Миома матки – hysteromyoma

This form of resuscitation is also known as EAR (expired air resuscitation). It is used in first aid where the subject has stopped breathing. The technique is taught in practical first aid courses such as that which is offered by St John Ambulance Australia. The following description is a guide only. It is recommended that a first aid course be taken to learn techniques such as EAR and CPR (cardiopulmonary resuscitation).

After establishing that the subject is not breathing, turn onto the back and kneel beside the subject, keeping her or his head tilted back. With one hand pinch the nostrils between your fingers. Use the other hands to lift the jaw forward. Open your mouth wide and take a deep breath, then place your mouth firmly over that of the subject, making an airtight seal, and breathe into the subject’s mouth. Remove your mouth and turn your head towards the subjects chest. Listen for exhaled air and observe whether the chest falls. If there is no exhalation make sure the head is tilted back and check for foreign objects in the airway, removing any obstructions if necessary. Breathe into the subject’s mouth again, giving five full breaths in 10 seconds, then check the pulse in the neck for 5 seconds, placing the ends of your fingers (not thumbs or fingertips) in the groove behind the Adam’s apple on one side only. If pulse is present continue EAR at the rate of 15 breaths per minute. If there is no pulse CPR will be required.

*13\69\2*

Anxiety may have an effect on stuttering. The right side of the body is controlled by the left side of the brain and vice versa. In the right-handed person the left side of the brain is dominant over the right, and as a result the right hand is given preference over the left. In those who are left-handed the right side of the brain is dominant over the left. It is believed that stuttering often develops when the dominance of the leading side of the brain is incomplete, or when a potentially left-handed child is trained to function as a right-hander. We see then that stuttering results when the messages from the brain to the organ of speech are indecisive. This indecision may be further increased by the presence of anxiety. This is shown very clearly by the fact that many quite normal people show a hesitancy in their speaking or even a mild stutter when confronted with the task of speaking in some formal situation which produces anxiety.

On the other hand, some people stutter without showing or feeling much tension or anxiety at all. As a general rule these people who stutter in the absence of anxiety do not gain much help in their speech difficulty by practising relaxing mental exercises. However, the majority of stutterers experience considerable tension when they are speaking, and with them the reduction of the general level of anxiety by relaxing mental exercises is a great help toward establishing a pattern of easy normal speech.

*16\57\2*

Relax the muscles of your chest first. Push your breasts as high into the air as you can. You will find that you tend to arch your back when you do this and you will feel tension along both your sides too. Breathe out and fall back, letting your breasts flop and remembering to drop those shoulders at the same time.

Now imagine that you have an extremely tight, old-fashioned corset on and it’s pulling in your belly even further than you thought possible. As you breathe in, wearing your corset, the tension will spread upwards into your chest and you’ll probably clench your buttocks too. As you breathe out, loosen the corset and let your belly flop and sag. This is a very difficult thing to do, because a lot of clothes are designed to show off a flat stomach- so a full, rounded belly is something most of us try to avoid. In other times and other places it was, and still is, considered to be a mark of great beauty. It may take quite a time to achieve entire relaxation of this part of the body. But it’s the most important bit, because these are the muscles which will clash with the muscles in your womb that are squeezing out the period, and they will squeeze no matter what you do. Don’t give them any opposition and the whole business immediately gets a lot easier. After all, they’re extremely powerful muscles; ten times stronger than any other muscle anywhere in your body.

At this point it’s a good idea to pay some attention to the position of your spine. If you started off supported by a lot of cushions and pillows and now your spine doesn’t feel comfortable, remove them all and start all over again. Many women find that if they imagine they are lying on their backs floating in pleasantly warm water they can curve their spines into a very comfortable position; others need to arch their spines up from the bed and then let them relax; others find that if they relax their necks and shoulders, their spines relax too. It takes time and experience to find the best method and position.

*11\177\2*

We have spoken of the problems of food allergy and chemical susceptibility as the two main components of environmental disease. This is technically correct, but in actuality these two problems are usually found together, tightly interlinked in the history of each chronically ill individual. One of the major ways in which these two elements interlock is in the chemical pollution of our food supply.

It is no secret that our food is now treated with synthetic chemicals of every sort. Some of these chemicals have been deliberately added, to impart color, flavor, or longer shelf life. These deliberately added substances are called additives. In addition, numerous chemicals accidentally enter the food supply as residues of pesticides, fertilizers, or environmental pollutants. These are called food contaminants.

Together, food additives and food contaminants have become a major source of the problem of chemical susceptibility in most Western countries, since everyone must eat, and most food now comes from the giant agribusiness conglomerates. These giant corporations are mainly concerned with maximizing profit, even if the health consequences for the population are negative. What is more, these companies are often closely linked to chemical companies and thus have a built-in bias in favor of synthetic pesticides and fertilizers.1

For any person who wants to avoid environmentally induced illness, it is necessary to understand the sources of such chemical contamination of the food supply. These chemicals can either cause, or help perpetuate, chronic illnesses of all sorts. However, their presence can be detected, and they themselves can be avoided, by methods which are explained later in this book.

I have already described how the role of chemical pesticides was discovered in the case of William Petersen, the man who found that he could eat unsprayed apples from an abandoned orchard, while commercial apples from a store gave him a headache. The principles discovered in this case were soon extended to many other food-allergy patients. It was determined that in some cases they were actually reacting only to chemical contaminants. Usually, however, patients with the chemical susceptibility problem also had the food allergy problem, and vice versa. Some patients appeared to react to commercial food in the winter, but to a much lesser degree in the warmer months. This was because in the cold months they were often cooped up in their houses and exposed to the cumulative effects of indoor air pollution (Chap. 6). The combination of food allergies, contaminated food, and such indoor pollutants greatly heightened their symptoms and made their winters miserable. Not infrequently their winter maladies, environmental in origin, masqueraded as colds or flus. In other cases, they did have genuine infections, but these were accentuated by allergic problems.

The variety of problems is endless, since environmental disease is above all things an individual problem. There is no single cause for all people, nor a single solution. Usually the disease is a result of the interaction between an individual, with his particular bodily makeup, and his environment. Certain exposures, however, stand out as most troublesome for the greatest number of patients. Of the food additives and contaminants, some of the most troublesome are residues of pesticide sprays which find their way into almost everything the average person eats.

*12\110\2*

Constipation is a condition in which the bowel movements are too hard. The frequency of bowel movements is not a factor of constipation. Passage of six too-firm bowel movements a day is considered constipation. Passage of one normal or soft bowel movement every third or fourth day is not constipation. Many normal, healthy children have a bowel movement only every few days and are not constipated. The hardness of a stool is judged by appearance and by diameter. A stool greater than twice the usual diameter is probably too hard.

Over 95 percent of constipation cases involve no physical abnormality. This form of constipation can always be cured by changes in the diet or by using medications that soften the stools.

Constipation occurs in the large bowel (colon). The function of the colon is to store unabsorbed food waste and to absorb and hold water from the liquid material received from the small intestine. If the colon absorbs too much water, the stools become hard.

In children, there are two common reasons for constipation. The first reason is that the diet does not include enough roughage, which holds water in the stools. Foods that prevent constipation are all fruit juices and all fruits – particularly those eaten with their skin on – except bananas and apples; all vegetables, especially if eaten raw, except peeled potatoes; unrefined grains (whole-grain cereals and breads); and unrefined sugars (brown sugar, molasses, honey). All other foods, including milk and milk products, promote constipation.

A second common reason for constipation in children is that the child resists the normal impulse to move the bowels. This allows the colon to continue absorbing water out of the retained stools; it results in stools that are too hard. A common reason why children resist the normal impulse to move the bowels is that the parents are putting too much pressure on the child during toilet training. Once the stools become too hard, bowel movements become painful. Fear of such pain makes the child even more determined to postpone bowel movements. Constipation enlarges the colon, causing a loss of muscle tone, and the physical impulse to empty the bowel becomes weaker. This cycle can lead to chronic constipation.

Signs and symptoms

The major sign of constipation is stools that are too hard, too dry, and larger in diameter than usual. Constipation can cause pain in the anus during bowel movements. Red blood may appear on and around the stools. Other symptoms are cramps in the abdomen and an eventual loss of appetite.

If constipation continues for days and weeks, paradoxical diarrhea may develop. In this condition, loose, watery stools seep around the hard stool in the colon and are passed as diarrhea. When this happens, it can be difficult to tell whether the child has constipation or diarrhea.

Home care

For immediate temporary relief, use a glycerin suppository or disposable commercial enema. For a long-term cure, increase the amount of roughage and decrease the amount of constipating foods in your child’s diet. If constipation occurs during toilet training, stop training efforts.

Precautions

• Check with your doctor before using laxatives in children. Laxatives may force passage of a hard stool and cause pain that leads to further holding back by the child.

• Enemas, suppositories, and laxatives are habit-forming. They should never be used on a regular basis.

• Do not assume that a child is constipated simply because bowel movements do not occur every day.

Medical treatment

Your doctor will perform a rectal examination and a careful examination of the child’s abdomen. X ray studies of the bowel may be taken to look for possible physical abnormalities. Directions and follow-up by your doctor may be needed.

*38/84/5*

Профилактика миомы матки сводится в первую очередь к исключению факторов риска, а также ранней диагностике этого грозного заболевания. Следствием поздней диагностике может быть хирургическое вмешательство с необратимыми последствиями.
На основании последних исследования стало известно, что с начала роста миомы до появления первых симптомов может проходить от 5 до 8 лет. Поэтому на первый план профилактических мероприятий выходят плановые посещения гинеколога с проведением ультразвукового исследования матки с целью раннего выявления зачатков миоматозных узлов и принятие превентивных мер.

The concepts of «health» and «Grateful Dead concerts» don’t often appear in the same sentence. But those enthusiastic souls who used to shake their whatevers nonstop while the Dead played 1 1/2 hours straight (without tuning up once) were faithfully, if unwittingly, engaged in a noble health pursuit-aerobic exercise.

Jane Fonda-style aerobic dance classes may have publicly appropriated the word, but the truth is that any activity that jacks your heart rate up for an extended period of time is aerobic exercise. That means running, cycling, swimming, rowing, skiing, inline skating, or anything else that gets you huffing and puffing enough to feel it but not so much that you can’t keep it up.

All those good things that exercise does to help you avoid heart disease come mostly from aerobic work. That’s eminently logical when you bear in mind that what aerobic exercise essentially does is strengthen your heart (hey, it’s a muscle, too) and improve your lung capacity, thus helping the flow of oxygen through your bloodstream.

Aerobic exercise is also the principal player in diabetes prevention. «Regular aerobic-type exercise will allow you to metabolize your blood sugar without requiring as much insulin,» says Ben Hurley, Ph.D., director of the Exercise Science Laboratory at the University of Maryland’s College of Health and Human Performance in College Park. «That’s important for both heart disease and diabetes prevention. And the research is very consistent.» If you want to take advantage of aerobic exercise’s health benefits, here’s all you need to do.

Do as you please. The kind of aerobic exercise that works best is whatever kind you’ll do. So your wisest choice, according to physical therapist Mark Taranta, director of the Physical Therapy Practice in Philadelphia, is to go with what you like. «Do something you’re familiar with or enjoyed doing in the past,» he advises. «Don’t go out and buy a big piece of equipment like a treadmill if you’ve never tried it before. You might hate it.»

Get that heart rate up. Any exercise expert will tell you that to reap the full benefits of aerobic exercise, you have to do it hard enough. Sorry, golf won’t cut it. (No, not even if you carry your clubs and take 130 strokes to finish.) The aerobic effect doesn’t kick in until your heart’s beating at 70 percent of its maximum rate.

Your maximum rate per minute, by the way, is 220 minus your age. So if you’re 40, you want to have your heart beating at 70 percent of 180 beats per minute while you’re exercising. (We’ll do the math for you, this time only-it’s 126 beats per minute.) Check your pulse by putting two fingers to the side of your neck and counting the beats for 10 seconds; multiply that by six, Taranta says.

And keep it up. Once you get your pulse up to 70 percent of your maximum, keep it there for at least 20 minutes. While you’re working your way up to that magic 20-minute mark, remember that accumulating the time over a 24-hour period (say, three seven-minute sessions on the stationary bike) will provide almost the same benefits.

Stick with it. If you get your aerobic workout three to five times a week, you’ll be amazed at how quickly the positive changes kick in. But you’ll be just as amazed at how fast they fade if you start backsliding. «If you don’t keep at it, you lose it,» Dr. Bortz warns. «The gains and losses are very transient. If you want to translate them into genuine health benefits, you have to do it regularly.»

Be reasonable. Assuming that your fitness goal is achieving overall health rather than medaling in the Olympics, it makes more sense to enjoy your exercise sessions than to turn them into torture tests. Yes, there are the minimum requirements we’ve mentioned, but you don’t have to go much beyond them. «It doesn’t take a whole lot to maintain your cardiovascular fitness,» says Tom Baechle, Ed. D., chairman of the exercise science department at Creighton University in Omaha, Nebraska. «We’ve gotten away from the killing-yourself mode. You can get it done in 20 minutes a day, three times a week, at a reasonable intensity.»

*44/36/5*

Partial mastectomy/segmentectomy

A variation of lumpectomy, this operation is done for a larger tumour and involves the removal of a larger wedge of normal tissue. Auxiliary lymph nodes may also be removed.

The advantage of this operation for women with larger breasts is that most of the breast tissue is preserved. There is also unlikely to be much swelling of the arm as most of the auxiliary lymph nodes remain intact. However, the breast may be left flattened or distorted, particularly the nipple.

Radiotherapy is likely to be necessary after a partial mastectomy in case any cancer remains in the breast tissue left behind. Again, radiotherapy must be avoided if all the auxiliary lymph nodes have been removed.

Mastectomy

In simple or total mastectomy, the entire breast is removed, usually together with some or all of the auxiliary lymph nodes. Breast reconstruction should be possible following this operation. Its advantages include the retention of the muscles of the chest wall, which are removed in a radical mastectomy. The risk of arm swelling is increased if the auxiliary lymph nodes are completely excised, or if some of them are removed for staging and then radiotherapy is given.

There is controversy about how many of the auxiliary lymph nodes should be removed. Some surgeons claim that complete removal leads to a very low recurrence rate and makes radiotherapy unnecessary. Others prefer to perform a wide lump excision (removing the lump itself as well as a wedge of the normal tissue surrounding it), with sampling of the auxiliary nodes for prognostication, and follow it up with radiotherapy to a large area around the breast and armpit. This is a quicker operation, involving less risk of damage to the nerves responsible for sensation in the arms.

For pre-menopausal women whose auxiliary nodes are involved, surgery may be followed by adjuvant chemotherapy for 6 to 12 months.

Radical mastectomy

This operation is now uncommon. It involves the removal of the entire breast, the auxiliary lymph nodes, fat, and the pectoral muscles of the chest wall. If metastasis has not already occurred, radical mastectomy can completely remove the malignant cells. However, it does leave a long scar, a hollow chest, restricted movement of the shoulder, and loss of arm strength due to the removal of the muscles which normally allow arm movement.

Modified radical mastectomy (Patey)

In this operation the entire breast, all the lymph nodes in the armpit and the smaller of the two chest muscles are removed.

As all the auxiliary lymph nodes are removed, swelling may occur in the arm, but muscle strength is retained.

Super-radical mastectomy

Another uncommon operation, this involves radical mastectomy as well as removal of further lymph nodes known as the internal mammary and supraclavicular nodes. However, there is no evidence to prove that this operation is more effective than radical mastectomy alone.

*23/39/5*

These include things such as stopping smoking, wearing seat-belts reducing alcohol consumption and so on. They are often extremely cheap to implement. A cost-benefit analysis on smoking and alcohol produces dramatic results. The cost of alcohol abuse and smoking accounts for one fifth of all health expenditure. When indirect costs are added the cost of smoking and alcohol abuse accounts for one quart of all the economic costs of illness. These figures would increase even more if the costs of fire losses, ca accidents and crime due to smoking and alcohol were added.

According to Dr John H. Knowles, President of the Rockefeller Foundation:

Over 99 per cent of us are born healthy am suffer premature death and disability only ñ result of personal misbehaviour and environmental conditions. . . . the individual has the ðîã indeed the moral responsibility to maintain own health by observance of simple prudent rules of behaviour. . . life is meant to be enjoyed . . . but the cost of individual responsibility health care now becomes prohibitive. The choice is individual responsibility or social failure. Responsibility and duty must gain some degree of parity with right and freedom.

So much for the costs of alcohol and smoking. The benefits are harder to quantify. The benefit could be the amount people are prepared to pay to indulge in these activities but this is probably an underestimate because presumably people prevented from smoking and drinking would need to do other things to answer the need; they have in the first place. Perhaps the cost of the drug bill would rise proportionately. A prevention plan to reduce smoking and alcohol use would, of course, cost money and there would be transitional costs as the two industries lost profits and put people out of work. Governments could, of course, compensate these industries temporarily in the interests of the nation’s health.

Even allowing for all these costs economists still think the financial advantages could be considerable. To see just how cost-effective a reduction in tobacco and alcohol use would be one need look no further than the Mormons and Seventh Day Adventists in the US who live without these drugs and have provably lower death rates and longer lives. Their healthy eating habits also give them a cancer mortality of between 50 and 65 per cent that of other Americans.

*38/72/5*

It wasn’t until Susan Ledford discovered the power of a fresh, sweet orange that she was able to pass up her biggest indulgence and lose 43 pounds.

A member of a big Southern family that loves food, Susan is no stranger to temptation. When special occasions call for family celebrations, «it’s like a race to see who can make the most disgustingly rich casserole,» says the 36-year-old newspaper designer from Tallahassee, Florida.

Such decadent dishes were standard fare while Susan was growing up. But they weren’t kind to her waistline. She gained weight throughout her teenage years, and by her twenties, she was trying all sorts of diets in an effort to slim down. «I’d go on one diet and lose a few pounds only to watch them return when I went back to my normal eating habits,» she recalls. By age 34, she topped out at 168 pounds.

Knowing that Susan was unhappy with her figure, a friend suggested that she join Weight Watchers. The program taught Susan how to make healthy food choices and control her portion sizes. Within a year, she took off 43 pounds.

Thrilled to have finally reached her goal weight of 125 pounds, Susan was determined to stay there. But she had one dietary hurdle to overcome. Susan loved to bake cookies for her family and friends, especially around the Christmas holidays. She especially enjoyed licking the bowl and sampling each batch fresh from the oven.

Realizing that her taste-testing ways would do nothing for her hard-earned figure, Susan decided to have a healthy snack before baking. Her food of choice: a fresh, juicy orange. She found that the intense flavor of the fruit quashed her cravings for cookies. She was i able to bake to her heart’s content without eating a thing.

Thanks to her ingenious strategy, Susan had an easier time sticking with her healthy eating habits. Her weight has held steady at 125 pounds since 1998.

WINNING ACTION

Feed your sweet tooth an orange. Susan’s strategy has real scientific merit. According to Marilyn C. Majchrzak, R.D., food-development manager at the Canyon Ranch Spa/Health Resort in Tucson, Arizona, intensely flavored foods such as oranges tend to be more satisfying than bland foods. So snacking on something sweet and juicy will help reduce temptation. Keep lots of oranges, fresh pineapple, strawberries, or your favorite tastebud-shocking fruit in your fridge.

*32\89\8*

The main drug in this group is ipratropium (Atrovent) which is taken by inhalation. Side-effects are rare except at high doses. They include dry mouth, difficulty in passing urine and constipation. Other anti-cholinergics include butethamate and atropine. Anti-cholinergics help to reduce the amount of mucus present in the airways as well as relaxing the muscles,

and may be useful where asthma and bronchitis occur together.

Sympathomimetics, such as adrenaline and ephedrine, are sometimes combined with anticholinergics in inhalers. Atropine is combined with adrenaline and a muscle relaxant in Brovon and Rybarvin. Butethamate is combined with ephedrine in CAM, which is taken by mouth. Ipratropium is combined with the bronchodilator fenoterol in Duovent.

Other bronchodilators

Sympathomimetics were once the main drugs used for bronchodilation, but they are much less specific for the bronchial muscles than the drugs described above. They produce side-effects more easily than modern bronchodilators and are much less used now. They include adrenaline, ephedrine and phenylephrine. Typical side-effects include nervousness, anxiety, tremor, irregular heartbeat and dry mouth.

*426\180\8*

For anyone with multiple food sensitivities, avoiding all their culprit foods can be very difficult. And it may mean that they eat too much of other foods, with die attendant risk of developing new sensitivities. Even those who are intolerant of just one or two foods may find it difficult to avoid them, especially if they eat away from home a lot. So there have been many attempts to develop alternative methods of treatment.

Given the lack of knowledge about how food intolerance arises, these attempts are largely a ‘suck-it-and-see’ exercise: trying out treatments and seeing if they work. No treatment has yet been devised which is 100 per cent effective for all patients, and there are some on offer from ‘alternative’ practitioners that are quite ineffective and even potentially dangerous (eg urine therapy). However, there are two methods currently being tried out by some doctors, known as neutralization or desensitization treatments, that are worthy of further investigation.

In some studies, these treatments have performed quite well, but in others they have been less successful. Consequently such techniques are controversial and many doctors feel that they should not be used until there is more evidence that they work. But given the complex nature of food intolerance, and the evidence suggesting that it is caused in several different ways (see Chapter Twelve), perhaps it is not surprising if a treatment gives varying results – it might be expected to work for some patients and not for others. Our own experience suggests that such methods are effective for a proportion of people with food intolerance. But they are probably not worth trying unless there is no reasonable dietary alternative.

These methods have also had some success in treating classical allergies, and in this context they may be very useful. The traditional method of desensitization, once widely used for hay fever and other allergies, cannot now be given by family doctors in Britain. This method involved injecting minute, but gradually increasing, doses of the allergen over a period of many months. There is a risk of collapse, due to anaphylactic shock, with this method, and a few patients have died as a result. Such desensitization treatment can now only be given in hospital, where resuscitation equipment is available.

Other uses claimed for these techniques include desensitization to environmental chemicals, such as exhaust fumes, and desensitization to Candida, where there is a sensitivity to the yeast’s products as a consequence of candidiasis.

*380\180\8*

Most of the cross-reactions that are seen (or suspected) in patients do not match so well with the biological classification. For many foods, the use of the family group to predict cross-reactions is more a matter of faith than science, but it is still the most useful guide we have. There are also some unexpected cross-reactions, which do not tally with classification schemes.

If you have reason to suspect any food before starting on your elimination diet (because you eat it in large amounts, for example) you should check the food-family list to discover which family it belongs to. All its relatives should be excluded during the first phase of the diet, along with the food itself. The food families may also be useful later, in interpreting your reactions to tested foods, and in planning your diet afterwards – just as you should not eat too much of any one food, you should not eat too much from any one food family either.

*333\180\8*

For the older baby, early weaning may be the answer, although it involves the risk of sensitizing the child to even more foods or – if all the high-risk foods are avoided – failing to give the child an adequate diet. Early weaning is only recommended if the baby is suffering quite badly and you have exhausted all other possibilities. It would not be appropriate, for example, in the case of a colicky baby who was otherwise well and growing normally. If you decide to try early weaning, remember the following points:

1. Certain foods seem to contain more potent allergens than others. Do not give the child eggs, fish, chocolate, wheat, oranges, peanuts or other nuts for at least the first six months, and preferably for the first year of life. If you introduce them before a year old, do not give them every day. Test out beef and chicken cautiously, as these can cross-react with milk and eggs respectively. If they seem to cause no problems, you can include them in the child’s diet.

2. Formula feeds commonly contain maize (corn) and tapioca, as well as cow’s milk, so your child may have become sensitive to these. Avoid these foods for at least six months and then try them out carefully. Maize comes in many guises, including cornflour, cornflakes, corn oil, corn syrup, sweetcorn, corn-on-the-cob and popcorn. Some medicines contain corn syrup: ask your pharmacist for advice if you are concerned about avoiding all corn products.

3. No food should be eaten in very large quantities, and it is best not to give any one food every day. This means using your imagination and buying some fairly unusual items. Foods such as millet and sweet potatoes make a good basis for baby foods, and if the baby does become sensitive to them, at least they are no trouble to avoid in later years.

4. Do not force the child to eat any food that is obviously disliked. Most children reject new foods the first time they are offered, but if your child clearly finds the food disagreeable, even after trying it three or four times, then don’t serve it up again. A dislike of the taste is sometimes an early sign of sensitivity.

5. If a child is not eating eggs, milk or fish, there is a risk of protein being in short supply. Make sure that you include other protein-rich foods, such as lamb, pork and other meats. Beans are a good source of protein, but they are also rather indigestible and cause wind; chickpeas (p303) are less of a problem, and have a milder taste.

6. Your child will probably need a calcium supplement, and the overall diet should be checked by a paediatric nutritionist to see if it contains enough of other minerals, as well as vitamins. Ask your doctor to arrange this for you.

*284\180\8*

Anyone who lives in a town or city will have been kept awake, at some time or another, by the sound of a burglar alarm ringing endlessly in an empty shop or house. The alarm is only meant to ring if someone breaks in, but it is triggered off by some other quite innocent event, such as a strong wind or the vibrations of a passing lorry. This is more or less what happens in the case of allergies. The mast cells, which are meant to respond to invasion by parasites, are triggered off by an innocuous substance such as eggs or cow’s milk. But why should this happen?

The answer is that the body misguidedly makes IgE antibodies that fit the antigens in these substances. A very complex and intricate set of controls normally prevent the body from making IgE in response to such harmless materials, but in the allergic individual something goes awry and the control mechanisms break down.

In the case of Jane, her body had mistakenly made IgE antibodies to an antigen in peanuts, probably a protein. The strange symptoms that she experienced on eating peanuts were all produced by mediators released from her mast cells. Mast cells in the tissues of the mouth were triggered as soon as the food came into contact with them, producing symptoms almost immediately. Her lips and tongue swelled up because tiny blood vessels inside them became leaky, allowing fluid to seep out into the surrounding tissues.

The cause of Jane’s collapse (anaphylactic shock) when she ate peanuts again was a sudden drop in blood pressure, likewise produced by the mediators. This time, it seems, more IgE was present and far more mediators released. By making the blood vessels all over her body expand, and at the same time become more leaky, the mediators left her without enough blood pressure to keep the vital organs functioning.

*34\180\8*

Petasites is one of the best, if not the best, natural remedies, often giving better results than one hopes and expects in cases of tumours, especially those of suspected cancer or actual cancer. If it is taken together with Viscum album, the reliable fresh plant extract from mistletoe, or in the form of a combination remedy made up of these two remedies, it is possible to experience satisfactory results even in cases where chemotherapy has no more to offer.

So when the doctor says that he has done everything possible, and that there is no hope left for an improvement in a patient’s condition, remember Petasites and Viscum album. These two remedies, together with an appropriate diet containing plenty of fruit juices and vegetable juices, can often achieve an improvement in the patient’s general well-being. At any rate, this treatment can definitely reduce sensitivity to pain and make life easier.

*694/28/1*

The importance to our health and well-being of caring for the feet will be clear from the preceding sections. Other interesting points will also be explored in the following pages. However, this section sets out to provide some useful guidelines on caring for the feet in general, as discussed above, as well as dealing with specific problems that may be experienced.

1. To start with, go and buy yourself shoes that are sensible and fit the foot rather than the fashion.

2. In the second place, take note of the following three points:

Wash your feet daily; afterwards knead and massage the muscles, then rub the feet with a little foot oil, such as Juniperosan.

If you suffer from rheumatism, arthritis or an ailment that causes water to accumulate in the feet, it is useful to add a tablespoon of herbal sea salt to a foot bath. This bath should last 15—30 minutes, at a constant temperature of 37°C (98.6°F).

Sore feet should be bathed in an infusion of mallow or sanicle.

*650/28/1*

The reaction in this case may be a mild form of heart trouble. Remove the gold and the problem goes too. If such a sensitivity to metals exists, the dentist cannot use them for your fillings, particularly silver, since its effect is worse than that of gold. However, the degree of sensitivity will vary from one person to another, depending on the individual’s constitution, especially the lymphatic system.

When fitting a crown, a good dentist will take great care to see that it fits well. It must come well up into the neck of the tooth, leaving no space, as this would become a breeding ground for micro-organisms. Neither should a crown be too long, as this might cause irritation and inflammation. The solution to these problems depends upon the dentist’s skill. A loose crown can lead to suppurative conditions and an abscess formation which, when prematurely closed in, can cause the most dreadful pain imaginable because of the gases that are produced that have no way out. Under such painful circumstances the taking of anodyne drugs will be unavoidable. A further consequence of incorrect treatment could be the infiltration of bacterial toxins into the system, a situation that is not only bad for health but can endanger one’s life. The heart may be affected; it may even stop beating momentarily. Great skill and experience in natural treatment methods would then be required to eradicate such an infiltration.

*606/28/1*

Unfortunately, even in our temperate zones it has become a hazardous thing to drink water, as was evidenced in an article published as long ago as 19 April 1964, in the journal Nationalzei-tung (No. 178), entitled ‘Carcinogenic Substances in Water’. The article discussed the results of analytical tests of the water in Lake Constance and its catchment area. According to the author, the results indicated that the water analysed contained considerable amounts of carcinogenic substances. Even though the author did not sufficiently exploit the material, his presentation of the findings was enough to make us take note. We must remember that many toxins, besides the effluents from industries, can enter rivers and lakes without our realising it. For example, quite a number of poisonous sprays are used in agriculture, and deposits of leaded petrol and diesel oil accumulate on the roads. Rain and the water from melted snow take up these and many other substances, eventually washing them into the rivers and lakes. Tests have also shown that the groundwater in certain places already contains certain amounts of such pollutants, none of which are at all conducive to good health.

*562/28/1*

Academic debate about the real origin of this illness still persists. It can be caused by micro-organisms, perhaps in the wake of an infection, or by any of a number of toxins. More often than not, we find in association with arthritis some local focus of infection which discharges a constant stream of toxins or pathogenic agents into the blood. The quantity can be so small that the person may remain totally unaware of what is going on, until the body finally reacts, and becomes seriously ill. As a rule, various changes take place in the blood and scientists such as Dr von Bremer, recently also Dr Isel, have found viruses in the blood as well. Nevertheless, no definitive and conclusive explanation has so far been presented despite all the research and theorising.

I have observed that patients suffering from rheumatoid arthritis usually have a family history of gout, arthritis or some other rheumatic disease. There would thus appear to be a definite predisposition to this condition, as it is the case with many other diseases. Not everyone with a dental abscess will be afflicted with rheumatoid arthritis.

*518/28/1*

It is theoretically possible to cure one member of a family by treating another. Freud, in the notable «Little Hans» case, did just that, curing a phobia in a small boy through work with the boy’s father. Some people claiming to be family therapists never see families, only individuals, basing their claim on the «ripple» effect of successful individual therapy. Similarly, some family therapists treat all individual intrapsychic problems as family problems, amenable to family therapy techniques. It is true that the resolution of family problems often eases the intensity of the intrapsychic difficulties of family members. Still, these seem inefficient ways of doing therapy: while the individual is being treated, the overall family can deteriorate (such cases are known to the author), or while the family is being treated as a unit, the intrapsychic problems of some members can be slighted or repressed. It would certainly appear to be true, and it has been my own experience (Witkin) that the most efficient individual, dyadic, or family therapy is when all of the significant people in the problem are treated in therapy at an appropriate time.

Holistic therapy, then, is primarily distinguished not by utilizing a variety of modalities but by the therapist’s attitude toward the patient. «What is transpiring in any therapeutic setting is not determined by whether it is distinguished as individual, marital, or family therapy. It is determined by the needs of the patients and the capabilities, versatility, and training of the psychotherapist» (Martin). In brief, the patient is treated as a whole person, the dyad is treated as two whole people trying to maintain a rewarding relationship, and the family is treated as several whole people in various stages of development with various, mutually dependent needs and satisfactions. Many treatment modalities may be required, since techniques sufficient for treating individuals may not be appropriate to treating families.

It seems likely that holistic therapy will develop along the lines of family and dyadic therapy, that is, a host of approaches and techniques deriving from the myriad backgrounds of the practitioners. It also seems likely that the holistic therapist will need a variety of skills and modalities and that among these will be those associated with sex therapy.

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A third stage which was not discussed by Freud but has been suggested as part of the psychosexual progression is that of the urethral stage. Some analysts have envisioned this phase of psychosexual development as a transitional stage between the anal and phallic stages. As such, it shares some of the characteristics of the earlier anal phase and by way of anticipation some from the subsequent phallic phase. More often than not, the characteristics of this urethral phase tend to be subsumed under the phallic phase. Urethral erotism can be taken to refer to pleasure in urination and the pleasure in urethral retention similar to the anal erotic pleasure of retention or expulsion of feces. The issues here are issues of performance and control. The classic image of urethral expression is the pride of the little boy in seeing how far he can project his urinary stream. Such urethral functioning can also be contaminated with sadistic impulses, often reflecting the persistence of residual anal-sadistic urges. Similar to the loss of bowel control, loss of urethral control (enuresis) can often have a regressive significance that reactivates and assimilates itself into underlying anal conflicts.

The pathological traits deriving from this period are those of competitiveness on the one hand and ambition on the other, probably connected with the need for compensating an underlying sense of shame due to the loss of urethral control. The conflicts over this issue may be the beginnings of the development of penis envy in connection with a feminine sense of shame and inadequacy in being unable to match the male urethral performance. Successful resolution of the urethral phase builds healthy personality traits, which are somewhat analogous to those derived from the anal period. Urethral competence offers a sense of pride and a feeling of self-competence derived from successful urethral functioning. The area of urethral functioning is one in which the small boy can begin to imitate his father’s more adult performance. In this sense then the resolution of urethral conflicts begins to set the stage for and make significant contributions to the shaping of gender identity and the subsequent gender-related identifications.

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Changing the attitudes and beliefs of an individual who has accepted a traditional view of women is no easy task. As Rosen and Jerdee have pointed out, there are many potential motivations for holding sex stereotypes. They suggest, for example, that past costly experiences with women, perceptions of women as a potential threat, commitment to traditional values, or needs for clarity in our complex world all are reasons for the maintenance of stereotypes and rigid adherence to them. Depending upon which of these (or other) motivations support stereotypic belief systems, the most effective change-strategy would differ.

It also should be remembered that, as Terborg first suggested, sex stereotypes have two separate although often overlapping components. Different dynamics may underlie each, and thus different change processes may be needed to change them. It is conceivable furthermore that both have to be changed if certain forms of sex discrimination are to be eliminated. Even if one’s stereotypes about women’s attributes are altered successfully, and women are viewed as equally competent as men, it may still seem inappropriate for them to take positions of authority. Or conversely, even if one views a position as suitable to a woman, assumptions about her lesser competence can prevent her from obtaining it. At least in some cases, it would be essential to change both normative expectations and stereotypic perceptions of attributes if women are to be treated in an unbiased manner.

For the most part, the programs developed in recent years have been built upon the implicit assumption that the basis of the stereotyping of women is ignorance—ignorance of what women really are like and ignorance of what women’s life experiences are. Consequently, their focus is on raising awareness of stereotypical conceptions and on transferring information about the realities of sex discrimination.

Human-relations training and other workshops dealing with these issues have become common within organizational settings. A host of exercises have been developed for individuals and groups to explore personal and societal prejudices and misconceptions. Techniques such as role-playing have been utilized to encourage men and women to experience the other’s dilemmas. Educational programs have become widespread. To fill in the presumed knowledge gap, facts, theory, and research findings are presented and discussed.

Unfortunately, the effects of these programs are rarely assessed systematically, so no conclusions about their effectiveness can be made. It is likely that such programs are successful only when an individual’s assumptions about women have been sustained as a convenience, or because they simply have never been put to the test. In these cases, forcing people to confront their stereotypes about women and to come to grips with the consequences of them should be sufficient to bring about change. But when stereotyped views are deeply rooted in value systems, such programs are likely to fail. Information by itself has little impact on value-laden convictions.

An incidental but nonetheless important point about implementation should be mentioned. Kanter warns of the consequences of using mixed-sex group techniques in change efforts. The very activities necessary to explore sex stereotypes fully—expressing one’s emotions, being open and honest, being concerned about the welfare of others, and collaborating rather than competing—are those consonant with the stereotypic attributes women are assumed to possess. Although Kanter’s concerns were related to the lack of opportunities for skill development available to women in such groups, the point she raises is no less important when one’s concern is the altering of sex stereotypes. Participation in such groups conceivably can reinforce rather than change men’s images of women, unless care is taken to ensure that women also have the opportunity to display behaviors that contradict and challenge the stereotypes men are likely to have.

Changing individuals’ sex stereotypes can be a very complicated process, and it is likely to be an expensive one. The training and development needed to accomplish such a change, if indeed it can be accomplished, are not realistic in terms of the money and time required.

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In many societies, ideas about sexuality assume more concrete form. In fact, the pronounced nature of sexuality in other societies has taken some anthropologists by surprise. For example, Harold Schneider writes of his work with the Turn, «I did not set out to study sexual behavior, but became acquainted with an important dimension of sexual roles in the normal course of a predominantly social anthropological study». Schapera made much the same transition upon contacting the Kgatla: «I was continually struck by the open importance they attached to the sexual aspect». In addition to these comments from Africa, the openness of sexuality has left impressions on researchers working in Polynesia, South America, the Caribbean, and Melanesia.

However, that which takes the ethnographer by surprise—sometimes requiring her or him to re-think the focus of a project—comes as no surprise to the native. «Alligatoring» makes sense to the Mehinaku. Sexual segregation at work and in ceremony makes sense to them too. It is this sense that the symbolic anthropologist hopes to reveal and understand. With this approach symbols are investigated as the basic building blocks of the ideological system. Symbols stand in relationships; they do not stand for something else.

Returning to the matter of Mehinaku extramarital sexual activity, we find that Gregor resorts to a Durkheimian notion of mechanical social cohesion in his explanation. Mehinaku affairs create relationships which keep the community together, though one wonders how. «Extramaritality,» to coin a workable expression, is also an important basis of economic distribution, according to Gregor. Women receive «modest but regular amounts of fish throughout the year» if they are sexually active.

There is yet a third component in Gregor’s analysis. Extramaritality engenders what Gregor calls an «underground kinship system,» «wherein the relationships engendered by extra-marital affairs are performed discreetly so as not to embarrass or anger the cuckolded spouses». Crocker, studying the Canela Indians of Brazil, reports on an «underground kinship system» that goes one step beyond the Mehinaku system. The Canela (or at least the men) appear to speak to their «underground kinsmen,» the consanguinal relatives of the «classificatory wives» or mistresses’ with the appropriate affinal term of address. He will even refer to their children as «my children,» and assume other aspects of the paternal role.

The Mehinaku and the Canela provide examples of systems in which the form of kinship relationships is extended to persons (and to persons related to persons, in the Canela case) understood to share paternity through sexual acts. In one case from Africa, however, the political dimension is constructed somewhat differently. Harold Schneider’s analysis of mbuya («lover,» or «paramour») among the Turn of Tanzania argues that the Turn family organization is based on productive cooperation, not romantic love. Apparently the Turu have learned that the political dimension of marriage is complicated enough without adding to that burden the emotional peaks and valleys of romantic love. In short, Turu love and marriage do not go together. Marriage is a «lease of rights in a woman to her husband in return for bridewealth». A smart husband would hesitate to divorce a productive wife, so presumably the fact that they have romantic affairs outside of marriage is tolerated by the husbands. Wives show similar tolerance. Schneider argues that «this tenuous marriage . . . would be endangered by romantic love, with its ups and downs». Whether or not Schneider is correct, that is, if romantic love would indeed contribute serious instability in a basically political relationship, he has directed our attention to a group whose ideology places marital relationships (I hesitate to call them sexual) and extramarital sexual relationships in tension and opposition.

The opposition appears to be somewhat differently structured among the Mehinaku and Canela for whom it has been reported that «kinship» is extended through the possibility of «multiple paternity.» For these people we probably will not find a sexual/political opposition as with the Turu; instead, they have achieved levels of kinship structure—the so-called underground and above-ground system of ratified kinsmen—that contribute to the tensions of social life. Although a Mehinaku or a Canela may have scores of kinsmen, groups of kinsmen are set off through an opposition between those who are related to ego through ego’s mother’s husband, and those whom ego knows to be related to him or her as partial fathers through their sexual activity with ego’s mother during her pregnancy. Acknowledgement of this latter group of kinsmen, on the instructions of ego’s mother, is a recognition of the multiple sexual relationships of the mother, in which case we can say that her sexuality contextualizes the child’s social world.

This cultural structure contrasts with the ideological universe of the Turu, who live in two worlds, a body politic and a body sexual, as it were. The important point here is that sexual symbolism can form part of the structure of a bisected world, the other world being political (e.g. the Turu case), or it can provide an overarching structure in which ratified and surreptitious kinsmen are identified and opposed (e.g., Mehinaku, Canela). These two contrasting cases illustrate the insight into cultural systems possible when sexuality is studied within a framework of ideology, rather than separately.

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According to the Kinsey data, masturbation is chiefly a phenomenon of young unmarried men, although it occurs to some extent among both sexes at every age and marital status level. Eighty-eight percent of the single males from sixteen to twenty in the Kinsey sample masturbated; the proportion of married males at this age level was considerably less (39%), presumably because marital intercourse was a preferred substitute. For young single males, masturbation represented the highest proportion of total outlet (60%). After age forty, masturbation was a relatively lower percentage of the total outlet (about 40% for the active sample). The average frequency of masturbation in the active single male sample dropped from 1.7 times per week in the teens to once a week or less by age forty. Kinsey did not report masturbation data for single males over fifty. Masturbation accounted for a lower proportion of the total outlet for married males than single males at every age. The average frequencies per week were from four to five times lower for married men.

Sixty-two percent of Kinsey’s total female sample reported that they had masturbated at some time, and 58% of these women had masturbated to orgasm. Among the single active sample, the average frequency of masturbation was .3 to .4 per week; for married females the mean was directionally lower (.2 per week). There was very little change in the active median frequencies for single and married women from the late teens through the fifties. Masturbation represented the highest percentage of total sexual outlet for single women; for married women, it accounted for 10% of the total outlet. Average frequencies of masturbation for single women showed virtually no decline with age (about 1 per week from the late teens through the fifties). For married women, average frequencies per week went from 1 in the teens, to .60 at age forty, to .2 at age fifty. For every age group, the percentage of total outlet was from three to seven times as great for single as for married women. Based on their clinical experience, Masters and Johnson suggest that both married and single women who masturbated during their adult years continue to masturbate in old age, although the frequency declines after age sixty. Christenson and Gagnon reported that 25% of a sample of postmarital women in their seventies were masturbating.

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We live at a time when science is pursuing so many fields of research, and in the medical field so many more drugs and medications are available to improve our health. The growth of our population over the age of sixty-five can be due at least in part, to the availability of effective medicines and vaccines. The D.H.S.S. reports that during 1984 as many as 53 per cent of prescriptions dispensed in England were for women over the age of sixty and for men over sixty-five. Of course, it is only natural that older people have more long-term illnesses (such as arthritis, heart disease and hypertension). And it is not uncommon to have a number of disabilities or diseases at the same time for which you need to take a number of different medications. But have we become an over-medicated society?

Generally speaking, the elderly can have different reactions to medicines than the young or middle-aged, probably because of the decrease in the percentage of lean tissue (including muscle) and an increase in the percentage of fat. Consequently, these differences can affect the drug amount that is absorbed by body tissues and the length of time it remains in the body. Older people seem to have more undesirable reactions to drugs than younger people, probably because organs like the kidneys and the liver are working less efficiently, so that drugs (including alcohol) are slower to leave the body.

Prescription drugs are generally more powerful and may have more side reactions than over-the-counter medicines; and yet when large quantities of non-prescription drugs are taken, if they have strong ingredients, they might equal or exceed a dose available in a prescription. Some medicines (including antacids, alcohol, cold remedies, laxatives and vitamins) can create difficulties if overused or abused or taken in combination with prescription drugs, causing dizziness or drowsiness that could result in stumbling or falling. These few basic rules can help you use medicines, mineral and vitamin supplements more safely:

1. Before you have a new prescription, tell your doctor all the

other medicines you are taking, including oral contraceptives, insulin, non-prescription drugs and those prescribed by other doctors, plus vitamin and mineral supplements. If you are pregnant, a heavy smoker, or a heavy drinker, ask your doctor if there are any special foods, alcohol or aspirin to avoid, and if medicines should be with or between meals. Ask specifically what effect the new medication will have on your bone mineralization (especially if it is cortisone, an anticoagulant, anticonvulsant, tranquillizer or stimulant), and if additional calcium or vitamin supplements may be necessary.

Tell your doctor about previous adverse reactions you have had with medications (dizziness, rashes, indigestion, constipation, etc.). Know exactly what the medication is supposed to do for you, and ask about any side effects that may occur with a new prescription. Phone your doctor immediately if you have unusual effects.

Understand exactly what the dosage should be and how frequent, and take precisely the dosage your doctor prescribes. Oral contraceptives, oestrogens and a few other drugs usually have an information leaflet detailing risks and benefits. Read this brochure carefully.

Never take medicines prescribed for a relative or friend, or give your medication to anyone else, even though you may have similar symptoms or illness. Medicines can produce different effects in everyone.

Make a complete daily record of each drug and supplement you are taking, particularly if you are taking more than one. Note the name of the drug, the amount you take and the times of day for the dose, and don’t forget to tick off each dose as you take it.

Ask the chemist for easy-to-open containers if child-proof tops are difficult for you. Be sure to keep all medicines and supplements locked up and well out of the reach of children. Ask the pharmacist about any special storage requirements for the medicines you take, such as refrigeration.

Ask your chemist to put large type on the medicine label if you find the usual type difficult to read. Make sure you have the name of the medicine clearly on the label with the dosage

directions, and that you understand them. If you have any doubt that they are different from what your doctor has told you, mention this to your pharmacist or doctor.

Never put medicines into unlabelled containers. Fancy pill boxes are not always suitable.

Never take medicines at night without turning on the light. Be sure you can see clearly what you are taking and how much.

If you feel a medicine may be doing you more harm than good, don’t stop taking it without asking your doctor; he may want to change the dosage or substitute another medication that is more suitable to your changing needs.

Never resume taking a drug you happen to have in the medicine cabinet without checking with your doctor.

Many medications lose their strength and effectiveness over a period of time, so expiry dates should be carefully checked. Old medicines should be cautiously discarded and the labels clearly marked ‘Empty’ (to give peace of mind if children are found playing with the old jars or bottles).

*60\114\2*

Hippocrates once said: ‘Thy food shall be thy cure’, and perhaps he was on the right track. The quality of your life can depend on the quality of your food. Some foods, or lack of them, can cause diseases; others prevent them. A sensible diet may add years to your life. There’s no doubt, diet has an influence. Food is not a preventive nor a cure for all human diseases, but more is being learned about the interaction of food on health, and how much is needed to give a full and happy life span. Sometimes the only difference between a healthy person and a sick person is the food eaten. When poorly nourished and abused, your body gets out of order, you can get sick, and might age and die needlessly prematurely. There’s still much you can do for yourself with preventive health practices and better nutrition. It’s a combination of the right living habits, the right food and ways of preparing food, knowing which foods to avoid and which supplements may be needed. For fitness and the longest life span, you need a lifetime concern for good nutrition. But it’s never too late to start on a programme of self-improvement, with the key points being: moderation in quantity, attention to ‘quality, and especially a variety of items from the four main food groups – milk and milk products; fruits and vegetables; breads and cereals; meat, fish, poultry, eggs or beans. As no individual item contains all the nutrients you need, an assortment of whole food makes for better health.

As a mother, you probably feel your family’s needs come first, and urge your youngsters to drink their milk or fruit juice and eat their vegetables, but make sure you too have your proper share of these foods.

Frequently, young people as well as the elderly, have to work with a limited budget for food. You may be bored with food and its preparation, or be in a hurry, or have little appetite, especially if you are living on your own. You may have difficulty chewing because of poor teeth or ill-fitting dentures, or have problems of indigestion. Or it may not be easy for you to get to the shops if you live some distance away from them, so you may not have much fresh food and choices may be limited or unwise. As years go by, you are probably less active and need fewer calories, but every calorie has to provide good sound nutrition and really count. There’s little room for the ‘empty calories’ in fats, sugars and alcohol. Each day can make different demands on your body and the nourishment it needs, with varying levels of activity, days of stress and days of relaxation.

For determining good bone health, it is crucial to consume sufficient calcium, largely found in dairy products, especially during adolescence and young adulthood, and to have the right ratio of calcium to other foodstuffs. In Yugoslavia, a study of women’s bone mass was conducted in two villages in regions of the country with different eating habits, one group consuming twice as much calcium as the other. In the village where calcium consumption was high, the women’s bones were definitely stronger at skeletal maturity, and fewer fractures were suffered by the elderly. It has been found that women with osteoporosis have generally had poor nutrition, with less calcium, or have had difficulty in absorbing it from their food. As we grow older, it can become more difficult to absorb calcium. Later on, you will read of the different foods that are calcium-rich and the role played by vitamins.

*13\114\2*

You need plenty of foods rich in this vitamin, also known as ascorbic acid. Vitamin C is utilized by your body for the production of collagen forming connective tissue; this vitamin will help if you have bone fracturing, sore or bleeding gums, or wounds that fail to heal. When our bodies evolved, they were not designed to store vitamin C for any length of time (because fruits and vegetables were plentiful), so the body needs vitamin C daily. The adrenal gland has a high level of vitamin C, and it is known that, in stressful situations, as the production of hormones goes up in this gland, its level of vitamin C goes down. Oral contraceptives, or overuse of laxatives, can decrease your absorption of vitamin C, with consequent reduced levels of this vitamin. Osteoporosis can develop from such nutritional disorders as scurvy, vitamin C deficiency; although only a few elderly people develop scurvy, many more have low reserves of this vitamin.

How much vitamin C do you need each day? The recommendation of the D.H.S.S. for adults is 30mg, with 60mg for pregnant women and nursing mothers.

There are between 50-60 mg of vitamin C in 0.5 cup of orange juice or one medium orange. Orange-flavoured breakfast drinks can be misleading, with many advertised as having more vitamin C than orange juice, but they have little else but vitamin C and sugar, with more calories. And the ‘juice’ in which fruit is canned, usually a sugar-water syrup, has no vitamin value. Real unsweetened orange juice has vitamin C plus other natural minerals and nutrients, so check the labels.

Other produce with this vitamin are: citrus fruits and natural citrus juices, blackcurrants, kiwifruit, canned pineapple juice and cranberry juice cocktail (but little in prune juice). Potatoes, especially baked and eaten with the skin, contribute substantial amounts of vitamin C. Other good sources are fresh picked tomatoes, tomato juice, green peppers and fresh green leafy vegetables.

Since water-soluble vitamin C is easily destroyed by heating, fruits and vegetables not eaten raw should be lightly cooked or steamed for a short time only. Carefully refrigerate leafy vegetables and don’t leave them soaking in water before cooking. Generally, more vitamin C is retained if cooking is in a microwave oven, well covered, than on a conventional stove-top.

Canned fruits and vegetables have generally lost some of their vitamin C through processing; some brands may have extra ascorbic acid added to make up the losses. Check the labels. Frozen fruits and vegetables will usually retain good amounts of vitamin C during freezing – but drying to preserve foods will destroy this delicate vitamin.

Small amounts of vitamin C are naturally present in milk, but 25 per cent is destroyed by pasteurization, with further losses in the heat process for UHT milk and sterilization. Don’t leave bottled milk on the doorstep in sunlight – substantial amounts of vitamin C can be lost. Don’t rely on milk alone to supply you with this vitamin.

It has been several years since Dr Linus Pauling wrote his book Vitamin C and the Common Cold advocating megadoses of vitamin C. Many subsequent studies, however, have shown no benefits from this practice. In fact, taking more than 1 gram daily can result in acidic urine and encourage the growth of kidney stones. Some studies show that high dosage vitamin C can change the level of oestrogen in oral contraceptives, according to Dr Daphne A. Roe, Professor of Nutrition at Cornell University, USA.

*48\114\2*

A minor but not insignificant factor in osteoporosis can be pollution in the environment, affecting your bone mass in two ways: the reduction of sunshine under murky skies (see vitamin D section on p. 96) and the toxic effects of particles of matter in pollution – the aluminium toxicity noted earlier, and especially high levels of lead, cadmium, mercury and zinc. When calcium in the body is low, it tends to be replaced by these other harmful minerals.

Lead. D. Bryce-Smith in Chemistry in Britain describes lead as ‘. . . one of the most insidiously toxic of the heavy metals to which we are exposed, particularly in its ability to accumulate in the body, and has been said to interfere with practically any life-process one chooses to study.’

When lead enters the bloodstream, about 10 per cent is excreted but the remainder is lodged in bone tissue. Lead can cross the placental barrier to a growing foetus and reach a nursed infant through lactation. It is well-known that high levels of lead in the blood can be fatal, but recent research has found that 30 micrograms per decilitre of blood can have an adverse effect – a level considered free of risk only two years ago. A safe level of lead in the blood has not been established. Unborn children are in danger of acquiring birth defects and children of one to three years of age are most susceptible to permanent damage. It can be absorbed into the body by inhaling, ingesting or through the skin.

Where is lead found? It is in the air, mainly from petrol and industrial processes, from burning coal or refuse. Lead is in food, from fertilizers, insecticides, pesticides and some ceramic glazes. It may be in drinking water, flowing through lead plumbing; and it is in lead-based paints, ammunition, fishing weights and some cosmetics.

What can you do to avoid it? Because children are most at risk from lead pollution, check around the home for old lead-based paint on walls (especially if it is chipping and peeling), or on painted toys, since youngsters tend to chew on paint chips. Unleaded paints are now available in shops for home decorators. In urban areas, lead accumulates in dust, so it is a good idea to do indoor dusting frequently, as well as sweeping porches, steps and driveways where children often play. Be sure that dirty hands are washed before food is prepared, and especially before eating. Buy fresh foods whenever possible, since metallic lead (mainly solder) gets into food during the canning process, particularly if the food is acidic. If you have to use tinned food, wipe the tops of cans carefully before opening; remove food promptly, without scraping the cans too vigorously, and transfer the contents to glass containers. Never store food or juices in tins. All unprocessed fruits and vegetables, from a greengrocer or home-grown, should be thoroughly washed in water or a mild vinegar-water solution, and outer leaves discarded, to remove pesticides, insecticides and contaminated soil as much as possible. If you take your own pie-shells and pastry-cases using pellets to weight the dough, use glass or ceramic beads or dry beans and not lead or aluminium shot. Discard old toothpaste tubes that sometimes contain lead – more recently, tubes are made of plastic.

If you have lead plumbing, use Water only from the cold water tap for the kettle or for food preparation, running it for a few minutes before using. And before installing a water softener, check that you have no lead pipes.

Controversy still surrounds the addition of lead to petrol, to increase the octane rating (in 1986, at the rate of 0.15g per litre), although the practice is a serious health hazard. Australia, New Zealand and the United States now have programmes for marketing lead-free petrol, and it is earnestly hoped that car manufacturers and the petroleum industry will soon reach agreements to ban completely the use of lead additives in the UK, EEC countries and world-wide. Meanwhile leaded petrol continues to be used and to cause concern.

Home potters use lead glazes because other safer glazes require firing at higher temperatures not always achieved with home kilns. If you are buying ceramics at a craft fair, or maybe in a foreign market, ask what kind of glaze was used. Coffee can pull the lead out of lead-glazed coffee mugs, for instance, and poison the person drinking it. Artist-potters may be exposed to glazes that contain the metals lead, cadmium and nickel; they are cautioned to read and follow the directions on labels of art material, use gloves and good ventilation. When glazing vessels intended for food and drink, use a lead glaze on the outside surfaces only, and some other non-toxic glaze on the inside.

Old traditional pewter may have a high lead content and should be avoided for drinking beer, cider or wines, or for storing fruits, pickles and preserves.

Although the sale of lead-containing cosmetics is banned in Britain, leaded eye make-up is still imported from the Indian subcontinent, and some medicines imported from the same area also have a high level of lead.

Cadmium. Cadmium is used in plating steel, iron, copper, brass and other alloys to prevent corrosion. It is used in storage batteries; as pigments in paints, enamels and lacquers. Poisoning can occur after drinking an acidic food or drink, such as lemonade, after preparation in a cadmium-plated can.

In Japan, cadmium poisoning is known as ‘Itai-itai’ disease, meaning ‘it hurts, it hurts’. In the 1960s, cadmium seeped downstream from toxic waste along the Jinzu River, contaminating drinking water and polluting rice paddies near the village of

Haginoshima. When villagers had had repeated pregnancies, severe bone disease developed in old age: calcium from their bones had been drawn off by each growing foetus, and replaced by cadmium, subsequently resulting in bones so weakened that they splinter with a sneeze. The Japanese cadmium dumping ended in 1971, but itai-itai disease is chronic; more than 100 villagers died, and other survivors receive benefits under the Japanese law devised to help people injured by hazardous waste or air pollution.

Closer to home, in Shipham, Somerset, where the village was built over old zinc mines, cadmium concentrations in the soil have been contaminating leafy vegetables and rhubarb. These villagers have now been cautioned to eat less home-grown produce to reduce their intake of cadmium. And in the Heathrow area near London, the use of sewage sludge on market gardens over a long period has increased the cadmium in lettuce and root vegetables. Cadmium is also known to accumulate in kidney meat and in brown crab; other shellfish is being carefully monitored by the Ministry of Agriculture, Fisheries and Food.

Mercury. Even in ancient Egypt mercury was known as a toxic substance, but was used for medical purposes. In the nineteenth century, a mercury compound was used to treat felt in the hat industry, causing poisoning with damage to the kidneys, tremors and other physical effects, hence the term ‘mad as a hatter’, and subsequently it was banned for that purpose. Today, under carefully controlled conditions, it is used in antiseptic salves, as a germicide, a fungicide, and in diuretics to increase urine flow. Because mercury compounds are presently used in fungicides for seeds, in water-based paints and in paper, the discharge of mercury-containing wastes into drainage systems is creating some concern. Build-up of mercury, through the ecological chain, in tuna, swordfish and salmon, has caused some governments to set definite limits on permissible levels in edible fish.

The Ministry of Agriculture, Fisheries and Food is monitoring the mercury content offish entering selected British seaports, and reporting to the D.H.S.S.’s Committee on Toxicity.

In the Mediterranean area, high mercury levels previously attributed to industrial wastes, have been found to be originating mainly in natural run-offs from mercury-rich soils, particularly from Spain, Italy, Yugoslavia and Turkey. Under the Mediterranean Action Plan, participating countries have banned dumping of the most dangerous wastes (mercury, DDT, PCBs, arsenic and radioactive substances), but eating raw shellfish in this region is still dangerous.

Zinc. The toxicity of zinc is lower, but still represents a hazard. Zinc is used as a coating for the protection of steel and the production of galvanized metal, frequently seen as a roofing material. It is in tyre production and in weedkillers. Zinc can occasionally enter pipes used for drinking water.

Approximately 63,000 chemical compounds are in common use, with 1000 new compounds added each year to that total. A recent study by the US National Academy of Sciences concluded that ‘of tens of thousands of commercially important chemicals, only a few have been subjected to extensive toxicity testing, and most have scarcely been tested at all.’ Is there any level of toxicity so low as to be harmless to humans? What is an acceptable risk? Many chemicals can cause cancer, damage to the central nervous system, liver and kidneys, from which it can be inferred that there is an effect on the proper functioning of these organs, impairing bone mineralization.

Write to your government representatives to express your concern; demand an acceleration in efforts to clean up the environment and ensure safe handling and storage of toxic wastes.

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Although insufficient information is available on whether moderate amounts of alcohol have an effect on bone loss, it has been observed that heavy drinkers have abnormally light bones that fracture easily, with impairment of calcium absorption through the intestines. Alcoholism produces inflammation of the liver, causing damaged cells to be replaced by scar tissue that impairs the organ’s function. Thus there is a reduced ability to produce enzymes for digestion and absorption of food nutrients.

Male alcoholics in their twenties have been known to have osteoporosis. A research team from Loma Linda University and Jerry Pettis Veterans Administration Hospital in California, has evidence that alcohol itself accelerates the breakdown of bone, although it is still uncertain whether alcoholics’ bone problems may also be the results of poor diet, the inability of the liver to activate vitamin D, and/or a lack of exercise. Heavy drinkers may be taking certain antacids to soothe their stomachs, adding further to their bone problems.

It is the amount of alcohol you drink, and not the particular kind of drink that the alcohol is in. Thus 1.5 oz of whisky equals

6 oz of wine, equals 12 oz of beer. Pure alcohol is 200° proof. Distilled spirits such as brandy, gin, vodka and whisky are about 40 per cent alcohol (80° proof). Fortified wines such as port, Madeira and sherry are about 20 per cent alcohol. Table wines, whether light or full-bodied, are about 10 per cent alcohol. Beers are about 5 per cent alcohol.

Many medications contain alcohol – for instance, medicines for coughs, colds and congestion – because alcohol is a better solvent and provides longer shelf-life than a water solution. A concentration of alcohol up to 35 per cent is used in many mouthwashes.

The problem is that we don’t stop to consider that alcoholic beverages are drugs that can have interactions with many other drugs, both over-the-counter and prescription. Alcohol can cause other drugs to be used more rapidly by your body, producing exaggerated effects (mixing alcohol with a high dosage of ‘Valium’ or ‘Darvon’ can be fatal). Drugs can intensify your reaction to alcohol, leading to more rapid intoxication. Your body’s response can also be influenced by menstrual periods and hormone levels, including the taking of oral contraceptives or hormone replacements after menopause – slowing the rate at which alcohol clears from your bloodstream.

Two-thirds of the population drink alcohol and certainly don’t think of themselves as drug users. Alcohol is present at most of the big celebrations: births and christenings, birthdays, graduations, weddings, promotions, deaths and funerals. Holidays and Christmas revolve around having a drink with family and friends.

But ask yourself honestly if you are drinking more than a moderate amount each day – an important factor when considering loss of bone mass. How would you answer the following questions?

Have you lost interest in food?

Do you crave a drink at a definite time each day, and need to

drink more to get the desired effect?

Do you drink to put yourself to sleep?

Do you gulp drinks too fast?

Do you drink alone?

Do you drink because you are shy, need to calm your nerves

or bolster your confidence?

Do you lie about how much you drink – and feel guilty?

Are you losing time from work because of drinking?

Has your efficiency and ambition decreased because of

drinking?

Has drinking made you indifferent about your family?

Do you drink to forget problems at home, at work, or to

reduce depression?

Is drinking making your life at home unhappy?

Are you in financial trouble because of heavy drinking?

Have you sought the help of a doctor or been to hospital

because of drinking?

Although alcohol abuse has been closely linked to the stresses of old age, with some studies estimating that 10 per cent to 15 per cent of people over the age of fifty-five may have a drinking problem, there is also great concern for the epidemic of teenage drinking. But the teen years are when the body should be building up its skeletal mass at the average rate of 10 per cent a year. Some young people under eighteen are already alcoholics or nearly so; many more are heading towards problem drinking that may be a lifetime handicap. Discourage your young daughter from drinking and smoking, and set yourself as an example.

For control of alcoholic beverage consumption, a physician will sometimes prescribe disulfiram (‘Antabuse’ by C. P. Pharmaceuticals) which is formulated to cause palpitations, flushing, sweating, shortness of breath or dizziness when even a small amount of drink is consumed or other drugs containing alcohol are taken.

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