Causes As a rule, a person is not conscious of the beating of the heart except when the nervous system is unduly excited. A disorder of the rhythm of the heart (ARRHYTHMIA) may cause palpitations. Sudden emotions, such as fright, or overuse of tobacco, tea, co?ee or alcohol may bring it on. Sometimes it may appear in people with organic heart disease.
Symptoms There may simply be a ?uttering of the heart and a feeling of faintness, or the heart may be felt pounding and the arteries throbbing, causing great distress. The subject may be conscious of the heart missing beats.
Treatment Although these symptoms can be unpleasant, they do not necessarily signify serious disease. Moderate exercise is a good thing. If the person is a smoker, he or she should stop. Tea, co?ee, alcohol or other stimulants should be taken sparingly. If symptoms persist or are severe, the individual should see a doctor and any underlying disorder should be investigated – including by exercise ECG – and treated. The BETA-ADRENOCEPTOR-BLOCKING DRUGS are the most useful drugs in controlling the palpitations of anxiety and those due to some cardiac arrhythmias.... palpitation
The blood pressure is biphasic, being greatest (systolic pressure) at each heartbeat and falling (diastolic pressure) between beats. The average systolic pressure is around 100 mm Hg in children and 120 mm Hg in young adults, generally rising with age as the arteries get thicker and harder. Diastolic pressure in a healthy young adult is about 80 mm Hg, and a rise in diastolic pressure is often a surer indicator of HYPERTENSION than is a rise in systolic pressure; the latter is more sensitive to changes of body position and emotional mood. Hypertension has various causes, the most important of which are kidney disease (see KIDNEYS, DISEASES OF), genetic predisposition and, to some extent, mental stress. Systolic pressure may well be over 200 mm Hg. Abnormal hypertension is often accompanied by arterial disease (see ARTERIES, DISEASES OF) with an increased risk of STROKE, heart attack and heart failure (see HEART, DISEASES OF). Various ANTIHYPERTENSIVE DRUGS are available; these should be carefully evaluated, considering the patient’s full clinical history, before use.
HYPOTENSION may result from super?cial vasodilation (for example, after a bath, in fevers or as a side-e?ect of medication, particularly that prescribed for high blood pressure) and occur in weakening diseases or heart failure. The blood pressure generally falls on standing, leading to temporary postural hypotension – a particular danger in elderly people.... blood pressure
Staphylococcal food poisoning occurs after food such as meat products, cold meats, milk, custard and egg products becomes contaminated before or after cooking, usually through incorrect handling by humans who carry S. aureus. The bacteria produce an ENTEROTOXIN which causes the symptoms of food poisoning 1–8 hours after ingestion. The toxin can withstand heat; thus, subsequent cooking of contaminated food will not prevent illness.
Heat-resistant strains of Cl. perfringens cause food poisoning associated with meat dishes, soups or gravy when dishes cooked in bulk are left unrefrigerated for long periods before consumption. The bacteria are anaerobes (see ANAEROBE) and form spores; the anaerobic conditions in these cooked foods allow the germinated spores to multiply rapidly during cooling, resulting in heavy contamination. Once ingested the bacteria produce enterotoxin in the intestine, causing symptoms within 8–24 hours.
Many di?erent types of Salmonella (about 2,000) cause food poisoning or ENTERITIS, from eight hours to three days after ingestion of food in which they have multiplied. S. brendeny, S. enteritidis, S. heidelberg, S. newport and S. thompson are among those commonly causing enteritis. Salmonella infections are common in domesticated animals such as cows, pigs and poultry whose meat and milk may be infected, although the animals may show no symptoms. Duck eggs may harbour Salmonella (usually S. typhimurium), arising from surface contamination with the bird’s faeces, and foods containing uncooked or lightly cooked hen’s eggs, such as mayonnaise, have been associated with enteritis. The incidence of human S. enteritidis infection has been increasing, by more than 15-fold in England and Wales annually, from around 1,100 a year in the early 1980s to more than 32,000 at the end of the 1990s, but has since fallen to about 10,000. A serious source of infection seems to be poultry meat and hen’s eggs.
Although Salmonella are mostly killed by heating at 60 °C for 15 minutes, contaminated food requires considerably longer cooking and, if frozen, must be completely thawed beforehand, to allow even cooking at a su?cient temperature.
Enteritis caused by Campylobacter jejuni is usually self-limiting, lasting 1–3 days. Since reporting of the disease began in 1977, in England and Wales its incidence has increased from around 1,400 cases initially to nearly 13,000 in 1982 and to over 42,000 in 2004. Outbreaks have been associated with unpasteurised milk: the main source seems to be infected poultry.
ESCHERICHIA COLI O157 was ?rst identi?ed as a cause of food poisoning in the early 1980s, but its incidence has increased sharply since, with more than 1,000 cases annually in the United Kingdom in the late 1990s. The illness can be severe, with bloody diarrhoea and life-threatening renal complications. The reservoir for this pathogen is thought to be cattle, and transmission results from consumption of raw or undercooked meat products and raw dairy products. Cross-infection of cooked meat by raw meat is a common cause of outbreaks of Escherichia coli O157 food poisoning. Water and other foods can be contaminated by manure from cattle, and person-to-person spread can occur, especially in children.
Food poisoning associated with fried or boiled rice is caused by Bacillus cereus, whose heat-resistant spores survive cooking. An enterotoxin is responsible for the symptoms, which occur 2–8 hours after ingestion and resolve after 8–24 hours.
Viruses are emerging as an increasing cause of some outbreaks of food poisoning from shell?sh (cockles, mussels and oysters).
The incidence of food poisoning in the UK rose from under 60,000 cases in 1991 to nearly 79,000 in 2004. Public health measures to control this rise include agricultural aspects of food production, implementing standards of hygiene in abattoirs, and regulating the environment and process of industrial food production, handling, transportation and storage.... food poisoning
Paralysis due to brain disease The most common form is unilateral palsy, or HEMIPLEGIA, generally arising from cerebral HAEMORRHAGE, THROMBOSIS or EMBOLISM affecting the opposite side of the BRAIN. If all four limbs and trunk are affected, the paralysis is called quadraplegia; if both legs and part of the trunk are affected, it is called paraplegia. Paralysis may also be divided into ?accid (?oppy limbs) or spastic (rigid).
In hemiplegia the cause may be an abscess, haemorrhage, thrombosis or TUMOUR in the brain. CEREBRAL PALSY or ENCEPHALITIS are other possible causes. Sometimes damage occurs in the parts of the nervous system responsible for the ?ne control of muscle movements: the cerebellum and basal ganglion are such areas, and lack of DOPAMINE in the latter causes PARKINSONISM.
Damage or injury Damage to or pressure on the SPINAL CORD may paralyse muscles supplied by nerves below the site of damage. A fractured spine or pressure from a tumour may have this e?ect. Disorders affecting the cord which can cause paralysis include osteoarthritis of the cervical vertebrae (see BONE, DISORDERS OF), MULTIPLE SCLEROSIS (MS), MYELITIS, POLIOMYELITIS and MENINGITIS. Vitamin B12 de?ciency (see APPENDIX 5: VITAMINS) may also cause deterioration in the spinal cord (see also SPINE AND SPINAL CORD, DISEASES AND INJURIES OF).
Neuropathies are a group of disorders, some inherited, that damage the peripheral nerves, thus affecting their ability to conduct electrical impulses. This, in turn, causes muscle weakness or paralysis. Among the causes of neuropathies are cancers, DIABETES MELLITUS, liver disease, and the toxic consequences of some drugs or metals – lead being one example.
Disorders of the muscles themselves – for example, muscular dystrophy (see MUSCLES, DISORDERS OF – Myopathy) – can disturb their normal working and so cause partial or complete paralysis of the part(s) affected.
Treatment The aim of treatment should be to remedy the underlying cause – for example, surgical removal of a displaced intervertebral
disc or treating diabetes mellitus. Sometimes the cause cannot be recti?ed but, whether treatable or not, physiotherapy is essential to prevent joints from seizing up and to try to maintain some tone in muscles that may be only partly affected. With temporary paralysis, such as can occur after a STROKE, physiotherapy can retrain the sufferers to use their muscles and joints to ensure mobility during and after recovery. Patients with permanent hemiplegia, paraplegia or quadraplegia need highly skilled nursing care, rehabilitative support and resources, and expert help to allow them, if possible, to live at home.... paralysis
Chronic paronychia occurs with reinfection of the nail bed. This is usually because the person’s hands are regularly immersed in water, making the skin vulnerable to infection. The ?nger should be kept dry and a dry dressing applied accompanied by a course of antibiotics
– FLUCLOXACILLIN or a cephalosporin.... paronychia
Pharmacologists not only research for new drugs, but also look for ways of synthesising them on a large scale. Most importantly, they organise with clinicians the thorough testing of drugs to ensure that these are safe to use, additionally helping to monitor the effects of drugs in regular use so as to identify unforeseen side-effects. Doctors and hospital pharmacists have a special reporting system (‘Yellow Cards’) under which they notify the government’s MEDICINES CONTROL AGENCY of any untoward consequences of drug treatments on their patients (see also MEDICINES).... pharmacology
Phobia is a form of obsession, and not uncommonly one of the features of anxiety. Treatment is behavioural therapy complemented in some patients with ANTIDEPRESSANT DRUGS. Care is needed, as some sufferers can become psychologically dependent on the drugs used to treat them (see DEPENDENCE). Those who suffer from what can be a most distressing condition can obtain help and advice from the Phobics Society. (See also MENTAL ILLNESS.)... phobia
The disease manifests itself in many ways. It may not be ?nally diagnosed and characterised until the infant is two years old, but may be apparent much earlier – even soon after birth. The child may be spastic or ?accid, or the slow, writhing involuntary movements known as athetosis may be the predominant feature. These involuntary movements often disappear during sleep and may be controlled, or even abolished, in some cases by training the child to relax. The paralysis varies tremendously. It may involve the limbs on one side of the body (hemiplegia), both lower limbs (paraplegia), or all four limbs (DIPLEGIA and QUADRIPLEGIA). Learning disability (with an IQ under 70) is present in around 75 per cent of all children but children with diplegia or athetoid symptoms may have normal or even high intelligence. Associated problems may include hearing or visual disability, behavioural problems and epilepsy.
The outlook for life is good, only the more severely affected cases dying in infancy. Although there is no cure, much can be done to help these disabled children, particularly if the condition is detected at an early stage. Assistance is available from NHS developmental and assessment clinics, supervised by community paediatricians and involving a team approach from experts in education, physiotherapy, occupational therapy and speech training. In this way many of these handicapped children reach adulthood able to lead near-normal lives. Much help in dealing with these children can be obtained from SCOPE (formerly the Spastics Society), and Advice Service Capability Scotland (ASCS).... cerebral palsy
– although lead-containing paints are no longer used for items that children may be in contact with.
Acute poisonings are rare. Clinical features include metallic taste, abdominal pain, vomiting, diarrhoea, ANOREXIA, fatigue, muscle weakness and SHOCK. Neurological effects may include headache, drowsiness, CONVULSIONS and COMA. Inhalation results in severe respiratory-tract irritation and systemic symptoms as above.
Chronic poisonings cause gastrointestinal disturbances and constipation. Other effects are ANAEMIA, weakness, pallor, anorexia, insomnia, renal HYPERTENSION and mental fatigue. There may be a bluish ‘lead line’ on the gums, although this is rarely seen. Neuromuscular dysfunction may result in motor weakness and paralysis of the extensor muscles of the wrist and ankles. ENCEPHALOPATHY and nephropathy are severe effects. Chronic low-level exposures in children are linked with reduced intelligence and behavioural and learning disorders.
Treatment Management of patients who have been poisoned is supportive, with removal from source, gastric decontamination if required, and X-RAYS to monitor the passage of metallic lead through the gut if ingested. It is essential to ensure adequate hydration and renal function. Concentrations of lead in the blood should be monitored; where these are found to be toxic, chelation therapy should be started. Several CHELATING AGENTS are now available, such as DMSA (Meso-2,3dimercaptosuccinic acid), sodium calcium edetate (see EDTA) and PENICILLAMINE. (See also POISONS.)... lead poisoning
Side-effects of paclitaxel include hypersensitivity, MYELOSUPPRESSION, cardiac ARRHYTHMIA and peripheral NEUROPATHY. Only a minority of patients respond to the drug, but when it works the results are often long-lasting.... paclitaxel
5: VITAMINS.)... pantothenic acid
The contents of the pelvis are the urinary bladder and rectum in both sexes; in addition the male has the seminal vesicles and the prostate gland surrounding the neck of the bladder, whilst the female has the womb, ovaries, and their appendages.
A second meaning is as in renal pelvis – that part of the collecting system proximal to the URETER which collects urine from the renal pyramids (see KIDNEYS).... pelvis
This makes the penis erect and ready for insertion into the woman’s vagina in sexual intercourse. The end of the penis, the glans, is covered by a loose fold of skin – the foreskin or PREPUCE – which retracts when the organ is erect. The foreskin is sometimes removed for cultural or medical reasons.
A common congenital disorder of the penis is HYPOSPADIAS, in which the urethra opens somewhere along the under side; it can be repaired surgically. BALANITIS is in?ammation of the glans and foreskin. (See also REPRODUCTIVE SYSTEM; EJACULATION; IMPOTENCE; PRIAPISM.)... penis
Habitat: Not common as a wild plant, except on damp heaths and commons. Frequently seen in cottage gardens. Indigenous to Britain and Europe.Features ? This member of the mint family grows up to twelve inches high, the stembeing bluntly quadrangular. The one to one and a half inch long, egg-shaped leaves are opposite, on short stalks ; they are slightly serrate and nearly smooth. Purple flowers appear in August. The odour is rather pungent, mint-like but characteristic.Part used ? The whole herb.
Action: Carminative, emmenagogue, diaphoretic and stimulant.An infusion of 1 ounce to 1 pint of boiling water, taken warm in teacupful doses frequently repeated, is helpful in hysteria, flatulence and sickness. For children's ailments such as feverish colds, disordered stomach and measles, Pennyroyal infusion may be given in appropriate doses with confidence. Its diaphoretic and stimulant action recommends it for chills and incipient fevers, and the infusion works as an emmenagogue when such ailments retard and obstruct menstruation. The oil of Pennyroyal is a first-rate protection against the bites of mosquitoes, gnats, and similar winged pests. The herb is used to some extent as a flavouring. Although not so popular as other herbs for this purpose, the mint-like flavour and carminative virtues of Pennyroyal should recommend it to cooks as adding to both palatability and digestibility of various dishes.American or Mock Pennyroyal are the names given to the dried leaves and flowering tops of Hedeoma pulegioides. This plant, although quite different in appearance from the European Pennyroyal, has similar medicinal values.... pennyroyal
Habitat: Cultivated in gardens.Features ? Stem two feet high, thick, smooth, branched leaves, pinnate or lobed. Flowers (May) large, red, single, terminal. Transverse section of root is starchy, medullary rays tinged purple. Taste sweet, becoming bitter.Part used ? Root.
Action: Tonic, antispasmodic.Convulsive and spasmodic nervous troubles as chorea and epilepsy. Infusion of 1 ounce powdered root to 1 pint boiling water in wineglassdoses three or four times daily.... peony
Acute peritonitis generally arises because bacteria enter the peritoneal cavity, from penetrating wounds, e.g. stabs, from the exterior or from the abdominal organs. Hence conditions leading to perforation of the STOMACH, INTESTINE, BILE DUCT, URINARY BLADDER, and other hollow organs such as gastric ulcer (see STOMACH, DISEASES OF), typhoid fever (see ENTERIC FEVER), gall-stones (see under GALLBLADDER, DISEASES OF), rupture of the bladder, strangulated HERNIA, and obstructions of the bowels, may lead to peritonitis. Numerous bacteria may cause the in?ammation, most common being E. coli, streptococci and the gonococcus.
The symptoms usually begin with a RIGOR together with fever, vomiting, severe abdominal pain and tenderness. Shock develops and the abdominal wall becomes rigid. If untreated the patient usually dies. Urgent hospital admission is required. X-ray examination may show gas in the peritoneal cavity. Treatment consists of intravenous ?uids, antibiotics and surgical repair of the causative condition. Such treatment, together with strong analgesics is usually successful if started soon enough.... peritonitis
The chief object of perspiration is to maintain an even body temperature by regulating the heat lost from the body surface. Sweating is therefore increased by internally produced heat, such as muscular activity, or external heat. It is controlled by two types of nerves: vasomotor, which regulate the local blood ?ow, and secretory (part of the sympathetic nervous system) which directly in?uence secretion.
Eccrine sweat is a faintly acid, watery ?uid containing less than 2 per cent of solids. The eccrine sweat-glands in humans are situated in greatest numbers on the soles of the feet and palms of the hands, and with a magnifying glass their minute openings or pores can be seen in rows occupying the summit of each ridge in the skin. Perspiration is most abundant in these regions, although it also occurs all over the body.
Apocrine sweat-glands These start functioning at puberty and are found in the armpits, the eyelids, around the anus in association with the external genitalia, and in the areola and nipple of the breast. (The glands that produce wax in the ear are modi?ed apocrine glands.) The ?ow of apocrine sweat is evoked by emotional stimuli such as fear, anger, or sexual excitement.
Abnormalities of perspiration Decreased sweating may occur in the early stages of fever, in diabetes, and in some forms of glomerulonephritis (see KIDNEYS, DISEASES OF). Some people are unable to sweat copiously, and are prone to HEAT STROKE. EXCESSIVE SWEATING, OR HYPERIDROSIS, may be caused by fever, hyperthyroidism (see THYROID GLAND, DISEASES OF), obesity, diabetes mellitus, or an anxiety state. O?ensive perspiration, or bromidrosis, commonly occurs on the hands and feet or in the armpits, and is due to bacterial decomposition of skin secretions. A few people, however, sweat over their whole body surface. For most of those affected, it is the palmar and/or axillary hyperhidrosis that is the major problem.
Conventional treatment is with an ANTICHOLINERGIC drug. This blocks the action of ACETYLCHOLINE (a neurotransmitter secreted by nerve-cell endings) which relaxes some involuntary muscles and tightens others, controlling the action of sweat-glands. But patients often stop treatment because they get an uncomfortably dry mouth. Aluminium chloride hexahydrate is a topical treatment, but this can cause skin irritation and soreness. Such antiperspirants may help patients with moderate hyperhidrosis, but those severely affected may need either surgery or injections of BOTULINUM TOXIN to destroy the relevant sympathetic nerves to the zones of excessive sweating.... perspiration
The pituitary gland is the most important ductless, or endocrine, gland in the body. (See
ENDOCRINE GLANDS.) It exerts overall control of the endocrine system through the media of a series of hormones which it produces. The adenohypophysis produces trophic hormones (that is, they work by stimulating or inhibiting other endocrine glands) and have therefore been given names ending with ‘trophic’ or ‘trophin’. The thyrotrophic hormone, or thyroid-stimulating hormone (TSH), exerts a powerful in?uence over the activity of the THYROID GLAND. The ADRENOCORTICOTROPHIC HORMONE (ACTH) stimulates the cortex of the adrenal glands. GROWTH HORMONE, also known as somatotrophin (SMH), controls the growth of the body. There are also two gonadotrophic hormones which play a vital part in the control of the gonads: these are the follicle-stimulating hormone (FSH), and the luteinising hormone (LH) which is also known as the interstitial-cell-stimulating hormone (ICSH) – see GONADOTROPHINS. The lactogenic hormone, also known as prolactin, mammotrophin and luteotrophin, induces lactation.
The neurohypophysis produces two hormones. One is oxytocin, which is widely used because of its stimulating e?ect on contraction of the UTERUS. The other is VASOPRESSIN, or the antidiuretic hormone (ADH), which acts on the renal tubules and the collecting tubules (see KIDNEYS) to increase the amount of water that they normally absorb.... pituitary gland
(2) Raised patch on the skin resulting from the merging or enlargement of papules (see PAPULE; PIMPLES).... plaque
– is caused by the bacterium Yersinis pestis. Plague remains a major infection in many tropical countries.
The reservoir for the bacillus in urban infection lies in the black rat (Rattus rattus), and less importantly the brown (sewer) rat (Rattus norvegicus). It is conveyed to humans by the rat ?ea, usually Xenopsylla cheopis: Y. pestis multiplies in the gastrointestinal tract of the ?ea, which may remain infectious for up to six weeks. In the pneumonic form (see below), human-to-human transmission can occur by droplet infection. Many lower mammals (apart from the rat) can also act as a reservoir in sylvatic transmission which remains a major problem in the US (mostly in the south-western States); ground-squirrels, rock-squirrels, prairie dogs, bobcats, chipmunks, etc. can be affected.
Clinically, symptoms usually begin 2–8 days after infection; disease begins with fever, headache, lassitude, and aching limbs. In over two-thirds of patients, enlarged glands (buboes) appear – usually in the groin, but also in the axillae and cervical neck; this constitutes bubonic plague. Haemorrhages may be present beneath the skin causing gangrenous patches and occasionally ulcers; these lesions led to the epithet ‘Black Death’. In a favourable case, fever abates after about a week, and the buboes discharge foul-smelling pus. In a rapidly fatal form (septicaemic plague), haematogenous transmission produces mortality in a high percentage of cases. Pneumonic plague is associated with pneumonic consolidation (person-to-person transmission) and death often ensues on the fourth or ?fth day. (The nursery rhyme ‘Ringo-ring o’ roses, a pocketful o’ posies, atishoo! atishoo!, we all fall down’ is considered to have originated in the 17th century and refers to this form of the disease.) In addition, meningitic and pharyngeal forms of the disease can occur; these are unusual. Diagnosis consists of demonstration of the causative organism.
Treatment is with tetracycline or doxycycline; a range of other antibiotics is also e?ective. Plague remains (together with CHOLERA and YELLOW FEVER) a quarantinable disease. Contacts should be disinfected with insecticide powder; clothes, skins, soft merchandise, etc. which have been in contact with the infection can remain infectious for several months; suspect items should be destroyed or disinfected with an insecticide. Ships must be carefully checked for presence of rats; the rationale of anchoring a distance from the quay prevents access of vermin. (See also EPIDEMIC; PANDEMIC; NOTIFIABLE DISEASES.)... plague
Tension pneumothorax is a life-threatening condition in which the air in the hemithorax is under such pressure that it forces the heart to the other side and compresses the still-in?ated lung on the other side. It must be promptly relieved by inserting a hollow tube into the pleural cavity – a chest drain.
Arti?cial pneumothorax was an operation often performed in the pre-antibiotic days to treat pulmonary tuberculosis. Air was run into the pleural cavity to cause collapse of one lung, which rested it and allowed cavities in it to heal.... pneumothorax
The disorder may, however, occur for no obvious reason and is then called polycythaemia vera. This type develops mainly in people over 40 and about 400 people develop the disorder every year in the United Kingdom. The blood thickens, the sufferer may develop high blood pressure, ?ushing, headaches, itching and an enlarged spleen. A stroke may occur later in the disease process. Treatment of polycythaemia vera is by regular removal of blood by VENESECTION, sometimes in combination with an anticancer drug. Secondary polycythaemia is treated by remedying the underlying cause.
Polycythaemia rubra vera A disorder in which the red blood cells increase in number along with an increase in the number of white blood cells and platelets. The cause is unknown. Severe cases may require treatment with CYTOTOXIC drugs or RADIOTHERAPY.... polycythaemia
The secretion of prolactin is normally kept under tonic inhibition by the secretion of DOPAMINE which inhibits prolactin. This is formed in the HYPOTHALAMUS and secreted into the portal capillaries of the pituitary stalk to reach the anterior pituitary cells. Drugs that deplete the brain stores of dopamine or antagonise dopamine at receptor level will cause HYPERPROLACTINAEMIA and hence the secretion of milk from the breast and AMENORRHOEA. METHYLDOPA and RESERPINE deplete brain stores of dopamine and the PHENOTHIAZINES act as dopamine antagonists at receptor level. Other causes of excess secretion of prolactin are pituitary tumours, which may be minute and are then called microadenomas, or may actually enlarge the pituitary fossa and are then called macroadenomas. The most common cause of hyperprolactinaemia is a pituitary tumour. The patient may present with infertility – because patients with hyperprolactinaemia do not ovulate – or with amenorrhea and even GALACTORRHOEA.
BROMOCRIPTINE is a dopamine agonist. Treatment with bromocriptine will therefore control hyperprolactinaemia, restoring normal menstruation and ovulation and suppressing galactorrhoea. If the cause of hyperprolactinaemia is an adenomatous growth in the pituitary gland, surgical treatment should be considered.... prolactin
Development of such mechanical and biomechanical devices points the way to a much wider use of e?ective prostheses, enabling people who would previously have died or been severely handicapped to lead normal or near normal lives. The technical hazards that have already been overcome provide a sound foundation for future successes. Progress so far in producing prostheses should also ensure that organ replacement is free from the serious ethical problems that surround the use of genetic manipulation to cure or prevent serious diseases (see ETHICS).
Limbs These are best made to meet the individual’s requirements but can be obtained ‘o? the shelf’. Arti?cial joints normally comprise complex mechanisms to stimulate ?exion and rotation movements. Leg prostheses are generally more useful than those for arms, because leg movements are easier to duplicate than those of the arm. Modern electronic circuitry that enables nerve impulses to be picked up and converted into appropriate movements is greatly improving the e?ectiveness of limb prostheses.
Eyes Arti?cial eyes are worn both for appearance and for psychological reasons. They are made of glass or plastic, and are thin shells of a boat-shape, representing the front half of the eye which has been removed. The stump which is left has still the eye-muscles in it, and so the arti?cial eye still has the power of moving with the other. A glass eye has to be replaced by a new one every year. Plastic eyes have the advantage of being more comfortable to wear, being more durable, and being unbreakable. Research is taking place aimed at creating a silicon chip that stimulates the visual cortex and thus helps to restore sight to the blind.
Dental prostheses is any arti?cial replacement of a tooth. There are three main types: a crown, a bridge and a denture. A crown is the replacement of the part of a tooth which sticks through the gum. It is ?xed to the remaining part of the tooth and may be made of metal, porcelain, plastic or a combination of these. A bridge is the replacement of two or three missing teeth and is usually ?xed in place. The replacement teeth are held in position by being joined to one or more crowns on the adjacent teeth. A denture is a removable prosthesis used to replace some or all the teeth. The teeth are made of plastic or porcelain and the base may be of plastic or metal. Removable teeth may be held more ?rmly by means of implants.
Heart The surgical replacement of stenosed or malfunctioning heart-valves with metal or plastic, human or pig valves has been routinely carried out for many years. So too has been the insertion into patients with abnormal heart rhythms of battery-driven arti?cial pacemakers (see CARDIAC PACEMAKER) to restore normal function. The replacement of a faulty heart with an arti?cial one is altogether more challenging. The ?rst working attempt to create an arti?cial heart took place in the early 1980s. Called the Jarvik-7, it had serious drawbacks: patients had to be permanently connected to apparatus the size of an anaesthetic trolley; and it caused deaths from infection and clotting of the blood. As a result, arti?cial hearts have been used primarily as bridging devices to keep patients alive until a suitable donor heart for transplantation can be found. Recent work in North America, however, is developing arti?cial hearts made of titanium and dacron. One type is planted into the chest cavity next to the patient’s own heart to assist it in its vital function of pumping blood around the body. Another replaces the heart completely. Eventually, it is probable that arti?cial hearts will replace heart transplants as the treatment of choice in patients with serious heart disorders.
Liver Arti?cial livers work in a similar way to kidney dialysis machines (see DIALYSIS). Blood is removed from the body and passed through a machine where it is cleaned and treated and then returned to the patient. The core of the device comprises several thousand ?exible membrane tubules on which live liver cells (from pigs or people) have been cultured. There is an exchange of biological molecules and water with the ‘circulating’ blood, and the membrane also screens the ‘foreign’ cells from the patient’s immune system, thus preventing any antagonistic immune reaction in the recipient.
Nose The making of a new nose is the oldest known operation in plastic surgery, Hindu records of such operations dating back to 1,000 BC. Loss of a nose may be due to eroding disease, war wounds, gun-shot wounds or dog bites. In essence the operation is the same as that practised a thousand years before Christ: namely the use of a skin graft, brought down from the forehead. Alternative sources of the skin graft today are skin from the arm, chest or abdomen. As a means of support, the new nose is built round a graft of bone or of cartilage from the ear.... prosthesis
Psychoanalysis aims at discovering these repressed memories, which are responsible for the diversion of mental power and of which the affected person usually is only dimly aware or quite unaware. The fundamental method of psychoanalytical treatment is the free expression of thoughts, ideas and fantasies on the part of the patient. To facilitate this, the analyst uses techniques to relax the patient and maintains a neutral attitude to his or her problems. In the course of analysis the patient will re-explore his or her early emotional attitudes and tensions.
The fundamental conception of psychoanalysis, although hard to prove by orthodox scienti?c methods and therefore challenged by some psychiatrists, has been widely adopted and developed by other schools of psychology. Freud’s work changed the attitudes of the scienti?c community and the public to the problems of the neurotic, the morbidly anxious, the fearful and to the mental and emotional develoment of the child.... psychoanalysis
Psychosurgery is now rare in Britain. The Mental Health Act 1983 requires not only consent by the patient – con?rmed by an independent doctor, and two other representatives of the Mental Health Act Commission – but also that the Commission’s appointed medical representative also advise on the likelihood of the treatment alleviating or preventing a deterioration in the patient’s condition.... psychosurgery
In girls, puberty is marked by the onset of MENSTRUATION and development of the BREASTS. The latter is usually the ?rst sign of puberty to appear, and may occur from nine years onwards; most girls show signs of breast development by the age of 13. The time from the beginning of breast development to the onset of menstruation is usually around two years but may range from six months to ?ve years. The ?rst sign of puberty in boys is an increase in testicular and penile size (see TESTICLE; PENIS) between the age of ten and 14. The LARYNX enlarges in boys, so that the voice – after going through a period of ‘breaking’ – ?nally assumes the deep manly pitch. Hair appears on the pubis and later in the armpits in both boys and girls, whilst in the former it also begins to grow on the upper lip, and skin eruptions are not uncommon on the face (see ACNE).
The period is one of transition from a physical and mental point of view. Puberty is not to be regarded as a physiological ‘coming of age’, for full development is usually achieved in the early 20s.... puberty
day of the puerperium. (See also PREGNANCY AND LABOUR.)
Management The mother should start practising exercises to help ensure that the stretched abdominal muscles regain their normal tone. There is no need for any restriction of diet, but care must be taken to ensure an adequate intake of ?uid, including at least 580 ml (a pint) of milk a day.
Milk, as already stated, appears copiously on the third day, but this is preceded by a secretion from the breast, known as colostrum, which is of value to the newborn child. The child should therefore be put to the breasts within 6–8 hours of being born. This also stimulates both the breasts and the natural changes taking place during this period. Suckling is bene?cial for both child and mother and encourages bonding between the two.... puerperium
The cause of the pulsation lies in the fact that, at each heartbeat, 80–90 millilitres of blood are driven into the AORTA, and a ?uid wave, distending the vessels as it passes, is transmitted along the ARTERIES all over the body. This pulsation falls away as the arteries grow smaller, and is ?nally lost in the minute capillaries, where a steady pressure is maintained. For this reason, the blood in the veins ?ows steadily on without any pulsation. Immediately after the wave has passed, the artery, by virtue of its great elasticity, regains its former size. The nature of this wave helps the doctor to assess the state of the artery and the action of the heart.
The pulse rate is usually about 70 per minute, but it may vary in health from 50 to 100, and is quicker in childhood and slower in old age than in middle life; it is low (at rest) in physically ?t athletes or other sports people. Fever causes the rate to rise, sometimes to 120 beats a minute or more.
In childhood and youth the vessel wall is so thin that, when su?cient pressure is made to expel the blood from it, the artery can no longer be felt. In old age, however, and in some degenerative diseases, the vessel wall becomes so thick that it may be felt like a piece of whipcord rolling beneath the ?nger.
Di?erent types of heart disease have special features of the pulse associated with them. In atrial FIBRILLATION the great character is irregularity. In patients with an incompetent AORTIC VALVE the pulse is characterised by a sharp rise and sudden collapse. (See HEART, DISEASES OF.)
An instrument known as the SPHYGMOGRAPH registers the arterial waves and a polygraph (an instrument that obtains simultaneous tracings from several di?erent sources such as radial and jugular pulse, apex beat of the heart and ELECTROCARDIOGRAM (ECG)) enables tracings to be taken from the pulse at the wrist and from the veins in the neck and simultaneous events in the two compared.
The pressure of the blood in various arteries is estimated by a SPHYGMOMANOMETER. (See BLOOD PRESSURE.)... pulse
Chronic pyelonephritis may start in childhood, and the usual cause is back ?ow of urine from the bladder into one of the ureters – perhaps because of a congenital deformity of the valve where the ureter drains into the bladder. Constant urine re?ux results in recurrent infection of the kidney and damage to its tissue. Full investigation of the urinary tract is essential and, if an abnormality is detected, surgery may well be required to remedy it. HYPERTENSION and renal failure may be serious complications of pyelonephritis (see also KIDNEYS, DISEASES OF).... pyelonephritis
A related condition, congenital hypertrophic pyloric stenosis, occurs in babies (commonly boys) about 3–5 weeks old, and surgery produces a complete cure.... pyloric stenosis
common pain pathways in the CENTRAL NERVOUS SYSTEM. (See also PAIN.)... referred pain
Aetiology. Injury, virus infection, cold, stroke. Recovery usually spontaneous. Herpes Simp. Alternatives. Chamomile, Wood Betony, Bryonia, Black Cohosh, Barberry, Asafoetida, Lobelia, Rosemary, Valerian, Sage. Echinacea has been used with convincing results internally and externally.
Tea. Equal parts. Chamomile, Wood Betony. Sage. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup 3 times daily.
Decoctions. Black Cohosh, Rosemary, Valerian, Echinacea.
Tablets/capsules. Black Cohosh. Ginseng. Echinacea. Valerian.
Powders. Formula. Rosemary 1; Echinacea 2; Valerian 1. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Tinctures. Formula. Echinacea 2; Rosemary 1; Black Cohosh 1; Pinch Tincture Capsicum. 1-2 teaspoons 3 times daily.
Evening Primrose oil. 4 × 500mg capsules daily.
Aromatherapy. 10 drops Oil Juniper to eggcup Almond oil; gentle massage affected side of face. Diet. Lacto-vegetarian.
Vitamin E. (400iu daily). ... bell’s palsy
Disorders are (1) hypoparathyroidism and (2) hyperparathyroidism. See entries. ... parathyroid glands
Symptoms: Severe itching. Thickened skin with shiny red patches which later become brown and scaly. Distinguish from psoriasis. Nails ridged and split.
Alternatives. Relief from itching by use of antihistamines: Garlic, Goldenseal, Ephedra, Lobelia.
Teas. Nettles, Boneset, Chickweed, Heartsease, Yucca.
Decoctions. (1) Combine: equal parts: Burdock, Sarsaparilla, Passion flower. OR (2) Combine: equal parts: Echinacea, Blue Flag root, Sarsaparilla. Half an ounce (14g) to 1 pint (500ml) water gently simmered 20 minutes. Dose: half-1 cup thrice daily.
Cold infusion. One heaped teaspoon Barberry (Berberis Vul) to cup cold water. Steep overnight. Half-1 cup thrice daily.
Powders, Liquid Extracts or Tinctures. Equal parts: Wild Yam, Blue Flag root, Fringe Tree bark. Powders: 500mg. Liquid Extracts: 30-60 drops in water. Tinctures: 1-2 teaspoons in water. Thrice daily before meals.
Mouth ulcers: Rinse mouth with Goldenseal and Myrrh drops, in water.
Topical. Ointment or pulp from any one: Aloe Vera, Comfrey, Chickweed, Houseleek, Marshmallow. Vaginal lesion. Aloe Vera pulp or gel.
Diet. Avoid citrus fruits and milk.
Vitamins. A. B-complex, B12, C. E. F. PABA.
Minerals. Dolomite. Zinc. Cod Liver oil: one dessertspoon daily. ... lichen planus
Some authorities believe cause is vitamin and mineral deficiency – those which promote bone health being calcium and magnesium (dolomite). Supplementation helps cases but evidence confirms that some pet-owners are at risk – a virus from cats and dogs possibly responsible. The prime candidate is one exposed to canine distemper. Dogs are involved twice as much as cats. The virus is closely related to the measles virus in humans.
Symptoms. Limbs deformed, hot during inflammatory stage. Headaches. Dull aching pain in bones. Deafness from temporal bone involvement. Loss of bone rigidity. Bowing of legs.
Surgical procedures may be necessary. Appears to be a case for immunisation of dogs against distemper.
Alternatives. Black Cohosh, Boneset, Cramp bark, Bladderwrack, German Chamomile, Devil’s Claw, Helonias, Oat husks, Prickly Ash, Sage, Wild Yam.
Tea. Oats (mineral nutrient for wasting diseases) 2; Boneset (anti-inflammatory) 1; Valerian (mild analgesic) 1; Liquorice quarter. Mix. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup thrice daily.
Decoction. Cramp bark 1; White Willow 2. Mix. 4 heaped teaspoons to 1 pint (500ml) water gently simmered 20 minutes. Dose: half-1 cup thrice daily.
Tablets/capsules. Cramp bark, Devil’s Claw, Echinacea, Helonias, Prickly Ash, Wild Yam.
Formula. Devil’s Claw 1; Black Cohosh 1; Valerian 1; Liquorice quarter. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Action enhanced when taken in cup of Fenugreek tea. Thrice daily. Every 2 hours acute cases.
Practitioner’s analgesic. Tincture Gelsemium: 10 drops in 100ml water. Dose: 1 teaspoon every 2 hours (inflammatory stage).
Topical. Comfrey root poultice.
Diet. High protein, low salt, low fat. Oily fish.
Supplements. Daily. Vitamin C (500mg); Vitamin D (1000mg); Calcium citrate (1 gram); Dolomite (1 gram); Beta-Carotene (7500iu). Kelp. ... paget’s disease
Treatment Oral steroids, if started early, increase the rate of recovery, which occurs in over 90 per cent of patients, usually starting after two or three weeks and complete within three months. Permanent loss of function with facial contractures occurs in about 5 per cent of patients. Recurrence of Bell’s palsy is unusual.... bell’s palsy
Habitat: Throughout India.English: Bryony.Ayurvedic: Lingini, Shivalingi, Chitraphalaa.Siddha/Tamil: Iyaveli, Iyaviraali.Folk: Lingadonda (Telugu).
Action: Seeds—anti-inflammatory, spasmolytic. Used for vaginal dysfunctions, as a fertility promoting drug. Powdered seeds, also roots, are given to help conception in women. Plant is also used in venereal diseases.... bryophyllum pinnatum
A tin-like metal, cadmium accumulates in the body. Long-term exposure can lead to EMPHYSEMA, renal failure (see KIDNEYS, DISEASES OF) and urinary-tract CALCULI. Acute exposure causes GASTROENTERITIS and PNEUMONITIS. Cadmium contamination of food is the most likely source of poisoning. The EU Directive on the Quality of Water for Human Consumption lays down 5 milligrams per litre as the upper safe level.... cadmium poisoning
Severe poisoning from ingestion of fungi is very rare, since relatively few species are highly toxic and most species do not contain toxic compounds. The most toxic species are those containing amatoxins such as death cap (Amanita phalloides); this species alone is responsible for about 90 per cent of all mushroom-related deaths. There is a latent period of six hours or more between ingestion and the onset of clinical effects with these more toxic species. The small intestine, LIVER and KIDNEYS may be damaged – therefore, any patient with gastrointestinal effects thought to be due to ingestion of a mushroom should be referred immediately to hospital where GASTRIC LAVAGE and treatment with activated charcoal can be carried out, along with parenteral ?uids and haemodialysis if the victim is severely ill. In most cases where effects occur, these are early-onset gastrointestinal effects due to ingestion of mushrooms containing gastrointestinal irritants.
Muscarine is the poisonous constituent of some species. Within two hours of ingestion, the victim starts salivating and sweating, has visual disturbances, vomiting, stomach cramps, diarrhoea, vertigo, confusion, hallucinations and coma, the severity of symptoms depending on the amount eaten and type of mushroom. Most people recover in 24 hours, with treatment.
‘Magic’ mushrooms are a variety that contains psilocybin, a hallucinogenic substance. Children who take such mushrooms may develop a high fever and need medical care. In adults the symptoms usually disappear within six hours.
Treatment If possible, early gastric lavage should be carried out in all cases of suspected poisoning. Identi?cation of the mushroom species is a valuable guide to treatment. For muscarine poisoning, ATROPINE is a speci?c antidote. As stated above, hospital referral is advisable for people who have ingested poisonous fungi.... fungus poisoning
In England and Wales, the age of consent for heterosexual and homosexual sex is 16 years; in Northern Ireland, 17 years; and in Scotland the age of consent for heterosexual sex is 12 for a girl and 14 for a boy. However, girls are protected by Section 5 of the Criminal Law (Consolidation) Act 1995 which makes it an o?ence to have sexual intercourse with a girl aged under
16. For girls under 13, the maximum sentence is life-imprisonment, and between 13 and 16, two years’ imprisonment. Homosexual consent in Scotland is 16.
Paedophiles suffer from personality problems rather than overt psychoses (see PSYCHOSIS) and the origins of their behaviour may lie in their own early sexual experiences. Their behaviour often has features of an addiction.
It is of note that most underaged sex is between family members such as stepfather and daughter rather than with a stranger or predatory paedophile.
(See CHILD ABUSE.)... paedophilia
Pansey, Pansi, Pansie, Pansee, Panzi, Panzy, Panzie, Panzee, Pansea, Panzea... pansy
Caution is needed when treating patients with bronchopulmonary disease or liver impairment; and intramuscular injection near the sciatic nerve should be avoided, as it may cause severe CAUSALGIA. Adverse effects include rashes; pain and sterile ABSCESS after intramuscular injection; rectal irritation after ENEMA.... paraldehyde
A pedicle is also found occurring between a tumour and its tissue of origin, and the term is used in anatomy to refer to any slim tubular process.... pedicle
Peniah, Penea, Peniya, Peneah, Peniyah... penia
Penicillin is a beta-lactam antibiotic, one of a group of drugs that also includes CEPHALOSPORINS. Drugs of this group have a four-part beta-lactam ring in their molecular structure and they act by interfering with the cell-wall growth of mutliplying bacteria.
Among the organisms to which it has been, and often still is, active are: streptococcus, pneumococcus, meningococcus, gonococcus, and the organisms responsible for syphilis and for gas gangrene (for more information on these organisms and the diseases they cause, refer to the separate dictionary entries). Most bacteria of the genus staphylococcus are now resistant because they produce an enzyme called PENICILLINASE that destroys the antibiotic. A particular problem has been the evolution of strains resistant to methicillin – a derivative originally designed to conquer the resistance problem. These bacteria, known as METHICILLINRESISTANT STAPHYLOCOCCUS AUREUS (MRSA), are an increasing problem, especially after major surgery. Some are also resistant to other antibiotics such as vancomycin.
An important side-e?ect of penicillins is hypersensitivity which causes rashes and sometimes ANAPHYLAXIS, which can be fatal.
Forms of penicillin These include the following broad groups: benzylpenicillin and phenoxymethyl-penicillin; penicillinase-resistant penicillins; broad-spectrum penicillins; antipseudomonal penicillins; and mecillinams. BENZYLPENICILLIN is given intramuscularly, and is the form that is used when a rapid action is required. PHENOXYMETHYLPENICILLIN (also called penicillin V) is given by mouth and used in treating such disorders as TONSILLITIS. AMPICILLIN, a broad-spectrum antibiotic, is another of the penicillins derived by semi-synthesis from the penicillin nucleus. It, too, is active when taken by mouth, but its special feature is that it is active against gram-negative (see GRAM’S STAIN) micro-organisms such as E. coli and the salmonellae. It has been superceded by amoxicillin to the extent that prescriptions for ampicillin written by GPs in the UK to be dispensed to children have fallen by 95 per cent in the last ten years. CARBENICILLIN, a semi-synthetic penicillin, this must be given by injection, which may be painful. Its main use is in dealing with infections due to Pseudomonas pyocanea. It is the only penicillin active against this micro-organism which can be better dealt with by certain non-penicillin antibiotics. PIPERACILLIN AND TICARCILLIN are carboxypenicillins used to treat infections caused by Pseudomonas aeruginosa and Proteus spp. FLUCLOXACILLIN, also a semi-synthetic penicillin, is active against penicillin-resistant staphylococci and has the practical advantage of being active when taken by mouth. TEMOCILLIN is another penicillinase-resistant penicillin, e?ective against most gram-negative bacteria. AMOXICILLIN is an oral semi-synthetic penicillin with the same range of action as ampicillin but less likely to cause side-effects. MECILLINAM is of value in the treatment of infections with salmonellae (see FOOD POISONING), including typhoid fever, and with E. coli (see ESCHERICHIA). It is given by injection. There is a derivative, pivmecillinam, which can be taken by mouth. TICARCILLIN is a carboxypenicillin used mainly for serious infections caused by Pseudomonas aeruginosa, though it is also active against some gram-negative bacilli. Ticarcillin is available only in combination with clarulanic acid.... penicillin
Habitat: Damp places by water courses. Largely cultivated, especially in the U.S.A., for its oil, which is probably the most used of all the volatile oils. Features ? Stem quadrangular, purplish, reaching three or four feet high. Leaves stalked, serrate, very slightly hairy, about two and a half inches by one inch.Characteristic taste and smell. Part used ? Herb.
Action: Carminative, stomachic, stimulant.In flatulence, colic and nausea. Usually combined with other remedies when a complete stomachic is needed. Particularly suitable for children. Dose, wineglassful of ounce to pint infusion.... peppermint
Uses Phenothiazines should be prescribed and used with care. The drugs di?er in predominant actions and side-effects; selection depends on the extent of sedation required and the susceptibility of the patient to extrapyramidal side-effects. The di?erences between the drugs, however, are less important than the variabilities in patients’ responses. Patients should not be prescribed more than one antipsychotic drug at a time. In the short term these therapeutically powerful drugs can be used to calm disturbed patients, whatever the underlying condition (which might have a physical or psychiatric basis). They also alleviate acute anxiety and some have antidepressant properties, while others worsen DEPRESSION (see also MENTAL ILLNESS).... phenothiazines
Action Physostigmine produces the same e?ect as stimulation of the PARASYMPATHETIC NERVOUS SYSTEM: i.e. it constricts the pupil of the eye, stimulates the gut, increases the secretion of saliva, stimulates the bladder, and increases the irritability of voluntary muscle. In poisonous doses it brings on a general paralysis.
Uses It is used in medicine in the form of eye drops or ointment to treat GLAUCOMA.... physostigmine
Pityriasis alba is a mild form of chronic eczema (see DERMATITIS) occurring mainly in children on the face and in young adults on the upper arms. It is characterised by round or oval ?aky patches which are paler than the surrounding skin due to partial loss of MELANIN pigment. The appearance is more dramatic in dark-skinned or suntanned subjects. Moisturising cream often su?ces, but 1 per cent HYDROCORTISONE cream is more e?ective.
Pityriasis rosea is a common self-limiting eruption seen mainly in young adults. It usually begins as a solitary red ?aky patch (often misdiagnosed as ringworm). Within a week this ‘herald patch’ is followed by a profuse symmetrical eruption of smaller rose-pink, ?aky, oval lesions on the trunk and neck but largely sparing the limbs and face. Itching is variable. The eruption usually peaks within 3 weeks and fades away leaving collarettes of scale, disappearing within 6–7 weeks. It rarely recurs and a viral cause is suspected but not proved. It is not contagious and there is no speci?c treatment, but crotamiton cream (Eurax) may relieve discomfort.... pityriasis
The condition is caused by an imbalance between LUTEINISING HORMONE (LH) and FOLLICLE-STIMULATING HORMONE (FSH); this imbalance stops OVULATION and varies the TESTOSTERONE output of the ovaries. The treatment may be with CLOMIPHENE; with a PROGESTOGEN drug; with LUTEINISING HORMONE-RELEASING HORMONE (LHRH); or with oral contraceptives (see under CONTRACEPTION – Non-barrier methods). The treatment chosen depends on the severity of the disease and whether the woman wants to conceive. Rarely a section of ovarian tissue is surgically removed.... polycystic ovary syndrome
Their removal is generally easy, as they are simply twisted o?, or cut o?, by some form of snare or ligature. (The tissue removed should be checked for malignant cells.) Those which are situated in the interior of the bladder or bowels, and whose presence is usually recognised because blood appears in the urine or stools, require a more serious operation – usually an endoscopic examination (see ENDOSCOPE).... polypus
Ben: Dalim;Tam: Madalai, Madalam;Mal: Urumampazham, Matalam, Talimatala m, Matalanarakam; Kan :Dalimbe;Tel: Dadima; Mar: Dalimba;Guj: Dadam; Ass: DalinImportance: Pomegranate has long been esteemed as food and medicine and as a diet in convalescence after diarrhoea. The rind of the fruit is highly effective in chronic diarrhoea and dysentery, dyspepsia, colitis, piles and uterine disorders. The powdered drug boiled with buttermilk is an efficacious reme dy for infantile diarrohoea. The root and stem bark are good for tapeworm and for strengthening the gums. The flowers are useful in vomiting, vitiated conditions of pitta, ophthalmodynia, ulcers, pharyngodynia and hydrocele. An extract of the flowers is very specific for epistaxis. The fruits are useful in anaemia, hyperdipsia, pharyngodynia, ophthalmodynia, pectoral diseases, splenopathy, bronchitis and otalgia. The fruit rind is good for dysentery, diarrhoea and gastralgia. Seeds are good for scabies, hepatopathy and splenopathy. The important preparations using the drug are Dadimadighrtam, Dadimastaka churnam, Hinguvacadi churnam, Hingvadi gulika, etc (Sivarajan et al, 1994, Warrier et al, 1995).Distribution: Pomegranate is a native of Iran, Afghanistan and Baluchistan. It is found growing wild in the warm valleys and outer hills of the Himalaya between 900m and 1800m altitude. It is cultivated throughout India, the largest area being in Maharastra.Botany: Punica granatum Linn. belongs to the family Punicaceace. It is a large deciduous shrub up to 10m in height with smooth dark grey bark and often spinescent branchlets. Leaves are opposite, glabrous, minutely pellucid-punctuate, shining above and bright green beneath. Flowers are scarlet red or sometime yellow, mostly solitary, sometimes 2-4 held together. Stamens are numerous and inserted on the calyx below the petals at various levels. Fruits are globose, crowned by the persistent calyx. Rind is coriaceous and woody, interior septate with membraneous walls containing numerous seeds. Seeds are angular with red, pink or whitish, fleshy testa (Warrier et al, 1995).Agrotechnology: Pomegranate is of deciduous nature in areas where winters are cold, but on the plains it is evergreen. A hot dry summer aids in the production of best fruits. Plants are grown from seeds as well as cuttings. Mature wood pieces cut into lengths of about 30cm are planted for rooting. The rooted plants are planted 4.5-6m apart. When planted close, they form a hedge which also yields fruits. Normal cultivation and irrigation practices are satisfactory for the pomegranate. An application of 30-45kg of FYM annually to each tree helps to produce superior quality fruits. The pomegranate may be trained as a tree with a single stem for 30-45cm or as a bush with 3 or 4 main stems. In either case suckers arising from the roots and similar growths from the trunk and main branches are removed once a year. Shortening of long slender branches and occasional thinning of branches should be done. The fruit has a tough rind and hence transportation loss is minimum (ICAR, 1966).Properties and activity: Pomegranate fruit rind gives an ellagitannin named granatin B, punicalagin, punicalin and ellagic acid. Bark contains the alkaloids such as iso-pelletierine, pseudopelletierine, methyl isopelletierine, methyl pelletierine, pelletierine as well as iso-quercetin, friedelin, D- mannitol and estrone. Flowers give pelargonidin-3, 5-diglucoside apart from sitosterol, ursolic acid, maslinic acid, asiatic acid, sitosterol- -D-glucoside and gallic acid. Seeds give malvidin pentose glycoside. Rind gives pentose glycosides of malvidin and pentunidin. Fluoride, calcium, magnesium, vitamin C and phosphate are also reported from fruits. Leaves give elligatannins-granatins A and B and punicafolin.Rind of fruit is astringent, fruit is laxative. Bark of stem and root is anthelmintic, and febrifuge. Rind of fruit and bark of stem and root is antidiarrhoeal. Pericarp possesses antifertility effect. Fixed oil from seeds are antibacterial. Bark, fruit pulp, flower and leaf are antifungal. Aerial part is CNS depressant, diuretic and hypothermic. The flower buds of pomegranate in combination with other plants showed excellent response to the patients of Giardiasis (Mayer et al, 1977; Singhal et al, 1983).... pomegranate
The organs from which the portal vein collects the blood are the large and small intestines, the stomach, spleen, pancreas, and gall-bladder.... portal vein
The haemagglutination inhibition test This, and the subsequent tests to be mentioned, are known as immunological tests. They are based upon the e?ect of the urine from a pregnant woman upon the interaction of red blood cells, which have been sensitised to human gonadotrophin, and anti-gonadotrophin serum. They have the great practical advantage of being performed in a test-tube or even on a slide. Because of their ease and speed of performance, a result can be obtained in two hours.
Enzyme-linked immunosorbent assay (ELISA) This is the basis of many of the pregnancy-testing kits obtainable from pharmacies. It is a highly sensitive antibody test and can detect very low concentrations of human chorionic gonadotrophin. Positive results show up as early as ten days after fertilisation – namely, four days before the ?rst missed period.
Ultrasound The fetal sac can be detected by ULTRASOUND from ?ve weeks, and a fetal echo at around six or seven weeks (see also PRENATAL SCREENING OR DIAGNOSIS).... pregnancy tests
The term is also used for the symptoms or signs with which a patient ?rst brings to a doctor.... presentation
Habitat: Flourishes in moist places throughout the United States, from which country the medicinal berries and bark are imported.Features ? A shrub varying between ten and fifteen feet in height with alternate branches covered with strong, sharp prickles, the leaves are pinnate, with lanceolate leaflets, the flowers green and white. Small, blue-black berries enclosed in a grey shell grow in clusters on the top of the branches. The bark is about one- twelfth of an inch thick, and has corky, conical spines nearly one inch in height. Fractures show green in the outer part and yellow in the inner. The taste is very pungent, causing salivation, and there is little odour.Part used ? Berries and bark, the berries being considered the more effective.
Action: Stimulant, alterative, nervine and diaphoretic.An infusion of the berries, or the crushed or powdered bark, is made in the proportion of 1/2 ounce to 1 pint of boiling water, the dose being one tablespoonful four times daily. The infusion should be allowed to stand in a covered vessel for two hours before use.In the treatment of chronic rheumatic trouble this medicine is given a prominent place, and it is also widely used wherever a general stimulant is needed. The powdered bark is applied directly to indolent ulcers. As an external application for rheumatism. Coffin recommends 1 ounce of the pulverised bark to 4 ounces of Olive oil, heated, the part to be well rubbed with this liniment night and morning.... prickly ash
Prymrose, Primula, Primulia, Primrosa, Prymrosa... primrose
– for example, LACTOBACILLUS or bi?dobacterium. Not all probiotics have the same properties or e?ectiveness. To be e?ective, a probiotic must survive passage through the stomach – an acid environment – and successfully colonise in the intestines, even when antibiotics are present. Research suggests that probiotics ameliorate the symptoms of childhood and travellers’ DIARRHOEA, reducing the period of acute symptoms – particularly if the infection is caused by one of the ROTAVIRUSES.... probiotics
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
Fever, an o?ensive-smelling post-partum vaginal discharge (lochia) and pain in the lower abdomen are the main features. Untreated, the women may develop SALPINGITIS, PERITONITIS and septicaemia. Antibiotics are used to treat the infection and any retained placental tissue must be removed.... puerperal sepsis
Static lung volumes and capacities can be measured: these include vital capacity – the maximum volume of air that can be exhaled slowly and completely after a maximum deep breath; forced vital capacity is a similar manoeuvre using maximal forceful exhalation and can be measured along with expiratory ?ow rates using simple spirometry; total lung capacity is the total volume of air in the chest after a deep breath in; functional residual capacity is the volume of air in the lungs at the end of a normal expiration, with all respiratory muscles relaxed.
Dynamic lung volumes and ?ow rates re?ect the state of the airways. The forced expiratory volume (FEV) is the amount of air forcefully exhaled during the ?rst second after a full breath – it normally accounts for over 75 per cent of the vital capacity. Maximal voluntary ventilation is calculated by asking the patient to breathe as deeply and quickly as possible for 12 seconds; this test can be used to check the internal consistency of other tests and the extent of co-operation by the patient, important when assessing possible neuromuscular weakness affecting respiration. There are several other more sophisticated tests which may not be necessary when assessing most patients. Measurement of arterial blood gases is also an important part of any assessment of lung function.... pulmonary function tests
Maria Treben’s Facial Pack: of any of the following – Thyme, Mullein, Chamomile or Yarrow. Fill small muslin bag and steep in boiling water. Ring out. Apply as hot as possible.
Internal: Chamomile tea. ... facial pain
Treatment. See entries for specific disorders. Teas, powders, tinctures, liquid extracts, or essential oils – see entry of appropriate remedy.
The following are brief indications for action in the absence of a qualified practitioner. Flatulence (gas in the intestine or colon), (Peppermint). Upper right pain due to duodenal ulcer, (Goldenseal). Inflamed pancreas (Dandelion). Gall bladder, (Black root). Liver disorders (Fringe Tree bark). Lower left – diverticulitis, colitis, (Fenugreek seeds). Female organs, (Agnus Castus). Kidney disorders, (Buchu). Bladder, (Parsley Piert). Hiatus hernia (Papaya, Goldenseal). Peptic ulcer, (Irish Moss). Bilious attack (Wild Yam). Gastro-enteritis, (Meadowsweet). Constipation (Senna). Acute appendicitis, pain central, before settling in low right abdomen (Lobelia). Vomiting of blood, (American Cranesbill). Enlargement of abdominal glands is often associated with tonsillitis or glandular disease elsewhere which responds well to Poke root. As a blanket treatment for abdominal pains in general, old-time physicians used Turkey Rhubarb (with, or without Cardamom seed) to prevent griping.
Diet: No food until inflammation disperses. Slippery Elm drinks. ... abdominal pain
People who have an antisocial personality lack a sense of guilt and cannot tolerate frustration.
They may have problems with relationships and are frequently in trouble with the law.
Behaviour therapy, and various forms of psychotherapy, may help to improve integration.
In general, the effects of this disorder decrease with age.... antisocial personality disorder
Mercury has an affinity for the central nervous system. Soon it concentrates in the kidney causing tubular damage. A common cause is the mercurial content (50 per cent) in the amalgam fillings in teeth which, under certain conditions, release a vapour. Fortunately, its use in dentistry is being superceded by an alternative composite filling.
A common cause of poisoning was demonstrated in 1972 when 6,000 people became seriously ill (600 died) from eating bread made from grain treated with a fungicide containing methylmercury. For every fungus in grain there is a mercuric compound to destroy it. The seed of all cereal grain is thus treated to protect its power of germination.
Those who are hypersensitive to the metal should as far as possible avoid button cells used in tape recorders, cassette players, watch and camera mechanisms. As the mercury cells corrode, the metal enters the environment and an unknown fraction is converted by micro organisms to alkylmercury compounds which seep into ground waters and eventually are borne to the sea. When cells are incinerated, the mercury volatilises and enters the atmosphere. (Pharmaceutical Journal, July 28/1984)
Mercury poisoning from inhalation of mercury fumes goes directly to the brain and pituitary gland. Autopsies carried out on dentists reveal high concentrations of mercury in the pituitary gland. (The Lancet, 5-27-89,1207 (letter))
Treatment. For years the common antidote was sulphur, and maybe not without reason. When brought into contact sulphur and mercury form an insoluble compound enabling the mercury to be more easily eliminated from the body. Sulphur can be provided by eggs or Garlic.
Old-time backwoods physicians of the North American Medical School used Asafoetida, Guaiacum and Echinacea. German pharmacists once used Bugleweed and Yellow Dock. Dr J. Clarke, USA physician recommends Sarsaparilla to facilitate breakdown and expulsion from the body.
Reconstructed formula. Echinacea 2; Sarsaparilla 1; Guaiacum quarter; Asafoetida quarter; Liquorice quarter. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Formula. Tinctures. Skullcap 2-15 drops; Pleurisy root 20-45 drops; Horehound 5-40 drops. Mercurial salivation. Thrice daily. (Indian Herbology of North America, by Alma Hutchens) Dental fillings: replace amalgam with safe alternative – ceramic, etc. Evidence of a link between tooth fillings containing mercury and ME has caused the use of dental amalgam to be banned in Sweden. ... mercury poisoning
OENOTHERA BIENNIS, commonly known as the evening primrose. The oil contains an anti-inflammatory substance called gamolenic acid, and is believed by some to be of benefit in treating eczema and premenstrual syndrome.... evening primrose oil
There are over 50 strains of human papillomavirus.
Infection with some of these strains is thought to be a causative factor in cervical cancer and anal cancer.... human papillomavirus
adolescents and obese people. It is not serious and usually clears up on its own. In severe cases, applying a mixture of salicylic acid and soft paraffin and scrubbing with a loofah may help.... keratosis pilaris
Klumpke’s paralysis is caused by injury to the 1st thoracic nerve (one of the spinal nerves) in the brachial plexus, which is usually the result of dislocation of the shoulder.... klumpke’s paralysis
Once used for lithotomy, the position is still used for pelvic examinations and some types of pelvic surgery.... lithotomy position
In severe injuries, there may be damage to both the upper and the lower nerve roots of the brachial plexus, producing complete paralysis of the arm.
Paralysis may be temporary if the stretching was not severe enough to tear nerve fibres.
Nerve roots that have been torn can be repaired by nerve grafting, a microsurgery procedure.
If a nerve root has become separated from the spinal cord, surgical repair will not be successful.
Apart from injuries, the brachial plexus may be compressed by the presence of a cervical rib (extra rib).... brachial plexus
Pancreatectomy may be performed to treat pancreatitis or localized cancer of the pancreas (see pancreas, cancer of).
Rarely, it is performed to treat insulinomas.
Pancreatectomy may lead to diabetes mellitus and malabsorption.... pancreatectomy
Temperament, intelligence, emotion, and motivation are important aspects.
The development of personality seems to depend on the interaction of heredity and environment.... personality
The thumb and big toe have 2 phalanges; all the other fingers and toes have 3.... phalanges
The term is also used in relation to the manufacture and sale of drugs.... pharmaceutical
Side effects include nausea, dizziness, tremor, and overgrown and tender gums.... phenytoin
PUVA combines the use of long-wave ultraviolet light with a psoralen drug, which sensitizes the skin to light. This is used to treat psoriasis and other skin diseases such as vitiligo. Psoriasis may also be treated using short-wave ultraviolet light, sometimes combined with the application of coal tar.
Visible blue light is used to treat neonatal jaundice (see jaundice, neonatal), which is due to high levels of the pigment bilirubin in the blood. In phototherapy, bilirubin is converted into a harmless substance that can be excreted. To maximize exposure, the baby is undressed and placed under the lights in an incubator to keep him warm.phrenic nerve One of the pair of main nerves supplying the diaphragm. Each phrenic nerve carries motor impulses to the diaphragm, and plays a part in controlling breathing. Injury to, or surgical cutting of, 1 of the nerves results in paralysis of 1 half of the diaphragm.... phototherapy
They are common in elderly people, and may be removed for cosmetic reasons.... pinguecula
Pioglitazone acts by reducing peripheral insulin resistance.
Side effects may include gastrointestinal disturbances, weight gain, and anaemia.... pioglitazone
There are many abnormalities of pigmentation.
Patches of pale skin occur in psoriasis, pityriasis alba, pityriasis versicolor, and vitiligo.
Albinism is caused by generalized melanin deficiency.
Phenylketonuria results in a reduced melanin level, making sufferers pale-skinned and fair-haired.
Areas of dark skin may be caused by disorders such as eczema or psoriasis, pityriasis versicolor, chloasma, or by some perfumes and cosmetics containing chemicals that cause photosensitivity.
Permanent areas of deep pigmentation, such as freckles and moles (see naevus), are usually due to an abnormality of melanocytes.
Acanthosis nigricans is characterized by dark patches of velvet-like, thickened skin.
Blood pigments may lead to abnormal colouring.
Excess of the bile pigment bilirubin in jaundice turns the skin yellow, and haemochromatosis turns the skin bronze.... pigmentation
Symptoms usually occur suddenly and depend on how much of the placenta has separated from the wall of the uterus. They include slight to heavy vaginal bleeding, which can be severe haemorrhaging in complete separation; cramps in the abdomen or backache; severe, constant abdominal pain; and reduced fetal movements. If the bleeding does not stop, or if it starts again, it may be necessary to induce labour (see
A small placental abruption is usu-tal. In more severe
ergency caesarean section is often necessary to save the the life of the fetus. A blood transfusion required.
placenta praevia Implantation of the placenta in the lower part of the uterus, near or over the cervix. Placenta praevia occurs in about 1 in 200 pregnancies. It varies in severity from marginal placenta praevia, when the placenta reaches the edge of the cervical opening, to complete placental praevia, when the entire opening of the cervix is covered. Mild placenta praevia may have no adverse effect. More severe cases often cause painless vaginal bleeding in late pregnancy. If the bleeding is slight and the pregnancy still has several weeks to run, bed rest in hospital may be all that is necessary. The baby will probably be delivered by caesarean section at the 38th week. If the bleeding is heavy or if the pregnancy is near term, an immediate delivery is carried out. placenta, tumours of See choriocarcinoma; hydatidiform mole.... placental abruption
The condition is usually evident from a physical examination, but ultrasound scanning may be needed.
In mild cases, only rest is needed.
In more severe cases, amniotic fluid may be withdrawn using a needle.
In late pregnancy, induction of labour may be performed.... polyhydramnios
There are 6 types of porphyria. Acute intermittent porphyria usually appears in early adulthood, causing abdominal pain, and often limb cramps, muscle weakness, and psychiatric disturbances. The patient’s urine turns red when left to stand. Barbiturate drugs, phenytoin, oral contraceptives, and tetracyclines precipitate attacks.
Variegate porphyria has similar effects but also causes blistering of sun-exposed
Protoporphyria usually causes skin symptoms after exposure to sunlight, as does porphyria cutanea tarda. In this type, wounds are slow to heal, and urine is sometimes pink or brown. Many cases are precipitated by liver disease.
The rarest and most serious form, congenital erythropoietic porphyria, causes red discoloration of urine and the teeth, excessive hair growth, severe skin blistering and ulceration, and haemolytic anaemia. Death may occur in childhood. Diagnosis is made from abnormal levels of porphyrins in the urine and faeces. Treatment is difficult. Avoiding sunlight and/or precipitating drugs is the most important measure. Acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria may be helped by administration of glucose or haematin. Cases of porphyria cutanea tarda may be helped by venesection.... porphyria
Most mothers first get the “blues” 4–5 days after childbirth and may feel miserable, irritable, and tearful. The cause is hormonal changes, perhaps coupled with a sense of anticlimax or an overwhelming sense of responsibility for the baby. With reassurance and support, the depression usually passes in 2–3 days. In about 10–15 per cent of women, the depression lasts for weeks and causes a constant feeling of tiredness, difficulty in sleeping, loss of appetite, and restlessness. The condition usually clears up of its own accord or is treated with antidepressant drugs.
Depressive psychosis usually starts 2–3 weeks after childbirth, causing severe mental confusion, feelings of worthlessness, threats of suicide or harm to the baby, and sometimes delusions.
Hospital admission, ideally with the baby, and antidepressant drugs are often needed.... postnatal depression
Common causes include natural disasters, violence, rape, torture, serious physical injury, and military combat.
Symptoms, which may develop many months after the event, include recurring memories or dreams of the event, a sense of personal isolation, and disturbed sleep and concentration.
There may be a deadening of feelings, or irritability and feelings of guilt, sometimes building up to depression.
Most people recover, in time, with emotional support and counselling.... post-traumatic stress disorder
Prazosin is also used to treat urinary symptoms resulting from an enlarged prostate gland (see prostate, enlarged).
Side effects include dizziness and fainting, nausea, headache, and dry mouth.... prazosin
There are 3 types of such conditions.
In the 1st, there are no tumours present but the condition carries an increased risk of cancer.
In the 2nd, there are noncancerous tumours that tend to become cancerous or are associated with the development of cancerous tumours elsewhere.
The 3rd type comprises disorders which have irregular features from the beginning but do not always become fully cancerous.... precancerous
The hormones may cause a premature growth spurt followed by early fusion of the bones. As a result, affected children may initially be tall but, if untreated, final height is often greatly reduced.
The child’s pattern of pubertal development is assessed by a doctor. Blood tests are performed to measure hormone levels. Ultrasound scanning of the ovaries and testes, and CT scanning of the adrenal glands or brain, may also be carried out, depending on the underlying cause suspected.
Treatment is of the underlying cause, and hormone drugs may be given to delay puberty and increase final height.... precocious puberty
A normal pregnancy lasts around 40 weeks from the first day of the woman’s last menstrual period. It is divided into 3 stages (trimesters) of 3 months each. For the first 8 weeks of pregnancy, the developing baby is called an embryo; thereafter it is called a fetus.
In the 1st trimester the breasts start to swell and may become tender. Morning sickness is common. The baby’s major organs have developed by the end of this stage. During the 2nd trimester, the mother’s nipples enlarge and darken and weight rises rapidly. The baby is usually felt moving by 22 weeks. During the 3rd trimester, stretch marks and colostrum may appear, and Braxton Hick’s contractions may be felt. The baby’s head engages at about 36 weeks.
Common, minor health problems during pregnancy include constipation, haemorrhoids, heartburn, pica, swollen ankles, and varicose veins. Other common disorders include urinary tract infections, stress incontinence (see incontinence, urinary), and candidiasis.Complications of pregnancy and disorders that affect it include antepartum haemorrhage; diabetic pregnancy; miscarriage; polyhydramnios; pre-eclampsia; prematurity; and Rhesus incompatibility. (See also childbirth; fetal heart monitoring; pregnancy, multiple.)... pregnancy
It consists of the encouragement of good oral hygiene, fluoride treatment, and scaling.... preventive dentistry
It is also used as an antiemetic drug, and sometimes as a premedication.
Possible adverse effects include dry mouth, blurred vision, and drowsiness.... promethazine
Possible adverse effects include dry mouth, blurred vision, and retention of urine.... propantheline
It may also be used to reduce the risk of further heart damage after myocardial infarction.
It relieves symptoms of hyperthyroidism and anxiety, and can prevent migraine attacks.
Possible adverse effects are typical of other beta-blocker drugs.... propranolol
The term also describes a rare childhood condition in which congenital abnormality of the lower half of the tibia leads to spontaneous fracture.... pseudarthrosis
The underlying cause is unknown; in rare cases, it is a complication of diabetes mellitus, hyperparathyroidism, and haemochromatosis.
Symptoms are similar to gout.
Diagnosis is from a sample of joint fluid.
Treatment is with nonsteroidal anti-inflammatory drugs (NSAIDs).... pseudogout
scrotum resembling labia. (See also hermaphroditism, sex determination.)... pseudohermaphroditism
Psychodrama is often carried out with a partner or in a group; music, dance, and mime are often used.... psychodrama
Infection is most often due to extensive tooth decay (see caries, dental) or dental fractures (see fracture, dental).
Pulpotomy prevents further degeneration of the pulp.
If treatment is unsuccessful, rootcanal treatment may be required.... pulpotomy
Pyloroplasty may be performed as part of the surgery for a peptic ulcer, or to prevent tightening of the pyloric muscles after vagotomy.... pyloroplasty
The 1st symptoms appear during or after adolescence and include night blindness.
Tests show a ring-shaped area of blindness which, over some years, extends to destroy an increasing area of the visual field, though central vision is retained, often for many years.
Opthalmoscopy reveals several masses of black pigment corresponding to the areas of visual loss.
Affected individuals and their parents should have genetic counselling.... retinitis pigmentosa
The phrase “sick role” describes the type of passive behaviour expected and allowed of a patient; people with social or emotional problems may unconsciously adopt this role to gain sympathy and understanding.... role-playing
The weakness may last for minutes, hours, or even days, but there is no lasting effect.
The cause is thought to be temporary damage to the motor cortex (the area of the brain that controls movement).... todd’s paralysis
Habitat: Kashmir, Himachal Pradesh, Tehri-Garhwal and other areas of northern India, at altitudes of 2,100-3,600 m.English: Pindrow-Fir, Silver-Fir, The West-Himalayan Low-Level Fir.Ayurvedic: Taalisha (related sp.).Folk: Badar, Morinda, Raisalla, Ransla.
Action: Uses similar to those of A. webbiana.Terpenoids, flavonoids, glycosides and steroids of the leaf were found to have mast cell stabilizing action in rats. Terpenoids and flavonoids offered bronchoprotection against his- tamine challenge in guinea pigs. The ulcer protective action of petroleum ether, benzene and chloroform fraction has been attributed to steroidal contents. Terephthalic acid demethyl ester (TADE), isolated from the leaf, exhibited protection against inflammation and bronchospasm in guinea pigs. Ethanolic extract of leaves showed significant anxiolytic effects on all the paradigms of anxiety, barbiturate hypnosis potentiation.Pindrolactone, a lanostane-based triterpene lactone, isolated from the leaves, showed mild activity against Gram-positive bacteria but exhibited potent antibacterial activity against Gram-negative bacteria E. coli.... abies pindrow
Habitat: Throughout the country, ascending to an altitude of about 1,050 m in the outer Himalayas.English: Indian Wild Liquorice, Jequirity, Crab's Eye, Precatory Bean.Ayurvedic: Gunjaa, Gunjaka, Chirihintikaa, Raktikaa, Chirmi- ti, Kakanti, Kabjaka, Tiktikaa, Kaakananti, Kaakchinchi. (Not to be used as a substitute for liquorice.)Unani: Ghunghchi, Ghamchi.Siddha/Tamil: Kunri.Folk: Chirmiti, Ratti.
Action: Uterine stimulant, abortifa- cient, toxic. Seeds—teratogenic. A paste of seeds is applied on vitiligo patches.Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India has indicated the use of seeds in baldness.Seeds contain abrin, a toxalbumin, indole derivatives, anthocyanins, ste- rols, terpenes. Abrin causes agglutination of erythrocytes, haemolysis and enlargement of lymph glands. A non- toxic dose of abrin (1.25 mcg/kg body weight), isolated from the seeds of red var., exhibited a noticeable increase in antibody-forming cells, bone marrow cellularity and alpha-esterase-positive bone marrow cells.Oral administration of agglutinins, isolated from the seeds, is useful in the treatment of hepatitis and AIDS.The seed extract exhibited antischis- tosomal activity in male hamsters.The methanolic extract of seeds inhibited the motility of human spermatozoa.The roots contain precol, abrol, gly- cyrrhizin (1.5%) and alkaloids—abra- sine and precasine. The roots also contain triterpenoids—abruslactone A, methyl abrusgenate and abrusgenic acid.Alkaloids/bases present in the roots are also present in leaves and stems.A. fruticulosus Wall. Ex Wight and Arn. synonym A. pulchellus Wall., A. laevigatus E. May. (Shveta Gunjaa) is also used for the same medicinal purposes as A. precatorius.Dosage: Detoxified seed—1-3 g powder. Root powder—3-6 g. (API Vols. I, II.)... abrus precatorius
Habitat: Throughout India; ascending to 1,700 m in the Himalayas.Ayurvedic: Lataakhadira, Aadaari, Ari.Siddha/Tamil: Indan, Indu. Iyak Koluntu (tender leaves).Folk: Aila.
Action: Bark—antibilious, antiasth- matic. Leaf—stomachic, styptic (for bleeding gum), antiseptic (for scalding of urine). A decoction of young leaves is taken for body pain, headache and fever.The bark contains tannin 9%, lupe-ol and alpha-spinasterol. Stem yields sitosterol.... acacia pennata
Habitat: Native to tropical Africa; common along the west coast of India.English: Baobab, Monkey Bread tree, African calabash.Ayurvedic: Sheet-phala, Ravanaam- likaa, Gorakshi, Panchparni.Unani: Gorakh Imli.Siddha/Tamil: Papparapuli.Folk: Gorakh Imli; Gorakh Chinchaa.
Action: Cooling, refrigerant (allays burning sensation). Leaves— diaphoretic (used as a prophylactic against fevers). Fruit—antidysen- teric, antiseptic, antihistaminic.The fruit pulp is a source of vitamin C (175.0-445.4 mg/100 g); dried pulp contains calcium and vitamin B1. Furfural (9.6%) is obtained after distillation of the fruit. In Africa, dried leaves provide much of the dietary calcium. Aqueous extract of the bark is used for treating sickle cell anaemia.An infusion of the leaves and flowers is given in respiratory disorders. (Powdered leaves prevented crisis in asthma induced by histamine in guinea pigs.) Dried fruit pulp also gives relief in bronchial asthma, allergic dermatitis and urticaria.Family: Leguminosae; Mimosaceae.
Habitat: The western Ghats, the Andamans and sub-Himalayan tract; also cultivated.English: Coral Wood, Red Wood.Ayurvedic: Rakta Kanchana, Rakta Kambala.Siddha/Tamil: Anai-gundumani.Folk: Ghumchi (bigger var.).
Action: Astringent and styptic (used in diarrhoea, haemorrhage from the stomach, haematuria), anti-inflammatory (in rheumatic affections, gout). Seeds— anticephalgic; also used for the treatment of paralysis. A decoction is given in pulmonary affections.The seed contains an anti-inflammatory active principle, O-acetyletha- nolamine. The leaves contain octa- cosanol, dulcitol, glucosides of beta- sitosterol and stigmasterol. The bark contains sitgmasterol glucoside.... adenanthera pavonina
The windpipe leads into the chest and divides above the heart into two bronchi, one of which goes to each lung, in which it splits into ?ner and ?ner tubes (see LUNGS). The larynx is enclosed in two strong cartilages: the thyroid (of which the most projecting part, the Adam’s apple, is a prominent point on the front of the neck), and the cricoid (which can be felt as a hard ring about an inch below the thyroid). Beneath this, the trachea – which is sti?ened by rings of cartilage so that it is never closed, no matter what position the body is in – can be traced down until it disappears behind the breastbone.... air passages
Habitat: All over India.Ayurvedic: Shveta Shirisha (bark- white or greenish-white).
Action: Bark—a decoction is given in rheumatism and haemorrhage.The bark contains beta-sitosterol and yields 12-17% tannins.An oleanolic acid saponin, proceric acid saponin mixture from seeds and root saponin exhibit spermicidal activity.... albizia procera
Habitat: The drier parts of Rajasthan, Gujarat, Punjab and Uttar Pradesh.English: Camel Thorn, Persian Manna Plant.Ayurvedic: Yavaasaka, Yavaasa, Yaasa, Duhsparshaa, Duraalab- haa, Kunaashak. Substitute for Dhanvayaasa. Yaasa-sharkaraa (Alhagi-manna).Unani: Jawaansaa. Turanjabeen (Alhagi-manna).Siddha/Tamil: Punaikanjuri, Kan- chori.
Action: Laxative, antibilious, diuretic, diaphoretic, expectorant. Leaves—used for fever, headache, rheumatism. Flowers—blood coagulant, used for piles. Alhagi- manna—expectorant, antiemetic, laxative.Along with other therapeutic applications, The Ayurvedic Pharmacopoeia of India indicates the use of dried whole plant in gout and haemorrhagic disorders.The aerial parts contain flavonoids, tannins, sterols, triterpenes, saponins and anthroquinones.The proanthocyanidins derived from the plant possess hypolipidemic and antiatherosclerotic properties. The compounds prevented an increase in rat serum cholesterol and triglycerides, and they decreased the manifestation of atherosclerosis.A polymeric proanthocyanidin, extracted from the plant, improved energy metabolism and increased the work capacity in rats.Ethanolic extract of the aerial parts produced positive inotropic effect on rabbit heart.Dosage: Whole plant—20-50 g for decoction. (API Vol. II.) Decoction—50-100 ml. (CCRAS.)... alhagi pseudalhagi
Habitat: Native to the Mediterranean region; cultivated in India.English: Leek.Folk: Vilaayati Piyaaz. Praan (Kashmir). Seemevangayam (Tamil Nadu).
Action: Expectorant; used as a substitute for garlic.Leek is poor in volatile oil content in comparison with garlic, but it contains sufficient amounts of non-toxic sapo- nins, which perhaps give it expectorant properties.The bulbs contain several thiosul- phinates, and also potentially anticar- cinogenic flavonoids, quercetin and kaempferol.... allium porrum
Habitat: Native to China; cultivated in Himalayan regions; grows in tropical and semi-tropical regions and temperate climates.English: Peach tree.Ayurvedic: Aaruka.Unani: Aaaduu, Khokh.
Action: Leaves and bark—expectorant (used in cough, whooping cough, and chronic bronchitis), sedative, stomachic, demulcent, antiscorbutic, diuretic. Fresh leaves—anthelmintic. Powder of leaves—styptic (externally). Fruit— stomachic, antiscorbutic.... amygdalus persica
Habitat: Native to the Mediterranean region; cultivated in Algeria.English: Spanish, Pellitory, Pyrethrum Root.Ayurvedic: Aakaarakarabha, Aakallaka, Aakulakrit, Agragraahi.Unani: Aaqarqarhaa.Siddha/Tamil: Akkiraakaaram.
Action: Stimulant, cordial, rubefa- cient.A gargle of infusion is prescribed for relaxed vulva. Root— used for toothache, rheumatic and neuralgic affections and rhinitis. Roots, along with the root of Witha- nia somnífera and Vitis vinifera, are used in epilepsy.Along with other therapeutic applications, Ayurvedic Pharmacopoeia of India indicates the use of the root in sciatica, paralysis, hemiplegia and amenorrhoea.The root contains anacycline, isobu- tylamide, inulin and a trace ofessential oil.The local anaesthetic activity of the alcoholic (2%) extract of the root was found to be comparable to that of xy- locaine hydrochloride (2%) in dental patients.Use of the drug in patients with insulin-dependent diabetes mellitus reduces the dose of insulin. It decreased the plasma glucose and serum cholesterol levels after oral administration for 3-6 weeks. (The plant is mixed with Helleborus nigar in a ratio of 1:3.) The plant extract inhibited tobacco-induced mutagenesis by 47.5% at a concentration of 1 mg/plate.Dosage: Root—500 mg to 1 g powder. (CCRAS.)... anacyclus pyrethrum
Habitat: Throughout India, from Himachal Pradesh to Assam and Mizoram, and all over southern India.English: Creat.Ayurvedic: Kaalmegha, Bhuunimba, Bhuuminimbaka, Vishwambharaa, Yavtikta, Kalpanaatha, Kiraata-tikta (var.).Unani: Kiryaat.Siddha/Tamil: Nilavembu.
Action: Hepatoprotective, cholin- ergic, antispasmodic, stomachic, anthelmintic, alterative, blood purifier, febrifuge. It acts well on the liver, promoting secretion of bile. Used in jaundice and torpid liver, flatulence and diarrhoea of children, colic, strangulation of intestines and splenomegaly; also for cold and upper respiratory tract infections.Key application: As bitter tonic, febrifuge and hepatoprotective. (Indian Herbal Pharmacopoeia.)Kaalmegha, officinal in IP, consists of dried leaves and tender shoots, which yield not less than 1% andro- grapholide on dry-weight basis.Several active constituents have been identified from the leaf and rhizome, including andrographolide, deoxyan- drographolide and other diterpenes.Andrographolide exhibited strong choleretic action when administered i.p. to rats. It induces increase in bile flow together with change in physical properties of bile secretion. It was found to be more potent than sily- marin.Andrographolide was found to be almost devoid of antihepatitis-B virus surface antigen-like activity (when compared with picroliv.)The leaf and stem extracts of Kaal- megha/andrographolide given s.c. or orally did not change blood sugar level of normal or diabetic rats.Alcoholic extract of the plant exhibited antidiarrhoeal activity against E. coli enterotoxins in animal models.Clinical evidence of effectiveness of andrographis in humans is limited to the common cold. Preliminary evidence suggests that it might increase antibody activity and phagocytosis by macrophages, and might have mast cell-stabilizing and antiallergy activity. (Natural Medicines Comprehensive Database, 2007.)The herb is contraindicated inbleed- ing disorders, hypotension, as well as male and female sterility (exhibited infertility in laboratory animals).Dosage: Whole plant—5-10 ml juice; 50-100 ml decotion; 1-3 g powder. (CCRAS.)... andrographis panicultata
Habitat: The sub-Himalayas tracts, Sikkim, Assam, Bengal, western Ghats and the Andamans.Ayurvedic: Rohitaka, Daadima- chhada, Daadima-pushpaka, Plihaghna. Tecoma undulata G. Don., Bignoniaceae, is also equated with Rohitaka.Siddha/Tamil: Malampuluvan.
Action: Bark—strongly astringent, used in the diseases of the liver and spleen, and for tumours, enlarged glands. Seed oil—used in muscular pains and rheumatism. All parts of the plant exhibit pesticidal activity. Seed extract—antibacterial, antifungal.An aqueous extract of the bark, when injected i.p. in normal guinea pigs, showed reduction in absolute lymphocyte count and an increase in spleen weight. The bark appears to be an effective immunosuppressive drug similar to prednisolone.The stembark contains a limonoid, ammorinin and a saponin, poriferas- terol-3-rhamnoside.... aphanamixis polystachya
Habitat: Throughout the hotter parts of India. Also, commonly grown as a hedge plant in gardens.English: Common Yellow Nail Dye Plant.Ayurvedic: Sahachara, Baana, Kurantaka, Kuranta, Koranda, Korandaka, Shairiya, Pita-saireyaka(yellow-flowered var.). Also equated with Vajradanti.Unani: Piyaabaansaa.Siddha/Tamil: Chemmulli.Folk: Piyaabaasaa, Jhinti, Kat- saraiyaa.
Action: Leaf—juicegiveninstomach disorders, urinary affections; mixed with honey and given to children with fever and catarrh; leaf juice is applied to lacerated soles of feet in the rainy season, mixed with coconut oil for pimples. Leaves and flowering tops—diuretic. Bark—diaphoretic and expectorant. Roots—paste is applied over boils and glandular swellings. Plant (Vajradanti)—antidontalgic, used for bleeding gums in Indian medicine. Ash, obtained from the whole plant, mixed with honey, is given in bronchial asthma.The Ayurvedic Pharmacopoeia of India recommends oil extract of the plant for arresting greying of hair.The leaves and flowering tops are diuretic, rich in potassium salts. Leaves and stems showed presence of iridoid glucosides, barlerin and acetylbarlerin. Flowers gave the flavonoid glycoside, scutellarein-7-neohesperidoside. The presence of beta-sitosterol is reported in the plant.In the south, Nila Sahachara is equated with Ecbolium linneanun Kurz. (known as Nilaambari), and Shveta Sa- hachara with Justica betonica Linn.Ecbolium linneanun plant is used for gout and dysuria; the root is prescribed for jaundice.Dosage: Whole plant—50-100 g for decoction. (API Vol. III.)... barleria prionitis
Habitat: The Himalayas, and distributed in Northern India, Assam, Khasi Hills. Also cultivated in gardens.English: Camel's Foot tree, Pink Bauhinia, Butterfly tree, Geramium tree, Orchid tree.Ayurvedic: Kovidaara, Rakta Kaanchanaara.Unani/Siddha: Sivappu mandaarai.Siddha: Mandarai.Folk: Koilaara, Khairwaal, Kaliaar, Rakta Kanchan.
Action: Bark—astringent, antidiar- rhoeal. Flower buds and flowers, fried in purified butter, are given to patients suffering from dysentery. Extract of stems are used internally and externally for fractured bones. Plant is used in goitre. It exhibited antithyroid-like activity in experimental animals.The flowers contain astragalin, iso- quercitrin and quercetin, also antho- cyanins. Seeds contain chalcone gly- cosides.... bauhinia purpurea
Habitat: Throughout India in gardens, waste places and tea plantations.Folk: Phutium (Gujarat), Kuri (Garhwal).
Action: Plant—cytotoxic. Leaf— applied to ulcers and swollen glands.The plant contains a number of poly- acetylenes which are toxic to bacteria, fungi and human fibroblast cells. Phenylheptatriyne is the major constituent of the leaves and stems.B. pilosa Linn. var. minor (Blume) Sherff, synonym B. pilosa Linn. var. bi- pinnata Hook. f. in part, gave phytos- terin-B, which like insulin, showed hy- poglycaemic activity both in normal and diabetic rats. B. pilosa auct. non Linn., synonym B. chinensis Willd., is used for leprosy, fistulae, pustules, tumours.... bidens pilosa
Habitat: Bihar, West Bengal and Assam, up to 900 m.Ayurvedic: Godhaapadi.Siddha/Tamil: Kattuppirandai.
Action: Leaves—astringent and refrigerant (used for ulcers, diarrhoea, uterine and other fluxes).Aerial parts—diuretic, spasmolytic.... cayratia pedata
Habitat: Cultivated in gardens throughout India.English: Barbados Pride, Peacock Flower.Ayurvedic: Padangam, Ratnagandhi, Krishnachuudaa.Siddha/Tamil: Mayirkonrai, Nalal.Folk: Guleturaa, Sankeshwara.
Action: Leaves—laxative, antipyretic. Used in Eastern India as a substitute for senna. Dried and powdered leaves are used in erysipelas. Flowers—anthelmintic. Also used for cough and catarrh. Root—a decoction is prescribed in intermittent fevers. Bark— emmenagogue, abortifacient.The plant contains a flavonoid, my- ricitroside. The leaves, flowers and fruits contain tannins, gums, resin, benzoic acid. Presence of cyanidin- 3,5-diglucoside is also reported from the flowers, hydrocyanic acid from the leaves. The root contains caesalpin type diterpenoids along with sitosterol.The leaves have displayed anticancer activity in laboratory animals. A diter- penoid, isolated from the root, also showed anticancer activity.In Pakistan, the leaf and flower extract exhibited activity against Grampositive bacteria.... caesalpinia pulcherrima
Habitat: An evergreen shrub distributed in West and Central India.English: Swallow-Wart, Milk Weed, (purple-flowered), King's Crown.Ayurvedic: Alarka, Surya, Su- uryaahvya, Vikirna, Vasuka, Tapana, Tuulaphala, Kshirparna, Arkaparna, Aasphota.Unani: Aakh, Madaar, Ashar.Siddha/Tamil: Vellerukku, Erukku.
Action: The plant is used against bronchial asthma (especially flowers with black pepper). Leaves—used for treating chronic cases of dyspepsia, flatulence, constipation and mucus in stool. Seed oil— geriatric and tonic. Leaves, flowers and root-bark oil—antimicrobial (maximum activity in leaves). The Ayurvedic Pharmacopoeia of India indicated the use of the root and leaf in asthma and dyspnoea; stem bark in diseases of the spleen.Root bark contains benzoylline- olone and benzolisolineolone. Root, stem and leaves, also latex contain beta-amyrin. Flowers contain evanidin 3-rhamnoglucoside. The plant contains a cardenolide, proceragenin, an antibacterial principle.The latex is given for treating epilepsy, also in painful, joints and swellings. The latex exhibited anti-inflammatory activity in carrageenan-and formalin- induced rat paw oedema model.The herb can alter menstrual cycle and temporarily inhibit ovulation. Cardiac glycosides may be additive when combined with Digoxin. (Sharon M. Herr.)Dosage: Leaf—250-750 mg powder; root—1-3 g for decoction (API Vol. I); stem bark—0.5-1 g powder (API Vol. III). Milky juice—500 mg to 1 g (CCRAS.)
Action: Anti-inflammatory. Root— hypocholesterolaemic. Poisonous to human beings in mature stages.The flowers contain flavonoids, 7- rhamnosides, 3-glucosides and 3-glu- co-7-rhamnosides of kaempferol and quercetin. Roots gave triterpenoid glycosides, which decreased serum cholesterol and total protein and increased blood sugar equivalent to bu- tadione in rats.EtOH (50%) extract of the plant exhibits CNS depressant and hypotensive activity in rat.... calotropis procera
Habitat: Throughout the Deccan Peninsula, from Gujarat and Maharashtra southwards, and in Bihar and Orissa.English: Wild Jasmine.Folk: Kaari.Siddha/Tamil: Karai, Kadan Karai, Nalla Karai, Kudiram.
Action: Leaves and fruits— astringent, antispasmodic; used against cough. A decoction of the root and leaves is given in flu. Bark—antidysenteric.The plant contains mannitol (0.5%) and alkaloids. Canthium umbellatum Wight is also known as Kaari.... canthium parviflorum
Habitat: Throughout India as a weed in cultivated areas and waste places, particularly in the temperate regions up to an altitude of 4,200 m.English: Shepherd's Purse, St. James's Wort.Folk: Mumiri.
Action: The herb or its juice extracts are employed to check menorrhagia and haemorrhages from renal and genitourinary tract. Also used in diarrhoea and dysentery and as a diuretic.Key application: In symptom-based treatment of mild menorrhagia and metrorrhagia. (German Commission E.) The British Herbal Pharmacopoeia reported antihaem- orrhagic action.Aerial parts contain flavonoids, polypeptides, choline, acetylcholine, histamine and tyramine.The extract of dried or green plant causes strong contraction of the small intestines and uterus of guinea pigs. A quarternary ammonium salt has been isolated from the herb which is reported to be responsible for its pharmacological activity.Young leaves contain vitamin A (5,000 IU/100 g) and ascorbic acid (91 mg/100 g); among other constituents are hesperidin and rutin, which reduced permeability of blood vessel walls in white mice. A neoplasm inhibitory substance has been identified as fumaric acid. An inhibitory effect of the extracts of the herb on Ehrlich solid tumour in mice was found to be due to the fumaric acid.Major constituent of the essential oil is camphor.... capsella bursa-pastoris
Although there are numerous possible sources of electrical interference with pacemakers, the overall risks are slight. Potential sources include anti-theft devices, airport weapon detectors, surgical diathermy, ultrasound, and short-wave heat treatment. Nevertheless, many pacemaker patients lead active and ful?lling lives.... cardiac pacemaker
Habitat: Native to West Indies and Central America; now cultivated in Uttar Pradesh, Punjab, Rajasthan, Gujarat, Maharashtra and South India.English: Papaya, Papaw.Ayurvedic: Erand-karkati, Papitaa.Unani: Papitaa Desi.Siddha/Tamil: Pappaali, Pappayi.
Action: Ripe fruit—stomachic, digestive, carminative, diuretic, galactagogue. Useful in bleeding piles, haemoptysis, dysentery and chronic diarrhoea. Seeds— emmengagogue, abortifacient, vermifuge. Juice of seeds is administered in enlarged liver and spleen, and in bleeding piles.Key application: Papain, the enzyme mixture extracted from raw papain (latex of Carica papaya), has been included among unapproved herbs by German Commission E. Experiment-based as well as clinical research indicate that papain may be effective (in the treatment of inflammations) in high doses (daily dose 1500 mg corresponding to 2520 FIP units).Unripe fruit—emmengagogue and abortifacient. Latex—applied topically on eczema, ringworm, psoriasis, corns, warts, sloughing wounds, carbuncles and eschar of burns.Green parts of the plant and seed contain an alkaloid carpaine. Seeds also contain carpasemine.Latex contain enzymes—papain and chymopapain and alkaloids carpaine and pseudocarpaine. A proteinaceous material from latex showed anticoagulant activity; in higher doses it is heart depressant and as a spasmogen on smooth muscle of guinea pig ileum. An alkaloid solution showed depressant action on heart, blood pressure and intestine.The anthelmintic action of seeds against Ascaris lumbricoides is due to carpasemine.Papain, an enzyme mixture prepared from the fruit, seeds and leaf, hydrolyses polypeptides, amides and esters, particularly when used in an alkaline environment, and is used in digestive disorders.Papain inhibits platelet aggregation, which may further increase the risk of bleeding in patients also taking anticoagulants. Concurrent administration of cyclophosphamide with papain caused sever damage to lung tissues in rats. (Sharon M. Herr.)Chymopapin C is an immunosup- pressive enzyme from plant extract. Carpaine, extracted from the plant, exhibited anti-tubercular activity, also antitumour in vitro, and hypotensive.Dosage: Leaf—40-80 ml infusion; latex—3-6 g (CCRAS.)... carica papaya
Habitat: West and South India. Often found planted around villages and temples.English: Kapok, White Silk Cotton.Ayurvedic: Kuuta-Shaalmali, Shveta Shaalmali.Siddha/Tamil: Ielavum (Tamil).
Action: Gum—laxative, astringent, demulcent (given in painful micturition). Unripe fruit—astringent. Root—diuretic, antidiabetic, an- tispasmodic (used in dysentery). Flowers—laxative; used in lochi- orrhoea. Unripe pods—used in vertigo and migraine. Seed oil— used in rheumatism.The plant contains linarin (acacetin 7-rutinoside). Seeds contain fatty acids, diglycerides and phospholipids. Leaves are considered a good source of iron and calcium. Stem-bark extract—antimicrobial.... ceiba pentandra
Habitat: The Himalayan terai from Punjab to Assam, and South India and the Andamans.Folk: Dillenia. Agai (Bihar), Agachi (Maharashtra).
Action: See D. indica.The bark contains 6% tannin.... dillenia pentagyna
Habitat: Sub-Himalayan tract up to 2,000 m and South Indian hills.English: Staff tree, Intellect tree.Ayurvedic: Jyotishmati, Paaraavat- padi. Kangunikaa, Kanguni, Vegaa, Maalkaanguni, Svarnalatikaa, Kaakaandaki, Katuveekaa.Unani: Maalkangani.Siddha/Tamil: Vaaluluvai.
Action: Seeds—nervine and brain tonic, diaphoretic, febrifugal, emetic. Seed-oil—used for treating mental depression, hysteria and for improving memory; also used for scabies, eczema, wounds, rheumatic pains, paralysis. A decoction of seeds is given in gout, rheumatism, paralysis and for treating leprosy and other skin diseases. Leaves— antidysenteric, emmenagogue. Root—a paste of root-bark is applied to swollen veins and pneumonic affections.Key application: As a tranquilizer (Indian Herbal Pharmacopoeia) and brain tonic (The Ayurvedic Pharmacopoeia of India). The Ayurvedic Pharmacopoeia of India indicated the use of ripe seed in leucoderma and vitiligo.The seeds are reported to contain the alkaloids, celastrine and paniculatine, which are the active principles of the drug.In experimental animals, the drug showed lowering of leptazol toxicity, motor activity and amphetamine toxi- city, and raising the capacity for learning process. It showed significant CNS depressant effect and a clear synergism with pentobarbital. The seed extract showed hypolipidaemic effect and prevented atherogenesis in rabbits.The seed oil showed tranquillizing effect and hastened the process of learning in experimental animals. It produced fall in blood pressure in anaesthetized dog, depressed the heart of frog, and was found to be toxic to rats.In addition to the seed, 70% alcoholic extract of the plant showed sedative, anti-inflammatory and antipyretic, anti-ulcerogenic effect in experimental animals.Methanolic extract of flowers showed both analgesic and anti- inflammatory activities experimentally.Dosage: Ripe seed, devoid of capsule wall—1-2 g; oil—5-15 drops. (API Vol. II.)... celastrus paniculatus
Habitat: Native to Europe.Unani: Daarunaj Aqrabi.
Action: Used in nervous depression, melancholia and as a constituent of cardiac tonic preparations.The plant contains photoactive thio- phenes, in amounts reported to be toxic. Roots and aerial parts yield sesquiterpene alcohol, paralianchol and its aetophenone derivatives.... doronicum pardalianches
Habitat: Throughout India except Jammu & Kashmir and northeastern India as a weed.Ayurvedic: Suuryaavart.Folk: Nilakanthi.
Action: Ash of root—bechic. Leaf— depurative. Seed—cathartic.Roots contain xanthone glycosides and a chromone glycoside. Seeds gave oil rich in linoleate. The plant contains 9.0% tannin.... chrozophora plicata
Habitat: The tropical and subtropical parts of India.English: Velvet-Leaf Pareira, Pareira Brava.Ayurvedic: Paathaa, Ambashthaa, Varatiktaaa, Vriki, Aviddhakarni, Piluphalaa, Shreyashi.Bigger var., Raaja Paathaa, is equated with Stephania hernandifolia Walp.)Unani: Paathaa.Siddha/Tamil: Paadakkizhangu, Appatta.
Action: Root astringent, an- tispasmodic (used for cramps, painful menstruation), analgesic, antipyretic, diuretic, antilithic and emmenagogue. Prescribed for diarrhoea, dysentery, piles, urogenital affections (cystitis, nephritis, menorrhagia) Root paste is applied topically on scabies and eruptions on the body. Also used for preventing miscarriage.The Ayurvedic Pharmacopoeia ofIn- dia attributed blood purifying properties to the root and indicated it in lactal disorders.Hayatine (dl-beberine) is the principal alkaloid of the root. Its derivatives, methiodide and methochloride are reported to be potent neuromus- cular-blocking agents.Not to be confused with Abuta grandiflora, a South American medicinal plant.Dosage: Root—3-6 g powder. (API Vol. I.) the plant hastens fracture-healing by reducing the total convalescent period by 33% in experimental rats and dogs; it aids in recovery of the strength of the bones up to 90% in 6 weeks.Dosage: Stem—10-20 ml juice. (API Vol. III.)... cissampelos pareira
Habitat: Cultivated as a hedge plant.Folk: Durantaa.
Action: Antifungal (topically).The leaves contain a saponin and fruits an alkaloid analogous to narco- tine. Macerated fruits, which even in dilutions of 1 : 100 parts of water, is lethal to mosquito larvae (the action is less marked on Culicine larvae.... duranta plumieri
Chronic bronchitis is typi?ed by chronic productive cough for at least three months in two successive years (provided other causes such as TUBERCULOSIS, lung cancer and chronic heart failure have been excluded). The characteristics of emphysema are abnormal and permanent enlargement of the airspaces (alveoli) at the furthermost parts of the lung tissue. Rupture of alveoli occurs, resulting in the creation of air spaces with a gradual breakdown in the lung’s ability to oxygenate the blood and remove carbon dioxide from it (see LUNGS). Asthma results in in?ammation of the airways with the lining of the BRONCHIOLES becoming hypersensitive, causing them to constrict. The obstruction may spontaneously improve or do so in response to bronchodilator drugs. If an asthmatic patient’s airway-obstruction is characterised by incomplete reversibility, he or she is deemed to have a form of COPD called asthmatic bronchitis; sufferers from this disorder cannot always be readily distinguished from those people who have chronic bronchitis and/ or emphysema. Symptoms and signs of emphysema, chronic bronchitis and asthmatic bronchitis overlap, making it di?cult sometimes to make a precise diagnosis. Patients with completely reversible air?ow obstruction without the features of chronic bronchitis or emphysema, however, are considered to be suffering from asthma but not from COPD.
The incidence of COPD has been increasing, as has the death rate. In the UK around 30,000 people with COPD die annually and the disorder makes up 10 per cent of all admissions to hospital medical wards, making it a serious cause of illness and disability. The prevalence, incidence and mortality rates increase with age, and more men than women have the disorder, which is also more common in those who are socially disadvantaged.
Causes The most important cause of COPD is cigarette smoking, though only 15 per cent of smokers are likely to develop clinically signi?cant symptoms of the disorder. Smoking is believed to cause persistent airway in?ammation and upset the normal metabolic activity in the lung. Exposure to chemical impurities and dust in the atmosphere may also cause COPD.
Signs and symptoms Most patients develop in?ammation of the airways, excessive growth of mucus-secreting glands in the airways, and changes to other cells in the airways. The result is that mucus is transported less e?ectively along the airways to eventual evacuation as sputum. Small airways become obstructed and the alveoli lose their elasticity. COPD usually starts with repeated attacks of productive cough, commonly following winter colds; these attacks progressively worsen and eventually the patient develops a permanent cough. Recurrent respiratory infections, breathlessness on exertion, wheezing and tightness of the chest follow. Bloodstained and/or infected sputum are also indicative of established disease. Among the symptoms and signs of patients with advanced obstruction of air?ow in the lungs are:
RHONCHI (abnormal musical sounds heard through a STETHOSCOPE when the patient breathes out).
marked indrawing of the muscles between the ribs and development of a barrel-shaped chest.
loss of weight.
CYANOSIS in which the skin develops a blue tinge because of reduced oxygenation of blood in the blood vessels in the skin.
bounding pulse with changes in heart rhythm.
OEDEMA of the legs and arms.
Some patients with COPD have increased ventilation of the alveoli in their lungs, but the levels of oxygen and carbon dioxide are normal so their skin colour is normal. They are, however, breathless so are dubbed ‘pink pu?ers’. Other patients have reduced alveolar ventilation which lowers their oxygen levels causing cyanosis; they also develop COR PULMONALE, a form of heart failure, and become oedematous, so are called ‘blue bloaters’.
Investigations include various tests of lung function, including the patient’s response to bronchodilator drugs. Exercise tests may help, but radiological assessment is not usually of great diagnostic value in the early stages of the disorder.
Treatment depends on how far COPD has progressed. Smoking must be stopped – also an essential preventive step in healthy individuals. Early stages are treated with bronchodilator drugs to relieve breathing symptoms. The next stage is to introduce steroids (given by inhalation). If symptoms worsen, physiotherapy – breathing exercises and postural drainage – is valuable and annual vaccination against INFLUENZA is strongly advised. If the patient develops breathlessness on mild exertion, has cyanosis, wheezing and permanent cough and tends to HYPERVENTILATION, then oxygen therapy should be considered. Antibiotic treatment is necessary if overt infection of the lungs develops.
Complications Sometimes rupture of the pulmonary bullae (thin-walled airspaces produced by the breakdown of the walls of the alveoli) may cause PNEUMOTHORAX and also exert pressure on functioning lung tissue. Respiratory failure and failure of the right side of the heart (which controls blood supply to the lungs), known as cor pulmonale, are late complications in patients whose primary problem is emphysema.
Prognosis This is related to age and to the extent of the patient’s response to bronchodilator drugs. Patients with COPD who develop raised pressure in the heart/lung circulation and subsequent heart failure (cor pulmonale) have a bad prognosis.... chronic obstructive pulmonary disease (copd)
Habitat: Throughout India, common in Uttar Pradesh.Ayurvedic: Ashoka-rohini (non- classical).Siddha/Tamil: Unamkodi.
Action: Bark—anticholerin. Ripe fruit eaten in constipation. Pounded root prescribed internally in fever. Bark is used in cholera.EtOH (50%) extract of aerial parts exhibit diuretic and hypotensive activity.... erycibe paniculata
Habitat: Pasture lands of Deccan from Konkan southwards.English: Salep (var.).Folk: Sataavari (Maharashtra).
Action: Tuber—used for scrofulous glands.... eulophia pratensis
Habitat: Khasi Hills, submountain- ous Himalayan ranges in Garhwal, Kumaon in U.P., Maland areas of South, Pachmarhi (Madhya Pradesh), Sikkim and Western Ghats.English: Citron.Ayurvedic: Maatulunga, Lunga, Maatulaka, Mahaalunga, Bijpuura, Bijaahva.Unani: Turanj.Siddha/Tamil: Kadaranrathai, Naarthankai, Thurinjippazham.Folk: Bijoraa.
Action: Fruit—antiscorbutic, refrigerant, astringent, carminative, stomachic, antibacterial. Used for dyspepsia, bilious vomiting, cold, fever, hiccough. Root— anthelmintic. Flowers and buds— astringent.The peel contains coumarins, limet- tin, scoparone, scopoletin and um- belliferon; besides nobiletin, limonin,Family: Rutaceae.
Habitat: Native to the West Indies. Commercialized in the USA. Cultivated mainly in Punjab.English: Grapefruit, 'Marsh' Grapefruit.Folk: Chakotraa. Chima Bombili- maas (Tamil Nadu).
Action: Young leaves—decoction is used to relieve cold or headache. Fruit—used for developing resistance against colds and influenza.Grapefruit is rich in vitamins, minerals, potassium and pectin, which balance the acid reaction in the stomach and stimulate appetite. Half grapefruit contains vitamin A 318 IU, vitamin C 46.8 mg, niacin 0.2 mg, potassium 158 mg. The fruit contains beta- carotene and cartenoid lycopene. Ly- copene is especially noted for reducing the risk of prostate cancer. The fruit juice contains furanocoumarins, including bergamottin, also naringin, naringenin, limonin, quercetin, kaem- pferol and obacunone.For drug interactions with grapefruit juice, see Natural Medicines Comprehensive Database, 2007.Grapefruit is not to be confused with grape (Vitis vinifera).... citrus paradisi
Habitat: The sub-Himalayan tract from Garhwal to Sikkim; also in Chakrata range.Folk: Ratanjot (var.), Rowana. Surasi is a doubtful synonym.
Action: Bark—anti-inflammatory, spasmolytic; used in veterinary medicine for wounds and sprains.Aerial parts contain coumarins— clausmarins A and B. Coumarins exhibit spasmolytic activity. The root also contains coumarins. Root and stem bark of Clausena excavata Burm. f. Eastern sub-Himalayan tract, Orissa and Bihar) also contain coumarins— clausenin and clausenidin. The root bark exhibits antibacterial activity against both Gram-positive and Gramnegative bacteria.A related species, C. anisata (Willd.) Oliver, is reported from Uttar Pradesh. Ethanolic extract of the aerial parts exhibited spasmolytic activity. The fu- ranocoumarins, anisolactone, xantho- toxol, indicolactone, imperatorin and 2', 3'-epoxy-anisolactone have been isolated from the extract.In West African traditional medicine, the decoction of the root is given to control convulsions in children. The anticonvulsant agent has been found to be heliettin, extracted from the stem bark and roots.... clausena pentaphylla
Habitat: A fungous parasite on a number of grasses particularly in rye, cultivated in the Nilgiris and at Chakrohi farm in Jammu.English: Ergot of Rye. Fungus of Rye.Ayurvedic: Annamaya, Sraavikaa.Unani: Argot.Siddha/Tamil: Ergot.
Action: Uterine stimulant. Oxy- tocic, abortifacient, parturient, vasoconstrictor, haemostatic. Used in obstetrics (difficult childbirth, for exciting uterine contractions in the final stages of parturition). Also used after abortion for removal of the placenta. It is no more employed in internal haemorrhages, as it has been found to raise blood pressure in pulmonary and cerebral haemorrhage. Included among unapproved herbs by German Commission E.The fungus gave indole alkaloids. The ergometrine or ergonovine group includes ergometrine and ergometri- nine. The ergotamine group includes ergotamine and ergotaminine. The er- gotoxine group includes ergocristine, ergocristinine, ergocryptine, ergo- cryptinine, ergocornine and ergo- corninine. The fungus also contains histamine, tyramine and other amines, sterols and acetylcholine.The alkaloids of ergot are being used independently (not as a herbal medicine). Ergotamine is used to relieve migrainous headaches as it is a vasoconstrictor and has antisero- tonin activity. Ergometrine is used after childbirth in the third stage of labour and for post-partum haemorrhage, as it is a powerful uterine stimulant, particularly of the puerperal uterus. (Both the constituents are used under medical supervision). Er- gocornine significantly inhibited the development of induced mammary tumours in rats. The derivatives of ergot alkaloids are known to have suppressing effect on human breast cancer in initial stages. This activity is linked to prolactin inhibitory action.The extract is toxic at 1.0-3.9 g, ergot alkaloids at 1 g in adults, 12 mg in infants. (Francis Brinker).Dosage: Whole plant—10-30 ml infusion. (CCRAS.)... claviceps purpurea
Habitat: Western Himalayas from Garhwal, westwards to Kashmir.Ayurvedic: Saatala, Saptalaa. (Substitute).
Action: Purgative, emetic. Root— used in fistulous sores.Prostratin, isolated from the roots of var. cornigeria Hook. f., was found to be pro-inflammatory.... euphorbia pilosa
Habitat: Throughout India, in the drier parts.Ayurvedic: Agnimantha, Tarkaari, Vikraantaa, Jayanti, Jai, Jayaa, Ganikaarikaa, Vaijayanti, Bigger var. is equated with Premna integri- folia Linn., Shriparni, Naadeyi.Siddha/Tamil: Tazhuthaazhai.Folk: Laghu Arni.
Action: Plant parts used in dyspepsia, stomachache, colic, cholera, dysentery, postnatal fever, during convalscence from measles. Root and bark—bitter tonic, used in debility and nervous disorders.The Ayurvedic Pharmacopoeia of India indicated the use of root in dysuria and retention of urine.Flavonoids, scutellarein and pec- tolinarin, have been isolated from the leaves. Stems gave d-mannitol, beta- sitosterol, its glucosides and ceryl alcohol. The roots contain ceryl alcohol, clerodin, clerosterol and clerodendrin A.The ethanolic extract of leaves exhibited hepatoprotective activity. The aqueous extract of leaves exhibited in vitro anthelmintic activity. The plant also exhibited antidiabetic activity.Dosage: Root—12-24 g for decoction. (API Vol. III.)... clerodendrum phlomidis
Clinical psychologists are involved in health care in the following ways: (1) Assessment of thoughts, emotions and behaviour using standardised methods. (2) Treatment based on theoretical models and scienti?c evidence about behaviour change. Behaviour change is considered when it contributes to physical, psychological or social functioning. (3) Consultation with other health-care professionals about problems concerning emotions, thinking and behaviour. (4) Research on a wide variety of topics including the relationship between stress, psychological functioning and disease; the aetiology of problem behaviours; methods and theories of behaviour change. (5) Teaching other professionals about normal and dysfunctional behaviour, emotions and functioning.
Clinical psychologists may specialise in work in particular branches of patient care, including surgery, psychiatry, geriatrics, paediatrics, mental handicap, obstetrics and gynaecology, cardiology, neurology, general practice and physical rehabilitation. Whilst the focus of their work is frequently the patient, at times it may encompass the behaviour of the health-care professionals.... clinical psychology
Habitat: Throughout India, Ascending To 2,000 M In The Himalayas.Ayurvedic: Shankhapushpi, Shankhaahvaa, Kshirapushpi, Maangalya Kusuma (White- Flowered). Blue-Flowered Var., Vishnukraanti, Vishnukraantaa, Vishnugandhi Is Equated With Evolvulus Alsinoides Linn.Unani: Sankhaahuli (Blue-Flowered)Siddha/Tamil: Sivakraandi (White- Flowered), Vishnukraandi (Blue- Flowered).
Action: Plant—Brain Tonic, Tranquilizer Used In Nervine Disorders, Mental Aberration, Anxiety Neurosis, Internal Haemorrhages, Spermatorrhoea. Also Astringent, Antidysenteric, Antispasmodic, Antiphlogistic, Febrifuge, Alterative. Flowers—Styptic, Used For Uterine Bleeding. Leaf—Antiasthmatic, Used In Chronic Bronchitis. Root— Used In Gastric And Duodenal Ulcers, Uterine Affections And For Promoting Fertility.The Ayurvedic Pharmacopoeia Of India Recommends The Plant For Epilepsy. The Plant Contains Sankhpushpine Alkaloids.The Alcoholic (50%) Extract Of The Plant, When Administered To Rats (Through Gastric Intubation At Different Intervals), Has Shown Enhanced Neuropeptide Synthesis Of The Brain. It Induces An Increase In Brain Protein Content And Increases Acquisition Efficiency.Evolvulus Alsinoides Contains Pen- Tatriacontane, Triacontane And Beta- Sitosterol.Shankhapushpi Syrup (A Compound Containing C. Pluricaulis, Centella Asiatica, Nardostachys Jatamansi, Nepeta Hindostana, Nepeta Elliptica And Onos- Ma Bracteatum), When Administered With Phenytoin, A Modern Antiepilep- Tic Drug, Reduced Not Only Antiepileptic Activity Of Phenytoin But Also Lowered Plasma Phenytoin Levels.Dosage: Whole Plant—3-6 G Powder. (Api Vol. III.)... convolvulus pluricaulis
Habitat: Wild on wastelands of Sindh, Baluchistan, Rajasthan; in dry districts of Bellary in the South.English: Wild Cucumber.Ayurvedic: Indravarruni (var.).Folk: Khar-indraayana.
Action: Emetic, purgative. Toxic.Fruit pulp—a bitter resinous body, myriocarpin, produces nausea and is slightly purgative.The fruit contain cucurbitacin B,C,D and Q1, and propheterosterol and its acetate. Cucurbitacin Q1 is an anti- tumour agent. Amino acids from the fruits are leucine, iso-leucine, pheny- lalanine, valine, tryptophan, tyrosine, proline, alanine threonine, glycine, arginine, crystine and aspartic acid.... cucumis prophetarum
Habitat: Native to N. Mexico and eastern U.S.A. Now commonly cultivated in Northern India.English: Pumpkin, Marrow.Unani: Safed Kaddu, Kumhraa.Siddha: Suraikayi (Tamil).
Action: See C. maxima.Key application: Seeds—in irritated bladder condition, micturition problems of benign prostatic hyperplasia stages 1 and 2. (German Commission E, The British Herbal Pharmacopoeia.) In childhood enuresis noctruna. (Expanded Commission E.)The roasted and fresh seeds yield 32.2 and 38.0% of fatty oil respectively. The oil filled capsules were administered to patients suffering from hypertrophy of the prostate. Results showed that the frequent urge to urinate decreased and the urine residues were minimized.The oil consists of the glycerides of linoleic 45, oleic 25, palmitic and stearic acids 30%. Sterols have been isolated.... cucurbita pepo
Treatment Administration of oxygen when available is the most important ?rst-aid management. Rescuers should be trained, must not put themselves at risk, and should use protective clothing and breathing apparatus. In unconscious victims, establish a clear airway and give 100 per cent oxygen. If breathing stops and oxygen is unavailable, initiate expired-air resuscitation. If cyanide salts were ingested, mouth-to-mouth contact must be avoided and a mask with a one-way valve employed instead. Some commercially available ?rst-aid kits contain AMYL NITRATE as an antidote which may be employed if oxygen is unavailable.
Once in hospital, or if a trained physician is on the scene, then antidotes may be administered. There are several di?erent intravenous antidotes that may be used either alone or in combination. In mild to moderate cases, sodium thiosulphate is usually given. In more severe cases either dicobalt edetate or sodium nitrite may be used, followed by sodium thio-sulphate. Some of these (e.g. dicobalt edetate) should be given only where diagnosis is certain, otherwise serious adverse reations or toxicity due to the antidotes may occur.... cyanide poisoning
Habitat: Sub-tropical Himalaya from Himachal Pradesh to Aruna- chal Pradesh at 500-2,500 m.Ayurvedic: Kshudra-Paashaana- bheda, Shilaa-valkaa, Shilaa- pushpa.
Action: Leaf—antilithic. Used for stones in kidney and bladder.The leaves contain a number of chal- cones, quinochalcones and flavanones. Pediflavone has also been isolated from young leaves.... didymocarpus pedicellata
Habitat: Native to West Europe. Cultivated in Tangmarg and Kishtawar in Kashmir, Darjeeling and the Nilgiris.English: Digitalis, Foxglove.Ayurvedic: Hritpatri, Tilapushpi (non-classical). (Purple var.)
Action: Main source of digoxin for the pharmaceutical industry. Digitalis glycosides increase the force of contraction of heart without increasing the oxygen consumption and slow the heart rate when auricular fibrillation is present. To be used only under strict medical supervision.Not used as a herbal drug.... digitalis purpurea
Habitat: Native to tropical Asia; distributed throughout India.Ayurvedic: Vaaraahikanda (var., dry pieces are sold as Vidaarikanda).Folk: Kaantaalu.
Action: Tubers contain 71.0780.77% carbohydrates, 8.68-15.93% albuminoids. Tubers are used to disperse swellings.... dioscorea pentaphylla
Habitat: The Himalaya from Nepal to Bhutan, up to 1,500 m, also in Naga Hills.Ayurvedic: Neelaalu.
Action: Tuber—antiphthiriac.The rhizomes are used as a hair wash for killing lice. They contain diogenin (on dry basis) 2.5%. Also obtained are steroidal sapogenins, sito- sterol glucoside, prazerigenin-A gluco- side, prazerigenin-A bioside and 9,10- dihydrophenanthrenes.... dioscorea prazeri
Social services are provided by local-authority social-services departments. They include: practical help in the home (usually through home helps or aids to daily living); assistance in taking advantage of available educational facilities; help with adaptations to the disabled person’s house; provision of meals (‘Meals on Wheels’ or luncheon centres); and help in obtaining a telephone. Many of these facilities will involve the disabled person in some expense, but full details can be obtained from the local social-services department which will, if necessary, send a social worker to discuss the matter in the disabled person’s home. Owing to lack of funds and sta?, many local-authority social-services departments are unable to provide the full range of services.
Aids to daily living There is now a wide range of aids for the disabled. Full details and addresses of local o?ces can be obtained from: Disabled Living Foundation and British Red Cross.
Aids to mobility and transport Some car manufacturers make specially equipped or adapted cars, and some have o?cial systems for discounts. Details can be obtained from local dealers. Help can also be obtained from Motability, which provides advice.... disabled persons
Habitat: Native to East Africa and Saudi Arabia.English: Dragon's Blood.Ayurvedic: Khoonkharaabaa, Heeraadokhi.Unani: Dammul-Akhwain.Family: Araceae.
Habitat: Maharashtra and Karnata- ka; cultivated in the South.Siddha/Tamil: Kattu Karunayikki- langu.Folk: Jangali Suuran.
Action: Root—antidiarrhoeal, anti-inflammatory (prescribed for haemorrhoids), antispasmodic (used in asthma), emmenagogue, abortifacient.... dracontium polyphyllum
Habitat: Throughout India, up to 2,438 m.Ayurvedic: Brahma-suvarchalaa (doubtful synonym).Folk: Mukhjali. (Drosera burmannii Vahl is also known as Mukhjali.)
Action: Resin from plant—used in bronchitis and whooping cough. Plant—antisyphyilitic. Bruised leaves, mixed with salt are applied for treating blisters.Key application: Drosera rotundifo- lia—in dry cough and coughing fits, as bronchoantispasmodic. (German Commission E.).The leaves contain napthaquinones, plumbagin (0.5%), droserone (3-hy- droxyplumbagin) and hydroxydro- serone (0.01%), and the flavonoids, quercetin, gossypetin, gossypin and isogossypitrin. The antispasmodic action of the herb has been attributed to naphthoquinones. Plumbagin is antimicrobial in vitro against some Gram-positive and Gram-negativebac- teria, influenza virus, pathogenic fungi and parasitic protozoa, and is active against some species of Leishmania. In large doses plumbagin is cytotoxic, but in small doses exhibits immunostimu- lating activity in vitro.A related species, Drosera indica Linn., is found in Deccan peninsula, particularly in the West coast. Plum- bagone, isolated from the plant, depresses the isolated intestine of the guinea-pig and suppresses the effect of acetylcholine. In Indo-China, a maceration of the plant is applied topically to corns.In Western herbal, Sundew is obtained from the aerial parts of Drosera rotundifolia which grows throughout Europe.... drosera peltata
The other dangers of administering drugs in pregnancy are the teratogenic effects (see TERATOGENESIS). It is understandable that a drug may interfere with a mechanism essential for growth and result in arrested or distorted development of the fetus and yet cause no disturbance in the adult, in whom these di?erentiation and organisation processes have ceased to be relevant. Thus the e?ect of a drug upon a fetus may di?er qualitatively as well as quantitatively from its e?ect on the mother. The susceptibility of the embryo will depend on the stage of development it has reached when the drug is given. The stage of early di?erentiation – that is, from the beginning of the third week to the end of the tenth week of pregnancy – is the time of greatest susceptibility. After this time the risk of congenital malformation from drug treatment is less, although the death of the fetus can occur at any time.... drugs in pregnancy
[catlist id=3 numberposts=100 pagination=yes instance=2 orderby=title order=asc]... indian medicinal plants
Eustachian catheters are small catheters that are passed along the ?oor of the nose into the Eustachian tube in order to in?ate the ear.
Nasal catheters are tubes passed through the nose into the stomach to feed a patient who cannot swallow – so-called nasal feeding.
Rectal catheters are passed into the RECTUM in order to introduce ?uid into the rectum.
Suprapubic catheters are passed into the bladder through an incision in the lower abdominal wall just above the pubis, either to allow urine to drain away from the bladder, or to wash out an infected bladder.
Ureteric catheters are small catheters that are passed up the ureter into the pelvis of the kidney, usually to determine the state of the kidney, either by obtaining a sample of urine direct from the kidney or to inject a radio-opaque substance preliminary to X-raying the kidney. (See PYELOGRAPHY.)
Urethral catheters are catheters that are passed along the urethra into the bladder, either to draw o? urine or to wash out the bladder.
It is these last three types of catheters that are most extensively used.... endotracheal catheters are used to pass
Habitat: Native to Amercia. Grows in Southern and Eastern India.English: Jalap.Unani: Jalaapaa.
Action: Tuber—drastic hydr- agogue cathartic, acts briskly, causes watery evacuations. Overdoses produce hypercatharsis. Contraindicated in inflammatory conditions of the bowels. (The roots of Operculina turpethum synonym Ipomoea turpethum are used as a substitute for jalap.)... exogonium purga
Habitat: Native to Arabia and Persia.English: Sagapenum.Unani: Sakbeenaj, Sakbekh.Family: Umbelliferae; Apiaceae.
Habitat: Native to Central Asia.English: Musk Root.Folk: Sumbul, Sambala.
Action: Used as a sedative in hysteria and other nervous disorders. Also used as a mild gastrointestinal stimulant. Formerly used for asthma, bronchitis and amenorrhoea.Ferula sumbul contains 0.2-0.4% volatile oil; 5-15% resin; hydroxy- coumarins including umbelliferone; sumbulic and angelic acids.... ferula persica
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
Habitat: Western Ghats, West Coast from Konkan to Kerala; abundant in the rainy season.Ayurvedic: Parpata (substitute).
Action: The plant contains naphthofuranones, justicidin A, B, C, D, G and H, and diphyllin, which are used for the treatment of osteoporosis. The flowers contain peonidine glucoside. Essential oil— antifungal.... justicia procumbens
Habitat: North-western India and Rajasthan, from Kashmir eastward to Nepal, ascending to 1,000 m.English: Indian Fig.Ayurvedic: Phalgu, Anjiri.Siddha: Manjimedi (Telugu).
Action: Fruit—demulcent and laxative. Latex is applied on pimples. Ripe fruits—hypotensive.Leaves gave bergapten and beta- sitosterol.... ficus palmata
Habitat: Sandy coasts of India.Ayurvedic: Gojihvaa, Golomikaa. (Gaozabaan, used in Unani medicine, is equated with Bor- aginaceae sp.)Folk: Vana-gobhi; Paathri (Maharashtra).
Action: Plant—galactagogue, soporific, diuretic, aperient.... launaea pinnatifida
Habitat: Uttaranchal, Himachal Pradesh.Ayurvedic: Kaakoli, Madhuraa, Kshira, Vayhasthaa, Karnikaa, Vaayasoli.
Action: Tuberous root—used as a tonic in emaciation and as a source of energy, after dry roasting.Dosage: Tuberous root—3-6 g. (API, Vol. III.)... lilium polyphyllum
Treatment This is urgent. If the skin has been contaminated with the lysol, it must be washed with water, and any lysol-contaminated clothing must be taken o?. Do not make the victim vomit if he or she has swallowed a corrosive substance such as lysol or phenol. Call an ambulance and say what the victim has taken. See APPENDIX 1: BASIC FIRST AID.... lysol poisoning
Habitat: At high altitudes in Tamil Nadu; up to 2,700 m on the Himalayas.English: Fumitory.Ayurvedic: Parpata, Parpata- ka, Varatikta, Renu, Kavacha, Sukshmapatra.Unani: Shaahtaraa.Siddha/Tamil: Thura.Folk: Pittapaaparaa.
Action: Detoxifying, laxative, diuretic, diaphoretic.The plant contains isoquinoline alkaloids-including protopine, sangui- narine, cryptopine, d-bicuculline, fu- maridine, fumaramine. The leaves contain kaempferol and quercetin glycosides.Dosage: Whole plant-1-3 g (API Vol. IV); 3-35 g powder; 50-100 ml decoction. (CCRAS.)... fumaria parviflora
Habitat: Forests of northeast Bengal, sporadic in NEFA, Manipur and upper AssamAyurvedic: Amlavetasa. Vetasaamla.Folk: Thaikala (Bengal).
Action: Antiscorbutic, astringent, cooling, cardiotonic, emollient. Used in anorexia, dyspepsia, colic, liver and spleen diseases difficult micturition. Cough and other respiratory disorders, ulcers and skin diseases.Dry fruits (pericarp) contain the benzophenones, pedunculol, garcinol and cambogin.The heartwood gave benzophenone and xanthone.Dosage: Fruit—5-10 ml juice. (CCRAS.)... garcinia pedunculata
Habitat: Throughout India, up to 1,000 m on the hills.English: Grey Downy Balsam.Ayurvedic: Paaranki, Kharpata. (Kinkiraata, Karnikaara, Mri- galindika are doubtful synonyms.)Siddha/Tamil: Karre Vembu, Arunelli.Folk: Ghogar, Toon.
Action: Fruit—stomachic. Leaf— astringent, antiasthmatic. Bark— antidiabetic.The leaves and stem bark contain sterols, sitosterol, stigmasterol and campesterol; fatty acids; aliphatic compounds; a mixture of long chain esters; along with tannins and waxes. The leaves also contain garu- garin and amentoflavone. Gum-resin contains alpha-amyrin, butyrospermol and dammarandiol.Aqueous and ethanolic extract of the leaves exhibit anti-inflammatory and antiallergic activities.... garuga pinnata
Habitat: Cultivated in Tamil Nadu and Karnataka.English: West Indian Cherry.Folk: Vallari (Telugu), Simeyaranelli (Kannada).
Action: See Malpighia glabra.Fruits contain ascorbic acid in high concentration (green fruits contain up to 3,000 mg/100 g). 3-methyl-3- buten-1-ol has been identified as major volatile constituent of the fruit.... malpighia punicifolia
Most GPs work in groups of self-employed individuals, who contract their services to the local Primary Care Trust (PCT) – see below. Those in full partnership are called principals, but an increasing number now work as non-principals – that is, they are employees rather than partners in a practice. Alternatively, they might be salaried employees of a PCT. The average number of patients looked after by a full-time GP is 1,800 and the average duration of consultation about 10 minutes. GPs need to be able to deal with all common medical conditions and be able to recognise conditions that require specialist help, especially those requiring urgent action.
Until the new General Medical Services Contract was introduced in 2004, GPs had to take individual responsibility for providing ‘all necessary medical services’ at all times to their patient list. Now, practices rather than individuals share this responsibility. Moreover, the contract now applies only to the hours between
8.00 a.m. and 6.30 p.m., Mondays to Fridays; out-of-hours primary care has become the responsibility of PCTs. GPs still have an obligation to visit patients at home on weekdays in case of medical need, but home-visiting as a proportion of GP work has declined steadily since the NHS began. By contrast, the amount of time spent attending to preventive care and organisational issues has steadily increased. The 2004 contract for the ?rst time introduced payment for speci?c indicators of good clinical care in a limited range of conditions.
A telephone advice service, NHS Direct, was launched in 2000 to give an opportunity for patients to ‘consult’ a trained nurse who guides the caller on whether the symptoms indicate that self-care, a visit to a GP or a hospital Accident & Emergency department, or an ambulance callout is required. The aim of this service is to give the patient prompt advice and to reduce misuse of the skills of GPs, ambulance sta? and hospital facilities.
Training of GPs Training for NHS general practice after quali?cation and registration as a doctor requires a minimum of two years’ post-registration work in hospital jobs covering a variety of areas, including PAEDIATRICS, OBSTETRICS, care of the elderly and PSYCHIATRY. This is followed by a year or more working as a ‘registrar’ in general practice. This ?nal year exposes registrars to life as a GP, where they start to look after their own patients, while still closely supervised by a GP who has him- or herself been trained in educational techniques. Successful completion of ‘summative assessment’ – regular assessments during training – quali?es registrars to become GPs in their own right, and many newly quali?ed GPs also sit the membership exam set by the Royal College of General Practitioners (see APPENDIX 8: PROFESSIONAL ORGANISATIONS).
A growing number of GP practices o?er educational attachments to medical students. These attachments provide experience of the range of medical and social problems commonly found in the community, while also o?ering them allocated time to learn clinical skills away from the more specialist environment of the hospital.
In addition to teaching commitments, many GPs are also choosing to spend one or two sessions away from their practices each week, doing other kinds of work. Most will work in, for example, at least one of the following: a hospital specialist clinic; a hospice; occupational medicine (see under OCCUPATIONAL HEALTH, MEDICINE AND DISEASES); family-planning clinics; the police or prison services. Some also become involved in medical administration, representative medicopolitics or journalism. To help them keep up to date with advances and changes in medicine, GPs are required to produce personal-development plans that outline any educational activities they have completed or intend to pursue during the forthcoming year.
NHS GPs are allowed to see private patients, though this activity is not widespread (see PRIVATE HEALTH CARE).
Primary Care Trusts (PCTs) Groups of GPs (whether working alone, or in partnership with others) are now obliged by the NHS to link communally with a number of other GPs in the locality, to form Primary Care Trusts (PCTs). Most have a membership of about 30 GPs, working within a de?ned geographical area, in addition to the community nurses and practice counsellors working in the same area; links are also made to local council social services so that health and social needs are addressed together. Some PCTs also run ambulance services.
One of the roles of PCTs is to develop primary-care services that are appropriate to the needs of the local population, while also occupying a powerful position to in?uence the scope and quality of secondary-care services. They are also designed to ensure equity of resources between di?erent GP surgeries, so that all patients living in the locality have access to a high quality and uniform standard of service.
One way in which this is beginning to happen is through the introduction of more overt CLINICAL GOVERNANCE. PCTs devise and help their member practices to conduct CLINICAL AUDIT programmes and also encourage them to participate in prescribing incentive schemes. In return, practices receive payment for this work, and the funds are used to improve the services they o?er their patients.... general practitioner (gp)
[catlist id=11 numberposts=100 pagination=yes instance=2 orderby=title order=asc]... medical dictionary
[catlist id=4 numberposts=100 pagination=yes instance=2 orderby=title order=asc]... medicinal plants
[catlist id=7 numberposts=100 pagination=yes instance=2 orderby=title order=asc]... medicinal plants glossary
Habitat: Peninsular India and Andaman Islands. Cultivated in gardens.Ayurvedic: Vana-nimbuukaa, Ashwa-shaakhota.Siddha/Tamil: Konji, Amam, Kula-pannai.Folk: Bana-Nimbu, Paanal (Kerala).
Action: Plant—bechic, anti- anaemic, antirheumatic. Root— anti-inflammatory. Leaf—used in Jaundice and liver disorders, eczema and other skin affections. Leaf and root—vermifuge, febrifuge. A paste of the wood is applied externally to pimples.Leaf extract from a Sri Lankan plant yielded the alkaloids arborine, skim- mianine and arborinine. The steam distillate of leaves showed significant antifungal activity.... glycosmis pentaphylla
Habitat: A native to Polynesia; introduced into Indian gardens.English: Caricature Plant.Folk: Kaalaa-aduusaa (Maharashtra). Ysjudemaram (Tamil Nadu).
Action: Leaves—emollient and resolvent; applied to swellings and ulcers. (Used as a substitute for Adhatoda vasica).... graptophyllum picum
Habitat: Cultivated in Punjab, Sind, Rajasthan and Western India, down to the Nilgiri Hills.Ayurvedic: Gaangeru(ki). Substitute for Gulshakari (Naagabalaa).Siddha/Tamil: Achhu.Folk: Gangeran.
Action: See G. hirsuta.The stem bark contains triterpe- noids.Dosage: Root—10-20 ml juice; 50100 ml decotion. (CCRAS.)... grewia populifolia
Habitat: North-eastern Indian hills.
Action: Leaf—used for ringworm of the scalp.A acetylenic glucoside, isolated from the leaf, showed antibacterial activity against Pseudomonas aeruginosa and Staphylococcus aureus.... microglossa pyrifolia
Habitat: Eastern Himalaya, Sikkim, Assam, and Western Ghats in Tamil Nadu and Kerala.
Action: Plant—emollient, resolvent. Used as a poultice in erysipelas and for tumours in the breast. Root—used both externally and internally for enhancing blood circulation especially when blue spots and blotches result from blows. The powdered root, mixed with tea, is given to parturient women. Leaves—used for poulticing pimples. The juice is used asa gargle for inflammations of the throat.... gynura pseudo-china
If you’re looking for a special herbal tea, you can try pipsissewa tea. It has a pleasant taste, slightly bitter, like most herbal teas, but also a bit sweet. Also, it comes with many health benefits. Read to find out more!
About Pipsissewa Tea
Pipsissewa tea is made from the pipsissewa plant, also known as Umbellate Wintergreen or Prince’s pine. It is a small, evergreen perennial plant, usually found in the dry woodlands or sandy soils of Southern Canada and northern United States.
The plant can grow up to 30cm tall. It usually has 4 evergreen, shiny leaves with a toothed margin; they’re arranged one opposite the other on the stem. It has 4-8 flowers, either pink or white, which bloom during summer.
The pipsissewa plant is used to make root beer. It can also be used to flavor candies and soft drinks.
How to prepare Pipsissewa Tea
You only need a few minutes to prepare a cup of pipsissewa tea. Put a tablespoon of herbs in the cup, then pour freshly boiled water over it. Let it steep for 2-4 minutes; then, strain the drink. Sweeten it with milk or honey, if you wish.
Pipsissewa Tea Benefits
Pipsisewa, as a plant, contains many important constituents which are also transferred to the pipsissewa tea. Some of them are hydroquinones (for example, arbutin), flavonoids, triterpenes, methyl salicylate, phenols, essential oils, and tannins. They have many health benefits.
Pipsissewa teais often recommended in the treatment for infections of the urinary tract, such as cystitis, painful urination, bladder and kidney stones, kidney inflammation, prostatitis, gonorrhea, and urethritis. It can also be used to treat arthritis, gout and rheumatism.
Drinking pipsissewa tea will help your body expel various infectious microorganisms. It can increase sweating in order to treat fever diseases. It is also often included in the treatment for ailments of the respiratory tract, such as colds, whooping cough, and bronchitis.
Pipsissewa tea can be used topically, as well. It can be used with blisters, tumors, and swellings. Also, you can use it as an eye wash if you’ve got sore eyes.
Pipsissewa Tea Side Effects
It is not well-known if pipsissewa tea can affect women during pregnancy or breast feeding. However, it’s considered safe not to drink it, just in case it might affect the baby.
It is best not to drink pipsissewa tea if you’re taking medication for the intestine, or if you’ve got iron deficiency.
Drinking a large amount of pipsissewa tea can also lead to a few side effects. The symptoms you might get are: diarrhea, nausea, vomiting, headaches, and loss of appetite.
You’ll definitely enjoy drinking pipsissewa tea, both for its pleasant taste and because of the health benefits it has.... have a cup of pipsissewa tea
Habitat: Temperate Western Himalayas from Kashmir to Shimla at 2,000-3,000 m.English: Common St. John's wort.Unani: Heufaariqoon, Bassant, Balsaan.
Action: Antidepressant, sedative, relaxing nervine, anti-inflammatory. Used in anxiety, stress, depression, menopausal nervousness, menstrual cramps, neuralgia and rheumatism.Key application: Psychovegetative disturbances, depressive moods, anxiety and or nervous unrest. Externally, oil preparation for treatment and post-therapy of acute and contused injuries, myalgia and first degree burns. (German Commission E, ESCOP, British Herbal Pharmocopoeia.)The herb contains hypericin and pseudohypericin (0.0095 to 0.466% in the leaves and as much as 0.24% in the flowers), rutin, quercetin, hyperoside, methylhesperidin, caffeic, chloro- genic, p-coumaric, ferulic, p-hydroxy- benzoic and vanillic acids.Plant's standardized extract (0.3% hypericin) shows antidepressant activity by inhibiting MAO.A biflavonoid, amentoflavone, isolated from the plant, exhibited anti- inflammatory and antiulcerogenic activity.Alcoholic extract of the plant shows in vivo hepatoprotective activity in rodents.The oily extract of the flowers have been found effective in wound-healing due to the antibiotically active acyl- phlorogucinol, hyperforin.The aerial parts show significant antibacterial activity against several Gram-positive and Gram-negative bacteria.A lyophilized infusion from the aerial parts exhibited antiviral activity and inhibited reproduction of different strains of influenza virus types A and B both in vivo and in vitro.The whole herb is effective against many viral infections.... hypericum perforatum
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
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
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)