get rid of bloom, melt the chocolate. The chocolate will turn dark, rich brown again when its fat recombines with the other ingredients. Chocolate with bloom makes a perfectly satisfactory chocolate sauce. Dark chocolate (bitter chocolate, semisweet chocolate) ages for at least six months after it is made, as its flavor becomes deeper and more intense. Wrapped tightly and stored in a cool, dry cabinet, it can stay fresh for a year or more. Milk chocolate ages only for about a month after it is made and holds its peak flavor for about three to six months, depending on how carefully it is stored. Plain cocoa, with no added milk powder or sugar, will stay fresh for up to a year if you keep it tightly sealed and cool.

What Happens When You Cook This Food Chocolate burns easily. To melt it without mishap, stir the chocolate in a bowl over a pot of hot water or in the top of a double boiler or put the chocolate in a covered dish and melt it in the microwave (which does not get as hot as a pot on the store). Simple chemistry dictates that chocolate cakes be leavened with baking soda rather than baking powder. Chocolate is so acidic that it will upset the delicate balance of acid (cream of tartar) and base (alkali = sodium bicarbonate = baking soda) in baking powder. But it is not acidic enough to balance plain sodium bicarbonate. That’s why we add an acidic sour-milk product such as buttermilk or sour cream or yogurt to a chocolate cake. Without the sour milk, the batter would be so basic that the chocolate would look red, not brown, and taste very bitter.

How Other Kinds of Processing Affect This Food Freezing. Chocolate freezes and thaws well. Pack it in a moistureproof container and defrost it in the same package to let it reabsorb moisture it gave off while frozen.

Medical Uses and/or Benefits Mood elevator. Chocolate’s reputation for making people feel good is based not only on its caffeine content—19 mg caffeine per ounce of dark (sweet) chocolate, which is one-third the amount of caffeine in a five-ounce cup of brewed coffee—but also on its naturally occurring mood altering chemicals phenylethylalanine and anandamide. Phenylethylalanine is found in the blood of people in love. Anandamide stimulates areas of your brain also affected by the active ingredients in marijuana. (NOTE : As noted by the researchers at the Neurosci- ences Institute in San Diego who identified anandamide in chocolate in 1996, to get even the faintest hint of marijuana-like effects from chocolate you would have to eat more than 25 pounds of the candy all at once.) Possible heart health benefits. Chocolate is rich in catechins, the antioxidant chemicals that give tea its reputation as a heart-protective anticancer beverage (see tea). In addition, a series of studies beginning with those at the USDA Agricultural Research Center in Peoria, Illinois, suggest that consuming foods rich in stearic acid like chocolate may reduce rather than raise the risk of a blood clot leading to a heart attack. Possible slowing of the aging process. Chocolate is a relatively good source of copper, a mineral that may play a role in slowing the aging process by decreasing the incidence of “protein glycation,” a reaction in which sugar molecules ( gly = sugar) hook up with protein molecules in the bloodstream, twisting the protein molecules out of shape and rendering them unusable. This can lead to bone loss, rising cholesterol, cardiac abnormalities, and a slew of other unpleasantries. In people with diabetes, excess protein glycation may be one factor involved in complications such as loss of vision. Ordinarily, increased protein glyca- tion is age-related. But at the USDA Grand Forks Human Nutrition Research Center in North Dakota, agricultural research scientist Jack T. Saari has found that rats on copper-deficient diets experience more protein glycation at any age than other rats. A recent USDA survey of American eating patterns says that most of us get about 1.2 mg copper a day, considerably less than the Estimated Safe and Adequate Daily Dietary Intake (ESADDI) or 1.5 mg to 3 mg a day. Vegetarians are less likely to be copper deficient because, as Saari notes, the foods highest in copper are whole grains, nuts, seeds, and beans, including the cocoa bean. One ounce of dark chocolate has .25 mg copper (8 –17 percent of the ESADDI).

Adverse Effects Associated with This Food Possible loss of bone density. In 2008, a team of Australian researchers at Royal Perth Hos- pital, and Sir Charles Gairdner Hospital published a report in the American Journal of Clinical Nutrition suggesting that women who consume chocolate daily had 3.1 percent lower bone density than women who consume chocolate no more than once a week. No explanation for the reaction was proposed; the finding remains to be confirmed. Possible increase in the risk of heart disease. Cocoa beans, cocoa powder, and plain dark chocolate are high in saturated fats. Milk chocolate is high in saturated fats and cholesterol. Eating foods high in saturated fats and cholesterol increases the amount of cholesterol in your blood and raises your risk of heart disease. NOTE : Plain cocoa powder and plain dark chocolate may be exceptions to this rule. In studies at the USDA Agricultural Research Center in Peoria, Illinois, volunteers who consumed foods high in stearic acid, the saturated fat in cocoa beans, cocoa powder, and chocolate, had a lower risk of blood clots. In addition, chocolate is high in flavonoids, the antioxidant chemicals that give red wine its heart-healthy reputation. Mild jitters. There is less caffeine in chocolate than in an equal size serving of coffee: A five- ounce cup of drip-brewed coffee has 110 to 150 mg caffeine; a five-ounce cup of cocoa made with a tablespoon of plain cocoa powder ( 1/3 oz.) has about 18 mg caffeine. Nonetheless, people who are very sensitive to caffeine may find even these small amounts problematic. Allergic reaction. According to the Merck Manual, chocolate is one of the 12 foods most likely to trigger the classic food allergy symptoms: hives, swelling of the lips and eyes, and upset stomach.* The others are berries (blackberries, blueberries, raspberries, strawberries), corn, eggs, fish, legumes (green peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see wheat cer ea ls).

Food/Drug Interactions Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyra- mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. Caffeine is a substance similar to tyramine. If you consume excessive amounts of a caffeinated food, such as cocoa or chocolate, while you are taking an M AO inhibitor, the result may be a hypertensive crisis. False-positive test for pheochromocytoma. Pheochromocytoma, a tumor of the adrenal gland, secretes adrenalin, which the body converts to VM A (vanillylmandelic acid). VM A is excreted in urine, and, until recently, the test for this tumor measured the level of VM A in the urine. In the past, chocolate and cocoa, both of which contain VM A, were eliminated from the patient’s diet prior to the test lest they elevate the level of VM A in the urine and produce a false-positive result. Today, more finely drawn tests usually make this unnecessary. * The evidence link ing chocolate to allergic or migraine headaches is inconsistent. In some people, phenylet hylamine (PEA) seems to cause headaches similar to t hose induced by t yramine, anot her pressor amine. The PEA-induced headache is unusual in t hat it is a delayed react ion t hat usually occurs 12 or more hours after t he chocolate is eaten.... chocolate

Coracidium

A ciliated oncosphere which develops in the eggs of pseudophyllidean tapeworms.... coracidium

Egg Capsule

A membranous structure containing eggs of a tapeworm, in the absence of uterus (e.g. in Dipylidium caninum).... egg capsule

Embryo Research

When a woman is treated for infertility it is necessary to nurture human embryos for a few days (until the ?rst cell divisions of the fertilised egg have occurred) in a specialised laboratory. More eggs are fertilised than are usually needed because not all fertilisations are successful. Surplus embryos may be frozen for use in later attempts to implant an embryo in the womb. Research has been done on very early embryos but the practice is controversial and some countries have either forbidden it or imposed tight restrictions. In the UK such research is controlled by the government Human Fertilisation & Embryology Authority (see ASSISTED CONCEPTION).... embryo research

Barley

See also Wheat Cereals.

Nutritional Profile Energy value (calories per serving): Moderate Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: B vitamins, folate Major mineral contribution: Iron, potassium

About the Nutrients in This Food Barley is a high-carbohydrate food, rich in starch and dietary fiber, particu- larly pectins and soluble gums, including beta-glucans, the fiber that makes cooked oatmeal sticky. The proteins in barley are incomplete, limited in the essential amino acid lysine. Barley is a good source of the B vitamin folate. One-half cup cooked barley has 4.5 grams dietary fiber and 12.5 mg folate (3 percent of the R DA for healthy adults).

The Most Nutritious Way to Serve This Food With a calcium-rich food and with a food such as legumes or meat, milk, or eggs that supplies the lysine barley is missing.

Diets That May Restrict or Exclude This Food Gluten-free diet

Buying This Food Look for: Clean, tightly sealed boxes or plastic bags. Stains indicate that something has spilled on the box and may have seeped through to con- taminate the grain inside. * Values are for pearled barley.

Storing This Food Store barley in air- and moisture-proof containers in a cool, dark, dry cabinet. Well protected, it will keep for several months with no loss of nutrients.

Preparing This Food Pick over the barley and discard any damaged or darkened grains.

What Happens When You Cook This Food Starch consists of molecules of the complex carbohydrates amylose and amylopectin packed into a starch granule. When you cook barley in water, its starch granules absorb water mol- ecules, swell, and soften. When the temperature of the liquid reaches approximately 140°F, the amylose and amylopectin molecules inside the granules relax and unfold, breaking some of their internal bonds (bonds between atoms on the same molecule) and forming new bonds between atoms on different molecules. The result is a network that traps and holds water molecules. The starch granules swell and the barley becomes soft and bulky. If you continue to cook the barley, the starch granules will rupture, releasing some of the amylose and amylopectin molecules inside. These molecules will attract and immobilize some of the water molecules in the liquid, which is why a little barley added to a soup or stew will make the soup or stew thicker. The B vitamins in barley are water-soluble. You can save them by serving the barley with the liquid in which it was cooked.

How Other Kinds of Processing Affect This Food Pearling. Pearled barley is barley from which the outer layer has been removed. Milling, the process by which barley is turned into flour, also removes the outer coating (bran) of the grain. Since most of the B vitamins and fiber are concentrated in the bran, both pearled and milled barley are lower in nutrients and fiber than whole barley. Malting. After barley is harvested, the grain may be left to germinate, a natural chemical process during which complex carbohydrates in the grain (starches and beta-glucans) change into sugar. The grain, now called malted barley, is used as the base for several fermented and distilled alcohol beverages, including beer and whiskey.

Medical Uses and/or Benefits To reduce cholesterol levels. The soluble gums and pectins in barley appear to lower the amount of cholesterol circulating in your blood. There are currently two theories to explain how this might work. The first theory is that the pectins form a gel in your stomach that sops up fats and keeps them from being absorbed by your body. The second is that bacteria living in your gut may feed on the beta-glucans in the barley to produce short-chain fatty acids that slow the natural production of cholesterol in your liver. Barley is very rich in beta-glucans; some strains have three times as much as oats. It also has tocotrienol, another chemical that mops up cholesterol.... barley

Fibroma

A benign tumour comprising mainly CONNECTIVE TISSUE – the substance that surrounds body structures, binding them together. Examples are neuro?broma, affecting connective tissue around nerves, and ovarian ?broma which develops around the follicles from which eggs (ova) develop in the OVARIES. Unless the ?broma is causing symptoms (as a result of pressure on surrounding tissues) it does not require treatment. If symptoms occur, the tumour is removed surgically.... fibroma

Fish

See also Shellfish, Squid.

Nutritional Profile Energy value (calories per serving): Moderate Protein: High Fat: Low to moderate Saturated fat: Low to moderate Cholesterol: Moderate Carbohydrates: Low Fiber: None Sodium: Low (fresh fish) High (some canned or salted fish) Major vitamin contribution: Vitamin A, vitamin D Major mineral contribution: Iodine, selenium, phosphorus, potassium, iron, calcium

About the Nutrients in This Food Like meat, poultry, milk, and eggs, fish are an excellent source of high- quality proteins with sufficient amount of all the essential amino acids. While some fish have as much or more fat per serving than some meats, the fat content of fish is always lower in saturated fat and higher in unsaturated fats. For example, 100 g/3.5 ounce cooked pink salmon (a fatty fish) has 4.4 g total fat, but only 0.7 g saturated fat, 1.2 g monounsaturated fat, and 1.7 g polyunsaturated fat; 100 g/3.5 ounce lean top sirloin has four grams fat but twice as much saturated fat (1.5 g), plus 1.6 g monounsatu- rated fat and only 0.2 g polyunsaturated fat. Omega-3 Fatty Acid Content of Various Fish (Continued) Fish  Grams/ounce Rainbow trout  0.30 Lake whitefish  0.25 Source: “Food for t he Heart,” American Health, April 1985. Fish oils are one of the few natural food sources of vitamin D. Salmon also has vita- min A derived from carotenoid pigments in the plants eaten by the fish. The soft bones in some canned salmon and sardines are an excellent source of calcium. CAUTION: do not eat the bones in r aw or cook ed fish. the only bones consider ed edible ar e those in the canned products.

The Most Nutritious Way to Serve This Food Cooked, to kill parasites and potentially pathological microorganisms living in raw fish. Broiled, to liquify fat and eliminate the fat-soluble environmental contaminants found in some freshwater fish. With the soft, mashed, calcium-rich bones (in canned salmon and canned sardines).

Diets That May Restrict or Exclude This Food Low-purine (antigout) diet Low-sodium diet (canned, salted, or smoked fish)

Buying This Food Look for: Fresh-smelling whole fish with shiny skin; reddish pink, moist gills; and clear, bulging eyes. The flesh should spring back when you press it lightly. Choose fish fillets that look moist, not dry. Choose tightly sealed, solidly frozen packages of frozen fish. In 1998, the FDA /National Center for Toxicological Research released for testing an inexpensive indicator called “Fresh Tag.” The indicator, to be packed with seafood, changes color if the product spoils. Avoid: Fresh whole fish whose eyes have sunk into the head (a clear sign of aging); fillets that look dry; and packages of frozen fish that are stained (whatever leaked on the package may have seeped through onto the fish) or are coated with ice crystals (the package may have defrosted and been refrozen).

Storing This Food Remove fish from plastic wrap as soon as you get it home. Plastic keeps out air, encouraging the growth of bacteria that make the fish smell bad. If the fish smells bad when you open the package, throw it out. Refrigerate all fresh and smoked fish immediately. Fish spoils quickly because it has a high proportion of polyunsaturated fatty acids (which pick up oxygen much more easily than saturated or monounsaturated fatty acids). Refrigeration also slows the action of microorgan- isms on the surface of the fish that convert proteins and other substances to mucopolysac- charides, leaving a slimy film on the fish. Keep fish frozen until you are ready to use it. Store canned fish in a cool cabinet or in a refrigerator (but not the freezer). The cooler the temperature, the longer the shelf life.

Preparing This Food Fresh fish. Rub the fish with lemon juice, then rinse it under cold running water. The lemon juice (an acid) will convert the nitrogen compounds that make fish smell “fishy” to compounds that break apart easily and can be rinsed off the fish with cool running water. R insing your hands in lemon juice and water will get rid of the fishy smell after you have been preparing fresh fish. Frozen fish. Defrost plain frozen fish in the refrigerator or under cold running water. Pre- pared frozen fish dishes should not be thawed before you cook them since defrosting will make the sauce or coating soggy. Salted dried fish. Salted dried fish should be soaked to remove the salt. How long you have to soak the fish depends on how much salt was added in processing. A reasonable average for salt cod, mackerel, haddock (finnan haddie), or herring is three to six hours, with two or three changes of water. When you are done, clean all utensils thoroughly with hot soap and hot water. Wash your cutting board, wood or plastic, with hot water, soap, and a bleach-and-water solution. For ultimate safety in preventing the transfer of microorganisms from the raw fish to other foods, keep one cutting board exclusively for raw fish, meats, and poultry, and a second one for everything else. Finally, don’t forget to wash your hands.

What Happens When You Cook This Food Heat changes the structure of proteins. It denatures the protein molecules so that they break apart into smaller fragments or change shape or clump together. These changes force moisture out of the tissues so that the fish turns opaque. The longer you cook fish, the more moisture it will lose. Cooked fish flakes because the connective tissue in fish “melts” at a relatively low temperature. Heating fish thoroughly destroys parasites and microorganisms that live in raw fish, making the fish safer to eat.

How Other Kinds of Processing Affect This Food Marinating. Like heat, acids coagulate the proteins in fish, squeezing out moisture. Fish marinated in citrus juices and other acids such as vinegar or wine has a firm texture and looks cooked, but the acid bath may not inactivate parasites in the fish. Canning. Fish is naturally low in sodium, but can ned fish often contains enough added salt to make it a high-sodium food. A 3.5-ounce ser ving of baked, fresh red salmon, for example, has 55 mg sodium, while an equal ser ving of regular can ned salmon has 443 mg. If the fish is can ned in oil it is also much higher in calories than fresh fish. Freezing. When fish is frozen, ice cr ystals form in the flesh and tear its cells so that mois- ture leaks out when the fish is defrosted. Commercial flash-freezing offers some protec- tion by freezing the fish so fast that the ice cr ystals stay small and do less damage, but all defrosted fish tastes drier and less palatable than fresh fish. Freezing slows but does not stop the oxidation of fats that causes fish to deteriorate. Curing. Fish can be cured (preser ved) by smoking, dr ying, salting, or pickling, all of which coagulate the muscle tissue and prevent microorganisms from growing. Each method has its own particular drawbacks. Smoking adds potentially carcinogenic chemicals. Dr ying reduces the water content, concentrates the solids and nutrients, increases the calories per ounce, and raises the amount of sodium.

Medical Uses and/or Benefits Protection against cardiovascular disease. The most important fats in fish are the poly- unsaturated acids k nown as omega-3s. These fatt y acids appear to work their way into heart cells where they seem to help stabilize the heart muscle and prevent potentially fatal arrhythmia (irregular heartbeat). A mong 85,000 women in the long-run n ing Nurses’ Health Study, those who ate fatt y fish at least five times a week were nearly 50 percent less likely to die from heart disease than those who ate fish less frequently. Similar results appeared in men in the equally long-run n ing Physicians’ Health Study. Some studies suggest that people may get similar benefits from omega-3 capsules. Researchers at the Consorzio Mario Negri Sud in Santa Maria Imbaro ( Italy) say that men given a one-gram fish oil capsule once a day have a risk of sudden death 42 percent lower than men given placebos ( “look-alike” pills with no fish oil). However, most nutrition scientists recom- mend food over supplements. Omega-3 Content of Various Food Fish Fish* (3 oz.)  Omega-3 (grams) Salmon, Atlantic  1.8 Anchovy, canned* 1.7 Mackerel, Pacific 1.6 Salmon, pink, canned* 1.4 Sardine, Pacific, canned* 1.4 Trout, rainbow  1.0 Tuna, white, canned* 0.7 Mussels  0.7 * cooked, wit hout sauce * drained Source: Nat ional Fisheries Inst itute; USDA Nut rient Data Laborator y. Nat ional Nut ri- ent Database for Standard Reference. Available online. UR L : http://w w w.nal.usda. gov/fnic/foodcomp/search /.

Adverse Effects Associated with This Food Allergic reaction. According to the Merck Manual, fish is one of the 12 foods most likely to trigger classic food allergy symptoms: hives, swelling of the lips and eyes, and upset stom- ach. The others are berries (blackberries, blueberries, raspberries, strawberries), chocolate, corn, eggs, legumes (green peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see wheat cer ea ls). NOTE : Canned tuna products may contain sulfites in vegetable proteins used to enhance the tuna’s flavor. People sensitive to sulfites may suf- fer serious allergic reactions, including potentially fatal anaphylactic shock, if they eat tuna containing sulfites. In 1997, tuna manufacturers agreed to put warning labels on products with sulfites. Environmental contaminants. Some fish are contaminated with methylmercury, a compound produced by bacteria that chemically alters naturally occurring mercury (a metal found in rock and soil) or mercury released into water through industrial pollution. The methylmer- cury is absorbed by small fish, which are eaten by larger fish, which are then eaten by human beings. The larger the fish and the longer it lives the more methylmercury it absorbs. The measurement used to describe the amount of methylmercury in fish is ppm (parts per mil- lion). Newly-popular tilapia, a small fish, has an average 0.01 ppm, while shark, a big fish, may have up to 4.54 ppm, 450 times as much. That is a relatively small amount of methylmercur y; it will soon make its way harmlessly out of the body. But even small amounts may be hazardous during pregnancy because methylmercur y targets the developing fetal ner vous system. Repeated studies have shown that women who eat lots of high-mercur y fish while pregnant are more likely to deliver babies with developmental problems. As a result, the FDA and the Environ men- tal Protection Agency have now warned that women who may become pregnant, who are pregnant, or who are nursing should avoid shark, swordfish, king mackerel, and tilefish, the fish most likely to contain large amounts of methylmercur y. The same prohibition applies to ver y young children; although there are no studies of newborns and babies, the young brain continues to develop after birth and the logic is that the prohibition during pregnancy should extend into early life. That does not mean no fish at all should be eaten during pregnancy. In fact, a 2003 report in the Journal of Epidemiology and Community Health of data from an 11,585-woman study at the University of Bristol (England) shows that women who don’t eat any fish while pregnant are nearly 40 percent more likely to deliver low birth-weight infants than are women who eat about an ounce of fish a day, the equivalent of 1/3 of a small can of tuna. One theory is that omega-3 fatty acids in the fish may increase the flow of nutrient-rich blood through the placenta to the fetus. University of Southern California researchers say that omega-3s may also protect some children from asthma. Their study found that children born to asthmatic mothers who ate oily fish such as salmon at least once a month while pregnant were less likely to develop asthma before age five than children whose asthmatic pregnant mothers never ate oily fish. The following table lists the estimated levels of mercury in common food fish. For the complete list of mercury levels in fish, click onto www.cfsan.fda.gov/~frf/sea-mehg.html. Mercury Levels in Common Food Fish Low levels (0.01– 0.12 ppm* average) Anchovies, butterfish, catfish, clams, cod, crab (blue, king, snow), crawfish, croaker (Atlantic), flounder, haddock, hake, herring, lobster (spiny/Atlantic) mackerel, mul- let, ocean perch, oysters, pollock, salmon (canned/fresh frozen), sardines, scallops, shad (American), shrimp, sole, squid, tilapia, trout (freshwater), tuna (canned, light), whitefish, whiting Mid levels (0.14 – 0.54 ppm* average) Bass (salt water), bluefish, carp, croaker ( Pacific), freshwater perch, grouper, halibut, lobster (Northern A merican), mackerel (Spanish), marlin, monkfish, orange roughy, skate, snapper, tilefish (Atlantic), tuna (can ned albacore, fresh/frozen), weakfish/ sea trout High levels (0.73 –1.45 ppm* average) King mackerel, shark, swordfish, tilefish * ppm = parts per million, i.e. parts of mercur y to 1,000,000 parts fish Source: U.S. Food and Drug Administ rat ion, Center for Food Safet y and Applied Nut rit ion, “Mercur y Levels in Commercial Fish and Shellfish.” Available online. UR L : w w w.cfsan.fda. gov/~frf/sea-mehg.ht ml. Parasitical, viral, and bacterial infections. Like raw meat, raw fish may carry various pathogens, including fish tapeworm and flukes in freshwater fish and Salmonella or other microorganisms left on the fish by infected foodhandlers. Cooking the fish destroys these organisms. Scombroid poisoning. Bacterial decomposition that occurs after fish is caught produces a his- taminelike toxin in the flesh of mackerel, tuna, bonito, and albacore. This toxin may trigger a number of symptoms, including a flushed face immediately after you eat it. The other signs of scombroid poisoning—nausea, vomiting, stomach pain, and hives—show up a few minutes later. The symptoms usually last 24 hours or less.

Food/Drug Interactions Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyramine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. If you eat a food such as pickled herring, which is high in tyramine, while you are taking an M AO inhibitor, your body may not be able to eliminate the tyramine and the result may be a hypertensive crisis.... fish

Flour

See also Bread, Corn, Oats, Pasta, Potatoes, R ice, Soybeans, Wheat cereals.

Nutritional Profile Energy value (calories per serving): High Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Low to high Sodium: Low (except self-rising flour) Major vitamin contribution: B vitamins Major mineral contribution: Iron

About the Nutrients in This Food Flour is the primary source of the carbohydrates (starch and fiber) in bread, pasta, and baked goods. All wheat and rye flours also provide some of the food fibers, including pectins, gums, and cellulose. Flour also contains significant amounts of protein but, like other plant foods, its proteins are “incomplete” because they are deficient in the essential amino acid lysine. The fat in the wheat germ is primarily polyunsaturated; flour contains no cholesterol. Flour is a good source of iron and the B vitamins. Iodine and iodophors used to clean the equipment in grain-processing plants may add iodine to the flour. In 1998, the Food and Drug Administration ordered food manufac- turers to add folates—which protect against birth defects of the spinal cord and against heart disease—to flour, rice, and other grain products. One year later, data from the Framingham Heart Study, which has fol- lowed heart health among residents of a Boston suburb for nearly half a century, showed a dramatic increase in blood levels of folic acid. Before the fortification of foods, 22 percent of the study participants had a folic acid deficiency; after, the number fell to 2 percent. Whole grain flour, like other grain products, contains phytic acid, an antinutrient that binds calcium, iron, and zinc ions into insoluble com- pounds your body cannot absorb. This has no practical effect so long as your diet includes foods that provide these minerals. Whole wheat flours. Whole wheat flours use every part of the kernel: the fiber-rich bran with its B vitamins, the starch- and protein-rich endosperm with its iron and B vitamins, and the oily germ with its vitamin E.* Because they contain bran, whole-grain flours have much more fiber than refined white flours. However, some studies suggest that the size of the fiber particles may have some bearing on their ability to absorb moisture and “bulk up” stool and that the fiber particles found in fine-ground whole wheat flours may be too small to have a bulking effect. Finely ground whole wheat flour is called whole wheat cake flour; coarsely ground whole wheat flour is called graham flour. Cracked wheat is a whole wheat flour that has been cut rather than ground; it has all the nutrients of whole wheat flour, but its processing makes it less likely to yield its starch in cooking. When dried and parboiled, cracked wheat is known as bulgur, a grain used primarily as a cereal, although it can be mixed with other flours and baked. Gluten flour is a low-starch, high-protein product made by drying and grinding hard- wheat flour from which the starch has been removed. Refined (“white”) flours. Refined flours are paler than whole wheat flours because they do not contain the brown bran and germ. They have less fiber and fat and smaller amounts of vitamins and minerals than whole wheat flours, but enriched refined flours are fortified with B vitamins and iron. Refined flour has no phytic acid. Some refined flours are bleached with chlorine dioxide to destroy the xanthophylls (carotenoid pigments) that give white flours a natural cream color. Unlike carotene, the carotenoid pigment that is converted to vitamin A in the body, xanthophylls have no vita- min A activity; bleaching does not lower the vitamin A levels in the flour, but it does destroy vitamin E. There are several kinds of white flours. All-purpose white flour is a mixture of hard and soft wheats, high in protein and rich in gluten.t Cake flour is a finely milled soft-wheat flour; it has less protein than all-purpose flour. Self-rising flour is flour to which baking powder has been added and is very high in sodium. Instant flour is all-purpose flour that has been ground extra-fine so that it will combine quickly with water. Semolina is a pale high-protein, low- gluten flour made from durum wheat and used to make pasta. Rye flours. Rye flour has less gluten than wheat flour and is less elastic, which is why it makes a denser bread.:j Like whole wheat flour, dark rye flour (the flour used for pumpernickel bread) contains the bran and the germ of the rye grain; light rye flour (the flour used for ordinary rye bread) The bran is t he kernel’s hard, brown outer cover, an ext raordinarily rich source of cellulose and lignin. The endosperm is t he kernel’s pale interior, where t he vitamins abound. The germ, a small part icle in t he interior, is t he part of t he kernel t hat sprouts. Hard wheat has less starch and more protein t han soft wheat. It makes a heavier, denser dough. Gluten is t he st icky substance formed when k neading t he dough relaxes t he long-chain molecules in t he proteins gliadin and glutenin so t hat some of t heir intermolecular bonds (bonds bet ween atoms in t he same molecule) break and new int ramolecular bonds (bonds bet ween atoms on different mol- ecules) are formed. Triticale flour is milled from triticale grain, a rye/wheat hybrid. It has more protein and less gluten than all-purpose wheat flour.

The Most Nutritious Way to Serve This Food With beans or a “complete” protein food (meat, fish, poultry, eggs, milk, cheese) to provide the essential amino acid lysine, in which wheat and rye flours are deficient.

Diets That May Restrict or Exclude This Food Low-calcium diet (whole grain and self-rising flours) Low-fiber diet (whole wheat flours) Low-gluten diet (all wheat and rye flour) Sucrose-free diet

Buying This Food Look for: Tightly sealed bags or boxes. Flours in torn packages or in open bins are exposed to air and to insect contamination. Avoid: Stained packages—the liquid that stained the package may have seeped through into the flour.

Storing This Food Store all flours in air- and moistureproof canisters. Whole wheat flours, which contain the germ and bran of the wheat and are higher in fat than white flours, may become rancid if exposed to air; they should be used within a week after you open the package. If you plan to hold the flour for longer than that, store it in the freezer, tightly wrapped to protect it against air and moisture. You do not have to thaw the flour when you are ready to use it; just measure it out and add it directly to the other ingredients. Put a bay leaf in the flour canister to help protect against insect infections. Bay leaves are natural insect repellents.

What Happens When You Cook This Food Protein reactions. The wheat kernel contains several proteins, including gliadin and glute- nin. When you mix flour with water, gliadin and glutenin clump together in a sticky mass. Kneading the dough relaxes the long gliadin and glutenin molecules, breaking internal bonds between individual atoms in each gliadin and glutenin molecule and allowing the molecules to unfold and form new bonds between atoms in different molecules. The result is a network structure made of a new gliadin-glutenin compound called gluten. Gluten is very elastic. The gluten network can stretch to accommodate the gas (carbon dioxide) formed when you add yeast to bread dough or heat a cake batter made with baking powder or baking soda (sodium bicarbonate), trapping the gas and making the bread dough or cake batter rise. When you bake the dough or batter, the gluten network hardens and the bread or cake assumes its finished shape. Starch reactions. Starch consists of molecules of the complex carbohydrates amylose and amylopectin packed into a starch granule. When you heat flour in liquid, the starch gran- ules absorb water molecules, swell, and soften. When the temperature of the liquid reaches approximately 140°F the amylose and amylopectin molecules inside the granules relax and unfold, breaking some of their internal bonds (bonds between atoms on the same molecule) and forming new bonds between atoms on different molecules. The result is a network that traps and holds water molecules. The starch granules then swell, thickening the liquid. If you continue to heat the liquid (or stir it too vigorously), the network will begin to break down, the liquid will leak out of the starch granules, and the sauce will separate.* Combination reaction. Coating food with flour takes advantage of the starch reaction (absorbing liquids) and the protein reaction (baking a hard, crisp protein crust).

Medical Uses and/or Benefits A lower risk of some kinds of cancer. In 1998, scientists at Wayne State University in Detroit conducted a meta-analysis of data from more than 30 well-designed animal studies mea- suring the anti-cancer effects of wheat bran, the part of grain with highest amount of the insoluble dietary fibers cellulose and lignin. They found a 32 percent reduction in the risk of colon cancer among animals fed wheat bran; now they plan to conduct a similar meta- analysis of human studies. Whole wheat flours are a good source of wheat bran. NOTE : The amount of fiber per serving listed on a food package label shows the total amount of fiber (insoluble and soluble). Early in 1999, however, new data from the long-running Nurses Health Study at Brigham Women’s Hospital/Harvard University School of Public Health showed that women who ate a high-fiber diet had a risk of colon cancer similar to that of women who ate a low-fiber diet. * A mylose is a long, unbranched, spiral molecule; amylopect in is a short, compact, branched molecule. A mylose has more room for forming bonds to water. Wheat flours, which have a higher rat io of amy- lose to amylopect in, are superior t hickeners. Because this study contradicts literally hundreds of others conducted over the past 30 years, researchers are awaiting confirming evidence before changing dietary recommendations.

Adverse Effects Associated with This Food Allergic reactions. According to the Merck Manual, wheat is one of the foods most commonly implicated as a cause of allergic upset stomach, hives, and angioedema (swollen lips and eyes). For more information, see under wheat cer ea ls. Gluten intolerance (celiac disease). Celiac disease is an intestinal allergic disorder that makes it impossible to digest gluten and gliadin (proteins found in wheat and some other grains). Corn flour, potato flour, rice flour, and soy flour are all gluten- and gliadin-free. Ergot poisoning. Rye and some kinds of wheat will support ergot, a parasitic fungus related to lysergic acid (LSD). Because commercial flours are routinely checked for ergot contamina- tion, there has not been a major outbreak of ergot poisoning from bread since a 1951 incident in France. Since baking does not destroy ergot toxins, the safest course is to avoid moldy flour altogether.... flour

Huevo

Egg; also, yema de huevo (egg yolk); used for treating anemia; said to fortify red blood cells; eggshell (cáscara de huevo) can be added as an ingredient to home remedies.... huevo

Indispensable Amino Acids

This is the new, preferred term for essential amino acids – amino acids which are essential for the body’s normal growth and development, but which the body is unable to produce. Nine essential amino acids exist – HISTIDINE, ISOLEUCINE, LEUCINE, LYSINE, METHIONINE, PHENYLALANINE, THREONINE, TRYPTOPHAN, and VALINE – and they are present in foods rich in protein: dairy products, eggs, meat, and liver.... indispensable amino acids

Ketogenic Diet

This contains such an excess of fats that acetone and other KETONE bodies appear in the urine. The diet is sometimes used in the treatment of EPILEPSY and chronic infections of the urinary tract by Escherichia coli; butter, cream, eggs and fat meat are allowed, whilst sugar, bread and other carbohydrates are cut out as far as possible.... ketogenic diet

Blackberries

(Boysenberries, dewberries, youngberries)

Nutritional Profile Energy value (calories per serving): Low Protein: Low Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: Low Major vitamin contribution: Vitamin A, vitamin C Major mineral contribution: Calcium

About the Nutrients in This Food Blackberries have no starch but do contain sugars and dietary fiber, pri- marily pectin, which dissolves as the fruit matures. Unripe blackberries contain more pectin than ripe ones. One-half cup fresh blackberries has 3.8 g dietary fiber, 15 mg vitamin C (20 percent of the R DA for a woman, 17 percent of the R DA for a man), and 18 mcg folate (5 percent of the R DA).

The Most Nutritious Way to Serve This Food Fresh or lightly cooked.

Buying This Food Look for: Plump, firm dark berries with no hulls. A firm, well-rounded berry is still moist and fresh; older berries lose moisture, which is why their skin wrinkles. Avoid: Baskets of berries with juice stains or liquid leaking out of the berries. The stains and leaks are signs that there are crushed—and possibly moldy—berries inside.

Storing This Food Cover berries and refrigerate them. Then use them in a day or two. Do not wash berries before storing. The moisture collects in spaces on the surface of the berries that may mold in the refrigerator. Also, handling the berries may damage their cells, releasing enzymes that can destroy vitamins.

Preparing This Food R inse the berries under cool running water, then drain them and pick them over carefully to remove all stems and leaves.

What Happens When You Cook This Food Cooking destroys some of the vitamin C in fresh blackberries and lets water-soluble B vitamins leach out. Cooked berries are likely to be mushy because the heat and water dis- solve their pectin and the skin of the berry collapses. Cooking may also change the color of blackberries, which contain soluble red anthocyanin pigments that stain cooking water and turn blue in basic (alkaline) solutions. Adding lemon juice to a blackberry pie stabilizes these pigments; it is a practical way to keep the berries a deep, dark reddish blue.

How Other Kinds of Processing Affect This Food Canning. The intense heat used in canning fruits reduces the vitamin C content of black- berries. Berries packed in juice have more nutrients, ounce for ounce, than berries packed in either water or syrup.

Medical Uses and/or Benefits Anticancer activity. Blackberries are rich in anthocyanins, bright-red plant pigments that act as antioxidants—natural chemicals that prevent free radicals (molecular fragments) from joining to form carcinogenic (cancer-causing) compounds. Some varieties of blackberries also contain ellagic acid, another anticarcinogen with antiviral and antibacterial properties.

Adverse Effects Associated with This Food Allergic reaction. Hives and angioedema (swelling of the face, lips, and eyes) are common allergic responses to berries, virtually all of which have been known to trigger allergic reactions. According to the Merck Manual, berries are one of the 12 foods most likely to trigger classic food allergy symptoms. The others are chocolate, corn, eggs, fish, legumes (peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see w h eat cer ea ls).... blackberries

Operculum

A lid-like structure covering certain cestode and most trematode eggs.... operculum

Parous Rate

The proportion of female mosquitoes that have laid eggs at least once. Use for age-grading a mosquito population.... parous rate

Pediculus Humanus Var. Corporis

(body louse) di?ers from the head and crab louse in that it lives in clothing and only goes on to the body to feed. Infestation is found in vagabonds, armies in the ?eld, or prisoners in conditions where even minimal hygiene is impossible. The lice are found in the seams of clothing together with multiple eggs. Typically excoriation and pigmentation are seen on the back of the infested person. Replacement of clothing or autoclaving or hot ironing of the clothes is curative.... pediculus humanus var. corporis

Pinworms

Also Threadworm, this is a widespread parasitic nematode, usually benign, but having a rural, white trash, skanky stigma. It mates and reproduces in the intestines of several mammals (including us) and the female exits the anus, usually at night, to shed its eggs and expire. The eggs become like dust motes, kids and puppies scratch their butts, the eggs spread into other mammals, until only a thermonuclear device or burning/razing/earth-salting will clear out a heavy infestation. It’s also the only worm likely to be encountered in temperate zones and the high country.... pinworms

Blueberries

(Huckleberries)

Nutritional Profile Energy value (calories per serving): Low Protein: Low Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: Low Major vitamin contribution: Vitamin C Major mineral contribution: Calcium

About the Nutrients in This Food Blueberries have some protein and a little fat. They have no starch but do contain sugars and dietary fiber—primarily pectin, which dissolves as the fruit matures—and lignin in the seeds. (The difference between blueber- ries and huckleberries is the size of their seeds; blueberries have smaller ones than huckleberries.) One-half cup fresh blueberries has 1.5 g dietary fiber and 9.5 mg. vitamin C (13 percent of the R DA for a woman, 11 percent of the R DA for a man).

The Most Nutritious Way to Serve This Food Fresh, raw, or lightly cooked.

Buying This Food Look for: Plump, firm dark-blue berries. The whitish color on the ber- ries is a natural protective coating. Avoid: Baskets of berries with juice stains or liquid leaking out of the berries. The stains and leaks are signs that there are crushed (and possibly moldy) berries inside.

Storing This Food Cover berries and refrigerate them. Then use them in a day or two. Do not wash berries before storing. The moisture increases the chance that they will mold in the refrigerator. Also, handling the berries can damage them, tearing cells and releas- ing enzymes that will destroy vitamins. Do not store blueberries in metal containers. The anthocyanin pigments in the berries can combine with metal ions to form dark, unattractive pigment/metal compounds that stain the containers and the berries.

Preparing This Food R inse the berries under cool running water, then drain them and pick them over carefully to remove all stems, leaves, and hard (immature) or soft (over-ripe) berries.

What Happens When You Cook This Food Cooking destroys some of the vitamin C in fresh blueberries and lets water-soluble B vitamins leach out. Cooked berries are likely to be mushy because heat dissolves the pectin inside. Blueberries may also change color when cooked. The berries are colored with blue anthocyanin pigments. Ordinarily, anthocyanin-pigmented fruits and vegetables turn red- dish in acids (lemon juice, vinegar) and deeper blue in bases (baking soda). But blueberries also contain yellow pigments (anthoxanthins). In a basic (alkaline) environments, as in a batter with too much baking soda, the yellow and blue pigments will combine, turning the blueberries greenish blue. Adding lemon juice to a blueberry pie stabilizes these pigments; it is a practical way to keep the berries a deep, dark reddish blue.

How Other Kinds of Processing Affect This Food Canning and freezing. The intense heat used in canning the fruit or in blanching it before freezing reduces the vitamin C content of blueberries by half.

Medical Uses and/or Benefits Anticancer activity. According to the U.S. Department of Agriculture, wild blueberries rank first among all fruits in antioxidant content; cultivated blueberries (the ones sold in most food markets) rank second. Antioxidants are natural chemicals that inactivate free radicals, molecule fragments that can link together to form cancer-causing compounds. Several ani- mal studies attest to the ability of blueberries to inhibit the growth of specific cancers. For example, in 2005, scientists at the University of Georgia reported in the journal Food Research International that blueberry extracts inhibited the growth of liver cancer cells in laboratory settings. The following year, researchers at Rutgers University (in New Jersey) delivered data to the national meeting of the American Chemical Society from a study in which laboratory rats fed a diet supplemented with pterostilbene, another compound extracted from blueber- ries, had 57 percent fewer precancerous lesions in the colon than rats whose diet did not contain the supplement. The findings, however, have not been confirmed in humans. Enhanced memory function. In 2008, British researchers at the schools of Food Biosciences and Psychology at the University of Reading and the Institute of Biomedical and Clinical Sciences at the Peninsula Medical School (England) reported that adding blueberries to one’s normal diet appears to improve both long-term and short-term memory, perhaps because anthocyanins and flavonoids (water-soluble pigments in the berries) activate signals in the hippocampus, a part of the brain that controls learning and memory. If confirmed, the data would support the role played by diet in maintaining memory and brain function. Urinary antiseptic. A 1991 study at the Weizmann Institute of Science (Israel) suggests that blueberries, like cr anber r ies, contain a compound that inhibits the ability of Escherichia coli, a bacteria commonly linked to urinary infections, to stick to the wall of the bladder. If it cannot cling to cell walls, the bacteria will not cause an infection. This discovery lends some support to folk medicine, but how the berries work, how well they work, or in what “dos- ages” remains to be proven.

Adverse Effects Associated with This Food Allergic reaction. Hives and angiodemea (swelling of the face, lips, and eyes) are common allergic responses to berries, virtually all of which have been reported to trigger these reac- tions. According to the Merck Manual, berries are one of the 12 foods most likely to trigger classic food allergy symptoms. The others are chocolate, corn, eggs, fish, legumes (peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see wheat cer ea ls).... blueberries

Pregnancy And Labour

Pregnancy The time when a woman carries a developing baby in her UTERUS. For the ?rst 12 weeks (the ?rst trimester) the baby is known as an EMBRYO, after which it is referred to as the FETUS.

Pregnancy lasts about 280 days and is calculated from the ?rst day of the last menstrual period – see MENSTRUATION. Pregnancy-testing kits rely on the presence of the hormone beta HUMAN CHORIONIC GONADOTROPHIN (b HCG) which is excreted in the woman’s urine as early as 30 days from the last menstrual period. The estimated date of delivery can be accurately estimated from the size of the developing fetus measured by ULTRASOUND (see also below) between seven and 24 weeks. ‘Term’ refers to the time that the baby is due; this can range from 38 weeks to 41 completed weeks.

Physical changes occur in early pregnancy – periods stop and the abdomen enlarges. The breasts swell, with the veins becoming prominent and the nipples darkening. About two in three women will have nausea with a few experiencing such severe vomiting as to require hospital admission for rehydration.

Antenatal care The aim of antenatal care is to ensure a safe outcome for both mother and child; it is provided by midwives (see MIDWIFE) and doctors. Formal antenatal care began in Edinburgh in the 1930s with the recognition that all aspects of pregnancy – normal and abnormal – warranted surveillance. Cooperation between general practitioners, midwives and obstetricians is now established, with pregnancies that are likely to progress normally being cared for in the community and only those needing special intervention being cared for in a hospital setting.

The initial visit (or booking) in the ?rst half of pregnancy will record the history of past events and the results of tests, with the aim of categorising the patients into normal or not. Screening tests including blood checks and ultrasound scans are a routine part of antenatal care. The ?rst ultrasound scan is done at about 11 weeks to date the pregnancy, with a further one done at 20 weeks – the anomaly scan – to assess the baby’s structure. Some obstetric units will check the growth of the baby with one further scan later in the pregnancy or, in the case of twin pregnancies (see below), many scans throughout. The routine blood tests include checks for ANAEMIA, DIABETES MELLITUS, sickle-cell disease and THALASSAEMIA, as well as for the blood group. Evidence of past infections is also looked for; tests for RUBELLA (German measles) and SYPHILIS are routine, whereas tests for human immunode?ciency virus (see AIDS/ HIV below) and HEPATITIS are being o?ered as optional, although there is compelling evidence that knowledge of the mother’s infection status is bene?cial to the baby.

Traditional antenatal care consists of regular appointments, initially every four weeks until 34 weeks, then fortnightly or weekly. At each visit the mother’s weight, urine and blood pressure are checked, and assessment of fetal growth and position is done by palpating the uterus. Around two-thirds of pregnancies and labours are normal: in the remainder, doctors and midwives need to increase the frequency of surveillance so as to prevent or deal with maternal and fetal problems.

Common complications of pregnancy

Some of the more common complications of pregnancy are listed below.

As well as early detection of medical complications, antenatal visits aim to be supportive and include emotional and educational care. Women with uncomplicated pregnancies are increasingly being managed by midwives and general practitioners in the community and only coming to the hospital doctors should they develop a problem. A small number will opt for a home delivery, but facilities for providing such a service are not always available in the UK.

Women requiring more intensive surveillance have their management targeted to the speci?c problems encountered. Cardiologists will see mothers-to-be with heart conditions, and those at risk of diabetes are cared for in designated clinics with specialist sta?. Those women needing more frequent surveillance than standard antenatal care can be looked after in maternity day centres. These typically include women with mildly raised blood pressure or those with small babies. Fetal medicine units have specialists who are highly skilled in ultrasound scanning and specialise in the diagnosis and management of abnormal babies still in the uterus. ECTOPIC PREGNANCY Chronic abdominal discomfort early in pregnancy may be caused by unruptured ectopic pregnancy, when, rarely, the fertilised OVUM starts developing in the Fallopian tube (see FALLOPIAN TUBES) instead of the uterus. The patient needs hospital treatment and LAPAROSCOPY. A ruptured ectopic pregnancy causes acute abdominal symptoms and collapse, and the woman will require urgent abdominal surgery. URINARY TRACT INFECTIONS These affect around 2 per cent of pregnant women and are detected by a laboratory test of a mid-stream specimen of urine. In pregnancy, symptoms of these infections do not necessarily resemble those experienced by non-pregnant women. As they can cause uterine irritability and possible premature labour (see below), it is important to ?nd and treat them appropriately. ANAEMIA is more prevalent in patients who are vegetarian or on a poor diet. Iron supplements are usually given to women who have low concentrations of HAEMOGLOBIN in their blood (less than 10.5 g/dl) or who are at risk of becoming low in iron, from bleeding, twin pregnancies and those with placenta previa (see below). ANTEPARTUM HAEMORRHAGE Early in pregnancy, vaginal bleedings may be due to a spontaneous or an incomplete therapeutic ABORTION. Bleeding from the genital tract between 24 completed weeks of pregnancy and the start of labour is called antepartum haemorrhage. The most common site is where the PLACENTA is attached to the wall of the uterus. If the placenta separates before delivery, bleeding occurs in the exposed ‘bed’. When the placenta is positioned in the upper part of the uterus it is called an abruption. PLACENTA PRAEVIA is sited in the lower part and blocks or partly blocks the cervix (neck of the womb); it can be identi?ed at about the 34th week. Ten per cent of episodes of antepartum bleeding are caused by placenta previa, and it may be associated with bleeding at delivery. This potentially serious complication is diagnosed by ultrasound scanning and may require a caesarean section (see below) at delivery. INCREASED BLOOD PRESSURE, associated with protein in the urine and swelling of the limbs, is part of a condition known as PRE-ECLAMPSIA. This occurs in the second half of pregnancy in about 1 in 10 women expecting their ?rst baby, and is mostly very mild and of no consequence to the pregnancy. However, some women can develop extremely high blood pressures which can adversely affect the fetus and cause epileptic-type seizures and bleeding disorders in the mother. This serious condition is called ECLAMPSIA. For this reason a pregnant woman with raised blood pressure or PROTEIN in her urine is carefully evaluated with blood tests, often in the maternity day assessment unit. The condition can be stopped by delivery of the baby, and this will be done if the mother’s or the fetus’s life is in danger. If the condition is milder, and the baby not mature enough for a safe delivery, then drugs can be used to control the blood pressure. MISCARRIAGE Also called spontaneous abortion, miscarriage is the loss of the fetus. There are several types:

threatened miscarriage is one in which some vaginal bleeding occurs, the uterus is enlarged, but the cervix remains closed and pregnancy usually proceeds.

inevitable miscarriage usually occurs before the 16th week and is typi?ed by extensive blood loss through an opened cervix and cramp-like abdominal pain; some products of conception are lost but the developing placental area (decidua) is retained and an operation may be necessary to clear the womb.

missed miscarriages, in which the embryo dies and is absorbed, but the decidua (placental area of uterine wall) remains and may cause abdominal discomfort and discharge of old blood.

THERAPEUTIC ABORTION is performed on more than 170,000 women annually in England and Wales. Sometimes the woman may not have arranged the procedure through the usual health-care channels, so that a doctor may see a patient with vaginal bleeding, abdominal discomfort or pain, and open cervix – symptoms which suggest that the decidua and a blood clot have been retained; these retained products will need to be removed by curettage.

Septic abortions are now much less common in Britain than before the Abortion Act (1967) permitted abortion in speci?ed circumstances. The cause is the passage of infective organisms from the vagina into the uterus, with Escherichia coli and Streptococcus faecalis the most common pathogenic agents. The woman has abdominal pain, heavy bleeding, usually fever and sometimes she is in shock. The cause is usually an incomplete abortion or one induced in unsterile circumstances. Antibiotics and curettage are the treatment. INTRAUTERINE GROWTH RETARDATION describes a slowing of the baby’s growth. This can be diagnosed by ultrasound scanning, although there is a considerable margin of error in estimates of fetal weight. Trends in growth are favoured over one-o? scan results alone. GESTATIONAL DIABETES is a condition that is more common in women who are overweight or have a family member with diabetes. If high concentrations of blood sugar are found, e?orts are made to correct it as the babies can become very fat (macrosomia), making delivery more di?cult. A low-sugar diet is usually enough to control the blood concentration of sugars; however some women need small doses of INSULIN to achieve control. FETAL ABNORMALITIES can be detected before birth using ultrasound. Some of these defects are obvious, such as the absence of kidneys, a condition incompatible with life outside the womb. These women can be o?ered a termination of their pregnancy. However, more commonly, the pattern of problems can only hint at an abnormality and closer examination is needed, particularly in the diagnosis of chromosomal deformities such as DOWN’S (DOWN) SYNDROME (trisomy 21 or presence of three 21 chromosomes instead of two).

Chromosomal abnormalities can be de?nitively diagnosed only by cell sampling such as amniocentesis (obtaining amniotic ?uid – see AMNION – from around the baby) done at 15 weeks onwards, and chorionic villus sampling (sampling a small part of the placenta) – another technique which can be done from 12 weeks onwards. Both have a small risk of miscarriage associated with them; consequently, they are con?ned to women at higher risk of having an abnormal fetus.

Biochemical markers present in the pregnant woman’s blood at di?erent stages of pregnancy may have undergone changes in those carrying an abnormal fetus. The ?rst such marker to be routinely used was a high concentration of alpha-fetol protein in babies with SPINA BIFIDA (defects in the covering of the spinal cord). Fuller research has identi?ed a range of diagnostic markers which are useful, and, in conjunction with other factors such as age, ethnic group and ultrasound ?ndings, can provide a predictive guide to the obstetrician – in consultation with the woman – as to whether or not to proceed to an invasive test. These tests include pregnancy-associated plasma protein assessed from a blood sample taken at 12 weeks and four blood tests at 15–22 weeks – alphafetol protein, beta human chorionic gonadotrophin, unconjugated oestriol and inhibin A. Ultrasound itself can reveal physical ?ndings in the fetus, which can be more common in certain abnormalities. Swelling in the neck region of an embryo in early pregnancy (increased nuchal thickness) has good predictive value on its own, although its accuracy is improved in combination with the biochemical markers. The e?ectiveness of prenatal diagnosis is rapidly evolving, the aim being to make the diagnosis as early in the pregnancy as possible to help the parents make more informed choices. MULTIPLE PREGNANCIES In the UK, one in 95 deliveries is of twins, while the prevalence of triplets is one in 10,000 and quadruplets around one in 500,000. Racial variations occur, with African women having a prevalence rate of one in 30 deliveries for twins and Japanese women a much lower rate than the UK ?gure. Multiple pregnancies occur more often in older women, and in the UK the prevalence of fertility treatments, many of these being given to older women, has raised the incidence. There is now an o?cial limit of three eggs being transferred to a woman undergoing ASSISTED CONCEPTION (gamete intrafallopian transfer, or GIFT).

Multiple pregnancies are now usually diagnosed as a result of routine ultrasound scans between 16 and 20 weeks of pregnancy. The increased size of the uterus results in the mother having more or worse pregnancy-related conditions such as nausea, abdominal discomfort, backache and varicose veins. Some congenital abnormalities in the fetus occur more frequently in twins: NEURAL TUBE defects, abnormalities of the heart and the incidence of TURNER’S SYNDROME and KLINEFELTER’S SYNDROME are examples. Such abnormalities may be detected by ultrasound scans or amniocentesis. High maternal blood pressure and anaemia are commoner in women with multiple pregnancies (see above).

The growth rates of multiple fetuses vary, but the di?erence between them and single fetuses are not that great until the later stages of pregnancy. Preterm labour is commoner in multiple pregnancies: the median length of pregnancy is 40 weeks for singletons, 37 for twins and 33 for triplets. Low birth-weights are usually the result of early delivery rather than abnormalities in growth rates. Women with multiple pregnancies require more frequent and vigilant antenatal assessments, with their carers being alert to the signs of preterm labour occurring. CEPHALOPELVIC DISPROPORTION Disparity between the size of the fetus and the mother’s pelvis is not common in the UK but is a signi?cant problem in the developing world. Disparity is classi?ed as absolute, when there is no possibility of delivery, and relative, when the baby is large but delivery (usually after a dif?cult labour) is possible. Causes of absolute disparity include: a large baby – heavier than 5 kg at birth; fetal HYDROCEPHALUS; and an abnormal maternal pelvis. The latter may be congenital, the result of trauma or a contraction in pelvic size because of OSTEOMALACIA early in life. Disproportion should be suspected if in late pregnancy the fetal head has not ‘engaged’ in the pelvis. Sometimes a closely supervised ‘trial of labour’ may result in a successful, if prolonged, delivery. Otherwise a caesarean section (see below) is necessary. UNUSUAL POSITIONS AND PRESENTATIONS OF THE BABY In most pregnant women the baby ?ts into the maternal pelvis head-?rst in what is called the occipito-anterior position, with the baby’s face pointing towards the back of the pelvis. Sometimes, however, the head may face the other way, or enter the pelvis transversely – or, rarely, the baby’s neck is ?exed backwards with the brow or face presenting to the neck of the womb. Some malpositions will correct naturally; others can be manipulated abdominally during pregnancy to a better position. If, however, the mother starts labour with the baby’s head badly positioned or with the buttocks instead of the head presenting (breech position), the labour will usually be longer and more di?cult and may require intervention using special obstetric forceps to assist in extracting the baby. If progress is poor and the fetus distressed, caesarean section may be necessary. HIV INFECTION Pregnant women who are HIV positive (see HIV; AIDS/HIV) should be taking antiviral drugs in the ?nal four to ?ve months of pregnancy, so as to reduce the risk of infecting the baby in utero and during birth by around 50 per cent. Additional antiviral treatment is given before delivery; the infection risk to the baby can be further reduced – by about 40 per cent – if delivery is by caesarean section. The mother may prefer to have the baby normally, in which case great care should be taken not to damage the baby’s skin during delivery. The infection risk to the baby is even further reduced if it is not breast fed. If all preventive precautions are taken, the overall risk of the infant becoming infected is cut to under 5 per cent.

Premature birth This is a birth that takes place before the end of the normal period of gestation, usually before 37 weeks. In practice, however, it is de?ned as a birth that takes place when the baby weighs less than 2·5 kilograms (5••• pounds). Between 5 and 10 per cent of babies are born prematurely, and in around 40 per cent of premature births the cause is unknown. Pre-eclampsia is the most common known cause; others include hypertension, chronic kidney disease, heart disease and diabetes mellitus. Multiple pregnancy is another cause. In the vast majority of cases the aim of management is to prolong the pregnancy and so improve the outlook for the unborn child. This consists essentially of rest in bed and sedation, but there are now several drugs, such as RITODRINE, that may be used to suppress the activity of the uterus and so help to delay premature labour. Prematurity was once a prime cause of infant mortality but modern medical care has greatly improved survival rates in developing countries.

Labour Also known by the traditional terms parturition, childbirth or delivery, this is the process by which the baby and subsequently the placenta are expelled from the mother’s body. The onset of labour is often preceded by a ‘show’ – the loss of the mucus and blood plug from the cervix, or neck of the womb; this passes down the vagina to the exterior. The time before the beginning of labour is called the ‘latent phase’ and characteristically lasts 24 hours or more in a ?rst pregnancy. Labour itself is de?ned by regular, painful contractions which cause dilation of the neck of the womb and descent of the fetal head. ‘Breaking of the waters’ is the loss of amniotic ?uid vaginally and can occur any time in the delivery process.

Labour itself is divided into three stages: the ?rst is from the onset of labour to full (10 cm) dilation of the neck of the womb. This stage varies in length, ideally taking no more than one hour per centimetre of dilation. Progress is monitored by regular vaginal examinations, usually every four hours. Fetal well-being is observed by intermittent or continuous monitoring of the fetal heart rate in relation to the timing and frequency of the contractions. The print-out is called a cardiotocograph. Abnormalities of the fetal heart rate may suggest fetal distress and may warrant intervention. In women having their ?rst baby (primigravidae), the common cause of a slow labour is uncoordinated contractions which can be overcome by giving either of the drugs PROSTAGLANDIN or OXYTOCIN, which provoke contractions of the uterine muscle, by an intravenous drip. Labours which progress slowly or not at all may be due to abnormal positioning of the fetus or too large a fetus, when prostaglandin or oxytocin is used much more cautiously.

The second stage of labour is from full cervical dilation to the delivery of the baby. At this stage the mother often experiences an irresistible urge to push the baby out, and a combination of strong coordinated uterine contractions and maternal e?ort gradually moves the baby down the birth canal. This stage usually lasts under an hour but can take longer. Delay, exhaustion of the mother or distress of the fetus may necessitate intervention by the midwife or doctor. This may mean enlarging the vaginal opening with an EPISIOTOMY (cutting of the perineal outlet – see below) or assisting the delivery with specially designed obstetric forceps or a vacuum extractor (ventouse). If the cervix is not completely dilated or open and the head not descended, then an emergency caesarean section may need to be done to deliver the baby. This procedure involves delivering the baby and placenta through an incision in the mother’s abdomen. It is sometimes necessary to deliver by planned or elective caesarean section: for example, if the placenta is low in the uterus – called placenta praevia – making a vaginal delivery dangerous.

The third stage occurs when the placenta (or afterbirth) is delivered, which is usually about 10–20 minutes after the baby. An injection of ergometrine and oxytocin is often given to women to prevent bleeding.

Pain relief in labour varies according to the mother’s needs. For uncomplicated labours, massage, reassurance by a birth attendant, and a warm bath and mobilisation may be enough for some women. However, some labours are painful, particularly if the woman is tired or anxious or is having her ?rst baby. In these cases other forms of analgesia are available, ranging from inhalation of NITROUS OXIDE GAS, injection of PETHIDINE HYDROCHLORIDE or similar narcotic, and regional local anaesthetic (see ANAESTHESIA).

Once a woman has delivered, care continues to ensure her and the baby’s safety. The midwives are involved in checking that the uterus returns to its normal size and that there is no infection or heavy bleeding, as well as caring for stitches if needed. The normal blood loss after birth is called lochia and generally is light, lasting up to six weeks. Midwives o?er support with breast feeding and care of the infant and will visit the parents at home routinely for up to two weeks.

Some complications of labour All operative deliveries in the UK are now done in hospitals, and are performed if a spontaneous birth is expected to pose a bigger risk to the mother or her child than a specialist-assisted one. Operative deliveries include caesarean section, forceps-assisted deliveries and those in which vacuum extraction (ventouse) is used. CAESAREAN SECTION Absolute indications for this procedure, which is used to deliver over 15 per cent of babies in Britain, are cephalopelvic disproportion and extensive placenta praevia, both discussed above. Otherwise the decision to undertake caesarean section depends on the clinical judgement of the specialist and the views of the mother. The rise in the proportion of this type of intervention (from 5 per cent in the 1930s to its present level of over 23 per cent

P

of the 600,000 or so annual deliveries in England) has been put down to defensive medicine

– namely, the doctor’s fear of litigation (initiated often because the parents believe that the baby’s health has suffered because the mother had an avoidably di?cult ‘natural’ labour). In Britain, over 60 per cent of women who have had a caesarean section try a vaginal delivery in a succeeding pregnancy, with about two-thirds of these being successful. Indications for the operation include:

absolute and relative cephalopelvic disproportion.

placenta previa.

fetal distress.

prolapsed umbilical cord – this endangers the viability of the fetus because the vital supply of oxygen and nutrients is interrupted.

malpresentation of the fetus such as breech or transverse lie in the womb.

unsatisfactory previous pregnancies or deliveries.

a request from the mother.

Caesarean sections are usually performed using regional block anaesthesia induced by a spinal or epidural injection. This results in loss of feeling in the lower part of the body; the mother is conscious and the baby not exposed to potential risks from volatile anaesthetic gases inhaled by the mother during general anaesthesia. Post-operative complications are higher with general anaesthesia, but maternal anxiety and the likelihood that the operation might be complicated and di?cult are indications for using it. A general anaesthetic may also be required for an acute obstetric emergency. At operation the mother’s lower abdomen is opened and then her uterus opened slowly with a transverse incision and the baby carefully extracted. A transverse incision is used in preference to the traditional vertical one as it enables the woman to have a vaginal delivery in any future pregnancy with a much smaller risk of uterine rupture. Women are usually allowed to get up within 24 hours and are discharged after four or ?ve days. FORCEPS AND VENTOUSE DELIVERIES Obstetric forceps are made in several forms, but all are basically a pair of curved blades shaped so that they can obtain a purchase on the baby’s head, thus enabling the operator to apply traction and (usually) speed up delivery. (Sometimes they are used to slow down progress of the head.) A ventouse or vacuum extractor comprises an egg-cup-shaped metal or plastic head, ranging from 40 to 60 mm in diameter with a hollow tube attached through which air is extracted by a foot-operated vacuum pump. The instrument is placed on the descending head, creating a negative pressure on the skin of the scalp and enabling the operator to pull the head down. In mainland Europe, vacuum extraction is generally preferred to forceps for assisting natural deliveries, being used in around 5 per cent of all deliveries. Forceps have a greater risk of causing damage to the baby’s scalp and brain than vacuum extraction, although properly used, both types should not cause any serious damage to the baby.

Episiotomy Normal and assisted deliveries put the tissues of the genital tract under strain. The PERINEUM is less elastic than the vagina and, if it seems to be splitting as the baby’s head

moves down the birth canal, it may be necessary to cut the perineal tissue – a procedure called an episiotomy – to limit damage. This is a simple operation done under local anaesthetic. It should be done only if there is a speci?c indication; these include:

to hasten the second stage of labour if the fetus is distressed.

to facilitate the use of forceps or vacuum extractor.

to enlarge a perineum that is restricted because of unyielding tissue, perhaps because of a scar from a previous labour. Midwives as well as obstetricians are trained

to undertake and repair (with sutures) episiotomies.

(For organisations which o?er advice and information on various aspects of childbirth, including eclampsia, breast feeding and multiple births, see APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELF-HELP.)... pregnancy and labour

Salpingitis

Inflammation situated in the FALLOPIAN TUBES; these run from the OVARIES to the UTERUS and carry the ova or eggs. The disorder is commonly caused by infection spreading upwards from the VAGINA, cervix or uterus. It is one feature of PELVIC INFLAMMATORY DISEASE (PID). Salpingitis is potentially serious and requires treatment with antibiotics and sometimes surgery to drain any PUS or, in persistent infections, to remove the Fallopian tubes.... salpingitis

Coconut

See also Nuts.

Nutritional Profile Energy value (calories per serving): High Protein: Low Fat: High Saturated fat: High Cholesterol: None Carbohydrates: Low Fiber: High Sodium: Low Major vitamin contribution: B vitamins, vitamin C Major mineral contribution: Iron, potassium, phosphorus

About the Nutrients in This Food Coconut is high in fiber, but its most plentiful nutrient is fat, the oil that accounts for 85 percent of the calories in coconut meat. Coconut oil, which is 89 percent saturated fatty acids, is the most highly saturated dietary fat (see but ter, v egeta ble oils). One piece of fresh coconut, 2” × 2”× 1/2”, has four grams dietar y fiber and 15 g fat (13 g saturated fat, 0.6 g monounsaturated fat, 0.2 g polyunsaturated fat). Like other nuts and seeds, coconut is a good source of some minerals, including 1.1 mg iron (6 percent of the R DA for a woman, 14 percent of the R DA for a man), 0. 5 mg zinc (6 percent of the R DA for a woman, 5 percent of the R DA for a man), and 4. 5 mg selen ium ( 8 percent of the R DA).

The Most Nutritious Way to Serve This Food In small servings, as a condiment.

Diets That May Restrict or Exclude This Food Low-fat diet Low-fiber, low-residue diet

Buying This Food Look for: Coconuts that are heavy for their size. You should be able to hear the liquid sloshing around inside when you shake a coconut; if you don’t, the coconut has dried out. Avoid nuts with a wet “eye” (the dark spots at the top of the nut) or with mold anywhere on the shell.

Storing This Food Store whole fresh coconuts in the refrigerator and use them within a week. Shredded fresh coconut should be refrigerated in a covered container and used in a day or so while it is still fresh and moist. Refrigerate dried, shredded coconut in an air- and moistureproof container once you have opened the can or bag.

Preparing This Food Puncture one of the “eyes” of the coconut with a sharp, pointed tool. Pour out the liquid. Then crack the coconut by hitting it with a hammer in the middle, where the shell is widest. Continue around the nut until you have cracked the shell in a circle around the middle and can separate the two halves. Pry the meat out of the shell. To shred coconut meat, break the shell into small pieces, peel off the hard shell and the brown papery inner covering, then rub the meat against a regular food grater.

What Happens When You Cook This Food Toasting caramelizes sugars on the surface of the coconut meat and turns it golden. Toasting also reduces the moisture content of the coconut meat, concentrating the nutrients.

How Other Kinds of Processing Affect This Food Drying. Drying concentrates all the nutrients in coconut. Unsweetened dried shredded coconut has about twice as much protein, fat, carbohydrate, iron, and potassium as an equal amount of fresh coconut. (Sweetened dried shredded coconut has six times as much sugar.) Coconut milk and cream. Coconut cream is the liquid wrung out of fresh coconut meat; coco- nut milk is the liquid wrung from fresh coconut meat that has been soaked in water; coconut water is the liquid in the center of the whole coconut. Coconut milk and cream are high in fat, coconut water is not. All coconut liquids should be refrigerated if not used immediately.

Adverse Effects Associated with This Food Increased risk of cardiovascular disease. Foods high in saturated fats increase the risk of heart attack from clogged arteries. Allergic reaction. According to the Merck Manual, nuts are one of the 12 foods most likely to trigger the classic food allergy symptoms: hives, swelling of the lips and eyes, and upset stomach. The others are berries (blackberries, blueberries, raspberries, strawberries), choco- late, corn, eggs fish, legumes (green peas, lima beans, peanuts, soybeans), milk, peaches, pork, shellfish, and wheat (see wheat cer ea ls).... coconut

Sex Hormones

These HORMONES control the development of primary and secondary sexual characteristics. They also regulate sex-related functions – for example, menstruation and the production of sperm and eggs. The three main types of sex hormone are androgens, or male sex hormones (see ANDROGEN); OESTROGENS, or female sex hormones; and progesterones, which are involved in pregnancy (see PROGESTERONE).... sex hormones

Vegetarianism

Restriction of one’s diet, for health, cultural or humanitarian reasons, to foods of fruit or vegetable origin. Most vegetarians, while excluding meat and ?sh from their diets, include foods of animal origin, such as milk, cheese, eggs, and butter. Such a diet should supply an adequate balance of nutrients, although people with special dietary requirements – such as pregnant or feeding mothers, and very strict vegetarians – may require dietary supplements (see APPENDIX

5: VITAMINS).... vegetarianism

Viviparous

A term used to describe animal groups – including most mammals – in which the embryos (see EMBRYO) develop inside the mother’s body with the young being born alive (in contrast to, say, birds and reptiles which hatch from eggs).... viviparous

Corn

(Hominy) See also Flour, Vegetable oils, Wheat cereals.

Nutritional Profile Energy value (calories per serving): Moderate Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Vitamin A (in yellow corn), B vitamins, vitamin C Major mineral contribution: Potassium

About the Nutrients in This Food Like other grains, corn is a high-carbohydrate, high-fiber food. Eighty-one percent of the solid material in the corn kernel consists of sugars, starch, and dietary fiber, including insoluble cellulose and noncarbohydrate lignin in the seed covering and soluble pectins and gums in the kernel.* Corn has small amounts of vitamin A, the B vitamin folate, and vitamin C. Corn is a moderately good source of plant proteins, but zein (its major protein) is deficient in the essential amino acids lysine, cystine, and tryptophan. Corn is low in fat and its oils are composed primarily of unsaturated fatty acids. Yellow corn, which gets its color from the xanthophyll pigments lutein and zeaxanthin plus the vitamin A-active pigments carotene and cryptoxanthin, contains a little vitamin A; white corn has very little. One fresh ear of yellow corn, 5.5– 6.5 inches long, has three grams dietar y fiber, one gram fat (0.1 g saturated fat, 0.3 g monounsaturated fat, 0.4 mg polyunsaturated fat), 137 IU vitamin A (6 percent of the R DA for a woman, 5 percent of the R DA for a man), 34 mcg folate (9 percent of the R DA), and 5 mg vitamin C (7 percent of the R DA for a woman, 6 percent of the R DA for a man). * The most plent iful sugar in sweet corn is glucose; hydrolysis (chemical splitt ing) of corn starch is t he principal indust rial source of glucose. Since glucose is less sweet t han sucrose, sucrose and fructose are added to commercial corn syrup to make it sweeter.

The Most Nutritious Way to Serve This Food With beans (which are rich in lysine) or milk (which is rich in lysine and tryptophan), to complement the proteins in corn. With meat or a food rich in vitamin C, to make the iron in corn more useful.

Diets That May Restrict or Exclude This Food Low-fiber diet

Buying This Food Look for: Cobs that feel cool or are stored in a refrigerated bin. Keeping corn cool helps retain its vitamin C and slows the natural conversion of the corn’s sugars to starch. Choose fresh corn with medium-sized kernels that yield slightly when you press them with your fingertip. Very small kernels are immature; very large ones are older and will taste starchy rather than sweet. Both yellow and white kernels may be equally tasty, but the husk of the corn should always be moist and green. A dry yellowish husk means that the corn is old enough for the chlorophyll pigments in the husk to have faded, letting the carotenes underneath show through.

Storing This Food Refrigerate fresh corn. At room temperature, fresh-picked sweet corn will convert nearly half its sugar to starch within 24 hours and lose half its vitamin C in four days. In the refrigera- tor, it may keep all its vitamin C for up to a week and may retain its sweet taste for as long as ten days.

Preparing This Food Strip off the husks and silk, and brush with a vegetable brush to get rid of clinging silky threads. R inse the corn briefly under running water, and plunge into boiling water for four to six minutes, depending on the size of the corn.

What Happens When You Cook This Food Heat denatures (breaks apart) the long-chain protein molecules in the liquid inside the corn kernel, allowing them to form a network of protein molecules that will squeeze out moisture and turn rubbery if you cook the corn too long. Heat also allows the starch granules inside the kernel to absorb water so that they swell and eventually rupture, releasing the nutrients inside. When you cook corn, the trick is to cook it just long enough to rupture its starch granules while keeping its protein molecules from turning tough and chewy. Cooking fresh corn for several minutes in boiling water may destroy at least half of its vitamin C. At Cornell University, food scientists found that cooking fresh corn in the microwave oven (two ears/without water if very fresh/4 minutes/600 –700 watts) preserves most of the vitamin C.

How Other Kinds of Processing Affect This Food Canning and freezing. Canned corn and frozen corn both have less vitamin C than fresh- cooked corn. The vitamin is lost when the corn is heated during canning or blanched before freezing to destroy the natural enzymes that would otherwise continue to ripen it. Blanch- ing in a microwave oven rather than in boiling water can preserve the vitamin C in frozen corn (see above). Milling. Milling removes the hull and germ from the corn kernel, leaving what is called hominy. Hominy, which is sometimes soaked in wood ash (lye) to increase its calcium con- tent, can be dried and used as a cereal (grits) or ground into corn flour. Coarsely ground corn flour is called cornmeal. Processed corn cereals. All processed, ready-to-eat corn cereals are much higher in sodium and sugar than fresh corn. Added calcium carbonate. Pellagra is a niacin-deficiency disease that occurs most com- monly among people for whom corn is the staple food in a diet lacking protein foods with the essential amino acid tryptophan, which can be converted to niacin in the human body. Pellagra is not an inevitable result of a diet high in corn, however, since the niacin in corn can be made more useful by soaking the corn in a solution of calcium carbonate (lime) and water. In Mexico, for example, the corn used to make tortillas is boiled in a dilute solution of calcium carbonate (from shells or limestone) and water, then washed, drained, and ground. The alkaline bath appears to release the bound niacin in corn so that it can be absorbed by the body.

Medical Uses and/or Benefits As a wheat substitute in baking. People who are allergic to wheat or cannot tolerate the glu- ten in wheat flour or wheat cereals can often use corn flour or hominy instead. Bath powder. Corn starch, a fine powder refined from the endosperm (inner part) of the corn kernel, can be used as an inexpensive, unperfumed body or face powder. Because it absorbs oils, it is also used as an ingredient in dry shampoos.

Adverse Effects Associated with This Food Allergic reaction. According to the Merck Manual, corn is one of the 12 foods most likely to trigger the classic food allergy symptoms: hives, swelling of the lips and eyes, and upset stomach. The others are berries (blackberries, blueberries, raspberries, strawberries), choco- late, eggs, fish, legumes (green peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see wheat cer ea ls).... corn

Acid Foods

Foods that produce acid when metabolised. Ash from these foods contains sulphur, phosphoric acid and chlorine, all essential for efficient metabolism. Breads, cereals, cheese, chicken, chocolate, cocoa, coffee, cranberries, eggs, fish, flour, fowl, grain products, lentils, meats (lean), nuts, oats, oatmeal, oysters, pasta, peanuts, peanut butter, pearl barley, plums, prunes, rhubarb, rabbit, rice (white), sugar, sweet corn, tea, veal, wholemeal bread, wheatgerm. ... acid foods

Fascioliasis

Disease caused by the liver ?uke, Fasciola hepatica. This is found in sheep, cattle and other herbivorous animals, in which it is the cause of the condition known as liver rot. It measures about 35 × 13 mm, and is transmitted to humans from the infected animals by snails. In Britain it is the most common disease found in animal slaughterhouses. The danger to humans is in eating vegetables – particularly wild watercress – that have been infected by snails; there have been several outbreaks of fascioliasis in Britain due to eating contaminated wild watercress, and much larger outbreaks from the same cause have been reported in France. The disease is characterised by fever, dyspepsia (indigestion), heavy sweating, loss of appetite, abdominal pain, URTICARIA, and a troublesome cough. In the more serious cases there may be severe damage to the LIVER, with or without JAUNDICE. The diagnosis is clinched by the ?nding of the eggs of the ?uke in the stools. The two drugs used in treatment are bithionol and chloroquine. Even though many cases are quite mild and recover spontaneously, prevention is particularly important. This consists primarily of never eating wild watercress, as this is the main cause of infestation. Lettuces have also been found to be infested.... fascioliasis

Food Poisoning

This illness is characterised by vomiting, diarrhoea and abdominal pain, and results from eating food contaminated with metallic or chemical poisons, certain micro-organisms or microbial products. Alternatively, the foods – such as undercooked red kidney beans or ?sh of the scombroid family (mackerel and tuna) – may contain natural posions. Food poisoning caused by chemical or metallic substances usually occurs rapidly, within minutes or a few hours of eating. Among micro-organisms, bacteria are the leading cause of food poisoning, particularly Staphylococcus aureus, Clostridium perfringens (formerly Cl. welchii), Salmonella spp., Campylobacter jejuni, and Escherichia coli O157.

Staphylococcal food poisoning occurs after food such as meat products, cold meats, milk, custard and egg products becomes contaminated before or after cooking, usually through incorrect handling by humans who carry S. aureus. The bacteria produce an ENTEROTOXIN which causes the symptoms of food poisoning 1–8 hours after ingestion. The toxin can withstand heat; thus, subsequent cooking of contaminated food will not prevent illness.

Heat-resistant strains of Cl. perfringens cause food poisoning associated with meat dishes, soups or gravy when dishes cooked in bulk are left unrefrigerated for long periods before consumption. The bacteria are anaerobes (see ANAEROBE) and form spores; the anaerobic conditions in these cooked foods allow the germinated spores to multiply rapidly during cooling, resulting in heavy contamination. Once ingested the bacteria produce enterotoxin in the intestine, causing symptoms within 8–24 hours.

Many di?erent types of Salmonella (about 2,000) cause food poisoning or ENTERITIS, from eight hours to three days after ingestion of food in which they have multiplied. S. brendeny, S. enteritidis, S. heidelberg, S. newport and S. thompson are among those commonly causing enteritis. Salmonella infections are common in domesticated animals such as cows, pigs and poultry whose meat and milk may be infected, although the animals may show no symptoms. Duck eggs may harbour Salmonella (usually S. typhimurium), arising from surface contamination with the bird’s faeces, and foods containing uncooked or lightly cooked hen’s eggs, such as mayonnaise, have been associated with enteritis. The incidence of human S. enteritidis infection has been increasing, by more than 15-fold in England and Wales annually, from around 1,100 a year in the early 1980s to more than 32,000 at the end of the 1990s, but has since fallen to about 10,000. A serious source of infection seems to be poultry meat and hen’s eggs.

Although Salmonella are mostly killed by heating at 60 °C for 15 minutes, contaminated food requires considerably longer cooking and, if frozen, must be completely thawed beforehand, to allow even cooking at a su?cient temperature.

Enteritis caused by Campylobacter jejuni is usually self-limiting, lasting 1–3 days. Since reporting of the disease began in 1977, in England and Wales its incidence has increased from around 1,400 cases initially to nearly 13,000 in 1982 and to over 42,000 in 2004. Outbreaks have been associated with unpasteurised milk: the main source seems to be infected poultry.

ESCHERICHIA COLI O157 was ?rst identi?ed as a cause of food poisoning in the early 1980s, but its incidence has increased sharply since, with more than 1,000 cases annually in the United Kingdom in the late 1990s. The illness can be severe, with bloody diarrhoea and life-threatening renal complications. The reservoir for this pathogen is thought to be cattle, and transmission results from consumption of raw or undercooked meat products and raw dairy products. Cross-infection of cooked meat by raw meat is a common cause of outbreaks of Escherichia coli O157 food poisoning. Water and other foods can be contaminated by manure from cattle, and person-to-person spread can occur, especially in children.

Food poisoning associated with fried or boiled rice is caused by Bacillus cereus, whose heat-resistant spores survive cooking. An enterotoxin is responsible for the symptoms, which occur 2–8 hours after ingestion and resolve after 8–24 hours.

Viruses are emerging as an increasing cause of some outbreaks of food poisoning from shell?sh (cockles, mussels and oysters).

The incidence of food poisoning in the UK rose from under 60,000 cases in 1991 to nearly 79,000 in 2004. Public health measures to control this rise include agricultural aspects of food production, implementing standards of hygiene in abattoirs, and regulating the environment and process of industrial food production, handling, transportation and storage.... food poisoning

Cobalt

Trace element essential to life.

RDA – none known. Has a vital relationship with Vitamin B12, a deficiency of which causes pernicious anaemia.

Deficiency. Anaemia, bowel disorders, nervousness, poor muscle tone.

Sources. Meats, liver, kidneys, eggs. ... cobalt

Crabs

Pediculosis pubis. Pubic hair lice. STD. Contracted during intercourse, infested blankets, toilet seats.

Symptoms. Nightly itching of pubic hair due to toxin excreted by this vampire-like louse.

Treatment. Remove nits or eggs with fine tooth comb.

Topical. Tea Tree oil, neat or diluted. Camphor, tincture or liniment. Garlic, oil or lotion. Use any one, not washing off for at least 24 hours. ... crabs

Diet - Low Protein

Reduce intake of foods, taking small helpings: meat, eggs, poultry, fish, milk, cheese, dried peas and beans, pulses, nuts, bread, pasta, wheat flour.

Accept: rice, cornflour, honey, salad vegetables, all fruits, preserves. ... diet - low protein

Gamete Intrafallopian Transfer (gift)

Another method of helping infertile couples. In over half of women diagnosed as infertile, the Fallopian tubes are normal, and in many it is unknown why they cannot conceive – although some have ENDOMETRIOSIS.

Eggs are obtained and mixed with the partner’s semen, then introduced into the woman’s Fallopian tubes for fertilisation to take place. The fertilised egg travels to the uterus where IMPLANTATION occurs and pregnancy proceeds. A variation of GIFT is zygote intrafallopian transfer (ZIFT) in which early development of the fertilised eggs happens in the laboratory before the young embryo is transferred to the Fallopian tubes. GIFT is best used in couples with unexplained infertility or with minor degrees of male or female cervical factor infertility. The success rate is about 17 per cent. (See also ARTIFICIAL INSEMINATION.)... gamete intrafallopian transfer (gift)

Gene Therapy

Gene therapy is the transfer of normal GENES into a patient to combat the effects of abnormal genes which are causing disease(s). The GENETIC ENGINEERING technique used is SOMATIC cell gene therapy in which the healthy gene is put into somatic cells that produce other cells – for example, stem cells that develop into BONE MARROW. Descendants of these altered cells will be normal and, when su?cient numbers have developed, the patient’s genetic disorder should be remedied. The abnormal gene, however, will still be present in the treated individual’s germ cells (eggs or sperm) so he or she can still pass the inherited defect on to succeeding generations.

Gene therapy is currently used to treat disorders caused by a fault in a single recessive gene, when the defect can remedied by introducing a normal ALLELE. Treating disorders caused by dominant genes is more complicated. CYSTIC FIBROSIS is an example of a disease caused by a recessive gene, and clinical trials are taking place on the e?ectiveness of using LIPOSOMES to introduce the normal gene into the lungs of someone with the disorder. Trials are also underway to test the e?ectiveness of introducing tumour-suppressing genes into cancer cells to check their spread.

Gene therapy was ?rst used in 1990 to treat an American patient. Eleven European medical research councils (including the UK’s) recommended in 1988 that gene therapy should be restricted to correcting disease or defects, and that it should be limited to somatic cells. Interventions in germ-line cells (the sperm and egg) to e?ect changes that would be inherited, though technically feasible, is not allowed (see CLONING; HUMAN GENOME).... gene therapy

Gordonia Obtusa

Wall.

Family: Theaceae.

Habitat: Konkan and Western Ghats.

Folk: Miyili, Atangi, Ola, Nagette, Thorilla (Tamil Nadu).

Action: Leaves—stomachic, appetizer.

Leaves contain 0.04% alkaloid and tannic acid. The bark contains ellagic acid and coumarin.

English: Tree Cotton, Desi Cotton.

Ayurvedic: Kaarpaasi.

Siddha/Tamil: Sempartthi (Red Cotton), Sivappuparutthi.

Folk: Kapaasa.

Action: Seed—anticatarrhal (used in consumption), antigonorrhoeic (used in gleet and chronic cystitis). Root—febrifuge. Plant (especially leaf)—uterine stimulant.

The glands contain 35-50% gossy- pol, a polyphenolic toxic compound. Seeds contain 18.5-25.4% protein, 0.57-2.38% free gossypol. Gossypol is a male contraceptive. At an initial dose of 20 mg/day orally for 3 months, followed by 50-60 mg weekly maintenance dose, sperm motility is reduced initially as it inhibits important enzymes of metabolic pathways thus affecting availability of enzyme to spermatozoa. Subsequently sperm production is blocked.

Gossypol is reported to cause a transient weakness early in therapy, hy- pokalaemia and changes in ECG among other side effects.

Gossypol also assists menstrual flow and effectively inhibits eggs implantation.

Gossypol and its derivatives have been shown to have significant antimicrobial activity as well as wound healing effect. It is reported to kill herpes virus.... gordonia obtusa

Life Cycle

The stages of development through which a plant or animal passes during its life. For mosquitoes these stages are: egg, larva, pupa, adult. Normally, development of nematodes included four moults and five successive stages as follows: Adult eggs • (fourth moult) ¯ • Fourth-stage larva First-stage larva • (third moult) (first moult) • Third-stage larva ¬ Second-stage larva (second moult) Generally, there are two types of life cycle for nematodes: direct and indirect types. 1. Direct Life Cycle: requires no intermediate host, after hatching from the eggs the larvae develop in the open from free-living to infective stages and gain access to the definitive host by mouth or penetration through skin. 2. Indirect Life Cycle: requires one or two intermediate hosts for development to infective stage.... life cycle

Diet - Thin People

Often more difficult to ‘put on’ than to ‘take off’ weight. Eat plenty of carbohydrates: bread and wholemeal products. Butter, margarine and other fats, meats, eggs, cream and cheese. In order to metabolise these effectively, without kidney or liver congestion, large quantities of fresh fruits and vegetables and juices should be eaten. Increase daily Vitamin B-complex intake. See: THIN PEOPLE. ... diet - thin people

Diet - Vegan

 A vegan is a strict vegetarian who does not eat meat, fish, eggs, milk and dairy products generally, He, or she, eats no animal products at all. By selecting a number of products from the plant kingdom they claim their diet is adequate.

As the Vegan diet is deficient in Vitamin B12 which may lead to anaemia, supplements are available. Some Vegan products have this vitamin added.

Their rule is to combine legumes with other cereals, seeds or nuts at the same meal. The combination is claimed to be equal to one animal based. ... diet - vegan

Allergen

A normally harmless substance that causes an allergic reaction (see allergy) in people who have become sensitized to it.

Allergens can include foods (for example, nuts, eggs, and shellfish); inhaled substances such as pollen, house dust, and fur; and some drugs.... allergen

Pellagra

A potentially fatal nutritional disorder caused by a de?ciency of vitamin B complex (niacin). The symptoms are DERMATITIS, diarrhoea and DEMENTIA. The de?ciency occurs mainly in poor people in developing countries where maize is a prime constituent of the diet. Nicotinic acid in maize is in a bound form that the consumer cannot utilise. Further, maize is de?cient in the amino acid, tryptophan, from which the human body can make nicotinic acid (see AMINO ACIDS).

Treatment The disease is prevented or cured by adding to the diet, foods such as fresh meat, eggs, milk, liver, and yeast extracts, as well as nicotinic acid – in addition to improving the general conditions of life.... pellagra

Strongyloidiasis

This infection is caused by nematode worms of the genus Strongyloides spp. – the great majority being from S. stercoralis. This helminth is present throughout most tropical and subtropical countries; a single case report has been made in England – about an individual who had not been exposed to such an environment. Larvae usually penetrate intact skin, especially the feet (as with hookworm infection). Unlike hookworm infection, eggs mature and hatch in the lower gastrointestinal tract; thus larvae can immediately re-enter the circulation in the colo-rectum or perianal region, setting up an auto-infection cycle. Therefore, infection can continue for the remaining lifespan of the individual. Severe malnutrition may be a predisposing factor to infection, as was the case in prisoners of war in south-east Asia during World War II.

Whilst an infected patient is frequently asymptomatic, heavy infection can cause jejunal mucosal abnormalities, and an absorptive defect, with weight loss. During the migratory phase an itchy linear rash (larva currens) may be present on the lower abdomen, buttocks, and groins; this gives rise to recurrent transient itching. In an immunosuppressed individual, the ‘hyperinfection syndrome’ may ensue; migratory larvae invade all organs and tissues, including the lungs and brain. Associated with this widespread infection, the patient may develop an Enterobacteriacae spp. SEPTICAEMIA; this, together with S. stercoralis larvae, produces a MENINGOENCEPHALITIS. There is no evidence that this syndrome is more common in patients with HIV infection.

Diagnosis consists of visualisation of S. stercoralis (larvae or adults) in a jejunal biopsy-section or aspirate. Larvae may also be demonstrable in a faecal sample, especially following culture. Eosinophilia may be present in peripheral blood, during the invasive stage of infection. Chemotherapy consists of albendazole. The formerly used benzimidazole compound, thiabendazole, is now rarely prescribed in an uncomplicated infection due to unpleasant side-effects; even so, in the ‘hyperinfection syndrome’ it probably remains the more e?ective of the two compounds.... strongyloidiasis

Calcium

The body’s most abundant mineral, essential for cell function, muscle contraction, the transmission of nerve impulses, and blood clotting. Calcium phosphate is the hard basic constituent of teeth and bones. Dietary sources of calcium include dairy products, eggs, and green, leafy vegetables. Calcium uptake is facilitated by vitamin D.

The body’s calcium levels are controlled by parathyroid hormone and calcitonin.

Abnormally high levels in the blood (hypercalcaemia) or abnormally low levels (hypocalcaemia) may seriously disrupt cell function, particularly in muscles and nerves. (See also mineral supplements.)... calcium

Chigoe

A painful, itchy, pea-sized swelling caused by a sand flea that lives in sandy soil in Africa and tropical America.

The flea penetrates the skin of the feet and lays eggs.

Chigoe fleas should be removed with a sterile needle, and the wounds treated with an antiseptic.... chigoe

Clone

An exact copy.

In medicine, the term usually refers to copies of cells, genes, or organisms.

Clones of cells are all descended from one original cell.

In many types of cancer, cells are thought to be derived from one abnormal cell.

Clones of genes are duplicates of a single gene.

In research, several copies of a gene can be made to enable the gene to be studied in detail.

Clones of organisms are produced by removing the nuclei from cells of a donor individual and transplanting them into the egg cells of another individual.

When the eggs mature into living plants or animals, they are all identical to the donor.... clone

Taeniasis

A parasitic disorder caused by taeniae or tapeworms.

In the case of infestation with Taenia saginata, the host may not have any symptoms and only become aware that he or she is infested upon sight of the tapeworm – or rather, part of it – in the stools (FAECES). In the case of Taenia solium the outlook is more serious because the eggs, when swallowed, are liable to migrate into the tissues of the body (as they do in the pig) and cause hydatid cysts. If these occur in the muscles they may cause little trouble but, if they occur in the brain or liver, they can prove very serious.

Hydatid cysts often grow to a great size, budding o? smaller cysts in their interior. The symptoms produced by a hydatid cyst depend mainly upon the effects of its size and consequent pressure.

Treatment of tapeworm infestation is the administration (on a named-patient basis) of niclosamide or praziquantal. Hydatid disease is treated by surgical removal, sometimes in coordination with albendazole.... taeniasis

Cryopreservation

The preservation of living cells by freezing. The technique is used to store human eggs for in vitro fertilization, sperm for artificial insemination, or plasma and blood belonging to rare blood groups.... cryopreservation

Gamete Intrafallopian Transfer

(GIFT) A technique for assisting conception (see infertility), which can only be used if a woman has normal fallopian tubes. In , eggs are removed from an ovary during laparoscopy and mixed with sperm in the laboratory before both are introduced into a fallopian tube. A fertilized egg may then become implanted in the uterus.... gamete intrafallopian transfer

Nits

The eggs of lice. Both head lice and pubic lice produce eggs, which they stick to the base of hairs. Nits measure only about 0.5 mm in diameter. They are light brown when newly laid, and white when hatched. (See also lice; pubic lice.)... nits

Nutrition

The scientific study of food and the processes by which it is digested and assimilated.

A good diet supplies adequate but not excessive quantities of proteins, carbohydrates, fats, vitamins, minerals, dietary fibre, and water. The daily diet should include foods from each of the 4 main food groups: milk and milk products; vegetables and fruits; breads and cereals; meat, eggs, and pulses.

Personal requirements of nutrients and energy vary, depending on individual body size, age, sex, and lifestyle. For example, an average woman requires about 2,000 kcal (8,400 kJ) daily, compared with about 2,750 kcal (11,550 kJ) for an average man. (See also energy requirements.)... nutrition

Actinomycosis

A suppurative disease from hard surfaces that soften and form punctured holes in the skin (multiple sinuses). Primarily a disease of cattle (hard mouth), infectious to man. Can affect lungs, abdomen, throat and mouth. Draining fistulas and ‘holes’ produce a pus with gram positive micro- organism (actinomyces israeli) which causes abscesses and hard swellings.

Differential diagnosis: tuberculosis and cancer.

Conventional treatment: antibiotics and surgical excision.

Herbal treatment: antiseptics, anti-microbials, vulneraries. In addition to basic formula, they will be given according to the organ or system involved. for skin give basic formula.

Alternatives. Basic formula: Combine: Echinacea 4; Goldenseal 1; Yellow Dock 2. Preparations: powders, liquid extracts, tinctures; doses taken in water or honey thrice daily.

For the lungs: add Balm of Gilead 1.

For the abdomen: add Sarsaparilla 2.

For the throat: add Red Sage 2.

For the mouth: add Myrrh quarter.

Powders. 500mg (two 00 capsules or one-third teaspoon).

Liquid Extracts: mix. Dose, 15-30 drops.

Tinctures: Dose, 30-60 drops thrice daily.

Dr Finlay Ellingwood. Echinacea liquid extract: 60 drops in water every 2 hours. Where ulcerative lesions are present: 10 drops in water applied externally.

Topical:– Lotion: 1 part oil Eucalyptus to 9 parts glycerine. shake well.

Diet: The fungus is more likely to become established where health is poor. Regular raw food days. Avoid liver-clogging eggs, ham, bacon, cream and excessive cheese. ... actinomycosis

Allergy

Hypersensitiveness to a foreign protein which produces a violent reaction taking the form of asthma, hay fever, urticaria, eczema, migraine, catarrh, irritable bowel. Sensitivity covers a wide range of irritants including animal odours, pollens, insect bites. All kinds of food may be responsible: milk, eggs, pork, tomatoes, strawberries, coffee, tea, etc, also preservatives and artificial colourings.

Substances that cause allergic reactions are known as allergens. Their number are limitless. Against these, the body produces antibodies to fight off invaders. If we are allergic, such defence mechanisms over-react. The reaction has the effect of releasing various chemicals such as histamine which causes irritation and swelling of mucous membranes. Removal of dental amalgam fillings sometimes relieves.

Perhaps the most common allergy is hay fever. It is now known that most sufferers have a family

history of the complaint. Asthma is a serious form, but with the aid of certain herbs (Lobelia, etc) sufferers may lead normal lives.

Premature babies fed on cow’s milk are at risk of cow’s milk allergy with increased histamine release. (Dunn Nutrition Unit, Cambridge)

Food allergies from shell fish and cereal grain fungi are difficult to detect. A large body of opinion favours Garlic (corm, tablets or capsules), being observed that Garlic eaters seldom suffer allergies. Agrimony tea.

Skin reactions may be severe. Hives, dermatitis and blisters can be the result of allergies triggered off by insect stings or animal bites, drugs, food additives, colourings, monosodium glutamate, chocolate, wines, aspirin, penicillin and other drugs. Cytotoxic tests are made to discover foods to which a person may be allergic.

Heredity predisposes, but forms vary. A ‘nettle rash’ father may have a ‘hay fever’ son. Stress is an important factor. While allergy is not a psychosomatic disturbance, there is general agreement that emotional distress – fright, fury or fatigue – can be related. An allergy can also be due to a flaw in the immune system, the body over-reacting to an allergen. Some allergies are treated with the antihistamines of orthodox pharmacy but which may induce drowsiness.

Treatment. The phytotherapist’s primary agent is Ephedra.

Teas. Chamomile, Centuary, Elderflowers, Ground Ivy, Lime flowers, Nettles, Plantain, Red Sage. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes. 1 cup 1 to 3 times daily.

Liquid Extract. Ephedra sinica BHP (1983): Dose – 1-3ml. Thrice daily.

Tincture. Ephedra sinica BHP (1983) 1:4 in 45 per cent alcohol. Dose: 6-8ml thrice daily.

A Vogel. Devil’s Claw, thrice daily.

J. Christopher. Burdock, Marshmallow root, Parsley root.

Valerian. Add to prescription in cases of nervous hyperactivity.

Diet. Low salt, low fat, high fibre. Eggs and dairy products are known to cause allergies. Raw salad once daily. Add more protein, cooked and raw vegetables. Rice is not known to cause any allergic reactions. Supplements. Daily. Vitamin A, B-complex, Vitamin C. Bromelain, Selenium, Zinc.

Note: No animals or birds in the house. ... allergy

Pregnancy, Multiple

The presence of more than 1 fetus in the uterus. Multiple pregnancy can occur if 2 or more ova (eggs) are fertilized at the same time, or if a single fertilized egg divides early in development.

Twins occur in about 1 in 80 pregnancies, triplets in about 1 in 8,000, and quadruplets in about 1 in 73,000.

Multiple pregnancies are more common in women who are treated with fertility drugs or if a number of fertilized ova are implanted during in vitro fertilization.... pregnancy, multiple

Pubic Lice

Small, wingless insects (PHTHIRUS PUBIS) that live in the pubic hair and feed on blood. Also called crab lice or crabs, they are usually spread by sexual contact. A louse has a flattened body, up to 2 mm across. Female lice lay eggs (nits) on the hair, where they hatch about 8 days later. On men, the lice may also be found in hair around the anus, on the legs, on the trunk, and even in facial hair. The bites sometimes cause itching. Children can become infested by transmission from parents, and the lice may live on the eyelids. An insecticide lotion kills the lice and eggs.... pubic lice

Somatic

A term meaning related to the body (soma), as opposed to the mind (psyche), or related to body cells, as opposed to germ cells (eggs and sperm).

It also refers to the body wall, in contrast to visceral (of the internal organs).... somatic

Twins

Two offspring resulting from one pregnancy. Monozygotic, or identical, twins develop when a single fertilized egg divides at an early stage of development. Incomplete division of the egg results in conjoined twins (see Siamese twins). Monozygotic twins share the same placenta. Dizygotic twins develop when 2 eggs are fertilized at the same time. They each have a placenta and may be of different sexes. Twins occur in about 1 in 80 pregnancies. (See also pregnancy, multiple.)... twins

Anaemia: Haemolytic

A blood condition due to abnormal destruction of red blood cells in the spleen.

Causes: hereditary background with deficiency of cell enzymes or cell membrane weakness; wrongly matched blood transfusion, environmental chemicals, food additives, colourings, drugs, infections. Symptoms. Pale face, sore tongue, headache, dizziness, palpitations, breathlessness, angina, weakness, loss of weight and appetite, jaundice (yellow skin), feverishness, vague aches and pains, enlarged spleen and pain under left ribs.

Treatment. Under hospital supervision.

Echinacea has a long reputation for regeneration of red blood cells: experience shows it beneficial for this type of anaemia. To assist control of symptoms: Gentian, Motherwort, Mugwort, Barberry, Hops, Saw Palmetto.

Bitter herbs stimulate the stomach, liver and pancreas. By increasing the appetite they benefit digestion and are given half an hour before meals by tea or decoction: Hops, Quassia chips, Angostura, Feverfew, Bogbean.

Formula. Tea. Milk Thistle 2; Betony 1; Hops 1. Mix. 1-2 teaspoon to each cup boiling water. Infuse 5-15 minutes. 1 cup, thrice daily.

Decoction. Echinacea 1; Sarsaparilla 1; Peruvian bark half; Saw Palmetto half. Mix. 2 teaspoons to 2 cups water, simmer gently 20 minutes. Half a cup, cold, thrice daily before meals.

For weak heart add one part Hawthorn; neurasthenia (Ginkgo); swelling of ankles (Lily of the Valley); loss of hormonal balance (Ginseng).

Prognosis. Surgical removal of spleen may be necessary.

Diet. Dandelion coffee, molasses, desiccated or fresh calves’ liver. Green leafy vegetables, dried beans, apricots. Shellfish, milk, eggs, Soya, meats. Supplements. Daily. Vitamin B12 1mg; Vitamin C, 1g; Folic acid 400mcg; Floradix. ... anaemia: haemolytic

Anaemia: Sickle Cell

A form of anaemia growing into an acute social problem, affecting people of African, Asian, and Mediterranean origin. Thalassaemias are caused by defects of a gene that produces the globin part of haemoglobin. Such defects in the DNA can now be detected in the womb before birth. The name derives from sickle-shaped cells instead of circular red blood cells. Few sufferers survive beyond their 40th year.

Symptoms. Unhealthy pallor, listlessness, sore tongue, dizziness, vague aches and pains, rapid pulse and breathing, tinnitus, palpitation. The skull may be disproportionately large, resistance to infection feeble, chances of survival poor. This form of anaemia is linked with defective colour vision. Impaired liver function. Stunted growth, great pain. Sufferers have a higher risk of infection.

Malaria. Sufferers are less likely to die of malaria because their red cells do not support the growth of malaria parasites very well.

Carriers: Carriers of the sickle-cell gene can now be identified by a simple blood test.

Treatment. No specifics exist but supportive herbal treatment has been known to increase output of red cells and raise haemoglobin levels:– Red Clover flowers, Yellow Dock, Echinacea, Burdock, Wild Indigo, Gentian, Nettles, Birch leaves, Sage, Walnut leaves, Centaury, Gota Kola (Indian Pennywort). Alternatives:– Tea. Mix equal parts: Iceland Moss, Nettles, Red Clover flowers. 2 teaspoons to each cup boiling water; infuse 15 minutes; 1 cup morning and evening.

Decoction. Mix equal parts; Echinacea, Walnut leaves, Balm of Gilead buds; 1 teaspoon to each cup water gently simmered for 20 minutes. Half-1 cup, cold, 3 times daily, before meals.

Tablets/capsules. Sarsaparilla. Ginseng. Iceland Moss. Red Clover. Echinacea. Gentian.

Powders. Formula: Echinacea 1; Fringe Tree half; Ginseng half; White Poplar bark 1. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily before meals.

Liquid extracts. Formula. Echinacea 2; Dandelion 1; Oat Husk (avena sativa) 1. Mix. Dose, 1-2 teaspoons before meals, in water or one of the above teas or decoctions.

Tinctures. Same combination. Dose: 2-3 teaspoons.

Dong quai. See entry.

Pollen. Claimed to be of value.

Diet. Dandelion coffee. Molasses. Desiccated liver. Calf liver, fresh. Green leafy vegetables contain chlorophyll, iron and folic acid. Cider vinegar. Dried beans, apricots and shellfish. Dandelion leaves in salads. Milk, eggs, meats, Soya. Carrot juice to increase red cells.

Supplements. Daily. Vitamin B12. Vitamin C, 1g; Folic acid 400mcg, Floradix. Of particular value: Vitamin E 400iu. Zinc.

Note: Those at risk should submit themselves for screening. The disease cannot be cured but can be controlled largely by orthodox measures and sometimes by natural medicine. ... anaemia: sickle cell

Ascaris

n. a genus of parasitic nematode worms. A. lumbricoides, widely distributed throughout the world, is the largest of the human intestinal nematodes – an adult female measures up to 35 cm in length. Eggs, passed out in the stools, may be transmitted to a new host in contaminated food or drink. Larvae hatch out in the intestine and then undergo a complicated migration, via the hepatic portal vein, liver, heart, lungs, windpipe, and pharynx, before returning to the intestine where they later develop into adult worms (see also ascariasis).... ascaris

Clonorchis

n. a genus of liver flukes, common parasites of humans and other fish-eating mammals in the Far East. The adults of C. sinensis cause clonorchiasis. Eggs are passed out in the stools and the larvae undergo their development in two other hosts, a snail and a fish.... clonorchis

Cysticercus

(bladderworm) n. a larval stage of some *tapeworms in which the scolex and neck are invaginated into a large fluid-filled cyst. The cysts develop in the muscles or brain of the host following ingestion of tapeworm eggs. See cysticercosis.... cysticercus

Dermatobia

n. a genus of nonbloodsucking flies inhabiting lowland woods and forests of South and Central America. The parasitic maggots of D. hominis can cause a serious disease of the skin in humans (see myiasis). The maggots burrow into the skin, after emerging from eggs transported by bloodsucking insects (e.g. mosquitoes), and produce painful boil-like swellings. Treatment involves surgical removal of the maggots.... dermatobia

Echinococcus

n. a genus of small parasitic tapeworms that reach a maximum length of only 8 mm. Adults are found in the intestines of dogs, wolves, or jackals. If the eggs are swallowed by a human, who can act as a secondary host, the resulting larvae penetrate the intestine and settle in the lungs, liver, or brain to form large cysts, usually 5–10 cm in diameter (see hydatid disease). Two species causing this condition are E. granulosus and E. multilocularis.... echinococcus

Asthenia

See: WEAKNESS.

ASTHMA. Spasmodic contraction of the bronchi following exercise, emotional tension, infection, allergens, pollens, house dust, colds.

Symptoms. Obstruction of airways with wheezing, rales or whistling sounds with a sense of constriction. Often related to eczema – ‘eczema of the epithelium’. Infantile eczema treated with suppressive ointments may drive the condition ‘inwards’ and worsen asthma. “My son’s eczema has got better, but he now has asthma” is a common observation.

Causes: hypersensitivity to domestic animals, horses and pet birds. Common salt. Red or white wine allergy. An older generation of practitioners recognised a renal-bronchial asthma encouraged by faulty kidney function. With addition of a relaxing diuretic (Dandelion, Buchu or Parsley root) to a prescription, respiratory symptoms often abate.

Broncho-dilators such as Ephedra and Wild Thyme are widely used by the practitioner. To relieve spasm: Lobelia, Pleurisy root. White Horehound, Ammoniacum, Cramp bark, Garlic, Grindelia, Hyssop.

Anti-cough agents serve to remove sticky sputum: Coltsfoot, Garden Thyme, Slippery Elm bark, Maidenhair Fern, Linseed, Bayberry bark.

For the chronic asthmatic, bacterial invasion spells distress, when Echinacea or Balm of Gilead should be added. Where an irregular pulse reveals heart involvement, add: Hawthorn or Lily of the Valley.

Lobelia is of special value for the anxious patient with spasm of the bronchi. Should be tried before resorting to powerful spray mists which frequently produce gastro-intestinal disturbance.

Alternatives. Teas. Coltsfoot, Comfrey, Horehound (White), Mullein, Skullcap, Marshmallow, Thyme, Valerian, Wild Cherry bark, Elecampane, Plantain. Formula: equal parts herbs Coltsfoot, Mullein, Valerian. 1-2 teaspoons to each cup boiling water; infuse 10-15 minutes; dose, 1 cup twice daily and when necessary.

Antispasmodic Drops. See entry.

Practitioner. Ephedra, Lobelia, Gelsemium, Grindelia, Euphorbia (pill-bearing spurge), Skunk Cabbage, Senega, Pulsatilla, Lily of the Valley (cardiac asthma), Thyme. Formula. Equal parts, Tincture Lobelia simp; Tincture Belladonna; Tincture Ephedra. 5-10 drops thrice daily (maintenance), 10-20 drops for spasm.

Cockayne, Ernest, FNIMH. Hyssop tea for children throughout childhood to avoid respiratory disorders. Dr Finlay Ellingwood. Gelsemium 3.5ml; Lobelia 3.5ml. Distilled water to 120ml. One 5ml teaspoon in water every 3 hours.

Dr Alfred Vogel. Ephedra 20 per cent; Ipecac 15 per cent; Hawthorn berry 10 per cent; Blessed Thistle 5 per cent; Burnet Saxifrage 5 per cent; Garden Thyme 5 per cent; Grindelia 1 per cent. 10-15 drops in water thrice daily.

Dr Wm Thomson. 1 teaspoon Ephedra herb to cup boiling water; infuse 10-15 minutes. Half-1 cup 2-3 times daily.

Traditional. 2 teaspoons shredded Elecampane root in cup cold water; stand overnight. Next day, heat to boiling point when required. Strain. Sips, hot, with honey: 1 cup 2-3 times daily.

Potter’s Asthma & Bronchitis Compound 32. 40g medicinal teabags. Ingredients: Clove BPC 4.84 per cent; Elecampane root 17.24 per cent; Horehound 26.20 per cent; Hyssop 17.24 per cent; Irish Moss 17.24 per cent; Liquorice 17.24 per cent. Dose: 1-2 teaspoons when necessary.

Chinese Medicine. Decoction or extract from the Gingko tree widely used, as also is Ephedra, Garlic, Liquorice and Bailcalensis.

Tablets/capsules. Lobelia. Iceland Moss, (Gerard). Euphorbia (Blackmore).

Powders. Formula. Lobelia 2; Hyssop 1; Elderflowers 1; Grindelia quarter; Liquorice quarter: pinch Cayenne. Dose: 750mg (three 00 capsules or half a teaspoon) 2-3 times daily.

Aromatherapy. 6 drops Rosemary oil in 2 teaspoons Almond oil for massage upper chest to relieve congestion.

Inhalation. See: INHALATIONS, FRIAR’S BALSAM.

Nebulizer. A germicidal solution is made from 5 drops oil Eucalyptus in one cup boiling water. Use in nebulizer for droplet therapy.

Ioniser – use of.

Cider Vinegar. Sips of the vinegar in water for whoop.

Supportives. Yoga. Singing. Cures have been reported of patients on taking up singing. “During singing, up to 90 per cent of the vital capacity may be used without a conscious effort to increase tidal volume.” (Dr M. Judson, New England Journal of Medicine)

Diet. Low salt, low fat, high fibre, cod liver oil, carrots, watercress, Soya beans or flour, lecithin, sunflower seed oil, green vegetables, raw fruit, fresh fish. These foods are valuable sources of antioxidant vitamins and minerals essential for the body’s defence mechanism. A diet deficient in these reduces ability of the airways to withstand the ravages of cigarette smoke and other air pollutants.

Foods that are craved are ones often causing sensitivity. Among problem foods are: milk, corn, wheat, eggs, nuts, chocolate, all dairy products, fat of meats. Check labels for tartrazine artificial colouring.

Salt intake. Linked with chest diseases. “Those who eat a lot of salt had more sensitive airways than those with low salt intake . . . excess salt tended to cause most pronounced symptoms.” (Institute of Respiratory Diseases, Oavia, Italy)

Asthma mortality could be significantly reduced by sufferers lowering their salt consumption, an epidemiologist predicted.

Supplements. Daily. Vitamin B6 50-100mg. Vitamin C 500mg. Vitamin E 400iu. Magnesium, Zinc. Cod liver oil: 2 teaspoons.

Anti-allergic bedding. Provides a protective barrier against the house dust mite on mattresses and bedding. Droppings from the tiny pests are worse in the bedroom. ... asthenia

Essential Amino Acid

an *amino acid that is essential for normal growth and development but cannot be synthesized by the body. Essential amino acids are obtained from protein-rich foods in the diet, such as meat, fish, eggs, and dairy products. Adults require eight essential amino acids: leucine, isoleucine, valine, phenylalanine, threonine, methionine, tryptophan, and lysine. Children require an additional nine, as their body’s requirement is greater than can be synthesised by it: tyrosine, glycine, cysteine, arginine, proline, histidine, glutamine, serine, and asparagine.... essential amino acid

Heterophyiasis

n. an infestation of the small intestine with the parasitic fluke *Heterophyes heterophyes. Humans become infected on eating raw or salted fish that contains the larval stage of the fluke. The presence of adult flukes may provoke symptoms of abdominal pain and diarrhoea; if the eggs reach the brain, spinal cord, and heart (via the bloodstream) they produce serious lesions. Tetrachloroethylene may be used in treatment of the infection.... heterophyiasis

Incubator

n. a transparent container for keeping premature babies in controlled conditions and protecting them from infection. Other forms of incubator are used for cultivating bacteria in Petri dishes and for hatching eggs.... incubator

Auto Immune Disease

An abnormal reaction of the body to groups of its own cells which the immune system attacks. In a case of anaemia, it may destroy the red blood cells. Failure of the body’s tolerance mechanism.

The immune system is the body’s internal defence armoury which protects from sickness and disease. White blood cells are influenced by the thymus gland and bone marrow to become “T” lymphocytes or “B” lymphocytes which absorb and destroy bacteria. There are times when these powerful defence components inflame and attack healthy tissue, giving rise to auto immune disease which may manifest as one of the numerous anaemic, rheumatic or nervous disorders, even cancer.

A watchful eye should be kept on any sub-acute, non-specific inflammation going on quietly over a long period – a certain indication of immune-inadequacy. It would appear that some unknown body intelligence operates behind the performance of the immune system; emotional and physic stresses such as divorce or job dissatisfaction can lead to a run-down of body defences. Some psychiatrists believe it to be a self-produced phenomenon due to an unresolved sense of guilt or a dislike of self. When this happens, bacterial, virus or fungus infections may invade and spread with little effective opposition. People who are happy at their home and work usually enjoy a robust immune system.

An overactive immune system may develop arthritis with painful joint inflammation, especially with a background of a fat-rich diet. A link between silicone implants and auto-immune disease is suspected.

“There is increasing evidence,” writes Dr D. Addy, Consulting Pediatrician, “that fevers may enhance the defence mechanism against infection.” (See: FEVER) “There is also increasing evidence of a weakening of the immune system through suppression of fevers by modern drugs. In this way, aspirin and other powerful anti-inflammatories may be responsible for feeble immune response.”

White cell stimulators: Liquorice, Ginseng (Siberian), Goldenseal, Echinacea. These increase ability of white blood cells to attack bacteria and invading cells. Chinese medicine: Ginseng (men), Chinese Angelica (women).

Treatment. To strengthen body defences. Garlic, Borage, Comfrey, Agrimony, Balm, Chamomile (German), Echinacea, Horsetail, Liquorice, Lapacho, Sage, Wild Yam, Wild Indigo, Poke root, Thuja. Shiitake Mushroom. Reishi Mushroom, Chlorella..

Tea. Combine, equal parts, St John’s Wort, Borage, Chamomile (German). 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.

Powders. Combine, Echinacea 4; Comfrey root 2; Wild Yam 1. 500mg (two 00 capsules, or one-third teaspoon) thrice daily.

Tinctures. Combine, Echinacea 4; Poke root 1; Thuja 1. 1-2 teaspoons in water thrice daily.

Tincture: Tincture Myrrh BPC 1973: 5-10 drops in water, morning and evening.

Decoctions. Horse-radish. Fenugreek seeds.

Bio-strath. Yeast-based herbal tonic. Exerts a positive influence on the immune system by rapid and marked increase in white blood cells.

Diet. Foods rich in essential fatty acids: nuts, seeds, beans, pulses, Evening Primrose oil, Cod Liver oil flavoured with mint or lemon. High protein: eggs, fish. (Low protein – acute stage). Foods rich in selenium. Yoghurt, cider vinegar, pineapple juice. Sugar has an immune suppressing effect.

Supplements. To rebuild immune system. Vitamins A, B5, B6, C, D, E. Zinc is required to produce histamine which is a vasodilator. Combination: zinc, selenium and GLA. Iron. Calcium.

Aromatherapy. Lavender oil: massage or baths.

Note: An alleged link exists between silicone implants and auto-immune disease. A new study reveals evidence that women with silicone breast implants who breast-feed their children put them at risk of developing systemic sclerosis. (JAMA Jan 19 1994) ... auto immune disease

Bergamot, Red

 Bee Balm. Oswego tea. Monardo didyma L. Part used: herb.

Action: Antiseptic, Carminative, Expectorant.

Use s. Flatulence. Stomach cramp. Intestinal colic. Weak digestion. Nausea. Headache. menstruation.

Preparation. Tea. 1 teaspoon to each cup boiling water; infuse 5-10 minutes. Half-1 cup as necessary. Bergamot imparts the distinctive flavour to Earl Grey tea.

Aromatherapy. Diluted oil for shingles: 6 drops to 2 teaspoons Almond oil as a soothing lotion.

BERI BERI. A disease caused by a deficiency of thiamine (Vitamin B1) by eating polished rice from which the husk (in which the vitamin is found) is discarded. Others at risk from Vitamin B1 deficiency are alcoholics, hypothyroids, pregnant women and those with a high intake of refined sugar but a low intake of fresh fruits and vegetables. Heavy coffee drinkers suffer temporary wastage.

Symptoms: weight loss, poor appetite, loss of sensation in arms and legs. Polyneuritis, muscular atrophy. Mood changes.

Painful Of value. Slippery Elm. Dandelion. Alfalfa sprouts or tea. Psyllium husks.

Diet. Vitamin B1 is present in green vegetables, eggs, meat, nuts, yeast, natural unprocessed brown rice, cereal germ and husks, oatmeal, peas, beans, asparagus, brewer’s yeast, desiccated liver.

Supplements. Vitamin B-complex. Vitamins B1 and C. ... bergamot, red

Miracidium

n. (pl. miracidia) the first-stage larva of a parasitic *fluke. Miracidia hatch from eggs released into water with the host’s excreta. They have *cilia and swim about until they reach a snail. The miracidia then bore into the snail’s soft tissues and there continue their development as *sporocysts.... miracidium

Mmr Vaccine

a combined vaccine against measles, mumps, and German measles (rubella). It is currently recommended that this vaccine is given to all children at 12 months of age with a booster dose at 3 years 4 months of age or soon after (see immunization). Specific contraindications include immunosuppression and allergy to eggs. Claims of a link between the vaccine and autism and Crohn’s disease have been investigated and no credible evidence for such a relationship has been found.... mmr vaccine

Nematode

(roundworm) n. any one of a large group of worms having an unsegmented cylindrical body, tapering at both ends. This distinguishes nematodes from other *helminths. Nematodes occur either as free-living forms in the sea, fresh water, and soil or as parasites of plants, animals, and humans. *Hookworms and *threadworms infest the alimentary canal. *Filariae are found in the lymphatic tissues. The *guinea worm and *Onchocerca affect connective tissue. Some nematodes (e.g. threadworms) are transmitted from host to host by the ingestion of eggs; others (e.g. *Wuchereria) by the bite of a bloodsucking insect.... nematode

Bilharzia

Schistosomiasis. One of the serious diseases of the tropics, caused by schistosomes, or blood flukes. Goes back into Egyptian history by 3,000 years when it was referred to as ‘blood in the urine’ (haematuria).

Bilharzial calcified eggs have been found in the rectum and bladder of mummified bodies. There is evidence that they received treatment with the plants Valerian and Hyoscyamus. Today, Poke root is favoured.

More than 300 million people are infected. Cure is difficult, in spite of our greater knowledge. No natural medicine has yet been discovered to kill the parasite worms except deep-acting poisons: Antimony (tartar emetic).

Causative organism pierces the skin or mucous membranes of walkers, swimmers, or farmers wading in contaminated water.

Medicinal plants are used, with varying degrees of success to discourage the flukes from invading the host and to make good their depredations.

Anti-Bilharzials – Gum arabic, Cannabis sativa (hemp), Citrullus colocynthis, Citric acid (from lemons), Cyperus esculentus, Douma thebaica, Hordeum vulgare (Barley), Phoenix dactylifera, Ricinus communis (Castor oil), Thymus capitata (Thyme), Vitis vinifera (Grapes), Pistacea terebinthus (the Mastic Tree), Morus nigra (fresh fruits, root bark and leaves of the Mulberry Tree), Ficus carica (Common Fig), Thymus vulgaris (Thyme similar to English Garden Thyme). Later in history these remedies were joined by Ginger and Ambrosia artemisia. (Samir Yahia El-Gammal, MD, in “Medical Times”, Journal for the Promotion of Eastern Medicine. Hamdard Centre, Nazimabad, Karachi, Pakistan. Vol XIX, Winter 1984)

Ginger, powdered root and aqueous extract, prevents hatching of schistosome eggs in host. In trials with schoolchildren, bloody urine stopped and egg count in the urine dropped. (Kucera et al., 1975; Theakston et al., 1975)

CORIANDER SEED. Tea. Original research, Lawrence D. Hills, Henry Doubleday Research Association.

Note: Berries of a native Ethiopian plant, the endod or Soapberry (Phytolacca dodecandra) contain a potent toxin that can, in minute quantities, kill the snails carrying the schistosomes. (New Scientist, 1989, No 1690, p21)

To be treated by or in liaison with a general medical practitioner. ... bilharzia

Bright’s Disease (chronic)

Chronic glomerulonephritis. The final stage. May follow the sub- acute stage or repeated attacks of the acute stage. Kidneys small and white due to scar tissue. Amount of urine passed is considerably increased, pale and low specific gravity. Kidneys ‘leak’ protein in large quantities of water passed, their efficiency as filters greatly impaired. Tissues of eyelids and ankles waterlogged. Symptoms include loin pain, anaemia, loss of weight, progressive kidney damage.

A constant fear is the onset of uraemia caused by accumulation in the blood of waste by-products of protein digestion, therefore the patient should reject meat in favour of fish. Eggs and dairy products taken in strict moderation.

Where urea accumulates in the circulation ‘sustaining’ diuretics are indicated; these favour excretion of solids without forcing the discharge of more urine: including Shepherd’s Purse, Gravel root, or Uva Ursi when an astringent diuretic is needed for a show of blood in the urine. According to the case, other agents in common practice: Dandelion root, Yarrow, Hawthorn, Marigold, Stone root, Hydrangea. Parsley Piert, Buchu, Hawthorn, Golden Rod.

The patient will feel the cold intensely and always be tired. Warm clothing and ample rest are essential. Heart symptoms require treatment with Lily of the Valley or Broom.

This condition should be treated by or in liaison with a qualified medical practitioner.

Treatment. As kidney damage would be established, treatment would be palliative; efforts being to relieve strain and obtain maximum efficiency. There may be days of total bed-rest, raw foods and quiet. Consumption of fluids may not be as abundant as formerly. Soothing herb teas promote well-being and facilitate elimination. Oil of Juniper is avoided.

Efforts should be made to promote a rapid absorption – to restore the balance between the circulation and the lymphatics. For this purpose Mullein is effective. A few grains of Cayenne or drops of Tincture Capsicum enhances action.

Indicated. Antimicrobials, urinary antiseptics, diuretics, anti-hypertensives. For septic conditions add Echinacea.

Of Therapeutic Value. Alfalfa, Broom, Buchu, Couchgrass, Cornsilk, Dandelion, Lime flowers, Marigold, Mullein, Marshmallow, Parsley Piert, Periwinkle (major), Wild Carrot, Water Melon seed tea. Tea. Combine equal parts: Couchgrass, Dandelion, Mullein. 2 teaspoons to each cup boiling water. Infuse 5-15 minutes. 1 cup freely.

Powders. Combine equal parts: Stone root, Hydrangea, Hawthorn. Dose: 500mg (two 00 capsules or one-third teaspoon) 3 or more times daily in water or cup Cornsilk tea. A few grains Cayenne enhances action. Formula. Buchu 2; Mullein 2; Echinacea 1; Senna leaves half. Mix. Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water or cup Cornsilk tea 3 or more times daily. 2-3 drops Tincture Capsicum to each dose enhances action.

Diffusive stimulant for the lymphatic vessels. Onion milk is an effective potassium-conserving diuretic and diaphoretic. Onions are simmered gently in milk for 2 hours and drunk when thirsty or as desired – a welcome alternative to water. May be eaten uncooked.

Diet. Salt-free, low fat, high protein. Spring water. Raw goat’s milk, potassium broth. Fish oils. Avoid eggs and dairy products. No alcohol.

Supplements. Vitamins A, B-complex, C plus bioflavonoids, B6, D, E, Magnesium, Lecithin. Herbal treatment offers a supportive role. ... bright’s disease (chronic)

Nit

n. the egg of a *louse. The eggs of head lice are firmly cemented to the hair, usually at the back of the head; those of body lice are fixed to the clothing. Nits, 0.8 × 0.3 mm, are visible as light white specks.... nit

Nymph

n. 1. an immature stage in the life history of certain insects, such as grasshoppers and *reduviid bugs. On emerging from the eggs, nymphs resemble the adult insects except that they are smaller, do not have fully developed wings, and are not sexually mature. 2. the late larval stage of a tick.... nymph

Paragonimus

n. a genus of large tropical parasitic *flukes that are particularly prevalent in the Far East. The adults of P. westermani live in the human lungs, where they cause destruction and bleeding of the tissues (see paragonimiasis). However, they may also be found in other organs of the body. Eggs are passed out in the sputum and the larvae undergo their development in two other hosts, a snail and a crab.... paragonimus

Candida, Vaginal

 Fungus infection by Candida albicans and other organisms including Torilopsis glabrala. Causes: oral contraceptives, broad spectrum antibiotics, iron deficiency anaemia, diabetes, steroid therapy, pregnancy, high sugar diet, alcohol. When sexually transmitted may appear together with mixed organisms which prove difficult to eliminate.

Greater incidence of the condition is found in women. By interfering with the hormone balance The Pill raises the female body to a constant state of false pregnancy. This affects the character of vaginal secretions and favours growth of fungi. Oestrogens in contraceptive pills create a tissue climate conducive to Candida. Vaginal deodorants and scented soaps irritate. Because of its effect upon the Fallopian tubes it is a common cause of infertility.

Symptoms. Vulva itching, soreness, white discharge of watery to cheesy consistency. Urination painful, recurring cystitis, irritability, premenstrual and menstrual problems, anxiety, heartburn and dyspepsia. Alternatives. Teas. Agnus Castus, Balm, Barberry bark, Chamomile, La Pacho (Pau d’arco), Sage, Thyme.

Tablets/capsules. Agnus Castus, Goldenseal, Pulsatilla, Poke root, Thuja, Garlic, La Pacho.

Tincture Thuja. 15-30 drops in water, once daily.

Tinctures. Combination for the average case. Echinacea 30ml; Calendula 15ml; Goldenseal 15ml; Ladysmantle 15ml. Dose: one 5ml teaspoon thrice daily. (Brenda Cooke MNIMH, Mansfield, Notts) Topical. Tea Tree oil pessaries/cream. Alternative:– (1) Impregnate tampon with plain yoghurt and insert into vagina. Or: inject with spermicidal cream applicator or cardboard tampon applicator 2-3 teaspoons yoghurt into vagina 2-3 times daily. The theory is that the lacto-bacilli in the yoghurt competes with the candida and finally reduces it to normal levels.

(2) 2-3 teaspoons Distilled Extract Witch Hazel to cup of water for cooling antiseptic lotion.

(3) 1-2 drops Eucalyptus oil well-shaken in 4oz (120ml) Distilled Extract Witch Hazel. Reputed to kill colonies of candida albicans and allay irritation.

(4) Aloe Vera gel.

(5) Capricin.

(6) Cloves are anti-fungal and may be chewed.

(7) Calendula and Hydrastis pessaries.

Avoid surgical spirit antiseptics. A smear of Olive oil or yoghurt or No 3 above to allay irritation. Frequent washing, hot baths and use of soap at first soothe, but later exacerbate. Use water only. When washing, wipe from front to back to avoid spreading spores from bowel. No smoking.

Diet. Gluten-free, low fat, high fibre.

Acidophilus. A large mixed salad once daily. Cooked vegetables, seafood, Vitamin A foods. Replace salt with Celery, Garlic or Kelp powders. All meats, game and chicken to be from animals raised on steroid-free fodder. Replace alcohol with fresh fruit and vegetable juices. Eggs.

Reject: Dairy products (butter, cheese, milk). Brewer’s yeast. Foods and drinks with which yeast has been associated: bread, beer, homemade wines. Dried fruit, mushrooms, monosodium glutamate, pickles and preserves, smoked fish and meats, foods known to be allergic to the patient, sugar, syrup, sweeteners, chocolate, puddings, pastry, white flour products.

Supplements. Daily. Vitamin A 7500iu, Vitamin C 200mg. Zinc. ... candida, vaginal

Cellulite

Not a medical term. Puffy skin from deposition of fat. “Orange peel skin”. Occurs chiefly in women as lumpy flesh on buttocks, thighs, stomach, knees and upper arm. Though not due to increased fluid in the tissues, it is sufficient to arrest the circulation. Constriction of capillaries causes toxic wastes to build up, forming nodules that lock away fat in the tissues. Hormone imbalance also suspected. Varicose veins may appear with cellulite from poorly supportive connective tissue. Usual cause: poor posture and unhealthy lifestyle.

Treatment. To activate capillary function and assist toxic elimination: Bladderwrack, Gotu Kola, Kola, Parsley tea. A diuretic may assist by eliminating excess fluid.

Gotu Kola tea: Quarter to half a teaspoon leaves to each cup boiling water; infuse 5-10 minutes. 1 cup morning and evening.

Formula. Tea. Equal parts: Alfalfa, Clivers, Fennel, Senna leaves. 1 heaped teaspoon to each cup boiling water: infuse 5-10 minutes. Half-1 cup morning and evening.

Seline. Tablets. Ingredients: Each tablet contains Lecithin 100mg; Pulverised Dandelion 100mg; Pulverised Horsetail 100mg; Pulverised extract Fucus 5:1 30mg; Vitamin C 40mg; Vitamin B6 1mg. 1 tablet thrice daily.

Aescin. Compound isolated from Horse-chestnuts to decrease capillary permeability and swelling. Topical. Decoction of Horse-chestnuts as a lotion. Or: infusion of Bladderwrack.

Aromatherapy and Herb essences. Combination for external use. Ingredients: Almond oil 47ml; Fennel oil 1ml; Juniper oil 1ml; Cypress essence 0.5ml; Lemon essence 0.5ml. Apply to affected areas morning and evening; small area 5 drops, large area 10 drops (Gerard). Gentle massage with a string glove, loofah or massage glove.

Diet. Reduce calorie intake. Raw fresh fruits and vegetable salads to account for 50 per cent of the diet. No sweet or dried fruits. Conservatively-cooked vegetables. Seafood. Iodine-rich foods. Wholegrain cereals. Protein: beans, chicken, poached eggs, fish, little lean meat: no pork, bacon or ham. Low-fat yoghurt. Cold-pressed unsaturated oils for salad dressings with lemon juice. Dandelion coffee to stimulate liver. Avoid sugar, alcohol, bananas and white flour products. Spring water.

Supportives. Stop smoking. Adopt an alternative to the contraceptive pill. To avoid fluid retention, 2-3 glasses of water daily. ... cellulite

Porocephaliasis

n. a rare infestation of the nasal cavities, windpipe, lungs, liver, or spleen by the nymphs of the parasitic arthropod *Porocephalus. Humans become infected on consumption of water or uncooked vegetables contaminated with the parasite’s eggs. There may be some abdominal pain while the parasite is in the gut but in many cases there are no symptoms.... porocephaliasis



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