December Health Dictionary

December: From 1 Different Sources


(American) Winter’s child; born in December

Decimber, Decymber, Decembar, Decimbar, Decymbar

Health Source: Medical Dictionary
Author: Health Dictionary

Holostemma

Holostemma ada-kodien

Asclepiadaceae

San: Jivanti;

Hin: Chirvel, Charivel;

Mal: Atapathiyan, Atapotiyan, Atakotiyan;

Tam: Palaikkirai;

Tel: Palagurugu; Mar: Dudurli, Shidodi;

Guj: Kharner, Khiravel

Importance: Holostemma is a twining shrub with large flowers. The roots of Holostemma are useful in ophthalmopathy, orchitis, cough, burning sensation, stomachalgia, constipation, fever and tridoshas. The leaves, flowers and fruits are eaten as vegetable. The root is also used in spermatorrhoea. It is used in preparations of Vidaryadiganam, Dhanwandharam thaila, Manasamithravatakam, Balarishta and Anuthaila. It is also useful in eye diseases and it imparts resistance to diseases.

Distribution: The plant occurs in tropical countries. In India, it is found in Himalayas, Dehradun, Konkan, Bombay, Deccan, Karnataka, Kerala and Tamilnadu. It grows over hedges and in open forests especially on the lower slopes of the hills. It is also distributed in Sri Lanka, Burma and W. China.

Botany: Holostemma ada-kodien Schult. syn. Holostemma annulare (Roxb.) K. Schum.

Holostemma rheedii Wall. belongs to the family Asclepiadaceae. It is a laticiferous twining shrub with large conspicuous flowers. Leaves are simple, opposite and cordate. Flowers are purple, arranged in axillary umbellate cymes. Fruits are thick follicles, 9 cm long, cylindrical and bluntly pointed. The roots are long upto 1 m or more, irregularly twisted, thick and cylindrical. When dry it is yellowish brown to brown black in colour with nearly smooth surface bearing white scars and small depressions. A mature root is about 1-2 cm thick when extracted for use (Warrier et al, 1995).

Agrotechnology: Holostemma prefers a tropical climate. The plant is propagated vegetatively by stem cuttings, but mainly by seeds. The seeds are collected from the plant in Novemb er-December before being dispersed. Seeds are cleaned, dried and stored for sowing. The stored seeds after soaking in water for 4-5 hours are sown in the seedbeds. About one month old seedlings are then planted in polybags of size 14x10cm which are filled with soil, sand and dried cowdung in 1:1:1 ratio, respectively. Polybags should be kept in shade and irrigated. About 1-1.5 month old seedlings are ready for transplanting. Pits of 30cm cube size are taken at 1-1.2m distance and filled with 10kg dried cowdung and sand. This is covered with surface soil and formed into a mound. Seedlings are transplanted on to the mounds from the polybags carefully. Regular irrigation is to be given till flowering. To aid in trailing, staking is given one month after planting. Flowering and fruiting occurs in November-December. Harvesting can be done at the end of second year when the vines start drying up. Harvesting is done by digging up the tubers. The tubers are cut into pieces of 10cm length and dried in sun before sale (Prasad et al, 1997).

Properties and activity: Holostemma tubers give -amyrin, lupeol and -sitosterol. Alanine, aspartic acid, glycine, serine, threonine and valine were detected chromatographically (Hussain et al, 1992). The root is antidiabetic, antigonorrhoeic, bechic, alterative, tonic, lactative, ophthalmic, emollient, stimulant, aphrodisiac, expectorant and galactagogue.... holostemma

Aids/hiv

Acquired Immune De?ciency Syndrome (AIDS) is the clinical manifestation of infection with Human Immunode?ciency Virus (HIV). HIV belongs to the retroviruses, which in turn belong to the lentiviruses (characterised by slow onset of disease). There are two main HIV strains: HIV-1, by far the commonest; and HIV-2, which is prevalent in Western Africa (including Ivory Coast, Gambia, Mali, Nigeria and Sierra Leone). HIV attacks the human immune system (see IMMUNITY) so that the infected person becomes susceptible to opportunistic infections, such as TUBERCULOSIS, PNEUMONIA, DIARRHOEA, MENINGITIS and tumours such as KAPOSI’S SARCOMA. AIDS is thus the disease syndrome associated with advanced HIV infection.

Both HIV-1 and HIV-2 are predominantly sexually transmitted and both are associated with secondary opportunistic infections. However, HIV-2 seems to result in slower damage to the immune system. HIV-1 is known to mutate rapidly and has given rise to other subtypes.

HIV is thought to have occurred in humans in the 1950s, but whether or not it infected humans from another primate species is uncertain. It became widespread in the 1970s but its latency in causing symptoms meant that the epidemic was not noticed until the following decade. Although it is a sexually transmitted disease, it can also be transmitted by intravenous drug use (through sharing an infected needle), blood transfusions with infected blood (hence the importance of e?ective national blood-screening programmes), organ donation, and occupationally (see health-care workers, below). Babies born of HIV-positive mothers can be infected before or during birth, or through breast feeding.

Although HIV is most likely to occur in blood, semen or vaginal ?uid, it has been found in saliva and tears (but not sweat); however, there is no evidence that the virus can be transmitted from these two body ?uids. There is also no evidence that HIV can be transmitted by biting insects (such as mosquitoes). HIV does not survive well in the environment and is rapidly destroyed through drying.

Prevalence At the end of 2003 an estimated 42 million people globally were infected with HIV – up from 40 million two years earlier. About one-third of those with HIV/AIDS are aged 15–24 and most are unaware that they are carrying the virus. During 2003 it is estimated that 5 million adults and children worldwide were newly infected with HIV, and that 3 million adults and children died. In Africa in 2003,

3.4 million people were newly infected and 2.3 million died, with more than 28 million carrying the virus. HIV/AIDS was the leading cause of death in sub-Saharan Africa where over half of the infections were in women and 90 per cent of cases resulted from heterosexual sex. In some southern African countries, one in three pregnant women had HIV.

In Asia and the Paci?c there were 1.2 million new infections and 435,000 deaths. The area with the fastest-growing epidemic is Eastern Europe, especially the Russian Federation where in 2002 around a million people had HIV and there were an estimated 250,000 new infections, with intravenous drug use a key contributor to this ?gure. Seventy-?ve per cent of cases occurred in men, with male-to-male sexual transmission an important cause of infection, though heterosexual activity is a rising cause of infection.

At the end of 2002 the UK had an estimated 55,900 HIV-infected adults aged between 15 and 59. More than 3,600 individuals were newly diagnosed with the infection in 2000, the highest annual ?gure since the epidemic started

– in 1998 the ?gure was 2,817 and in 1999 just over 3,000 (Department of Health and Communicable Disease Surveillance Centre). The incidence of AIDS in the UK has declined sharply since the introduction of highly active antiretroviral therapy (HAART) and HIV-related deaths have also fallen: in 2002 there were 777 reported new AIDS cases and 395 deaths, compared with 1,769 and 1,719 respectively in 1995. (Sources: UNAIDS and WHO, AIDS Epidemic Update, December 2001; Public Health Laboratory Services AIDS and STD Centre Communicable Disease Surveillance and Scottish Centre for Infection and Environmental Health, Quarterly Surveillance Tables.)

Poverty is strongly linked to the spread of AIDS, for various reasons including lack of health education; lack of e?ective public-health awareness; women having little control over sexual behaviour and contraception; and, by comparison with the developed world, little or no access to antiretroviral drugs.

Pathogenesis The cellular target of HIV infection is a subset of white blood cells called T-lymphocytes (see LYMPHOCYTE) which carry the CD4 surface receptor. These so-called ‘helper T-cells’ are vital to the function of cell-mediated immunity. Infection of these cells leads to their destruction (HIV replicates at an enormous rate – 109) and over the course of several years the body is unable to generate suf?cient new cells to keep pace. This leads to progressive destruction of the body’s immune capabilities, evidenced clinically by the development of opportunistic infection and unusual tumours.

Monitoring of clinical progression It is possible to measure the number of viral particles present in the plasma. This gives an accurate guide to the likely progression rate, which will be slow in those individuals with fewer than 10,000 particles per ml of plasma but progressively more rapid above this ?gure. The main clinical monitoring of the immune system is through the numbers of CD4 lymphocytes in the blood. The normal count is around 850 cells per ml and, without treatment, eventual progression to AIDS is likely in those individuals whose CD4 count falls below 500 per ml. Opportunistic infections occur most frequently when the count falls below 200 per ml: most such infections are treatable, and death is only likely when the CD4 count falls below 50 cells per ml when infection is developed with organisms that are di?cult to treat because of their low intrinsic virulence.

Simple, cheap and highly accurate tests are available to detect HIV antibodies in the serum. These normally occur within three months of infection and remain the cornerstone of the diagnosis.

Clinical features Most infected individuals have a viral illness some three weeks after contact with HIV. The clinical features are often non-speci?c and remain undiagnosed but include a ?ne red rash, large lymph nodes, an in?uenza-like illness, cerebral involvement and sometimes the development of opportunistic infections. The antibody test may be negative at this stage but there are usually high levels of virus particles in the blood. The antibody test is virtually always positive within three months of infection. HIV infection is often subsequently asymptomatic for a period of ten years or more, although in most patients progressive immune destruction is occurring during this time and a variety of minor opportunistic infections such as HERPES ZOSTER or oral thrush (see CANDIDA) do occur. In addition, generalised LYMPHADENOPATHY is present in a third of patients and some suffer from severe malaise, weight loss, night sweats, mild fever, ANAEMIA or easy bruising due to THROMBOCYTOPENIA.

The presentation of opportunistic infection is highly variable but usually involves either the CENTRAL NERVOUS SYSTEM, the gastrointestinal tract or the LUNGS. Patients may present with a sudden onset of a neurological de?cit or EPILEPSY due to a sudden onset of a STROKE-like syndrome, or epilepsy due to a space-occupying lesion in the brain – most commonly TOXOPLASMOSIS. In late disease, HIV infection of the central nervous system itself may produce progressive memory loss, impaired concentration and mental slowness called AIDS DEMENTIA. A wide variety of opportunistic PROTOZOA or viruses produces DYSPHAGIA, DIARRHOEA and wasting. In the respiratory system the commonest opportunistic infection associated with AIDS, pneumonia, produces severe shortness of breath and sometimes CYANOSIS, usually with a striking lack of clinical signs in the chest.

In very late HIV infection, when the CD4 count has fallen below 50 cells per ml, infection with CYTOMEGALOVIRUS may produce progressive retinal necrosis (see EYE, DISORDERS OF) which will lead to blindness if untreated, as well as a variety of gastrointestinal symptoms. At this stage, infection with atypical mycobacteria is also common, producing severe anaemia, wasting and fevers. The commonest tumour associated with HIV is Kaposi’s sarcoma which produces purplish skin lesions. This and nonHodgkin’s lymphoma (see LYMPHOMA), which is a hundred times more frequent among HIV-positive individuals than in the general population, are likely to be associated with or caused by opportunistic viral infections.

Prevention There is, as yet, no vaccine to prevent HIV infection. Vaccine development has been hampered

by the large number of new HIV strains generated through frequent mutation and recombination.

because HIV can be transmitted as free virus and in infected cells.

because HIV infects helper T-cells – the very cells involved in the immune response. There are, however, numerous research pro

grammes underway to develop vaccines that are either prophylactic or therapeutic. Vaccine-development strategies have included: recombinant-vector vaccines, in which a live bacterium or virus is genetically modi?ed to carry one or more of the HIV genes; subunit vaccines, consisting of small regions of the HIV genome designed to induce an immune response without infection; modi?ed live HIV, which has had its disease-promoting genes removed; and DNA vaccines – small loops of DNA (plasmids) containing viral genes – that make the host cells produce non-infectious viral proteins which, in turn, trigger an immune response and prime the immune system against future infection with real virus.

In the absence of an e?ective vaccine, preventing exposure remains the chief strategy in reducing the spread of HIV. Used properly, condoms are an extremely e?ective method of preventing exposure to HIV during sexual intercourse and remain the most important public-health approach to countering the further acceleration of the AIDS epidemic. The spermicide nonoxynol-9, which is often included with condoms, is known to kill HIV in vitro; however, its e?ectiveness in preventing HIV infection during intercourse is not known.

Public-health strategies must be focused on avoiding high-risk behaviour and, particularly in developing countries, empowering women to have more control over their lives, both economically and socially. In many of the poorer regions of the world, women are economically dependent on men and refusing sex, or insisting on condom use, even when they know their partners are HIV positive, is not a straightforward option. Poverty also forces many women into the sex industry where they are at greater risk of infection.

Cultural problems in gaining acceptance for universal condom-use by men in some developing countries suggests that other preventive strategies should also be considered. Microbicides used as vaginal sprays or ‘chemical condoms’ have the potential to give women more direct control over their exposure risk, and research is underway to develop suitable products.

Epidemiological studies suggest that male circumcision may o?er some protection against HIV infection, although more research is needed before this can be an established public-health strategy. Globally, about 70 per cent of infected men have acquired the virus through unprotected vaginal sex; in these men, infection is likely to have occurred through the penis with the mucosal epithelia of the inner surface of the foreskin and the frenulum considered the most likely sites for infection. It is suggested that in circumcised men, the glans may become keratinised and thus less likely to facilitate infection. Circumcision may also reduce the risk of lesions caused by other sexually transmitted disease.

Treatment AIDS/HIV treatment can be categorised as speci?c therapies for the individual opportunistic infections – which ultimately cause death – and highly active antiretroviral therapy (HAART) designed to reduce viral load and replication. HAART is also the most e?ective way of preventing opportunistic infections, and has had a signi?cant impact in delaying the onset of AIDS in HIV-positive individuals in developed countries.

Four classes of drugs are currently in use. Nucleoside analogues, including ZIDOVUDINE and DIDANOSINE, interfere with the activity of the unique enzyme of the retrovirus reverse transcriptase which is essential for replication. Nucleotide analogues, such as tenofovir, act in the same way but require no intracellular activation. Non-nucleoside reverse transcriptase inhibitors, such as nevirapine and EFAVIRENZ, act by a di?erent mechanism on the same enzyme. The most potent single agents against HIV are the protease inhibitors, such as lopinavir, which render a unique viral enzyme ineffective. These drugs are used in a variety of combinations in an attempt to reduce the plasma HIV viral load to below detectable limits, which is achieved in approximately 90 per cent of patients who have not previously received therapy. This usually also produces a profound rise in CD4 count. It is likely, however, that such treatments need to be lifelong – and since they are associated with toxicities, long-term adherence is di?cult. Thus the optimum time for treatment intervention remains controversial, with some clinicians believing that this should be governed by the viral load rising above 10,000 copies, and others that it should primarily be designed to prevent the development of opportunistic infections – thus, that initiation of therapy should be guided more by the CD4 count.

It should be noted that the drug regimens have been devised for infection with HIV-1; it is not known how e?ective they are at treating infection with HIV-2.

HIV and pregnancy An HIV-positive woman can transmit the virus to her fetus, with the risk of infection being particularly high during parturition; however, the risk of perinatal HIV transmission can be reduced by antiviral drug therapy. In the UK, HIV testing is available to all women as part of antenatal care. The bene?ts of antenatal HIV testing in countries where antiviral drugs are not available are questionable. An HIV-positive woman might be advised not to breast feed because of the risks of transmitting HIV via breastmilk, but there may be a greater risk associated with not breast feeding at all. Babies in many poor communities are thought to be at high risk of infectious diseases and malnutrition if they are not breast fed and may thus be at greater overall risk of death during infancy.

Counselling Con?dential counselling is an essential part of AIDS management, both in terms of supporting the psychological wellbeing of the individual and in dealing with issues such as family relations, sexual partners and implications for employment (e.g. for health-care workers). Counsellors must be particularly sensitive to culture and lifestyle issues. Counselling is essential both before an HIV test is taken and when the results are revealed.

Health-care workers Health-care workers may be at risk of occupational exposure to HIV, either through undertaking invasive procedures or through accidental exposure to infected blood from a contaminated needle (needlestick injury). Needlestick injuries are frequent in health care – as many as 600,000 to 800,000 are thought to occur annually in the United States. Transmission is much more likely where the worker has been exposed to HIV through a needlestick injury or deep cut with a contaminated instrument than through exposure of mucous membranes to contaminated blood or body ?uids. However, even where exposure occurs through a needlestick injury, the risk of seroconversion is much lower than with a similar exposure to hepatitis C or hepatitis B. A percutaneous exposure to HIV-infected blood in a health-care setting is thought to carry a risk of about one infection per 300 injuries (one in 1,000 for mucous-membrane exposure), compared with one in 30 for hepatitis C, and one in three for hepatitis B (when the source patient is e-antigen positive).

In the event of an injury, health-care workers are advised to report the incident immediately where, depending on a risk assessment, they may be o?ered post-exposure prophylaxis (PEP). They should also wash the contaminated area with soap and water (but without scrubbing) and, if appropriate, encourage bleeding at the site of injury. PEP, using a combination of antiretroviral drugs (in a similar regimen to HAART – see above), is thought to greatly reduce the chances of seroconversion; it should be commenced as soon as possible, preferably within one or two hours of the injury. Although PEP is available, safe systems of work are considered to o?er the greatest protection. Double-gloving (latex gloves remove much of the blood from the surface of the needle during a needlestick), correct use of sharps containers (for used needles and instruments), avoiding the resheathing of used needles, reduction in the number of blood samples taken from a patient, safer-needle devices (such as needles that self-blunt after use) and needleless drug administration are all thought to reduce the risk of exposure to HIV and other blood-borne viruses. Although there have been numerous cases of health-care workers developing HIV through occupational exposure, there is little evidence of health-care workers passing HIV to their patients through normal medical procedures.... aids/hiv

Ephedra Gerardiana

Wall. ex Stapf.

Family: Ephedraceae.

Habitat: The drier regions of the temperate and alpine Himalayas from Kashmir to Sikkim from 2,350 to 5,350 m.

English: Ephedra (Ephedra sinica Stapf.)

Ayurvedic: Soma, Soma-valli (substitute).

Folk: Asmaaniyaa, Budaagur (Punjab); Tipat, Traani (Himalayan region).

Action: Circulatory stimulant, bron- chodilator, vasodilator, antiallergic, antiasthmatic (usualy given with expectorants), diaphoretic. Not prescribed with antidepressants.

Key application: Ephedra sinica— in diseases of the respiratory tract and mild bronchospasms. Also in acute coryza, allergic rhinitis and sinusitis. (German Commission E.) In the treatment of nasal congestion due to hay fever, allergic rhinitis, acute coryza, cold, sinusitis and as abronchodilator. (WHO.)

Contraindicated in anxiety, restlessness, high blood pressure, glucoma, impaired circulation of the cerebrum, adenoma of prostate with residual urine accumulation, pheochromocy- toma, thyrotoxicosis. (German Commission E.)

Ephedra is official in the national pharmacopoeias of China, Japan and Germany. The herb is listed in Ayurvedic Pharmacopoeia. Only its isolated derivatives, ephedrine and ephedrine hydrochloride are official in Indian Pharmacopoeia.

Ephedrine is toxic at more than 300 mg in 1 day (Francis Brinker.)

Aerial parts yielded ephedrine and ephedroxane. Pseudoephedrine is the most active anti-inflammatory principle of Ephedra sp., it exhibited inhibitory action on a number of acute inflammations. Ephedroxane possesses a minor anti-inflammatory principle. Among the Indian species, Ephedra major, found in Lahul, contains over 2.56% alkaloids of which nearly three fourths is ephidrine. Ephedra gerardiana contains 1.22% total alkaloids and 0.68% ephedrine.

On 30 December 2003, the FDA banned ephedra products in the US.... ephedra gerardiana

Asparagus

Nutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: Moderate Fiber: Moderate Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Potassium, iron

About the Nutrients in This Food Asparagus has some dietary fiber, vitamin A, and vitamin C. It is an excel- lent source of the B vitamin folate. A serving of four cooked asparagus spears (½ inch wide at the base) has 1.2 g dietary fiber, 604 IU vitamin A (26 percent of the R DA for a woman, 20 percent of the R DA for a man), 4.5 mg vitamin C (6 percent of the R DA for a woman, 5 percent of the R DA for a man), and 89 mcg folate (22 percent of the R DA).

The Most Nutritious Way to Serve This Food Fresh, boiled and drained. Canned asparagus may have less than half the nutrients found in freshly cooked spears.

Diets That May Restrict or Exclude This Food Low-sodium diet (canned asparagus)

Buying This Food Look for: Bright green stalks. The tips should be purplish and tightly closed; the stalks should be firm. Asparagus is in season from March through August. Avoid: Wilted stalks and asparagus whose buds have opened.

Storing This Food Store fresh asparagus in the refrigerator. To keep it as crisp as possible, wrap it in a damp paper towel and then put the whole package into a plastic bag. Keeping asparagus cool helps it hold onto its vitamins. At 32°F, asparagus will retain all its folic acid for at least two weeks and nearly 80 percent of its vitamin C for up to five days; at room temperature, it would lose up to 75 percent of its folic acid in three days and 50 percent of the vitamin C in 24 hours.

Preparing This Food The white part of the fresh green asparagus stalk is woody and tasteless, so you can bend the stalk and snap it right at the line where the green begins to turn white. If the skin is very thick, peel it, but save the parings for soup stock.

What Happens When You Cook This Food Chlorophyll, the pigment that makes green vegetables green, is sensitive to acids. When you heat asparagus, its chlorophyll will react chemically with acids in the asparagus or in the cooking water to form pheophytin, which is brown. As a result, cooked asparagus is olive-drab. You can prevent this chemical reaction by cooking the asparagus so quickly that there is no time for the chlorophyll to react with acids, or by cooking it in lots of water (which will dilute the acids), or by leaving the lid off the pot so that the volatile acids can float off into the air. Cooking also changes the texture of asparagus: water escapes from its cells and they collapse. Adding salt to the cooking liquid slows the loss of moisture.

How Other Kinds of Processing Affect This Food Canning. The intense heat of can ning makes asparagus soft, robs it of its bright green color, and reduces the vitamin A, B, and C content by at least half. ( White asparagus, which is bleached to remove the green color, contains about 5 percent of the vitamin A in fresh asparagus.) With its liquid, can ned asparagus, green or white, contains about 90 times the sodium in fresh asparagus ( 348 mg in 3.5 oz. can ned against 4 mg in 3.5 oz. fresh boiled asparagus).

Medical Uses and/or Benefits Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The R DA for folate is 400 mcg for healthy adult men and women, 600 mcg for pregnant women, and 500 mcg for women who are nursing. Taking folate supplements before becoming pregnant and through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Woman’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, from either food or supplements, more than twice the current R DA for each, may reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the analysis, the results are assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verify whether taking folic acid supplements reduces the risk of cardiovascular disease.

Adverse Effects Associated with This Food Odorous urine. After eating asparagus, we all excrete the sulfur compound methyl mercap- tan, a smelly waste product, in our urine.

Food/Drug Interactions Anticoagulants. Asparagus is high in vitamin K, a vitamin manufactured naturally by bac- teria in our intestines, an adequate supply of which enables blood to clot normally. Eating foods that contain this vitamin may interfere with the effectiveness of anticoagulants such as heparin and warfarin (Coumadin, Dicumarol, Panwarfin) whose job is to thin blood and dissolve clots.... asparagus

Avocados

Nutritional Profile Energy value (calories per serving): Moderate Protein: Low Fat: High Saturated fat: High Cholesterol: None Carbohydrates: Moderate Fiber: High to very high Sodium: Low Major vitamin contribution: Vitamins A, folate, vitamin C Major mineral contribution: Potassium

About the Nutrients in This Food The avocado is an unusual fruit because about 16 percent of its total weight is fat, primarily monounsaturated fatty acids. Like many other fruits, avo- cados are high in fiber (the Florida avocado is very high in fiber), a good source of the B vitamin folate, vitamin C, and potassium. The edible part of half of one average size avocado (100 g/3.5 ounces) provides 6.7 g dietary fiber, 15 g fat (2.1 g saturated fat, 9.7 g monoun- saturated fat, 1.8 g polyunsaturated fat), 81 mcg folate (20 percent of the R DA), 20 mg vitamin C (26 percent of the R DA for a woman, 22 percent for a man), and 485 mg potassium (the equivalent of one eight-ounce cup of fresh orange juice). The edible part of one-half a Florida avocado (a.k.a. alligator pear) has eight grams dietary fiber, 13.5 g fat (2.65 g saturated fat), 81 mcg folate (41 percent of the R DA for a man, 45 percent of the R DA for a woman), 12 mg vitamin C (20 percent of the R DA), and 741 mg potassium, 50 percent more than one cup fresh orange juice.

Diets That May Exclude or Restrict This Food Controlled-potassium diet Low-fat diet

Buying This Food Look for: Fruit that feels heavy for its size. The avocados most commonly sold in the U.S. are the Hass—a purple-black bumpy fruit that accounts for 85 percent of the avocados shipped from California—and the smooth-skinned Florida avocado (“alligator pear”). The oval, midwinter Bacon; the pear-shaped, late-fall Fuerte; the Gwen, a slightly larger Hass; Pinkerton, pear-shaped with a smaller seed; the round summer Reed; and the yellow-green, pear-shaped Zutano. Avoid: Avocados with soft dark spots on the skin that indicate damage underneath.

Storing This Food Store hard, unripened avocados in a warm place; a bowl on top of the refrigerator will do. Avocados are shipped before they ripen, when the flesh is hard enough to resist bruising in transit, but they ripen off the tree and will soften nicely at home. Store soft, ripe avocados in the refrigerator to slow the natural enzyme action that turns their flesh brown as they mature even when the fruit has not been cut.

Preparing This Food When you peel or slice an avocado, you tear its cell walls, releasing polyphenoloxidase, an enzyme that converts phenols in the avocado to brownish compounds that darken the avocado’s naturally pale green flesh. You can slow this reaction (but not stop it completely) by brushing the exposed surface of the avocado with an acid (lemon juice or vinegar). To store a cut avocado, brush it with lemon juice or vinegar, wrap it tightly in plastic, and keep it in the refrigerator—where it will eventually turn brown. Or you can store the avocado as guacamole; mixing it with lemon juice, tomatoes, onions, and mayonnaise (all of which are acidic) is an efficient way to protect the color of the fruit.

Medical Uses and/or Benefits Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The current R DA for folate is 180 mcg for a healthy woman and 200 mcg for a healthy man, but the FDA now recommends 400 mcg for a woman who is or may become pregnant. Taking folate supple- ments before becoming pregnant and through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Woman’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, from either food or supplements, more than twice the current R DA for each, may reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the analysis, the results are assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to ascertain whether taking folic acid supplements reduces the risk of cardiovascular disease. Lower levels of cholesterol. Avocados are rich in oleic acid, a monounsaturated fat believed to reduce cholesterol levels. Potassium benefits. Because potassium is excreted in urine, potassium-rich foods are often recommended for people taking diuretics. In addition, a diet rich in potassium (from food) is associated with a lower risk of stroke. A 1998 Harvard School of Public Health analysis of data from the long-running Health Professionals Study shows 38 percent fewer strokes among men who ate nine servings of high potassium foods a day vs. those who ate less than four servings. Among men with high blood pressure, taking a daily 1,000 mg potas- sium supplement—about the amount of potassium in one avocado—reduced the incidence of stroke by 60 percent.

Adverse Effects Associated with This Food Latex-fruit syndrome. Latex is a milky fluid obtained from the rubber tree and used to make medical and surgical products such as condoms and protective latex gloves, as well as rubber bands, balloons, and toys; elastic used in clothing; pacifiers and baby-bottle nipples; chewing gum; and various adhesives. Some of the proteins in latex are allergenic, known to cause reactions ranging from mild to potentially life-threatening. Some of the pro- teins found naturally in latex also occur naturally in foods from plants such as avocados, bananas, chestnuts, kiwi fruit, tomatoes, and food and diet sodas sweetened with aspar- tame. Persons sensitive to these foods are likely to be sensitive to latex as well. NOT E : The National Institute of Health Sciences, in Japan, also lists the following foods as suspect: A lmonds, apples, apricots, bamboo shoots, bell peppers, buckwheat, cantaloupe, carrots, celer y, cherries, chestnuts, coconut, figs, grapefruit, lettuce, loquat, mangoes, mushrooms, mustard, nectarines, oranges, passion fruit, papaya, peaches, peanuts, peppermint, pine- apples, potatoes, soybeans, strawberries, walnuts, and watermelon.

Food/Drug Interactions MAO inhibitors. Monoamine oxidase (M AO) inhibitors are drugs used as antidepressants or antihypertensives. They inhibit the action of enzymes that break down the amino acid tyramine so it can be eliminated from the body. Tyramine is a pressor amine, a chemical that constricts blood vessels and raises blood pressure. If you eat a food such as avocado that contains tyramine while you are taking an M AO inhibitor you cannot eliminate the pressor amine, and the result may be abnormally high blood pressure or a hypertensive crisis (sus- tained elevated blood pressure). False-positive test for tumors. Carcinoid tumors (which may arise from tissues in the endo- crine system, the intestines, or the lungs) secrete serotonin, a natural chemical that makes blood vessels expand or contract. Because serotonin is excreted in urine, these tumors are diagnosed by measuring the levels of serotonin by-products in the urine. Avocados contain large amounts of serotonin; eating them in the three days before a test for an endocrine tumor might produce a false-positive result, suggesting that you have the tumor when in fact you don’t. (Other foods high in serotonin are bananas, eggplant, pineapples, plums, tomatoes, and walnuts.)... avocados

Bael Fruit

Aegle marmelos

Description: This is a tree that grows from 2.4 to 4.6 meters tall, with a dense spiny growth. The fruit is 5 to 10 centimeters in diameter, gray or yellowish, and full of seeds.

Habitat and Distribution: Bael fruit is found in rain forests and semievergreen seasonal forests of the tropics. It grows wild in India and Burma.

Edible Parts: The fruit, which ripens in December, is at its best when just turning ripe. The juice of the ripe fruit, diluted with water and mixed with a small amount of tamarind and sugar or honey, is sour but refreshing. Like other citrus fruits, it is rich in vitamin C.... bael fruit

Broccoli

Nutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: Moderate Fiber: Very high Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Calcium

About the Nutrients in This Food Broccoli is very high-fiber food, an excellent source of vitamin A, the B vitamin folate, and vitamin C. It also has some vitamin E and vitamin K, the blood-clotting vitamin manufactured primarily by bacteria living in our intestinal tract. One cooked, fresh broccoli spear has five grams of dietary fiber, 2,500 IU vitamin A (108 percent of the R DA for a woman, 85 percent of the R DA for a man), 90 mcg folate (23 percent of the R DA), and 130 mg vitamin C (178 percent of the R DA for a woman, 149 percent of the R DA for a man).

The Most Nutritious Way to Serve This Food Raw. Studies at the USDA Agricultural Research Center in Beltsville, Maryland, show that raw broccoli has up to 40 percent more vitamin C than broccoli that has been cooked or frozen.

Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet

Buying This Food Look for: Broccoli with tightly closed buds. The stalk, leaves, and florets should be fresh, firm, and brightly colored. Broccoli is usually green; some varieties are tinged with purple. Avoid: Broccoli with woody stalk or florets that are open or turning yellow. When the green chlorophyll pigments fade enough to let the yellow carotenoids underneath show through, the buds are about to bloom and the broccoli is past its prime.

Storing This Food Pack broccoli in a plastic bag and store it in the refrigerator or in the vegetable crisper to protect its vitamin C. At 32°F, fresh broccoli can hold onto its vitamin C for as long as two weeks. Keep broccoli out of the light; like heat, light destroys vitamin C.

Preparing This Food First, rinse the broccoli under cool running water to wash off any dirt and debris clinging to the florets. Then put the broccoli, florets down, into a pan of salt water (1 tsp. salt to 1 qt. water) and soak for 15 to 30 minutes to drive out insects hiding in the florets. Then cut off the leaves and trim away woody section of stalks. For fast cooking, divide the broccoli up into small florets and cut the stalk into thin slices.

What Happens When You Cook This Food The broccoli stem contains a lot of cellulose and will stay firm for a long time even through the most vigorous cooking, but the cell walls of the florets are not so strongly fortified and will soften, eventually turning to mush if you cook the broccoli long enough. Like other cruciferous vegetables, broccoli contains mustard oils (isothiocyanates), natural chemicals that break down into a variety of smelly sulfur compounds (including hydrogen sulfide and ammonia) when the broccoli is heated. The reaction is more intense in aluminum pots. The longer you cook broccoli, the more smelly compounds there will be, although broccoli will never be as odorous as cabbage or cauliflower. Keeping a lid on the pot will stop the smelly molecules from floating off into the air but will also accelerate the chemical reaction that turns green broccoli olive-drab. Chlorophyll, the pigment that makes green vegetables green, is sensitive to acids. When you heat broccoli, the chlorophyll in its florets and stalk reacts chemically with acids in the broccoli or in the cooking water to form pheophytin, which is brown. The pheophytin turns cooked broccoli olive-drab or (since broccoli contains some yellow carotenes) bronze. To keep broccoli green, you must reduce the interaction between the chlorophyll and the acids. One way to do this is to cook the broccoli in a large quantity of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the hydrogen atoms can float off into the air, but this allows the smelly sulfur compounds to escape, too. The best way is probably to steam the broccoli quickly with very little water, so it holds onto its vitamin C and cooks before there is time for reac- tion between chlorophyll and hydrogen atoms to occur.

How Other Kinds of Processing Affect This Food Freezing. Frozen broccoli usually contains less vitamin C than fresh broccoli. The vitamin is lost when the broccoli is blanched to inactivate catalase and peroxidase, enzymes that would otherwise continue to ripen the broccoli in the freezer. On the other hand, according to researchers at Cornell University, blanching broccoli in a microwave oven—two cups of broccoli in three tablespoons of water for three minutes at 600 –700 watts—nearly doubles the amount of vitamin C retained. In experiments at Cornell, frozen broccoli blanched in a microwave kept 90 percent of its vitamin C, compared to 56 percent for broccoli blanched in a pot of boiling water on top of a stove.

Medical Uses and/or Benefits Protection against some cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in Brussels sprouts, broccoli, cabbage, cauli- flower, and other cruciferous vegetables appear to reduce the risk of some forms of cancer, perhaps by preventing the formation of carcinogens in your body or by blocking cancer- causing substances from reaching or reacting with sensitive body tissues or by inhibiting the transformation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inacti- vate and help eliminate carcinogens. At the Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. To get a protective amount of sulforaphane from broccoli you would have to eat about two pounds a week. But in 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old sprouts contain as much sulphoraphane as 150 grams of mature broccoli. * Broccoli will lose large amounts of vitamin C if you cook it in water t hat is cold when you start. As it boils, water releases ox ygen t hat would ot her wise dest roy vitamin C, so you can cut t he vitamin loss dramat ically simply by lett ing t he water boil for 60 seconds before adding t he broccoli. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss. Lower risk of some birth defects. Up to two or every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their mothers’ not having gotten adequate amounts of folate during pregnancy. The current R DA for folate is 180 mcg for a woman, 200 mcg for a man, but the FDA now recommends 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becoming pregnant and continuing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Broccoli is a good source of folate. One raw broccoli spear has 107 mcg folate, more than 50 percent of the R DA for an adult. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to ascertain whether taking folic acid supplements reduces the risk of cardiovascular disease. Possible inhibition of the herpes virus. Indoles, another group of chemicals in broccoli, may inhibit the growth of some herpes viruses. In 2003, at the 43rd annual Interscience Confer- ence on Antimicrobial Agents and Chemotherapy, in Chicago, researchers from Stockholm’s Huddinge University Hospital, the University of Virginia, and Northeastern Ohio University reported that indole-3-carbinol (I3C) in broccoli stops cells, including those of the herpes sim- plex virus, from reproducing. In tests on monkey and human cells, I3C was nearly 100 percent effective in blocking reproduction of the HSV-1 (oral and genital herpes) and HSV-2 (genital herpes), including one strain known to be resistant to the antiviral drug acyclovir (Zovirax).

Adverse Effects Associated with This Food Enlarged thyroid gland. Cruciferous vegetables, including broccoli, contain goitrin, thio- cyanate, and isothiocyanate, chemical compounds that inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. These chemicals, known collectively as goitrogens, are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have thyroid problems or are taking thyroid medication. False-positive test for occult blood in the stool. The guaiac slide test for hidden blood in feces relies on alphaguaiaconic acid, a chemical that turns blue in the presence of blood. Broccoli contains peroxidase, a natural chemical that also turns alphaguaiaconic acid blue and may produce a positive test in people who do not actually have blood in the stool.

Food/Drug Interactions Anticoagulants Broccoli is rich in vitamin K, the blood-clotting vitamin produced natu- rally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of drained, boiled broccoli contains 220 mcg vitamin K, nearly four times the R DA for a healthy adult.... broccoli

Brussels Sprouts

Nutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Potassium, iron

About the Nutrients in This Food Brussels sprouts are high in dietary fiber, especially insoluble cellulose and lignan in the leaf ribs. They are also a good source of vitamin A and vitamin C. One-half cup cooked fresh brussels sprouts has three grams of dietary fiber, 1,110 IU vitamin A (48 percent of the R DA for a woman, 37 percent of the R DA for a man), 47 mcg folate (16 percent of the R DA), and 48 mg vitamin C (64 percent of the R DA for a woman, 53 percent of the R DA for a man). Brussels sprouts also contain an antinutrient, a natural chemical that splits the thiamin (vitamin B1) molecule so that it is no longer nutritionally useful. This thiamin inhibitor is inactivated by cooking.

The Most Nutritious Way to Serve This Food Fresh, lightly steamed to preserve the vitamin C and inactivate the antinutrient.

Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet

Buying This Food Look for: Firm, compact heads with bright, dark-green leaves, sold loose so that you can choose the sprouts one at a time. Brussels sprouts are available all year round. Avoid: Puff y, soft sprouts with yellow or wilted leaves. The yellow carotenes in the leaves show through only when the leaves age and their green chlorophyll pigments fade. Wilting leaves and puff y, soft heads are also signs of aging. Avoid sprouts with tiny holes in the leaves through which insects have burrowed.

Storing This Food Store the brussels sprouts in the refrigerator. While they are most nutritious if used soon after harvesting, sprouts will keep their vitamins (including their heat-sensitive vitamin C) for several weeks in the refrigerator. Store the sprouts in a plastic bag or covered bowl to protect them from moisture loss.

Preparing This Food First, drop the sprouts into salted ice water to flush out any small bugs hiding inside. Next, trim them. Remove yellow leaves and leaves with dark spots or tiny holes, but keep as many of the darker, vitamin A–rich outer leaves as possible. Then, cut an X into the stem end of the sprouts to allow heat and water in so that the sprouts cook faster.

What Happens When You Cook This Food Brussels sprouts contain mustard oils (isothiocyanates), natural chemicals that break down into a variety of smelly sulfur compounds (including hydrogen sulfide and ammonia) when the sprouts are heated, a reaction that is intensified in aluminum pots. The longer you cook the sprouts, the more smelly compounds there will be. Adding a slice of bread to the cook- ing water may lessen the odor; keeping a lid on the pot will stop the smelly molecules from floating off into the air. But keeping the pot covered will also increase the chemical reaction that turns cooked brussels sprouts drab. Chlorophyll, the pigment that makes green vegetables green, is sensi- tive to acids. When you heat brussels sprouts, the chlorophyll in their green leaves reacts chemically with acids in the sprouts or in the cooking water to form pheophytin, which is brown. The pheophytin turns cooked brussels sprouts olive or, since they also contain yel- low carotenes, bronze. To keep cooked brussels sprouts green, you have to reduce the interaction between chlorophyll and acids. One way to do this is to cook the sprouts in a lot of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the hydrogen atoms can float off into the air, but this allows the smelly sulfur compounds to escape, too. The best solution is to steam the sprouts quickly in very little water, so they retain their vitamin C and cook before there is time for reaction between chlorophyll and hydrogen atoms to occur.

How Other Kinds of Processing Affect This Food Freezing. Frozen brussels sprouts contain virtually the same amounts of vitamins as fresh boiled sprouts.

Medical Uses and/or Benefits Protection against cancer. Naturally occurring chemicals (indoles, isothiocyanates, gluco- sinolates, dithiolethiones, and phenols) in brussels sprouts, broccoli, cabbage, cauliflower and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by pre- venting the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the transformation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. In 1997, the Johns Hopkins researchers discovered that broccoli seeds and three- day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated. Lower risk of some birth defects. Up to two or every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their mothers’ not having gotten adequate amounts of folate during pregnancy. NOTE : The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends * Brussels sprouts will lose as much as 25 percent of their vitamin C if you cook them in water that is cold when you start. As it boils, water releases oxygen that would otherwise destroy vitamin C. You can cut the vitamin loss dramatically simply by letting the water boil for 60 seconds before adding the sprouts. 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becoming pregnant and continuing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss.

Adverse Effects Associated with This Food Enlarged thyroid gland (goiter). Cruciferous vegetables, including brussels sprouts, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condi- tion or are taking thyroid medication. Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in brussels sprouts and produce gas that some people find distressing.

Food/Drug Interactions Anticoagulants Brussels sprouts are rich in vitamin K, the blood-clotting vitamin produced naturally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of drained, boiled brussels sprouts contains 219 mcg vitamin K, nearly three times the R DA for a healthy adult.... brussels sprouts

Bean Sprouts

See also Beans.

Nutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: Low Major vitamin contribution: B vitamins, folate, vitamin C Major mineral contribution: Iron, potassium

About the Nutrients in This Food Because beans use stored starches and sugars to produce green shoots called sprouts, sprouted beans have less carbohydrate than the beans from which they grow. But bean sprouts are a good source of dietary fiber, including insoluble cellulose and lignin in leaf parts and soluble pectins and gums in the bean. The sprouts are also high in the B vitamin folate and vitamin C. One-half cup raw mung bean sprouts has 1.2 mg dietary fiber, 31.5 mcg folate (8 percent of the R DA), and 7 mg vitamin C (9 percent of the R DA for a woman, 7 percent of the R DA for a man). Raw beans contain anti-nutrient chemicals that inhibit the enzymes we use to digest proteins and starches; hemagglutinins (substances that make red blood cells clump together); and “factors” that may inactivate vita- min A. These chemicals are usually destroyed when the beans are heated. with the bean must be cooked before serving. Sprouted beans served

The Most Nutritious Way to Serve This Food Cooked (see Adverse effects associated with this food ).

Diets That May Restrict or Exclude This Food Low-fiber, low-residue diet

Buying This Food Look for: Fresh, crisp sprouts. The tips should be moist and tender. (The shorter the sprout, the more tender it will be.) It is sometimes difficult to judge bean sprouts packed in plastic bags, but you can see through to tell if the tip of the sprout looks fresh. Sprouts sold from water-filled bowls should be refrigerated, protected from dirt and debris, and served with a spoon or tongs, not scooped up by hands. Avoid: Mushy sprouts (they may be decayed) and soft ones (they have lost moisture and vitamin C).

Storing This Food Refrigerate sprouts in a plastic bag to keep them moist and crisp. If you bought them in a plastic bag, take them out and repack them in bags large enough that they do not crush each other. To get the most vitamin C, use the sprouts within a few days.

Preparing This Food R inse the sprouts thoroughly under cold running water to get rid of dirt and sand. Discard any soft or browned sprouts, then cut off the roots and cook the sprouts. Do not tear or cut the sprouts until you are ready to use them. When you slice into the sprouts, you tear cells, releasing enzymes that begin to destroy vitamin C.

What Happens When You Cook This Food Cooking destroys some of the heat-sensitive vitamin C in sprouts. To save it, steam the sprouts quickly, stir-fry them, or add them uncooked just before you serve the dish.

How Other Kinds of Processing Affect This Food Canning. Vitamin C is heat-sensitive, and heating the sprouts during the canning process reduces their vitamin C content.

Medical Uses and/or Benefits Lower risk of some birth defects. As many as t wo of ever y 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their mothers’ not having gotten adequate amounts of folate during pregnancy. The R DA for folate is 400 mcg for healthy adult men and women, 600 mcg for pregnant women, and 500 mcg for women who are nursing. Taking folate supplements before becoming pregnant and continuing through the first t wo months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Woman’s Hospital, in Boston, demonstrated that a diet provid- ing more than 400 mcg folate and 3 mg vitamin B6 daily, from either food or supplements, more than twice the current R DA for each, may reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the analysis, the results are assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane University examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.

Adverse Effects Associated with This Food Food poisoning: Reacting to an outbreak of Salmonella and E. coli O157:H7 food poisoning associated with eating raw alfalfa sprouts, the Food and Drug Administration issued a warn- ing in 1998 and again in summer 1999, cautioning those at high risk of food-borne illness not to eat any raw sprouts. The high-risk group includes children, older adults, and people with a weakened immune system (for example, those who are HIV-positive or undergoing cancer chemotherapy). Tests conducted by the U.S. Department of Agriculture in 1999 sug- gest that irradiating raw sprouts and bathing them in an antiseptic solution at the processing plant may eliminate disease organisms and prolong the vegetable’s shelf life; this remains to be proven.... bean sprouts

Cabbage

(Bok choy [Chinese cabbage], green cabbage, red cabbage, savoy cabbage) See also Broccoli, Brussels sprouts, Cabbage, Cauliflower, Lettuce, Radishes, Spinach, Turnips.

Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Low Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Calcium (moderate)

About the Nutrients in This Food All cabbage has some dietary fiber food: insoluble cellulose and lignin in the ribs and structure of the leaves. Depending on the variety, it has a little vitamin A, moderate amounts of the B vitamin folate and vitamin C. One-half cup shredded raw bok choy has 0.1 g dietary fiber, 1,041 IU vitamin A (45 percent of the R DA for a woman, 35 percent of the R DA for a man), and 15.5 mg vitamin C (21 percent of the R DA for a woman, 17 percent of the R DA for a man). One-half cup shredded raw green cabbage has 0.5 g dietary fiber, 45 IU vitamin A (1.9 percent of the R DA for a woman, 1.5 percent of the R DA for a man), 15 mcg folate (4 percent of the R DA), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man). One-half cup chopped raw red cabbage has 0.5 g dietary fiber, 7 mcg folate (2 percent of the R DA), and 20 mg vitamin C (27 percent of the R DA for a woman, 22 percent of the R DA for a man). One-half cup chopped raw savoy cabbage has one gram dietary fiber, 322 IU vitamin A (14 percent of the R DA for a woman, 11 percent of the R DA for a man), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man). Raw red cabbage contains an antinutrient enzyme that splits the thiamin molecule so that the vitamin is no longer nutritionally useful. This thiamin in hibitor is inactivated by cooking.

The Most Nutritious Way to Serve This Food Raw or lightly steamed to protect the vitamin C.

Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet

Buying This Food Look for: Cabbages that feel heavy for their size. The leaves should be tightly closed and attached tightly at the stem end. The outer leaves on a savoy cabbage may curl back from the head, but the center leaves should still be relatively tightly closed. Also look for green cabbages that still have their dark-green, vitamin-rich outer leaves. Avoid: Green and savoy cabbage with yellow or wilted leaves. The yellow carotene pig- ments show through only when the cabbage has aged and its green chlorophyll pigments have faded. Wilted leaves mean a loss of moisture and vitamins.

Storing This Food Handle cabbage gently; bruising tears cells and activates ascorbic acid oxidase, an enzyme in the leaves that hastens the destruction of vitamin C. Store cabbage in a cool, dark place, preferably a refrigerator. In cold storage, cabbage can retain as much as 75 percent of its vitamin C for as long as six months. Cover the cabbage to keep it from drying out and losing vitamin A.

Preparing This Food Do not slice the cabbage until you are ready to use it; slicing tears cabbage cells and releases the enzyme that hastens the oxidation and destruction of vitamin C. If you plan to serve cooked green or red cabbage in wedges, don’t cut out the inner core that hold the leaves together. To separate the leaves for stuffing, immerse the entire head in boiling water for a few minutes, then lift it out and let it drain until it is cool enough to handle comfortably. The leaves should pull away easily. If not, put the cabbage back into the hot water for a few minutes.

What Happens When You Cook This Food Cabbage contains mustard oils (isothiocyanates) that break down into a variet y of smelly sulfur compounds (including hydrogen sulfide and ammon ia) when the cabbage is heated, a reaction that occurs more strongly in aluminum pots. The longer you cook the cabbage, the more smelly the compounds will be. Adding a slice of bread to the cooking water may lessen the odor. Keeping a lid on the pot will stop the smelly molecules from floating off into the air, but it will also accelerate the chemical reaction that turns cooked green cabbage drab. Chlorophyll, the pigment that makes green vegetables green, is sensitive to acids. When you heat green cabbage, the chlorophyll in its leaves reacts chemically with acids in the cabbage or in the cooking water to form pheophytin, which is brown. The pheophytin gives the cooked cabbage its olive color. To keep cooked green cabbage green, you have to reduce the interaction between the chlorophyll and the acids. One way to do this is to cook the cabbage in a large quantity of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the volatile acids can float off into the air, but this allows the smelly sulfur compounds to escape too. The best way may be to steam the cabbage ver y quickly in ver y little water so that it keeps its vitamin C and cooks before there is time for the chlorophyll/acid reaction to occur. Red cabbage is colored with red anthocyanins, pigments that turn redder in acids (lemon juice, vinegar) and blue purple in bases (alkaline chemicals such as baking soda). To keep the cabbage red, make sweet-and-sour cabbage. But be careful not to make it in an iron or aluminum pot, since vinegar (which contains tannins) will react with these metals to create dark pigments that discolor both the pot and the vegetable. Glass, stainless-steel, or enameled pots do not produce this reaction.

How Other Kinds of Processing Affect This Food Pickling. Sauerkraut is a fermented and pickled produce made by immersing cabbage in a salt solution strong enough to kill off pathological bacteria but allow beneficial ones to sur- vive, breaking down proteins in the cabbage and producing the acid that gives sauerkraut its distinctive flavor. Sauerkraut contains more than 37 times as much sodium as fresh cabbage (661 mg sodium/100 grams canned sauerkraut with liquid) but only one third the vitamin C and one-seventh the vitamin A. * According to USDA, if you cook t hree cups of cabbage in one cup of water you will lose only 10 percent of t he vitamin C; reverse t he rat io to four t imes as much water as cabbage and you will lose about 50 percent of t he vitamin C. Cabbage will lose as much as 25 percent of its vitamin C if you cook it in water t hat is cold when you start. As it boils, water releases ox ygen t hat would ot her wise dest roy vitamin C, so you can cut t he vitamin loss dramat ically simply by lett ing t he water boil for 60 seconds before adding t he cabbage.

Medical Uses and/or Benefits Protection against certain cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in cabbage, brussels sprouts, broccoli, cauli- flower, and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by preventing the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the trans- formation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. In 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss. Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becom- ing pregnant and through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.

Adverse Effects Associated with This Food Enlarged thyroid gland (goiter). Cruciferous vegetables, including cabbage, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to pro- duce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condition or are taking thyroid medication. Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in cabbage, producing gas that some people find distressing.

Food/Drug Interactions Anticoagulants Cabbage contains vitamin K, the blood-clotting vitamin produced natu- rally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of shredded common green cabbage contains 163 mcg vitamin K, nearly three times the R DA for a healthy adult; one cup of drained boiled common green cabbage contains 73 mcg vita- min K, slightly more than the R DA for a healthy adult. Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyra- mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. If you eat a food such as sauerkraut which is high in tyramine while you are taking an M AO inhibitor, you cannot effectively eliminate the tyramine from your body. The result may be a hypertensive crisis.... cabbage

Cucurbits

Cucurbitaceae

The family Cucurbitaceae includes a large group of plants which are medicinally valuable. The important genera belonging to the family are Trichosanthes, Lagenaria, Luffa, Benincasa, Momordica, Cucumis, Citrullus, Cucurbita, Bryonopsis and Corallocarpus. The medicinally valuable species of these genera are discussed below.

1. Trichosanthes dioica Roxb.

Eng: Wild Snake-gourd; San: Meki,Pargavi, Parvara, Patola;

Hin: Palval, Parvar

Ben: Potol;

Mal: Kattupatavalam, Patolam;

Tam: Kombuppudalai;

Tel: Kommupotta

Wild snake-gourd is a slender-stemmed, extensively climbing, more or less scabrous and woolly herb found throughout the plains of N. India, extending to Assam and W. Bengal. Tendrils are 2-4 fid. Leaves are 7.5x5cm in size, ovate-oblong, cordate, acute, sinuate- dentate, not lobed, rigid, rough on both surface and with a petiole of 2cm. Flowers are unisexual. Male flowers are not racemed but woolly outside. Calyx tube is 4.5cm long, narrow, teeth linear and erect. Anthers are free. Fruit is 5.9cm long, oblong or nearly spherical, acute, smooth and orange-red when ripe. Seeds are half-ellipsoid, compressed and corrugated on the margin (Kirtikar and Basu, 1988). The unripe fruit of this is generally used as a culinary vegetable and is considered very wholesome and specially suited for the convalescent. The tender shoots are given in decoction with sugar to assist digestion. The seeds are useful for disorders of the stomach. The leaf juice is rubbed over the chest in liver congestion and over the whole body in intermittent fevers (Nadkarni, 1998). The fruit is used as a remedy for spermatorrhoea. The fresh juice of the unripe fruit is often used as a cooling and laxative adjunct to some alterative medicines. In bilious fever, a decoction of patola leaves and coriander in equal parts is given. The fruit in combination with other drugs is prescribed in snakebite and scorpion sting (Kirtikar and Basu, 1988).

Fruits contain free amino acids and 5-hydroxy tryptamine. Fatty acids from seeds comprise elaeostearic, linoelic, oleic and saturated acids. The aerial part is hypoglycaemic. Leaf and root is febrifuge. Root is hydragogue, cathartic and tonic. Unripe leaf and fruit is laxative (Husain et al, 1992). The plant is alterative and tonic. Leaves are anthelmintic. Flower is tonic and aphrodisiac. The ripe fruit is sour to sweet, tonic, aphrodisiac, expectorant and removes blood impurities.

The other important species belonging to the genus Trichosanthes are as follows.

T. palmata Roxb. T. cordata Roxb. T. nervifolia Linn.

T. cucumerina Linn.

T. anguina Linn.

T. wallichiana Wight. syn. T. multiloba Clarke

2. Lagenaria vulgaris Ser. syn. Cucurbita Lagenaria Linn. ; Roxb.

Eng: Bottle gourd San: Alabu Hin: Lauki, Jangli-khaddu

Ben: Lau, Kodu

Mal: Katuchuram, Churakka

Tam: Soriai-kay

Tel: Surakkaya

Bottle gourd is a large softly pubescent climbing or trailing herb which is said to be indigenous in India, the Molucas and in Abyssinia. It has stout 5-angled stems with bifid tendrils. Leaves are ovate or orbiculate, cordate, dentate, 5-angular or 5-lobed, hairy on both surfaces. Flowers are large, white, solitary, unisexual or bisexual, the males long and females short peduncled. Ovary is oblong, softly pubescent with short style and many ovules. Fruits are large, usually bottle or dumb-bell-shaped, indehiscent and polymorphous. Seeds are many, white, horizontal, compressed, with a marginal groove and smooth. There are sweet fruited and bitter-fruited varieties (Kirtikar and Basu, 1988). The fruit contains a thick white pulp which, in the cultivated variety (kodu) is sweet and edible, while in the smaller wild variety (tamri) it is bitter and a powerful purgative. The seeds yield clear limpid oil which is cooling and is applied to relieve headache. The pulp of the cultivated forms is employed as and adjunct to purgatives and considered cool, diuretic and antibilious, useful in cough, and as an antidote to certain poisons. Externally it is applied as a poultice. The leaves are purgative and recommended to be taken in the form of decoction for jaundice (Nadkarni, 1998). In the case of sweet-fruited variety, the stem is laxative and sweet. The fruit is sweet oleagenous, cardiotonic, general tonic, aphrodisiac, laxative and cooling. In the case of bitter-fruited variety, the leaves are diuretic, antibilious; useful in leucorrhoea, vaginal and uterine complaints and earache. The fruit is bitter, hot, pungent, emetic, cooling, cardiotonic, antibilious; cures asthma, vata, bronchitis, inflammations ulcers and pains.

3. Luffa acutangula (Linn.) Roxb.

Eng: Ridged gourd; San: Dharmargavah, Svadukosataki;

Hin: Tori, Katitori;

Ben: Ghosha

Mal: Peechil, Peechinga;

Tam: Pikangai, Prikkangai;

Tel: Birakaya;

Kan: Kadupadagila

Ridged gourd or ribbed gourd is a large monoecious climber cultivated throughout India. It is with 5-angled glabrous stems and trifid tendrils. Leaves are orbicular-cordate, palmately 5-7 lobed, scabrous on both sides with prominent veins and veinlets. Flowers are yellow, males arranged in 12-20 flowered axillary racemes. Female flowers are solitary, arranged in the axils of the males. Ovary is strongly ribbed. Fruits are oblong-clavate with 10-sharp angles 15-30cm long, tapering towards the base. Seeds are black, ovoid-oblong, much compressed and not winged (Warrier et al, 1995). The leaves are used in haemorrhoids, leprosy, granular-conjunctivitis and ringworm. The seeds are useful in dermatopathy. The juice of the fresh leaves is dropped into the eyes of children in granular conjunctivitis, also to prevent the lids from adhering at night on account of excessive meihomian secretion (Nadkarni, 1998). Fruits are demulcent, diuretic, tonic, expectorant, laxative and nutritive. The seeds are bitter, emetic, cathartic, expectorant and purgative.

The other important species of the genus Luffa are:

L. aegyptiaca Mill.

L. acutangula var. amara Clarke

L. echinata Roxb.

4. Benincasa hispida (Thumb.) Cogn. syn. B. cerifera Savi.

Eng: Ash gourd, White gourd melon; San: Kusmandah;

Hin: Petha, Raksa;

Ben: Kumra

Mal: Kumpalam;

Tam: Pusanikkai;

Kan: Bile Kumbala;

Tel: Bodigummadi

Ash gourd or White gourd melon is a large trailing gourd climbing by means of tendrils which is widely cultivated in tropical Asia. Leaves are large and hispid beneath. Flowers are yellow, unisexual with male peduncle 7.5-10cm long and female peduncle shorter. Fruits are broadly cylindric, 30-45cm long, hairy throughout and ultimately covered with a waxy bloom. The fruits are useful in asthma, cough, diabetes, haemoptysis, hemorrhages from internal organs, epilepsy, fever and vitiated conditions of pitta. The seeds are useful in dry cough, fever, urethrorrhea, syphilis, hyperdipsia and vitiated conditions of pitta (Warrier et al,1993). It is a rejuvenative drug capable of improving intellect and physical strength. In Ayurveda, the fresh juice of the fruit is administered as a specific in haemoptysis and other haemorrhages from internal organs. The fruit is useful in insanity, epilepsy and other nervous diseases, burning sensation, diabetes, piles and dyspepsia. It is a good antidote for many kinds of vegetable, mercurial and alcoholic poisoning. It is also administered in cough, asthma or respiratory diseases, heart diseases and catarrah. Seeds are useful in expelling tapeworms and curing difficult urination and bladder stones. The important formulations using the drug are Kusmandarasayana, Himasagarataila, Dhatryadighrita, Vastyamantakaghrita, Mahaukusmandakaghrita, etc. (Sivarajan et al, 1994).

Fruits contain lupeol, -sitosterol, n-triacontanol, vitamin B, mannitol and amino acids. The fruit is alterative, laxative, diuretic, tonic, aphrodisiac and antiperiodic. Seed and oil from seed is anthelmintic (Husain et al, 1992).

5. Momordica charantia Linn.

Eng: Bitter gourd, Carilla fruit San: Karavellam

Hin: Karela, Kareli

Mal: Kaypa, Paval

Tam: Pavakkai, Paval, Pakar

Tel: Kakara

Bitter gourd or Carilla fruit is a branched climbing annual which is cultivated throughout India. It is a monoecious plant with angled and grooved stems and hairy or villous young parts. Tendrils are simple, slender and elongate. Leaves are simple, orbicular, cordate and deeply divided into 5-7 lobes. Flowers are unisexual, yellow and arranged on 5-10cm long peduncles. Fruits are 5-15cm long with 3-valved capsules, pendulous, fusiform, ribbed and beaked bearing numerous triangular tubercles. Seeds are many or few with shining sculptured surface. The roots are useful in coloptosis and ophthalmopathy. The leaves are useful in vitiated conditions of pita, helminthiasis, constipation, intermittent fever, burning sensation of the sole and nyctalopia. The fruits are useful in skin diseases, leprosy, ulcers, wounds, burning sensation, constipation, anorexia, flatulence, colic, helminthiasis, rheumatalgia, gout, diabetes, asthma, cough, dysmenorrhoea, impurity of breast milk, fever and debility. Seeds are useful in the treatment of ulcers, pharyngodynia, and obstructions of the liver and spleen. The leaves and fruits are used for external application in lumbago, ulceration and bone fractures and internally in leprosy, haemorrhoids and jaundice (Warrier et al, 1995). The drug improves digestion, calms down sexual urge, quells diseases due to pitta and kapha and cures anaemia, anorexia, leprosy, ulcers, jaundice, flatulence and piles. Fruit is useful in gout, rheumatism and complaints of liver and spleen (Nadkarni, 1954; Aiyer and Kolammal, 1966; Mooss, 1976; Kurup et al, 1979). Kaccoradi taila is an important preparation using the drug (Sivarajan et al, 1994).

The seeds give triterpene glycosides, named momordicosides A, B, C, D and E, which are glycosides of cucurbit-5-en-triol, tetraol or pentaol. Leaves and vines give tetracyclic triterpenes-momordicines I, II and III (bitter principles). Immature fruits give several non-bitter and 2 bitter cucurbitacin glycosides. Four of the non-bitter glycosides, momordicosides F1, F2, G and I and the bitter momordicosides; K and L have also been characterized. Fruits, seeds and tissue culture give a polypeptide which contained 17 types of amino acids and showed hypoglycaemic activity. Fruits also give 5-hydroxy tryptamine and a neutral compound charantin (a steroidal glucoside), diosgenin, cholesterol, lanosterol and -sitosterol. Leaf is emetic, purgative and antibilious. Fruit is stomachic, tonic, carminative, febrifuge, antirheumatic and hypoglycaemic. Root is astringent. Fruit and leaf is anti-leprotic. Fruit, leaf and root are abortifacient and anti-diabetic. Leaf and seed is anthelmintic. Seed oil possesses antifeeding and insecticidal properties. Unsaponifiable matter from seed oil exhibited pronounced inhibitory activity against gram negative bacteria. Seed and fruit are hypoglycaemic, cytotoxic and anti-feedant (Husain et al, 1992).

Other important species belonging to the genus Momordica are as follows.

M. dioica Roxb.

M. cochinchinensis Spreng.

M. tuberosa Cogn.

M. balsamina Linn.

6. Cucumis melo Linn. syn. C. melo Linn. var. cultis Kurz., C. pubescens

Willd., C. callosus (Rottl.) Cogn.

Eng: Sweet melon San,

Hin: Kharbuja

Ben: Kharmul

Mal: Mulam

Tam: Chukkari-kai, Thumatti-kai, Mulampazham

Tel: Kharbuja-doshavSweet melon is a creeping annual extensively cultivated throughout India, found wild in India, Baluchistan and tropical Africa. The stem is creeping, angular and scabrous. Leaves are orbicular-reniform in outline, 5-angled or lobed, scabrous on both surfaces and often with soft hairs. Lobes of leaves are not very deep nor acute and with 5cm long petiole. Female peduncle is 5cm. Fruit is spherical, ovoid, elongate or contorted, glabrous or somewhat hairy, not spinous nor tuberculate.

Cucumis melo includes two varieties, namely,

C. melo var. momordica syn. C. momordica Roxb.

C. melo var. utilissimus Duthie & Fuller. syn. C. utilissimus Roxb.

The fruit is eaten raw and cooked. Its pulp forms a nutritive, demulcent, diuretic and cooling drink. It is beneficial as a lotion in chronic and acute eczema as well as tan and freckles and internally in cases of dyspepsia. Pulp mixed with cumin seeds and sugar candy is a cool diet in hot season. Seeds yield sweet edible oil which is nutritive and diuretic, useful in painful discharge and suppression of urine. The whole fruit is useful in chronic eczema (Kirtikar & Basu, 1988).

Seeds contain fatty acids-myristic, palmitic, oleic, linoleic; asparagine, glutamine, citrulline, lysine, histidine, arginine, phenylalanine, valine, tyrosine, leucine, iso-leucine, methionine, proline, threonine, tryptophan and crystine. Seed is tonic, lachrymatory, diuretic and urease inhibitor. Fruit pulp is eczemic. Fruit is tonic, laxative, galactagogue, diuretic and diaphoretic. The rind is vulnerary (Husain et al, 1992).

7. Cucumic sativus Linn.

Eng: Cucumber, Common cucumber; San: Trapusah;

Hin,

Ben: Khira;

Mal: Vellari

Tam: Vellarikkai, Pippinkai;

Kan: Mullusavte;

Tel: Dosekaya

Cucumber is a climbing annual which is cultivated throughout India, found wild in the Himalayas from Kumaon to Sikkim. It is a hispidly hairy trailing or climbing annual. Leaves are simple, alternate, deeply cordate, 3-5 lobed with both surfaces hairy and denticulate margins. Flowers are yellow, males clustered, bearing cohering anthers, connective crusted or elevated above the cells. Females are solitary and thickly covered with very bulbous based hairs. Fruits are cylindrical pepo of varying sizes and forms. Seeds are cream or white with hard and smooth testa. The fruits are useful in vitiated conditions of pitta, hyperdipsia, burning sensation, thermoplegia, fever, insomnia, cephalgia, bronchitis, jaundice, haemorrhages, strangury and general debility. The seeds are useful in burning sensation, pitta, constipation, intermittent fevers, strangury, renal calculus, urodynia and general debility (Warrier et al, 1994). The leaves boiled and mixed with cumin seeds, roasted, powdered and administered in throat affections. Powdered and mixed with sugar, they are powerful diuretic (Nadkarni, 1998). The fruits and seeds are sweet, refrigerant, haemostatic, diuretic and tonic. Other important species belonging to the genus are:

C. trigonus Roxb. syn. C. pseudo-colocynthis

C. prophetarum Linn.

8. Citrullus colocynthis (Linn.) Schrader. syn. Cucumis colocynthis Linn.

Eng: Colocynth, Bitter apple; San: Visala, Mahendravaruni;

Hin: Badi indrayan, Makkal

Ben: Makhal;

Mal: Kattuvellari (Valutu), Valiya pekkummatti;

Tel: Etti-puchcha

Tam: Paitummatti, Petummatti;

Colocynth or Bitter apple is found, cultivated and wild, throughout India in warmer areas. It is an extensively trailing annual herb with bifid tendrils angular branching stems and wooly tender shoots. Leaves are deeply divided, lobes narrow thick, glabrous or somewhat hairy. Flowers are unisexual, yellow, both males and females solitary and with pale-yellow corolla. Fruit is a globose or oblong fleshy indehiscent berry, 5-7.5cm in diameter and variegated with green and white. Seeds are pale brown. The fruits are useful in tumours, ascites, leucoderma, ulcers, asthma, bronchitis, urethrorrhea, jaundice, dyspepsia, constipations, elephantiasis, tubercular glands of the neck and splenomegaly (Warrier et al, 1994). It is useful in abnormal presentations of the foetus and in atrophy of the foetus. In addition to the above properties, the root has a beneficial action in inflammation of the breasts, pain in the joints; externally it is used in ophthalmia and in uterine pains. The fruit and root, with or without is rubbed into a paste with water and applied to boils and pimples. In rheumatism, equal parts of the root and long pepper are given in pill. A paste of the root is applied to the enlarged abdomen of children (Kirtikar and Basu, 1988). The fruit is useful in ascites, biliousness, jaundice, cerebral congestion, colic, constipation dropsy, fever, worms and sciatica. Root is given in cases of abdominal enlargement, cough, asthma, inflammation of the breast, ulcers, urinary diseases and rheumatism. Oil from seeds is used for poisonous bites, bowel complaints, epilepsy and also for blackening the hair (Nadkarni, 1954; Dey, 1980). The important formulations using the root and fruit are Abhayarista, Mahatiktakam kasaya, Manasamitravatakam, Cavikasava, Madhuyastyadi taila, etc. (Sivarajan et al, 1994). The powder is often used as an insecticide. The extract should never be given without some aromatic to correct its griping tendency (Nadkarni, 1998).

Fruit contains a glycoside- colocynthin, its aglycone- -elaterin, citrulluin, citrullene and citrullic acid. Unripe fruit contains p-hydroxy benzyl methyl ester. Roots contain - elaterin and hentriacontane (Husain et al, 1992). Colocynth is, in moderate doses, drastic, hydrogogue, cathartic and diuretic. In large doses, it is emetic and gastro-intestinal irritant and in small doses, it is expectorant and alterative. Colocynthin is a cathartic and intensely bitter principle. It has a purgative action. All parts of the plant are very bitter. The fruit has been described as cathartic (Nadkarni, 1982).

9. Citrullus vulgaris Schrad. syn. C. lanatus (Thunb.) Mats. & Nakai.

Eng: Water melon; San: Tarambuja;

Hin: Tarbuj;

Ben: Tarbuz

Mal: Thannimathan;

Tam: Pitcha, Dharbusini

Watermelon is an extensively climbing annual which is largely cultivated throughout India and in all warm countries. It has thick angular branching stems. Tendrils are bifid, stout and pubescent. Leaves are long, deeply divided or moderately lobed, glabrous or somewhat hairy and hardly scabrous. Petiole is a little shorter than the limb and villous. Calyx-lobes are narrowly lanceolate, equalling the tube. Corolla is yellow within, greenish outside and villous. Lobes are ovate-oblong, obtuse and prominently 5-nerved. Fruit is sub-globose or ellipsoid, smooth, greenish or clouded, often with a glaucous waxy coating. Flesh is juicy, red or yellowish white. Seeds are usually margined. C. vulgaris var. fistulosus Duthie & Fuller. syn. C. fistulosus has its fruit about the size of small turnip, the seeds of which are used medicinally. The fruit is tasteless when unripe and sweet when ripe. The unripe fruit is used to cure jaundice. Ripe fruit cures kapha and vata and causes biliousness. It is good for sore eyes, scabies and itching. The seeds are tonic to the brain and used as a cooling medicine. An emulsion of the seeds is made into a poultice with the pounded leaves and applied hot in cases of intestinal inflammations (Kirtikar and Basu, 1988). Fruit juice is good in quenching thirst and it is used as an antiseptic in typhus fever with cumin and sugar. It is used as a cooling drink in strangury and affections of urinary organs such as gonorrhoea; in hepatic congestion and intestinal catarrh. The bitter watermelon of Sind is known as “Kirbut” and is used as a purgative.

Seeds yield a fixed oil and proteids; citrullin. Seeds are cooling, demulcent, diuretic, vermifuge and nutritive. Pulp is cooling and diuretic. Fruit-juice is cooling and refreshing (Nadkarni, 1982).

10. Curcurbita pepo Linn. syn. Pepo vulgaris et P. verrucosus Moench

Meth.

Eng: Pompion, Pumpkin, Vegetable Marrow; San: Karkaru, Kurkaru, Kushmandi

Hin,

Ben: Kadimah, Konda, Kumra, Safedkkadu;

Mal: Mathan, Matha

Tel: Budadegummadi, Pottigummadi

Pompion or Pumpkin is a climbing herb which is considered to be a native of America and cultivated in many parts of India. The stem and leaves are with a harsh prickly armature. Foliage is stiff, more or less rigid and erect. Leaves are with a broad triangular pointed outline and often with deep lobes. Corolla is mostly with erect or spreading (not drooping) pointed lobes, the tube narrowing towards the base. Peduncle is strongly 5-angled and little or much expanding near the fruit. The fruit is cooling and astringent to the bowels, increases appetite, cures leprosy, ‘kapha and vata’, thirst, fatigue and purifies the blood. The leaves are used to remove biliousness. Fruit is good for teeth, throat and eyes and allays thirst. Seeds cure sore chests, haemoptysis, bronchitis and fever. It is good for the kidney and brain. The leaves are used as an external application for burns. The seeds are considered anthelmintic. The seeds are largely used for flavouring certain preparations of Indian hemp, and the root for a nefarious purpose, viz., to make the preparation more potent. The seeds are taeniacide, diuretic and demulcent. The fruit is cooling, laxative and astringent. The leaves are digestible, haematinic and analgesic.

The other important species belonging to the genus Cucurbita is C. maxima Duchena, the seeds of which are a popular remedy for tape-worm and oil as a nervine tonic (Kirtikar & Basu, 1988).

11. Corallocarpus epigaeus Benth. ex Hook. f. syn. Bryonia epigaea Wight.

San: Katunahi;

Hin: Akasgaddah;

Mal: Kadamba, Kollankova

Tam: Akashagarudan, Gollankovai;

Tel: Murudonda, Nagadonda

Corallocarpus is a prostrate or climbing herb distributed in Punjab, Sind, Gujarat, Deccan, Karnataka and Sri Lanka. It is monoecious with large root which is turnip-shaped and slender stem which is grooved, zigzag and glabrous. Tendrils are simple, slender and glabrous. Leaves are sub-orbicular in outline, light green above and pale beneath, deeply cordate at the base, angled or more or less deeply 3-5 lobed. Petiole is long and glabrous. Male flowers are small and arranged at the tip of a straight stiff glabrous peduncle. Calyx is slightly hairy, long and rounded at the base. Corolla is long and greenish yellow. Female flowers are usually solitary with short, stout and glabrous peduncles. Fruit is stalked, long, ellipsoid or ovoid. Seeds are pyriform, turgid, brown and with a whitish corded margin. It is prescribed in later stages of dysentery and old veneral complaints. For external use in chronic rheumatism, it is made into a liniment with cumin seed, onion and castor oil. It is used in case of snakebite where it is administered internally and applied to the bitten part. The root is given in syphilitic rheumatism and later stages of dysentery. The plant is bitter, sweet, alexipharmic and emetic. The root is said to possess alterative and laxative properties (Kirtikar and Basu, 1988). Root contains a bitter principle like Breyonin (Chopra et al, 1980).

Agrotechnology: Cucurbits can be successfully grown during January-March and September- December. For the rainfed crop, sowing can also be started after the receipt of the first few showers.

Pits of 60cm diameter and 30-45cm depth are to be taken at the desired spacing. Well rotten FYM or vegetable mixture is to be mixed with topsoil in the pit and seeds are to be sown at 4-5/pit. Unhealthy plants are to be removed after 2 weeks and retained 2-3 plants/pit. FYM is to be applied at 20-25t/ha as basal dose along with half dose of N (35kg/ha) and full dose of P (25kg) and K (25kg). The remaining dose of N (35kg) can be applied in 2 equal split doses at fortnightly intervals. During the initial stages of growth, irrigation is to be given at an interval of 3-4 days and at alternate days during flowering and fruiting periods. For trailing cucumber, pumpkin and melon, dried twigs are to be spread on the ground. Bitter gourd, bottle gourd, snake gourd and ash gourd are to be trailed on Pandals. Weeding and raking of the soil are to be conducted at the time of fertilizer application. Earthing up may be done during rainy season. The most dreaded pest of cucurbits is fruit flies which can be controlled by using fruit traps, covering the fruits with polythene, cloth or paper bags, removal and destruction of affected fruits and lastly spraying with Carbaryl or Malathion 0. 2% suspension containing sugar or jaggery at 10g/l at fortnightly intervals after fruit set initiation. During rainy season, downy mildew and mosaic diseases are severe in cucurbits. The former can be checked by spraying Mancozeb 0.2%. The spread of mosaic can be checked by controlling the vectors using Dimethoate or Phosphamidon 0.05% and destruction of affected plants and collateral hosts. Harvesting to be done at least 10 days after insecticide or fungicide application (KAU,1996).... cucurbits

Revalidation

n. the process by which licensed doctors are required to demonstrate to the *General Medical Council on a regular basis that they are up to date and fit to practise medicine. Revalidation aims to give extra confidence to patients that their doctor is being regularly checked by their employer and the GMC. Revalidation started in the UK in December 2012. Licensed doctors usually have to revalidate every five years, by having regular annual appraisals based on the GMC’s core guidance for doctors. Only doctors who have a licence to practise are required to revalidate. See licensing. See also clinical governance.... revalidation

Beets

Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: Moderate Major vitamin contribution: Vitamin C Major mineral contribution: Potassium

About the Nutrients in This Food Beets are roots, high-carbohydrate foods that provide sugars, starch, and small amounts of dietary fiber, insoluble cellulose in the skin, and soluble pectins in the flesh. Beets are also a good source of the B vitamin folate. One-half cup cooked fresh beets has one gram of dietar y fiber and 68 mcg folate (17 percent of the R DA).

The Most Nutritious Way to Serve This Food Cooked, to dissolve the stiff cell walls and make the nutrients inside available.

Diets That May Restrict or Exclude This Food Anti-kidney-stone diet Low-sodium diet

Buying This Food Look for: Smooth round globes with fresh, crisp green leaves on top. Avoid: Beets with soft spots or blemishes that suggest decay underneath.

Storing This Food Protect the nutrients in beets by storing the vegetables in a cool place, such as the vegetable crisper in your refrigerator. When stored, the beet root converts its starch into sugars; the longer it is stored, the sweeter it becomes. Remove the green tops from beets before storing and store the beet greens like other leaf y vegetables, in plastic bags in the refrigerator to keep them from drying out and losing vitamins (also see gr eens). Use both beets and beet greens within a week.

Preparing This Food Scrub the globes with a vegetable brush under cold running water. You can cook them whole or slice them. Peel before (or after) cooking.

What Happens When You Cook This Food Betacyamin and betaxanthin, the red betalain pigments in beets, are water-soluble. (That’s why borscht is a scarlet soup.) Betacyanins and betaxanthins turn more intensely red when you add acids; think of scarlet sweet-and-sour beets in lemon juice or vinegar with sugar. They turn slightly blue in a basic (alkaline) solution such as baking soda and water. Like carrots, beets have such stiff cell walls that it is hard for the human digestive tract to extract the nutrients inside. Cooking will not soften the cellulose in the beet’s cell walls, but it will dissolve enough hemicellulose so that digestive juices are able to penetrate. Cook- ing also activates flavor molecules in beets, making them taste better.

How Other Kinds of Processing Affect This Food Canning. Beets lose neither their color nor their texture in canning.

Medical Uses and/or Benefits Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The R DA for folate is 400 mcg for healthy adult men and women, 600 mcg for pregnant women, and 500 mcg for women who are nursing. Taking folate supplements before becoming pregnant and continu- ing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records of more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular diseases were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.

Adverse Effects Associated with This Food Pigmented urine and feces. The ability to metabolize betacyanins and be taxanthins is a genetic trait. People with two recessive genes for this trait cannot break down these red pig- ments, which will be excreted, bright red, in urine. Eating beets can also turn feces red, but it will not cause a false-positive result in a test for occult blood in the stool. Nitrosamine formation. Beets, celery, eggplant, lettuce, radishes, spinach, and collard and turnip greens contain nitrates that convert naturally into nitrites in your stomach—where some of the nitrites combine with amines to form nitrosamines, some of which are known carcinogens. This natural chemical reaction presents no known problems for a healthy adult. However, when these vegetables are cooked and left standing for a while at room tempera- ture, microorganisms that convert nitrates to nitrites begin to multiply, and the amount of nitrites in the food rises. The resulting higher-nitrite foods may be dangerous for infants (see spinach).... beets

Indian Gooseberry

Phyllanthus emblica

Euphorbiaceae

San: Amalaka, Adiphala

Tel: Amalakam

Hin, Mar: Amla

Kan: Amalaka

Ben: Amlaki

Guj: Ambala

Mal,

Tam: Nelli

Kas: Aonla

Importance: Indian gooseberry or emblic myrobalan is a medium sized tree the fruit of which is used in many Ayurvedic preparations from time immemorial. It is useful in haemorrhage, leucorrhaea, menorrhagia, diarrhoea and dysentery. In combination with iron, it is useful for anaemia, jaundice and dyspepsia. It goes in combination in the preparation of triphala, arishta, rasayan, churna and chyavanaprash. Sanjivani pills made with other ingredients is used in typhoid, snake-bite and cholera. The green fruits are made into pickles and preserves to stimulate appetite. Seed is used in asthma, bronchitis and biliousness. Tender shoots taken with butter milk cures indigestion and diarrhoea. Leaves are also useful in conjunctivitis, inflammation, dyspepsia and dysentery. The bark is useful in gonorrhoea, jaundice, diarrhoea and myalgia. The root bark is astringent and is useful in ulcerative stomatitis and gastrohelcosis. Liquor fermented from fruit is good for indigestion, anaemia, jaundice, heart complaints, cold to the nose and for promoting urination. The dried fruits have good effect on hair hygiene and used as ingredient in shampoo and hair oil. The fruit is a very rich source of Vitamin C (600mg/100g) and is used in preserves as a nutritive tonic in general weakness (Dey, 1980).

Distribution: Indian gooseberry is found through out tropical and subtropical India, Sri Lanka and Malaca. It is abundant in deciduous forests of Madhya Pradesh and Darjeeling, Sikkim and Kashmir. It is also widely cultivated.

Botany: Phyllanthus emblica Linn. syn. Emblica officinalis Gaertn. belongs to Euphorbiaceae family. It is a small to medium sized deciduous tree growing up to 18m in height with thin light grey, bark exfoliating in small thin irregular flakes. Leaves are simple, many subsessile, closely set along the branchlets, distichous light green having the appearance of pinnate leaves. Flowers are greenish yellow in axillary fascicles, unisexual; males numerous on short slender pedicels; females few, subsessile; ovary 3-celled. Fruits are globose, 1-5cm in diameter, fleshy, pale yellow with 6 obscure vertical furrows enclosing 6 trigonous seeds in 2-seeded 3 crustaceous cocci. Two forms Amla are generally distinguished, the wild ones with smaller fruits and the cultivated ones with larger fruits and the latter are called ‘Banarasi’(Warrier et al, 1995).

Agrotechnology: Gooseberry is quite hardy and it prefers a warm dry climate. It needs good sunlight and rainfall. It can be grown in almost all types of soils, except very sandy type. A large fruited variety “Chambakad Large“ was located from the rain shadow region of the Western Ghats for cultivation in Kerala. Amla is usually propagated by seeds and rarely by root suckers and grafts. The seeds are enclosed in a hard seed coat which renders the germination difficult. The seeds can be extracted by keeping fully ripe fruits in the sun for 2-3 days till they split open releasing the seeds. Seeds are soaked in water for 3-4 hours and sown on previously prepared seed beds and irrigated. Excess irrigation and waterlogging are harmful. One month old seedlings can be transplanted to polythene bags and one year old seedlings can be planted in the main field with the onset of monsoon. Pits of size 50 cm3 are dug at 6-8m spacing and filled with a mixture of top soil and well rotten FYM and planting is done. Amla can also be planted as a windbreak around an orchard. Irrigation and weeding are required during the first year. Application of organic manure and mulching every year are highly beneficial. Chemical fertilisers are not usually applied. No serious pests or diseases are generally noted in this crop. Planted seedlings will commence bearing from the 10th year, while grafts after 3-4 years. The vegetative growth of the tree continues from April to July. Along with the new growth in the spring, flowering also commences. Fruits will mature by December-February. Fruit yield ranges from 30-50kg/tree/year when full grown (KAU,1993).

Properties and activity: Amla fruit is a rich natural source of vitamin C. It also contains cytokinin like substances identified as zeatin, zeatin riboside and zeatin nucleotide. The seeds yield 16% fixed oil, brownish yellow in colour. The plant contains tannins like glucogallia, corilagin, chebulagic acid and 3,6-digalloyl glucose. Root yields ellagic acid, lupeol, quercetin and - sitosterol (Thakur et al, 1989).

The fruit is diuretic, laxative, carminative, stomachic, astringent, antidiarrhoeal, antihaemorrhagic and antianaemic.... indian gooseberry

Liquorice

Glycyrrhiza glabra

Papilionaceae

San: Yashtimadhu Hin: Jathimadh Mal: Irattimadhuram Tam:Athimadhuram

Tel: Yashtimadhukam

Ben: Yashtomadhu Pun:Muleti

Importance: Liquorice or Muleti is a perennial herb or undershrub about 1m high. Its dried peeled or unpeeled underground stems and roots constitute the drug which is an important constituent of all cough and catarrh syrups, throat lozenges and pastilles. This has been used in medicine for more than 4000 years. Hippocrates (400 BC) mentioned its use as a remedy for ulcers and quenching of thirst. Dioscorides, the father of Greek medicine described this drug in detail and considered it useful for maintaining shape of arteries and in burning stomach, trouble of liver and kidney, scabies, healing of wounds and as a remedy for eye diseases. It has been used in Arab system of medicine for more than 600 years from where it has been adopted to modern medicine (Gibson, 1978).

The commercial name of the dried rhizome and root of the plant is liquorice which is used as flavouring agent and the taste coorigent in pharmaceutical and confectionery industries and its products are widely reported to be useful in ulcer therapy. Glycyrrhizin, a triterpene glucoside, is the principal constituent of G. glabra which is 50 times sweeter than sugar.

Distribution: Liquorice is native to Mediterranean region, South Europe and Middle East. It is widely distributed in Spain, Italy, Greece, Syria, Iraq, Afghanistan, Turkey, parts of USSR and China. However its cultivation is limited to small areas in USSR, UK, and USA. In India, it grows in Punjab and Jammu and Kashmir. Semi arid areas of Haryana, Rajasthan and Gujarath states are suitable for the cultivation of Liquorice. However, its commercial cultivation has not yet been possible and the domestic requirement is largely met through imports.

Botany: Glycyrrhiza glabra Linn. belongs to the family Papilionaceae. The word Glycyrrhiza is of Greek origin meaning ‘sweet’ and glabra means ‘smooth’ which refers to smooth fruit of the species. This is a tall perennial, self pollinated herb or undershrub about 1m high with long cylindrical burrowing rootstock and horizontal creeping stolons which reach 1.5-1.8m in length. Leaves are alternate, pinnate with 9-17 leaflets. Leaflets are yellowish-green, 2.5-5cm long, ovate and obtuse. Flowers are pale blue arranged in a raceme and 1.25cm long. Calyx is glandular and pubescent. The pods are glabrous, red to brown having 3-4 seeds. Rhizome is soft, flexible and fibrous with light yellow colour and a characteristic sweet taste.

Agrotechnology: This plant thrives well in subtropical areas with very warm summers and cool winters with a rainfall not exceeding 500mm. Semi -arid and arid areas in subtropical zones are not suitable for the cultivation of this crop. It does not tolerate high humidity and waterlogged conditions. Well drained light loam soils which are rich in calcium and magnesium with slightly alkaline pH and free from stones are ideal for this crop. There are a number of varieties of this crop among which Spanish, Russian and Persian liquorice are quite common. Commercial varieties are Typica, Regel and Herd. This is propagated by seed, but usually multiplied vegetatively either through crown cuttings or stolon pieces. In the case of crown cuttings, 10-15cm long crown pieces with 2-3 buds are planted vertically at a distance of 0.6-0.7m in rows 1-1.5m apart. However, most of the liquorice is propagated through stolon pieces of the above size planted horizontally, preferably on ridges during spring at the same distance as above. Rapid clonal propagation is also possible by tissue culture technique. Murashige and Skoog’s medium supplemented with 6-benzylaminopurine and indole-3-acetic acid favoured multiple shoot production without any intervening callus phase. These regenerated plantlets can be transferred to earthen pots in the glass house and after a brief hardening phase, these are transplanted in the field with a high rate (90-95%) of survival. This plant normally does not require much fertilizers but in deficient soils, it is better to apply 10-15 tonnes FYM per hectare before planting. The field should be immediately irrigated after planting in spring and after the crop has sprouted, it requires very little irrigation. Space between the rows should be kept free from weeds. Short term vegetables like carrot or cabbage can be planted between the rows for additional income. In order to produce good rhizome, flowering shoots are clipped. No serious disease except leaf spot caused by Cercospora cavarae has been reported in this crop. Roots are ready for harvesting after 3-4 years. The root is dug when the top has dried during autumn (November- December). A trench 60cm deep is dug along the ridges and the entire root is lifted. Broken parts of the root left in the soil, sprout again and give another crop after 2-3 years. Thus liquorice once planted properly can be harvested for 10-15 years.

Postharvest technology: Harvested roots are cut into pieces of 15-20cm long and 1-2cm in diameter. They are washed and dried upto 6-8% moisture in the sun and shade alternately which reduces the weight by 50%. The average yield of dried roots varies from 1-3 tonnes per hectare depending on the variety, soil and climatic conditions.

Properties and activity: Roots gave a number of compounds the most important bieng a glucoside, glycyrrhizin which gave glycyrrhetinic acid on enzyme hydrolysis. Root also contains flavans, flavones, iso-flavanoes and coumarins including a 4-methyl coumarin, liqcoumarin, glabridin, glabrene, 4’-0-methyl and 3’-methoxyglabridin, formononetin, salicylic acid, 0-acetyl salicylic acid which has been isolated first time from nature, hispaglabridins A and B and 4’0- methylglabridin.On hydrolysis it also gave two molecules of d-glucuronic acid, each linked with 1-2 linkage to 3-hydroxyl of the sapogenin (Elgamal et al, 1969) Glycyrrhizin is antidiuretic, antiinflammatory, expectorant, antiulcerous, antihistamine. Glycyrrhizic acid is antiviral. The roots are emetic, tonic, diuretic, demulcent, mild laxative, aphrodisiac, trichogenous, expectorant, emmenagogue, alexipharmic, alterant and intellect promoting.... liquorice

Serpentwood

Rauvolfia serpentina

Apocynaceae

San: Sarpagandha

Hin: Chandrabhaga

Mal: Sarpagandhi, Amalpori

Tam: Chivan amelpodi

Kan: Sutranbhi

Tel: Patalagandhi

Introduction: Serpentwood is an erect, evergreen , perennial undershrub whose medicinal use has been known since 3000 years. Its dried root is the economical part which contains a number of alkaloids of which reserpine, rescinnamine, deserpidine, ajamalacine, ajmaline, neoajmalin, serpentine, -yohimbine are pharmacologically important. The root is a sedative and is used to control high blood pressure and certain forms of insanity. In Ayurveda it is also used for the treatment of insomnia, epilepsy, asthma, acute stomach ache and painful delivery. It is used in snake-bite, insect stings, and mental disorders. It is popular as “Madman’s medicine” among tribals. ‘Serpumsil’ tablet for high blood pressure is prepared from Rauvolfia roots. Reserpine is a potent hypotensive and tranquillizer but its prolonged usage stimulates prolactine release and causes breast cancer. The juice of the leaves is used as a remedy for the removal of opacities of the cornea.

Distribution: Rauvolfia serpentina is native to India. Several species of Rauvolfia are observed growing under varying edaphoclimatic conditions in the humid tropics of India, Nepal, Burma, Thailand, Bangladesh, Indonesia , Cambodia, Philippines and Sri Lanka. In India, it is cultivated in the states of Uttar Pradesh, Bihar, Tamil Nadu, Orissa, Kerala, Assam, West Bengal and Madhya Pradesh (Dutta and Virmani, 1964). Thailand is the chief exporter of Rauvolfia alkaloids followed by Zaire, Bangladesh, Sri Lanka, Indonesia and Nepal. In India, it has become an endangered species and hence the Government has prohibited the exploitation of wild growing plants in forest and its export since 1969.

Botany: Plumier in 1703 assigned the name Rauvolfia to the genus in honour of a German physcian -Leonhart Rauvolf of Augsburg. The genus Rauvolfia of Apocynaceae family comprises over 170 species distributed in the tropical and subtropical parts of the world including 5 species native to India. The common species of the genus Rauvolfia and their habitat as reported by Trivedi (1995) are given below.

R. serpentina Benth. ex Kurz.(Indian serpentwood) - India ,Bangladesh, Burma, Sri Lanka, Malaya, Indonesia

R. vomitoria Afz. (African serpentwood) - West Africa, Zaire, Rwanda, Tanzania R. canescens Linn. syn. R. tetraphylla (American serpentwood) - America, India R. mombasina - East Africa , Kenya, Mozambique

R. beddomei - Western ghats and hilly tracts of Kerala

R. densiflora - Maymyo, India

R. microcarpa - Thandaung

R. verticillata syn. R. chinensis - Hemsl

R. peguana - Rangoon-Burma hills

R. caffra - Nigeria, Zaire, South Africa

R. riularis - Nmai valley

R. obscura - Nigeria, Zaire

R. serpentina is an erect perennial shrub generally 15-45 cm high, but growing upto 90cm under cultivation. Roots nearly verticle, tapering up to 15 cm thick at the crown and long giving a serpent-like appearance, occasionally branched or tortuous developing small fibrous roots. Roots greenish-yellow externally and pale yellow inside, extremely bitter in taste. Leaves born in whorls of 3-4 elliptic-lanceolate or obovate, pointed. Flowers numerous borne on terminal or axillary cymose inflorscence. Corolla tubular, 5-lobed, 1-3 cm long, whitish-pink in colour. Stamens 5, epipetalous. Carpels 2, connate, style filiform with large bifid stigma. Fruit is a drupe, obliquely ovoid and purplish black in colour at maturity with stone containing 1-2 ovoid wrinkled seeds. The plant is cross-pollinated, mainly due to the protogynous flowers (Sulochana ,1959).

Agrotechnology: Among the different species of Rauvolfia, R. serpentina is preferred for cultivation because of higher reserpine content in the root. Though it grows in tropical and subtropical areas which are free from frost, tropical humid climate is most ideal. Its common habitats receive an annual rain fall of 1500-3500 mm and the annual mean temperature is 10-38 C. It grows up to an elevation of 1300-1400m from msl. It can be grown in open as well as under partial shade conditions. It grows on a wide range of soils. Medium to deep well drained fertile soils and clay-loam to silt-loam soils rich in organic matter are suitable for its cultivation. It requires slightly acidic to neutral soils for good growth.

The plant can be propagated vegetatively by root cuttings, stem cuttings or root stumps and by seeds. Seed propagation is the best method for raising commercial plantation. Seed germination is very poor and variable from 10-74%. Seeds collected during September to November give good results. It is desirable to use fresh seeds and to sock in 10% sodium chloride solution. Those seeds which sink to the bottom should only be used. Seeds are treated with ceresan or captan before planting in nursery to avoid damping off. Seed rate is 5-6 kg/ha. Nursery beds are prepared in shade, well rotten FYM is applied at 1kg/m2 and seeds are dibbled 6-7cm apart in May-June and irrigated.

Two months old seedlings with 4-6 leaves are transplanted at 45-60 x 30 cm spacing in July -August in the main field. Alternatively, rooted cuttings of 2.5-5cm long roots or 12-20cm long woody stems can also be used for transplanting. Hormone (Seradix) treatment increases rooting. In the main field 10-15 t/ha of FYM is applied basally. Fertilisers are applied at 40:30:30kg N: P2O5 :K2O/ha every year. N is applied in 2-3 splits. Monthly irrigation increases the yield. The nursery and the main field should be kept weed free by frequent weeding and hoeing. In certain regions intercroping of soybean, brinjal, cabbage, okra or chilly is followed in Rauvolfia crop.

Pests like root grubs (Anomala polita), moth (Deilephila nerii), caterpillar (Glyophodes vertumnalis), black bugs and weevils are observed on the crop, but the crop damage is not serious. The common diseases reported are leaf spot (Cercospora rauvolfiae, Corynespora cassiicola), leaf blotch (Cercospora serpentina), leaf blight (Alternaria tenuis), anthracnose (Colletotrichum gloeosporioides), die back (Colletotrichum dematrium), powdery mildew (Leviellula taurica), wilt (Fusarium oxysporum), root-knot (Meloidogyne sp.), mosaic and bunchy top virus diseases. Field sanitation, pruning and burning of diseased parts and repeated spraying of 0.2% Dithane Z-78 or Dithane M-45 are recommended for controlling various fungal diseases. Rauvolfia is harvested after 2-3 years of growth. The optimum time of harvest is in November -December when the plants shed leaves, become dormant and the roots contain maximum alkaloid content. Harvesting is done by digging up the roots by deeply penetrating implements (Guniyal et al, 1988).

Postharvest technology: The roots are cleaned washed cut into 12-15cm pieces and dried to 8-10% moisture.

The dried roots are stored in polythene lined gunny bags in cool dry place to protect it from mould. The yield is 1.5-2.5 t/ha of dry roots. The root bark constitutes 40-45% of the total weight of root and contributes 90% of the total alkaloids yield.

Properties and activity: Rauvolfia root is bitter, acrid, laxative, anthelmintic, thermogenic, diuretic and sedative. Over 200 alkaloids have been isolated from the plant. Rauvolfia serpentina root contains 1.4-3% alkaloids. The alkaloids are classsified into 3 groups, viz, reserpine, ajmaline and serpentine groups. Reserpine group comprising reserpine, rescinnamine, deserpine etc act as hypotensive, sedative and tranquillising agent. Overdose may cause diarrhoea, bradycardia and drowsiness. Ajmaline, ajmalicine, ajmalinine, iso-ajmaline etc of the ajmaline group stimulate central nervous system, respiration and intestinal movement with slight hypotensive activity. Serpentine group comprising serpentine, sepentinine, alstonine etc is mostly antihypertensive. (Husain,1993; Trivedi, 1995; Iyengar, 1985).... serpentwood

Strychnine Tree

Strychnos nux-vomica

Loganiaceae

San: Karaskara;

Hin: Kajra, Kuchila;

Mal: Kanjiram; ;

Tam: Itti, Kagodi, Kanjirai Mar:Jharkhatchura;

Kan: Hemmushti, Ittangi;

Tel: Mushti, Mushidi; Ori: Kora, Kachila

Importance: It is a large deciduous tree, with simple leaves and white fragrant flowers.

Strychnos is highly toxic to man and animals producing stiffness of muscles and convulsions, ultimately leading to death. However, in small doses it can also serve as efficacious cure forms of paralysis and other nervous disorders. The seeds are used as a remedy in intermittent fever, dyspepsia, chronic dysentery, paralytic and neuralgic affections, worms, epilepsy, chronic rheumatism, insomnia and colic. It is also useful in impotence, neuralgia of face, heart disease, spermatorrhoea, skin diseases, toxins, wounds, emaciation, cough and cholera. Leaves are applied as poultice in the treatment of chronic wounds and ulcers and the leaf decoction is useful in paralytic complaints. Root and root bark used in fever and dysentery (Nadkarni, 1982; Kurup et al, 1979).

Distribution: The plant is distributed throughout India in deciduous forests up to 1200m. It is also found in Sri Lanka, Siam, Indochina and Malaysia.

Botany: Strychnos nux-vomica Linn. is a large tree belonging to the family Loganiaceae. Leaves are simple, opposite, orbicular to ovate, 6-11.5x6-9.5cm, coriaceous, glabrous, 5 nerved, apex obtuse, acute or apiculate, transverse nerves irregular and inconspicuous. Inflorescence is many flowered terminal cymes, 2.5-5cm across. Bracts (5mm) and bracteoles (1.5mm) small. Flowers are white or greenish white and fragrant. Calyx 5 lobed, pubescent and small (2mm). Corolla salver shaped, tube cylindrical slightly hairy near the base within and greenish white, tube much elongate than the lobes. Tube 7mm and lobes 2.5mm long. Lobes 5 and valvate. Stamens 5, filaments short, 0.1mm long. Anthers 1.5mm subexerted, linear oblong. Ovary 1.5 mm, pubescent, 2 celled, ovules one to many. Style 9mm, stigma capitate. Fruit is a berry, 5-6cm diameter, globose, indehiscent, thick shelled, orange red when ripe with fleshy pulp enclosing the seeds. Seeds 1-many, discoid, compressed, coin like, concave on one side and convex on the other, covered with fine grey silky hairs.

The leaf fall is during December (do not shed all the leaves at a time) and new foliage appears in February. Flowering is during March - April and fruiting during May - December. Fruits take about 8-9 months to mature.

Properties and activity: Strychnine and brucine are the most important and toxic alkaloids present in the plant. They occur not only in the seeds but also in roots, wood, bark, fruit pulp and hard fruit shells. The minor alkaloids present in the plant are vomicine, -colubrine, -colubrine, pseudostrychnine and N-methyl-sec-pseudobrucine (novacine). Loganin a glycoside is also present (Warnat, 1932; Martin et al, 1953; Guggisberg et al, 1966; Bisset and Chaudhary, 1974). Chatterji and Basa (1967) reported vomicine as the major constituent alkaloid along with unidentified alkaloid in leaves and identified another alkaloid kajine (N-methyl pseudostrychnine) from the leaves of very young plants.

Root bark of S. nux-vomica yeilded 4-hydroxy-3-methoxy strychnine, 4 hydroxy strychine, nor-macusine, a new alkaloid 12 , 13 dihydro-12 -hydroxy isostrychnine named protostrychnine (Baser et al, 1979) methoxy strychnine, and mavacurine (Guggisberg et al, 1966). Leaves and root bark also yeilded 11 new alkaloids. 10-hydroxy strychnine, 3-12-dihydroxystrychnine, 12-hydroxy–11- methoxy strychnine, 3-12-dihydroxy- 11-methoxy strychnine,12-hydroxy strychnine-N- oxide 12-hydroxy-11-methoxy strychnine- N-oxide-19,20–dihydro isostrychnine, 16 , 17 dihydro-17 -hydroxy isostrychnine, O- methyl-macusine B, 16-epi-o-methyl–macusine B and normelinone B (Baser and Bisset, 1982).

De and Datta (1988) isolated 5 tertiary indole alkaloids viz. strychnine, brucine, vomicine, icajine and novacine from S.nux-vomica flowers. Bisset et al (1989) isolated and identified two phenolic glycosides salidroside and cuchiloside – a compound consisting of salidroside and an attached xylose unit, from the fruit of S.nux-vomica.

Rodriguez et al (1979) isolated an indole alkaloid from the seeds of S. nux- vomica and identified as a 3-methoxy icajine. A new alkaloid 15-hydroxy strychnine has been isolated from the seeds and the structure of the alkaloid established by spectroscopic data (Galeffi et al, 1979). Cai et al (1990a) isolated 4 new alkaloids isobrucine, isobrucine N-oxide, isostrychnine N-oxide and 2 hydroxy–3-methoxy strychnine from the heat treated seeds of S. nuxvomica and the structure of the alkaloids were determined by 13 CNMR (Cai et al, 1994). Cai et al (1990 b) studied the changes in the alkaloid composition of the seeds during drug processing. Saily et al (1994) determined the mineral elements in Strychnos nux-vomica. Corsaro et al (1995) reported polysaccharides from the seeds of Strychnos species.

Seeger and Neumann (1986) reviewed the physico-chemical characteristics, occurrence, identification, utilisation, poisoning, toxicity, kinetics, differential diagnosis and therapeutic uses of strychnine and brucine. Aspergillus niger, A. flavus and Pencillium citrinum showed regular association with Strychnos seeds and effectively deteriorated the alkaloid content of the seeds (Dutta, 1988; Dutta and Roy, 1992). Nicholson (1993) described the history, structure and synthesis of strychnine which occur in the seeds of S. nux-vomica. Rawal and Michoud (1991) developed a general solution for the synthesis of 2- azabicyclo (3.3.1) nonane substructure of Strychnos alkaloids.

Villar et al (1984) and Hayakawa et al (1984) developed HPLC method for the analysis of strychnine and brucine. Graf and Wittliner (1985), Kostennikova (1986) and Gaitonde and Joshi (1986) suggested different methods for the assay of strychnine and brucine. Biala et al, (1996) developed new method for the assay of alkaloids in S. nux- vomica.

The seeds are bitter, acrid, alexeteric, aphrodisiac, appetiser, antiperiodic, anthelmintic, digestive, febrifuge, emmenagogue, purgative, spinal, respiratory and cardiac stimulant and stomachic. The bark is bitter, and tonic and febrifuge (Nadkarni, 1954; Kurup et al, 1979; Warrier et al, 1996).

The quarternery alkaloid from the root bark of the Sri Lankan plant exhibited muscle-relaxant activity (Baser and Bisset, 1982). Antimicrobial activity of indole alkaloid isolated from the Strychnos nux-vomica was studied by Verpoorte et al, 1983. Shukla et al (1985) evaluated the efficacy of Rasnadigugglu compound consisting of S. nux-vomica, on rheumatoid arthritis and found to be effective in reducing inflammatory oedoma and rheumatoid arthritis. It also exhibited analgesic activity. A compound Unani formulation containing S. nux-vomica significantly attenuated withdrawal intensity in morphine dependent rats (Zatar et al, 1991). Shahana et al (1994) studied the effect of Unani drug combination (UDC) having Strychnos nux-vomica on the abstinence syndrome in moderately and severely morphine dependent rats. The UDC strikingly suppressed the abstinence syndrome was seen to possess central depressant and analgesic action.

Melone et al (1992) reported brucine-lethality in mice. Panda and Panda (1993) and Satyanarayanan et al (1994) reported antigastric ulcer activity of nux vomica in Shay rats. Banerjee and Pal (1994) reported the medicinal plants used by the tribals of plain land in India for hair and scalp preparation and S. nux-vomica being used to cure alopecia (baldness) by the tribals. Tripathi and Chaurasia (1996) studied the effect of S. nux-vomica alcohol extract on lipid peroxidation in rat liver.... strychnine tree

Meningitis

Cerebrospinal fever. Inflammation of the pia mater and arachnoid covering of the brain and spinal cord. A notifiable disease. Hospitalisation. Diagnosis is difficult without a lumbar puncture. Caused by a wide range of virus, bacteria, protozoa and fungi. Three most common bacterial causes in England and Wales are N. Meningotidis, H. influenzae and streptococcus-like infection with sore throat; then fever, vomiting, headache and mental confusion; half-open eyes when asleep, delirium, sensitive to light, possibly drifting into coma. Sometimes onset is gradual over 2-3 weeks. Treatment by hospital specialist.

Poor housing and passive smoking suspected. Its association with non-germ meningitis, and inflammatory drugs is well recognised. Also caused by injury or concussion.

Commence by cleansing bowel with Chamomile enema.

Cerebrospinal relaxants indicated: Passion flower (cerebral), Black Cohosh (meningeal), Ladyslipper (spinal meningeal). (A.W. & L.R. Priest)

If patient is cold, give Cayenne pepper in honey to promote brisk circulation.

Aconite and Gelsemium. “For irritation of the meninges of the brain and spinal cord Aconite is indispensible. Combined with Gelsemium for restlessness it is an exceptional remedy. Tincture Aconite (5-15 drops) with Gelsemium (3-10 drops) hourly. Also used in combination with other agents as may be dictated by the course of the disease. (W.W. Martin MD., Kirksville, Mo., USA)

Crawley root. Decoction: 1 teaspoon to half a pint water, simmer 20 minutes. Dose: 1 teaspoon or more 3-4 times daily for children over 6 months. A powerful diaphoretic and sedative. (Dr Baker, Adrian, Michigan, USA)

Lobelia and Echinacea. Equal parts, Liquid Extract 30 drops in water every 3 hours. (Dr Finlay Ellingwood)

Lobelia, alone. Hypodermic injections of Lobelia in five cases of epidemic spinal meningitis, with complete recovery in every case. Dose: 10 drops hourly until symptoms abate, then twice daily. (Dr A.E. Collyer, Ellingwood Therapeutist)

Ecclectic School. Echinacea commended.

Before the Doctor comes. As onset is rapid, often less than 5 hours, an anti-inflammatory is justified. Teas or decoctions from any of the following: Catmint (Catnep), Prickly Ash berries, Pleurisy root, Boneset, Wild Cherry bark, Bugleweed (Virginian), Ladyslipper. When temperature abates and patient feels better: Chamomile tea or cold Gentian decoction with pinch Cayenne.

Hydrotherapy. Hot baths make patient feel worse. Sponge down with cold water.

Protective throat spray: equal parts, Tincture Myrrh and Tincture Goldenseal.

Protective gargle: 10-20 drops Tincture Myrrh and Goldenseal to glass of water.

Garlic. Dr Yan Cai, Department of Neurology, Ren Ji Hospital (affiliated to Shanghai Second Medical University), China, referred to the extensive use of Garlic in Chinese folk medicine and his hospital’s experience with Garlic products – diallyl trisulphide in particular – to treat viral infections including crypotococcal meningitis for which disease results were impressive.

Garlic appears to be a reliable preventative.

Diet. Fast as long as temperature is elevated; with fruit juices, red beet juice, carrot juice or herb teas. Note. GPs and other practitioners may help stop meningitis claiming lives by giving massive doses of Echinacea before they are admitted to hospital.

Note: The infection is often difficult to diagnose. At the end of each year (November and December) when the peak in cases approaches, every feverish patient with headache should be suspected, especially where accompanied by stiff neck.

The above entry is of historic interest only; more effective orthodox treatment being available. ... meningitis




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