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This means just that parenrs wean the child from the dependency without any intervening steps. This can be quite a shock to the child and the parents. When the child wakes during the night and calls out or cries, he is ignored. Ignore means ignore. Parents should not respond in any way, either by calling out, reassuring, ordering him to go back to sleep, threatening, feeding, cuddling, tucking may cry the rest of the night. This is obviously the difficult part for one or both parents; one or other is likely to weaken, not being able to bear their child being so upset.

The next night, if the scenario is repeated, the child will cry a little less, and the night after that even less until, in a short space of time, he stops altogether. The problem will be cured as soon as the child is convinced that his parents will not pay any attention in the middle of the night. The next morning the child should be praised for the fact that the parents did not have to attend to him during the night. Again, to allow the child to cry for a couple of nights and then give in just makes the problem more difficult to deal with the next time.

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“The common people call them piles, the aristocracy call them haemorrhoids, the French call them figs — what does it matter, so long as you can cure them?”

What John of Arderne, regarded as the first English surgeon, said in the 14th century is still applicable today.

Haemorrhoids are varicose veins in the anus. They are common, but rarely seen before the age of 30 except in pregnant women.

There are many factors associated with their cause. The condition is common in families, as are varicose veins of the legs. Some hereditary weakness of the veins is also believed to play a part.

Chronic constipation and the subsequent straining at stool may be the most important factor.

Developed nations’ highly processed diet, which is low in vegetable fibre, is believed to be associated with an increased risk, not only of developing piles, but also several other conditions, including cancer of the bowel, diverticulitis, appendicitis and varicose veins.

*388/71/1*

In the past 10 years, there has been controversy about whether or not childbirth should be induced or be allowed to progress naturally.

There has been an increasing tendency for doctors to induce labor.

Associated with this has been a progression in childbirth technology, so that the strength of the contractions of the womb can be controlled by drugs and the progress of the baby closely monitored.

Those parents who see induced labor as too technological, and a complication of what should be a natural and shared family experience, have been increasingly vocal in demanding that their viewpoints be heard and considered.

Medical proponents of the management of labor argue that the method allows the whole medical team to be available to deal with any problems which may arise, whereas spontaneous natural labor may occur at night, on weekends or holidays when the full medical team is not available.

In a British Medical Journal review of reports from several centres, it was found that there can be different interpretations and different results from various groups in matters of usage and observation of natural or induced labor. And so the debate continues.

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This means that the narrow canal that leads from the stomach into the next part of the intestinal tract, the duodenum, is extremely narrow. For this reason it does not allow food to pass normally. It is more common in males, and more frequent with first babies.

The most important and earliest symptom is vomiting. This often commences about the 14th day of life, and becomes worse. It frequently occurs about half an hour after a feed. Because the food is not being absorbed by the system, baby is always hungry, but fails to thrive. As time progresses, vomiting may become projectile—it comes out with force and vigour—not merely dribbling down the side of the face, which is the common form of baby vomiting (as with burping). Later on, appetite is lost, as serious changes commence internally. The bowel actions tend to become loose and green in colour. As baby loses weight and fails to thrive, symptoms continue unabated. Between two and five per cent develop jaundice. The baby may become dehydrated, and the stomach may become distended.

Treatment

Any symptoms like these need prompt investigation by the doctor. Often the cause is readily diagnosed, sometimes from an X-ray of the bowel.

Treatment is by surgery. The risks are low and the results are usually strikingly good. The baby soon starts to eat normally, can now digest food, starts to thrive, looks better, and rapidly becomes a normal infant. Long-term the results are also excellent. In short, the beneficial effects are usually dramatic.

*61\87\2*

In this book we will discuss many symptoms. Most of these will be related to a specific disease. For example, the child has abdominal pain, vomiting, loss of appetite and constipation. Tummy is tender to the touch, and probably the muscles are in a rigid spasm. Cause and effect. An inflamed diseased organ has produced symptoms which lead to a correct diagnosis and treatment. Acute appendicitis. Surgery. A satisfactory cure.

But take another case. The child has abdominal pains. Probably vomiting, a mild fever, feeling off-colour and looks pale and ill. Stops playing with friends, lies down, and looks and feels unhappy. This happened last month, and investigation revealed that there had been a mild altercation with a playmate over the bat and ball. This time, it was an argument about whose turn it was next. After an hour’s rest, the pains have vanished, the patient has miraculously recovered and is back playing with friends as well as enemies.

In this case, there is no organic cause for the child’s symptoms. But the symptoms are certainly there. The pain is just as real as it is for the little fellow with appendicitis. But the cause is different. Emotional stress and mental tension have somehow reverberated via the child’s mental system to produce very real, organic-type symptoms.

Enormous numbers of symptoms occurring during infancy and childhood are caused by emotional stress. Often the parents are unaware of this, and frequently it has the doctor puzzled also. The symptoms not only relate to abdominal pains (which are enormously common) but to aches and pains elsewhere, as well as many other common symptoms.

Investigators believe that with abdominal and limb pains, fewer than five cases in a hundred have an organic cause. Recurring headaches are similar. Doctors often refer to these as psychosomatic symptoms.

Everybody is born with a brain that has two parts. The smaller part (probably only 20 per cent of the brain) is the so-called conscious part which operates when the person is awake. This is the area that knowingly controls the person’s actions.

The larger part (probably encompassing 80 per cent, or maybe more) is the subconscious brain. This works tirelessly, morning, noon and night, whether the person is asleep or awake. It is often called the body’s in-built computer. Into this is channelled, right from birth, information picked up by all the body’s senses: hearing, seeing, feeling, tasting, smelling, warmth, sense of pressure, as well as emotional senses. All this is stored in the brain’s memory cells, and much of it will remain there indefinitely. Although much will not be consciously remembered, the storehouse of data builds up, and gradually this forms the bank of information that is often referred to as experience.

*14\87\2*

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*

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*

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*

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*

Many people rub a sprain or strain immediately with a heat rub or with hot and cold compresses. This is wrong. Apply cold water or ice to the area as soon as possible. This should be done at 20-minute intervals for the first half day to stop the swelling and to help reduce the injury and bruising. This is very important. We need to start the healing process and this can be done by rubbing on a cream containing comfrey. Comfrey ointment speeds up the healing process. On the second day, start using heat rubs to return circulation and speed up the healing process. Remember, ice first and heat the next day.

The sprain should be supported using an elastic or conforming bandage. It may be walked on if there is no pain. A little discomfort is alright. Rest the sprained joint as much as possible by elevating it above the heart. This will help reduce pain and swelling.

SUPPLEMENTS

vitamin C 2000 mg daily

zinc 25 mg daily

silica 25 mg daily

cod liver oil 5 ml daily

Localised treatment:

Comfrey ointment and a heat rub.

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