n. the time a patient spends in one hospital or treatment centre, from admission to discharge or transfer to another such. This may consist of one or more *finished consultant episodes. See also continuous patient pathway.
Support and advice may be obtained from the British Dyslexia Association.... dyslexia
– supply, leading to NECROSIS of the skin and, in severe cases, of the underlying tissues. Chie?y affecting exposed parts of the body, such as the face and the limbs, frostbite occurs especially in people exercising at high altitudes, or in those at risk of peripheral vascular disease, such as diabetics (see DIABETES MELLITUS), who should take particular care of their ?ngers and toes when in cold environments.
In mild cases – the condition sometimes known as frostnip – the skin on exposed parts of the body, such as the cheeks or nose, becomes white and numb with a sudden and complete cessation of cold and discomfort. In more severe cases, blisters develop on the frozen part, and the skin then gradually hardens and turns black until the frozen part, such as a ?nger, is covered with a black shell of dead tissue. Swelling of the underlying tissue occurs and this is accompanied by throbbing and aching. If, as is often the case, only the skin and the tissues immediately under it are frozen, then in a matter of months the dead tissue peels o?. In the most severe cases of all, muscles, bone and tendon are also frozen, and the affected part becomes cold, swollen, mottled and blue or grey. There may be no blistering in these severe cases. At ?rst there is no pain, but in time shooting and throbbing pains usually develop.
Prevention This consists of wearing the right clothing and never venturing on even quite short expeditions in cold weather, particularly on mountains, without taking expert advice as to what should be worn.
Treatment Frostnip is the only form of frostbite that should be treated on the spot. As it usually occurs on exposed parts, such as the face, each member of the party should be on the lookout for it in another. The moment that whitening of the skin is seen, the individual should seek shelter and warm the affected part by covering it with his or her warm hand or a glove until the normal colour and consistency of the affected part are restored. In more severe cases, treatment should only be given in hospital or in a well-equipped camp. In essence this consists of warming the affected part, preferably in warm water, against a warm part of the body or warm air. Rewarming should be done for spells of 20 minutes at a time. The affected part should never be placed near an open ?re. Generalised warming of the whole body may also be necessary, using hot drinks, and putting the victim in a sleeping bag.... frostbite
Symptoms: (acute) abdominal pain, muscle weakness, vomiting, low blood pressure due to dehydration, tiredness, mental confusion, loss of weight and appetite. Vomiting, dizzy spells. Increased dark pigmentation around genitals, nipples, palms and inside mouth. Persistent low blood pressure with occasional low blood sugar. Crisis is treated by increased salt intake. Research project revealed a craving for liquorice sweets in twenty five per cent of patients.
Herbs with an affinity for the adrenal glands: Parsley, Sarsaparilla, Wild Yam, Borage, Liquorice, Ginseng, Chaparral. Where steroid therapy is unavoidable, supplementation with Liquorice and Ginseng is believed to sustain function of the glands. Ginseng is supportive when glands are exhausted by prolonged stress. BHP (1983) recommends: Liquorice, Dandelion leaf.
Alternatives. Teas. Gotu Kola, Parsley, Liquorice root, Borage, Ginseng, Balm.
Tea formula. Combine equal parts: Balm and Gotu Kola. Preparation of teas and tea mixture: 1 heaped teaspoon to each cup boiling water: infuse 5-10 minutes; 1 cup 2 to 3 times daily.
Tablets/capsules. Ginseng, Seaweed and Sarsaparilla, Wild Yam, Liquorice. Dosage as on bottle. Formula. Combine: Gotu Kola 3; Sarsaparilla 2; Ginseng 1; Liquorice quarter. Doses. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 30-60 drops. Tinctures: 1-2 teaspoons 2 to 3 times daily.
Formula. Alternative. Tinctures 1:5. Echinacea 20ml; Yellow Dock 10ml; Barberry 10ml; Sarsaparilla 10ml; Liquorice (liquid extract) 5ml. Dose: 1-2 teaspoons thrice daily.
Supplementation. Cod liver oil. Extra salt. B-Vitamins. Folic acid. ... addison’s disease
Word deafness is an associated condition in which, although hearing remains perfect, the patient has lost the power of referring the names heard to the articles they denote. (See also DYSPHASIA.)... word blindness
Genes carry, in coded form, the detailed speci?cations for the thousands of kinds of protein molecules required by the cell for its existence, for its enzymes, for its repair work and for its reproduction. These proteins are synthesised from the 20 natural AMINO ACIDS, which are uniform throughout nature and which exist in the cell cytoplasm as part of the metabolic pool. The protein molecule consists of amino acids joined end to end to form long polypeptide chains. An average chain contains 100–300 amino acids. The sequence of bases in the nucleic acid chain of the gene corresponds in some fundamental way to the sequence of amino acids in the protein molecule, and hence it determines the structure of the particular protein. This is the genetic code. Deoxyribonucleic acid (see DNA) is the bearer of this genetic information.
DNA has a long backbone made up of repeating groups of phosphate and sugar deoxyribose. To this backbone, four bases are attached as side groups at regular intervals. These four bases are the four letters used to spell out the genetic message: they are adenine, thymine, guanine and cystosine. The molecule of the DNA is made up of two chains coiled round a common axis to form what is called a double helix. The two chains are held together by hydrogen bonds between pairs of bases. Since adenine only pairs with thymine, and guanine only with cystosine, the sequences of bases in one chain ?xes the sequence in the other. Several hundred bases would be contained in the length of DNA of a typical gene. If the message of the DNA-based sequences is a continuous succession of thymine, the RIBOSOME will link together a series of the amino acid, phenylalanine. If the base sequence is a succession of cytosine, the ribosome will link up a series of prolines. Thus, each amino acid has its own particular code of bases. In fact, each amino acid is coded by a word consisting of three adjacent bases. In addition to carrying genetic information, DNA is able to synthesise or replicate itself and so pass its information on to daughter cells.
All DNA is part of the chromosome and so remains con?ned to the nucleus of the cell (except in the mitochondrial DNA). Proteins are synthesised by the ribosomes which are in the cytoplasm. DNA achieves control over pro-tein production in the cytoplasm by directing the synthesis of ribonucleic acid (see RNA). Most of the DNA in a cell is inactive, otherwise the cell would synthesise simultaneously every protein that the individual was capable of forming. When part of the DNA structure becomes ‘active’, it acts as a template for the ribonucleic acid, which itself acts as a template for protein synthesis when it becomes attached to the ribosome.
Ribonucleic acid exists in three forms. First ‘messenger RNA’ carries the necessary ‘message’ for the synthesis of a speci?c protein, from the nucleus to the ribosome. Second, ‘transfer RNA’ collects the individual amino acids which exist in the cytoplasm as part of the metabolic pool and carries them to the ribosome. Third, there is RNA in the ribosome itself. RNA has a similar structure to DNA but the sugar is ribose instead of deoxyribose and uracil replaces the base thymine. Before the ribosome can produce the proteins, the amino acids must be lined up in the correct order on the messenger RNA template. This alignment is carried out by transfer RNA, of which there is a speci?c form for each individual amino acid. Transfer RNA can not only recognise its speci?c amino acid, but also identify the position it is required to occupy on the messenger RNA template. This is because each transfer RNA has its own sequence of bases and recognises its site on the messenger RNA by pairing bases with it. The ribosome then travels along the chain of messenger RNA and links the amino acids, which have thus been arranged in the requisite order, by peptide bonds and protein is released.
Proteins are important for two main reasons. First, all the enzymes of living cells are made of protein. One gene is responsible for one enzyme. Genes thus control all the biochemical processes of the body and are responsible for the inborn di?erence between human beings. Second, proteins also ful?l a structural role in the cell, so that genes controlling the synthesis of structural proteins are responsible for morphological di?erences between human beings.... genetic code
ASTHMA. Spasmodic contraction of the bronchi following exercise, emotional tension, infection, allergens, pollens, house dust, colds.
Symptoms. Obstruction of airways with wheezing, rales or whistling sounds with a sense of constriction. Often related to eczema – ‘eczema of the epithelium’. Infantile eczema treated with suppressive ointments may drive the condition ‘inwards’ and worsen asthma. “My son’s eczema has got better, but he now has asthma” is a common observation.
Causes: hypersensitivity to domestic animals, horses and pet birds. Common salt. Red or white wine allergy. An older generation of practitioners recognised a renal-bronchial asthma encouraged by faulty kidney function. With addition of a relaxing diuretic (Dandelion, Buchu or Parsley root) to a prescription, respiratory symptoms often abate.
Broncho-dilators such as Ephedra and Wild Thyme are widely used by the practitioner. To relieve spasm: Lobelia, Pleurisy root. White Horehound, Ammoniacum, Cramp bark, Garlic, Grindelia, Hyssop.
Anti-cough agents serve to remove sticky sputum: Coltsfoot, Garden Thyme, Slippery Elm bark, Maidenhair Fern, Linseed, Bayberry bark.
For the chronic asthmatic, bacterial invasion spells distress, when Echinacea or Balm of Gilead should be added. Where an irregular pulse reveals heart involvement, add: Hawthorn or Lily of the Valley.
Lobelia is of special value for the anxious patient with spasm of the bronchi. Should be tried before resorting to powerful spray mists which frequently produce gastro-intestinal disturbance.
Alternatives. Teas. Coltsfoot, Comfrey, Horehound (White), Mullein, Skullcap, Marshmallow, Thyme, Valerian, Wild Cherry bark, Elecampane, Plantain. Formula: equal parts herbs Coltsfoot, Mullein, Valerian. 1-2 teaspoons to each cup boiling water; infuse 10-15 minutes; dose, 1 cup twice daily and when necessary.
Antispasmodic Drops. See entry.
Practitioner. Ephedra, Lobelia, Gelsemium, Grindelia, Euphorbia (pill-bearing spurge), Skunk Cabbage, Senega, Pulsatilla, Lily of the Valley (cardiac asthma), Thyme. Formula. Equal parts, Tincture Lobelia simp; Tincture Belladonna; Tincture Ephedra. 5-10 drops thrice daily (maintenance), 10-20 drops for spasm.
Cockayne, Ernest, FNIMH. Hyssop tea for children throughout childhood to avoid respiratory disorders. Dr Finlay Ellingwood. Gelsemium 3.5ml; Lobelia 3.5ml. Distilled water to 120ml. One 5ml teaspoon in water every 3 hours.
Dr Alfred Vogel. Ephedra 20 per cent; Ipecac 15 per cent; Hawthorn berry 10 per cent; Blessed Thistle 5 per cent; Burnet Saxifrage 5 per cent; Garden Thyme 5 per cent; Grindelia 1 per cent. 10-15 drops in water thrice daily.
Dr Wm Thomson. 1 teaspoon Ephedra herb to cup boiling water; infuse 10-15 minutes. Half-1 cup 2-3 times daily.
Traditional. 2 teaspoons shredded Elecampane root in cup cold water; stand overnight. Next day, heat to boiling point when required. Strain. Sips, hot, with honey: 1 cup 2-3 times daily.
Potter’s Asthma & Bronchitis Compound 32. 40g medicinal teabags. Ingredients: Clove BPC 4.84 per cent; Elecampane root 17.24 per cent; Horehound 26.20 per cent; Hyssop 17.24 per cent; Irish Moss 17.24 per cent; Liquorice 17.24 per cent. Dose: 1-2 teaspoons when necessary.
Chinese Medicine. Decoction or extract from the Gingko tree widely used, as also is Ephedra, Garlic, Liquorice and Bailcalensis.
Tablets/capsules. Lobelia. Iceland Moss, (Gerard). Euphorbia (Blackmore).
Powders. Formula. Lobelia 2; Hyssop 1; Elderflowers 1; Grindelia quarter; Liquorice quarter: pinch Cayenne. Dose: 750mg (three 00 capsules or half a teaspoon) 2-3 times daily.
Aromatherapy. 6 drops Rosemary oil in 2 teaspoons Almond oil for massage upper chest to relieve congestion.
Inhalation. See: INHALATIONS, FRIAR’S BALSAM.
Nebulizer. A germicidal solution is made from 5 drops oil Eucalyptus in one cup boiling water. Use in nebulizer for droplet therapy.
Ioniser – use of.
Cider Vinegar. Sips of the vinegar in water for whoop.
Supportives. Yoga. Singing. Cures have been reported of patients on taking up singing. “During singing, up to 90 per cent of the vital capacity may be used without a conscious effort to increase tidal volume.” (Dr M. Judson, New England Journal of Medicine)
Diet. Low salt, low fat, high fibre, cod liver oil, carrots, watercress, Soya beans or flour, lecithin, sunflower seed oil, green vegetables, raw fruit, fresh fish. These foods are valuable sources of antioxidant vitamins and minerals essential for the body’s defence mechanism. A diet deficient in these reduces ability of the airways to withstand the ravages of cigarette smoke and other air pollutants.
Foods that are craved are ones often causing sensitivity. Among problem foods are: milk, corn, wheat, eggs, nuts, chocolate, all dairy products, fat of meats. Check labels for tartrazine artificial colouring.
Salt intake. Linked with chest diseases. “Those who eat a lot of salt had more sensitive airways than those with low salt intake . . . excess salt tended to cause most pronounced symptoms.” (Institute of Respiratory Diseases, Oavia, Italy)
Asthma mortality could be significantly reduced by sufferers lowering their salt consumption, an epidemiologist predicted.
Supplements. Daily. Vitamin B6 50-100mg. Vitamin C 500mg. Vitamin E 400iu. Magnesium, Zinc. Cod liver oil: 2 teaspoons.
Anti-allergic bedding. Provides a protective barrier against the house dust mite on mattresses and bedding. Droppings from the tiny pests are worse in the bedroom. ... asthenia
Symptoms: weakened eye muscles producing drooping eyelids (ptosis). Double vision (diplopia). Weakness of neck muscles served by the cranial nerves. Thymus gland abnormality. Difficult swallowing, chewing, slurred speech, fatigue, ‘simply cannot hold her head up’.
Lid-lag test and Tensilon tests establish diagnosis.
Treatment should give support to the thymus gland.
Alternatives. To improve nerve transmission: but not cure. Ephedra tea BHP (1983). 1 teaspoon to each cup boiling water; infuse 15 minutes, thrice daily.
Formula. Oats 2; Ginseng 1; Sarsaparilla 1; pinch Cayenne or drops Tincture Capsicum. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Practitioner: Ephedrine.
Diet: Gluten-free. ... myasthenia gravis (mg)
In partial (or focal) seizures, the nature of the seizure depends upon the location of the damage in the brain. For example, a simple partial motor seizure consists of convulsive movements that might spread from the thumb to the hand, arm, and face (this spread of symptoms is called the Jacksonian march); there is no loss of awareness. Complex partial seizures are commonly caused by damage to the cortex of the temporal lobe or the adjacent parietal lobe of the brain: this form of epilepsy is often called temporal lobe (or psychomotor) epilepsy. Symptoms may include *hallucinations of smell, taste, sight, and hearing, paroxysmal disorders of memory, and *automatism. Throughout an attack the patient is in a state of clouded awareness and afterwards may have no recollection of the event (see also déjà vu; jamais vu). A number of these symptoms are due to scarring and atrophy (mesial temporal sclerosis) affecting the temporal lobe.
The different forms of epilepsy can be controlled by the use of antiepileptic drugs (see anticonvulsant). Surgical resection of focal epileptogenic lesions in the brain is appropriate in a strictly limited number of cases. See also aura; postictal phase. —epileptic adj., n.... epilepsy
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