Nosebleed Health Dictionary

Achillea millefolium. N.O. Compositae. Synonym: Milfoil, Nosebleed, Thousand-leaf.

Habitat: A wayside herb, also often seen in the pasture and meadow lands of Europe and the United States. Features ? Yarrow has a rough, angular stem, and grows from twelve to eighteen inches in height. The alternate leaves are pinnatifid, clasp the stem at the base, are slightly woolly, and are cut into very fine segments. The flowers are small, white (occasionally pink or purplish), daisy-like, and bloom in dense, flattened, terminal corymbs, appearing at their best in July. Part used ? Herb.

Action: Diaphoretic, stimulant and tonic. The herb is extremely useful in colds and acute catarrhs of the respiratory tract generally. As it has the effect of opening the pores, thus permitting free perspiration, Yarrow is taken at the commencement of influenza and in other feverish conditions. An infusion of 1 ounce to 1 pint of foiling water is drunk warm in wineglass doses. As a very popular remedy for influenza colds it is usually combined with Elder flowers and Peppermint in equal quantities. It was sometimes prescribed by the old herbalists as a tonic in nervous debility, but there are many better herbal medicines for this condition.... yarrow

A method of sealing blood vessels using heat generated by high-frequency electric current through ?ne needles or a surgical knife. The procedure is used during surgery to close newly cut vessels. It can also be used to stop nosebleeds and to remove vascular deformities such as naevi (see NAEVUS).... electrocoagulation

Nosebleeds.... epistaxis

(Ale)

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

About the Nutrients in This Food Beer and ale are fermented beverages created by yeasts that convert the sugars in malted barley and grain to ethyl alcohol (a.k.a. “alcohol,” “drink- ing alcohol”).* The USDA /Health and Human Services Dietary Guidelines for Americans defines one drink as 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits. One 12-ounce glass of beer has 140 calo- ries, 86 of them (61 percent) from alcohol. But the beverage—sometimes nicknamed “liquid bread”—is more than empty calories. Like wine, beer retains small amounts of some nutrients present in the food from which it was made. * Because yeasts cannot digest t he starches in grains, t he grains to be used in mak ing beer and ale are allowed to germinate ( “malt” ). When it is t ime to make t he beer or ale, t he malted grain is soaked in water, forming a mash in which t he starches are split into simple sugars t hat can be digested (fermented) by t he yeasts. If undisturbed, t he fermentat ion will cont inue unt il all t he sugars have been digested, but it can be halted at any t ime simply by raising or lowering t he temperature of t he liquid. Beer sold in bott les or cans is pasteurized to k ill t he yeasts and stop t he fermentat ion. Draft beer is not pasteurized and must be refrigerated unt il tapped so t hat it will not cont inue to ferment in t he container. The longer t he shipping t ime, t he more likely it is t hat draft beer will be exposed to temperature variat ions t hat may affect its qualit y—which is why draft beer almost always tastes best when consumed near t he place where it was brewed. The Nutrients in Beer (12-ounce glass)

Nutrients	Beer	%R DA
Calcium	17 mg	1.7
Magnesium	28.51 mg	7–9*
Phosphorus	41.1 mg	6
Potassium	85.7 mg	(na)
Zinc	0.06 mg	0.5– 0.8*
Thiamin	0.02 mg	1.6 –1.8*
R iboflavin	0.09 mg	7– 8*
Niacin	1.55 mg	10
Vitamin B6	0.17 mg	13
Folate	20.57 mcg	5

  * t he first figure is t he %R DA for a man; t he second, for a woman Source: USDA Nut rient Database: w w w.nal.usda.gov/fnic/cgi-bin /nut _search.pl.

Diets That May Restrict or Exclude This Food Bland diet Gluten-free diet Low-purine (antigout) diet

Buying This Food Look for: A popular brand that sells steadily and will be fresh when you buy it. Avoid: Dusty or warm bottles and cans.

Storing This Food Store beer in a cool place. Beer tastes best when consumed within two months of the day it is made. Since you cannot be certain how long it took to ship the beer to the store or how long it has been sitting on the grocery shelves, buy only as much beer as you plan to use within a week or two. Protect bottled beer and open bottles or cans of beer from direct sunlight, which can change sulfur compounds in beer into isopentyl mercaptan, the smelly chemical that gives stale beer its characteristic unpleasant odor.

When You Are Ready to Serve This Food Serve beer only in absolutely clean glasses or mugs. Even the slightest bit of grease on the side of the glass will kill the foam immediately. Wash beer glasses with detergent, not soap, and let them drain dry rather than drying them with a towel that might carry grease from your hands to the glass. If you like a long-lasting head on your beer, serve the brew in tall, tapering glasses to let the foam spread out and stabilize. For full flavor, serve beer and ales cool but not ice-cold. Very low temperatures immo- bilize the molecules that give beer and ale their flavor and aroma.

What Happens When You Cook This Food When beer is heated (in a stew or as a basting liquid), the alcohol evaporates but the flavor- ing agents remain intact. Alcohol, an acid, reacts with metal ions from an aluminum or iron pot to form dark compounds that discolor the pot or the dish you are cooking in. To prevent this, prepare dishes made with beer in glass or enameled pots.

Medical Uses and/or Benefits Reduced risk of heart attack. Data from the American Cancer Society’s Cancer Prevention Study 1, a 12-year survey of more than 1 million Americans in 25 states, shows that men who take one drink a day have a 21 percent lower risk of heart attack and a 22 percent lower risk of stroke than men who do not drink at all. Women who have up to one drink a day also reduce their risk of heart attack. Numerous later studies have confirmed these findings. Lower risk of stroke. In January 1999, the results of a 677-person study published by researchers at New York Presbyterian Hospital-Columbia University showed that moder- ate alcohol consumption reduces the risk of stroke due to a blood clot in the brain among older people (average age: 70). How the alcohol prevents stroke is still unknown, but it is clear that moderate use of alcohol is a key. Heavy drinkers (those who consume more than seven drinks a day) have a higher risk of stroke. People who once drank heavily, but cut their consumption to moderate levels, can also reduce their risk of stroke. Numerous later studies have confirmed these findings. Lower cholesterol levels. Beverage alcohol decreases the body’s production and storage of low-density lipoproteins (LDLs), the protein and fat particles that carr y cholesterol into your arteries. As a result, people who drink moderately tend to have lower cholesterol levels and higher levels of high density lipoproteins (HDLs), the fat and protein particles that carr y cholesterol out of the body. The USDA /Health and Human Services Dietar y Guidelines for Americans defines moderation as two drinks a day for a man, one drink a day for a woman. Stimulating the appetite. Alcoholic beverages stimulate the production of saliva and the gastric acids that cause the stomach contractions we call hunger pangs. Moderate amounts of alcoholic beverages, which may help stimulate appetite, are often prescribed for geriatric patients, convalescents, and people who do not have ulcers or other chronic gastric problems that might be exacerbated by the alcohol. Dilation of blood vessels. Alcohol dilates the capillaries (the tiny blood vessels just under the skin), and moderate amounts of alcoholic beverages produce a pleasant flush that temporar- ily warms the drinker. But drinking is not an effective way to warm up in cold weather since the warm blood that flows up to the capillaries will cool down on the surface of your skin and make you even colder when it circulates back into the center of your body. Then an alco- hol flush will make you perspire, so that you lose more heat. Excessive amounts of beverage alcohol may depress the mechanism that regulates body temperature.

Adverse Effects Associated with This Food Increased risk of breast cancer. In 2008, scientists at the National Cancer Institute released data from a seven-year survey of more than 100,000 postmenopausal women showing that even moderate drinking (one to two drinks a day) may increase by 32 percent a woman’s risk of developing estrogen-receptor positive (ER+) and progesterone-receptor positive (PR+) breast cancer, tumors whose growth is stimulated by hormones. No such link was found between consuming alcohol and the risk of developing ER-/PR- tumors (not fueled by hor- mones). The finding applies to all types of alcohol: beer, wine, and spirits. Increased risk of oral cancer (cancer of the mouth and throat). Numerous studies confirm the American Cancer Society’s warning that men and women who consume more than two drinks a day are at higher risk of oral cancer than are nondrinkers or people who drink less. Note: The Dietary Guidelines for Americans describes one drink as 12 ounces of beer, five ounces of wine, or 1.5 ounces of distilled spirits. Increased risk of cancer of the colon and rectum. In the mid-1990s, studies at the University of Oklahoma suggested that men who drink more than five beers a day are at increased risk of rectal cancer. Later studies suggested that men and women who are heavy beer or spirits drinkers (but not those who are heavy wine drinkers) have a higher risk of colorectal cancers. Further studies are required to confirm these findings. Fetal alcohol syndrome. Fetal alcohol syndrome is a specific pattern of birth defects—low birth weight, heart defects, facial malformations, and mental retardation—first recognized in a study of babies born to alcoholic women who consumed more than six drinks a day while pregnant. Subsequent research has found a consistent pattern of milder defects in babies born to women who consume three to four drinks a day or five drinks on any one occasion while pregnant. To date, there is no evidence of a consistent pattern of birth defects in babies born to women who consume less than one drink a day while pregnant, but two studies at Columbia University have suggested that as few as two drinks a week while preg- nant may raise a woman’s risk of miscarriage. (“One drink” means 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits.) Alcoholism. Alcoholism is an addiction disease, the inability to control one’s alcohol consumption. It is a potentially life-threatening condition, with a higher risk of death by accident, suicide, malnutrition, or acute alcohol poisoning, a toxic reaction that kills by para- lyzing body organs, including the heart. Malnutrition. While moderate alcohol consumption stimulates appetite, alcohol abuse depresses it. In addition, an alcoholic may drink instead of eating. When an alcoholic does eat, excess alcohol in his/her body prevents absorption of nutrients and reduces the ability to synthesize new tissue. Hangover. Alcohol is absorbed from the stomach and small intestine and carried by the bloodstream to the liver, where it is oxidized to acetaldehyde by alcohol dehydrogenase (ADH), the enzyme our bodies use to metabolize the alcohol we produce when we digest carbohydrates. The acetaldehyde is converted to acetyl coenzyme A and either eliminated from the body or used in the synthesis of cholesterol, fatty acids, and body tissues. Although individuals vary widely in their capacity to metabolize alcohol, on average, normal healthy adults can metabolize the alcohol in one quart of beer in approximately five to six hours. If they drink more than that, they will have more alcohol than the body’s natural supply of ADH can handle. The unmetabolized alcohol will pile up in the bloodstream, interfering with the liver’s metabolic functions. Since alcohol decreases the reabsorption of water from the kidneys and may inhibit the secretion of an antidiuretic hormone, they will begin to urinate copiously, losing magnesium, calcium, and zinc but retaining more irritating uric acid. The level of lactic acid in the body will increase, making them feel tired and out of sorts; their acid-base balance will be out of kilter; the blood vessels in their heads will swell and throb; and their stomachs, with linings irritated by the alcohol, will ache. The ultimate result is a “hangover” whose symptoms will disappear only when enough time has passed to allow their bodies to marshal the ADH needed to metabolize the extra alcohol in their blood. Changes in body temperature. Alcohol dilates capillaries, tiny blood vessels just under the skin, producing a “flush” that temporarily warms the drinker. But drinking is not an effective way to stay warm in cold weather. Warm blood flowing up from the body core to the surface capillaries is quickly chilled, making you even colder when it circulates back into your organs. In addition, an alcohol flush triggers perspiration, further cooling your skin. Finally, very large amounts of alcohol may actually depress the mechanism that regulates body temperature. Impotence. Excessive drinking decreases libido (sexual desire) and interferes with the ability to achieve or sustain an erection. “Beer belly.” Data from a 1995, 12,000 person study at the University of North Carolina in Chapel Hill show that people who consume at least six beers a week have more rounded abdomens than people who do not drink beer. The question left to be answered is which came first: the tummy or the drinking.

Food/Drug Interactions Acetaminophen (Tylenol, etc.). The FDA recommends that people who regularly have three or more drinks a day consult a doctor before using acetaminophen. The alcohol/acetamino- phen combination may cause liver failure. Disulfiram (Antabuse). Taken with alcohol, disulfiram causes flushing, nausea, low blood pressure, faintness, respiratory problems, and confusion. The severity of the reaction gener- ally depends on how much alcohol you drink, how much disulfiram is in your body, and how long ago you took it. Disulfiram is used to help recovering alcoholics avoid alcohol. (If taken with alcohol, metronidazole [Flagyl], procarbazine [Matulane], quinacrine [Atabrine], chlorpropamide (Diabinase), and some species of mushrooms may produce a mild disulfi- ramlike reaction.) Anticoagulants. Alcohol slows the body’s metabolism of anticoagulants (blood thinners) such as warfarin (Coumadin), intensif ying the effect of the drugs and increasing the risk of side effects such as spontaneous nosebleeds. Antidepressants. Alcohol may increase the sedative effects of antidepressants. Drinking alcohol while you are taking a monoamine oxidase (M AO) inhibitor is especially hazard- ous. M AO inhibitors inactivate naturally occurring enzymes in your body that metabolize tyramine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. If you eat a food containing tyramine while you are taking an M AO inhibitor, you cannot effectively eliminate the tyramine from your body. The result may be a hypertensive crisis. Ordinarily, fermentation of beer and ale does not produce tyramine, but some patients have reported tyramine reactions after drinking some imported beers. Beer and ale are usually prohibited to those using M AO inhibitors. Aspirin, ibuprofen, ketoprofen, naproxen, and nonsteroidal anti-inflammatory drugs. Like alcohol, these analgesics irritate the lining of the stomach and may cause gastric bleeding. Combining the two intensifies the effect. Insulin and oral hypoglycemics. Alcohol lowers blood sugar and interferes with the metabo- lism of oral antidiabetics; the combination may cause severe hypoglycemia. Sedatives and other central nervous system depressants (tranquilizers, sleeping pills, antidepres- sants, sinus and cold remedies, analgesics, and medication for motion sickness). Alcohol inten- sifies sedation and, depending on the dose, may cause drowsiness, respiratory depression, coma, or death.... beer

(Brandy, gin, rum, tequila, whiskey, vodka)

Nutritional Profile Energy value (calories per serving): Moderate to high Protein: None Fat: None Saturated fat: None Cholesterol: None Carbohydrates: None (except for cordials which contain added sugar) Fiber: None Sodium: Low Major vitamin contribution: None Major mineral contribution: Phosphorus

About the Nutrients in This Food Spirits are the clear liquids produced by distilling the fermented sugars of grains, fruit, or vegetables. The yeasts that metabolize these sugars and convert them into alcohol stop growing when the concentration of alcohol rises above 12–15 percent. In the United States, the proof of an alcoholic beverage is defined as twice its alcohol content by volume: a beverage with 20 percent alcohol by volume is 40 proof. This is high enough for most wines, but not high enough for most whiskies, gins, vodkas, rums, brandies, and tequilas. To reach the concentra- tion of alcohol required in these beverages, the fermented sugars are heated and distilled. Ethyl alcohol (the alcohol in beer, wine, and spirits) boils at a lower temperature than water. When the fermented sugars are heated, the ethyl alcohol escapes from the distillation vat and condenses in tubes leading from the vat to a collection vessel. The clear liquid that collects in this vessel is called distilled spirits or, more technically, grain neutral spirits. Gins, whiskies, cordials, and many vodkas are made with spirits American whiskeys (which include bourbon, rye, and distilled from grains. blended whiskeys) and Canadian, Irish, and Scotch whiskies are all made from spirits aged in wood barrels. They get their flavor from the grains and their color from the barrels. (Some whiskies are also colored with caramel.) Vodka is made from spirits distilled and filtered to remove all flavor. By law, vodkas made in America must be made with spirits distilled from grains. Imported vodkas may be made with spirits distilled either from grains or potatoes and may contain additional flavoring agents such as citric acid or pepper. Aquavit, for example, is essentially vodka flavored with caraway seeds. Gin is a clear spirit flavored with an infusion of juniper berries and other herbs (botanicals). Cordials (also called liqueurs) and schnapps are flavored spirits; most are sweetened with added sugar. Some cordials contain cream. Rum is made with spirits distilled from sugar cane (molasses). Tequila is made with spirits distilled from the blue agave plant. Brandies are made with spirits distilled from fruit. (Arma- gnac and cognac are distilled from fermented grapes, calvados and applejack from fermented apples, kirsch from fermented cherries, slivovitz from fermented plums.) Unless they contain added sugar or cream, spirits have no nutrients other than alcohol. Unlike food, which has to be metabolized before your body can use it for energy, alcohol can be absorbed into the blood-stream directly from the gastrointestinal tract. Ethyl alcohol provides 7 calories per gram.

The Most Nutritious Way to Serve This Food The USDA /Health and Human Services Dietary Guidelines for Americans defines one drink as 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits, and “moderate drinking” as two drinks a day for a man, one drink a day for a woman.

Diets That May Restrict or Exclude This Food Bland diet Lactose-free diet (cream cordials made with cream or milk) Low-purine (antigout) diet

Buying This Food Look for: Tightly sealed bottles stored out of direct sunlight, whose energy might disrupt the structure of molecules in the beverage and alter its flavor. Choose spirits sold only by licensed dealers. Products sold in these stores are manufac- tured under the strict supervision of the federal government.

Storing This Food Store sealed or opened bottles of spirits in a cool, dark cabinet.

Preparing This Food All spirits except unflavored vodkas contain volatile molecules that give the beverage its characteristic taste and smell. Warming the liquid excites these molecules and intensifies the flavor and aroma, which is the reason we serve brandy in a round glass with a narrower top that captures the aromatic molecules as they rise toward the air when we warm the glass by holding it in our hands. Whiskies, too, though traditionally served with ice in America, will have a more intense flavor and aroma if served at room temperature.

What Happens When You Cook This Food The heat of cooking evaporates the alcohol in spirits but leaves the flavoring intact. Like other alcoholic beverages, spirits should be added to a recipe near the end of the cooking time to preserve the flavor while cooking away any alcohol bite. Alcohol is an acid. If you cook it in an aluminum or iron pot, it will combine with metal ions to form dark compounds that discolor the pot and the food you are cooking. Any recipe made with spirits should be prepared in an enameled, glass, or stainless-steel pot.

Medical Uses and/or Benefits Reduced risk of heart attack. Data from the American Cancer Society’s Cancer Prevention Study 1, a 12-year survey of more than 1 million Americans in 25 states, shows that men who take one drink a day have a 21 percent lower risk of heart attack and a 22 percent lower risk of stroke than men who do not drink at all. Women who have up to one drink a day also reduce their risk of heart attack. Numerous later studies have confirmed these findings. Lower cholesterol levels. Beverage alcohol decreases the body’s production and storage of low density lipoproteins (LDLs), the protein and fat particles that carry cholesterol into your arteries. As a result, people who drink moderately tend to have lower cholesterol levels and higher levels of high density lipoproteins (HDLs), the fat and protein particles that carry cholesterol out of the body. Numerous later studies have confirmed these findings. Lower risk of stroke. In January 1999, the results of a 677-person study published by researchers at New York Presbyterian Hospital-Columbia University showed that moderate alcohol consumption reduces the risk of stroke due to a blood clot in the brain among older people (average age: 70). How alcohol prevents stroke is still unknown, but it is clear that moderate use is a key. Heavy drinkers (those who consume more than seven drinks a day) have a higher risk of stroke. People who once drank heavily, but cut their consumption to moderate levels, reduce their risk of stroke. Stimulating the appetite. Alcoholic beverages stimulate the production of saliva and the gastric acids that cause the stomach contractions we call hunger pangs. Moderate amounts of alcoholic beverages, which may help stimulate appetite, are often prescribed for geriatric patients, convalescents, and people who do not have ulcers or other chronic gastric problems that might be exacerbated by the alcohol. Dilation of blood vessels. Alcoholic beverages dilate the tiny blood vessels just under the skin, bringing blood up to the surface. That’s why moderate amounts of alcoholic beverages (0.2–1 gram per kilogram of body weight, or two ounces of whiskey for a 150-pound adult) temporarily warm the drinker. But the warm blood that flows up to the surface of the skin will cool down there, making you even colder when it circulates back into the center of your body. Then an alcohol flush will make you perspire, so you lose more heat. Excessive amounts of beverage alcohol may depress the mechanism that regulates body temperature.

Adverse Effects Associated with This Food Alcoholism. Alcoholism is an addiction disease, the inability to control one’s alcohol consumption. It is a potentially life-threatening condition, with a higher risk of death by accident, suicide, malnutrition, or acute alcohol poisoning, a toxic reaction that kills by para- lyzing body organs, including the heart. Fetal alcohol syndrome. Fetal alcohol syndrome is a specific pattern of birth defects—low birth weight, heart defects, facial malformations, learning disabilities, and mental retarda- tion—first recognized in a study of babies born to alcoholic women who consumed more than six drinks a day while pregnant. Subsequent research has found a consistent pattern of milder defects in babies born to women who drink three to four drinks a day or five drinks on any one occasion while pregnant. To date there is no evidence of a consistent pattern of birth defects in babies born to women who consume less than one drink a day while preg- nant, but two studies at Columbia University have suggested that as few as two drinks a week while pregnant may raise a woman’s risk of miscarriage. (One drink is 12 ounces of beer, five ounces of wine, or 1.25 ounces of distilled spirits.) Increased risk of breast cancer. In 2008, scientists at the National Cancer Institute released data from a seven-year survey of more than 100,000 postmenopausal women showing that even moderate drinking (one to two drinks a day) may increase by 32 percent a woman’s risk of developing estrogen-receptor positive (ER+) and progesterone-receptor positive (PR+) breast cancer, tumors whose growth is stimulated by hormones. No such link was found between consuming alcohol and the risk of developing ER-/PR- tumors (not fueled by hor- mones). The finding applies to all types of alcohol: beer, wine, and distilled spirits. Increased risk of oral cancer (cancer of the mouth and throat). Numerous studies confirm the A merican Cancer Societ y’s warn ing that men and women who consume more than t wo drinks a day are at higher risk of oral cancer than are nondrinkers or people who drink less. Increased risk of cancer of the colon and rectum. In the mid-1990s, studies at the University of Oklahoma suggested that men who drink more than five beers a day are at increased risk of rectal cancer. Later studies suggested that men and women who are heavy beer or spirits drinkers (but not those who are heavy wine drinkers) have a higher risk of colorectal cancers. Further studies are required to confirm these findings. Malnutrition. While moderate alcohol consumption stimulates appetite, alcohol abuses depresses it. In addition, an alcoholic may drink instead of eating. When an alcoholic does eat, excess alcohol in his/her body prevents absorption of nutrients and reduces the ability to synthesize new tissue. Hangover. Alcohol is absorbed from the stomach and small intestine and carried by the bloodstream to the liver, where it is oxidized to acetaldehyde by alcohol dehydrogenase (ADH), the enzyme our bodies use every day to metabolize the alcohol we produce when we digest carbohydrates. The acetaldehyde is converted to acetyl coenzyme A and either eliminated from the body or used in the synthesis of cholesterol, fatty acids, and body tis- sues. Although individuals vary widely in their capacity to metabolize alcohol, an adult of average size can metabolize the alcohol in four ounces (120 ml) whiskey in approximately five to six hours. If he or she drinks more than that, the amount of alcohol in the body will exceed the available supply of ADH. The surplus, unmetabolized alcohol will pile up in the bloodstream, interfering with the liver’s metabolic functions. Since alcohol decreases the reabsorption of water from the kidneys and may inhibit the secretion of an antidiuretic hormone, the drinker will begin to urinate copiously, losing magnesium, calcium, and zinc but retaining uric acid, which is irritating. The level of lactic acid in the body will increase, making him or her feel tired and out of sorts; the acid-base balance will be out of kilter; the blood vessels in the head will swell and throb; and the stomach, its lining irritated by the alcohol, will ache. The ultimate result is a hangover whose symptoms will disappear only when enough time has passed to allow the body to marshal the ADH needed to metabolize the extra alcohol in the person’s blood. Changes in body temperature. Alcohol dilates capillaries, tiny blood vessels just under the skin, producing a “flush” that temporarily warms the drinker. But drinking is not an effective way to stay warm in cold weather. Warm blood flowing up from the body core to the surface capillaries is quickly chilled, making you even colder when it circulates back into your organs. In addition, an alcohol flush triggers perspiration, further cooling your skin. Finally, very large amounts of alcohol may actually depress the mechanism that regulates body temperature. Impotence. Excessive drinking decreases libido (sexual desire) and interferes with the ability to achieve or sustain an erection. Migraine headache. Some alcoholic beverages contain chemicals that inhibit PST, an enzyme that breaks down certain alcohols in spirits so that they can be eliminated from the body. If they are not broken down by PST, these alcohols will build up in the bloodstream and may trigger a migraine headache. Gin and vodka appear to be the distilled spirits least likely to trigger headaches, brandy the most likely.

Food/Drug Interactions Acetaminophen (Tylenol, etc.). FDA recommends that people who regularly have three or more drinks a day consult a doctor before using acetaminophen. The alcohol/acetaminophen combination may cause liver failure. Anti-alcohol abuse drugs (disulfiram [Antabuse]). Taken concurrently with alcohol, the anti- alcoholism drug disulfiram can cause flushing, nausea, a drop in blood pressure, breathing difficulty, and confusion. The severity of the symptoms, which may var y among individu- als, generally depends on the amount of alcohol consumed and the amount of disulfiram in the body. Anticoagulants. Alcohol slows the body’s metabolism of anticoagulants (blood thinners), intensif ying the effect of the drugs and increasing the risk of side effects such as spontane- ous nosebleeds. Antidepressants. Alcohol may strengthen the sedative effects of antidepressants. Aspirin, ibuprofen, ketoprofen, naproxen and nonsteroidal anti-inflammatory drugs. Like alco- hol, these analgesics irritate the lining of the stomach and may cause gastric bleeding. Com- bining the two intensifies the effect. Insulin and oral hypoglycemics. Alcohol lowers blood sugar and interferes with the metabo- lism of oral antidiabetics; the combination may cause severe hypoglycemia. Sedatives and other central nervous system depressants (tranquilizers, sleeping pills, antide- pressants, sinus and cold remedies, analgesics, and medication for motion sickness). Alcohol intensifies the sedative effects of these medications and, depending on the dose, may cause drowsiness, sedation, respiratory depression, coma, or death. MAO inhibitors. Monoamine oxidase (M AO) inhibitors are drugs used as antidepressants or antihypertensives. They inhibit the action of natural enzymes that break down tyramine, a substance formed naturally when proteins are metabolized. Tyramine is a pressor amine, a chemical that constricts blood vessel and raises blood pressure. If you eat a food that contains tyramine while you are taking an M AO inhibitor, the pressor amine cannot be eliminated from your body and the result may be a hypertensive crisis (sustained elevated blood pressure). Brandy, a distilled spirit made from wine (which is fermented) contains tyramine. All other distilled spirits may be excluded from your diet when you are taking an M AO inhibitor because the spirits and the drug, which are both sedatives, may be hazard- ous in combination.... distilled spirits

If you haven’t tried reishi tea until now, you should get some. Made from a “cure-all” herb, reishi tea has plenty of health benefits and helps you stay healthy with every gulp. About Reishi Tea Reishi tea is made form reishi, which is considered the best and most superior of all Chinese herbs. Reishi is a polypore mushroom which can be found growing in dark forests, on deciduous trees and logs. It is soft, corky, and flat, and has a conspicuous red-varnished cap, kidney-shaped, and with pores underneath it. It is classified based on its color and shape, and each variety protects and nourishes a different body organ. The classification is the following: white (lungs and skin), purple (joints), red (heart), green (liver), black (brain and kidney), and yellow (spleen). How to prepare Reishi Tea For a cup of reishi tea, you need about 5 grams of dried reishi mushroom herbs. Add them to the necessary amount of water for one cup and boil for about 10 minutes. Then, let the mixture steep for 2-3 hours, before you strain it to remove the herbs. If you don’t like the taste too much or you think it’s too bitter, you can add honey or fruit juice to sweeten it. Reishi Tea Constituents Reishi tea gets many of its health benefits thanks to the active constituents found in the reishi mushroom - the tea’s main ingredient. Some of them include triterpenes (ganoderic acids), polysaccharides, alkaloids, lactones, mannitol and coumarin. Also, reishi tea has various vitamins, proteins, and minerals. Reishi Tea Benefits Reishi tea is an important element in the fight against cancer. It helps by enhancing the human ability to fight abnormal cells and, consequently, it can improve the synthesis of proteins and nucleic acid. It also protects the cells against further damage, and it helps alleviate the pain and discomfort caused by chemotherapy. Drinking reishi tea will keep the heart diseases away, as it lowers bad cholesterol levels and blood pressure. It helps strengthen the immune system, and it will also slow down the aging process by nurturing the cells in your body. Not only is reishi tea good for your immune system, but it also helps your nervous system. This tea is bound to help you relax, by soothing the mind and sedating the nerves. It will also help you sleep properly during the night. You can drink reishi tea if you’ve got problems with coughing or asthma. It protects your liver, therefore it is recommended to persons who suffer from acute and chronic hepatitis. Besides this, it also helps with diabetes, skin allergy, and duodenal ulcers. Reishi Tea Side Effects You might have an allergic reaction to reishi tea. If you end up with an upset stomach, or you feel your mouth, nose and/or throat dry, you might have an allergic reaction. Stop drinking reishi tea and contact your doctor, just in case. Other side effects you might get when drinking reishi tea include dizziness, nosebleeds, sore bones, gastrointestinal distress, or irritated skin. It is best not to drink reishi tea if you’re taking blood thinning medication (aspirin, warfarin). The tea might intensify the effects of the medicine. It is also considered that this tea may interfere with immunosuppressive drugs or even organ transplants.   According to the Chinese, the reishi mushroom is a plant which can bring “the dying back to life”. Reishi tea has quite similar properties too, as it comes with many health benefits. This should encourage you to drink reishi tea every day!... enjoy a cup of reishi tea!

The suppression of monoamine oxydase (flavin-containing amine oxydase). MAO is critical in modifying nerve-ending storage of certain mono­amines (in this case, epinephrine, norepinephrine and dopamine...another type of MAO works on histamines), and MAO inhibitor drugs were, along with tricyclics, the first wave of anti-depressants. The problem was that if you ate brie cheese or chopped chicken livers while taking the drugs you could get a nosebleed or cerebral aneurysm...a double adrenergic whammy, since some foods are also strongly MAO-inhibiting (at least functionally). Although most current manuals (Merck’s and Harrison’s among others) consider these first generation drugs as safer and preferable to the recent Prozac and such, fashion am fashion, with docs as much as patients. Most of the patients a doctor sees are People That See Doctors (most Americans have infrequent medical contact). Some come with clippings in hand, a few find out about new stuff before their doctor does (they only have ONE patient..themselves) and the pressure for gilt-edged newness is hard to resist all around. The only herb I know of with any consequential MAO inhibition is Hypericum, and its effect, although not to be ignored, is less than French semi-soft cheeses.... mao inhibition

A corticosteroid drug prescribed as a nasal spray to relieve nasal congestion caused by allergic rhinitis, as eye drops in the treatment of iritis, and as eardrops in the treatment of otitis externa. It is given in tablet form or injected to treat severe asthma and other inflammatory disorders in order to reduce inflammation of the brain due, for example, to head injury. It may be injected into an inflamed joint to relieve the symptoms of osteoarthritis.

The nasal spray may cause nosebleeds; eye drops may cause irritation. Prolonged use or high doses of tablet may cause adverse effects common to the corticosteroids.... dexamethasone

The means of applying ice to the skin (in a towel or other material) in order to relieve pain, stem bleeding, or reduce inflammation. Cold causes the blood vessels to contract, reducing blood flow. Ice-packs are used to relieve pain in a variety of disorders, including severe headache. They are used on sports injuries to minimize swelling and bruising, and they also help to stop bleeding from small vessels, as in a nosebleed. ... ice-packs

In?ammation of the LIVER which damages liver cells and may ultimately kill them. Acute injury of the liver is usually followed by complete recovery, but prolonged in?ammation after injury may result in FIBROSIS and CIRRHOSIS. Excluding trauma, hepatitis has several causes:

Viral infections by any of hepatitis A, B, C, D, or E viruses and also CYTOMEGALOVIRUS (CMV), EPSTEIN BARR VIRUS, and HERPES SIMPLEX.

Autoimmune disorders such as autoimmune chronic hepatitis, toxins, alcohol and certain drugs – ISONIAZID, RIFAMPICIN, HALOTHANE and CHLORPROMAZINE.

WILSON’S DISEASE.

Acute viral hepatitis causes damage throughout the liver and in severe infections may destroy whole lobules (see below).

Chronic hepatitis is typi?ed by an invasion of the portal tract by white blood cells (mild hepatitis). If these mononuclear in?ammatory cells invade the body (parenchyma) of the liver tissue, ?brosis and then chronic disease or cirrhosis can develop. Cirrhosis may develop at any age and commonly results in prolonged ill health. It is an important cause of premature death, with excessive alcohol consumption commonly the triggering factor. Sometimes, cirrhosis may be asymptomatic, but common symptoms are weakness, tiredness, poor appetite, weight loss, nausea, vomiting, abdominal discomfort and production of abnormal amounts of wind. Initially, the liver may enlarge, but later it becomes hard and shrunken, though rarely causing pain. Skin pigmentation may occur along with jaundice, the result of failure to excrete the liver product BILIRUBIN. Routine liver-function tests on blood are used to help diagnose the disease and to monitor its progress. Spider telangiectasia (caused by damage to blood vessels – see TELANGIECTASIS) usually develop, and these are a signi?cant pointer to liver disease. ENDOCRINE changes occur, especially in men, who lose their typical hair distribution and suffer from atrophy of their testicles. Bruising and nosebleeds occur increasingly as the cirrhosis worsens, and portal hypertension (high pressure of venous blood circulation through the liver) develops due to abnormal vascular resistance. ASCITES and HEPATIC ENCEPHALOPATHY are indications of advanced cirrhosis.

Treatment of cirrhosis is to tackle the underlying cause, to maintain the patient’s nutrition (advising him or her to avoid alcohol), and to treat any complications. The disorder can also be treated by liver transplantation; indeed, 75 per cent of liver transplants are done for cirrhosis. The overall prognosis of cirrhosis, however, is not good, especially as many patients attend for medical care late in the course of the disease. Overall, only 25 per cent of patients live for ?ve years after diagnosis, though patients who have a liver transplant and survive for a year (80 per cent do) have a good prognosis.

Autoimmune hepatitis is a type that most commonly occurs in women between 20 and 40 years of age. The cause is unknown and it has been suggested that the disease has several immunological subtypes. Symptoms are similar to other viral hepatitis infections, with painful joints and AMENORRHOEA as additional symptoms. Jaundice and signs of chronic liver disease usually occur. Treatment with CORTICOSTEROIDS is life-saving in autoimmune hepatitis, and maintenance treatment may be needed for two years or more. Remissions and exacerbations are typical, and most patients eventually develop cirrhosis, with 50 per cent of victims dying of liver failure if not treated. This ?gure falls to 10 per cent in treated patients.

Viral hepatitis The ?ve hepatic viruses (A to E) all cause acute primary liver disease, though each belongs to a separate group of viruses.

•Hepatitis A virus (HAV) is an ENTEROVIRUS

which is very infectious, spreading by faecal contamination from patients suffering from (or incubating) the infection; victims excrete viruses into the faeces for around ?ve weeks during incubation and development of the disease. Overcrowding and poor sanitation help to spread hepatitis A, which fortunately usually causes only mild disease.

Hepatitis B (HBV) is caused by a hepadna virus, and humans are the only reservoir of infection, with blood the main agent for transferring it. Transfusions of infected blood or blood products, and injections using contaminated needles (common among habitual drug abusers), are common modes of transfer. Tattooing and ACUPUNCTURE may spread hepatitis B unless high standards of sterilisation are maintained. Sexual intercourse, particularly between male homosexuals, is a signi?cant infection route.

Hepatitis C (HCV) is a ?avivirus whose source of infection is usually via blood contacts. E?ective screening of blood donors and heat treatment of blood factors should prevent the spread of this infection, which becomes chronic in about 75 per cent of those infected, lasting for life. Although most carriers do not suffer an acute illness, they must practise life-long preventive measures.

Hepatitis D (HDV) cannot survive independently, needing HBV to replicate, so its sources and methods of spread are similar to the B virus. HDV can infect people at the same time as HBV, but it is capable of superinfecting those who are already chronic carriers of the B virus. Acute and chronic infection of HDV can occur, depending on individual circumstances, and parenteral drug abuse spreads the infection. The disease occurs worldwide, being endemic in Africa, South America and the Mediterranean littoral.

Hepatitis E virus (HEV) is excreted in the stools, spreading via the faeco-oral route. It causes large epidemics of water-borne hepatitis and ?ourishes wherever there is poor sanitation. It resembles acute HAV infection and the patient usually recovers. HEV does not cause chronic infection. The clinical characteristics of the ?ve hepatic

viruses are broadly similar. The initial symptoms last for up to two weeks (comprising temperature, headache and malaise), and JAUNDICE then develops, with anorexia, nausea, vomiting and diarrhoea common manifestations. Upper abdominal pain and a tender enlarged liver margin, accompanied by enlarged cervical lymph glands, are usual.

As well as blood tests to assess liver function, there are speci?c virological tests to identify the ?ve infective agents, and these are important contributions to diagnosis. However, there is no speci?c treatment of any of these infections. The more seriously ill patients may require hospital care, mainly to enable doctors to spot at an early stage those developing acute liver failure. If vomiting is a problem, intravenous ?uid and glucose can be given. Therapeutic drugs – especially sedatives and hypnotics – should be avoided, and alcohol must not be taken during the acute phase. Interferon is the only licensed drug for the treatment of chronic hepatitis B, but this is used with care.

Otherwise-?t patients under 40 with acute viral hepatitis have a mortality rate of around

0.5 per cent; for those over 60, this ?gure is around 3 per cent. Up to 95 per cent of adults with acute HBV infection recover fully but the rest may develop life-long chronic hepatitis, particularly those who are immunode?cient (see IMMUNODEFICIENCY).

Infection is best prevented by good living conditions. HVA and HVB can be prevented by active immunisation with vaccines. There is no vaccine available for viruses C, D and E, although HDV is e?ectively prevented by immunisation against HBV. At-risk groups who should be vaccinated against HBV include:

Parenteral drug abusers.

Close contacts of infected individuals such as regular sexual partners and infants of infected mothers.

Men who have sex with men.

Patients undergoing regular haemodialysis.

Selected health professionals, including laboratory sta? dealing with blood samples and products.... hepatitis

In?uenza is an acute infectious disease, characterised by a sudden onset, fever and generalised aches and pains. It usually occurs in epidemics and pandemics (see EPIDEMIC; PANDEMIC).

Cause The disease is caused by a VIRUS of the in?uenza group. There are at least three types of in?uenza virus, known respectively as A, B and

C. One of their most characteristic features is that infection with one type provides no protection against another. Equally important is the ease with which the in?uenza virus can change its character. It is these two characteristics which explain why one attack of in?uenza provides little, if any, protection against a subsequent attack, and why it is so di?cult to prepare an e?ective vaccine against the disease.

Epidemics of in?uenza due to virus A occur in Britain at two- to four-year intervals, and outbreaks of virus B in?uenza in less frequent cycles. Virus A in?uenza, for instance, was the prevalent infection in 1949, 1951, 1955 and 1956, whilst virus B in?uenza was epidemic in 1946, 1950, 1954 and, along with virus A, in 1958–59. The pandemic of 1957, which swept most of the world, although fortunately not in a severe form, was due to a new variant of virus A

– the so-called Asian virus – and it has been suggested that it was this variant that was responsible for the pandemics of 1889 and 1918. Since 1957, variants of virus A have been the predominating causes of in?uenza, accompanied on occasions by virus B.

In 1997 and 2004, outbreaks of Chinese avian in?uenza caused alarm. The in?uenza virus had apparently jumped species from birds

– probably chickens – to infect some people. Because no vaccine is available, there was a risk that this might start an epidemic.

Symptoms The incubation period of in?uenza A and B is 2–3 three days, and the disease is characterised by a sudden onset. In most cases this is followed by a short, sharp febrile illness of 2–4 days’ duration, associated with headache, prostration, generalised aching, and respiratory symptoms. In many cases the respiratory symptoms are restricted to the upper respiratory tract, and consist of signs of irritation of the nose, pharynx and larynx. There may be nosebleeds, and a dry, hacking cough is often a prominent and troublesome symptom. The fever is usually remittent and the temperature seldom exceeds 39·4 °C (103 °F), tending to ?uctuate between 38·3 and 39·4 °C (101 and 103 °F).

The most serious complication is infection of the lungs. This infection is usually due to organisms other than the in?uenza virus, and is a complication which can have serious results in elderly people.

The very severe form of ’?u which tends to occur during pandemics – and which was so common during the 1918–19 pandemic – is characterised by the rapid onset of bronchopneumonia and severe prostration. Because of the toxic e?ect on the heart, there is a particularly marked form of CYANOSIS, known as heliotrope cyanosis.

Convalescence following in?uenza tends to be prolonged. Even after an attack of average severity there tends to be a period of weakness and depression.

Treatment Expert opinion is still divided as to the real value of in?uenza vaccine in preventing the disease. Part of the trouble is that there is little value in giving any vaccine until it is known which particular virus is causing the infection. As this varies from winter to winter, and as the protection given by vaccine does not exceed one year, it is obviously not worthwhile attempting to vaccinate the whole community. The general rule therefore is that, unless there is any evidence that a particularly virulent type of virus is responsible, only the most vulnerable should be immunised – such as children in boarding schools, elderly people, and people who suffer from chronic bronchitis or asthma, chronic heart disease, renal failure, diabetes mellitus or immunosuppression (see under separate entries). In the face of an epidemic, people in key positions, such as doctors, nurses and those concerned with public safety, transport and other public utilities, should be vaccinated.

For an uncomplicated attack of in?uenza, treatment is symptomatic: that is, rest in bed, ANALGESICS to relieve the pain, sedatives, and a light diet. A linctus is useful to sooth a troublesome cough. The best analgesics are ASPIRIN or PARACETAMOL. None of the sulphonamides or the known antibiotics has any e?ect on the in?uenza virus; on the other hand, should the lungs become infected, antibiotics should be given immediately, because such an infection is usually due to other organisms. If possible, a sample of sputum should be examined to determine which organisms are responsible for the lung infection. The choice of antibiotic then depends upon which antibiotic the organism is most sensitive to.... influenza

The emission of fluid from the nose. Nasal discharge is commonly caused by inflammation of the mucous membrane lining the nose and is often accompanied by nasal congestion. A discharge of mucus may indicate allergic rhinitis, a cold, or an infection that has spread from the sinuses (see sinusitis). A persistent runny discharge may be an early indication of a tumour (see nasopharynx, cancer of).

Bleeding from the nose (see nosebleed) is usually caused by injury or a foreign body in the nose.

A discharge of cerebrospinal fluid from the nose may follow a fracture at the base of the skull.... nasal discharge

A surgical speciality, also known as surgery, that is concerned with diseases of the ear, nose, and throat. specialists treat

sinus problems, otitis media, glue ear, tonsillitis, minor hearing loss, otosclerosis, Ménière’s disease, airway problems in children, uncontrollable nosebleeds, and cancer of the larynx and sinuses.... otorhinolaryngology

A poisonous weedkiller that is available in high concentrations for agricultural use and which can be fatal if swallowed, inhaled, or absorbed through the skin. Paraquat poisoning requires urgent medical attention. The symptoms may include breathing difficulties, mouth ulcers, nosebleeds, diarrhoea, and later, respiratory and kidney failure. Treatments include eating activated charcoal or Fuller’s earth. Haemodialysis may also be used.... paraquat

a collection of symptoms resulting from an increase in the viscosity of blood. These symptoms include epistaxis (nosebleed), blurred vision, dizziness, headaches, drowsiness, confusion, and breathlessness. Hyperviscosity of the blood occurs in conditions such as polycythaemia, plasma-cell myeloma, leukaemia, and Waldenström’s macroglobulinaemia.... hyperviscosity syndrome

a collection of capillaries in the mucosa at the anterior part of the nasal septum. Nosebleeds frequently have their origin from this plexus. See epistaxis; Little’s area. [W. Kiesselbach (1839–1902), German laryngologist]... kiesselbach’s plexus

Cocklebur, Church Steeples. Agrimonia eupatoria. French: Aigremoine. Italian: Agrimonia. German: Leberkraut. Spanish: Agrimonia.

Constituents: coumarins, tannins, flavonoids, phytosterol.

Action: diuretic, hepatic, astringent (mild), haemostatic, vulnerary, cholagogue, Promotes assimilation of food. Bitter tonic.

Uses: weak acid stomach, indigestion, sluggish liver and debility, gall bladder disorders, nosebleed, sore throat, laryngitis (gargle), bed-wetting, incontinence, diarrhoea, to promote flow of gastric juices.

Local: ulceration – to cleanse and heal. Ancient remedy for suppurating sores and wounds.

Preparations: Thrice daily.

Tea: 1 teaspoon to each cup boiling water. Or, as part of Spring Tonic combination: equal parts, Agrimony, Raspberry leaves, Balm and Nettles. 2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup freely.

Liquid extract: BHP (1983). 1:1 in 25 per cent alcohol. Dose 15-45 drops (1-3ml). Tincture: BHP (1983). 1:5 in 45 per cent alcohol. Dose 15-60 drops (1-4ml). Tablets. Agrimony (Blackmore’s Labs). ... agrimony

Wake Robin. Lamb’s Quarter. Birth Root. Trillium erectum L. Part used: rhizome. Action. Genito-urinary anti-haemorrhagic; alterative; soothing tonic astringent. “Natural sex-hormone precursor” (D. Hoffman)

Uses: Used in American Indian medicine for excessive bleeding from the womb, and for easy childbirth. Bleeding from lungs, kidneys, bladder and uterine fibroids. Flooding of the menopause. Candida, leucorrhoea (decoction used as a vaginal douche).

To strengthen female constitution.

Preparations: Thrice daily.

Decoction. Half-2 grams to each cupful water simmered gently 10 minutes. Dose: half-1 cup. Liquid extract. 10-30 drops in water.

Tincture. BHP (1983) 1:5 in 40 per cent alcohol.

Dose: 1-4ml in water.

Powdered root. Half-2 grams in capsules.

Poultice: for bleeding ulcers: equal parts Beth root and Slippery Elm bark powder. Snuff: for nosebleed.

Douche (per vagina). 1oz to 2 pints water (decoction). Allow to cool; inject warm. ... beth root

Adderwort. Polygonum bistorta L. German: Matterkno?terich. French: Bistorte. Italian: Bistorta. Malayan: Se?ludang. Root and rhizome.

Action: powerful astringent, anti-inflammatory, anti-catarrhal, anti-diarrhoeal, demulcent, anti- haemorrhagic.

Uses: Chiefly to arrest flow of internal bleeding. Haemorrhage from lungs, stomach or bowel. Irritable bowel, diverticulosis, incontinence of urine, uterine infection with discharge (vaginal douche), ulcerated mouth and spongy gums, nasal polypus (juice of fresh plant or decoction injected into nostrils), nosebleed (powder snuffed into nose), sore mouth (mouth wash).

Preparations: Thrice daily.

Decoction: (internal), 1 heaped teaspoon to each cup water gently simmered 20 minutes. Half cup. Decoction may also be used as a douche.

Liquid extract: 15-30 drops, in water.

Powder: half a teaspoon in water or honey.

Tincture BHP (1983) 1:5 in 25 per cent alcohol.

Dose, 1-3ml (15-45 drops) in water. Gargle. Mouthwash. Ointment. ... bistort

the anterior region of the nasal septum (see nose). It has a rich capillary supply, called *Kiesselbach’s plexus, and is a common site from which nosebleeds arise. See epistaxis. [J. L. Little (1836–85), US surgeon]... little’s area

(hereditary haemorrhagic telangiectasia) a hereditary (autosomal *dominant) disorder characterized by thinning of the blood vessel walls, resulting in abnormally wide and fragile blood vessels. Patients may develop telangiectasia (see telangiectasis), nosebleeds, and arteriovenous malformations (see angioma). It is caused by mutations in the endoglin (ENG) gene or the activin receptor-like kinase (ALK-1) gene. [Sir W. Osler (1849–1919), Canadian physician; H. J. M. Rendu (1844–1902), French physician; F. P. Weber (1863–1962), British physician]... osler–rendu–weber disease

(SPA) a surgical procedure to identify and occlude the sphenopalatine artery in the nose using endoscopic surgery. It is used in the treatment of severe epistaxis (nosebleed).... sphenopalatine artery ligation

 Acacia catechu Wild. dried extract from heartwood chips.

Action: antibacterial, antiseptic, haemostatic, powerful astringent to stomach and intestines.

Uses: Irritable bowel, dysentery, mucous colitis, chronic catarrh, haemorrhage, mouth ulcer, spongy and bleeding gums (mouth wash), sore throat (gargle). A wash for varicose ulcer. Nosebleed. “Indigestion in children.” (Chinese Traditional)

Reported use in cancer (J.L. Hartwell, Lloydia, 33, 97, 1970)

Preparations: Thrice daily.

Powder: 0.3 to 1 gram in honey or banana mash.

Tincture BHP (1983) 1:5 in 45 per cent alcohol. Dose half-1 teaspoon (2.5-5ml) in water. ... catechu, black

Nosebleed. Midsummer daisy. Tanacetum parthenium L. Schultz Bip., (dark green leaf). Healing properties of Chrysanthemum parthenium (gold leaf) are less conclusive. Part used: leaves. Keynote: migraine. Extracts of Feverfew inhibit prostaglandin biosynthesis.

Constituents: sesquiterpene lactones, volatile oil, parthenolides.

Action: Anti-migraine, anti-rheumatic, febrifuge, bitter, carminative, tranquilliser, diuretic, antispasmodic, laxative, vermifuge. Anti-thrombotic (inhibits deposition of platelets). Vasodilator. Anti- inflammatory.

Uses: Protection against clot formation. Meniere’s disease, vertigo; painful, absent or irregular menstruation, threatened miscarriage, psoriasis. Inflammatory rheumatism, arthritis. After 12 years with osteo-arthritis of the hands, a patient ate 3 leaves a day and was soon able to turn most taps without a tapeze.

Migraine preventative. Dr John Hill (Hill’s Family Herbal, 1808) recommended it for violent headache and as an antidote for mercurial poisoning. In psychosomatic medicine for depression or hysteria due to menstrual disorders. Especially effective for migraine relieved by hot packs. Preparations. The herb is said to be less effective when subjected to heat, hence its popular use as the fresh leaf, powder, tincture or essence prepared ‘cold’.

Fresh leaves. 1 or 2 large or 3 or 4 small, every day until positive results achieved. If too acrid, may be eaten with bread in a sandwich or in mashed banana. 125mg of the leaf provides 0.2 per cent parthenolides which a Canadian authority regards as a minimum dose.

Tablets. One 125ml tablet or capsule is equivalent to 2 leaves daily.

Tincture. The tincture best captures its therapeutic properties where laid down within 2 hours of harvesting. To prepare: 1 part pulp Feverfew leaves (fresh) to 5 parts 45 per cent alcohol. Macerate 7 days. Filter. Dose: 5-20 drops every 2 hours for acute conditions; thrice daily, chronic.

Liquid Extract. Dose: 3-15 drops.

Poultice. Crushed leaves for aching muscles and joints. Suppositories. For piles.

Allergic effects (rare). Mouth ulcer, sore tongue, skin rash.

Not used in pregnancy or by women on the contraceptive pill.

Note: Extracts and products should be kept out of a bright light and stored below room temperature. Roots and stalks are of no value. (Dr S. Heptinstall, Nottingham University Medical School) ... feverfew

A disease of the liver with hardened and fibrotic patches. Scar tissue obstructs the flow of blood through the liver, back pressure causing damage. As they wear out liver cells are not renewed.

Causes: damage from gall-stones, aftermath of infections, drugs; the commonest is alcohol. Usually made up of three factors: toxaemia (self-poisoning), poor nutrition, infective bacteria or virus.

Symptoms. Loss of appetite, dyspepsia, low grade fever, nosebleeds, lethargy, spidery blood vessels on face, muscular weakness, jaundice, loss of sex urge, redness of palms of hands, unable to lie on left side. Mechanical pressure may cause dropsy and ascites. Alcohol-induced cirrhosis correlates with low phospholipid levels.

Treatment. Bitter herbs are a daily necessity to keep the bile fluid and flowing. Among other agents, peripheral vaso-dilators are indicated. Regulate bowels.

Teas. Balmony, Milk Thistle, Boldo, Bogbean. Dandelion coffee. Barberry tea (cold water). Tablets/capsules. Calamus, Blue Flag, Wild Yam.

Formula. Wahoo 2; Wild Yam 1; Blue Flag root 1. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Milk Thistle (Silybum marianum). Based on its silymarin contents: 70-210mg, thrice daily.

Practitioner. For pain. Tincture Gelsemium: 5-10 drops in water when necessary.

Enema. Constipation may be severe for which warm water injection should be medicated with few drops Tincture Myrrh.

Diet. High protein, high starch, low fat. Reject alcohol. Accept: Dandelion coffee, artichokes, raw onion juice, turmeric as a table spice.

Lecithin. Soy-derived lecithin to antidote alcohol-induced cirrhosis. (Study: Bronx Veterans Affairs Medical Center & Mount Sinai Hospital School of Medicine, New York City)

Supplements. B-complex, B12, C (1g), K, Magnesium, Zinc.

Treatment by or in liaison with a general medical practitioner or gastro-enterologist. ... liver – cirrhosis

Pot marigold. Calendula officinalis L. German: Ringelblume. French: Souci des Jardins. Spanish: Calendula. Italian: Calendola. Dried florets. One of the most versatile and important herbal medicines. This is the same Calendula as used by the homoeopaths but the method of preparation and therapy is different. Contains high levels of nitrogen, phosphoric acid and Vitamin A.

Keynote: injuries. Not the same plant as French Marigold (Tagetes patula).

Constituents: volatile oil, flavonoids, triterpenes.

Action: immune stimulant, anti-protazoal, anti-inflammatory, anti-fungal, anti-spasmodic, anti- haemorrhage, anti-histamine, anti-bacterial effect particularly against staphylococcus and streptococcus, anti-emetic, anti-cancer, antiseptic, styptic, haemostatic, diaphoretic, anthelmintic, oestrogenic activity (extract from fresh flowers), menstrual regulator.

Uses: Internal. A remedy which should follow all surgical operations. Enlarged and inflamed lymphatic glands, gastric and duodenal ulcer, jaundice, gall bladder inflammation, absent or painful menstruation, balanitis, rectum – inflammation of, gum disease, nose-bleeds, sebaceous cysts, measles (cup of tea drunk freely), pneumonia – a cooling drink which is anti-inflammatory. Vaginal thrush.

Uses: External. Rapid epithelisation process in damaged skin tissue, especially alcoholic extract; rapid wound adhesion and granulation without suppuration. (Weleda)

Wounds where the skin has been broken: laceration with bleeding (Arnica for unbroken skin). Sores, leg ulcers, abscess etc. Sore nipples in nursing mothers, varicose veins, nosebleeds, grazed knees in schoolchildren. Bee, wasp and other insect stings. Chilblains, fistula, inflamed nails, whitlow, dry chapped skin and lips, wind burn, air pollution.

Dentistry: Tooth extractions: rinse mouth with infusion of the florets or much-diluted tincture – 5-10 drops in water.

Malignancy: strong tea, 1-2oz to 1 pint boiling water; use as a wash to cleanse exudations.

STD purulent discharge: inject douche of strong infusion as above.

Wm M. Gregory MD, Berea, Ohio, USA. “I have never seen one drop of pus develop in any wound, however dirty.”

Preparations: For internal or external use. Average dose, 1-4 grams, or equivalent. Thrice daily.

Tea: dried petals/florets. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Drink freely.

Home tincture. 1 handful petals/florets (approximately 50g) to 1 pint (500ml) 70 per cent alcohol (Vodka); stand 14 days in a warm place, shake daily. Filter. Dose: 5-20 drops in water.

Poultice. Handful petals/florets to 1 pint boiling water; infuse 15 minutes. Apply on suitable material to injuries where skin is broken; replenish when dry.

Herbalist’s Friend. 1 part Tincture Calendula to 4 parts Witch Hazel, for phlebitis and painful varicose veins.

Weleda. Calendula lotion locally, or as a mouth wash and gargle. ... marigold

Mouse-ear hawkweed. Hieracium pilosella L. Dried herb. Keynote: cough. Constituents: flavonoids, coumarin.

Action: antitussive, anticatarrhal, expectorant, diuretic, sialogogue, antispasmodic, astringent, antibiotic (fresh plant only). A drying agent for profuse mucous discharge.

Uses: whooping cough, cough productive of much mucus. Profuse catarrh, haemoptysis (blood in the sputum), brucellosis (Malta fever), colitis. Bruised fresh plant used by Spanish shepherds for injuries in the field. Nosebleeds. Liver disorders.

BHP (1983) combination: Mouse-ear, White Horehound, Mullein and Coltsfoot (whooping cough). Preparations. Average dose: 2-4 grams, or equivalent; thrice daily (5-6 times daily, acute cases). Works best as a tea or in combination of teas rather than in alcohol.

Tea: 1-2 teaspoons to each cup boiling water; infuse 15 minutes; dose, half-1 cup.

Liquid Extract: 30-60 drops, in water.

Home tincture: 1 part to 5 parts 45 per cent alcohol (Vodka, gin, etc). Macerate 8 days, shake daily.

Filter. Dose: 1-3 teaspoons in water.

Powder. 500mg (two 00 capsules or one-third teaspoon). ... mouse-ear

A rare but serious type of anaemia in which the red cells, white cells, and platelets in the blood are all reduced in number. Aplastic anaemia is caused by a failure of the bone marrow to produce stem cells, the initial form of all blood cells.

Treatment of cancer with radiotherapy or anticancer drugs can temporarily interfere with the cell-producing ability of bone marrow, as can certain viral infections and other drugs. Long-term exposure to insecticides or benzene fumes may cause more persistent aplastic anaemia, and a moderate to high dose of nuclear radiation is another recognized cause. An autoimmune disorder is responsible in about half of all cases. Aplastic anaemia sometimes develops for no known reason.

A low level of red blood cells may cause symptoms common to all types of anaemia, such as fatigue and breathlessness. White-cell deficiency increases susceptibility to infections; platelet deficiency may lead to a tendency to bruise easily, bleeding gums, and nosebleeds.

The disorder is usually suspected from blood-test results, particularly a blood count, and is confirmed by a bone marrow biopsy.

Blood and platelet transfusions can control symptoms.

Immunosuppression is used to treat anaemia due to an autoimmune process.

Severe persistent aplastic anaemia may be fatal unless a bone marrow transplant is carried out.... anaemia, aplastic

The passage connecting the nasal cavity behind the nose to the top of the throat behind the soft palate. The nasopharynx is part of the respiratory tract and forms the upper section of the pharynx. During swallowing, the nasopharynx is sealed off by the soft palate pressing against the back of the throat, preventing food from entering. It contains the lower openings of the eustachian tubes (passages connecting the back of the nose to the middle ear)and, in children, the adenoids, which can enlarge to block the nasopharynx, forcing the child to breathe through the mouth. nasopharynx, cancer of A cancerous tumour of the nasopharynx that usually spreads to the nasal cavity, nasal sinuses, base of the skull, and lymph nodes in the neck.

Cancer of the nasopharynx is rare in the West but common in the Far East. Most common at age 40–50, it affects twice as many men as women. One cause is believed to be the Epstein–Barr virus.

Common first signs are recurrent nosebleeds, a runny nose, and voice change. Loss of sense of smell, double vision, deafness, paralysis of one side of the face, and severe pain may develop.

Diagnosis is through a biopsy, MRI scans, and X-rays.

Treatment is usually with radiotherapy, but surgery may also be performed.

If treated early, the outlook can be good.... nasopharynx

The uppermost part of the respiratory tract, and the organ of smell. The nose is an air passage connecting the nostrils at its front to the nasopharynx (the upper part of the throat) at its rear. The nasal septum, which is made of cartilage at the front and bone at the rear, divides the passage into 2 chambers. The bridge of the nose is formed from 2 small nasal bones and from cartilage. The roof of the nasal passage is formed by bones at the base of the skull; the walls by the maxilla (upper jaw); and the floor by the hard palate. Three conchae (thin, downward-curving plates of bone) covered with mucous membrane project from each wall.Air-filled, mucous membrane-lined cavities known as paranasal sinuses open into the nasal passage. There is an opening in each wall to the nasolacrimal duct, which drains away tears. Projecting into the roof of the nasal passage are the hair-like endings of the olfactory nerves, which are responsible for the sense of smell.

A main function of the nose is to filter, warm, and moisten inhaled air before it passes into the rest of the respiratory tract. Just inside the nostrils, small hairs trap large dust particles and foreign bodies. Smaller dust particles are filtered from the air by the microscopic hairs of the conchae. The mucus on the conchae flows inwards, carrying microorganisms and other foreign bodies back towards the nasopharynx to be swallowed and destroyed in the stomach.

The nose detects smells by means of the olfactory nerve endings, which, when stimulated by inhaled vapours, transmit this information to the olfactory bulb in the brain.

The nose is susceptible to a wide range of disorders. Allergies (see rhinitis, allergic), infections such as colds (see cold, common), and small boils are common. Backward spread of infection from the nose occasionally causes a serious condition called cavernous sinus thrombosis. The nose is also particularly prone to injury (see nosebleed; nose, broken). Obstruction of the nose may be caused by a nasal polyp (a projection of swollen mucous membrane).

Noncancerous tumours of blood vessels, known as haemangiomas, commonly affect the nasal cavity in babies. Basal cell carcinoma and squamous cell carcinoma may occur around the nostril. The nose may also be invaded by cancers originating in the sinuses.... nose

A highly contagious infectious disease, also called whooping cough, which mainly affects infants and young children. The main features of the illness are bouts of coughing, often ending in a characteristic “whoop”. The main cause is infection with BORDETELLA PERTUSSIS bacteria, which are spread in airborne droplets.

After an incubation period of 7–10 days, the illness starts with a mild cough, sneezing, nasal discharge, fever, and sore eyes. After a few days, the cough becomes more persistent and severe, especially at night. Whooping occurs in most cases. Sometimes the cough can

cause vomiting. In infants, there is a risk of temporary apnoea following a coughing spasm. The illness may last for a few weeks. The possible complications include nosebleeds, dehydration, pneumonia, pneumothorax, bronchiectasis (permanent widening of the airways), and convulsions. Untreated, pertussis may prove fatal.

Pertussis is usually diagnosed from the symptoms. In the early stages, erythromycin is often given to reduce the child’s infectivity. Treatment consists of keeping the child warm, giving small, frequent meals and plenty to drink, and protecting him or her from stimuli, such as smoke, that can provoke coughing. If the child becomes blue or persistently vomits after coughing, hospital admission is needed.

In developed countries, most infants are vaccinated against pertussis in the 1st year of life. It is usually given as part of the DPT vaccination at 2, 3, and 4 months of age. Possible complications include a mild fever and fretfulness. Very rarely, an infant may have a severe reaction, with high-pitched screaming or seizures.... pertussis

A rare illness resembling influenza that is caused by the microorganism CHLAMYDIA PSITTACI. The disease is contracted by inhaling dust containing the droppings of infected birds, such as pigeons or poultry. Most cases occur among poultry farmers, pigeon owners, and people working in pet shops. Common symptoms are severe headache, fever, and cough, developing a week or more after infection. Other symptoms may include muscle pains, sore throat, nosebleed, lethargy, depression, and, in some cases, breathing difficulty.

A diagnosis is made by finding antibodies against CHLAMYDIA PSITTACI in the blood. Treatment is with tetracycline antibiotic drugs. With no treatment, death may result.... psittacosis

A water-soluble vitamin that plays an essential role in the activities of various enzymes. Vitamin C is important for the growth and maintenance of healthy bones, teeth, gums, ligaments, and blood vessels; in the production of certain neurotransmitters and adrenal gland hormones; in the response of the immune system to infection; in wound healing; and in the absorption of iron.

The main dietary sources are fruits and vegetables. Considerable amounts of vitamin C are lost when foods are processed, cooked, or kept warm.

Mild deficiency of vitamin C may result from a serious injury or burn, major surgery, the use of oral contraceptives, fever, or continual inhalation of carbon monoxide (from traffic fumes or tobacco smoke). It may cause weakness, general aches, swollen gums, and nosebleeds. More serious deficiency is usually caused by a very restricted diet. Severe deficiency leads to scurvy and anaemia.

If the daily dose of vitamin C exceeds about 1g, it may cause nausea, stomach cramps, diarrhoea, or kidney stones

(see calculi, urinary tract).... vitamin c

A fat-soluble vitamin that is essential for the formation in the liver of substances that promote blood clotting. Good sources are green vegetables, vegetable oils, egg yolk, cheese, pork, and liver. Vitamin K is also manufactured by bacteria in the intestine.

Dietary deficiency rarely occurs.

Deficiency may develop in people with malabsorption, certain liver disorders, or chronic diarrhoea.

It may also result from prolonged treatment with antibiotics.

Newborns lack the intestinal bacteria that produce vitamin K and are routinely given supplements to prevent deficiency.

Vitamin K deficiency may cause nosebleeds and bleeding from the gums, intestine, and urinary tract.

In rare, severe cases, brain haemorrhage may result.

Excessive intake of vitamin K is not known to cause harmful effects.... vitamin k

A symptom of bleeding from within the digestive tract. Vomiting blood may be caused by a tear in the lower oesophagus (see Mallory–Weiss syndrome), bleeding from oesophageal varices, erosive gastritis, peptic ulcer, or, rarely, stomach cancer. Blood can also be vomited if it is swallowed during a nosebleed. Vomited blood may be dark red, brown, black, or may resemble coffee grounds. Vomiting of blood is often accompanied by the passing of black, tarry faeces.

The cause of vomiting blood is investigated by endoscopy of the oesophagus and stomach, or by barium X-ray examinations. If blood loss is severe, blood transfusion, and possibly surgery to stop the bleeding, may be required.... vomiting blood

An inherited lifelong bleeding disorder similar to haemophilia. People with the condition have a reduced concentration in their blood of a substance called von Willebrand factor, which helps platelets in the blood to plug injured blood vessel walls and forms part of factor VIII (a substance vital to blood coagulation). Symptoms of deficiency of this factor include excessive bleeding from the gums and from cuts and nosebleeds. Women may have heavy menstrual bleeding. In severe cases, bleeding into joints and muscles may occur.

The disease is diagnosed by bloodclotting tests and measurement of blood levels of von Willebrand factor. Bleeding episodes can be prevented or controlled by desmopressin (a substance resembling ADH). Factor or concentrated von Willebrand factor may also be used to treat bleeding.... von willebrand’s disease

An infectious disease of short duration and variable severity that is caused by a virus transmitted by mosquitoes. In severe cases, the skin yellows due to jaundice, from which the name yellow fever derives. The infection may be spread from monkeys to humans in forest areas through various species of mosquito; and in urban areas it can be transmitted between humans by AEDES AEGYPTI mosquitoes.

Today, yellow fever is contracted only in Central America, parts of South America, and a large area of Africa. Eradication of the causative mosquito from populated areas has greatly reduced its incidence.

Yellow fever is characterised by a sudden onset of fever and headache, often with nausea and nosebleeds and, despite the high fever, a very low heart-rate. In

more serious cases, the fever is higher and there is severe headache and pain in the neck, back, and legs. Damage may occur rapidly to the liver and kidneys, causing jaundice and kidney failure. This may be followed by severe agitation and delirium, leading to coma and death.

Vaccination confers long-lasting immunity and should always be obtained before travel to affected areas. A single injection of the vaccine gives protection for at least 10 years. Reactions to the vaccine are rare and are usually trivial, although children under the age of 1 should not be vaccinated.

During yellow fever epidemics, diagnosis is simple. A diagnosis can be confirmed by carrying out blood tests to isolate the causative virus or to find antibodies to the virus.

No drug is effective against the yellow fever virus; treatment is directed at maintaining the blood volume.

Transfusion of fluids is often necessary.

Many patients recover in about 3 days and, in mild to moderate cases, complications are few.

Relapses do not occur and one attack confers lifelong immunity.

Overall, however, about 10 per cent of victims die.... yellow fever

n. the act of vomiting fresh blood. The blood may have been swallowed (e.g. following a nosebleed or tonsillectomy) but more often arises from bleeding in the oesophagus, stomach, or duodenum. Common causes of upper gastrointestinal bleeding are *oesophageal varices or peptic ulcers. Vomited blood needs to be replaced by transfused blood. Gastroscopy may identify the source of bleeding and enables endoscopic treatments to arrest it. These include adrenaline injection, thermocoagulation with a *heater-probe or by *argon plasma coagulation, band ligation of oesophageal varices, glue injection for gastric varices, and the placement of metallic clips (endoclips) on bleeding vessels.... haematemesis

an acute highly infectious disease usually caused by the bacterium Bordetella pertussis, primarily affecting infants and often occurring in epidemics. After an incubation period of 1–2 weeks there is a catarrhal stage, in which the infant has signs of an upper respiratory tract infection; transmission is through droplet spread. This is followed by an irritating cough that gradually becomes paroxysmal within 1–2 weeks. The paroxysms are followed by a characteristic *whoop and vomiting. In the very young the classical whoop may not develop and instead the paroxysms may be followed by periods of *apnoea. The illness can last 2–3 months, giving it the name ‘the cough of 100 days’ in some countries. Infection can be complicated by bronchopneumonia, weight loss due to repeated vomiting, *bronchiectasis, and convulsions due to *asphyxia or bleeding into the brain tissue. Minor complications include subconjunctival haemorrhage, *epistaxis (nosebleed), facial *oedema, and ulceration of the tongue.

*Immunization against the infection was introduced in the UK in the 1950s and offers protection. An attack usually confers lifelong immunity. Despite good vaccine coverage resulting in the current low levels of disease, whooping cough is still a significant cause of illness and death in the very young. Medical name: pertussis.... whooping cough

Citrus limon

FAMILY: Rutaceae

SYNONYMS: C. limonum, cedro oil.

GENERAL DESCRIPTION: A small evergreen tree up to 6 metres high with serrated oval leaves, stiff thorns and very fragrant flowers. The fruit turns from green to yellow on ripening.

DISTRIBUTION: Native to Asia, probably east India; it now grows wild in the Mediterranean region especially in Spain and Portugal. It is cultivated extensively worldwide in Italy, Sicily, Cyprus, Guinea, Israel, South and North America (California and Florida).

OTHER SPECIES: There are about forty-seven varieties which are said to have been developed in cultivation, such as the Java lemon (C. javanica). The lemon is also closely related to the lime, cedrat (or citron) and bergamot.

HERBAL/FOLK TRADITION: The juice and peel are widely used as a domestic seasoning. It is very nutritious, being high in vitamins A, B and C. In Spain and other European countries, lemon is something of a ‘cure-all’, especially with regard to infectious illness. It was used for fever, such as malaria and typhoid, and employed specifically for scurvy on English ships at sea.

Taken internally, the juice is considered invaluable for acidic disorders, such as arthritis and rheumatism, and of great benefit in dysentery and liver congestion.

ACTIONS: Anti-anaemic, antimicrobial, antirheumatic, antisclerotic, antiscorbutic, antiseptic, antispasmodic, antitoxic, astringent, bactericidal, carminative, cicatrisant, depurative, diaphoretic, diuretic, febrifuge, haemostatic, hypotensive, insecticidal, rubefacient, stimulates white corpuscles, tonic, vermifuge.

EXTRACTION: Essential oil by cold expression from the outer part of the fresh peel. A terpeneless oil is also produced on a large scale (cedro oil).

CHARACTERISTICS: A pale greeny-yellow liquid (turning brown with age), with a light, fresh, citrus scent. It blends well with lavender, neroli, ylang ylang, rose, sandalwood, olibanum, chamomile, benzoin, fennel, geranium, eucalyptus, juniper, oakmoss, lavandin, elemi, labdanum and other citrus oils.

PRINCIPAL CONSTITUENTS: Limonene (approx. 70 per cent), terpinene, pinenes, sabinene, myrcene, citral, linalol, geraniol, octanol, nonanol, citronellal, bergamotene, among others.

SAFETY DATA: Non-toxic; may cause dermal irritation or sensitization reactions in some individuals – apply in moderation. Phototoxic do not use on skin exposed to direct sunlight.

AROMATHERAPY/HOME: USE

Skin care: Acne, anaemia, brittle nails, boils, chilblains, corns, cuts, greasy skin, herpes, insect bites, mouth ulcers, spots, varicose veins, warts.

Circulation muscles and joints: Arthritis, cellulitis, high blood pressure, nosebleeds, obesity (congestion), poor circulation, rheumatism.

Respiratory system: Asthma, throat infections, bronchitis, catarrh.

Digestive system: Dyspepsia.

Immune system: Colds, ’flu, fever and infections.

OTHER USES: Used as a flavouring agent in pharmaceuticals. Extensively used as a fragrance component in soaps, detergents, cosmetics, toilet waters and perfumes. Extensively employed by the food industry in most types of product, including alcoholic and soft drinks.... lemon