Laxatives Health Dictionary

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Laxatives: From 1 Different Sources

Drugs or other substances used to treat CONSTIPATION. Also called aperients or purgatives, laxatives are classi?ed according to their mode of action. The four main groups are bulk, stimulant, faecal softeners and osmotics. In addition, bowel-cleansing solutions are used before surgery, ENDOSCOPY, or radiological examination of the COLON, to ensure that the bowel is clear of solid matter. However, these are not procedures for treating constipation.

People should be aware that normal bowel habits vary greatly, from twice a day to once every two or even three days. Any change from normal frequency to irregular or infrequent defaecation may signal constipation. Furthermore, before laxatives are prescribed, it is essential to ensure that the constipation is not the result of an underlying condition producing ‘secondary’ constipation. Individuals should not use laxatives too often or indiscriminately; persistent constipation is a reason to seek medical advice.

Bulk laxatives include bran and most high-?bre foods, such as fruit, vegetables and wholemeal foods. These leave a large indigestible residue that holds water in the gut and produces a large soft stool. Isphaghula husk, methyl cellulose and stercula are helpful when bran is ine?ective. Inorganic salts such as magnesium sulphate (Epsom Salts) have a similar e?ect.

Stimulant laxatives – for example, bisacodyl, senna and docusate sodium – stimulate PERISTALSIS, although the action may be accompanied by colicky pains.

Faecal softeners (emollients) There are two groups: surface active agents such as dioctyl sodium and sulphosuccinate which retain water in the stools and are often combined with a stimulant purgative; and liquid para?n which is chemically inert and is said to act by lubrication.

Osmotic laxatives These substances act by holding ?uid in the bowel by OSMOSIS, or by altering the manner in which water is distributed in the FAECES. Magnesium salts are used to produce rapid bowel evacuation, although one of them, magnesium hydroxide, should be used only occasionally. Phosphate or sodium citrate enemas (see ENEMA) can be used for constipation, while the former is used to ensure bowel evacuation before abdominal radiological procedures, endoscopy and surgery.

Health Source: Medical Dictionary
Author: Health Dictionary

Constipation

A condition in which a person infrequently passes hard FAECES (stools). Patients sometimes complain of straining, a feeling of incomplete evacuation of faeces, and abdominal or perianal discomfort. A healthy individual usually opens his or her bowels once daily but the frequency may vary, perhaps twice daily or once only every two or three days. Constipation is generally de?ned as fewer than three bowel openings a week. Healthy people may have occasional bouts of constipation, usually re?ecting a temporary change in diet or the result of taking drugs – for example, CODEINE – or any serious condition resulting in immobility, especially in elderly people.

Constipation is a chronic condition and must be distinguished from the potentially serious disorder, acute obstruction, which may have several causes (see under INTESTINE, DISEASES OF). There are several possible causes of constipation; those due to gastrointestinal disorders include:

Dietary: lack of ?bre; low ?uid consumption.

Structural: benign strictures (narrowing of gut); carcinoma of the COLON; DIVERTICULAR DISEASE.

Motility: poor bowel training when young; slow transit due to reduced muscle activity in the colon, occurring usually in women; IRRITABLE BOWEL SYNDROME (IBS); HIRSCHSPRUNG’S DISEASE.

•Defaecation: anorectal disease such as ?ssures, HAEMORRHOIDS and CROHN’S DISEASE; impaction of faeces. Non-gastrointestinal disorders causing constipation include:

Drugs: opiates (preparations of OPIUM), iron supplements, ANTACIDS containing aluminium, ANTICHOLINERGIC drugs.

Metabolic and endocrine: DIABETES MELLITUS, pregnancy (see PREGNANCY AND LABOUR), hypothyroidism (see under THYROID GLAND, DISEASES OF).

Neurological: cerebrovascular accidents (STROKE), MULTIPLE SCLEROSIS (MS), PARKINSONISM, lesions in the SPINAL CORD. Persistent constipation for which there is no

obvious cause merits thorough investigation, and people who experience a change in bowel habits – for example, alternating constipation and diarrhoea – should also seek expert advice.

Treatment Most people with constipation will respond to a dietary supplement of ?bre, coupled, when appropriate, with an increase in ?uid intake. If this fails to work, judicious use of LAXATIVES for, say, a month is justi?ed. Should constipation persist, investigations on the advice of a general practitioner will probably be needed; any further treatment will depend on the outcome of the investigations in which a specialist will usually be involved. Successful treatment of the cause should then return the patient’s bowel habits to normal.... constipation

Laxative

For non-persistent constipation. An aperient for stool-softening purposes, milder than a cathartic. Sometimes given with a carminative to prevent griping.

Agar-agar, Balmony, Barberry, Black root, Blue Flag root, Bogbean, Boneset, Buckthorn, Burdock, Clivers, Dandelion, Figs, Frangula bark, Fenugreek, Fringe Tree bark, Lignum Vitae, Liquorice root (mild), Ispaghula seeds, Mountain Grape, Rhubarb root, Senna pods, Wahoo, Yellow Dock. If constipation persists or worsens a practitioner should be consulted.

Tea: Formula:– Dandelion root, crushed or shredded, 1; Senna leaves 2; Peppermint 3. Mix. 2 teaspoons to each cup boiling water, infuse 15 minutes. Cup 1-3 times daily.

Tablet: Active constituents: Aloes (Cape) BP 50mg; Pulverised Fennel BHP (1983) 15mg; Pulverised Valerian BP 30mg; Pulverised Holy Thistle BHP (1983) 60mg. A traditional herbal remedy for the relief of occasional or non-persistent constipation. (Gladlax – Gerard House)

Long term use of laxatives should be avoided. ... laxative

Bulimia

Bulimia means insatiable appetite of psychological origin. This eating-disorder symptom may be of psychological origin or the result of neurological disease – for example, a lesion of the HYPOTHALAMUS. Bulimia nervosa is linked to anorexia nervosa and is sometimes called the binge and purge syndrome. Bulimia nervosa is characterised by overpowering urges to eat large amounts of food, followed by induced vomiting or abuse of laxatives to avoid any gain in weight. Most of the victims are prone to being overweight and all have a morbid fear of obesity. They indulge in bouts of gross overeating, or ‘binge rounds’ as they describe them, to ‘?ll the empty space inside’. By their bizarre behaviour, most of them manage to maintain a normal weight. The condition is most common in women in their 20s; it is accompanied by irregular menstruation, often amounting to amenorrhoea (see MENSTRUATION). Although there are many similarities to anorexia nervosa, bulimia nervosa di?ers in that there is no attempt at deceit; sufferers freely admit to an eating disorder and feel distress about the symptoms that it produces. In spite of this, the response to treatment is, as in anorexia nervosa, far from satisfactory. (See EATING DISORDERS.)... bulimia

Cathartics

Substances which produce an evacuation of the bowels (see LAXATIVES). The term ‘cathartic’ also means possessing the power to cleanse.... cathartics

Chiretta

Swertia chirata. N.O. Gentianaceae.

Synonym: Brown Chirata, Chirayta, Griseb.

Habitat: Northern India.

Features ? Stem purplish-brown, cylindrical below, becoming quadrangular higher up, pithy, nearly quarter-inch thick. Leaves opposite, three to seven longitudinal ribs, entire. Fruit (capsule) one-celled, two valved. Extremely bitter taste.

Part used ? Whole plant.

Action: Bitter tonic.

In all cases where a tonic is indicated. With suitable hepatics and laxatives, sometimes forms part of prescriptions for liver complaints, dyspepsia and constipation.

Dose, two to four tablespoonfuls of 1/2 ounce to 1 pint infusion.... chiretta

Evacuant

Evacuant is a name for a purgative medicine (see LAXATIVES).... evacuant

Lactulose

An osmotic laxative (see OSMOSIS; LAXATIVES), lactulose is a semisynthetic disaccharide – a type of carbohydrate – which is not absorbed from the GASTROINTESTINAL TRACT. It reduces the acidity of FAECES.... lactulose

Magnesium Trisilicate

A white powder with mild antacid properties (see ANTACIDS) and a prolonged action, it is used for treating peptic ulceration – commonly combined with quickly acting antacids. It has a mild laxative e?ect (see LAXATIVES).... magnesium trisilicate

Purgatives

See LAXATIVES.... purgatives

Sciatica

This is neuralgia of the sciatic nerve. These are the two largest nerves in the body, composed of the tibial and common perineal nerves, bound together and containing elements of the lowest two lumbar and upper three sacral spinal cord nerves. Sciatica is felt as severe pain from the buttocks, down the back of the thighs, often radiating to the inside of the leg, even to the point of parasthesia or prickly numbness. Although tumors can cause the problem, far and away the most common causes are a lower back subluxation (responding to adjustment) or pelvic congestion and edema (responding to laxatives, exercise, and decreasing portal vein and lymphatic congestion).... sciatica

Senna

The leaves of various species of Cassia senna. It is one of the most active of the simple laxative drugs (see LAXATIVES). Senna is excreted in the urine, giving it a dark red or yellow colour. In the case of nursing mothers, some of the drug is excreted in the milk and may affect the infant. A standardised preparation of senna, Senokot®, is widely used for the management of constipation in children and old people. A side-e?ect of senna is HYPOKALAEMIA; like other laxatives, it should not be used too often.... senna

Eating Disorders

The term ‘eating disorders’ covers OBESITY, feeding problems in childhood, anorexia nervosa, and bulimia nervosa. The latter two are described here.

Anorexia nervosa Often called the slimmer’s disease, this is a syndrome characterised by the loss of at least a quarter of a person’s normal body weight; by fear of normal weight; and, in women, by AMENORRHOEA. An individual’s body image may be distorted so that the sufferer cannot judge real weight and wants to diet even when already very thin.

Anorexia nervosa usually begins in adolescence, affecting about 1–2 per cent of teenagers and college students at any time. It is 20 times more common among women than men. Up to 10 per cent of sufferers’ sisters also have the syndrome. Anorexia may be linked with episodes of bulimia (see below).

The symptoms result from secretive self-starvation, usually with excessive exercise, self-induced vomiting, and misuse of laxatives. An anorexic (or anorectic) person may wear layers of baggy clothes to keep warm and to hide the ?gure. Starvation can cause serious problems such as ANAEMIA, low blood pressure, slow heart rate, swollen ankles, and osteoporosis. Sudden death from heart ARRHYTHMIA may occur, particularly if the sufferer misuses DIURETICS to lose weight and also depletes the body’s level of potassium.

There is probably no single cause of anorexia nervosa. Social pressure to be thin seems to be an important factor and has increased over the past 20–30 years, along with the incidence of the syndrome. Psychological theories include fear of adulthood and fear of losing parents’ attention.

Treatment should start with the general practitioner who should ?rst rule out other illnesses causing similar signs and symptoms. These include DEPRESSION and disorders of the bowel, PITUITARY GLAND, THYROID GLAND, and OVARIES.

If the diagnosis is clearly anorexia nervosa, the general practitioner may refer the sufferer to a psychiatrist or psychologist. Moderately ill sufferers can be treated by COGNITIVE BEHAVIOUR THERAPY. A simple form of this is to agree targets for daily calorie intake and for acceptable body weight. The sufferer and the therapist (the general practitioner or a member of the psychiatric team) then monitor progress towards both targets by keeping a diary of food intake and measuring weight regularly. Counselling or more intensely personal PSYCHOTHERAPY may help too. Severe life-threatening complications will need urgent medical treatment in hospital, including rehydration and feeding using a nasogastric tube or an intravenous drip.

About half of anorectic sufferers recover fully within four years, a quarter improve, and a quarter remain severely underweight with (in the case of women) menstrual abnormalities. Recovery after ten years is rare and about 3 per cent die within that period, half of them by suicide.

Bulimia nervosa is a syndrome characterised by binge eating, self-induced vomiting and laxative misuse, and fear of fatness. There is some overlap between anorexia nervosa and bulimia but, unlike the former, bulimia may start at any age from adolescence to 40 and is probably more directly linked with ordinary dieting. Bulimic sufferers say that, although they feel depressed and guilty after binges, the ‘buzz’ and relief after vomiting and purging are addictive. They often respond well to cognitive behaviour therapy.

Bulimia nervosa does not necessarily cause weight loss because the binges – for example of a loaf of bread, a packet of cereal, and several cans of cold baked beans at one sitting – are cancelled out by purging, by self-induced vomiting and by brief episodes of starvation. The full syndrome has been found in about 1 per cent of women but mild forms may be much more common. In one survey of female college students, 13 per cent admitted to having had bulimic symptoms.

Bulimia nervosa rarely leads to serious physical illness or death. However, repeated vomiting can cause oesophageal burns, salivary gland infections, small tears in the stomach, and occasionally dehydration and chemical imbalances in the blood. Inducing vomiting using ?ngers may produce two tell-tale signs – bite marks on the knuckles and rotten, pitted teeth.

Those suffering from this condition may obtain advice from the Eating Disorders Association.... eating disorders

Linum Usitatissimum

Linn.

Habitat: Cultivated mainly in Madhya Pradesh, Uttar Pradesh, Maharashtra, Bihar and Rajasthan.

English: Linseed, Flax.

Ayurvedic: Atasi, Umaa, Masrnaa, Nilapushpi, Kshumaa.

Unani: Kattan.

Siddha/Tamil: (Seed).

Action: Seed—demulcent, emollient, laxative, antilipidemic, antitussive, pectoral (used in bronchitis and cough). Flowers—used as nervine and cardiac tonic. Oil— used in burns, skin injuries and sores.

Key application: Internally, for chronic constipation, for colons damaged by abuse of laxatives, irritable bowel syndrome, diverticular disease, symptomatic short-term treatment of gastritis and enteritis. Externally, for painful skin inflammations. (German Commission E, ESCOP, The British Herbal Pharmacopoeia.)

The plant contains chlorogenic acid and its isomer. Also present are palmitic, stearic, oleic, linoleic acids, along with amino acids, and sugars. Linseed also contains mucilage (3-10%) in epidermis; fatty oil (30-40%); cyanogenic glycosides (0.05-00.1%) mainly linus- tatin, neolinustatin and linamarin; lig- nans; phenylpropane derivatives including linusitamarin. (Cyanogenic glycosides are not found toxic in therapeutic doses as these are broken down only to a limited extent in the body.)

The seeds are an excellent source of dietary alpha-linolenic acid for modifying plasma and tissue lipids. Flaxseed preparations reduced atherogenic risk in hyperlipemic patients. (Cited in Expanded Commission E Monographs.)

Human studies have indicated Flax- seed's use in atherosclerosis, hyperc- holesterolemia, lupus nephritis, chronic renal diseases and in cancer prevention (active principle: lignan precursor secoisolariciresinol diglycoside). (Sharon M. Herr. Also Am J Clin Nutr, 1999, 69, 395-402.)

The PP glucose response to a 50 g carbohydrate load given as Flaxseed bread was found to be 27% lower when compared with regular white bread.

Taking Flaxseed oil daily for 3 months did not improve symptoms of pain and stiffness in rheumatoid arthritis and no effect was observed on RA, such as C-reactive protein and ESR. (Natural Medicines Comprehensive Database, 2007.)

The water-binding capacity and rhe- ological properties of linseed mucilage resembled those of guar gum.

Dosage: Ripe seed—3-6 g powder. (API, Vol. I.) Flower-bud—3-6 g; oil—5-10 ml. (CCRAS.)... linum usitatissimum

Magnesium

Magnesium is a light metallic element; it is one of the essential mineral elements of the body, without which the body cannot function properly. The adult body contains around 25 grams of magnesium, the greater part of which is in the bones. More than two-thirds of our daily supply comes from cereals and vegetables; as most other foods also contain useful amounts, there is seldom any di?culty in maintaining an adequate amount in the body. Magnesium is also an essential constituent of several vital enzymes (see ENZYME). De?ciency leads to muscular weakness and interferes with the e?cient working of the heart. The salts of magnesium used as drugs are the hydroxide of magnesium, the oxide of magnesium – generally known as ‘magnesia’ – and the carbonate of magnesium, all of which have an antacid action; also the sulphate of magnesium known as ‘Epsom salts’, which acts as a purgative.

Uses Compounds of magnesia are used to correct hyperacidity of the stomach and as a laxative (see LAXATIVES).... magnesium

Medicines

Medicines are drugs made stable, palatable and acceptable for administration. In Britain, the Medicines Act 1968 controls the making, advertising and selling of substances used for ‘medicinal purposes’, which means diagnosing, preventing or treating disease, or altering a function of the body. Permission to market a medicine has to be obtained from the government through the MEDICINES CONTROL AGENCY, or from the European Commission through the European Medicines Evaluation Agency. It takes the form of a Marketing Authorisation (formerly called a Product Licence), and the uses to which the medicine can be put are laid out in the Summary of Product Characteristics (which used to be called the Product Data Sheet).

There are three main categories of licensed medicinal product. Drugs in small quantities can, if they are perceived to be safe, be licensed for general sale (GSL – general sales list), and may then be sold in any retail shop. P (pharmacy-only) medicines can be sold from a registered pharmacy by or under the supervision of a pharmacist (see PHARMACISTS); no prescription is needed. P and GSL medicines are together known as OTCs – that is, ‘over-thecounter medicines’. POM (prescription-only medicines) can only be obtained from a registered pharmacy on the prescription of a doctor or dentist. As more information is gathered on the safety of drugs, and more emphasis put on individual responsibility for health, there is a trend towards allowing drugs that were once POM to be more widely available as P medicines. Examples include HYDROCORTISONE 1 per cent cream for skin rashes, CIMETIDINE for indigestion, and ACICLOVIR for cold sores. Care is needed to avoid taking a P medicine that might alter the actions of another medicine taken with it, or that might be unsuitable for other reasons. Patients should read the patient-information lea?et, and seek the pharmacist’s advice if they have any doubt about the information. They should tell their pharmacist or doctor if the medicine results in any unexpected effects.

Potentially dangerous drugs are preparations referred to under the Misuse of Drugs Act 1971 and subsequent regulations approved in 1985. Described as CONTROLLED DRUGS, these include such preparations as COCAINE, MORPHINE, DIAMORPHINE, LSD (see LYSERGIC ACID

DIETHYLAMIDE (LSD)), PETHIDINE HYDROCHLORIDE, AMPHETAMINES, BARBITURATES and most BENZODIAZEPINES.

Naming of drugs A European Community Directive (92/27/EEC) requires the use of the Recommended International Non-proprietary Name (rINN) for medicinal substances. For most of these the British Approved Name (BAN) and rINN were identical; where the two were di?erent, the BAN has been modi?ed in line with the rINN. Doctors and other authorised subscribers are advised to write titles of drugs and preparations in full because uno?cial abbreviations may be misinterpreted. Where a drug or preparation has a non-proprietary (generic) title, this should be used in prescribing unless there is a genuine problem over the bioavailability properties of a proprietary drug and its generic equivalent.

Where proprietary – commercially registered

– names exist, they may in general be used only for products supplied by the trademark owners. Countries outside the European Union have their own regulations for the naming of medicines.

Methods of administration The ways in which drugs are given are increasingly ingenious. Most are still given by mouth; some oral preparations (‘slow release’ or ‘controlled release’ preparations) are designed to release their contents slowly into the gut, to maintain the action of the drug.

Buccal preparations are allowed to dissolve in the mouth, and sublingual ones are dissolved under the tongue. The other end of the gastrointestinal tract can also absorb drugs: suppositories inserted in the rectum can be used for their local actions – for example, as laxatives – or to allow absorption when taking the drug by mouth is di?cult or impossible – for example, during a convulsion, or when vomiting.

Small amounts of drug can be absorbed through the intact skin, and for very potent drugs like OESTROGENS (female sex hormones) or the anti-anginal drug GLYCERYL TRINITRATE, a drug-releasing ‘patch’ can be used. Drugs can be inhaled into the lungs as a ?ne powder to treat or prevent ASTHMA attacks. They can also be dispersed (‘nebulised’) as a ?ne mist which can be administered with compressed air or oxygen. Spraying a drug into the nostril, so that it can be absorbed through the lining of the nose into the bloodstream, can avoid destruction of the drug in the stomach. This route is used for a small number of drugs like antidiuretic hormone (see VASOPRESSIN).

Injection remains an important route of administering drugs both locally (for example, into joints or into the eyeball), and into the bloodstream. For this latter purpose, drugs can be given under the skin – that is, subcutaneously (s.c. – also called hypodermic injection); into muscle – intramuscularly (i.m.); or into a vein – intravenously (i.v.). Oily or crystalline preparations of drugs injected subcutaneously form a ‘depot’ from which they are absorbed only slowly into the blood. The action of drugs such as TESTOSTERONE and INSULIN can be prolonged by using such preparations, which also allow contraceptive ‘implants’ that work for some months (see CONTRACEPTION).... medicines

Aperient

A mild laxative. Ispaghula seeds, Liquorice, Fenugreek, Boneset, Figs, Dandelion, Senna, Honey, Cowslip, Linseed. For stronger agents, see: LAXATIVES. ... aperient

Laxative Drugs

A group of drugs used to treat constipation.

There are various types.

Bulk-forming laxatives increase the volume and softness of faeces and make them easier to pass.

Stimulant laxatives stimulate the intestinal wall to contract and speed up the elimination of faeces.

Lubricant laxatives soften and facilitate the passage of faeces.

Osmotic laxatives increase the water content and volume of the faeces.

If used in excess, laxative drugs may cause diarrhoea, abdominal cramps, and flatulence, and may impair normal bowel function.... laxative drugs

Plantain, Broad And Narrow Leaf

Plantago species

Description: The broad leaf plantain has leaves over 2.5 centimeters across that grow close to the ground. The flowers are on a spike that rises from the middle of the cluster of leaves. The narrow leaf plantain has leaves up to 12 centimeters long and 2.5 centimeters wide, covered with hairs. The leaves form a rosette. The flowers are small and inconspicuous.

Habitat and Distribution: Look for these plants in lawns and along roads in the North Temperate Zone. This plant is a common weed throughout much of the world.

Edible Parts: The young tender leaves are edible raw. Older leaves should be cooked. Seeds are edible raw or roasted.

Other Uses: To relieve pain from wounds and sores, wash and soak the entire plant for a short time and apply it to the injured area. To treat diarrhea, drink tea made from 28 grams (1 ounce) of the plant leaves boiled in 0.5 liter of water. The seeds and seed husks act as laxatives.... plantain, broad and narrow leaf

Abdominal Pain

(Acute). Sudden unexplained colicky pain with distension in a healthy person justifies immediate attention by a doctor or suitably trained practitioner. Persistent tenderness, loss of appetite, weight and bowel action should be investigated. Laxatives: not taken for undiagnosed pain. Establish accurate diagnosis.

Treatment. See entries for specific disorders. Teas, powders, tinctures, liquid extracts, or essential oils – see entry of appropriate remedy.

The following are brief indications for action in the absence of a qualified practitioner. Flatulence (gas in the intestine or colon), (Peppermint). Upper right pain due to duodenal ulcer, (Goldenseal). Inflamed pancreas (Dandelion). Gall bladder, (Black root). Liver disorders (Fringe Tree bark). Lower left – diverticulitis, colitis, (Fenugreek seeds). Female organs, (Agnus Castus). Kidney disorders, (Buchu). Bladder, (Parsley Piert). Hiatus hernia (Papaya, Goldenseal). Peptic ulcer, (Irish Moss). Bilious attack (Wild Yam). Gastro-enteritis, (Meadowsweet). Constipation (Senna). Acute appendicitis, pain central, before settling in low right abdomen (Lobelia). Vomiting of blood, (American Cranesbill). Enlargement of abdominal glands is often associated with tonsillitis or glandular disease elsewhere which responds well to Poke root. As a blanket treatment for abdominal pains in general, old-time physicians used Turkey Rhubarb (with, or without Cardamom seed) to prevent griping.

Diet: No food until inflammation disperses. Slippery Elm drinks. ... abdominal pain

Anti-catarrhals

Agents that reduce the production of mucus. Angelica, Avens, Bayberry, Bistort, Blood root, Cayenne, Chamomile (German), Coltsfoot, Comfrey, Elderflowers, Elecampane, Eyebright, Fenugreek, Garlic, Ginger, Goldenseal, Gotu Kola, Ground Ivy, Hyssop, Iceland Moss, Irish Moss, Juniper, Liquorice, Marsh Cudweed, Marshmallow, Mountain Grape, Mouse Ear, Mullein, Myrrh, Parsley, Plantain, Poke root, Senega, Skunk Cabbage, White Horehound, Wild Cherry bark, Wild Indigo, Witch Hazel, Yarrow. Successful treatment of catarrh is often dependent upon efficient kidney, skin and bowel function which may require also, diuretics, alteratives and laxatives. ... anti-catarrhals

Aromatherapy

The external use of essential oils from seeds, resins, herbs, barks and spices for relaxant purposes.

Plant essences give plants their scent and were known to the ancient civilisations of Egypt and Greece as the ‘vital force’ or spirit of the plant. They were used for inhalation, rubbing on the skin or as a healthful addition to baths and foot-baths. The art is complementary to phytotherapy, acupuncture and other systems of alternative medicine.

The aromatherapist uses oils individually or in blends of different oils. The natural concentrated oil is usually diluted by adding a vegetable oil before direct application to the skin. A massage oil usually comprises 6 drops essential oil to 10ml (2 teaspoons) carrier oil – Almond, Peanut or other vegetable oil.

The skin is known to be an integral part of the immune system. T-cells are scattered throughout, primarily in the epidermis or outer layer. It has been demonstrated that oils rubbed on the skin are readily absorbed and borne to distant organs in the body via the bloodstream to soothe, relax and heal. Some oils should not be used during pregnancy or lactation.

An oil may be used as a natural perfume. As a bath oil, 5-6 drops of a favourite oil may be added to bathwater. Oils freshen a room; stimulate or relax as desired when added to water on a warm radiator. Oils are never used on the skin undiluted.

The aromatherapist never uses essential oils internally. Other carrier oils may be used: Sesame seed, Sunflower seed, Apricot kernel and Wheatgerm. Usual methods of applying essential oils: massage, inhalation and baths. When adding oils to baths water should not be too hot which causes oils to evaporate.

Remedies absorbed into the body via the skin avoid metabolism by the liver as when taken by mouth.

When the therapy was used in a geriatric ward in Oxford drug expenditure on laxatives and night sedatives fell. It was reported to have given profoundly deaf patients, many of whom had multiple sensory deficits, tranquillity. The results of a randomised trial in patients on an intensive care unit showed significantly greater psychological improvement (as demonstrated with anxiety and mood rating scales) in those given aromatherapy (1 per cent Lavender and Grapeseed oil) over those massaged with Grapeseed oil only or those prescribed rest alone. (The Lancet 1990 336 (8723) 1120)

The governing body of the therapy in the UK is the Aromatherapy Organisations Council (AOC) which represents the majority of professional practitioners. Enquiries: AOC, 3 Latymer Close, Braybrooke, Market Harborough. Leicester LE16 8LN. Tel/Fax 01858 434242. ... aromatherapy

Melanosis Coli

Black or brown discoloration of the colon lining, associated with chronic constipation and prolonged use of certain laxative drugs, such as senna, rhubarb, and cascara.

The discoloration is most common in elderly people and is usually symptomless, clearing up when the laxatives are stopped.

Rarely, it is associated with colon cancer (see colon, cancer of).... melanosis coli

Drastic

n. any agent causing a major change in a body system or function, e.g. strong laxatives.... drastic

Appendicitis

Inflammation of the vermiform appendix – a small worm-like offshoot from the gut at the junction of the colon and small intestine, in the low right fossa of the abdomen. Blockage leads to stasis and infection. Pain starts from the centre of the abdomen and moves down towards the low right groin focusing on a sensitive spot known as McBurney’s point (midway between the naval and the right groin). Possible history of constipation.

Symptoms. Attack may be sudden, with acute low right abdominal pain. Lost appetite. Vomiting occurs usually only once. Nausea. Temperature slightly raised (102°). Muscles rigid and boardlike. The sufferer tries to find relief by lying on his back with right leg drawn up. Rapid heartbeat.

May lapse into abscess, perforation or peritonitis. If neglected, gangrene is a possibility, therefore a modern hospital is the safest place. In any case surgical excision may be necessary to prevent a burst when pus would discharge into the surrounding cavity causing peritonitis.

Differential diagnosis. Inflammation of the right ovary, gall bladder or kidney, ileitis, diverticulitis, perforated peptic ulcer.

Skin temperature aids diagnosis. Application of Feverscan thermometer detects local skin temperature over the right iliac fossa and records at least 1°C warmer than that on the left.

An added aid to diagnosis is the facial expression which predominantly conveys an aura of malaise with an obvious upward curving of the upper lip. This is not a wince or grimace but a slower reaction, and occurs on gentle pressure over the appendix. Rectal tenderness may indicate peritonitis.

A practitioner’s prescription would be raised according to the individual requirements of each case; some calling for support of nervous system (Skullcap, Lady’s Slipper) or for the heart (Hawthorn, Motherwort), etc.

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

Treatment. Acute stage – immediate hospitalisation.

Tea. Formula. For non-acute stage: equal parts – German Chamomile, Yarrow, Black Horehound. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes. 1 cup thrice daily.

Tea: children. Agrimony.

Tablets/capsules. (non-acute stage), Goldenseal, Blue Flag root, Calamus, Cranesbill, Wild Yam. Juice: Aloe Vera.

Chinese medicine. Fenugreek seeds: 2 teaspoons to each cup water simmer 5 minutes. 1 cup thrice daily, consuming the seeds.

Powders. Formula. Echinacea 2; Myrrh half; Wild Yam half; trace of Cayenne. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily. Every 2 hours for acute cases.

Tinctures. Formula. Echinacea 2; Wild Yam half; Elderflowers 1; few drops Tincture Capsicum (cayenne). Dose: 1-2 teaspoons in water or herb tea thrice daily or every 2 hours for acute cases.

Finlay Ellingwood MD. Equal parts, Liquid Extract Bryonia and Echinacea. Dose: 20 drops in water, hourly. For prevention of sepsis and pus formation.

Eric F.W. Powell, MNIMH. 1 teaspoon Tincture Echinacea; 10 drops Tincture Myrrh; 2 drops Tincture

Capsicum; in wineglassful hot water. Each wineglass taken in sips; dose repeated hourly until pain eases; then less frequently.

Frank Roberts, MNIMH. Liquid extracts: Equal parts, Wild Yam, Echinacea, Lobelia. Mix. 30-60 drops in wineglassful water, sipped 4 times daily.

John Cooper MD, Waldron, Arkansas, USA. 20 grains Epsom’s salts in hot water every 2 hours until pain ceases, then continue half that quantity. To control pain: Tincture Belladonna, 8 drops in water, when necessary.

Enema. Large enemas are not indicated. Warm strong infusion of German Chamomile proves helpful (50 flowers to 1 pint boiling water). Inject with 1 tablespoon warm olive oil.

Topical. Castor oil packs. Chamomile, Catnep, or Linseed poultices. In France, cases of acute appendicitis are treated with Tea Tree oil by abdominal massage as an alternative to surgery; good results reported.

Diet. No solid food taken as long as raised temperature persists. Herb tea and fruit-juice fast.

Remission of fever or after surgery: Slippery Elm gruel. Convalescent stage requires extra protein to make good muscle wastage and loss of weight. Low fibre.

Supplements. Daily. Beta-carotene 300,000iu. Vitamin C 2-3g. Vitamin E 400-800iu. Child: quarter of adult dose.

Acute stage: until the doctor comes. Do not eat or drink, take laxatives or painkillers. Go to bed. Hot water bottle to ease pain. ... appendicitis

Cardiac

From the Greek pertaining to the heart. Cardio-vascular pertains to the heart and blood vessels.

Cardio-actives. Herbs exercising a direct action on the heart due to the cardiac glycosides they contain. They increase output by sustaining the heart muscle without a demand for more oxygen. This group includes: Motherwort, Hawthorn, Broom, Lily of the Valley, Figwort, Bugleweed, Squills.

Cardiac glycosides, especially those of the Foxglove (digitalis) which is administered by a physician only, tend to accumulate in the body and may prove toxic when their elimination is retarded. The most important cardio-active used by the Consulting Herbalist is Lily of the Valley which has an action similar to Foxglove but without toxic effect. It is a reliable alternative to Foxglove for failure of the heart with retention of water in the body.

Cardio-tonics. Herbalists use other plants that do not contain cardiac glycosides but which have an indirect effect upon the heart. These dilate arteries and peripheral vessels, speeding the circulation, reducing high blood pressure, relieving any back-pressure on the heart caused by accumulation of blood in the lungs. There are peripheral dilators to resolve any hold-up in the circulation and others that assist a failing heart by eliminating obstruction in the bowel (laxatives), liver and kidneys (hepatics and diuretics), skin (diaphoretics and alteratives, chief of which is Figwort). The heart also may feel the benefit of a timely relaxing nervine such as Skullcap or Lime flowers. Even treatment of varicose veins indirectly assists. All of these reduce the work-load of the muscle and tend to ‘normalise’ function of the heart. Cardio-tonics include Ephedra, Motherwort, Rosemary, Mistletoe, Hawthorn, Lime flowers, Cayenne, Yarrow, Garlic, Balm.

Bugleweed is often overlooked as a cardiac sedative to relax capillaries and soothe arterial excitement. ... cardiac

Children

Massive and long continued medication should be avoided, parents acquiring some ability to distinguish between the purely miserable and the critically ill. It is easy to become alarmed at the sight of a child in the throes of a convulsion or feverishness when there may be a tendency to over-prescribe. German Chamomile tea is a splendid children’s remedy. Liquid Extract and Tincture doses for children are 1 drop and 2 drops, respectively, for each year of age.

Anti-depressants should not be given for bed-wetting, drugs for sleep problems or strong laxatives for the chronically constipated. Mild herbal alternatives exist. Fresh carrot juice daily helps a child to avoid some complaints. Some herbs are not advised for children under 12, except under the care of a qualified practitioner.

Parental smoking habits are known to be responsible for crying and digestive symptoms in infants. Sleeplessness. German Chamomile or Balm tea: children 2-10 years quarter to half a cup; over 10 years: 1 cup. Babies: 3-6 teaspoons in feeding bottle – sweeten with honey if necessary.

Night seizures, with screaming: Passion Flower tea. 1 heaped teaspoon to cup boiling water; infuse 5-15 minutes. Strain. A few teaspoons at bedtime. When a brain storm starts place pinch of salt on the tongue. Calcium deficiency. Nettle tea. Carrot juice. Cod Liver oil with fresh orange juice.

Colic. Any tea: Dill, Catnep, Spearmint or Fennel. Few teaspoons frequently. Abdominal massage: 3 drops Chamomile oil in teaspoon olive oil.

Constipation. Prune or carrot juice. Dandelion coffee.

Cough. Oil of Thyme – few drops in water.

Crusta Lacta (milk rash). Weak teas: Plantain, Heartsease, Red Clover. Anoint with St John’s Wort oil. Buttermilk, Wheatgerm.

Diarrhoea. Teas: Yarrow, Tormentil. Breast feeding during the first 4-6 months of life reduces the risk of children’s diarrhoea.

Digestion, weak. Teas: Fennel, Caraway, Dill. 1 teaspoon crushed seeds to cup boiling water. Infuse 15 minutes in a covered vessel. Teaspoon doses for under 2s; half-1 cup thereafter. Also for flatulence. Feverishness. Alarm at a baby’s fever and fractiousness may attract complete medical treatment including nose drops, cough linctus, antipyretics and antibiotics, together with something to let the parents get some sleep. Avoid where possible. Mild fevers: teas – Yarrow, Marigold, Thyme, Elderflowers and Peppermint, Catmint, Carragheen Moss. Sweeten with honey. Topical: Flannels wrung out in these hot teas. Zinc can cut short the common cold. Echinacea tablets/capsules offer antiviral protection.

It is common for a child to convulse with fever. A feverish child, kept cool, is less likely to have convulsions. Remove most of child’s clothes so he can lose heat through the skin. Fruit juices (Vitamin C) in abundance. Do not feed solid foods. Wash in lukewarm (not cold) water.

Eyes. Deep hollows under the eyes reveal exhaustion, for which blood and nerve tonics and iron supplements are indicated.

Growth problems. Under-developed children respond well to herbal aids: Gentian, Ginseng, Horsetail, Marigold, Oats, German Chamomile, Wood Betony, Kelp, Alfalfa. Supplementation with brewer’s yeast, Calcium, Pollen and Zinc yield convincing results.

Hyperactivity. Nerve restoratives for highly-strung children: Teas: Lime flowers, Chamomile, Lemon Balm, B-vitamins. Porridge. Tablets: Passion flower, Valerian, Skullcap. Vitamins B6 and C. Powders: formula. Passion flower 2; Valerian 1; Liquorice 1. Dose: 250mg (one 00 capsule or one-sixth teaspoon) thrice daily.

Irritability and impaired school performance may be due to Tartrazine and other additives, sugar, and anticonvulsant drugs. See previous paragraph.

Infection. Infection of the upper respiratory tract may manifest as inflammation of the middle ear, nasal discharge or tonsillitis. Echinacea tablets, powder or liquid extract indicated. For specific infection such as measles, see under MEASLES, or other appropriate entry.

Skin. Reject cow’s in favour of goat’s milk. See appropriate entry for each skin disease (ECZEMA, etc). Care of skin after bathing: St John’s Wort oil, Evening Primrose oil. ... children

Eliminative

A herb to disperse and promote excretion from the body accumulated poisonous substances, metabolites, that may have been ingested as additives in food, inhaled as part of the environment, or acquired as morbid products of inflammation left behind after some acute disease, such as influenza.

Some eliminatives have a biochemical action on cell wastes and toxins, breaking them down preparatory to voiding from the body. Others stimulate organs of elimination to speed them on their journey: liver, kidneys, skin, bowel. This group will therefore include diuretics, hepatics, lymphatics, expectorants, diaphoretics or laxatives according to indications of the case. ... eliminative

Fluid Retention Syndrome (frs)

Accumulation of fluid beneath the skin; frequent sites – fingers, abdomen, breast, ankles.

Symptoms. Headache, frequency of urine, palpitation, possible irritable bowel syndrome. “My feet are killing me”, “I can’t get my wedding ring off” are typical complaints by women with FRS. Sometimes a complication of diabetes, or follows abuse of laxatives or diuretic drugs. A part of the premenstrual syndrome.

Alternatives. Teas. Any of the following: Buchu, Dandelion, Hawthorn, Motherwort, Yarrow. One or more cups daily, cold.

Tablets. Popular combination. Powdered Dandelion root BHP (1983) 90mg; powdered Horsetail extract 3:1 10mg; powdered Uva Ursi extract 3:1 75mg. (Gerard House)

Formula. Equal parts: Hawthorn, Dandelion, Broom. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 1-2 teaspoons. Thrice daily.

Practitioner. Tincture Lily of the Valley (Convallaria) BHP (1983) (1:5 in 40 per cent alcohol). Dose 8- 15 drops (0.5-1ml). Thrice daily.

Aromatherapy. 6 drops Lavender oil on wet handkerchief: use as a compress for relief of ankles during a journey.

Traditional Gypsy Medicine. The sufferer is exposed to the rising smoke of smouldering Juniper berries which exudes volatile oils and has a gentle diuretic effect.

Diet. Salt-free. High protein. Dandelion coffee. Supplements. Vitamin B-complex, Potassium, Copper. ... fluid retention syndrome (frs)

Headache, Common

 Usually due to muscular tension. Where persistent the underlying cause should be treated. Causes are many and varied including fevers, infected sinus cavities, kidney disorders, dental problems, thrombosis, neuralgias, nasal congestion, arteritis, pressure within the eyes, spread of pain from bones, etc.

See separate entry for migraine.

As indicated: relaxants, antispasmodics, hepatics (liver agents), laxatives. BHP (1983) recommends: Betony, Hops, St John’s Wort, Yerba Mate, Catmint, Passion flower, Jamaican Dogwood, Pulsatilla, Rosemary. A diuretic may release excess body fluid and surprisingly relieve headache as in pre-menstrual tension.

Frontal headache: Agnus Castus.

From eyestrain: Rue, Witch Hazel.

After heavy physical work: Ginseng.

Neuralgia of the skull: Gelsemium.

Low blood pressure: Gentian.

High blood pressure: Lime flowers.

Depressive conditions: Cola.

Pain, back of the head: Oats, Ladyslipper.

Pre-menstrual: Cramp bark, Agnus Castus.

Excess mental exertion: Rosemary.

Following anger: Sumbul.

In children: see CHILDREN’S COMPLAINTS.

Pain, top of head: Pulsatilla, Cactus.

Throbbing headache: Chamomile.

Sick headache: Blue Flag.

Tension headache: Skullcap, Betony, Passion flower.

Cluster headache, associated with shingles: Vervain, Skullcap.

Menstrual headache: see entry: MENSTRUAL HEADACHE.

Alternatives. Tea. Combine equal parts: Skullcap, Betony, Chamomile. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup when necessary.

Decoction. Combine equal parts: Valerian, Blue Flag, Barberry bark. 1 teaspoon to each cup water gently simmered 20 minutes. Half-1 cup whens necessary.

Tablets/capsules. Blue Flag, Valerian, Chamomile, Passion flower.

Powders. Formula. Equal parts: Skullcap, Rosemary, Valerian. 500mg (two 00 capsules or one-third teaspoon) when necessary.

Tinctures. Combine equal parts: Mistletoe, Valerian, Skullcap. One to two teaspoons in water every 3 hours as necessary.

Tincture Rosemary. 15-30 drops in water as necessary.

Practitioner. Tincture Gelsemium 5 drops to 100ml water (half cup) – 1 teaspoon hourly.

Traditional combination: Skullcap, Valerian, Mistletoe.

Topical. Hot footbaths. Cold compress to head.

Aromatherapy. Anoint forehead with few drops: Lavender, Chamomile, Rosemary, Mint, Balm, or Tiger Balm essential oils.

Diet. Low fat. Low salt. Avoid meats preserved in sodium nitrite (bacon, ham, red meats, etc). Supplementation. Vitamins A, B-complex, B6 (50mg), B12, C (up to 1 gram), E (up to 1000iu). Magnesium, Zinc. ... headache, common

Materia Medica

The science which deals with the source, origin, distribution, composition, preparation and action of medicinal plants used in herbalism. Although the modern herbalist no longer forages his own herbs from fields and hedgerows, a knowledge of materia medica is important.

“Crudes” are mostly imported from abroad, cut fine, and sold by skilled suppliers or druggists to herb shops for sale in their native state or for compounding into preparations by practitioners.

The art of preparing medicines is known as pharmacy; that of herbal medicine is often referred to as biopharmacy or “green pharmacy”. There are certain disadvantages of buying crude material from other than specialist sources; the risk of stale or otherwise inactive material is one.

An accredited manufacturer will compound materials according to a fixed formula published in an official pharmacopoeia. A practitioner writes his prescription which he compounds himself or gives it to an assistant who acts as a dispenser. This art of dispensing evolves as Herbal Pharmacy.

The traditional herbalist will endeavour to relieve a condition by giving a remedy which produces an opposite effect. For instance, a loose condition of the bowels, as in colitis, would be reversed by astringents; a ‘tight’ colon, as in some forms of constipation, would be relaxed by laxatives. They thus work to a system of cure known as contraria contraribus curantur.

Rational herbalism has evolved from a knowledge of the behaviour of disease patterns and an understanding of remedies used to combat them. Periwinkle (Vinca), for instance, kills off white blood cells over-produced in leukaemia without harming the body. Treatment of leukaemia with Vinca in the form of Vinplastine or other derivatives is therefore rational.

It is well-known that alkalies inhibit secretion of gastric juice. Hyper-acidity (over-secretion of acid) is the common cause of many forms of indigestion. A herbal pharmacopoeia describes effective plants with a positive alkaline action. Herbal alkalies are therefore rationally indicated.

Plant medicines obtain their objective by chemical means. During its life, a plant will take up from the soil various minerals from which it synthesises alkaloids, glycosides, saponins, etc, that are the real activators. Their strength depends upon the quality of soil on which they are grown. ... materia medica

Dying, Care Of The

Physical and psychological care with the aim of making the final period of a dying person’s life as free from pain, discomfort, and emotional distress as possible. Carers may include doctors, nurses, other medical professionals, counsellors, social workers, clergy, family, and friends.

Pain can be relieved by regular low doses of analgesic drugs. Opioid analgesics, such as morphine, may be given if pain is severe. Other methods of pain relief include nerve blocks, cordotomy, and TENS. Nausea and vomiting may be controlled by drugs. Constipation can be treated with laxatives. Breathlessness is another common problem in the dying and may be relieved by morphine.

Towards the end, the dying person may be restless and may suffer from breathing difficulty due to heart failure or pneumonia. These symptoms can be relieved by drugs and by placing the patient in a more comfortable position.

Emotional care is as important as the relief of physical symptoms.

Many dying people feel angry or depressed and feelings of guilt or regret are common responses.

Loving, caring support from family, friends, and others is important.

Many terminally ill people prefer to die at home.

Few terminally ill patients require complicated nursing for a prolonged period.

Care in a hospice may be offered.

Hospices are small units that have been established specifically to care for the dying and their families.... dying, care of the

Anorexia Nervosa

a psychiatric illness in which the patients starve themselves or use other techniques, such as vomiting or taking laxatives, to induce weight loss. To fulfil ICD-10 criteria for anorexia nervosa a patient must have a distorted body image (thinking they are overweight when they are not), a defined weight loss or *body mass index reduction, amenorrhoea, and vomiting or purging. The illness is most common in female adolescents, but about 10% of sufferers are male. There is a significant mortality associated with anorexia nervosa because of the medical consequences of weight loss. The causes of the illness are not clearly understood: problems within the family, rejection of adult sexuality, self-harming behaviour in the context of an *emotionally unstable personality disorder, and performance pressure are hypothesized as factors involved. Patients must be persuaded to eat enough to maintain a normal body weight and their emotional disturbance is usually treated with *psychotherapy supported by a dietician and possibly the *community mental health team. See also bulimia.... anorexia nervosa

Bloating

n. the subjective experience of abdominal fullness, often (but not always) accompanied by abdominal distension. Its many causes include air swallowing (*aerophagia), abnormal intestinal gas handling or abdominal wall reflexes, increased gas production, and organ hypersensitivity. Bloating may be associated with increased belching, excessive flatus, or changes in bowel habit, particularly constipation. It tends to be aggravated by meals, fluctuates in severity throughout the day (with particular discomfort in the evening), and is relieved at night. Treatment includes the removal of exacerbating factors (such as specific dietary products), avoidance of carbonated drinks and fat-rich diets, reduction in dietary fibre, and reassurance. Drug therapy has limited efficacy, but antispasmodics, laxatives, peppermint oil, simeticone, prokinetics (such as domperidone), nonabsorbable antibiotics (rifaximin), and tricyclic antidepressants (to reduce hypersensitivity) may be tried.... bloating

Irritable Bowel Syndrome

(IBS) a common functional bowel disorder characterized by recurrent abdominal pain, altered stool consistency, and variable frequency of defecation. The symptoms, which may differ from individual to individual, may be caused by abnormal contractions of the colon, heightened sensitivity to such stimuli as stretching or distension, stress, and changes in diet. A minority of people may develop symptoms following an episode of gastroenteritis (postinfectious irritable bowel syndrome). Tests may be needed to rule out organic disease. Treatment includes reassurance, dietary manipulation (see FODMAPS), the use of antispasmodics, antidiarrhoeal drugs or laxatives, and drugs that reduce the sensitivity of the bowel (such as low-dose amitriptyline).... irritable bowel syndrome

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