An aqueous extract of one or a few herbs ; a common method for preparing tea (té); typically 2 teaspoons of dried plant material (1/4 cup if fresh) in 1 cup of hot (boiling) water, infused for 10-15 minutes; technically, an infusion is not boiled, whereas when making a decoction, the herbs are boiled in water. Most Dominican herbal remedies are prepared as decoctions.... infusion

The ability to resist infection and to heal. The process may involve acquired immunity, (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).... immunity

An inflammation of the skin associated with discrete vesicles due to streptococcal infection... impetigo

Inability to perform the sexual act due to failure of the reflex mechanism... impotence

The inability to retain urine in the bladder for a reasonable length of time. It is can be caused by urethral irritation, loss of tone to the basement muscle of the bladder (the trigone), scarification or growths on the urethral lining, nerve damage, or emotional stress.... incontinence

The entry and development or multiplication of an infectious agent in the body of humans or animals. Infection is not synonymous with infectious disease; the result may be inapparent or manifest. The presence of living infectious agents on exterior surfaces of the body, or upon articles or apparel or soiled articles, is not infection but contamination of such surfaces and articles.... infection

Any agent which kills or destroys insects... insecticide

The condition of being unable to sleep... insomnia

An antiviral chemical secreted by an infected cell which strengthens the defence of nearby cells not yet infected.... interferon

See EYE.... iris

Illness, disease, or imbalances created by medical or nonmedical treatment that were not present before treatment. In medicine the therapy is blamed (not the therapist) and changed to something else. In alternative medicine it may be called a “healing crisis” and deemed good for you. Beware: if the therapy makes you feel worse in a new way, it is almost always the wrong therapy.... iatrogenic

No known cause.... idiopathic

The operation by which an arti?cial opening is made into the ILEUM and brought through the abdominal wall to create an arti?cial opening or STOMA. It is most often performed as part of the operation for cancer of the RECTUM, in which the rectum has usually to be removed. An ileostomy is then performed which acts as an arti?cial anus, to which a bag is attached to collect the waste matter. Distressing though this may at ?rst be, the vast majority of people with an ileostomy learn to lead a fully active and normal life. Help and advice in adjusting to what can be described as an ‘ileostomy life’ can be obtained from the Ileostomy and Internal Pouch Support Group.... ileostomy

The lower two-thirds of the small intestine, ending in the ileocecal valve and emptying into the cecum of the colon. The last foot of the ileum is the only absorption site available for such important dietary substances as vitamin Bl2, folic acid, some essential fatty acids, fat soluble vitamins, and recycled bile acids.... ileum

See IMMUNITY.

Age Disease and mode of administration

3 days BCG (Bacille Calmette-Guerin) by injection if tuberculosis in family in past 6 months.

2 months Poliomyelitis (oral); adsorbed diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

3 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

4 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

12–18 months Measles, mumps, and rubella (German measles)4 (given together live by injection).

(SCHOOL ENTRY)

4–5 years Poliomyelitis (oral); adsorbed diphtheria and tetanus (given together by injection); give MMR vaccine if not already given at 12–18 months.

10–14 females Rubella (by injection) if they have missed MMR.

10–14 BCG (Bacille Calmette-Guerin) by injection to tuberculin-negative children to prevent tuberculosis.

15–18 Poliomyelitis single booster dose (oral); tetanus (by injection).

1 Pertussis may be excluded in certain susceptible individuals.

2 Known as DPT or triple vaccine.

3 Haemophilus in?uenzae immunisation (type B) is being introduced to be given at same time, but di?erent limb.

4 Known as MMR vaccine. (Some parents are asking to have their infants immunised with single-constituent vaccines because of controversy over possible side-effects – yet to be con?rmed scienti?cally – of the combined MMR vaccine.)

Recommended immunisation schedules in the United Kingdom... immune system

A type of cancer treatment which involves stimulating the body’s immune system.... immunotherapy

The number of cases of disease, infection or some other event having their onset during a prescribed period of time. It is often expressed as a rate (for example, the incidence of cardiovascular disease per 1000 population aged 65-74 years during a specified year). Incidence is a measure of morbidity or other events that occur within a specified period of time. See also “prevalence”.... incidence

See DYSPEPSIA.... indigestion

An invasion by animal ectoparasites. Infestation is used more for gross parasites on the surface of the body that produce mechanical effects; infection of parasites within the body.... infestation

The condition into which tissues enter as a reaction to injury. Usually manifested by heat, pain and swelling.... inflammation

This is diagnosed when a couple has not achieved a pregnancy after one year of regular unprotected sexual intercourse. Around 15–20 per cent of couples have diffculties in conceiving; in half of these cases the male partner is infertile, while the woman is infertile also in half; but in one-third of infertile couples both partners are affected. Couples should be investigated together as e?ciently and quickly as possible to decrease the distress which is invariably associated with the diagnosis of infertility. In about 10–15 per cent of women suffering from infertility, ovulation is disturbed. Mostly they will have either irregular periods or no periods at all (see MENSTRUATION).

Checking a hormone pro?le in the woman’s blood will help in the diagnosis of ovulatory disorders like polycystic ovaries, an early menopause, anorexia or other endocrine illnesses. Ovulation itself is best assessed by ultrasound scan at mid-cycle or by a blood hormone progesterone level in the second half of the cycle.

The FALLOPIAN TUBES may be damaged or blocked in 20–30 per cent of infertile women. This is usually caused by previous pelvic infection or ENDOMETRIOSIS, where menstrual blood is thought to ?ow backwards through the fallopian tubes into the pelvis and seed with cells from the lining of the uterus in the pelvis. This process often leads to scarring of the pelvic tissues; 5–10 per cent of infertility is associated with endometriosis.

To assess the Fallopian tubes adequately a procedure called LAPAROSCOPY is performed. An ENDOSCOPE is inserted through the umbilicus and at the same time a dye is pushed through the tubes to assess their patency. The procedure is performed under a general anaesthetic.

In a few cases the mucus around the cervix may be hostile to the partner’s sperm and therefore prevent fertilisation.

Defective production is responsible for up to a quarter of infertility. It may result from the failure of the testes (see TESTICLE) to descend in early life, from infections of the testes or previous surgery for testicular torsion. The semen is analysed to assess the numbers of sperm and their motility and to check for abnormal forms.

In a few cases the genetic make-up of one partner does not allow the couple ever to achieve a pregnancy naturally.

In about 25 per cent of couples no obvious cause can be found for their infertility.

Treatment Ovulation may be induced with drugs.

In some cases damaged Fallopian tubes may be repaired by tubal surgery. If the tubes are destroyed beyond repair a pregnancy may be achieved with in vitro fertilisation (IVF) – see under ASSISTED CONCEPTION.

Endometriosis may be treated either with drugs or laser therapy, and pregnancy rates after both forms of treatment are between 40–50 per cent, depending on the severity of the disease.

Few options exist for treating male-factor infertility. These are arti?cial insemination by husband or donor and more recently in vitro fertilisation. Drug treatment and surgical repair of VARICOCELE have disappointing results.

Following investigations, between 30 and 40 per cent of infertile couples will achieve a pregnancy usually within two years.

Some infertile men cannot repair any errors in the DNA in their sperm, and it has been found that the same DNA repair problem occurs in malignant cells of some patients with cancer. It is possible that these men’s infertility might be nature’s way of stopping the propagation of genetic defects. With the assisted reproduction technique called intracytoplasmic sperm injection, some men with defective sperm can fertilise an ovum. If a man with such DNA defects fathers a child via this technique, that child could be sterile and might be at increased risk of developing cancer. (See ARTIFICIAL INSEMINATION; ASSISTED CONCEPTION.)... infertility

A specific type of acute viral respiratory infection, with one virus (many strains) and a short, nasty stay. A few thousand people die from it every year, but humans alive at present have almost universal partial resistance. It was not so during WWI, when it first began to spread. It was variously called Spanish Influenza, La Grippe, and Influenza (Italian for Influence)...everyone blamed some other country for it. The Turks and Armenians took a break from mutual mutilation and blamed it on each other, since it was killing as many people as the 1,000,000 fatalities THAT bit of genocide fostered. It ran across the world like some Bergmanesque horseman, and killed at least 20 million people before it petered out around 1925. The villages of Northern New Mexico, filled with grim and genetically toughened Spanish settlers, survivors of terrible weather, 300 years of isolation, the Inquisition and Anglo carpetbaggers, suffered fatalities that reached 40% in some places. The flu is new.... influenza

Mental disease of a grave kind... insanity

A short period of intensive rehabilitation and treatment to enable people to return home following hospitalization or to prevent admission to hospital or residential care.... intermediate care

A condition occurring in middle-aged and elderly people, which is characterised by pain in the legs after walking a certain distance. The pain is relieved by resting for a short time. It is due to arteriosclerosis (see ARTERIES, DISEASES OF) of the arteries to the leg, which results in inadequate blood supply to the muscles. Drugs usually have little e?ect in easing the pain, but useful preventive measures are to stop smoking, reduce weight (if overweight), and to take as much exercise as possible within the limits imposed by the pain.... intermittent claudication

In?ammation between two skin surfaces in contact, typically in the toe clefts, axillae, under the breasts or in the anogenital folds. Heat, friction and obesity are aggravating factors. Secondary fungal or bacterial infection with CANDIDA or bacteria is common.

Interventional Radiology

The use of radiology (see X-RAYS) to enable doctors to carry out diagnostic or treatment procedures under direct radiological vision. This X-ray procedure is used in MINIMALLY INVASIVE SURGERY (MIS) – for example, ANGIOPLASTY, the removal of stones from the kidney (see KIDNEYS, DISEASES OF), and the observation of obstructions in the bile ducts (percutaneous CHOLANGIOGRAPHY). (See also magnetic resonance imaging – MRI.)... intertrigo

Injected into or delivered through a needle in a vein.... intravenous

General condition which results following the absorption and diffusion in the body of a soluble poison... intoxication

One of two proteins secreted from the lining of the stomach whose sole purpose is (it seems) to cradle B12 in a pre-fitted styrofoam mold and (A) carry it through the Seven Levels of Digestive Hell until it reaches those few absorption sites in the last foot of small intestine that understand its “Special Needs” (sounds either sexually kinky or the airplane dinner label on kosher food for flying Hassidim jewelers) and finally (B) slip it from one protein to the other, and thence into the cell membranes where its is turn handed over to (C) the specialized blood protein that can carry it safely to the final target tissues (3 times out of 4, the bone marrow). Cyanocobalamin (B12) has parts that fall off, radicals that twirl around in five directions on three charge potentials, and is as durable as a 49¢ water pistol. And, if we have an ulcer, chronic enteritis or long-standing steatorrhea, we either get B12 shots (and hope the liver still makes that blood carrier) or walk around with pernicious anemia and a hematocrit of 16.... intrinsic factor

A non-metallic element which is found largely in seaweed. The body contains about 30 mg, largely concentrated in the THYROID GLAND where it is used to synthesise thyroid hormones. Iodine has a highly irritating action and, when applied to the skin, stains the latter dark brown and causes it to peel o? in ?akes, while internally it is a violent irritant poison in large doses.

Externally iodine is used as an antiseptic. Its drawback is that it is ?xed by protein, which reduces its antiseptic e?ciency in open wounds. Its main use in this sphere therefore is for sterilising the unbroken skin, as before an operation. Radioactive iodine is used for diagnosing and treating disease of the thyroid gland.... iodine

See UVEITIS.... iritis

Lack of tissue oxygen and nutrients usually due to impaired (arterial) blood flow.... ischaemia

A metal which is an essential constituent of the red blood corpuscles, where it is present in the form of HAEMOGLOBIN. It is also present in muscle as MYOGLOBIN, and in certain respiratory pigments which are essential to the life of many tissues in the body. Iron is absorbed principally in the upper part of the small intestine. It is then stored: mainly in the liver; to a lesser extent in the spleen and kidneys, where it is available, when required, for use in the bone marrow to form the haemoglobin in red blood corpuscles. The daily iron requirement of an adult is 15–20 milligrams. This requirement is increased during pregnancy.

Uses The main use of iron is in the treatment of iron-de?ciency anaemias (See ANAEMIA.) Iron preparations sometimes cause irritation of the gastrointestinal tract, and should therefore always be taken after meals. They sometimes produce a tendency towards constipation. Whenever possible, iron preparations should be given by mouth; if PARENTERAL administration is clinically necessary because of malabsorption, a suitable preparation is iron sorbitol injection given intramuscularly. Most patients respond successfully to oral iron preparations.... iron

The separation, for the period of communicability, of infected persons or animals from others, in such places and under such conditions as will prevent the direct or indirect conveyance of the infectious agent from those infected to those who are susceptible or who may spread the agent to others. Can also be used in relation to microorganisms (e.g. a bacterial species isolated from the patient).... isolation

Having the same salinity as body fluids. You can make a quart of water isotonic by adding a slightly rounded measuring teaspoon of table salt to a quart of water.... isotonic

All forms of illness in which psychological, emotional or behavioural disturbances are the dominating feature. The term is relative and variable in different cultures, schools of thought and definitions. It includes a wide range of types and severities.... mental illness

Body Mass Index (BMI) provides objective criteria of size to enable an estimation to be made of an individual’s level or risk of morbidity and mortality. The BMI, which is derived from the extensive data held by life-insurance companies, is calculated by dividing a person’s weight by the square of his or her height (kilograms/ metres2). Acceptable BMIs range from 20 to 25 and any ?gure above 30 characterises obesity. The Index may be used (with some modi?cation) to assess children and adolescents. (See OBESITY.)... body mass index

An outdated term for the tertiary stage of SYPHILIS.... general paralysis of the insane

Donovanosis.... granuloma inguinale

Diabetes insipidus is a relatively rare condition and must be di?erentiated from DIABETES MELLITUS which is an entirely di?erent disease.

It is characterised by excessive thirst and the passing of large volumes of urine which have a low speci?c gravity and contain no abnormal constituents. It is either due to a lack of the antidiuretic hormone normally produced by the HYPOTHALAMUS and stored in the posterior PITUITARY GLAND, or to a defect in the renal tubules which prevents them from responding to the antidiuretic hormone VASOPRESSIN. When the disorder is due to vasopressin insu?ciency, a primary or secondary tumour in the area of the pituitary stalk is responsible for one-third of cases. In another one-third of cases there is no apparent cause, and such IDIOPATHIC cases are sometimes familial. A further one-third of cases result from a variety of lesions including trauma, basal MENINGITIS and granulomatous lesions in the pituitary-stalk area. When the renal tubules fail to respond to vasopressin this is usually because of a genetic defect transmitted as a sex-linked recessive characteristic, and the disease is called nephrogenic diabetes insipidus. Metabolic abnormalities such as HYPERCALCAEMIA and potassium depletion render the renal tubule less sensitive to vasopressin, and certain drugs such as lithium and tetracycline may have a similar e?ect.

If the disease is due to a de?ciency of vasopressin, treatment should be with the analogue of vasopressin called desmopressin which is more potent than the natural hormone and has less pressor activity. It also has the advantage in that it is absorbed from the nasal mucosa and so does not need to be injected.

Nephrogenic diabetes insipidus cannot be treated with desmopressin. The urine volume can, however, usually be reduced by half by a thiazide diuretic (see THIAZIDES).... diabetes insipidus

Victims of eye injuries are advised to seek prompt medical advice if the injury is at all serious or does not resolve with simple ?rst-aid measures – for example, by washing out a foreign body using an eye bath.

Blunt injuries These may cause haemorrhage inside the eye, cataract, retinal detachment or even rupture of the eye (see also EYE, DISORDERS OF). Injuries from large blunt objects – for example, a squash ball – may also cause a ‘blow-out fracture’ of the orbital ?oor resulting in double vision. Surgical treatment may be required depending on the patient’s speci?c problems.

Chemical burns Most chemical splashes cause conjunctivitis and super?cial keratitis in the victim (see EYE, DISORDERS OF); both conditions are self-limiting. Alkalis are, however, more likely to penetrate deeper into the eye and cause permanent damage, particularly to the cornea. Prompt irrigation is important. Further treatment may involve testing the pH of the tears, topical antibiotics and CORTICOSTEROIDS, and vitamin C (drops or tablets – see APPENDIX 5: VITAMINS), depending on the nature of the injury.

Corneal abrasion Loss of corneal epithelium (outermost layer). Almost any sort of injury to the eye may cause this. The affected eye is usually very painful. In the absence of other problems, the epithelium heals rapidly: small defects may close within 24 hours. Treatment conventionally consists of antibiotic ointment and sometimes a pad over the injured eye.

Foreign bodies Most foreign bodies which hit the eye are small and are found in the conjunctival sac or on the cornea; most are super?cial and can be easily removed. A few foreign bodies penetrate deeper and may cause infection, cataract, retinal detachment or haemorrhage within the eye. The foreign body is usually removed and the damage repaired; nevertheless the victim’s sight may have been permanently damaged. Particularly dangerous activities include hammering or chiselling on metal or stone; people carrying out these activities (and others, such as hedge-cutting and grass-strimming) should wear protective goggles.... eye injuries

This is divided into food aversion, where a person simply avoids a food they dislike; food intolerance, where taking the food causes symptoms; and food allergy, where the symptoms are due to an immunological reaction. Some cases of food intolerance are due to idiosyncrasy – that is, a genetic defect in the patient, such as alactasia, where the intestine lacks the enzyme that digests milk sugar, with the result that individuals so affected develop diarrhoea when they drink milk. Intolerance to speci?c foods, as distinct from allergy, is probably quite common and may be an important factor in the aetiology of the IRRITABLE BOWEL SYNDROME (IBS).

For the diagnosis of true food allergy, it is necessary to demonstrate that there is a reproducible intolerance to a speci?c food; also, that there is evidence of an abnormal immunological reaction to it. Occasionally the allergic response may not be to the food itself but to food contaminants such as penicillin, or to food additives such as tartrazine. There may also be reactions to foods which have pharmacological effects, such as ca?eine in strong co?ee or histamine in fermented cheese, or such reactions may be due to the irritant e?ect on the intestinal mucosa (especially if it is already diseased) by, say, highly spiced curries.

Testing blood and skin for food allergy is beloved of some alternative practitioners but, in practice, the results of tests do not necessarily agree with what happens when the food is taken. Therefore, a careful history is as useful as any test in making a diagnosis.... food intolerance

Any injury to the head, whether associated with a skull fracture (see BONE, DISORDERS OF – Bone fractures) or not. Patients with head injuries should be assessed for signs of neurological damage, which may not develop at once. Patients who after a head injury are or have been UNCONSCIOUS or who are drowsy, vomiting, confused or have any focal neurological signs – for example, blurred vision or a motor or sensory malfunction – should be seen by a doctor. Particular care should be taken with individuals who have consumed alcohol and sustained a head injury in a ?ght, fall or vehicle accident. Symptoms indicative of a severe head injury may be attributed (wrongly) to the effects of alcohol, and crucial time thus lost in treating the injury.

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

One of the NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS) with analgesic properties, Ibuprofen is used to treat rheumatoid arthritis and other forms of rheumatism as well as headaches and muscular pains. It can cause gastric irritation and bleeding in susceptible individuals if used regularly.... ibuprofen

Cetraria islandica

Description: This moss grows only a few inches high. Its color may be gray, white, or even reddish.

Habitat and Distribution: Look for it in open areas. It is found only in the arctic.

Edible Parts: All parts of the Iceland moss are edible. During the winter or dry season, it is dry and crunchy but softens when soaked. Boil the moss to remove the bitterness. After boiling, eat by itself or add to milk or grains as a thickening agent. Dried plants store well.... iceland moss

Jaundice... icterus

A disorder in which the skin is permanently dry and scaly. It is usually genetically determined and several di?erent forms are recognised:

Ichthyosis vulgaris Common and inherited as a dominant trait. Beginning in early childhood, it is often associated with atopic eczema (see DERMATITIS). The limb ?exures and face are spared.

X-linked ichthyosis is much less common, more severe and appears earlier than ichthyosis vulgaris. The ?sh-like scales are larger and darker and do not spare the ?exures and face.

Ichthyosiform erythroderma Of two types and very rare: in the recessive form, the appearance at birth is of the so-called ‘collodion baby’; in the dominant form the baby is born with universally red, moist and eroded skin with an unpleasant smell. Gradually, over several months, thick scales replace the ERYTHEMA.

Treatment Minor forms are helped by constant use of EMOLLIENTS and moisturising applications. Cream containing UREA can be valuable. The rare erythrodermic patterns in the neonate require skilled intensive care as thermoregulation is disturbed and massive ?uid loss occurs through the skin. Later in childhood, oral RETINOIDS are useful.... ichthyosis

The uppermost of the three bones forming each side of the PELVIS. (See also BONE.)... ilium

A person’s own perceptions, experience and evaluation of a disease or condition, or how he or she feels. For example, an individual may feel pain, discomfort, weakness, depression or anxiety, but a disease may or may not be present.... illness

The term applied to a condition which develops as a result of prolonged immersion of the feet in cold or cool water. It was a condition commonly seen during World War II in shipwrecked sailors and airmen who had crashed into the sea, spending long periods there before being rescued. Such prolonged exposure results in VASOCONSTRICTION of the smaller arteries in the feet, leading to coldness and blueness and ?nally, in severe cases, to ulceration and GANGRENE. (See also TRENCH FOOT.)... immersion foot

Procedures which measure the concentration of any antigenic material (see ANTIGEN) to which an antibody (see ANTIBODIES) can be created. The amount of antigen bound to this antibody is proportional to the parent substance. Enzymes (see ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA)) or radioactive labels (RADIOIMMUNOASSAY) are used to measure the concentration of antigenic material.... immunoassay

The study of immune responses to the environment. Its main clinical applications include improving resistance to microbial infections (see IMMUNITY), combating the effects of impaired immunity (see IMMUNODEFICIENCY), controlling harmful immune reactions (see ALLERGY), and manipulating immune responses (see IMMUNOTHERAPY) to prevent harmful immunological responses such as graft rejection and autoimmune diseases (see AUTOIMMUNITY). The clinical study of disordered immunity now forms the allied discipline of clinical immunology, which is closely linked to the laboratory-based discipline of immunopathology.... immunology

An agent that acts to suppress the body’s natural immune response. This is totally understandable in tissue and organ transplants, and in some dangerous inflammatory conditions, but nearly all anti-inflammatory medications are immunosuppressant, including cortisone, antihistamines, and even aspirin. Some medical radicals are convinced that the chronic viral and fungal disorders of our age are partially facilitated by such medications.... immunosuppressant

An adjective meaning lack of an opening. For example, occasionally the ANUS fails to develop properly, resulting in partial or complete obstruction of the opening. Sometimes pubertal girls have an imperforate HYMEN which obstructs the opening to the VAGINA and prevents menstrual ?ow of blood draining to the exterior.... imperforate

A cut or wound; a term especially applied to surgical openings.... incision

The term for the four front TEETH of each jaw.... incisor

A term applied to irregularity of movements produced either by loss of the sensations by which they are governed, or by defects in the muscles themselves or somewhere in the nervous system.... incoordination

The time interval between exposure to an infectious agent (eg, bite) and appearance of the first sign or symptom of the disease in question.... incubation period

The ability to perform an activity with no or little help from others, including having control over any assistance required rather than the physical capacity to do everything oneself.... independence

Previously indomethacin, this is one of many drugs used in the treatment of GOUT and RHEUMATOID ARTHRITIS. A proprionic-acid derivative, it may help to relieve night pain and morning sti?ness. It is also used to treat the congenital abnormality of the heart known as DUCTUS ARTERIOSUS.... indometacin

A disease of humans or animals resulting from an infection.... infectious disease

See MONONUCLEOSIS.... infectious mononucleosis

Also known as salaam attacks, these are a rare but serious type of EPILEPSY, usually starting in the ?rst eight months of life. The spasms are short and occur as involuntary ?exing of the neck, arms, trunk and legs. They may occur several times a day. If the baby is sitting, it may collapse into a ‘salaam’ position; more usually there is a simple body jerk, sometimes accompanied by a sudden cry. An electroencephalogram (see ELECTROENCEPHALOGRAPHY (EEG)) shows a picture of totally disorganised electrical activity called hypsarrhythmia. The condition results from any one of many brain injuries, infections or metabolic insults that may have occurred before, during, or in the ?rst few months after birth. Its importance is that in most cases, the baby’s development is seriously affected such that they are likely to be left with a profound learning disability. Consequently, prompt diagnosis is important. Treatment is with CORTICOSTEROIDS or with certain anti-convulsants – the hope being that prompt and aggressive treatment might prevent further brain damage leading to learning disability.... infantile spasms

A patient’s/client’s explicit agreement to the care and treatment to be provided, based on full information on his or her condition/diagnosis, the existing options for treatment and the possible beneficial and adverse effects of those options.... informed consent

(1) The act of taking ?uid, food, or medicine into the stomach. (2) The way in which a phagocytic cell surrounds and absorbs foreign substances such as bacteria in the blood.... ingestion

The sides of the toenail curve downwards, resulting in in?ammation of the skin next to the nail which spreads to the base of the nail. The skin and nail base may become painful and badly infected. If antibiotics and local dressing do not cure the condition, surgery to remove part of the nail will be required.... ingrowing toenail

An extrusion of the abdominal PERITONEUM, sometimes containing a loop of bowel, through natural openings in the region of either groin (see HERNIA).... inguinal hernia

A method of applying drugs in a ?nely divided or gaseous state, so that, when breathed in, they may come into contact with the nose, throat and lungs. There are two chief means by which drugs are mingled with the air and so taken in by breathing: these are traditional steam inhalations, and modern aerosol devices which deliver a ?ne spray direct into the mouth. (See INHALANTS; INHALER.)... inhalation

Inhibition means arrest or restraint of some process e?ected by nervous in?uence. The term is applied to the action of certain inhibitory nerves: for example, the vagus nerve which contains ?bres that inhibit or control the action of the heart. The term is also applied generally to the mental processes by which instinctive but undesirable actions are checked by a process of self-control.... inhibition

The process by which infective material is brought into the system through a small wound in the skin or in a mucous membrane. Many infectious diseases are contracted by accidental inoculation of microbes – as is blood-poisoning (see SEPTICAEMIA). Inoculation is now used as a preventive measure against many infectious diseases. (See also VACCINE.)... inoculation

An o?cial inquiry conducted by a CORONER into the cause of an individual’s death. The coroner is a judicial o?cer who, when a death is sudden, unexpected or occurs in suspicious circumstances, considers the results of medical and legal investigation and, sitting with a jury or on his or her own, makes the conclusions public. He/she has wide powers, and, in deaths of uncertain cause, no o?cial death certi?cate can be issued without his or her approval. A coroner may be legally or medically quali?ed (or both). In Scotland the comparable o?cer is the procurator ?scal.... inquest

A person’s knowledge of him or herself. The description is especially relevant to a person’s realisation that he or she has psychological dif?culties. Thus, someone with a psychosis (see MENTAL ILLNESS) lacks insight. Insight also refers to an individual’s concept of his or her personality and problems.... insight

A tumour in the beta cells in the Islets of Langerhans in the PANCREAS that produces insulin. Symptoms of HYPOGLYCAEMIA occur. Treatment is surgical removal or oral administration of diazoxide.... insulinoma

A POLYPEPTIDE hormone (see HORMONES) produced in the PANCREAS by the beta cells of the ISLETS OF LANGERHANS. It plays a key role in the body’s regulation of CARBOHYDRATE, FAT, and PROTEIN, and its de?ciency leads to DIABETES MELLITUS. Diabetic patients are described as type 1 (insulin dependent), or type 2 (non-insulin dependent), although many of the latter may need insulin later on, in order to maintain good control.

Insulin is extracted mainly from pork pancreas and puri?ed by crystallisation; it may be made biosynthetically by recombinant DNA technology using Escherichia coli, or semisynthetically by enzymatic modi?cation of porcine insulin to produce human insulin. The latter is the form now generally used, although some patients ?nd it unsuitable and have to return to porcine insulin.

The hormone acts by enabling the muscles and other tissues requiring sugar for their activity to take up this substance from the blood. All insulin preparations are to a greater or lesser extent immunogenic in humans, but immunological resistance to insulin action is uncommon.

Previously available in three strengths, of 20, 40, and 80 units per millilitre (U/ml), these have now largely been replaced by a standard strength of 100 U/ml (U100). Numerous different insulin preparations are listed; these differ in their speed of onset and duration of action, and hence vary in their suitability for individual patients.

Insulin is inactivated by gastrointestinal enzymes and is therefore generally given by subcutaneous injection, usually into the upper arms, thighs, buttocks, or abdomen. Some insulins are also available in cartridge form, which may be administered by injection devices (‘pens’). The absorption may vary from di?erent sites and with strenuous activity. About 25 per cent of diabetics require insulin treatment: most children from the onset, and all patients presenting with ketoacidosis. Insulin is also often needed by those with a rapid onset of symptoms such as weight loss, weakness, and sometimes vomiting, often associated with ketonuria.

The aim of treatment is to maintain good control of blood glucose concentration, while avoiding severe HYPOGLYCAEMIA; this is usually achieved by a regimen of preprandial injections of short-acting insulin (often with a bedtime injection of long-acting insulin). Insulin may also be given by continuous subcutaneous infusion with an infusion pump. This technique has many disadvantages: patients must be well motivated and able to monitor their own blood glucose, with access to expert advice both day and night; it is therefore rarely used.

Hypoglycaemia is a potential hazard for many patients converting from porcine to human insulin, because human insulin may result in them being unaware of classical hypoglycaemic warning symptoms. Drivers must be particularly careful, and individuals may be forbidden to drive if they have frequent or severe hypoglycaemic attacks. For this reason, insurance companies should be warned, and diabetics should – after taking appropriate medical advice – either return to porcine insulin or consider stopping driving.... insulin

The ?brous disc that acts as a cushion between the bony vertebrae (see SPINAL COLUMN), enabling them to rotate and bend one on another. The disc tends to degenerate with age and may get ruptured and displaced – prolapsed or slipped disc – as a result of sudden strenuous action. Prolapsed disc occurs mainly in the lower back; it is more common in men than in women, and in the 30–40 age group.... intervertebral disc

All the alimentary canal beyond below the stomach. In it, most DIGESTION is carried on, and through its walls all the food material is absorbed into the blood and lymph streams. The length of the intestine in humans is about 8·5–9 metres (28–30 feet), and it takes the form of one continuous tube suspended in loops in the abdominal cavity.

Divisions The intestine is divided into small intestine and large intestine. The former extends from the stomach onwards for 6·5 metres (22 feet) or thereabouts. The large intestine is the second part of the tube, and though shorter (about 1·8 metres [6 feet] long) is much wider than the small intestine. The latter is divided rather arbitrarily into three parts: the duodenum, consisting of the ?rst 25–30 cm (10–12 inches), into which the ducts of the liver and pancreas open; the jejunum, comprising the next 2·4–2·7 metres (8–9 feet); and ?nally the ileum, which at its lower end opens into the large intestine.

The large intestine begins in the lower part of the abdomen on the right side. The ?rst part is known as the caecum, and into this opens the appendix vermiformis. The appendix is a small tube, closed at one end and about the thickness of a pencil, anything from 2 to 20 cm (average 9 cm) in length, which has much the same structure as the rest of the intestine. (See APPENDICITIS.) The caecum continues into the colon. This is subdivided into: the ascending colon which ascends through the right ?ank to beneath the liver; the transverse colon which crosses the upper part of the abdomen to the left side; and the descending colon which bends downwards through the left ?ank into the pelvis where it becomes the sigmoid colon. The last part of the large intestine is known as the rectum, which passes straight down through the back part of the pelvis, to open to the exterior through the anus.

Structure The intestine, both small and large, consists of four coats, which vary slightly in structure and arrangement at di?erent points but are broadly the same throughout the entire length of the bowel. On the inner surface there is a mucous membrane; outside this is a loose submucous coat, in which blood vessels run; next comes a muscular coat in two layers; and ?nally a tough, thin peritoneal membrane. MUCOUS COAT The interior of the bowel is completely lined by a single layer of pillar-like cells placed side by side. The surface is increased by countless ridges with deep furrows thickly studded with short hair-like processes called villi. As blood and lymph vessels run up to the end of these villi, the digested food passing slowly down the intestine is brought into close relation with the blood circulation. Between the bases of the villi are little openings, each of which leads into a simple, tubular gland which produces a digestive ?uid. In the small and large intestines, many cells are devoted to the production of mucus for lubricating the passage of the food. A large number of minute masses, called lymph follicles, similar in structure to the tonsils are scattered over the inner surface of the intestine. The large intestine is bare both of ridges and of villi. SUBMUCOUS COAT Loose connective tissue which allows the mucous membrane to play freely over the muscular coat. The blood vessels and lymphatic vessels which absorb the food in the villi pour their contents into a network of large vessels lying in this coat. MUSCULAR COAT The muscle in the small intestine is arranged in two layers, in the outer of which all the ?bres run lengthwise with the bowel, whilst in the inner they pass circularly round it. PERITONEAL COAT This forms the outer covering for almost the whole intestine except parts of the duodenum and of the large intestine. It is a tough, ?brous membrane, covered upon its outer surface with a smooth layer of cells.... intestine

A procedure consisting in the introduction, through the mouth or nose into the larynx, of a tube designed to keep the air passage open at this point.... intubation

Pre?x indicating inside or within. For example, intracellular: within a cell; intra-articular: within a joint.... intra

A form of obstruction of the bowels in which part of the INTESTINE enters within that part immediately beneath it. This can best be understood by observing what takes place in the ?ngers of a tightly ?tting glove as they turn outside-in when the glove is pulled o? the hand. Mostly, the condition affects infants. Often it occurs during the course of a viral infection or a mild attack of gastroenteritis, or it may be that swelling of lymphoid tissue in the gut provokes the event. The point at which it most often occurs is the junction between the small and the large intestines, the former passing within the latter. The symptoms are those of intestinal obstruction in general (see INTESTINE, DISEASES OF – Obstruction), and in addition there is often a discharge of blood-stained mucus from the bowel. Unless the symptoms rapidly subside, when it may be assumed that the bowel has righted itself, treatment consists of either hydrostatic reduction by means of a barium or air ENEMA, or an operation. At operation the intussusception is either reduced or, if this not possible, the obstructed part is cut out and the ends of the intestine then stitched together. If treated adequately and in time, the mortality is now reduced to around 1 per cent. The condition may recur in about 5 per cent of patients.... intussusception

The root of Cephaëlis ipecacuanha, a Brazilian shrub. It contains an alkaloid, emetine, which acts as an irritant when brought into contact with the interior of the stomach, producing vomiting. Formerly used to induce vomiting among young children after poisoning and if still alert, but now of uncertain value, it was used in many traditional expectorant mixtures

(see EXPECTORANTS) given in the treatment of BRONCHITIS. (See POISONS.)... ipecacuanha

The operation by which a hole is made in the iris of the EYE – as, for example, in the treatment of GLAUCOMA or as part of CATARACT surgery.... iridectomy

(IBS) This is a common and generally benign condition of the colon, taking different forms but usually characterized by alternating constipation and diarrhea. There is often some pain accompanying the diarrhea phase. The bowel equivalent of spasmodic asthma, its main cause is stress, often accompanied by a history of GI infections. Adrenalin stress slows the colon and causes constipation, followed by a cholinergic rebound overstimulation of the colon. It is also called spastic colon, colon syndrome, mucous colitis, even chronic colitis. True colitis is a potentially or actually serious pathology.... irritable bowel syndrome

An agent that causes inflammation... irritant

Ischium is the bone which forms the lower and hinder part of the pelvis. It bears the weight of the body in sitting.... ischium

The use of naturally occurring isotopes, or arti?cially produced X-rays, in the killing of tumour cells. The amount of radiation is the adsorbed dose; the SI unit is the gray (Gy).

Di?erent tumours seem to be particularly sensitive to radiation; radiotherapy plays an important role in the management of germ-cell tumours (SEMINOMA; TERATOMA) and lymphomas (see LYMPHOMA). Many head and neck tumours, gynaecological cancers, and localised prostate and bladder cancers are curable with radiotherapy. It may be used to reduce the pain

– for example, from bone metastases.

Unwanted effects Generalised: lethargy, loss of appetite. Skin: ERYTHEMA, dry desquamation with itching, moist desquamation. Patients should keep the treated area(s) dry and clean and avoid soap, antiseptic mouthwashes, smoking and spicy food if possible. (See ISOTOPE; RADIATION SICKNESS; RADIOTHERAPY).... irradiation

One of the anti-tuberculous drugs. It has the advantages of being relatively non-toxic and of being active when taken by mouth. Unfortunately, like streptomycin, it may render the Mycobacterium tuberculosis resistant to its action. This tendency to produce resistance is considerably reduced if it is given in conjunction with RIFAMPICIN and PYRAZINAMIDE.... isoniazid

See PRURITUS.... itching

A triazole antifungal drug taken orally for oropharyngeal and vulvovaginal CANDIDA, PITYRIASIS versicolor, and tinea corporis and pedis (see under RINGWORM). It is also used for systemic fungal infections such as ASPERGILLOSIS, candidiasis and cryptococcosis where other fungicidal drugs have not worked. Itraconazole is metabolised in the liver so should not be given to patients who have or have had liver disease. The drug can be given as maintenance treatment of AIDS (see AIDS/HIV) patients to prevent resurgence of underlying fungal disease to which they are vulnerable. (See FUNGAL AND YEAST INFECTIONS.)... itraconazole

is due to lack in the INTESTINE of the ENZYME known as LACTASE which is responsible for the digestion of lactose, the sugar in milk. The result is that drinking milk or eating milk-containing products is followed by nausea, a sensation of bloating, or distension, in the gut, abdominal pain and diarrhoea. (Similar disturbances after taking milk may also occur in those who do not lack lactase but have an allergy to milk protein). Treatment is by means of a low-lactose diet avoiding fresh or powdered milk and milk puddings. Many can tolerate fermented milk products, as well as the small amounts of milk used in baking and added to margarine and sausages. However, infamts may have to be fed exclusively on a lactose-free formula as even breast milk may produce symptoms.... lactose intolerance

See HEART, DISEASES OF – Coronary thrombosis.... myocardial infarction

A hereditary disease due to an inherited abnormality of COLLAGEN. It is characterised by extreme fragility of the skeleton, resulting in fractures and deformities. It may be accompanied by blue sclera (the outermost, normally white coat of the eyeball), transparent teeth, hypermobility (excessive range of movement) of the joints, deafness, and dwar?sm (shortness of stature). The exact cause is not known, although there is some evidence that it may be associated with collagen formation. Parents of affected children can obtain help and advice from the Brittle Bone Society.... osteogenesis imperfecta

(PID) Also called salpingitis, the term is applied to infections of the fallopian tubes that follow or are concurrent with uterine and cervical infections. Gonorrhea and Chlamydia are the most common organisms, and the infection is usually begun through sexual contact, although metabolic imbalances, subtler systemic infections like a slow virus, the local insult of herpes or candidiasis, the sequela of medication or recreational drugs, birth control pills, even an IUD...all can alter the vaginal flora and induce inflammation sufficient to allow an endogenous organism to start the infection. PID after birth, on the other hand, is usually the result of staph or strep infections infecting injured membranes.... pelvic inflammatory disease

An injury to the neck region caused by the neck being forcibly bent backwards and forwards (or the other way around). Car accidents are a common cause, when a driver or passenger is suddenly decelerated. The injury usually affects the ligaments, spinal joints and soft tissues of the neck. Subluxation (partial dislocation) of a cervical joint sometimes occurs and cervical vertebra may occasionally be fractured if the forces are severe. Pain and sti?ness of the neck result and these may worsen after a day or so. Treatment includes immobilisation of the neck in a collar, and analgesic and muscle-relaxing drugs. PHYSIOTHERAPY may be necessary. The patient usually recovers fully but may take several weeks to do so.... whiplash injury

See also REGURGITATION. This is the back ?ow of blood through the AORTIC VALVE of the HEART into the left ventricle, caused by an incompetent valve. The failure to close may be caused by a congenital defect or by damage from disease. The defect may be cured by surgical replacement of the damaged valve with an arti?cial valve. (See HEART, DISEASES OF.)... aortic incompetence

A drug that curbs the action of an ENZYME in the blood controlling the production of carbonic acid or bicarbonate from CARBON DIOXIDE (CO2). Called carbonic anhydrase, the enzyme is present in ERYTHROCYTES and it has a key part in maintaining the acid-base balance in the blood. Inhibiting drugs include ACETAZOLAMIDE and DORZOLAMIDE, and these are used as weak DIURETICS to reduce the increased intraocular pressure in ocular hypertension or open-angle GLAUCOMA (see EYE, DISORDERS OF).... carbonic anhydrase inhibitor

Washing out the large bowel with an ENEMA of water or other medication.... colonic irrigation

A range of values for a variable of interest, e.g. a rate, constructed so that this range has a specified probability of including the true value of the variable. The specified probability is called the confidence level, and the end points of the confidence interval are called the confidence limits.... confidence interval

The personal cost of acute or chronic disease. The cost to the patient may be an economic, social or psychological cost or loss to himself, his family or community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, quality of life, etc. It differs from health care costs in that this concept is restricted to the cost of providing services related to the delivery of health care, rather than the impact on the personal life of the patient. See “burden of disease”.... cost of illness

Use of the SEMEN of an anonymous donor to produce fertilisation in cases of INFERTILITY where the male partner has OLIGOSPERMIA or IMPOTENCE. The donor is chosen for ethnic and physiognomic similarity to the male partner and is screened for transmissible diseases

(e.g. HIV, syphilis, hepatitis, gonorrhoea, and genetic disorders). Insemination is performed at the time of ovulation by introducing the semen into the upper vagina. Semen may be fresh or have been stored frozen in liquid nitrogen. (See ARTIFICIAL INSEMINATION.)... donor insemination

Also known as caisson disease, this affects workers operating in compressed-air environments, such as underwater divers and workers in caissons (such as an ammunition wagon, a chest of explosive materials, or a strong case for keeping out the water while the foundations of a bridge are being built; derived from the French caisse, meaning case or chest). Its chief symptoms are pains in the joints and limbs (bends); pain in the stomach; headache and dizziness; and paralysis. Sudden death may occur. The condition is caused by the accumulation of bubbles of nitrogen in di?erent parts of the body, usually because of too-rapid decompression when the worker returns to normal atmospheric presure – a change that must be made gradually.... compressed air illness

This is a structured, multi-disciplinary process for assessing and improving the health consequences of projects and policies in the non-health sector. It combines a range of qualitative and quantitative evidence in preparing conclusions. Applications of the assessments include appraisal of national policies, local urban planning, and the progress of transport, water and agricultural projects.... health impact assessment

A level of immunity found in a community of animals/humans and related to a particular infection to which the community has been exposed.... herd immunity

Another method of helping infertile couples. In over half of women diagnosed as infertile, the Fallopian tubes are normal, and in many it is unknown why they cannot conceive – although some have ENDOMETRIOSIS.

Eggs are obtained and mixed with the partner’s semen, then introduced into the woman’s Fallopian tubes for fertilisation to take place. The fertilised egg travels to the uterus where IMPLANTATION occurs and pregnancy proceeds. A variation of GIFT is zygote intrafallopian transfer (ZIFT) in which early development of the fertilised eggs happens in the laboratory before the young embryo is transferred to the Fallopian tubes. GIFT is best used in couples with unexplained infertility or with minor degrees of male or female cervical factor infertility. The success rate is about 17 per cent. (See also ARTIFICIAL INSEMINATION.)... gamete intrafallopian transfer (gift)

Disease induced by a physician: most commonly a drug-induced disease.... iatrogenic disease

Ictus is another term for a STROKE.... ictus

See MULTIPLE BIRTHS.... identical twins

A generally unexpected, so unpredictable, abnormal reaction to a drug caused by a constitutional defect in the patient. In some cases the underlying disorder is already known or discovered after the ?rst event, so that the drug in question can be avoided thereafter. The abnormal sensitivity of patients with PORPHYRIAS to BARBITURATES is an example. Hereditary biochemical defects of red blood cells are responsible for many drug-induced haemolytic anaemias (see under ANAEMIA) and for FAVISM. Porphyria variegata, the South African variety of porphyria, is an example of an inborn error of metabolism which was without serious symptoms until the advent of barbiturate drugs, prescription of which is now strongly discouraged. If anyone with this metabolic disorder takes barbiturates, the consequences may be fatal.... idiosyncrasy

See CYTOTOXIC.... ifosfamide

In?ammation of the ileum – the lower part of the small INTESTINE. It may be caused by CROHN’S DISEASE, typhoid fever (see ENTERIC FEVER), TUBERCULOSIS or the bacterium Yersinia enterocolitica. Ileitis may also accompany ULCERATIVE COLITIS (see also INFLAMMATORY BOWEL DISEASE (IBD)).

Patients and their relatives can obtain help and guidance from the National Association for Colitis and Crohn’s Disease.... ileitis

Paralysis of the bowel muscle (see INTESTINE, DISEASES OF).... ileus

A well-established, relatively safe tricyclic antidepressant (see ANTIDEPRESSANT DRUGS) used to treat DEPRESSION; the drug does, however, have antimuscarinic and cardiac side-effects. It is also used to treat ENURESIS by an action distinct from its antidepressant e?ect.... imipramine

The characteristic of a substance that can provoke an immune response (see IMMUNITY). This includes how ‘foreign’ a substance entering or contacting the body is; route of entry; dose; number and period of exposure to antigen; and the genetic make-up of the host. The characteristics of molecules that determine immunogenicity are:

Foreignness: molecules recognised as ‘self’ are generally not immunogenic; the body tolerates these self-molecules. To be immunogenic, molecules must be recognised as non-self or foreign.

Molecular size: proteins with high molecular weights (over 100,000) are the most e?ective immunogens; those below 10,000 are weakly immunogenic; and small ones, for example, AMINO ACIDS, are non-immunogenic.

Chemical complexity: the greater the chemical complexity, the more immunogenic the substance.

Dosage, route and timing of antigen administration: all these are important factors.... immunogenicity

Body proteins that act as antibodies. 1. IgG: The immunoglobulin that can be measured in the serum approximately two weeks after a challenge by an antigen. Can cross the placenta from mother to foetus. 2. IgM: The immunoglobulin that can be measured very soon after a challenge by an antigen. The level returns to a non-measurable level very quickly and so this measurement is useful as a test for recent envenomation (or illness). Cannot cross the placenta from mother to foetus. Presence in a neonate therefore indicates infection of the body. 3. IgE: Reaginic antibody; immunoglobulin found in association with allergic or homocytotrophic responses. 4. IgA: Secretory antibody; immunoglobulin found in nonvascular fluids, such as the saliva, bile, aqueous humor, synovial fluide etc.... immunoglobulins

The term given to suppression of harmful immune responses (see IMMUNITY), the most obvious application being the prevention of organ rejection by people who receive kidney, heart or bone-marrow transplants (see TRANSPLANTATION). Immunosuppression is also used in certain diseases in a way that is non-speci?c – that is, it inhibits the entire immune system, not just harmful reactions. CORTICOSTEROIDS are the commonest dugs used in this way, as are METHOTREXATE and AZATHIOPRINE. Tacrolimus, a macrolide (see MACROLIDES) IMMUNOSUPPRESSANT, is used not only for engrafted patients but also in treating eczema (see DERMATITIS).

There has been a rapid introduction in recent years of monoclonal antibodies which prevent T-cells from proliferating. They can be recognised by the su?x ‘mab’ (standing for monoclonal antibody) and include rituximab and alemtuzumab. In?iximab, used in CROHN’S DISEASE and RHEUMATOID ARTHRITIS, inhibits tumour necrosis factor alpha.... immunosuppression

Any loss or abnormality of psychological, physiological or anatomical structure or function. It is concerned with abnormalities of body structure and appearance, organ or system resulting from any cause. In principle, impairments represent disturbances at the organ level. See also “handicap”; “disability”.... impairment

(1) The placing of a substance such as a drug, or an object such as a pacemaker, in a body tissue.

(2) The surgical replacement of injured or unhealthy tissue or organ with healthy tissue or organ (also known as TRANSPLANTATION).

(3) Attachment of the early EMBRYO to the lining of the UTERUS, which occurs around six days after conception; the site where this happens is where the placenta will develop.... implantation

In dentistry, a mould (using a rubber or alginate compound) of the teeth and gums from which a plaster-of-Paris model is prepared. This model provides a base on which to construct a denture, bridge or dental inlay. A similar process is used in ORTHODONTICS to make dental appliances to correct abnormalities in the positioning of teeth.... impression

In the context of animal behaviour, this is a quick and irreversible type of learning in which patterns are imprinted on the animal’s mind during the ?rst few hours of life. The smell and feel of its mother are one such imprint.... imprinting

Exhaustion in an individual caused by lack of appropriate nutrients in the circulating blood. Starvation, malnutrition or intestinal disorders are among the causes.... inanition

The birth of o?spring to parents who are closely related (see CONSANGUINOUS). In traditional rural communities, marriage between cousins was common and this could lead to a higher-than-average number of children with congenital anomalies or learning diffculties. This is now seen in certain ethnic groups who have brought the custom of inbreeding with them to their new homes in the western world.... inbreeding

A quotient, with the number of cases of a specified disease diagnosed or reported during a stated period of time as the numerator, and the number of persons in the population in which they occurred as the denominator.... incidence rate

Particles found in the CYTOPLASM and NUCLEUS of CELLS, usually a consequence of a viral infection. This phenomenon can be helpful in the diagnosis of such an infection.... inclusion bodies

(1) In the pharmacological context, the use of two or more drugs in treatment which together produce adverse consequences for the patient. The British National Formulary carries an appendix devoted to drug interactions.

(2) In the haematological context, an adverse reaction in a patient given a blood TRANSFUSION in which the donor blood is incompatible with that of the recipient.... incompatibility

Incompetence is a term applied to the valves of the heart when, as a result of disease in the valves or alterations in size of the chambers of the heart, the valves become unable to close the ori?ces which they should protect. (See HEART, DISEASES OF.)... incompetence

The period elapsing between the time when a person becomes infected by some agent and the ?rst appearance of the symptoms of the disease. Most acute infectious diseases have fairly definite periods of incubation, and it is of great importance that people who have run the risk of infection should know the length of time which must elapse before they can be sure whether or not they are to contract the disease in question. A person who has been exposed to infection is, during the incubation period, technically known as a contact. By isolating and watching contact cases, medical o?cers can often successfully check a threatened EPIDEMIC.

It must be noted that diseases are not communicated to others by a person who is incubating an illness. Some diseases, however, such as MEASLES, become infectious as soon as the ?rst symptoms set in after the incubation period is over; others, like SCARLET FEVER and SMALLPOX, are not so infectious then as in their later stages. The incubation period for any given disease is remarkably constant, although in the case of a severe attack the incubation is usually slightly shortened, and if the oncoming attack is a mild one, the period may be lengthened. All, however, may take a few days longer than the time stated to show themselves (see INFECTION), and several – especially WHOOPINGCOUGH – may be di?cult to recognise in their early stages.

Incubation periods of the more common infectious diseases:

The fore?nger or second digit of the hand.... incubation

A clinical symptom or circumstance indicating that the use of a particular intervention would be appropriate.... indication

A protease-inhibitor antiviral drug used in combination with nucleoside reverse transcriptase inhibitors (see REVERSE TRANSCRIPTASE INHIBITOR) to treat HIV infection (see AIDS/ HIV). A drug with a range of potentially serious side-effects, its use should be coupled with counselling and monitoring of the effects.... indinavir

A sluggish and unresolving condition, often with ulcerations and necrosis.... indolent

An alpha-adrenoreceptor-blocking drug used in the treatment of high blood pressure. It has several side-effects including sleepiness, dizziness, depression and failure to ejaculate. (See ALPHA ADRENERGIC BLOCKERS; ADRENERGIC RECEPTORS.)... indoramin

Bringing about a particular event – for example, the induction or starting of labour (see PREGNANCY AND LABOUR), or the induction of ANAESTHESIA. Newly arrived hospital doctors are given an induction period during their ?rst day or two at work.... induction

The pathological hardening of a tissue or organ. This may occur when a tissue is infected or when it is invaded by cancer. (See also SCLEROSIS.)... induration

Cassia senna

Caesalpiniaceae

San: Svarnapatri;

Hin: Sanay, Sana Ka Patt;

Ben: Sonamukhi;

Mal: Sunnamukki, Chonnamukki, Nilavaka;

Tam: Nilavirai, Nilavakai;

Tel: Netatangedu

Importance: Indian Senna or Tinnevelly senna is a shrub very highly esteemed in India for its medicinal value. The leaves are useful in constipation, abdominal disorders, leprosy, skin diseases, leucoderma, splenomegaly, hepatopathy, jaundice, helminthiasis, dyspepsia, cough, bronchitis, typhoid fever, anaemia, tumours and vitiated conditions of pitta and vata (Warrier et al,1994). It is used in Ayurvedic preparations; “Pancha Sakara Churna”, “Shat Sakara Churna” and “Madhu Yastyadi Churna” used for constipation. Its use is widespread in Unani system and some of the important products of this system containing senna are “Itrifal Mulayyin”, “Jawarish Ood Mulayyin”, “Hab Shabyar”, “Sufuf Mulliyin”, “Sharbat Ahmad Shahi”, etc. used as a mild laxative (Thakur et al, 1989).

Distribution: The plant is of Mediterranean origin. It is found in Somalia, Saudi Arabia, parts of Pakistan and Kutch area of Gujarat. It is largely cultivated in Tirunelveli, Ramanathapuram, Madurai and Salem districts of Tamil Nadu.

Botany: The genus Cassia, belonging to the family Caesalpiniaceae, comprises of a number of species, namely,

C. senna Linn. syn. C. angustifolia Vahl.

C. absus Linn.

C. alata Linn.

C. auriculata Linn.

C. burmanni Wight. syn. C. obovata (Linn.) Collad.

C. glauca Lam.

C. javanica Linn.

C. mimosoides Linn.

C. obtusifolia Linn. syn. C. tora Linn.

C. occidentalis Linn.

C. pumila Lam.

C. slamea Lam.

C. acutifolia Delile.

C. sophera Linn.

C. senna is a shrub or undershrub, 60-75cm in height with pale subterete or obtusely angled erect or spreading branches. Leaves are paripinnate. Leaflets are 5-8 in number, ovate-lanceolate and glabrous. Flowers are yellowish, many and arranged in axillary racemes. Fruits are flat legumes, greenish brown to dark brown and nearly smooth (Chopra et al,1980, Warrier et al,1994).

In commerce, the leaves and pods obtained from C. senna are known as “ Tinnevelly Senna” and those from C. acutifolia Delile. as “Alexandrian Senna”. The leaves of C. acutifolia are narrower than C. senna, otherwise both resemble to a large extent (Thakur et al, 1989). All the true Sennas have the portions of their leaves unequally divided. In some kinds the lower part of one side is reduced to little more than a line in breadth, while the other is from a quarter to half an inch in breadth. The drug known under the name of East Indian Senna is nearly free from adulteration; and as its properties appear identical with those of the Alexandrian and the price being less, it probably will supersede it in general practice. Its size and shape readily identify it (Graves, 1996).

Agrotechnology: The plant requires a mild subtropical climate with warm winters which are free from frost for its growth. Semiarid areas with adequate irrigation facilities are ideal for cultivation. Areas having high rainfall, humidity and poor drainage are not suitable. Light or medium loamy soils with adequate drainage and pH varying from 7.0-8.2 are preferable. In South India both summer and winter crops are possible. The plant is propagated by seeds. The seed rate required is 15-20kg/ha. Seeds are sown in October-November (winter rainfed crop) or in February-March (irrigated crop). Higher seed rate is required for unirrigated crop. Seeds are sown in lines 30cm apart. Application of 5-10t of FYM/ha before planting or raising a green manure crop is beneficial. About 40kg N and 25-50kg P2O5/ha applied as basal dressing and 40kg N/ha applied in 2 split dozes as top dressing gave better yield. While the rainfed crop is grown without irrigation, the irrigated crop requires 5-8 light irrigations during the entire growing season. The crop requires 2-3 weedings and hoeings in order to keep it free from weeds. Alternaria alternata causes leaf spot and dieback but the disease is not serious. In North India, the plant is attacked by the larvae of butterfly Catopsilia pyranthe which can be controlled by planting the crop in March-April instead of June-July. Under irrigated conditions, the first crop is obtained after 90 days of planting. The leaves are stripped by hand when they are fully green, thick and bluish-green in colour. The second crop is taken 4 weeks after the first harvest and the third 4-6 weeks after the second one. The last harvest of leaves is done when the entire crop is harvested along with the pods. Yield under irrigated conditions is nearly1.4t of leaves and 150kg pods/ha and under unirrigated conditions is 500-600kg leaves and 80-100kg pods/ha. The leaves are dried in thin layers under shade so as to retain the green colour and the pods are hung for 10-12 days to get dried. The leaves and pods are cleaned, graded and marketed (Husain et al, 1993).

Properties and Activity: Leaves contain glucose, fructose, sucrose and pinnitol. Mucilage consists of galactose, arabinose, rhamnose and galacturonic acid. Leaves also contain sennoside-C(8,8’- diglucoside of rhein-aloe-emodin-dianthrone). Pods contain sennosides A and B, glycoside of anthraquinones rhein and chrysophanic acid. Seeds contain -sitosterol (Husain et al, 1992). Leaves and pods also contain 0.33% -sterol and flavonols-kaempferol, kaempferin, and iso-rhamnetin. Sennoside content of C. acutifolia is higher ranging from 2.5% to 4.5% as compared to C. angustifolia ranging from 1.5 % to 2.5%.

The purgative activity of Senna is attributed to its sennosides. The pods cause lesser griping than the leaves. Leaf and pod is laxative. The leaves are astringent, bitter, sweet, acrid, thermogenic, cathartic, depurative, liver tonic, anthelmintic, cholagogue, expectorant and febrifuge.... indian senna

A baby who is under one year old.... infant

The condition characterised by imperfect sexual development at puberty. It may or may not be associated with small stature, and may be due to lack of development of certain of the ENDOCRINE GLANDS: for example, the gonads, pituitary gland or adrenal glands. In other cases it may be associated with a generalised disease such as diabetes mellitus, asthma, ulcerative colitis and rheumatoid arthritis (for more information, see under separate entries).... infantilism

The changes in an organ when an artery is suddenly blocked, leading to the formation of a dense, wedge-shaped mass of dead tissue in the part of the organ supplied by the artery. It occurs as the result of EMBOLISM or of THROMBOSIS.... infarction

The band of electromagnetic radiation which has a longer wavelength than that of the red in the visible spectrum. Infrared radiation is used in the special photographic process essential to THERMOGRAPHY. Its property of transmitting radiant heat has made infrared radiation invaluable in PHYSIOTHERAPY, where it warms tissues, soothes pain and increases the local circulation.... infrared radiation

A funnel-shaped passage. The word is used speci?cally to describe the hollow conical stalk that links the HYPOTHALAMUS to the posterior lobe of the PITUITARY GLAND.... infundibulum

A mechanism for administering a drug in the form of a powder or aerosol. mainly used by patients with ASTHMA. Inhalers are basically of two types: aerosol, and dry-powder inhaler. The former delivers the drug as an aerosol spray when the patient presses the top of the canister containing the drug; the latter works by putting a drug capsule in the end of the chamber and, when the patient presses the top, the capsule is pierced and the drug released. A variety of ‘spacing devices’ are available to use with pressurised (aerosol) inhalers, providing metered doses. The space introduced between the inhaler and the mouth reduces the velocity of the aerosol and thus the impact it has on the oropharynx. More time is therefore allowed for evaporation of the propellant, with a greater concentration of drug particles being inhaled. Inhalers with larger spacing devices and a one-way valve are very e?ective and particularly useful for children and patients needing higher doses of the drug. (See INHALANTS; NEBULISERS.)... inhaler

The transfer of characteristics, traits and disorders from parents to children by means of

GENES carried in the CHROMOSOMES of the germ cells. (See GERM CELL; GENETIC CODE; GENETIC DISORDERS.)... inheritance

The nerve supply to a tissue, organ or part of the body. It carries motor impulses to and sensory impulses away from the part.... innervation

A sugar compound that is one constituent of some phospholipids (see LIPID) found in cells. It is found in many foods but, although sometimes classi?ed as a VITAMIN, it is not a vital part of the human diet.... inositol

Adjective describing anything that affects the force of muscle contraction. It is usually applied to the heart muscle; an inotrope such as DIGOXIN is a drug that improves its contraction. Beta-blocker drugs such as PROPRANOLOL HYDROCHLORIDE have negative inotropic properties.... inotropic

An individual who has been admitted to a hospital or other facility for diagnosis and/or treatment that requires at least an overnight stay.... inpatient

The ejaculation of SEMEN in the VAGINA in the act of sexual intercourse. In ARTIFICIAL INSEMINATION the semen is placed there by the use of an instrument. (See also ASSISTED CONCEPTION.)... insemination

A disorder in which the body produces excess INSULIN, which then reduces the amount of glucose in the blood (HYPOGLYCAEMIA). Treatment is with glucose or GLUCAGON. Untreated, the patient goes into a COMA and dies.... insulin shock

An ENZYME occurring in body tissues, such as the kidney and liver, that breaks down INSULIN in the body.... insulinase

A coherent set of methods and models, on the funding, administrative, organizational, service delivery and clinical levels, designed to create connectivity, alignment and collaboration within the health sector.... integration

(American) One who is truthful; of good character

Integritey, Integritee, Integritea, Integriti, Integritie... integrity

Another name for skin. The term is also used for a layer or membrane surrounding any of the body’s organs.... integument

A standardised procedure of mental assessment to determine an individual’s intellectual ability. The result is produced as a score termed the INTELLIGENCE QUOTIENT (IQ). The Wechsler Adult Intelligence Scale (WAIS) and one for children, the Wechsler Intelligence Scale for Children (WICS), are commonly used, as is the Stanford-Binet Scale. Assessments are made for educational purposes and to help in the diagnoses of people with possible mental retardation or intellectual deterioration.... intelligence test

Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in a specially equipped unit of a health care facility. It can also be administered at home under certain circumstances (dialysis, respirators, etc.).... intensive care

The term applied to the nerves, vessels and muscles that lie between the ribs, as well as to diseases affecting these structures.... intercostal

Consists of members who work together interdependently to develop goals and a common treatment plan, although they maintain distinct professional responsibilities and individual assignments. In contrast to multidisciplinary teams, leadership functions are shared.... interdisciplinary team

A substance produced by T-lymphocytes that stimulates activated T-lymphocytes and some activated B-Lymphocytes to proliferate. Also known as T-Cell growth factor.... interleukin-2

A regularly recurring fever... intermittent fever

An American term for a doctor-in-training who carries out his or her duties and learns in hospital, usually spending some of his/her time living there. The terms preferred in the UK are house o?cer or senior house o?cer (SHO).... intern

Generally, that branch of medicine concerned with diseases that do not require surgery, specifically the study and treatment of internal organs and body systems; it encompasses many subspecialties.... internal medicine

The length of the AXON (of a nerve cell) that is covered with a MYELIN sheath. The nodes of Ranvier, which have no myelin sheath, separate the internodes. (See also NERVE.)... internode

Interstitial is a term applied to indi?erent tissue set among the proper active tissue of an organ. It is generally of a supporting character and formed of ?brous tissue. The term is also applied to the ?uid always present in this in a small amount, and to diseases which specially affect this tissue, such as interstitial keratitis.... interstitial

Also called Leydig cells, these cells are scattered between the SEMINIFEROUS TUBULES of the testis (see TESTICLE). LUTEINISING HORMONE from the anterior PITUITARY GLAND stimulates the interstitial cells to produce androgens, or male hormones.... interstitial cells

Comparison of outcomes between two or more groups of patients who have been intentionally given di?erent treatments or preventative measures, for example, diets. The subjects in the trial should be randomly allocated to the groups, with patients in one group – called controls – receiving no active treatment. If possible, neither patients nor doctors participating in a study should know which patients are receiving what treatment (double blind study/trial). Furthermore, groups should exchange treatments after a prearranged time (crossover study/trial). (See CLINICAL TRIALS; RANDOMISED CONTROLLED TRIAL.)... intervention study

Intrathecal means within the membranes or meninges which envelop the SPINAL CORD. The intrathecal space, between the arachnoid and the pia mater, contains the CEREBROSPINAL FLUID (see INTRACRANIAL PRESSURE).... intrathecal

A method of helping CONCEPTION to occur when a man is infertile (see INFERTILITY) because his sperm (see SPERMATOZOON) cannot penetrate either the cervical mucus at the entrance of the UTERUS or the barriers that surround the OVUM. The sperm, often treated chemically beforehand to increase motility, are injected directly into the uterus via the VAGINA.... intrauterine insemination

Intracytoplasmic sperm injection (ICSI) is the most signi?cant therapeutic advance in male INFERTILITY treatment in the past 30 years. The technique is used when in vitro fertilisation (IVF – see under ASSISTED CONCEPTION) is not possible because the man has very few, motile, normal sperm (see SPERMATOZOON), or when previous attempts at IVF have not produced a fertilised EMBRYO. ICSI requires a single sperm which is injected directly into the cytoplasm of an egg previously retrieved from the woman. Once fertilised, the embryo is transferred to her UTERUS. For men with no sperm in the semen, it may be possible to retrieve sperm by needle aspiration of the EPIDIDYMIS under local anaesthetic (see ANAESTHESIA). Other techniques involve microsurgical retrieval from the epididymis or TESTICLE under a general anaesthetic. Potential complications include scrotal pain, bruising, HAEMATOMA formation and infection. ICSI and surgical sperm-retrieval require extensive training and expertise and is currently available in only a few selected

infertility units. Safety concerns relate to a higher-than-expected rate of abnormalities in the SEX CHROMOSOMES after ICSI, and also the potential risk of transmitting paternal genetic defects in the Y chromosome to sons born after ICSI.... intracytoplasmic sperm injection

The introduction of one organ or part into another. An example is the insertion of the erect penis into the vagina during copulation.... intromission

(1) In physical terms, to turn a hollow structure into itself – for example, a length of the intestine may ‘enter’ the succeeding portion, also known as INTUSSUSCEPTION.

(2) A psychological term to describe what happens when an individual is more interested in his or her ‘inner world’ than in what is happening around in the real world. An INTROVERT tends to have few friends and prefers to persist in activities that they have started. Karl Jung (see JUNGIAN ANALYSIS) described introversion as a person’s tendency to distance him or herself from others; to have philosophical interests;

and to have reactions that are reserved and defensive.... introversion

Physically it means turning inside out. Psychologically, the term refers to an individual whose character looks inwards on him or herself and who may also be obsessive and have few friends. (See INTROVERSION.)... introvert

The innermost coat lining the arteries and the veins.... intima

An adverse reaction of a patient to a drug or treatment. (See ADVERSE REACTIONS TO DRUGS.)... intolerance

Intracranial is the term applied to structures, diseases, etc. contained in or rising within the head.... intracranial

The entry of bacteria into the body; the spread of cancer into normal, nearby tissues or organs.... invasion

The sheath of new bone which is formed round a piece of dead bone in, for example, OSTEOMYELITIS.... involucrum

Muscle that does not operate under a person’s conscious control. Involuntary muscle – also called smooth muscle, because the cells do not contain the striations that occur in VOLUNTARY MUSCLE – is found in blood vessels, the heart, stomach, and intestines. (See PARASYMPATHETIC NERVOUS SYSTEM.)... involuntary muscle

The process of change whereby the UTERUS returns to its resting size after parturition (birth). The term is also applied to any retrograde biological change, as in senility (see AGEING).... involution

An ANTICHOLINERGIC, BRONCHODILATOR drug, given by aerosol inhalation to treat ASTHMA, BRONCHITIS and RHINITIS.... ipratropium

Money, Luck, Protection... irish moss

Irrigation is the method of washing-out wounds, or cavities of the body, like the bladder and bowels. (See DOUCHE; ENEMA.)... irrigation

An ABSCESS arising in the space between the RECTUM and ischial bone (see ISCHIUM) and often resulting in a FISTULA. It may occur spontaneously or be secondary to an anal ?ssure, thrombosed HAEMORRHOIDS or other anal disease. The disorder is painful and usually accompanied by fever. Treatment is by a combination of antibiotics and surgery.... ischiorectal abscess

A disorder of the intestinal tract that affects its motility and causes abdominal distension and irregular defaecation. Traditional, but now discarded, names have been spastic or irritable colon. The disease affects around 20 per cent of the general population but in most it is no more than a minor nuisance. The causes are not fully understood, but it is generally believed that symptoms develop in response to psychological factors, changed gastrointestinal motility, or altered visceral sensation. About 50 per cent of patients meet criteria for a psychiatric diagnosis. Anxiety, depression, neurosis, panic attacks, acute disease are among possible triggering factors. Some patients have diarrhoea, others are constipated, and some alternate between the two. Many have increased sensitivity to distension of the intestine. Dietary factors such as intolerance to dairy products and wheat are apparent in certain patients.

Common features of IBS include:

abdominal distension.

altered bowel habit.

colicky lower abdominal pain, eased by defaecation.

mucous discharge from rectum.

feelings of incomplete defaecation.

Investigations usually produce normal results. Positive diagnosis in people under 40 is usually straightforward. In older patients, however, barium ENEMA, X-rays and COLONOSCOPY should be done to exclude colorectal cancer.

Reassurance is the initial and often e?ective treatment. If this fails, treatment should be directed at the major symptoms. Several months of the antidepressant amitriptyline (see ANTIDEPRESSANT DRUGS) may bene?t patients with intractable symptoms, given at a dose lower than that used to treat depression. The majority of patients follow a relapsing/remitting course, with episodes provoked by stressful events in their daily lives. (See also INTESTINE, DISEASES OF.)... irritable bowel syndrome (ibs)

Groups of specialised cells distributed throughout the PANCREAS, that produce three hormones: INSULIN, GLUCAGON, and SOMATOSTATIN.... islets of langerhans

One of the essential AMINO ACIDS, which are fundamental components of all proteins. It cannot be synthesised by the body and so must be obtained from the diet.... isoleucine

Of similar measurement. Isometric exercises are based on the isometric contraction of the muscles. Fibres are provoked into working by pushing or pulling an immovable object, but this technique prevents them from shortening in length. These exercises improve a person’s ?tness and builds up his or her muscle strength.... isometric

An INOTROPIC sympathomimetic drug which is used as a short-term emergency treatment of heart block or severe BRADYCARDIA. (See HEART, DISEASES OF.)... isoprenaline

Itch is a popular name for SCABIES.... itch

This is a form of a chemical element with the same chemical properties as other forms, but which has a di?erent atomic mass. It contains an identical number of positively charged particles called protons, in the nucleus, giving it the same atomic number, but the numbers of neutrons di?er. A radioactive isotope, or radionuclide, is one that decays into other isotopes, and in doing so emits alpha, beta or gamma radiation.

Applications of radionuclides to diagnosis The use of radionuclides in diagnosis is based on the fact that it is possible to tag many of the substances normally present in the body with a radioactive label. Certain synthetic radioactive elements, such as technetium, can also be used. Because it is possible to detect minute quantities of radioactive material, only very small doses are needed, making the procedure a safe one. Furthermore the body pool of the material is therefore not appreciably altered, and metabolism is not disturbed. Thus in studies of iodine metabolism the ratio of radioactive atoms administered to stable atoms in the body pool is of the order of 1:1,000 million. By measuring radioactivity in the body, in blood samples, or in the excreta it is possible to gain information about the fate of the labelled substance, and hence of the chemically identical inactive material. Therefore it is theoretically possible to trace the absorption, distribution and excretion of any substance normally present in the body, provided that it can be tagged with a suitable radioactive label.

If the investigation necessitates tracing the path of the material through the body by means of external counting over the body surface, it is obviously essential to use an isotope that emits gamma radiation or positrons. If, however, only measurements on blood sample or excreta are required, it is possible to use pure beta emitters. Whole-body counters measure the total radioactivity in the body, and these are of great value in absorption studies.

Moving images can provide information on body functions such as the movements of the heart, blood ?ow, bile ?ow in the liver, and urine in the kidneys. The development of COMPUTED TOMOGRAPHY or CT scanning has replaced radionuclide scanning for some imaging procedures.

Five main groups of diagnostic uses may be de?ned:

(1) METABOLIC STUDIES The use of radioactive materials in metabolic studies is based on the fundamental property that all isotopes of an element are chemically identical. The radioactive isotope is used as a true isotope tracer – that is, when introduced into the body (in whatever form) it behaves in the same way as the inactive element. For example, isotopes of iodine are used to measure thyroid function (see THYROID GLAND), and isotopes of calcium enable kinetic studies of bone formation and destruction to be performed.... isotope

Ivory, or dentine, is the hard material which forms the chief bulk of the TEETH.... ivory

A temporary restoration of consciousness after a person has been rendered unconscious from a blow to the head. The victim subsequently relapses into COMA. This is a sign of raised INTRACRANIAL PRESSURE from arterial bleeding and indicates that surgery may be required to control the intracranial haemorrhage. (See also GLASGOW COMA SCALE.)... lucid interval

A disorder characterized by the display of an intellectual defect, as manifested by diminished cognitive, interpersonal, social and vocational effectiveness and quantitatively evaluated by psychological examination and assessment.... mental impairment

A defect in the MITRAL VALVE of the HEART which allows blood to leak from the left VENTRICLE into the left ATRIUM. It is also known as mitral regurgitation; incompetence may occur along with MITRAL STENOSIS. The left ventricle has to work harder to compensate for the faulty valve, so it enlarges, but eventually the ventricle cannot cope with the extra load and left-sided heart failure may develop. A common cause of mitral incompetence is RHEUMATIC FEVER or damage following a heart attack. The condition is treated with drugs to help the heart, but in severe cases heart surgery may be required.... mitral incompetence

Accidental perforation of the skin by an injection needle, commonly of the hand or ?nger and usually by a nurse or doctor administering a therapeutic injection. The term also refers to accidental injuries from injection needles discarded by drug abusers. Dangerous infections such as viral HEPATITIS or HIV may be acquired from needle-stick injuries, and there are strict procedures about the disposal of used syringes and needles in medical settings.... needle-stick injury

Infection pertaining to a hospital or an infirmary.... nosocomial infection

Vent. 453

Action: Emmenagogue, antispasmodic, carminative, expectorant. Leaves and seed— astringent, antispasmodic. Warm infusion of herb—promotes suppressed menstrual flow.

The herb contains about 3% volatile oil comprising sabinene hydrate, sa- binene, linalool, carvacrol, estrogole, eugenol and terpenes; flavonoids including luteolin-7-glucoside, dios- metin-7-glucoside, apigenin-7-gluco- side; rosmarinic acid, caffeic acid; and triterpenoids such as ursolic acid, olea- nolic acid, sterols.

Marjoram herb and oil exhibit antibacterial action. (German Commission E.) The herb contains arbutin and hydroxyquinone (a carcinogenic agent) in low concentrations. The herb is not suited for extended use. Topical application of hydroxyquinone leads to depigmentation of the skin. There is no reports of similar side effects with marjoram ointment. (German Commission E.)

Origanum vulgare Linn. (Wild Marjoram) contains volatile oil with a widely varying composition; major components include thymol, beta-bisabolene, caryophyllene, linalool and borneol; other constituents are similar to those of O. majorana.

The leaves of Wild Marjoram contain phenolic acids. The phenyl propionic acid and the phenyl glucoside showed antioxidant activity comparable to that of BHA, a synthetic antiox- idant.

Wild Marjoram preparations are used for bronchial catarrh and disturbances of the gastrointestinal tract in Unani medicine.

Sweet Marjoram shows stronger effect on the nervous system than Wild Marjoram and gives better results in anxiety, headaches and insomnia.

Both the species have been included among unapproved herbs by German Commission E.... oroxylum indicum

These are drugs that inhibit the production of acid in the stomach by blocking a key enzyme system, known as the PROTON PUMP, of the parietal cells of the stomach. The drugs include omeprazole, lansoprazole and pantoprazole, and they are the treatment of choice for oesophagitis (erosion and stricture – see under OESOPHAGUS, DISEASES OF); for the short-term treatment for gastric ulcer (see under STOMACH, DISEASES OF) and DUODENAL ULCER; and, in combination with ANTIBIOTICS, for the eradication of Helicobacter pylori.... proton-pump inhibitors

The interval in an ELECTROCARDIOGRAM (ECG) that registers the electrical activity generated during ventricular contraction of the HEART.... q-t interval

The SPINAL COLUMN is built up of a series of bones, known as vertebrae, placed one upon the other. Between these vertebrae lies a series of thick discs of ?bro-cartilage known as intervertebral discs. Each disc consists of an outer portion known as the anulus ?brosus, and an inner core known as the nucleus pulposus. The function of these discs is to give ?exibility and resiliency to the spinal column and to act as bu?ers against undue jarring. In other words, they are most e?cient shock-absorbers. They may, however, PROLAPSE, or protrude, between the two adjacent vertebrae. If this should happen they press on the neighbouring spinal nerve and cause pain. As the most common sites of protrusion are between the last two lumbar vertebrae and between the last lumbar vertebra and the sacrum, this means that the pain occurs in the back, causing LUMBAGO, or down the course of the sciatic nerve causing SCIATICA. The prolapse is most likely to occur in middle age, which suggests that it may be associated with degeneration of the disc involved, but it can occur in early adult life as well. It usually occurs when the individual is performing some form of exercise which involves bending or twisting, as in gardening. The onset of pain may be acute and sudden, or gradual and more chronic in intensity. (See also INTERVERTEBRAL DISC.)

Treatment varies, depending (amongst other things) on the severity of the condition. In the acute phase, rest in bed is advisable, along with ANALGESICS. Later, exercise and physiotherapy are helpful, and in some cases manipulation of the spine brings relief by allowing the herniated, or prolapsed, disc to slip back into position. The injection of a local anaesthetic into the spine (epidural ANAESTHESIA) is yet another measure that often helps the more chronic cases. If those measures fail, surgery to remove the prolapsed disc may be necessary, but the patient’s condition should be carefully reviewed before surgery is considered since success is not certain. An alternative form of treatment is the injection into the disc of chymopapain, an ENZYME obtained from the paw-paw, which dissolves the disc.... prolapsed intervertebral disc

A transient EXANTHEM of toddlers. Mild malaise is followed by a RUBELLA-like rash. It is caused by herpes virus 6 (see HERPES VIRUSES).... roseola infantum

See FOOD POISONING; ENTERIC FEVER; DYSENTERY.... salmonella infections

The way in which a characteristic or an illness determined by the SEX CHROMOSOMES in an individual’s cells is passed on to the succeeding generation. Men have one X and one Y sex chromosome and women have two X chromosomes. Disorders that result from an abnormal number of sex chromosomes include KLINEFELTER’S SYNDROME, which affects only men, and TURNER’S SYNDROME, which affects mainly women. Recessive GENES on the X chromosome cause most other sex-linked characteristics; in women these may well be masked because one of their two X chromosomes carries a normal (dominant) gene. In men, who have just one X chromosome, no such masking occurs – so more men than women are affected by X-linked characteristics or diseases. (See also HEREDITY.)... sex-linked inheritance

In anticancer therapy, this is the ratio of a dose of the treatment agent that damages normal cells to the dose necessary to produce a determined level of anticancer activity. The index shows the e?ectiveness of the treatment against the cancer.... therapeutic index

Linn. 643

English: Big Marigold, Aztec or African Marigold.

Ayurvedic: Jhandu, Gendaa.

Unani: Sadbarg, Gul-hazaaraa, Gul-jaafari.

Siddha: Thuruksaamanthi.

Action: Whole plant—infusion useful in cold and bronchitis, also in the treatment of rheumatism.

Flowers—alterative; juice used for bleeding piles. Leaves—styptic, applied externally to boils and carbuncles; muscle pains. Leaves and florets— emengagogue, diuretic, vermifuge.

The flowers gave lutein esters of dipalmitate, dimyristate and mono- myristate. Fresh petals gave hydrox- yflavones, quercetagetin and tagetiin.

The plant yields an essential oil containing limonene, ocimene, linalyl acetate, linalool, tagetone and n-nonyl aldehyde as major components.

The aqueous extract of flowers showed activity against Gram-positive bacteria.

Tagetes mmuta Linn., synonym T. glandulifera Schrank (North-west Himalayas; native to South America), known as Stinking-Roger, gives highest yield of the essential oil with high carbonyl content, calculated as tagetone among the Tagetes sp. grown in India.... tamarindus indica

Failure of the TRICUSPID VALVE in the HEART to close fully, thus permitting blood to leak back into the right atrium during contractions of the right ventricle. This reduces the heart’s pumping e?ciency, and right-sided heart failure usually results. Treatment for heart failure (using DIURETICS and ACE inhibitor drugs) usually restores function, but sometimes heart surgery is required to repair or replace the defective valve.... tricuspid incompetence

Sycosis. See: FOLLICULITIS. ... barber’s itch

An agent which produces vaso-dilation of peripheral blood vessels by stimulating nerve-endings of the skin to generate irritation intended to relieve deep-seated pain. Arnica, Balm of Gilead, Black Mustard, Bryony (white), Cajuput (oil of), Camphor, Canada Balsam, Cayenne, Eucalyptus, Nutmeg (oil of), Sassafras, Thuja. ... counter irritant

Any block-age or hindrance arresting the flow of contents of the intestines. May be mechanical (adhesions, hernias, tumours, etc) or paralytic.

Symptoms: distension, dehydration, atony, vomiting, constipation.

Alternatives. Wild Yam. Calamus. Papaya.

Condition may have to be resolved by surgery. Simple obstruction: large doses (4-8 teaspoons) Isphaghula seeds. Lime flower tea. See: COLITIS. ... intestinal obstruction

A disorder resulting from excessive retention of water in the brain. Main symptoms are dizziness, headaches, confusion and nausea. In severe cases the patient may have ?ts (see SEIZURE) or lose consciousness. Several conditions can disturb the body’s water balance causing accumulation of water in the tissues. Heart or kidney failure, CIRRHOSIS of the liver and disorders of the ADRENAL GLANDS can all result in water retention. Other causes are stress as a result of surgery, when increased secretion of antidiuretic hormone (VASOPRESSIN) by the adrenal gland may occur. Treatment is of the underlying condition and the judicious use of DIURETICS, with careful monitoring of the body’s ELECTROLYTES.... water intoxication

A person’s perception of the different parts of his or her own body.... body image

An artificial structure surgically introduced into the breast to increase its size (see mammoplasty).... breast implant

Abnormal weakness of the cervix that can result in recurrent miscarriages. An incompetent cervix may gradually widen under the weight of the fetus from about the 12th week of pregnancy onwards, or may suddenly open during the second trimester. The condition is detected by an internal examination or by ultrasound scanning.

Treatment is with a suture (stitch) applied like a purse string around the cervix during the 4th month of pregnancy. The suture is left in position until the pregnancy is at or near full term and is then cut to allow the mother to deliver the baby normally.... cervical incompetence

Also known as , abnormalities in the cells of the cervix which may become cancerous.

The grading system is used to distinguish levels of change in the surface cells of the cervix in biopsy samples taken during colposcopy, a procedure usually performed following an abnormal cervical smear test.

Grades 1–3 broadly correspond to mild to severe cervical dysplasia in cells obtained from a smear.... cervical intraepithelial neoplasia

A device used to treat profoundly deaf people who are not helped by hearing aids. A cochlear implant consists of tiny electrodes surgically implanted in the cochlea deep in the inner ear and a receiver that is embedded in the skull just behind and above the ear. A microphone, sound processor, and transmitter are worn externally. A cochlear implant does not restore normal hearing, but it enables patterns of sound to be detected. Combined with lip-reading, it may enable speech to be understood.... cochlear implant

A method of contraception (see contraception, withdrawal method of) in which the male partner withdraws his penis from the vagina before ejaculation occurs. Coitus interruptus is unreliable because sperm can be released before orgasm occurs, and it may cause psychosexual dysfunction in men and women.... coitus interruptus

(DIC) A type of bleeding disorder in which abnormal clotting leads to depletion of coagulation factors in the blood; the consequence may be severe spontaneous bleeding.... disseminated intravascular coagulation

A condition in which a large mass of hard faeces cannot be evacuated from the rectum. It is usually associated with long-standing constipation. Faecal impaction is most common in very young children and in the elderly, especially those who are bedridden.

The main symptoms are an intense desire to pass a bowel movement; pain in the rectum, anus, and centre of the abdomen; and, in some cases, watery faeces that are passed around the mass. Treatment is with enemas or by manual removal of the faecal mass.... faecal impaction

(GIFT) A technique for assisting conception (see infertility), which can only be used if a woman has normal fallopian tubes. In , eggs are removed from an ovary during laparoscopy and mixed with sperm in the laboratory before both are introduced into a fallopian tube. A fertilized egg may then become implanted in the uterus.... gamete intrafallopian transfer

Reaction to any insect bite is due to either venom released or allergic response. Symptoms: redness, pain, itching, swelling. Remove sting where possible.

Alternatives. External.

Tinctures: Arnica, Acid tincture of Lobelia, Echinacea, Marigold, Myrrh, St John’s Wort.

Fresh plants. Crush and apply: Comfrey, Garlic, Houseleek, Marigold, Onion, Plantain. St John’s Wort: specific – horsefly.

Witch Hazel Lotion.

Cider Vinegar: wasp bites.

Bee and ant bites: in absence of any of the above: bicarbonate of soda.

Aromatherapy. Any one oil – Eucalyptus, Clove, Lavender.

For shock: with faintness and pallor: few grains Cayenne pepper in honey or cup of tea. Supplements. Vitamin A and B-complex. ... insect bites

An orthopaedic term for techniques used to prevent movement of joints or displacement of fractured bones so that the bones can unite properly (see fracture).... immobilization

The body’s defensive reaction to microorganisms, cancer cells, transplanted tissue, and other substances or materials that are recognized as antigenic or “foreign”.

The response consists of the production of cells called lymphocytes, substances called antibodies, or immunoglobulins, and other substances and cells that act to destroy the antigenic material.

(See also immune system.)... immune response

A form of assisted conception in which semen is introduced artificially into the uterus, instead of by sexual intercourse, with the aim of inducing pregnancy.

There are 2 types of artificial insemination: , artificial insemination with the semen of the woman’s male partner; and , insemination with a donor’s sperm. is usually used for couples who are unable to have intercourse, or if the man has a low sperm count or a low volume of ejaculate. It is also used when semen has been stored from a man prior to treatment (such as chemotherapy) that has made him sterile. is available to couples if the man is infertile or is a carrier of a genetic disease. It may also be used by a woman who wants children but has no male partner.

Insemination is timed to coincide with natural ovulation or may be combined with treatment to stimulate ovulation.... artificial insemination

Any material, either natural or artificial, inserted into the body for medical or cosmetic purposes. For example, artificial joints can replace diseased structures and breast implants can improve appearance. Implants are also used to maintain proper functioning of an internal organ, treat certain disorders, or deliver drugs or hormones.... implant

An intramuscular injection of a drug that gives a slow, steady release of its active chemicals into the bloodstream. Release of the drug is slowed by the inclusion of substances such as oil or wax. The release of the active drug can be made to last for hours, days, or weeks.

A depot injection is useful for patients who may not take their medication correctly.

It also prevents the necessity of giving a series of injections over a short period.

Hormonal contraceptives (see contraception, hormonal methods of), corticosteroid drugs, and antipsychotic drugs may be given by depot injection.

Side effects may arise due to the uneven release of the drug into the bloodstream.... depot injection

A type of hernia in which the intestine bulges through a scarred area of the abdominal wall because the muscle has been weakened by a previous surgical incision.... incisional hernia

A transparent plastic cot in which oxygen, temperature, and humidity are controlled in order to provide premature or sick infants with ideal conditions for survival. Incubators have portholes to allow handling of the baby and smaller ones through which monitoring cables and intravenous and respiratory tubing can pass.... incubator

One of the 3 tiny, linked bones (ossicles) in the middle ear. The incus (the Latin name for anvil) is so-called because of its shape.... incus

A neurotic state of mind that develops because of repeated hurts or failures in the past. Inferiority complex arises from a conflict between the positive wish to be recognized as someone worthwhile and the haunting fear of frustration and failure. Attempts to compensate for the sense of worthlessness may take the form of aggression and violence, or an overzealous involvement in activities. (See also superiority complex.)... inferiority complex

A form of female circumcision in which the labia majora (the outer lips surrounding the vagina) are removed and the entrance to the vagina narrowed (see circumcision, female).... infibulation

A distorted sensation based on misinterpretation of a real stimulus (for example, a pen is seen as a dagger). It is differs from a hallucination, in which a perception occurs without any stimulus.Usually, illusions are brief and can be understood when explained. They may be due to tiredness or anxiety, to drugs, or to forms of brain damage. Delirium tremens is a classic inducer of illusions. imaging techniques Techniques that produce images of structures within the body. The most commonly used and simplest techniques are X-rays (to view dense structures such as bone) and contrast X-rays, in which a medium, such as barium, that is opaque to X-rays is introduced into the body. Contrast X-ray techniques include barium X-ray examinations (used to examine the oesophagus, the stomach and the small intestine); cholecystography (used to visualize the gallbladder and common bile duct); bronchography (to view the airways connecting the windpipe to the lungs); angiography and venography (to provide images of the blood vessels); intravenous urography (to visualize the kidneys and urinary tract); and ERCP (by which the pancreatic duct and biliary system are examined).

Many X-ray imaging techniques have been superseded by newer procedures. These include ultrasound scanning, MRI (magnetic resonance imaging), PET scanning, and radionuclide scanning. However, X-rays are used in CT scanning. Some of these techniques use computers to process the raw imaging data and produce the actual image. Others can produce images without a computer, although one may be used to enhance the image. imipramine A tricyclic antidepressant drug most commonly used as a longterm treatment for depression. Possible adverse effects include excessive sweating, blurred vision, dizziness, dry mouth, constipation, nausea, and, in older men, difficulty passing urine.... illusion

The process of inducing immunity as a preventive measure against infectious diseases. Immunization may be active or passive. In the passive form,antibodies are injected into the blood to provide immediate but short-lived protection against specific bacteria, viruses, or toxins. Active immunization, also called vaccination, primes the body to make its own antibodies and confers longer-lasting immunity.

Routine childhood immunization programmes exist for diseases such as diphtheria, pertussis, and tetanus (see DPT vaccination), haemophilus influenza (Hib), measles, mumps, and rubella (see MMR vaccination), meningitis C, and poliomyelitis. Additional immunizations before foreign travel may also be necessary (see travel immunization).

Most immunizations are given by injection, and usually have no after effects. However, some vaccines cause pain and swelling at the injection site and may produce a slight fever or flu-like symptoms. Some may produce a mild form of the disease. Very rarely, severe reactions occur due, for example, to an allergy to 1 of the vaccine’s components. Not all vaccines provide complete protection. Cholera and typhoid fever vaccinations, in particular, give only partial protection.

People with immunodeficiency disorders, widespread cancer, those taking corticosteroid drugs, or those who have previously had a severe reaction to a vaccine should not be immunized. Some vaccines should not be given to young children or during pregnancy.... immunization

A collective term for chronic disorders affecting the small and/or large intestine that cause abdominal pain, bleeding, and diarrhoea. Crohn’s disease and ulcerative colitis are the most common types of inflammatory bowel disease.... inflammatory bowel disease

Relating to the groin (the area between the abdomen and thigh), as in inguinal hernia.... inguinal

Introduction of a substance into the body from a syringe via a needle.

Injections may be intravenous (into a vein), intramuscular (into a muscle), intradermal (into the skin), intra-articular (into a joint), or subcutaneous (under the skin).... injection

A type of protein found in blood and tissue fluids, also known as an antibody. Such proteins are produced by B-lymphocytes (a type of white blood cell), and their function is to bind to substances in the body that are recognized as foreign antigens. This binding is crucial for the destruction of antigenbearing microorganisms. Immunoglobulins also play a key role in allergies and hypersensitivity reactions.

Immunoglobulin G (IgG) is the major class of immunoglobulin of the 5 in the blood (IgA, IgD, IgE, IgG, and IgM). Its molecule consists of 2 parts: 1 binds to an antigen; the other binds to other cells, which then engulf the microorganisms bearing the antigen.

Immunoglobulins can be extracted from the blood of people who have recovered from certain infectious diseases and used for passive immunization.... immunoglobulin

An innate primitive urge.

The need for warmth, food, love, and sex are all forms of instinct, but the instinct for survival is probably the most powerful.... instinct

Loss of personal independence that stems from living for long periods under a rigid regime, such as in a prison or other large institution.

Apathy, obeying orders unquestioningly, accepting a standard routine, and loss of interests are the main features.... institutionalization

A prefix that means between, as in intercostal (between the ribs). (See also intra-.)... inter-

A group of abnormalities in which the affected person has ambiguous genitalia (abnormal external sex organs) or external genitalia that have the opposite appearance to the chromosomal sex of the individual (see sex determination).... intersex

A treatment for male infertility in which a single sperm is collected from a sample of semen and used to fertilize an ovum in vitro (see in vitro fertilization).

The ovum is then placed in the uterus.... (icsi)

A medical term meaning into or within the upper layers of the skin.

An intradermal injection is made into the skin; whereas a subcutaneous injection is made under the skin.... intradermal

A medical term meaning within a muscle, as in an intramuscular injection, in which a drug is injected deep within a muscle.... intramuscular

See IUD.... intrauterine contraceptive device

An X-ray procedure, commonly abbreviated to , used to give a clear image of the urinary tract. The procedure involves intravenous infusion of a contrast medium into the arm. The medium is carried in the blood to the urinary system, where it passes through the kidneys, ureters, and bladder to be excreted in the urine. X-rays taken at intervals show outlines of the urinary system. detects abnormalities such as tumours and obstructions, and signs of kidney disease.... intravenous urography

A general term for the entrance to a body cavity or space, most commonly used for the vagina.... introitus

Inflammation of the iris and ciliary body. Iridocyclitis is more usually known as “anterior uveitis”. (See also eye, disorders of.)... iridocyclitis

A surgical procedure performed on the eye, in which an incision is made in the iris using a knife or a laser. (See also iridectomy.)... iridotomy

A large machine formerly used to maintain breathing, especially in people paralysed by poliomyelitis. The iron lung has been replaced by more efficient means of maintaining breathing (see ventilation).... iron lung

A drug derived from vitamin A used in the treatment of severe acne. It works by reducing the formation of sebum (natural skin oils) and keratin (a tough protein that is the major component of the outer layer of skin).

Side effects include itching, dryness and flaking of the skin, and cracking of the lips. Isotretinoin may damage a developing fetus; pregnancy must be avoided during treatment and for at least 3 months after taking the drug. Regular blood tests are recommended to check for complications.... isotretinoin

A suffix meaning “inflammation of”.

Virtually every organ or tissue in the body can suffer inflammation, so “itis” is by far the most common word ending in medicine.

Examples of its use are bronchitis (inflammation of the bronchi) and hepatitis (inflammation of the liver).... itis

An abbreviation for intrauterine contraceptive device (see IUD).... iucd

A plastic prosthesis used to replace the removed opaque lens in cataract surgery.... lens implant

See MRI.... magnetic resonance imaging

Surgery using a rigid endoscope passed into the body through a small incision. Further small openings are made for surgical instruments so that the operation can be performed without a long surgical incision. Minimally invasive surgery may be used for many operations in the abdomen (see laparoscopy), including appendicectomy, cholecystectomy, hernia repair, and many gynaecological procedures. Knee operations (see arthroscopy) are also often performed by minimally invasive surgery.... minimally invasive surgery

See child abuse.... nonaccidental injury

(RSI) An overuse injury that affects keyboard workers and musicians, causing weakness and pain in the wrists and fingers.... repetitive strain injury

The sudden, unexpected death of an infant that cannot be explained.

Possible risk factors include: laying the baby face-down to sleep; overheating; parental smoking after the birth; prematurity and low birth weight; and poor socioeconomic background.

Preventive measures include: ensuring that the baby sleeps on its back at the foot of the cot; regulating the baby’s temperature (using the same amount of clothing and blankets that an adult would need); and stopping smoking.... sudden infant death syndrome

(TIA) A brief interruption of the blood supply to part of the brain, which causes temporary impairment of vision, speech, sensation, or movement. The episode typically lasts for several minutes or, at the most, for a few hours. TIAs are sometimes described as mini strokes, and they can be the prelude to a stroke.

TIAs may be caused by a blood clot (see embolism) temporarily blocking an artery that supplies the brain, or by narrowing of an artery as a result of atherosclerosis.

After a TIA, tests such as CT scanning, blood tests, ultrasound scanning, or angiography may be needed to determine a cause. In some cases, the heart is studied as a possible source of blood clots. Treatment is aimed at preventing stroke, which occurs within 5 years in up to one third of patients with TIA. Treatments include endarterectomy, anticoagulant drugs, or aspirin.... transient ischaemic attack

1. adj. describing a drug that reduces *inflammation. The various groups of anti-inflammatory drugs act against one or more of the mediators that initiate or maintain inflammation. Some groups suppress only certain aspects of the inflammatory response. The main groups of anti-inflammatory drugs are the *antihistamines, the glucocorticoids (see corticosteroid), and the nonsteroidal anti-inflammatory drugs (see NSAID). 2. n. an anti-inflammatory drug.... anti-inflammatory

Linn. Sweet.

Synonym: A. indicum G. Don.

Family: Malvaceae.

Habitat: Throughout the hotter parts of India. Found as a weed in the sub-Himalayan tract and other hills up to 1,200 m.

English: Country Mallow, Flowering Maples, Chinese Bell-flowers.

Ayurvedic: Atibalaa, Kankatikaa, Rishyaproktaa.

Unani: Kanghi, Musht-ul-Ghaul, Darkht-e-Shaan.

Siddha/Tamil: Thutthi.

Folk: Kanghi, Kakahi, Kakahiyaa.

Action: Dried, whole plant— febrifuge, anthelmintic, demulcent, diuretic, anti-inflammatory (in urinary and uterine discharges, piles, lumbago). Juice of the plant— emollient. Seeds—demulcent (used in cough, chronic cystitis), laxative. Leaves—cooked and eaten for bleeding piles. Flowers— antibacterial, anti-inflammatory. Bark—astringent, diuretic. Root— nervine tonic, given in paralysis; also prescribed in strangury.

Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of the root in gout, polyuria and haemorrhagic diseases.

The plant contains mucilage, tannins, asparagines, gallic acid and ses- quiterpenes. Presence of alkaloids, leucoanthocyanins, flavonoids, sterols, triterpenoids, saponins and cardiac glycosides is also reported.

Asparagine is diuretic. Gallic acid is analgesic. Mucilages act by reflex, loosen cough as well as bronchial tension. Essential oil—antibacterial, antifungal.

The drug exhibits immunological activity. It augments antibody in animals. EtOH (50%) extract of A. indicum ssp. guineense Borssum, synonym A. asiaticum (Linn.) Sweet, exhibits anticancer activity.

Related sp. include: Abutilon avicen- nae Gaertn., synonym A. theophrastii

Medic.; A. fruticosum Guill. et al.; A. hirtum (Lam.) Sweet, synonym A. graveolens Wt. and Arn.; A. muticum Sweet, synonym A. glaucum Sweet; and A. polyandrum Wight and Arn., synonym A. persicum (Burm. f.) Merrill (known as Naani-khapaat, Jhinaki- khapaat, Kanghi, Makhamali-khapaat and Khaajavani-khapaat, respectively, in folk medicine).

Dosage: Root—3-6 g powder. (API Vol I.)... abutilon indicum

Linn.

Family: Euphorbiaceae.

Habitat: Occurs throughout the plains of India, ascending the hills in Orissa up to 210 m.

English: Indian Acalypha.

Ayurvedic: Kuppi, Muktavarchaa, Haritamanjari

Siddha/Tamil: Kuppaimeni.

Folk: Khokli, Kuppi, Aamaabhaaji.

Action: Antibacterial (leaf used in scabies). Plant—emetic, expectorant (used in bronchitis, asthma, pneumonia). Tincture of fresh plant is used in homoeopathy for incipient phthisis with bloody expectorations, emaciation and arterial haemorrhage.

The plant contains kaempferol; leaves and twigs contain acalyphamide and other amides, quinone, sterols, cyanogenic glycoside.

The herb causes intestinal irritation.... acalypha indica

Linn.

Family: Acanthaceae.

Habitat: Common in tidal forests along the East and West coasts; also distributed in Meghalaya and the Andamans.

English: Sea Holly.

Ayurvedic: Krishna Saraiyaka. (Blue-flowered Katasaraiyaa.)

Siddha/Tamil: Kollimulli.

Folk: Hargozaa.

Action: Decoction—antacid (used in dyspepsia with acid eructations), also diuretic (used in dropsy and bilious swellings). Aerial parts show effect on nictitating membrane. The root is a cordial attenuant and is used in debility associated with asthma, paralysis, leucorrhoea.

The air-dried plant contains an alkaloid, acanthicifoline, and a flavone.... acanthus ilicifolius

See ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS.... ace inhibitors

A severe manifestation of infection with the Human immunodeficiency virus (HIV).... acquired immune deficiency syndrome (aids)

A disease which is characterized by a single or repeated episode of relatively rapid onset and short duration from which the patient usually returns to his/her normal or previous state or level of activity. An acute episode of a chronic disease (for example, an episode of diabetic coma in a patient with diabetes) is often treated as an acute disease.... acute disease / illness

... adenitis means inflammation of a gland.

See ANALGESICS; NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS).... anti-inflammatory drugs

A group of drugs that stop the action of the ENZYME, aromatase. This enzyme converts androgens (see ANDROGEN) to OESTROGENS. If this conversion is inhibited, the concentrations of oestrogens in the body are reduced – so these drugs operate against tumours, such as breast cancer, that depend on oestrogen for their growth. Aromatase inhibitors include anastrazole and formestane, and they are usually prescribed as second-line treatment after TAMOXIFEN, the prime drug treatment for breast cancer.... aromatase inhibitors

Forsk.

Synonym: A. caudatum Linn.

Family: Adiantaceae.

Habitat: The plains and the lower slopes of the hills in Punjab, Rajasthan, West Bengal, Tamil Nadu and Maharashtra.

Ayurvedic: Nilakantha-shikhaa, Mayurshikhaa, Vahrishikhaa.

Action: Used in hemicrania, cough, fever; externally in skin diseases; used as a substitute for A. capillus-veneris.

The fern yields adiantone, isoadian- tone, fernene, hentriacontane, hentri- acontanone-16, beta-sitosterol.... adiantum incisum

Hook.

Family: Sapindaceae; Hippocastana- ceae.

Habitat: The Himalayas from Kashmir to western Nepal, Kulu and Chamba in Himachal Pradesh, Tehri-Garhwal and Kumaon in Uttar Pradesh at 900-3,600 m.

English: Indian Horse Chestnut, Himalayan Chestnut.

Folk: Bankhor.

Action: Antirheumatic, galacto- genic, antileucorrhocic.

The leaves contain aescin, quercetin and beta-sitosterol. Stems also contain rutin, astragalin, aesculin. Seeds contain aescin, aesculuside A and B, also aliphatic esters. Seeds possess anti- inflammatory activity.

The extract of seeds is considered to be active against P-388 lymphocy- tic leukaemia and human epidermoid carcinoma of nasopharynx.... aesculus indica

Albizia tea is largely-spread worldwide and it provides plenty of health benefits to consumers. It is mainly recommended to patients suffering from ailments afflicting the nerve and brain. Albizia Tea description Albizia is a genus of more than 150 species of trees, occurring in large areas of the world, but mainly in the Old World tropics. It is regarded as an invasive species, growing in dry plains and sandy valleys. The parts considered to have healthy properties are the flowers and the bark. The heads of the Albizia flower are said to have sedative and tonic properties, whereas the bark has proven a stimulant and diuretic action. In ancient traditional Chinese literature, the use of the Albizia herb was related to promoting joy, assuaging sorrow and brightening the eyes. Albizia tea is made from dried blossoms of the abovementioned plant. Albizia Tea brewing To prepare Albizia tea:

• steep the dried blossoms in a 12-gram cup of hot water (5 minutes)
• alternatively, place a teaspoon of dried Albizia herb powder in newly-boiled water and similarly steep for about 5 minutes
• drink the tea slowly

Albizia Tea benefits Albizia tea has proved its efficiencyin:

• fighting insomnia
• improving the mood, uplifting the spirit and fighting depression, melancholy and anxiety
• fighting irritability
• strengthening mental health
• relieving stress
• relieving tightness in the chest

Albizia Tea side effects Albizia tea may interfere with other drugs that one intakes. Before drinking Albizia tea, consumers should consider consulting a licensed health care provider to avoid any possible inconvenience. However, Albizia is not recommended for pregnant or breastfeeding women, because there is little scientific evidence that it does not harm the baby. Albizia tea is a healthy type of tea, extensively used to treat insomnia and improve the mood, but it is also recommended to consumers willing to strengthen their mental health.... albizia tea fights insomnia

(Lour.) Spach.

Synonym: A. macrorrhiza (Linn.) G. Don

Family: Araceae.

Habitat: A genus of topical Asia, Malayasia and the Pacific. Found wild and cultivated all over India.

English: Giant Taro.

Ayurvedic: Maanaka, Maana, Maankanda, Kasaalu, Hastikarni.

Siddha/Tamil: Merukan kizhangu.

Action: Rootstock—mild laxative, diuretic (in anasarca); used in inflammations and diseases of abdomen and spleen. Leaf—astringent, styptic, antitumour. Root and leaf—rubefacient. Tubers—used as vegetable after eliminating oxalate content.

All parts of the plant, except tubers, contain cyanogenic principle, a mixture of triglochinin and iso- triglochinin. The tubers contain sterols and high concentration of soluble oxa- lates (prolonged use may lead to calcium deficiency and oxaluria.) The tubers contain a trypsin/chymotrypsin inhibitor. The plant contains HCN (0.0027%). It is found to be mitogenic to human peripheral blood lymphocytes.

Dosage: Tuber—5-10 g powder. (CCRAS.)... alocasia indica

The design and study of computer systems that have properties resembling human intelligence, such as natural language, problem-solving, and analysis of novel situations.... artificial intelligence (ai)

Hochr.

Synonym: A. roxburghiana A. Juss.

Family: Malpighiaceae.

Habitat: Eastern Himalayas, Assam, Meghalaya, Orissa and peninsular India.

Folk: Chuttakulaa-tigaa (Telugu).

Action: The extract of aerial parts— hypotensive.... aspidopterys indica

Asthma triggered by boggy membranes, congested tissues, or other native causes...even adrenalin stress or exertion... asthma, intrinsic

The ratio of the number of new cases of the disease and the amount of population-time of follow-up (e.g. person-year) of the disease-free population.... average incidence density

While many people love drinking hot tea during the winter, you can’t really do the same during summer. Drinking something hot won’t help you fight off the heat. However, if you love tea and you don’t want to give up on it, try iced tea! Cold and refreshing, you’ll surely enjoy it during the hot days of summer. Why Iced Tea? During hot summer days, a cold beverage is the best solution. Sodas might be tempting, but they’re far from the best solution. Fruit juices sound good, but if you’re a fan of teas, then iced tea sounds just as tempting. It is refreshing and, based on your preferences, you can enjoy the iced tea in many fruity flavors. There are various kinds of recipes which you can follow, in order to drink a pleasant iced tea. Iced Tea Recipes Iced tea is available in bottles, already made, just like juices and sodas. Also, it can be bought as a powder, for you to prepare it at home. However, you can use a more classic recipe to make your own iced tea. It’ll also be a lot more natural and, therefore, better for your health. For about two liters of iced tea, you mostly need cold water and tea leaves. Heat about 4 cups of cold water, add about two tablespoons of dried tea leaves and let them steep according to the time required by the types of leaves you use. Once the steeping time is done, strain to remove the leaves and pour the ‘tea’ inside a pitcher filled with ice. Some recipes of unsweetened tea recommend you to let the steeping last for an hour under the sun, for example, or even overnight in the refrigerator. Iced Tea Flavors The iced tea recipe uses leaves of the classic types of tea, like green tea or black tea. This doesn’t mean you can’t flavor it to your liking. To sweeten the iced tea, you can use sugar or honey. You can also add fresh fruits, but also frozen fruits, which will help keep the tea cold. Herbs and spices can be used too: mint, sage, lemongrass, lavender, basil, and lemon balm, or cardamom, cinnamon, nutmeg, and ginger. Fruit juices or fruit purees make a good sweetener, too. Pros and cons of iced tea Prepared with fresh ingredients, iced tea can serve as a healthy beverage - definitely more natural than cold sodas. If you use honey or fruits to sweeten it instead of sugar, it’s even better for your health. You have to be careful with the amount of iced tea you drink, and how fast you drink it. If you know you’ve got throat problems, you might end up with a sore throat in the middle of summer. Also, be careful with the caffeine content it might have from the tea leaves you use. Tea leaves from the plant Camellia sinensis contain caffeine. If you know coffee’s not good for you, especially if you’ve got heart problems, you can use herbal leaves to make your iced tea.   Iced tea is the perfect choice for a healthy, refreshing beverage during hot summer days. Prepare it yourself at home and you’ll surely enjoy it!... all you need to know about iced tea!

Retz.

Synonym: A. azurea Mill.

Family: Boraginaceae.

Habitat: Indian gardens, and hills.

English: Cow's Tongue Plant.

Ayurvedic: Gojihvikaa (considered as a vegetable, equated with Launaea asplenifolia Hook. f., Compositae, Asteraceae.) Unani Gaozabaan is a different drug.

Unani: Gaozabaan. (Now equated with species of Boraginaceae, particularly Borago officinalis Linn. Imported Unani drug Gaozabaan consists of the leaves and nutlets of Anchusa strigosa Labill and Echium amoenum Fisch. and Mey.)

Action: Stimulant, tonic, demulcent; used in bilious complaints, fever, cough, asthma; as diuretic in bladder and kidney stones. Oil—a rich source of vitamin E (0.72%), more than that of wheat-germ oil (0.18%). The nutlets show positive tests for alkaloids and tannins. The flowers yield anthocyanins and the leafy stems yield bornesitol.... anchusa italica

The ENZYME that converts angiotensin I to angiotensin II (see ANGIOTENSIN) is called angiotensin-converting enzyme. Angiotensin II controls the blood pressure and is the most potent endogenous pressor substance produced in the body; angiotensin I has no such pressor activity. Inhibition of the enzyme that converts angiotensin I to angiotensin II will thus have marked effects on lowering the blood pressure, and ACE inhibitors have a valuable role in treating heart failure when thiazides and beta blockers cannot be used or fail to work, especially after myocardial infarction (see HEART, DISEASES OF). Captopril was the ?rst ACE inhibitor to be synthesised: it reduces peripheral resistance by causing arteriolar dilatation and thus lowers blood pressure. Other drugs such as enalapril, lisinopril, cilazapril, quinapril and ramipril have since been developed. Some kidney disorders increase the production of angiotensin II and so cause HYPERTENSION.... angiotensin-convertingenzyme (ace) inhibitors

Hook. f.

Family: Balanophoraceae.

Habitat: The Himalayas from Kashmir to Sikkim and Darjeeling at altitudes of 1,800-3,400 m

Ayurvedic: Chavya (tentative synonym).

Action: Astringent. Used in piles, also in rheumatism.

A related species, B.polyandra Griff., found in Nagaland, Manipur, West Bengal, Bihar, Orissa and Andhra Pradesh at 2,000 m, gave a phenolic gly- coside, coniferin. The plant is used as an antiasthmatic.... balanophora involucrata

See SYCOSIS.... barber’s itch

Bather’s itch, also called schistosome DERMATITIS, is the term given to a blotchy rash on the skin occurring in those bathing in water which is infested with the larvae of certain trematode worms known as schistosomes (see SCHISTOSOMIASIS). The worm is parasitic in snails. The skin rash is caused by penetration of the skin by the free-swimming larval cercaria. Bather’s itch is common in many parts of the world.... bather’s itch

Linn.

Family: Aristolochiaceae.

Habitat: Throughout the country, mainly in the plains and lower hilly regions.

English: The Indian Birthwort.

Ayurvedic: Ishvari, Gandhnaakuli, Naagadamani, Arkamuula.

Unani: Zaraavand-Hindi.

Siddha/Tamil: Adagam.

Folk: Isarmuula, Isrola.

Action: Oxytocic, abortifacient, emmenagogue.

Aristolochia sp. contain aristolochic acids and aristolactams.... aristolochia indica

Linn. f.

Synonym: A. heterophyllus Lam.

Family: Moraceae.

Habitat: Cultivated throughout the hotter parts of India.

English: Jackfruit, Jack tree.

Ayurvedic: Panasa, Kantakiphala, Ativrihatphala, Aamaashayaphala.

Siddha/Tamil: Murasabalam.

Folk: Katahal, Phanasa.

Action: Latex—bacteriolytic, promotes healing of abscesses. Juice of the plant—applied to glandular swellings and abscesses for promoting suppuration. Root— used for diarrhoea, asthma, skin diseases. Unripe fruit—acrid, astringent. Ripe fruit—cooling, laxative, difficult to digest. Seeds— diuretic. Lactin extraction showed potent and selective stimulation of distinct human T and B cells.

The seed extract stimulates the heart and causes a fall in arterial blood pressure of experimental animals pretreat- edwithphysostigmine. The seeds show equal inhibitory activity against trypsin and chymotrypsin. (The activity is destroyed when the seeds are boiled or baked.)

The leaves and stems show presence of sapogenins, and exhibit estrogenic activity.

An aqueous extract of mature leaves exhibited hypoglycaemic activity in experimental animals. Leaves contain cycloartenone, cycloartenol and beta-sitosterol. Heartwood contains flavonoids, artocarpesin and norarto- carpetin and their structures.

Dosage: Fruit—50-100 ml decoction. (CCRAS.)... artocarpus integrifolia

Ashwagandha tea has a long medicinal history, being used for its healing properties byAyurveda practitioners, native Americans and Africans. At present, it is used to improve memory, but not only. What is Ashwagandha? Ashwagandha is a stout shrub that belongs to the nightshade family, but it does not possess poisonous properties.  It grows in India, Pakistan, Sri Lanka, Nepal and Bangladesh. Literally translated, Ashwagandha means horse smell. It has been also known as “India’s ginseng” or “winter cherry.” In Ayurveda, practitioners use Ashwagandha for its medicinal properties which enhance longevity and health in general. Native Americans and Africans have been using Ashwagandha to heal inflammation, fevers and infection. The plant has anti-microbial and anti-bacterial properties. Ashwagandha can be taken as tea, as tincture, in capsule form, or as an extract. Ashwagandha tea is the resulting beverage from brewing the abovementioned plant. Ashwagandha tea brewing To prepare Ashwagandha tea:

• Place about 1 teaspoon of dried ashwagandha leaves in boiling water.
• Let the mix steep for about 15 minutes and cool.
• Strain and then drink.

Ashwagandha tea benefits Studies revealed that Ashwagandha tea is successfully used to:

• calm the nerves and treat severe stress and nervous exhaustion
• help in the treatment of hypertension
• clear the mind, as well as to improve memory and cognitive abilities
• help in fighting arthritis
• help in restoring sexual vitality, especially in males

It also has anti-carcinogenic and anti-cancer properties. Ashwagandha tea is recommended for expectant mothers. It is said to purify the mother’s blood and strengthen her immune system. Because it acts as a uterine sedative, Ashwagandha tea is used during childbirth, bytraditional Ayurvedic medicine. Ashwagandha tea side effects Ashwagandha tea is not recommended to pregnant women. To avoid any possible side effects, consumers should not intake the tea in high doses or for long periods of time. Ashwagandha tea is a good choice when looking for an increased libido, or an adjuvant against cancer, due to its antioxidant content. It can be also used to enhance the immune system and thus, to release stress.... ashwagandha tea increases libido

See Bejuco de indio.... bohuco de indio

Health insurance which provides protection against the high cost of treating severe or lengthy illnesses or disabilities. Generally such policies cover all, or a specified percentage of medical expenses above an amount that is the responsibility of another insurance policy, up to a maximum limit of liability.... catastrophic health insurance

A defence mechanism involving the coordinated activity of two subpopulations of TLymphocytes, helper T-Cells and killer T-Cells. Helper T-Cells produce a variety of substances that stimulate and regulate other participants in the immune response. Killer T-Lymphocytes destroy cells in the body that bear foreign antigens (e.g. cells that are infected with viruses or other microorganisms).... cell-mediated immunity

A. Juss.

Synonym: Melia azadirachta Linn.

Family: Meliaceae.

Habitat: Native to Burma; found all over India.

English: Neem tree, Margosa tree.

Ayurvedic: Nimba, Nimbaka, Arishta, Arishtaphala, Pichumarda, Pichumanda, Pichumandaka, Tiktaka, Sutiktak, Paaribhadra.

Unani: Aazaad-Darakht-e-Hindi.

Siddha/Tamil: Vemmu, Veppu, Veppan, Arulundi.

Action: Leaf, bark—antimicrobial, antifungal, anthelmintic, insecti- cidal, antiviral, antipyretic, anti- malarial, antiperiodic, mosquito larvicidal, anti-inflammatory, antifertility, spermicidal, hypogly- caemic; used in inflammation of gums, gingivitis, periodonitis, sores, boils, enlargement of spleen, malarial fever, fever during childbirth, measles, smallpox, head scald and cutaneous affections. Oil—used as a contraceptive for intravaginal use, for the treatment of vaginal infections, and as a mosquito repellent.

Plant tetranortriterpenoids have been examined extensively for their antibiotic, antitumour, insecticidal, antibacterial and antifungal activities.

The methanolic extract of the bark shows antimalarial activity against Plasmodium falciparum.

The aqueous extract of leaves exhibited antiulcer and anti-inflammatory activity.

The water-soluble portion of alcoholic extract of leaves reduces blood sugar in glucose-fed and adrenaline- induced hyperglycaemic rats (but not in normal and streptozotocin-induced diabetic rats).

A volatile fraction of the Neem oil is reported to be responsible for sper- micidal activity at a dose of 25 mg/ml for human sperm. The oil has been found to retard the growth of human immunodeficiency virus.

Neem oil has caused mitochondri- al injury in mice; poisonous in high doses. (Sharon M. Herr.)

Dosage: Dried leaf—1-3 g powder; 10-20 g for decoction; stembark— 2-4 g powder decoction for external use. (API Vol. II.) Leaf juice— 10-20 ml; oil—5-10 drops; bark decoction—50-100 ml. (CCRAS.)... azadirachta indica

Basil tea is an Ayurvedic natural remedy used to treat a wide variety of diseases such as asthma, diabetes and high cholesterol. Hindus worship the plant for its religious significance as well. Basil Tea description Basil, a plant from the mint family, is original from India and Asia. It is an aromatic herb with a strong fragrance being largely used in spaghetti sauces, stews and tomato recipes. Basil is a source of vitamins and other nutrients.  Studies showed that this herb has anti-bacterial and anti-inflammatory health properties, fighting against intestinal problems, headaches and ulcers, as well. In aromatherapy, basil is used to alleviate mental fatigue. Basil tea is the resulting beverage from brewing the abovementioned plant. Basil Tea brewing To prepare Basil tea:

• bring the water and the basil leaves to boil (in a small tea pan)
• lower the heat and allow it to brew for 3-4 minutes
• add the tea leaves or tea bags and sugar according to taste
• bring to boil
• turn off the heat
• strain it into cups and add milk according to taste

Basil Tea benefits Studies claimed that Basil Tea is successesfully used to:

• treat intestinal colics, gastric ulcers and bloating/swelling of the abdomen
• treat anorexia
• fight urinary tract infections
• help against diarrhea
• help fight insomnia
• help treat lesions and inflammations in the mouth
• enhance the body’s ability to resist stress
• help to relieve pain

Basil Tea side effects Basil tea side effects are generally associated to large intakes. There have been thus noticed:shallow breathing, blood in the urine or sputum, mouth and throat burns, nausea, racing heartbeat, seizures, dizziness and coma. Pregnant or breastfeeding women, as well as women trying to become pregnant should not use Basil tea. Basil tea has anti-inflammatory and anti-microbial properties, proving itself to be an important adjuvant in treating arthritis, fevers and other ailments. It is also constantly used to add savor to several dishes.... basil tea has anti-inflammatory properties

The schedule laid down by most countries to recommend which routine immunizations should be given to children and the intervals at which boosters should be administered. Such routine immunizations usually include tetanus, diphtheria, pertussis, polio, Hepatitis B, Haemophilus influenzae type b (H.I.B.) and after one year of age, measles, rubella and mumps vaccines.... childhood immunization schedule

A variety of in?uenza in chickens occurring in southern China that in 1997 appeared to jump the species barrier and infect humans. Some cases of the human version of the infection occurred in Hong Kong. There were fears of a serious epidemic which, because of a lack of natural resistance among humans, might have led to its worldwide spread. This has not so far occurred.... chinese avian influenza

The difference between the lower and upper limits of a class.... class interval

An information system that collects, stores and transmits information that is used to support clinical applications (e.g. transmission of laboratory test results, radiology results, prescription drug orders). Electronic medical records are one method by which clinical information systems can be created.... clinical information system

A cost-sharing requirement under a health insurance policy. It provides that the insured party will assume a portion or percentage of the costs of covered services.... co-insurance

Cold-weather itch is a common form of itchiness that occurs in cold weather. It is characterised by slight dryness of the skin, and is particularly troublesome in the legs of old people. The dryness may be accompanied by some mild in?ammation of the skin. Treatment is by the application of emollients such as aqueous cream or zinc ointment.... cold-weather itch

Chewstick (Gouania lupuloides).

Plant Part Used: Stem, leaf, root, water from inside stem.

Dominican Medicinal Uses: The stem is traditionally used in multi-herb preparations and taken orally for infections, kidney ailments, reproductive disorders, venereal disease, blood-cleansing, menstrual disorders, uterine fibroids and menopause symptoms.

Safety: No data on the safety of this plant in humans has been identified in the available literature. This plant has shown some evidence of toxicity in animal studies, but more research is needed.

Contraindications: Unknown; insufficient information identified in the available literature.

Drug Interactions: Unknown; insufficient information identified in the available literature.

Laboratory & Preclinical Data: In animal studies the leaf and branch extract has shown muscle-relaxant effects. In vitro isolated compounds have demonstrated anti-inflammatory and antimicrobial activity and CNS sedative effects and the plant extract has shown vasodilatory effects.

* See entry for Bejuco de indio in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... bejuco de indio

Boxing injuries rank eighth in frequency among sports injuries. According to the Report on the Medical Aspects of Boxing issued by the Committee on Boxing of the Royal College of Physicians of London in 1969, of 224 ex-professional boxers examined, 37 showed evidence of brain damage and this was disabling in

13.

The ?rst type of damage occurs as an acute episode in which one or more severe blows leads to loss of consciousness and occasionally to death. Death in the acute phase is usually due to intracranial haemorrhage and this carries a mortality of 45 per cent even with the sophisticated surgical techniques currently available. The second type of damage develops over a much longer period and is cumulative, leading to the atrophy of the cerebral cortex and brain stem. The repair processes of the brain are very limited and even after mild concussion it may suffer a small amount of permanent structural damage. Brain-scanning techniques now enable brain damage to be detected during life, and brain damage of the type previously associated with the punch-drunk syndrome is now being detected before obvious clinical signs have developed. Evidence of cerebral atrophy has been found in relatively young boxers including amateurs and those whose careers have been considered successful. The tragedy is that brain damage can only be detected after it has occurred. Many doctors are opposed to boxing, even with the present, more stringent medical precautions taken by those responsible for running the sport. Since the Royal College’s survey in 1969, the British Medical Association and other UK medical organisations have declared their opposition to boxing on medical grounds, as have medical organisations in several other countries.

In 1998, the Dutch Health Council recommended that professional boxing should be banned unless the rules are tightened. It claimed that chronic brain damage is seen in 40–80 per cent of boxers and that one in eight amateur bouts end with a concussed participant.

There is currently no legal basis on which to ban boxing in the UK, although it has been suggested that an injured boxer might one day sue a promoter. One correspondent to the British Medical Journal in 1998 suggested that since medical cover is a legal requirement at boxing promotions, the profession should consider if its members should withdraw participation.... boxing injuries

Most blows to the head cause no loss of consciousness and no brain injury. If someone is knocked out for a minute or two, there has been a brief disturbance of the brain cells (concussion); usually there are no after-effects. Most patients so affected leave hospital within 1–3 days, have no organic signs, and recover and return quickly to work without further complaints.

Severe head injuries cause unconsciousness for hours or many days, followed by loss of memory before and after that period of unconsciousness. The skull may be fractured; there may be ?ts in the ?rst week; and there may develop a blood clot in the brain (intracerebral haematoma) or within the membranes covering the brain (extradural and subdural haematomata). These clots compress the brain, and the pressure inside the skull – intracranial pressure – rises with urgent, life-threatening consequences. They are identi?ed by neurologists and neurosurgeons, con?rmed by brain scans (see COMPUTED TOMOGRAPHY; MRI), and require urgent surgical removal. Recovery may be complete, or in very severe cases can be marred by physical disabilities, EPILEPSY, and by changes in intelligence, rational judgement and behaviour. Symptoms generally improve in the ?rst two years.

A minority of those with minor head injuries have complaints and disabilities which seem disproportionate to the injury sustained. Referred to as the post-traumatic syndrome, this is not a diagnostic entity. The complaints are headaches, forgetfulness, irritability, slowness, poor concentration, fatigue, dizziness (usually not vertigo), intolerance of alcohol, light and noise, loss of interests and initiative, DEPRESSION, anxiety, and impaired LIBIDO. Reassurance and return to light work help these symptoms to disappear, in most cases within three months. Psychological illness and unresolved compensation-claims feature in many with implacable complaints.

People who have had brain injuries, and their relatives, can obtain help and advice from Headwat and from www.neuro.pmr.vcu.edu and www.biausa.org... brain injuries

See CHILBLAIN; FROSTBITE; HYPOTHERMIA.... cold, injuries from

In health care, usually any insurance for hospital or medical care which has the objective of making a profit.... commercial insurance

See HEALTHCARE COMMISSION.... commission for health improvement

An integrated collection of computer and telecommunication capabilities that permit multiple providers, payers, employers and related health care entities within a geographic area to share and communicate client, clinical and payment information.... community health information network (chin)

The active involvement of people living together in some form of social organization and cohesion in the planning, operation and control of primary health care, using local, national and other resources. In community involvement, individuals and families assume responsibility for their and their communities’ health and welfare, and develop the capacity to contribute to their own and their communities’ development.... community involvement

Bugleweed Tea  is an important ingredient in the field of modern alternative medicine because it proved its efficiency against thyroid problems, as well as breast pain. Bugleweed Tea description Bugleweed is a low-growing flowering plant from the mint family, native to Europe. It is also known as sweet bugle and it grows in marshlands. The bugleweed has oval-shaped leaves which resemble spinach leaves. Bugleweed flowers grow in clusters and have a pink to blue color. This plant has a fresh, mild, mint-like aroma. The leaves and flowers are used for medicinal purposes. Bugleweed tea is the resulting beverage from brewing the abovementioned plant. Bugleweed Tea brewing To prepare Bugleweed tea:

• add one teaspoonful of dried bugleweed herbs to a cup of boiling water
• allow the mixture to steep for 10-15 minutes

Bugleweed tea may be drunk three times a day. Also, it can be applied topically either as tincture or as poultice. Bugleweed Tea benefits Bugleweed tea has been successfully used to:

• treat hyperthyroidism
• alleviate cyclic breast pain in women by moderating estrogen levels
• sedate and calm the nerves
• suppress cough and fighting tuberculosis and other disorders of the lungs
• moderate a rapid heart rate
• remove excess fluid in the body and promote better circulation
• accelerate the healing of bruises and other wounds (when applied topically)

Bugleweed Tea side effects Bugleweed tea should not be consumed by pregnant or nursing women. Bugleweed tea is a herbal remedy for a large array of diseases, being best known for its healing properties against hyperthyroidism, breast pain and lungs disorders.... bugleweed tea for endocrine issues

California Poppy tea is a natural remedy against insomnia. It is largely used for its healing properties against anxiety, too. California Poppy Tea description California poppy is an annual or perennial plant, originating from the Pacific coast. Its orange-yellow flowers flourish during spring and midsummer. North Americans used to consume this plant for stress-caused illnesses. Landscape artists appreciate California poppy plant for its beauty. California Poppy tea is the beverage resulting from brewing the abovementioned plant. California Poppy Tea brewing To prepare California Poppy tea, place the flowers, stems and leaves in boiling water for about 10 minutes. California Poppy Tea benefits California Poppy tea has been successfully used to:

• fight insomnia by ushering in restful sleep
• fight anxiety
• fight headaches
• fight toothaches and stomachaches
• fight skin sores and ulcers

California Poppy Tea side effects Pregnant women and children should not consume California Poppy tea. California Poppy tea is a healthy beverage able to deal with a large array of diseases such as stomachaches and ulcers and it also proved to be helpful for skin sores.... california poppy tea against insomnia

Linn.

Family: Guttiferae; Clusiaceae.

Habitat: Coastal regions, particularly Orissa, Karnataka, Maharashtra and the Andamans. Also cultivated as an ornamental tree.

English: Indian Laurel, Alexandrian Laurel.

Ayurvedic: Punnaaga, Tunga, Sultaan champaa, Naagchampaa, Raajchampaa.

Siddha/Tamil: Punnai, Punnagam.

Action: Oil of seeds—specific for scabies and other skin diseases, and for rheumatism. Used in the treatment of genitourinary and venereal diseases. Bark—juice is taken as purgative; pounded with water is applied in orchitis, and for dressing ulcers. Root bark— antibacterial, used for indolent ulcers. Leaf—used in vertigo and migraine, also for chicken pox, skin inflammations, scabies, sunburn. Flowers and stamens—used as a substitute for Naagakesara (Mesua ferrea Linn.)

The root bark and heartwood contain xanthones. The xanthones exhibited anti-inflammatory activity in rats against carrageenan-induce oedema; also CNS depressant activity. Jaca- reubin and 6-deoxy derivatives exhibited antiulcer activity in rats.

Calophyllolide, a complex 5-Ph- coumarin isolated from nuts, showed antiarrhythmic (as effective as quini- dine), bradycardiac coronary dilator, and anticoagulant, also anti-inflammatory and antiarthritic activity.

Dosage: Leaf, flower, bark—3-5 g powder; 50-100 ml decoction. (CCRAS.)... calophyllum inophyllum

A firmly-applied, broad, elastic bandage applied to a limb to prevent the spread of venom injected after certain bites or stings. The pressure is enough to compress veins and lymphatic vessels, but not to cut off arterial supply and so it can remain on indefinitely. The bandage is first applied directlyover the envenomated area, and then extended over the entire limb which is then immobilised in a splint.... compression/immobilisation bandage

A determination of the economic impact of a disease or health condition, including treatment costs.... cost-of-illness analysis

(Brot.) A. Rich.

Psychotria ipecacuanha

Family: Rubiaceae.

Habitat: Native to tropical America. Now cultivated in Darjeeling, Assam, in the Nilgiris, and in Sikkim.

English: Ipecac, Ipecacuanha.

Action: Root—Antiprotozal, expectorant (in low doses), diaphoretic, emetic (in high doses); used in amoebic dysentery, stubborn cough, whopping cough (for liquefying bronchial phlegm).

Key application: As expectorant, emetic. (The British Herbal Pharmacopoeia.)

The root contains isoquinoline alkaloids (consisting mainly of emetine and cephaeline); tannins (ipecacuanha and ipecacuanhic acid; glycosides including a monoterpene isoquinoline derivative); saponins; a mixture of glycoproteins; starch; choline; resins.

The alkaloids are clinically useful in the treatment of amoebiasis.

Emetine and cephaeline are emetic due to their irritating effect on stomach; cephaeline is more toxic. Emetine is a standard antiamoebic principle. In smaller doses, both are expectorant.

The fluid extract is 14 times stronger than the syrup of the crude drug. The powder is toxic at 1-2 g.

Emetine accumulates in liver, lungs, kidneys and spleen; traces are detectable after 40-60 days. (Francis Brinker.)... cephaelis ipecacuanha

(Linn.) Ach.

Family: Parmeliaceae.

Habitat: Lichen found in the hills from Tehri Garhwal to East Nepal.

English: Cetraria, Iceland Lichen, Iceland Moss.

Ayurvedic: Shaileya (black var.)

Folk: Charela (black var.)

Action: A food and tonic in convalescence and exhausting diseases. Used for chronic catarrh and bronchitis.

Key application: In irritation of the oral and pharyngeal mucous membrane and accompanying dry cough. (German Commission E, ESCOP.) As demulcent. (The British Herbal Pharmacopoeia.) As a bitter remedy for lack of appetite. (ESCOP.)

The moss contains lichen acids (dep- sidones); mainly cetraric, protoce- traric, fumarprotocetraric, lichesteric and usnic acids; polysaccharides about 50%—lichenin 40% and isolichenin 10%; also furan derivatives, fatty acid lactones and terpenes. Lichenin is a moss-starch. Demulcent, expectorant and antiemetic properties are due mainly to the polysaccharides.

The usnic acid and protolichesteri- nic acid in the lichen and its crude, aqueous extract showed antibacterial activity against several pathogenic bacteria.

Contraindicated in gastric or duodenal ulcers due to its mucosa irritating properties. (Sharon M. Herr.)

Lozenges containing 160 mg of an aqueous extract of Iceland moss, were determined to be positive in 86% cases with good gastric tolerance. (ESCOP 1997.)... cetraria islandica

Discover the unique features of this Indian blend and learn more about how to get an interesting Chai tea every time and how to combine its ingredients for a special tasty experience. What is Chai tea Many people think Chai tea comes from China like most other types of tea. In fact, the word chai means tea in Hindi where it has its origin. Chai tea is actually a blend that combines black tea with milk, spices (like cinnamon, cloves, pepper and ginger) and sweeteners, creating a full tasty drink, perfect for you and your family. This Indian type of tea is also called “masala tea” and “spyce tea”. The smell of it draws plenty of attention and many people say that it helps them to relax. Drink Chai tea The way you make Chai tea is very important to get the right taste. Being a mixture of spices in different combinations, the brewing methods vary widely. There are traditional methods together with customized ones, depending on the spices contained in the blend. The milk should be added to the black tea while it is still boiling. This will make the tea turn darker and it will get a stronger flavor than many other type of teas. Chai Tea Benefits Learn how the amazing benefits of black tea combine successfully with those of other herbs and spices that form this unique mixture and how can they help you lead a healthier life. Chai tea prevents cardiovascular diseases. Catechins and polyphenols from the black tea lowers blood pressure and reduces bad cholesterol, thus preventing the formation of blood clots. Spices contained are perfect to fight viruses and bacteria. If you suffer from digestion problems, be sure that drinking this tea will help you in this regard. Chai tea is good if you want to treat colds, flu or even fever. It is a very good coffee substitute and the addition of milk and honey provide you even more health benefits within each cup. Chai Tea Side Effects Because it contains many ingredients in one mixture, Chai tea may have some precautions. For example, if you suffer from ulcers and heartburns you shouldn’t drink it as it may worsen your condition. If you have intolerance to lactose, you can abandon the idea of adding milk into it. If you have problems with caffeine, try to chose another blend, based or green tea or anything but black tea. Chai tea is an interesting tea with lots of health benefits. Its numerous ways of mixing its ingredients and the different flavor according to it will certainly not bore you, because you can create a new one every time you drink it.... chai tea - a famous indian blend

The proportion of number of newly detected cases that developed during follow-up by the number of disease-free subjects at the start of follow-up.... cumulative incidence

See COX-2 INHIBITORS.... cyclo-oxygenase-2 selective inhibitors

An illness suffered by divers when diving too deep, or too long and characterised bynitrogen bubbles forming in the tissues of the body. This may cause a multitude of symptoms although joint pains are those most-commonly encountered. Confusion may be caused in divers that have suffered an Irukandji sting as the symptoms have some similarities. See also, cerebral gas embolism.... decompression illness (dci)

Cherry Tea is a dark red beverage with an intense fruity flavour whose colour resembles ripe cherries and it can be enjoyed hot or cold. The delightful cherry scent is often blended with other aromas which results in savory and exotic mixtures. Cherry Tea Brewing Regarding cherry tea, the brewing time can vary, but the standard procedure entails a five-minute steeping process. Consequently, you will rejoice in the lovely cherry aroma of your amazingly enticing and enjoyable beverage. Health Benefits of Cherry Tea Cherry Tea is a beneficial fruity beverage with numerous health benefits. Cherry fruits are renowned for their delightfully refreshing flavour and delicious sweet taste, but they are also packed with nutrients, vitamins and minerals that essentially contribute to our wellbeing. These fruits are rich in antioxidants which protect our body from free radicals and thus lower the risk of cancer and various neurological diseases, but they also delay the aging process. Cherries also contain melatonin, an antioxidant with calming effects on the brain, which helps releave irritability, insomnia and headaches, thus improving the quality of sleep. The countless health benefits of cherry tea also include anti-inflammatory properties and could potentially prove effective against pain caused by diseases or injuries. Cherry fruits are low in calories, but they contain vitamin C which unfortunately entices you to consume approximately 180 calories more a day. This could possibly result in the accumulation of some extra weight if consumed for large periods of time. Therefore, adjust your dietary plan accordingly. Side effects of Cherry Tea Cherry Tea contains extracts from the cherries which can induce an allergic reaction to people sensitive to these fruits, but it is generally side-effect-free. You can enjoy a savory cup of cherry tea at any given time of the day in order to boost your overall energy level and metabolism. The full flavour of succulent fresh cherries along with a delectable and lingering aftertaste will enchant you. Cherry tea is without doubt a delightful juicy drink with an exotic character.... cherry tea - ingredients and health benefits

Linn.

Synonym: Pyrethrum indicum L.

Family: Compositae; Asteraceae.

Habitat: Native to China and Japan. Cultivated as an ornamental.

English: Chrysanthemum.

Ayurvedic: Shatapatri.

Unani: Guldaaudi.

Siddha/Tamil: Samanthipoo, Akkarakkaram.

Action: Flowers—stomachic, aperient, anti-inflammatory. Leaves— prescribed in migraine (as circulatory stimulant). Uses same as those of chamomile.

The flowers contain daucosterol, cumambrin-A, glyceryl-l-monobehe- nate and palmitic acid. The flowers also contain chrysanthemol which showed strong anti-inflammatory activity in mice. The flavones, apigenin and lu- teolin, are reported to exhibit marked antitumour activity.

Flowers yield an essential oil containing camphor (16.0%), trans-cara- ne-trans-2-ol (15.0%), bornyl acetate (12.0%) and sabinene (7%).

A related species C. parthenium (Linn.) Berhh., Feverfew, synonym Tanacetum parthenium, used for the management of migraine in Western herbal, is found in Jammu and Kashmir. The plant extracts have a powerful and prostaglandin-independent inhibitory effect on the secretion of granule content by leucocytes and platelets. The inhibition of the agonist-induced serotonins release by platelets could be accounted for the benefit in migraine. The compound responsible for the anti-secretory activity has been identified as sesquiterpene alpha-methylene- gamma-lactone derivatives; partheno- lide being the main constituent of the lactones. (Two fresh or frozen leaves a day are chewed or capsules or pills containing 86 mg of the leaf material is taken for migraine. Fresh leaves may cause mouth sores.)... chrysanthemum indicum

Linn.

Family: Compositae; Asteraceae.

Habitat: Native to Europe; commonly occurs in North West India, Tamil Nadu and parts of Andhra Pradesh.

English: Chicory, Indian Endive.

Ayurvedic: Kaasani.

Unani: Kaasani Dashti (Barri).

Siddha/Tamil: Kasinikkeerai.

Action: Diuretic, laxative, chol- agogue, mild hepatic. Excites peristalsis without affecting the functions of the stomach. Used in liver congestion, jaundice, rheumatic and gouty joints.

Key application (herb and root): In loss of appetite, dyspepsia. (German Commission E.)

The herb contains inulin (up to 58% in the root); sesquiterpene lactones (including lactucin and lactucopicrin); coumarins (chicoriin, esculetin, es- culin, umbelliferone and scopoletin); the root includes a series of glucofruc- tosans. Raw chicory root contains only citric and tartaric acids; roasted chicory contains acetic, lactic, pyru- vic, pyromucic, palmitic and tartaric acids. The carcinogenic hydrocarbons and floranthene are also reported in the chicory (a potent carcinogen 3,4- benzpyrene has been detected).

Added to coffee, chicory root counteracts caffeine and helps in digestion.

An alcoholic extract of the plant was found effective against chlorproma- zine-induced hepatic damage in adult albino rats. The cholagogue activity is attributed to polyphenols.

The sedative effect of chicory is attributed to lactucopicrin. The sedative effect antagonizes the stimulant effect of tea and coffee. (Natural Medicines Comprehensive Database, 2007.)

The extracts of roots were found to be active against several bacteria.

Dosage: Seed—3-6 g powder; leaf—10-20 ml juice; root—50- 100 ml. (CCRAS.)... cichorium intybus

Viral, bacterial and fungal PNEUMONIA

Lung trauma or contusion

Inhalation of toxic gases or smoke

ASPIRATION of gastric contents

Near-drowning... direct insult

Linn.

Synonym: C. viscosa Linn.

Family: Capparidaceae.

Habitat: Throughout India; Tripura, West Bengal and Gangetic valley, as a weed.

English: Wild Mustard.

Ayurvedic: Tilaparni, Hurhur (yellow var.), Aadityabhakta.

Unani: Panwaar, Hulhul.

Siddha/Tamil: Nayikkadugu, Nalvellai.

Action: Seed—carminative, antiseptic, anthelmintic (for round worms). Leaf—sudorific. Bark— externally rubefacient, vesicant. Root—vermifuge.

The aerial parts contain a macro- cyclic diterpene, cleomaldeic acid, and a bicyclic diterpene, cleomeolide. The seeds contain coumarino-lignans, cleomiscosin A,B,C and D. The leaf extract exhibited fungitoxicity against ringworm causing fungi with reported mycelian inhibitions.

The aqueous extract of seeds exhibited significant analgesic and local anaesthetic activities in mice and guinea pigs, respectively. It failed to protect rats against convulsions induced by picrotoxin, though it potentiated the barbiturate sleeping time.

The purple var. of Hurhur is equated with Cleome monophylla L. (Bihar, Orissa, Andhra Pradesh and Tamil Nadu).... cleome icosandra

(Linn.) Kuntze.

Synonym: Clerodendron siphonan- thus (R. Br.) C. B. Clarke.

Family: Verbenaceae.

Habitat: Cultivated as an ornamental throughout India, especially in South and Eastern India.

English: Turk's Turban, Tube- Flower.

Ayurvedic: Vaamana-haati (a substitute for Bhaarangi).

Siddha/Tamil: Kavalai, Narivalai.

Action: Root—used for asthma, cough, scrofulous affections. Leaf— vermifuge. Resin—antirheumatic. The plant is also used in fever, atrophy, emaciation of cachexia and consumption.

The leaves contain flavonoids—scu- tellarein (0.5%), hispidulin (0.1%) and their 7-O-glucuronides; also sterols. Flowers contain beta-sitosterol and tri- terpenoids. The bark yields hexitol and sorbitol.

The flavone, pectolinarin and a di- terpene, oncinotine, exhibit antifee- dant activity.... clerodendrum indicum

(L.) Gaertn.

Family: Verbenaceae.

Habitat: Throughout India in tidal forests, wild all over coastal areas; planted in gardens in Tamil Nadu.

English: Smooth Volkameria.

Ayurvedic: Putigandhaa, Kundali, Vanajai.

Siddha/Tamil: Peenaari, Sangan- kuppi.

Folk: Lanjai.

Action: Leaf—febrifuge, alterative. Used as a substitute for Swertia chirayita and quinine in remittent and intermittent fevers. The leaf juice is taken orally to relieve muscular pains and stiffness of legs (in tetanus).

The leaves and stem contain a number of triterpenes, neolignans, diter- penoids, sterols and flavones.

The roots are prescribed in venereal diseases. The methanolic extract of the roots contains verbascoside which exhibits analgesic and antimicrobial properties.... clerodendrum inerme

auct. non Linn. C.B.Clarke.

Family: Verbenaceae.

Habitat: Throughout India. Ayurvedic: Bhaandira, Bhaandi, Kaari. Also known as Bhaarangi (C. serratum). Siddha/Tamil: Karukanni, Perugilai.

Action: Leaves—used as a substitute for Chiretta. Leaves and roots— employed externally for skin diseases and alopecia. Leaves are prescribed in headache. Roots are given in cramps and rheumatism.

In homoeopathy, the fresh leaves are employed for colic due to worms, diarrhoea associated with nausea, chronic fever with loss of appetite and in enlargement of liver and spleen with indigestion and constipation.

The alcoholic extract of the whole plant showed antiprotozoal activity against Entamoeba histolytica. It also exhibited hypoglycaemic activity in albino rats. The leaves exhibit antifun- gal activity.

Dosage: Leaf—10-20 ml juice. (CCRAS.)... clerodendrum infortunatum

Duchesnea indica

Description: The duchesnea is a small plant that has runners and three-parted leaves. Its flowers are yellow and its fruit resembles a strawberry.

Habitat and Distribution: It is native to southern Asia but is a common weed in warmer temperate regions. Look for it in lawns, gardens, and along roads.

Edible Parts: Its fruit is edible. Eat it fresh.... duchesnea or indian strawberry

Dilatation of the DUODENUM due to its chronic obstruction, caused by an abnormal position of arteries in the region of the duodenum pressing on it.... duodenal ileus

Action at an early stage of a disease or social process.... early intervention

Insertion of a rubber or plastic tube through the nose or mouth into the TRACHEA. The tube often has a cu? at its lower end which, when in?ated, provides an airtight seal. This allows an anaesthetist to supply oxygen or anaesthetic gases to the lungs with the knowledge of exactly how much the patient is receiving. Endotracheal intubation is necessary to undertake arti?cial ventilation of a patient (see ANAESTHESIA).... endotracheal intubation

This is a sensitive method for measuring the quantity of a substance. An antibody to the substance is prepared along with an ENZYME which binds to the antibody and which can be accurately measured using colour changes that occur as a result of the chemical reaction.... enzyme-linked immunosorbent assay (elisa)

W. & A.

Synonym: C. cordifolia Cogn. Cephalandra indica Naud.

Family: Cucurbitaceae.

Habitat: Cultivated in Assam, West Bengal, Bihar, Orissa, Maharashtra, Andhra Pradesh, Tamil Nadu; wild in many parts of India.

English: Ivy-Gourd.

Ayurvedic: Bimbi, Tundi, Tundikaa, Tundikeri, Kunduru, Raktaphala, Piluparni, Dantchhadaa.

Unani: Kanduri.

Siddha/Tamil: Kovvai.

Action: Carminative, antipyretic, galactagogue. Powder of root is taken with water to stop vomiting. Juice of leaves—antispasmodic and expectorant. Applied externally in eruptions of the skin. Root— antiprotozoal. Fruit, leaf and root— antidiabetic. Various plant parts are used in slow pulse and convulsions, also against infective hepatitis.

The Ayurvedic Pharmacopoeia ofIn- dia recommends the whole plant for oedema, anaemia, disorders due to vitiated blood, cough and dyspnoea.

The fruit yielded beta-amyrin and its acetate, lupeol and cucurbitacin B.

Dosage: Whole plant—3-6 g powder; 5-10 ml juice. (API Vol. III.)... coccinia indica

A cochlear implant is an electronic device, inserted under a general anaesthetic, which stimulates the auditory system, restoring partial hearing in profound sensory deafness. Although there are many types of cochlear implant, they all consist of a microphone, a signal processor, a signal coupler (transmitter and receiver), and an array of electrodes. Most are multi-channel implants. The microphone and signal processor are worn outside the body, like a conventional hearing aid: they receive sound and convert it into an electronic signal which is transmitted through the skin to the receiver. Here the signal is transmitted to the array of electrodes which stimulates the cochlear nerve. Although cochlear implants do not provide normal hearing, most profoundly deaf patients who receive a cochlear implant are able to detect a variety of sounds, including environmental sounds and speech. The duration of hearing-loss and age at implantation are among the many factors which in?uence the results (see DEAFNESS).... cochlear implants

This stands for cyclo-oxygenase 2 inhibitors – a class of drugs used in treating ARTHRITIS – of which the most well-used is celecoxib. Their main claim is that they are less likely to cause gastrointestinal disturbance than NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS). In 2001, the National Institute for Clinical Excellence (NICE) recommended that they should not be used routinely in rheumatoid arthritis or osteoarthritis but only in patients with a history of peptic ulcer or gastrointestinal bleeding. They should also be considered in persons over the age of 65 taking other drugs which could cause gastrointestinal bleeding, those who are very debilitated, and those who are taking maximum doses of NSAIDs. In 2005, rofecoxib was withdrawn because of concerns about cardiac side-effects.... cox-2 inhibitors

Mill.

Synonym: D. metel auct. non Linn.

Family: Solanaceae.

Habitat: Western Himalayas and hilly regions of the western parts of Peninsular India, abundantly in Maharashtra.

English: Thornapple.

Ayurvedic: Dhattuura.

Unani: Dhaturaa, Joz Maasil.

Action: The plant is the source of alkaloid scopolamine which is used as a pre-anaesthetic in surgery and childbirth, in ophthalmology and for the prevention of motion sickness.

Hyoscyamine and hyoscine and me- teloidine were found in the leaves, flowers, pericarp and seeds of the plant. The root gave tropane, tropine and pseu- dotropine.... datura innoxia

See MUNCHAUSEN’S SYNDROME.... fabricated and induced illness

A tick-borne disease found on Flinder’s Island, north of Tasmania. Zoonotic and caused by Rickettsia honei.... flinder’s island spotted fever

L.

Family: Liliaceae.

Habitat: Kashmir at 1,700-3,000 m.

English: Crown Imperial, Imperial Fritillary.

Action: Bulbs—emollient, diuretic, resolvent, spasmolytic, hypotensive, cardiotonic.... fritillaria imperialis

Insurance which covers the risk of loss for most accidents and injuries to third parties (the insured and its employees are not covered) which arise from the actions or negligence of the insured, and for which the insured may have legal liability, except those injuries directly related to the provision of professional health care services (the latter risks are covered by professional liability insurance).... general liability insurance

Indigofera tinctoria

Papilionaceae

San:Nilini, Ranjani, Nilika, Neelam, Aklika, Asita, Bhadra; Ben, Guj:Nil;

Hin:Gouli;

Mal: Neelamari;

Tam: Averi;

Tel: Aviri, Nili;

Kan: Nili; Mar: Nali; Ori: Neli

Importance: Common indigo or Indian indigo is a branching shrub which grows upto 2m high. Nili is a reputed drug produced from this plant which is used in ayurveda for the promotion of hair growth and it forms a major ingredient of preparations like nilibhringadi oil. This is the original source of natural indigo. Due to antitoxic property it is also a good remedy for poisons. According to Bhavaprakasa, nili is purgative in action, bitter, hot, cures giddiness, abdominal enlargement, vatarakta, gout and intestinal obstruction. The decoction or powder of the plant is used in whooping cough, bronchitis, palpitation of the heart, enlargement of the liver and spleen, dropsy, diseases of lungs and kidney, epilepsy and nervous disorders. A poultice of the leaves is recommended in skin diseases, piles, ulcer and haemorrhoids. A wine glass full juice of the leaves is administered in the morning with or without milk for three days to those who have been bitten by mad dogs. Root decoction is given in calculous diseases and used as an antidote to arsenic poisoning. The seed of the plant is powered and steeped in arrack or rum, yield a tincture, which is used to distroy lice. Indigo, the dye extracted from the leaves, is a soothing balm for burns and scalds, insect stings and animal bites. The synonyms visaghni and sodhani indicate the antitoxic and laxative properties of the drug nili, respectively (Aiyer and Kolammal, 1960).

Distribution: This plant is distributed in South and South East Asia, tropical Africa and is introduced in tropical America. In India, it is found almost throughout and cultivated in many parts.

Botany: Indigofera tinctoria Linn. syn. I. summatrana Gaertn, Pigmentum indicum belongs to Papilionaceae family. This is a branching shrub which grows upto 2m high. Stems and branches are green; branchlets silvery pubescent. Leaves are alternate, stipulate, imparipinnate and got 7-13 leaflets which are elliptic-oblong, membraneous,1.7x0.9cm, shortly mucronate, pale green or bluish. Flowers are small, rose-coloured in axillary racemes. Calyx 5-cleft, gamosepalous; corolla papilionaceous; stamens diadelphous; ovary sessile with a short incurved style ending in a capitate stigma. Pods are linear, cylindrical, 2-5cm long, deflexed having 8-12 seeds.

Agrotechnology: The Indian indigo requires good sunlight and grows well in hilly areas. This is usually propagated by seeds. Seeds are very small and the seed rate is 3kg/ha. Seeds require pretreatment for good germination as the seed coat is hard. Seeds are mixed with sand and ground gently to break the seed coat. An alternate method for enhancing germination is dipping the seeds in boiling water for a second. After pretreatment seeds are broadcasted. Broadcast the seeds preferably mixed with sand 2 or 3 times its volume to ensure uniform coverage. The seedbeds should be covered with straw and irrigated. Seeds germinate within 15 days. Seedlings are ready for transplanting after one month. For the land preparation, the soil is brought to fine tilth by ploughing 2 or 3 time s. Cattle manure should be applied at the rate of 10t/ha as basal dressing and incorporated into soil along with last ploughing. The best time for sowing is September-October. Weeding has to be done two times; 3 weeks after sowing and 6 weeks after sowing. Plants start flowering 2-3 months after sowing. Harvesting is done by cutting the plants at this time, at a height of about 10cm from ground level. Irrigate plants after harvest. Subsequent harvests can be made at 1.5-2 months interval. Four to five cuttings can be taken in an year depending on the growth. A few plants per plot are left without cutting to set seeds. Ripe pods are to be harvested in the early morning to prevent loss of seeds by shattering during harvest.

Properties and activity: A blue dyestuff is obtained from the indigofera which does not exist ready formed, but is produced during fermentation from another agent existing in the plant, known as indocan. Indocan is yellow amorphous of a nauseous bitter taste with an acid reaction, readily soluble in water, alcohol and ether. An artificial product indigotine is manufactured chemically and used as a substitute. Indirubin is another component of the plant.

The plant is deobstruent, alterative, antitoxic, antiasthmatic and antiepileptic. Aerial part is hypoglycaemic, CNS depressant and antitoxic. The leaves, flowers and tender shoots are considered to be cooling, demulcent and alterative. Leaf is antiinflammatory. Root and stem is laxative, expectorant, antitumourous, febrifuge, anticephalalgic, antidote for snake bite, anthelmintic and promotes growth of hair. Root is divertic. Indirubin is antineoplastic and has toxicity. Nili is antitoxic, purgative and laxative. Indigo is said to produce nausea and vomiting.... common indigo

D. Don.

Family: Orchidaceae.

Habitat: The Himalayan region. Found in Ranikhet.

Ayurvedic: Riddhi, Vriddhi. (Substitute: Dioscorea bulbifera.)

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

Any establishment that is engaged in direct patient care on site.... health care institution / facility

A characteristic of an individual, population or environment which is subjected to measurement and can be used to describe one or more aspects of the health of an individual or population (quality, quantity and time). A health index comprises a number of indicators.... health indicator / index

The generation and the use of appropriate health information to support decision-making, health care delivery and management of health services at national and subnational level.... health information system

Linn.

Synonym: Dillenia speciosa Thunb.

Family: Dilleniaceae.

Habitat: The Himalayas from Nepal to Bhutan; north Bengal, Bihar, Orissa and Madhya Pradesh.

English: Elephant Apple.

Ayurvedic: Bhavya.

Folk: Uva, Chaaltaa.

Action: Fruit—laxative, carminative, bechic, febrifuge, antispasmodic (used for abdominal pains). Bark and leaves—astringent.

The sepals contain (on dry weight basis): tannin 0.37, glucose 2.92 and malic acid 0.51%. The bark and leaves contain about 10% and 9% tannin (on dry weight basis) respectively.

The fruit yielded a polysaccharide, arabingalactan.

The leaves yielded cycloartenone, n-hentriacontanol, betulin, betulinic acid and beta-sitosterol. The bark gave iso-rhamnetin, naringenin, quercetin derivatives and kaempferol.... dillenia indica

Many patients are on several prescribed drugs, and numerous medicines are available over the counter, so the potential for drug interaction is large. A drug may interact with another by inhibiting its action, potentiating its action, or by simple summation of effects.

The interaction may take place:

(1) Prior to absorption or administration – for example, antacids bind tetracycline in the gut and prevent absorption.

(2) By interfering with protein binding – one drug may displace another from binding sites on plasma proteins. The action of the displaced drug will be increased because more drug is now available; for example, anticoagulants are displaced by analgesics.

(3) During metabolism or excretion of the drug – some drugs increase or decrease the activity of liver enzymes which metabolise drugs, thus affecting their rate of destruction; for example, barbiturates, nicotine, and alcohol all activate hepatic enzymes. Altering the pH of urine will affect the excretion of drugs via the kidney.

(4) At the drug receptor – one drug may displace another at the receptor, affecting its e?cacy or duration of action.... drug interactions

These are usually caused by the passage through the body of an electric current of high voltage owing to accidental contact with a live wire or to a discharge of lightning. The general effects produced are included under the term electric shock, but vary greatly in degree. The local effects include spasmodic contraction of muscles, fracture of bones, and in severe cases more or less widespread destruction of tissues which may amount simply to burns of the skin or may include necrosis of masses of muscle and internal organs. Fright due to the unexpectedness of the shock, and pain due to the sudden cramp of muscles, are the most common symptoms and in most cases pass o? within a few minutes. In more severe cases – especially when the person has remained in contact with a live wire for some time, or has been unable to let go of the electrical contact owing to spasmodic contraction of the muscles – the effects are more pronounced and may include concussion or compression of the brain (see BRAIN, DISEASES OF). In still more severe cases, death may ensue either from paralysis of the respiration or stoppage of the heart’s action. If prompt measures are taken for treatment, the victim can often be resuscitated.

In Britain there are an average of 110 deaths a year from electrocution, half of these occurring in the home.

Treatment No electrical apparatus or switch should be touched by anyone who is in metallic contact with the ground, such as through a metal pipe, especially, for example, from a bath. The ?rst action is to break the current. This can sometimes be done by turning o? a switch. If the victim is grasping or in contact with a live wire, the contact may be severed with safety only by someone wearing rubber gloves or rubber boots; but as these are not likely to be immediately available, the rescuer’s hands may be protected by a thick wrapping of dry cloth, or the live wire may be hooked or pushed out of the way with a long wooden stick such as a broom-handle. If the injured person is unconscious, and especially if breathing has stopped, arti?cial respiration should be applied as described in APPENDIX 1: BASIC FIRST AID – Electrocution. When the patient begins to breathe again, he or she must be treated for shock and professional help obtained urgently.... electrical injuries

Financial protection against the health care costs arising from disease or accidental bodily injury. Such insurance usually covers all or part of the costs of treating the disease or injury. Insurance may be obtained on either an individual or a group basis.... health insurance

Gaertin.

Family: Gramineae, Poaceae.

Habitat: Australia, North America; throughout the warmer parts of the world. In India, in wet plains and low hills and pasture grounds.

English: Crowfoot Grass, Crab Grass.

Ayurvedic: Nandimukha (var.).

Folk: Nandiaa (Orissa), Mahaar Naachni (Maharashtra), Thippa Ragi (Tamil Nadu).

Action: Used for biliary disorders. In Vietnamese traditional medicine, a decoction of the whole plant is used as stomachic, diuretic, febrifuge, and in sprains.

Aerial parts contain vitexin, 3-O- beta-D-glucopyranosyl-beta-sitosterol and its 6'-O-palmitoyl derivatives. of intoxication. Used for abdominal pains, nausea, bleeding nose. Fresh plants from Uttaranchal gave 0.4% essential oil having dehydroelsholtzia ketone 88.7% as the main constituent, followed by humulene 2.4% and caryophyllene 0.9% (the oil composition of the species which grow in Japan and Kashmir is different.)

Plant contains linarin, apigenin and 7-O-glucosides of apigenin and lute- olin.

The Japanese species, used for hangovers, gave compounds including tri- terpenoids, steroids and flavonoids.

Elsholtzia blenda Benth., synonym Perilla elata D. Don, is also equated with Ban-Tulasi. Major constituent of the essential oil is geranyl acetate. Other constituents are p-cymene, sa- binene, borneol, geraniol, linalyl acetate, fernesol, limonene, linalool, cit- ronellol, thymol and nerolidol.... eleusine indica

Lam.

Synonym: E. variegata Linn. var. orientalis (Linn.) Merril.

Family: Papilionaceae; Fabaceae.

Habitat: Grown as an ornamental.

English: Indian Coral tree.

Ayurvedic: Paaribhadra, Paarib- hadraka, Paarijaataka, Mandaara, Dadap. Kantaki-palaasha, Kant- kimshuka, Raktapushpa; Nimba- taru. (Erythrina suberosa Roxb. is also equated with Paaribhadra.)

Siddha/Tamil: Kaliyanamurukkan.

Folk: Farhad.

Action: Leaf—cathartic, diuretic, antiseptic, anti-inflammatory. Applied externally for dispersing venereal buboes. Bark—antibilious, anthelmintic, febrifuge, astringent, expectorant. (E. variegata is an adulterant to the Ayurvedic drug Rohitaka.) Different parts of the plant are used as nervine sedative, antiepileptic, astringent, antiasthmatic and antiseptic. Bark is used in liver ailments, fever and rheumatism.

A number of tetracyclic alkaloids have been isolated from the plant.

The alkaloids showed a muscle relaxant activity and increased the sedative effects of hexabarbital. The alkaloids extracted from the leaves are reported to have anti-inflammatory activity. Bark alkaloids are neuromus- cular blocking, smooth muscle relaxant, CNS depressant, hydrocholeretic and anticonvulsant. The bark contains 0.05% alkaloids.

The root extracts exhibited antimicrobial activity in vitro against Staphy- lococcus aureus and Mycobacterium smegmatis.

The seeds of many of the species of Erythrina contain alkaloids with curare-like activity. Clinical trials on biologically standardized beta-ery- throidine hydrochloride and dihydro- beta-erythroidine hydrochloride have shown promising results in the treatment of conditions involving certain types of muscular rigidity.

Dosage: Stem bark—6-12 g powder; 12-24 g for decoction. (API Vol. II.)... erythrina indica

Services, facilities, institutions, personnel or establishments, organizations and those operating them for the delivery of a variety of health programmes.... health system infrastructure

The name of the causative agent of AIDS.... hiv (human immunodeficiency virus)

An organization offering advice and practical assistance to older people who need to repair, improve or adapt their homes.... home improvement agency

(Burm. f.) Merr.

Synonym: F. ramontchi L'Herit.

Family: Flacourtiaceae.

Habitat: Cultivated in Assam, Maharashtra and Bengal.

English: Ramontchi, Madagascar Plum, Mauritius Plum, Governor's Plum.

Ayurvedic: Vikankata, Yajnya- vrksha, Gopakantaa, Sruva-vrksha.

Siddha/Tamil: Sottai-kala, Katukala.

Folk: Poniol (Assam), Kataaya, Kakaiyaa.

Action: Gum—anticholerin. Used as a gargle. Applied to eczema and skin diseases. Bark—antidysenteric, astringent, diuretic. Seed— antirheumatic. Fruit—stomachic. Root—applied externally in skin diseases. Leaves and young shoots— astringent and stomachic.

The Ayurvedic Pharmacopoeia of India recommends the use of the leaf and stem bark in jaundice, oedema and diseases due to vitiated blood.

The bark contains a phenolic gluco- side ester, (-)-flacourtin. The heart- wood contains the steroid, ramonto- side, beta-sitosterol and its beta-D- glucopyranoside.

The fruits contain 3.9-7.2% protein, vitamin C and mineral matter 0.39%; calcium 24.1 and phosphorus 12.5 mg/100 g. Fruits are given in jaundice and enlarged spleen.

Dosage: Leaf—50-100 g for decoction. (API Vol. IV.) (Also bark—CCRAS.)... flacourita indica

These infections, also called mycoses (see MYCOSIS), are common and particularly affect the skin or mucosal membranes in, for example, the mouth, anus or vagina. Fungi consist of threadlike hyphae which form tangled masses or mycelia – common mould. In what is called dermatophyte (multicellular fungi) fungal infection of the hair, nails and SKIN, these hyphae invade the KERATIN. This is usually described as ‘RINGWORM’, although no worm is present and the infection does not necessarily occur in rings. PITYRIASIS versicolor and candidosis (monoliasis – see CANDIDA), called thrush when it occurs in the vulva, vagina and mouth, are caused by unicellular fungi which reproduce by budding and are called yeasts. Other fungi, such as ACTINOMYCOSIS, may cause deep systemic infection but this is uncommon, occurring mainly in patients with immunosuppressive disorders or those receiving prolonged treatment with ANTIBIOTICS.

Diagnosis and treatment Any person with isolated, itching, dry and scaling lesions of the skin with no obvious cause – for example, no history of eczema (see DERMATITIS) – should be suspected of having a fungal infection. Such lesions are usually asymmetrical. Skin scrapings or nail clippings should be sent for laboratory analysis. If the lesions have been treated with topical steroids they may appear untypical. Ultraviolet light ?ltered through glass (Wood’s light) will show up microsporum infections, which produce a green-blue ?uorescence.

Fungal infections used to be treated quite e?ectively with benzoic-acid compound ointment; it has now been superseded by new IMIDAZOLES preparations, such as CLOTRIMAZOLE, MICONAZOLE and terbina?ne creams. The POLYENES, NYSTATIN and AMPHOTERICIN B, are e?ective against yeast infections. If the skin is macerated it can be treated with magenta (Castellani’s) paint or dusting powder to dry it out.

Refractory fungal infection can be treated systematically provided that the diagnosis of the infection has been con?rmed. Terbina?ne, imidazoles and GRISEOFULVIN can all be taken by mouth and are e?ective for yeast infections. (Griseofulvin should not be taken in pregnancy or by people with liver failure or porphyria.) (See also FUNGUS; MICROBIOLOGY.)... fungal and yeast infections

Merging of two or more firms at the same level of production in some formal, legal relationship. In hospital networks, this may refer to the grouping of several hospitals, the grouping of outpatient clinics with the hospital, or a geographic network of various health care services. Integrated systems seek to integrate both vertically with some organizations and horizontally with others. See “vertical integration”.... horizontal integration

An infection acquired by a patient while in hospital. Because of the high level of antibiotic use in hospitals, some bacteria become resistant

– for example, METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA). This makes hospital-acquired infections potentially dangerous and sometimes life-threatening, and is one of the developments that is prompting calls for greater care in the prescribing of antibiotics as well as higher standards of cleanliness.... hospital-acquired infection

A composite index that measures the overall achievements in a country in three basic dimensions of human development— longevity, knowledge and a decent standard of living. It is measured by life expectancy, educational attainment and adjusted income per capita in purchasing power parity (PPP) US dollars. The HDI is a summary, not a comprehensive measure of human development.... human development index (hdi)

Choisy.

Synonym: G. Purpurea Roxb.

Family: Guttiferae; Clusiaceae.

Habitat: Evergreen forests of Western Ghats from Konkan southwards and in Goa. Also cultivated in southern districts of Maharashtra and on lower slopes of Nilgiris.

English: Kokam Butter tree, Mangosteen Oil tree.

Ayurvedic: Vrkshaamla, Tintidika, Chukra, Amlavrkshak, Kokam, Amsula.

Siddha/Tamil: Murgal.

Folk: Kokam.

Action: Fruit—antiscorbutic, cholagogue, cooling, antibilious, emollient and demulcent. A syrup from the fruit juice is given in bilious affections. Bark—astringent, Oil or Kokam Butter—used for dysentery and diarrhoea with mucus. Applied externally to ulcerations, fissures of lips, chapped skin and skin diseases.

The fruit rind contain a polyiso- prenylated phenolic pigment, garci- nol and its isomer isogarcinol, along with (-)-hydroxycitric acid, cyanidin- 3-glucoside and cyanidin-3-sambubio- side. L-leucine and DNP-L-leucine hy- drochloride have been reported from the leaves.

EtOH (50%) extract of aerial parts exhibited semen coagulant and CNS depressant activity.

Kokum butter contains fatty acids— palmtic 2.0, stearic 57.5, oleic 39.0, linoleic 1.3 and others 0.2%.

Dosage: Fruit—10-20 ml juice; root bark—40-80 ml decoction. (CCRAS.)... garcinia indica

Gender identity is the inner sense of masculinity or femininity, and gender role is an individual’s public expression of being male, female, or a ‘mix’ (androgynous). Most people have no di?culty because their gender identity and role are congruous. A person with a gender identity disorder, however, has a con?ict between anatomical sex and gender identity.

Gender is determined by a combination of genetic and environmental factors, in which the in?uence of family upbringing is an important factor. When physical sexual characteristics are ambiguous, the child’s gender identity can usually be established if the child is reared as being clearly male or female. Should, however, the child be confused about its sexual identity, the uncertainty may continue into adult life. Transsexuals generally experience con?icts of identity in childhood, and such problems usually occur by the age of two years. In this type of identity disorder, which occurs in one in 30,000 male births and one in 100,000 female births, the person believes that he or she is the victim of a biological accident, trapped in a body different from what is felt to be his or her true sex.

Treatment is di?cult: psychotherapy and hormone treatment may help, but some affected individuals want surgery to change their body’s sexual organs to match their innately felt sexual gender. The decision to seek a physical sex change raises major social problems for individuals, and ethical problems for their doctors. Surgery, which is not always successful in the long term, requires careful assessment, discussion and planning. It is important to preclude mental illness; results in homosexual men who have undergone surgery are not usually satisfactory. Advice and information may be obtained from Gender Identity Consultancy Services.... gender identity disorders

See AIDS/HIV.... human immunodeficiency virus

(Arabic) Of the moon Iamarah, Iamaria, Iamarea, Iamarra, Iamariah, Iamareah, Iamarrah... iamar

(Hawaiian) God is gracious Ianeki, Ianekie, Ianeky, Ianekey, Ianekea, Ianekee... ianeke

(Gaelic) Feminine form of Ian; God is gracious

Iannah, Iana, Ianah, Ionna, Iona... ianna

(Greek) Resembling the violet flower; in mythology, a sea nymph and a daughter of Oceanus

Iantha, Ianthia, Ianthina, Ianthyna, Ianthea, Ianthiya, Ianthya... ianthe

(Brazilian) In mythology, a water queen Iarah, Iarra, Iarrah... iara

Anything pertaining to a physician (see also DOCTOR).... iatric

Launched in 1999 in England and Wales as CHI, this is an inspectorate charged with protecting patients from ‘unacceptable failings in the National Health Service’. A statutory body under the 1999 Health Act, it evaluates and re?nes local systems designed to safeguard standards of clinical quality. Working separately from the NHS and the health departments, it o?ers an independent safeguard that provides systems to monitor and improve clinical quality in primary care, community services and hospitals. As of 2004 it became responsible for dealing with patients’ complaints if they could not be settled by the trust concerned. The board members include health professionals, academics and eight lay members. Scotland has set up a similar statutory body. (See APPENDIX 7: STATUTORY ORGANISATIONS.)... healthcare commission (commission for health improvement)

Linn.

Family: Sterculiaceae.

Habitat: Dry forests throughout the country.

English: East Indian Screw tree.

Ayurvedic: Aavartani, Aavartphalaa, Aavartaki.

Unani: Marorphali.

Siddha/Tamil: Valampiri.

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.

The plant contains a 4-quinolone alkaloid, malatyamine, an antidiarrhoeal principle.

The seeds gave diosgenin. Root gave cytotoxic principles—cucurbitacin B and iso-cucurbitacin B. Leaves yielded as ester tetratriacontanyl—tetratri- acontanoate along with tetratriacon- tanoic acid, tetratriacontanol and sitos- terol.

Dosage: Fruit, bark—3-6 g powder; 50-100 ml decoction. (CCRAS.)... helicteres isora

Linn.

Family: Boraginaceae.

Habitat: Throughout India.

English: Scorpion Tail.

Ayurvedic: Hastishundi Shrihastini, Vrischikaali.

Siddha/Tamil: Thaelkodukku.

Action: Plant—diuretic, astringent, emollient, vulnerary. Used as a local application for ulcers, wounds, sores, gum boils and skin affections. Decoction of leaves is used in urticaria and fevers; that of root in coughs. Flowers—emmenagogue in small doses, abortifacient in large doses. Masticated seeds— stomachic.

Aerial parts of the plant contain alkaloids—indicine (principal base), echinatine, supinine, heleurine, he- liotrine, lasiocarpine and lasiocarpine- N-oxide. Aerial parts and root gave an anticancer principle—indicine-N- oxide.

The aqueous and alcohol extracts of the plant possess oxytocic activity. The roots contain significant amounts of estradiol, a sex hormone.

The inflorescences are used by trib- als for scorpion bite.... heliotropium indicum

(L.) R. Br.

Synonym: Periploca indica Linn.

Family: Asclepiadaceae, Periplo- caceae.

Habitat: Throughout India; common in Bengal, Maharashtra and extending to Travancore.

English: Indian Sarsaparilla (white var.). Sarsaparilla root is equated with Smilax sp. in Western herbal.

Ayurvedic: Shveta Saarivaa, Anant- muula, Gopi, Gopaa, Gopakanyaa, Gopavalli, Gopasutaa, Krishodari, Sphotaa, Utpalsaarivaa, Kapuuri, Dugdhgarbhaa.

Unani: Ushbaa Hindi.

Siddha/Tamil: Nannaari, Sugan- thipala.

Action: Blood purifier, antisyphilitic, antileucorrhoeic, galactogenic, antidiarrhoeal, antirheumatic, febrifuge, alterative. Roots used against gonorrhoea, leucoderma, bleeding piles, jaundice and dysentery.

Key application: Smilax sp.—in skin diseases and urinary infections. (German Commission E included Smilax sp. among unapproved herbs.)

Hemidesmus indicus does not contain the same saponins or other principal constituents which are found in sarsaparilla. (Tyler's Honest Herbal.)

The root contains coumarino-lig- noids, hemidesmine, hemidesmin-1, 2. The stem contains pregnane glyco- sides, hemidine, hemidescine, emidine and indicine, a triterpene lactone, a lu- panone, besides lupeol acetate, sitos- terol and hexadecanoic acid and several hydroxy- methoxybenzaldehydes.

Aqueous extract of the root is bacteriostatic against Mycobacterium leprae.

Dosage: Root—20-30 g for decoction. (API Vol. I.) palmitoleic, stearic, oleic, linoleic and arachidic. Pyrocatechol, tannins, fla- vonoids and amino acids were also present.... hemidesmus indicus

Negative effect resulting from a medical treatment.... iatrogenic illness (or injury)

(Irish) Woman of Ireland Iberniah, Ibernea, Iberneah, Iberniya, Iberniyah, Ibernya, Ibernyah... ibernia

(Hungarian) Violet; resembling a flower Ibollya, Ibolyah, Ibolia, Iboliya... ibolya

(Arabic) One who smiles often Ibtisam, Ibtysam... ibtesam

(Arabic) A delight; bringer of joy Ibtehaj, Ibtyhaj... ibtihaj

Planch.

Family: Ulmaceae.

Habitat: Throughout greater parts of India, also grown in gardens.

Ayurvedic: Chirbilva, Putika, Prakirya.

Siddha/Tamil: Avil thol, Ayil pattai (bark)

Action: Bark—internally and externally used in rheumatism. Stem bark paste—in scabies. Seeds—used topically on ringworm.

The Ayurvedic Pharmacopoeia of India recommends dried fruits in poly- uria and other urinary disorders.

The stem bark contains the triter- penoidal fatty acid esters, holoptelin-A (epi-friedelinol palmitate) and holop- telin-B (epi-friedelinol stearate), frie- delin and epi-friedelinol.

The powdered bark exhibited lipoly- tic action and mobilized fat from adipose tissues in rats and consequently helped in the reduction of obesity.

Dosage: Dried fruit—1-3 g. (API Vol. III.)... holoptelea integrifolia

Linn.

Family: Cruciferae; Brassicaceae.

Habitat: Native to Europe; cultivated in gardens. Reported to occur in Chamba.

English: Rocket Candytuft, Clown's Mustard.

Action: Used for gout, rheumatism, also for bronchitis and asthma; as a tonic in enlargement of heart to allay excited action of the heart.

The seeds contain a mustard oil and a glycoside, glucoiberin. The plant contains sulphur-containing glucosi- nolates; also contains bitter and toxic tetracycloterpenoids, cucurbitacin E and I.

The seed extract exhibited cytotox- icity against renal and brain tumours and melanoma cell lines. The activity may be attributed to the presence of cucurbitacins E and I.... iberis amara

Iceland Moss Tea is known by the people from Iceland, Finland, Norway, Russia and Sweden as being a remedy for disorders of the respiratory system. The Iceland moss grows mainly in the tree barks of Iceland and most Scandinavian countries and reaches a height of almost 4 inches. You can distinguish the plant by its curled leaves and unique spiny margins. The constituent of Iceland Moss Tea is the lichenin, a type of starch. It also contains polysaccharides that strengthen your immune system. How To Make Iceland Moss Tea To make Iceland Moss Tea you will need to place a teaspoon of dried Iceland moss herbs in a kettle of boiling water. Let it boil for about 3 minutes and after that let the mix stand for 10 minutes. It is advised to drink 2 cups of Iceland Moss Tea per day, one in the morning and one in the afternoon. Iceland Moss Tea Benefits

• Helps treating bronchitis.
• Cough remedy.
• Helps combat irritable bowel infections, gastritis and dysentery.
• Prevents congestion.
• Fights infestation of intestinal worms.

Iceland Moss Tea Side Effects

• Over consumption can be unsafe, because the dried Iceland moss plant can be contaminated with lead.
• Pregnant and breastfeeding women should avoid drinking Iceland Moss Tea. During pregnancy, it can be harmful to the mother and to the unborn child.
• It can cause ulcers in the stomach or small intestine.
• Iceland Moss Tea may interact with the effects of some medications, so make sure you always consult your doctor before drinking Iceland Moss Tea or any kind of herbal tea.
• It can cause nausea and liver problems.

Iceland Moss Tea is a healthy herbal tea known for its medicinal properties. Try not to drink more than 1-2 cups per day of Iceland Moss Tea in order not to experience its side effects!... iceland moss tea

Ichthammol is ammonium ichthosulphonate – an almost black, thick liquid of ?shy smell, prepared from a bituminous shale. It is used in chronic eczema (see DERMATITIS).... ichthammol

(Hindi) Woman of the earth... idaa

(Greek) One with a sweet disposition Idahliah, Idahlea, Idahleah, Idahliya, Idahliyah, Idahlya, Idahlyah... idahlia

(Arabic) A queen; born to royalty Idalikah, Idalicca, Idalica, Idalicka, Idalyka, Idalykah... idalika

(American) A social butterfly Idara, Idarra, Idarrah... idarah

(English) Filled with joy Idasiah, Idasea, Idaseah... idasia

(Welsh) One who is happy; bountiful Idelisa, Idella, Idelissa, Idele, Idela... idelle

(Latin) A pleasant woman Idyl, Idill, Idyll... idil

See BELL’S PALSY.... idiopathic facial nerve palsy

R. Br.

Family: Apocynaceae.

Habitat: Uttar Pradesh, Madhya Pradesh, Bihar, Assam and the Sunderbans.

English: Black Creeper.

Ayurvedic: Gopavalli, Krishna Saarivaa (var.), Krishna-muuli, Shyaamalataa.

Siddha/Tamil: Karunannari, Makalikilanzhu.

Folk: Kaalisar, Karantaa.

Action: Root—demulcent, diuretic, alterative, diaphoretic; used in fevers, dyspepsia and cutaneous affections. The roots of the plant are used as a substitute for Indian sarsaparilla and are often mixed with the roots of Hemidesmus indicus (their therapeutic properties for use as sarsaparilla have bot been established).

The root gave 2-hydroxy-4-meth- oxybenzaldehyde.

Alkaloids and flavonoids were present in the roots but not in the leaves and fruits. Saponins were absent in these parts. The whole plant gave n-butyl sorboside, kaempferol and its gluco- side.... ichnocarpus frutescens

Sometimes described as thrombocytopenia, this is an autoimmune disorder in which blood PLATELETS are destroyed. This disturbs the blood’s coagulative properties (see COAGULATION) and spontaneous bleeding (PURPURA) occurs into the skin. The disease may be acute in children but most recover without treatment. Adults may develop a more serious, chronic variety which requires treatment with CORTICOSTEROIDS and sometimes SPLENECTOMY. Should the disease persist despite these treatments, intravenous immunoglobulin or immunosuppressive drugs (see IMMUNOSUPPRESSION) are worth trying. Should the bleeding be or become life-threatening, concentrates of platelets should be administered.... idiopathic thrombocytopenic purpura (itp)

(Spanish) Refers to the Virgin Mary Idoea, Idurre, Iratze, Izazkun... idoia

(German) A hardworking woman Idolah, Idolla, Idollah, Idolina, Idolyna, Idoleena, Idoleana, Idoleina, Idoliena... idola

(Scandinavian) A fresh-faced woman Idonah, Idonna, Idonnah, Idonia, Idoniah, Idonea, Idoneah, Idonya, Idonyah... idona

(Scandinavian) One who has been reborn

Idoney, Idonee, Idonea, Idoni, Idonie... idony

(African) Daughter born after twins... idowu

An iodine-containing antiviral agent once used to treat HERPES SIMPLEX involvement of the cornea of the EYE, its e?ectiveness is now doubtful.... idoxuridine

(Aramaic) A flourishing woman Idrah... idra

(Hebrew) A wealthy woman Idriyah, Idria, Idriah... idriya

(Norse) In mythology, goddess of youth, fertility, and death Iduna, Idunna, Idunn, Idunnor... idun

(Spanish) A dedicated woman Iduvinah, Iduveena, Iduveenah, Iduviena, Iduvienah, Iduveina, Iduveinah, Iduveana, Iduveanah... iduvina

(Irish) Woman from Ireland... ierne

(English) Form of Aisha, meaning “lively; womanly”

Ieshia, Ieshea, Ieesha, Ieasha, Ieashia, Ieashiah, Ieeshah, Ieeshia... iesha

(African) One’s well-being Ifamah, Ifamma, Ifammah... ifama

(African) A beautiful woman; a good thing

Ifeomah, Ifyoma, Ifyomah... ifeoma

(Latin) A fiery woman; burning brightly

Igantiah, Ignacia, Ignazia, Iniga... ignatia

(Basque) Feminine form of Igon; ascension

Igona, Igoneh, Igonia, Igonea... igone

(English) In Arthurian legend, Arthur’s mother

Igrayne, Igrain, Igerne, Igrayn, Igraen, Igraene... igraine

(Arabic) A gift from God... ihab

(Hawaiian) Lifted up by God... iheoma

(Arabic) Goodwill toward others Ihsane, Ihsann, Ihsana, Ihsanna, Ihsanne... ihsan

(Spanish) As beautiful as jade... ijada

(Hawaiian) Form of Isabel, meaning “my God is bountiful” Ikabell, Ikabelle, Ikabel, Ikabele, Ikabella... ikabela

(Scandinavian) Having smooth skin Ikeah, Ikiya, Ikiyah, Ikia, Ikiah... ikea

(American) A spontaneous woman Ikeidah, Ikeyda, Ikeydah, Ikeda, Ikedah, Ikieda, Ikiedah, Ikeeda, Ikeedah, Ikeada, Ikeadah... ikeida

(French) From the island Ilamaye, Ilamai, Ilamae... ilamay

(Hebrew) Feminine form of Ilan; from the trees Ilane, Ilania, Ilanit... ilana

(American) Moon woman Ilander, Ilanderre, Ilandera, Ilanderra... ilandere

(Italian) Form of Hilary, meaning “a cheerful woman; bringer of joy” Illaire, Ilarea, Illaria, Ilaire, Ilariya, Illariya... ilaria

(Hungarian) Form of Hilda, meaning “a battlemaiden; a protector” Ildyko, Ildicko, Ildycko, Ilda, Ildah... ildiko

(English) Form of Aileen, meaning “the light-bearer; from the green meadow” Ilene, Ilean, Ileen, Ileene, Ileena, Ilenna, Ileana... ilena

The term applied to the region of the junction between the small and large intestines in the right lower corner of the abdomen. The ileocaecal valve is a structure which allows the contents of the INTESTINE to pass onwards from the small to the large intestine, but, in the great majority of cases, prevents their passage in the opposite direction.... ileo-caecal

Pertaining to both the last section of the small intestine (the ileum) and the beginning of the large intestines, the ascending colon or cecum. EXAMPLE: Ileocecal valve... ileocecal

(Hebrew) Form of Hephzibah, meaning “she is my delight” Ilepsi, Ilepsy, Ilepsey, Ilepsee, Ilepsea... ilepsie

(Hindi) Of the earth Ileshah, Ileesha, Ileeshah, Ileasha, Ileashah, Ilysha, Ilyshah... ilesha

(Arabic) The heart’s inspiration... ilham

(Greek) From the ancient city Iliah, Ilea, Ileah, Iliya, Iliyah, Ilya, Ilyah... ilia

(Greek) Form of Helen, meaning “the shining light”

Ileana, Ileane, Ileanna, Ileanne, Illeanna, Illia, Illiana, Illianna, Illionya, Ilona, Ilonna, Iliona, Ilone, Ilonka, Illonna, Ilon... iliana

(Hebrew) The flower of Oahu Ilimah, Illima, Ilyma, Ilymah, Iliema, Iliemah, Ileima, Ileimah, Ileema, Ileemah, Ileama, Ileamah... ilima

(Tonga) The blessed child Ilisapesie, Ilysapesi, Ilysapesy, Ilisapesy, Ilisapesea, Ilysapesie, Ilysapesea... ilisapesi

(Greek) In mythology, goddess of childbirth

Ilithya, Ilithiya, Ilithyiah... ilithyia

(Slavic) A hardworking woman Ilkah, Ilke, Ilkeh... ilka

Linn.

Family: Aquifolilaceae.

Habitat: Native to Europe; grown occasionally in gardens at hill stations.

English: English Holly, Common Holly.

Action: Leaves—diaphoretic, febrifuge. Used in catarrh, pleurisy, intermittent fever, smallpox and rheumatism. Also in jaundice. Berries—violently emetic and purgative; employed in dropsy. Powdered berries are used as astringent to check bleeding.

(Berries possess totally different qualities as compared to leaves.)

The plant contains ilicin (a bitter principle), ilexanthin, theobromine (only in the leaf) and caffeic acid. Alkaloid theobromine is used for asthma. In Greece, boiled leaves are used for treating enlarged prostate.

An extract of the plant caused a fatal drop in blood pressure in rats.

The ethanolic extract of the fruits yields cyanogenic glucosides.... ilex aquifolium

St.-Hil.

Family: Aquifoliaceae.

Habitat: Native to South America; cultivated in some Indian gardens. In northern India, grows in Lucknow.

English: Mate Tea, Yerba Mate. Paraguay Tea.

Action: Stimulant to brain and nervous system, mild antispasmod- ic, eliminates uric acid. Used for physical exhaustion, rheumatism, gout and nervous headache. (A national drink of Paraguay and Brazil.) Causes purging and even vomiting in large doses.

Key application: In physical and mental fatigue. (German Commission E, WHO.) In fatigue, nervous depression, psychogenic headache especially from fatigue, rheumatic pains. (The British Herbal Pharmacopoeia.) German Commission E reported analeptic, positively inotropic, positively chronotropic, glycogenolytic, lipolytic and diuretic properties.

The leaves contain xanthine derivatives, including caffeine (0.2-2%), theobromine (0.3-00.5%), theophylline (absent in some samples), polyphe- nolics, tannins and chlorogenic acid, vanillin, vitamin C, volatile oil. Used in the same way as tea, due to its caffeine and theobromine content.

Mate is a world famous tea and is commonly consumed in several South American countries.

The flavour constituents exhibited moderate to weak broad-spectrum antimicrobial activity against several Gram-positive bacteria. Some components are bactericidal, particularly against the most carcinogenic bacteria, Streptococcus mutans.... ilex paraguariensis

Linn.

Family: Magnoliaceae; Illiciaceae.

Habitat: Indigenous to China.

English: Star Anise.

Unani: Baadiyaan (related species).

Action: Carminative and pectoral. Used in hard, dry cough where expectoration is difficult. (Oil of Anise is distilled in Europe from the fruits of Pimpinella anisum.)

The seeds, though used as a substitute for Star Anise, contain toxic constituents, anisatin, neoanisatin, 6- deoxymajucin, besides pseudoanisatin and sesquiterpene lactones.... illicium anisatum

Hook. f.

Family: Magnoliaceae, Illiciaceae.

Habitat: Native to China. Fruits imported from China and IndoChina.

English: Star Anise, Chinese Anise, Aniseed Stars.

Unani: Baadyaan Khataai.

Siddha/Tamil: Takkola, Anasippo.

Folk: Anasphal.

Action: Carminative (used for colic), stimulant, diuretic. Also used in rheumatism.

Key application: In catarrhs of the respiratory tract and peptic discomforts. (German Commission E.)

The fruit contains a volatile oil containing trans-anethole 80-90%, and feniculin (14.56%), with estragole, beta-bisabolene, beta-farnesene, ca- ryophyllene, nerolidol.

The intake of trans-anethole (1.0%) does not show any chronic toxicity in rats. Veranisatins, isolated from the extract, showed convulsive effect in mice. Methanolic extract exhibited a hypothermic effect in mice.

Illicium griffithii Hook. f. & Thoms. is found in Bhutan and Khasi hills at altitudes of 1,400-1,100 m. The fruit, known as Baadiyaan, is bitter and astringent, reported to be poisonous. It is used as stimulant and carminative. Essential oil resembles that from aniseed (Pimpinella anisum Linn.) and fennel (Foeniculum vulgare Mill.)... illicium verum

(Native American) From the tribe of warriors; from the state of Illinois... illinois

See HALLUCINATIONS.... illusions

(German) Form of Wilhelmina, meaning “determined protector” Ilmah, Illma, Illmah... ilma

(African) A special child; one who is treasured

Illori, Ilorie, Illorie, Ilory, Illory, Ilorey, Illorey, Iloree, Illoree, Ilorea, Illorea... ilori

(German) Form of Elizabeth, meaning “my God is bountiful” Ilseh, Ilsa, Ilsah, Ilisa, Illsa, Ilsae, Ilsaie, Ilyssa, Ilysa, Ilsea... ilse

(Finnish) Born at night Iltah, Illta... ilta

(Spanish) One who shines brightly

Iluminata, Ilumynada, Ilumynata, Iluska, Ilu... iluminada

(German / Greek) Born into the nobility / form of Elyse, meaning “my God is bountiful” Ilysea, Ilysia, Ilysse, Ilysea... ilyse

(Native American) One who disciplines others

Imalah, Imalla, Imallah, Immala, Immalla... imala

(Arabic) Having great faith Imani, Imanie, Imania, Imaan, Imany, Imaney, Imanee, Imanea, Imain, Imaine, Imaen, Imaene, Imayn, Imayne... iman

(Spanish) A faithful woman Imanuella, Imanuel, Imanuele, Imanuell... imanuela

(Hungarian) A great ruler Imarah, Imarra, Imarrah... imara

(Japanese) Daughter of today Imarie, Imaree, Imarea, Imary, Imarey... imari

(Italian) Warrior in the universal battle

Imeldah, Imalda, Imaldah... imelda

(African) A dream Imenah, Imenna, Imina, Imyna... imena

A group of antifungal drugs active against a wide range of fungi and yeasts (see FUNGAL AND YEAST INFECTIONS). Some are also e?ective against bacteria and HELMINTHS. Econazole, clotrimazole, ketoconazole, ?uconazole and itraconazole are examples: the drugs are given by mouth or externally as creams.... imidazoles

(Latin) Refers to the Immaculate Conception Immaculatta, Immaculatah, Immaculada... immaculata

A person or animal that possesses specific previous antibodies or cellular immunity as a result of previous infection or immunisation, or is so conditioned by such previous specific experience as to respond adequately with production of antibodies sufficient to prevent illness following exposure to the specific infectious agent of the disease. Immunity is relative; an ordinarily effective protection may be overwhelmed by an excessive dose of the infectious agent or an unusual portal of entry.... immune person/animal

The introduction of antigens (see ANTIGEN) into a body to produce IMMUNITY. The table above gives the immunisation programme recommended by the UK departments of health.... immunisation

Impaired IMMUNITY resulting from inherited or acquired abnormalities of the immune system. This leads to increased vulnerability to infection. Important inherited examples of immunode?ciency are defects in function of GRANULOCYTES and the COMPLEMENT SYSTEM. Common acquired forms of immunode?ciency are defective function of B-type lymphocytes and hence antibody de?ciency in ‘common variable hypogammaglobulinaemia’, and grossly de?cient CD4 T-cell function – malfunctioning T-type lymphocytes – in AIDS, secondary to HIV infection (see AIDS/HIV).... immunodeficiency

A specialist (medically or scienti?cally quali?ed) who practises or researches IMMUNOLOGY.... immunologist

An agent that stimulates either innate or acquired immunity. In the U.S., immunotherapy is relegated to experimental medicine, but a number of plant substances are used in Europe as immunostimulants. The presumption of immunostimulation is that you increase native resistance and let it run its course. American Standard Practice, with all good intentions, tends to aggressive procedures, and feels empowered only when intervening against, not with, physiologic responses. Medicine is the only approach to many problems, but in the U.S. we all tend to forget that our brand of standard practice is uniquely aggressive and invasive amongst the industrialized nations. There are other ways...which is presumably why you are using this glossary in the first place.... immunostimulant

A state of the body where the immune system defences do not work properly. This can be the result of illness or the administration of certain drugs (commonly ones used to fight cancer).... immunosuppressed

(Gaelic / Latin) A maiden / one who is innocent and pure Imogene, Imogenia, Imogine, Imojean, Imojeen, Imogenea, Immy, Immi, Immie... imogen

The total, direct and indirect, effects of a programme, service or institution on health status and overall health and socioeconomic development. See also “outcome”.... impact

A term applied to a condition in which two things are ?rmly lodged together. For example, when one piece of bone is driven within another following a fracture, this is known as an impacted fracture; when a tooth is ?rmly lodged in its socket so that its eruption is prevented, this is known as dental impaction. Intractable constipation is termed faecal impaction.... impaction

Linn.

Family: Balsaminaceae.

Habitat: Cultivated in plains throughout India.

English: Garden Balsam. (Balsam Apple is not related to Impatiens. It is the fruit of Momordica balsamina.)

Ayurvedic: Tarini (provisional synonym).

Unani: Gul-menhdi.

Siddha/Tamil: Kasittumbai.

Action: Cathartic, diuretic, antirheumatic. Flowers—used in burns and scalds.

The plant is reported to contain cyanochroic constituents, antibacterial substances and an alkaloid. The seeds contain the triterpenoid hosenkol A, the first baccharance triterpenoid from natural source. The seeds also contain a protein-associated amyloid, galac- toxyloglucan and beta-sitosterol.

In China, the aerial parts are used for the treatment of articular rheumatism. In Korea, the plant is used for treating tuberculosis. In Brunei, a decoction of the root is given in irregular menstruation. In Japan, the juice, obtained from the white petals, is applied topically to treat several types of dermatitis, including urticaria.

The flowers contain flavonols, flavo- noid pigments, phenolic compounds and quinones.

An ethanolic extract (35%) of flowers shows significant anti-anaphylactic activity in mice.

The methanolic extract of the whole plant exhibited strong antibacterial activity against Bacillus subtilis and Salmonella typhimurium; antibacterial and antifungal activity has been attributed to a naphthoquinone derivative.... impatiens balsamina

Rausch.

Synonym: I. arundinacea Cyr.

Family: Gramineae; Poaceae.

Habitat: The hotter parts of India, both in plains and hills, ascending up to 2,300 m in the Himalayas.

English: Thatch Grass.

Ayurvedic: Darbha, Suuchyagra, Yagnika, Yagyabhuushana, Bahir.

Siddha/Tamil: Dharba.

Folk: Daabh.

Action: Diuretic, anti-inflammatory.

The rhizomes contain flavonoids, together with lignans, graminone A and B. A sesquiterpenoid, cylindrene, and biphenylether compounds, cylindol A and B, are also reported.

Cylindrene and graminone B show inhibitory activity on the contractions of vascular smooth muscles and aorta of rabbit respectively; while cylin- dol A exhibits 5-lipoxygenase inhibitory activity.

The hot aqueous extract of the rhizomes show moderate GTP activity on primary cultured rat hepatocytes intoxicated with carbon tetrachloride cy- totoxicity.

The leaves and stem contain cyano- chroic constituents. The roots contain antibacterial substances. The root is used in fevers but does not possess antipyretic activity.

Dosage: Root—50-100 ml decoction. (CCRAS.)... imperata cylindrica

(Latin) A majestic woman Imperiah, Imperea, Impereah, Imperial, Imperiel, Imperielle, Imperialle... imperia

(Arabic) One who is polite and obedient

Imtithala, Imtithaal, Imtithalia, Imtithalea... imtithal

(Arabic) One who bestows kindness... in’am

This may occur in diseases of intestinal malabsorption. A severe form of this anaemia in women, known as chlorosis, used to be common but is seldom seen nowadays.... inadequate absorption of iron

(Asian) Having a generous nature Inakie, Inaky, Inakey, Inakea, Inakee... inaki

(Sumerian) A lady of the sky; in mythology, goddess of love, fertility, war, and the earth

Inannah, Inana, Inanah, Inann, Inanne, Inane... inanna

The daily requirement of iron for an adult is 12 mg, and 15–20 mg for an adult woman during pregnancy. This is well covered by an ordinary diet, so that by itself it is not a common cause. But if there is a steady loss of blood, as a result of heavy menstrual loss or ‘bleeding piles’, the intake of iron in the diet may not be su?cient to maintain adequate formation of haemoglobin.

Symptoms These depend upon whether the anaemia is sudden in onset, as in severe haemorrhage, or gradual. In all cases, however, the striking sign is pallor, the depth of which depends upon the severity of the anaemia. The colour of the skin may be misleading, except in cases due to severe haemorrhage, as the skin of many Caucasian people is normally pale. The best guide is the colour of the internal lining of the eyelid. When the onset of the anaemia is sudden, the patient complains of weakness and giddiness, and loses consciousness if he or she tries to stand or sit up. The breathing is rapid and distressed, the pulse is rapid and the blood pressure is low. In chronic cases the tongue is often sore (GLOSSITIS), and the nails of the ?ngers may be brittle and concave instead of convex (koilonychia). In some cases, particularly in women, the Plummer-Vinson syndrome is present: this consists of di?culty in swallowing and may be accompanied by huskiness; in these cases glossitis is also present. There may be slight enlargement of the SPLEEN, and there is usually some diminution in gastric acidity.

CHANGES IN THE BLOOD The characteristic change is a diminution in both the haemoglobin and the red cell content of the blood. There is a relatively greater fall in the haemoglobin than in the red cell count. If the blood is examined under a microscope, the red cells are seen to be paler and smaller than normal. These small red cells are known as microcytes.

Treatment consists primarily of giving suf?cient iron by mouth to restore, and then maintain, a normal blood picture. The main iron preparation now used is ferrous sulphate, 200 mg, thrice daily after meals. When the blood picture has become normal, the dosage is gradually reduced. A preparation of iron is available which can be given intravenously, but this is only used in cases which do not respond to iron given by mouth, or in cases in which it is essential to obtain a quick response.

If, of course, there is haemorrhage, this must be arrested, and if the loss of blood has been severe it may be necessary to give a blood transfusion (see TRANSFUSION – Transfusion of blood). Care must be taken to ensure that the patient is having an adequate diet. If there is any underlying metabolic, oncological, toxic or infective condition, this, of course, must be adequately treated after appropriate investigations.

Megaloblastic hyperchromic anaemia There are various forms of anaemia of this type, such as those due to nutritional de?ciencies, but the most important is that known as pernicious anaemia.

PERNICIOUS ANAEMIA An autoimmune disease in which sensitised lymphocytes (see LYMPHOCYTE) destroy the PARIETAL cells of the stomach. These cells normally produce INTRINSIC FACTOR, the carrier protein for vitamin B12 (see APPENDIX 5: VITAMINS) that permits its absorption in the terminal part of the ILEUM. Lack of the factor prevents vitamin B12 absorption and this causes macrocytic (or megaloblastic) anaemia. The disorder can affect men and women, usually those over the age of 40; onset is insidious so it may be well advanced before medical advice is sought. The skin and MUCOSA become pale, the tongue is smooth and atrophic and is accompanied by CHEILOSIS. Peripheral NEUROPATHY is often present, resulting in PARAESTHESIA and numbness and sometimes ATAXIA. A rare complication is subacute combined degeneration of the SPINAL CORD.

In 1926 two Americans, G R Minot and W P Murphy, discovered that pernicious anaemia, a previously fatal condition, responded to treatment with liver which provides the absent intrinsic factor. Normal development requires a substance known as extrinsic factor, and this depends on the presence of intrinsic factor for its absorption from the gut. The disease is characterised in the blood by abnormally large red cells (macrocytes) which vary in shape and size, while the number of white cells (LEUCOCYTES) diminishes. A key diagnostic ?nd is the presence of cells in the BONE MARROW.

Treatment consists of injections of vitamin B12 in the form of hydroxocobalamin which must be continued for life.

Aplastic anaemia is a disease in which the red blood corpuscles are very greatly reduced, and in which no attempt appears to be made in the bone marrow towards their regeneration. It is more accurately called hypoplastic anaemia as the degree of impairment of bone-marrow function is rarely complete. The cause in many cases is not known, but in rather less than half the cases the condition is due to some toxic substance, such as benzol or certain drugs, or ionising radiations. The patient becomes very pale, with a tendency to haemorrhages under the skin and mucous membranes, and the temperature may at times be raised. The red blood corpuscles diminish steadily in numbers. Treatment consists primarily of regular blood transfusions. Although the disease is often fatal, the outlook has improved in recent years: around 25 per cent of patients recover when adequately treated, and others survive for several years. In severe cases promising results are being reported from the use of bone-marrow transplantation.

Haemolytic anaemia results from the excessive destruction, or HAEMOLYSIS, of the red blood cells. This may be the result of undue fragility of the red blood cells, when the condition is known as congenital haemolytic anaemia, or of acholuric JAUNDICE.

Sickle-cell anaemia A form of anaemia characteristically found in people of African descent, so-called because of the sickle shape of the red blood cells. It is caused by the presence of the abnormal HAEMOGLOBIN, haemoglobin S, due to AMINO ACID substitutions in their polypeptide chains, re?ecting a genetic mutation. Deoxygenation of haemoglobin S leads to sickling, which increases the blood viscosity and tends to obstruct ?ow, thereby increasing the sickling of other cells. THROMBOSIS and areas of tissue INFARCTION may follow, causing severe pain, swelling and tenderness. The resulting sickle cells are more fragile than normal red blood cells, and have a shorter life span, hence the anaemia. Advice is obtainable from the Sickle Cell Society.... inadequate intake of iron

The presence of infection in a host without occurrence of recognisable clinical signs or symptoms. Inapparent infections are only identifiable by laboratory means. A synonym would be subclinical infection.... inapparent infection

(Arabic) A heaven-sent daughter; one who shines with light Inarah, Innara, Inarra, Innarra... inara

(Finnish / Japanese) Woman from the lake / one who is successful Inarie, Inaree, Inary, Inarey, Inarea, Inareah... inari

(Arabic) One who is friendly and sociable

Inass, Inasse, Inasa, Inassa... inas

(Arabic) One who cares for the well- being of others Inayah, Inayat... inaya

(Indian) An adventurer Incah, Inka, Inkah, Incka, Inckah... inca

The reporting and tracking of adverse incidents by care providers.... incidence monitoring and reporting

Particles in the cytoplasm or nucleus of cells infected with certain viruses or bacteria such as the chlamydiae.... inclusions

See “cost”.... incremental cost

Health insurance benefits provided in the form of cash payments rather than services. An indemnity insurance contract usually defines the maximum amounts which will be paid for covered services.... indemnity

Provides reimbursement to the insured without regard to the expenses actually incurred.... indemnity plan

Living at home without the need for continuous help and with a degree of self determination or control over one’s activities.... independent living

A rental unit in which services are not included as part of the rent, although services may be available on site and may be purchased by residents for an additional fee.... independent living facility

Umbrella term describing the private and voluntary sectors. The private sector consists of individuals or organizations that run services for a profit. The voluntary sector covers a range of not-for-profit organizations, such as charities, housing associations, some religious organizations and some self-help groups.... independent sector

A variable that precedes, influences or predicts the dependent variable.... independent variable

In epidemiology and related sciences, this word usually means a rating scale, e.g. a set of numbers derived from a series of observations of specified variables.... index

A monthly publication produced by the National Library of Medicine in the USA. The publication indexes leading biomedical literature from throughout the world. Indexing is by author and by subject.... index medicus

(English) From the river; woman from India

Indea, Indiah, Indeah, Indya, Indiya, Indee, Inda, Indy, Indi... india

Commiphora mukul

Burseraceae

San: Gugulu, Mahisaksah, Koushikaha, Devadhupa

Hin: Gugal Mal:Gulgulu Tam,

Tel: Gukkulu

Kan: Guggul

Ben: Guggul

Importance: Indian bdellium is a small, armed, deciduous tree from the bark of which gets an aromatic gum resin, the ‘Guggul’ of commerce. It is a versatile indigenous drug claimed by ayurvedists to be highly effective in the treatment of rheumatism, obesity, neurological and urinary disorders, tonsillitis, arthritis and a few other diseases. The fumes from burning guggul are recommended in hay- fever, chronic bronchitis and phytises.

The price of guggulu gum has increased ten fold in ten years or so, indicating the increase in its use as well as decrease in natural plant stand. It has been listed as a threatened plant by Botanical Survey of India (Dalal, 1995) and is included in the Red Data Book (IUCN) and over exploited species in the country (Billare,1989).

Distribution: The center of origin of Commiphora spp. is believed to be Africa and Asia. It is a widely adapted plant well distributed in arid regions of Africa (Somalia, Kenya and Ethiopia in north east and Madagascar, Zimbabwe, Botswana, Zaire in south west Africa), Arabian peninsula (Yemen, Saudi Arabia and Oman). Different species of Commiphora are distributed in Rajasthan, Gujarat, Maharashtra and Karnataka states of India and Sind and Baluchistan provinces of Pakistan (Tajuddin et al, 1994). In India, the main commercial source of gum guggul is Rajasthan and Gujarat.

Botany: The genus Commiphora of family Burseraceae comprises about 185 species. Most of them occur in Africa, Saudi Arabia and adjoining countries. In India only four species have been reported. They are C. mukul(Hook. ex Stocks) Engl. syn. Balsamodendron mukul (Hook. ex Stocks), C. wightii (Arnott) Bhandari, C.stocksiana Engl., C. berryi and C.agallocha Engl.

In early studies about the flora of India, the ‘guggul’ plant was known as Commiphora mukul(Hook. ex Stocks) Engl. or Balsamodendron mukul (Hook. ex Stocks). It was renamed as C. roxburghii by Santapau in 1962. According to Bhandari the correct Latin name of the species is C. wightii(Arnott) Bhandari, since the specific name ‘wightii’ was published in 1839, prior to ‘roxburghi’ in 1848 (Dalal and Patel, 1995).

C. mukul is a small tree upto 3-4m height with spinescent branching. Stem is brownish or pale yellow with ash colored bark peeling off in flakes. Young parts are glandular and pubescent. Leaves are alternate, 1-3 foliate, obovate, leathery and serrate (sometimes only towards the apex). Lateral leaflets when present only less than half the size of the terminal ones. Flowers small, brownish red, with short pedicel seen in fascicles of 2-3. Calyx campanulate, glandular, hairy and 4-5 lobed. Corolla with brownish red, broadly linear petals reflexed at apex. Stamens 8-10, alternatively long and short. Ovary oblong, ovoid and stigma bifid. Fruit is a drupe and red when ripe, ovate in shape with 2-3 celled stones. The chromosome number 2n= 26 (Warrier et al, 1994; Tajuddin et al, 1994).

Agrotechnology: Guggal being a plant of arid zone thrives well in arid- subtropical to tropical climate.

The rainfall may average between 100mm and 500mm while air temperature may vary between 40 C in summer and 3 C during winter. Maximum relative humidity prevails during rainy season (83% in the morning and 48% in the evening).Wind velocity remains between 20-25 km/hour during the year is good. Though they prefer hard gypseous soil, they are found over sandy to silt loam soils, poor in organic matter but rich in several other minerals in arid tracks of western India (Tajuddin et al, 1994).

Plants are propagated both by vegetatively and seeds. Plants are best raised from stem cuttings from the semi woody (old) branch. For this purpose one metre long woody stem of 10mm thickness is selected and the cut end is treated with IBA or NAA and planted in a well manured nursery bed during June-July months; the beds should be given light irrigation periodically. The cuttings initiate sprouting in 10-15 days and grow into good green sprout in 10-12 months. These rooted plants are suitable for planting in the fields during the next rainy season. The cuttings give 80-94% sprouting usually. Air layering has also been successfully attempted and protocol for meristem culture is available in literature. Seed germination is very poor (5%) but seedling produce healthier plants which withstand high velocity winds.

The rooted cuttings are planted in a well laid-out fields during rainy season. Pits of size 0.5m cube are dug out at 3-4 m spacing in rows and given FYM and filler soil of the pit is treated with BHC (10%) or aldrin (5%) to protect the new plants from white ants damage. Fertilizer trials have shown little response except due to low level of N fertilization. Removal of side branches and low level of irrigation supports a good growth of these plants. The plantation does not require much weeding and hoeing. But the soil around the bushes be pulverised twice in a year to increase their growth and given urea or ammonium sulphate at 25- 50g per bush at a time and irrigated. Dalal et al (1989) reported that cercospora leaf spot was noticed on all the cultures. Bacterial leaf blight was also noticed to attack the cultures. A leaf eating caterpillar (Euproctis lanata Walker) attack guggal, though not seriously. White fly (Bemisia tabaci) is observed to suck sap of leaves and such leaves become yellowish and eventually drop. These can be effectively controlled by using suitable insecticide.

Stem or branch having maximum diameter of about 5cm at place of incision, irrespective of age is tapped. The necrotic patch on the bark is peeled off with a sharp knife and Bordeaux paste is applied to the exposed (peeled off) surface of the stem or branch. A prick chisel of about 3cm width is used to make bark- deep incisions and while incising the bark, the chisel is held at an acute angle so that scooped suspension present on the body of the chisel flows towards the blade of the chisel and a small quantity of suspension flows inside the incised bark. If tapping is successful, gum exudation ensures after about 15-20 days from the date of incision and continues for nearly 30-45 days. The exuded gum slides down the stem or branch, and eventually drops on the ground and gets soiled. A piece of polythene sheet can be pouched around the place of incision to collect gum. Alternatively, a polythene sheet can be spread on the ground to collect exuded gum. A maximum of about 500g of gum has been obtained from a plant (Dalal, 1995).

Post harvest technology: The best grade of guggul is collected from thick branches of tree. These lumps of guggul are translucent. Second grade guggul is usually mixed with bark, sand and is dull coloured guggul. Third grade guggul is usually collected from the ground which is mixed with sand, stones and other foreign matter. The final grading is done after getting cleansed material. Inferior grades are improved by sprinkling castor oil over the heaps of the guggul which impart it a shining appearance (Tajuddin et al, 1994).

Properties and activity: The gum resin contains guggul sterons Z and E, guggul sterols I-V, two diterpenoids- a terpene hydrocarbon named cembreneA and a diterpene alcohol- mukulol, -camphrone and cembrene, long chain aliphatic tetrols- octadecan-1,2,3,4-tetrol, eicosan-1,2,3,4-tetrol and nonadecan-1,2,3,4-tetrol. Major components from essential oil of gum resin are myrcene and dimyrcene. Plant without leaves, flowers and fruits contains myricyl alcohol, -sitosterol and fifteen aminoacids. Flowers contain quercetin and its glycosides as major flavonoid components, other constituents being ellagic acid and pelargonidin glucoside (Patil et al, 1972; Purushothaman and Chandrasekharan, 1976).

The gum resin is bitter, acrid, astringent, thermogenic, aromatic, expectorant, digestive, anthelmintic, antiinflammatory, anodyne, antiseptic, demulcent, carminative, emmenagogue, haematinic, diuretic, lithontriptic, rejuvenating and general tonic. Guggulipid is hypocholesteremic (Husain et al, 1992; Warrier et al, 1994).... indian bdellium

Kaempferia rotunda

Zingiberaceae

San: Bhumicampaka, Bhucampaka, Hallakah

Hin: Abhuyicampa

Mal: Chengazhuneerkizhengu, Chengazhuneerkuva

Tam: Nerppicin

Kan: Nelasampiga

Tel: Bhucampakamu, Kondakaluva Mar: Bhuichampa

Importance: The tubers of Indian crocus are widely used as a local application for tumours, swellings and wounds. They are also given in gastric complaints. They help to remove blood clots and other purulent matter in the body. The juice of the tubers is given in dropsical affections of hands and feet, and of effusions in joints. The juice causes salivation and vomiting. In Ayurveda, the improvement formulations using the herb are Chyavanaprasam, Asokarishtam, Baladthatryaditailam, Kalyanakaghritham, etc. The drug “HALLAKAM” prepared from this is in popular use in the form of powder or as an ointment application to wounds and bruises to reduce swellings. It also improves complexion and cures burning sensation, mental disorders and insomnia (NRF, 1998; Sivarajan et al, 1994).

Distribution: The plant is distributed in the tropics and sub-tropics of Asia and Africa. The plant grows wild in shaded areas which are wet or humid, especially in forests in South India. It grows in gardens and is known for their beautiful flowers and foliage. It is also cultivated as an intercrop with other commercial crops.

Botany: Kaempferia rotunda Linn. belonging to the family Zingiberaceae is an aromatic herb with tuberous root-stalk and very short stem. Leaves are simple, few, erect, oblong or ovate- lanceolate, acuminate, 30cm long, 10cm wide, variegated green above and tinged with purple below. Flowers are fragrant, white, tip purple or lilac arranged in crowded spikes opening successively. The plant produces a subglobose tuberous rhizome from which many roots bearing small oblong or rounded tubers arise (Warrier et al, 1995).

Agrotechnology: The plant is a tropical one adapted for tropical climate. Rich loamy soil having good drainage is ideal for the plant. Laterite soil with heavy organic manure application is also well suited. Planting is done in May-June with the receipt of 4 or 5 pre-monsoon showers. The seed rate recommended is 1500-2000kg rhizomes/ha. Whole or split rhizome with one healthy sprout is the planting material. Well developed healthy and disease free rhizomes with the attached root tubers are selected for planting. Rhizomes can be stored in cool dry place or pits dug under shade plastered with mud or cowdung. The field is ploughed to a fine tilth, mixed with organic manure at 10-15t/ha. Seed beds are prepared at a size of 1m breadth and convenient length. Pits are made at 20cm spacing in which 5cm long pieces of rhizomes are planted. Pits are covered with organic manure. They are then covered with rotten straw or leaves. Apply FYM or compost as basal dose at 20 t/ha either by broadcasting and ploughing or by covering the seed in pits after planting. Apply fertilisers at the rate of 50:50:50 kg N, P2O5 and K2O/ha at the time of first and second weeding. After planting, mulch the beds with dry or green leaves at 15 t/ha. During heavy rainy months, leaf rot disease occurs which can be controlled by drenching 1% Bordeaux mixture. The crop can be harvested after 7 months maturity. Drying up of the leaves is the indication of maturity. Harvest the crop carefully without cutting the rhizome, remove dried leaves and roots. Wash the rhizome in water. They are stored in moisture-proof sheds. Prolonged storage may cause insect and fungus attack (Prasad et al, 1997).

Properties and activity: The tubers contain crotepoxide and -sitosterol. Tuber contains essential oil which give a compound with melting point 149oC which yielded benzoic acid on hydrolysis.

The tubers are acrid, thermogenic aromatic, stomachic, antiinflammatory, sialagogue, emetic, antitumour and vulnerary.... indian crocus

See CANNABIS.... indian hemp

Indian Medicinal Plants

[catlist id=3 numberposts=100 pagination=yes instance=2 orderby=title order=asc]

... indian medicinal plants

Love... indian paint brush

Claytonia species

Description: All Claytonia species are somewhat fleshy plants only a few centimeters tall, with showy flowers about 2.5 centimeters across.

Habitat and Distribution: Some species are found in rich forests where they are conspicuous before the leaves develop. Western species are found throughout most of the northern United States and in Canada.

Edible Parts: The tubers are edible but you should boil them before eating.... indian potato or eskimo potato

Pongamia pinnata

Papilionaceae

San: Karanj;

Hin: Karanja, Dittouri;

Ben: Dehar karanja;

Mal: Ungu, Pongu; Guj, Mar, Pun: Karanj;

Kan: Hongae;

Tel: Kangu;

Tam: Puggam; Ass: Karchaw; Ori: Koranjo

Importance: Indian beech, Pongam oil tree or Hongay oil tree is a handsome flowering tree with drooping branches, having shining green leaves laden with lilac or pinkish white flowers. The whole plant and the seed oil are used in ayurvedic formulations as effective remedy for all skin diseases like scabies, eczema, leprosy and ulcers. The roots are good for cleaning teeth, strengthening gums and in gonorrhoea and scrofulous enlargement. The bark is useful in haemorhoids, beriberi, ophthalmopathy and vaginopathy. Leaves are good for flatulence, dyspepsia, diarrhoea, leprosy, gonorrhoea, cough, rheumatalgia, piles and oedema. Flowers are given in diabetes. Fruits overcomes urinary disease and piles. The seeds are used in inflammations, otalgia, lumbago, pectoral diseases, chronic fevers, hydrocele, haemorrhoids and anaemia. The seed oil is recommended for ophthalmia, haemorrhoids, herpes and lumbagoThe seed oil is also valued for its industrial uses. The seed cake is suggested as a cheap cattle feed. The plant enters into the composition of ayurvedic preparations like nagaradi tailam, varanadi kasayam, varanadi ghrtam and karanjadi churna.

It is a host plant for the lac insect. It is grown as a shade tree. The wood is moderately hard and used as fuel and also for making agricultural implements and cart- wheels.

Distribution: The plant is distributed throughout India from the central or eastern Himalaya to Kanyakumari, especially along the banks of streams and rivers or beach forests and is often grown as an avenue tree. It is distributed in Sri Lanka, Burma, Malaya, Australia and Polynesia.

Botany: Pongamia pinnata (Linn.) Pierre syn. P. glabra Vent., Derris indica (Lam.) Bennet, Cystisus pinnatus Lam. comes under family Papilionaceae. P. pinnata is a moderate sized, semi -evergreen tree growing upto 18m or more high, with a short bole, spreading crown and greyish green or brown bark. Leaves imparipinnate, alternate, leaflets 5-7, ovate and opposite. Flowers lilac or pinkish white and fragrant in axillary recemes. Calyx cup-shaped, shortly 4-5 toothed, corolla papilionaceous. Stamens 10 and monadelphous, ovary subsessile, 2-ovuled with incurved, glabrous style ending in a capitate stigma. Pod compressed, woody, indehiscent, yellowish grey when ripe varying in size and shape, elliptic to obliquely oblong, 4.0-7.5cm long and 1.7-3.2cm broad with a short curved beak. Seeds usually 1, elliptic or reniform, wrinkled with reddish brown, leathery testa.

Agrotechnology: The plant comes up well in tropical areas with warm humid climate and well distributed rainfall. Though it grows in almost all types of soils, silty soils on river banks are most ideal. It is tolerant to drought and salinity. The tree is used for afforestation, especially in watersheds in the drier parts of the country. It is propagated by seeds and vegetatively by rootsuckers. Seed setting is usually in November. Seeds are soaked in water for few hours before sowing. Raised seed beds of convenient size are prepared, well rotten cattle manure is applied at 1kg/m2 and seeds are uniformly broadcasted. The seeds are covered with a thin layer of sand and irrigated. One month old seedlings can be transplanted into polybags, which after one month can be planted in the field. Pits of size 50cm cube are dug at a spacing of 4-5m, filled with top soil and manure and planted. Organic manure are applied annually. Regular weeding and irrigation are required for initial establishment. The trees flower and set fruits in 5 years. The harvest season extends from November- June. Pods are collected and seeds are removed by hand. Seed, leaves, bark and root are used for medicinal purposes. Bark can be collected after 10 years. No serious pests and diseases are reported in this crop.

Properties and activity: The plant is rich in flavonoids and related compounds. Seeds and seed oil, flowers and stem bark yield karanjin, pongapin, pongaglabrone, kanugin, desmethoxykanugin and pinnatin. Seed and its oil also contain kanjone, isolonchocarpin, karanjachromene, isopongachromene, glabrin, glabrachalcone, glabrachromene, isopongaflavone, pongol, 2’- methoxy-furano 2”,3”:7,8 -flavone and phospholipids. Stem-bark gives pongachromene, pongaflavone, tetra-O-methylfisetin, glabra I and II, lanceolatin B, gamatin, 5-methoxy- furano 2”,3”:7,8 -flavone, 5-methoxy-3’,4’-methelenedioxyfurano 2”,3”:7,8 -flavone and - sitosterol. Heartwood yields chromenochalcones and flavones. Flowers are reported to contain kanjone, gamatin, glabra saponin, kaempferol, -sitosterol, quercetin glycocides, pongaglabol, isopongaglabol, 6-methoxy isopongaglabol, lanceolatin B, 5-methoxy-3’,4’- methelenedioxyfurano 8,7:4”,5” -flavone, fisetin tetramethyl ether, isolonchocarpin, ovalichromene B, pongamol, ovalitenon, two triterpenes- cycloart-23-ene,3 ,25 diol and friedelin and a dipeptide aurantinamide acetate.

Roots and leaves give kanugin, desmethoxykanugin and pinnatin. Roots also yield a flavonol methyl ether-tetra-O-methyl fisetin. The leaves contain triterpenoids, glabrachromenes I and II, 3’-methoxypongapin and 4’-methoxyfurano 2”,3”:7,8 -flavone also. The gum reported to yield polysaccharides (Thakur et al, 1989; Husain et al, 1992).

Seeds, seed oil and leaves are carminative, antiseptic, anthelmintic and antirheumatic. Leaves are digestive, laxative, antidiarrhoeal, bechic, antigonorrheic and antileprotic. Seeds are haematinic, bitter and acrid. Seed oil is styptic and depurative. Karanjin is the principle responsible for the curative properties of the oil. Bark is sweet, anthelmintic and elexteric.... indian beech

(English) From the land of the Indians; from the state of Indiana Indianna, Indyana, Indyanna... indiana

A variable, with characteristics of quality, quantity and time, used to measure, directly or indirectly, changes in a situation and to appreciate the progress made in addressing it. It also provides a basis for developing adequate plans for improvement. It is a variable that helps to measure changes in a health situation directly or indirectly and to assess the extent to which the objectives and targets of a programme are being attained.... indicator

(American) A capable woman Indeice, Indeace, Indeece, Indiese, Indeise, Indeese, Indease... indiece

(English) Resembling the plant; a purplish-blue dye Indygo, Indeego... indigo

Withania somnifera

Solanceae

San: Aswagandha, Varahakarni

Hin: Asgandh, Punir Mal: Amukkuram

Tam: Amukkira

Tel: Vajigandha

Mar: Askandha

Guj: Ghoda

Kan: Viremaddinagaddi

Importance: Indian ginseng or Winter cherry is an erect branching perennial undershrub which is considered to be one of the best rejuvenating agents in Ayurveda. Its roots, leaves and seeds are used in Ayurvedic and Unani medicines, to combat diseases ranging from tuberculosis to arthritis. The pharmacological activity of the plant is attributed to the presence of several alkaloids and withaniols. Roots are prescribed in medicines for hiccup, several female disorders, bronchitis, rheumatism, dropsy, stomach and lung inflammations and skin diseases. Its roots and paste of green leaves are used to relieve joint pains and inflammation. It is also an ingredient of medicaments prescribed for curing disability and sexual weakness in male. Leaves are used in eye diseases. Seeds are diuretic. It is a constituent of the herbal drug ‘Lactare’ which is a galactagogue.

Aswagandha was observed to increase cell-mediated immunity, prevent stress induced changes in adrenal function and enhance protein synthesis. Milk fortified with it increases total proteins and body weight. It is a well known rejuvenating agent capable of imparting long life, youthful vigour and intellectual power. It improves physical strength and is prescribed in all cases of general debility. Aswagandha powder (6-12g) twice a day along with honey and ghee is advised for tuberculosis in Sushruta Samhita. It also provides sound sleep (Prakash, 1997).

Distribution: Aswagandha is believed to have oriental origin. It is found wild in the forests of Mandsaur and Bastar in Mandhya Pradesh, the foot hills of Punjab, Himachal Pradesh, Uttar Pradesh and western Himalayas in India. It is also found wild in the Mediterranean region in North America. In India it is cultivated in Madhya Pradesh, Rajastan and other drier parts of the country.

Botany: Aswagandha belongs to the genus Withania and family Solanaceae. Two species, viz, W. coagulans Dunal and W. somnifera Dunal are found in India. W. coagulans is a rigid grey under shrub of 60-120cm high. W. somnifera is erect, evergreen, tomentose shrub, 30-75cm in height. Roots are stout, fleshy, cylindrical, 1-2cm in diameter and whitish brown in colour. Leaves are simple, ovate, glabrous and opposite. Flowers are bisexual, inconspicuous, greenish or dull yellow in colour born on axillary umbellate cymes, comprising 5 sepals, petals and stamens each; the two celled ovary has a single style and a bilobed stigma. The petals are united and tubular. The stamens are attached to the corolla tube and bear erect anthers which form a close column or cone around the style. Pollen production is poor. The fruit is a small berry, globose, orange red when mature and is enclosed in persistent calyx. The seeds are small, flat, yellow and reniform in shape and very light in weight. The chromosome number 2n = 48.

The cultivated plants have sizable differences from the wild forms not only in their morphological characters but also in the therapeutical action, though the alkaloids present are the same in both (Kaul, 1957). Some botanists, therefore, described the cultivated plant distinct from wild taxa and have coined a new name W. aswagandha (Kaul, 1957) which is contested by Atal and Schwarting (1961).

Agrotechnology: Asgandh is a tropical crop growing well under dry climate. The areas receiving 600 to 750mm rainfall is best suited to this crop. Rainy season crop requires relatively dry season and the roots are fully developed when 1-2 late winter rains are received. Sandy loam or light red soils having a pH of 7.5- 8.0 with good drainage are suitable for its cultivation. It is usually cultivated on poor and marginal soils. Withania is propagated through seeds. It is a late kharif crop and planting is done in August. Seeds are either broadcast-sown or seedlings are raised in nursery and then transplanted. Seed rate is 10-12 kg/ha for broadcasting and 5kg/ha for transplanting. In direct sown crop plants are thinned and gap filling is done 25-30 days after sowing. Seeds should be treated with Dithane M-45 at 3g/kg of seeds before sowing. Seeds are sown in the nursery just before the onset of rainy season and covered with light soil. Seeds germinate in 6-7 days. When seedlings are six weeks old they are transplanted at 60cm in furrows taken 60cm apart. The crop is mainly grown as a rainfed crop on residual fertility and no manure or fertilizers are applied to this crop generally. However, application of organic manure is beneficial for realizing better yields. It is not a fertilizer responsive crop. One hand weeding 25-30 days after sowing helps to control weeds effectively. No serious pest is reported in this crop. Diseases like seedling rot and blight are observed. Seedling mortality becomes serious under high temperature and humid conditions. The disease can be minimized by use of disease free seeds and treatment with thiram or deltan at 3-4g/kg seed before sowing. Further, use of crop rotation, timely sowing and keeping field well drained also protect the crop. Spraying with 0.3% fytolan, dithane Z-78 or dithane M-45 will help controlling the disease incidence. Spraying is repeated at 15 days interval if the disease persists. Aswagandha is a crop of 150-170 days duration. The maturity of the crop is judged by the drying of the leaves and reddening of berries. Harvesting usually starts from January and continues till March. Roots, leaves and seeds are the economical parts. The entire plant is uprooted for roots, which are separated from the aerial parts. The berries are plucked from dried plants and are threshed to obtain the seeds. The yield is 400-500kg of dry roots and 50-75kg seeds per hectare.

Post harvest technology: The roots are separated from the plant by cutting the stem 1-2cm above the crown.

Roots are then cut into small pieces of 7-10cm to facilitate drying. Occasionally, the roots are dried as a whole. The dried roots are cleaned, trimmed, graded, packed and marketed. Roots are carefully hand sorted into the following four grades.

Grade A: Root pieces 7cm long, 1-1.5cm diameter, brittle, solid, and pure white from outside.

Grade B: Root pieces 5cm long, 1cm diameter, brittle, solid and white from outside.

Grade C: Root pieces 3-4cm long, less than 1cm diameter and solid. Lower grade: Root pieces smaller, hollow and yellowish from outside.

Properties and activity: Aswagandha roots contain alkaloids, starch, reducing sugar, hentriacontane, glycosides, dulcital, withaniol acid and a neutral compound. Wide variation (0.13-0.31%) is observed in alkaloid content. Majumdar (1955) isolated 8 amorphous bases such as withanine, somniferine, somniferinine, somnine, withananine, withananinine, pseudowithanine and withasomnine. Other alkaloids reported are nicotine, tropine, pseudotropine, 3, -tigloyloxytropane, choline, cuscudohygrine, anaferine, anahygrine and others. Free aminoacids in the roots include aspartic acid, glycine, tyrosine, alanine, proline, tryptophan, glutamic acid and cystine. Leaves contain 12 withanolides, alkaloids, glycosides, glucose and free amino acids. Berries contain a milk coagulating enzyme, two esterases, free amino acids, fatty oil, essential oil and alkaloids. Methods for alkaloid’s analysis in Asgandh roots have also been reported (Majumdar, 1955; Mishra, 1989; Maheshwari, 1989). Withania roots are astringent, bitter, acrid, somniferous, thermogenic, stimulant, aphrodisiac, diuretic and tonic. Leaf is antibiotic, antitumourous, antihepatotoxic and antiinflammatory. Seed is milk coagulating, hypnotic and diuretic.... indian ginseng

Phyllanthus emblica

Euphorbiaceae

San: Amalaka, Adiphala

Tel: Amalakam

Hin, Mar: Amla

Kan: Amalaka

Ben: Amlaki

Guj: Ambala

Mal,

Tam: Nelli

Kas: Aonla

Importance: Indian gooseberry or emblic myrobalan is a medium sized tree the fruit of which is used in many Ayurvedic preparations from time immemorial. It is useful in haemorrhage, leucorrhaea, menorrhagia, diarrhoea and dysentery. In combination with iron, it is useful for anaemia, jaundice and dyspepsia. It goes in combination in the preparation of triphala, arishta, rasayan, churna and chyavanaprash. Sanjivani pills made with other ingredients is used in typhoid, snake-bite and cholera. The green fruits are made into pickles and preserves to stimulate appetite. Seed is used in asthma, bronchitis and biliousness. Tender shoots taken with butter milk cures indigestion and diarrhoea. Leaves are also useful in conjunctivitis, inflammation, dyspepsia and dysentery. The bark is useful in gonorrhoea, jaundice, diarrhoea and myalgia. The root bark is astringent and is useful in ulcerative stomatitis and gastrohelcosis. Liquor fermented from fruit is good for indigestion, anaemia, jaundice, heart complaints, cold to the nose and for promoting urination. The dried fruits have good effect on hair hygiene and used as ingredient in shampoo and hair oil. The fruit is a very rich source of Vitamin C (600mg/100g) and is used in preserves as a nutritive tonic in general weakness (Dey, 1980).

Distribution: Indian gooseberry is found through out tropical and subtropical India, Sri Lanka and Malaca. It is abundant in deciduous forests of Madhya Pradesh and Darjeeling, Sikkim and Kashmir. It is also widely cultivated.

Botany: Phyllanthus emblica Linn. syn. Emblica officinalis Gaertn. belongs to Euphorbiaceae family. It is a small to medium sized deciduous tree growing up to 18m in height with thin light grey, bark exfoliating in small thin irregular flakes. Leaves are simple, many subsessile, closely set along the branchlets, distichous light green having the appearance of pinnate leaves. Flowers are greenish yellow in axillary fascicles, unisexual; males numerous on short slender pedicels; females few, subsessile; ovary 3-celled. Fruits are globose, 1-5cm in diameter, fleshy, pale yellow with 6 obscure vertical furrows enclosing 6 trigonous seeds in 2-seeded 3 crustaceous cocci. Two forms Amla are generally distinguished, the wild ones with smaller fruits and the cultivated ones with larger fruits and the latter are called ‘Banarasi’(Warrier et al, 1995).

Agrotechnology: Gooseberry is quite hardy and it prefers a warm dry climate. It needs good sunlight and rainfall. It can be grown in almost all types of soils, except very sandy type. A large fruited variety “Chambakad Large“ was located from the rain shadow region of the Western Ghats for cultivation in Kerala. Amla is usually propagated by seeds and rarely by root suckers and grafts. The seeds are enclosed in a hard seed coat which renders the germination difficult. The seeds can be extracted by keeping fully ripe fruits in the sun for 2-3 days till they split open releasing the seeds. Seeds are soaked in water for 3-4 hours and sown on previously prepared seed beds and irrigated. Excess irrigation and waterlogging are harmful. One month old seedlings can be transplanted to polythene bags and one year old seedlings can be planted in the main field with the onset of monsoon. Pits of size 50 cm3 are dug at 6-8m spacing and filled with a mixture of top soil and well rotten FYM and planting is done. Amla can also be planted as a windbreak around an orchard. Irrigation and weeding are required during the first year. Application of organic manure and mulching every year are highly beneficial. Chemical fertilisers are not usually applied. No serious pests or diseases are generally noted in this crop. Planted seedlings will commence bearing from the 10th year, while grafts after 3-4 years. The vegetative growth of the tree continues from April to July. Along with the new growth in the spring, flowering also commences. Fruits will mature by December-February. Fruit yield ranges from 30-50kg/tree/year when full grown (KAU,1993).

Properties and activity: Amla fruit is a rich natural source of vitamin C. It also contains cytokinin like substances identified as zeatin, zeatin riboside and zeatin nucleotide. The seeds yield 16% fixed oil, brownish yellow in colour. The plant contains tannins like glucogallia, corilagin, chebulagic acid and 3,6-digalloyl glucose. Root yields ellagic acid, lupeol, quercetin and - sitosterol (Thakur et al, 1989).

The fruit is diuretic, laxative, carminative, stomachic, astringent, antidiarrhoeal, antihaemorrhagic and antianaemic.... indian gooseberry

Linn.

Synonym: I. prostrata Willd.

Family: Fabaceae.

Habitat: Throughout greater parts of India.

Folk: Vana-methi.

Action: Astringent, antileucor- rhoeic, antirheumatic, alterative, restorative.

The seeds contain crude protein 31.5 pentosan 7.3, water soluble gum 3.0%.... indigofera trifoliata

(Hindi) A beautiful woman; in Hinduism, another name for Lakshmi Indirah, Indyra, Indiera, Indeera, Indeira, Indeara, Indyrah, Indierah, Indeerah, Indeirah, Indearah... indira

See “cost”.... indirect cost

This is the new, preferred term for essential amino acids – amino acids which are essential for the body’s normal growth and development, but which the body is unable to produce. Nine essential amino acids exist – HISTIDINE, ISOLEUCINE, LEUCINE, LYSINE, METHIONINE, PHENYLALANINE, THREONINE, TRYPTOPHAN, and VALINE – and they are present in foods rich in protein: dairy products, eggs, meat, and liver.... indispensable amino acids

See “data”.... individual data

See “care plan”.... individual programme plan

Hemidesmus indicus

Asclepiadaceae

San: Anantamulah, Sariba;

Hin: Anantamul, Magrabu;

Ben: Anantamul;

Mal: Nannari, Naruninti, Narunanti;

Tam: Nannari, Saribam;

Tel: Sugandipala;

Kan: Namadaballi

Importance: Indian Sarasaparilla or Country Sarasaparilla is a climbing slender plant with twining woody stems and a rust-coloured bark. The roots are useful in vitiated conditions of pitta, burning sensation, leucoderma, leprosy, skin diseases, pruritus, asthma, bronchitis, hyperdipsia, opthalmopathy, hemicrania, epileptic fits, dyspepsia, helminthiasis, diarrhoea, dysentery, haemorrhoids, strangury, leucorrhoea, syphilis, abcess, arthralgia, fever and general debility. The leaves are useful in vomiting, wounds and leucoderma. The stems are bitter, diaphoretic and laxative and are useful in inflammations, cerebropathy, hepatopathy, nephropathy, syphilis, metropathy, leucoderma, odontalgia, cough and asthma. The latex is good for conjunctivitis (Warrier et al, 1995). The important formulations using the drug are Saribadyasava, Pindataila, Vidaryadi lehya, Draksadi kasaya, Jatyadi ghrita, etc. (Sivarajan et al, 1994). The Hemidesmus root powdered and mixed with cow’s milk is given with much benefit in the case of strangury. In the form of syrup, it has demulcent and diuretic proportions. The root, roasted in plantain leaves, then beaten into a mass with cumin and sugar and mixed with ghee is a household remedy in genito-urinary diseases. The hot infusion of the root-bark with milk and sugar is a good alterative tonic especially for children in cases of chronic cough and diarrhoea (Nadkarni, 1998). It has been successfully used in the cure of venereal diseases where American Sarasaparilla (Aralia nudicaulis Linn.) has failed. Native doctors utilize it in nephritic complaints and for sore mouths of children (Grieve and Leyel, 1992).

Distribution: Hemidesmus is distributed throughout India, the Moluccas and Sri Lanka.

Botany: Hemidesmus indicus (Linn.) R. Br. syn. Periploca indica Linn. belongs to the family Asclepiadaceae. It is a perennial, slender, laticiferous, twining or prostrate, wiry shrub with woody rootstock and numerous slender, terete stems having thickened nodes. Leaves are simple, opposite, very variable from elliptic-oblong to linear-lanceolate, variegated with white above and silvery white and pubescent beneath. Flowers are greenish purple crowded in sub-sessile cymes in the opposite leaf-axils. Fruits are slender follicles, cylindrical, 10cm long, tapering to a point at the apex. Seeds are flattened, black, ovate-oblong and coma silvery white. The tuberous root is dark-brown, coma silvery white, tortuous with transversely cracked and longitudinally fissured bark. It has a strong central vasculature and a pleasant smell and taste (Warrier et al, 1995).

The Ayurvedic texts mention two varieties, viz. a krsna or black variety and a sveta or white variety (Aiyer, 1951) which together constitute the pair, Saribadvayam. The drug is known as Sariba. Svetasariba is H. indicus. Two plants, namely, Ichnocarpus fructescens (Apocynaceae) known as pal-valli in vernacular and Cryptolepis buchanani (Asclepidaceae) known as Katupalvalli (Rheeds, 1689) are equated with black variety or Krsnasariba (Chunekar, 1982; Sharma, 1983).

Agrotechnology: Hemidesmus is propagated through root cuttings. The root cuttings of length 3-5cm can be planted in polybags or in the field. They can be planted in flat beds or on ridges. Planting is done usually at a spacing of 50x20cm. Heavy application of organic manure is essential for good growth and root yield. Inorganic fertilizers are not usually applied. Frequent weeding and earthing up are required, as the plant is only slow growing. Provision of standards for twining will further improve the growth and yield of the plant.

Properties and activity: The twigs of the plant give a pregnane ester diglycoside named desinine. Roots give -sitosterol, 2-hydroxy-4-methoxy benzaldehyde, -amyrin, -amyrin and its acetate, hexatriacontane, lupeol octacosonate, lupeol and its acetate. Leaves, stem and root cultures give cholesterol, campesterol, -sitosterol and 16-dehydro-pregnenolone. Leaves and flowers also give flavonoid glycosides rutin, hyperoside and iso-quercitin (Husain et al,1992). “Hemidesmine”- a crystallizible principle is found in the volatile oil extracted from roots. Some suggest that it is only a stearoptene. It also contains some starch, saponin and in the suberous layer, tannic acid (Grieve and Leyel, 1992). The root is alterative, febrifuge, antileucorrhoeic, antisyphilitic, demulcent, diaphoretic, diuretic, tonic, galactogenic, antidote for scorpion-sting and snake-bite, antidiarrhoeal, blood purifier, antirheumatic and aperitive. Essential oil from root is anti-bacterial and the plant is antiviral (Husain et al, 1992).... indian sarasaparilla

(Hindi) One who possesses the rain; in Hinduism, a deity of thunder and rain Indrah, Indrani, Indranie, Indranee, Indrina... indra

(American) One who is outspoken Indraye, Indrae, Indrai, Indree... indray

(Hindi) Woman of splendor... indre

(Hindi) Woman of the moon Indukala, Induma... indu

(Hindi) Born beneath the full moon

Indumatie, Indumaty, Indumatey, Indumatee, Indumatea... indumati

See OCCUPATIONAL HEALTH, MEDICINE AND DISEASES.... industrial diseases

(American) A sparkling woman Ineeshah, Ineisha, Ineishah, Iniesha, Inieshah, Ineasha, Ineashah, Ineysha, Ineyshah... ineesha

(Japanese) One who nurtures... ineke

(Spanish) Form of Agnes, meaning “one who is pure; chaste” Inez, Inesa, Inesita, Inessa, Inetta, Ineta... ines

An old name for POLIOMYELITIS.... infantile paralysis

Indigo Root Tea has been known for many years due to its antiseptic, astringent, antibiotic, emetic and antibacterial properties. Wild indigo (baptisia tinctoria) is a herbaceous annual plant that can be recognized by its branching stems and bluish green leaves. Its flowers usually bloom during May and September and they pose as bright yellow flowers. The constituents of Indigo Root Tea are flavonoids, isoflavones, alkaloids, coumarins and polysaccharides. They usually are active when the indigoo root is made into a decoction or used as a tincture. How To Make Indigo Root Tea If you want to make Indigo Root Tea, simply place a handful of indigo root in a cup of boiling water for about 10-15 minutes. After that, take it out of the heat and let it stand for about 3 minutes. Indigo Root Tea Benefits

• Strenghtens the immune system.
• Can speed recovery from the common cold.
• Helps heal wounds and cuts.
• Treats respiratory infections such as pharyngitis and tonsilitis.
• Heals sore thorat.
• Helps reduce fever.
• Helps in the treatment of chronic fatigue syndrome when combined with echinacea.

Indigo Root Tea Side Effects

• Taking in large doses, Indigo Root Tea can cause nausea, diarrhea, voming or asphyxiation.
• Pregnant and breastfeeding women should avoid drinking Indigo Root Tea.
• People with auto-immune disorders should not drink Indigo Root Tea.

Indigo Root Tea is an amazing tea with many health benefits. Just make sure you don’t drink too much indigo root tea, in order not to experience any of its side effects!... indigo root tea

Hochst.

Family: Fabaceae.

Habitat: Cultivated in Assam, Bihar and in parts of Uttar Pradesh.

English: Natal Indigo, Java Indigo, Bengal Indigo.

Ayurvedic: Nili (related species).

Action: See I. tinctoria.

Aqueous extract of the plant exhibits antihyperglycaemic activity in rats due to insulinotropic property.

The indigotin content of the plant (0.8-1.0%) is higher than that of other species of Indigofera. The leaves contain up to 4% of a flavonol glycoside which on hydrolysis yields rhamnose and kaempferol.

Indigofera articulata auct. non-Gouan.

Synonym: I. caerulea Roxb.

Family: Fabaceae.

Habitat: Bihar and Western and Peninsular India.

English: Egyptian Indigo, Arabian Indigo, Wild Indigo, Surat Indigo.

Ayurvedic: Nili (related species).

Siddha/Tamil: Aaramuri, Irup- pumuri, Kattavuri.

Folk: Surmai Nila.

Action: Root, leaf—bitter tonic. Seed—anthelmintic.... indigofera arrecta

Vahl ex DC.

Family: Fabaceae.

Habitat: Plains of Karnataka, Andhra Pradesh and Tamil Nadu.

English: Wiry Indigo.

Ayurvedic: Nili (related species), Shivanimba.

Siddha/Tamil: Sivanaarvembu, Iraivanvembu.

Folk: Shivanimba (Maharashtra).

Action: Antileprotic, antitumour, anti-inflammatory. Used in psoriasis and erysipelas. Ash of the burnt plant is used for dandruff. Root is used in aphthae.... indigofera aspalathoides

Linn.

Synonym: I. linnaei Ali.

Family: Fabaceae.

Habitat: The Himalayas up to 1,200 m and in plains of India.

English: Trailing indigo.

Ayurvedic: Vaasukaa.

Siddha/Tamil: Cheppunerinjil.

Folk: Hanumaan-buuti, Bhui-nila.

Action: Juice of the plant— antiscorbutic, diuretic, alterative. The plant, boiled with oil, is applied to burns. A decoction is given in epilepsy and insanity.

The plant contains two unsaturat- ed hydrocarbons—indigoferin and en- neaphyllin. The seeds contain 37.8% protein, also yield lipids (4.4%) containing palmitic and oleic acid. The toxicity of the plant is attributed to a non-protein amino acid, indospicine (6-amidino-2-aminohexanoic acid). (Consumption of the plant produces a neurological syndrome, known as Birdsville disease, in horses. The toxic- ity is greatly reduced when the material is chopped and dried.)

The aerial parts gave 3-nitropropa- noyl esters of D-glucose.... indigofera enneaphylla

A person who harbours an infectious agent and who has either manifest disease or inapparent infection. An infectious person is one from whom the infectious agent can be naturally acquired.... infected person

Forsk Synonym: I. paucifolia Delile.Family: Fabaceae.

Habitat: Throughout greater parts of India.English: Wild Indigo, Mysore Panicled Indigo.Ayurvedic: Bana-Nila, Dill, Jhill.Unani: Vasmaa.Siddha/Tamil: Kattukkarchamathi.Folk: Jhil (Gujarat).

Action: Plant—antisyphilitic. All parts of the plant are found useful in enlargement of liver and spleen.The leaves gave apigenin 7-rhamno- glucoside, apigenin 7, 4'-diglucoside, kaempferol-3-neohesperidoside and rhoifolin, along with protocatechuic, p-coumaric, p-hydroxybenzoic, salicylic and vanillic acid.... indigofera oblongifolia

Roxb. in part.

Synonym: I. cassioides Rottl. ex DC.

Family: Fabaceae.

Habitat: The hills in India.

Ayurvedic: Nili (related species).

Siddha/Tamil: Nirinji.

Action: Root—used for cough. Powder of the root applied externally for muscular pain in chest.

Leaves and roots—used for swelling of the stomach.

The seeds contain crude protein 27.6, pentosans 8.9 and water soluble gum 12.8%.... indigofera pulchella

Linn.

Family: Fabaceae.

Habitat: Cultivated in many parts of India.

English: Indigo.

Ayurvedic: Nilikaa, Nilaa, Nila, Nili, Nilini, Nilapushpa, Ranjani, Shaaradi, Tutthaa.

Unani: Habb-ul-Neel.

Siddha/Tamil: Nili, Averi, Asidai, Attipurashadam.

Action: Plant—antiseptic, hepato- protective, hypoglycaemic, nervine tonic. Used in enlargement of liver and spleen, skin diseases, leucoder- ma, burns, ulcers, piles, nervous disorders, epilepsy, asthma, lumbago, gout. Leaf—anti-inflammatory. Used in blennorrhagia. Root— diuretic. Used in hepatitis. Root and stem—laxative, expectorant, febrifuge, anticephalalgic, anti- tumour, anthelmintic, promote growth of hair.

The Ayurvedic Pharmacopoeia of India recommends the use of dried whole plant in phobia, delusion and disturbed mental state.

Indicine (5-15 mg/g, dry basis) and the flavonoids, apigenin, kaempferol, luteolin and quercetin are present in various plant parts, maximum in the leaves and minimum in the roots (however quercetin was minimum in leaves). The presence of coumarins, cardiac glycosides, saponins and tannins is also reported.

Alcoholic extract of the aerial parts showed hepatoprotective activity in experimental animals against CCl4- induced hepatic injury. The extract increased bile flow and liver weight in rats. The alcoholic extract also exhibited hypoglycaemic activity in rats.

The plant is used in the treatment of endogenous depression. It contains appreciable amounts of conjugated in- doxyl (indican). The use of indigo and its constituents, indirubin and indigotin, prevents allergic contact dermatitis. The 8 weeks old tissues in culture contain maximum histamine content (5.0 mg/g dry weight).

Dosage: Dried leaf—50-100 g for decoction; root—48 g for decoction (API Vol. II); whole plant—10-20 g for decoction. (API Vol. III.)... indigofera tinctoria

Septic, haemorrhagic and cardiogenic SHOCK

METABOLIC DISORDERS such as URAEMIA and pancreatitis (see PANCREAS, DISORDERS OF)

Bowel infarction

Drug ingestion

Massive blood transfusion, transfusion reaction (see TRANSFUSION OF BLOOD), CARDIOPULMONARY BYPASS, disseminated intravascular coagulation

Treatment The principles of management are supportive, with treatment of the underlying condition if that is possible. Oxygenation is improved by increasing the concentration of oxygen breathed in by the patient, usually with mechanical ventilation of the lungs, often using continuous positive airways pressure (CPAP). Attempts are made to reduce the formation of pulmonary oedema by careful management of how much ?uid is given to the patient (?uid balance). Infection is treated if it arises, as are the possible complications of prolonged ventilation with low lung compliance (e.g. PNEUMOTHORAX). There is some evidence that giving surfactant through a nebuliser or aerosol may help to improve lung e?ectiveness and reduce oedema. Some experimental evidence supports the use of free-radical scavengers and ANTIOXIDANTS, but these are not commonly used. Other techniques include the inhalation of NITRIC OXIDE (NO) to moderate vascular tone, and prone positioning to improve breathing. In severe cases, extracorporeal gas exchange has been advocated as a supportive measure until the lungs have healed enough for adequate gas exchange. (See also RESPIRATORY DISTRESS SYNDROME; HYALINE MEMBRANE DISEASE; SARS.)... indirect insult

An organism, chiefly a microorganism but including helminths, that is capable of producing infection or infectious disease.... infectious agent

The quality of being infectious; infectiousness.... infectivity

The process of passing from observations and axioms to generalizations. In statistics, the development of generalizations from sample data, usually with calculated degrees of uncertainty.... inference

The Industrial Injuries Scheme provides money for people who have suffered injury or illness because of their work. Bene?ts for employment-related disability (selfemployment is excluded) have been altered many times since they were introduced in 1948. There is now a mix of bene?ts, eligibility for which depends on several factors: the date, onset and type of disability are among the most important. ‘Industrial’ includes almost all forms of employment. In addition to accidents, there is a long list of prescribed industrial diseases ranging from BURSITIS, hearing loss, ASTHMA and viral HEPATITIS to unusual ones such as ORF. Psychological as well as physical disablement may attract bene?t, which is calculated on a percentage basis according to the extent of disability. The onus is on the individual to claim, and trade unions and representative organisations can advise on procedures. Injured employees should always report details of an accident to their employer and record it in the accident book promptly: even seemingly minor injuries may subsequently lead to some disability. Relevant information lea?ets are available – for example, from local bene?t agencies, local-authority advice centres and public libraries.... industrial injuries benefit

The newborn infant may be fed naturally from the breast, or arti?cially from a bottle.

Breast feeding Unless there is a genuine contraindication, every baby should be breast fed. The nutritional components of human milk are in the ideal proportions to promote the healthy growth of the human newborn. The mother’s milk, especially colostrum (the ?uid secreted before full lactation is established) contains immune cells and antibodies that increase the baby’s resistance to infection. From the mother’s point of view, breast feeding helps the womb to return to its normal size and helps her to lose excess body fat gained during pregnancy. Most importantly, breast feeding promotes intimate contact between mother and baby. A ?nal point to be borne in mind, however, is that drugs taken by a mother can be excreted in her milk. These include antibiotics, sedatives, tranquillisers, alcohol, nicotine and high-dose steroids or vitamins. Fortunately this is rarely a cause of trouble. (See also main entry on BREAST FEEDING.)

Arti?cial feeding Unmodi?ed cows’ milk is not a satisfactory food for the human newborn and may cause dangerous metabolic imbalance. If breast feeding is not feasible, one of the many commerciallly available formula milks should be used. Most of these are made from cows’ milk which has been modi?ed to re?ect the composition of human milk as closely as possible. For the rare infant who develops cows’-milk-protein intolerance, a milk based on soya-bean protein is indicated.

Feeding and weight gain The main guide as to whether an infant is being adequately fed is the weight. During the ?rst days of life a healthy infant loses weight, but should by the end of the second week return to birth weight. From then on, weight gain should be approximately 6oz. (170g) each week.

The timing of feeds reffects social convention rather than natural feeding patterns. Among the most primitive hunter-gatherer tribes of South America, babies are carried next to the breast and allowed to suckle at will. Fortunately for developed society, however, babies can be conditioned to intermittent feedings.

As the timing of breast feeding is ?exible – little or no preparation time being required – mothers can choose to feed their babies on demand. Far from spoiling the baby, demand feeding is likely to lead to a contented infant, the only necessary caution being that a crying baby is not always a hungry baby.

In general, a newborn will require feeding every two to four hours and, if well, is unlikely to sleep for more than six hours. After the ?rst months, a few lucky parents will ?nd their infant sleeping through the night.

Weaning Weaning on to solid foods is again a matter of individuality. Most babies will become dissatis?ed with a milk-only diet at around six months and develop enthusiasm for cereal-based weaning foods. Also at about this time they enjoy holding objects and transferring them to their mouths – the mouth being an important sense organ in infants. It is logical to include food items that they can hold, as this clearly brings the baby pleasure at this time. Introduction of solids before the age of four months is unusual and best avoided. The usual reason given for early weaning is that the baby appears hungry, but this is unlikely to be the case; crying due to COLIC, for example, is more probable. Some mothers take the baby’s desire to suck – say, on their ?nger – as a sign of hunger when this is, in fact, re?ex activity.

Delaying the start of weaning beyond nine months is nutritionally undesirable. As weaning progresses, the infant’s diet requires less milk. Once established on a varied solid diet, breast and formula milks can be safely replaced with cows’ milk. There is, however, no nutritional contraindication to continued breast feeding until the mother wishes to stop.

It is during weaning that infants realise they can arouse extreme maternal anxiety by refusing to eat. This can lead to force-feeding and battles of will which may culminate in a breakdown of the mother-child relationship. To avoid this, parents must resist the temptation to coax the child to eat. If the child refuses solid food, the meal should be taken away with a minimum of fuss. Children’s appetites re?ect their individual genetic structure and a well child will eat enough to grow and maintain satisfactory weight gain. If a child is not eating properly, weight gain will be inadequate over a prolonged period and an underlying illness is the most likely cause. Indeed, failure to thrive is the paediatrician’s best clue to chronic illness.

Advice on feeding Many sources of con?icting advice are available to new parents. It is impossible to satisfy everyone, and ultimately it is the well-being of the mother and infant and the closeness of their relationship that matter. In general, mothers should be wary of rigid advice. An experienced midwife, health visitor or well-baby-clinic nursing sister are among the most reliable sources of information.

Protein Fat per Sugar Calories per cent cent per cent per cent

Human milk 1·1 4·2 7·0 70 Cows’ milk 3·5 3·9 4·6 66

Composition of human and cows’ milk... infant feeding

The most extensive form of female CIRCUMCISION, involving removal of CLITORIS and both LABIA.... infibulation

The invasion of tissues or organs by cells or ?uid not normally present – for example, local anaesthetic is in?ltrated into an area of tissue to produce analgesia in a de?ned area.... infiltration

(American) A woman unbounded by space or time

Infinitey, Infiniti, Infinitie, Infinitee, Infinitye, Infinitea... infinity

The number of deaths of infants under one year of age. The IMR in any given year is calculated as the number of deaths in the ?rst year of life in proportion to every 1,000 registered live births in that year. Along with PERINATAL MORTALITY, it is accepted as one of the most important criteria for assessing the health of the community and the standard of the social conditions of a country.

The improvement in the infant mortality rate has occurred mainly in the period from the second month of life. There has been much less improvement in the neonatal mortality rate – that is, the number of infants dying during the ?rst four weeks of life, expressed as a proportion of every 1,000 live births. During the ?rst week of life the main causes of death are asphyxia, prematurity, birth injuries and congenital abnormalities. After the ?rst week the main cause of death is infection.

Social conditions also play an important role in infant mortality. In England and Wales the infant mortality rate in 1930–32 was: Social Class I (professional), 32·7; Social Class III (skilled workers), 57·6; Social Class V (unskilled workers), 77·1. Many factors come into play in producing these social variations, but overcrowding is undoubtedly one of the most important.

1838–9 146 1950–52 30 1851–60 154 1960–62 22 1900–02 142 1970–72 18 1910–12 110 1980–82 12 1920–22 82 1990–92 7 1930–32 67 1996 6·2 1940–42 59 1999 5.8 2000 5.6

It is thus evident that for a reduction of the infant mortality rate to the minimum ?gure, the following conditions must be met. Mothers and potential mothers must be housed adequately in healthy surroundings, particularly with regard to safe water supplies and sewage disposal. The pregnant and nursing mother must be ensured an adequate diet. E?ective antenatal supervision must be available to every mother, as well as skilled supervision during labour (see PREGNANCY AND LABOUR). The newborn infant must be adequately nursed and fed and mothers encouraged to breast feed. Environmental and public-health measures must be taken to ensure adequate housing, a clean milk supply and full availability of medical care including such protective measures as IMMUNISATION against diphtheria, measles, poliomyelitis and whooping-cough. (See also PERINATAL MORTALITY.)... infant mortality rate (imr)

The reaction of the tissues to any injury, which may be the result of trauma, infection or chemicals. Local blood vessels dilate, thus increasing blood ?ow to the injured site. White blood cells invade the affected tissue, engul?ng bacteria or other foreign bodies; related cells consume any dead cells, thus producing PUS after which the site starts to heal. The patient feels pain and the affected tissue becomes hot, red and swollen, with its functioning affected. If the infection is severe it may persist locally – chronic in?ammation – or spread elsewhere in the body

– systemic infection.... inflammation

CROHN’S DISEASE and ULCERATIVE COLITIS are chronic in?ammatory diseases characterised by relapsing and remitting episodes over many years. The diseases are similar and are both classi?ed as IBD, but a signi?cant distinction is that Crohn’s disease can affect any part of the GASTROINTESTINAL TRACT from mouth to anus, whereas ulcerative colitis affects only the COLON. The incidence of IBD varies widely between countries, being rare in the developing world but much more common in westernised nations, where the incidence of Crohn’s disease is around 5–7 per 100,000 (and rising) and that of ulcerative colitis at a broadly stable 10 per 100,000. It is common for both disorders to develop in young adults, but there is a second spike of incidence in people in their 70s. Details about the two disorders are given under the individual entries elsewhere in the dictionary. In?ammatory bowel disease should not be confused with IRRITABLE BOWEL SYNDROME (IBS) which has some of the same symptoms of IBD but a di?erent cause and outcome.... inflammatory bowel disease (ibd)

An IMMUNOSUPPRESSANT monoclonal antibody (see ANTIBODIES) designed to inhibit the pro-in?ammatory cytokine (see CYTOKINES), tumour necrosis factor alpha. It is used in treating CROHN’S DISEASE and RHEUMATOID ARTHRITIS.... infliximab

Help or supervision (usually unpaid) that is provided to persons with one or more disabilities by family, friends or neighbours (may or may not be living with them in a household).... informal assistance

See “informal assistance”.... informal care

A designated site or contact for locating needed services or care for older adults.... information and referral service

Decision processes oriented towards the creation or acquisition of information and knowledge, the design of information storage and flow, and the allocation and utilization of information in organizational work processes. See also “health information system”.... information management

The advent of computing has had widespread effects in all areas of society, with medicine no exception. Computer systems are vital – as they are in any modern enterprise – for the administration of hospitals, general practices and health authorities, supporting payroll, ?nance, stock ordering and billing, resource and bed management, word-processing correspondence, laboratory-result reporting, appointment and record systems, and management audit.

The imaging systems of COMPUTED TOMOGRAPHY (CT) and magnetic resonance imaging (see MRI) have powerful computer techniques underlying them.

Computerised statistical analysis of study data, population databases and disease registries is now routine, leading to enhanced understanding of the interplay between diseases and the population. And the results of research, available on computerised indexes such as MEDLINE, can be obtained in searches that take only seconds, compared with the hours or days necessary to accomplish the same task with its paper incarnation, Index Medicus.

Medical informatics The direct computerisation of those activities which are uniquely medical – history-taking, examination, diagnosis and treatment – has proved an elusive goal, although one hotly pursued by doctors, engineers and scientists working in the discipline of medical informatics. Computer techniques have scored some successes: patients are, for example, more willing to be honest about taboo areas, such as their drug or alcohol consumption, or their sexual proclivities, with a computer than face to face with a clinician; however, the practice of taking a history remains the cornerstone of clinical practice. The examination of the patient is unlikely to be supplanted by technological means in the foreseeable future; visual and tactile recognition systems are still in their infancy. Skilled interpretation of the result by machine rather than the human mind seems equally as remote. Working its way slowly outwards from its starting point in mathematical logic, ARTIFICIAL INTELLIGENCE that in any way mimics its natural counterpart seems a distant prospect. Although there have been successes in computer-supported diagnosis in some specialised areas, such as the diagnosis of abdominal pain, workable systems that could supplant the mind of the generalist are still the dream of the many developers pursuing this goal, rather than a reality available to doctors in their consulting rooms now.

In therapeutics, computerised prescribing systems still require the doctor to make the decision about treatment, but facilitate the process of writing, issuing, and recording the prescription. In so doing, the system can provide automated checks, warning if necessary about allergies, potential drug interactions, or dosing errors. The built-in safety that this process o?ers is enhanced by the superior legibility of the script that ensues, reducing the potential for error when the medicine is dispensed by the nurse or the pharmacist.

Success in these individual applications continues to drive development, although the process has its critics, who are not slow to point to the lengthier consultations that arise when a computer is present in the consulting room and its distracting e?ect on communication with the patient.

Underlying these many software applications lies the ubiquitous personal computer – more powerful today than its mainframe predecessor of only 20 years ago – combined with networking technology that enables interconnection and the sharing of data. As in essence the doctor’s role involves the acquisition, manipulation and application of information – from the individual patient, and from the body of medical knowledge – great excitement surrounds the development of open systems that allow di?erent software and hardware platforms to interact. Many problems remain to be solved, not least the fact that for such systems to work, the whole organisation, and not just a few specialised individuals, must become computer literate. Such systems must be easy to learn to use, which requires an intuitive interface between user(s) and system(s) that is predictable and logical in its ordering and presentation of information.

Many other issues stand in the way of the development towards computerisation: standard systems of nomenclature for medical concepts have proved surprisingly di?cult to develop, but are crucial for successful information-sharing between users. Sharing information between existing legacy systems is a major challenge, often requiring customised software and extensive human intervention to enable the previous investments that an organisation has made in individual systems (e.g. laboratory-result reporting) to be integrated with newer technology. The beginnings of a global solution to this substantial obstacle to networking progress is in sight: the technology that enables the Internet – an international network of telephonically linked personal computers – also enables the establishment of intranets, in which individual servers (computers dedicated to serving information to other computers) act as repositories of ‘published’ data, which other users on the network may ‘browse’ as necessary in a client-server environment.

Systems that support this process are still in early stages of development, but the key conceptualisations are in place. Developments over the next 5–10 years will centre on the electronic patient record available to the clinician on an integrated clinical workstation. The clinical workstation – in essence a personal computer networked to the hospital or practice system – will enable the clinician to record clinical data and diagnoses, automate the ordering of investigations and the collection of the results, and facilitate referral and communication between the many professionals and departments involved in any individual patient’s care.

Once data is digitised – and that includes text, statistical tables, graphs, illustrations and radiological images, etc. – it may be as freely networked globally as locally. Consultations in which live video and sound transmissions are the bonds of the doctor-patient relationship (the techniques of telemedicine) are already reality, and have proved particularly convenient and cost-e?ective in linking the patient and the generalist to specialists in remote areas with low population density.

As with written personal medical records, con?dentiality of personal medical information on computers is essential. Computerised data are covered by the Data Protection Act 1984. This stipulates that data must:

be obtained and processed fairly and lawfully.

be held only for speci?ed lawful purposes.

•not be used in a manner incompatible with those purposes.

•only be recorded where necessary for these purposes.

be accurate and up to date.

not be stored longer than necessary.

be made available to the patient on request.

be protected by appropriate security and backup procedures. As these problems are solved, concerns about

privacy and con?dentiality arise. While paper records were often only con?dential by default, the potential for breaches of security in computerised networks is much graver. External breaches of the system by hackers are one serious concern, but internal breaches by authorised users making unauthorised use of the data are a much greater risk in practice. Governing network security so that clinical users have access on a need-to-know basis is a di?cult business: the software tools to enable this – encryption, and anonymisation (ensuring that clinical information about patients is anonymous to prevent con?dential information about them leaking out) of data collected for management and research processes – exist in the technical domain but remain a complex conundrum for solution in the real world.

The mushroom growth of websites covering myriad subjects has, of course, included health information. This ranges from clinical details on individual diseases to facts about medical organisations and institutes, patient support groups, etc. Some of this information contains comments and advice from orthodox and unorthodox practitioners. This open access to health information has been of great bene?t to patients and health professionals. But web browsers should be aware that not all the medical information, including suggested treatments, has been subject to PEER REVIEW, as is the case with most medical articles in recognised medical journals.... information technology in medicine

(Scandinavian) A fertile woman Ingalyll, Ingalil, Ingalyl, Ingalille, Ingalylle... ingalill

(American) A peaceful woman... ingalls

(Scandinavian) Protected by the god Ing

Ingaberg, Ingaborg, Inge, Ingegerg, Inngeborg, Ingibjorg, Inga, Ingunn, Ingunna, Injerd... ingeborg

(Scandinavian) Of the god Ing’s kingdom

Ingagard, Ingegerd, Ingagerd, Ingigard, Ingigerd... ingegard

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

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

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

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

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

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

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

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

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

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

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

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

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

(Danish) Having the grace of the god Ing

Ingelisse, Ingeliss, Ingelyse, Ingelisa, Ingelissa, Ingelysa, Ingelyssa... ingelise

(Scottish) Her father’s daughter Ingheane, Inghinn, Ingheene, Ingheen, Inghynn... inghean

(Scandinavian) Having the beauty of the god Ing

Ingred, Ingrad, Inga, Inge, Inger, Ingmar, Ingrida, Ingria, Ingrit, Inkeri... ingrid

Lymph nodes in the groin, next to the genitalia... inguinal nodes

The groin – that area of the body where the lower part of the abdomen meets the upper thigh. The inguinal ligaments extend on each side from the superior spines of the iliac bones to the pubic bone. It is also called Poupart’s ligament (see diagram of ABDOMEN).... inguinal region

Substances that can be inhaled into the body through the lungs. They may be delivered in traditional form dissolved in hot water and inhaled in the steam, or as an aerosol – a suspension of very small liquid or solid particles in the air. The latter are now usually delivered by devices in which the aerosol is kept under pressure in a small hand-held cylinder and delivered in required doses by a release mechanism.

Aerosols Asthmatic patients (see ASTHMA) ?nd aerosol devices to be of value in controlling their attacks. They provide an e?ective and convenient way of applying drugs directly to the bronchi, thus reducing the risks of unwanted effects accompanying SYSTEMIC therapy. BRONCHODILATOR aerosols contain either a beta-sympathomimetic agent or ipratropium bromide, which is an ANTICHOLINERGIC drug.

ISOPRENALINE was the ?rst compound to be widely used as an aerosol. It did however stimulate beta1 receptors in the heart as well as beta2 receptors in the bronchi, and so produced palpitations and even dangerous cardiac arrhythmias. Newer beta-adrenoceptor agonists are speci?c for the beta2 receptors and thus have a greater safety margin. They include SALBUTAMOL, TERBUTALINE, rimiterol, fenoterol and reproterol. Unwanted effects such as palpitations, tremor and restlessness are uncommon with these, more speci?c preparations. In patients who get insu?cient relief from the beta-adrenoreceptor agonist, the drug ipratropium bromide is worth adding. Salmeterol is a longer-acting choice for twice-daily administration: it is not intended for the relief of acute attacks, for which shorter-acting beta2 stimulants such as salbutamol should be used. Salmeterol should be added to existing corticosteroid therapy (see CORTICOSTEROIDS), rather than replacing it.

Patients must be taught carefully and observed while using their inhalers. It is important for them to realise that if the aerosol no longer gives more than slight transient relief, they should not increase the dose but seek medical help.... inhalants

(Spanish) A good woman... iniguez

(African) Daughter born during hardship

Inicko, Inicco, Inico, Inyko, Inycko, Inycco, Inyco... iniko

(Irish) Woman from Ennis Iniss, Inisse, Innis, Inys, Innys, Inyss, Inysse... inis

An injection is the introduction of a substance into the body using a syringe and an attached needle. Injections may be given under the skin (subcutaneous), via a vein (intravenous), deep into a muscle (intramuscular), or into the ?uid surrounding the spinal cord (intrathecal).... injections

(Spanish) One who is pure and innocent

Innocencia, Innocenta, Inocenta, Inocentia, Inoceneia, Innoceneia, Innocentia, Innocence... inocencia

(Hawaiian) A faithful woman... inoke

The ability of a mosquito or other insect to survive contact with an insecticide in quantities that would normally kill a mosquito of the same species.... insecticide resistance

Substances which kill insects. Since the discovery of the insecticidal properties of DDT (see DICHLORODIPHENYL TRICHLOROETHANE) in 1940, a steady stream of new ones has been introduced. Their combined use has played an outstanding part in international public health campaigns, such as that of the World Health Organisation for the eradication of MALARIA.

Unfortunately, insects are liable to become resistant to insecticides, just as bacteria are liable to become resistant to antibiotics, and it is for this reason that so much research work is being devoted to the discovery of new ones. Researchers are also exploring new methods, such as releasing sexually sterile insects into the natural population.

The useful effects of insecticides must be set against increasing evidence that the indiscriminate use of some of these potent preparations is having an adverse e?ect – not only upon human beings, but also upon the ecosystems. Some, such as DDT – the use of which is now banned in the UK – are very stable compounds that enter the food chain and may ultimately be lethal to many animals, including birds and ?shes.... insecticides

A process to check on standards.... inspection

The process of the drying or thickening of ?uids or excretions by evaporation.... inspissation

Documented verification that all key aspects of the installation adhere to the appropriate codes and approved design intentions and that manufacturers recommendations are duly considered... installation- qualification

Stages of insect growth and development. In mosquitoes there are four larval instars, each terminating with the shedding of the cuticle.... instars

A residential facility providing care.... institution

Health services delivered on an inpatient basis in hospitals, nursing homes or other inpatient institutions. The term may also refer to services delivered on an outpatient basis by departments or other organizational units of such institutions, or sponsored by them.... institutional (care) health services

A condition brought about by a prolonged stay in an impersonal institution. The individual becomes apathetic and listless as a result of inadequate stimulation in an uninteresting environment. The condition can occur in mental institutions or long-stay nursing homes; the affected person loses the ability to make any decisions and becomes pathetic and increasingly dependent on others.... institutionalisation

Activities with aspects of cognitive and social functioning, including shopping, cooking, doing housework, managing money and using the telephone. See also “activities of daily living (ADLs)”.... instrumental activities of daily living (iadl)

Insu?ation means the blowing of powder or vapour into a cavity, especially through the air passages, for the treatment of disease.... insufflation

The cost of pain and suffering resulting from a disease, condition or intervention.... intangible cost

(Latin) A woman of importance... integra

The methods and strategies for linking and coordinating the various aspects of care delivered by different care systems, such as the work of general practitioners, primary and specialty care, preventive and curative services, and acute and long-term care, as well as physical and mental health services and social care, to meet the multiple needs/problems of an individual client or category of persons with similar needs/problems.... integrated care

A combination of biological and insecticidal methods of control, e.g. the introduction of predacious fish to breeding places which are also sprayed with insecticides that have minimum effect on the fish.... integrated control

Also called Juvenile-onset Diabetes, IDDM (Insulin-Dependent Diabetes) and Type I, it is a deficiency condition wherein the pancreas does not manufacture enough insulin or what it makes is formed improperly. It is usually inherited, although it may not surface until pregnancy, recovering from a life-threatening illness, boot camp or some other profound metabolic stress. It can have a not-hereditary source, since it seems to enigmatically follow after a viral disorder, and can occur spontaneously as an auto-immune condition. The percentage of folks with non-hereditary Type I diabetes is constantly increasing (or the other group is stable, but total numbers are increasing). Radical environmentalists and tree-hugging Gaiaist Pagans (I’m using the dialectic current to the pro-business backlash of the 1990s, when Green is out, and White-With-Green i$ in) claim this is another aspect of massive though subtle pollution from organochemical soup, which even some Real Doctors admit can cause increased auto-immune disease. (SOMETHING is causing it, at any rate, not simply cola drinks.)... insulin-dependent diabetes

Also called NIDDM (Non-Insulin-Dependent Diabetes) and Type II (Type II), it generally means you make your own insulin, you eat too many calories, your storage cells are filled and are taking no more fuel, your liver is stuck in a rut and keeps making more glucose out of everything you eat, your brain has no control over its consumption of glucose, but you have run out of places to put it so you pee it out, sweat it out, etc. etc. Also called Adult-onset Diabetes. An Internist may cry out in dismay at this simplification, and there are many subtle distinctions between the various types, as well as a number of distinct hereditary considerations. This, however, is the glossary of an herbalist, and this is the common picture of the Type II person that herbs will help.... insulin-resistant diabetes

A network of organizations, usually including hospitals and medical practitioner groups, that provides or arranges to provide a coordinated continuum of services to a defined population and is held both clinically and financially accountable for the outcomes in the populations served.... integrated delivery system / integrated services network (isn)

See “synthetic study”.... integrative study

This is the ratio between the mental age and chronological age multiplied by 100. Thus, if a boy of 10 years of age is found to have a mental age of 12 years, his IQ will be 120. On the other hand, if he is found to have a mental age of 8 years, his IQ will be 80.

The mental age is established by various tests, the most widely used of which are the Stanford-Binet Scale, the Wechsler Adult Intelligence Scale, and the Mill Hill Vocabulary Test.

Average intelligence is represented by an IQ of 100, with a range of 85 to 115. For practical purposes it is taken that the intellectual level reached by the average 15-year-old is indistinguishable from that of an adult.... intelligence quotient (iq)

The origin of this important branch of medicine lies in the e?ective use of positive-pressure VENTILATION of the lungs to treat respiratory breathing failure in patients affected by POLIOMYELITIS in an outbreak of this potentially fatal disease in Denmark in 1952. Doctors reduced to 40 per cent, the 90 per cent mortality in patients receiving respiratory support with the traditional cuirass ventilator by using the new technique. They achieved this with a combination of manual positive-pressure ventilation provided through a TRACHEOSTOMY by medical students, and by looking after the patients in a speci?c area of the hospital, allowing the necessary sta?ng and equipment resources to be concentrated in one place.

The principle of one-to-one, 24-hours-a-day care for seriously ill patients has been widely adopted and developed for the initial treatment of many patients with life-threatening conditions. Thus, severely injured patients – those with serious medical conditions such as coronary thrombosis or who have undergone major surgery, and individuals suffering from potentially lethal toxic affects of poisons – are treated in an INTENSIVE THERAPY UNIT (ITU). Patients whose respiratory or circulatory systems have failed bene?t especially by being intensively treated. Most patients, especially post-operative ones, leave intensive care when their condition has been stabilised, usually after 24 or 48 hours. Some, however, need support for several weeks or even months. Since 1952, intensive medicine has become a valued specialty and a demanding one because of the range of skills needed by the doctors and nurses manning the ITUs.... intensive care medicine

Sometimes called an intensive care unit, this is a hospital unit in which seriously ill patients undergo resuscitation, monitoring and treatment. The units are sta?ed by doctors and nurses trained in INTENSIVE CARE MEDICINE, and patients receive 24-hour, one-to-one care with continuous monitoring of their condition with highly specialised electronic equipment that assesses vital body functions such as heart rate, respiration, blood pressure, temperature and blood chemistry. The average ITU in Britain has four to six beds, although units in larger hospitals, especially those dealing with tertiary-care referrals – for example, neurosurgical or organ transplant cases – are bigger, but 15 beds is usually the maximum. Annual throughput of patients ranges from fewer than 200 to more than 1,500 patients a year. As well as general ITUs, specialty units are provided for neonatal, paediatric, cardiothoracic and neurological patients in regional centres. The UK has 1–2 per cent of its hospital beds allocated to intensive care, a ?gure far below the average of 20 per cent provided in the United States. Thus patients undergoing intensive care in the UK are usually more seriously ill than those in the US. This is re?ected in the shortage of available ITU beds in Britain, especially in the winter. (See CORONARY CARE UNIT (CCU); HIGH DEPENDENCY UNIT.)... intensive therapy unit (itu)

Links between generations which often involve exchanges of support.... intergenerational relations / contract

Care provided in geriatric centres and acute hospitals to older persons who are in need of limited medical care and who are awaiting nursing home placement.... interim nursing home care

An institution which is licensed to provide, on a regular basis, health-related care and services to individuals who do not require the degree of care or treatment which a hospital or skilled nursing facility is designed to provide.... intermediate care facility (icf)

An animal or human host where the juvenile stages of the parasite undergo an asexual reproductive phase of development but not reaching adult stage.... intermediate host

A term applied to fevers which continue for a time, subside completely and then return again. The name is also used in connection with a pulse in which occasional heartbeats are not felt, in consequence of irregular action of the heart.... intermittent

Interleukins are lymphokines – that is, polypeptides produced by activated lymphocytes. They are involved in signalling between cells of the immune system (see IMMUNITY) and are released by several cell types, including lymphocytes. They interact to control the immune response of cells and also participate in HAEMOPOIESIS. There are seven varieties, interleukins 1 to 7. For example, interleukin 1 is produced as a result of in?ammation and stimulates the proliferation of T and B lymphocytes, enhancing the immune response by stimulating other lymphocytes and activating dormant T cells. Interleukin 2 has anti-cancer effects as it is able to activate T lymphocytes to become killer cells which destroy foreign antigens (see ANTIGEN) such as cancer cells, and this anti-cancer e?ect is being developed for clinical use. The remaining interleukins have a range of properties in cell growth and di?erentiation.... interleukins

The simplest form of intermittent positive-pressure ventilation is mouth-to-mouth resuscitation (see APPENDIX 1: BASIC FIRST AID) where an individual blows his or her own expired gases into the lungs of a non-breathing person via the mouth or nose. Similarly gas may be blown into the lungs via a face mask (or down an endotracheal tube) and a self-in?ating bag or an anaesthetic circuit containing a bag which is in?ated by the ?ow of fresh gas from an anaesthetic machine, gas cylinder, or piped supply. In all these examples expiration is passive.

For more prolonged arti?cial ventilation it is usual to use a specially designed machine or ventilator to perform the task. The ventilators used in operating theatres when patients are anaesthetised and paralysed are relatively simple devices.They often consist of bellows which ?ll with fresh gas and which are then mechanically emptied (by means of a weight, piston, or compressed gas) via a circuit or tubes attached to an endotracheal tube into the patient’s lungs. Adjustments can be made to the volume of fresh gas given with each breath and to the length of inspiration and expiration. Expiration is usually passive back to the atmosphere of the room via a scavenging system to avoid pollution.

In intensive-care units, where patients are not usually paralysed, the ventilators are more complex. They have electronic controls which allow the user to programme a variety of pressure waveforms for inspiration and expiration. There are also programmes that allow the patient to breathe between ventilated breaths or to trigger ventilated breaths, or inhibit ventilation when the patient is breathing.

Indications for arti?cial ventilation are when patients are unable to achieve adequate respiratory function even if they can still breathe on their own. This may be due to injury or disease of the central nervous, cardiovascular, or respiratory systems, or to drug overdose. Arti?cial ventilation is performed to allow time for healing and recovery. Sometimes the patient is able to breathe but it is considered advisable to control ventilation – for example, in severe head injury. Some operations require the patient to be paralysed for better or safer surgical access and this may require ventilation. With lung operations or very unwell patients, ventilation is also indicated.

Arti?cial ventilation usually bypasses the physiological mechanisms for humidi?cation of inspired air, so care must be taken to humidify inspired gases. It is important to monitor the e?cacy of ventilation – for example, by using blood gas measurement, pulse oximetry, and tidal carbon dioxide, and airways pressures.

Arti?cial ventilation is not without its hazards. The use of positive pressure raises the mean intrathoracic pressure. This can decrease venous return to the heart and cause a fall in CARDIAC OUTPUT and blood pressure. Positive-pressure ventilation may also cause PNEUMOTHORAX, but this is rare. While patients are ventilated, they are unable to breathe and so accidental disconnection from the ventilator may cause HYPOXIA and death.

Negative-pressure ventilation is seldom used nowadays. The chest or whole body, apart from the head, is placed inside an airtight box. A vacuum lowers the pressure within the box, causing the chest to expand. Air is drawn into the lungs through the mouth and nose. At the end of inspiration the vacuum is stopped, the pressure in the box returns to atmospheric, and the patient exhales passively. This is the principle of the ‘iron lung’ which saved many lives during the polio epidemics of the 1950s. These machines are cumbersome and make access to the patient di?cult. In addition, complex manipulation of ventilation is impossible.

Jet ventilation is a relatively modern form of ventilation which utilises very small tidal volumes (see LUNGS) from a high-pressure source at high frequencies (20–200/min). First developed by physiologists to produce low stable intrathoracic pressures whilst studying CAROTID BODY re?exes, it is sometimes now used in intensive-therapy units for patients who do not achieve adequate gas exchange with conventional ventilation. Its advantages are lower intrathoracic pressures (and therefore less risk of pneumothorax and impaired venous return) and better gas mixing within the lungs.... intermittent positive pressure (ipp)

A technique in which a patient (of either sex) inserts a disposable catheter (see CATHETERS) through the URETHRA into the bladder to empty it of urine. It is increasingly used to manage patients with chronic retention of urine, or whose bladders do not empty properly

– usually the result of neurological disorder affecting the bladder (neuropathic bladder). (See URINARY BLADDER, DISEASES OF.)... intermittent self-catheterisation

See “benchmark”.... internal benchmark

See “validity”.... internal validity

A World Health Organisation classi?cation of all known diseases and syndromes. The diseases are divided according to system (respiratory, renal, cardiac, etc.) or type (accidents, malignant growth, etc.). Each of them is given a three-digit number to facilitate computerisation. This classi?cation allows mortality and morbidity rates to be compared nationally and regionally. A revised ICD is published every ten years; a similar classi?cation is being developed for impairments, disabilities and handicaps.... international classification of disease (icd)

Classification of health and health-related domains that describe body functions and structures, activities and participation. The domains are classified from body, individual and societal perspectives. Since an individual’s functioning and disability occurs in a context, this classification includes a list of environmental factors.... international classification of functioning, disability and health (icf) a

A classification of diseases, conditions and other reasons for attendance for primary care. This classification is an adaptation of the ICD but makes allowance for the diagnostic uncertainty that prevails in primary care.... international classification of health problems in primary care (ichppc)

A systematic taxonomy of the consequences of injury and disease. See “disability”; “handicap”; “impairment”.... international classification of impairments, disabilities and handicaps (icidh)

The official classification of the World Organisation of Family Doctors. It includes three elements of the doctor-patient encounter: the reason for the encounter; the diagnosis; and the treatment or other action or intervention.... international classification of primary care (icpc)

A list of diagnoses and identifying codes used by medical practitioners and other health care providers. The coding and terminology provide a uniform language that permits consistent communication on claim forms. Data from earlier time periods were coded using the appropriate revision of the ICD for that time period. Changes in classification of causes of death in successive revisions of the ICD may introduce discontinuities in cause of death statistics over time.... international statistical classification of diseases and related health problems, tenth revision (icd-10)

Access to medical information via the Internet is widespread in some populations, often serving more patients than doctors. In addition to the huge variety of information available, patients can share experiences via electronic discussion groups, or obtain e-mail advice on a fee-for-service basis. Some professional organisations and journals provide free access to information, and the Internet can be a useful resource for medical practitioners and researchers. Concerns have arisen about the growth in electronic medical information: some believe that patients who have unlimited access to information via the Internet will be less likely to tolerate health-care rationing or will demand treatments that may be inappropriate in their individual circumstances. Other criticisms relate to the quality and accuracy of the information provided, potential breaches of patient CONFIDENTIALITY, and the risk of increased accusations of medical negligence (see also ETHICS).... internet

See “physician”.... internist

The central portion of a distribution, calculated as the difference between the third quartile and the first quartile; this range includes about one half of the observations in the set, leaving one quarter of the observations on each side.... interquartile range

A recognized relationship between part or parts of different sectors of society which has been formed to take action on an issue to achieve health outcomes or intermediate health outcomes in a way which is more effective, efficient or sustainable than might be achieved by the health sector acting alone. For practical purposes, intersectoral action and multisectoral action are synonymous terms, the former perhaps emphasizing the element of coordination, the latter the contribution of a number of sectors.... intersectoral action / multisectoral action

The hydrogel that surrounds cells in soft tissues. It is a mucopolysaccaride starch gel, and the serum that leaves the blood capillaries flows through this gel, some to return to the exiting venous blood, some to enter the lymph system. There is an old medical axiom: the blood feeds the lymph, and the lymph feeds the cells. Interstitial fluid that flows through the starch colloid is this lymph.... interstitial fluid

Intersexuality is a state of indeterminate sexuality of an individual, and may present in many di?erent forms. A characteristic is that only one type of gonad – testis or ovary – is present; in a HERMAPHRODITE both types are present. Intersexuality may be due to a fault in the genetic mechanism of sex determination as early as conception, or to later errors in sexual di?erentiation of the embryo and fetus, or after birth. Some cases may result from abnormal metabolism of the sex hormones, or may be drug-induced (for example, women given androgens [see ANDROGEN] or PROGESTERONE for repeated miscarriages may give birth to girls with some genital VIRILISATION). Abnormalities of the sex chromosomes may be associated with delayed (or failure of) sexual development, so that the individual shows some of the characteristics (often underdeveloped) of both sexes. Some of the more common presentations of the condition include HYPOGONADISM, CRYPTORCHIDISM, and primary AMENORRHOEA.

Intersexuality inevitably leads to considerable psychological disturbance as the child grows up. It is therefore important to reach an early decision as to the child’s sex – or at least, the sex that he or she is to be brought up as. Surgical or hormonal means should then be employed, when appropriate, to develop the attributes of that sex and diminish those of the other, together with psychological counselling.... intersexuality

Time between paroxysms in malaria.... interval

See “measurement scale”.... interval scale

An activity or set of activities aimed at modifying a process, course of action or sequence of events in order to change one or several of their characteristics, such as performance or expected outcome. For example, it is used in public health to describe a programme or policy designed to have an impact on an illness or disease.... intervention / intervention strategy

The precisely designed set of questions used in an interview.... interview schedule

This is the pressure that is maintained by the brain tissue, intracellular and extracellular ?uid, cerebrospinal ?uid and blood. An increase in intracranial pressure may occur as a result of in?ammation, injury, haemorrhage, or tumour in the brain tissue as well as of some congenital conditions. The pressure is measured by lumbar puncture in which a syringe attached to a mamometer (pressure-measuring device) is inserted into the cerebrospinal ?uid surrounding the lower part of the spinal cord. Where continuous pressure monitoring is necessary, an in-dwelling device can be implanted into a cerebral ventricle. Normal pressure is around 10 mm of mercury (Hg), with the acceptable upper limit being 25 mm Hg.... intracranial pressure

A procedure for getting X-ray pictures of the URINARY TRACT. A radio-opaque medium is injected into a vein and, when it is excreted by the kidneys, the substance can be identi?ed on X-rays. Any abnormalities in structure or foreign bodies such as calculi are outlined by the dye (see KIDNEYS, DISEASES OF).... intravenous pyelogram (urogram)

Arising from the nature of a thing...native or inherent. Intrinsic asthma, as an example, arises from congestive inflammation, neurohormonal and auto-allergic conditions of the lung and bronchial membranes themselves, not from EXTRINSIC causes, like Juniper pollen or a bee sting.... intrinsic

The observation of one’s own thoughts or feelings. The term is generally applied to this process when it occurs to an abnormal extent in association with MELANCHOLIA.... introspection

The immediate understanding of a situation by someone without the customary mental process of reasoning.... intuition

The principal signs of trouble which has its origin in the intestine consist of pain somewhere about the abdomen, sometimes vomiting, and irregular bowel movements: constipation, diarrhoea or alternating bouts of these.

Several diseases and conditions are treated under separate headings. (See APPENDICITIS; CHOLERA; COLITIS; CONSTIPATION; CROHN’S DISEASE; DIARRHOEA; DYSENTERY; ENTERIC FEVER; HAEMORRHOIDS; HERNIA; INFLAMMATORY BOWEL DISEASE (IBD); ILEITIS; INTUSSUSCEPTION; IRRITABLE BOWEL SYNDROME (IBS); PERITONITIS; RECTUM, DISEASES OF; ULCERATIVE COLITIS.)

In?ammation of the outer surface is called peritonitis, a serious disease. That of the inner surface is known generally as enteritis, in?ammation of special parts receiving the names of colitis, appendicitis, irritable bowel syndrome (IBS) and in?ammatory bowel disease (IBD). Enteritis may form the chief symptom of certain infective diseases: for example in typhoid fever (see ENTERIC FEVER), cholera and dysentery. It may be acute, although not connected with any de?nite organism, when, if severe, it is a very serious condition, particularly in young children. Or it may be chronic, especially as the result of dysentery, and then constitutes a less serious if very troublesome complaint.

Perforation of the bowel may take place as the result either of injury or of disease. Stabs and other wounds which penetrate the abdomen may damage the bowel, and severe blows or crushes may tear it without any external wound. Ulceration, as in typhoid fever, or, more rarely, in TUBERCULOSIS, may cause an opening in the bowel-wall also. Again, when the bowel is greatly distended above an obstruction, faecal material may accumulate and produce ulcers, which rupture with the ordinary movements of the bowels. Whatever the cause, the symptoms are much the same.

Symptoms The contents of the bowel pass out through the perforation into the peritoneal cavity, and set up a general peritonitis. In consequence, the abdomen is painful, and after a few hours becomes extremely tender to the touch. The abdomen swells, particularly in its upper part, owing to gas having passed also into the cavity. Fever and vomiting develop and the person passes into a state of circulatory collapse or SHOCK. Such a condition may be fatal if not properly treated.

Treatment All food should be withheld and the patient given intravenous ?uids to resuscitate them and then to maintain their hydration and electrolyte balance. An operation is urgently necessary, the abdomen being opened in the middle line, the perforated portion of bowel found, the perforation stitched up, and appropriate antibiotics given.

Obstruction means a stoppage to the passage down the intestine of partially digested food. Obstruction may be acute, when it comes on suddenly with intense symptoms; or it may be chronic, when the obstructing cause gradually increases and the bowel becomes slowly more narrow until it closes altogether; or subacute, when obstruction comes and goes until it ends in an acute attack. In chronic cases the symptoms are milder in degree and more prolonged.

Causes Obstruction may be due to causes outside the bowel altogether, for example, the pressure of tumours in neighbouring organs, the twisting around the bowel of bands produced by former peritonitis, or even the twisting of a coil of intestine around itself so as to cause a kink in its wall. Chronic causes of the obstruction may exist in the wall of the bowel itself: for example, a tumour, or the contracting scar of an old ulcer. The condition of INTUSSUSCEPTION, where part of the bowel passes inside of the part beneath it, in the same way as one turns the ?nger of a glove outside in, causes obstruction and other symptoms. Bowel within a hernia may become obstructed when the hernia strangulates. Finally some body, such as a concretion, or the stone of some large fruit, or even a mass of hardened faeces, may become jammed within the bowel and stop up its passage.

Symptoms There are four chief symptoms: pain, vomiting, constipation and swelling of the abdomen.

Treatment As a rule the surgeon opens the abdomen, ?nds the obstruction and relieves it or if possible removes it altogether. It may be necessary to form a COLOSTOMY or ILEOSTOMY as a temporary or permanent measure in severe cases.

Tumours are rare in the small intestine and usually benign. They are relatively common in the large intestine and are usually cancerous. The most common site is the rectum. Cancer of the intestine is a disease of older people; it is the second most common cancer (after breast cancer) in women in the United Kingdom, and the third most common (after lung and prostate) in men. Around 25,000 cases of cancer of the large intestine occur in the UK annually, about 65 per cent of which are in the colon. A history of altered bowel habit, in the form of increasing constipation or diarrhoea, or an alternation of these, or of bleeding from the anus, in a middle-aged person is an indication for taking medical advice. If the condition is cancer, then the sooner it is investigated and treated, the better the result.... intestine, diseases of

(Arabic) One who is victorious; triumphant

Intisara, Intisarah, Intizar, Intizara, Intizarah, Intisarr, Intysarr, Intysar... intisar

A narrowed or blocked coronary artery (see ARTERIES) can compromise the blood supply to the heart muscle (see HEART, DISEASES OF). A supportive tube or stent passed into each affected artery can restore the blood supply. The stent has a HEPARIN coating to stop blood clots from forming. Since it was ?rst performed in 1987, intracoronary stents have cut the reblockage rate from one in three patients who have had coronary ANGIOPLASTY to fewer than one in ten in cases where a stent was used with angioplasty.... intracoronary artery stenting

A mechanical device, commonly a coil, inserted into the UTERUS to prevent CONCEPTION, probably by interfering with the implantation of the EMBRYO. For many women, IUCDs are an e?ective and acceptable form of contraception, although only about 10 per cent of women in the UK use them. The devices are of various shapes and made of plastic or copper; most have a string that passes through the cervix and rests in the vagina.

About one-third of women have adverse effects as the result of IUCD use: common ones are backache and heavy menstrual bleeding (see MENSTRUATION). The frequency of unwanted pregnancies is about 2 per 100 women-years of use. (See CONTRACEPTION.)... intrauterine contraceptive device (iucd)

Hook. f.

Synonym: I. royleana auct. non-DC.

Family: Compositae; Asteraceae.

Habitat: Temperate and Alpine Himalayas from Chitral to Nepal at 1,500-4,200 m.

English: Elecampane.

Ayurvedic: Pushkaramuula, Pushkara, Paushkara, Padmapatra, Kaashmira, Kushtha-bheda.

Action: Antispasmodic, stomachic, antihistaminic, expectorant, anticatarrhal. Used for asthma, chronic bronchitis and pulmonary disorders.

Key application: Inula helenium— as expectorant. (The British Herbal Pharmacopoeia.)

Roots are used in Kashmir as adulterant of Saussurea lappa.

The root contains a volatile oil, about 1-4%; major constituents being in- ulin (10.0) and sesquiterpene lactones, mainly alantolactone, isoalantolactone and their dihydro derivatives. Alan- tolactone and others in the mixture known as helenalin (sesquiterpene lactones) are toxic constituents of the root.

Alantolactone is anti-inflammatory in animals and has been shown to stimulate the immune system. It is also hypotensive and anthelmintic in animals; antibacterial and antifungal in vitro It irritates mucous membranes. It is used as an anthelmintic in Europe and UK.

Plant extract showed potent antispasmodic effect against bronchial spasm induced by histamine and various plant pollens.

The root, when combined with Commiphora mukul gum-resin, acts as a hypolipidaemic agent, exhibits beta- blocking activity and beneficial effect in myocardial ischaemia.

The roots also exhibit sedative and blood pressure lowering activity.

The European species is equated with Inula helenium Linn.

Dosage: Root—1-3 g powder. (API Vol. IV.)... inula racemosa

The ability of a microorganism to enter the body and to spread more or less widely throughout the tissues. The organism may or may not cause clinical symptoms.... invasiveness

A list of quantities and locations of different kinds of facilities, major equipment, and personnel that are available in a geographic area and the amount, type and distribution of services those resources can support. An inventory system is the set of policies and controls that monitor the levels of inventory and determines what levels should be maintained, replaced and ordered.... inventory

(Latin) An envious woman Invidiah, Invidea, Invideah, Invydia, Invydea, Invidiya, Invidiyah... invidia

Salts of iodine, those which are especially used in medicine being the iodide of potassium and iodide of sodium. Iodides are excreted in the mucus secretions, as well as in the urine, saliva and sweat, and have an action in liquefying the mucus secretion of the bronchial tree. They are therefore used in EXPECTORANTS. They are also used to assist in providing a supply of iodine in patients with goitre, or in individuals who live in an area where goitre is liable to occur because of a de?ciency of IODINE in the drinking water. They may be given in the form of iodised salt. (See THYROID GLAND, DISEASES OF – Goitre.)... iodides

(Hawaiian) God will develop Iokinah, Iokyna, Iokeena, Iokine, Iokyne, Iokeen, Iokeane, Iokeana... iokina

(Greek) Of the violet-colored dawn Iolah, Iolla, Iollah, Iole, Iolle, Inola, Inolah, Inolla, Inollah... iola

(Hawaiian) Soaring like a hawk Iolanah, Iolanna, Iolann, Iolanne, Iolane, Iolani, Iolanie, Iolanee, Iolany, Iolaney... iolana

(Greek) Resembling a violet flower Iolanda, Iolanta, Iolantha, Iolante, Iolande, Iolanthia, Iolanthea... iolanthe

(Greek) Woman from the island Ionna, Ioane, Ioann, Ioanne... iona

(Hebrew) Filled with grace Ionannah, Ionana, Ionann, Ionane, Ionanne... ionanna

(Greek) Resembling the violet flower Ionie, Ioni, Ionee, Ioney, Iony... ione

(Greek) Of the sea and islands Ionya, Ionija, Ioniah, Ionea, Ionessa, Ioneah, Ioniya... ionia

Ging.

Synonym: Hybanthus enneaspermus (Linn.) F. Muell.

Family: Violaceae.

Habitat: The warmer parts of India from Delhi to Bengal and throughout Deccan Peninsula.

Ayurvedic: Amburuha.

Siddha/Tamil: Orilaithamarai.

Folk: Ratna-purush.

Action: Diuretic, antigonorrhoetic and demulcent. Root—given in urinary infections, for bowel complaints of children.

The plant gave a dipeptide alkaloid, aurantiamide acetate and a triterpene, iso-arborinol, and beta-sitosterol.... ionidium suffruticosum

Ionisation means the breaking up of a substance in solution into its constituent.... ionisation

(Greek) A birdlike woman Iorra, Ioria, Iorea, Iore, Iorie, Iori, Iory, Iorey, Ioree... iora

(Welsh) A beautiful woman Iorwenn, Iorwenne, Iorwin, Iorwinn, Iorwinne, Iorwyn, Iorwynn, Iorwynne... iorwen

(Hawaiian) Form of Josephine, meaning “God will add” Iosephine, Iosefa, Iosefena, Iosefene, Iosefina, Iosefine, Iosepha, Iosephe, Iosephene, Iosephina, Iosephyna, Iosephyna, Iosephyne, Iosepyne, Iosapine, Iosapyne, Iosepeen, Iosapeen... iosepine

(Native American) Of the Iowa tribe; from the state of Iowa... iowa

(Hebrew) One who is saved by the Lord

Iphedeia, Iphedia, Iphedea, Iphidea, Iphidia, Iphideia... iphedeiah

(Greek) One who is born strong; in mythology, daughter of Agamemnon Iphigeneia, Iphigenie, Iphagenia, Iphegenia, Iphegenie, Iphegeneia, Ifigenia, Ifegenia, Ifagenia... iphigenia

(Greek) In mythology, the wife of Poseidon

Iphimedea, Iphimedea, Ifimedeia, Ifimedea, Ifimedia... iphimedeia

(L.) Jacq.

Family: Convolvulaceae.

Habitat: North American species. Not found wild in India. Grown in Indian gardens.

Folk: Krishna-bija, Kaalaadaanaa. Kakkattan (Tamil Nadu). Jirki (Andhra Pradesh).

Action: Seed—purgative. Used as a substitute for Jalap (Exogonium purga).

The seed gave alkaloids—lysergol, chanoclavine, penniclavine, iso-penni- clavine and elymoclavine.... ipomoea hederacea

Blume.

Synonym: Merremia vitifolia (Burm. f.) Hallier. Convululus vitifolius Burm. f.

Family: Convolvulaceae.

Habitat: Throughout warmer parts of India, except the north-western arid region.

Folk: Nauli, Nawal (Maharashtra).

Action: Diuretic. Used in strangury, urethral discharges.... ipomoea vitifolia

Cephaelis ipecacuanha

Rubiaceae

Importance: Ipecac is a small evergreen herb with much branched beaded roots. It is used in powdered form or as liquid total extract, syrup and tincture. Ipecac syrup in small doses is used as an expectorant, as it is well tolerated by children. It is used in treatment of whooping cough. Ipecac with opium as in Dover’s powder is used as a diaphoretic, tincture and syrup. Emetine hydrochloride in the form of injection is used for treatment of amoebic dysentery. Emetine bismuth iodide is also given orally for amoebic dysentery. Ipecac is also used as gastric stimulant and as an anti-inflammatory agent in rheumatism.

Distribution: The plant is a native of Bolivia and Brazil. It is cultivated in Mungpoo, near Darjeeling and on the Nilgiris, especially New Kallar, and at the Rungbee Cinchona plantation in Sikkim.

Botany: Cephaelis ipecacuanha (Brot.) A. Rich. syn. Psychotria ipecacuanha Stokes. belongs to the family Rubiaceae. The plant grows upto 0.7m high, with slender cylindrical stem. When mature the roots are dark brown and have transverse furrows giving it a beaded appearance. Above ground stem is quadrangular and trailing with few or new branches. Leaves are opposite near the top of the plant and alternate below, 5-10x3-6cm area, dark green above and pale green underneath. Flowers are white, sessile, funnel-like, less than 1cm wide and are borne in dense clusters. Fruit is purple with two stones containing single seed (Husain, 1993).

Agrotechnology: Ipecac prefers an average rainfall ranging between 2000-3000mm and evenly distributed. Maximum temperature should not exceed 38 C and the minimum not below 10 C. It thrives well in tropical mild humid climates similar to Malaysian rain forests. Virgin forest soils rich in humus are ideal for Ipecac. It prefers deep medium fertile soils which are acidic and rich in humus, potash and magnesium. Soil should be well drained and protected from wind and storm. As Ipecac grows only in shade, it can be cultivated as an intercrop, or planted in artificially shaded beds. The plant is propagated both by seeds and vegetatively by root, stem and leaf cuttings. Vegetative propagation is preferred to maintain genetic uniformity of the plant. Most of the commercial plantations are raised by seeds. Raised seed beds of 2x6m size are made and are mi xed with well rotten leaf compost and sand. These are provided with shade on the top as well as on the sides. Seeds are drilled or broadcasted in the beds and watered regularly. Seeds take 3-5 months to germinate. Seed treatment with limewater for 48 hours or H2O2 improves germination. It has been observed that providing mulch or black polythene in nursery beds improves germination as well as results in control of weeds. The suitable season of planting is January-March in West Bengal. Seedlings are planted in production beds at a spacing of 10x10cm after they are 8-12 weeks old. In West Bengal, it is a practice to transfer seedlings to other nursery beds before being transferred to final production seedbeds. FYM and leaf compost application is required during second and third year. Super phosphate applications is found to improve root growth. Frequent irrigation is required. Waterlogging should be avoided. Both the seedbeds and production beds should be kept free from weeds. Seedlings are often attacked by damping off fungi like Rhizoctonia sp. in nursery. It is better to treat the seeds with a suitable seed dressing fungicide before planting. Fusarium wilt caused by F. moniliforme has been reported from India. The plants are ready for harvesting after 4 years. The roots should be dug out, washed and dried in the sun. Rhizome and root are the economical parts (Husain, 1993).

Properties and activity: Ipecac root contains 2.2-2.5% total alkaloids. The main alkaloids are cephaeline and emetine. In addition, it also contains psychotrine and psychotrine ethyl ether. The drug also contains a crystalline glucosidal tannin, starch and calcium oxalate (60-70% of the alkaloids is emetine). Root contains minor amounts of O-methyl psychotrine, emetamine, protoemetine and others. Other constituents of ipecac include choline, glycoside-ipecoside, saponins, resins, tannins-ipecacuanhin, an allergen composed of mixture of glycoproteins, ipecacuanhic acid, a neutral monoterpene acid and calcium oxalate. Cephaeline could be converted into emetine on methylation.

The powdered dried rhizome and root cause severe asthmatic attacks and vasomotorrhinitis. Emetine hydrochloride is anti-amoebic. Root is emetic, expectorant and diaphoretic (Husain et al, 1992).... ipecac

Forsk.

Synonym: I. reptans Poir.

Family: Convolvulaceae.

Habitat: Throughout the greater part of India.

English: Swamp Cabbage.

Ayurvedic: Kalambi, Naalikaa.

Siddha/Tamil: Vellaikeerai, Koilan- gu.

Action: Emetic and purgative. Used as an antidote to arsenical or opium poisoning. Plant juice is used for liver complaints; buds for ringworm.

The leaves are a good source of minerals (2.1%), vitamins (especially, carotene and tocopherol). Plant is given for nervous and general debility. Whole plant gave beta-carotene, xan- thophyll, traces of taraxanthin, hentri- acontane, beta-sitosterol and its gluco- side.

The buds of pigmented variety are recommended as a food for diabetics. An insulin-like substance is reported from the buds.

The stems contain N-trans- and N- ris-feruloyltyramines, which have been found to be the inhibitors of in vitro prostaglandin synthesis.

The plant shows abundant growth in waste water and absorbs some organic and inorganic components, including heavy metals from waste water. The plant may be useful in the treatment of waste water by biogeofiltration.... ipomoea aquatica

(Indian) One who is desired Ipsita, Ipsyta, Ipseeta, Ipseata, Ipsah... ipsa

(Basque) Refers to the Virgin Mary Iratza, Iratzia, Iratzea, Iratzi, Iratzie, Iratzy, Iratzey, Iratzee... iratze

(Turkish) From the heavenly gardens Irema, Ireme, Iremia, Iremea... irem

(Greek) A peaceful woman; in mythology, the goddess of peace Ira, Irayna, Ireen, Iren, Irena, Irenea, Irenee, Irenka, Iriana, Irina, Irine, Iryna, Irenke, Iryne, Irini, Irinia, Irynia... irene

(Linn.) Lam.

Habitat: Native to tropical America; cultivated throughout India for edible tubers.

English: Sweet potato.

Ayurvedic: Mukhaaluka, Rataalu, Raktaalu, Raktapindaka, Raktakan- da.

Siddha/Tamil: Sakkareivelleikulan- gu.

Unani: Shakarkand, Rataalu.

Action: Root—used in strangury, urinary discharges, burning sensation, thirst. Whole plant—used in low fever and skin diseases.

Cooked tubers contain reducing sugars 6.45, sucrose 2.23, maltose 864, dextrins 0.51 and polysaccharides 14-13%. Cooking increases the sweetness as a result of the hydrolysis of starch to maltose and dextrins through the action of beta-amylase.

Sweet potatoes are rich in starch content. During the storage a part of starch content is converted into reducing sugars and subsequently into sucrose. In a sample stored for 5 months, the starch content was reduced from 19.1% to 14.1% while the percentage of reducing sugars (as dextrose) and sucrose increased from 0.9 to 1.7 and 1.9 to 6.1% respectively.

Indian types with white flesh contain little or no carotene, while American types with pink flesh contain as high as 5.4-7.2 mg/100 g of carotene. Vitamins present in the tubers are : thiamine 0.09-0.14, riboflavin 0.05-0.10 and vitamin C 16-22 mg/100 g.

The hot aqueous extract of leaves exhibits significant inhibitory activity of rat lens aldose reductase (AR). Ellagic and 3,5-dicaffoylquinic acids have been isolated as potent inhibitors.

The leaves also contain polysaccha- rides which increase the platelet count in experimental animals due to enhanced production ofthrombopoietin.

From the stem and root, hexadecyl, octadecyl and eicosyl p-coumarates have been isolated.

The tubers show significant lectin activity and exhibit haemagglutinating activity in trypsinized rabbit erythro- cytes.... ipomoea batatas

Linn.

Synonym: I. alba Linn. Calonyction bona-nox Bojer. C. aculeatum (Linn.) House.

Family: Convolvulaceae.

Habitat: Throughout India.

English: Moon Flower.

Ayurvedic: Chandrakaanti, Gul- chaandani, Dudhiaa Kalami.

Siddha/Tamil: Naganamukkori.

Folk: Chaandani, Dudhiaa Kalami.

Action: Root bark—purgative. Leaves—used in filariasis.

The plant contains pentasaccharide glucoside of ethyl-ll-hydroxy hexade- canoate. The seeds contain alkaloids, ipomine, isoipomine, methoxyipo- mine, dimethoxyipomine, ipalkidini- um, ipalbidine and ipalbine.... ipomoea bona-nox

Linn.

Synonym: I. paniculata R. Br. Burm. I. mauritiana Jacq.

Family: Convolvulaceae.

Habitat: Tropical India in moist regions.

English: Milky Yam.

Ayurvedic: Kshira-vidaari, Kshir- valli, Payasvini, Swaadukandaa, Ikshukandaa, Gajavaajipriyaa, Kan- dapalaasha, Bhuumikuushmaanda.

Siddha: Paalmudukkan kizhangu.

Folk: Bilaaikanda. Bhuin Kakhaaru (Orissa).

Action: Cholagogue, galactagogue, alterative, demulcent, purgative. Resin from root—uses similar to Jalap. Flour of raw rhizome is given in enlargement of liver and spleen, also for menorrhagia, debility and fat accumulation.

Rhizomes gave taraxerol acetate and beta-sitosterol. Fresh leaves contain 6.3 mg/100 g of carotene.

Vidaari is equated with Pueraria tuberosa DC. (Fabaceae). Dry pieces of Dioscorea pentaphylla Linn. are sold as Vidaari Kanda.

Dosage: Tuber—3-6 g powder. (CCRAS.)... ipomoea digitata

(Greek) One who is serene Iretah, Iretta, Irettah, Irete, Iret, Irett, Ireta... ireta

The study of the iris (see EYE). It is an old practice dating back to the days of Aristotle, and has been revived as a non-conventional treatment (see COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)).... iridology

D. Don.

Family: Iridaceae.

Habitat: Temperate Himalaya and in Khasi Hills.

Ayurvedic: Paarseeka Vachaa.

Folk: Sosan, Shoti, Chalnundar, Chiluchi.

Action: Deobstruent (in bilious obstructions), diuretic, cathartic. Used in diseases of the liver.

The plant contains an isoflavone, irisolidone. Rhizomes contain iriso- lone and irigenin.... iris nepalensis

Linn.

Family: Iridaceae.

Habitat: On river banks, by the side of lakes, ponds. Native to Great Britain.

English: Yellow Flag.

Folk: Paashaanabheda (Gujarat).

Action: Cathartic and acrid. Used in dysmenorrhoea and leucorrhoea. Juice of the root—used for obstinate coughs and convulsions.

Rhizomes contain a glycoside, irisin, iridin or irisine, reportedly present, with myristic acid.... iris pseudacorus

R. Br.

Synonym: I. hispida Roem. & Schult.

I. sessiliflora Roth.

Family: Convolvulaceae.

Habitat: Throughout India.

Ayurvedic: Aakhukarni (related species), Sheetavalli (provisional synonym).

Folk: Nikhari, Bhanwar (Punjab).

Action: Antirheumatic, anticepha- lalgic, antiepileptic and antileprotic.

The plant is boiled in oil and used as an application for rheumatism, headache, epilepsy, fevers, ulcers, leprosy. The seeds are reported to contain a resin similar to that present in the seeds of Ipomoea nil.... ipomoea eriocarpa

(Desr.) Verdc.

Family: Convolvulaceae.

Habitat: Throughout India in the plains, especially on the bank of stream and rivers.

Ayurvedic: Lakshmanaa (Also equated with Ipomoea obscura (Linn.) Ker-Gawler.), Putradaa, Putrajanani.

Folk: Tirutaalli (Kerala).

Action: Used as a single drug for curing sterility in women, and for promoting fertility and virility.

The seeds of Ipomoea obscura contain non-ergolin type indole alkaloids, ipobscurine A and B and serotonin also alkaloid ipobscurine C.... ipomoea marginata

(Linn.) Jacq., non-Cav.

Synonym: I. turbinata Lag. Convolvulus muricatus Linn.

Family: Convolvulaceae.

Habitat: The Himalayas, West Bengal, Bihar, Orissa, Maharashtra and South India.

English: Traveller’s Midnight Lilies.

Ayurvedic: Krishnabija (related species). (Sold as Kaalaadaanaa, seeds of Ipomoea nil.)

Siddha/Tamil: Kattu Talai.

Folk: Michaai.

Action: Purgative, febrifuge. Seeds—cardiac depressant, spasmolytic, hypotensive, antibacterial, antifungal. Plant juice destroys bedbugs.

The seeds contain resin glycosides which are laxative. Lysergol is also present in the seeds. It exhibits hypotensive, psychotropic, analgesic, and uterus and intestine-stimulating properties. The presence of indole alkaloids is reported in the seed.... ipomoea muricata

(Linn.) Roth

Synonym: Convolvulus bilobatus Roxb. Convolvulus nil Linn.

Family: Convolvulaceae.

Habitat: Throughout India; also occurs as a weed.

English: Pharbitis seeds.

Ayurvedic: Antah-kotarpushpi, Kaalaanjani (provisional synonym), Krishnabija, Kaalaadaanaa, Shyaamabija, Shankhani, Jhaara- maaricha.

Unani: Kaalaadaanaa.

Siddha/Tamil: Kaakkattan.

Action: Purgative and blood- purifier. A substitute for Jalap. Seeds—antifungal.

The seeds from Pakistan contain al- kaloids—lysergol, chanoclavine, pen- niclavine, isopenniclavine and elymo- clavine. Also contain 14.2% resin and glucosides.

Commercial samples of the drug contain 14-15% of crude resinous matter. Research has shown that glycosi- dal part of the resin is inert; the non- glycosidal resin (2% of the drug) causes copious purgation in doses of 250 mg. Besides the resinous matter, the seeds contain a fixed oil (12.4%) and small amounts of saponin, mucilage and tannin.

The flowers of the plant contains an- thocyanin pigments.

The plant extract exhibited hypogly- caemic activity in rats.

Dosage: Seed—3-6 g powder. (CCRAS.)

Synonym: I. hederacea auct., non- Jacq.... ipomoea nil

(American) Woman from Ireland Irysh, Irisha, Irysha... irish

An autoimmune (rheumatoid factor) inflammation of the iris. This is a face of rheumatoid arthritis seldom diagnosed, along with rheumatoid otitis. Although antiinflammatory drugs may be necessary, I would recommend starting off with simple things like Arctium, Rumex crispus and Taraxacum, along with alkalizing teas such as Nettles, Red Clover and Alfalfa (oops...I mean Urtica, Trifolium and Medicago). If they don’t help enough you can STILL take the drugs.... iritis, rheumatoid

A viral infection of the iris. It appears red, swollen, and pupil contraction and relaxation is erratic and pulled. The usual cause is a herpes infection, often resident in the trigeminal nerve, and reoccurring during times of stress or sympathetic to a larger viral condition.... iritis, viral

(German) A universal woman Irmina, Irmine, Irmgard, Irmgarde, Irmagard, Irmagarde, Irmeena, Irmyna, Irmuska... irma

(American) A peaceful woman Irodelle, Irodel, Irodele, Irodella, Irodela... irodell

(Linn.) Sweet.

Synonym: I. biloba Forsk.

Family: Convolvulaceae.

Habitat: Near sea, especially on the West Coast.

English: Goat's Foot Creeper.

Ayurvedic: Chhagalaantri, Mar- yaada-valli.

Siddha/Tamil: Adambu, Attukkal, Musattalai.

Action: Astringent, stomachic, laxative, antidiarrhoeal, antiemetic, analgesic. Leaf—diuretic, anti- inflammatory. Used in colic, prolapsus ani; externally in rheumatism. Essential oil of leaves— antagonistic to histamine. Leaf extract is used for different types of inflammations including injuries caused by poisonous jelly-fish.

Clinical trials have proved that an extract (IPA) inhibited the action of jelly-fish toxins. Its topical application inhibited carrageenan-induced paw and ear oedema induced by arachi- donic acid or ethyl phenylpropionate in rats. The crude extract of leaves also show inhibitory effect on prostaglan- din synthesis in vitro.

Crude extract (IPA) of the leaves has also been shown to antagonize smooth muscle contraction induced by several agonists via non-specific mechanism. Antispasmodic isoprenoids, beta-damascenone and E-phytol have been isolated from the extract. The an- tispasmodic activity was found to be in the same range as that of papaverine.

The alcoholic extract of leaves showed insulinogenic and hypogly- caemic activities in rats, comparable to the hypoglycaemic drug chlor- propamide.

The leaves and seeds contain indole alkaloid. Plant also contains a steroid, an amide, pentatriacontane, triacon- tane, volatile oil and behenic, melissic, butyric and myristic acids.... ipomoea pes-caprae

Choisy.

Operculina petaloidea

Family: Convolvulaceae.

Habitat: Throughout India; ascending to 300 m.

Ayurvedic: Shyaamaa, Chhaa- galaantri, Vriddhadaaraka, Vrid- dhadaaru. Argyreia nervosa (Burm. f.) Boj., synonym A. spiciosa Sweet, Convolvulaceae, is equated with Vriddhadaaru and Vriddhadaaruka, while Ipomoea petaloidea and I. pes-caprae are also known by identical synonyms. Operculina turpethum, synonym I. turpethum is used as a substitute for I. petaloidea.

Unani: Shaaraf.

Siddha: Nilapoosani.

Folk: Bidhaaraa, Nishoth (black var.)

Action: Purgative. Used as a supporting herb for diseases of the nervous system.

Dosage: Leaf, root—3-6 g powder; leaf juice—5-10 ml. (CCRAS.)... ipomoea petaloidea

Hayne.

Synonym: I. jalapa Scheide and Deppe.

Exogonium purga (Hayne) Benth.

Family: Convolvulaceae.

Habitat: Cultivated in the Nilgiris and Poona.

English: Jalap.

Folk: Jalaapaa.

Action: Strong cathartic and purgative. Usually used with carminatives.

Resin from dried root (commercial jalap) contains beta-D-quinovoside of 11-OH-tetradecanoic acid. The glycosi- dal resin is known as "convolvulin'l... ipomoea purga

(Linn.) Roth.

Family: Convolvulaceae.

Habitat: Native of tropical America; found throughout greater part of India, grown in gardens.

English: Tall Morning-Glory.

Folk: Karakatiyaa (seeds).

Action: Purgative. Seed extract— antibacterial.

The stem contains a soft resin (4.8%), essential oil (0.08%) and tannin. The resin is the active principle, it contains ipuranol, which is identical with sitosterol glucoside, ipurolic acid, d- methyl acetic acid, hydroxylauric acid and glucose.... ipomoea purpurea

(Greek) Resembling a pearl Irtah... irta

A jellyfish and a syndrome name derived from the name of a tribe of Aboriginals near Palm Cove, Cairns in north Queensland where many jellyfish stings with severe systemic symptoms were first reported (and still occur).... irukandji

(Basque) Refers to the Holy Trinity Iroon, Iroone, Iroun, Iroune... irune

(English) Friend of the sea Irvetta, Irvett, Irvete, Irvet, Irveta, Irvina, Irvinna, Irvena... irvette

(Spanish) Consecrated to God Isabeau, Isabele, Isabell, Isabelle, Ishbel, Isobel, Isobell, Isobelle, Issie, Issy, Izabel, Izabelle, Izzie, Izzy, Ibby, Ib, Ibbi, Ibbie, Isa, Isibeal, Isibelle, Isibel, Isibell, Isahel, Isahelle, Iseabal, Isobail, Isobael, Isohel... isabel

(Italian / Spanish) Form of Isabel, meaning “consecrated to God” Isabela, Isabelita, Isobella, Izabella, Isibella, Isibela, Isahella... isabella

(African) A beautiful child Isabys, Isabiss, Isabisse, Isabyss, Isabysse... isabis

(Greek) A gift from the goddess Isis Isadora, Isador, Isadoria, Isidor, Isidoro, Isidorus, Isidro, Isidora, Isidoria, Isidore, Izidore, Izadore, Izidora, Izadora, Izidoria, Izadoria... isadore

(Spanish) A lively woman Isairys, Isaeris, Isaerys, Isaire, Isaere, Isair... isairis

Linn.

Synonym: Quamoclitpinnata Bojer.

Family: Convolvulaceae.

Habitat: Native to tropical America; grown as an ornamental.

English: Cypress Vine, Indian Pink.

Ayurvedic: Kaamalataa.

Siddha/Tamil: Kembumalligai, Mayirmanikkam.

Folk: Sitaakesh.

Action: Powdered root is given as a sternutatory. Pounded leaves are applied to bleeding piles.

The leaves and stems are reported to contain small amounts of alkaloids. Traces of hydrocyanic acid are present also in roots, stems and flowers.... ipomoea quamoclit

Choisy.

Synonym: Merremia emarginata (Burm. f.) Hallier f. M. gangetica (L.) Cufod.

Family: Convolvulaceae.

Habitat: In damp places in upper Gangetic plains; Bihar, Bengal, Peninsular India.

Ayurvedic: Aakhuparni, Aakhu- parnika, Muusaakarni, Aakhukarni. Undurukarnikaa. (Also equated with Dravanti.)

Siddha/Tamil: Yelikkaadhukeerai, Perettaikkirai.

Action: Deobstruent, diuretic, alterative. Used for rheumatic affections, neuralgia, headache, skin diseases and urinary affections.

Evolvulus nummularis Linn. (Con- volvulaceae) is also known as Muusa- akarni (Muusaakaani) and is used for cutaneous affections.... ipomoea reniformis

Koen. ex Roxb.

Synonym: I. maxima (Linn. f.) G. Don.

Family: Convolvulaceae.

Habitat: Throughout greater part of India.

Ayurvedic: Banakalami, Hanumaan- Vel, Manjika. (Also equated with Lakshmanaa.)

Siddha/Tamil: Thaalikeerai (Laksh- manaa of the South).

Action: Juice of the plant—de- obstruent, diuretic, hypotensive, uterine tonic, antidote to arsenic poisoning. Seeds—cardiac depressant, hypotensive, spasmolytic.... ipomoea sepiaria

Thunb.

Family: Iridaceae.

Habitat: Temperate Northwestern Himalaya at 1,500-2,700 m. and from Kashmir to Himachal Pradesh. Often grown in gardens.

Ayurvedic: Paarseeka Vachaa, Haimavati, Shveta Vachaa, Baalbach.

Unani: Irsaa, Sosan, Iris.

Folk: Marjal, Unarjal (Kashmir).

Action: Used in diseases of the liver.

Aerial parts contain xanthone gly- cosides; C-glycoside of apigenin and phenolic acids. Roots contain ceryl alcohol.

Natural irones, the main constituent of Orris oil, are obtained from different species of Iris. The laccases, obtained from Iris species and other plants are used in hair cosmetic preparations, as an oxidizing agent in oxidative hair dyes and permanent hair wave-setting compositions. The root extracts of Iris species are used in cosmetic preparations for the prevention of skin roughness and ageing.... iris ensata

Linn.

English: Orris, Iridis Rhizome, German Iris.

Ayurvedic: Paarseeka Vachaa, Haimavati, Shveta Vachaa (also considered as Pushkarmuula), Baal-bach.

Action: Demulcent, antidiarrhoeal, expectorant. Extract of the leaf is used for the treatment of frozen feet.

Key application: In irritable bowel, summer diarrhoea in children, in stubborn cases of respiratory congestion. (Folk medicine.) (Claims negatively evaluated by German Commission E: "blood-purifying," "stomach-strengthening" and "gland-stimulating.")

The rhizomes gave triterpenes, beta- sitosterol, alpha-and beta-amyrin and isoflavonoids; an essential oil, about 0.1-2%, known as "Orris butter," consisting of about 85% myristic acid, with irone, ionone, methyl myris- tate. Isoflavonoids include irisolidone, irigenin and iridin. In volatile oil, chief constituents are cis-alpha and cis-gamma-irones. Triterpenes include iridal and irigermanal. Rhizomes also gave xanthones C. glucosylxanthones (Orris root is the root of Iris germanica. In homoeopathy, Iris versicolor is used.)

Related species ? I. florentina Linn.; I. pallida Lam.

Habitat: The Himalayas from Garhwal to Arunachal Pradesh at 2,400-3,600 m.

Folk: Karkar, Tezma (Punjab).

Action: Diuretic, spasmolytic, febrifuge; antidote for opium addiction.

The rhizomes contain isoflavones— iridin, iriskumaonin and its methyl ether, irisflorentin, junipegenin A and irigenin.... iris germanica

(Japanese) One who has a lot of energy... isamu

(German) A strong-willed woman Isanah, Isanna, Isane, Isann, Isanne, Isan... isana

(Greek) Of the soft breeze Isaure, Isauria, Isaurea... isaura

See HEART, DISEASES OF.... ischaemic heart disease

Linn.

Family: Iridaceae.

Habitat: In swamps. Native to America and Canada.

English: Blue Flag Root, Liver Lily.

Ayurvedic: Haimavati Vachaa.

Action: Anti-inflammatory, astringent, cholagogue, laxative, diuretic, antiemetic, blood and lymph purifier, alterative for sluggish conditions of liver, gallbladder and glandular system.

Key application: As laxative. (The British Herbal Pharmacopoeia.)

The rhizomes contain a volatile oil; a glycoside, iridin; acids including salicylic and isophthalic; a monocyclic C31 triterpenoid; sterols, gum, resin. Irisin is the toxic constituent of the resin. It irritates the mucous membrane, liver and pancreas.

The drug is contraindicated in pregnancy. The root powder is toxic at 2 g and fluid extract at 3.7 ml.... iris versicolour

Black tea is popular since ancient times when it was used even for meditation. Irish Breakfast black tea has lots of benefits if you drink it moderately and follow the storage instructions. Short description of Irish Breakfast tea Irish breakfast tea is a mixture of strong Indian black teas grown in Assam region. As a black tea, it has a strong flavour and higher caffeine content than green teas but considerably less than coffee. This type of tea is obtained allowing the tea leaves to fully oxidize naturally before being dried. The leaves are left to dry in wooden boxes, then rolled and stretched damp and cold. This process gives black leaves. In Chinese tradition it is also named Hongcha. This type of black tea keeps its flavor better and longer than green tea. Infusion color goes from dark red to brown and may have many intense flavors like almonds, wild flowers, fruits or malt. Due to its strength, Irish breakfast tea is usually served with milk, but may also be consumed plain or with lemon or sugar. This type of tea is often drunk in the morning. When it comes to storage, it is advisable to keep Irish Breakfast tea in ceramic, porcelain containers or in metal airtight boxes in a clean dry air light place. Don’t keep the tea in the refrigerator as it will lose its flavor because of too much moisture. Ingredients of Irish Breakfast tea Like most teas, the Irish breakfast tea version contains flavanoids, which contain anti-oxidative properties when consumed. Recent studies have shown that this type of tea also contains more caffeine than other teas. How to prepare the Irish Breakfast tea If you are using tea bags, usually use 1 tea bag per cup of water. Pour boiling water, in order to cover the leaves. Allow the Irish Breakfast tea to infuse for 3-5 minutes allowing the steam to release the leaves’ flavor. After that, remove the leaves, blend, let it cool for a few moments and enjoy. Your specific tea may come with a recommendation for preparation and brewing as well. Benefits of Irish Breakfast tea Like other black teas, consumption of Irish Breakfast tea has many health benefits. Drinking Irish Breakfast tea strengthens teeth and bones and helps boost the immune system keeping the viruses away. It also prevents tooth decay. It blocks LDL (bad) cholesterol and increase HDL (good) cholesterol, which improves artery function. The essential oils in tea leaves help digestion. Caffeine contained in this type of tea has many positive functions like relieving headaches, improving mood and helping concentration. It is also considered an old remedy for asthma symptoms. It also eliminates tiredness. Irish Breakfast tea reduces tumor growth. Some studies showed that TF-2 substance contained in tea, cause destruction of colon and rectum cancer cells, contributing to tumor reduction. Researchers also found that the benefits of black tea may include lowering the risk of heart attack and stroke. According to their findings, certain compounds found in the tea help relax and expand the arteries, thus increasing blood flow to the heart and minimizing clogging of the arteries. It is said that 4 cups of Irish Breakfast tea daily lower with 50% the risk of heart attack. Side effects of Irish Breakfast tea The side effect of Irish Breakfast tea may arise if you drink too much. They are mostly associated with caffeine may cause restlessness, palpitations, difficulty sleeping, anxiety, irritability, increased heart rate, and elevated blood pressure. Caffeine is also diuretic. Due to its interesting flavors and benefits, Irish Breakfast teas are suitable for regular consumption, but always remember to keep your moderation when you drink it.... irish breakfast - a well known type of black tea

(American) A giving woman Iselah, Isella, Isellah... isela

(Indian / Hebrew) The protector / a lively woman Ishah... isha

(Indian) A wealthy lady Ishanah, Ishanna, Ishannah, Ishann, Ishanne, Ishane, Ishani, Ishanie, Ishany, Ishaney, Ishanee, Ishara, Isharah, Isharra... ishana

(Japanese) As solid as a rock Ishie, Ishy, Ishey, Ishee, Ishea, Isheah, Ishiko... ishi

A test for colour vision, introduced by a Japanese doctor, comprising several plates with round dots of di?erent colours and sizes. It is also the name of a type of blood test for SYPHILIS.... ishihara’s test

(Persian) In mythology, a mother goddess of love and fertility Ishtarr, Ishtarre, Ishtara, Ishtarah, Ishtarra, Ishtarrah... ishtar

(Egyptian) In mythology, the most powerful of all goddess... isis

(Gaelic) From the island Islay, Islae, Islai, Isleta, Isletta, Islyta... isla

(Gaelic) Form of Aislinn, meaning “a dream or vision; an inspiration” Isleene, Islyne, Islyn, Isline, Isleine, Isliene, Islene, Isleyne, Isleane... isleen

Linn.

Family: Crucifere; Brassicaceae.

Habitat: Native to Afghanistan and Western Tibet. Now cultivated as an ornamental.

English: Dyer's Woad.

Action: Plant—used in the form of an ointment for ulcers, oedematous and malignant tumours. Leaves— antimicrobial, antifungal.

The aerial parts yield tryptanthrin, indole-3-acetonitrile and p-coumaric acid methylester.

The roots contain anti-blood platelet aggregation constituents, uridine, hy- poxanthine, uracil and salicylic acid together with indigo, palmitic acid and beta-sitosterol.

In China, tablets made from the leaves and roots of Isatis tinctoria and Artemisia scoparia have been found to be effective in treating hepatitis B patients.... isatis tinctoria