See sensation.
– touch, taste, sight, hearing.... agnosia
The effects of ageing include: cessation of MENSTRUATION in females; wrinkling of the skin due to a loss of elastic tissue; failing memory (especially short term) and a reduced ability to learn new skills, along with slowed responses
– changes caused by the loss of or less e?cient working of nerve cells; the senses become less acute; the lungs become less e?cient, as does heart muscle, both causing a fall in exercise tolerance; arteries harden, resulting in a rise in blood pressure and poor blood circulation; joints are less mobile, bones beome more brittle (OSTEOPOROSIS) and muscle bulk and strength are reduced; the lens of the EYE becomes less elastic, resulting in poorer sight, and it may also become opaque (CATARACT).
In developed countries people are living longer, in part because infant and child mortality rates have dropped dramatically over the past 100 years or so. Improved standards of living and more e?ective health care have also contributed to greater longevity: the proportion of people over 65 years of age has greatly increased, and that of the over-75s is still rising. The 2001 census found 336,000 people in the UK aged over 90 and there are 36,000 centenarians in the US. This extreme longevity is attributed to a particular gene (see GENES) slowing the ageing process. Interestingly, those living to 100 often retain the mental faculties of people in their 60s, and examination of centenarians’ brains show that these are similar to those of 60-year-olds. (See MEDICINE OF AGEING; CLIMACTERIC.)
Help and advice can be obtained from Age
Concern and Help the Aged. See www.helpthaged.org.uk www.ageconcern.org.uk... ageing
Enteric-coated capsules, which have been largely superseded by enteric-coated tablets, are capsules treated in such a manner that the ingredients do not come in contact with the acid stomach contents but are only released when the capsule disintegrates in the alkaline contents of the intestine.
The term is also applied to the ?brous or membranous envelope of various organs, as of the spleen, liver or kidney. Additionally, it is applied to the ligamentous bag surrounding various joints and attached by its edge to the bones on either side.... capsule
Psychiatrists like to categorise mental illnesses because mental signs and symptoms do occur together in clusters or syndromes, each tending to respond to certain treatments. The idea that illnesses can be diagnosed simply by recognising their symptom patterns may not seem very scienti?c in these days of high technology. For most common mental illnesses, however, this is the only method of diagnosis; whatever is going wrong in the brain is usually too poorly understood and too subtle to show up in laboratory tests or computed tomography scans of the brain. And symptom-based definitions of mental illnesses are, generally, a lot more meaningful than the vague lay term ‘nervous breakdown’, which is used to cover an attack of anything from AGORAPHOBIA to total inability to function.
There is still a lot to learn about the workings of the brain, but psychiatry has developed plenty of practical knowledge about the probable causes of mental illness, ways of relieving symptoms, and ways of aiding recovery. Most experts now believe that mental illnesses generally arise from di?erent combinations of inherited risk and psychological STRESS, sometimes with additional environmental exposure – for example, viruses, drugs or ALCOHOL.
The range of common mental illnesses includes anxiety states, PHOBIA, DEPRESSION, alcohol and drug problems, the EATING DISORDERS anorexia and bulimia nervosa, MANIC DEPRESSION, SCHIZOPHRENIA, DEMENTIA, and a group of problems related to coping with life that psychiatrists call personality disorders.
Of these mental illnesses, dementia is the best understood. It is an irreversible and fatal form of mental deterioration (starting with forgetfulness and eventually leading to severe failure of all the brain’s functions), caused by rapid death of brain cells and consequent brain shrinkage. Schizophrenia is another serious mental illness which disrupts thought-processes, speech, emotions and perception (how the brain handles signals from the ?ve senses). Manic depression, in which prolonged ‘highs’ of extremely elevated mood and overexcitement alternate with abject misery, has similar effects on the mental processes. In both schizophrenia and manic depression the sufferer loses touch with reality, develops unshakeable but completely unrealistic ideas (delusions), and hallucinates (vividly experiences sensations that are not real, e.g. hears voices when there is nobody there). This triad of symptoms is called psychosis and it is what lay people, through fear and lack of understanding, sometimes call lunacy, madness or insanity.
The other mental illnesses mentioned above are sometimes called neuroses. But the term has become derogatory in ordinary lay language; indeed, many people assume that neuroses are mild disorders that only affect weak people who cannot ‘pull themselves together’, while psychoses are always severe. In reality, psychoses can be brief and reversible and neuroses can cause lifelong disability.
However de?ned and categorised, mental illness is a big public-health problem. In the UK, up to one in ?ve women and around one in seven men have had mental illness. About half a million people in Britain suffer from schizophrenia: it is three times commoner than cancer. And at any one time, up to a tenth of the adult population is ill with depression.
Treatment settings Most people with mental-health problems get the help they need from their own family doctor(s), without ever seeing a psychiatrist. General practictitioners in Britain treat nine out of ten recognised mental-health problems and see around 12 million adults with mental illness each year. Even for the one in ten of these patients referred to psychiatrists, general practitioners usually handle those problems that continue or recur.
Psychiatrists, psychiatric nurses, social workers, psychologists, counsellors and therapists often see patients at local doctors’ surgeries and will do home visits if necessary. Community mental-health centres – like general-practice health centres but catering solely for mental-health problems – o?er another short-cut to psychiatric help. The more traditional, and still more common, route to a psychiatrist for many people, however, is from the general practititioner to a hospital outpatient department.
Specialist psychiatric help In many ways, a visit to a psychiatrist is much like any trip to a hospital doctor – and, indeed, psychiatric clinics are often based in the outpatient departments of general hospitals. First appointments with psychiatrists can last an hour or more because the psychiatrist – and sometimes other members of the team such as nurses, doctors in training, and social workers – need to ask lots of questions and record the whole consultation in a set of con?dential case notes.
Psychiatric assessment usually includes an interview and an examination, and is sometimes backed up by a range of tests. The interview begins with the patient’s history – the personal story that explains how and, to some extent, why help is needed now. Mental-health problems almost invariably develop from a mixture of causes – emotional, social, physical and familial – and it helps psychiatrists to know what the people they see are normally like and what kind of lives they have led. These questions may seem unnecessarily intrusive, but they allow psychiatrists to understand patients’ problems and decide on the best way to help them.
The next stage in assessment is the mental-state examination. This is how psychiatrists examine minds, or at least their current state. Mental-state examination entails asking more questions and using careful observation to assess feelings, thoughts and mental symptoms, as well as the way the mind is working (for example, in terms of memory and concentration). During ?rst consultations psychiatrists usually make diagnoses and explain them. The boundary between a life problem that will clear up spontaneously and a mental illness that needs treatment is sometimes quite blurred; one consultation may be enough to put the problem in perspective and help to solve it.
Further assessment in the clinic may be needed, or some additional tests. Simple blood tests can be done in outpatient clinics but other investigations will mean referral to another department, usually on another day.
Further assessment and tests
PSYCHOLOGICAL TESTS Psychologists work in or alongside the psychiatric team, helping in both assessment and treatment. The range of psychological tests studies memory, intelligence, personality, perception and capability for abstract thinking. PHYSICAL TESTS Blood tests and brain scans may be useful to rule out a physical illness causing psychological symptoms. SOCIAL ASSESSMENT Many patients have social diffculties that can be teased out and helped by a psychiatric social worker. ‘Approved social workers’ have special training in the use of the Mental Health Act, the law that authorises compulsory admissions to psychiatric hospitals and compulsory psychiatric treatments. These social workers also know about all the mental-health services o?ered by local councils and voluntary organisations, and can refer clients to them. The role of some social workers has been widened greatly in recent years by the expansion of community care. OCCUPATIONAL THERAPY ASSESSMENT Mental-health problems causing practical disabilities – for instance, inability to work, cook or look after oneself – can be assessed and helped by occupational therapists.
Treatment The aims of psychiatric treatment are to help sufferers shake o?, or at least cope with, symptoms and to gain or regain an acceptable quality of life. A range of psychological and physical treatments is available.
COUNSELLING This is a widely used ‘talking cure’, particularly in general practice. Counsellors listen to their clients, help them to explore feelings, and help them to ?nd personal and practical solutions to their problems. Counsellors do not probe into clients’ pasts or analyse them. PSYCHOTHERAPY This is the best known ‘talking cure’. The term psychotherapy is a generalisation covering many di?erent concepts. They all started, however, with Sigmund Freud (see FREUDIAN THEORY), the father of modern psychotherapy. Freud was a doctor who discovered that, as well as the conscious thoughts that guide our feelings and actions, there are powerful psychological forces of which we are not usually aware. Applying his theories to his patients’ freely expressed thoughts, Freud was able to cure many illnesses, some of which had been presumed completely physical. This was the beginning of individual analytical psychotherapy, or PSYCHOANALYSIS. Although Freud’s principles underpin all subsequent theories about the psyche, many di?erent schools of thought have emerged and in?uenced psychotherapists (see ADLER; JUNGIAN ANALYSIS; PSYCHOTHERAPY). BEHAVIOUR THERAPY This springs from theories of human behaviour, many of which are based on studies of animals. The therapists, mostly psychologists, help people to look at problematic patterns of behaviour and thought, and to change them. Cognitive therapy is very e?ective, particularly in depression and eating disorders. PHYSICAL TREATMENTS The most widely used physical treatments in psychiatry are drugs. Tranquillising and anxiety-reducing BENZODIAZEPINES like diazepam, well known by its trade name of Valium, were prescribed widely in the 1960s and 70s because they seemed an e?ective and safe substitute for barbiturates. Benzodiazepines are, however, addictive and are now recommended only for short-term relief of anxiety that is severe, disabling, or unacceptably distressing. They are also used for short-term treatment of patients drying out from alcohol.
ANTIDEPRESSANT DRUGS like amitriptyline and ?uoxetine are given to lift depressed mood and to relieve the physical symptoms that sometimes occur in depression, such as insomnia and poor appetite. The side-effects of antidepressants are mostly relatively mild, when recommended doses are not exceeded – although one group, the monoamine oxidase inhibitors, can lead to sudden and dangerous high blood pressure if taken with certain foods.
Manic depression virtually always has to be treated with mood-stabilising drugs. Lithium carbonate is used in acute mania to lower mood and stop psychotic symptoms; it can also be used in severe depression. However lithium’s main use is to prevent relapse in manic depression. Long-term unwanted effects may include kidney and thyroid problems, and short-term problems in the nervous system and kidney may occur if the blood concentration of lithium is too high – therefore it must be monitored by regular blood tests. Carbamazepine, a treatment for EPILEPSY, has also been found to stabilise mood, and also necessitates blood tests.
Antipsychotic drugs, also called neuroleptics, and major tranquillisers are the only e?ective treatments for relieving serious mental illnesses with hallucinations and delusions. They are used mainly in schizophrenia and include the short-acting drugs chlorpromazine and clozapine as well as the long-lasting injections given once every few weeks like ?uphenazine decanoate. In the long term, however, some of the older antipsychotic drugs can cause a brain problem called TARDIVE DYSKINESIA that affects control of movement and is not always reversible. And the antipsychotic drugs’ short-term side-effects such as shaking and sti?ness sometimes have to be counteracted by other drugs called anticholinergic drugs such as procyclidine and benzhexol. Newer antipsychotic drugs such as clozapine do not cause tardive dyskinesia, but clozapine cannot be given as a long-lasting injection and its concentration in the body has to be monitored by regular blood tests to avoid toxicity. OTHER PHYSICAL TREATMENTS The other two physical treatments used in psychiatry are particularly controversial: electroconvulsive therapy (ECT) and psychosurgery. In ECT, which can be life-saving for patients who have severe life-threatening depression, a small electric current is passed through the brain to induce a ?t or seizure. Before the treatment the patient is anaesthetised and given a muscle-relaxing injection that reduces the magnitude of the ?t to a slight twitching or shaking. Scientists do not really understand how ECT works, but it does, for carefully selected patients. Psychosurgery – operating on the brain to alleviate psychiatric illness or di?cult personality traits – is extremely uncommon these days. Stereo-tactic surgery, in which small cuts are made in speci?c brain ?bres under X-ray guidance, has super-seded the more generalised lobotomies of old. The Mental Health Act 1983 ensures that psychosurgery is performed only when the patient has given fully informed consent and a second medical opinion has agreed that it is necessary. For all other psychiatric treatments (except another rare treatment, hormone implantation for reducing the sex drive of sex o?enders), either consent or a second opinion is needed – not both. TREATMENT IN HOSPITAL Psychiatric wards do not look like medical or surgical wards and sta? may not wear uniforms. Patients do not need to be in their beds during the day, so the beds are in separate dormitories. The main part of most wards is a living space with a day room, an activity and television room, quiet rooms, a dining room, and a kitchen. Ward life usually has a certain routine. The day often starts with a community meeting at which patients and nurses discuss issues that affect the whole ward. Patients may go to the occupational therapy department during the day, but there may also be some therapy groups on the ward, such as relaxation training. Patients’ symptoms and problems are assessed continuously during a stay in hospital. When patients seem well enough they are allowed home for trial periods; then discharge can be arranged. Patients are usually followed up in the outpatient clinic at least once.
TREATING PATIENTS WITH ACUTE PSYCHIATRIC ILLNESS Psychiatric emergencies – patients with acute psychiatric illness – may develop from psychological, physical, or practical crises. Any of these crises may need quick professional intervention. Relatives and friends often have to get this urgent help because the sufferer is not ?t enough to do it or, if psychotic, does not recognise the need. First, they should ring the person’s general practitioner. If the general practitioner is not available and help is needed very urgently, relatives or friends should phone the local social-services department and ask for the duty social worker (on 24-hour call). In a dire emergency, the police will know what to do.
Any disturbed adult who threatens his or her own or others’ health and safety and refuses psychiatric help may be moved and detained by law. The Mental Health Act of 1983 authorises emergency assessment and treatment of any person with apparent psychiatric problems that ful?l these criteria.
Although admission to hospital may be the best solution, there are other ways that psychiatric services can respond to emergencies. In some districts there are ‘crisis intervention’ teams of psychiatrists, nurses, and social workers who can visit patients urgently at home (at a GP’s request) and, sometimes, avert unnecessary admission. And research has shown that home treatment for a range of acute psychiatric problems can be e?ective.
LONG-TERM TREATMENT AND COMMUNITY CARE Long-term treatment is often provided by GPs with support and guidance from psychiatric teams. That is ?ne for people whose problems allow them to look after themselves, and for those with plenty of support from family and friends. But some people need much more intensive long-term treatment and many need help with running their daily lives.
Since the 1950s, successive governments have closed the old psychiatric hospitals and have tried to provide as much care as possible outside hospital – in ‘the community’. Community care is e?ective as long as everyone who needs inpatient care, or residential care, can have it. But demand exceeds supply. Research has shown that some homeless people have long-term mental illnesses and have somehow lost touch with psychiatric services. Many more have developed more general long-term health problems, particularly related to alcohol, without ever getting help.
The NHS and Community Care Act 1990, in force since 1993, established a new breed of professionals called care managers to assess people whose long-term illnesses and disabilities make them unable to cope completely independently with life. Care managers are given budgets by local councils to assess people’s needs and to arrange for them tailor-made packages of care, including services like home helps and day centres. But co-ordination between health and social services has sometimes failed – and resources are limited – and the government decided in 1997 to tighten up arrangements and pool community-care budgets.
Since 1992 psychiatrists have had to ensure that people with severe mental illnesses have full programmes of care set up before discharge from hospital, to be overseen by named key workers. And since 1996 psychiatrists have used a new power called Supervised Discharge to ensure that the most vulnerable patients cannot lose touch with mental-health services. There is not, however, any law that allows compulsory treatment in the community.
There is ample evidence that community care can work and that it need not cost more than hospital care. Critics argue, however, that even one tragedy resulting from inadequate care, perhaps a suicide or even a homicide, should reverse the march to community care. And, according to the National Schizophrenia Fellowship, many of the 10–15 homicides a year carried out by people with severe mental illnesses result from inadequate community care.
Further information can be obtained from the Mental Health Act Commission, and from MIND, the National Association for Mental Health. MIND also acts as a campaigning and advice organisation on all aspects of mental health.... mental illness
Recently chemotherapy has become increasingly e?ective in the treatment of cancer. Numerous drugs, generally CYTOTOXIC, are available; great care is required in their selection and to minimise side-effects. Certain tumours are highly sensitive to chemotherapy
– especially testicular tumours, LEUKAEMIA, LYMPHOMA and various tumours occurring in childhood (e.g. Wilm’s tumour – see NEPHROBLASTOMA) – and may even be cured.... chemotherapy
Causes The cause of these dilatations on the tendon-sheaths is either some irregular growth of the SYNOVIAL MEMBRANE which lines them and secretes the ?uid that lubricates their movements, or the forcing-out of a small pouch of this membrane through the sheath in consequence of a strain. In either case a bag-like swelling forms, whose connection with the synovial sheath becomes cut o?, so that synovial ?uid collects in it and distends it more and more.
Symptoms A soft, elastic, movable swelling forms, most often on the back of the wrist. It is usually small and gives no problems. Sometimes weakness and discomfort may develop. A ganglion which forms in connection with the ?exor tendons in front of the wrist sometimes attains a large size, and extends down to form another swelling in the palm of the hand.
Treatment Sudden pressure with the thumbs may often burst a ganglion and disperse its contents beneath the skin. If this fails, surgical excision is necessary but, as the ganglion may disappear spontaneously, there should be no rush to remove it unless it is causing inconvenience or pain.... ganglion
(iii) blockage of the circulation of CSF. Such disturbances in the circulation of the ?uid may be due to congenital reasons (most commonly associated with SPINA BIFIDA), to MENINGITIS, or to a tumour.
Symptoms In children, the chief symptoms observed are the gradual increase in size of the upper part of the head, out of all proportion to the face or the rest of the body. The head is globular, with a wide anterior FONTANELLE and separation of the bones at the sutures. The veins in the scalp are prominent, and there is a ‘crackpot’ note on percussion. The normal infant’s head should not grow more than 2·5 cm (1 inch) in each of the ?rst two months of life, and much more slowly subsequently; growth beyond this rate should arouse suspicions of hydrocephalus, so medical professionals caring for infants use centile charts for this purpose.
The cerebral ventricles are widely distended, and the convolutions of the brain ?attened, while occasionally the ?uid escapes into the cavity of the cranium, which it ?lls, pressing down the brain to the base of the skull. As a consequence of such changes, the functions of the brain are interfered with, and in general the mental condition of the patient is impaired. Untreated, the child is dull and listless, irritable and sometimes suffers from severe mental subnormality. The special senses become affected as the disease advances, especially vision, and sight is often lost, as is also hearing. Towards the end, paralysis is apt to occur.
Treatment Numerous ingenious operations have been devised for the treatment of hydrocephalus. The most satisfactory of these utilise unidirectional valves and shunts (tubes), whereby the cerebrospinal ?uid is bypassed from the brain into the right atrium of the heart or the peritoneal cavity. The shunt may have to be left in position inde?nitely.... hydrocephalus
Information is collected by millions of sense receptors found throughout body tissues and in special sense organs, such as the eye.
Certain sensory information, mainly that from the special sense organs and skin receptors, enters the sensory cortex of the brain, where sensations are consciously perceived.
Other types of sensory information, for example about body posture, are processed elsewhere and do not produce conscious sensation.... sensation
During registration, information from the sense organs and the cerebral cortex is put into codes for storage in the short-term memory system. The codes are usually acoustic (based on the sounds and words that would be used to describe the information) but may use any of the ?ve senses. This system can take only a few chunks of information at a time: for example, only about seven longish numbers can be retained and recalled at once – the next new number displaces an earlier one that is then forgotten. And if a subject is asked to describe a person just met, he or she will recall only seven or so facts about that person. This depends on attention span and can be improved by concentration and rehearsal – for example, by reciting the list of things that must be remembered.
Material needing storage for several minutes stays in the short-term memory. More valuable information goes to the long-term memory where it can be kept for any period from a few minutes to a lifetime. Storage is more reliable if the information is in meaningful codes – it is much easier to remember people’s names if their faces and personalities are memorable too. Using techniques such as mnemonics takes this into account.
The ?nal stage is retrieval. Recognising and recalling the required information involves searching the memory. In the short-term memory, this takes about 40-thousandths of a second per item – a rate that is surprisingly consistent, even in people with disorders such as SCHIZOPHRENIA.
Most kinds of forgetting or AMNESIA occur during retrieval. Benign forgetfulness is usually caused by interference from similar items because the required information was not clearly coded and well organised. Retrieval can be improved by recreating the context in which the information was registered. This is why the police reconstruct scenes of crimes, and why revision for exams is more e?ective if facts are learnt in the form of answers to mock questions.
Loss of memory or amnesia mainly affects long-term memory (information which is stored inde?nitely) rather than short-term memory which is measured in minutes. Short-term memory may, however, be affected by unconsciousness caused by trauma. Drivers involved in an accident may be unable to recall the event or the period leading up to it. The cause of amnesia is disease of or damage to the parts of the brain responsible for memory. Degenerative disorders such as ALZHEIMER’S DISEASE, brain tumours, infections (for example, ENCEPHALITIS), STROKE, SUBARACHNOID HAEMORRHAGE and alcoholism all cause memory loss. Some psychiatric illnesses feature loss of memory and AGEING is usually accompanied by some memory loss, although the age of onset and severity vary greatly.... memory
Touch sense proper, by which we perceive a touch or stroke and estimate the size and shape of bodies with which we come into contact, but which we do not see.
Pressure sense, by which we judge the heaviness of weights laid upon the skin, or appreciate the hardness of objects by pressing against them.
Heat sense, by which we perceive that an object is warmer than the skin.
Cold sense, by which we perceive that an object touching the skin is cold.
Pain sense, by which we appreciate pricks, pinches and other painful impressions.
Muscular sensitiveness, by which the painfulness of a squeeze is perceived. It is produced probably by direct pressure upon the nerve-?bres in the muscles.
Muscular sense, by which we test the weight of an object held in the hand, or gauge the amount of energy expended on an e?ort.
Sense of locality, by which we can, without looking, tell the position and attitude of any part of the body.
Common sensation, which is a vague term used to mean composite sensations produced by several of the foregoing, like tickling, or creeping, and the vague sense of well-being or the reverse that the mind receives from internal organs. (See the entry on PAIN.)
The structure of the end-organs situated in the skin, which receive impressions from the outer world, and of the nerve-?bres which conduct these impressions to the central nervous system, have been described under NERVOUS SYSTEM. (See also SKIN.)
Touch affects the Meissner’s or touch corpuscles placed beneath the epidermis; as these di?er in closeness in di?erent parts of the skin, the delicacy of the sense of touch varies greatly. Thus the points of a pair of compasses can be felt as two on the tip of the tongue when separated by only 1 mm; on the tips of the ?ngers they must be separated to twice that distance, whilst on the arm or leg they cannot be felt as two points unless separated by over 25 mm, and on the back they must be separated by more than 50 mm. On the parts covered by hair, the nerves ending around the roots of the hairs also take up impressions of touch.
Pressure is estimated probably through the same nerve-endings and nerves that have to do with touch, but it depends upon a di?erence in the sensations of parts pressed on and those of surrounding parts. Heat-sense, cold-sense and pain-sense all depend upon di?erent nerve-endings in the skin; by using various tests, the skin may be mapped out into a mosaic of little areas where the di?erent kinds of impressions are registered. Whilst the tongue and ?nger-tips are the parts most sensitive to touch, they are comparatively insensitive to heat, and can easily bear temperatures which the cheek or elbow could not tolerate. The muscular sense depends upon the sensory organs known as muscle-spindles, which are scattered through the substance of the muscles, and the sense of locality is dependent partly upon these and partly upon the nerves which end in tendons, ligaments and joints.
Disorders of the sense of touch occur in various diseases. HYPERAESTHESIA is a condition in which there is excessive sensitiveness to any stimulus, such as touch. When this reaches the stage when a mere touch or gentle handling causes acute pain, it is known as hyperalgesia. It is found in various diseases of the SPINAL CORD immediately above the level of the disease, combined often with loss of sensation below the diseased part. It is also present in NEURALGIA, the skin of the neuralgic area becoming excessively tender to touch, heat or cold. Heightened sensibility to temperature is a common symptom of NEURITIS. ANAESTHESIA, or diminution of the sense of touch, causing often a feeling of numbness, is present in many diseases affecting the nerves of sensation or their continuations up the posterior part of the spinal cord. The condition of dissociated analgesia, in which a touch is quite well felt, although there is complete insensibility to pain, is present in the disease of the spinal cord known as SYRINGOMYELIA, and a?ords a proof that the nerve-?bres for pain and those for touch are quite separate. In tabes dorsalis (see SYPHILIS) there is sometimes loss of the sense of touch on feet or arms; but in other cases of this disease there is no loss of the sense of touch, although there is a complete loss of the sense of locality in the lower limbs, thus proving that these two senses are quite distinct. PARAESTHESIAE are abnormal sensations such as creeping, tingling, pricking or hot ?ushes.... touch
The patient may start as a food faddist with depressive tendencies. Some gorge huge meals (bulimia) and induce vomiting later. Such women are known to be oestrogen deficient; most have a low dietary intake of calcium, resulting in reduced bone density (osteoporosis). Lack of exercise has a worsening influence, often with severe loss of weight.
It is now established that one cause is a deficiency of zinc in the diet. Individuals suffering from the condition (with its depression) may recover when given 15mg zinc daily. Starvation causes increased urinary zinc secretion, thus further reducing body levels of the mineral. Most anorectics complain of loss of sense of taste and smell which is a symptom of zinc deficiency. Loss of these two senses reduces further the desire for food.
Symptoms. Excessive thinness. Anaemia. Poor haemoglobin levels. Absence of menses. Episodic hyperactivity. Slow pulse when resting. Teeth decay, brittle bones. Heart weakness. Low blood pressure, hormonal disorders, yellowing skin, blood disorders, abnormal drowsiness and weakness. Reduced bone density may develop during the illness, the subject being prone to bone fracture for years afterwards. Treatment. Correct anaemia with iron-bearing herbs, Vitamin B12, mineral supplements and nourishing food.
Angelica root, Barberry, Bogbean, Burdock root, Calamus, Centuary herb, Chamomile flowers, Condurango bark, Dandelion (coffee), Garden Sage, Gentian, Ginkgo, Helonias, Hops, Marshmallow root, Milk Thistle, Quassia chips, White Poplar.
Alternatives:– Tea. Formula. Equal parts, Centuary, Chamomile, Peppermint. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes. Dose: 1 cup thrice daily, before meals.
Decoction. Formula. Combine Angelica root 1; Burdock root 1; Condurango bark half. 1 teaspoon to each cupful water simmered gently 20 minutes. Dose: Half-1 cup thrice daily before meals.
Powders. Formula. German Chamomile 2; Gotu Kola 1; Ginkgo 1. Dose: 500mg (two 00 capsules or one- third teaspoon) before meals thrice daily.
Tinctures. Formula. Combine: Condurango quarter; Burdock root half; White Poplar 1; Ginkgo 1; add 2- 10 drops Tincture Capsicum fort. 1-2 teaspoons in water thrice daily, before meals.
Tincture: Tincture Gentian Co BP. Dose: 2-4ml (30-60 drops).
Ginger, stem. Success reported.
Milk Thistle and Turmeric: popular in general herbal practice.
Diet. High protein, low fat, low salt. Dandelion coffee. Liver. Artichokes. 2-3 bananas (for potassium) daily.
Supplements. Daily. Vitamin B-complex. Vitamin C, 1g. Vitamin E, 200iu. Zinc, 15mg. Magnesium, 250mg morning and evening. ... anorexia nervosa
While an internal mechanism slows down the body, caffeine in tea, cola and coffee restores alertness. Caffeine acts by blocking the action of the compound, adenosine – one of the building blocks of DNA which promotes cell energy. Caffeine interferes with natural metabolic processes. In the aged, coffee increases production of uric acid, causing irritation of the kidneys, joint and muscle pains. vCaffeinism is responsible for a wide range of disorders. Increases the heart beat, promotes excessive stomach acid and increases flow of urine. It may give rise to birth defects and should be taken with caution in pregnancy.
Symptoms. Restlessness, nervous agitation, extreme sensitiveness. Intolerance of pain, nervous palpitation, all senses acute.
To antidote. Chamomile tea.
Practitioner. Tincture Nux vom BP: 10 drops to 100ml water. Dose: 1 teaspoon thrice daily. Inhalation: Strong spirits of Camphor.
Diet. Plenty asparagus. ... caffeine poisoning
Dr Joanna Brandt knew that grapes may sometimes check malignancy. Facing up squarely to the reality of cancer, she resolved not to take any medicines to check its course or alleviate the pain . . . neither would she submit to the surgeon’s knife.
For nine years she had been desperately seeking something to destroy the growth effectively, to eliminate virulent cancer toxins and rebuild new tissue.
At the conclusion of a seven-day fast she developed a craving for grapes. From the first mouthful she felt their purifying influence and a lift physically and mentally. She was miraculously cured.
As in other cases, improvement was attended by the senses becoming abnormally acute, dim eyes became bright, faded hair took on a new gloss, a lifeless voice became vibrant, the complexion cleared; teeth, loose and suppurating in their sockets became fixed and healthy.
In “The Grape Cure”, she records: “While the system is drained of its poisons, external wounds are kept open with frequent applications of Grape poultices and compresses . . . No scabs or crusts are formed as long as the lesions are kept moist . . . From glistening bones outwards, the process of reconstruction goes on. Healthy, rosy granulations of new flesh appear and cavities are filled in.”
The body is prepared for the regime by fasting for 2-3 days, drinking plenty of pure cold water and by taking a two-pint enema of lukewarm water daily.
After the fast, she advises – “Drink one or two glasses of cold water on rising. Half hour later, have a meal of grapes, discard seeds, chew skins thoroughly, swallowing a few for medicine and fibre. Have a grape meal every two hours from 8am to 8pm (7 meals daily). Continue two weeks – even for one month. Begin with 1, 2 or 3 ounces per meal, increasing gradually to half pound. The maximum should not exceed 4 pounds. Patients taking large quantities should allow 3 hours for digestion and not take all skins.”
After years of suffering, Dr Brandt discovered a cure which worked in her particular case and which she was able to repeat in a number of others. ... grapes
called the corpus callosum carries nerve signals between the 2 hemispheres.
The outer surface layer of each hemisphere is the cerebral cortex – the “grey matter’’, where much of the sensory information from organs such as the eyes and ears is processed. Specific sensory processing takes place in separate regions. For example, visual perception is located in a part of the occipital lobe called the visual cortex.
The cortex also contains “motor’’ areas concerned with the initiation of signals for movement by the skeletal muscles.
Linked to the sensory and motor areas of the cortex are association areas, which integrate information from various senses and also perform functions such as comprehension and recognition, memory storage and recall, thought and decision making.
Some of these cortical functions are localized to one “dominant’’ hemisphere (the left in almost all right-handed and many left-handed people).
Two clearly defined areas in the dominant hemisphere are Wernicke’s area, responsible for the comprehension of words, and Broca’s area, which is concerned with language expression.... cerebrum
Added to the above are:– muscular rigidity, loss of reflexes, drooling – escape of saliva from the mouth. Muscles of the face are stiff giving a fixed expression, the back presents a bowed posture. The skin is excessively greasy and the patient is unable to express emotional feelings. Loss of blinking. Pin- rolling movement of thumb and forefinger.
Causes: degeneration of groups of nerve cells deep within the brain which causes a lack of neurotransmitting chemical, dopamine. Chemicals such as sulphur used by agriculture, drugs and the food industry are suspected. Researchers have found an increase in the disease in patients born during influenza pandemics.
Treatment. While cure is not possible, a patient may be better able to combat the condition with the help of agents that strengthen the brain and nervous system.
Tea. Equal parts: Valerian, Passion flower, Mistletoe. 1 heaped teaspoon to each cup water; bring to boil; simmer 1 minute; dose: half-1 cup 2-3 times daily.
Gotu Kola tea. (CNS stimulant).
Tablets/capsules. Black Cohosh, Cramp bark, Ginseng, Prickly Ash, Valerian.
Formula. Ginkgo 2; Black Cohosh 1; Motherwort 2; Ginger 1. Mix. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 1-3 teaspoons in water or honey. Fava Bean Tea.
Case report. Two patients unresponsive to Levodopa treatment reported improvement following meals of fresh broad beans. (Vicia faba) The beans contain levodopa in large amounts. (Parkinson Disease Update Vol 8, No 66, p186, Medical Publications, PO Box 24622-H, Philadelphia, USA) See also: BROAD BEANS. L-DOPA.
Nacuna Pruriens. Appropriate. Essential active constituent: L-dopa. (Medicinal plants and Traditional Medicine in Africa, by Abayomi Sofowora, Pub: John Wiley)
Practitioner. To reduce tremor: Tincture Hyoscyamus BP. To reduce spasm: Tincture Belladonna BP. To arrest drooling: Tincture Stramonium BP.
Diet. It is known that people who work in manganese factories in Chile may develop Parkinson’s disease after the age of 30. Progress of the disease is arrested on leaving the factory. Two items of diet highest in manganese are wheat and liver which should be avoided, carbohydrates in place of wheat taking the form of rice and potatoes.
Supplements. Daily: B-complex, B2, B6, niacin. C 200mg to reduce side-effects of Levodopa. Vitamin E 400iu to possibly reduce rigidity, tremors and loss of balance.
Treatment of severe nerve conditions should be supervised by neurologists and practitioners whose training prepares them to recognise serious illness and to integrate herbal and supplementary intervention safely into the treatment plan.
Antioxidants. Evidence has been advanced showing how nutritional antioxidants, high doses of Vitamin C and E, can retard onset of the disease, delaying the use of Levodopa for an average of 2 and a half years. (Fahn S., High Dose Alpha-tocopherol and ascorbate in Early Parkinson’s Disease – Annals of Neurology, 32-S pp128-132 1992)
For support and advice: The Parkinson’s Disease Society, 22 Upper Woburn Place, London WC1H 0RA, UK. Send SAE. ... parkinson’s disease
Numbness and pins-and-needles are common abnormal sensations. The special senses can be impaired by damage to the relevant sensory apparatus (see vision, disorders of; smell; deafness; tinnitus). Other causes of abnormal sensation include peripheral nerve damage caused by diabetes mellitus, herpes zoster infection, or pressure from a tumour, and disruption of nerve pathways in the brain or spinal cord due to spinal injury, head injury, stroke, and multiple sclerosis.
Pressure on or damage to nerves can sometimes be relieved by surgery or by treatments for the cause.
In other cases, distressing abnormal sensation can be relieved only by cutting the relevant nerve fibres or by giving injections to block the transmission of signals.... sensation, abnormal
Possible causes of loss of the sense of smell include inflammation of the nasal membrane, as in a common cold; cigarette smoking; hypertrophic rhinitis,in which thickening of the mucous membrane obscures olfactory nerve endings; atrophic rhinitis, in which the nerves waste away; head injury that tears the nerves; or a tumour of the meninges or nasopharynx. The perception of illusory, unpleasant odours may be a feature of depression, schizophrenia, some forms of epilepsy, or alcohol withdrawal. smelling salts A preparation of ammonia that was used in the past to revive a person who felt faint.... smell
FAMILY: Oleaceae
SYNONYMS: Sweet osmanthus, sweet olive, tea olive, fragrant olive, silang, holly osmanthus, holly olive, kwai hwa.
GENERAL DESCRIPTION: An evergreen shrub or small tree growing up to 12 metres tall, with broad leaves and bearing purple-black fruits containing a single hard-shelled seed. The small flowers, which appear in clusters late in the season, can be white, pale yellow, gold, orange or reddish in colour, with a strong sweet fragrance much like fresh apricots or peaches.
DISTRIBUTION: This plant is native to Asia from the Himalayas through southern China to Taiwan and southern Japan. It is the ‘city flower’ of the cities of Hangzhou, Suzhou and Guilin in China. Today it is cultivated as an ornamental plant in gardens in Asia, Europe, North America, and elsewhere in the world, mainly for its deliciously fragrant flowers.
OTHER SPECIES: Osmanthus is a genus of about 30 species belonging to the olive family, which are mainly found growing in warm climates. While the flowers of O. fragrans range in colour from silver-white (O. fragrans Lour. var. latifolius) to gold-orange (O. fragrans Lour. var. thunbergii) to reddish (O. fragrans Lour. var. aurantiacus), the absolute is usually prepared from the gold-orange flowered species. A number of cultivars of this species have also been selected for garden use, with specific names: for example, in Japan, the white and orange-blossoming subspecies are distinguished as silver osmanthus and gold osmanthus respectively.
HERBAL/FOLK TRADITION: The exotic flowers from this plant have traditionally been cherished in the East for a range of purposes. Due to the time of its blossoming, sweet osmanthus is closely associated with the Chinese mid-autumn festival when osmanthus-flavoured wine and tea are traditionally served. The flowers are also used to produce a special osmanthus-scented jam, called guì huà jiàng. The tree is known as tea olive because in ancient times the Chinese used it to make a natural ‘de-tox’ herbal tea to flush out excessive nitric oxide from the system; the tisane was also recommended for menstrual irregularities. In some regions of North India, especially in the state of Uttarakhand, the flowers of sweet osmanthus are still used to protect clothes from insects.
Traditional Chinese medical literature describes the usefulness of the flowers of Osmanthus fragrans in the treatment of phlegm reduction, dysentery with blood in the bowel, indigestion and diarrhoea. The Chinese also used the flowers as a natural medicine to improve the complexion of the skin and today the absolute is still employed in cosmetic preparations. However, modern evidence regarding the therapeutic efficacy of the flowers has shown them to be somewhat limited, although studies have indicated they do have anti-oxidant properties, valuable for skincare. Findings also confirmed the ability of the O. fragrans flowers to reduce phlegm and suggest that they may be useful as an anti-allergic agent. Although little used in aromatherapy, since the aroma is relaxing and soothing, helping bring relief from mental stress and depression, it can make a valuable addition to floral-based blends.
ACTIONS: Anti-oxidant, anti-allergic, expectorant, depurative, insecticide, nervine, regulating, sedative.
EXTRACTION: A concrete and absolute by solvent extraction from the fresh flowers. Since the yield of absolute from concrete is only about one kilo per 3,000 kilos of flowers, the enfleurage method or the infusion process have also been applied to these flowers.
CHARACTERISTICS: A green to brown viscous liquid with a very strong sweet-honey, floral, fruity perfume with notes of peach and apricot. It blends well with lime, orange, sandalwood, rose, benzoin, violet, jasmine, mimosa and ylang ylang.
PRINCIPAL CONSTITUENTS: Main constituents include beta ionone, gamma-decanolid, palmitic acid, linoleic acid, linalool oxide, dihydro-beta-Ionone, trans-beta-Ionone and cis-jasmone.
SAFETY DATA: No recorded contraindications for external application: best avoided during pregnancy.
AROMATHERAPY/HOME: USE
Skin care: Dry or mature skin and general skin care.
Nervous system: Anxiety, depression, nervous debility and tension, mood swings, stress.
OTHER USES: Osmanthus absolute (although often adulterated) is used in high-class perfumes for its exquisite aroma, which is very pleasing to the senses. It is also used as a cosmetic ingredient.... osmanthus
FAMILY: Lamiaceae (Labiatae)
SYNONYMS: Garden sage, true sage, Dalmatian sage.
GENERAL DESCRIPTION: An evergreen, shrubby, perennial herb up to 80 cms high with a woody base, soft, silver, oval leaves and a mass of deep blue or violet flowers.
DISTRIBUTION: Native to the Mediterranean region; cultivated worldwide especially in Albania, Yugoslavia, Greece, Italy, Turkey, France, China and the USA.
OTHER SPECIES: There are several different species and cultivars which have been developed, such as the Mexican sage (S. azurea grandiflora) and the red sage (S. colorata) both of which are used medicinally. Essential oils are also produced from other species including the Spanish sage (S. lavendulaefolia) and clary sage (S. selarea) – see separate entries and Botanical Classification section.
HERBAL/FOLK TRADITION: A herb of ancient repute, valued as a culinary and medicinal plant – called herba sacra or ‘sacred herb’ by the Romans. It has been used for a variety of disorders including respiratory infections, menstrual difficulties and digestive complaints. It was also believed to strengthen the senses and the memory.
It is still current in the British Herbal Pharmacopoeia as a specific for inflammations of the mouth, tongue and throat.
ACTIONS: Anti-inflammatory, antimicrobial, anti-oxidant, antiseptic, antispasmodic, astringent, digestive, diuretic, emmenagogue, febrifuge, hypertensive, insecticidal, laxative, stomachic, tonic.
EXTRACTION: Essential oil by steam distillation from the dried leaves. (A so-called ‘oleoresin’ is also produced from the exhausted plant material.)
CHARACTERISTICS: A pale yellow mobile liquid with a fresh, warm-spicy, herbaceous, somewhat camphoraceous odour. It blends well with lavandin, rosemary, rosewood, lavender, hyssop, lemon and other citrus oils. The common sage oil is preferred in perfumery work to the Spanish sage oil which, although safer, has a less refined fragrance.
PRINCIPAL CONSTITUENTS: Thujone (about 42 per cent), cineol, borneol, caryophyllene and other terpenes.
SAFETY DATA: Oral toxin (due to thujone). Abortifacient; avoid in pregnancy. Avoid in epilepsy. Use with care or avoid in therapeutic work altogether – Spanish sage or clary sage are good alternatives.
AROMATHERAPY/HOME: USE None.
OTHER USES: Used in some pharmaceutical preparations such as mouthwashes, gargles, toothpastes, etc. Employed as a fragrance component in soaps, shampoos, detergents, anti-perspirants, colognes and perfumes, especially men’s fragrances. The oil and oleoresin are extensively used for flavouring foods (mainly meat products), soft drinks and alcoholic beverages, especially vermouth. It also serves as a source of natural anti-oxidants.... sage, common
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