adj. 1. (of a living organism) barren; unable to reproduce its kind (see sterility). 2. (of inanimate objects) completely free from bacteria, fungi, viruses, or other microorganisms that could cause infection.
There are 2 types of artificial insemination: , artificial insemination with the semen of the woman’s male partner; and , insemination with a donor’s sperm. is usually used for couples who are unable to have intercourse, or if the man has a low sperm count or a low volume of ejaculate. It is also used when semen has been stored from a man prior to treatment (such as chemotherapy) that has made him sterile. is available to couples if the man is infertile or is a carrier of a genetic disease. It may also be used by a woman who wants children but has no male partner.
Insemination is timed to coincide with natural ovulation or may be combined with treatment to stimulate ovulation.... artificial insemination
Treatment The most e?ective form of treatment consists in the thorough and immediate cleansing of the wound with soap and water. An antiseptic such as 1 per cent cetrimide can then be applied, and a sterile dry dressing.... abrasion
Bacteria are classi?ed according to their shape: BACILLUS (rod-like), coccus (spherical – see COCCI), SPIROCHAETE (corkscrew and spiral-shaped), VIBRIO (comma-shaped), and pleomorphic (variable shapes). Some are mobile, possessing slender hairs (?agellae) on the surfaces. As well as having characteristic shapes, the arrangement of the organisms is signi?cant: some occur in chains (streptococci) and some in pairs (see DIPLOCOCCUS), while a few have a ?lamentous grouping. The size of bacteria ranges from around 0.2 to 5 µm and the smallest (MYCOPLASMA) are roughly the same size as the largest viruses (poxviruses – see VIRUS). They are the smallest organisms capable of existing outside their hosts. The longest, rod-shaped bacilli are slightly smaller than the human erythrocyte blood cell (7 µm).
Bacterial cells are surrounded by an outer capsule within which lie the cell wall and plasma membrane; cytoplasm ?lls much of the interior and this contains genetic nucleoid structures containing DNA, mesosomes (invaginations of the cell wall) and ribosomes, containing RNA and proteins. (See illustration.)
Reproduction is usually asexual, each cell dividing into two, these two into four, and so on. In favourable conditions reproduction can be very rapid, with one bacterium multiplying to 250,000 within six hours. This means that bacteria can change their characteristics by evolution relatively quickly, and many bacteria, including Mycobacterium tuberculosis and Staphylococcus aureus, have developed resistance to successive generations of antibiotics produced by man. (METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA)) is a serious hazard in some hospitals.
Bacteria may live as single organisms or congregate in colonies. In arduous conditions some bacteria can convert to an inert, cystic state, remaining in their resting form until the environment becomes more favourable. Bacteria have recently been discovered in an inert state in ice estimated to have been formed 250 million years ago.
Bacteria were ?rst discovered by Antonj van Leewenhoek in the 17th century, but it was not until the middle of the 19th century that Louis Pasteur, the famous French scientist, identi?ed bacteria as the cause of many diseases. Some act as harmful PATHOGENS as soon as they enter a host; others may have a neutral or benign e?ect on the host unless the host’s natural immune defence system is damaged (see IMMUNOLOGY) so that it becomes vulnerable to any previously well-behaved parasites. Various benign bacteria that permanently reside in the human body are called normal ?ora and are found at certain sites, especially the SKIN, OROPHARYNX, COLON and VAGINA. The body’s internal organs are usually sterile, as are the blood and cerebrospinal ?uid.
Bacteria are responsible for many human diseases ranging from the relatively minor – for example, a boil or infected ?nger – to the potentially lethal such as CHOLERA, PLAGUE or TUBERCULOSIS. Infectious bacteria enter the body through broken skin or by its ori?ces: by nose and mouth into the lungs or intestinal tract; by the URETHRA into the URINARY TRACT and KIDNEYS; by the vagina into the UTERUS and FALLOPIAN TUBES. Harmful bacteria then cause disease by producing poisonous endotoxins or exotoxins, and by provoking INFLAMMATION in the tissues – for example, abscess or cellulitis. Many, but not all, bacterial infections are communicable – namely, spread from host to host. For example, tuberculosis is spread by airborne droplets, produced by coughing.
Infections caused by bacteria are commonly treated with antibiotics, which were widely introduced in the 1950s. However, the con?ict between science and harmful bacteria remains unresolved, with the overuse and misuse of antibiotics in medicine, veterinary medicine and the animal food industry contributing to the evolution of bacteria that are resistant to antibiotics. (See also MICROBIOLOGY.)... bacteria
Bone fractures These occur when there is a break in the continuity of the bone. This happens either as a result of violence or because the bone is unhealthy and unable to withstand normal stresses.
SIMPLE FRACTURES Fractures where the skin remains intact or merely grazed. COMPOUND FRACTURES have at least one wound which is in communication with the fracture, meaning that bacteria can enter the fracture site and cause infection. A compound fracture is also more serious than a simple fracture because there is greater potential for blood loss. Compound fractures usually need hospital admission, antibiotics and careful reduction of the fracture. Debridement (cleaning and excising dead tissue) in a sterile theatre may also be necessary.
The type of fracture depends on the force which has caused it. Direct violence occurs when an object hits the bone, often causing a transverse break – which means the break runs horizontally across the bone. Indirect violence occurs when a twisting injury to the ankle, for example, breaks the calf-bone (the tibia) higher up. The break may be more oblique. A fall on the outstretched hand may cause a break at the wrist, in the humerus or at the collar-bone depending on the force of impact and age of the person. FATIGUE FRACTURES These occur after the bone has been under recurrent stress. A typical example is the march fracture of the second toe, from which army recruits suffer after long marches. PATHOLOGICAL FRACTURES These occur in bone which is already diseased – for example, by osteoporosis (see below) in post-menopausal women. Such fractures are typically crush fractures of the vertebrae, fractures of the neck of the femur, and COLLES’ FRACTURE (of the wrist). Pathological fractures also occur in bone which has secondary-tumour deposits. GREENSTICK FRACTURES These occur in young children whose bones are soft and bend, rather than break, in response to stress. The bone tends to buckle on the side opposite to the force. Greenstick fractures heal quickly but still need any deformity corrected and plaster of Paris to maintain the correction. COMPLICATED FRACTURES These involve damage to important soft tissue such as nerves, blood vessels or internal organs. In these cases the soft-tissue damage needs as much attention as the fracture site. COMMINUTED FRACTURES A fracture with more than two fragments. It usually means that the injury was more violent and that there is more risk of damage to vessels and nerves. These fractures are unstable and take longer to unite. Rehabilitation tends to be protracted. DEPRESSED FRACTURES Most commonly found in skull fractures. A fragment of bone is forced inwards so that it lies lower than the level of the bone surrounding it. It may damage the brain beneath it.
HAIR-LINE FRACTURES These occur when the bone is broken but the force has not been severe enough to cause visible displacement. These fractures may be easily missed. Symptoms and signs The fracture site is usually painful, swollen and deformed. There is asymmetry of contour between limbs. The limb is held uselessly. If the fracture is in the upper
limb, the arm is usually supported by the patient; if it is in the lower limb then the patient is not able to bear weight on it. The limb may appear short because of muscle spasm.
Examination may reveal crepitus – a bony grating – at the fracture site. The diagnosis is con?rmed by radiography.
Treatment Healing of fractures (union) begins with the bruise around the fracture being resorbed and new bone-producing cells and blood vessels migrating into the area. Within a couple of days they form a bridge of primitive bone across the fracture. This is called callus.
The callus is replaced by woven bone which gradually matures as the new bone remodels itself. Treatment of fractures is designed to ensure that this process occurs with minimal residual deformity to the bone involved.
Treatment is initially to relieve pain and may involve temporary splinting of the fracture site. Reducing the fracture means restoring the bones to their normal position; this is particularly important at the site of joints where any small displacement may limit movement considerably.
with plaster of Paris. If closed traction does not work, then open reduction of the fracture may
be needed. This may involve ?xing the fracture with internal-?xation methods, using metal plates, wires or screws to hold the fracture site in a rigid position with the two ends closely opposed. This allows early mobilisation after fractures and speeds return to normal use.
External ?xators are usually metal devices applied to the outside of the limb to support the fracture site. They are useful in compound fractures where internal ?xators are at risk of becoming infected.
Consolidation of a fracture means that repair is complete. The time taken for this depends on the age of the patient, the bone and the type of fracture. A wrist fracture may take six weeks, a femoral fracture three to six months in an adult.
Complications of fractures are fairly common. In non-union, the fracture does not unite
– usually because there has been too much mobility around the fracture site. Treatment may involve internal ?xation (see above). Malunion means that the bone has healed with a persistent deformity and the adjacent joint may then develop early osteoarthritis.
Myositis ossi?cans may occur at the elbow after a fracture. A big mass of calci?ed material develops around the fracture site which restricts elbow movements. Late surgical removal (after 6–12 months) is recommended.
Fractured neck of FEMUR typically affects elderly women after a trivial injury. The bone is usually osteoporotic. The leg appears short and is rotated outwards. Usually the patient is unable to put any weight on the affected leg and is in extreme pain. The fractures are classi?ed according to where they occur:
subcapital where the neck joins the head of the femur.
intertrochanteric through the trochanter.
subtrochanteric transversely through the upper end of the femur (rare). Most of these fractures of the neck of femur
need ?xing by metal plates or hip replacements, as immobility in this age group has a mortality of nearly 100 per cent. Fractures of the femur shaft are usually the result of severe trauma such as a road accident. Treatment may be conservative or operative.
In fractures of the SPINAL COLUMN, mere damage to the bone – as in the case of the so-called compression fracture, in which there is no damage to the spinal cord – is not necessarily serious. If, however, the spinal cord is damaged, as in the so-called fracture dislocation, the accident may be a very serious one, the usual result being paralysis of the parts of the body below the level of the injury. Therefore the higher up the spine is fractured, the more serious the consequences. The injured person should not be moved until skilled assistance is at hand; or, if he or she must be removed, this should be done on a rigid shutter or door, not on a canvas stretcher or rug, and there should be no lifting which necessitates bending of the back. In such an injury an operation designed to remove a displaced piece of bone and free the spinal cord from pressure is often necessary and successful in relieving the paralysis. DISLOCATIONS or SUBLUXATION of the spine are not uncommon in certain sports, particularly rugby. Anyone who has had such an injury in the cervical spine (i.e. in the neck) should be strongly advised not to return to any form of body-contact or vehicular sport.
Simple ?ssured fractures and depressed fractures of the skull often follow blows or falls on the head, and may not be serious, though there is always a risk of damage which is potentially serious to the brain at the same time.
Compound fractures may result in infection within the skull, and if the skull is extensively broken and depressed, surgery is usually required to check any intercranial bleeding or to relieve pressure on the brain.
The lower jaw is often fractured by a blow on the face. There is generally bleeding from the mouth, the gum being torn. Also there are pain and grating sensations on chewing, and unevenness in the line of the teeth. The treatment is simple, the line of teeth in the upper jaw forming a splint against which the lower jaw is bound, with the mouth closed.
Congenital diseases These are rare but may produce certain types of dwar?sm or a susceptibility to fractures (osteogenesis imperfecta).
Infection of bone (osteomyelitis) may occur after an open fracture, or in newborn babies with SEPTICAEMIA. Once established it is very di?cult to eradicate. The bacteria appear capable of lying dormant in the bone and are not easily destroyed with antibiotics so that prolonged treatment is required, as might be surgical drainage, exploration or removal of dead bone. The infection may become chronic or recur.
Osteomalacia (rickets) is the loss of mineralisation of the bone rather than simple loss of bone mass. It is caused by vitamin D de?ciency and is probably the most important bone disease in the developing world. In sunlight the skin can synthesise vitamin D (see APPENDIX 5: VITAMINS), but normally rickets is caused by a poor diet, or by a failure to absorb food normally (malabsorbtion). In rare cases vitamin D cannot be converted to its active state due to the congenital lack of the speci?c enzymes and the rickets will fail to respond to treatment with vitamin D. Malfunction of the parathyroid gland or of the kidneys can disturb the dynamic equilibrium of calcium and phosphate in the body and severely deplete the bone of its stores of both calcium and phosphate.
Osteoporosis A metabolic bone disease resulting from low bone mass (osteopenia) due to excessive bone resorption. Su?erers are prone to bone fractures from relatively minor trauma. With bone densitometry it is now possible to determine individuals’ risk of osteoporosis and monitor their response to treatment.
By the age of 90 one in two women and one in six men are likely to sustain an osteoporosis-related fracture. The incidence of fractures is increasing more than would be expected from the ageing of the population, which may re?ect changing patterns of exercise or diet.
Osteoporosis may be classi?ed as primary or secondary. Primary consists of type 1 osteoporosis, due to accelerated trabecular bone loss, probably as a result of OESTROGENS de?ciency. This typically leads to crush fractures of vertebral bodies and fractures of the distal forearm in women in their 60s and 70s. Type 2 osteoporosis, by contrast, results from the slower age-related cortical and travecular bone loss that occurs in both sexes. It typically leads to fractures of the proximal femur in elderly people.
Secondary osteoporosis accounts for about 20 per cent of cases in women and 40 per cent of cases in men. Subgroups include endocrine (thyrotoxicosis – see under THYROID GLAND, DISEASES OF, primary HYPERPARATHYROIDISM, CUSHING’S SYNDROME and HYPOGONADISM); gastrointestinal (malabsorption syndrome, e.g. COELIAC DISEASE, or liver disease, e.g. primary biliary CIRRHOSIS); rheumatological (RHEUMATOID ARTHRITIS or ANKYLOSING SPONDYLITIS); malignancy (multiple MYELOMA or metastatic CARCINOMA); and drugs (CORTICOSTEROIDS, HEPARIN). Additional risk factors for osteoporosis include smoking, high alcohol intake, physical inactivity, thin body-type and heredity.
Individuals at risk of osteopenia, or with an osteoporosis-related fracture, need investigation with spinal radiography and bone densitometry. A small fall in bone density results in a large increase in the risk of fracture, which has important implications for preventing and treating osteoporosis.
Treatment Antiresorptive drugs: hormone replacement therapy – also valuable in treating menopausal symptoms; treatment for at least ?ve years is necessary, and prolonged use may increase risk of breast cancer. Cyclical oral administration of disodium etidronate – one of the bisphosphonate group of drugs – with calcium carbonate is also used (poor absorption means the etidronate must be taken on an empty stomach). Calcitonin – currently available as a subcutaneous injection; a nasal preparation with better tolerance is being developed. Calcium (1,000 mg daily) seems useful in older patients, although probably ine?ective in perimenopausal women, and it is a safe preparation. Vitamin D and calcium – recent evidence suggests value for elderly patients. Anabolic steroids, though androgenic side-effects (masculinisation) make these unacceptable for most women.
With established osteoporosis, the aim of treatment is to relieve pain (with analgesics and physical measures, e.g. lumbar support) and reduce the risk of further fractures: improvement of bone mass, the prevention of falls, and general physiotherapy, encouraging a healthier lifestyle with more daily exercise.
Further information is available from the National Osteoporosis Society.
Paget’s disease (see also separate entry) is a common disease of bone in the elderly, caused by overactivity of the osteoclasts (cells concerned with removal of old bone, before new bone is laid down by osteoblasts). The bone affected thickens and bows and may become painful. Treatment with calcitonin and bisphosphonates may slow down the osteoclasts, and so hinder the course of the disease, but there is no cure.
If bone loses its blood supply (avascular necrosis) it eventually fractures or collapses. If the blood supply does not return, bone’s normal capacity for healing is severely impaired.
For the following diseases see separate articles: RICKETS; ACROMEGALY; OSTEOMALACIA; OSTEOGENESIS IMPERFECTA.
Tumours of bone These can be benign (non-cancerous) or malignant (cancerous). Primary bone tumours are rare, but secondaries from carcinoma of the breast, prostate and kidneys are relatively common. They may form cavities in a bone, weakening it until it breaks under normal load (a pathological fracture). The bone eroded away by the tumour may also cause problems by causing high levels of calcium in the plasma.
EWING’S TUMOUR is a malignant growth affecting long bones, particularly the tibia (calfbone). The presenting symptoms are a throbbing pain in the limb and a high temperature. Treatment is combined surgery, radiotherapy and chemotherapy.
MYELOMA is a generalised malignant disease of blood cells which produces tumours in bones which have red bone marrow, such as the skull and trunk bones. These tumours can cause pathological fractures.
OSTEOID OSTEOMA is a harmless small growth which can occur in any bone. Its pain is typically removed by aspirin.
OSTEOSARCOMA is a malignant tumour of bone with a peak incidence between the ages of ten and 20. It typically involves the knees, causing a warm tender swelling. Removal of the growth with bone conservation techniques can often replace amputation as the de?nitive treatment. Chemotherapy can improve long-term survival.... bone, disorders of
Cardiac catheters are introduced through a vein in the arm and passed into the heart in order to diagnose some of the more obscure forms of congenital heart disease, and often as a preliminary to operating on the heart.... catheters
– may be dried and in powder form kept almost inde?nitely; when wanted it is reconstituted by adding sterile distilled water. In powder form it can be transported easily and over long distances. Transfusion of plasma is especially useful in the treatment of SHOCK. One advantage of plasma transfusion is that it is not necessary to carry out testing of blood groups before using it.... plasma transfusion
Severe and extensive burns are most frequently produced by the clothes – for example, of a child – catching ?re. This applies especially to cotton garments, which blaze up quickly. It should be remembered that such a ?ame can immediately be extinguished by making the individual lie on the ?oor so that the ?ames are uppermost, and wrapping him or her in a rug, mat or blanket. As prevention is always better than cure, particular care should always be exercised with electric ?res and kettles or pots of boiling water in houses where there are young children or old people. Children’s clothes, and especially night-clothes, should be made of non-in?ammable material: pyjamas are also much safer than nightdresses.
Severe scalds are usually produced by escape of steam in boiler explosions. Cigarettes are a common cause of ?res and therefore of burns; people who have fallen asleep in bed or in a chair while smoking may set ?re to the bed or chair. Discarded, unextinguished cigarettes are another cause.
Degrees of burns Burns are referred to as either super?cial (or partial-thickness) burns, when there is su?cient skin tissue left to ensure regrowth of skin over the burned site; and deep (or full-thickness) burns, when the skin is totally destroyed and grafting will be necessary.
Symptoms Whilst many domestic burns are minor and insigni?cant, more severe burns and scalds can prove to be very dangerous to life. The main danger is due to SHOCK, which arises as a result of loss of ?uid from the circulating blood at the site of a serious burn. This loss of ?uid leads to a fall in the volume of the circulating blood. As the maintenance of an adequate blood volume is essential to life, the body attempts to compensate for this loss by withdrawing ?uid from the uninjured areas of the body into the circulation. If carried too far, however, this in turn begins to affect the viability of the body cells. As a sequel, essential body cells, such as those of the liver and kidneys, begin to suffer, and the liver and kidneys cease to function properly. This will show itself by the development of JAUNDICE and the appearance of albumin in the urine (see PROTEINURIA). In addition, the circulation begins to fail with a resultant lack of oxygen (see ANOXIA) in the tissues, and the victim becomes cyanosed (see CYANOSIS), restless and collapsed: in some cases, death ensues. In addition, there is a strong risk of infection occurring. This is the case with severe burns in particular, which leave a large raw surface exposed and very vulnerable to any micro-organisms. The combination of shock and infection can all too often be life-threatening unless expert treatment is immediately available.
The immediate outcome of a burn is largely determined by its extent. This is of more signi?cance than the depth of the burn. To assess the extent of a burn in relation to the surface of the body, what is known as the Rule of Nine has been evolved. The head and each arm cover 9 per cent of the body surface, whilst the front of the body, the back of the body, and each leg each cover 18 per cent, with the perineum (or crutch) accounting for the remaining 1 per cent. The greater the extent of the burn, the more seriously ill will the victim become from loss of ?uid from his or her circulation, and therefore the more prompt should be his or her removal to hospital for expert treatment. The depth of the burn, unless this is very great, is mainly of import when the question arises as to how much surgical treatment, including skin grafting, will be required.
Treatment This depends upon the severity of the burn. In the case of quite minor burns or scalds, all that may be necessary if they are seen immediately is to hold the part under cold running water until the pain is relieved. Cooling is one of the most e?ective ways of relieving the pain of a burn. If the burn involves the distal part of a limb – for example, the hand and forearm – one of the most e?ective ways of relieving pain is to immerse the burned part in lukewarm water and add cold water until the pain disappears. As the water warms and pain returns, more cold water is added. After some three to four hours, pain will not reappear on warming, and the burn may be dressed in the usual way. Thereafter a simple dressing (e.g. a piece of sterile gauze covered by cotton-wool, and on top of this a bandage or adhesive dressing) should be applied. The part should be kept at rest and the dressing kept quite dry until healing takes place. Blisters should be pierced with a sterile needle, but the skin should not be cut away. No ointment or oil should be applied, and an antiseptic is not usually necessary.
In slightly more severe burns or scalds, it is probably advisable to use some antiseptic dressing. These are the cases which should be taken to a doctor – whether a general practitioner, a factory doctor, or to a hospital Accident & Emergency department. There is still no general consensus of expert opinion as to the best ‘antiseptic’ to use. Among those recommended are CHLORHEXIDINE, and antibiotics such as BACITRACIN, NEOMYCIN and polymixin. An alternative is to use a Tulle Gras dressing which has been impregnated with a suitable antibiotic.
In the case of severe burns and scalds, the only sound rule is immediate removal to hospital. Unless there is any need for immediate resuscitation, such as arti?cial respiration, or attention to other injuries there may be, such as fractures or haemorrhage, nothing should be done on the spot to the patient except to make sure that s/he is as comfortable as possible and to keep them warm, and to cover the burn with a sterile (or clean) cloth such as a sheet, pillowcases, or towels wrung out in cold water. If pain is severe, morphine should be given – usually intravenously. Once the victim is in hospital, the primary decision is as to the extent of the burn, and whether or not a transfusion is necessary. If the burn is more than 9 per cent of the body surface in extent, a transfusion is called for. The precise treatment of the burn varies, but the essential is to prevent infection if this has not already occurred, or, if it has, to bring it under control as quickly as possible. The treatment of severe burns has made great advances, with quick transport to specialised burns units, modern resuscitative measures, the use of skin grafting and other arti?cial covering techniques and active rehabilitation programmes, o?ering victims a good chance of returning to normal life.
CHEMICAL BURNS Phenol or lysol can be washed o? promptly before they do much damage. Acid or alkali burns should be neutralised by washing them repeatedly with sodium bicarbonate or 1 per cent acetic acid, respectively. Alternatively, the following bu?er solution may be used for either acid or alkali burns: monobasic potassium phosphate (70 grams), dibasic sodium phosphate (70 grams) in 850 millilitres of water. (See also PHOSPHORUS BURNS.)... burns and scalds
Dialysis is available as either haemodialysis or peritoneal dialysis.
Haemodialysis Blood is removed from the circulation either through an arti?cial arteriovenous ?stula (junction) or a temporary or permanent internal catheter in the jugular vein (see CATHETERS). It then passes through an arti?cial kidney (‘dialyser’) to remove toxins (e.g. potassium and urea) by di?usion and excess salt and water by ultra?ltration from the blood into dialysis ?uid prepared in a ‘proportionator’ (often referred to as a ‘kidney machine’). Dialysers vary in design and performance but all work on the principle of a semi-permeable membrane separating blood from dialysis ?uid. Haemodialysis is undertaken two to three times a week for 4–6 hours a session.
Peritoneal dialysis uses the peritoneal lining (see PERITONEUM) as a semi-permeable membrane. Approximately 2 litres of sterile ?uid is run into the peritoneum through the permanent indwelling catheter; the ?uid is left for 3–4 hours; and the cycle is repeated 3–4 times per day. Most patients undertake continuous ambulatory peritoneal dialysis (CAPD), although a few use a machine overnight (continuous cycling peritoneal dialysis, CCPD) which allows greater clearance of toxins.
Disadvantages of haemodialysis include cardiovascular instability, HYPERTENSION, bone disease, ANAEMIA and development of periarticular AMYLOIDOSIS. Disadvantages of peritoneal dialysis include peritonitis, poor drainage of ?uid, and gradual loss of overall e?ciency as endogenous renal function declines. Haemodialysis is usually done in outpatient dialysis clinics by skilled nurses, but some patients can carry out the procedure at home. Both haemodialysis and peritoneal dialysis carry a relatively high morbidity and the ideal treatment for patients with end-stage renal failure is successful renal TRANSPLANTATION.... dialysis
Unfortunately, insects are liable to become resistant to insecticides, just as bacteria are liable to become resistant to antibiotics, and it is for this reason that so much research work is being devoted to the discovery of new ones. Researchers are also exploring new methods, such as releasing sexually sterile insects into the natural population.
The useful effects of insecticides must be set against increasing evidence that the indiscriminate use of some of these potent preparations is having an adverse e?ect – not only upon human beings, but also upon the ecosystems. Some, such as DDT – the use of which is now banned in the UK – are very stable compounds that enter the food chain and may ultimately be lethal to many animals, including birds and ?shes.... insecticides
Habitat: Common in English gardens; native of South America.
Features ? Stem angular, hairy up to one foot high. Lower leaves stalked, spatulate, upper sessile, all hairy. Flower-heads yellow, the tubular florets sterile. Fruit semicircular, angular, rough, no pappus. Taste bitter, smell unpleasantly strong.Part used ? Herb, flowers.Action: Diaphoretic, stimulant, antispasmodic.
The infusion of 1 ounce of the flowers or herb to 1 pint boiling water is prescribed both for internal use in 1-2 tablespoonful doses, and externally as a lotion for chronic ulcers and varicose veins. The infusion is also given to children (in doses according to age) suffering from measles and other feverish and eruptive complaints. Sprained muscles gain relief from the hot fomentation. Marigold is frequently combined with Witch Hazel when a lotion is required.... marigoldThe flea penetrates the skin of the feet and lays eggs.
Chigoe fleas should be removed with a sterile needle, and the wounds treated with an antiseptic.... chigoe
The scheme is aimed at reducing the risks of infections, such as HIV and hepatitis, transmitted by the sharing of contaminated needles.... needle exchange
The risk of infection of open wounds during surgery is reduced by a ventilation system that continually provides clean, filtered air, and walls and floors that are easily washable.
Surgeons, assistants, and nurses use sterile brushes and bactericidal soaps to scrub their hands and forearms before putting on sterile gowns, masks, and gloves.
The theatre is equipped with shadowless operating lights; lightboxes for viewing X-ray images; anaesthetic machines (see anaesthesia, general); and a diathermy machine, which controls bleeding.
A heart–lung machine may also be used.... operating theatre
Checking a hormone pro?le in the woman’s blood will help in the diagnosis of ovulatory disorders like polycystic ovaries, an early menopause, anorexia or other endocrine illnesses. Ovulation itself is best assessed by ultrasound scan at mid-cycle or by a blood hormone progesterone level in the second half of the cycle.
The FALLOPIAN TUBES may be damaged or blocked in 20–30 per cent of infertile women. This is usually caused by previous pelvic infection or ENDOMETRIOSIS, where menstrual blood is thought to ?ow backwards through the fallopian tubes into the pelvis and seed with cells from the lining of the uterus in the pelvis. This process often leads to scarring of the pelvic tissues; 5–10 per cent of infertility is associated with endometriosis.
To assess the Fallopian tubes adequately a procedure called LAPAROSCOPY is performed. An ENDOSCOPE is inserted through the umbilicus and at the same time a dye is pushed through the tubes to assess their patency. The procedure is performed under a general anaesthetic.
In a few cases the mucus around the cervix may be hostile to the partner’s sperm and therefore prevent fertilisation.
Defective production is responsible for up to a quarter of infertility. It may result from the failure of the testes (see TESTICLE) to descend in early life, from infections of the testes or previous surgery for testicular torsion. The semen is analysed to assess the numbers of sperm and their motility and to check for abnormal forms.
In a few cases the genetic make-up of one partner does not allow the couple ever to achieve a pregnancy naturally.
In about 25 per cent of couples no obvious cause can be found for their infertility.
Treatment Ovulation may be induced with drugs.
In some cases damaged Fallopian tubes may be repaired by tubal surgery. If the tubes are destroyed beyond repair a pregnancy may be achieved with in vitro fertilisation (IVF) – see under ASSISTED CONCEPTION.
Endometriosis may be treated either with drugs or laser therapy, and pregnancy rates after both forms of treatment are between 40–50 per cent, depending on the severity of the disease.
Few options exist for treating male-factor infertility. These are arti?cial insemination by husband or donor and more recently in vitro fertilisation. Drug treatment and surgical repair of VARICOCELE have disappointing results.
Following investigations, between 30 and 40 per cent of infertile couples will achieve a pregnancy usually within two years.
Some infertile men cannot repair any errors in the DNA in their sperm, and it has been found that the same DNA repair problem occurs in malignant cells of some patients with cancer. It is possible that these men’s infertility might be nature’s way of stopping the propagation of genetic defects. With the assisted reproduction technique called intracytoplasmic sperm injection, some men with defective sperm can fertilise an ovum. If a man with such DNA defects fathers a child via this technique, that child could be sterile and might be at increased risk of developing cancer. (See ARTIFICIAL INSEMINATION; ASSISTED CONCEPTION.)... infertility
Caution is needed when treating patients with bronchopulmonary disease or liver impairment; and intramuscular injection near the sciatic nerve should be avoided, as it may cause severe CAUSALGIA. Adverse effects include rashes; pain and sterile ABSCESS after intramuscular injection; rectal irritation after ENEMA.... paraldehyde
The predisposition to psoriasis is genetic, multiple genes being involved, but postnatal factors such as acute infection, hormonal disturbance, pregnancy and drugs can in?uence or provoke it. The sexes are equally affected and onset is most common in the second or third decade of life.
The psoriatic lesion is dull red, scaly and well de?ned. Scale is shed constantly, either in tiny pieces or as large plaques. The scalp is usually affected but the disease does not cause signi?cant hair loss. The ?ngernails may be pitted or ridged and the toenails grossly thickened. Several clinical patterns occur: in guttate psoriasis, a sudden explosion of multiple tiny lesions may follow a streptococcal throat infection, especially in children. Larger lesions are characteristic of discoid (plaque) psoriasis, the usual adult form. In the elderly the plaques may be mainly in the large body folds – ?exural psoriasis. Rarely, psoriasis may be universal (psoriatic erythroderma), or a sterile pustular eruption may supervene (pustular psoriasis).
Mucous membranes in the mouth and elsewhere are not affected. Psoriasis does not affect internal organs, but in about 1 per cent of subjects an in?ammatory joint disease (psoriatic arthritis) may be associated with the condition.
Treatment There is no absolute cure, but several agents used topically are of value including coal-tar extracts, DITHRANOL, CORTICOSTEROIDS and synthetic derivatives of vitamins A and D. Ultraviolet B phototherapy (and natural sunlight) bene?ts most but not all psoriatics. Systemic therapy, including PHOTOCHEMOTHERAPY, is reserved for severe forms of psoriasis. METHOTREXATE, CICLOSPORIN A and oral RETINOIDS are the most e?ective drugs, but they are potentially dangerous and require expert monitoring.
Patient information may be obtained through the Psoriasis Association.... psoriasis
Hydrocoele is a collection of ?uid distending one or both sides of the scrotum with ?uid. Treatment is by withdrawal of the ?uid using a sterile syringe and aspiration needle.
Hypogonadism Reduced activity of the testes or ovaries (male and female gonads). The result is impaired development of the secondary sexual characteristics (growth of the genitals, breast and adult hair distribution). The cause may be hereditary or the result of a disorder of the PITUITARY GLAND which produces GONADOTROPHINS that stimulate development of the testes and ovaries.
Varicocoele is distension of the veins of the spermatic cord, especially on the left side, the causes being similar to varicose veins elsewhere (see VEINS, DISEASES OF). The chief symptom is a painful dragging sensation in the testicle, especially after exertion. Wearing a support provides relief; rarely, an operation may be advisable. Low sperm-count may accompany a varicocele, in which case surgical removal may be advisable.
Orchitis or acute in?ammation may arise from CYSTITIS, stone in the bladder, and in?ammation in the urinary organs, especially GONORRHOEA. It may also follow MUMPS. Intense pain, swelling and redness occur; treatment consists of rest, support of the scrotum, analgesics as appropriate, and the administration of antibiotics if a de?nitive microorganism can be identi?ed. In some patients the condition may develop and form an ABSCESS.
Torsion or twisting of the spermatic cord is relatively common in adolescents. About half the cases occur in the early hours of the morning during sleep. Typically felt as pain of varying severity in the lower abdomen or scrotum, the testis becomes hard and swollen. Treatment consists of immediate undoing of the torsion by manipulation. If done within a few hours, no harm should ensue; however, this should be followed within six hours by surgical operation to ensure that the torsion has been relieved and to ?x the testes. Late surgical attention may result in ATROPHY of the testis.
Tuberculosis may occur in the testicle, especially when the bladder is already affected. Causing little pain, the infection is often far advanced before attracting attention. The condition generally responds well to treatment with a combination of antituberculous drugs (see also main entry for TUBERCULOSIS).
Tumours of the testes occur in around 600 males annually in the United Kingdom, and are the second most common form of malignant growth in young males. There are two types: SEMINOMA and TERATOMA. When adequately treated the survival rate for the former is 95 per cent, while that for the latter is 50 per cent.
Injuries A severe blow may lead to SHOCK and symptoms of collapse, usually relieved by rest in bed; however, a HAEMATOMA may develop.... testicle, diseases of
TUBERCULIN PURIFIED PROTEIN DERIVATIVE (TUBERCULIN PPD) is the active principle of OT (see above), and is prepared from the ?uid medium on which the Mycobacterium tuberculosis has been grown. It is supplied as a liquid, a powder, or as sterile tablets. The liquid contains 100,000 units per millilitre, and the dry powder contains 30,000 units per milligram. It is distributed in sterile containers sealed so as to exclude micro-organisms. It is more constant in composition and potency than OT.
Uses The basis of the tuberculin reaction is that any person who has been infected with the Mycobacterium tuberculosis gives a reaction when a small amount of tuberculin is injected into the skin. A negative reaction means either that the individual has never been infected with the tubercle bacillus, or that the infection has been too recent to have allowed of sensitivity developing.
There are various methods of carrying out the test, of which the following are the most commonly used. The Mantoux test is the most satisfactory of all, and has the advantage that the size of the reaction is a guide to the severity of the tuberculous infection: it is performed by injecting the tuberculin into the skin on the forearm. The Heaf multiple puncture test is reliable: it is carried out with the multiple puncture apparatus, or Heaf gun. The Vollmer patch test, using an impregnated ?lter paper, is useful in children because of the ease with which it can be carried out.... varieties
Care should be taken to trace any underlying cause which should receive primary treatment: diabetes, kidney inflammation, anaemia, etc. The ‘core’ or centre of the boil should be extracted, although pustular matter may disperse and eruption aborted. Echinacea counters infection and hastens ripening. Goldenseal is shown to be effective for staph. aureus.
Alternatives. Teas. Chickweed, Clivers, Comfrey leaves, Figwort, Linseed, Marshmallow leaves, Plantain, Nettles.
Combination tea. Equal parts: Dandelion root, Nettles, Senna leaf, Burdock leaves. 1-2 teaspoons to each cup boiling water, thrice daily.
Decoctions from any of the following: one teaspoon to two cups water; gently simmer 20 minutes; strain when cold. Half-1 cup thrice daily. Blue Flag root, Burdock root, Echinacea root, Marshmallow root, Yellow Dock, Wild Indigo.
Tablets/capsules. Echinacea, Blue Flag, Queen’s Delight, Poke root.
Powders. Formula: Echinacea 1; Poke root half; Goldenseal quarter. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Tinctures. Formula. Echinacea 1; Burdock 1; Yellow Dock 1; Few drops Tincture Myrrh. Mix. Dose: 1 teaspoon in water thrice daily.
Tincture Myrrh, BPC (1973). 10-20 drops in water, 3 times daily.
BHP (1983) recommends, internal – combination: Burdock, Poke root, Violet and Wild Indigo.
Topical. Self-cleansing process is promoted by hot poultices of equal parts: Marshmallow root and Slippery Elm bark (preferably in powder form). An ointment with this combination is available. In the absence of herbs, use honey on clean lint, cover with cotton wool and fix in position. Alternatives: poultices of Carrot, Cabbage, White Pond Lily, Chickweed, Comfrey, Plantain, Linseed, Fenugreek. Cover with clean linen or gauze.
Dr A. Vogel. Tincture Marigold; pulped Cabbage leaves.
Tea Tree oil. After cleansing site, use lotion: 5 drops oil in eggcup boiled water, 3-4 times daily. Supplements. Vitamins A, C, D, E. Zinc.
Preventative: 2 Garlic capsules at night. ... boils
Transfusion of blood is a technique that has been used since the 17th century – although, until the 20th century, with a subsequent high mortality rate. It was only when incompatibility of BLOOD GROUPS was considered as a potential cause of this high mortality that routine blood-testing became standard practice. Since the National Blood Transfusion Service was started in the United Kingdom (in 1946), blood for transfusion has been collected from voluntary, unpaid donors: this is screened for infections such as SYPHILIS, HIV, HEPATITIS and nvCJD (see CREUTZFELDT-JAKOB DISEASE (CJD)), sorted by group, and stored in blood-banks throughout the country.
In the UK in 2004, the National Blood Authority – today’s transfusion service – announced that it would no longer accept donations from anyone who had received a blood transfusion since 1980 – because of the remote possibility that they might have been infected with the PRION which causes nvCJD.
A standard transfusion bottle has been developed, and whole blood may be stored at 2–6 °C for three weeks before use. Transfusions may then be given of whole blood, plasma, blood cells, or PLATELETS, as appropriate. Stored in the dried form at 4–21 °C, away from direct sunlight, human plasma is stable for ?ve years and is easily reconstituted by adding sterile distilled water.
The National Blood Authority prepares several components from each donated unit of blood: whole blood is rarely used in adults. This permits each product, whether plasma or various red-cell concentrates, to be stored under ideal conditions and used in appropriate clinical circumstances – say, to restore blood loss or to treat haemostatic disorders.
Transfusion of blood products can cause complications. Around 5 per cent of transfused patients suffer from a reaction; most are mild, but they can be severe and occasionally fatal. It can be di?cult to distinguish a transfusion reaction from symptoms of the condition being treated, but the safe course is to stop the transfusion and start appropriate investigation.
In the developed world, clinicians can expect to have access to high-quality blood products, with the responsibility of providing blood resting with a specially organised transfusion service. The cause of most fatal haemolytic transfusion reactions is a clerical error due to faulty labelling and/or failure to identify the recipient correctly. Hospitals should have a strict protocol to prevent such errors.
Arti?cial blood Transfusion with blood from donors is facing increasing problems. Demand is rising; suitable blood donors are becoming harder to attract; the processes of taking, storing and cross-matching donor blood are time-consuming and expensive; the shelf-life is six weeks; and the risk of adverse reactions or infection from transfused blood, although small, is always present. Arti?cial blood would largely overcome these drawbacks. Several companies in North America are now preparing this: one product uses puri?ed HAEMOGLOBIN from humans and another from cows. These provide oxygen-carrying capacity, are unlikely to be infectious and do not provoke immunological rejections. Yet another product, called Oxygene®, does not contain any animal or human blood products; it comprises salt water and a substance called per?ubron, the molecules of which store oxygen and absorb carbon dioxide more e?ectively than does haemoglobin. Within 24 hours of being transfused into a person’s bloodstream, per?ubron evaporates and is harmlessly breathed out by the recipient. Arti?cial blood is especially valuable in that it contains no unwanted proteins that can provoke adverse immunological reactions. Furthermore, it is disease-free, lasts for up to three years and is no more expensive than donor blood. It could well take the place of donor blood within a few years.
Autologous transfusion is the use of an individual’s own blood, provided in advance, for transfusion during or after a surgical operation. This is a valuable procedure for operations that may require large transfusions or where a person has a rare blood group. Its use has increased for several reasons:
fear of infection such as HIV and hepatitis.
shortages of donor blood and the rising cost of units of blood.
substantial reduction of risk of incompatible transfusions. In practice, blood transfusion in the UK is
remarkably safe, but there is always room for improvement. So, in the 1990s, a UK inquiry on the Serious Hazards of Transfusion (SHOT) was launched. It established (1998) that of 169 recently reported serious hazards following blood transfusion, 81 had involved a blood component being given to the wrong patient, while only eight were the result of viral or bacterial infections.
There are three ways to use a patient’s own blood in transfusion:
(1) predeposit autologous donation (PAD) – taking blood from a patient before operation and transfusing this blood back into the patient as required during and after operation.
(2) acute normovalaemic haemodilution (ANH) – diluting previously withdrawn blood and thus increasing the volume before transfusion.
(3) perioperative cell salvage (PCS) – the use of centrifugal cell separation on blood saved during an operation, particularly spinal surgery where blood loss may be considerable.
The government has urged NHS trusts to consider the introduction of PCS as a possible adjunct or alternative to banked-blood transfusion. In one centre (Nottingham), PCS has been used in the form of continuous autologous transfusion for several years with success.
Exchange transfusion is the method of treatment in severe cases of HAEMOLYTIC DISEASE OF THE NEWBORN. It consists of replacing the whole of the baby’s blood with Rh-negative blood of the correct blood group for the baby.... transfusion
All burns are serious. Vulnerary herbs are available to promote healing and cell growth, including: Aloe Vera, Comfrey, Fenugreek, Marigold, Marshmallow, Slippery Elm, Chickweed, Myrrh (powder).
Even hospital authorities may find these effective, enhancing healing, reducing risk of infection, and often concluding with a minimum of scar tissue. Echinacea – to mobilise the immune system.
Exclude air from affected parts as soon as possible. Remove no clothing adhering to wound; cut round. For corrosive alkalis: bathe with cider vinegar (2-4 teaspoons to teacup water). Follow with honey: apply lint and bandage. Honey has a long traditional reputation for burns. The following are analgesic and antiseptic, keeping wounds clean and free from pus. Apply sterile dressings.
Tea for internal use: Nettles 1; Valerian 1; Comfrey leaf 2. Mix. 2 teaspoons to each cup boiling water; infuse 15 minutes. 1 cup every 2 hours. Or, cup of ordinary tea laced with 2-3 drops Life Drops.
Topical. (1) Tea Tree oil: 1 part to 20 parts Almond oil. (2) Strong Nettle tea – pain killer. (3) St John’s Wort oil. (4) Aloe Vera – cut off piece of leaf and pulp; or, gel. (5) Slippery Elm – Powder mixed with little milk to form a paste. (6) Pierce Vitamin E capsule and anoint area. (7) Distilled extract of Witch Hazel. (8) Cod liver oil.
Compress. Apply piece of suitable material steeped in teas of any of the following: Chamomile, Chickweed, Comfrey, Cucumber, Elderflowers, Marigold, Plantain, St John’s Wort.
Alcohol should not be taken.
Supplementation. Vitamins A, B-complex, C, D, E. Potassium. Zinc. ... burns & scalds
In the absence of sterile dressings and modern hospital amenities, powdered vegetable charcoal has an ancient reputation as an astringent dressing. It absorbs bacterial toxins and is useful for chronic bowel discharge. Powdered charcoal dressings were used during World War I. Rubbed in lard, was used for purulent foul discharging wounds to neutralise smell and promote healing.
Other indications: relaxed veins, stomach tense and full of wind, constant belching. For weak and cachetic individuals where vital powers are weak.
Available in biscuits, tablets and capsules for its purifying properties and as an aid to digestion. Tablets containing a high sodium content should be avoided. ... charcoal, vegetable
Causes: nappies sealed in plastic pants for hours on end. Eggs.
Seborrhoea is a common type.
Treatment. After soiling, the nappy area should be washed in warm water and powdered with cornflour (cornstarch); this may be used as a substitute for talcum powder for reducing friction. Nappy rash is rare in Greece where it is a mother’s habit to clean a baby’s soiled bottom with a stream of warm water from a mixer tap, holding the infant over the left arm in the washbasin, and washing with the right hand. Topical. Emollient herbal creams: Comfrey, Marshmallow, Chickweed, Slippery Elm, Aloe Vera, Marigold (Calendula). Evening Primrose oil. Zinc and Castor oil ointment. A paste made from Slippery Elm and teaspoon Vitamin E oil. Fresh juice of Plantain or Comfrey.
Tea Tree oil: 10 drops in glass warm water. Saturate handkerchief or sterile dressing and apply.
Diet. Slippery Elm gruel. Avoid eggs. ... nappy rash
Avoid overstocking; some herbs lose their potency on the shelf in time, especially if exposed. Do not keep on a high shelf out of the way. Experts suggest a large box with a lid to protect its contents, kept in a cool dry place away from foods and other household items. Store mixtures containing Camphor separately elsewhere. Camphor is well-known as a strong antidote to medicinal substances. Keep all home-made ointments in a refrigerator. However harmless, keep all remedies out of reach of children. Be sure that all tablet containers have child-resistant tops.
Keep a separate box, with duplicates, permanently in the car. Check periodically. Replace all tablets when crumbled, medicines with changed colour or consistency. Always carry a large plastic bottle of water in the car for cleansing dirty wounds and to form a vehicle to Witch Hazel and other remedies. Label all containers clearly.
Health care items: Adhesive bandages of all sizes, sterile gauze, absorbant cotton wool, adhesive tape, elastic bandage, stitch scissors, forceps (boiled before use), clinical thermometer, assorted safety pins, eye-bath for use as a douche for eye troubles, medicine glass for correct dosage.
Herbal and other items: Comfrey or Chickweed ointment (or cream) for sprains and bruises. Marshmallow and Slippery Elm (drawing) ointment for boils, abscesses, etc. Calendula (Marigold) ointment or lotion for bleeding wounds where the skin is broken. An alternative is Calendula tincture (30 drops) to cupful of boiled water allowed to cool; use externally, as a mouth rinse after dental extractions, and sipped for shock. Arnica tincture: for bathing bruises and swellings where the skin is unbroken (30 drops in a cup of boiled water allowed to cool). Honey for burns and scalds. Lobelia tablets for irritating cough and respiratory distress. Powdered Ginger for adding to hot water for indigestion, vomiting, etc. Tincture Myrrh, 5-10 drops in a glass of water for sore throats, tonsillitis, mouth ulcers and externally, for cleansing infected or dirty wounds. Tincture Capsicum (3-10 drops) in a cup of tea for shock, or in eggcup Olive oil for use as a liniment for pains of rheumatism. Cider vinegar (or bicarbonate of Soda) for insect bites. Oil Citronella, insect repellent. Vitamin E capsules for burns; pierce capsule and wipe contents over burnt area. Friar’s balsam to inhale for congestion of nose and throat. Oil of Cloves for toothache. Olbas oil for general purposes. Castor oil to assist removal of foreign bodies from the eye. Slippery Elm powder as a gruel for looseness of bowels. Potter’s Composition Essence for weakness or collapse. Antispasmodic drops for pain.
Distilled extract of Witch Hazel deserves special mention for bleeding wounds, sunburn, animal bites, stings, or swabbed over the forehead to freshen and revive during an exhausting journey. See: WITCH HAZEL.
Stings of nettles or other plants are usually rendered painless by a dock leaf. Oils of Tea Tree, Jojoba and Evening Primrose are also excellent for first aid to allay infection. For punctured wounds, as a shoemaker piercing his thumb with an awl or injury from brass tacks, or for shooting pains radiating from the seat of injury, tincture or oil of St John’s Wort (Hypericum) is the remedy. ... first aid and medicine chest
Severe acute pancreatitis may lead to hypotension, heart failure, kidney failure, respiratory failure, cysts, and ascites. Chronic pancreatitis may also lead to the development of ascites and cysts, as well as bile duct obstruction and diabetes mellitus.
A diagnosis may be made by blood tests, abdominal X-rays, ultrasound scanning, CT scanning, MRI, or ERCP. Acute pancreatitis is treated with intravenous infusion of fluids and salts and opioid analgesic drugs. In some cases, the gut may be washed out with sterile fluid, or a pancreatectomy may be performed and any gallstones that are present removed. Treatment for the chronic form is with painkillers, insulin, pancreatin, and, in some cases, pancreatectomy.... pancreatitis
With a dose of 10–30 Gy there is also an early onset of nausea and vomiting, which tends to disappear a few hours later. However, damage to the gastrointestinal tract, which causes severe and frequently bloody diarrhoea (called the gastrointestinal syndrome), and overwhelming infection due to damage to the immune system is likely to result in death 4–14 days after exposure.
Acute exposures of more than 30–100 Gy cause the rapid onset of nausea, vomiting, anxiety, and disorientation.
Within hours, the victim usually dies due to nervous system damage and oedema of the brain; these effects are called the central nervous system syndrome.... radiation sickness
FAMILY: Asteraceae (Compositae)
SYNONYMS: Estragon (oil), little dragon, Russian tarragon.
GENERAL DESCRIPTION: A perennial herb with smooth narrow leaves; an erect stem up to 1.2 metres tall, and small yellowy-green, inconspicuous flowers.
DISTRIBUTION: Native to Europe, southern Russia and western Asia. Now cultivated worldwide, especially in Europe and the USA. The oil is mainly produced in France, Holland, Hungary and the USA.
OTHER SPECIES: The so-called French tarragon or ‘sativa’, which is cultivated as a garden herb, is a smaller plant with a sharper flavour than the Russian type and is a sterile derivative of the wild species.
HERBAL/FOLK TRADITION: The leaf is commonly used as domestic herb, especially with chicken or fish, and to make tarragon vinegar. The name is thought to derive from an ancient use as an antidote to the bites of venomous creatures and ‘madde dogges’. It was favoured by the maharajahs of India who took it as a tisane, and in Persia it was used to induce appetite.
‘The leaves, which are chiefly used, are heating and drying, and good for those that have the flux, or any prenatural discharge.’. The leaf was also formerly used for digestive and menstrual irregularities, while the root was employed as a remedy for toothache.
ACTIONS: Anthelmintic, antiseptic, antispasmodic, aperitif, carminative, digestive, diuretic, emmenagogue, hypnotic, stimulant, stomachic, vermifuge.
EXTRACTION: Essential oil by steam distillation from the leaves.
CHARACTERISTICS: A colourless or pale yellow mobile liquid (turning yellow with age), with a sweet-anisic, spicy-green scent. It blends well with labdanum, galbanum, lavender, oakmoss, vanilla, pine and basil.
PRINCIPAL CONSTITUENTS: Estragole (up to 70 per cent), capillene, ocimene, nerol, phellandrene, thujone and cineol, among others.
SAFETY DATA: Moderately toxic due to ‘estragole’ (methyl chavicol); use in moderation only. Possibly carcinogenic. Otherwise non-irritant, non-sensitizing. Avoid during pregnancy.
AROMATHERAPY/HOME: USE
Digestive system: Anorexia, dyspepsia, flatulence, hiccoughs, intestinal spasm, nervous indigestion, sluggish digestion.
Genito-urinary system: Amenorrhoea, dysmenorrhoea, PMT.
OTHER USES: Used as a fragrance component in soaps, detergents, cosmetics and perfumes. Employed as a flavour ingredient in most major food categories, especially condiments and relishes, as well as alcoholic and soft drinks.... tarragon
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