Ribs: From 1 Different Sources
The bones, 12 on each side, which enclose the cavity of the chest. The upper seven are joined to the breast-bone by their costal cartilages and are therefore known as true ribs. The lower ?ve do not reach the breast-bone, and are therefore known as false ribs. Of the latter, the eighth, ninth and tenth are joined by their costal cartilages, each one to the rib immediately above it, while the 11th and 12th are free from any such connection and are therefore known as ?oating ribs. Each rib has a head, by which it is joined to the upper part of the body of the vertebra with which it corresponds, as well as to the vertebra immediately above. The greater part of the bone is made up of the shaft, which runs at ?rst outwards and at the angle turns sharply forwards. On the lower margin of the shaft is a groove, which lodges the corresponding intercostal artery and nerve.
This is the beat of the APEX of the HEART, which can be felt through the skin to the left of the breastbone between the ?fth and sixth ribs.... apex beat
Pain in the ribs.... costalgia
The scienti?c name for the breastbone. This is a long, ?at, bony plate that comprises the central part of the chest. Made up of three parts: an upper triangular piece (manubrium); a middle part (the body); and at the bottom end the small, ?exible xiphoid process. The two clavicles articulate to the manubrium. Seven pairs of costal cartilages link the sternum to the ribs. The sternum is very strong and a powerful blow is needed to fracture it: such an injury may damage the underlying heart and lungs.... sternum
The lower part of the trunk. Above, and separated from it by the diaphragm, lies the thorax or chest, and below lies the PELVIS, generally described as a separate cavity though continuous with that of the abdomen. Behind are the SPINAL COLUMN and lower ribs, which come within a few inches of the iliac bones. At the sides the contained organs are protected by the iliac bones and down-sloping ribs, but in front the whole extent is protected only by soft tissues. The latter consist of the skin, a varying amount of fat, three layers of broad, ?at muscle, another layer of fat, and ?nally the smooth, thin PERITONEUM which lines the whole cavity. These soft tissues allow the necessary distension when food is taken into the STOMACH, and the various important movements of the organs associated with digestion. The shape of the abdomen varies; in children it may protrude considerably, though if this is too marked it may indicate disease. In healthy young adults it should be either slightly prominent or slightly indrawn, and should show the outline of the muscular layer, especially of the pair of muscles running vertically (recti), which are divided into four or ?ve sections by transverse lines. In older people fat is usually deposited on and inside the abdomen. In pregnancy the abdomen enlarges from the 12th week after conception as the FETUS in the UTERUS grows (see PREGNANCY AND LABOUR; ANTENATAL CARE).
Contents The principal contents of the abdominal cavity are the digestive organs, i.e. the stomach and INTESTINE, and the associated glands, the LIVER and PANCREAS. The position
of the stomach is above and to the left when the individual is lying down, but may be much lower when standing. The liver lies above and to the right, largely under cover of the ribs, and occupying the hollow of the diaphragm. The two KIDNEYS lie against the back wall on either side, protected by the last two ribs. From the kidneys run the URETERS, or urinary ducts, down along the back wall to the URINARY BLADDER in the pelvis. The pancreas lies across the spine between the kidneys, and on the upper end of each kidney is a suprarenal gland
(see ADRENAL GLANDS). The SPLEEN is positioned high up on the left and partly behind the stomach. The great blood vessels and nerves lie on the back wall, and the remainder of the space is taken up by the intestines or bowels (see INTESTINE). The large intestine lies in the ?anks on either side in front of the kidneys, crossing below the stomach from right to left, while the small intestine hangs from the back wall in coils which ?ll up the spaces between the other organs. Hanging down from the stomach in front of the bowels is the OMENTUM, or apron, containing much fat and helping to protect the bowels. In pregnancy the UTERUS, or womb, rises up from the pelvis into the abdomen as it increases in size, lifting the coils of the small intestine above it.
The PELVIS is the part of the abdomen within the bony pelvis (see BONE), and contains the rectum or end part of the intestine, the bladder, and in the male the PROSTATE GLAND; in the female the uterus, OVARIES, and FALLOPIAN TUBES.... abdomen
Anything pertaining to the ribs.... costal
The term applied to the nerves, vessels and muscles that lie between the ribs, as well as to diseases affecting these structures.... intercostal
The name applied to the part of the back between the lower ribs and the pelvis. (For pain in the loins, see BACKACHE; LUMBAGO.)... loin
Nutritional Profile
Energy value (calories per serving): Low
Protein: Moderate
Fat: Low
Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: High
Major vitamin contribution: Folate
Major mineral contribution: Potassium, phosphorus
About the Nutrients in This Food
Celery has moderate amounts of dietary fiber and small amounts of the B vitamin folate.
One-half cup diced raw celery has one gram dietary fiber and 17 mcg folate (4 percent of the R DA).
The Most Nutritious Way to Serve This Food
Fresh, filled with cheese to add protein.
Diets That May Restrict or Exclude This Food
Low-fiber diet
Low-sodium diet
Buying This Food
Look for: Crisp, medium-size pale green celery with fresh leaves. Darker stalks have more vitamin A but are likely to be stringy.
Avoid: Wilted or yellowed stalks. Wilted stalks have lost moisture and are low in vitamins A and C. Yellowed stalks are no longer fresh; their chlorophyll pigments have faded enough to let the yellow carotenes show through.
Avoid bruised or rotten celery. Celery cells contain chemicals called furocoumarins (pso- ralens) that may turn carcinogenic when the cell membranes are damaged and the furocou- marins are exposed to light. Bruised or rotting celery may contain up to a hundred times the psoralens in fresh celery.
Storing This Food
Handle celery carefully to avoid damaging the stalks and releasing furocoumarins.
Refrigerate celery in plastic bags or in the vegetable crisper to keep them moist and crisp. They will stay fresh for about a week.
Preparing This Food
R inse celery under cold running water to remove all sand and dirt. Cut off the leaves, blanch them, dry them thoroughly, and rub them through a sieve or food mill. The dry powder can be used to season salt or frozen for later use in soups or stews.
What Happens When You Cook This Food
When you cook celery the green flesh will soften as the pectin inside its cells dissolves in water, but the virtually indestructible cellulose and lignin “strings” on the ribs will stay stiff. If you don’t like the strings, pull them off before you cook the celery.
Cooking also changes the color of celery. Chlorophyll, the pigment that makes green vegetables green, is very sensitive to acids. When you heat celery, the chlorophyll in its stalks reacts chemically with acids in the celery or in the cooking water to form pheophytin, which is brown. The pheophytin will turn the celery olive-drab or, if the stalks have a lot of yellow carotene, bronze.
You can prevent this natural chemical reaction and keep the celery green by cooking it so quickly that there is no time for the chlorophyll to react with the acids, or by cooking it in lots of water (which will dilute the acids), or by cooking it with the lid off the pot so that the volatile acids can float off into the air.
Adverse Effects Associated with This Food
Contact dermatitis. Celery contains limonene, an essential oil known to cause contact der- matitis in sensitive individuals. (Limonene is also found in dill, caraway seeds, and the peel of lemon and limes.)
Photosensitivity. The furocoumarins (psoralens) released by damaged or moldy celery are photosensitizers as well as potential mutagens and carcinogens. Constant contact with these chemicals can make skin very sensitive to light, a problem most common among food work- ers who handle large amounts of celery without wearing gloves.
Nitrate/nitrite poisoning. Like beets, eggplant, lettuce, radish, spinach, and collard and turnip greens, celery contains nitrates that convert naturally into nitrites in your stomach and then react with the amino acids in proteins to form nitrosamines. Although some nitro- samines are known or suspected carcinogens, this natural chemical conversion presents no known problems for a healthy adult. However, when these nitrate-rich vegetables are cooked and left to stand at room temperature, bacterial enzyme action (and perhaps some enzymes in the plants) convert the nitrates to nitrites at a much faster rate than normal. These higher-nitrite foods may be hazardous for infants; several cases of “spinach poison- ing” have been reported among children who ate cooked spinach that had been left standing at room temperature.... celery
The reverse of the normal movements of breathing (see RESPIRATION). The chest wall moves in instead of out when breathing in (inspiration), and out instead of in when breathing out (expiration). The spaces between the ribs are indrawn on inspiration – a symptom seen in children with respiratory distress, say, as a result of ASTHMA or lung infections. Patients with CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) often suffer from paradoxical breathing; and trauma to the rib cage, with fractured sternum and ribs, also cause the condition. Treatment is of the underlying cause.... paradoxical breathing
All the organs and tissues associated with the act of RESPIRATION or breathing. The term includes the nasal cavity (see NOSE) and PHARYNX, along with the LARYNX, TRACHEA, bronchi (see BRONCHUS), BRONCHIOLES and LUNGS. The DIAPHRAGM and other muscles, such as those between the RIBS, are also part of the respiratory system which is responsible for oxygenating the blood and removing carbon dioxide from it.... respiratory system
The operation of removing a varying number of ribs so that the underlying lung collapses. It was formerly done to treat pulmonary TUBERCULOSIS.... thoracoplasty
The region on each side of the upper abdomen, situated below the lower ribs.... hypochondrium
Bornholm disease, also known as devil’s grip, and epidemic myalgia, is an acute infective disease due to COXSACKIE VIRUSES. It is characterised by the abrupt onset of pain around the lower margin of the ribs, headache, and fever; it occurs in epidemics, usually during warm weather, and is more common in young people than in old. The illness usually lasts seven to ten days. It is practically never fatal. The disease is named after the island of Bornholm in the Baltic, where several epidemics have been described.... bornholm disease
Nutritional Profile
Energy value (calories per serving): Low
Protein: High
Fat: Low
Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High
Sodium: Low
Major vitamin contribution: Vitamin A, folate, vitamin C
Major mineral contribution: Potassium, iron
About the Nutrients in This Food
Brussels sprouts are high in dietary fiber, especially insoluble cellulose and lignan in the leaf ribs. They are also a good source of vitamin A and vitamin C.
One-half cup cooked fresh brussels sprouts has three grams of dietary fiber, 1,110 IU vitamin A (48 percent of the R DA for a woman, 37 percent of the R DA for a man), 47 mcg folate (16 percent of the R DA), and 48 mg vitamin C (64 percent of the R DA for a woman, 53 percent of the R DA for a man).
Brussels sprouts also contain an antinutrient, a natural chemical that splits the thiamin (vitamin B1) molecule so that it is no longer nutritionally useful. This thiamin inhibitor is inactivated by cooking.
The Most Nutritious Way to Serve This Food
Fresh, lightly steamed to preserve the vitamin C and inactivate the antinutrient.
Diets That May Restrict or Exclude This Food
Antiflatulence diet
Low-fiber diet
Buying This Food
Look for: Firm, compact heads with bright, dark-green leaves, sold loose so that you can choose the sprouts one at a time. Brussels sprouts are available all year round.
Avoid: Puff y, soft sprouts with yellow or wilted leaves. The yellow carotenes in the leaves show through only when the leaves age and their green chlorophyll pigments fade. Wilting leaves and puff y, soft heads are also signs of aging.
Avoid sprouts with tiny holes in the leaves through which insects have burrowed.
Storing This Food
Store the brussels sprouts in the refrigerator. While they are most nutritious if used soon after harvesting, sprouts will keep their vitamins (including their heat-sensitive vitamin C) for several weeks in the refrigerator.
Store the sprouts in a plastic bag or covered bowl to protect them from moisture loss.
Preparing This Food
First, drop the sprouts into salted ice water to flush out any small bugs hiding inside. Next, trim them. Remove yellow leaves and leaves with dark spots or tiny holes, but keep as many of the darker, vitamin A–rich outer leaves as possible. Then, cut an X into the stem end of the sprouts to allow heat and water in so that the sprouts cook faster.
What Happens When You Cook This Food
Brussels sprouts contain mustard oils (isothiocyanates), natural chemicals that break down into a variety of smelly sulfur compounds (including hydrogen sulfide and ammonia) when the sprouts are heated, a reaction that is intensified in aluminum pots. The longer you cook the sprouts, the more smelly compounds there will be. Adding a slice of bread to the cook- ing water may lessen the odor; keeping a lid on the pot will stop the smelly molecules from floating off into the air.
But keeping the pot covered will also increase the chemical reaction that turns cooked brussels sprouts drab. Chlorophyll, the pigment that makes green vegetables green, is sensi- tive to acids. When you heat brussels sprouts, the chlorophyll in their green leaves reacts chemically with acids in the sprouts or in the cooking water to form pheophytin, which is brown. The pheophytin turns cooked brussels sprouts olive or, since they also contain yel- low carotenes, bronze.
To keep cooked brussels sprouts green, you have to reduce the interaction between chlorophyll and acids. One way to do this is to cook the sprouts in a lot of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the hydrogen atoms can float off into the air, but this allows the smelly sulfur compounds to escape, too. The best solution is to steam the sprouts quickly in very little water, so they retain their vitamin C and cook before there is time for reaction between chlorophyll and hydrogen atoms to occur.
How Other Kinds of Processing Affect This Food
Freezing. Frozen brussels sprouts contain virtually the same amounts of vitamins as fresh boiled sprouts.
Medical Uses and/or Benefits
Protection against cancer. Naturally occurring chemicals (indoles, isothiocyanates, gluco- sinolates, dithiolethiones, and phenols) in brussels sprouts, broccoli, cabbage, cauliflower and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by pre- venting the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the transformation of healthy cells to malignant ones.
All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane.
In 1997, the Johns Hopkins researchers discovered that broccoli seeds and three- day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated.
Lower risk of some birth defects. Up to two or every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their mothers’ not having gotten adequate amounts of folate during pregnancy. NOTE : The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends
* Brussels sprouts will lose as much as 25 percent of their vitamin C if you cook them in water that is cold when you start. As it boils, water releases oxygen that would otherwise destroy vitamin C. You can cut the vitamin loss dramatically simply by letting the water boil for 60 seconds before adding the sprouts.
400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becoming pregnant and continuing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects.
Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well.
However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.
Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss.
Adverse Effects Associated with This Food
Enlarged thyroid gland (goiter). Cruciferous vegetables, including brussels sprouts, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condi- tion or are taking thyroid medication.
Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in brussels sprouts and produce gas that some people find distressing.
Food/Drug Interactions
Anticoagulants Brussels sprouts are rich in vitamin K, the blood-clotting vitamin produced naturally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of drained, boiled brussels sprouts contains 219 mcg vitamin K, nearly three times the R DA for a healthy adult.... brussels sprouts
(Bok choy [Chinese cabbage], green cabbage, red cabbage, savoy cabbage)
See also Broccoli, Brussels sprouts, Cabbage, Cauliflower, Lettuce, Radishes,
Spinach, Turnips.
Nutritional Profile
Energy value (calories per serving): Low
Protein: Moderate
Fat: Low
Saturated fat: Low Cholesterol: None Carbohydrates: High
Fiber: Low
Sodium: Low
Major vitamin contribution: Vitamin A, folate, vitamin C
Major mineral contribution: Calcium (moderate)
About the Nutrients in This Food
All cabbage has some dietary fiber food: insoluble cellulose and lignin in the ribs and structure of the leaves. Depending on the variety, it has a little vitamin A, moderate amounts of the B vitamin folate and vitamin C.
One-half cup shredded raw bok choy has 0.1 g dietary fiber, 1,041 IU vitamin A (45 percent of the R DA for a woman, 35 percent of the R DA for a man), and 15.5 mg vitamin C (21 percent of the R DA for a woman, 17 percent of the R DA for a man).
One-half cup shredded raw green cabbage has 0.5 g dietary fiber, 45 IU vitamin A (1.9 percent of the R DA for a woman, 1.5 percent of the R DA for a man), 15 mcg folate (4 percent of the R DA), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man).
One-half cup chopped raw red cabbage has 0.5 g dietary fiber, 7 mcg folate (2 percent of the R DA), and 20 mg vitamin C (27 percent of the R DA for a woman, 22 percent of the R DA for a man).
One-half cup chopped raw savoy cabbage has one gram dietary fiber, 322 IU vitamin A (14 percent of the R DA for a woman, 11 percent of the R DA for a man), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man).
Raw red cabbage contains an antinutrient enzyme that splits the thiamin molecule so that the vitamin is no longer nutritionally useful. This thiamin in hibitor is inactivated by cooking.
The Most Nutritious Way to Serve This Food
Raw or lightly steamed to protect the vitamin C.
Diets That May Restrict or Exclude This Food
Antiflatulence diet
Low-fiber diet
Buying This Food
Look for: Cabbages that feel heavy for their size. The leaves should be tightly closed and attached tightly at the stem end. The outer leaves on a savoy cabbage may curl back from the head, but the center leaves should still be relatively tightly closed.
Also look for green cabbages that still have their dark-green, vitamin-rich outer leaves.
Avoid: Green and savoy cabbage with yellow or wilted leaves. The yellow carotene pig- ments show through only when the cabbage has aged and its green chlorophyll pigments have faded. Wilted leaves mean a loss of moisture and vitamins.
Storing This Food
Handle cabbage gently; bruising tears cells and activates ascorbic acid oxidase, an enzyme in the leaves that hastens the destruction of vitamin C.
Store cabbage in a cool, dark place, preferably a refrigerator. In cold storage, cabbage can retain as much as 75 percent of its vitamin C for as long as six months. Cover the cabbage to keep it from drying out and losing vitamin A.
Preparing This Food
Do not slice the cabbage until you are ready to use it; slicing tears cabbage cells and releases the enzyme that hastens the oxidation and destruction of vitamin C.
If you plan to serve cooked green or red cabbage in wedges, don’t cut out the inner core that hold the leaves together.
To separate the leaves for stuffing, immerse the entire head in boiling water for a few minutes, then lift it out and let it drain until it is cool enough to handle comfortably. The leaves should pull away easily. If not, put the cabbage back into the hot water for a few minutes.
What Happens When You Cook This Food
Cabbage contains mustard oils (isothiocyanates) that break down into a variet y of smelly sulfur compounds (including hydrogen sulfide and ammon ia) when the cabbage is heated, a reaction that occurs more strongly in aluminum pots. The longer you cook the cabbage, the more smelly the compounds will be. Adding a slice of bread to the cooking water may lessen the odor. Keeping a lid on the pot will stop the smelly molecules from floating off into the air, but it will also accelerate the chemical reaction that turns cooked green cabbage drab.
Chlorophyll, the pigment that makes green vegetables green, is sensitive to acids. When you heat green cabbage, the chlorophyll in its leaves reacts chemically with acids in the cabbage or in the cooking water to form pheophytin, which is brown. The pheophytin gives the cooked cabbage its olive color.
To keep cooked green cabbage green, you have to reduce the interaction between the chlorophyll and the acids. One way to do this is to cook the cabbage in a large quantity of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the volatile acids can float off into the air, but this allows the smelly sulfur compounds to escape too. The best way may be to steam the cabbage ver y quickly in ver y little water so that it keeps its vitamin C and cooks before there is time for the chlorophyll/acid reaction to occur.
Red cabbage is colored with red anthocyanins, pigments that turn redder in acids (lemon juice, vinegar) and blue purple in bases (alkaline chemicals such as baking soda). To keep the cabbage red, make sweet-and-sour cabbage. But be careful not to make it in an iron or aluminum pot, since vinegar (which contains tannins) will react with these metals to create dark pigments that discolor both the pot and the vegetable. Glass, stainless-steel, or enameled pots do not produce this reaction.
How Other Kinds of Processing Affect This Food
Pickling. Sauerkraut is a fermented and pickled produce made by immersing cabbage in a salt solution strong enough to kill off pathological bacteria but allow beneficial ones to sur- vive, breaking down proteins in the cabbage and producing the acid that gives sauerkraut its distinctive flavor. Sauerkraut contains more than 37 times as much sodium as fresh cabbage (661 mg sodium/100 grams canned sauerkraut with liquid) but only one third the vitamin C and one-seventh the vitamin A.
* According to USDA, if you cook t hree cups of cabbage in one cup of water you will lose only 10 percent of t he vitamin C; reverse t he rat io to four t imes as much water as cabbage and you will lose about 50 percent of t he vitamin C. Cabbage will lose as much as 25 percent of its vitamin C if you cook it in water t hat is cold when you start. As it boils, water releases ox ygen t hat would ot her wise dest roy vitamin C, so you can cut t he vitamin loss dramat ically simply by lett ing t he water boil for 60 seconds before adding t he cabbage.
Medical Uses and/or Benefits
Protection against certain cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in cabbage, brussels sprouts, broccoli, cauli- flower, and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by preventing the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the trans- formation of healthy cells to malignant ones.
All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane.
In 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated.
Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss.
Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becom- ing pregnant and through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects.
Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well.
However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills
with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.
Adverse Effects Associated with This Food
Enlarged thyroid gland (goiter). Cruciferous vegetables, including cabbage, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to pro- duce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condition or are taking thyroid medication.
Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in cabbage, producing gas that some people find distressing.
Food/Drug Interactions
Anticoagulants Cabbage contains vitamin K, the blood-clotting vitamin produced natu- rally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of shredded common green cabbage contains 163 mcg vitamin K, nearly three times the R DA for a healthy adult; one cup of drained boiled common green cabbage contains 73 mcg vita- min K, slightly more than the R DA for a healthy adult.
Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyra- mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. If you eat a food such as sauerkraut which is high in 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.... cabbage
Compression of the outside of the sternum and ribs, effectively emptying and filling the heart to push blood through arteries to supply oxygen to the body - particularly to the brain.... external cardiac compression
The framework upon which the rest of the body is built up. The bones are generally called the skeleton, though this term also includes the cartilages which join the ribs to the breastbone, protect the larynx, etc.
Structure of bone Bone is composed partly of ?brous tissue, partly of bone matrix comprising phosphate and carbonate of lime, intimately mixed together. The bones of a child are about two-thirds ?brous tissue, whilst those of the aged contain one-third; the toughness of the former and the brittleness of the latter are therefore evident.
The shafts of the limb bones are composed of dense bone, the bone being a hard tube surrounded by a membrane (the periosteum) and enclosing a fatty substance (the BONE MARROW); and of cancellous bone, which forms the short bones and the ends of long bones, in which a ?ne lace-work of bone ?lls up the whole interior, enclosing marrow in its meshes. The marrow of the smaller bones is of great importance. It is red in colour, and in it red blood corpuscles are formed. Even the densest bone is tunnelled by ?ne canals (Haversian canals) in which run small blood vessels, nerves and lymphatics, for the maintenance and repair of the bone. Around these Haversian canals the bone is arranged in circular plates called lamellae, the lamellae being separated from one another by clefts, known as lacunae, in which single bone-cells are contained. Even the lamellae are pierced by ?ne tubes known as canaliculi lodging processes of these cells. Each lamella is composed of very ?ne interlacing ?bres.
GROWTH OF BONES Bones grow in thickness from the ?brous tissue and lime salts laid down by cells in their substance. The long bones grow in length from a plate of cartilage (epiphyseal cartilage) which runs across the bone about 1·5 cm or more from its ends, and which on one surface is also constantly forming bone until the bone ceases to lengthen at about the age of 16 or 18. Epiphyseal injury in children may lead to diminished growth of the limb.
REPAIR OF BONE is e?ected by cells of microscopic size, some called osteoblasts, elaborating the materials brought by the blood and laying down strands of ?brous tissue, between which bone earth is later deposited; while other cells, known as osteoclasts, dissolve and break up dead or damaged bone. When a fracture has occurred, and the broken ends have been brought into contact, these are surrounded by a mass of blood at ?rst; this is partly absorbed and partly organised by these cells, ?rst into ?brous tissue and later into bone. The mass surrounding the fractured ends is called the callus, and for some months it forms a distinct thickening which is gradually smoothed away, leaving the bone as before the fracture. If the ends have not been brought accurately into contact, a permanent thickening results.
VARIETIES OF BONES Apart from the structural varieties, bones fall into four classes: (a) long bones like those of the limbs; (b) short bones composed of cancellous tissue, like those of the wrist and the ankle; (c) ?at bones like those of the skull; (d) irregular bones like those of the face or the vertebrae of the spinal column (backbone).
The skeleton consists of more than 200 bones. It is divided into an axial part, comprising the skull, the vertebral column, the ribs with their cartilages, and the breastbone; and an appendicular portion comprising the four limbs. The hyoid bone in the neck, together with the cartilages protecting the larynx and windpipe, may be described as the visceral skeleton.
AXIAL SKELETON The skull consists of the cranium, which has eight bones, viz. occipital, two parietal, two temporal, one frontal, ethmoid, and sphenoid; and of the face, which has 14 bones, viz. two maxillae or upper jaw-bones, one mandible or lower jaw-bone, two malar or cheek bones, two nasal, two lacrimal, two turbinal, two palate bones, and one vomer bone. (For further details, see SKULL.) The vertebral column consists of seven vertebrae in the cervical or neck region, 12 dorsal vertebrae, ?ve vertebrae in the lumbar or loin region, the sacrum or sacral bone (a mass formed of ?ve vertebrae fused together and forming the back part of the pelvis, which is closed at the sides by the haunch-bones), and ?nally the coccyx (four small vertebrae representing the tail of lower animals). The vertebral column has four curves: the ?rst forwards in the neck, the second backwards in the dorsal region, the third forwards in the loins, and the lowest, involving the sacrum and coccyx, backwards. These are associated with the erect attitude, develop after a child learns to walk, and have the e?ect of diminishing jars and shocks before these reach internal organs. This is aided still further by discs of cartilage placed between each pair of vertebrae. Each vertebra has a solid part, the body in front, and behind this a ring of bone, the series of rings one above another forming a bony canal up which runs the spinal cord to pass through an opening in the skull at the upper end of the canal and there join the brain. (For further details, see SPINAL COLUMN.) The ribs – 12 in number, on each side – are attached behind to the 12 dorsal vertebrae, while in front they end a few inches away from the breastbone, but are continued forwards by cartilages. Of these the upper seven reach the breastbone, these ribs being called true ribs; the next three are joined each to the cartilage above it, while the last two have their ends free and are called ?oating ribs. The breastbone, or sternum, is shaped something like a short sword, about 15 cm (6 inches) long, and rather over 2·5 cm (1 inch) wide.
APPENDICULAR SKELETON The upper limb consists of the shoulder region and three segments – the upper arm, the forearm, and the wrist with the hand, separated from each other by joints. In the shoulder lie the clavicle or collar-bone (which is immediately beneath the skin, and forms a prominent object on the front of the neck), and the scapula or shoulder-blade behind the chest. In the upper arm is a single bone, the humerus. In the forearm are two bones, the radius and ulna; the radius, in the movements of alternately turning the hand palm up and back up (called supination and pronation respectively), rotating around the ulna, which remains ?xed. In the carpus or wrist are eight small bones: the scaphoid, lunate, triquetral, pisiform, trapezium, trapezoid, capitate and hamate. In the hand proper are ?ve bones called metacarpals, upon which are set the four ?ngers, each containing the three bones known as phalanges, and the thumb with two phalanges.
The lower limb consists similarly of the region of the hip-bone and three segments – the thigh, the leg and the foot. The hip-bone is a large ?at bone made up of three – the ilium, the ischium and the pubis – fused together, and forms the side of the pelvis or basin which encloses some of the abdominal organs. The thigh contains the femur, and the leg contains two bones – the tibia and ?bula. In the tarsus are seven bones: the talus (which forms part of the ankle joint); the calcaneus or heel-bone; the navicular; the lateral, intermediate and medial cuneiforms; and the cuboid. These bones are so shaped as to form a distinct arch in the foot both from before back and from side to side. Finally, as in the hand, there are ?ve metatarsals and 14 phalanges, of which the great toe has two, the other toes three each.
Besides these named bones there are others sometimes found in sinews, called sesamoid bones, while the numbers of the regular bones may be increased by extra ribs or diminished by the fusion together of two or more bones.... bone
A hard but pliant substance forming parts of the skeleton – for example, the cartilages of the ribs, of the larynx and of the ears. Microscopically, cartilage is found to consist of cells arranged in twos or in rows, and embedded in a ground-glass-like material devoid of blood vessels and nerves. The end of every long bone has a smooth layer of hyaline cartilage on it where it forms a joint with other bones (articular cartilage), and in young persons up to about the age of 16 there is a plate of cartilage (epiphyseal cartilage) running right across the bone about 12 mm (half an inch) from each end. The latter, by constantly thickening and changing into bone, causes the increase in length of the bone. (See also BONE.) In some situations there is found a combination of cartilage and ?brous tissue, as in the discs between the vertebrae of the spine. This ?bro-cartilage, as it is known, combines the pliability of ?brous tissue with the elasticity of cartilage. (For cartilages of the knee, see KNEE.)... cartilage
The formation of BONE. In early life, centres appear in the bones previously represented by cartilage or ?brous tissue; and these cells, called osteoblasts, initiate the formation of true bone, which includes the deposition of calcium salts. When a fracture occurs, the bone mends by ossi?cation of the clot which forms between the fragments (see under BONE, DISORDERS OF). In old age, an unnatural process of ossi?cation often takes place in parts which should remain cartilaginous – for example, in the cartilages of the larynx and of the ribs, making these parts unusually brittle.... ossification
Also known as throbbing. An appearance seen or felt naturally below the fourth and ?fth ribs on the left side, where the heart lies, and also at every point where an artery lies close beneath the surface. In other situations, it may be a sign of ANEURYSM. In thin people, pulsation can often be seen and felt in the upper part of the abdomen, due to the throbbing of the normal abdominal AORTA.... pulsation
This is a term encompassing chronic BRONCHITIS, EMPHYSEMA, and chronic ASTHMA where the air?ow into the lungs is obstructed.
Chronic bronchitis is typi?ed by chronic productive cough for at least three months in two successive years (provided other causes such as TUBERCULOSIS, lung cancer and chronic heart failure have been excluded). The characteristics of emphysema are abnormal and permanent enlargement of the airspaces (alveoli) at the furthermost parts of the lung tissue. Rupture of alveoli occurs, resulting in the creation of air spaces with a gradual breakdown in the lung’s ability to oxygenate the blood and remove carbon dioxide from it (see LUNGS). Asthma results in in?ammation of the airways with the lining of the BRONCHIOLES becoming hypersensitive, causing them to constrict. The obstruction may spontaneously improve or do so in response to bronchodilator drugs. If an asthmatic patient’s airway-obstruction is characterised by incomplete reversibility, he or she is deemed to have a form of COPD called asthmatic bronchitis; sufferers from this disorder cannot always be readily distinguished from those people who have chronic bronchitis and/ or emphysema. Symptoms and signs of emphysema, chronic bronchitis and asthmatic bronchitis overlap, making it di?cult sometimes to make a precise diagnosis. Patients with completely reversible air?ow obstruction without the features of chronic bronchitis or emphysema, however, are considered to be suffering from asthma but not from COPD.
The incidence of COPD has been increasing, as has the death rate. In the UK around 30,000 people with COPD die annually and the disorder makes up 10 per cent of all admissions to hospital medical wards, making it a serious cause of illness and disability. The prevalence, incidence and mortality rates increase with age, and more men than women have the disorder, which is also more common in those who are socially disadvantaged.
Causes The most important cause of COPD is cigarette smoking, though only 15 per cent of smokers are likely to develop clinically signi?cant symptoms of the disorder. Smoking is believed to cause persistent airway in?ammation and upset the normal metabolic activity in the lung. Exposure to chemical impurities and dust in the atmosphere may also cause COPD.
Signs and symptoms Most patients develop in?ammation of the airways, excessive growth of mucus-secreting glands in the airways, and changes to other cells in the airways. The result is that mucus is transported less e?ectively along the airways to eventual evacuation as sputum. Small airways become obstructed and the alveoli lose their elasticity. COPD usually starts with repeated attacks of productive cough, commonly following winter colds; these attacks progressively worsen and eventually the patient develops a permanent cough. Recurrent respiratory infections, breathlessness on exertion, wheezing and tightness of the chest follow. Bloodstained and/or infected sputum are also indicative of established disease. Among the symptoms and signs of patients with advanced obstruction of air?ow in the lungs are:
RHONCHI (abnormal musical sounds heard through a STETHOSCOPE when the patient breathes out).
marked indrawing of the muscles between the ribs and development of a barrel-shaped chest.
loss of weight.
CYANOSIS in which the skin develops a blue tinge because of reduced oxygenation of blood in the blood vessels in the skin.
bounding pulse with changes in heart rhythm.
OEDEMA of the legs and arms.
decreasing mobility.
Some patients with COPD have increased ventilation of the alveoli in their lungs, but the levels of oxygen and carbon dioxide are normal so their skin colour is normal. They are, however, breathless so are dubbed ‘pink pu?ers’. Other patients have reduced alveolar ventilation which lowers their oxygen levels causing cyanosis; they also develop COR PULMONALE, a form of heart failure, and become oedematous, so are called ‘blue bloaters’.
Investigations include various tests of lung function, including the patient’s response to bronchodilator drugs. Exercise tests may help, but radiological assessment is not usually of great diagnostic value in the early stages of the disorder.
Treatment depends on how far COPD has progressed. Smoking must be stopped – also an essential preventive step in healthy individuals. Early stages are treated with bronchodilator drugs to relieve breathing symptoms. The next stage is to introduce steroids (given by inhalation). If symptoms worsen, physiotherapy – breathing exercises and postural drainage – is valuable and annual vaccination against INFLUENZA is strongly advised. If the patient develops breathlessness on mild exertion, has cyanosis, wheezing and permanent cough and tends to HYPERVENTILATION, then oxygen therapy should be considered. Antibiotic treatment is necessary if overt infection of the lungs develops.
Complications Sometimes rupture of the pulmonary bullae (thin-walled airspaces produced by the breakdown of the walls of the alveoli) may cause PNEUMOTHORAX and also exert pressure on functioning lung tissue. Respiratory failure and failure of the right side of the heart (which controls blood supply to the lungs), known as cor pulmonale, are late complications in patients whose primary problem is emphysema.
Prognosis This is related to age and to the extent of the patient’s response to bronchodilator drugs. Patients with COPD who develop raised pressure in the heart/lung circulation and subsequent heart failure (cor pulmonale) have a bad prognosis.... chronic obstructive pulmonary disease (copd)
The application of strips of adhesive plaster, one overlapping the other, so as to cover and exert pressure on an area of the body. This treatment is used in cases of injury or disease when it is desired to keep a part at rest: for example, strapping may be applied to the chest in cases of pleurisy and fracture of the ribs. Also, it is often used to prevent the movement of joints which are sprained or otherwise injured.... strapping
The term is used in two distinct senses. As a descriptive term in anatomy, a tubercle means a small elevation or roughness upon a BONE, such as the tubercles of the ribs. In the pathological sense, a tubercle is a small mass, barely visible to the naked eye, formed in some organ as the starting-point of TUBERCULOSIS. The name of tubercle bacillus was originally given to the micro-organism that causes this disease, but was subsequently changed to Mycobacterium tuberculosis. The term ‘tubercular’ should strictly be applied to anything connected with or resembling tubercles or nodules, and the term ‘tuberculous’ to anything pertaining to the disease tuberculosis.... tubercle
Herpes zoster, or shingles, is a skin eruption of acute nature, closely related to CHICKENPOX and consisting in the appearance of small yellow vesicles, which spread over an area, dry up, and heal by scabbing. It receives its name from the Greek word for a ‘circingle’ or girdle, because it spreads in a zone-like manner along the intercostal nerves around half the chest. Herpes of the face also occurs, particularly on the brow and around the eye.
Causes Shingles is due to the same virus that causes chickenpox. This invades the ganglia of the nerves, particularly the spinal nerves of the chest and the ?fth cranial nerve which supplies the face. Despite being due to the same virus as chickenpox, it is rare for herpes zoster to occur as a result of contact with a case of chickenpox. On the other hand, it is not unusual for a patient with herpes zoster to infect a child with chickenpox. It is a disease of adults rather than children, and the older the person, the more likely he or she is to develop the disease. Thus in adults under 50, the incidence is around 2·5 per 1,000 people a year; between 50 and 60 it is around 5 per 1,000; whilst in octogenarians it is 10 per 1,000. Occasionally it may be associated with some serious underlying disease such as LEUKAEMIA, LYMPHADENOMA, or multiple myeloma (see MYELOMATOSIS).
Symptoms The ?rst symptoms are much like those of any feverish attack. The person feels unwell for some days, has a slight rise of temperature, and feels vague pain in the side or in various other parts. Often the area of skin to be affected feels hypersensitive (hyperaesthesia) as though something were rubbing on it. The pain ?nally settles at a point in the side, and, two or three days after the ?rst symptoms, the rash appears. Minute yellow blebs – or vesicles, as they are known – are seen on the skin of the back, of the side, or of the front of the chest, or simultaneously on all three, the points corresponding to the space between one pair of ribs right around. These blebs increase in number for some days, and spread until there is often a complete half-girdle around one side of the chest. The pain in this stage is severe, but it appears to vary a good deal with age, being slight in children and very severe in old people, in whom indeed herpes sometimes forms a serious illness. After one or two weeks, most of the vesicles have dried up and formed scabs. The pain may not pass o? when the eruption disappears, but may remain for weeks or even months – a condition known as post-herpetic NEURALGIA. Old people are prone to develop this condition.
Treatment ACICLOVIR or famciclovir can be given orally, and are e?ective if started in large doses early in the attack. Later, topical antibiotics may be required. Analgesics may be necessary if neuralgia is severe.... herpes zoster
Moringa pterygospermaDescription: This tree grows from 4.5 to 14 meters tall. Its leaves have a fernlike appearance. Its flowers and long, pendulous fruits grow on the ends of the branches. Its fruit (pod) looks like a giant bean. Its 25-to 60-centimeter-long pods are triangular in cross section, with strong ribs. Its roots have a pungent odor.Habitat and Distribution: This tree is found in the rain forests and semievergreen seasonal forests of the tropical regions. It is widespread in India, Southeast Asia, Africa, and Central America. Look for it in abandoned fields and gardens and at the edges of forests.Edible Parts: The leaves are edible raw or cooked, depending on their hardness. Cut the young seedpods into short lengths and cook them like string beans or fry them. You can get oil for frying by boiling the young fruits of palms and skimming the oil off the surface of the water. You can eat the flowers as part of a salad. You can chew fresh, young seedpods to eat the pulpy and soft seeds. The roots may be ground as a substitute for seasoning similar to horseradish.... horseradish tree
In?ammation of the PLEURA or serous membrane investing the lung and lining the inner surface of the ribs. It is a common condition, and may be either acute or chronic, the latter being usually tuberculous in origin (see TUBERCULOSIS).
Many cases of pleurisy are associated with only a little e?usion, the in?ammation consisting chie?y in exudation of FIBRIN: to this form the term ‘dry pleurisy’ is applied. Further, pleurisy may be limited to a very small area – or, on the contrary, may affect, throughout a greater or less extent, the pleural surfaces of both lungs.
Causes Pleurisy is often associated with other forms of in?ammatory disease within the chest, more particularly PNEUMONIA, BRONCHIECTASIS, and tuberculosis; it occasionally accompanies PERICARDITIS. It may also be due to carcinoma of the lung, or be secondary to abdominal infections such as subphrenic abscess. Further, wounds or injuries of the thoracic walls are apt to set up pleurisy.
Symptoms The symptoms of pleurisy vary, being generally well marked, but sometimes obscure. DRY PLEURISY In the case of dry pleurisy, which is, on the whole, the milder form, the chief symptom is a sharp pain in the side, felt especially on breathing. Fever may or may not be present. There is a slight, dry cough, and breathing is quicker than normal and shallow. PLEURISY WITH EFFUSION is usually more severe than dry pleurisy, and, although it may in some cases develop insidiously, it is in general ushered in sharply by shivering and fever, like other acute in?ammatory diseases. Pain is felt in the side or breast, of a severe cutting or stabbing character. A dry cough usually occurs and breathing is painful and di?cult.
Treatment The treatment varies greatly with the form and severity of the attack. Bed rest, antibiotics, analgesics and antipyretics are advisable. A large pleural e?usion may need to be drained via an aspiration needle.... pleurisy
Plumbago spp.PlumbaginaceaeThe genus Plumbago belonging to the family Plumbaginaceae is a popular and medicinally very important group of medicinal plants. Three species, namely P. rosea, P. zeylanica and P. auriculata have been identified. Among these P. rosea and P. zeylanica are important ones.Plumbago, in general is an esteemed remedy for leucoderma and other skin diseases. The synonyms of fire like agnih, vahnih, etc. are attributed to this drug to indicate the very burning action of the root, causing blisters on the skin (daranah). The drug is used only after adequate curing and purification. Root is the officinal part and it enters into the composition of preparations like Citrakasavam, Dasamularista, Gulgulutiktaka kasaya, Yogarajachurna, etc.1. P. rosea Linn. syn. P. indica Linn.Eng: Rosy-flowered Leadwort; San: Citrakah, Dhahanah;Hin: Lalcitra, Raktacitra;Ben: Lalchita;Mal: Kotuveli, Chettikkoduveli, Chuvannakotuveli;Tam: Chenkotuveli, Cittiramulam;Kan: Kempacitramula;Tel: YerracitramulamRosy-flowered leadwort or Fire plant is a native of Coromandel Coast. It is found throughout India, in moist situations as well as cultivated. The roots are useful in dyspepsia, colic, inflammations, cough, bronchitis, helmenthiasis, haemorrhoids, elephantiasis, chronic and intermittent fever, leprosy, leucoderma, ringworm, scabies, hepatosplenomegaly, amenorrhoea, odontalgia, vitiated conditions of vata, kapha and anaemia. It is a pretty subscandent perennial shrub with semi -woody striate stems and flexible branches. Leaves are simple, alternate oblong, short cuneate at the base passing into a very short amplexicaul, exauriculate, and reddish petiole. Flowers are bright red, arranged in long terminal spikes. The calyx ribs are covered with stipitate, bifarious and subsessile gland. Corolla tube is slender and four times as long as the calyx. The stout roots are cylindrical, irregularly bent, light yellowish brown with smooth surface having short transverse shallow fissures at the regions of the bents. A light yellowish juice excudes from the cut surface. A healthy plant may produce 18-20 stout roots (Warrier et al, 1995).The chemical constituents include plumbagin and sitosterol glucoside. Clinical trials have demonstrated that plumbagin oil from P. indica is useful in common wart (Satyavati et al, 1987). The roots are acrid, astringent, thermogenic, anthelmintic, constipating, expectorant, antiinflammmatory, abortifacient, alterant, anti-periodic, carminative, digestive, sudorific, narcotic, gastric, nervous stimulant and rejuvenating. Root is a powerful sialogogue and vesicant.2. P. zeylanica Linn.Eng:White flowered Leadwort; San:Chitraka;Hin, Ben:Chitarak, Chitra; Mal:VellakotuveliTam: Sittragam, Chittiramoolam;Kan: Vahini; Mar: Chitraka;Tel: ChitramulamWhite flowered Leadwort or Chitarak is found wild in peninsular India and mostly in West Bengal. Root is used externally in leprosy and other skin diseases or obstinate character, aphthae, abscesses, influenza, piles and anasarca. Juice is used externally in scabies and ulcers. One of the important preparations of Chitrak is “Yograjguggal”, prescribed for arthritis, rheumatism, etc. The other well known preparations are “Chitrak Adivati” and “ Chitraka Haritaki”. In Unani system it is an ingredient of “Aqaruva-i- Kabir”, “Hab Ashkhar”, “Ma’jun Baladur”, “Ma’jun Raig Mahi”, etc. It is a branched undershrub. Roots are long and tuberous. Stem is striate. Leaves are simple, alternate, short petioled, ovate or ovate-oblong, acute with entire or wavy margin, 7x3.8cm and glabrous. Flowers are white, arranged in terminal spikes. Calyx is tubular, glandular-hairy. Corolla tube is slender; limb rotate and 5 lobbed. Stamens are 5 on a disc. Style is slender with 5 stigmatic branches. Fruit is membranous capsule enclosed within the persistent calyx.The roots of P. zeylanica have been exhaustively studied and naphthaquinones have been isolated, namely, plumbagin, 3-chlroplumbagin, droserone (Sidhu et al, 1971; Padhye et al, 1973), 3,3’-biplumbagin(Chitranone), zeylanone and iso-zeylanone and a coumarin, elliptinone (Sankaram et al, 1976, 1979). It also contains 1,2(3)-tetrahydro-3,3’-biplumbagin and plumbazeylanone. The leaf is antirheumatic. Root is appetiser, sudorific, relieves pain, vasicant, diuretic, caustic, antidiarrhoeal and expellent of phlegmatic tumours. Root is uterine stimulant. Root and fruits have antiimplantation activity. Plumbagin induces antiimplantation, has abortifacient and antiovulatory activity and causes selective testicular lesions in dogs. It is also a mitotic inhibitor. In lower concentration it behaves like a spindle, poison but in higher concentration it exhibits radiomimetic, nucleotoxic and cyclotoxic effects. It also has antibacterial, antifungal and anticoagulant activities and shows antagonism to amphetamine hyperactivity in mice.3. P. auriculata Lam. syn. P. capensisEng: Blue flowered Leadwort;Mal: NeelakotuveliThe blue flowered Leadwort is often grown in gardens throughout India (Moos, 1976; Chunekar, 1982; Sharma, 1983). It is a native of Cape Province in South Africa. It is a constituent of many Ayurvedic drugs (KAU, 1991). The plant is a subshrub growing to a height of 1-1.5m. Leaves are elliptic to obovate, 3-4 x 1.5-2cm. Inflorescence is a raceme of length 3-4cm. Corolla is blue to violet. Stamens are 5 in number. Flowers and fruits may be upto 12 in number (Matthew, 1995).Agrotechnology: The plant is grown in tropical to subtropical ecosystems. Warm humid tropical climate is most suited. They come up well in almost all types of deep and well drained soils. It is propagated vegetatively by stem cuttings. Three stem cuttings of size 15cm long are planted in polybags of size 14x10cm. IAA and IBA treatments will improve rooting of cuttings. The land is to be ploughed well. About 4 tonnes of FYM are to be applied, mixed thoroughly and seed bed of size 50cm breadth, 1.5cm height and convenient length are to be prepared. On these beds pits are taken at a distance of 25cm and the rooted plants are transplanted from the polybags. Regular irrigation and weeding are to be carried out. In the second year with the onset of monsoon, seedbeds are again refreshed after adding about 4 tonnes of FYM. At the end of second year tubers are collected. Care should be taken to wear gloves, else the chemical plumbagin present in the roots will cause burning sensation. The collected tubers are washed, tied into bundles and marketed. Plumbago yields about 7-10t tubers/ha with good management (Prasad et al, 1997).... leadwort
Various conditions affecting the LUNGS are dealt with under the following headings: ASTHMA; BRONCHIECTASIS; CHEST, DEFORMITIES OF; CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD); COLD, COMMON; EMPHYSEMA; EXPECTORATION; HAEMOPTYSIS; HAEMORRHAGE; OCCUPATIONAL HEALTH, MEDICINE AND DISEASES; PLEURISY; PNEUMONIA; PULMONARY EMBOLISM; TUBERCULOSIS.
In?ammation of the lungs is generally known as PNEUMONIA, when it is due to infection; as ALVEOLITIS when the in?ammation is immunological; and as PNEUMONITIS when it is due to physical or chemical agents.
Abscess of the lung consists of a collection of PUS within the lung tissue. Causes include inadequate treatment of pneumonia, inhalation of vomit, obstruction of the bronchial tubes by tumours and foreign bodies, pulmonary emboli (see EMBOLISM) and septic emboli. The patient becomes generally unwell with cough and fever. BRONCHOSCOPY is frequently performed to detect any obstruction to the bronchi. Treatment is with a prolonged course of antibiotics. Rarely, surgery is necessary.
Pulmonary oedema is the accumulation of ?uid in the pulmonary tissues and air spaces. This may be caused by cardiac disease (heart failure or disease of heart valves – see below, and HEART, DISEASES OF) or by an increase in the permeability of the pulmonary capillaries allowing leakage of ?uid into the lung tissue (see ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)).
Heart failure (left ventricular failure) can be caused by a weakness in the pumping action of the HEART leading to an increase in back pressure which forces ?uid out of the blood vessels into the lung tissue. Causes include heart attacks and HYPERTENSION (high blood pressure). Narrowed or leaking heart valves hinder the ?ow of blood through the heart; again, this produces an increase in back pressure which raises the capillary pressure in the pulmonary vessels and causes ?ooding of ?uid into the interstitial spaces and alveoli. Accumulation of ?uid in lung tissue produces breathlessness. Treatments include DIURETICS and other drugs to aid the pumping action of the heart. Surgical valve replacement may help when heart failure is due to valvular heart disease.
Acute respiratory distress syndrome Formerly known as adult respiratory distress syndrome (ARDS), this produces pulmonary congestion because of leakage of ?uid through pulmonary capillaries. It complicates a variety of illnesses such as sepsis, trauma, aspiration of gastric contents and di?use pneumonia. Treatment involves treating the cause and supporting the patient by providing oxygen.
Collapse of the lung may occur due to blockage of a bronchial tube by tumour, foreign body or a plug of mucus which may occur in bronchitis or pneumonia. Air beyond the blockage is absorbed into the circulation, causing the affected area of lung to collapse. Collapse may also occur when air is allowed into the pleural space – the space between the lining of the lung and the lining of the inside of the chest wall. This is called a pneumothorax and may occur following trauma, or spontaneously
– for example, when there is a rupture of a subpleural air pocket (such as a cyst) allowing a communication between the airways and the pleural space. Lung collapse by compression may occur when ?uid collects in the pleural space (pleural e?usion): when this ?uid is blood, it is known as a haemothorax; if it is due to pus it is known as an empyema. Collections of air, blood, pus or other ?uid can be removed from the pleural space by insertion of a chest drain, thus allowing the lung to re-expand.
Tumours of the lung are the most common cause of cancer in men and, along with breast cancer, are a major cause of cancer in women. Several types of lung cancer occur, the most common being squamous cell carcinoma, small- (or oat-) cell carcinoma, adenocarcinoma, and large-cell carcinoma. All but the adenocarcinoma have a strong link with smoking. Each type has a di?erent pattern of growth and responds di?erently to treatment. More than 30,000 men and women die of cancer of the trachea, bronchus and lung annually in England and Wales.
The most common presenting symptom is cough; others include haemoptisis (coughing up blood), breathlessness, chest pain, wheezing and weight loss. As well as spreading locally in the lung – the rate of spread varies – lung cancer commonly spawns secondary growths in the liver, bones or brain. Diagnosis is con?rmed by X-rays and bronchoscopy with biopsy.
Treatment Treatment for the two main categories of lung cancer – small-cell and nonsmall-cell cancer – is di?erent. Surgery is the only curative treatment for the latter and should be considered in all cases, even though fewer than half undergoing surgery will survive ?ve years. In those patients unsuitable for surgery, radical RADIOTHERAPY should be considered. For other patients the aim should be the control of symptoms and the maintenance of quality of life, with palliative radiotherapy one of the options.
Small-cell lung cancer progresses rapidly, and untreated patients survive for only a few months. Because the disease is often widespread by the time of diagnosis, surgery is rarely an option. All patients should be considered for CHEMOTHERAPY which improves symptoms and prolongs survival.
Wounds of the lung may cause damage to the lung and, by admitting air into the pleural cavity, cause the lung to collapse with air in the pleural space (pneumothorax). This may require the insertion of a chest drain to remove the air from the pleural space and allow the lung to re-expand. The lung may be wounded by the end of a fractured rib or by some sharp object such as a knife pushed between the ribs.... lungs, diseases of
A prefix that means between, as in intercostal (between the ribs). (See also intra-.)... inter-
The process in which air passes into and out of the lungs so that the blood can absorb oxygen and give o? carbon dioxide and water. This occurs 18 times a minute in a healthy adult at rest and is called the respiratory rate. An individual breathes more than 25,000 times a day and during this time inhales around 16 kg of air.
Mechanism of respiration For the structure of the respiratory apparatus, see AIR PASSAGES; CHEST; LUNGS. The air passes rhythmically into and out of the air passages, and mixes with the air already in the lungs, these two movements being known as inspiration and expiration. INSPIRATION is due to a muscular e?ort which enlarges the chest, so that the lungs have to expand in order to ?ll up the vacuum that would otherwise be left, the air entering these organs by the air passages. The increase of the chest in size from above downwards is mainly due to the diaphragm, the muscular ?bres of which contract and reduce its domed shape and cause it to descend, pushing down the abdominal organs beneath it. EXPIRATION is an elastic recoil, the diaphragm rising and the ribs sinking into the position that they naturally occupy, when muscular contraction is ?nished. Occasionally, forced expiration may occur, involving powerful muscles of the abdomen and thorax; this is typically seen in forcible coughing.
Nervous control Respiration is usually either an automatic or a REFLEX ACTION, each expiration sending up sensory impulses to the CENTRAL NERVOUS SYSTEM, from which impulses are sent down various other nerves to the muscles that produce inspiration. Several centres govern the rate and force of the breathing, although all are presided over by a chief respiratory centre in the medulla oblongata (see under BRAIN – Divisions). This in turn is controlled by the higher centres in the cerebral hemispheres, so that breathing can be voluntarily stopped or quickened.
Quantity of air The lungs do not completely empty themselves at each expiration and re?ll at each inspiration. With each breath, less than one-tenth of the total air in the lungs passes out and is replaced by the same quantity of fresh air, which mixes with the stale air in the lungs. This renewal, which in quiet breathing amounts to about 500 millilitres, is known as the tidal air. By a special inspiratory e?ort, an individual can draw in about 3,000 millilitres, this amount being known as complemental air. By a special expiratory e?ort, too, after an ordinary breath one can expel much more than the tidal air from the lungs – this extra amount being known as the supplemental or reserve air, and amounting to about 1,300 millilitres. If an individual takes as deep an inspiration as possible and then makes a forced expiration, the amount expired is known as the vital capacity, and amounts to around 4,000 millilitres in a healthy adult male of average size. Figures for women are about 25 per cent lower. The vital capacity varies with size, sex, age and ethnic origin.
Over and above the vital capacity, the lungs contain air which cannot be expelled; this is known as residual air, and amounts to another 1,500 millilitres.
Tests of respiratory e?ciency are used to assess lung function in health and disease. Pulmonary-function tests, as they are known, include spirometry (see SPIROMETER), PEAK FLOW METER (which measures the rate at which a person can expel air from the lungs, thus testing vital capacity and the extent of BRONCHOSPASM), and measurements of the concentration of oxygen and carbon dioxide in the blood. (See also LUNG VOLUMES.)
Abnormal forms of respiration Apart from mere changes in rate and force, respiration is modi?ed in several ways, either involuntarily or voluntarily. SNORING, or stertorous breathing, is due to a ?accid state of the soft palate causing it to vibrate as the air passes into the throat, or simply to sleeping with the mouth open, which has a similar e?ect. COUGH is a series of violent expirations, at each of which the larynx is suddenly opened after the pressure of air in the lungs has risen considerably; its object is to expel some irritating substance from the air passages. SNEEZING is a single sudden expiration, which di?ers from coughing in that the sudden rush of air is directed by the soft palate up into the nose in order to expel some source of irritation from this narrow passage. CHEYNE-STOKES BREATHING is a type of breathing found in persons suffering from stroke, heart disease, and some other conditions, in which death is impending; it consists in an alternate dying away and gradual strengthening of the inspirations. Other disorders of breathing are found in CROUP and in ASTHMA.... respiration
A disease of childhood characterised chie?y by a softened condition of the bones (see BONE), and by other evidence of poor nutrition.
Causes This disease is the result of de?ciency of vitamin D in the diet. Healthy bones cannot be built up without calcium (or lime) salts, and the body cannot use these salts in the absence of vitamin D. Want of sunlight and fresh air in the dwellings where children are reared is also of importance. Once a common condition in industrial areas, it had almost disappeared in Great Britain but has recurred in recent years, largely amongst children of Asian and African origin.
The periosteum – the membrane enveloping the bones – becomes in?amed, and the bone formed beneath it is defective in lime salts and very soft. Changes also occur at the growing part of the bone, the epiphyseal plate.
Symptoms The symptoms of rickets most usually appear towards the end of the ?rst year, and rarely after the age of ?ve. The children are often ‘snu?y’ and miserable.
Gradually, changes in the shape of the bones becomes visible, ?rst chie?y noticed at the ends of the long bones. The softened bones also tend to become distorted, the legs bending outwards and forwards so the child becomes bow-legged or knock-kneed. Changes occur in the ribs (‘rickets rosary’) and cranial bones, while teeth appear late and decay or fall out.
The disease usually ends in recovery with more or less of deformity and dwar?ng – the bones, although altered in shape, becoming ultimately ossi?ed.
Treatment The speci?c remedy is vitamin D in the form of calciferol (vitamin D2). A full diet is of course essential, with emphasis upon a su?cient supply of milk. Rickets is very rare in breast-fed children but it is a wise precaution to give breast-fed babies supplementary vitamin
D. After the child is weaned, the provision of suitable food is vital, supplemented with some source of vitamin D. Regular exposure to sunlight is desirable. Controversy exists as to whether vitamin D should be added in the manufacture of ?our, particularly of types used by the Asian community.
De?ciency of vitamin D in adults results in osteomalacia (see under BONE, DISORDERS OF). (See also APPENDIX 5: VITAMINS.)... rickets
Also known as the spine, this forms an important part of the skeleton, acting both as the rigid pillar which supports the upper parts of the body and as a protection to the SPINAL CORD and nerves arising from it. The spinal column is built up of a number of bones placed one upon another, which, in consequence of having a slight degree of turning-movement, are known as the vertebrae. The possession of a spinal cord supported by a vertebral column distinguishes the higher animals from the lower types, and is why they are called vertebrates. Of the vertebrates, humans alone stand absolutely erect, and this erect carriage of the body gives to the skull and vertebral column certain distinctive characters.
The human backbone is about 70 cm (28
inches) in length, and varies little in full-grown people; di?erences in height depend mainly upon the length of the lower limbs. The number of vertebrae is 33 in children, although in adult life ?ve of these fuse together to form the sacrum, and the lowest four unite in the coccyx, so that the number of separate bones is reduced to 26. Of these there are seven in the neck, known as cervical vertebrae; 12 with ribs attached, in the region of the thorax known as thoracic or dorsal vertebrae; ?ve in the loins, called lumbar vertebrae; ?ve fused to form the sacrum; and four joined in the coccyx. These numbers are expressed in a formula thus: C7, D12, L5, S5, Coc4=33.
Although the vertebrae in each of these regions have distinguishing features, all the vertebrae are constructed on the same general plan. Each has a thick, rounded, bony part in front, known as the body, and these bodies form the main thickness of the column. Behind the body of each is a ring of bone, the neural ring, these rings placed one above another forming the bony canal which lodges the spinal cord. From each side of the ring a short process of bone known as the transverse process stands out, and from the back of the ring a larger process, the spinous process, projects. These processes give attachment to the strong ligaments and muscles which unite, support, and bend the column. The spines can be seen or felt beneath the skin of the back lying in the centre of a groove between the muscular masses of the two sides, and they give to the column its name of the spinal column. One of these spines, that of the seventh cervical vertebra, is especially large and forms a distinct bony prominence, where the neck joins the back. Between the bodies of the vertebrae lies a series of thick discs of ?brocartilage known as intervertebral discs. Each disc consists of an outer portion, known as the annulus ?brosus, and an inner core, known as the nucleus pulposus. These 23 discs provide the upper part of the spine with pliability and resilience.
The ?rst and second cervical vertebrae are specially modi?ed. The ?rst vertebra, known as the atlas, is devoid of a body, but has a specially large and strong ring with two hollows upon which the skull rests, thus allowing forward and backward movements (nodding). The second vertebra, known as the axis, has a pivot on its body which ?ts into the ?rst vertebra and thus allows free rotation of the head from side to side. The spinal column has four natural curves (see diagram) which help to cushion the shocks of walking and running.
The neural rings of the vertebrae form a canal, which is wide in the neck, smaller and almost round in the dorsal region, and wide again in the lumbar vertebrae. Down the canal runs the spinal cord, and the nerves leaving the cord do so through openings between the vertebrae which are produced by notches on the upper and lower margins of each ring. The intervertebral foramina formed by these notches are so large in comparison with the nerves passing through them that there is no chance of pressure upon the latter, except in very serious injuries which dislocate and fracture the spine.... spinal column
n. an uncommon malignant tumour of cartilage cells occurring in a bone, most frequently in the femur, humerus, ribs, or pelvis, and most commonly affecting adults in their fifties and sixties. It has a typical ‘snowstorm’ appearance on X-ray. Treatment is by surgical removal; these tumours are not usually sensitive to radiotherapy or chemotherapy.... chondrosarcoma
(costo-) combining form denoting the ribs. Example: costectomy (excision of).... cost
a cartilage that connects a *rib to the breastbone (*sternum). The first seven ribs (true ribs) are directly connected to the sternum by individual costal cartilages. The next three ribs are indirectly connected to the sternum by three costal cartilages, each of which is connected to the one immediately above it.... costal cartilage
A blood condition due to abnormal destruction of red blood cells in the spleen.
Causes: hereditary background with deficiency of cell enzymes or cell membrane weakness; wrongly matched blood transfusion, environmental chemicals, food additives, colourings, drugs, infections. Symptoms. Pale face, sore tongue, headache, dizziness, palpitations, breathlessness, angina, weakness, loss of weight and appetite, jaundice (yellow skin), feverishness, vague aches and pains, enlarged spleen and pain under left ribs.
Treatment. Under hospital supervision.
Echinacea has a long reputation for regeneration of red blood cells: experience shows it beneficial for this type of anaemia. To assist control of symptoms: Gentian, Motherwort, Mugwort, Barberry, Hops, Saw Palmetto.
Bitter herbs stimulate the stomach, liver and pancreas. By increasing the appetite they benefit digestion and are given half an hour before meals by tea or decoction: Hops, Quassia chips, Angostura, Feverfew, Bogbean.
Formula. Tea. Milk Thistle 2; Betony 1; Hops 1. Mix. 1-2 teaspoon to each cup boiling water. Infuse 5-15 minutes. 1 cup, thrice daily.
Decoction. Echinacea 1; Sarsaparilla 1; Peruvian bark half; Saw Palmetto half. Mix. 2 teaspoons to 2 cups water, simmer gently 20 minutes. Half a cup, cold, thrice daily before meals.
For weak heart add one part Hawthorn; neurasthenia (Ginkgo); swelling of ankles (Lily of the Valley); loss of hormonal balance (Ginseng).
Prognosis. Surgical removal of spleen may be necessary.
Diet. Dandelion coffee, molasses, desiccated or fresh calves’ liver. Green leafy vegetables, dried beans, apricots. Shellfish, milk, eggs, Soya, meats. Supplements. Daily. Vitamin B12 1mg; Vitamin C, 1g; Folic acid 400mcg; Floradix. ... anaemia: haemolytic
n. a painful condition of the chest wall, caused by inflammation in the joints between ribs and cartilage, breastbone and cartilage, or breastbone and clavicles. It can be caused by strenuous or repetitive movements. The condition is usually shortlived and resolves without treatment. Compare Tietze’s syndrome.... costochondritis
prefix denoting between. Examples: intercostal (between the ribs); intertrochanteric (between the trochanters).... inter
muscles that occupy the spaces between the ribs and are responsible for controlling some of the movements of the ribs. The superficial external intercostals lift the ribs during inspiration; the deep internal intercostals draw the ribs together during expiration.... intercostal muscles
n. severe paroxysmal pain arising from the muscles between the ribs. It is often thought to be of rheumatic origin.... pleurodynia
n. one of four paired muscles of the neck (scalenus anterior, medius, minimus, and posterior), extending from the cervical (neck) vertebrae to the first and second ribs. They are responsible for raising the first and second ribs in inspiration and for bending the neck forward and to either side.... scalenus
n. 1. a surgical knife used in the operation of *sclerotomy. 2. (in embryology) the part of the segmented mesoderm (see somite) in the early embryo that gives rise to all the skeletal tissue of the body. The vertebrae and ribs retain the segmented structure, which is lost in the skull and limbs.... sclerotome
Pain along a sensory nerve serving the chest, without loss of sensation and power of movement. Differs from neuritis in which nerves are inflamed.
Causes: all kinds of infective diseases. Rheumatism, bad teeth, bony spinal lesions, gall stone, liver disorder, thickening of pleura, fractured ribs, shingles – see: SHINGLES. In simple cases a cup of Chamomile tea may suffice. Persistent cases require one of the following alternatives.
Alternatives. Decoction. Combine equal parts: Black Cohosh, Jamaica Dogwood (or White Willow), Pleurisy root. 1 heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup thrice daily. Formula. Cramp bark 2; Black Cohosh 1; Valerian 1. Pinch of Cayenne or few drops Tincture Capsicum. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one- third teaspoon). Thrice daily.
Neuralgia associated with bronchi and lung: Formula: Cramp bark 2; Pleurisy root 2; Liquorice half. Dose: as above.
Practitioner. Tincture Gelsemium BPC (1973). 0.3ml (5 drops) in water as necessary.
Dr Finlay Ellingwood. Tincture Pleurisy root (Asclepias). 20 drops, every 2 hours.
Topical. Poultice: Chamomile, Hops, Linseed or Bran. Acute cases (cold), chronic cases (hot). Grated or bruised Horseradish root. Evening Primrose oil. Hot Cider vinegar. Tincture Arnica or Hypericum. Aromatherapy. 2 drops each: Juniper, Lavender, Chamomile, to 2 teaspoons vegetable oil. Massage. Diet, vitamins, minerals. Same as for general neuralgia. Cold water packs. ... neuralgia, intercostal
Bone-softening due to lack or poor absorption of Vitamin D in the diet. Occurs in the elderly and immigrants with dark skins and of indoor habits. In children it is similar to rickets, producing bow legs, kyphosis or compressed spinal vertebrae. Almost unknown in sunny lands. Symptoms. Bone pains in back, hips, legs and ribs. Children learn to walk late. Teeth badly formed. Thinning and softening of the skull.
Comfrey root promotes bone cell growth. Marigold (Calendula) encourages granulation. Horsetail assists calcium metabolism. Cayenne is a positive circulatory stimulant.
For bone bruised by injury: Rue.
Alternatives. Tea. Combine: Oats 3; Comfrey leaves 2; Horsetail 1; Marigold petals 1. One heaped teaspoon to each cup boiling water; infuse 5-15 minutes. 1 cup freely.
Fenugreek tea. See entry.
Tablets/capsules. Bamboo gum, Black Cohosh, Echinacea, Kelp, Prickly Ash.
Formula 1. Powders. Bamboo gum 3; Fenugreek 2; Calendula 2; Echinacea 2; Liquorice 1. Cayenne quarter. Mix. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily.
Formula 2. Burdock root 1; Horsetail 1; Calendula half. Mix. Liquid extracts: 1 teaspoon. Tinctures: 1-2 teaspoons. Doses enhanced when taken in cup of Fenugreek tea. Thrice daily.
Comfrey root. Use of this root would appear to be of value, its potential benefit outweighing possible risk.
Diet. Oily fish. Natural spring water. Low salt. Irish Moss and Slippery Elm for minerals.
Reject: soft drinks, alcohol, heavy meat meals.
Supplements. Vitamin B12 (50mcg); Vitamin C (500mg); Vitamin D; Vitamin E (400iu), Magnesium, Zinc. Supportives: sunbathing, stop smoking. ... osteomalacia
n. any of several muscles arising from or inserted by a series of processes that resemble the teeth of a saw. An example is the serratus anterior, a muscle situated between the ribs and shoulder blade in the upper and lateral parts of the thorax. It is the chief muscle responsible for pushing and punching movements.... serratus
(sterno-) combining form denoting the sternum. Example: sternocostal (relating to the sternum and ribs).... stern
prefix denoting 1. below; underlying. Examples: subcostal (below the ribs); sublingual (below the tongue); submandibular (below the mandible). 2. partial or slight.... sub
n. a slightly movable joint (see amphiarthrosis) in which the surfaces of the bones are separated by hyaline cartilage, as occurs between the ribs and sternum. This cartilage may become ossified in later development, as between the *epiphyses and shaft of a long bone.... synchondrosis
the 12 bones of the *backbone to which the ribs are attached. They lie between the cervical (neck) and lumbar (lower back) vertebrae and are characterized by the presence of facets for articulation with the ribs. See also vertebra.... thoracic vertebrae
n. the chest: the part of the body cavity between the neck and the diaphragm. The skeleton of the thorax is formed by the sternum, costal cartilages, ribs, and thoracic vertebrae of the backbone. It encloses the lungs, heart, oesophagus, and associated structures. Compare abdomen. —thoracic adj.... thorax
(xipho-) combining form denoting the xiphoid process of the sternum. Example: xiphocostal (relating to the xiphoid process and ribs).... xiphi
(xiphoid cartilage) the lowermost section of the breastbone (see sternum): a flat pointed cartilage that gradually ossifies until it is completely replaced by bone, a process not completed until after middle age. It does not articulate with any ribs. Also called: ensiform process or cartilage, xiphisternum.... xiphoid process
(spinal column, spine, vertebral column) n. a flexible bony column extending from the base of the skull to the small of the back. It encloses and protects the spinal cord, articulates with the skull (at the atlas), ribs (at the thoracic vertebrae), and hip girdle (at the sacrum), and provides attachment for the muscles of the back. It is made up of individual bones (see vertebra) connected by discs of fibrocartilage (see intervertebral disc) and bound together by ligaments. The backbone of a newborn baby contains 33 vertebrae: seven cervical (neck), 12 thoracic (chest), five lumbar (lower back), five sacral (hip), and four coccygeal. In the adult the sacral and coccygeal vertebrae become fused into two single bones (sacrum and coccyx, respectively); the adult vertebral column therefore contains 26 bones (see illustration). Anatomical name: rachis.... backbone
n. 1. (in anatomy) a thin musculomembranous dome-shaped muscle that separates the thoracic and abdominal cavities. The diaphragm is attached to the lower ribs at each side and to the breastbone and the backbone at the front and back. It bulges upwards against the heart and the lungs, arching over the stomach, liver, and spleen. There are openings in the diaphragm through which the oesophagus, blood vessels, and nerves pass. The diaphragm plays an important role in *breathing. It contracts with each inspiration, becoming flattened downwards and increasing the volume of the thoracic cavity. With each expiration it relaxes and is restored to its dome shape. 2. a hemispherical rubber cap fitted inside the vagina over the neck (cervix) of the uterus as a contraceptive. When combined with the use of a chemical spermicide the diaphragm provides reliable contraception with a failure rate as low as 2–10 pregnancies per 100 woman-years.... diaphragm
n. (originally) any of a group of skin diseases typified by the development of fine branlike scales. The term is now used only with a modifying adjective. Pityriasis alba is a common condition in children in which pale scaly patches occur on the face; it is related to atopic *eczema. Pityriasis rosea is a common skin rash, believed to be viral in origin, typically starting with a single patch (a herald patch) on the trunk and followed by an eruption of oval pink scaly *macules. The spots are often aligned along the ribs. The rash usually clears completely in about eight weeks. Pityriasis versicolor is a common chronic infection of the skin caused by the yeast Malassezia furfur, which produces a persistent pale or brown scaly rash on the trunk. Treatment with *selenium sulphide shampoo or with oral itraconazole readily kills the organism but the skin may take months to regain its normal colour. See also dandruff.... pityriasis
resistance to the flow of electricity through the heart muscle during *defibrillation due to the thoracic structures lying between the defibrillation paddles and the heart. These structures include the skin and soft subcutaneous tissues, the ribs and sternum, the lungs, and the pericardium. The best way to reduce the impedance, and thus to deliver the maximum available current to the heart, is to use defibrillation gel pads (see coupling agents), to deliver the shock when the lungs are empty of air, or to press firmly down if using hand-held paddles. Transthoracic impedance is usually between 70 and 80 ohms.... transthoracic impedance
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