See fasciculation; tic.
It is a recurrent and paroxysmal disorder starting suddenly and ceasing spontaneously due to occasional sudden excessive rapid and local discharge of the nerve cells in the grey matter (cortex) of the BRAIN. Epilepsy always arises in this way from the brain, but its origin is often of microscopic size. It is diagnosed by the clinical symptoms based on the observations of witnesses. Its cause can sometimes be established by laboratory tests, and brain scanning. Fits can be the ?rst sign of a tumour, or follow a stroke, brain injury or infection, but in the large majority no underlying cause is found – so-called idiopathic epilepsy.
A single epileptic ?t is not epilepsy. Of those people who have a single seizure, a signi?cant minority (20 per cent) have no further attacks.
Major (generalised) seizures have a sudden, often unprovoked onset; the patient emits a cry, then falls to the ground, rigid, blue, and then twitching or jerking both sides of the body: the tonic-clonic convulsion. Drowsiness and confusion may last for some hours after recovering consciousness. Some experience a momentary warning (AURA): a smell, or sensation in the head or abdomen, vision, or déjà vu.
Partial seizures: focal motor (Jacksonian) begin with twitching of the angle of the mouth, the thumb, or the big toe. If the seizure discharge then spreads, the twitching or jerking spreads gradually through the limbs. Consciousness is preserved unless the seizure spreads to produce a secondary generalised ?t. In some attacks the eyes and head may turn, the arm may rise, and the body may turn, while some patients feel tingling in the limbs.
Complex partial seizures (temporal lobe epilepsy) The patient usually appears blank, vacant and may be unable to talk, or may mumble or chatter – though later they often have no memory of this period. They may be able to carry out complex tasks, taking o? gloves or clothes, and may smack their lips or rub repeatedly on one limb (automatisms). A sense of strangeness supervenes: unreality, or a feeling of having experienced it all before (déja vu). There may be a sense of panic. Strange unpleasant smells and tastes are olfactory and gustatory hallucinations. The visual hallucinations evoke complex scenes. An initial rising sense of warmth or discomfort in the stomach, or ‘speeding-up’ of thoughts are common psychomotor symptoms. All these strange symptoms are brief, disappearing within a few seconds or up to 3–4 minutes.
Minor seizures (petit mal) Attacks start in childhood. They last a few seconds. The child ceases what he or she is doing, stares, looks a little pale, and may ?utter the eyelids. The head may drop forwards. Attacks are commonly provoked by overbreathing. The child and parents may be unaware of the attacks
– ‘just daydreaming’. Major ?ts develop in one-third of subjects. By contrast with other types of epilepsy, the ELECTROENCEPHALOGRAM (EEG) is diagnostic.
Precautions Children with epilepsy should take normal school exercises and games, and can swim under supervision. Adults must avoid working at heights, with exposed dangerous machinery, and driving vehicles on public roads. Current legislation allows driving after two years of complete freedom from attacks during waking hours; those who for more than three years have had a history of attacks only while asleep may also drive.
Treatment identi?es, and avoids where possible, any factors (such as shortage of sleep or excessive ?uids) which aggravate or trigger attacks. If ?ts are very infrequent, treatment may not be recommended. However, frequent ?ts may be embarassing, may cause injury or may cause long-term brain damage so treatment is advisable. Anti-epileptic drugs are usually necessary for several years under medical supervision. Carbamazepine and sodium valproate are the most frequently prescribed. The dose is governed by the degree of control of ?ts and sometimes drug levels can be monitored by blood tests to check on dosage. Strict adherence to the drug schedule gives a reasonable chance of total suppression of ?ts, especially in younger patients whose ?ts have started recently. The table summarises anticonvulsant drugs in use. Interactions can occur between anti-epileptics and, if drug treatment is changed, the patient needs careful monitoring. In particular, abrupt withdrawal of a drug should be avoided as this may precipitate severe rebound seizures.
Indications First-choice drugs: Ethosuximide PM, JME Phenobarbitone M, P Phenytoin M, P, CP Carbamazepine M, P, CP Valproate M, PM, JME Second-line drugs: Primidone M, P, CP Clobazam M, CP Vigabatrin M, P, CP Lamotrigine M, P, CP Gabapentin M, P, CP Topirimate P
M = major generalised tonic-clonic; P = partial or focal; CP = complex partial (temporal lobe); PM = petit mal; JME = juvenile myoclonic epilepsy.
Anticonvulsant drugs
As all anticonvulsant drugs have an e?ect on the brain, it is not surprising that there may be side-effects, especially inolving alertness or behaviour. In each case careful assessment is necessary for doctor and patient to agree on the best compromise between stopping ?ts and avoiding ill-effects of medication.
Patients who have an epileptic seizure should not be restrained or have a gag or anything else placed in their mouths; nor should they be moved unless in danger of further injury. Any tight clothing around the neck should be loosened and, when the seizure has passed, the person should be placed in the recovery position to facilitate a return to consciousness (see APPENDIX 1: BASIC FIRST AID).
Patients with epilepsy and their relatives can obtain further advice and information from the British Epilepsy Association or Epilepsy Action Scotland.... epilepsy
A child may avoid looking a person in the face, occupying himself or herself elsewhere to avoid direct contact. Obsessional motions include erratic movements of the fingers or limbs or facial twitch or grimace. Corrective efforts by parents to educate into more civilised behaviour meet with instant hostility, even hysteria. Hyperactivity may give rise to tantrums when every degree of self-control is lost. For such times, harmless non habit-forming herbal sedatives are helpful (Skullcap, Valerian, Mistletoe).
A link has been discovered between a deficiency of magnesium and autism. Magnesium is essential for the body’s use of Vitamin B6. Nutritionists attribute the condition stemming from an inadequate intake of vitamins and minerals at pregnancy. Alcohol in the expectant mother is a common cause of such deficiencies. Personal requirements of autistic children will be higher than normal levels of Vitamin B complex (especially B6) C, E and Magnesium.
Such children grow up to be ‘temperamental’, of extreme sensibility, some with rare talents. Medicine is not required, but for crisis periods calm and poise can be restored by:–
Motherwort tea: equal parts, Motherwort, Balm and Valerian: 1-2 teaspoons to each cup boiling water; infuse 10-15 minutes; 1 cup 2-3 times daily. Honey renders it more palatable.
Alternatives:– Teas, tablets or other preparations: Hops, German Chamomile, Ginseng, Passion flower, Skullcap, Devil’s Claw, Vervain, Mistletoe, Ginkgo.
Diet. Lacto-vegetarian. 2-3 bananas (for potassium) daily.
Supplements. Daily. Vitamin B-complex, Vitamin B6 50mg, Calcium, Magnesium, Zinc. Aromatherapy. Inhalation of Lavender oil may act as a mood-lifter.
Note: A scientific study revealed a link with the yeast syndrome as associated with candidiasis. ... autism
The chorea usually affects the face, arms, and trunk, resulting in random grimaces and twitches, and clumsiness. Dementia takes the form of irritability, personality and behavioural changes, memory loss, and apathy.
At present, there is no cure for Huntington’s disease, and treatment is aimed at reducing symptoms with drugs.... huntington’s disease
Possible adverse effects of neostigmine include nausea and vomiting, increased salivation, abdominal cramps, diarrhoea, blurred vision, muscle cramps, sweating, and twitching.... neostigmine
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
Constituents: volatile oil, Vitamin A.
Keynote: bladder and kidneys. This is the grass to which a dog is said to go instinctively when sick, hence its name – dog grass.
Action: Soothing demulcent diuretic for simple inflammation of the urinary tract. Uric acid solvent. Laxative. Urinary antiseptic. Nutritive, emollient. Anti-cholesterol.
Uses: Cystitis, nephritis, urethritis, painful and incontinent urination, liver disorder, renal colic, kidney stone, gravel, gout, rheumatism, backache. Reduction of blood cholesterol. Chronic skin disorders.
Combines with Hydrangea (equal parts) for prostatitis.
Herbal tea for kidneys and bladder: Couchgrass 15 per cent; Buchu 15 per cent; Wild Carrot 15 per cent; Bearsfoot 15 per cent; Alfalfa 45 per cent. 2 teaspoons to each cup water, gently simmer 5 minutes. Half-2 cups thrice daily.
Preparations: Thrice daily.
Decoction. 2-3 teaspoons to each cup water, gently simmer 5 minutes. 1-2 cups.
Liquid Extract BHP (1983) 1:1 in 25 per cent alcohol. Dose: 4-8ml.
Tincture BHP (1983) 1:5 in 40 per cent alcohol. Dose: 5-15ml (1-3 teaspoons).
Powder. 250mg in capsules; 3 capsules thrice daily. (Arkocaps)
Kasbah remedy. Alpine herb teabags.
Antitis tablets (Potter’s) ... couch grass
Women who use barrier contraceptives are more than twice as likely to develop pre-eclampsia in pregnancy than those using non-barrier methods. (North Carolina Memorial Hospital)
Symptoms. Headache, dizziness, nausea, upper abdominal pain, twitching of face and limbs, albumin in the urine. Extreme cases: high blood pressure, rigidity, congestive heart failure.
Treatment. Hospitalisation. To be treated by qualified obstetrician.
Formula. Cramp bark 2; Motherwort 1; Black Cohosh 1. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: one to two 5ml teaspoons. Tinctures: 1-3 teaspoons. Hourly, or more frequently as tolerated; in water or honey. Magnesium sulphate for fits.
Suppression of urine. Dilation of kidney arterioles to increase flow of blood and to re-start kidney function.
Bearberry (Uva Ursi) tea. 1-2 teaspoon to each cup boiling water; infuse 15 minutes; 1 cup freely. Bearberry Liquid extract. 2-4ml hourly, or as tolerated, in water or honey.
White Willow. Conventional treatment places high-risk women on low-dose aspirin therapy. As White Willow is a source of natural aspirin, it would appear to offer some benefit. White Willow reduces platelet aggregation, and encourages placental blood flow. Aspirin of pharmacy cuts the risk of pregnancy-induced high blood pressure by two-thirds.
Diet. Pre-eclampsia: oily fish or fish oil supplements. (Journal of Obstetrics and Gynaecology 1990, 97 (12) 1077-79)
Supplements. Calcium. Magnesium.
Note: A serious condition which can be fatal but which can be prevented by regular antenatal examinations by a qualified obstetrician. ... eclampsia
Constituents: flavonoids, oil, tannins.
Berries contain Vitamin C and iron. Elderblossom works well with Peppermint or Yarrow, as a tea. Action: anti-inflammatory, laxative (especially berries and bark), anticatarrhal, relaxing diaphoretic, hydragogue (inner bark), cathartic (inner bark). Elderblossom is an emollient skin care product. Emetic (inner bark). Diuretic (urinary antiseptic). An ancient household remedy for promoting flow of urine (cold infusion). Expectorant (hot infusion).
Uses: the common cold, influenza, winter’s chills, early stages of fevers with dry skin and raised body temperature. Nasal catarrh, sinusitis. Tonsillitis, inflammation of mouth, throat and trachea (mouth wash and gargle). Night sweats (cold infusion). Chilblains (local).
“The inner bark of Elder has been used with success in epilepsy by taking suckers or branches 1-2 years old. The grey outer bark is scraped off and 2oz of it steeped in 5oz boiling water for 48 hours. Strain. Give a wineglassful every 15 minutes when a fit is threatening. Have the patient fast. Resume every 6 to 8 days.” (Dr F. Brown (1875))
Croup (combined with Coltsfoot – equal parts). Eyestrain, conjunctivitis, twitching: cotton wool pads soaked in cold Elder tea applied to the closed lids, patient lying down.
Preparations: Tea (flowers) 2 teaspoons (2-4g) in each cup boiling water; infuse 5 minutes. Half-1 cup two-hourly for acute conditions. Cold tea is laxative and sedative. Hot tea excites and stimulates. Cold tea soothes and heals chapped hands and useful for sunbathing.
Distilled Elderflower water: for inflamed eyes.
Liquid Extract. 1 teaspoon in water, thrice daily.
Home tincture (traditional). Chippings of inner green bark macerated in white wine for 8 days, strain; for dropsy and constipation.
Ointment. 3 parts fresh Elder leaves. Heat with 6 parts Vaseline until leaves are crisp; strain and store. (David Hoffmann)
Elderberry wine: traditional.
Powder: dose, 3-5g.
Veterinary. “If sheep or farm animals with foot-rot have access to the bark and young leaves, they soon cure themselves.” (Dr John Clarke, Dictionary of Materia Medica) ... elder
All nervous habits increase during periods of tension or anxiety, and may be severe in some forms of depression, anxiety disorder, or drug withdrawal.... nervous habit
Symptoms: skin hot, dry and flushed. High temperature and high humidity dispose. Sweating mechanism disorganised. Delirium, headache, shock, dizziness, possible coma, nausea, profuse sweating followed by absence of sweat causing skin to become hot and dry; rapid rise in body temperature, muscle twitching, tachycardia, dehydration.
Treatment. Hospital emergency. Reduce temperature by immersion of victim in bath of cold water. Wrap in a cold wet sheet. Lobelia, to equalise the circulation. Feverfew to regulate sweating mechanism. Yarrow to reduce temperature. Give singly or in combination as available.
Alternatives. Tea. Lobelia 1; Feverfew 2; Yarrow 2. Mix. 2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup freely. Vomiting to be regarded as favourable.
Tinctures. Combine: Lobelia 1; Pleurisy root 2; Valerian 1. Dose: 1-2 teaspoons in water every 2 hours. Decoction. Irish Moss; drink freely.
Practitioner. Tincture Gelsemium BPC (1973). Dose: 0.3ml (5 drops).
Alternate hot and cold compress to back of neck and forehead. Hot Chamomile footbath.
Diet. Irish Moss products. High salt. Abundant drinks of spring water.
Supplements. Kelp tablets, 2 thrice daily. Vitamin C (1g after meals thrice daily). Vitamin E (one 500iu capsule morning and evening).
Vitamin C for skin protection. Increasing Vitamin C after exposure to the sun should help protect against the sun’s ultra violet rays, as skin Vitamin C levels were shown to be severely depleted after exposure. (British Journal of Dermatology 127, 247-253) ... heatstroke
Action. Many bacteria cannot live in the presence of honey since honey draws from them the moisture essential to their existence. It is a potent inhibitor of the growth of bacteria: salmonella, shigella and E. coli. Taken internally and externally, hastens granulation and arrests necrotic tissue. A natural bacteriostatic and bactericide.
Of an alkaline action, honey assists digestion, decreasing acidity. It has been used with success for burns, frostbite, colic, dry cough, inflammations, involuntary twitching of eyes and mouth; to keep a singer’s throat in condition. Some cases of tuberculosis have found it a life-preserver.
A cooling analgesic: dressings smeared with honey and left on after pain has subsided to prevent swelling – for cuts, scratches, fistula, boils, felon, animal bites; stings of mosquitoes, wasps, bees, fleas, etc. May be applied to any kind of wound: dip gauze strips in pure honey and bind infected area; leave 24 hours.
Insomnia: 2 teaspoons to glass of hot milk at bedtime.
Arterio-sclerosis: with pollen, is said to arrest thickening of the arteries.
2, 3 or more teaspoons daily to prevent colds and influenza.
2 teaspoons in water or tea for renewed vitality when tired.
Rheumatism and arthritis: 2 teaspoons honey and 2 teaspoons Cider vinegar in water 2-3 times daily.
“The taking of honey each day is advised in order to keep the lymph flowing at its normal tempo and thus avoid degenerative disease which shortens life. The real value of honey is to maintain a normal flow of the tissue fluid called lymph. When this flow-rate slows down, then calcium and iron are precipitated as sediment. When the lymph flow is stagnant, then harmful micro-organisms invade the body and sickness appears.” (D.C. Jarvis MD)
Where sweetening is required to ensure patient compliance, honey is better than sugar. Its virtues deteriorate in open sunlight. Should not be heated above 40°C. ... honey
Alternatives. Teas. Horsetail, Nettles, Plantain, Oats, Comfrey leaves, Silverweed, Scarlet Pimpernel.
Skullcap, Bay.
Tablets/capsules. Iceland Moss, Irish Moss, Skullcap, Kelp.
Powders. Formula. Equal parts: Fenugreek, Horsetail, with pinch of Ginger. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily.
Liquid Extracts. Formula. Equal parts: German Chamomile, Ginkgo, Horsetail. Dose: 1 teaspoon thrice daily.
Tinctures. As Liquid Extract formula; double dose. ... hypoparathyroidism
From food we eat, sugar (glucose) is converted into glycogen which is stored in the liver and muscles. To ensure its removal from the bloodstream to storage areas a balancing mechanism causes the pancreas to produce insulin for this purpose. Exhaustion of the pancreas may follow too frequent release of insulin for reducing high levels of sugar. All symptoms are temporarily relieved by eating sweet foods, chocolate, etc, or by drinking stimulating beverages: tea, coffee, cola, alcohol, etc.
Convincing evidence shows how large amounts of refined and concentrated sugars overwork the pancreas, causing wide swings in blood sugar levels. This is the reverse of diabetes which occurs from a lack of insulin.
Another factor is over-stimulation of the adrenal glands that produce adrenalin which has the power to release stored sugars. When adrenalin is discharged too frequently into the bloodstream the conversion of glycogen to glucose is impaired. This leads to a craving for sweet foods and stimulating beverages.
Symptoms are numerous and often confuse the doctor: constant hunger, tightness in the chest, dizziness, headaches, twitching of limbs, digestive disorders, fatigue, weakness in legs, irritability, migraine, nervous tension, nervous mannerisms, insomnia, memory lapses, phobia – sense of panic, cold sweats. Cold hands and feet, visual disturbances, vague aches and pains and depression.
Life becomes a succession of erratic rises and falls of the blood sugar. Symptoms are worse when the person is passing through a ‘low’ period. All this is reflected upon the sympathetic nervous system and affects the emotional life. A special blood test is carried out to assess the situation; the Glucose Tolerance Test.
Alternatives. To raise low blood sugar levels: Avens, Balmony, Bayberry, Calamus, Centuary, Chamomile (German), Dandelion root, Echinacea, Feverfew, Gentian (Yellow), Ginger, Ginseng, Goldenseal, Holy Thistle, Hops, Horehound (White), Liquorice, Quassia, Southernwood, Betony.
Teas. Chamomile (German), Ginseng, Avens, Centuary, Hops, Betony.
Decoctions. Yellow Gentian (cold infusion), Calamus (cold infusion), Dandelion root (hot infusion), Angustura bark (hot infusion).
Tablets/capsules. Calamus, Dandelion, Ginseng, Goldenseal, Echinacea, Liquorice, Kelp.
Powders. Formula. Balmony 2; Bayberry 2; White Poplar 1; Ginger 1. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily, before meals.
Liquid Extracts. Formula. Goldenseal 10ml; Dandelion root 20ml; Holy Thistle 20ml; Cayenne 1ml. 30- 60 drops thrice daily in water before meals.
Tinctures. Same formula, double dose.
Angostura wine. Wineglassful daily.
Diet: Herb teas, juices and mineral water instead of tea, coffee and other drinks containing caffeine. Honey. Wholefoods. Adequate protein intake. Small meals throughout the day. Avoid: alcohol, sugary snacks, white flour and white sugar products.
Supplementation. Daily. B-complex, B6 50mg, E 200iu, C 1g, Chromium 125mcg, Calcium Pantothenate 500mg, Kelp, Lecithin, Zinc.
Notes: Brewer’s yeast tablets contain chromium which assists sugar metabolism. Smoking causes both glucagon and insulin to be released thus aggravating the condition. Diabetics should carry in their pocket some form of sugar against emergency. ... hypoglycaemia
Constituents: tannin, resin.
Action: nerve relaxant, autonomic regulator, mild pain-killer, thymoleptic. A fine brain and spinal remedy and should be at the hand of every spinal manipulator. Antidote to caffeine poisoning.
Use s. Nervous excitability, insomnia, irritability, neuralgia, muscle twitching, anxiety states, schizophrenia, pressive headache, nerve tension, epilepsy, pre-menstrual tension, spermatorrhoea, post- influenzal depression, weepiness.
“Yellow Lady’s Slipper was held in big esteem by the Indians as a sedative and an antispasmodic, acting like Valerian in alleviating nervous symptoms . . . said to have proved itself in hysteria and chorea.” (Virgil Vogel)
Combinations. (1) with Oats and Skullcap for anxiety states and (2) with Hops for insomnia with depression BHP (1983).
Preparations: Average dose: 2-4g. Thrice daily.
Tea. Half-1 teaspoon to each cupful water; bring to boil; simmer 2-3 minutes in covered vessel; infuse 15 minutes. Half-1 cup.
Liquid Extract BHP (1983) 1:1 in 45 per cent alcohol. Dose: 2-4ml.
Powder. Dose, 2-4g. ... lady’s slipper
Constituents: alkaloids, glycoproteins, polypeptides, flavonoids.
Action: tranquilliser, vasodilator – reducing blood pressure after an initial rise. Cardiac depressant. Used as an alternative to beta-blocking drugs when they produce sore eyes and skin rash. Stimulates the vagus nerve which slows the pulse. Contains acetylcholine. Diuretic. Immune enhancer. Anti-inflammatory. Uses. Arterial hypertension, insomnia, temporal arteritis, nervous excitability, hyperactivity, limb- twitching, epilepsy, (petit mal), chorea, tinnitus, rabies (Dr Laville). Benzodiazepine addiction – to assist withdrawal. Arteriosclerosis (with Horsetail). Headache, dizziness, fatigue.
Cancer: some success reported in isolated cases. Juice of the berries has been applied to external cancers since the time of the Druids. Present-day pharmacy: Iscador (Weleda), Viscotoxin. Pliny the Elder (AD 23-79) and Hippocrates record its use in epilepsy and for tumours. The berries may be prescribed by a medical practitioner only (UK). As an immune enhancer it is used as an adjunct to surgery and radiotherapy for patients for whom cytotoxic drugs are inappropriate because of adverse side-effects. Lymphocytes divide more readily by production of interferon.
Combinations: (1) with Skullcap and Valerian for nervous disorders (2) with Motherwort and Hawthorn for myocarditis (3) with Blue Cohosh for menstrual irregularity (4) with Hawthorn and Lime flowers for benign hypertension. Never combine with Gotu Kola. (Dr John Heinerman)
Preparations: Average dose: 2-6g, or equivalent. Thrice daily.
Tea: 1 heaped teaspoon to each cup cold water steeped 2 hours. Dose: half-1 cup.
Green Tincture. 4oz bruised freshly-gathered leaves in spring to 1 pint 45 per cent alcohol (Vodka, strong wine, etc). Macerate 8 days, shaking daily. Filter and bottle. Dose: 3-5 drops: (every 2 hours if an epileptic attack is suspected).
Powder, capsules: 300mg. 2 capsules thrice daily before meals. (Arkocaps)
Plenosol. (Madaus)
Liquid Extract (1:1): 8-10 drops.
Sale: pharmacy only. ... mistletoe
In sinus tachycardia, the rate is raised, the rhythm is regular, and the beat originates in the sinoatrial node (see pacemaker). Supraventricular tachycardia is faster and the rhythm is regular. It may be caused by an abnormal electrical pathway that allows an impulse to
circulate continuously in the heart and take over from the sinoatrial node. Rapid, irregular beats that originate in the ventricles are called ventricular tachycardia. In atrial flutter, the atria (see atrium) beat regularly and very rapidly, but not every impulse reaches the ventricles, which beat at a slower rate. Uncoordinated, fast beating of the atria is called atrial fibrillation and produces totally irregular ventricular beats. Ventricular fibrillation is a form of cardiac arrest in which the ventricles twitch very rapidly in a disorganized manner.
Sinus bradycardia is a slow, regular beat. In heart block, the conduction of electrical impulses through the heart muscle is partially or completely blocked, leading to a slow, irregular heartbeat. Periods of bradycardia may alternate with periods of tachycardia due to a fault in impulse generation (see sick sinus syndrome).
A common cause of arrhythmia is coronary artery disease, particularly after myocardial infarction. Some tachycardias are due to a congenital defect in the heart’s conducting system. Caffeine can cause tachycardia in some people. Amitriptyline and some other antidepressant drugs can cause serious arrhythmias if they are taken in high doses.
An arrhythmia may be felt as palpitations, but in some cases arrhythmias can cause fainting, dizziness, chest pain, and breathlessness, which may be the 1st symptoms.
Arrhythmias are diagnosed by an ECG. If they are intermittent, a continuous recording may need to be made using an ambulatory ECG.
Treatments for arrhythmias include antiarrhythmic drugs, which prevent or slow tachycardias.
With an arrhythmia that has developed suddenly, it may be possible to restore normal heart rhythm by using electric shock to the heart (see defibrillation).
Abnormal conduction pathways in the heart can be treated using radio frequency ablation during cardiac catheterization (see catheterization, cardiac).
In some cases, a pacemaker can be fitted to restore normal heartbeat by overriding the heart’s abnormal rhythm.... arrhythmia, cardiac
of the brain or nervous system, or children with a family history of epilepsy.... convulsion, febrile
Treatment may include washing out the stomach (see lavage, gastric) or removing soiled clothing and washing contaminated skin.
Injections of atropine may be given, and oxygen therapy and/or artificial ventilation may be needed.
With rapid treatment, people may survive doses that would otherwise have been fatal.
Long term effects of organophosphates in sheep dips are thought to be responsible for debilitating illness with neural, muscular, and mental symptoms.... organophosphates
Most infected children have no symptoms. In others, there is a slight fever, sore throat, headache, and vomiting after a 3–5-day incubation period. Most children recover completely, but inflammation of the meninges may develop. Symptoms are fever, severe headache, stiff neck and back, and aching muscles, sometimes with widespread twitching. Often, extensive paralysis, usually of the legs and lower trunk, occurs in a few hours. If infection spreads to the brainstem, problems with, or total loss of, swallowing and breathing may result.
Diagnosis is made by lumbar puncture, throat swab, or a faeces sample. Characteristic paralysis with an acute feverish illness allows an immediate diagnosis. There is no effective drug treatment for polio. Nonparalytic patients usually need bed rest and analgesic drugs. In paralysis, physiotherapy and, in some cases, catheterization, tracheostomy, and artificial ventilation are needed.
Recovery from nonparalytic polio is complete. More than half of those with paralysis make a full recovery, fewer than a quarter are left with severe disability, and fewer than 1 in 10 dies.
In the , vaccination against polio is given at about age 2, 3, and 4 months, with a booster dose at about 5 years (see immunization). Parents and carers should also be immunized because the active vaccine can cause polio.... poliomyelitis
Health Encyclopedia