Shape and size In adults the heart is about the size and shape of a clenched ?st. One end of the heart is pointed (apex); the other is broad (base) and is deeply cleft at the division between the two atria. One groove running down the front and up the back shows the division between the two ventricles; a circular, deeper groove marks o? the atria above from the ventricles below. The capacity of each cavity is somewhere between 90 and 180 millilitres.

Structure The heart lies within a strong ?brous bag, known as the pericardium. Since the inner surface of this bag and the outer surface of the heart are both covered with a smooth, glistening membrane faced with ?at cells and lubricated by a little serous ?uid (around 20 ml), the movements of the heart are accomplished almost without friction. The main thickness of the heart wall consists of bundles of muscle ?bres, some of which run in circles right around the heart, and others in loops, ?rst round one cavity, then round the corresponding cavity of the other side. Within all the cavities is a smooth lining membrane, continuous with that lining the vessels which open into the heart. The investing smooth membrane is known as epicardium; the muscular substance as myocardium; and the smooth lining membrane as endocardium.

Important nerves regulate the heart’s action, especially via the vagus nerve and with the sympathetic system (see NERVOUS SYSTEM). In the near part of the atria lies a collection of nerve cells and connecting ?bres, known as the sinuatrial node or pacemaker, which forms the starting-point for the impulses that initiate the beats of the heart. In the groove between the ventricles and the atria lies another collection of similar nerve tissue, known as the atrioventricular node. Running down from there into the septum between the two ventricles is a band of special muscle ?bres, known as the atrioventricular bundle, or the bundle of His. This splits up into a right and a left branch for the two ventricles, and the ?bres of these distribute themselves throughout the muscular wall of the ventricles and control their contraction.

Openings There is no direct communication between the cavities on the right side and those on the left; but the right atrium opens into the right ventricle by a large circular opening, and similarly the left atrium into the left ventricle. Into the right atrium open two large veins, the superior and inferior venae cavae, with some smaller veins from the wall of the heart itself, and into the left atrium open two pulmonary veins from each lung. One opening leads out of each ventricle – to the aorta in the case of the left ventricle, to the pulmonary artery from the right.

Before birth, the FETUS’s heart has an opening (foramen ovale) from the right into the left atrium through which the blood passes; but when the child ?rst draws air into his or her lungs this opening closes and is represented in the adult only by a depression (fossa ovalis).

Valves The heart contains four valves. The mitral valve consists of two triangular cusps; the tricuspid valve of three smaller cusps. The aortic and pulmonary valves each consist of three semilunar-shaped segments. Two valves are placed at the openings leading from atrium into ventricle, the tricuspid valve on the right side, the mitral valve on the left, so as completely to prevent blood from running back into the atrium when the ventricle contracts. Two more, the pulmonary valve and the aortic valve, are at the entrance to these arteries, and prevent regurgitation into the ventricles of blood which has been driven from them into the arteries. The noises made by these valves in closing constitute the greater part of what are known as the heart sounds, and can be heard by anyone who applies his or her ear to the front of a person’s chest. Murmurs heard accompanying these sounds indicate defects in the valves, and may be a sign of heart disease (although many murmurs, especially in children, are ‘innocent’).

Action At each heartbeat the two atria contract and expel their contents into the ventricles, which at the same time they stimulate to contract together, so that the blood is driven into the arteries, to be returned again to the atria after having completed a circuit in about 15 seconds through the body or lungs as the case may be. The heart beats from 60 to 90 times a minute, the rate in any given healthy person being about four times that of the respirations. The heart is to some extent regulated by a nerve centre in the MEDULLA, closely connected with those centres which govern the lungs and stomach, and nerve ?bres pass to it in the vagus nerve. The heart rate and force can be diminished by some of these ?bres, by others increased, according to the needs of the various organs of the body. If this nerve centre is injured or poisoned – for example, by lack of oxygen – the heart stops beating in human beings; although in some of the lower animals (e.g. frogs, ?shes and reptiles) the heart may under favourable conditions go on beating for hours even after its entire removal from the body.... heart

Varieties Haemorrhoids are classi?ed into ?rst-, second- and third-degree, depending on how far they prolapse through the anal canal. First-degree ones do not protrude; second-degree piles protrude during defaecation; third-degree ones are trapped outside the anal margin, although they can be pushed back. Most haemorrhoids can be described as internal, since they are covered with glandular mucosa, but some large, long-term ones develop a covering of skin. Piles are usually found at the three, seven and eleven o’clock sites when viewed with the patient on his or her back.

Causes The veins in the anus tend to become distended because they have no valves; because they form the lowest part of the PORTAL SYSTEM and are apt to become over?lled when there is the least interference with the circulation through the portal vein; and partly because the muscular arrangements for keeping the rectum closed interfere with the circulation through the haemorrhoidal veins. An absence of ?bre from western diets is probably the most important cause. The result is that people often strain to defaecate hard stools, thus raising intra-abdominal pressure which slows the rate of venous return and engorges the network of veins in the anal mucosa. Pregnancy is an important contributory factor in women developing haemorrhoids. In some people, haemorrhoids are a symptom of disease higher up in the portal system, causing interference with the circulation. They are common in heart disease, liver complaints such as cirrhosis or congestion, and any disease affecting the bowels.

Symptoms Piles cause itching, pain and often bleeding, which may occur whenever the patient defaecates or only sometimes. The piles may prolapse permanently or intermittently. The patient may complain of aching discomfort which, with the pain, may be worsened.

Treatment Prevention is important; a high-?bre diet will help in this, and is also necessary after piles have developed. Patients should not spend a long time straining on the lavatory. Itching can be lessened if the PERINEUM is properly washed, dried and powdered. Prolapsed piles can be replaced with the ?nger. Local anaesthetic and steroid ointments can help to relieve symptoms when they are relatively mild, but do not remedy the underlying disorder. If conservative measures fail, then surgery may be required. Piles may be injected, stretched or excised according to the patient’s particular circumstances.

Where haemorrhoids are secondary to another disorder, such as cancer of the rectum or colon, the underlying condition must be treated – hence the importance of medical advice if piles persist.... haemorrhoids

Haemoglobin exists in two forms: simple haemoglobin, found in venous blood; and oxy-haemoglobin, which is a loose compound with oxygen, found in arterial blood after the blood has come into contact with the air in the lungs. This oxyhaemoglobin is again broken down as the blood passes through the tissues, which take up the oxygen for their own use. This is the main function of haemoglobin: to act as a carrier of oxygen from the lungs to all the tissues of the body. When the haemoglobin leaves the lungs, it is 97 per cent saturated with oxygen; when it comes back to the lungs in the venous blood, it is 70 per cent saturated. The oxygen content of 100 millilitres of blood leaving the lungs is 19·5 millilitres, and that of venous blood returning to the lungs, 14·5 millilitres. Thus, each 100 millilitres of blood delivers 5 millilitres of oxygen to the tissues of the body. Human male blood contains 13–18 grams of haemoglobin per 100 millilitres; in women, there are 12–16 grams per 100 millilitres. A man weighing 70 kilograms (154 pounds) has around 770 grams of haemoglobin circulating in his red blood corpuscles.... haemoglobin

Haemophilia affects approximately 1:4,000 of the UK population but only 1:20,000 is severely affected. Severity of the disease depends upon the percentage, compared with normal, of factor VIII activity present. Less than 1 per cent and there will be spontaneous bleeding into joints and muscles; 1–5 per cent and there will be occasional spontaneous bleeding and severe bleeding after minor injury; 5–25 per cent and there will only be severe bleeding after major injury. Before treatment was available, severe haemophiliacs suffered from acute pain and deformity from bleeds into joints and muscles. Bleeding also occurred into the gut, kidneys and brain, and few survived past adolescence.

Freeze-dried factor VIII may be kept in domestic refrigerators. Haemophiliacs can use it to abort minor bleeds by reconstituting it and injecting it intravenously. More major bleeding or preparation for surgery involves raising factor VIII levels to 30–100 per cent by giving cryoprecipitate.

With treatment, most haemophiliacs lead normal lives, although obviously dangerous or contact sports should be avoided. Before donors of blood were screened for HEPATITIS B and C or for HIV infection (see AIDS/HIV), some individuals with haemophilia receiving factor VIII were unwittingly infected with those diseases. Today’s screening procedures make such infections very unlikely.

There is a National Haemophilia Register and each registered sufferer carries a card with details about his or her condition. Information may also be obtained from NHS haemophilia centres and the Haemophilia Society.... haemophilia

Forming the ball of the thumb and that of the little ?nger, and ?lling up the gaps between the metacarpal bones, are other muscles, which act to separate and bring together the ?ngers, and to bend them at their ?rst joints (knuckles).... hand

Persistent heartburn may be a sign of more serious oesophageal disease and medical advice should be sought.... heartburn

The treatment of hirsutism is that of the primary cause. Idiopathic hirsutism must be managed by simple measures such as bleaching the hair and the use of depilatory waxes and creams. Coarse facial hairs can be removed by electrolysis, although this is time-consuming. Shaving is often the most e?ective remedy and neither increases the rate of hair growth nor causes the hairs to become coarser.... hirsutism

Habitat: Extensively farmed for the brewing industry, and is found growing wild in hedges and open woods.

Action: Tonic, diuretic.

(iii) blockage of the circulation of CSF. Such disturbances in the circulation of the ?uid may be due to congenital reasons (most commonly associated with SPINA BIFIDA), to MENINGITIS, or to a tumour.

Symptoms In children, the chief symptoms observed are the gradual increase in size of the upper part of the head, out of all proportion to the face or the rest of the body. The head is globular, with a wide anterior FONTANELLE and separation of the bones at the sutures. The veins in the scalp are prominent, and there is a ‘crackpot’ note on percussion. The normal infant’s head should not grow more than 2·5 cm (1 inch) in each of the ?rst two months of life, and much more slowly subsequently; growth beyond this rate should arouse suspicions of hydrocephalus, so medical professionals caring for infants use centile charts for this purpose.

The cerebral ventricles are widely distended, and the convolutions of the brain ?attened, while occasionally the ?uid escapes into the cavity of the cranium, which it ?lls, pressing down the brain to the base of the skull. As a consequence of such changes, the functions of the brain are interfered with, and in general the mental condition of the patient is impaired. Untreated, the child is dull and listless, irritable and sometimes suffers from severe mental subnormality. The special senses become affected as the disease advances, especially vision, and sight is often lost, as is also hearing. Towards the end, paralysis is apt to occur.

Treatment Numerous ingenious operations have been devised for the treatment of hydrocephalus. The most satisfactory of these utilise unidirectional valves and shunts (tubes), whereby the cerebrospinal ?uid is bypassed from the brain into the right atrium of the heart or the peritoneal cavity. The shunt may have to be left in position inde?nitely.... hydrocephalus

Signs and symptoms A general malaise and depression are common, with generalised muscular weakness, anorexia and vomiting. Disturbed renal function causes increased urine output and thirst, with calcium deposits eventually leading to renal stones. Primary bone disease may cause pain and weakness, with an increased incidence of fractures, and there may be gritty deposits of calcium in the eyes. Severe hypercalcaemia produces ANURIA, with confusion and COMA leading to death.

Treatment The patient should be rehydrated and a diuretic (see DIURETICS) given. Attention should then be focused on the underlying cause – usually a parathyroid adenoma or bone tumour – and surgical removal should produce complete clinical cure, provided that advanced renal disease is not already present.... hypercalcaemia

Treatment Hypochondriacal patients may also develop physical illness, and any new symptoms must always be carefully evaluated. In most patients the condition is secondary, and treatment should be directed to the underlying depression or schizophrenia. In the rare cases of primary hypochondriasis, supportive measures are the mainstay of treatment.... hypochondriasis

Habitat: Cultivated in gardens.

Action: Stimulant, pectoral, carminative, diaphoretic, febrifuge.

Habitat: This shrub, like the Alders and the Hazel, grows in bunches as high as eight or ten feet, and is found on high lands and the stony banks of streams.

Action: Astringent and tonic.

For many years growth hormone was extracted from human corpses and very rarely this caused CREUTZFELDT-JAKOB DISEASE (CJD) in the recipients. The hormone is now genetically engineered, so safe.... growth hormone

Treatment In severely affected fetuses, a fetal blood transfusion may be required and/or the baby may be delivered early for further treatment. Mild cases may need observation only, or the reduction of jaundice by phototherapy alone (treatment with light, involving the use of sunlight, non-visible ULTRAVIOLET light, visible blue light, or LASER).

Whatever the case, the infant’s serum BILIRUBIN – the bilirubin present in the blood – and its HAEMOGLOBIN concentration are plotted regularly so that treatment can be given before levels likely to cause brain damage occur. Safe bilirubin concentrations depend on the maturity and age of the baby, so reference charts are used.

High bilirubin concentrations may be treated with phototherapy; extra ?uid is given to prevent dehydration and to improve bilirubin excretion by shortening the gut transit time. Severe jaundice and anaemia may require exchange TRANSFUSION by removing the baby’s blood (usually 10 millilitres at a time) and replacing it with rhesus-negative fresh bank blood. Haemolytic disease of the newborn secondary to rhesus incompatibility has become less common since the introduction of anti-D (Rho) immunoglobulin. This antibody should be given to all rhesus-negative women at any risk of a fetomaternal transfusion, to prevent them from mounting an antibody response. Anti-D is given routinely to rhesus-negative mothers after the birth of a rhesus-positive baby, but doctors should also give it after threatened abortions, antepartum haemorrhages, miscarriages, and terminations of pregnancy.

Occasionally haemolytic disease is caused by ABO incompatibility or that of rarer blood groups.... haemolytic disease of the newborn

has no connection with foot and mouth disease in cattle, deer, pigs and sheep.... hand, foot and mouth disease

In hospital the possible need for urgent action is monitored by use of the GLASGOW COMA SCALE.

People suffering the results of such injuries and their relatives can obtain help and advice from Headway – the brain injury association.... head injury

Stress and anxiety are probably the most common causes of headache and, where possible, the reasons – overwork, family problems, unemployment, ?nancial diffculties, etc. – should be tackled. An unpleasant environment such as tra?c pollution or badly ventilated or overcrowded working conditions may provoke headaches in some people, as may excessive smoking or ca?eine intake. MIGRAINE is a characteristic and often disabling type of headache; high blood pressure may cause the condition (see HYPERTENSION); and, occasionally, refractive errors of the eyes (see EYE, DISORDERS OF) are associated with headaches. SINUS infections are often characterised by frontal headaches. Rheumatism in the muscles of the neck and scalp produce headaches; fever is commonly accompanied by a headache; and sunstroke and HEAT STROKE customarily result in headaches. Finally, diseases in the brain such as meningitis, tumours and HAEMORRHAGE may ?rst manifest themselves as persistent or recurrent headaches.

Treatment Obtaining a reliable diagnosis – with the help of further investigations, including CT (see COMPUTED TOMOGRAPHY) or MRI scanning when indicated – should always be the initial aim; treatment in most cases should then be aimed at the underlying condition. Particular concerns include headache that worsens at night or in the early morning; ever-increasing headaches; those associated with abnormal neurological signs on examination; or those associated with ?ts (see FIT).

Whether the cause is physical or stress-induced, used sensibly and for a limited period a low dose of aspirin or paracetamol may be helpful. In many cases of stress-induced headache, however, the most e?ective treatment is relaxation. There are many speci?c treatments for migraine and hypertension. Sinusitis is treated with antibiotics and sometimes by surgery.... headache

– a group which includes morphine, codeine, pethidine and methadone. It is a powerful analgesic and cough suppressant, but its capacity to produce euphoria rapidly induces DEPENDENCE. Popular with addicts, its mostly pleasant effects soon produce TOLERANCE; the need to inject the drug, with associated risks of HIV infection, has affected its use by addicts. Withdrawal symptoms include restlessness, insomnia, muscle cramps, vomiting and diarrhoea; signs include dilated pupils, raised pulse rate, and disturbed temperature control. Although rarely life-threatening, the effects of withdrawal may cause great distress, and for this reason methadone, which has a slower and less severe withdrawal syndrome, is commonly used when weaning addicts o? heroin. Legally still available to doctors in the UK, heroin is normally only used in patients with severe pain, or to comfort the dying.... heroin

Symptoms Symptoms vary with the age of infection. In young infants, herpes simplex may cause a generalised infection which is sometimes fatal. In young children the infection is usually in the mouth, and this may be associated with enlargement of the glands in the neck, general irritability and fever. The condition usually settles in 7–10 days. In adults the vesicles may occur anywhere in the skin or mucous membranes: the more common sites are the lips, mouth and face, where they are known as cold sores. The vesicles may also appear on the genitalia (herpes genitalis) or in the conjunctiva or cornea of the EYE, and the brain may be infected, causing ENCEPHALITIS or MENINGITIS. The ?rst sign is the appearance of small painful swellings; these quickly develop into vesicles which contain clear ?uid and are surrounded by a reddened area of skin. Some people are particularly liable to recurrent attacks, and these often tend to be associated with some debilitating condition or infection, such as pneumonia.

Except in the case of herpes of the cornea, the eruption clears completely unless it becomes contaminated with some other organism. In the case of the cornea, there may be residual scarring, which may impair vision.

Treatment Aciclovir is e?ective both topically as cream or eye drops or orally. In severe systemic infections it can be given intravenously.... herpes simplex

Habitat: Indigenous to England and Eastern Europe.

Action: Stimulant, diaphoretic, diuretic, emetic.

Hyacintha, Hyacinthe, Hycinth, Hycynth, Hyacinthia, Hyacinthea, Hyacinthie, Hyacynth, Hyacyntha... hyacinth

?udrocortisone (see ADRENAL GLANDS; CORTICOSTEROIDS).... hydrocortisone

Treatment There is evidence that therapy which lowers the lipid concentration reduces the progression of premature atheroma, particularly in those who suffer from the familial disorder. Treatment should include appropriate diets, usually food that is low in cholesterol and saturated fats. There are a number of drugs available for lowering the lipid content of the plasma, but these should be reserved for patients in whom severe hyperlipidaemia is inadequately controlled by weight reduction. Anion-exchange resins – clo?brate, beza?brate and gem?brozil, for example – and statins such as atorvastatin and simvastatin, as well as nicotinic acid, all lower plasma cholesterol and plasma triglyceride concentration through their e?ect on reducing the hepatic production of lipoproteins. Cholestyramine and colestipol, both of which are anion-exchange resins, bind bile salts in the gut and so decrease the absorption of the cholesterol that these bile salts contain – hence lowering plasma cholesterol concentrations. Probucol lowers plasma cholesterol concentrations by increasing the metabolism of low-density lipoproteins.

The statins (atorvastatin, cerivastatin, ?uvastatin, pravastatin and simvastatin) inhibit an enzyme involved in synthesising cholesterol, especially in the liver. They are more e?ective than anion-exchange resins in lowering LDL (low-density lipoprotein) cholesterol – a form of low-density cholesterol carried in the bloodstream, high levels of which are believed to be the main cause of atheroma. Statins are, however, less e?ective than the clo?brate group in reducing triglycerides and raising HDL (highdensity lipoprotein) cholesterol (high-density cholesterol).... hyperlipidaemia

Hyperventilation is a manifestation of chest and heart diseases which raise carbon dioxide tension or cause HYPOXIA (e.g. severe CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) or PULMONARY OEDEMA). Mechanically ventilated patients may be hyperventilated to lower carbon dioxide tension in order to reduce INTRACRANIAL PRESSURE. (See also HYPOCAPNIA.)... hyperventilation

Indicated: German Chamomile, St John’s Wort, Balm, Valerian or Lobelia. In the form of tincture, tea, liquid extract or tablets. ... globus hystericus

Symptoms: numbness, nerves may swell like iron rods. Infected nerves kill all sensation. In endemic areas, pins and needles in hands may call attention to it. A disease of nerves rather than skin. NOTIFIABLE DISEASE.

Many laymen and practitioners will never have seen a case. In the absence of modern medicine some good can be achieved by traditional remedies. Ancient Hindu and Chinese records refer to the use of Gotu Kola (internally and externally). Dr C.D. de Granpre? (1888) refers. (Martindale 27; p.441)

Oil of Chaulmoogra was used up to one hundred years ago before introduction of modern drugs. It fell into dis-use until discovered by a Director of Health in the Philippine Islands during World War I when he used it successfully in combination with camphor. In South America, where the disease is still active, Sarsaparilla has a long traditional reputation. Walnut oil is used as a dressing, in China. An anti- staphylococcal fraction has been isolated from the seeds of Psoralea corylifolia for use in leprosy. (Indian Journal of Pharmacy 26: 141, 1964)

Tea. Gotu Kola. Half a teaspoon to each cup boiling water; infuse 15 minutes. Drink freely. Stronger infusions may be used externally to cleanse ulceration.

Decoction. Combine: Sarsaparilla 1; Gotu Kola 1; Echinacea 2. Half an ounce to 1 pint water gently simmered 20 minutes. Dose: Half a cup 3 times daily.

Formula. Echinacea 2; Sarsaparilla 1; Gotu Kola 2. Dose. Powders 500mg. Liquid Extracts 3-5ml. Tinctures 5-10ml. Thrice daily.

Note: Antibody-positive cases of AIDS are vulnerable to leprosy, both diseases being caused by a similar bacterium.

To be treated by infectious diseases specialist. ... hansen’s disease

Internal. Elderflower and Peppermint tea (catarrhal). Ginkgo tea.

Tablets/capsules. Ginkgo. Improvement reported in moderate loss.

Topical. Garlic oil. Injection of 3-4 drops at night.

Wax in the ear. Mixture: 30 drops oil Eucalyptus, 1 drop Tincture Capsicum (or 3 of Ginger), 1oz (30ml) Olive oil. Inject 4-5 drops, warm.

Black Cohosh Drops. It is claimed that John Christopher (USA) improved many cases of moderate hearing loss with topical use of 5-10 drops Liquid Extract in 1oz oil of Mullein (or Olive oil).

Pulsatilla Drops. Tincture Pulsatilla and glycerol 50/50. 2-3 drops injected at bedtime. Assists auditory nerve function. (Arthur Hyde)

Nerve deafness due to fibroma of the 8th cranial nerve, or after surgery – oral: Mistletoe tea for temporary relief. ... hearing loss

Causes: myocardial infarction, atherosclerosis, coronary thrombosis or other heart disorder.

Symptoms: slow feeble heart beats down to 36 beats per minute with fainting and collapse, breathlessness, Stoke Adams syndrome.

Treatment. Intensive care. Until the doctor comes: 1-5 drops Oil of Camphor in honey on the tongue or taken in a liquid if patient is able to drink. Freely inhale the oil. On recovery: Motherwort tea, freely. OR, Formula of tinctures: Lily of the Valley 2; Cactus 1; Motherwort 2. Mix. Dose – 30-60 drops in water thrice daily. A fitted pace-maker may be necessary.

Spartiol. 20 drops thrice daily. (Klein) ... heart block

Symptoms: heavy sweating, failure of surface circulation, low blood pressure, weakness, cramps, rapid heartbeat, face is pale, cool and moist. Collapse. Recovery after treatment is rapid.

Alternatives. Cayenne pepper, or Tincture Capsicum, to promote peripheral circulation and sustain the heart. Prickly Ash bark restores vascular tone and stimulates capillary circulation. Bayberry offers a diffusive stimulant to promote blood flow, and Cayenne to increase arterial force.

Decoction. Combine equal parts Prickly Ash and Bayberry. 1 teaspoon to each cup water gently simmered 20 minutes. Half a cup (to which 3 drops Tincture Capsicum, or few grains red pepper is added). Dose: every 2 hours.

Tablets/capsules. Prickly Ash. Bayberry. Motherwort. Cayenne.

Tinctures. Formula. Prickly Ash 2; Horseradish 1; Bayberry 1. 15-30 drops in water every 2 hours. Traditional. Horseradish juice or grated root, in honey.

Life Drops. ... heat exhaustion

Symptoms: skin hot, dry and flushed. High temperature and high humidity dispose. Sweating mechanism disorganised. Delirium, headache, shock, dizziness, possible coma, nausea, profuse sweating followed by absence of sweat causing skin to become hot and dry; rapid rise in body temperature, muscle twitching, tachycardia, dehydration.

Treatment. Hospital emergency. Reduce temperature by immersion of victim in bath of cold water. Wrap in a cold wet sheet. Lobelia, to equalise the circulation. Feverfew to regulate sweating mechanism. Yarrow to reduce temperature. Give singly or in combination as available.

Alternatives. Tea. Lobelia 1; Feverfew 2; Yarrow 2. Mix. 2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup freely. Vomiting to be regarded as favourable.

Tinctures. Combine: Lobelia 1; Pleurisy root 2; Valerian 1. Dose: 1-2 teaspoons in water every 2 hours. Decoction. Irish Moss; drink freely.

Practitioner. Tincture Gelsemium BPC (1973). Dose: 0.3ml (5 drops).

Alternate hot and cold compress to back of neck and forehead. Hot Chamomile footbath.

Diet. Irish Moss products. High salt. Abundant drinks of spring water.

Supplements. Kelp tablets, 2 thrice daily. Vitamin C (1g after meals thrice daily). Vitamin E (one 500iu capsule morning and evening).

Vitamin C for skin protection. Increasing Vitamin C after exposure to the sun should help protect against the sun’s ultra violet rays, as skin Vitamin C levels were shown to be severely depleted after exposure. (British Journal of Dermatology 127, 247-253) ... heatstroke

A lack of oestrogen induces hot flushes, night sweats, thinning of the bones (osteoporosis) with possible fractures, and a wide range of physical and emotional disorders.

HRT also prevents the increased frequency of coronary disease which may follow the menopause. With oestrogen only, HRT appears to increase the incidence of cancer of the uterine body. Use of oestrogen and progestogen avoids this.

HRT is available as a tablet, transdermal patch, implant or topical cream. Most women notice temporary improvement in their appearance and hot flushes as long as treatment is continued. HRT is not prescribed by the herbal practitioner. Soya and Hops are a mild alternative.

Side-effects of such treatment include blood pressure rise, weight gain and periods probably continue with a monthly bleed. Elderly women taking HRT for osteoporosis may develop bleeding problems, the risk of blood clot and gall bladder diseases.

Helonias has proved a useful alternative, effective in eliminating excess fluids, reducing hot flushes, and relieving that bloated feeling, thus helping the older woman to live a normal life.

Damiana. 1 heaped teaspoon leaves to each cup boiling water; infuse 5-10 minutes; strain. 1 cup 2-3 times daily for 3-6 weeks.

Sarsaparilla. 1oz (30g) root in 1 pint (500ml) water; simmer gently 20 minutes; strain. 1 cup 2-3 times daily for 3-6 weeks.

Supplementation. Daily. Vitamin E, 400iu. Vitamin B-complex (high potency). Evening Primrose oil capsules, 500mg morning and evening. Dolomite, for Calcium and Magnesium, 2 tablets morning and evening.

Note: An extensive study of breast cancer risks with HRT revealed a positive link between the risk of cancer and length of use. Risk of the disease increased with all types of women using HRT with every year of use. Pre-menstrual women were more than twice at risk. It would appear that oestrogens cannot be taken without risk. (Centre for Disease Control, Atlanta, USA) See: OESTROGENS. ... hormone replacement therapy (hrt)

Symptoms. Hard rubbery glands are general, chiefly detected under the arm and groin. Enlarged nodes may compress nearby structures to produce nerve pains. Weight loss. Accumulation of fluid in lungs and abdomen. Obstruction of bile duct leads to jaundice. Patient may be prone to shingles. High fever heralds approaching fatality. Blood count, bone marrow aspiration and node biopsy confirm. Tubercula glands may simulate Hodgkin’s disease.

Some success reported by the use of the Periwinkle plant. (vinca rosea – Vinchristine) Wm Boericke, M.D. refers to Figwort as a powerful agent in Hodgkin’s disease.

Alternatives. Although there is no known cure, emphasis on the cortex of the adrenal gland may reduce skin irritation and pain in the later stages (Gotu Kola, Liquorice, Sarsaparilla). To arrest wasting and constitutional weakness: Echinacea. Anti-pruritics, alteratives and lymphatics are indicated.

Tea. Formula. Equal parts, Nettles, Gotu Kola, Red Clover. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup 3 or more times daily.

Decoction. Formula. Equal parts – Yellow Dock, Queen’s Delight, Echinacea. 1 teaspoon to each cup water gently simmered 20 minutes. Half-1 cup 3 or more times daily.

Tablets/capsules. Poke root. Blue Flag root. Echinacea. Mistletoe.

Powders. Formula. Echinacea 2; Poke root 1; Bladderwrack 1. Dose: 500mg (two 00 capsules or one- third teaspoon) 3 or more times daily.

Tinctures. Mixture. Parts: Echinacea 2; Goldenseal quarter; Thuja quarter; Poke root half; Periwinkle 1. Dose: 1-2 teaspoons, 3 or more times daily. Where active inflammation is present – add Wild Yam 1. External. Castor oil packs to abdomen.

Treatment by a general medical practitioner or hospital specialist.

HOLISTIC MEDICINE. A school of thought which regards disease as a manifestation of an inner disturbance of the vital force, and not merely abnormality of certain groups of nerves, muscles, veins, or even the mind itself. Article 43 of Dr Samuel Hahnemann’s Organon of the Healing Art describes it:

“No organ, no tissue, no cell, no molecule is independent of the activities of the others but the life of each one of these elements is merged into the life of the whole. The unit of human life cannot be the organ, the tissue, the cell, the molecule, the atom, but the whole organism, the whole man.”

Holistic medicine relates disease to a patient’s personality, posture, diet, emotional life, and lifestyle. Treatment will be related to body, mind and spirit. It encourages a positive psychological response to the disease from which a patient suffers. For instance, its gentle approach to cancer embraces stress control, meditation, forms of visualisation and other life-enhancing skills.

Diet may be vegetarian, even vegan.... hodgkin’s disease

Supplementation. Vitamin B12.

HYDRAGOGUE. A herbal cathartic that causes watery evacuation and drastic purgation. White Bryony, American Mandrake. (Practitioner use only) ... hydatid disease

Prevention consists of minimising exposure to detergents and soapy water, and wearing rubber gloves for all routine household duties.... chapped hands

The death rate is 2–10 per cent and the majority of patients survive without renal failure. The longer the period of OLIGURIA, the greater the risk of chronic renal failure.

Treatment is supportive, with replacement of blood and clotting factors, control of HYPERTENSION, and careful observation of ?uid balance.... haemolytic uraemic syndrome

– all potentially fatal disesases.... haemophilus

Haemostatic preparations of gelatine and cellulose are used to stem bleeding from the skin and gums, or as a result of tooth extractions.... haemostatics

Electronic aids consist, essentially, of a microphone, an ampli?er, and an earphone. In postaural aids the microphone and ampli?er are contained in a small box worn behind the ear or attached to spectacles. The earphone is on a specially moulded earpiece. Some patients ?nd it di?cult to manipulate the controls of an aid worn behind the ear, and they may be better o? with a device worn on the body. Some hearing aids are worn entirely within the ear and are very discreet. They are particularly useful for people who have to wear protective headgear such as helmets.

The most sophisticated aids sit entirely within the ear canal so are virtually invisible. They may be tuned so that only the frequencies the wearer cannot hear are ampli?ed.

Many have a volume control and a special setting for use with telephone and in rooms ?tted with an inductive coupler that screens out background noise.

In making a choice therefore from the large range of e?ective hearing aids now available, the expert advice of an ear specialist must be obtained. The RNID (Royal National Institute for Deaf People) provides a list of clinics where such a specialist can be consulted. It also gives reliable advice concerning the purchase and use of hearing aids – a worthwhile function, as some aids are very expensive.... hearing aids

Heart transplant Replacement of a person’s unhealthy heart with a normal heart from a healthy donor. The donor’s heart needs to be removed immediately after death and kept chilled in saline before rapid transport to the recipient. Heart transplants are technically demanding operations used to treat patients with progressive untreatable heart disease but whose other body systems are in good shape. They usually have advanced coronary artery disease and damaged heart muscle (CARDIOMYOPATHY). Apart from the technical diffculties of the operation, preventing rejection of the transplanted heart by the recipient’s immune system requires complex drug treatment. But once the patient has passed the immediate postoperative phase, the chances of ?ve-year survival is as high as 80 per cent in some cardiac centres. A key di?culty in doing heart transplants is a serious shortage of donor organs.... heart surgery

Habitat: Cultivated fields.

Action: Diaphoretic, diuretic.

Hibiskus, Hibyscus, Hibyskus, Hybiscus, Hybiskus, Hybyscus, Hybyskus... hibiscus

c.460 to 377 BC and who taught students at the medical school in Cos. Often called the ‘father of medicine’, he is renowned for drawing up the HIPPOCRATIC OATH, some of which may have been derived from the ancient oath of the Aesclepiads. Apart from his oath, Hippocrates has about 60 other medical works attributed to him, forming a corpus which was collected around 250 BC in the famous library of Alexandria in Egypt. Hippocratic medicine appealed ‘to reason rather than to rules or to supernatural forces’ is how the late Roy Porter, the English social historian, summed up its ethos in his medical history, The Greatest Bene?t to Mankind (Harper Collins, 1997). Porter also commended Hippocrates as being patient-centred rather than disease-orientated in his practice of medicine.... hippocrates

Action: Although more popular among the old herbalists than among those of to-day. Holy Thistle is still valued for its tonic, stimulant and diaphoretic properties.

Honestey, Honesti, Honestie, Honestee, Honestea... honesty

The number of homosexual men and women in the UK is unknown. Re-analysis of the Kinsey report suggests that only 3 per cent of adult men have exclusively homosexual leanings and a further 3 per cent have extensive homosexual and heterosexual experience. Homosexuality among women (lesbianism) seems to be less common. Some homosexual men have high rates of sexual activity and multiple partners and, as with heterosexual men and women, this increases the risk of acquiring sexually transmitted diseases, unless appropriate precautionary measures are taken – for example, the use of condoms for penetrative sex, whether vaginal or anal. It was in homosexual males that the virus responsible for AIDS (see AIDS/HIV) was ?rst identi?ed, but the infection now occurs in both sexes.... homosexuality

Habitat: Horehound flourishes in dry, and particularly chalky waste ground.

Action: Aromatic and bitter, having expectorant and slight diuretic action.

Habitat: Hedgerows, waste ground.

Action: Stimulant, expectorant, diaphoretic, antispasmodic.

Carried out as two separate exercises – one by a privately funded American team; another by an international joint venture between tax-funded American laboratories, a charitably funded British one and several other smaller research teams from around the world – the ?rst results were announced on 26 June 2000. In February 2001 the privately funded American group, known as Celera Genomics, announced that it had identi?ed 26,558 genes. At the same time the Human Genome Project consortium reported that it had identi?ed 31,000. Allowing for margins of error, this gives a ?gure much lower than the 100,000 or more human genes previously forecast by scientists. Interestingly, genes were found to make up only 3 per cent of the human genome. The remaining 97 per cent of the genome comprises non-coding DNA which, though not involved in producing the protein-initiating genetic activity, does have signi?cant roles in the structure, function and evolution of the genome.

One surprise from the Project so far is that the genetic di?erences between humans and other species seem much smaller than previously expected. For example, the Celera team found that people have only 300 genes that mice do not have; yet, the common ancestor of mice and men probably lived 100 million years or more in the past. Mice and humans, however, have around twice as many genes as the humble fruit ?y.

Cells die out when they become redundant during embryonic development: genes also die out during evolution, according to evidence from the Genome Project – a ?nding that supports the constant evolutionary changes apparent in living things; the Darwinian concept of survival of the ?ttest.

Apart from expanding our scienti?c knowledge, the new information – and promise of much more as the Genome Project continues – should enhance and expand the use of genetic engineering in the prevention and cure of disease. Studies are in progress on the gene for a receptor protein in the brain which will shed light on how the important neurotransmitter SEROTONIN in the brain works, and this, for example, should help the development of better drugs for the treatment of DEPRESSION. Another gene has been found that is relevant to the development of ASTHMA and yet another that is involved in the production of amyloid, a complex protein which is deposited in excessive amounts in both DOWN’S (DOWN) SYNDROME and ALZHEIMER’S DISEASE.... human genome

Air hunger is an instinctive craving for oxygen resulting in breathlessness, either when a person ascends to great heights where the pressure of air is low, or in some diseases such as pneumonia and DIABETES MELLITUS which affect the body’s METABOLISM and therefore its need for oxygen – an essential constituent in this process.... hunger

Treatment includes the full gamut of neonatal intensive care, as well as speci?c therapy with PULMONARY SURFACTANT.... hyaline membrane disease

(2) Muscles with abnormally increased tone

(e.g. following a STROKE).... hypertonic

If required in states of chronic distress, whether induced by disease or environment, it is especially important to limit the drugs to a short time to prevent undue reliance on them, and to prevent the use of hypnotics and sedatives from becoming a means of avoiding the patient’s real problem. In many cases, such as chronic depression, overwork, and alcohol abuse, hypnotics are quite inappropriate; some form of counselling and relaxation therapy is preferable.

Hypnotics should always be chosen and prescribed with care, bearing in mind the patient’s full circumstances. They are generally best avoided in the elderly (confusion is a common problem), and in children – apart from special cases. Barbiturates should not now be used as they tend to be addictive. The most commonly used hypnotics are the BENZODIAZEPINES such as nitrazepam and temazepam; chloral derivatives, while safer for the few children who merit them, are generally second choice and should be used in the lowest possible dose for the minimum period.

Side-effects include daytime drowsiness – which may interfere with driving and other skilled tasks – and insomnia following withdrawal, especially after prolonged use, is a hazard. Occasionally benzodiazepines will trigger hostility and aggression. Zolpidem and zopiclone are two drugs similar to the benzodiazepines, indicated for short-term treatment of insomnia in the elderly. Adverse effects include confusion, incoordination and unsteadiness, and falls have been reported.

FLUNITRAZEPAM is a tranquilliser/hypnotic that has been misused as a recreational drug.... hypnotics

Hypnosis is induced by various methods, but the basis of all is some rhythmic stimulus accompanied by the repetition of carefully worded suggestions. The most commonly used method is to ask the patient to ?x his or her eye on a given spot, or light, and then to keep on repeating, in a quiet and soothing voice, that the patient’s eyes will gradually become tired and that he or she will want to close them.

There are various levels of hypnosis, usually classi?ed as light, medium, and deep, and it has been estimated that 10 per cent of people cannot be hypnotised; 35 per cent can be taken into light hypnosis; 35 per cent into medium hypnosis; and 20 per cent into deep hypnosis.

Hypnosis can be used as a treatment for some psychiatric patients and in some people with psychosomatic conditions in which emotional or psychological disturbances precipitate physical disorders such as skin lesions or headaches. Hypnosis may help to relieve pain in childbirth; asthma may also respond to it. Some people may ?nd hypnosis to be of help in overcoming addictions to smoking, alcohol or gambling. The process has associated risks, and its use in treatment should be by doctors trained in the technique.... hypnotism

Anticoagulant therapy will also cause a fall in prothrombin levels.... hypoprothrombinaemia

(2) Muscles with abnormally reduced tone.... hypotonic

The drugs used in combination are:

The receptor antagonists, which reduce the output of gastric acid by histamine H2receptor blockade; they include CIMETIDINE, FAMOTIDINE and RANITIDINE.

ANTIBIOTICS to eradicate Helicobacter pylori infection, a major cause of peptic ulceration. They are usually used in combination with one of the PROTON-PUMP INHIBITORS and include clarithomycin, amoxacillin and metronidazole.

BISMUTH chelates.

The prostaglandin analogue misoprostol has antisecretory and protective properties.

Proton-pump inhibitors omeprazole, lansoprazole, pantaprazole and rabeprazole, all of which inhibit gastric-acid secretion by blocking the proton pump enzyme system.... ulcer healing drugs

Coronary thrombosis is more common in the West because of its preference for animal fats; whereas in the East fats usually take the form of vegetable oils – corn, sunflower seed, sesame, etc. Fatty deposits (atheroma) form in the wall of the coronary artery, obstructing blood-flow. Vessels narrowed by atheroma and by contact with calcium and other salts become hard and brittle (arterio-sclerosis) and are easily blocked. Robbed of oxygen and nutrients heart muscle dies and is replaced by inelastic fibrous (scar) tissue which robs the heart of its maximum performance.

Severe pain and collapse follow a blockage. Where only a small branch of the coronary arterial tree is affected recovery is possible. Cause of the pain is lack of oxygen (Vitamin E). Incidence is highest among women over 40 who smoke excessively and who take The Pill.

The first warning sign is breathlessness and anginal pain behind the breastbone which radiates to arms and neck. Sensation as if the chest is held in a vice. First-line agent to improve flow of blood – Cactus.

For cholesterol control target the liver. Coffee is a minor risk factor.

Measuring hair calcium levels is said to predict those at risk of coronary heart disease. Low hair concentrations may be linked with poor calcium metabolism, high aortic calcium build-up and the formation of plagues. (Dr Allan MacPherson, nutritionist, Scottish Agricultural College, Ayr, Scotland)

Evidence has been advanced that a diagonal ear lobe crease may be a predictor for coronary heart disease. (American Journal of Cardiology, Dec. 1992)

Tooth decay is linked to an increased risk of coronary heart disease and mortality, particularly in young men. (Dr Frank De Stefano, Marshfield Medical Research Foundation, Wisconsin, USA) Treatment. Urgency. Send for doctor or suitably qualified practitioner. Absolute bedrest for 3 weeks followed by 3 months convalescence. Thereafter: adapt lifestyle to slower tempo and avoid undue exertion. Stop smoking. Adequate exercise. Watch weight.

Cardiotonics: Motherwort, Hawthorn, Mistletoe, Rosemary. Ephedra, Lily of the Valley, Broom.

Cardiac vasodilators relax tension on the vessels by increasing capacity of the arteries to carry more blood. Others contain complex glycosides that stimulate or relax the heart at its work. Garlic is strongly recommended as a preventative of CHD.

Hawthorn, vasodilator and anti-hypertensive, is reputed to dissolve deposits in thickened and sclerotic arteries BHP (1983). It is believed to regulate the balance of lipids (body fats) one of which is cholesterol.

Serenity tea. Equal parts: Motherwort, Lemon Balm, Hawthorn leaves or flowers. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup freely.

Decoction. Combine equal parts: Broom, Lily of the Valley, Hawthorn. 1-2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup freely.

Tablets/capsules. Hawthorn, Motherwort, Cactus, Mistletoe, Garlic.

Practitioner. Formula. Hawthorn 20ml; Lily of the Valley 10ml; Pulsatilla 5ml; Stone root 5ml; Barberry 5ml. Tincture Capsicum 1ml. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or honey.

Prevention: Vitamin E – 400iu daily.

Diet. See: DIET – HEART AND CIRCULATION.

Supplements. Daily. Vitamin C, 2g. Vitamin E possesses anti-clotting properties, 400iu. Broad spectrum multivitamin and mineral including chromium, magnesium selenium, zinc, copper.

Acute condition. Strict bed-rest; regulate bowels; avoid excessive physical and mental exertion. Meditation and relaxation techniques dramatically reduce coronary risk. ... coronary heart disease

Symptoms. Dry mouth, thirst, increased output of urine, fatigue, irritability. Alcohol increases REM (rapid eye movement) during sleep. Brain cell excitability is followed by depression.

Potassium loss may be severe, as also loss of Vitamins B, B6 and C. Bananas are rich in potassium. Alternatives. Tea. 1-2 cups Chamomile tea. Ginger. Gin-and-tonic with juice of lemon, plus teaspoon honey.

Morning-after tea. Meadowsweet (antacid) 1; Centuary (bitter) 1; Black Horehound (antiemetic) 1; Gentian (tonic) quarter; Ginger (stomach settler) quarter. Mix. 2 teaspoons to each cup boiling water; infuse 10 minutes. Drink freely.

Diet. Honey for energy. Slippery Elm gruel. Avoid coffee.

Supplements. B-complex, C, E. Essential fatty acids. Potassium, Magnesium, Selenium, Zinc.

Note: Alcohol is a strong diuretic which drains the body and brain cells of vital fluids. Alcohol also contains congeners, the chemical by-products of fermentation which have a poisonous effect upon the body. The most important treatment is water – long drinks to rehydrate the body and brain. Water also helps the kidneys and liver to wash out the poisons. ... hangover

Alternatives. Treatment. Echinacea is the key remedy.

Others indicated: Red Clover flower, Blue Flag root, Horsetail, Poke root, Bladderwrack. May be taken singly, as available.

Tea: Combine Bladderwrack 2; Echinacea 2; Horsetail 1. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup thrice daily.

Tinctures. Combine: Bladderwrack 2; Echinacea 2; Horsetail 1. Dose: one to two 5ml teaspoons in water thrice daily.

Diet. Iodised salt. Avoid cabbage which contains a factor which depresses the thyroid gland. Supplementation. Vitamin A. B-complex. Kelp. ... hashimoto’s disease

Alternatives. To sustain.

Teas. Lime flowers, Motherwort, Buckwheat, Hawthorn.

Tablets/capsules. Hawthorn, Mistletoe, Motherwort.

Formula. Hawthorn 2; Lily of the Valley 1; Selenicereus grandiflorus 1. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water morning and evening. ... heart disease – congenital

Admission to hospital is necessary for investigation and treatment.

Ultrasound scanning is used to diagnose problems with the placenta.

If the bleeding is severe, the woman is given a blood transfusion, and the baby is delivered immediately by caesarean section.... antepartum haemorrhage

Symptoms: redness, soreness, itching followed by blisters on the penis or vulva. Blisters ulcerate before crusting over. Lesions on anus of homosexual men.

Treatment by general medical practitioner or hospital specialist.

Alternatives. Sarsaparilla, Echinacea, Chaparral and St John’s Wort often give dramatic relief to itching rash. See entry: ECHINACEA.

Tea. Formula. Equal parts: Clivers, Gotu Kola, Valerian. One heaped teaspoon to each cup boiling water; infuse 5-10 minutes. Dose: 1 cup thrice daily.

Decoction. Combine: Echinacea 2; Valerian 1; Jamaican Dogwood 1. One heaped teaspoon to each cup water gently simmered 20 minutes. Half-1 cup thrice daily.

Tablets/capsules. Poke root. Valerian. Passion flower. St John’s Wort. Echinacea. Chaparral. Pulsatilla. Red Clover.

Powders. Formula. Echinacea 2; Valerian 1; Jamaica Dogwood 1. Dose: 500mg (two 00 capsules or one- third teaspoon) thrice daily.

Tinctures. Formula. Echinacea 2; Sarsaparilla 1; Thuja quarter; Liquorice quarter. Dose: 1-2 teaspoons thrice daily.

Topical. Apply any of the following 3, 4 or more times daily. Pulp or gel of Aloe Vera, Houseleek, Echinacea lotion. Garlic – apply slice of fresh corm as an antihistamine. Yoghurt compresses (improved by pinch of Goldenseal powder). Zinc and Castor oil (impressive record). Apply direct or on tampons. Diet. Porridge oats, or muesli oats.

Supplementation: same as for Shingles.

Prevention. Women should be advised to submit for an annual cytosmear. Information. Herpes Association, 41 North Road, London N7 9DP, UK. Send SAE. ... herpes, genital

The child usually becomes red or even blue in the face after a few seconds, and may faint.

Breathing quickly resumes as a natural reflex, ending the attack.

Attacks cause no damage and are usually outgrown.... breath-holding attacks

Hippocrates was aware of the universal law similia similibus curentur (like cures like). He taught that some diseases were cured by similars, and others by contraries. Stahl (1738) was also aware of this law of healing: “diseases will yield to and be cured by remedies that produce a similar affection”. But it was Samuel Hahnemann (1755-1843) who proved to the world this doctrine held the key to the selection of specifically acting medicines. His early experiments with nux vomica, arnica, ignatia and veratrum showed how the medicine which cured produced a similar condition in healthy people.

While no one has yet discovered the ‘modus operandi’ of the science, it has grown up largely through empiric experience, especially during certain historical epidemics in different parts of the world. For example, in 1836 cholera raged through most of the cities of Austria. Orthodox medicine could do little.

Out of desperation, the Government commissioned the aid of homoeopathy. A crude hospital was hastily prepared and patients admitted. Results convinced the most hardened sceptics. Physician-in-charge, Dr Fleischman, lost only 33 per cent, whereas other treatments showed a death rate of over 70 per cent.

It is said that reduction of inflammatory fevers by homoeopathic Aconite, Gelsemium, Baptisia and Belladonna played no small part in reducing the practice of blood-letting in the early 19th century.

Since Hahneman, homoeopathy has been the object of intense professional bitterness by its opponents but since the 1968 Medicines Act (UK) provision has been made for homoeopathic treatment on the “National Health Service”. Conversion of medical opinion has been gradual and today many registered medical practitioners also use the therapy.

“It is the general theory that the process of dilution and succussion (a vigorous shaking by the hand or by a machine) “potentises” a remedy.

“To prepare. A remedy is first prepared in solution as a “mother tincture”. In the decimal system of dilution a small quantity is then diluted ten times by the addition of nine parts by volume of diluent – either alcohol or water and then shaken vigorously by hand or machine (succussion). A small quantity of this is then diluted to one tenth and succussed a second time; this process is repeated again and again, producing solutions identified as 3x, 6x, 30x according to the number of times diluted. It may even be continued a thousand times (1 M). The resulting solutions are adsorbed on to an inert tablet or granules, usually of lactose, and in this form it is claimed that they remain therapeutically active indefinitely.

“For higher dilutions the centesimal system is used, when each dilution is by 1 in 100. The resulting solutions or tablets are referred to as 3C, 6C, 12C etc according to the number of times diluted.

“When dealing with a remedy which is insoluble, e.g. Carbo Veg, the first three dilutions and succussions are done in powder form, i.e. to “3x” beyond which the remedy is sufficiently soluble for further dilutions to proceed in liquid form.

“In homoeopathy a remedy may in some cases be given in a dilution so great that no single molecule of the original substance remains. The concept of “memory laden” water implies that the effect lies in a pattern impressed on the water molecules and that this is carried over from one dilution to the next.” (John Cosh MD., FRCP)

Homoeopathic medicines can stand most tests for safety, since it is widely held that they are completely safe and non-addictive, with no side-effects. ... homoeopathy

GVH disease can usually be prevented by administration of immunosuppressant drugs. If the disease develops, it can be treated with corticosteroid drugs and immunosuppressant drugs such as ciclosporin In some cases, however, it can be difficult to control.... graft-versus-host disease

Examples of haemoglobinopathies include sickle cell anaemia and the thalassaemias.... haemoglobinopathy

The causes of are not fully understood, but the disorder often runs in families, which suggests that genetic factors may be involved. is not, as popularly believed, a result of poor parenting or abuse.

Symptoms develop in early childhood, usually between the ages of 3 and 7, and may include inability to finish tasks; short attention span; inability to concentrate in class; difficulty in following instructions; a tendency to talk excessively, frequently interrupting other people; difficulty in waiting or taking turns; inability to play quietly alone; and physical impulsiveness. Children with may have difficulty in forming friendships. Self-esteem is often low because an affected child is frequently scolded and criticized.

Treatment includes behaviour modification techniques, both at home and at school. In some children, avoidance of certain foods or food additives seems to reduce symptoms. In severe cases, stimulant drugs, usually methylphenidate, may be prescribed. Paradoxically, the use of stimulants in reduces hyperactivity and improves concentration. In general, the condition improves by adolescence but may be followed by antisocial behaviour and drug abuse or substance abuse.... attention deficit hyperactivity disorder

Handedness is related to the division of the brain into 2 hemispheres, each of which controls movement and sensation on the opposite side of the body.

In most right-handed people the speech centre is in the left brain hemisphere.

Inheritance is probably the most important factor in determining handedness.... handedness

Left-sided heart failure may be caused by hypertension, anaemia, hyperthyroidism, a heart valve defect (such as aortic stenosis, aortic incompetence, or mitral incompetence), or a congenital heart defect (see heart disease, congenital). Other causes of left-sided heart failure include coronary artery disease, myocardial infarction, cardiac arrhythmias, and cardiomyopathy.

The left side of the heart fails to empty completely with each contraction, or has difficulty in accepting blood that has been returned from the lungs. The retained blood creates a back pressure that causes the lungs to become congested with blood. This condition leads to pulmonary oedema.

Right-sided heart failure most often results from pulmonary hypertension, which is itself caused by left-sided failure or by lung disease (such as chronic obstructive pulmonary disease (see pulmonary disease, chronic obstructive). Right-sided failure can also be due to a valve defect, such as tricuspid incompetence, or a congenital heart defect.

There is back pressure in the circulation from the heart into the venous system, causing swollen neck veins, enlargement of the liver, and oedema, especially of the legs and ankles. The intestines may become congested, causing discomfort.

Immediate treatment consists of bed rest, with the patient sitting up. Diuretic drugs are given, and digitalis drugs and vasodilators, especially ACE inhibitors, may also be administered. Morphine and oxygen may be given as emergency treatment in acute left-sided failure.... heart failure

Abscesses develop beneath the skin, which becomes reddened and painful and may ooze pus.

The condition tends to be recurrent and can eventually cause scarring in the affected areas.

Antibiotic drugs may help to reduce the severity of an outbreak.... hidradenitis suppurativa

The disease is rare and tends to run in families. It occurs about 4 times more often in boys. Symptoms, which include constipation and bloating, usually develop in the first few weeks of life, but may become evident in infancy or early childhood. The child usually has a poor appetite and may fail to grow properly.

A barium X-ray examination can show the narrowed segment of the intestine.

A biopsy may be taken.

Treatment of Hirschsprung’s disease involves removing the narrowed segment and rejoining the normal intestine to the anus.... hirschsprung’s disease

There are over 50 strains of human papillomavirus.

Infection with some of these strains is thought to be a causative factor in cervical cancer and anal cancer.... human papillomavirus

The chorea usually affects the face, arms, and trunk, resulting in random grimaces and twitches, and clumsiness. Dementia takes the form of irritability, personality and behavioural changes, memory loss, and apathy.

At present, there is no cure for Huntington’s disease, and treatment is aimed at reducing symptoms with drugs.... huntington’s disease

Affected children may appear normal at birth but, at 6–12 months of age, they develop cardiac abnormalities, umbilical hernia, skeletal deformities, and enlargement of the tongue, liver, and spleen.

Growth is limited and mental development slows.

If the condition is diagnosed in early infancy, a bone marrow transplant may be curative.... hurler’s syndrome

Hydralazine may cause nausea, headache, dizziness, irregular heartbeat, loss of appetite, rash, and joint pain.

Taken long term in high doses it may cause lupus erythematosus.... hydralazine

Excessive sweating may be caused by hot weather, exercise, or anxiety. In some cases it is due to an infection, thyrotoxicosis, hypoglycaemia, or a nervous system disorder. Usually, the disorder has no known cause, and begins at puberty, disappearing by the mid-20s or early 30s.

If hyperhidrosis is persistent and cannot be controlled by antiperspirants, surgery may be considered to destroy the nerve centres that control sweating.... hyperhidrosis

Hypersplenism causes anaemia and thrombocytopenia, and there may be a decrease in resistance to infection.

Primary hypersplenism is treated with splenectomy.

Treatment of secondary hypersplenism aims to control the cause.... hypersplenism

Hypertonia causes episodes of continuous muscle spasm.

Persistent hypertonia in limb muscles following a stroke or head injury leads to spasticity.... hypertonia

hyperuricaemia An abnormally high level of uric acid in the blood. Hyperuricaemia may lead to gout due to the deposition of uric acid crystals in the joints; it may also cause kidney stones (see calculus, urinary tract) and tophus.

Hyperuricaemia may be caused by an inborn error of metabolism (see metabolism, inborn errors of), by the rapid destruction of cells in a disease such as leukaemia, or by medication that reduces the excretion of uric acid by the kidneys, such as diuretic drugs. Large amounts of purine in the diet may also cause hyperuricaemia.

Drugs such as allopurinol or sulfinpyrazone are prescribed for the duration of the patient’s life. Purine-rich foods should be avoided.... hypertrichosis

Initially, there may be blurred vision, but the blood usually disappears completely within a few days and vision is restored.... hyphaema

Some psychoanalysts induce a hypnotic state as a means of helping patients remember and come to terms with disturbing events.

More often, hypnosis is used to help patients to relax.

It may be useful in people suffering from anxiety, panic attacks, or phobias, or in those wishing to correct addictive habits.... hypnosis

Hypohidrosis is a feature of hypohidrotic ectodermal dysplasia, a rare, inherited, incurable condition that is characterized by reduced sweating and is accompanied by dry, wrinkled skin, sparse hair, small, brittle nails, and conical teeth.

Other causes of hypohidrosis include exfoliative dermatitis and some anticholinergic drugs.... hypohidrosis

Normally, a muscle that is not being used has a certain inbuilt tension, but in a number of disorders affecting the nervous system (such as Huntington’s disease) this natural tension is reduced.... hypotonia

Hypovitaminosis may be due to an inadequate dietary intake or a digestive disorder that causes malabsorption.... hypovitaminosis

Act (1983) details the rights of patients with mental illness and the grounds for detaining mentally ill people against their will. It also outlines forms of legal guardianship for such patients.

When a person is endangering his or her own or other people’s health or safety (for example, threatening harm or suicide) because of a recognized mental illness, he or she may be compulsorily taken into hospital to be given treatment.

If a person breaks the law because of a mental disorder, the courts may remand him or her to hospital.... mental health act

These abnormal red cells are readily broken up when blood passes through the spleen.

At times, the rate of red cell destruction exceeds the rate at which new cells can be made in the bone marrow, leading to symptoms of anaemia.

Other symptoms include jaundice and enlargement of the spleen.

Occasionally, crises occur (usually triggered by infection) in which all symptoms worsen.

Gallstones are a frequent complication.

Splenectomy usually leads to permanent improvement.... hereditary

Usually due to trauma, it can also be a sign of infective endocarditis.... splinter haemorrhage

Umbilical hernias sometimes develop in adults, especially in women after childbirth. Surgery may be necessary for a large, persistent, or disfiguring hernia.... umbilical hernia

The vitreous humour consists almost entirely of water.... vitreous humour

An international organization established in 1948 as an agency of the United Nations with responsibilities for international health matters and public health. The headquarters are in Geneva, Switzerland.

The has campaigned effectively against some infectious diseases, most

notably smallpox, tuberculosis, and malaria.

Other functions include sponsoring medical research programmes, organizing a network of collaborating national laboratories, and providing expert advice and specific targets to its 160 member states with regard to health matters.... world health organization

• boil the dried roots of the plant ( 20 to 25 minutes)
• allow the mix to steep (5 minutes)
• drink it slowly

• fight kidney stones and bladder infections
• alleviate fever
• counter jaundice
• ease symptoms of arthritis and rheumatism
• fight gonorrhea
• treat anemia

Habitat: The alpine Himalayas from Sikkim to Garhwal and Assam.

Action: Narcotic, sedative, antilepro- tic, anti-inflammatory. Extremely poisonous. (Roots possess depressant activity, but after mitigation in cow's milk for 2-3 days, they exhibit stimulant activity.)

Habitat: Cultivated at Manali and Rahla in Himachal Pradesh. Also found in northwestern Himalayas at altitudes ranging from 2,000 to 4,000 m.

Action: Often regarded as non- poisosnous, antiperiodic, anti- inflammatory, astringent (used in cough, diarrhoea, dyspepsia), tonic (used after fevers), febrifuge, antispasmodic (used in irritability of stomach and abdominal pains).

Habitat: The western Ghats, Orissa and Sikkim up to 1,500 m.

Action: Infusion of leaves—urinary tract disinfectant, antidiabetic, spasmolytic.

Habitat: Endemic to the mountains of Balkan Peninsula and western Asia. Introduced into India; occasionally grown as an ornamental tree.

Action: Anti-inflammatory, vasodilator, astringent (used for rheumatism, venous congestion, haemorrhoids), febrifuge. Leaf— used in whooping cough.

• put the granules into a cup
• put 50-100ml boiling water into the cup and stir it with a spoon
• drink it when it is lukewarm

• treating diarrhea
• fighting malaria
• fighting asthma
• helping in the treatment of uterine bleeding or menorrhagia
• fighting scarlet fever
• fighting diphtheria
• fighting typhoid fever
• fighting palpitations, asthma and epilepsy

Habitat: Arabia, Palestine, Syria.

Action: Used in difficult labour.... anastatica hierochuntica

• place 1 teaspoon of dried andrographis in a tea infuser (10 grams of fresh leaves)
• place the infuser in a tea cup
• cover it with 1 cup of boiling water
• steep the tea for 10 minutes
• drink it slowly

• Treating gastrointestinal complains
• Treating throat infections
• Dispelling toxins
• Increasing biliary flow
• Treating coughs, headaches, edema
• Treating pain conditions, inflammation
• Treating arthritis, rheumatism
• Treating constipation
• Treating pneumonia, tuberculosis, leprosy, hepatitis, herpes, diabetes, bronchitis

Habitat: Native to Brazil, but widely grown for its pods in southern India, Maharashtra and Gujarat.

Action: Kernels—contain protease inhibitors. Peanut skin— haemostatic.

Habitat: Southern India, largely grown in gardens.

Action: Cardiac stimulant, uterine stimulant, muscle relaxant.

Habitat: Found in the plains of Punjab.

Action: Nervine tonic (used in nervous and catarrhal affections), antirheumatic, anti-inflammatory, emollient, diuretic, galactogenic.

• inflammation due to bacterial ear, nose and throat infection
• bacterial and viral forms of diarrhea
• psoriasis
• the function of the gallbladder
• urinary tract infection
• heartburn
• candida
• epilepsy

Habitat: Cultivated largely in Uttar Pradesh, Punjab, Rajasthan and Bihar.

Action: Leaves—cooling, juice rubbed on bruises. Fruit decoction—laxative, diuretic, nutritious, styptic (given for internal haemorrhages and diseases of the respiratory tract.) Juice of fruit— used for treating epilepsy, insanity and other nervous diseases. The ash of fruit rind—applied on painful swellings. Seeds—anthelmintic.

• fight headaches
• fight asthma, cough and bronchitis
• fight fever
• fight bacteria and viruses
• heal wounds, treat burns, as well as improve the growth of hair, when applied topically
• help in the treatment of excessive menstruation
• fight hemorrhages
• ease arthritic pain
• help in the treatment of premature baldness
• soothe and calm the nerves
• fight constipation among the elderly

• treat digestive problems, like gas, constipation and stomach upset
• improve appetite
• detoxify the body
• support liver and gallbladder
• stimulate menstrual flow

• stomach irritation and vomiting
• liver disease
• gastrointestinal and liver problems and esophageal or nasal cancer

• stimulate the liver and thus, it is helpful in the treatment of jaundice and hepatitis
• fight impurities of the blood
• fight against skin problems like acne and psoriasis
• detoxify the body by increasing the production of bile, as well as frequency of urination
• help treat indigestion
• treat rheumatism
• help in weight loss

It is important for a paediatrician to determine that such events are not epileptic (see EPILEPSY). Generally they require no treatment other than reassurance, as recovery is spontaneous and rapid – although a small number of severely affected children have been helped by a PACEMAKER. Parents should avoid dramatising the attacks.... breath-holding

• Pour boiling water over the desired amount of herbs.
• Cover and let them steep 10 to 20 minutes.
• Strain off the herbs using a tea strainer or coffee filter.

• soothe the skin and gastrointestinal tract
• improve appetite and digestion
• reduce liver damage
• mildly lower blood sugar (hypoglycemic effect)
• purify the blood
• fight the effects of rheumatism
• treat some kidney disorders
• counter bronchial cough and other irritations of the pulmonary tract

Habitat: Throughout the plains of India, as a wild climber.

Action: Used in rheumatism, lumbago, skeletal fractures, nervous diseases, amenorrhoea, haemorrhoids, erysipelas. The herb is used in hairoils for treating dandruff, alopecia and for darkening hair.

Habitat: Throughout tropical and sub-tropical tracts of India.

Action: Root—laxative, sudorific, alterative, antirheumatic. Leaf— used externally for eczema, prurigo and inpetigo. A decoction of leaves is taken in eczema, leucorrhoea and gonorrhoea.

History Child health services were originally designed, before the NHS came into being, to ?nd or prevent physical illness by regular inspections. In the UK these were carried out by clinical medical o?cers (CMOs) working in infant welfare clinics (later, child health clinics) set up to ?ll the gap between general practice and hospital care. The services expanded greatly from the mid 1970s; ‘inspections’ have evolved into a regular screening and surveillance system by general practitioners and health visitors, while CMOs have mostly been replaced by consultant paediatricians in community child health (CPCCH).

Screening Screening begins at birth, when every baby is examined for congenital conditions such as dislocated hips, heart malformations, cataract and undescended testicles. Blood is taken to ?nd those babies with potentially brain-damaging conditions such as HYPOTHYROIDISM and PHENYLKETONURIA. Some NHS trusts screen for the life-threatening disease CYSTIC FIBROSIS, although in future it is more likely that ?nding this disease will be part of prenatal screening, along with DOWN’S (DOWN) SYNDROME and SPINA BIFIDA. A programme to detect hearing impairment in newborn babies has been piloted from 2001 in selected districts to ?nd out whether it would be a useful addition to the national screening programme. Children from ethnic groups at risk of inherited abnormalities of HAEMOGLOBIN (sickle cell disease; thalassaemia – see under ANAEMIA) have blood tested at some time between birth and six months of age.

Illness prevention At two months, GPs screen babies again for these abnormalities and start the process of primary IMMUNISATION. The routine immunisation programme has been dramatically successful in preventing illness, handicap and deaths: as such it is the cornerstone of the public health aspect of child health, with more potential vaccines being made available every year. Currently, infants are immunised against pertussis (see WHOOPING COUGH), DIPHTHERIA, TETANUS, POLIOMYELITIS, haemophilus (a cause of MENINGITIS, SEPTICAEMIA, ARTHRITIS and epiglottitis) and meningococcus C (SEPTICAEMIA and meningitis – see NEISSERIACEAE) at two, three and four months. Selected children from high-risk groups are o?ered BCG VACCINE against tuberculosis and hepatitis vaccine. At about 13 months all are o?ered MMR VACCINE (measles, mumps and rubella) and there are pre-school entry ‘boosters’ of diphtheria, tetanus, polio, meningococcus C and MMR. Pneumococcal vaccine is available for particular cases but is not yet part of the routine schedule.

Health promotion and education Throughout the UK, parents are given their child’s personal health record to keep with them. It contains advice on health promotion, including immunisation, developmental milestones (when did he or she ?rst smile, sit up, walk and so on), and graphs – called centile charts – on which to record height, weight and head circumference. There is space for midwives, doctors, practice nurses, health visitors and parents to make notes about the child.

Throughout at least the ?rst year of life, both parents and health-care providers set great store by regular weighing, designed to pick up children who are ‘failing to thrive’. Measuring length is not quite so easy, but height measurements are recommended from about two or three years of age in order to detect children with disorders such as growth-hormone de?ciency, malabsorption (e.g. COELIAC DISEASE) and psychosocial dwar?sm (see below).

All babies have their head circumference measured at birth, and again at the eight-week check. A too rapidly growing head implies that the infant might have HYDROCEPHALUS – excess ?uid in the hollow spaces within the brain. A too slowly growing head may mean failure of brain growth, which may go hand in hand with physically or intellectually delayed development.

At about eight months, babies receive a surveillance examination, usually by a health visitor. Parents are asked if they have any concerns about their child’s hearing, vision or physical ability. The examiner conducts a screening test for hearing impairment – the so-called distraction test; he or she stands behind the infant, who is on the mother’s lap, and activates a standardised sound at a set distance from each ear, noting whether or not the child turns his or her head or eyes towards the sound. If the child shows no reaction, the test is repeated a few weeks later; if still negative then referral is made to an audiologist for more formal testing.

The doctor or health visitor will also go through the child’s developmental progress (see above) noting any signi?cant deviation from normal which merits more detailed examination. Doctors are also recommended to examine infants developmentally at some time between 18 and 24 months. At this time they will be looking particularly for late walking or failure to develop appropriate language skills.... child health

The new Council for Healthcare Regulatory Excellence will help to promote the interests of patients and to improve co-operation between the existing regulatory bodies – providing, in e?ect, a quality-control mechanism for their activities. The government and relevant professions will nominate individuals for this overarching council. The new council will not have the authority to intervene in the determination by the eight regulatory bodies of individual ?tness-to-practise cases unless these concern complaints about maladministration.... council for healthcare regulatory excellence

Habitat: Deccan Peninsula; common in the forest areas of Western Ghats.

Action: Root—appetizer, blood purifier, bacteriostatic. Used as a substitute for Shveta Saarivaa (Hemidesmus indicus). Sold as Saarivaa in Kerala, Tamil Nadu and Karnataka. The root powder is given to diabetics.

Habitat: The Western Ghats, Sikkim, Assam, Orissa and Bengal.

Action: Tubers contain 85.50% carbohydrates, 8.30% albuminoids.... dioscorea hamiltonii

Habitat: The Himalayas at Lachen and Tungu, and Sikkim.

Action: Root—used as a constituent of cardiac and nervine tonics. Used as exhilarant. Acts as a stomachic and dissolves trapped gases.... doronicum hookeri

• Helps in the treatment of kidney and bladder problems.
• Prevents and treats rheumatism, arthritis and gout.
• It is a remedy for cold and cough.
• Helps disinfecting the urinary tract.
• It is a strong allied in the treatment of cystitis.
• Tears various gastrointestinal problems.

• You shouldn’t drink too much heather tea because it can cause liver damage.
• Heather tea can alter the effects of some medications, especially the ones related to the urinary and gastro intestinal tract, so make sure you consult your doctor before drinking it.
• Pregnant and breastfeeding women should avoid drinking heather tea.

• It is most commonly used as a diuretic since washes away the toxins, having a cleansing effect to the kidneys.
• Strengthens your lungs thanks to its main component - silica acid helps strengthen the walls of the air sacs in the lungs.
• Promotes healthy hair. You can add 4 oz. of cooled horsetail tea into your shampoo or you can use the tea as a hair rinse.
• Reduces swellings and gets rid of water retention.
• Treats urinary infections.
• Helps healing and treating burns and wounds thanks to its anti-inflammatory properties.

• Pregnant or breastfeeding women are advised not to drink horsetail tea.
• If you have kidney stones, try to stay away from this tea.
• You can experience nausea, muscle weakness, fever or certain skin problems if you drink too much horsetail tea.
• Before you start drinking horsetail tea, make sure you don’t have theamine deficiency or weak heart. In case you do, do not drink this tea.

Health has driven much of environmental policy since the work of Edwin Chadwick in the early 1840s. The ?rst British public-health act was introduced in 1848 to improve housing and sanitation with subsequent provision of puri?ed water, clean milk, food hygiene regulations, vaccinations and antibiotics. In the 21st century there are now many additional environmental factors that must be monitored, researched and controlled if risks to human health are to be well managed and the impact on human morbidity and mortality reduced.

Environmental impacts on health include:

noise

air pollution

water pollution

dust •odours

contaminated ground

loss of amenities

vermin

vibration

animal diseases

Environmental risk factors Many of the major determinants of health, disease and death are environmental risk factors. Some are natural hazards; others are generated by human activities. They may be directly harmful, as in the examples of exposure to toxic chemicals at work, pesticides, or air pollution from road transport, or to radon gas penetrating domestic properties. Environmental factors may also alter people’s susceptibility to disease: for example, the availability of su?cient food. In addition, they may operate by making unhealthy choices more likely, such as the availability and a?ord-ability of junk foods, alcohol, illegal drugs or tobacco.

Populations at risk Children are among the populations most sensitive to environmental health hazards. Their routine exposure to toxic chemicals in homes and communities can put their health at risk. Central to the ability to protect communities and families is the right of people to know about toxic substances. For many, the only source of environmental information is media reporting, which often leaves the public confused and frustrated. To bene?t from public access to information, increasingly via the Internet, people need basic environmental and health information, resources for interpreting, understanding and evaluating health risks, and familiarity with strategies for prevention or reduction of risk.

Risk assessment Environmental health experts rely on the principles of environmental toxicology and risk assessment to evaluate the environment and the potential effects on individual and community health. Key actions include:

identifying sources and routes of environmental exposure and recommending methods of reducing environmental health risks, such as exposure to heavy metals, solvents, pesticides, dioxins, etc.

assessing the risks of exposure-related health hazards.

alerting health professionals, the public, and the media to the levels of risk for particular potential hazards and the reasons for interventions.

ensuring that doctors and scientists explain the results of environmental monitoring studies – for example, the results of water ?uoridation in the UK to improve dental health.

National policies In the United Kingdom in 1996, an important step in linking environment and health was taken by a government-initiated joint consultation by the Departments of Health and Environment about adding ‘environment’ as a key area within the Health of the Nation strategy. The ?rst UK Minister of State for Public Health was appointed in 1997 with responsibilities for health promotion and public-health issues, both generally and within the NHS. These responsibilities include the implementation of the Health of the Nation strategy and its successor, Our Healthy Nation. The aim is to raise the priority given to human health throughout government departments, and to make health and environmental impact assessment a routine part of the making, implementing and assessing the impact of policies.

Global environmental risks The scope of many environmental threats to human health are international and cannot be regulated e?ectively on a local, regional or even national basis. One example is the Chernobyl nuclear reactor accident, which led to a major release of radiation, the effects of which were felt in many countries. Some international action has already been taken to tackle global environmental problems, but governments should routinely measure the overall impacts of development on people and their environments and link with industry to reduce damage to the environment. For instance, the effects of global warming and pollution on health should be assessed within an ecological framework if communities are to respond e?ectively to potential new global threats to the environment.... environment and health

Habitat: Western Himalayas, Bengal and Western parts of Deccan Peninsula.

Action: Tubers—used as a substitute for Salep.... eulophia herbacea

Habitat: Throughout warmer regions of India.

Action: Pectoral, antiasthmatic, antispasmodic. Used for asthma, laryngitis, chronic nasal and bronchial catarrh; diarrhoea, dysentery, intestinal parasitosis Also used in postnatal complaints, failure of lactation. Latex— vermifuge. Used in diseases of urinogenitory tract.

Habitat: Throughout warmer regions of India, up to 1,500 m in the Himalaya.

Action: Plant—used in colic, diarrhoea and dysentery. Leaf— astringent, antidysenteric, antileuc- orrhoeic (also used in menorrhagia).

Habitat: Cultivated in the Himalayas, especially in the colder parts of Ladakh, Zaskar and Western Tibet.

Action: See F. esculentum. Duck- wheat is a better source of rutin than the common Buckwheat. It contains 45-80% more rutin than the latter, and maintains its high rutin content for a longer period.

Habitat: Mediterranean region, eastwards to India and southwards to tropical Africa.

Action: Antirheumatic.

Habitat: Sub-Himalayan tract from Chenab eastward to Bhutan and in Assam, Bengal and Orissa.

Action: See F. carica. Fruits— spasmolytic; used in aphthous complaints. Root—used for bladder and visceral troubles. Bark-decoction—used for washing ulcers; juice and powdered bark— applied to wounds and bruises. Syconium—used for ulcers of mucous membrane. Syconium and bark—antileprotic.

Habitat: Outer Himalaya from Chenab eastwards to West Bengal Assam, Central and South India and the Andaman Islands.

Action: Syconium—galactagogue. Bark and seed—purgative, emetic.

Habitat: Evergreen forests of Assam and Khasi Hills.

Action: Gum-resin—drastic hydragogue, cathartic; used for dropsical conditions. Toxic. The gum-resin contains 70-75% resins consisting mainly of alpha- and beta-garcinolic acids with gambogic acids; about 20-25% gum.

Habitat: Temperate and sub-tropical Himalayas from Kashmir to Sikkim, and in Assam and Khasi hills.

Action: Leaves—decoction is given in fevers; applied externally to swollen joints, also as a paste for headache. (Due to stringing hair, the plant causes dermatitis and is known as Bichhuu.)

Habitat: Southern parts of Uttar Pradesh adjoining Madhya Pradesh, also in Bihar and Western Ghats.

Action: Leaf—when chewed, temporarily paralyses the sense of taste for sweet and bitter substances. Plant—used as stomachic, bechic, expectorant, and in male impotency, poor lactation.

Habitat: Cultivated mainly in Maharashtra, Tamil Nadu, Andhra Pradesh and Karnataka.

Action: Root bark—diuretic, oxytocic. Bark—emmenagogue, haemostatic. Seed—demulcent, laxative, expectorant, abortifacient, galactagogue, nervine, anticepha- lalgic.

Habitat: Sub-Himalayan tract from the Indus to Nepal up to 1,500 m, also in hills of Bihar, Orissa and Tamil Nadu.

Action: Fruit and root—diuretic, antidiarrhoeal. Roots and leaves, crushed with sugar candy, are prescribed for spermatorrhoea.

Habitat: Outer range of Western Himalayas from Punjab to Kumaon.

Action: Nervine and cardiac tonic.... habenaria edgeworthii

Habitat: The Himalayan region. Found in Ranikhet.

Action: Nervine and cardiac tonic.... habenaria intermedia

• Use good quality water to prepare a good Gyokuro tea
• The optimal brewing temperature is between 122 F and 140 F degrees.
• First, preheat the cups or the teapot, because pouring the moderately warm tea into a cold cup changes its temperature.
• Pour some of the boiled water into the tea kettle and wait one or two minutes.
• Add the leaves and the remaining water.
• Use 2 table spoons of tea to approx. 4-5 ounces of water.
• Brewing time is between two and three minutes. While brewing, don’t mix, stir or shake the tea. Try to leave enough room for the leaves to expand.

• stimulate the metabolism
• burn off  calories
• lower cholesterol
• protect against various cardiovascular diseases
• soothe and relax the mind
• enhance cognition and alertness
• improve concentration
• keep one energetic
• prevent dental plaque, bacterial infections and dental decay
• freshen your breathe
• protect against bacteria

Hadennah, Hadena, Hadynna, Hadinna, Hadyna, Hadina... hadenna

Hadiyah, Hadiyyah, Haadiyah, Haadiya, Hadeeya, Hadeeyah, Hadieya, Hadieyah, Hadeiya, Hadeiyah, Hadeaya, Hadeayah... hadiya

Hadlae, Hadlay, Hadlaye... hadlai

Hadrea, Hadriana, Hadriane, Hadrianna, Hadrien, Hadrienne, Hadriah, Hadreah... hadria

Habitat: Native to tropical America and the West Indies. Grown in Indian gardens.

Action: Astringent. Used for atonic dyspepsia, diarrhoea, summer diarrhoea, dysentery, internal haemorrhages, menorrhagia, leucorrhoea. (It imparts red colour to urine and stool. Incompatible with chalk or lime-water.)

Hafwenne, Hafwin, Hafwyn, Hafwinne, Hafwynne, Hafwenn, Hafwinn, Hafwynn... hafwen

Hagae, Hagay, Hagaye, Haggai, Haggae, Hagie, Haggie, Hagi, Haggi, Hagee, Haggee, Hagea, Haggea, Hagy, Haggy, Hagey, Haggey... hagai

Haggithe, Haggyth, Haggythe, Hagith, Hagithe, Hagyth, Hagythe... haggith

Hadee, Haydee, Haydy, Haidi, Haidie, Haydi, Haydie, Haidy, Haedee, Haedi, Haedie, Haedy, Haedey, Haedea, Haidea, Haydea... haidee

Haimatie, Haimaty, Haimatey, Haimatee, Haymati, Haymatie, Haymatee, Haimatea, Haymatea... haimati

Haimie, Haimy, Haimey, Haimee, Haymi, Haymie, Haymee, Haimea, Haymea... haimi

Haiwea, Haiwie, Haiwi, Haiwy, Haiwey... haiwee

Hajnale, Hajnala, Hajnalla, Hajnalka... hajnal

Hakoz, Hakkoze, Hakoze, Hakkoza, Hakoza... hakkoz

Haldah, Haldane, Haldayn, Haldayne, Haldain, Haldaine, Haldaen, Haldaene, Haldana, Haldania, Haldanea, Halden, Haldin, Haldyn, Haldi, Haldie, Haldee, Haldea, Haldey, Haldy, Haldis... halda

Haldisa, Haldys, Haldiss, Haldisse, Haldyss, Haldysse, Halldis, Halldiss, Halldisse, Halldys, Halldyss, Halldysse... haldis

Haldorah, Haldoria, Haldorea, Haldorra, Halldora, Halldorra, Halldoria, Halldorea... haldora

Hayle, Haile, Haylan, Haylen, Hael, Haele, Hayl... hale

Haleea, Haleya, Halya... haleigha

Halett, Halet, Haleta, Halette, Halete... haletta

Halimah, Haleema, Haleemah, Haleima, Halyma, Helima, Helimah, Helyma, Heleema, Heleemah, Haleama, Haleamah, Heleama, Heleamah... halima

Halinah, Haleena, Haleenah, Halyna, Halynah, Haleina, Haleinah, Haleana, Haleanah, Haliena, Halienah, Halena, Halenah... halina

Halleluja... hallelujah

Halley, Hallie, Halle, Hallee, Hally, Halleigh, Hallea, Halleah... hallie

Causes They may be the result of intense emotion or suggestion, sensory deprivation (for example, overwork or lack of sleep), disorders of sense organs, or disorders of the central nervous system. Although hallucinations may occur in perfectly sane people, they are more commonly an indication of a MENTAL ILLNESS. They may be deliberately induced by the use of HALLUCINOGENS.... hallucinations

Haloka, Halokia, Halokea... haloke

Halonna, Halonah, Halonia, Halonea... halona

Hamathe, Hamoth, Hamothe, Hamatha, Hamotha... hamath

Hamylton, Hamilten, Hamylten, Hamiltyn, Hamyltyn... hamilton

Haniya, Haniyyah, Haniyya, Hani, Hanie, Hanee, Hany, Haney, Hanea, Haneah... haniyah

Hannabelle, Hannabell, Hannabele, Hannabela, Hannabella... hannabel

Hansyne, Hanseen, Hansinah, Hansina, Hansyna, Hannes, Hanseane, Hanseana, Hanseena... hansine

Habitat: Hills of Deccan Peninsula and parts of western and central India.

Action: Febrifuge, bitter tonic.

Haqika, Haquikah, Haquika, Haqyka... haqikah

Haraldene, Haraldina, Harolda, Haroldene, Haroldina, Haraldia, Harelda, Hareldina, Hareldene, Harelde, Harolde, Haraldyna, Haroldyna, Hareldyna, Haraldyne, Haroldyne, Hareldyne... haralda

Habitat: Dry forests of Deccan Peninsula, Central India and parts of Uttar Pradesh and Bihar.

Action: Balsam—used for sexually transmitted diseases. The balsam is similar to Copaiba balsam (Copaifera langsdorffii Desf., Leguminosae) of Brasil and is used in leucorrhoea, chronic cystitis, gonorrhoea, combined with cubebs and sandal. The resin (not the oleo-resin) is used as diuretic.

Harhure, Harhurr, Harhura, Harhurra... harhur

Harinakshie, Harynakshi, Harinakshy, Harynakshy, Harinakshea, Harynakshea, Harynakshie... harinakshi

Harlea, Harlee, Harleen, Harleigh, Harlene, Harlie, Harli, Harly... harley

Harmonie, Harmoni, Harmonee, Harmonia, Harmoney, Harmonea... harmony

Harpur, Harpar, Harpir, Harpyr... harper

Harriett, Hanriette, Hanrietta, Harriette, Harrietta, Harrette, Harriot, Harriotte, Harriotte, Harriotta, Heirierte, Heirrierte... harriet

Haruko, Haruo, Haruki, Harue... haru

Hasinah, Hasyna, Hasynah, Haseena, Haseenah, Hasiena, Hasienah, Haseina, Haseinah, Haseana, Haseanah... hasina

Hathora, Hathoria, Hathorea, Hathore... hathor

Hatitah, Hatyta, Hatytah, Hateetah, Hateeta, Hateata, Hateatah... hatita

Hausisse, Hausiss, Hausys, Hausyss, Hausysse... hausis

Havanah, Havanna, Havannah, Havane, Havann, Havanne... havana

Hayven, Havan, Hayvan, Havon, Hayvon, Havin, Hayvin, Havyn, Hayvyn, Haeven, Haevin, Haevan... haven

Hawaa, Hawwah, Hawwaa... hawwa

Hazara, Hazarah, Hazarenanna, Hazarena, Hazaryna... hazarenan

Hazargadda, Hazargada, Hazargadah... hazargaddah

Maintaining an up-to-date evidence base of ‘what works’ in public health and health improvements.

Providing useful information to health practitioners.

Commissioning research to remedy the gaps in the evidence base for medical practice.

Improving health promotion and advising on the standards for (and implementation of) public-health activities.

(See APPENDIX 7: STATUTORY ORGANISATIONS.)... health development agency (hda)

Arrhythmias An abnormal rate or rhythm of the heartbeat. The reason is a disturbance in the electrical impulses within the heart. Sometimes a person may have an occasional irregular heartbeat: this is called an ECTOPIC beat (or an extrasystole) and does not necessarily mean that an abnormality exists. There are two main types of arrhythmia: bradycardias, where the rate is slow – fewer than 60 beats a minute and sometimes so slow and unpredictable (heartblock) as to cause blackouts or heart failure; and tachycardia, where the rate is fast – more than 100 beats a minute. A common cause of arrhythmia is coronary artery disease, when vessels carrying blood to the heart are narrowed by fatty deposits (ATHEROMA), thus reducing the blood supply and damaging the heart tissue. This condition often causes myocardial infarction after which arrhythmias are quite common and may need correcting by DEFIBRILLATION (application of a short electric shock to the heart). Some tachycardias result from a defect in the electrical conduction system of the heart that is commonly congenital. Various drugs can be used to treat arrhythmias (see ANTIARRHYTHMIC DRUGS). If attacks constantly recur, the arrhythmia may be corrected by electrical removal of dead or diseased tissue that is the cause of the disorder. Heartblock is most e?ectively treated with an arti?cial CARDIAC PACEMAKER, a battery-activated control unit implanted in the chest.

Cardiomyopathy Any disease of the heart muscle that results in weakening of its contractions. The consequence is a fall in the e?ciency of the circulation of blood through the lungs and remainder of the body structures. The myopathy may be due to infection, disordered metabolism, nutritional excess or de?ciency, toxic agents, autoimmune processes, degeneration, or inheritance. Often, however, the cause is not identi?ed. Cardiomyopathies are less common than other types of heart diseases, and the incidence of di?erent types of myopathy (see below) is not known because patients or doctors are sometimes unaware of the presence of the condition.

The three recognised groups of cardiomyopathies are hypertrophic, dilated and restrictive.

•Hypertrophic myopathy, a familial condition, is characterised by great enlargement of the muscle of the heart ventricles. This reduces the muscle’s e?ciency, the ventricles fail to relax properly and do not ?ll suf?ciently during DIASTOLE.

In the dilated type of cardiomyopathy, both ventricles overdilate, impairing the e?ciency of contraction and causing congestion of the lungs.

In the restrictive variety, proper ?lling of the ventricles does not occur because the muscle walls are less elastic than normal. The result is raised pressure in the two atria (upper cavities) of the heart: these dilate and develop FIBRILLATION. Diagnosis can be di?cult and treatment is symptomatic, with a poor prognosis. In suitable patients, heart TRANSPLANTATION may be considered. Disorders of the heart muscle may also be

caused by poisoning – for example, heavy consumption of alcohol. Symptoms include tiredness, palpitations (quicker and sometimes irregular heartbeat), chest pain, di?culty in breathing, and swelling of the legs and hands due to accumulation of ?uid (OEDEMA). The heart is enlarged (as shown on chest X-ray) and ECHOCARDIOGRAPHY shows thickening of the heart muscle. A BIOPSY of heart muscle will show abnormalities in the cells of the heart muscle.

Where the cause of cardiomyopathy is unknown, as is the case with most patients, treatment is symptomatic using DIURETICS to control heart failure and drugs such as DIGOXIN to return the heart rhythm to normal. Patients should stop drinking alcohol. If, as often happens, the patient’s condition slowly deteriorates, heart transplantation should be considered.

Congenital heart disease accounts for 1–2 per cent of all cases of organic heart disease. It may be genetically determined and so inherited; present at birth for no obvious reason; or, in rare cases, related to RUBELLA in the mother. The most common forms are holes in the heart (atrial septal defect, ventricular septal defect – see SEPTAL DEFECT), a patent DUCTUS ARTERIOSUS, and COARCTATION OF THE AORTA. Many complex forms also exist and can be diagnosed in the womb by fetal echocardiography which can lead to elective termination of pregnancy. Surgery to correct many of these abnormalities is feasible, even for the most severe abnormalities, but may only be palliative giving rise to major diffculties of management as the children become older. Heart transplantation is now increasingly employed for the uncorrectable lesions.

Coronary artery disease Also known as ischaemic heart disease, this is a common cause of symptoms and death in the adult population. It may present for the ?rst time as sudden death, but more usually causes ANGINA PECTORIS, myocardial infarction (heart attack) or heart failure. It can also lead to a disturbance of heart rhythm. Factors associated with an increased risk of developing coronary artery disease include diabetes, cigarette smoking, high blood pressure, obesity, and a raised concentration of cholesterol in the blood. Older males are most affected.

Coronary thrombosis or acute myocardial infarction is the acute, dramatic manifestation of coronary-artery ischaemic heart disease – one of the major killing diseases of western civilisation. In 1999, ischaemic heart disease was responsible for about 115,000 deaths in England and Wales, compared with 153,000 deaths in 1988. In 1999 more than 55,600 people died of coronary thrombosis. The underlying cause is disease of the coronary arteries which carry the blood supply to the heart muscle (or myocardium). This results in narrowing of the arteries until ?nally they are unable to transport su?cient blood for the myocardium to function e?ciently. One of three things may happen. If the narrowing of the coronary arteries occurs gradually, then the individual concerned will develop either angina pectoris or signs of a failing heart: irregular rhythm, breathlessness, CYANOSIS and oedema.

If the narrowing occurs suddenly or leads to complete blockage (occlusion) of a major branch of one of the coronary arteries, then the victim collapses with acute pain and distress. This is the condition commonly referred to as a coronary thrombosis because it is usually due to the affected artery suddenly becoming completely blocked by THROMBOSIS. More correctly, it should be described as coronary occlusion, because the ?nal occluding factor need not necessarily be thrombosis.

Causes The precise cause is not known, but a wide range of factors play a part in inducing coronary artery disease. Heredity is an important factor. The condition is more common in men than in women; it is also more common in those in sedentary occupations than in those who lead a more physically active life, and more likely to occur in those with high blood pressure than in those with normal blood pressure (see HYPERTENSION). Obesity is a contributory factor. The disease is more common among smokers than non-smokers; it is also often associated with a high level of CHOLESTEROL in the blood, which in turn has been linked with an excessive consumption of animal, as opposed to vegetable, fats. In this connection the important factors seem to be the saturated fatty acids (low-density and very low-density lipoproteins [LDLs and VLDLs] – see CHOLESTEROL) of animal fats which would appear to be more likely to lead to a high level of cholesterol in the blood than the unsaturated fatty acids of vegetable fats. As more research on the subject is carried out, the arguments continue about the relative in?uence of the di?erent factors. (For advice on prevention of the disease, see APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELFHELP.)

Symptoms The presenting symptom is the sudden onset, often at rest, of acute, agonising pain in the front of the chest. This rapidly radiates all over the front of the chest and often down over the abdomen. The pain is frequently accompanied by nausea and vomiting, so that suspicion may be aroused of some acute abdominal condition such as biliary colic (see GALLBLADDER, DISEASES OF) or a perforated PEPTIC ULCER. The victim soon goes into SHOCK, with a pale, cold, sweating skin, rapid pulse and dif?culty in breathing. There is usually some rise in temperature.

Treatment is immediate relief of the pain by injections of diamorphine. Thrombolytic drugs should be given as soon as possible (‘rapid door to needle time’) and ARRHYTHMIA corrected. OXYGEN is essential and oral ASPIRIN is valuable. Treatment within the ?rst hour makes a great di?erence to recovery. Subsequent treatment includes the continued administration of drugs to relieve the pain; the administration of ANTIARRHYTHMIC DRUGS that may be necessary to deal with the heart failure that commonly develops, and the irregular action of the heart that quite often develops; and the continued administration of oxygen. Patients are usually admitted to coronary care units, where they receive constant supervision. Such units maintain an emergency, skilled, round-the-clock sta? of doctors and nurses, as well as all the necessary resuscitation facilities that may be required.

The outcome varies considerably. The ?rst (golden) hour is when the patient is at greatest risk of death: if he or she is treated, then there is a 50 per cent reduction in mortality compared with waiting until hospital admission. As each day passes the prognosis improves with a ?rst coronary thrombosis, provided that the patient does not have a high blood pressure and is not overweight. Following recovery, there should be a gradual return to work, care being taken to avoid any increase in weight, unnecessary stress and strain, and to observe moderation in all things. Smoking must stop. In uncomplicated cases patients get up and about as soon as possible, most being in hospital for a week to ten days and back at work in three months or sooner.

Valvular heart disease primarily affects the mitral and aortic valves which can become narrowed (stenosis) or leaking (incompetence). Pulmonary valve problems are usually congenital (stenosis) and the tricuspid valve is sometimes involved when rheumatic heart disease primarily affects the mitral or aortic valves. RHEUMATIC FEVER, usually in childhood, remains a common cause of chronic valvular heart disease causing stenosis, incompetence or both of the aortic and mitral valves, but each valve has other separate causes for malfunction.

Aortic valve disease is more common with increasing age. When the valve is narrowed, the heart hypertrophies and may later fail. Symptoms of angina or breathlessness are common and dizziness or blackouts (syncope) also occur. Replacing the valve is a very e?ective treatment, even with advancing age. Aortic stenosis may be caused by degeneration (senile calci?c), by the inheritance of two valvular leaflets instead of the usual three (bicuspid valve), or by rheumatic fever. Aortic incompetence again leads to hypertrophy, but dilatation is more common as blood leaks back into the ventricle. Breathlessness is the more common complaint. The causes are the same as stenosis but also include in?ammatory conditions such as SYPHILIS or ANKYLOSING SPONDYLITIS and other disorders of connective tissue. The valve may also leak if the aorta dilates, stretching the valve ring as with HYPERTENSION, aortic ANEURYSM and MARFAN’S SYNDROME – an inherited disorder of connective tissue that causes heart defects. Infection (endocarditis) can worsen acutely or chronically destroy the valve and sometimes lead to abnormal outgrowths on the valve (vegetations) which may break free and cause devastating damage such as a stroke or blocked circulation to the bowel or leg.

Mitral valve disease leading to stenosis is rheumatic in origin. Mitral incompetence may be rheumatic but in the absence of stenosis can be due to ISCHAEMIA, INFARCTION, in?ammation, infection and a congenital weakness (prolapse). The valve may also leak if stretched by a dilating ventricle (functional incompetence). Infection (endocarditis) may affect the valve in a similar way to aortic disease. Mitral symptoms are predominantly breathlessness which may lead to wheezing or waking at night breathless and needing to sit up or stand for relief. They are made worse when the heart rhythm changes (atrial ?brillation) which is frequent as the disease becomes more severe. This leads to a loss of e?ciency of up to 25 per cent and a predisposition to clot formation as blood stagnates rather than leaves the heart e?ciently. Mitral incompetence may remain mild and be of no trouble for many years, but infection must be guarded against (endocarditis prophylaxis).

Endocarditis is an infection of the heart which may acutely destroy a valve or may lead to chronic destruction. Bacteria settle usually on a mild lesion. Antibiotics taken at vulnerable times can prevent this (antibiotic prophylaxis) – for example, before tooth extraction. If established, lengthy intravenous antibiotic therapy is needed and surgery is often necessary. The mortality is 30 per cent but may be higher if the infection settles on a replaced valve (prosthetic endocarditis). Complications include heart failure, shock, embolisation (generation of small clots in the blood), and cerebral (mental) confusion.

PERICARDITIS is an in?ammation of the sac covering the outside of the heart. The sac becomes roughened and pain occurs as the heart and sac rub together. This is heard by stethoscope as a scratching noise (pericardial rub). Fever is often present and a virus the main cause. It may also occur with rheumatic fever, kidney failure, TUBERCULOSIS or from an adjacent lung problem such as PNEUMONIA or cancer. The in?ammation may cause ?uid to accumulate between the sac and the heart (e?usion) which may compress the heart causing a fall in blood pressure, a weak pulse and circulatory failure (tamponade). This can be relieved by aspirating the ?uid. The treatment is then directed at the underlying cause.... heart, diseases of

Heavely, Heavenly, Hevean, Hevan, Heavynne, Heavenli, Heavenlie, Heavenleigh, Heavenlee, Heavenley, Heavenlea, Heavyn... heaven

Hebrona, Hebronah, Hebrone, Hebrun... hebron

Hadvig, Hadwig, Hedvig, Hedviga, Hedvige, Hedwiga, Hedwige, Hedda, Heda, Heddi, Heddie, Hedi, Hedy, Haduwig, Hadu... hedwig

Heat collapse is characterised by fatigue, giddiness, and temporary loss of consciousness. It is accompanied by HYPOTENSION and BRADYCARDIA; there may also be vomiting and muscular cramps. Urinary volume is diminished. Recovery is usual.

Heat exhaustion is characterised by increasing weakness, dizziness and insomnia. In the majority of sufferers, sweating is defective; there are few, if any, signs of dehydration. Pulse rate is normal, and urinary output good. Body temperature is usually 37·8–38·3 °C.

Heat cramps (usually in the legs, arms or back, and occasionally involving the abdominal muscles) are associated with hard physical work at a high temperature. Sweating, pallor, headache, giddiness and intense anxiety are present. Body temperature is only mildly raised.

Heat hyperpyrexia is heralded by energy loss and irritability; this is followed by mental confusion and diminution of sweating. The individual rapidly becomes restless, then comatose; body temperature rises to 41–42 °C or even higher. The condition is fatal unless expertly treated as a matter of urgency.

Treatment With the ?rst two syndromes, the affected individual must be removed immediately to a cool place, and isotonic saline administered – intravenously in a severe case. The fourth syndrome is a medical emergency. The patient should be placed in the shade, stripped, and drenched with water; fanning should be instigated. He or she should be wrapped in a sheet soaked in cool water and fanning continued. When rectal temperature has fallen to 39 °C, the patient is wrapped in a dry blanket. Immediately after consciousness returns, normal saline should be given orally; this usually provokes sweating. The risk of circulatory collapse exists. Convalescence may be protracted and the patient should be repatriated to a cool climate. Prophylactically, personnel intended for work in a tropical climate must be very carefully selected. Adequate acclimatisation is also essential; severe physical exertion must be avoided for several weeks, and light clothes should be worn. The diet should be light but nourishing, and ?uid intake adequate. Those performing hard physical work at a very high ambient temperature should receive sodium chloride supplements. Attention to ventilation and air-conditioning is essential; fans are also of value.... heat stroke

Habitat: Hills of Tamil Nadu. Grown in gardens as an ornamental.

Action: Leaf—expectorant, anti- spasmodic, antineuralgic, vasocon- strictive.

Habitat: The Himalayas; from Kashmir to Bhutan at 1,5002,000 m and Assam at 1,3502,000 m.

Action: Leaves and berries— cathartic, diaphoretic, febrifuge, antispasmodic, expectorant. Used in whooping cough. Leaves— used in glandular enlargements. A decoction of the leaves is used topically to destroy lice in the hair. An infusion of berries is given in rheumatism. Gum— emmenagogue.

Heenie, Heeny, Heeney, Heenee, Heenea, Heani, Heanie, Heany, Heaney, Heanee, Heanea... heeni

Hehewutie, Hehewute, Hehewuty, Hehewutey, Hehewutee, Hehewutea... hehewuti

Habitat: Throughout the moist parts of India, up to 2,000 m. Also grown in gardens of Assam and South India.

Action: Anti-inflammatory, antirheumatic, febrifuge, tranquilizer.

Habitat: Central Himalaya at 1,1002,500 m, East India and hills of South India.

Action: Rhizome—carminative, spasmolytic, hepatoprotective, anti-inflammatory, antiemetic, antidiarrhoeal, analgesic, expectorant, antiasthmatic, emmenagogue, hypoglycaemic, hypotensive, antimicrobial, anthelmintic, insect- repellent.

Habitat: A weed in wet, low lands and in cultivated fields.

Action: Purifies blood, improves digestion, stimulates action of liver.

Heirnyne, Heirneine, Heirniene, Heirneene, Heirneane... heirnine

Helene, Halina, Helaine, Helana, Heleena, Helena, Helenna, Hellen, Helaina, Helenka, Heleana, Heley, Helina, Heleanor, Helenore, Helenann, HelEne, Hellena, Hellene, Hellenor, Hellia, Heli, Helli, Helie, Hella, Helle... helen

Habitat: Native to America. Cultivated in India.

Action: Seeds—build up physical endurance and resistance against diseases; a decoction is used in coughs and colds, bronchial, laryngeal and pulmonary affections, whooping cough, also as a febrifuge and diuretic.

• Improves digestion.
• Alleviates gastrointestinal spasms.
• Prevents atherosclerotic plaques.
• Helps in the treatment of rheumatism.
• Helps fight cystitis.
• Energy booster.
• Calms menstrual cramps.

• Pregnant and breastfeeding women should avoid drinking Helichrysum tea.
• Helichrysum tea may interact with the effects of certain medications or supplements, so make sure you always consult your doctor before drinking Helichrysum tea or any herbal teas.

Habitat: Dry forests throughout the country.

Action: Pods and bark—antidiar- rhoeal, astringent, antibilious. Bark and root—antigalactic, demulcent, expectorant (used in cough and asthma). Leaf—paste used against skin diseases. Pods—anthelmintic. Used in fever due to cold. Seeds— aqueous extract administered in colic and dysentery.