Litre Health Dictionary

The number of each of the cellular components per litre of blood. It may be calculated using a microscope or by an automated process.... blood count

The volume of blood pumped out per minute by the ventricles of the heart. It is one measure of the heart’s e?ciency. At rest, the heart of a healthy adult will pump between 2.5 and 4.5 litres of blood every minute. Exercise will raise this to as much as 30 litres a minute but, if this ?gure is low, it suggests that the heart muscle may be diseased or that the person has suffered severe blood loss.... cardiac output

Millilitre is the 1,000th part of 1 litre. It is practically the equivalent of a cubic centimetre (1 cm3 = 0·999973 ml); ml is the usual abbreviation.... millilitre

A LIPID that is an important constituent of body cells and so widely distributed throughout the body. It is especially abundant in the brain, nervous tissue, adrenal glands and skin. It is also found in egg yolk and gall-stones (see GALLBLADDER, DISEASES OF). Cholesterol plays an important role in the body, being essential for the production of the sex hormones as well as for the repair of membranes. It is also the source from which BILE acids are manufactured. The total amount in the body of a man weighing 70 kilograms (10 stones) is around 140 grams, and the amount present in the blood is 3·6–7·8 mmol per litre or 150–250 milligrams per 100 millilitres.

A high blood-cholesterol level – that is, one over 6 mmol per litre or 238 mg per 100 ml – is undesirable as there appears to be a correlation between a high blood cholesterol and ATHEROMA, the form of arterial degenerative disease associated with coronary thrombosis and high blood pressure. This is well exempli?ed in DIABETES MELLITUS and HYPOTHYROIDISM, two diseases in which there is a high blood cholesterol, sometimes going as high as 20 mmol per litre; patients with these diseases are known to be particularly prone to arterial disease. There is also a familial disease known as hypercholesterolaemia, in which members of affected families have a blood cholesterol of around 18 mmol per litre or more, and are particularly liable to premature degenerative disease of the arteries. Many experts believe that there is no ‘safe level’ and that everybody should attempt to keep their cholesterol level as low as possible.

Cholesterol exists in three forms in the blood: high-density lipoproteins (HDLs) which are believed to protect against arterial disease, and a low-density version (LDLs) and very low-density type (VLDLs), these latter two being risk factors.

The rising incidence of arterial disease in western countries in recent years has drawn attention to this relationship between high levels of cholesterol in the blood and arterial disease. The available evidence indicates that there is a relationship between blood-cholesterol levels and the amount of fat consumed; however, the blood-cholesterol level bears little relationship to the amount of cholesterol consumed, most of the cholesterol in the body being produced by the body itself.

On the other hand, diets high in saturated fatty acids – chie?y animal fats such as red meat, butter and dripping – tend to raise the blood-cholesterol level; while foods high in unsaturated fatty acids – chie?y vegetable products such as olive and sun?ower oils, and oily ?sh such as mackerel and herring – tend to lower it. There is a tendency in western society to eat too much animal fat, and current health recommendations are for everyone to decrease saturated-fat intake, increase unsaturated-fat intake, increase daily exercise, and avoid obesity. This advice is particulary important for people with high blood-cholesterol levels, with diabetes mellitus, or with a history of coronary thrombosis (see HEART, DISEASES OF). As well as a low-cholesterol diet, people with high cholesterol values or arterial disease may be given cholesterol-reducing drugs such as STATINS, but this treatment requires full clinical assessment and ongoing medical monitoring. Recent research involving the world’s largest trial into the effects of treatment to lower concentrations of cholesterol in the blood showed that routine use of drugs such as statins reduced the incidence of heart attacks and strokes by one-third, even in people with normal levels of cholesterol. The research also showed that statins bene?ted women and the over-70s.... cholesterol

A procedure used to ?lter o? waste products from the blood and remove surplus ?uid from the body in someone who has kidney failure (see KIDNEYS, DISEASES OF). The scienti?c process involves separating crystalloid and COLLOID substances from a solution by interposing a semi-permeable membrane between the solution and pure water. The crystalloid substances pass through the membrane into the water until a state of equilibrium, so far as the crystalloid substances are concerned, is established between the two sides of the membrane. The colloid substances do not pass through the membrane.

Dialysis is available as either haemodialysis or peritoneal dialysis.

Haemodialysis Blood is removed from the circulation either through an arti?cial arteriovenous ?stula (junction) or a temporary or permanent internal catheter in the jugular vein (see CATHETERS). It then passes through an arti?cial kidney (‘dialyser’) to remove toxins (e.g. potassium and urea) by di?usion and excess salt and water by ultra?ltration from the blood into dialysis ?uid prepared in a ‘proportionator’ (often referred to as a ‘kidney machine’). Dialysers vary in design and performance but all work on the principle of a semi-permeable membrane separating blood from dialysis ?uid. Haemodialysis is undertaken two to three times a week for 4–6 hours a session.

Peritoneal dialysis uses the peritoneal lining (see PERITONEUM) as a semi-permeable membrane. Approximately 2 litres of sterile ?uid is run into the peritoneum through the permanent indwelling catheter; the ?uid is left for 3–4 hours; and the cycle is repeated 3–4 times per day. Most patients undertake continuous ambulatory peritoneal dialysis (CAPD), although a few use a machine overnight (continuous cycling peritoneal dialysis, CCPD) which allows greater clearance of toxins.

Disadvantages of haemodialysis include cardiovascular instability, HYPERTENSION, bone disease, ANAEMIA and development of periarticular AMYLOIDOSIS. Disadvantages of peritoneal dialysis include peritonitis, poor drainage of ?uid, and gradual loss of overall e?ciency as endogenous renal function declines. Haemodialysis is usually done in outpatient dialysis clinics by skilled nurses, but some patients can carry out the procedure at home. Both haemodialysis and peritoneal dialysis carry a relatively high morbidity and the ideal treatment for patients with end-stage renal failure is successful renal TRANSPLANTATION.... dialysis

The red fluid that circulates in the body’s veins, arteries, and capillaries. Blood is pumped by the heart via the arteries to the lungs and all other tissues and is then returned to the heart in veins (see circulatory system). Blood is the body’s transport system and plays an important role in the defence against infection. An average adult has about 5 litres of blood.

Almost half of the volume of blood consists of blood cells; these include red blood cells (erythrocytes), which carry oxygen to tissues; white blood cells (leukocytes), which fight infection; and platelets (thrombocytes), which are involved in blood clotting. The remainder of the blood volume is a watery, strawcoloured fluid called plasma, which contains dissolved proteins, sugars, fats, salts, and minerals. Nutrients are transported in the blood to the tissues after absorption from the intestinal tract or after release from storage depots such as the liver. Waste products, including urea and bilirubin are carried in the plasma to the kidneys and liver respectively.

Plasma proteins include fibrinogen; which is involved in blood clotting; immunoglobulins (also called antibodies) and complement, which are part of the immune system; and albumin. Hormones are also transported in the blood to their target organs.... blood

Abelmoschus moschatus

Malvaceae

San: Latakasturika Hin, Guj,

Ben: Mushkdana Mal: Kasthurivenda Mar: Kasthuri- bhendi

Tel: Kasturi benda

Tam: Varttilaikasturi

Kan: Kasturi bende Ass: Gorukhiakorai

Importance: Ambrette, also popularly known as musk or Muskmallow, is an erect annual herb which yields musk-like scented seeds and woos everybody through its sensuous musky fragrance. Every part of this medicinal plant is used in one or the other way. Seeds are effective aphrodisiac and antispasmodic, and used in tonics. They check vomiting and cure diseases due to kapha and vata and are useful in treating intestinal disorders, urinary discharge, nervous disorders, hysteria, skin diseases, snake bites, pruritus, leucoderma and general debility. Flower infusion is contraceptive. The leaves and roots are used for gonorrhoea and to treat boils and swellings.

Ambrette oil of commerce is extracted from the seeds and is used in perfumery, flavouring, cosmetic and agarbathi industries. The essential oil is employed in non-alcoholic beverages, ice-creams, candies and baked foods. The aromatic concrete and absolute, extracted from seeds are used as base material for preparing high grade perfumes, scents and cosmetics. It is also known for exalting, amplifying and diffusing effects it imparts to perfumes. It blends well with rose, neroli, and sandal wood oil and aliphatic aldehydes.

The flowers are in great demand for making ‘zarda’ a flavoured tobacco in India. The seeds are mixed with tea and coffee for flavour. The seed is rich in essential amino acids and is used as cattle or poultry feed. The stem bark yields a good quality fibre. Seeds are used to protect woollen garments against moth and it imparts a musky odour to sachets, hair powder, panmasala and incense. Its tender shoots are used in soups, green pods as vegetable and seed husk in flower arrangements. From perfumes to panmasalas and tonics, it is the musky musk all the way. In addition to internal consumption, its seeds are exported to Canada, France and UK because of its diversified uses (Srinivasan et al, 1997).

Distribution: The musk plant is a native of India and it grows in the tropical subtropical and hilly regions of the country; particularly in the states of Maharashta, Gujarat, Madhyapresh, Tamil Nadu and Kerala. More than 50 collections of the plant are maintained by the National Bureau of Plant Genetic Resources (NBPGR), New Delhi and its regional station in Akola, Maharashtra.

Botany: Abelmoschus moschatus Medicus syn. Hibiscus abelmoshus Linn. belongs to Family Malvaceae. Muskmallow is an erect annual or biennial hirsute or hispid herb of 60-180 cm height. The leaves are simple polymorphous, usually palmately 3-7 lobed; lobes narrow, acute or oblong-ovate, crenate, serrate or irregularly toothed, hairy on both surfaces. Flowers are large and bright yellow with purple centre. Fruits are fulvous, hairy and capsular. Seeds are many, subreniform, black or greyish - brown and musk scented (Husain et al, 1992).

Agrotechnology: Ambrette is a hardy plant which can be grown in varied climate under tropical and subtropical conditions. It can be grown both as a rainfed crop and as an irrigated crop. It grows on well drained loamy and sandy loam soils. Loamy soils with neutral pH and plenty of organic matter are ideal for its cultivation.

Musk of propagated through seeds. The optimum time of sowing is June-July with pre- monsoon showers. The land is prepared well by ploughing, harrowing and levelling. Well decomposed FYM or compost is incorporated into the soil at 10 - 15 t/ha. Ridges and furrows are formed giving a spacing of 60 - 100 cm. Seed rate is 2-3 kg/ha. Seeds are soaked in water before sowing for 24 hours. Two to three seeds are sown per hole at 60 cm spacing on one side of the ridge at a depth of 1 cm and covered with a pinch of sand or loose soil. It takes 5-7 days for proper germination. After germination, extra seedlings are thinned out leaving one healthy growing plant per hole within 20 days. Fertilisers are applied at 120:40:40 kg N, P2O5, K2O/ha generally. However, a dose 160:80:80 kg/ha is recommended for best yields of seed and oil. Phosphorus is applied fully as basal. N and K are applied in 3 equal doses at planting, 2 and 4 months after planting. Fertilizers are applied 10 cm away from the plants. For irrigated crop, field is irrigated soon after sowing. Irrigation is given twice a week during the initial period and once a week thereafter. The field is kept weed free by regular weeding during the growing period (Farooqi and Khan, 1991).

Musk plants suffer from pests like spider mites, fruit bores and leaf eating caterpillars. Diseases like powdery mildew and wilt are also observed on the plant. Spider mites and powdery mildew are controlled by spraying 30g wettable sulphur in 10 litres of water. Pod borers can be controlled by spraying 20ml oxydemeton methyl in 10 litres of water.

The crop starts flowering about 75 days after sowing. The flowers set into fruits in 3-4 days and the pods take nearly a month to mature. Flowering and fruit setting extends from October to April. Harvesting is arduous. Fruits have to be plucked as soon as they attain black colour; otherwise, they split and seeds scatter. Therefore, weekly collection of pods is necessary and in all 20-25 pluckings may be required as it is a 170-180 days duration crop. The fruits are further dried and threshed to separate seeds. The seed yield is 1-1.5 /ha

Postharvest technology:. The oil is extracted from seed by steam distillation followed by solvent extraction.

The concrete of solvent extraction is further extracted with alcohol to get the absolute, that is, the alcohol soluble volatile concentrate.

Properties and activity: The fatty oil of seeds contain phospholipids as 2 - cephalin, phosphatidylserine and its plasmalogen and phosphatidyl choline plasmalogen. Absolute contains farnesol and ambrettolic acid lactone. - sitosterol and its - d - glucosides are isolated from leaves. Petals contain -sitosterol, flavonoid myricetin and its glucoside. Anthocyanins like cyanidin - 3 - sambubioside and cyanidin - 3 - glucoside are present in the flowers. (Chopra and Nayar, 1980) Seeds are aphrodisiac, antispasmodic, diuretic, demulcent, antiseptic, stomachic, tonic, carminative, antihysteric, antidiarrhoeal, ophthalmic, cardiac and antivenum.... ambrette

Amnion is the tough ?brous membrane which lines the cavity of the womb (UTERUS) during pregnancy, and contains between 0·5 and 1 litre (1–2 pints) of ?uid in which the EMBRYO ?oats. It is formed from the ovum (egg) along with the embryo, and in labour the part of it at the mouth of the womb forms the ‘bag of waters’. (See PREGNANCY AND LABOUR.) When a child is ‘born with a CAUL’, the caul is a piece of amnion.... amnion

The clear ?uid contained within the AMNION that surrounds the FETUS in the womb and protects it from external pressure. The ?uid, comprising mainly water, is produced by the amnion and is regularly circulated, being swallowed by the fetus and excreted through the kidneys back into the amniotic sac. By the 35th week of pregnancy there is about 1 litre of ?uid, but this falls to 0.5 litres at term. The amniotic sac normally ruptures in early labour, releasing the ?uid or ‘waters’.... amniotic fluid

Aspiration means the withdrawal of ?uid or gases from the natural cavities of the body or from cavities produced by disease. It may be performed for curative purposes; alternatively, a small amount of ?uid may be drawn o? for diagnosis of its nature or origin. An instrument called an aspirator is used to remove blood and ?uid from a surgical-operation site – for example, the abdomen or the mouth (in dentistry).

PLEURISY with e?usion is a condition requiring aspiration, and a litre or more of ?uid may be drawn o? by an aspirator or a large syringe and needle. Chronic abscesses and tuberculous joints may call for its use, the operation being done with a small syringe and hollow needle. PERICARDITIS with e?usion is another condition in which aspiration is sometimes performed. The spinal canal is aspirated by the operation of LUMBAR PUNCTURE. In children the ventricles of the brain are sometimes similarly relieved from excess of ?uid by piercing the fontanelle (soft spot) on the infant’s head. (See HYDROCEPHALUS.)... aspiration

Cadmium poisoning is a recognised hazard in certain industrial processes, such as the manufacture of alloys, cadmium plating and glass blowing. Sewage sludge, which is used as fertiliser, may be contaminated by cadmium from industrial sources; such cadmium could be taken up into vegetable crops and cadmium levels in sewage are carefully monitored.

A tin-like metal, cadmium accumulates in the body. Long-term exposure can lead to EMPHYSEMA, renal failure (see KIDNEYS, DISEASES OF) and urinary-tract CALCULI. Acute exposure causes GASTROENTERITIS and PNEUMONITIS. Cadmium contamination of food is the most likely source of poisoning. The EU Directive on the Quality of Water for Human Consumption lays down 5 milligrams per litre as the upper safe level.... cadmium poisoning

A fall in the water content of the body. Sixty per cent of a man’s body weight is water, and 50 per cent of a woman’s; those proportions need to be maintained within quite narrow limits to ensure proper functioning of body tissues. Body ?uids contain a variety of mineral salts (see ELECTROLYTES) and these, too, must remain within narrow concentration bands. Dehydration is often accompanied by loss of salt, one of the most important minerals in the body.

The start of ‘dehydration’ is signalled by a person becoming thirsty. In normal circumstances, the drinking of water will relieve thirst and serious dehydration does not develop. In a temperate climate an adult will lose 1.5 litres or more a day from sweating, urine excretion and loss of ?uid through the lungs. In a hot climate the loss is much higher – up to 10 litres if a person is doing hard physical work. Even in a temperate climate, severe dehydration will occur if a person does not drink for two or three days. Large losses of ?uid occur with certain illnesses – for example, profuse diarrhoea; POLYURIA in diabetes or kidney failure (see KIDNEYS, DISEASES OF); and serious blood loss from, say, injury or a badly bleeding ULCER in the gastrointestinal tract. Severe thirst, dry lips and tongue, TACHYCARDIA, fast breathing, lightheadedness and confusion are indicative of serious dehydration; the individual can lapse into COMA and eventually die if untreated. Dehydration also results in a reduction in output of urine, which becomes dark and concentrated.

Prevention is important, especially in hot climates, where it is essential to drink water even if one is not thirsty. Replacement of salts is also vital, and a diet containing half a teaspoon of table salt to every litre of water drunk is advisable. If someone, particularly a child, suffers from persistent vomiting and diarrhoea, rehydration therapy is required and a salt-andglucose rehydration mixture (obtainable from pharmacists) should be taken. For those with severe dehydration, oral ?uids will be insu?cient and the affected person needs intravenous ?uids and, sometimes, admission to hospital, where ?uid intake and output can be monitored and rehydration measures safely controlled.... dehydration

A solution commonly used as a means of ?uid replacement in dehydrated patients (see also DEHYDRATION). Each litre contains 3·1 grams of sodium lactate, 6 grams of sodium chloride, 0·4 grams of potassium chloride, and 0·7 grams of calcium chloride.... hartmann’s solution

A term used in several di?erent senses. Generally speaking, it is applied to anything which agrees with the regular and established type. In chemistry, the term is applied to solutions of acids or bases of such strength that each litre contains the number of grams corresponding to the molecular weight of the substance in question. In physiology the term ‘normal’ is applied to solutions of such strength that, when mixed with a body ?uid, they are ISOTONIC and cause no disturbance: for example, normal saline solution.... normal

This is the essential initial treatment for DIARRHOEA, and is particularly valuable for dehydrated children in developing countries ill with diseases such as CHOLERA. A litre of water containing one teaspoonful of salt and eight of sugar, taken by mouth, is readily absorbed. It replaces salts and water lost because of the diarrhoea and usually no other treatment is required.

In developed countries ORT is useful in treating gastroenteritis. There are a number of proprietary preparations, often dispensed as ?avoured sachets, including Dioralyte® and Rehydrate®.... oral rehydration therapy (ort)

(Ultra-low-volume) Application of concentrated insecticidal solutions sprayed sparsely over a large area in a vehicle or aeroplane at dosage rates of 740 ml to 1 litre per hectare for mosquito control. This technique produces very large droplets forming a fog or aerosol of concentrated insecticide.... ulv

Popular in France as an “elixir of life”, digestive and tonic for anaemia, poor appetite and low spirits. Formula: 3 litres spirits of wine, 500g fresh Lemon Balm leaves and flowers, 16g Angelica root, 125g Lemon Peel, 200g Coriander, 40g Nutmeg, 4g Cinnamon and 2g Cloves. Steep finely rubbed herbs and roots and powdered seeds in spirits of wine eight days in a dark place, stirring daily; decant, filter and bottle. ... carmelite tea

The use of a person’s own blood, donated earlier, for blood transfusion. Autologous transfusion eliminates the slight but serious risk of contracting a serious infectious illness from contaminated blood. There is no risk of a transfusion reaction occurring as a result of incompatibility between donor and recipient blood. Up to 3.5 litres of blood can be removed and stored in several sessions at least 4 days apart and up to 3 days before planned surgery. Blood may be salvaged during surgery, filtered and returned to the circulation, reducing the need for transfusion of donated blood.... blood transfusion, autologous

An activity requiring physical exertion. Everyone should take regular exercise: this keeps muscles in tone, maintains the CARDIOVASCULAR SYSTEM in good shape, helps to keep weight at an optimum level and promotes relaxation and sleep. When an individual is at rest, the heart’s output is 5 litres of blood per minute. When running at 12 km (7••• miles) per hour, this rises to around 25 litres, obliging the heart and lungs to operate more e?ciently and speeding up the metabolism of food to provide the necessary energy. Lack of exercise by children may lead to faulty posture and ?abby muscles; in adults it results in an increase in weight and poorly functioning respiratory and cardiovascular system, with an increased chance of heart disease later in life. Adolescents and adults, participating regularly in sporting activities, should train regularly, preferably under expert supervision, to ensure that they do not place potentially damaging demands on their cardiovascular, respiratory and musculoskeletal systems. Those wanting to participate in demanding sports would be wise to have a medical examination before embarking on training programmes (see SPORTS MEDICINE).... exercise

The appropriate balance of ?uid input and output (along with dissolved salts essential for life) over 24 hours. During this period, about 2,500 millilitres (ml) of ?uid should be taken in by a 70-kg man and the same amount excreted; of this, 1,500 ml will be drunk, 800 ml will be in the food eaten, and 200 ml produced by food metabolism. Excreted water is made up of 1,500 ml of urine, 800 ml insensible loss and 200 ml in the faeces. A 70-kg man’s total body ?uid is 42 litres – 60 per cent of body weight. Intracellular ?uid comprises 28 litres, extracellular, 14 litres and blood, 5 litres. Water is controlled mainly by the sodium concentration in the body ?uids via the release of antidiuretic hormone (ADH – see VASOPRESSIN) from the posterior part of the PITUITARY GLAND. In seriously ill people, close monitoring of ?uid intake and output, along with measurements of PLASMA sodium and calcium concentrations, is an essential factor in treatment.... fluid balance

Each of the two KIDNEYS ?lters a large volume of blood – 25 per cent of cardiac output, or around 1,300 ml – through its two million glomeruli (see GLOMERULUS) every minute. The glomeruli ?lter out cell, protein, and fat-free ?uid which, after reabsorption of certain chemicals, is excreted as urine. The rate of this ultra?ltration process, which in health is remarkably constant, is called the glomerular ?ltration rate (GFR). Each day nearly 180 litres of water plus some small molecular-weight constituents of blood are ?ltrated. The GFR is thus an indicator of kidney function. The most widely used measurement is CREATININE clearance and this is assessed by measuring the amount of creatinine in a 24-hour sample of urine and the amount of creatinine in the plasma; a formula is applied that gives the GFR.... glomerular filtration rate (gfr)

The air we breathe must be moist for the e?cient working of the lungs (see RESPIRATION). Humidi?cation, or moistening of the air, is achieved largely by the NOSE, which acts as an air-conditioner, warming, moistening and ?ltering the 10,000 litres of air which we inhale daily – in the process of which, incidentally, it produces around 1·5 litres of secretion daily.

Humidity is expressed as relative humidity (RH). This is the amount of moisture in the air expressed as a percentage of the maximum possible at that temperature. If the temperature of a room is raised without increasing the moisture content, the RH falls. The average outdoor RH in Britain is around 70–80 per cent; with central heating it may drop to 25 per cent or lower. This is why humidi?cation, as it is known, of the air is essential in buildings heated by modern heating systems. The aim should be to keep the RH at around 30–50 per cent. In houses this may be achieved quite satisfactorily by having a jug or basin of water in the room, or some receptacle that can be attached to the heater. In o?ces, some more elaborate form of humidi?er is necessary. Those suffering from chronic BRONCHITIS are particularly susceptible to dry air, as are those individuals with disorders of the EYE because the secretions that bathe the eyes and keep them moist are unnaturally dried out. (See also VENTILATION.)... humidification

A term applied to solutions which have the same power of di?usion as one another. An isotonic solution used in medicine is one which can be mixed with body ?uids without causing any disturbance. An isotonic saline solution for injection into the blood, so that it may possess the same osmotic pressure (see OSMOSIS) as the blood SERUM, is one of 0·9 per cent strength – that is, containing 9 grams of sodium chloride to 1 litre of water. This is also known as normal or physiological salt solution. An isotonic solution of bicarbonate of soda for injection into the blood is one of 1·35 per cent strength in water. An isotonic solution of glucose for injection into the blood is one of 5 per cent strength in water.

Solutions which are weaker, or stronger, than the ?uids of the body with which they are intended to be mixed are known as hypotonic and hypertonic, respectively.... isotonic

The measurement of the calorie value of foodstuffs or the energy expenditure of a person. In direct calorimetry, a small measure of food is burned up inside a sealed container, which is immersed in water. The rise in water temperature that results is used to calculate the calorie value.

Energy production in humans is measured by oxygen uptake.

Every litre of oxygen taken into the body produces 4.8 kilocalories of energy.

Energy production is calculated by comparing the percentage of oxygen in air inhaled and exhaled.... calorimetry

The production of more than 2.5 litres of urine per day. The medical term is polyuria.

Causes include psychiatric problems, which may cause a person to drink compulsively; diabetes mellitus; disorders of the kidney known as salt-losing states; and central diabetes insipidus. Any person who passes large quantities of urine should consult a doctor.... urination, excessive

The pale yellow fluid produced by the kidneys and excreted from the body via the ureters, bladder, and urethra. Urine is produced when blood is filtered through the kidneys to remove waste products and excess water or chemical substances. The main component is urea. A healthy adult produces between 0.5 and 2 litres of urine per day. The minimum volume of urine needed to remove all waste products is about 0.5 litres. A high fluid intake increases the amount of urine produced; high fluid loss from sweating, vomiting, or diarrhoea leads to reduced production.... urine

Urinary incontinence The International Continence Society de?nes urinary incontinence as an involuntary loss of URINE that is objectively shown and is a social and hygiene problem. The elderly suffer most from this disorder because the e?ectiveness of the sphincter muscles surrounding the URETHRA declines with age. Men are less often affected than women; 20 per cent of women over 40 years of age have problems with continence. It is estimated that around three million people are regularly incontinent in the UK, a prevalence of about 40 per 1,000 adults.

Incontinence can be divided broadly into two groups: stress incontinence and incontinence due to an overactive URINARY BLADDER – also called detrusor instability – which affects one-third of incontinent women, prevalence increasing with age. Bladder symptoms do not necessarily correlate with the underlying diagnosis, and accurate diagnosis may require urodynamic studies – examination of urine within, and the passage of urine through and from, the urinary tract. However, such studies are best deferred until conservative treatment has failed or when surgery is planned.

Incontinence causes embarassment, inconvenience and distress in women, and men are reluctant to seek advice for what remains a social taboo for most people. Su?erers should be encouraged to seek help early and to discuss their anxieties and problems frankly. Often it is a condition which can be managed e?ectively at primary care centres, and quite simple measures can greatly improve the lives of those affected. STRESS INCONTINENCE is the most common cause of urinary incontinence in women. This is the involuntary loss of urine during activities that raise the intra-abdominal pressure, such as sneezing, coughing, laughing, exercise or lifting. The condition is caused by injury or weakness of the urethral sphincter muscle; this weakness may be either congenital or the result of childbirth, PROLAPSE of the VAGINA, MENOPAUSE or previous surgery. A CYSTOCOELE may be present. Urinary infection may cause incontinence or aggravate the symptoms of existing incontinence.

The ?rst step is to diagnose and treat infection, if present. Patients bene?t from simple advice on incontinence pads and garments, and on ?uid intake. Those with a high ?uid intake should restrict this to a litre a day, especially if frequency is a problem. Constipation should be treated and smoking stopped. The use of DIURETICS should be reduced if possible, or stopped entirely. Postmenopausal women may bene?t from oestrogen-replacement therapy; elderly people with chronic incontinence may need an indwelling urethral catheter.

Pelvic-?oor exercises can be successful and the insertion of vaginal cones can be a useful subsidiary treatment, as can electrical stimulation of the pelvic muscles. If these procedures are unsuccessful, then continence surgery may be necessary. The aim of this is to raise the neck of the bladder, support the mid part of the urethra and increase urethral resistance. Several techniques are available. URGE INCONTINENCE An overactive or unstable bladder results in urge incontinence, also known as detrusor incontinence – the result of uninhibited contractions of the detrusor muscle of the bladder. The bladder contracts (spontaneously or on provocation) during the ?lling phase while the patient attempts to stop passing any urine. Hyperexcitability of the muscle or a disorder of its nerve supply are likely causes. The symptoms include urgency (acute wish to pass urine), frequency and stress incontinence. Diagnosis can be con?rmed with CYSTOMETRY. Bladder training is the ?rst step in treatment, with the aim of reducing the frequency of urination to once every three to four hours. BIOFEEDBACK, using visual, auditory or tactile signals to stop bladder contractions, will assist the bladder training. Drug treatments such as CALCIUM-CHANNEL BLOCKERS, antimuscarinic agents (see ANTIMUSCARINE), TRICYCLIC ANTIDEPRESSANT DRUGS, and oestrogen replacement can be e?ective. Surgery is rarely used and is best reserved for di?cult cases. OVERFLOW INCONTINENCE Chronic urinary retention with consequent over?ow – more common in men than in women. The causes include antispasmodic drugs, continence surgery, obstruction from enlargement and post-prostatectomy problems (in men), PSYCHOSIS, and disease or damage to nerve roots arising from the spinal cord. Urethral dilatation or urethrotomy may be required when obstruction is the cause. Management is intermittent selfcatheterisation or a suprapubic catheter and treatment of any underlying cause.

Faecal incontinence is the inability to control bowel movements and may be due to severe CONSTIPATION, especially in the elderly; to local disease; or to injury or disease of the spinal cord or nervous supply to rectum and anal muscles. Those with the symptom require further investigation.... incontinence

1. n. a variety of white blood cell distinguished by a lobed nucleus and the presence in its cytoplasm of coarse granules that stain purple-black with *Romanowsky stains. Basophils are capable of ingesting foreign particles and contain *histamine and *heparin. There are normally 30–150 × 106 basophils per litre of blood. See also polymorph. 2. (basophilic) adj. describing any cell that stains well with basic dyes. For example, certain cells in the anterior pituitary gland are basophilic.... basophil

the concentration of glucose in the blood, normally expressed in millimoles per litre. The normal range is 3.5–5.5 mmol/l. Blood-sugar estimation is an important investigation in a variety of diseases, most notably in diabetes mellitus. See also hyperglycaemia; hypoglycaemia.... blood sugar

the volume of blood pumped from the heart’s left ventricle divided by body surface area, expressed as litres per minute per square metre (l/min/m2). It is determined by heart rate and stroke volume index (the volume of blood pumped by the heart with each beat), and provides a normal range (2.5–4.0 l/min/m2) regardless of the size of the patient.... cardiac index

(renal clearance) n. a quantitative measure of the rate at which waste products are removed from the blood by the kidneys or through the process of dialysis. It is expressed in terms of the volume of blood that could be completely cleared of a particular substance in a particular unit of time. Clearance by the kidney is usually measured as ml/min while clearance with, say, peritoneal dialysis is usually measured in litres/week.... clearance

(differential blood count) a determination of the proportions of the different kinds of white cells (leucocytes) present in a sample of blood. Usually 100 white cells are counted and classified under the microscope or by electronic apparatus, so that the results can readily be expressed as percentages of the total number of leucocytes and the absolute numbers per litre of blood. The information often aids diagnosis of disease.... differential leucocyte count

The nose and nasal sinuses (see SINUS) produce up to a litre of MUCUS in 24 hours, most of which enters the stomach via the NASOPHARYNX. Changes in the nasal lining mucosa occur in response to changes in humidity and atmospheric temperature; these may cause severe congestion, as might an allergic reaction or nasal polyp.

Treatment Topical nasal decongestants include sodium chloride drops and corticosteroid nasal drops (for polyps). For commoncold-induced congestion, vapour inhalants, decongestant sprays and nasal drops, including EPHEDRINE drops, are helpful. Overuse of decongestants, however, can produce a rebound congestion, requiring more treatment and further congestion, a tiresome vicious circle. Allergic RHINITIS (in?ammation of the nasal mucosa) usually responds to ipratropium bromide spray.

Systemic nasal decongestants given by mouth are not always as e?ective as topical administrations but they do not cause rebound congestion. Pseudoephedrine hydrochoride is available over the counter, and most common-cold medicines contain anticongestant substances.... nasal congestion

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

Also known as plasmapheresis. The removal of the circulating PLASMA from the patient. It is done by removing blood from a patient and returning the red cells with a plasma expander. The plasma exchange is carried out through an in-dwelling CANNULA in the femoral vein, and the red cells and plasma are separated by a hemonetics separator. Usually a sequence of three or four sessions is undertaken, at each of which 2–3 litres of plasma are removed. The lost plasma can either be replaced by human serum albumin (see ALBUMINS) or a plasma expander.

In autoimmune disorders, disease is due to damage wrought by circulating ANTIBODIES or sensitised lymphocytes (see LYMPHOCYTE). If the disease is due to circulating humoral antibodies, removal of these antibodies from the body should theoretically relieve the disorder. This is the principle on which plasma exchange was used in the management of autoimmune diseases due to circulating antibodies. Such disorders include Goodpasture’s syndrome, SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) and MYASTHENIA GRAVIS. One of the problems in the use of plasma exchange in the treatment of such diseases is that the body responds to the removal of an antibody from the circulation by enhanced production of that antibody by the immune system. It is therefore necessary to suppress this homeostatic response with cytotoxic drugs such as AZATHIOPRINE. Nevertheless, remissions can be achieved in autoimmune diseases due to circulating antibodies by the process of plasma exchange.... plasma exchange

n. a variety of white blood cell distinguished by a lobed nucleus and the presence in its cytoplasm of coarse granules that stain orange-red with *Romanowsky stains. Eosinophils are capable of ingesting foreign particles, is present in large numbers in lining or covering surfaces within the body, is involved in allergic responses, and may be involved in host defence against parasites. There are normally 40–400 × 106 eosinophils per litre of blood. See also polymorph.... eosinophil

(red blood cell) n. a *blood cell containing the red pigment *haemoglobin, the principal function of which is the transport of oxygen. A mature erythrocyte has no nucleus and its shape is that of a biconcave disc, approximately 7 ?m in diameter. There are normally about 5 ×1012 erythrocytes per litre of blood. See also erythropoiesis.... erythrocyte

Sheep Sorrel is a sour perennial plant that grows up to three feet in height, native to Europe and Asia. It is commonly found in fields, woods and shaded areas. The leaves of the plant are thin and delicate, having a purplish hue. It has been used for centuries as a herbal remedy for cancer and degenerative conditions. Sheep Sorrel is also used as a garnish for salads due to its sour, lemony flavour. Sheep Sorrel Tea Brewing The most simple and fastest method of brewing Sheep Sorrel tea is to use tea bags. Pour hot water into the cup over the tea bag and let it steep for approximately five minutes. You can add fruit juice for a more pleasant taste. Enjoy! If you want to brew a larger quantity, add ten grams of Sheep Sorrel in one litre of water. Sheep Sorrel Tea Health Benefits Sheep Sorrel tea has antioxidant, diuretic, anti-inflammatory, laxative and detoxifying properties. Due to its high content of vitamins and minerals, Sheep Sorrel tea promotes overall glandular health and has blood cleansing effects. The antioxidants found in the plant boost the immune system, lower cholesterol and aid in the relief of cancer. Sheep Sorrel tea in believed to have anti-cancerous properties that help prevent and reduce tumours and cysts. Other health benefits of Sheep Sorrel tea include its ability to regulate digestion, remove toxins, reduce fever and inflammation, treat intestinal worms, diarrhea or heavy menstrual flow. Sheep Sorrel Tea Side Effects Sheep Sorrel tea has no known side effects when consumed in normal quantities, but excessive intake can lead to unpleasant side effects, such as nausea, gastric problems, diarrhea and even poisoning. Sheep Sorrel Tea is a rich source of vitamins and minerals which strengthen the immune system and it can also help in the weight loss process due to its diuretic properties.... sheep sorrel tea

This is a distensible, sac-like organ with an average adult capacity of 1·5 litres situated in the upper abdomen. It is positioned between the OESOPHAGUS and DUODENUM, lying just beneath the DIAPHRAGM to the right of the SPLEEN and partly under the LIVER. The stomach is a part of the gastrointestinal tract with its walls formed of layers of longitudinal and circular muscles and lined by glandular cells that secrete gastric juice. It is well supplied with blood vessels as well as nerves from the autonomic system which enter via the phrenic nerve. The exit of the stomach is guarded by a ring of muscle called the pyloric sphincter which controls the passage of food into the duodenum.

Function As well as the stomach’s prime role in physically and physiologically breaking down the food delivered via the oesophagus, it also acts as a storage organ – a function that enables people to eat three or four times a day instead of every 30 minutes or so as their metabolic needs would otherwise demand. Gastric secretion is stimulated by the sight and smell of food and its subsequent arrival in the stomach. The secretions, which contain mucus and hydrochloric acid (the latter produced by parietal cells), sterilise the food; pepsin, a digestive ENZYME in the gastric juices, breaks down the protein in food. The juices also contain intrinsic factor, vital for the absorption of vitamin B12 when the chyle – as the stomach contents are called – reaches the intestine. This chyle is of creamy consistency and is the end product of enzymic action and rhythmic contractions of the stomach’s muscles every 30 seconds or so. Food remains in the stomach for varying lengths of time depending upon its quantity and nature. At regular intervals a bolus of chyle is forced into the duodenum by contractions of the stomach muscles coordinated with relaxation of the pyloric sphincter.... stomach

Failure of the bone marrow to produce red cells because of infection, also neutropenia and depletion of platelets in the blood through chronic disease (TB etc) elsewhere in the body, or through chemicals in food and medicine. Other causes include food preservatives, X-ray radiation, fluoride in water supply and environmental pollution. The condition is serious.

Possibility of mercurial poisoning. A 59-year-old man employed filling thermometers with mercury developed aplastic anaemia and died. His urine contained 1.01mg mercury per litre. (D.R. Ryrie. Brit. Medical Journal, i/1970, 499. A similar report D.R. Wilson, ibid., ii/1966, 1534)

Symptoms. Headache, dizziness, pallor of skin, loss of weight and appetite, sore or burning tongue, jaundice, bruising, nose-bleeds. A low state of the immune system exposes the subject to infection. Treatment. Hospital supervision. Necessary to identify the causative toxic agent and eliminate it. Condition fails to respond to usual preparations of iron taken by mouth. No specific exists but supportive adaptogen herbs sustain and raise haemoglobin levels, marginally increasing red cells.

To facilitate elimination of toxic chemicals:– Teas: Alfalfa, Red Clover, German Chamomile, Ground Ivy, Milk Thistle, Gotu Kola, Nettles, Fennel.

Tea. Formula. Equal parts: Dandelion, Nettles, Alfalfa. 1 heaped teaspoon in each cup boiling water, infuse 10-15 minutes. One cup freely.

Decoction: Gentian – 1 teaspoon in cup cold water. Steep overnight; drink on rising.

Tinctures. To stimulate bone marrow. Formula: equal parts, Echinacea, Prickly Ash bark, Horsetail. Dose: 1-2 teaspoons thrice daily, taken in water or cup of one of the above teas.

Tincture Cinnamon BP (1949). Dose: 2-4ml (30-60 drops).

Powders. Combine: Gentian 1; Yellow Dock 1; Echinacea 2; Cinnamon quarter; Cayenne quarter. Dose: 500mg (two 00 capsules or one-third teaspoon), before meals.

Liquid Extracts: Combine Echinacea 2; Black Cohosh half; Damiana 1; Ginger quarter. Dose: 1 teaspoon in cup Red Clover tea, before meals.

Diet. Dandelion coffee, high fibre, low fat, low salt, molasses, lamb’s liver. Foods containing Vitamin B12.

Supplements daily. Vitamin B12. Folic acid 400mcg, Vitamin C, Floradix. ... anaemia: aplastic

(bleeding) n. the escape of blood from a ruptured blood vessel, externally or internally. Arterial blood is bright red and emerges in spurts, venous blood is dark red and flows steadily, while damage to minor vessels may produce only an oozing. Rupture of a major blood vessel such as the femoral artery can lead to the loss of several litres of blood in a few minutes, resulting in *shock, collapse, and death, if untreated. See also haematemesis; haematuria; haemoptysis.... haemorrhage

n. one thousandth of a mole (see mole1). The concentration of a solution is expressed in millimoles per litre. Symbol: mmol.... millimole

6.5 cm wide, 5 cm thick, and weighs around 140 grams.

Adult kidneys have a smooth exterior, enveloped by a tough ?brous coat that is bound to the kidney only by loose ?brous tissue and by a few blood vessels that pass between it and the kidney. The outer margin of the kidney is convex; the inner is concave with a deep depression, known as the hilum, where the vessels enter. The URETER, which conveys URINE to the URINARY BLADDER, is also joined at this point. The ureter is spread out into an expanded, funnel-like end, known as the pelvis, which further divides up into little funnels known as the calyces. A vertical section through a kidney (see diagram) shows two distinct layers: an outer one, about 4 mm thick, known as the cortex; and an inner one, the medulla, lying closer to the hilum. The medulla consists of around a dozen pyramids arranged side by side, with their base on the cortex and their apex projecting into the calyces of the ureter. The apex of each pyramid is studded with tiny holes, which are the openings of the microscopic uriniferous tubes.

In e?ect, each pyramid, taken together with the portion of cortex lying along its base, is an independent mini-kidney. About 20 small tubes are on the surface of each pyramid; these, if traced up into its substance, repeatedly subdivide so as to form bundles of convoluted tubules, known as medullary rays, passing up towards the cortex. One of these may be traced further back, ending, after a tortuous course, in a small rounded body: the Malpighian corpuscle or glomerulus (see diagram). Each glomerulus and its convoluted tubule is known as a nephron, which constitutes the functional unit of the kidney. Each kidney contains around a million nephrons.

After entering the kidney, the renal artery divides into branches, forming arches where the cortex and medulla join. Small vessels come o? these arches and run up through the cortex, giving o? small branches in each direction. These end in a tuft of capillaries, enclosed in Bowman’s capsule, which forms the end of the uriniferous tubules just described; capillaries with capsule constitute a glomerulus.

After circulating in the glomerulus, the blood leaves by a small vein, which again divides into capillaries on the walls of the uriniferous tubules. From these it is ?nally collected into the renal veins and then leaves the kidney. This double circulation (?rst through the glomerulus and then around the tubule) allows a large volume of ?uid to be removed from the blood in the glomerulus, the concentrated blood passing on to the uriniferous tubule for removal of parts of its solid contents. Other arteries come straight from the arches and supply the medulla direct; the blood from these passes through another set of capillaries and ?nally into the renal veins. This circulation is con?ned purely to the kidney, although small connections by both arteries and veins exist which pass through the capsule and, joining the lumbar vessels, communicate directly with the aorta.

Function The kidneys work to separate ?uid and certain solids from the blood. The glomeruli ?lter from the blood the non-protein portion of the plasma – around 150–200 litres in 24 hours, 99 per cent of which is reabsorbed on passing through the convoluted tubules.

Three main groups of substances are classi?ed according to their extent of uptake by the tubules:

(1) SUBSTANCES ACTIVELY REABSORBED These include amino acids, glucose, sodium, potassium, calcium, magnesium and chlorine (for more information, see under separate entries).

(2) SUBSTANCES DIFFUSING THROUGH THE TUBULAR EPITHELIUM when their concentration in the ?ltrate exceeds that in the PLASMA, such as UREA, URIC ACID and phosphates.

(3) SUBSTANCES NOT RETURNED TO THE BLOOD from the tubular ?uid, such as CREATINE, accumulate in kidney failure, resulting in general ‘poisoning’ known as URAEMIA.... structure each kidney is about 10 cm long,

A form of anaemia following a deficiency of Vitamin B12. Usually occurs middle life, 45-60.

Symptoms. Skin of yellow tinge, failing eyesight, swollen ankles, feeble heart action, numbness of feet and legs, dyspepsia, tingling in limbs, diarrhoea, red beefy sore tongue, patches of bleeding under skin, unsteadiness and depression.

Treatment. Hospitalisation. Intramuscular injections of Vitamin B12. Herbs known to contain the vitamin – Comfrey, Iceland Moss. Segments of fresh Comfrey root and Garlic passed through a blender produce a puree – good results reported.

Alternatives:– Teas: Milk Thistle, Hops, Wormwood, Betony, White Horehound, Motherwort, Parsley, Nettles, Centuary.

Formula. Combine Centuary 2; Hyssop 1; White Horehound 1; Red Clover flower 1; Liquorice quarter. 1-2 teaspoons to each cup boiling water, infuse 15 minutes. 1 cup thrice daily.

Decoction. Combine Yellow Dock 1; Peruvian bark quarter; Blue Flag root quarter; Sarsaparilla 1; Bogbean half. 1 teaspoon to each cup of water, or 4oz (30 grams) to 1 pint (half litre) water. Simmer gently 10-15 minutes in covered vessel. Dose: Half-1 cup, thrice daily.

Decoction. Combine Yellow Dock 1; Peruvian bark quarter; Blue Flag root quarter; Sarsaparilla 1; Bogbean half. 1 teaspoon to each cup of water, or 4oz (30 grams) to 1 pint (one-half litre) water. Simmer gently 10-15 minutes in covered vessel. Dose: Half-1 cup, thrice daily.

Tablets/capsules. Echinacea, Dandelion, Kelp.

Powders. Formula. Equal parts: Gentian, Balm of Gilead, Yellow Dock. Dose: 500mg (two 00 capsules or one-third teaspoon), thrice daily before meals.

Liquid Extracts. Combine, Echinacea 2; Gentian 1; Dandelion 1; Ginger quarter. Dose: 15-30 drops in water thrice daily.

Gentian decoction. 1 teaspoon dried root to each cup cold water.

Diet. Dandelion coffee. Calves’ liver. Absorption of nutritious food may be poor through stomach’s inability to produce sufficient acid to break down food into its elements. Indicated: 2-3 teaspoons Cider vinegar in water between meals. Contraindicated – vegetarian diet.

Supplements. Vitamin B12, (in absence of injections). Iron – Floradix. Desiccated liver. Vitamin C 1g thrice daily at meals. Folic acid. 400mcg thrice daily. ... anaemia: pernicious

n. the strength of a solution, expressed as the weight of dissolved substance in grams per litre divided by its molecular weight, i.e. the number of moles per litre. Molarity is indicated as 0.1 M, 1 M, 2 M, etc.... molarity

n. a variety of white blood cell, 16–20 ?m in diameter, that has a kidney-shaped nucleus and greyish-blue cytoplasm (when treated with *Romanowsky stains). Its function is the ingestion of foreign particles, such as bacteria and tissue debris. There are normally 0.2–0.8 × 109 monocytes per litre of blood. —monocytic adj.... monocyte

Acorus calamus

Araceae

San: Vaca, Ugragandha, Bhadra;

Hin: Bacc, Gorbacc;

Ben: Bach; Mal:Vayampu;

Tam: Vasampu;

Kan: Bajai;

Tel: Vasa Vadaja

Importance: The sweet flag is an important medhya drug, capable of improving memory power and intellect. It is used in vitiated conditions of vata and kapha, stomatopathy, hoarseness, colic, flatulence, dyspepsia, helminthiasis, amenorrhoea, dismenorrhoea, nephropathy, calculi, strangury, cough, bronchitis, odontalgia, pectoralgia, hepatodynia, otalgia, inflammations, gout, epilepsy, delirium, amentia, convulsions, depression and other mental disorders, tumours, dysentery, hyperdipsia, haemorrhoids, intermittent fevers, skin diseases, numbness and general debility. It is reportedly useful in improving digestion, clearing speech and curing diarrhoea, dysentery, abdominal obstruction and colic. It is also useful in infantile fever, cough bronchitis and asthma. The drug is reported to cure hysteria, insanity and chronic rheumatic complaints. The rhizome is an ingredient of preparations like Vacaditaila, Ayaskrti, Kompancadi gulika, Valiya rasnadi kashaya, etc.

Distribution: The plant is a native of Europe. It is distributed throughout the tropics and subtropics, especially in India and Sri Lanka. It is found in marshes, wild or cultivated, ascending the Himalayas upto 1800m in Sikkim. It is plentiful in marshy tracts of Kashmir and Sirmoor, in Manipur and Naga Hills.

Botany: Acorus calamus Linn. belonging to the family Araceae is a semi -aquatic rhizomatous perennial herb. Rhizome is creeping, much branched, cylindrical or slightly compressed, light brown or pinkish brown externally, white and spongy within. Leaves are bright green, distichous, ensiform, base equitant, thickened in the middle and with wavy margins. Flowers are light brown and densely packed in sessile cylindric spadix. Fruits are oblong, turbinate berries with a pyramidal top. Seeds are few and pendant from the apex of the cells (Warrier et al, 1993).

Another species belonging to the genus Acorus is A. gramineus Soland, the roots of which are used in tonic, antiseptics and insecticidal preparations (Chopra et al, 1956).

Agrotechnology: Acorus is a hardy plant found growing from tropical to subtropical climates. It needs a good and well distributed rainfall throughout the year. It needs ample sunlight during the growth period as well as after harvest for drying the rhizomes. It may be cultivated in any good but fairly moist soil. It is usually grown in areas where paddy can be grown. It comes up well in clayey soils and light alluvial soils of river bank. The field is laid out and prepared exactly as for rice, irrigated sufficiently and after ploughing twice, watered heavily and again ploughed in the puddle. Sprouted rhizome pieces are used for planting and pressed into the mud at a depth of about 5cm at a spacing of 30x30cm. The rhizomes are planted in such a way that the plants in the second row comes in between the plants of the first row and not opposite to them. FYM is to be applied at 25t/ha. Fertilisers are applied at 25:50:60 kg N:P2O5:K2O/ha/yr. Whole of FYM and 1/3 of N, P2O5 and K2O are to be added in the field during March - April as a basal dose. The remaining 2/3 of nutrients is to be given in two equal split doses at 4 months and 8 months after planting. The field is to be regularly irrigated. About 5 cm of standing water is to be maintained in the field in the beginning. Later, it is to be increased to 10 cm as the plant grows. The field is to be regularly weeded. About 8 weedings are to be carried out in all. At each weeding the plants are pressed into the soil. The plant is attacked by mealy bugs. Both shoot and root mealy bugs can be controlled by spraying the shoot and drenching the roots of grown up plants with 10 ml Methyl parathion or 15ml Oxydemeton methyl or 20ml Quinalphos in 10 litres of water. The crop is ready for harvest at the end of first year. The field is to be dried partially so that sufficient moisture is left in the soil to facilitate deep digging. The leaves start turning yellow and dry, indicating maturity. The rhizome will be at a depth of 60cm and having about 30-60cm spread. Therefore, harvesting is to be done carefully. The rhizomes are to be cut into 5-7.5cm long pieces and all the fibrous roots are to be removed. Yield of rhizome is about 10t/ha (Farooqi et al, 1991).

Properties and Activity:Rhizomes, roots and leaves yield essential oil. The important constituents of the Indian oil are asarone and its -isomer. Other constituents are and -pinene, myrcene, camphene, p-cymene, camphor and linalool, sesquiterpenic ketones like asarone, calamone, calacone, acolamone, iso-acolamone, acoragermacrone, epishyobunone, shyobunone and iso- shyobunone. Alcohol present is preisocalamendiol. Sesquiterpene hydrocarbons like elemene, elemane and calarene are also present. Tricyclic sesquiterpenes present are caryophyllene, humulene, guaiene, S-guaizulene, arcurcumene, -cadinene, cadinane, calamenene, calacorene, dihydrocalacorene(calamenene), cadalene and selinene. Roots yield acoric acid as a main constituent in addition to choline. Plant also yields a flavone diglycoside- luteolin 6,8-C-diglucoside.

-asarone is the ma jor constituent of essential oil from rhizome (Dandiya et al, 1958,1959; Raquibuddoula, 1967).

Rhizome is insecticidal, pisicidal, spasmolytic, hypothermic, CNS active and analgesic. Essential oil is anticonvulsant. Rhizome is acrid, bitter, thermogenic, aromatic, intellect promoting, emetic, laxative, carminative, stomachic, anthelmintic, emmenagogue, diuretic, alexeteric, expectorant, anodyne, antispasmodic, aphrodisiac, antiinflammatory, sudorific, antipyretic, sialagogue, insecticidal, tranquillizer, sedative, analgesic, antithermic, antiasthmatic, hypotensive, respiratory depressant, aperitive and tonic.... sweet flag

n. a variety of *granulocyte (a type of white blood cell) distinguished by a lobed nucleus and the presence in its cytoplasm of fine granules that stain purple with *Romanowsky stains. It is capable of ingesting and killing bacteria and provides an important defence against infection. There are normally 2.0–7.5 × 109 neutrophils per litre of blood. See also polymorph.... neutrophil

(PEFR) the maximum rate at which a person can forcibly expel air from the lungs at any time, expressed usually in litres per minute (occasionally in litres per second). A low value can help diagnose asthma in the correct clinical context, and differences between the morning and evening values can also be a feature of poor control of asthma. There is a place for PEFR in the monitoring of acute exacerbations of chronic pulmonary obstructive disease (COPD) but not in the diagnosis of COPD.... peak expiratory flow rate

(thrombocyte) n. a disc-shaped cell structure, 1–2 ?m in diameter, that is present in the blood. With *Romanowsky stains platelets appear as fragments of pale-blue cytoplasm with a few red granules. They have several functions, all relating to the arrest of bleeding (see blood coagulation; platelet activation). There are normally 150–400 × 109 platelets per litre of blood. See also thrombopoiesis.... platelet

Tinospora cordifolia

Menispermaceae

San: Amrita, Guduchi;

Hin,

Ben: Giloe;

Mal: Amritu, Chittamritu;

Tam: Amridavalli

Kan: Amritaballi;

Tel: Tivantika, Tippatige; Pun: Batindu Ori: Gulochi

Importance: Tinospora is a common climbing shrub which is used in medicine, usually in the fresh state, though it is commercially available in the dried state. It is probably the most useful preparation acting as a tonic and aphrodisiac. As a tonic it is best given in infusion with or without milk. It is a popular remedy for snake-bite and leprosy. It is generally prescribed in general debility, diabetes, fever, jaundice, skin diseases, rheumatism, urinary diseases, dyspepsia, gout, gonorrhoea and leucorrhoea. It is a constituent of several preparations like guduchayado churna, gududyadi kwath, guduchilouha, amritarista, sanjivanivati, guduchi taila, amiritastak kwath, etc. The juice mixed with the pulp of long pepper and honey is a house hold remedy for gonorrhoea. Several oils for external applications are prepared with amrita and applied to skin diseases, rheumatic affections and other nervous complaints. A small quantity of bruised stem soaked for three hours in half a litre of water and strained combined with ammonium acetate is administered in intermittent and milder forms of fevers. It is rendered more agreeable with cinnamon, cloves and other aromatics. (Viswanathan, 1997).

Distribution: The plant is widely seen in tropical countries like India, Myanmar, Sri Lanka and in Andaman Islands. It is mostly found trailing on forest trees, fences and hedges along the boundaries.

Botany: Tinospora cordifolia (Willd) Miers ex Hk. f & Thoms. syn. Menispermum cordifolium Willd, Cocculus cordifolius (Willd) DC. belongs to the family Menispermaceae. It is a climbing shrub with rough corky bark. Leaves are glabrous, cordate 5-10cm broad, acute or accuminate. The plant is dioecious. Male flowers are in fascicles; sepals oval; petals half the length of sepals. Female flowers are usually solitary, having ovary on the fleshy receptacle. Fruits are red when ripe.

Agrotechnology: Giloe requires a warm humid tropical climate. It thrives well in deep fertile soils which are rich in organic matter. It is propagated vegetatively by stem cuttings. About 10-15cm long stem cuttings having at least 2 nodes are planted in the field or polybags. Treatment of cut ends with hormones gives better results. The usual planting time is with the onset of monsoon in May-June. Usually it is planted along boundaries or nearby tall trees and allowed to trail on the trees or hedges and hence regular spacing is not followed. While planting, adequate amounts of organic manure are applied. Once the plant is established no much management is needed. The stem is the most economic part. Harvesting can be commenced after one year and usually partial harvesting is followed depending on the necessity. The stem and root should be collected in hot season when the concentration of the bitter principle is the highest. A full grown well ramified plant may give 2-3kg vines, which are cut into smaller pieces and traded either fresh or after drying.

Properties and activity: The plant contains cordifol, tinosporidine, tinosporide, perberilin, heptacosanol, - sitosterol, cordifolone, tinosporon, tinosporic acid, tinosporol, cordifolide, tinosporine, magnoflorine and tembetarine (Husain et al,1992).

The plant is antigonorrhoric, stomachic, antispasmodic, antiinflammatory, stimulant, diuretic, emetic, antidiabetic, aphrodisiac, antiperiodic, antileprotic antirheumantic and tonic. The root is an emetic in large doses. The tincture and extract are alterative and tonic and in a less degree antiperiodic and diuretic. (Dey,1980).... tinospora

Aqua waters are weak and simple solutions of volatile oils in distilled water obtained either by distillation or by simple solution. Still popular as harmless carminatives in infantile colic, mild antispasmodics, etc.

A natural basis for skin lotions (Witch Hazel).

Dill water. (Anethi). Dill seeds 4oz; water 2 and a quarter litres. Distil down to 1 and a quarter litres. Dose: 1-3 teaspoon for children’s colic.

Aniseed water. (Anisi). Aniseeds 4oz; distilled water 2 and a quarter litres. Distil down to 1 and a quarter litres. Antispasmodic for children’s colic, teething troubles, etc. Dose: 1-3 teaspoons. Elderflower water. (Sambuci). Elderflowers 8oz; distilled water 1 and a quarter litres. Distil down to one-fifth. Eye lotion.

Eyebright water. (Euphrasia). Eyebright herb and flowers 4oz; distilled water 2 and a quarter litres. Distil down to 1 and a quarter litres. Antihistamine eye lotion. ... aquae waters

Leopard’s Bane. Wolf’s Bane. Arnica Montana L. German: Wolferlei, Arnika. French: Arnica, Aronique. Spanish: Arnica. Italian: Arnica, Polmonaria di Montagna. Dried flowerheads.

Action: external use only.

Uses: Bruises and contusions where skin is unbroken. Severe bruising after surgical operation. Neuralgia, sprains, rheumatic joints, aches and pains after excessive use as in sports and gardening.

Combination, in general use: 1 part Tincture Arnica to 10 parts Witch Hazel water as a lotion. Contra- indications: broken or lacerated skin.

Preparations: Compress: handful flowerheads to 1 pint boiling water. Saturate handtowel or suitable material in mixture and apply.

Tincture. 1 handful (50g) flowerheads to 1 pint 70 per cent alcohol (say Vodka) in wide-necked bottle. Seal tight. Shake daily for 7 days. Filter. Use as a lotion or compress: 1 part tincture to 20 parts water. Weleda Lotion. First aid remedy to prevent bruise developing.

Nelson’s Arnica cream.

Ointment. Good for applying Arnica to parts of the body where tincture or lotion is unsuitable. 2oz flowers and 1oz leaves (shredded or powdered) in 16oz lard. Moisten with half its weight of distilled water. Heat together with the lard for 3-4 hours and strain. For wounds and varicose ulcers.

Wet Dressing. 2 tablespoons flowers to 2 litres boiling water. For muscular pain, stiffness and sprains. Tincture. Alternative dosage: a weak tincture can be used with good effect, acceptable internally: 5 drops tincture to 100ml water – 1 teaspoon hourly or two-hourly according to severity of the case.

Widely used in Homoeopathic Medicine.

First used by Swiss mountaineers who chewed the leaves to help prevent sore and aching limbs.

Note: Although no longer used internally in the UK, 5-10 drop doses of the tincture are still favoured by some European and American physicians for anginal pain and other acute heart conditions; (Hawthorn for chronic).

Pharmacy only sale. ... arnica

Lemon balm. Melissa officinalis L. German: Zitronen-melisse. French: Citronelle. Spanish: Erba cedrata. Italian: Cedronella. Indian: Badaranj. Part used: herb.

Action: antispasmodic, antidepressant, antihistamine, antiviral – topical application, anti-stress, antiflatulent, febrifuge, mild tranquilliser, nerve relaxant, heart-sedating effect.

Antibacterial, especially against myco-bacterium phlei and streptococcus haemolytica (H. Wagner & L. Springkmeyer. Dtsch, Apoth., Zrg, 113, 1159(1973))

Uses: Hyperthyroidism, dizziness, migraine, nervous heart or stomach, insomnia, little energy, stomach cramps, urinary infection, feverishness in children, mumps, shingles, reaction to vaccination or inoculation. Nervous excitability.

Psychiatry. To strengthen the brain in its resistance to shock and stress; low spirits, restlessness, fidgety limbs, “cold and miserable”, anxiety neurosis.

Rudolf F. Weiss MD. Balm protects the cerebrum of the brain and is effective in treatment of autonomic disorders – an action similar to modern tranquillisers . . . usually combined with Peppermint. (Herbal Medicine, Beaconsfield Publishers)

Preparations: Tea: 1-2 teaspoons to each cup boiling water; infuse 5 minutes; 1 cup freely. Liquid Extract: BHP (1983). 1:1 in 45 per cent alcohol; dose – 2-4ml.

Tincture BHP (1983) 1:5 in 45 per cent alcohol; dose 2-6ml. Thrice daily.

Powders. Two 210mg capsules thrice daily. (Arkocaps)

Traditional combination: Balm and Peppermint (equal parts) tea. 2 teaspoons to each cup boiling water; infuse 15 minutes; cup at bedtime for restful sleep or to improve digestion. (Rudolf F. Weiss MD) Historical. John Evelyn writes: “Balm is sovereign for the brain. It strengthens the memory and powerfully chases away melancholy.”

Balm Bath. 8oz dried (or 12oz fresh) herb to 10 pints (7 litres) boiling water: infuse 15 minutes: add to bathwater. For sleeplessness or nervous heart. Aromatherapy: 10-20 drops Oil Melissa (Balm) added to bath water.

Note: Combined with a pinch of Nutmeg it has a reputation for nervous headache (migraine) and neuralgia. Popular in all European pharmacopoeias. ... balm

A transmission of blood from donor to recipient subject to check for compatibility (ABO groups) and freedom from HIV, hepatitis and other viruses.

“There are as many different bloods as there are different people,” wrote Dr Alonzo J. Shadman. In his practice as a physician and surgeon he claimed he never lost a case for lack of blood and never employed blood transfusion or drugs. For bloodlessness he advised normal saline to give the heart sufficient fluid- load to work on.

Normal saline solution he used was with 2 teaspoons table salt to one of sodium bicarbonate in two quarts (approximately 2 litres) water. Normal saline keeps the blood vessels “open”.

Dr Shadman continues: “Where infection has occurred, expressed fresh juice from the flowering Marigold (Calendula) is mixed with sufficient alcohol to prevent fermentation. It should not be used full strength but diluted one part to ten parts water. Any left after the emergency should be thrown away.” (The Layman Speaks, April 1963, p. 137-139)

Garlic. Study showed a marked reduction in platelet aggregation over a 5-week period in a group of patients with normally increased tendency to aggregation. (Dr F. Jung, Department of Clinical Haemostasiology and Transfusion Medicine, Saarland University) ... blood transfusion

Red pepper. Chillies. Capsicum minimum Roxb. French: Piment capsique. German: Beisbeere. Italian: Peperone. Indian: Mirch. Malayan: Chabe-sabrong. Chinese: La-chiao. Bright red dried ripe pods. Powder known as Cayenne pepper.

Action: Regarded by the professional herbalist as the purest and safest stimulant known. Opens up every tissue in the body to an increased flow of blood.

Produces natural warmth, equalising the circulation in the aged. Stimulant and iron-bearer, it accelerates oxygenation of cells. Antiseptic. Antispasmodic for relief of pain. Carminative.

Prostaglandin antagonist and analgesic. (F. Fletcher Hyde, The Herbal Practitioner (Dec. 1977))

Well suited to persons of feeble constitution with poor circulation, lacking in energy and fear of the slightest draft. Hypothermia. Encourages the adrenal glands to produce corticosteroids.

Uses: Poor digestion in the aged, wind, nervous depression, impotency. To increase gatrointestinal secretion and thus improve the appetite. A mere pinch (one-eighth teaspoon) of the powder may suffice. Practitioner: Official tincture Capsicum Fort BPC (1934). 1 part to 3 parts 60 per cent alcohol. Dose 0.06-0.2ml. (1-3 drops).

Preparations: An active ingredient of Life Drops: see entry. A few grains of red pepper on food at table aids digestion and improves circulation.

Home-tincture: 1oz bruised chillies or coarse powder to half a litre 60 per cent alcohol (Vodka, etc); macerate 7 days; shake daily, decant. 2 or more teaspoons in wineglass water. 1-2 drops of the tincture enhances action of most herbal agents and may also be taken in tea or other beverages for cold hands and feet, pale lips and small feeble pulse.

Tincture Capsicum Fort. 1934: dose, 0.06-0.2ml.

External use as a rubefacient, antiseptic or counter-irritant. As a warming lotion, cream or ointment for rheumatism, neuralgia, backache, lumbago.

Cayenne salve: vegetable oil (16), Beeswax (2), Tincture Cayenne (1). Melt oil and beeswax in a stone jar in oven on low heat; add Cayenne. Stir gently few minutes to produce smooth consistency. Pour into jars.

Case Records. “I was called in haste to a lady who was dying. I found her gasping for breath with no wrist pulse and very cold. Seven specialists had treated her and were positive nothing could be done. I gave her tincture Capsicum in one drop doses, often and persistently. The specials made all kinds of fun at me. The patient became well and strong at 80 years. I suggest that if Cayenne pepper had been given in all cases where whisky had been taken for relief, many of those who are now dead would be alive today.” (C.S. Dyer, MD)

External: “Capsicum has a peculiar action on bones of the external ear and mastoid process – abscesses round about and below the ear, and caries. It is frequently indicated in mastoid abscess. A girl seen in hospital with a constant temperature of about 100 degrees since a mastoid operation some years ago resulted in a normal temperature ever since.” (Dr M.L. Tyler)

Ingredient of: Peerless Composition Essence; Antispasmodic drops; Life Drops; Elderflower; Peppermint and Composition Essence. (Potter’s) ... cayenne

Wild Chamomile. Matricaria recutita L. German: Hundskamille. French: Camomille. Italian: Camomilla. Spanish: Camomile. Part used: flowerheads. Contains chamazulene which is active against staphylococcus aureus.

Constituents: volatile oil, flavonoids, tannic acid.

Action. Anti-inflammatory, antimicrobial, antiseptic (mild), anti-peptic ulcer, anodyne (mild), antispasmodic, bitter, carminative, vulnerary. Mild nerve sedative but tonic to the alimentary canal.

Uses: Internal use. Nervous excitability, convulsions, restlessness, hyperactivity in children, insomnia, early stages of fever, measles (warm tea), travel sickness, pin and thread worms, peptic ulcer, gastro- intestinal spasm – calms down digestive system, pre-menstrual tension, hysteria from womb irritation, Candida albicans, inflammation of respiratory and gastro-intestinal tracts, sore throat and mouth. Psychosomatic illness: see CHAMOMILE ROMAN. May be used in pregnancy.

External use. “Inflammation and irritation of skin and mucosa, including the oral cavity and gums, respiratory tract and anal and genital area.” (EM) Conjunctivitis (cold tea). Gangrene (poultice with few drops Tincture Myrrh).

Combinations. With Valerian, Passion flower and Hops (equal parts) for nervous excitability. With Liquorice 1 and Chamomile 4 for gastric ulcer and chronic dyspepsia. Chamomile works well with Peppermint and Balm; equal parts.

Preparations: One teaspoon to each cup boiling water; infuse 5-10 minutes; one cup freely. Powder. Quarter to half a teaspoon; tablets/capsules.

Liquid extract BHC Vol 1. 1:1 in 45 per cent ethanol. Dose: 1-4ml (15-60 drops). Tincture. 1 part to 5 parts 45 per cent alcohol. Dose: 5-10ml (1-2 teaspoons).

Oil of Chamomile. Prepare as for OILS – IMPREGNATED.

Essential oil (Aromatherapy). Externally for neuralgia.

Compress: See: CHAMOMILE FLOWERS, ROMAN. Rinses. Gargles.

Chamomile bath. Add strong infusion to bath water for irritable skin rash, eczema.

Chamomile enema. 1 tablespoon flowers in 2 litres (3 and a half pints) boiling water; infuse, strain and inject warm.

Side-effects: rare contact skin allergy. ... chamomile flowers (german)

The ancient disease cholera resurfaces from time to time. Thousands still die each year. It is an acute infectious disease caused by vibrio cholerae and is notifiable under the Public Heath (Control of Diseases) Act 1984. Human Carriers maintain infection. Incubation may be from a few hours to a number of days. See: NOTIFIABLE DISEASES.

It is spread by polluted water as in the case of the composer, Tchaikovsky, who died imprudently drinking unboiled water during a cholera epidemic, despite warnings of his friends. It is transmitted also by milk, shellfish and by the faeces of infected people.

Symptoms. Profuse rice-water diarrhoea, vomiting and shock from severe loss of body fluids. Muscle cramps, cyanosis, stupor.

Alternatives. Powders. Formula: Tormentil root 2; Ginger 8; Poplar bark 2; Ipecacuanha half; Gum Myrrh quarter; Cloves; Cayenne quarter; Slippery Elm 5. (Reformed School of Medicine, W. Beach MD, USA) No dosage recorded. Suggested hourly dose: Liquid Extract: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg.

Tinctures. Formula No 1. Turkey Rhubarb 3; Hops 2; Peppermint 1. Dose: 1-2 teaspoons in water hourly, as tolerated.

Tinctures. Formula No 2. Turkey Rhubarb 2; Camphor (spirits) 1; Capsicum quarter; Peppermint quarter. Dose: 1-2 teaspoons hourly, as tolerated.

Orange berries. (Maeso lanceolata) Tea drunk by natives before visiting cholera epidemic areas. (Dr Isno Kufo, University of California, Berkeley)

Barberry. Berberine alkaloid. (Indian Journal of Medical Research, 50. 732, 1962)

Camphor. In the Cholera epidemic of 1831, a Russian Consol-General reported 70 cases in two places, all were cured. Elsewhere, of 1270 cases only 108 died. Practitioner use: Spirits of Camphor (10 per cent Camphor in 90 per cent brandy, gin or Vodka). 0.3 to 2ml (5 to 30 drops). Effective in the early stages. Also, rub into soles of feet and use as an inhalant.

Calamint. Old European remedy.

Enema. Bring 2 pints (1 litre) water to boiling point. Allow to cool. Add 20 drops Goldenseal and 20 drops Tincture Myrrh; for soothing and healing injection.

Diet. During an outbreak of cholera: avoid unboiled or unbottled water, uncooked seafood, vegetables and fruit unless fruit can be peeled.

Strict sanitary hygiene. Wash hands frequently.

Recovery period. Replacement of body fluids: glasses of boiled water to which 2-3 teaspoons cider vinegar has been added. Make up potassium loss with 3-4 bananas daily. Calcium, Magnesium and Potassium. Multivitamins.

Alternative rehydration therapy: spring or bottled water with sugar and salt; salt to replace water in the blood, sugar to promote absorption. Glass of water to contain 1 teaspoon salt and 2 teaspoons sugar.

To be treated by a general medical practitioner or hospital specialist.

CHOLERETIC. An agent which reduces cholesterol levels by excreting cholesterol. It also causes bile to flow freely. Differs from a cholagogue in that the latter increases the flow of bile (Artichoke). ... cholera

Injection of a strong infusion of coffee into the rectum is given in some cases of terminal disease to cleanse the bowel, and for sedative effect to assuage the pain of malignancy. When cancer cells are released into the bloodstream they are borne to the liver where they are broken down and expelled from the body via the eliminative organs. Such organs may be congested by by-products of disease. Coffee enemas are used for their detoxifying effect.

3 heaped tablespoons of ground coffee (not Instant) to 2 pints (1 litre) water. Bring to boil. Simmer 20 minutes. Strain when warm. Inject one or more pints according to tolerance. “Coffee retention enemas may be given at frequent intervals where well-tolerated, with no side effects.” (Mayo Clinic) (JAMA 245, 591, 1981) ... enema, coffee

Myoma of the womb. Non-malignant, non-painful growth of smooth muscle tissue enlarging into a mass on the wall of the womb. Accounts for most hysterectomies. Women may have them without knowing. Responsible for heavy menstruation and clots. Surgical removal is known as myomectomy.

Fibroids depend on oestrogen for their growth. High levels, as in The Pill, are believed to increase their size. Low levels cause shrinkage. Size: anything from a marble to a turnip, producing a sense of fullness. After the menopause when oestrogen declines they may shrink and finally disappear. When enlarged, they cause frequency of urine and constipation, sometimes resultant anaemia. A common cause of infertility. Not all are removed by surgery. Women with fibroids should not take steroids.

Alternatives. Anti-mitotics – Damiana, Motherwort, Helonias, Goldenseal, Life root, Prickly Ash, White Pond Lily, Thuja, Violet leaves (wild), Blue or Black Cohosh.

To arrest bleeding: add Shepherd’s Purse or Beth root.

For pain: Cramp bark. Goldenseal has a mixed success record and can constipate.

Tea. Formula. Equal parts: Corn Silk, Shepherd’s Purse, Violet. 2 teaspoons to each cup boiling water; infuse 15 minutes; dose, one cup thrice daily.

Decoction. Formula. Equal parts: Violet leaves, Clivers, Yellow Dock. 1 teaspoon to each cup of water simmered 20 minutes. Half-1 cup thrice daily.

Tinctures. Alternatives:

(1) Combine Cornsilk 3; White Pond Lily 2; Goldenseal quarter. Dose: 15-30 drops in water thrice daily. (Edgar G. Jones, MNIMH)

(2) Yellow Parilla, 60 drops; Yarrow 1oz; White Pond Lily 60 drops; Tincture Goldenseal 60 drops. Water (preferably distilled) to 8oz. Dose: 2 teaspoons in water after meals. (Arthur Barker, FNIMH) Powders. Formula. Blue Cohosh 1; Poke root 1; Goldenseal half. Dose: 500mg (two 00 capsules or one- third teaspoon) thrice daily.

A.W. & L.R. Priest. Combination: Goldenseal, Balmony, Galangal. (Oral and local suppository) Douche. 1 litre boiled water. Allow to cool. Add 30-40 drops Liquid Extract Goldenseal, Bayberry or Thuja. Castor oil packs over affected area. Three thicknesses cotton wool or suitable material soaked in Castor oil. Cover with an electric heating pad. Apply 3-4 nights a week for 6 months. Disappearance of fibroid reported. ARE Journal, Vol 19, May 84, p.127

Note: Correction of anaemia, if present. Simple iron deficiency – Nettle tea. Floradix. Special care during pregnancy. ... fibroids

Flavones. Natural chemicals that prevent the deposit of fatty material in blood vessels. A group of coloured (yellow) aromatic plant constituents with a spicy taste and smell, chiefly due to the presence of benzene. Efficient absorption of Vitamin C is dependent upon them. Their action is chiefly diuretic, antispasmodic and antiseptic. Some strengthen fragile capillaries and tone relaxed blood vessels, as in veinous disorders. They lower blood pressure.

Notable examples: Buckwheat, Coltsfoot, Citrus fruits, Hawthorn, Euphorbia, Figs, Heartsease, Pellitory of the Wall, Rutin, Skullcap, Lime flowers, Elderflowers, Shepherd’s Purse, Silver Birch, Wild Carrot, Yerba Santa and members of the labiatae family. All are immune enhancers and useful for chronic conditions where prolonged treatment produces no known toxicity. Of value in heart medicines.

Flavonoids are also pigments usually responsible for the colour of flowers and fruits and protect the plant against stress. A diet rich in raw fruit and vegetables provides adequate flavonoids.

Zutphen Elderly Study. Revealed that tea, onions and apples provided the majority of flavonoids in the overall diet. The mortality rate from coronary heart disease and myocardial infarction was lower in those with a high flavonoid intake. (Hertog MGL, National Institute of Public Health, Holland, et al The Lancet, 1993, Oct 23,1007-11)

Among red wines, Italian Chianti has the most flavonoids, with 20mg per litre, fostering healthy changes in the blood. All flavonoids are antioxidants and platelet inhibitors. Antioxidants stop oxygen from binding with LDL, a type of cholesterol. The oxygen-LDL pair clings to blood vessel walls, impeding blood flow. Flavonoids seem to suppress the stickiness. Platelet inhibitors prevent blood clots.

A diet rich in flavonoids would appear to prevent heart disease. ... flavonoids

Digitalis purpurea L. French: Doigts de la Vierge. German: Fingerhut. Spanish: Dedalera. Dutch: Vingerhoed. Italian: Guancelli. Chinese: Mao-ti-huany. Dried leaves. Keynote: heart. The most important cardiovascular agent in modern medicine. Digitalis lanata is superior to the purpurea. Constituents: Cardenolides, saponins, flavonoids, anthraquinones.

Action: Digitalis stimulates the vagus nerve thus slowing the heart rate. Prolongs diastole which increases the heart’s filling-time and improves coronary circulation. Effects of digitalis are cumulative. The herbalist uses an alternative: Lily of the Valley for the failing heart.

Preparation. Tincture B.P. Each millilitre possesses one unit of activity and is equivalent to 0.1 gramme of the International Standard digitalis powder. Prepared from the leaf in 70 per cent alcohol by a pharmacist. Dose: 0.3ml to 1ml (5-15 drops). Used only under medical supervision.

Digoxin toxicity occurs at levels above 2.6m mol/litre. Schedule 1 P. (POM) (UK) ... foxglove

Disorders of the stomach and intestines. A non-specific term for a number of infections caused by viruses, bacteria and protozoa. May be caused by domestic pets, dogs, birds, poultry, farm animals, milk, drugs, environmental poisons.

Symptoms. Onset sudden, with abdominal pain, nausea, vomiting, wind, malaise, shock, loose stool. Alternatives. Commence 3-day fast. Agrimony, German Chamomile, Milk Thistle, Ladies Mantle, Marshmallow root, Slippery Elm.

Tea. Combine, equal parts: Agrimony, Gotu Kola, Meadowsweet. 1 teaspoon to each cup boiling water; infuse 10-15 minutes. Half-1 cup thrice daily, or more frequently as tolerated.

Decoction. Fenugreek seeds. 2 teaspoons to each cup water gently simmered 15 minutes. 1 cup freely. Formula. German Chamomile 2; Marshmallow root 1; Goldenseal half; Liquorice quarter. Dose: Powders – 750mg (three 00 capsules or half a teaspoon). Liquid Extracts: 1-2 teaspoons. Tinctures: 1-3 teaspoons. Thrice daily.

Aloe Vera, gel or juice. (Linus Pauling Institute of Science and Medicine) Enemata. 15 drops Tincture Myrrh in 2 pints (1 litre) warm water.

Diet. Commence 3-day fast. Slippery Elm gruel. Bilberries. ... gastroenteritis

Herbs containing essential oils are sometimes used as inhalations. 1oz (30g) herb is infused in 2 pints (one and a quarter litres) boiling water for 15 minutes, strained, and the steam inhaled with the aid of a towel above the head. Soothing to irritable and sensitive mucous surfaces. Anti- microbial effects on colds, whooping cough, croup, laryngitis, coryza, asthma and early stages of fevers. To relieve spasm of bronchioles: Lobelia, Stramonium, Eucalyptus, Aloe Vera.

Important inhalants: Eucalyptus, Thyme, Hyssop, Rosemary, Lavender, Chamomile, Mint, Tea Tree. Aromatherapy offers oils of the above herbs: 6-12 drops floated on the surface of 2 pints boiling water after being allowed to stand 3 minutes. See: FRIAR’S BALSAM. TEA TREE.

Alternative method. In place of a basin use an aluminium hot water bottle into which boiling water is poured. Add few drops Friar’s Balsam, Olbas, or essential oil. Insert a large funnel into which the mouth and nose are placed to breathe the vapour. Stop up any free space in the neck of the bottle with a tissue. Camphorated oil. 4 teaspoons to litre boiling water. Inhale steam with aid of a towel over head.

Inhalant Salve for nasal congestion and frontal sinusitis. Oil Pine 1ml; Oil Eucalyptus 2ml; Oil Peppermint 2ml; Vaseline to 30 grams. Melt the Vaseline. Add oils. Stir until cold. For direct use or inhaled from boiling water. (F. Fletcher Hyde, FNIMH)

Note: Inhalation: also through a tissue, steam or air-diffuser. Odours act upon the sense of smell and influence mucous secretion of the respiratory organs. ... inhalations

Lion’s foot. Alchemilla vulgaris L. Dried herb (oral), root (topical). Keynote: bleeding.

Constituents: tannins.

Action: powerful styptic and astringent because of its high tannin content. Haemostatic. Alterative. Drying and binding. Menstrual regulator.

Uses: Excessive menstruation. Non-menstrual bleeding of the womb between periods. Children’s summer diarrhoea, colitis with bleeding. Gastric and duodenal ulcer. Children’s convulsions. (Swedish traditional)

Not used in pregnancy.

Combinations. (1) with Avens for gastritis and mucous colitis. (2) with Agnus Castus for menstrual disorders.

Preparations: Average dose: 2-4g. Thrice daily. Tea: 1-2 teaspoons to each cup boiling water; infuse 15 minutes. One cup.

Liquid extract BHP (1983) 1:1 in 25 per cent alcohol. Dose: 2-4ml.

Powdered root. Dose, 2-4g.

Vaginal douche: 2oz to 2 pints (60g to 1 litre) boiling water. Infuse 30 minutes. Inject warm for leucorrhoea, Candida, inflammation; or as a lotion for pruritus.

Decoction (roots) offer a powerful deterrant to passive bleeding. ... lady’s mantle

English oak. Quercus robur L. Dried inner bark. German: Stieleiche. French: Bouvre. Italian: Rovere.

Constituents: tannins, quercin, pectin, resin.

Action: astringent, styptic, antiseptic, anti-inflammatory, haemostatic.

Uses: Alcoholism, diarrhoea, dysentery, colitis. To cleanse external ulcers and suppurating wounds. Mouth ulcers, spongy gums, sore throat, tonsillitis, (gargle and mouth-wash). Non-infectious vaginal discharge, leucorrhoea, (douche). Chilblains (decoction as a lotion). Piles (decoction as an enema). Preparations. Average dose, half-2 grams, or equivalent. Thrice daily.

Decoction. Half an ounce to 1 pint water gently simmered 20 minutes. Dose, one-third to half a cup (internally).

Liquid extract BHP (1983). 1:1 in 25 per cent alcohol; dose, 1-2ml.

Tincture of acorns. Dehusk and pulverise acorns. 1 part to 5 parts 45 per cent alcohol (vodka etc). Macerate 8 days, shake daily. Filter. Dose, 15-30 drops. External: 1 part to 20 parts boiled water. Powder, inner bark or acorns, for dusting foul-smelling ulcers and septic wounds.

Oak Bath. 6-8oz bark to 10 litres (7 pints) water simmered 20 minutes. Add to bath water. Oak Compress. Soak a piece of lint in decoction and fix firmly for acute eye troubles. ... oak

Oatstraw. Avena sativa L. Husks of oats. German: Evenhafer. French: Avoine. Spanish: Avena. Italian: Biada.

Constituents: glycosyl flavones, proteins, Vitamin E, oil, proteins.

Action: nerve restorative, antidepressant, tranquilliser, brain tonic. Cardiac tonic BHP (1983). Nutrient with selective action on brain and nerve cells. Source of minerals. Thymoleptic. Improves performance of athletes and stamina.

“Oats have the highest content of iron, zinc and manganese of all grain species.” (Dr A. Vogel)

Uses: Benzodiazepine, Valium or other drug addiction – with Valerian and Skullcap to assist withdrawal. Alcoholism. Nerve and physical weakness with depression and anxiety. Debility following illness; recovery from surgical operation. Neurasthenia. Tension and irritability through overwork. Headache with pain at back of the neck; sleeplessness, shingles, hyperactivity in children. Nerve tremor in the aged not caused by Parkinson’s or other nerve degenerative diseases. May be taken with benefit for general well-being in chronic nerve dyscrasies but with limited improvement in basic condition. Sometimes proves of benefit for schizophrenic tendency. Sexual weakness with night losses and impotence. Combines well with Saw Palmetto for spermatorrhoea. Combines with Valerian and Wood Betony for nerve weakness, to minimise attacks of petit mal, chorea and other convulsive states. Does not combine well with Passion flower or Cypripedium.

Contra-indicated in cases sensitive to gluten.

Preparations: Average dose, 1-2 grams or equivalent. Thrice daily. An older generation of herbalists prepared their tinctures and extracts from the green flowering unripe wild Oats as the effective constituent is unstable. Taken hot, effects are more immediate.

Tea: oatstraw: 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Drink freely.

Tincture BHP (1983) 1 part to 5 parts 45 per cent alcohol. Macerate and shake daily for 8 days; dose, 1- 5ml.

Extracts, groats and oatmeal products are all beneficial but are not of the same efficacy as the fresh green plant.

Oatstraw bath: 2-3 handfuls oatstraw. Simmer in 2-3 litres water for 5 minutes; strain; add to bathwater. Liquid Extract: dose: 1-2ml in water.

Traditional combination: equal parts – Oats, Passion flower, Hops and Valerian. Diet. Porridge, but not to be eaten by the gluten intolerant.

Side-effects: none known. ... oats

The hollow, muscular organ in the lower abdomen that acts as a reservoir for urine. It lies within, and is protected by, the pelvis. An adult bladder can hold about 0.5 litres of urine before the need to pass urine is felt.

The bladder walls consist of muscle and an inner lining.

Two ureters carry urine to the bladder from the kidneys.

At the lowest point of the bladder is the opening into the urethra, which is known as the bladder neck.

This is normally kept tightly closed by a ring of muscle (the urethral sphincter).

The function of the bladder is to collect and store urine until it can be expelled.

Defective bladder function, leading to problems such as incontinence and urinary retention, can have a variety of causes.

(See also bladder, disorders of; enuresis).... bladder

n. one of the pair of organs of *respiration, situated in the chest cavity on either side of the heart and enclosed by a serous membrane (see pleura). The lungs are fibrous elastic sacs that are expanded and compressed by movements of the rib cage and diaphragm during *breathing. They communicate with the atmosphere through the *trachea, which opens into the pharynx. The trachea divides into two bronchi (see bronchus), which enter the lungs and branch into *bronchioles. These divide further and terminate in minute air sacs (see alveolus), the sites of gaseous exchange. (See illustration.) Atmospheric oxygen is absorbed and carbon dioxide from the blood of the pulmonary capillaries is released into the lungs; in each case down a concentration gradient (see pulmonary circulation). The total capacity of the lungs in an adult male is about 5.5 litres, but during normal breathing only about 500 ml of air is exchanged (see also residual volume). Other functions of the lung include water evaporation: an important factor in the fluid balance and heat regulation of the body.

British Lung Foundation: basic information on the lungs and some common lung conditions... lung

n. a variety of white blood cell (leucocyte), present also in the lymph nodes, spleen, thymus gland, gut wall, and bone marrow. With *Romanowsky stains, lymphocytes can be seen to have dense nuclei with clear pale-blue cytoplasm. Lymphocytes with scanty cytoplasm are small lymphocytes; those with abundant cytoplasm are large lymphocytes. There are normally 1.5–4.0 × 109 lymphocytes per litre of blood. They are involved in *immunity and can be subdivided into B lymphocytes (or B cells), which produce circulating antibodies, and T lymphocytes (or T cells), which are primarily responsible for cell-mediated immunity. T lymphocytes can differentiate into *helper T cells or *cytotoxic T cells. There is an increase in the number of lymphocytes in the blood and bone marrow in chronic lymphocytic *leukaemia. —lymphocytic adj.... lymphocyte

a solution in which the number of grams of dissolved substance per litre equals its molecular weight, i.e. a solution of molarity 1 M.

mole1 n. the *SI unit of amount of substance, equal to the amount of substance that contains as many elementary units as there are atoms in 0.012 kilograms of carbon-12. The elementary units, which must be specified, may be atoms, molecules, ions, electrons, etc., or a specified group of such entities. One mole of a compound has a mass equal to its molecular weight expressed in grams. Symbol: mol.

mole2 n. a nonmalignant collection of pigmented cells in the skin. Moles are rare in infancy, increase in numbers during childhood and especially in adolescence, but decline in numbers in old age. They vary widely in appearance, being flat or raised, smooth or hairy. Changes in the shape, colour, etc., of moles in adult life should be investigated as this may be an early sign of malignant *melanoma. Medical name: pigmented naevus. See also atypical mole syndrome.... molar solution

n. a mineral element and an important constituent of the human body. It is the main base ion of intracellular fluid. Together with *sodium, it helps to maintain the electrical potential of the nervous system and is thus essential for the functioning of nerve and muscle. Normal blood levels are between 3.5 and 5 mmols/litre. High concentrations occur particularly in kidney failure and may lead to *arrhythmia and finally to cardiac arrest. Low values result from fluid loss, e.g. due to vomiting or diarrhoea, and this may lead to general muscle paralysis. A diet high in potassium can help to lower blood pressure; good sources are fruit, vegetables, and wholegrain cereals. Symbol: K.... potassium