Excretion: From 3 Different Sources
Discharge of waste material from the body, including the by-products of digestion, waste products from the repair of tissues, and excess water.
The kidneys excrete excess nitrogen in the urine in the form of urea, along with excess water, salts, some acids, and most drugs.
The liver excretes bile, which contains waste products and bile pigments formed from the breakdown of red blood cells.
Some of the bile is passed from the body in the faeces.
The large intestine excretes undigested food, some salts, and excess water in the form of faeces.
The lungs discharge carbon dioxide and water vapour into the air.
Sweat glands excrete salt and water onto the surface of the skin as a method of regulating the body’s temperature.
The process by which the residue of undigested food in the gastrointestinal tract (faeces) and the waste products of the body’s metabolism – mainly as urine via the kidneys, but also as sweat from the skin, and water and carbon dioxide from the lungs – are eliminated.
n. the removal of the waste products of metabolism from the body, mainly through the action of the *kidneys. Excretion also includes the loss of water, salts, and some urea through the sweat glands and carbon dioxide and water vapour from the lungs, and the term is also used to include the egestion of faeces.
The way in which the body deals with a drug. This includes the drug’s absorption, distribution in the tissues, METABOLISM, and excretion.... pharmacokinetics
A benzoic-acid derivative which interferes with the excretion by the KIDNEYS of certain compounds, including PENICILLIN and PARA-AMINO SALICYLIC ACID. Probenecid and was originally introduced into medicine for this reason, as a means of increasing and maintaining the concentration of penicillin in the body; it is also used to treat chronic GOUT.... probenecid
Commonly called sweat, it is an excretion from the SKIN, produced by microscopic sweat-glands, of which there are around 2·5 million, scattered over the surface. There are two di?erent types of sweat-glands, known as eccrine and apocrine. Insensible (that is unnoticed) perspiration takes place constantly by evaporation from the openings of the sweat-glands, well over a litre a day being produced. Sensible perspiration (that is, obvious) – to which the term ‘sweat’ is usually con?ned – occurs with physical exertion and raised body temperature: up to 3 litres an hour may be produced for short periods. Normal sweating maintains the body within its customary temperature range and ensures that the skin is kept adequately hydrated – for example, properly hydrated skin of the palm helps the e?ectiveness of a person’s normal grip.
The chief object of perspiration is to maintain an even body temperature by regulating the heat lost from the body surface. Sweating is therefore increased by internally produced heat, such as muscular activity, or external heat. It is controlled by two types of nerves: vasomotor, which regulate the local blood ?ow, and secretory (part of the sympathetic nervous system) which directly in?uence secretion.
Eccrine sweat is a faintly acid, watery ?uid containing less than 2 per cent of solids. The eccrine sweat-glands in humans are situated in greatest numbers on the soles of the feet and palms of the hands, and with a magnifying glass their minute openings or pores can be seen in rows occupying the summit of each ridge in the skin. Perspiration is most abundant in these regions, although it also occurs all over the body.
Apocrine sweat-glands These start functioning at puberty and are found in the armpits, the eyelids, around the anus in association with the external genitalia, and in the areola and nipple of the breast. (The glands that produce wax in the ear are modi?ed apocrine glands.) The ?ow of apocrine sweat is evoked by emotional stimuli such as fear, anger, or sexual excitement.
Abnormalities of perspiration Decreased sweating may occur in the early stages of fever, in diabetes, and in some forms of glomerulonephritis (see KIDNEYS, DISEASES OF). Some people are unable to sweat copiously, and are prone to HEAT STROKE. EXCESSIVE SWEATING, OR HYPERIDROSIS, may be caused by fever, hyperthyroidism (see THYROID GLAND, DISEASES OF), obesity, diabetes mellitus, or an anxiety state. O?ensive perspiration, or bromidrosis, commonly occurs on the hands and feet or in the armpits, and is due to bacterial decomposition of skin secretions. A few people, however, sweat over their whole body surface. For most of those affected, it is the palmar and/or axillary hyperhidrosis that is the major problem.
Conventional treatment is with an ANTICHOLINERGIC drug. This blocks the action of ACETYLCHOLINE (a neurotransmitter secreted by nerve-cell endings) which relaxes some involuntary muscles and tightens others, controlling the action of sweat-glands. But patients often stop treatment because they get an uncomfortably dry mouth. Aluminium chloride hexahydrate is a topical treatment, but this can cause skin irritation and soreness. Such antiperspirants may help patients with moderate hyperhidrosis, but those severely affected may need either surgery or injections of BOTULINUM TOXIN to destroy the relevant sympathetic nerves to the zones of excessive sweating.... perspiration
Excretion of an acid URINE.... aciduria
A group of drugs used to treat high blood pressure (HYPERTENSION). Untreated hypertension leads to STROKE, heart attacks and heart failure. The high incidence of hypertension in western countries has led to intensive research to discover antihypertensive drugs, and many have been marketed. The drugs may work by reducing the power of the heartbeat, by dilating the blood vessels or by increasing the excretion of salts and water in the urine (diuresis). Antihypertensive treatment has greatly improved the prognosis of patients with high blood pressure by cutting the frequency of heart and renal failure (see KIDNEYS, DISEASES OF), stroke, and coronary thrombosis (see HEART, DISEASES OF). Drugs used for treatment can be classi?ed as follows: diuretics; vasodilator antihypertensives; centrally acting antihypertensives; adrenergic neurone-blocking drugs; alpha-adrenoreceptorblocking drugs; drugs affecting the renin-angiotensin system; ganglion-blocking drugs; and tyrosine hydroxylase inhibitors. The drugs prescribed depend on many factors, including the type of hypertension being treated. Treatment can be di?cult because of the need to balance the e?ectiveness of a drug in reducing blood pressure against its side-effects.... antihypertensive drugs
Complete cessation of the secretion and excretion of urine... anuria
The phenomenon of killing so many infectious organisms so quickly that the amount of dead biomass itself causes liver overload, allergic reactions, or a mild foreign-body response. It can occur with antibiotic therapy, treatment of candidiasis, and even with use of some herbal antivirals. Outside of prescription antifungals, it is seldom acknowledged as a medical problem. If you use a liver stimulant, diaphoretic, and diuretic, you will increase the efficiency of transport, catabolism, and excretion, and lessen the effects of die-off.... die-off
A means of encouraging EXCRETION via the KIDNEYS of a compound by altering the pH and increasing the volume of the urine. Forced diuresis is occasionally used after drug overdoses, but is potentially dangerous and so only suitable where proper intensive monitoring of the patient is possible. Excretion of acid compounds, such as salicylates, can be encouraged by raising the pH of the urine to 7·5–8·5 by the administration of an alkali such as bicarbonate (forced alkali diuresis) and that of bases, such as AMPHETAMINES, by lowering the pH of the urine to 5·5–6·5 by giving an acid such as ammonium chloride (forced acid diuresis).... forced diuresis
A small knot of blood vessels about the size of a grain of sand, of which around 1,000,000 are found in each of the two KIDNEYS, and from which the excretion of ?uid out of the blood into the tubules of the kidney takes place.... glomerulus
ASPIRIN is a commonly available analgesic (see ANALGESICS) which is frequently taken in overdose. Clinical features of poisoning include nausea, vomiting, TINNITUS, ?ushing, sweating, HYPERVENTILATION, DEHYDRATION, deafness and acid-base and electrolyte disturbances (see ELECTROLYTES). In more severe cases individuals may be confused, drowsy and comatose. Rarely, renal failure (see KIDNEYS, DISEASES OF), PULMONARY OEDEMA or cardiovascular collapse occur. Severe toxicity may be delayed, as absorption of the drug may be prolonged due to the formation of drug concretions in the stomach. Treatment involves the repeated administration of activated CHARCOAL, monitoring of concentration of aspirin in the blood, and correction of acid-base and electrolyte imbalances. In more severely poisoned patients, enhanced excretion of the drug may be necessary by alkalinising the urine (by intravenous administration of sodium bicarbonate – see under SODIUM) or HAEMODIALYSIS.... aspirin poisoning
Horsetail (Equisetum species).Plant Part Used: Leaf-stem.Dominican Medicinal Uses: Leaves and stems: decoction, orally, for bladder, urinary tract or kidney infection, kidney stones, kidney ailments (general), infections (general), vaginal infections, menstrual cramps, to cleanse the blood and as a diuretic.Safety: Considered safe when used appropriately; must be taken with plenty of water due to diuretic effect; high silica content may be toxic if plant is ingested.Contraindications: Children, case of heart or kidney disorders.Drug Interactions: Cardiac glycosides, digitalis (may enhance toxicity); thiamine (breaks down vitamin).Clinical Data: Human clinical trials: diuretic (aqueous plant extract), metabolism effects and renal excretion (standardized extract).Laboratory & Preclinical Data: In vivo: diuretic, anti-ulcer, gastroprotective, hypoglycemic (organic plant extracts).In vitro: anti-platelet-aggregant, antimicrobial, contractile response enhancement, cytogenic, hepatoprotective, radical scavenging (plant extracts and constituents).* See entry for Cola de caballo in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... cola de caballo
Excretion of sugar in the urine... glycosuria
The time taken for the PLASMA concentration of an administered drug to decline by half as a result of redistribution, METABOLISM and EXCRETION.... half life
Bleeding, pure and simply. Menses is not blood but the carefully orchestrated excretion of excess endometrium. If the membranes fail to vasoconstrict and bleed further, THAT is hemorrhage.... hemorrhage
The process of the drying or thickening of ?uids or excretions by evaporation.... inspissation
Drugs used in pulmonary oedema (excess ?uid in the lungs) caused by failure of the left VENTRICLE of the HEART. DIURETICS cause an increase in excretion of URINE, thus reducing the amount of ?uid in the body. Intravenous administration of loop diuretics relieves patients’ breathlessness. They work by inhibiting resorption of ?uid in the renal tubule loops of the KIDNEYS. Frusemide and bumetanide are commonly used loop diuretic drugs that act quickly and last for six hours so that they can be given twice in 24 hours without disturbing the patient’s sleep.... loop diuretics
Linn.
Synonym: C. domestica Valeton.
Family: Zingiberaceae.
Habitat: Cultivated all over India, particularly in West Bengal, Tamil Nadu and Maharashtra.
English: Turmeric.
Ayurvedic: Haridraa, Priyaka, Haridruma, Kshanda, Gauri, Kaanchani, Krimighna, Varavarni- ni, Yoshitapriyaa, Hattavilaasini, Naktaahvaa, Sharvari.
Unani: Zard Chob.
Action: Anti-inflammatory, cholagogue, hepatoprotective, blood-purifier, antioxidant, detoxi- fier and regenerator of liver tissue, antiasthmatic, anti-tumour, anticu- taneous, antiprotozoal, stomachic, carminative. Reduces high plasma cholesterol. Antiplatelet activity offers protection to heart and vessels. Also protects against DNA damage in lymphocytes.
Key application: In dyspeptic conditions. (German Commission E, ESCOP, WHO.) As antiinflammatory, stomachic. (Indian Herbal Pharmacopoeia.)The rhizomes gave curcuminoids, the mixture known as curcumin, consisting of atleast four phenolic diaryl- heptanoids, including curcumin and monodesmethoxycurcumin; volatile oil (3-5%), containing about 60% of turmerones which are sesquiterpene ketones, and bitter principles, sugars, starch, resin.Curcumin related phenolics possess antioxidant, anti-inflammatory, gastroprotective and hepatoprotective activities. The antioxidant activity of curcumin is comparable to standard antioxidants—vitamin C and E, BHA and BHT.The volatile oil, also curcumin, exhibited anti-inflammatory activity in a variety of experimental models (the effects were comparable to those of cortisone and phenylbutazone). Used orally, curcumin prevents the release of inflammatory mediators. It depletes nerve endings of substance P, the neu- rotransmitter of pain receptors.Curcumin's cholesterol-lowering actions include interfering with intestinal cholesterol uptake, increasing the conversion of cholesterol into bile acids and increasing the excretion of bile acids via its choleretic effects.Curcuminoids prevent the increases in liver enzymes, SGOT and SGPT; this validates the use of turmeric as a he- patoprotective drug in liver disorders. Curlone, obtained from the dried rhizome, is used against hepatitis.Turmeric and curcumin increase the mucin content of the stomach and exert gastroprotective effects against stress, alcohol, drug-induced ulcer formation. (Curcumin at doses of 100 mg/kg weight exhibited ulcerogenic activity in rats.)The ethanolic extract of the rhizome exhibited blood sugar lowering activity in alloxan-induced diabetic rats.Piperine (a constituent of black and long pepper) enhances absorption and bioavailability of curcumin.
Dosage: Cured rhizome—1-3 g powder. (API Vol. I.)... curcuma longa
This is a syndrome in women, characterised by irregular intermittent bouts of generalised swelling. Sometimes the ?uid retention is more pronounced before the menstrual period (see MENSTRUATION). The eyelids are pu?y and the face and ?ngers feel sti? and bloated. The breasts may feel swollen and the abdomen distended, and ankles may swell. The diurnal weight gain may exceed 4 kg. The underlying disturbance is due to increased loss of ?uid from the vascular compartment, probably from leakage of protein from the capillaries increasing the tissue osmotic pressure. Recent evidence suggests that a decrease in the urinary excretion of DOPAMINE may contribute, as this has a natriuretic action (see NATRIURESIS). This may explain why drugs that are dopamine antagonists, such as chlorpromazine, may precipitate or aggravate cyclical oedema. Conversely, bromocriptine, a dopamine agonist, may improve the oedema.... cyclical oedema
A pre?x which means little or scanty: for example, oliguria, excretion of smaller than normal quantities of urine.... olig(o)
An abnormally low excretion of URINE, such as occurs in acute NEPHRITIS.... oliguria
The excretion product of the hormone, PROGESTERONE, manufactured by the corpus luteum of the ovary (see OVARIES). Pregnandiol is excreted in the urine during the second half of the menstrual period, and its excretion rises steadily throughout pregnancy.... pregnandiol
The term applied to the material formed by a GLAND as the result of its activity. For example, saliva is the secretion of the salivary glands; gastric juice that of the glands in the stomach wall; bile that of the liver. Some secretions consist apparently of waste material which is of no further use in the chemistry of the body. These secretions are often spoken of as excretions: for example, the URINE and the sweat – see PERSPIRATION. (For further details, see ENDOCRINE GLANDS, and also under the headings of the various organs.)... secretion
One of a variety of procedures for collecting and diverting URINE from its customary channel of excretion following surgical removal of the bladder for disease, usually cancer. The ureters (see URETER) may be implanted in the large bowel, or a reservoir or small pouch may be fashioned using a section of small or large INTESTINE. In the latter method the pouch is emptied through a small STOMA using a catheter (see CATHETERS), thus dispensing with the need for a urinary drainage bag.... urinary diversion
Many factors in?uence the activity with which drugs operate. Among the factors which affect the necessary quantity are age, weight, sex, idiosyncrasy, genetic disorders, habitual use, disease, fasting, combination with other drugs, the form in which the drug is given, and the route by which it is given.
Normally, a young child requires a smaller dose than an adult. There are, however, other factors than age to be taken into consideration. Thus, children are more susceptible than adults to some drugs such as MORPHINE, whilst they are less sensitive to others such as ATROPINE. The only correct way to calculate a child’s dose is by reference to texts supplying a recommended dose in milligrams per kilogram. However, many reference texts simply quote doses for certain age-ranges.
Old people, too, often show an increased susceptibility to drugs. This is probably due to a variety of factors, such as decreased weight; diminished activity of the tissues and therefore diminished rate at which a drug is utilised; and diminished activity of the KIDNEYS resulting in decreased rate of excretion of the drug.
Weight and sex have both to be taken into consideration. Women require slightly smaller doses than men, probably because they tend to be lighter in weight. The e?ect of weight on dosage is partly dependent on the fact that much of the extra weight of a heavy individual is made up of fatty tissue which is not as active as other tissues of the body. In practice, the question of weight seldom makes much di?erence unless the individual is grossly over- or underweight.
Idiosyncrasy occasionally causes drugs administered in the ordinary dose to produce unexpected effects. Thus, some people are but little affected by some drugs, whilst in others, certain drugs – for example, psychoactive preparations such as sedatives – produce excessive symptoms in normal or even small doses. In some cases this may be due to hypersensitivity, or an allergic reaction, to the drug, which is a possibility that must always be borne in mind
(e.g. with PENICILLIN). An individual who is known to be allergic to a certain medication is strongly advised to carry a card to this e?ect, and always to inform medical and dental practitioners and/or a pharmacist before accepting a new prescription or buying an over-the-counter preparation.
Habitual use of a drug is perhaps the in?uence that causes the greatest increase in the dose necessary to produce the requisite e?ect. The classical example of this is with OPIUM and its derivatives.
Disease may modify the dose of medicines. This can occur in several ways. Thus, in serious illnesses the patient may be more susceptible to drugs, such as narcotics, that depress tissue activity, and therefore smaller doses must be given. Again, absorption of the drug from the gut may be slowed up by disease of the gut, or its e?ect may be enhanced if there is disease of the kidneys, interfering with the excretion of the drug.
Fasting aids the rapidity of absorption of drugs, and also makes the body more susceptible to their action. Partly for this reason, as well as to avoid irritation of the stomach, it is usual to prescribe drugs to be taken after meals, and diluted with water.
Combination of drugs is to be avoided if possible as it is often di?cult to assess what their combined e?ect may be. In some cases they may have a mutually antagonistic e?ect, which means that the patient will not obtain full bene?t. Sometimes a combination may have a deleterious e?ect.
Form, route and frequency of administration Drugs are now produced in many forms, though tablets are the most common and, usually, convenient. In Britain, medicines are given by mouth whenever possible, unless there is some degree of urgency, or because the drug is either destroyed in, or is not absorbed from, the gut. In these circumstances, it is given intravenously, intra-muscularly or subcutaneously. In some cases, as in cases of ASTHMA or BRONCHITIS, the drug may be given in the form of an inhalant (see INHALANTS), in order to get the maximum concentration at the point where it is wanted: that is, in the lungs. If a local e?ect is wanted, as in cases of diseases of the skin, the drug is applied topically to the skin. In some countries there is a tendency to give medicines in the form of a suppository which is inserted in the rectum.
Recent years have seen developments whereby the assimilation of drugs into the body can be more carefully controlled. These include, for example, what are known as transdermals, in which drugs are built into a plaster that is stuck on the skin, and the drug is then absorbed into the body at a controlled rate. This method is now being used for the administration of GLYCERYL TRINITRATE in the treatment of ANGINA PECTORIS, and of hyoscine hydrobromide in the treatment of MOTION (TRAVEL) SICKNESS. Another is a new class of implantable devices. These are tiny polymers infused with a drug and implanted just under the skin by injection. They can be tailored so as to deliver drugs at virtually any rate – from minutes to years. A modi?cation of these polymers now being investigated is the incorporation of magnetic particles which allow an extra burst of the incorporated drug to be released in response to an oscillating magnetic ?eld which is induced by a magnetic ‘watch’ worn by the patient. In this way the patient can switch on an extra dose of drug when this is needed: insulin, for instance, in the case of diabetics. In yet another new development, a core of drug is enclosed in a semi-permeable membrane and is released in the stomach at a given rate. (See also LIPOSOMES.)... dosage
An adjective relating to the organs and tissues involved in the anatomically closely related functions of excretion and reproduction.... urogenital
Wilson’s disease, or hepatolenticular degeneration, is a familial disease in which there is an increased accumulation of COPPER in the liver, brain, and other tissues including the kidneys. Its main manifestation is the development of tremor and rigidity, with di?culty in speech. In many cases there is improvement following the administration of dimercaprol, penicillamine, or trientine dihydrochloride; these substances cause an increased excretion of copper.... wilson’s disease
Pertaining to the organs of fluid excretion or reproduction. Genito-Urinary astringent – Horsetail. Genito-Urinary tonics – Beth root, Saw Palmetto, Damiana. Genito-Urinary relaxant – Black Willow. ... genito-urinary
The kidneys are responsible for the excretion of many waste products, chiefly urea from the blood. They maintain the correct balance of salts and water. Any of the individual kidney disorders may interfere with these important functions. See: ABSCESS (kidney). BRIGHT’S DISEASE. CARDIAC DROPS. RENAL FLUID RETENTION. GRAVEL. HYDRONEPHROSIS. NEPHROSIS. PROTEINURIA. PYELITIS. RENAL COLIC. RETENTION OF URINE. STONE IN THE KIDNEY. SUPPRESSION OF URINE. URAEMIA. ... kidney disorders
This is a form of a chemical element with the same chemical properties as other forms, but which has a di?erent atomic mass. It contains an identical number of positively charged particles called protons, in the nucleus, giving it the same atomic number, but the numbers of neutrons di?er. A radioactive isotope, or radionuclide, is one that decays into other isotopes, and in doing so emits alpha, beta or gamma radiation.
Applications of radionuclides to diagnosis The use of radionuclides in diagnosis is based on the fact that it is possible to tag many of the substances normally present in the body with a radioactive label. Certain synthetic radioactive elements, such as technetium, can also be used. Because it is possible to detect minute quantities of radioactive material, only very small doses are needed, making the procedure a safe one. Furthermore the body pool of the material is therefore not appreciably altered, and metabolism is not disturbed. Thus in studies of iodine metabolism the ratio of radioactive atoms administered to stable atoms in the body pool is of the order of 1:1,000 million. By measuring radioactivity in the body, in blood samples, or in the excreta it is possible to gain information about the fate of the labelled substance, and hence of the chemically identical inactive material. Therefore it is theoretically possible to trace the absorption, distribution and excretion of any substance normally present in the body, provided that it can be tagged with a suitable radioactive label.
If the investigation necessitates tracing the path of the material through the body by means of external counting over the body surface, it is obviously essential to use an isotope that emits gamma radiation or positrons. If, however, only measurements on blood sample or excreta are required, it is possible to use pure beta emitters. Whole-body counters measure the total radioactivity in the body, and these are of great value in absorption studies.
Moving images can provide information on body functions such as the movements of the heart, blood ?ow, bile ?ow in the liver, and urine in the kidneys. The development of COMPUTED TOMOGRAPHY or CT scanning has replaced radionuclide scanning for some imaging procedures.
Five main groups of diagnostic uses may be de?ned:
(1) METABOLIC STUDIES The use of radioactive materials in metabolic studies is based on the fundamental property that all isotopes of an element are chemically identical. The radioactive isotope is used as a true isotope tracer – that is, when introduced into the body (in whatever form) it behaves in the same way as the inactive element. For example, isotopes of iodine are used to measure thyroid function (see THYROID GLAND), and isotopes of calcium enable kinetic studies of bone formation and destruction to be performed.... isotope
Linn. var. saxatillis Palias.
Synonym: J. communis auct. non L.
Family: Pinaceae; Cupressaceae.
Habitat: Native to Europe and North America. Distributed in Western Himalayas from Kumaon westwards at 1,700-4,200 m.
English: Common Juniper.
Ayurvedic: Hapushaa, Havushaa, Haauber, Matsyagandha.
Unani: Abahal, Haauber, Hubb-ul- arar, Aarar.
Action: Berries—diuretic, urinary antiseptic, carminative, digestive, sudorific, anti-inflammatory, emmenagogue. Used for acute and chronic cystitis, renal suppression (scanty micturition), catarrh of the bladder, albuminuria, amenorrhoea, leucorrhoea. Aerial parts—abortifacient.
Key application: In dyspepsia. (German Commission E.) Juniper berry may increase glucose levels in diabetics. (ESCOP.) As a diuretic.(The British Herbal Pharmacopoeia.)The Ayurvedic Pharmacopoeia of India recommends the dried fruit in malabsorption syndrome.Animal studies have shown an increase in urine excretion as well as a direct effect on sooth muscle contraction. (German Commission E, ESCOP.)Con- traindicated in kidney disease. (Sharon M. Herr.)(In Kerala, Hapushaa and Mundi are considered to be synonyms; Syphaer- anthus indicus,Asteraceae, is used as Hapushaa.)The major constituents of the volatile oil are alpha-pinene, sabinene and alpha-terpinene. Methanolic extract of the plant gave several labdane diter- penoids and diterpenes. The leaves contain the biflavones, cupressufla- vone, amentoflavone, hinokiflavone, isocryptomerin and sciadopitysin. The berries also contain condensed tannins. Seeds gave haemagglutinin.Juniperus recurva Buch-Ham ex D. Don, syn. J. excelsa auct. non-Bieb. (temperate Himalaya from Kashmir to Bhutan) is known as Weeping Blue Juniper. J. macropoda Boiss. (the Himalaya from Nepal onwards) is known as Himalayan Indian Juniper. Both the species are used like J. communis var. saxatillis.The berries gave a diterpene ketone, sugrol, beta-sitosterol glucoside and 10-nonacosanol.Plant extract can be used in toothpastes and mouth-rinses to reduce dental plaque and bleeding.
Dosage: Dried fruit—2-6 g powder. (API, Vol. III.)... juniperus communis
A group of hormones produced by the adrenal glands that control the body’s use of nutrients and the excretion of salts and water in the urine.... corticosteroid hormones
A drug used to rid the body tissues of excess iron that accumulates as a result of repeated blood transfusions in anaemias, such as aplastic anaemia and thalassaemia. It is also used to treat iron poisoning and may also be used to treat excess aluminium in people on dialysis. The drug is administered by intravenous injection or subcutaneous infusion and may be given with vitamin C to boost excretion of the iron. Side effects may include gastrointestinal disturbances, dizziness, and skin reactions.... desferrioxamine
These are several minute glandular masses embedded in the lower edge of the thyroid gland. They produce Parathyroid Hormone (PTH), part of the calcium-phosphorus control system. Calcium levels in the blood MUST be within a narrow band of safety. If free calcium drops too low, PTH acts on the kidneys and blocks calcium loss in urine, amplifies calcium absorption into the portal blood (from food and from submucosal storage) and stimulates release of calcium from bone storage. When levels are back up, the hormone backs off. Oddly enough, the thyroid gland secretes its virtual antagonist, calcitonin, which, when calcium levels are too high, stimulates the urine excretion, bone retention and digestive resistance to calcium, and when the blood levels drop, recedes. The body finds calcium levels to be so critical that it has in place TWO separate, mutually antagonistic negative feedback systems,,,like a binary star system. (Be thankful I didn’t bring in the calcium maintenance of minerocortical steroid hormones or vasopressin)... parathyroids
Also called pharmacogenetics – the use of human genetic variations to optimise the discovery and development of drugs and the treatment of patients. The human race varies much more in its genetic make-up than has previously been realised; these variations in GENES and their PROTEIN products could be utilised to provide safer and more e?ective drugs. Genes affect drug absorption, distribution, METABOLISM and excretion. Drugs are designed and prescribed on the basis of a population’s needs, but patients comprise a diverse range of individuals. For example, nearly one-third of patients fail to respond to the cholesterol-reducing group of drugs, the STATINS. Around half do not respond to the tricyclic ANTIDEPRESSANT DRUGS. Over 80 per cent of patients’ responses to drugs depends on their genetics: this genetic variation needs to be identi?ed so as to make the prescription of drugs more e?ective, and technology for analysing genetic variants is progressing. Assessing drug e?ectiveness, however, is not simple because the health and diets of individuals are di?erent and this can affect the response to a drug. Even so, the genetic identi?cation of people who would or would not respond to a particular drug should bene?t patients by ensuring a more accurately targeted drug and by reducing the risks to a person of side-effects from taking a drug that would not work. There would also be substantial economic savings.... pharmacogenomics
An aluminium compound used as an ingredient in some antidiarrhoeal drugs. Kaolin is taken orally and increases the bulk of faeces. It is also believed to adsorb bacteria, viruses, and toxins in the intestine, transporting them through the digestive tract for excretion in the faeces.... kaolin
n. the part of the body cavity below the chest (see thorax), from which it is separated by the *diaphragm. The abdomen contains the organs of digestion – stomach, liver, intestines, etc. – and excretion – kidneys, bladder, etc.; in women it also contains the ovaries and uterus. The regions and quadrants of the abdomen are shown in the illustration: the four quadrants, demarcated by broken lines, are the right upper (RUQ), right lower (RLQ), left upper (LUQ), and left lower (LLQ). Terms to designate the regions are those used in day-to-day medical practice rather than in anatomy textbooks. —abdominal adj.... abdomen
n. a potassium-sparing *diuretic that causes the increased excretion of sodium and chloride; it is often combined with a thiazide or loop diuretic (e.g. hydrochlorothiazide as co-amilozide) to reduce the potassium loss that occurs with these drugs. Amiloride may produce dizziness and weakness and its continued use may lead to an excessive concentration of potassium in the blood.... amiloride
an inherited condition of the kidney, which causes abnormalities in the excretion and reabsorption of salts from the blood. This results in lowered levels of potassium and chloride and an increased level of calcium. The baby fails to grow properly and becomes progressively weaker and dehydrated. Treatment consists of correcting the salt imbalance with appropriate supplements. [F. C. Bartter (1914–83), US physician]... bartter syndrome
n. poisoning caused by an overdose of cinchona or the alkaloids quinine, quinidine, or cinchonine derived from it. The symptoms are commonly ringing noises in the ears, dizziness, blurring of vision (and sometimes complete blindness), rashes, fever, and low blood pressure. Treatment with *diuretics increases the rate of excretion of the toxic compounds from the body.... cinchonism
An overgrowth of lymphoid tissue at the junction of the throat and nose. After exposure to inflammation from colds, dust, allergy or faulty diet adenoids may become enlarged and diseased. Chiefly in children, ages 3 to 10.
Symptoms. Mouth always half open through inability to breathe freely through nose. Nose thin and shrunken. Teeth may protrude. Snoring. Possible deafness from ear infection. Where the child does not ‘grow out of it’ flat chestedness and spinal curvature may ensue because of inadequate oxygenation. Children gritting their teeth at night may be suspected. Children may also have enlarged tonsils. Both tonsils and adenoids are lymph glands which filter harmful bacteria and their poisons from the blood stream. Herbs can be used to facilitate their elimination from the site of infection for excretion from the body.
Alternatives. Clivers, Echinacea, Goldenseal, Marigold, Poke root, Queen’s Delight, Sarsaparilla, Thuja, Wild Indigo.
Tea. Formula. Equal parts: Red Clover, Red Sage, Wild Thyme. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes. 1 cup thrice daily.
Tablets/capsules. Echinacea, Poke root, Goldenseal. Dosage as on bottle.
Powders. Formula. Equal parts: Echinacea, Poke root, Goldenseal. 500mg (two 00 capsules or one-third teaspoon). Children 250mg or one capsule. Thrice daily.
Tinctures. Formula: Echinacea 20ml; Elderflowers 20ml; Poke root 10ml; Thuja 1ml, Tincture Capsicum 5 drops. Dose: 1-2 teaspoons. Children: 15-30 drops, in water, thrice daily.
Topical. Lotion: Liquid Extract Thuja 1; Aloe Vera gel 2. Apply to affected area on a probe with cotton wool.
Gargle: Equal parts tinctures Myrrh and Goldenseal: 10-15 drops in glass of water, freely.
Snuff: Bayberry bark powder.
Diet. 3-day fast, followed with low fat, low salt, high fibre diet.
On retiring: 2 Garlic capsules/tablets to prevent infection. ... adenoids
(dimethicone) n. a silicone preparation used to treat head lice; it forms a coating around the parasites that prevents their excretion of water. Dimeticone is also included in various *barrier creams (with antiseptics and astringents) to prevent undue drying of the skin and protect it against irritating external agents. See also simeticone.... dimeticone
n. (in physiology) the entire process of excretion of metabolic waste products from the blood by the kidneys and urinary tract.... elimination
(erythro-) combining form denoting 1. redness. Example: erythuria (excretion of red urine). 2. erythrocytes.... erythr
a disorder of the proximal kidney tubules, which may be inherited or acquired and is most common in children. It is characterized by the urinary excretion of large amounts of amino acids, glucose, and phosphates (though blood levels of these substances are normal). Symptoms may include osteomalacia, rickets, muscle weakness, and *cystinosis. Treatment is directed to the cause. [G. Fanconi]... fanconi syndrome
n. an organ or group of cells that is specialized for synthesizing and secreting certain fluids, either for use in the body or for excretion. There are two main groups of glands: the *exocrine glands, which discharge their secretions by means of ducts, and the *endocrine glands, which secrete their products – hormones – directly into the bloodstream. See also secretion.... gland
The previous subject is obviously an endless one, but as this is the glossary of an herbal nature, let me assure you, virtually no plants have a direct steroid hormone-mimicking effect. There are a few notable exceptions with limited application, like Cimicifuga and Licorice. Plant steroids are usually called phytosterols, and, when they have any hormonal effect at all, it is usually to interfere with human hormone functions. Beta sitosterol, found in lots of food, interferes with the ability to absorb cholesterol from the diet. Corn oil and legumes are two well-endowed sources that can help lower cholesterol absorption. This is of only limited value, however, since cholesterol is readily manufactured in the body, and elevated cholesterol in the blood is often the result of internal hormone and neurologic stimulus, not the diet. Cannabis can act to interfere with androgenic hormones, and Taraxacum phytosterols can both block the synthesis of some new cholesterol by the liver and increase the excretion of cholesterol as bile acids; but other than that, plants offer little direct hormonal implication. The first method discovered for synthesizing pharmaceutical hormones used a saponin, diosgenin, and a five-step chemical degradation, to get to progesterone, and another, using stigmasterol and bacterial culturing, to get to cortisol. These were chemical procedures that have nothing to do with human synthesis of such hormones, and the plants used for the starting materials-Mexican Wild Yam, Agave, and Soy were nothing more than commercially feasible sources of compounds widely distributed in the plant kingdom. A clever biochemist could obtain testosterone from potato sterols, but no one would be likely to make the leap of faith that eating potatoes makes you manly (or less womanly), and there is no reason to presume that Wild Yam (Dioscorea) has any progesterone effects in humans. First, the method of synthesis from diosgenin to progesterone has nothing to do with human synthesis of the corpus luteum hormone; second, oral progesterone has virtually no effect since it is rapidly digested; and third, orally active synthetic progesterones such as norethindrone are test-tube born, and never saw a Wild Yam. The only “precursor” the ovaries, testes and adrenal cortices EVER need (and the ONLY one that they can use if synthesizing from scratch) is something almost NONE of us ever run out of...Low Density Cholesterol. Unless you are grimly fasting, anorectic, alcoholic, seriously ill or training for a triathlon, you only need blood to make steroid hormones from. If hormones are off, it isn’t from any lack of building materials...and any product claiming to supply “precursors” better contain lard or butter (they don’t)...or they are profoundly mistaken, or worse. The recent gaggle of “Wild Yam” creams actually do contain some Wild Yam. (Dioscorea villosa, NOT even the old plant source of diosgenin, D. mexicana...if you are going to make these mistakes, at least get the PLANT right) This is a useful and once widely used antispasmodic herb...I have had great success using it for my three separate bouts with kidney stones...until I learned to drink more water and alkalizing teas and NEVER stay in a hot tub for three hours. What these various Wild Yam creams DO contain, is Natural Progesterone. Although this is inactive orally (oral progesterone is really a synthetic relative of testosterone), it IS active when injected...or, to a lesser degree, when applied topically. This is pharmaceutical progesterone, synthesized from stigmasterol, an inexpensive (soy-bean oil) starting substance, and, although it is identical to ovarian progesterone, it is a completely manufactured pharmaceutical. Taking advantage of an FDA loophole (to them this is only a cosmetic use...they have the misguided belief that it is not bioactive topically), coupled with some rather convincing (if irregular) studies showing the anti-osteoporotic value of topical progesterone for SOME women, a dozen or so manufacturers are marketing synthetic Natural Progesterone for topical use, yet inferring that Wild Yam is what’s doing good. I am not taking issue with the use of topical progesterone. It takes advantage of the natural slow release into the bloodstream of ANY steroid hormones that have been absorbed into subcutaneous adipose tissue. It enters the blood from general circulation the same way normal extra-ovarian estradiol is released, and this is philosophically (and physiologically) preferable to oral steroids, cagily constructed to blast on through the liver before it can break them down. This causes the liver to react FIRST to the hormones, instead of, if the source is general circulation, LAST. My objection is both moral and herbal: the user may believe hormonal effects are “natural”, the Wild Yam somehow supplying “precursors” her body can use if needed, rejected if not. This implies self-empowerment, the honoring of a woman’s metabolic choice...something often lacking in medicine. This is a cheat. The creams supply a steady source of pharmaceutical hormone (no precursor here) , but they are being SOLD as if the benefits alone come from the Wild Yam extract, seemingly formulated with the intent of having Wild Yam the most abundant substance so it can be listed first in the list of constituents. I have even seen the pharmaceutical Natural Progesterone labeled as “Wild Yam Progesterone” or “Wild Yam Estrogen precursor” or, with utter fraud, “Wild Yam Hormone”. To my knowledge, the use of Mexican Yam for its saponins ceased to be important by the early 1960’s, with other processes for synthesizing steroids proving to be cheaper and more reliable. I have been unable to find ANY manufacturer of progesterone that has used the old Marker Degradation Method and/or diosgenin (from whatever Dioscorea) within the last twenty years. Just think of it as a low-tech, non invasive and non-prescription source of progesterone, applied topically and having a slow release of moderate amounts of the hormone. Read some of the reputable monographs on its use, make your choice based solely on the presence of the synthetic hormone, and use it or don’t. It has helped some women indefinitely, for others it helped various symptoms for a month or two and then stopped working, for still other women I have spoken with it caused unpleasant symptoms until they ceased its use. Since marketing a product means selling as much as possible and (understandably) presenting only the product’s positive aspects, it would be better to try and find the parameters of “use” or “don’t use” from articles, monographs, and best of all, other women who have used it. Then ask them again in a month or two and see if their personal evaluation has changed. If you have some bad uterine cramps, however, feel free to try some Wild Yam itself...it often helps. Unless there is organic disease, hormones are off is because the whole body is making the wrong choices in the hormones it does or doesn’t make. It’s a constitutional or metabolic or dietary or life-stress problem, not something akin to a lack of essential amino acids or essential fatty acids that will clear up if only you supply some mythic plant-derived “precursor”. End of tirade.... steroids, plant
One of the largest groups of herbs. Herbs that contract blood vessels and certain body tissues (mucous membranes) with the effect of reducing secretion and excretion. Binders. They are used for debility, internal and external bleeding, catarrhal discharges, etc, their action due to the tannins they contain. Main astringents: Agrimony, Avens, Bayberry, Beth root, Bistort, Black Catechu, Burr-Marigold, American Cranesbill, Eyebright, Golden Rod, Great Burnet, Ground Ivy, Hemlock Spruce bark, Kola, Ladies Mantle, Meadowsweet, Mouse Ear, Mullein, Nettles, Oak bark, Periwinkle, Pilewort, Plantain, Raspberry leaves, Sage, Rosemary, Shepherd’s Purse, Tormentil, Wild Cherry bark, Witch Hazel, Yarrow, White Pond Lily. ... astringents
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)
(gluco-) combining form denoting glucose. Example: glucosuria (urinary excretion of).... gluc
n. 1. the excretion of sweat. 2. excessive sweating.... hidrosis
n. a derivative of the amino acid tryptophan, excreted in the urine and faeces. Abnormal patterns of urinary indole excretion are found in some mentally retarded patients.... indole
n. an agent that promotes the excretion of sodium salts in the urine. Most *diuretics are natriuretics.... natriuretic
n. the active unit of excretion in the kidney (see illustration). Blood, which is supplied by branches of the renal artery, is filtered through a knot of capillaries (glomerulus) into the cup-shaped Bowman’s capsule so that water, nitrogenous waste, and many other substances (excluding colloids) pass into the renal tubule. Here most of the substances are reabsorbed back into the blood, the remaining fluid (*urine) passing into the collecting duct, which drains into the *ureter.... nephron
the relationship between the nitrogen taken into the body and that excreted, denoting the balance between the manufacture and breakdown of the body mass. A negative nitrogen balance, when excretion exceeds intake, is usual after injury or operations as the energy requirements of the body are met disproportionately from endogenous sources.... nitrogen balance
Agents that increase the flow of urine from the kidneys and so excrete excess fluid from the body. As well as elimination of fluid, diuretics cause potassium to be expelled. To restore the chemical balance, potassium is often prescribed. The advantage of some herbal diuretics is their ability to make good the loss without the use of synthetics, i.e., Dandelion root contains an abundance of potassium (three times as much as some). Liquorice reduces the action of a diuretic by causing fluid and salt retention.
Demulcent diuretics (Marshmallow root, Corn Silk, Couch Grass) protect the delicate parenchyma of the kidneys against irritation by gravel, stone or inflammation. All detoxifying prescriptions, as given for such chronic diseases as rheumatism, arthritis, etc, would include a diuretic to ensure complete excretion of by-products and metabolism.
Diuretics are prescribed for high blood pressure, water retention, inflammation of kidneys or bladder and oedema. They are usually combined with ‘heart’ remedies (Hawthorn, Lily of the Valley, Broom, etc) for dropsy of cardiac origin. Best taken cold on an empty stomach.
The possibility of diuretic abuse should be borne in mind when women and sportsmen seek to lose weight by such means. The following is a selection from over 300 herbs known as diuretics.
Agrimony, Bearberry, Bilberry leaves, Blue Flag root, Bogbean, Boldo, Boneset, Broom, Buchu, Bugleweed (cardio-active diuretic to increase force of the heart beat), Burdock, Celery seed, Clivers, Corn Silk, Couchgrass, Dandelion, Devil’s Claw, Elder, Fennel seed, Gravel root, Heather flowers, Juniper berries, Kava Kava, Kola, Life root, Lignum Vitae, Lily of the Valley, Lime flowers, Marshmallow, Mullein, Pai Shu, Parsley Piert, Pellitory, Pumpkin seed, Sarsaparilla, Saw Palmetto, Sea Holly, Stone root, Vervain, Wild Carrot, Yarrow, Yerba Mate tea, Garden Nasturtium.
See: POTASSIUM. DANDELION. ... diuretics
Failure of the left ventricle to receive blood from the pulmonary circulation and to maintain efficient output of incoming blood to the arterial system. Failure to do so leads to congestion of blood in the lungs followed by fluid retention. If uncorrected, leads to kidney disturbance, low blood pressure, cyanosis (blueness of the skin). Onset may be tragically sudden.
Failure of the left ventricle may occur in cases of pericarditis, disease of the aortic valve, nephritis or high blood pressure.
Left ventricular failure is often of sudden onset, urgent, and may manifest as “cardiac asthma”.
Causes: blood clot, anaemia, thyroid disorder, coronary disease, congenital effects, drug therapy (beta blockers, etc), and to fevers that make heavy demands on the left ventricle.
Symptoms: breathlessness, wheezing, sweating, unproductive cough, faintness, bleeding from the lungs, palpitation. Cardiac asthma at night: feels he needs air; better upright than lying flat. Exertion soon tires. Sensation as if heart would stop. Blueness of lips and ears from hold-up in circulation of the blood through the lungs. Frequent chest colds. Awakes gasping for breath. Always tired. Cold hands and feet. Symptoms abate as compensation takes place. ‘Cream and roses’ complexion. The failure of left ventricle soon drags into failure of the right ventricle.
Right ventricular failure leads to congestive heart failure, with raised venous pressure in neck veins and body generally, causing oedema, ascites and liver engorgement.
Treatment. Agents to strengthen, support, and eliminate excess fluids from the body. BHP (1983) advises four main remedies: Hawthorn, Motherwort, Broom and Lily of the Valley. The latter works in a digitaloid manner, strengthening the heart, contracting the vessels, and lessening congestion in the lungs. Tinctures. Hawthorn 2; Stone root 1. Lily of the Valley 1. Dose: 15-45 drops thrice daily.
Broom tea. 2 teaspoons flowers, or 2-3 teaspoons tops and flowers, in cup water brought to boil and simmered one minute. 1 cup freely.
To remove fluid retention in the lungs, diuretics are indicated; chief among which is Dandelion root because of its high potassium content to prevent hypokalaemia. Dandelion coffee. As urinary excretion increases, patient improves.
Vitamin E. Not to be taken in left ventricular disorders.
Diet. See entry: DIET – HEART AND CIRCULATION.
UK Research. Researchers found that left ventricular failure was reduced by a quarter when patients were given magnesium intravenously for the first 24 hours after admission to the coronary care unit. They conclude that it should be given before any other heart therapy is commenced, and that patients should receive regular infusions if no other drug treatment is used. (The Lancet, 2.4.1994). This supports the use of magnesium sulphate (Epsom’s salts) by a past generation of herbal practitioners for the condition. ... heart – left ventricular failure (lvf)
n. a drug that binds metals and therefore aids their excretion (see chelating agent). It is used to treat *Wilson’s disease and severe rheumatoid arthritis (see disease-modifying antirheumatic drug). It may cause blood disorders (blood counts should be carried out during treatment); other side-effects include nausea, loss of taste, and rashes.... penicillamine
Failure of the right ventricle to hold its own with the return flow of blood and to re-direct it through the lungs where it is re-oxygenated before entering the left ventricle for completing the circulatory cycle. Usually secondary to failure of the left ventricle. May be caused by valvular disease, especially narrowing of the orifice of the mitral valve.
Mitral disease leads to heart failure either by a narrowing of the orifice (stenosis) or a regurgitation blocks the passage of blood from the left atrium (auricle) to the left ventricle. The left atrium enlarges (hypertrophies) in an effort to counter the impediment. Real compensation – increased thrust of the blood – is provided by the right ventricle. In order to overcome a mitral impediment the right ventricle has to enlarge.
Sooner or later the right ventricle cannot enlarge any further and general heart failure sets in. Though caused primarily by a lesion of the mitral valve, it may be secondary to left ventricular failure (LVF), thyroid disorder (thyrotoxicosis), pericarditis, congenital heart disease, or any disease which weakens ventricular muscle.
Venous congestion and back pressure of RVF leads to congestion and accumulation of fluid in the lungs, cough and spitting of blood, painful swelling of the liver, nausea, loss of appetite and severe wasting.
Where the right ventricle fails to move the blood forward as it arrives from the systemic circulation, generalised dropsy sets in. Congestion of the kidneys leads to reduced urinary excretion and presence of albumin in the urine.
The picture is well known to the cardiac practitioner: blueness of the skin, congestion of the brain circulation with sleeplessness and delirium. Soon the tension of water-logged tissues results in pain and extreme anxiety. Feet are swollen and ankles pit on pressure; chest cavities fill with fluid and the abdomen swells (ascites).
Alternatives. Cardio-tonics would be given to strengthen the ventricle and diuretics to correct fluid retention: Lily of the Valley, Hawthorn, Motherwort, Broom. BHP (1983).
Due to rheumatic fever: Hawthorn.
High Blood Pressure: Mistletoe.
Effort Syndrome: Motherwort.
Tinctures. Combine, Lily of the Valley 2; Hawthorn 2; Motherwort 3. Dose: 1 teaspoon thrice daily after meals.
Diet. Low salt, low fat, high fibre. Restricted fluids, vegetarian protein foods, yoghurt. See also: DIET – HEART AND CIRCULATION.
Supplements. Potassium (bananas), Vitamin B6.
General. Stop smoking. Correction of overweight. Complete bed-rest with legs raised above level of the abdomen and patient propped-up to relieve difficult breathing. ... heart – right ventricular failure (rvf)
n. an inborn defect of sugar metabolism causing abnormal excretion of pentose in the urine. There are no serious ill-effects.... pentosuria
n. the excretion of phosphorescent urine, which glows in the dark, due to the presence of certain phosphorus-containing compounds derived from phosphates.... photuria
(urogenital) adj. of or relating to the organs and tissues concerned with both excretion and reproduction, which are anatomically closely associated.... urinogenital
aids excretion of bile by the liver, so there is a greater flow of bile.... choleretic
Nutrients that provide the body with its most concentrated form of energy. Fats, which are also called lipids, are compounds containing chains of carbon and hydrogen with very little oxygen. Chemically, fats consist mostly of fatty acids combined with glycerol. They are divided into 2 main groups, saturated and unsaturated, depending on the proportion of hydrogen atoms. If the fatty acids contain the maximum possible quantity of hydrogen, the fats are saturated. If some sites on the carbon chain are unoccupied by hydrogen, they are unsaturated; when many sites are vacant, they are polyunsaturated. Monounsaturated fats are unsaturated fats with only one site that could take an extra hydrogen. Animal fats, such as those in meat and dairy products, are largely saturated, whereas vegetable fats tend to be unsaturated.
Fats are usually solid at room temperature; oils are liquid. The amount and types of fat in the diet have important implications for health. A diet containing a large amount of fat, particularly saturated fat, is linked to an increased risk of atherosclerosis and subsequent heart disease and stroke.
Some dietary fats, mainly triglycerides (combinations of glycerol and 3 fatty acids), are sources of the fat-soluble vitamins A, D, E, and K and of essential fatty acids. Triglycerides are the main form of fat stored in the body. These stores act as an energy reserve and also provide insulation and a protective layer for delicate organs. Phospholipids are structural fats found in cell membranes. Sterols, such as cholesterol, are found in animal and plant tissues; they have a variety of functions, often being converted into hormones or vitamins.
Dietary fats are first emulsified by bile salts before being broken down by lipase, a pancreatic enzyme. They are absorbed via the lymphatic system before entering the bloodstream.Lipids are carried in the blood bound to protein; in this state they are known as lipoproteins. There are 4 classes of lipoprotein: very low-density lipoproteins (VLDLs), low-density lipoproteins (LDLs), high-density lipoproteins (HDLs), and chylomicrons. LDLs and VLDLs contain large amounts of cholesterol, which they carry through the bloodstream and deposit in tissues. HDLs pick up cholesterol and carry it back to the liver for processing and excretion. High levels of LDLs are associated with atherosclerosis, whereas HDLs have a protective effect. (See also nutrition.)... fats and oils
n. a drug that increases the volume of urine produced by promoting the excretion of salts and water from the kidney. The main classes of diuretics act by inhibiting the reabsorption of salts and water from the kidney tubules into the bloodstream. Thiazide diuretics (e.g. *bendroflumethiazide, *chlortalidone) act at the distal convoluted tubules (see nephron), preventing the reabsorption of sodium and potassium. Potassium-sparing diuretics (e.g. *amiloride, *spironolactone, *triamterene) prevent excessive loss of potassium at the distal convoluted tubules, and loop diuretics (e.g. *furosemide) prevent reabsorption of sodium and potassium in *Henle’s loop. Diuretics are used to reduce the oedema due to salt and water retention in disorders of the heart, kidneys, liver, or lungs. Thiazides and potassium-sparing diuretics are also used – in conjunction with other drugs – in the treatment of high blood pressure. Treatment with thiazide and loop diuretics often results in potassium deficiency; this is corrected by simultaneous administration of potassium salts or a potassium-sparing diuretic.... diuretic
n. a disease in which a defect in purine metabolism causes an excess of uric acid and its salts (urates) to accumulate in the bloodstream and the joints respectively. It results in attacks of acute gouty arthritis and chronic destruction of the joints and deposits of urates (tophi) in the skin and cartilage, especially of the ears. The excess of urates also damages the kidneys, in which stones may form. Long-term treatment with drugs that increase the excretion of urates (*uricosuric drugs), or with urate-lowering therapy, such as, *allopurinol or *febuxostat, can control the joint disease. Urate-lowering therapy may also help with urate stones, but uricosurics are not used as they can precipitate uric acid stones by increasing uric acid excretion in the urine. Acute attacks of gout are treated with anti-inflammatory analgesics, colchicine, or corticosteroids. See also podagra.... gout
n. either of the pair of organs responsible for the excretion of nitrogenous wastes, principally urea, from the blood (see illustrations). The kidneys are situated at the back of the abdomen, below the diaphragm, one on each side of the spine; they are supplied with blood by the renal arteries. Each kidney is enclosed in a fibrous capsule and is composed of an outer cortex and an inner medulla. The active units of the kidney are the *nephrons, within the cortex and medulla, which filter the blood under pressure and then reabsorb water and selected substances back into the blood. The *urine thus formed is conducted from the nephrons via the renal tubules into the renal pelvis and from here to the ureter, which leads to the bladder. See also haemodialysis; horseshoe kidney; renal function tests.... kidney
A group of watersoluble vitamins comprising thiamine (vitamin B1), riboflavin (vitamin B2), niacin, pantothenic acid, pyridoxine (vitamin B6), biotin (vitamin H), and folic acid. Vitamin B12 is discussed above.
Thiamine plays a role in the activities of various enzymes involved in the utilization of carbohydrates and thus in the functioning of nerves, muscles, and the heart. Sources include whole-grain cereals, wholemeal breads, brown rice, pasta, liver, kidney, pork, fish, beans, nuts, and eggs.
Those susceptible to deficiency include elderly people on a poor diet, and people who have hyperthyroidism, malabsorption, or severe alcohol dependence. Deficiency may also occur as a result of severe illness, surgery, or injury.
Mild deficiency may cause tiredness, irritability, and loss of appetite. Severe deficiency may cause abdominal pain, constipation, depression, memory impairment, and beriberi; in alcoholics, it may cause Wernicke–Korsakoff syndrome. Excessive intake is not known to cause harmful effects.
Riboflavin is necessary for the activities of various enzymes involved in the breakdown and utilization of carbohydrates, fats, and proteins; the production of energy in cells; the utilization of other B vitamins; and hormone production by the adrenal glands. Liver, whole grains, milk, eggs, and brewer’s yeast are good sources. People who are susceptible to riboflavin deficiency include those taking phenothiazine antipsychotic drugs, tricyclic antidepressant drugs, or oestrogen-containing oral contraceptives, and those with malabsorption or severe alcohol dependence. Riboflavin deficiency may also occur as a result of serious illness, surgery, or injury.
Prolonged deficiency may cause soreness of the tongue and the corners of the mouth, and eye disorders such as amblyopia and photophobia.
Excessive intake of riboflavin is not known to have any harmful effects.
Niacin plays an essential role in the activities of various enzymes involved in the metabolism of carbohydrates and fats, the functioning of the nervous and digestive systems, the manufacture of sex hormones, and the maintenance of healthy skin. The main dietary sources are liver, lean meat, fish, nuts, and dried beans. Niacin can be made in the body from tryptophan (an amino acid). Most cases of deficiency are due to malabsorption disorders or to severe alcohol dependence. Prolonged niacin deficiency causes pellagra. Excessive intake is not known to cause harmful effects.
Pantothenic acid is essential for the activities of various enzymes involved in the metabolism of carbohydrates and fats, the manufacture of corticosteroids and sex hormones, the utilization of other vitamins, the functioning of the nervous system and adrenal glands, and growth and development. It is present in almost all vegetables, cereals, and animal foods. Deficiency of pantothenic acid usually occurs as a result of malabsorption or alcoholism, but may also occur after severe illness, surgery, or injury. The effects include fatigue, headache, nausea, abdominal pain, numbness and tingling, muscle cramps, and susceptibility to respiratory infections. In severe cases, a peptic ulcer may develop. Excessive intake has no known harmful effects.Pyridoxine aids the activities of various enzymes and hormones involved in the utilization of carbohydrates, fats, and proteins, in the manufacture of red blood cells and antibodies, in the functioning of the digestive and nervous systems, and in the maintenance of healthy skin. Dietary sources are liver, chicken, pork, fish, whole grains, wheatgerm, bananas, potatoes, and dried beans. Pyridoxine is also manufactured by intestinal bacteria. People who are susceptible to pyridoxine deficiency include elderly people who have a poor diet, those with malabsorption or severe alcohol dependence, or those who are taking certain drugs (including penicillamine and isoniazid). Deficiency may cause weakness, irritability, depression, skin disorders, inflammation of the mouth and tongue, anaemia, and, in infants, seizures. In very large amounts, pyridoxine may cause neuritis.
Biotin is essential for the activities of various enzymes involved in the breakdown of fatty acids and carbohydrates and for the excretion of the waste products of protein breakdown. It is present in many foods, especially liver, peanuts, dried beans, egg yolk, mushrooms, bananas, grapefruit, and watermelon. Biotin is also manufactured by bacteria in the intestines. Deficiency may occur during prolonged treatment with antibiotics or sulphonamide drugs. Symptoms are weakness, tiredness, poor appetite, hair loss, depression, inflammation of the tongue, and eczema. Excessive intake has no known harmful effects.
Folic acid is vital for various enzymes involved in the manufacture of nucleic acids and consequently for growth and reproduction, the production of red blood cells, and the functioning of the nervous system. Sources include green vegetables, mushrooms, liver, nuts, dried beans, peas, egg yolk, and wholemeal bread. Mild deficiency is common, but can usually be corrected by increasing dietary intake. More severe deficiency may occur during pregnancy or breastfeeding, in premature or low-birthweight infants, in people undergoing dialysis, in people with certain blood disorders, psoriasis, malabsorption, or alcohol dependence, and in people taking certain drugs. The main effects include anaemia, sores around the mouth, and, in children, poor growth. Folic acid supplements taken just before conception, and for the first 12 weeks of pregnancy, have been shown to reduce the risk of a neural tube defect.... vitamin b complex
a rare autosomal *dominant condition characterized by hypertension associated with hypokalaemia, metabolic alkalosis, and low levels of plasma *renin and *aldosterone. The hypertension often starts in infancy and is due to excess resorption of sodium and excretion of potassium by the renal tubules. The syndrome is caused by a single genetic mutation on chromosome 16, which results in dysregulation of a sodium channel in the distal convoluted tubule. Treatment is with a low salt diet and a potassium-sparing diuretic that directly blocks the sodium channel, such as amiloride or triamterene. [G. G. Liddle (1921–89), US endocrinologist]... liddle’s syndrome
any of several peptides that stimulate diuresis (increased urine production) and vasodilatation (widening of blood vessels). They act on the kidney tubules to promote excretion of sodium (natriuresis) and water. Atrial natriuretic peptide (ANP) is produced in the atria of the heart in response to a rise in atrial pressure. Brain natriuretic peptide (BNP) is produced in the brain and the ventricles of the heart, mainly in response to stretching of the ventricular muscle (as occurs in congestive heart failure). Measurement of blood levels of BNP can be used as a diagnostic test for heart failure and also as an indicator of prognosis.... natriuretic peptide
n. one of a group of rare disorders due to *inborn errors of metabolism in which there are deficiencies in the enzymes involved in the biosynthesis of haem. The accumulation of the enzyme’s substrate gives rise to symptoms of the disorder. The defect may be primarily in the liver (hepatic porphyria) or in the bone marrow (erythropoietic porphyria) or both. The prominent features include the excretion of *porphyrins and their derivatives in the urine, which may change colour on standing (see porphobilinogen); sensitivity of the skin to sunlight causing chronic inflammation or blistering; inflammation of the nerves (neuritis); mental disturbances; and attacks of abdominal pain. The commonest porphyria is porphyria cutanea tarda, which affects up to 1 in 5000 people in some countries. It is a hereditary or acquired hepatic porphyria in which light-exposed areas of the skin become blistered and fragile. Acute intermittent porphyria is a hereditary hepatic porphyria characterized by recurrent attacks of acute abdominal pain, severe constipation, and psychotic behaviour. Factors triggering attacks include alcohol and many drugs.... porphyria
(RTA) metabolic acidosis due to failure of the kidney to excrete acid into the urine. Three types of RTA are recognized. Type 1 (distal RTA) results from a reduction in net acid secretion in the distal convoluted tubule (see nephron) and an inability to acidify the urine. Hypokalaemia is often present and may be severe. The condition can be either genetically determined or, more commonly, the result of systemic disease (e.g. autoimmune disorders) or drugs (e.g. amphotericin). Type II (proximal RTA) is due to a lowered threshold for bicarbonate reabsorption; eventually a steady state is established with a low serum bicarbonate but capacity to acidify the urine. Hypokalaemia is present due to *aldosteronism caused by the increased delivery of sodium to the distal tubule. Proximal RTA usually occurs as part of more widespread proximal tubule dysfunction with the *Fanconi syndrome. Type IV RTA results from impaired excretion of both acid and potassium and results in acidosis with hyperkalaemia. It is most commonly seen with aldosterone deficiency. This may be isolated, especially in diabetics, or it may be induced by drugs (angiotensin II antagonists or ACE inhibitors).... renal tubular acidosis
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