(English) From the far meadow Fairley, Fairlee, Fairleigh, Fairli, Fairlie, Faerly, Faerli, Faerlie, Faerley, Fayrly, Fayrley, Fayrleigh, Fayrlee, Fayrli, Fayrlie, Fayrlea
Hin: Gular, Umar
Ben: Jagya dumurMal, Tam,Kan: AthiTel: Udambaramu, PaidiGular fig, Cluster fig or Country fig, which is considered sacred, has golden coloured exudate and black bark. It is distributed all over India. Its roots are useful in treating dysentery. The bark is useful as a wash for wounds, highly efficacious in threatened abortions and recommended in uropathy. Powdered leaves mixed with honey are given in vitiated condition of pitta. A decoction of the leaves is a good wash for wounds and ulcers. Tender fruits (figs) are used in vitiated conditions of pitta, diarrhoea, dyspepsia and haemorrhages. The latex is administered in haemorrhoids and diarrhoea (Warrier et al, 1995). The ripe fruits are sweet, cooling and are used in haemoptysis, thirst and vomiting (Nadkarni, 1954; Aiyer et al, 1957; Moos, 1976). Nalpamaradi coconut oil, Candanasava, Valiya Arimedastaila, Dinesavalyadi Kuzhambu, Abhrabhasma, Valiya candanaditaila, etc. are some important preparations using the drug (Sivarajan et al, 1994).It is a moderate to large-sized spreading laticiferous, deciduous tree without many prominent aerial roots. Leaves are dark green and ovate or elliptic. Fruit receptacles are 2-5cm in diameter, sub- globose or pyriform arranged in large clusters on short leafless branches arising from main trunk or large branches. Figs are smooth or rarely covered with minute soft hairs. When ripe, they are orange, dull reddish or dark crimson. They have a pleasant smell resembling that of cedar apples. The bark is rusty brown with a fairly smooth and soft surface, the thickness varying from 0.5-2cm according to the age of the trunk or bark. Surface is with minute separating flakes of white tissue. Texture is homogeneously leathery (Warrier et al, 1995).Stem-bark gives gluanol acetate, -sitosterol, leucocyanidin-3-O- -D-glucopyrancoside, leucopelargonidin-3-O- -D-glucopyranoside, leucopelargonidin -3-O- -L-rhamnopyranoside, lupeol, ceryl behenate, lupeol acetate and -amyrin acetate. Stem- bark is hypoglycaemic and anti-protozoal. Gall is CVS active. Bark is tonic and used in rinder pest diseases of cattle. Root is antidysenteric and antidiabetic. Leaf is antibilious. Latex is antidiarrhoeal and used in piles. Bark and syconium is astringent and used in menorrhagia (Husain et al, 1992).2. Ficus microcarpa Linn. f. syn. F. retusa auct. Non. Linn.San: Plaksah; Hin,Ben: Kamarup;Mal: Ithi, Ithiyal;Tam: Kallicci, Icci;
Kan: Itti;
Tel: PlaksaPlaksah is the Ficus species with few branches and many adventitious roots growing downward. It is widely distributed throughout India and in Sri Lanka, S. China, Ryuku Isles and Britain. Plakasah is one of the five ingredients of the group panchvalkala i.e, five barks, the decoction of which is extensively used to clear ulcers and a douche in leucorrhoea in children. This decoction is administered externally and internally with satisfactory results. Plaksah is acclaimed as cooling, astringent, and curative of raktapitta doshas, ulcers, skin diseases, burning sensation, inflammation and oedema. It is found to have good healing property and is used in preparation of oils and ointments for external application in the treatment of ulcers (Aiyer and Kolammal, 1957). The stem-bark is used to prepare Usirasava, Gandhataila, Nalpamaradi taila, Valiya marmagulika, etc. (Sivarajan et al, 1994). The bark and leaves are used in wounds, ulcers, bruises, flatulent colic, hepatopathy, diarrhoea, dysentery, diabetes, hyperdipsia, burning sensation, haemaorrhages, erysipelas, dropsy, ulcerative stomatitis, haemoptysis, psychopathy, leucorrhoea and coporrhagia (Warrier et al,1995) F. microcarpa is a large glabrous evergreen tree with few aerial roots. Leaves are short- petioled, 5-10cm long, 2-6cm wide and apex shortly and bluntly apiculate or slightly emarginate. Main lateral nerves are not very prominent and stipules are lanceolate. Fruit receptacles are sessile and globose occurring in axillary pairs. It is yellowish when ripe without any characteristic smell. Bark is dark grey or brown with a smooth surface except for the lenticels. Outer bark is corky and crustaceous thin and firmly adherent to inner tissue. Inner bark is light and flesh coloured with firbrous texture (Warrier et al, 1995). It is also equated with many other species of the genus. viz. F. Singh and Chunekar, 1972; Kapoor and Mitra, 1979; Sharma, 1983).The bark contains tannin, wax and saponin. Bark is antibilious. Powdered leaves and bark is found very good in rheumatic headache. The bark and leaves are astringent, refrigerant, acrid and stomachic.3. Ficus benghalensis Linn.Eng: Banyan tree; San: Nyagrodhah, Vatah;Hin: Bat, Bargad;Ben: Bar, Bot; Mar: Vada; Mal: Peral, Vatavriksham;Tam: Alamaram, Peral;Kan: Ala;Tel: Peddamarri;Guj: VadBanyan tree is a laticiferous tree with reddish fruits, which is wound round by aerial adventitious roots that look like many legs. It is found in the Sub-Himalayan tract and Peninsular India. It is also grawn throughout India. It is widely used in treatment of skin diseases with pitta and rakta predominance. Stem-bark, root -bark, aerial roots, leaves, vegetative buds and milky exudate are used in medicine. It improves complexion, cures erysepelas, burning sensation and vaginal disorders, while an infusion of the bark cures dysentery, diarrhoea, leucorrhoea, menorrhagia, nervous disorders and reduces blood sugar in diabetes. A decoction of the vegetative buds in milk is beneficial in haemorrhages. A paste of the leaves is applied externally to abcesses and wounds to promote suppuration, while that of young aerial roots cure pimples. Young twigs when used as a tooth brush strengthen gum and teeth (Nadkarni, 1954; Aiyer and Kolammal, 1957; Mooss,1976). The drug forms an important constituent of formulations like Nalpamaradi Coconut oil, Saribadyasava, Kumkumadi taila, Khadi ra gulika, Valiyacandanadi taila, Candanasava, etc. (Sivarajan et al, 1994). The aerial roots are useful in obstinate vomiting and leucorrhoea and are used in osteomalacia of the limbs. The buds are useful in diarrhoea and dysentery. The latex is useful in neuralgia, rheumatism, lumbago, bruises, nasitis, ulorrhagia, ulitis, odontopathy, haemorrhoids, gonorrhoea, inflammations, cracks of the sole and skin diseases (Warrier et al, 1995).It is a very large tree up to 30m in height with widely spreading branches bearing many aerial roots functioning as prop roots. Bark is greenish white. Leaves are simple, alternate, arranged often in clusters at the ends of branches. They are stipulate, 10-20cm long and 5-12.5cm broad, broadly elliptic to ovate, entire, coriaceous, strongly 3-7 ribbed from the base. The fruit receptacles are axillary, sessile, seen in pairs globose, brick red when ripe and enclosing male, female and gall flowers. Fruits are small, crustaceous, achenes, enclosed in the common fleshy receptacles. The young bark is somewhat smooth with longitudinal and transverse row of lenticels. In older bark, the lenticels are numerous and closely spaced; outer bark easily flakes off. The fresh cut surface is pink or flesh coloured and exudes plenty of latex. The inner most part of the bark adjoining the wood is nearly white and fibrous (Warrier et al, 1995).The bark yields flavanoid compounds A, B and C; A and C are identified as different forms of a leucoanthocyanidin and compound B a leucoanthocyanin. All the 3 were effective as hypoglycaemic agents. Leaves give friedelin, -sitosterol, flavonoids- quercetin-3-galactoside and rutin. Heart wood give tiglic acid ester of taraxasterol. Bark is hypoglycemic, tonic, astringent, antidiarrhoeal and antidiabetic. Latex is antirheumatic. Seed is tonic. Leaf is diaphoretic. Root fibre is antigonorrhoeic. Aerial root is used in debility and anaemic dysentery (Husain et al, 1992)..4. Ficus religiosa Linn.Eng:Peepal tree, Sacred fig; San:Pippalah, Asvatthah; Hin:Pippal, Pipli, Pipar; Mal:ArayalBen: Asvatha;Tam: Arasu, Asvattam;Kan: Aswatha;Tel: Ravi; Mar: Ashvata, PimpalaPeepal tree or Sacred fig is a large deciduous tree with few or no aerial roots. It is common throughout India, often planted in the vicinity of the temples. An aqueous extract of the bark has an antibacterial activity against Staphylococcus aureus and Escherichia coli. It is used in the treatment of gonorrhoea, diarrhoea, dysentery, haemorrhoids and gastrohelcosis. A paste of the powdered bark is a good absorbent for inflammatory swellings. It is also good for burns. Leaves and tender shoots have purgative properties and are also recommended for wounds and skin diseases. Fruits are laxative and digestive. The dried fruit pulverized and taken in water cures asthma. Seeds are refrigerant and laxative. The latex is good for neuralgia, inflammations and haemorrhages (Warrier et al, 1995). Decoction of the bark if taken in honey subdues vatarakta (Nadkarni, 1954; Aiyer and Kolammal, 1957; Mooss, 1976; Kurup et al, 1979). The important preparations using the drug are Nalpamaradi taila, Saribadyasava, Candanasava, Karnasulantaka, Valiyamarma gulika etc (Sivarajan et al, 1994). branches bearing long petioled, ovate, cordate shiny leaves. Leaves are bright green, the apex produced into a linear-lanceolate tail about half as long as the main portion of the blade. The receptacles occurring in pairs and are axillary, depressed globose, smooth and purplish when ripe. The bark is grey or ash coloured with thin or membranous flakes and is often covered with crustose lichen patches. The outer bark is not of uniform thickness, the middle bark in sections appear as brownish or light reddish brown. The inner part consists of layers of light yellowish or orange brown granular tissue (Warrier et al, 1995).Bark gives -sitosterol and its glucoside. Bark is hypoglycaemic. Stem bark is antiprotozoal, anthelmintic and antiviral. Bark is astringent, antigonorrheic, febrifuge, aphrodisiac and antidysenteric. Syconium, leaf and young shoot is purgative (Husain et al, 1992).Agrotechnology: Ficus species can be cultivated in rocky areas, unused lands, or other wastelands of the farmyard. The plant is vegetatively propagated by stem cuttings. A few species are also seed propagated. Stem cuttings of pencil thickness taken from the branches are to be kept for rooting. Rooted cuttings are to be transplanted to prepared pits. No regular manuring is required. Irrigation is not a must as a plant is hardy. The plant is not attacked by any serious pests or diseases. Bark can be collected after 15 years. Ficus species generally has an economic life span of more than hundred years. Hence bark can be regularly collected from the tree. Root, bark, leaves, fruits and latex form the economic parts (Prasad et al,1995).... ficusApoptosis, ?rst identi?ed in 1972, is involved in biological activities including embryonic development, ageing and many diseases. Its importance to the body’s many physiological and pathological processes has only fairly recently been understood, and research into apoptosis is proceeding apace.
In adults, around 10 billion cells die each day
– a ?gure which balances the number of cells arising from the body’s stem-cell populations (see STEM CELL). Thus, the body’s normal HOMEOSTASIS is regulated by apoptosis. As a person ages, apoptopic responses to cell DNA damage may be less e?ectively controlled and so result in more widespread cell destruction, which could be a factor in the onset of degenerative diseases. If, however, apoptopic responses become less sensitive, this might contribute to the uncontrolled multiplication of cells that is typical of cancers. Many diseases are now associated with changed cell survival: AIDS (see AIDS/HIV); ALZHEIMER’S DISEASE and PARKINSONISM; ischaemic damage after coronary thrombosis (see HEART, DISEASES OF) and STROKE; thyroid diseases (see THYROID GLAND, DISEASES OF); and AUTOIMMUNE DISORDERS. Some cancers, autoimmune disorders and viral infections are associated with reduced or inhibited apoptosis. Anticancer drugs, GAMMA RAYS and ULTRAVIOLET RAYS (UVR) initiate apoptosis. Other drugs – for example, NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) – alter the process of apoptosis. Research is in train to harness new knowledge about apoptosis for the development of new treatments and modi?cations of existing ones for serious disorders such as cancer and degenerative nervous diseases.... apoptosis
Habitat: Native to Malaysia; cultivated throughout the warmer parts of India, especially in Kerala.
English: Carambola, Star Fruit, Chinese Gooseberry.Ayurvedic: Karmaranga.Unani: Khamraq, Karmal.Siddha/Tamil: Tamarattai.Folk: Kamarakh.Action: Root—antidote in poisoning. Leaf and shoot—applied externally in ringworm, scabies, chickenpox. Flower—vermicidal. Fruit—laxative, antidysenteric, antiphlogistic, febrifuge, anti- inflammatory, antispasmodic (used in hepatic colic, bleeding piles). Seeds—galactogenic; in large doses act as an emmenagogue and cause abortion.
The fruits are a fairly good source of iron but deficient in calcium. They also contain oxalic acid and potassium oxalate. The presence of fluorine is also reported. A wide variation of vitamin-C content (0.3-23.0 mg/100 g) is recorded from different places in India. Sugar (3.19%) consists mainly of glucose (1.63%).... averrhoa carambolaDisposable lenses are soft lenses designed to be thrown away after a short period of continuous use; their popularity rests on the fact that they need not be cleaned. The instructions on use should be followed carefully because the risk of complications, such as corneal infection, are higher than with other types of contact lenses.
Contraindications to the use of contact lenses include a history of ATOPY, ‘dry eyes’, previous GLAUCOMA surgery and a person’s inability to cope with the management of lenses. The best way to determine whether contact lenses are suitable, however, may be to try them out. Good hygiene is essential for wearers so as to minimise the risk of infection, which may lead to a corneal abscess – a serious complication. Corneal abrasions are fairly common and, if a contact-lens wearer develops a red eye, the lens should be removed and the eye tested with ?uorescein dye to identify any abrasions. Appropriate treatment should be given and the lens not worn again until the abrasion or infection has cleared up.... contact lenses
The outer coat consists of the sclera and the cornea; their junction is called the limbus. SCLERA This is white, opaque, and constitutes the posterior ?ve-sixths of the outer coat. It is made of dense ?brous tissue. The sclera is visible anteriorly, between the eyelids, as the ‘white of the eye’. Posteriorly and anteriorly it is covered by Tenons capsule, which in turn is covered by transparent conjunctiva. There is a hole in the sclera through which nerve ?bres from the retina leave the eye in the optic nerve. Other smaller nerve ?bres and blood vessels also pass through the sclera at di?erent points. CORNEA This constitutes the transparent, colourless anterior one-sixth of the eye. It is transparent in order to allow light into the eye and is more steeply curved than the sclera. Viewed from in front, the cornea is roughly circular. Most of the focusing power of the eye is provided by the cornea (the lens acts as the ‘?ne adjustment’). It has an outer epithelium, a central stroma and an inner endothelium. The cornea is supplied with very ?ne nerve ?bres which make it exquisitely sensitive to pain. The central cornea has no blood supply – it relies mainly on aqueous humour for nutrition. Blood vessels and large nerve ?bres in the cornea would prevent light from entering the eye. LIMBUS is the junction between cornea and sclera. It contains the trabecular meshwork, a sieve-like structure through which aqueous humour leaves the eye.
The middle coat (uveal tract) consists of the choroid, ciliary body and iris. CHOROID A highly vascular sheet of tissue lining the posterior two-thirds of the sclera. The network of vessels provides the blood supply for the outer half of the retina. The blood supply of the choroid is derived from numerous ciliary vessels which pierce the sclera in front and behind. CILIARY BODY A ring of tissue extending 6 mm back from the anterior limitation of the sclera. The various muscles of the ciliary body by their contractions and relaxations are responsible for changing the shape of the lens during ACCOMMODATION. The ciliary body is lined by cells that secrete aqueous humour. Posteriorly, the ciliary body is continuous with the choroid; anteriorly it is continuous with the iris. IRIS A ?attened muscular diaphragm that is attached at its periphery to the ciliary body, and has a round central opening – the pupil. By contraction and relaxation of the muscles of the iris, the pupil can be dilated or constricted (dilated in the dark or when aroused; constricted in bright light and for close work). The iris forms a partial division between the anterior chamber and the posterior chamber of the eye. It lies in front of the lens and forms the back wall of the anterior chamber. The iris is visible from in front, through the transparent cornea, as the ‘coloured part of the eye’. The amount and distribution of iris pigment determine the colour of the iris. The pupil is merely a hole in the centre of the iris and appears black.
The inner layer The retina is a multilayered tissue (ten layers in all) which extends from the edges of the optic nerve to line the inner surface of the choroid up to the junction of ciliary body and choroid. Here the true retina ends at the ora serrata. The retina contains light-sensitive cells of two types: (i) cones – cells that operate at high and medium levels of illumination; they subserve ?ne discrimination of vision and colour vision; (ii) rods – cells that function best at low light intensity and subserve black-and-white vision.
The retina contains about 6 million cones and about 100 million rods. Information from them is conveyed by the nerve ?bres which are in the inner part of the retina, and leave the eye in the optic nerve. There are no photoreceptors at the optic disc (the point where the optic nerve leaves the eye) and therefore there is no light perception from this small area. The optic disc thus produces a physiological blind spot in the visual ?eld.
The retina can be subdivided into several areas: PERIPHERAL RETINA contains mainly rods and a few scattered cones. Visual acuity from this area is fairly coarse. MACULA LUTEA So-called because histologically it looks like a yellow spot. It occupies an area 4·5 mm in diameter lateral to the optic disc. This area of specialised retina can produce a high level of visual acuity. Cones are abundant here but there are few rods. FOVEA CENTRALIS A small central depression at the centre of the macula. Here the cones are tightly packed; rods are absent. It is responsible for the highest levels of visual acuity.
The chambers of the eye There are three: the anterior and posterior chambers, and the vitreous cavity. ANTERIOR CHAMBER Limited in front by the inner surface of the cornea, behind by the iris and pupil. It contains a transparent clear watery ?uid, the aqueous humour. This is constantly being produced by cells of the ciliary body and constantly drained away through the trabecular meshwork. The trabecular meshwork lies in the angle between the iris and inner surface of the cornea. POSTERIOR CHAMBER A narrow space between the iris and pupil in front and the lens behind. It too contains aqueous humour in transit from the ciliary epithelium to the anterior chamber, via the pupil. VITREOUS CAVITY The largest cavity of the eye. In front it is bounded by the lens and behind by the retina. It contains vitreous humour.
Lens Transparent, elastic and biconvex in cross-section, it lies behind the iris and in front of the vitreous cavity. Viewed from the front it is roughly circular and about 10 mm in diameter. The diameter and thickness of the lens vary with its accommodative state. The lens consists of: CAPSULE A thin transparent membrane surrounding the cortex and nucleus. CORTEX This comprises newly made lens ?bres that are relatively soft. It separates the capsule on the outside from the nucleus at the centre of the lens. NUCLEUS The dense central area of old lens ?bres that have become compacted by new lens ?bres laid down over them. ZONULE Numerous radially arranged ?bres attached between the ciliary body and the lens around its circumference. Tension in these zonular ?bres can be adjusted by the muscles of the ciliary body, thus changing the shape of the lens and altering its power of accommodation. VITREOUS HUMOUR A transparent jelly-like structure made up of a network of collagen ?bres suspended in a viscid ?uid. Its shape conforms to that of the vitreous cavity within which it is contained: that is, it is spherical except for a shallow concave depression on its anterior surface. The lens lies in this depression.
Eyelids These are multilayered curtains of tissue whose functions include spreading of the tear ?lm over the front of the eye to prevent desiccation; protection from injury or external irritation; and to some extent the control of light entering the eye. Each eye has an upper and lower lid which form an elliptical opening (the palpebral ?ssure) when the eyes are open. The lids meet at the medial canthus and lateral canthus respectively. The inner medial canthus is ?xed; the lateral canthus more mobile. An epicanthus is a fold of skin which covers the medial canthus in oriental races.
Each lid consists of several layers. From front to back they are: very thin skin; a sheet of muscle (orbicularis oculi, whose ?bres are concentric around the palpebral ?ssure and which produce closure of the eyelids); the orbital septum (modi?ed near the lid margin to form the tarsal plates); and ?nally, lining the back surface of the lid, the conjunctiva (known here as tarsal conjunctiva). At the free margin of each lid are the eyelashes, the openings of tear glands which lie within the lid, and the lacrimal punctum. Toward the medial edge of each lid is an elevation known as the papilla: the lacrimal punctum opens into this papilla. The punctum forms the open end of the cannaliculus, part of the tear-drainage mechanism.
Orbit The bony cavity within which the eye is held. The orbits lie one on either side of the nose, on the front of the skull. They a?ord considerable protection for the eye. Each is roughly pyramidal in shape, with the apex pointing backwards and the base forming the open anterior part of the orbit. The bone of the anterior orbital margin is thickened to protect the eye from injury. There are various openings into the posterior part of the orbit – namely the optic canal, which allows the optic nerve to leave the orbit en route for the brain, and the superior orbital and inferior orbital ?ssures, which allow passage of nerves and blood vessels to and from the orbit. The most important structures holding the eye within the orbit are the extra-ocular muscles, a suspensory ligament of connective tissue that forms a hammock on which the eye rests and which is slung between the medial and lateral walls of the orbit. Finally, the orbital septum, a sheet of connective tissue extending from the anterior margin of the orbit into the lids, helps keep the eye in place. A pad of fat ?lls in the orbit behind the eye and acts as a cushion for the eye.
Conjunctiva A transparent mucous membrane that extends from the limbus over the anterior sclera or ‘white of the eye’. This is the bulbar conjunctiva. The conjunctiva does not cover the cornea. Conjunctiva passes from the eye on to the inner surface of the eyelid at the fornices and is continuous with the tarsal conjunctiva. The semilunar fold is the vertical crescent of conjunctiva at the medial aspect of the palpebral ?ssure. The caruncle is a piece of modi?ed skin just within the inner canthus.
Eye muscles The extra-ocular muscles. There are six in all, the four rectus muscles (superior, inferior, medial and lateral rectus muscles) and two oblique muscles (superior and inferior oblique muscles). The muscles are attached at various points between the bony orbit and the eyeball. By their combined action they move the eye in horizontal and vertical gaze. They also produce torsional movement of the eye (i.e. clockwise or anticlockwise movements when viewed from the front).
Lacrimal apparatus There are two components: a tear-production system, namely the lacrimal gland and accessory lacrimal glands; and a drainage system.
Tears keep the front of the eye moist; they also contain nutrients and various components to protect the eye from infection. Crying results from excess tear production. The drainage system cannot cope with the excess and therefore tears over?ow on to the face. Newborn babies do not produce tears for the ?rst three months of life. LACRIMAL GLAND Located below a small depression in the bony roof of the orbit. Numerous tear ducts open from it into predominantly the upper lid. Accessory lacrimal glands are found in the conjunctiva and within the eyelids: the former open directly on to the surface of the conjunctiva; the latter on to the eyelid margin. LACRIMAL DRAINAGE SYSTEM This consists of: PUNCTUM An elevated opening toward the medial aspect of each lid. Each punctum opens into a canaliculus. CANALICULUS A ?ne tube-like structure run-ning within the lid, parallel to the lid margin. The canaliculi from upper and lower lid join to form a common canaliculus which opens into the lacrimal sac. LACRIMAL SAC A small sac on the side of the nose which opens into the nasolacrimal duct. During blinking, the sac sucks tears into itself from the canaliculus. Tears then drain by gravity down the nasolacrimal duct. NASOLACRIMAL DUCT A tubular structure which runs down through the wall of the nose and opens into the nasal cavity.
Visual pathway Light stimulates the rods and cones of the retina. Electrochemical messages are then passed to nerve ?bres in the retina and then via the optic nerve to the optic chiasm. Here information from the temporal (outer) half of each retina continues to the same side of the brain. Information from the nasal (inner) half of each retina crosses to the other side within the optic chiasm. The rearranged nerve ?bres then pass through the optic tract to the lateral geniculate body, then the optic radiation to reach the visual cortex in the occipital lobe of the brain.... eye
Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low (fresh or dried fruit) High (dried fruit treated with sodium sulfur compounds) Major vitamin contribution: Vitamin A Major mineral contribution: Iron
About the Nutrients in This Food Apricots are a good source of dietary fiber with insoluble cellulose and lignin in the skin and soluble pectins in the flesh. The apricot’s creamy golden color comes from deep yellow carotenes (including beta-carotene) that make the fruit a good source of vitamin A. Apricots also have vitamin C and iron. One apricot has 0.7 g dietary fiber, 674 IU vitamin A (21 percent of the R DA for a woman, 23 percent of the R DA for a man), and 3.5 mg vitamin C (5 percent of the R DA for a woman, 4 percent of the R DA for a man). Two dried apricot halves provide 0.6 g dietary fiber, 252 IU vitamin A (11 percent of the R DA for a woman, 8 percent of the R DA for a man), no vitamin C, and 2 mg iron (11 percent of the R DA for a woman, 25 percent of the R DA for a man). The bark, leaves, and inner stony pit of the apricot all contain amyg- dalin, a naturally occurring compound that degrades to release hydrogen cyanide (prussic acid) in your stomach. Apricot oil, treated during processing to remove the cyanide, is marked FFPA to show that it is “free from prussic acid.” Cases of fatal poisoning from apricot pits have been reported, including one in a three-year-old girl who ate 15 apricot kernels (the seed inside the pit). Extract of apricot pits, known medically as Laetrile, has been used by some alternative practitioners to treat cancer on the theory that the cyanide in amygdalin is released only when it comes in contact with beta-glucuronidase, an enzyme common to tumor cells. Scientifically designed tests of amygdalin have not shown this to be true. Laetrile is illegal in the United States.
The Most Nutritious Way to Serve This Food Ounce for ounce, dried apricots are richer in nutrients and fiber than fresh ones.
Diets That May Restrict or Exclude This Food Low-fiber diet Low-potassium diet Low-sodium diet (dried apricots containing sodium sulfide)
Buying This Food Look for: Firm, plump orange fruit that gives slightly when you press with your thumb. Avoid: Bruised apricots. Like apples and potatoes, apricots contain polyphenoloxidase, an enzyme that combines with phenols in the apricots to produce brownish pigments that discolor the fruit. When apricots are bruised, cells are broken, releasing the enzyme so that brown spots form under the bruise. Avoid apricots that are hard or mushy or withered; all are less flavorsome than ripe, firm apricots, and the withered ones will decay quickly. Avoid greenish apricots; they are low in carotenes and will never ripen satisfactorily at home.
Storing This Food Store ripe apricots in the refrigerator and use them within a few days. Apricots do not lose their vitamin A in storage, but they are very perishable and rot fairly quickly.
Preparing This Food When you peel or slice an apricot, you tear its cells walls, releasing polyphenoloxidase, an enzyme that reacts with phenols in the apricots, producing brown compounds that darken the fruit. Acids inactivate polyphenoloxidase, so you can slow down this reaction (but not stop it completely) by dipping raw sliced and/or peeled apricots into a solution of lemon juice or vinegar and water or by mixing them with citrus fruits in a fruit salad. Polyphenoloxidase also works more slowly in the cold, but storing peeled apricots in the refrigerator is much less effective than an acid bath. To peel apricots easily, drop them into boiling water for a minute or two, then lift them out with a slotted spoon and plunge them into cold water. As with tomatoes, this works because the change in temperature damages a layer of cells under the skin so the skin slips off easily.
What Happens When You Cook This Food Cooking dissolves pectin, the primary fiber in apricots, and softens the fruit. But it does not change the color or lower the vitamin A content because carotenes are impervious to the heat of normal cooking.
How Other Kinds of Processing Affect This Food Juice. Since 2000, following several deaths attributed to unpasteurized apple juice contami- nated with E. coli O157:H7, the FDA has required that all juices sold in the United States be pasteurized to inactivate harmful organisms such as bacteria and mold. Drying. Five pounds of fresh apricots produce only a pound of dried ones. Drying removes water, not nutrients; ounce for ounce, dried apricots have 12 times the iron, seven times the fiber, and five times the vitamin A of the fresh fruit. Three and a half ounces of dried apricots provide 12,700 IU vitamin A, two and a half times the full daily requirement for a healthy adult man, and 6.3 mg of iron, one-third the daily requirement for an adult woman. In some studies with laboratory animals, dried apricots have been as effective as liver, kidneys, and eggs in treating iron-deficiency anemia. To keep them from turning brown as they dry, apricots may be treated with sulfur dioxide. This chemical may cause serious allergic reactions, including anaphylactic shock, in people who are sensitive to sulfites.
Medical Uses and/or Benefits * * *
Adverse Effects Associated with This Food Sulfite allergies. See How other kinds of processing affect this food.
Food/Drug Interactions * * *... apricots
Bone fractures These occur when there is a break in the continuity of the bone. This happens either as a result of violence or because the bone is unhealthy and unable to withstand normal stresses.
SIMPLE FRACTURES Fractures where the skin remains intact or merely grazed. COMPOUND FRACTURES have at least one wound which is in communication with the fracture, meaning that bacteria can enter the fracture site and cause infection. A compound fracture is also more serious than a simple fracture because there is greater potential for blood loss. Compound fractures usually need hospital admission, antibiotics and careful reduction of the fracture. Debridement (cleaning and excising dead tissue) in a sterile theatre may also be necessary.
The type of fracture depends on the force which has caused it. Direct violence occurs when an object hits the bone, often causing a transverse break – which means the break runs horizontally across the bone. Indirect violence occurs when a twisting injury to the ankle, for example, breaks the calf-bone (the tibia) higher up. The break may be more oblique. A fall on the outstretched hand may cause a break at the wrist, in the humerus or at the collar-bone depending on the force of impact and age of the person. FATIGUE FRACTURES These occur after the bone has been under recurrent stress. A typical example is the march fracture of the second toe, from which army recruits suffer after long marches. PATHOLOGICAL FRACTURES These occur in bone which is already diseased – for example, by osteoporosis (see below) in post-menopausal women. Such fractures are typically crush fractures of the vertebrae, fractures of the neck of the femur, and COLLES’ FRACTURE (of the wrist). Pathological fractures also occur in bone which has secondary-tumour deposits. GREENSTICK FRACTURES These occur in young children whose bones are soft and bend, rather than break, in response to stress. The bone tends to buckle on the side opposite to the force. Greenstick fractures heal quickly but still need any deformity corrected and plaster of Paris to maintain the correction. COMPLICATED FRACTURES These involve damage to important soft tissue such as nerves, blood vessels or internal organs. In these cases the soft-tissue damage needs as much attention as the fracture site. COMMINUTED FRACTURES A fracture with more than two fragments. It usually means that the injury was more violent and that there is more risk of damage to vessels and nerves. These fractures are unstable and take longer to unite. Rehabilitation tends to be protracted. DEPRESSED FRACTURES Most commonly found in skull fractures. A fragment of bone is forced inwards so that it lies lower than the level of the bone surrounding it. It may damage the brain beneath it.
HAIR-LINE FRACTURES These occur when the bone is broken but the force has not been severe enough to cause visible displacement. These fractures may be easily missed. Symptoms and signs The fracture site is usually painful, swollen and deformed. There is asymmetry of contour between limbs. The limb is held uselessly. If the fracture is in the upper
limb, the arm is usually supported by the patient; if it is in the lower limb then the patient is not able to bear weight on it. The limb may appear short because of muscle spasm.
Examination may reveal crepitus – a bony grating – at the fracture site. The diagnosis is con?rmed by radiography.
Treatment Healing of fractures (union) begins with the bruise around the fracture being resorbed and new bone-producing cells and blood vessels migrating into the area. Within a couple of days they form a bridge of primitive bone across the fracture. This is called callus.
The callus is replaced by woven bone which gradually matures as the new bone remodels itself. Treatment of fractures is designed to ensure that this process occurs with minimal residual deformity to the bone involved.
Treatment is initially to relieve pain and may involve temporary splinting of the fracture site. Reducing the fracture means restoring the bones to their normal position; this is particularly important at the site of joints where any small displacement may limit movement considerably.
with plaster of Paris. If closed traction does not work, then open reduction of the fracture may
be needed. This may involve ?xing the fracture with internal-?xation methods, using metal plates, wires or screws to hold the fracture site in a rigid position with the two ends closely opposed. This allows early mobilisation after fractures and speeds return to normal use.
External ?xators are usually metal devices applied to the outside of the limb to support the fracture site. They are useful in compound fractures where internal ?xators are at risk of becoming infected.
Consolidation of a fracture means that repair is complete. The time taken for this depends on the age of the patient, the bone and the type of fracture. A wrist fracture may take six weeks, a femoral fracture three to six months in an adult.
Complications of fractures are fairly common. In non-union, the fracture does not unite
– usually because there has been too much mobility around the fracture site. Treatment may involve internal ?xation (see above). Malunion means that the bone has healed with a persistent deformity and the adjacent joint may then develop early osteoarthritis.
Myositis ossi?cans may occur at the elbow after a fracture. A big mass of calci?ed material develops around the fracture site which restricts elbow movements. Late surgical removal (after 6–12 months) is recommended.
Fractured neck of FEMUR typically affects elderly women after a trivial injury. The bone is usually osteoporotic. The leg appears short and is rotated outwards. Usually the patient is unable to put any weight on the affected leg and is in extreme pain. The fractures are classi?ed according to where they occur:
subcapital where the neck joins the head of the femur.
intertrochanteric through the trochanter.
subtrochanteric transversely through the upper end of the femur (rare). Most of these fractures of the neck of femur
need ?xing by metal plates or hip replacements, as immobility in this age group has a mortality of nearly 100 per cent. Fractures of the femur shaft are usually the result of severe trauma such as a road accident. Treatment may be conservative or operative.
In fractures of the SPINAL COLUMN, mere damage to the bone – as in the case of the so-called compression fracture, in which there is no damage to the spinal cord – is not necessarily serious. If, however, the spinal cord is damaged, as in the so-called fracture dislocation, the accident may be a very serious one, the usual result being paralysis of the parts of the body below the level of the injury. Therefore the higher up the spine is fractured, the more serious the consequences. The injured person should not be moved until skilled assistance is at hand; or, if he or she must be removed, this should be done on a rigid shutter or door, not on a canvas stretcher or rug, and there should be no lifting which necessitates bending of the back. In such an injury an operation designed to remove a displaced piece of bone and free the spinal cord from pressure is often necessary and successful in relieving the paralysis. DISLOCATIONS or SUBLUXATION of the spine are not uncommon in certain sports, particularly rugby. Anyone who has had such an injury in the cervical spine (i.e. in the neck) should be strongly advised not to return to any form of body-contact or vehicular sport.
Simple ?ssured fractures and depressed fractures of the skull often follow blows or falls on the head, and may not be serious, though there is always a risk of damage which is potentially serious to the brain at the same time.
Compound fractures may result in infection within the skull, and if the skull is extensively broken and depressed, surgery is usually required to check any intercranial bleeding or to relieve pressure on the brain.
The lower jaw is often fractured by a blow on the face. There is generally bleeding from the mouth, the gum being torn. Also there are pain and grating sensations on chewing, and unevenness in the line of the teeth. The treatment is simple, the line of teeth in the upper jaw forming a splint against which the lower jaw is bound, with the mouth closed.
Congenital diseases These are rare but may produce certain types of dwar?sm or a susceptibility to fractures (osteogenesis imperfecta).
Infection of bone (osteomyelitis) may occur after an open fracture, or in newborn babies with SEPTICAEMIA. Once established it is very di?cult to eradicate. The bacteria appear capable of lying dormant in the bone and are not easily destroyed with antibiotics so that prolonged treatment is required, as might be surgical drainage, exploration or removal of dead bone. The infection may become chronic or recur.
Osteomalacia (rickets) is the loss of mineralisation of the bone rather than simple loss of bone mass. It is caused by vitamin D de?ciency and is probably the most important bone disease in the developing world. In sunlight the skin can synthesise vitamin D (see APPENDIX 5: VITAMINS), but normally rickets is caused by a poor diet, or by a failure to absorb food normally (malabsorbtion). In rare cases vitamin D cannot be converted to its active state due to the congenital lack of the speci?c enzymes and the rickets will fail to respond to treatment with vitamin D. Malfunction of the parathyroid gland or of the kidneys can disturb the dynamic equilibrium of calcium and phosphate in the body and severely deplete the bone of its stores of both calcium and phosphate.
Osteoporosis A metabolic bone disease resulting from low bone mass (osteopenia) due to excessive bone resorption. Su?erers are prone to bone fractures from relatively minor trauma. With bone densitometry it is now possible to determine individuals’ risk of osteoporosis and monitor their response to treatment.
By the age of 90 one in two women and one in six men are likely to sustain an osteoporosis-related fracture. The incidence of fractures is increasing more than would be expected from the ageing of the population, which may re?ect changing patterns of exercise or diet.
Osteoporosis may be classi?ed as primary or secondary. Primary consists of type 1 osteoporosis, due to accelerated trabecular bone loss, probably as a result of OESTROGENS de?ciency. This typically leads to crush fractures of vertebral bodies and fractures of the distal forearm in women in their 60s and 70s. Type 2 osteoporosis, by contrast, results from the slower age-related cortical and travecular bone loss that occurs in both sexes. It typically leads to fractures of the proximal femur in elderly people.
Secondary osteoporosis accounts for about 20 per cent of cases in women and 40 per cent of cases in men. Subgroups include endocrine (thyrotoxicosis – see under THYROID GLAND, DISEASES OF, primary HYPERPARATHYROIDISM, CUSHING’S SYNDROME and HYPOGONADISM); gastrointestinal (malabsorption syndrome, e.g. COELIAC DISEASE, or liver disease, e.g. primary biliary CIRRHOSIS); rheumatological (RHEUMATOID ARTHRITIS or ANKYLOSING SPONDYLITIS); malignancy (multiple MYELOMA or metastatic CARCINOMA); and drugs (CORTICOSTEROIDS, HEPARIN). Additional risk factors for osteoporosis include smoking, high alcohol intake, physical inactivity, thin body-type and heredity.
Individuals at risk of osteopenia, or with an osteoporosis-related fracture, need investigation with spinal radiography and bone densitometry. A small fall in bone density results in a large increase in the risk of fracture, which has important implications for preventing and treating osteoporosis.
Treatment Antiresorptive drugs: hormone replacement therapy – also valuable in treating menopausal symptoms; treatment for at least ?ve years is necessary, and prolonged use may increase risk of breast cancer. Cyclical oral administration of disodium etidronate – one of the bisphosphonate group of drugs – with calcium carbonate is also used (poor absorption means the etidronate must be taken on an empty stomach). Calcitonin – currently available as a subcutaneous injection; a nasal preparation with better tolerance is being developed. Calcium (1,000 mg daily) seems useful in older patients, although probably ine?ective in perimenopausal women, and it is a safe preparation. Vitamin D and calcium – recent evidence suggests value for elderly patients. Anabolic steroids, though androgenic side-effects (masculinisation) make these unacceptable for most women.
With established osteoporosis, the aim of treatment is to relieve pain (with analgesics and physical measures, e.g. lumbar support) and reduce the risk of further fractures: improvement of bone mass, the prevention of falls, and general physiotherapy, encouraging a healthier lifestyle with more daily exercise.
Further information is available from the National Osteoporosis Society.
Paget’s disease (see also separate entry) is a common disease of bone in the elderly, caused by overactivity of the osteoclasts (cells concerned with removal of old bone, before new bone is laid down by osteoblasts). The bone affected thickens and bows and may become painful. Treatment with calcitonin and bisphosphonates may slow down the osteoclasts, and so hinder the course of the disease, but there is no cure.
If bone loses its blood supply (avascular necrosis) it eventually fractures or collapses. If the blood supply does not return, bone’s normal capacity for healing is severely impaired.
For the following diseases see separate articles: RICKETS; ACROMEGALY; OSTEOMALACIA; OSTEOGENESIS IMPERFECTA.
Tumours of bone These can be benign (non-cancerous) or malignant (cancerous). Primary bone tumours are rare, but secondaries from carcinoma of the breast, prostate and kidneys are relatively common. They may form cavities in a bone, weakening it until it breaks under normal load (a pathological fracture). The bone eroded away by the tumour may also cause problems by causing high levels of calcium in the plasma.
EWING’S TUMOUR is a malignant growth affecting long bones, particularly the tibia (calfbone). The presenting symptoms are a throbbing pain in the limb and a high temperature. Treatment is combined surgery, radiotherapy and chemotherapy.
MYELOMA is a generalised malignant disease of blood cells which produces tumours in bones which have red bone marrow, such as the skull and trunk bones. These tumours can cause pathological fractures.
OSTEOID OSTEOMA is a harmless small growth which can occur in any bone. Its pain is typically removed by aspirin.
OSTEOSARCOMA is a malignant tumour of bone with a peak incidence between the ages of ten and 20. It typically involves the knees, causing a warm tender swelling. Removal of the growth with bone conservation techniques can often replace amputation as the de?nitive treatment. Chemotherapy can improve long-term survival.... bone, disorders of
The imaging systems of COMPUTED TOMOGRAPHY (CT) and magnetic resonance imaging (see MRI) have powerful computer techniques underlying them.
Computerised statistical analysis of study data, population databases and disease registries is now routine, leading to enhanced understanding of the interplay between diseases and the population. And the results of research, available on computerised indexes such as MEDLINE, can be obtained in searches that take only seconds, compared with the hours or days necessary to accomplish the same task with its paper incarnation, Index Medicus.
Medical informatics The direct computerisation of those activities which are uniquely medical – history-taking, examination, diagnosis and treatment – has proved an elusive goal, although one hotly pursued by doctors, engineers and scientists working in the discipline of medical informatics. Computer techniques have scored some successes: patients are, for example, more willing to be honest about taboo areas, such as their drug or alcohol consumption, or their sexual proclivities, with a computer than face to face with a clinician; however, the practice of taking a history remains the cornerstone of clinical practice. The examination of the patient is unlikely to be supplanted by technological means in the foreseeable future; visual and tactile recognition systems are still in their infancy. Skilled interpretation of the result by machine rather than the human mind seems equally as remote. Working its way slowly outwards from its starting point in mathematical logic, ARTIFICIAL INTELLIGENCE that in any way mimics its natural counterpart seems a distant prospect. Although there have been successes in computer-supported diagnosis in some specialised areas, such as the diagnosis of abdominal pain, workable systems that could supplant the mind of the generalist are still the dream of the many developers pursuing this goal, rather than a reality available to doctors in their consulting rooms now.
In therapeutics, computerised prescribing systems still require the doctor to make the decision about treatment, but facilitate the process of writing, issuing, and recording the prescription. In so doing, the system can provide automated checks, warning if necessary about allergies, potential drug interactions, or dosing errors. The built-in safety that this process o?ers is enhanced by the superior legibility of the script that ensues, reducing the potential for error when the medicine is dispensed by the nurse or the pharmacist.
Success in these individual applications continues to drive development, although the process has its critics, who are not slow to point to the lengthier consultations that arise when a computer is present in the consulting room and its distracting e?ect on communication with the patient.
Underlying these many software applications lies the ubiquitous personal computer – more powerful today than its mainframe predecessor of only 20 years ago – combined with networking technology that enables interconnection and the sharing of data. As in essence the doctor’s role involves the acquisition, manipulation and application of information – from the individual patient, and from the body of medical knowledge – great excitement surrounds the development of open systems that allow di?erent software and hardware platforms to interact. Many problems remain to be solved, not least the fact that for such systems to work, the whole organisation, and not just a few specialised individuals, must become computer literate. Such systems must be easy to learn to use, which requires an intuitive interface between user(s) and system(s) that is predictable and logical in its ordering and presentation of information.
Many other issues stand in the way of the development towards computerisation: standard systems of nomenclature for medical concepts have proved surprisingly di?cult to develop, but are crucial for successful information-sharing between users. Sharing information between existing legacy systems is a major challenge, often requiring customised software and extensive human intervention to enable the previous investments that an organisation has made in individual systems (e.g. laboratory-result reporting) to be integrated with newer technology. The beginnings of a global solution to this substantial obstacle to networking progress is in sight: the technology that enables the Internet – an international network of telephonically linked personal computers – also enables the establishment of intranets, in which individual servers (computers dedicated to serving information to other computers) act as repositories of ‘published’ data, which other users on the network may ‘browse’ as necessary in a client-server environment.
Systems that support this process are still in early stages of development, but the key conceptualisations are in place. Developments over the next 5–10 years will centre on the electronic patient record available to the clinician on an integrated clinical workstation. The clinical workstation – in essence a personal computer networked to the hospital or practice system – will enable the clinician to record clinical data and diagnoses, automate the ordering of investigations and the collection of the results, and facilitate referral and communication between the many professionals and departments involved in any individual patient’s care.
Once data is digitised – and that includes text, statistical tables, graphs, illustrations and radiological images, etc. – it may be as freely networked globally as locally. Consultations in which live video and sound transmissions are the bonds of the doctor-patient relationship (the techniques of telemedicine) are already reality, and have proved particularly convenient and cost-e?ective in linking the patient and the generalist to specialists in remote areas with low population density.
As with written personal medical records, con?dentiality of personal medical information on computers is essential. Computerised data are covered by the Data Protection Act 1984. This stipulates that data must:
be obtained and processed fairly and lawfully.
be held only for speci?ed lawful purposes.
•not be used in a manner incompatible with those purposes.
•only be recorded where necessary for these purposes.
be accurate and up to date.
not be stored longer than necessary.
be made available to the patient on request.
be protected by appropriate security and backup procedures. As these problems are solved, concerns about
privacy and con?dentiality arise. While paper records were often only con?dential by default, the potential for breaches of security in computerised networks is much graver. External breaches of the system by hackers are one serious concern, but internal breaches by authorised users making unauthorised use of the data are a much greater risk in practice. Governing network security so that clinical users have access on a need-to-know basis is a di?cult business: the software tools to enable this – encryption, and anonymisation (ensuring that clinical information about patients is anonymous to prevent con?dential information about them leaking out) of data collected for management and research processes – exist in the technical domain but remain a complex conundrum for solution in the real world.
The mushroom growth of websites covering myriad subjects has, of course, included health information. This ranges from clinical details on individual diseases to facts about medical organisations and institutes, patient support groups, etc. Some of this information contains comments and advice from orthodox and unorthodox practitioners. This open access to health information has been of great bene?t to patients and health professionals. But web browsers should be aware that not all the medical information, including suggested treatments, has been subject to PEER REVIEW, as is the case with most medical articles in recognised medical journals.... information technology in medicine
Habitat: Indigenous to West Asia and North Africa; occurring scattered from Punjab to Nilgiri hills as a grass-like sedge. English: Earth Almond, Chufa, Rush Nut, Tiger Nut. (Tuber is called Nut.) Ayurvedic: Chichoda.Folk: Chichodaa, Kaseru (Punjab). Also equated with Naagaramustaka.
Action: A digestive tonic (used for indigestion, flatulence, colic, diarrhoea, dysentery); promotes diuresis and menstruation. The juice is taken for treating ulcers of the mouth and gums.Tiger Nut is used in debility and as a nervine tonic due to its high crude lipid and carbohydrate contents and fairly good essential amino acid composition.... cyperus esculentus
Retention cysts In these, in consequence of irritation or another cause, some cavity which ought naturally to contain a little ?uid becomes distended, or the natural outlet from the cavity becomes blocked. Wens are caused by the blockage of the outlet from sebaceous glands in the skin, so that an accumulation of fatty matter takes place. RANULA is a clear swelling under the tongue, due to a collection of saliva in consequence of an obstruction to a salivary duct. Cysts in the breasts are, in many cases, the result of blockage in milk ducts, due to in?ammation; they should be assessed to exclude cancer (see BREASTS, DISEASES OF). Cysts also form in the kidney as a result of obstruction to the free out?ow of the urine.
Developmental cysts Of these, the most important are the huge cysts that originate in the OVARIES. The cause is doubtful, but the cyst probably begins at a very early period of life, gradually enlarges, and buds o? smaller cysts from its wall. The contents are usually a clear gelatinous ?uid. Very often both ovaries are affected, and the cysts may slowly reach a great size – often, however, taking a lifetime to do so.
A similar condition sometimes occurs in the KIDNEYS, and the tumour may have reached a great size in an infant even before birth (congenital cystic kidney).
Dermoid cysts are small cavities, which also originate probably early in life, but do not reach any great size until fairly late in life. They appear about parts of the body where clefts occur in the embryo and close up before birth, such as the corner of the eyes, the side of the neck, and the middle line of the body. They contain hair, fatty matter, fragments of bone, scraps of skin, even numerous teeth.
Hydatid cysts are produced in many organs, particularly in the liver, by a parasite which is the larval stage of a tapeworm found in dogs. They occur in people who keep dogs and allow them to contaminate their food. (See TAENIASIS.)... cysts
Habitat: Mild climatic regions of south and central Europe, north Africa and West Asia. C. scoparius is fairly common in and around Oatacmund (Nilgiris) and is found wild as a garden escape. It grows also in Simla and neighbouring places. An allied species, C. monspessulanus Linn., White Broom, also occurs in the Nilgiri hills.
English: Broom, Scotch Broom, Yellow Broom.Folk: Broom.Action: Green twigs of the plant, collected before flowering, either fresh or after drying, are used as diuretic and cathartic. Emetic in large doses. The seeds are also used similarly. The herb is used chiefly in the form of sulphate in tachycardia and functional palpitation. (The action of the whole plant is stated to be different from that of isolated alkaloids.) The whole herb has been used to treat tumours.
Key application: For functional heart and circulatory disorders. Aqueous-ethanolic extracts are used internally. Simultaneous administration of MAO-inhibitors contraindicated due to the tyramine content. (German Commission E.) The British Herbal Pharmacopoeia reported antiarrhythmic and diuretic action of the herb.The herb contains quinolizidine alkaloids; main alkaloids are (-)-spar- teine, lupanine, ammodendrine and various derivatives; biogenic amines, including tryramine, epinine, dopa- mine; isoflavone glycosides including genistein, scoparin; flavonoids; essential oil; caffeic acid and p-coumaric acids; tannins. Seeds contain lectins (phytohaemagglutinins).The herb contains over 2% tyramine. Tyramine acts as an indirect sympa- thomimetic, vasoconstrictive and hy- potensive.The herb is contraindicated in high blood pressure, A-V block and pregnancy.Scoparin's action on renal mucous membrane is similar to that of Buchu and Uva-ursi. (A decoction or infusion of broom is used in dropsical complaints of cardiac origin.)Sparteine produces a transient rise in arterial pressure followed by a longer period of decreased vascular tension (contradictory observations have been recorded). Some researchers are of the opinion that sparteine is a regulator in chronic vulvar disease. It showed no cumulative action like digitalis. In large doses, it is highly toxic and impairs the activity of respiratory organs.C. monopessulanus (a related species) contains. 9% alkaloids.Sparteine is toxic at more than 300 mg dose. (Francis Brinker.)... cytisus scopariusIt must be noted that diseases are not communicated to others by a person who is incubating an illness. Some diseases, however, such as MEASLES, become infectious as soon as the ?rst symptoms set in after the incubation period is over; others, like SCARLET FEVER and SMALLPOX, are not so infectious then as in their later stages. The incubation period for any given disease is remarkably constant, although in the case of a severe attack the incubation is usually slightly shortened, and if the oncoming attack is a mild one, the period may be lengthened. All, however, may take a few days longer than the time stated to show themselves (see INFECTION), and several – especially WHOOPINGCOUGH – may be di?cult to recognise in their early stages.
Incubation periods of the more common infectious diseases:
The fore?nger or second digit of the hand.... incubation
(1) the external ear, consisting of the auricle on the surface of the head, and the tube which leads inwards to the drum; (2) the middle ear, separated from the former by the tympanic membrane or drum, and from the internal ear by two other membranes, but communicating with the throat by the Eustachian tube; and (3) the internal ear, comprising the complicated labyrinth from which runs the vestibulocochlear nerve into the brain.
External ear The auricle or pinna consists of a framework of elastic cartilage covered by skin, the lobule at the lower end being a small mass of fat. From the bottom of the concha the external auditory (or acoustic) meatus runs inwards for 25 mm (1 inch), to end blindly at the drum. The outer half of the passage is surrounded by cartilage, lined by skin, on which are placed ?ne hairs pointing outwards, and glands secreting a small amount of wax. In the inner half, the skin is smooth and lies directly upon the temporal bone, in the substance of which the whole hearing apparatus is enclosed.
Middle ear The tympanic membrane, forming the drum, is stretched completely across the end of the passage. It is about 8 mm (one-third of an inch) across, very thin, and white or pale pink in colour, so that it is partly transparent and some of the contents of the middle ear shine through it. The cavity of the middle ear is about 8 mm (one-third of an inch) wide and 4 mm (one-sixth of an inch) in depth from the tympanic membrane to the inner wall of bone. Its important contents are three small bones – the malleus (hammer), incus (anvil) and stapes (stirrup) – collectively known as the auditory ossicles, with two minute muscles which regulate their movements, and the chorda tympani nerve which runs across the cavity. These three bones form a chain across the middle ear, connecting the drum with the internal ear. Their function is to convert the air-waves, which strike upon the drum, into mechanical movements which can affect the ?uid in the inner ear.
The middle ear has two connections which are of great importance as regards disease (see EAR, DISEASES OF). In front, it communicates by a passage 37 mm (1.5 inches) long – the Eustachian (or auditory) tube – with the upper part of the throat, behind the nose; behind and above, it opens into a cavity known as the mastoid antrum. The Eustachian tube admits air from the throat, and so keeps the pressure on both sides of the drum fairly equal.
Internal ear This consists of a complex system of hollows in the substance of the temporal bone enclosing a membranous duplicate. Between the membrane and the bone is a ?uid known as perilymph, while the membrane is distended by another collection of ?uid known as endolymph. This membranous labyrinth, as it is called, consists of two parts. The hinder part, comprising a sac (the utricle) and three short semicircular canals opening at each end into it, is the part concerned with the balancing sense; the forward part consists of another small bag (the saccule), and of a still more important part, the cochlear duct, and is the part concerned with hearing. In the cochlear duct is placed the spiral organ of Corti, on which sound-waves are ?nally received and by which the sounds are communicated to the cochlear nerve, a branch of the vestibulocochlear nerve, which ends in ?laments to this organ of Corti. The essential parts in the organ of Corti are a double row of rods and several rows of cells furnished with ?ne hairs of varying length which respond to di?ering sound frequencies.
The act of hearing When sound-waves in the air reach the ear, the drum is alternately pressed in and pulled out, in consequence of which a to-and-fro movement is communicated to the chain of ossicles. The foot of the stapes communicates these movements to the perilymph. Finally these motions reach the delicate ?laments placed in the organ of Corti, and so affect the auditory nerve, which conveys impressions to the centre in the brain.... ear
Habitat: A common plant in the United States and Canada, the root is imported into this country in large quantities for medicinal purposes.
Features ? The rhizome (as the part used should more strictly be termed) is reddish- brown in colour, fairly smooth, and has knotty joints at distances of about two inches. The fracture shows whitish and mealy.American Mandrake is an entirely different plant from White Bryony or English Mandrake, dealt with elsewhere. Preparations of the rhizome of the American Mandrake are found in practice to be much more effective than those of the resin. This is one of the many confirmations of one of the basic postulates of herbal medicine—the nearer we can get to natural conditions the better the results. Therapeutic principles are never the same when taken from their proper environment.Podophyllum is a very valuable hepatic, and a thorough but slow-acting purgative. Correctly compounded with other herbs it is wonderfully effective in congested conditions of the liver, and has a salutary influence on other parts of the system, the glands in particular being helped to normal functioning. Although apparently unrecognised in Coffin's day, the modern natural healer highly appreciates the virtues of this medicine and has many uses for it.As American Mandrake is so powerful in certain of its actions, and needs such skillful combination with other herbs, it should not be used by the public without the advice of one experienced in prescribing it toindividual needs.... mandrake, americanThe tumour starts as a small, painless lump or patch (usually on the lip, ear, or back of the hand), which enlarges fairly rapidly, often resembling a wart or ulcer. Left untreated, the cancer may spread to other parts of the body and prove fatal.
Diagnosis is based on a skin biopsy. The tumour is removed surgically or destroyed by radiotherapy.... squamous cell carcinoma
Anxiety, phobias and depression are fairly common. For instance, surveys show that up to
2.5 per cent of children and 8 per cent of adolescents are depressed at any one time, and by the age of 18 a quarter will have been depressed at least once. Problems such as OBSESSIVE COMPULSIVE DISORDER, ATTENTION DEFICIT DISORDER (HYPERACTIVITY SYNDROME), AUTISM, ASPERGER’S SYNDROME and SCHIZOPHRENIA are rare.
Mental-health problems may not be obvious at ?rst, because children often express distress through irritability, poor concentration, dif?cult behaviour, or physical symptoms. Physical symptoms of distress, such as unexplained headache and stomach ache, may persuade parents to keep children at home on school days. This may be appropriate occasionally, but regularly avoiding school can lead to a persistent phobia called school refusal.
If a parent, teacher or other person is worried that a child or teenager may have a mental-health problem, the ?rst thing to do is to ask the child gently if he or she is worried about anything. Listening, reassuring and helping the child to solve any speci?c problems may well be enough to help the child feel settled again. Serious problems such as bullying and child abuse need urgent professional involvement.
Children with emotional problems will usually feel most comfortable talking to their parents, while adolescents may prefer to talk to friends, counsellors, or other mentors. If this doesn’t work, and if the symptoms persist for weeks rather than days, it may be necessary to seek additional help through school or the family’s general practitioner. This may lead to the child and family being assessed and helped by a psychologist, or, less commonly, by a child psychiatrist. Again, listening and counselling will be the main forms of help o?ered. For outright depression, COGNITIVE BEHAVIOUR THERAPY and, rarely, antidepressant drugs may be used.... mental health problems in children
The primary problem is seen as a change in structure of cartilage and BONE, rather than an in?ammatory SYNOVITIS. Osteoarthritis usually implies a loss of the central load-bearing area of articular hyaline cartilage, with outgrowth of cartilage at the articular margin and subsequent ossi?cation to form bony outgrowths known as OSTEOPHYTES. Osteophytes form with increasing age, whether or not there is signi?cant cartilage loss, and in the elderly may lead to local frictional symptoms, and in the spine, to nerve compression.
The condition has a wide range of causes, of which some, like dysplasia and trauma, are known and others have yet to be identi?ed. The main clinical problems occur in the hip and knee. The cartilage loss in the hip usually occurs in the sixth or seventh decade. It may affect both hips in fairly rapid succession, or only one hip; such patients often have no problems in other joints. Cartilage loss in the knee occurs from the ?fth decade onwards and is often associated with cartilage loss in small joints in the hand and elsewhere. Cartilage loss in the distal interphalangeal joints of the hand is associated with the formation of bony swellings known as Heberden’s nodes.
Treatment Management is largely directed at maintaining activity, with physical and social support as necessary. ANALGESICS may be of some value, particularly in the management of night pain. NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS) may help patients with early-morning sti?ness and may also reduce pain on movement and night pain. Their bene?t, however, tends to be less marked than in RHEUMATOID ARTHRITIS and their long-term usage has considerable toxicity problems. Advanced cartilage loss is best treated by joint replacement. Hip- and knee-joint replacements – with a wide variety of arti?cial joints – are now common surgical procedures which greatly improve the mobility of affected individuals. (See ARTHROPLASTY.)
People with arthritis and their relatives can obtain help and advice from Arthritis Care.... osteoarthritis
Sensory These carry signals to the central nervous system (CNS) – the BRAIN and SPINAL CORD – from sensory receptors. These receptors respond to di?erent stimuli such as touch, pain, temperature, smells, sounds and light.
Motor These carry signals from the CNS to activate muscles or glands.
Interneurons These provide the interconnecting ‘electrical network’ within the CNS.
Structure Each neurone comprises a cell body, several branches called dendrites, and a single ?lamentous ?bre called an AXON. Axons may be anything from a few millimetres to a metre long; at their end are several branches acting as terminals through which electrochemical signals are sent to target cells, such as those of muscles, glands or the dendrites of another axon.
Axons of several neurones are grouped
together to form nerve tracts within the brain or spinal cord or nerve-?bres outside the CNS. Each nerve is surrounded by a sheath and contains bundles of ?bres. Some ?bres are medullated, having a sheath of MYELIN which acts as insulation, preventing nerve impulses from spreading beyond the ?bre conveying them.
The cellular part of the neurones makes up the grey matter of the brain and spinal cord – the former containing 600 million neurones. The dendrites meet with similar outgrowths from other neurones to form synapses. White matter is the term used for that part of the system composed of nerve ?bres.
Functions of nerves The greater part of the bodily activity originates in the nerve cells (see NERVE). Impulses are sent down the nerves which act simply as transmitters. The impulse causes sudden chemical changes in the muscles as the latter contract (see MUSCLE). The impulses from a sensory ending in the skin pass along a nerve-?bre to affect nerve cells in the spinal cord and brain, where they are perceived as a sensation. An impulse travels at a rate of about 30 metres (100 feet) per second. (See NERVOUS IMPULSE.)
The anterior roots of spinal nerves consist of motor ?bres leading to muscles, the posterior roots of sensory ?bres coming from the skin. The terms, EFFERENT and AFFERENT, are applied to these roots, because, in addition to motor ?bres, ?bres controlling blood vessels and secretory glands leave the cord in the anterior roots. The posterior roots contain, in addition to sensory ?bres, the nerve-?bres that transmit impulses from muscles, joints and other organs, which among other neurological functions provide the individual with his or her
proprioceptive faculties – the ability to know how various parts of the body are positioned.
The connection between the sensory and motor systems of nerves is important. The simplest form of nerve action is that known as automatic action. In this, a part of the nervous system, controlling, for example, the lungs, makes rhythmic discharges to maintain the regular action of the respiratory muscles. This controlling mechanism may be modi?ed by occasional sensory impressions and chemical changes from various sources.
Re?ex action This is an automatic or involuntary activity, prompted by fairly simple neurological circuits, without the subject’s consciousness necessarily being involved. Thus a painful pinprick will result in a re?ex withdrawal of the affected ?nger before the brain has time to send a ‘voluntary’ instruction to the muscles involved.
Voluntary Actions are more complicated than re?ex ones. The same mechanism is involved, but the brain initially exerts an inhibitory or blocking e?ect which prevents immediate re?ex action. Then the impulse, passing up to the cerebral hemispheres, stimulates cellular activity, the complexity of these processes depending upon the intellectual processes involved. Finally, the inhibition is removed and an impulse passes down to motor cells in the spinal cord, and a muscle or set of muscles is activated by the motor nerves. (Recent advances in magnetic resonance imaging (MRI) techniques have provided very clear images of nerve tracts in the brain which should lead to greater understanding of how the brain functions.) (See BRAIN; NERVOUS SYSTEM; SPINAL CORD.)... neuron(e)
Acute tonsillitis The infection is never entirely con?ned to the tonsils; there is always some involvement of the surrounding throat or pharynx. The converse is true that in many cases of ‘sore throat’, the tonsils are involved in the generalised in?ammation of the throat.
Causes Most commonly caused by the ?haemolytic STREPTOCOCCUS, its incidence is highest in the winter months. In the developing world it may be the presenting feature of DIPHTHERIA, a disease now virtually non-existant in the West since the introduction of IMMUNISATION.
Symptoms The onset is usually fairly sudden with pain on swallowing, fever and malaise. On examination, the tonsils are engorged and covered with a whitish discharge (PUS). This may occur at scattered areas over the tonsillar crypts (follicular tonsillitis), or it may be more extensive. The glands under the jaw are enlarged and tender, and there may be pain in the ear on the affected side: although usually referred pain, this may indicate spread of the infection up the Eustachian tube to the ear, particularly in children. Occasionally an ABSCESS, or quinsy, develops around the affected tonsil. Due to a collection of pus, it usually comes on four to ?ve days after the onset of the disease, and requires specialist surgical treatment.
Treatment Most cases need no treatment. Therefore, it is advisable to take a throat swab to assess the nature of any bacterial treatment before starting treatment. Penicillin or erythromycin are the drugs of choice where betahaemolytic streptococci are isolated, together with paracetamol or aspirin, and plenty of ?uids. Removal of tonsils is indicated: when the tonsils and adenoids are permanently so enlarged as to interfere with breathing (in such cases the adenoids are removed as well as the tonsils); when the individual is subject to recurrent attacks of acute tonsillitis which are causing signi?cant debility, absence from school or work on a regular basis (more than four times a year); when there is evidence of a tumour of the tonsil. Recurrent sore throat is not an indication for removing tonsils.... tonsillitis
Imperforate anus, or absence of the anus, may occur in newly born children, and the condition is relieved by operation.
Itching at the anal opening is common and can be troublesome. It may be due to slight abrasions, to piles, to the presence of threadworms (see ENTEROBIASIS), and/or to anal sex. The anal area should be bathed once or twice a day; clothing should be loose and smooth. Local application of soothing preparations containing mild astringents (bismuth subgallate, zinc oxide and hamamelis) and CORTICOSTEROIDS may provide symptomatic relief. Proprietary preparations contain lubricants, VASOCONSTRICTORS and mild ANTISEPTICS.
Pain on defaecation is commonly caused by a small ulcer or ?ssure, or by an engorged haemorrhoid (pile). Haemorrhoids may also cause an aching pain in the rectum. (See also PROCTALGIA.)
Abscess in the cellular tissue at the side of the rectum – known from its position as an ischio-rectal abscess – is fairly common and may produce a ?stula. Treatment is by ANTIBIOTICS and, if necessary, surgery to drain the abscess.
Prolapse or protrusion of the rectum is sometimes found in children, usually between the ages of six months and two years. This is generally a temporary disorder. Straining at defaecation by adults can cause the lining of the rectum to protrude outside the anus, resulting in discomfort, discharge and bleeding. Treatment of the underlying constipation is essential as well as local symptomatic measures (see above). Haemorrhoids sometimes prolapse. If a return to normal bowel habits with the production of soft faeces fails to restore the rectum to normal, surgery to remove the haemorrhoids may be necessary. If prolapse of the rectum recurs, despite a return to normal bowel habits, surgery may be required to rectify it.
Tumours of small size situated on the skin near the opening of the bowel, and consisting of nodules, tags of skin, or cauli?ower-like excrescences, are common, and may give rise to pain, itching and watery discharges. These are easily removed if necessary. Polypi (see POLYPUS) occasionally develop within the rectum, and may give rise to no pain, although they may cause frequent discharges of blood. Like polypi elsewhere, they may often be removed by a minor operation. (See also POLYPOSIS.)
Cancer of the rectum and colon is the commonest malignancy in the gastrointestinal tract: around 17,000 people a year die from these conditions in the United Kingdom. Rectal cancer is more common in men than in women; colonic cancer is more common in women. Rectal cancer is a disease of later life, seldom affecting young people, and its appearance is generally insidious. The tumour begins commonly in the mucous membrane, its structure resembling that of the glands with which the membrane is furnished, and it quickly in?ltrates the other coats of the intestine and then invades neighbouring organs. Secondary growths in most cases occur soon in the lymphatic glands within the abdomen and in the liver. The symptoms appear gradually and consist of diarrhoea, alternating with attacks of constipation, and, later on, discharges of blood or blood-stained ?uid from the bowels, together with weight loss and weakness. A growth can be well advanced before it causes much disturbance. Treatment is surgical and usually this consists of removal of the whole of the rectum and the distal two-thirds of the sigmoid colon, and the establishment of a COLOSTOMY. Depending upon the extent of the tumour, approximately 50 per cent of the patients who have this operation are alive and well after ?ve years. In some cases in which the growth occurs in the upper part of the rectum, it is now possible to remove the growth and preserve the anus so that the patient is saved the discomfort of having a colostomy. RADIOTHERAPY and CHEMOTHERAPY may also be necessary.... rectum, diseases of
Habitat: Drier parts of Punjab, Gujarat, Simla and Kumaon.
English: Vegetable Rennet, Indian Cheese-maker.Unani: Desi Asgandh, Kaaknaj-e- Hindi, Paneer, Paneer-band. Akri (fruit).Siddha/Tamil: Ammukkura.Action: Alterative, emetic, diuretic. Ripe fruits—sedative, CNS depressant, antibilious, emetic, antiasth- matic, diuretic, anti-inflammatory; used in chronic liver troubles and strangury. Dried fruits— carminative, depurative; used for dyspepsia, flatulence and strangury. Leaf—alterative, febrifuge. Seeds— anti-inflammatory, emetic, diuretic, emmenagogue.
Though known as Desi Asgandh, the root is not used in Indian medicine. Ashwagandhaa (Bengali) and Ashwa- gandhi (Kannada) are confusing synonyms of W. coagulans. In the market no distinction is made between the berries of W. coagulans and W. somnifera.The berries contain a milk-coagulating enzyme, esterases, free amino acids, fatty oil, an essential oil and alkaloids. The amino acid composition fairly agrees with that of papain. The essential oil was active against Micro- coccus pyogenes var. aureus and Vibro cholerae; also showed anthelmintic activity.The withanolides, withacoagin, coagulan and withasomidienone have been isolated from the plant, along with other withanolides and withaferin. 3- beta-hydroxy-2,3- dihydrowithanolide E, isolated from the fruit showed significant hepatoprotective activity and anti-inflammatory activity equal to hydrocortisone. The ethanolic extract of the fruit showed antifungal and that of the leaves and stem antibacterial activity.... withania coagulansThose in the row nearest the hand are the trapezium, trapezoid, capitate and hamate. These latter articulate with the metacarpal bones in the hand and are closely bound to one another by short, strong ligaments; and the wrist-joint is the union of the composite mass thus formed with the RADIUS and ULNA in the forearm. The wrist and the radius and ulna are united by strong outer and inner lateral ligaments, and by weaker ligaments before and behind, whilst the powerful tendons passing to the hand and ?ngers strengthen the wrist.
The joint can move in all directions, and its shape and many ligaments mean that it rarely dislocates – although stretching or tearing of some of these ligaments is a common accident, constituting a sprain. (See JOINTS, DISEASES OF.) In?ammation of the tendon-sheaths may occur as a result of injury or repetitive movement (see UPPER LIMB DISORDERS). A fairly common condition is the presence of a GANGLION, in which an elastic swelling full of ?uid develops on the back or front of the wrist in connection with the sheaths of the tendons. (See also HAND.)... wrist
Dehydration occurs due to inadequate intake of fluids or excessive fluid loss. The latter may occur with severe or prolonged vomiting or diarrhoea or with uncontrolled diabetes mellitus, diabetes insipidus, and some types of kidney failure. Children are especially susceptible to dehydration by diarrhoea.
Severe dehydration causes extreme thirst, dry lips and tongue, an increase in heart rate and breathing rate, dizziness, confusion, lethargy, and eventual coma. The skin looks dry and loses its elasticity. Any urine passed is small in quantity and dark-coloured. If there is also salt depletion, there may also be headaches, cramps, and pallor.
Bottled mineral water can help maintain the intake of salts. For vomiting and diarrhoea, rehydration therapy is needed; salt and glucose rehydration mixtures are available from chemists.
In severe cases of dehydration, fluids are given intravenously.
The water/salt balance is carefully monitored by blood tests and adjusted if necessary.... dehydration
The largest bone of the foot, the heelbone (see calcaneus), is jointed with the ankle bone (the talus). In front of the talus and calcaneus are the tarsal bones, which are jointed the 5 metatarsals. The phalanges are the bones of the toes; the big toe has 2 phalanges; all the other toes have 3.
Tendons passing around the ankle connect the muscles that act on the foot bones. The main blood vessels and nerves pass in front of and behind the inside of the ankle to supply the foot. The undersurface of the normal foot forms an arch supported by ligaments and muscles. Fascia (fibrous tissue) and fat form the sole of the foot, which is covered by a layer of tough skin.
Injuries to the foot commonly result in fracture of the metatarsals and phalanges. Congenital foot abnormalities are fairly common and include club-foot (see talipes), and claw-foot. A bunion is a common deformity in which a thickened bursa (fluid-filled pad) lies over the joint at the base of the big toe. Corns are small areas of thickened skin and are usually a result of tight-fitting shoes. Verrucas (see plantar warts) develop on the soles of the feet. Athlete’s foot is a fungal infection that mainly affects the skin in between the toes. Gout often affects the joint at the base of the big toe. An ingrowing toenail (see toenail, ingrowing) commonly occurs on the big toe and may result in inflammation and infection of the surrounding tissues (see paronychia). Foot-drop is the inability to raise the foot properly when walking and is the result of a nerve problem.... foot
Acute hepatitis is fairly common.
The most frequent cause is infection with one of the hepatitis viruses (see hepatitis, viral), but it can arise as a result of other infections such as cytomegalovirus infection or Legionnaires’ disease.
It may also occur as a result of overdose of halothane or paracetamol or exposure to toxic chemicals including alcohol (see liver disease, alcoholic).
Symptoms range from few and mild to severe with pain, fever, and jaundice.
Blood tests, including liver function tests, may be used for diagnosis.
In most cases of acute viral hepatitis, natural recovery occurs within a few weeks.
If the disorder is caused by exposure to a chemical or drug, detoxification using an antidote may be possible.
Intensive care may be required if the liver is badly damaged.
Rarely, a liver transplant is the only way of saving life.
In all cases, alcohol should be avoided.... hepatitis, acute
the acetabulum, a cup-like cavity in the pelvis. Tough ligaments attach the femur to the pelvis, further stabilizing the joint and providing it with the necessary strength to support the weight of the body and take the strain of leg movements. The structure of the hip allows a considerable range of leg movement. hip, clicking A fairly common condition in adults in which a characteristic clicking is heard and felt during certain movements of the hip joint. Clicking hip is caused by a tendon slipping over the bony prominence on the outside of the femur, and does not indicate disease. Clicking of the hip that can be heard during examination of newborn babies indicates possible dislocation of the hip (see developmenal hip displasia).... hip
Congenital abnormalities, such as horseshoe kidney, are fairly common and usually harmless. Serious inherited disorders include polycystic kidney disease (see kidney, polycystic), Fanconi’s syndrome, and renal tubular acidosis.
Blood vessels in the kidneys can be damaged by shock, haemolytic–uraemic syndrome, polyarteritis nodosa, diabetes mellitus, and systemic lupus erythematosus. The filtering units may be inflamed (see glomerulonephritis). Allergic reactions to drugs, prolonged treatment with analgesic drugs, and some antibiotics can damage kidney tubules. Noncancerous kidney tumours are rare, as is kidney cancer. Metabolic disorders, such as hyperuricaemia, may cause kidney stones (see calculus, urinary tract). Infection of the kidney is called pyelonephritis. Hydronephrosis is caused by urinary tract obstruction. In crush syndrome, kidney function is disrupted by proteins released into the blood from damaged muscle. Hypertension can be a cause and an effect of kidney damage. The most obvious symptom of acute kidney failure is usually oliguria (reduced volume of urine). This leads to a build-up of urea and other waste products in the blood and tissues, which may cause drowsiness, nausea, and breathlessness. Symptoms of chronic kidney failure develop more gradually and may include nausea, loss of appetite, and weakness. If acute kidney failure is due to sudden reduction in blood flow, blood volume and pressure can be brought back to normal by saline intravenous infusion or blood transfusion. Surgery may be needed to remove an obstruction in the urinary tract. Acute kidney disease may be treated with corticosteroid drugs. Treatment may also involve diuretic drugs and temporary dialysis (artificial purification of the blood). A high-carbohydrate, lowprotein diet with controlled fluid and salt intake is important for both types of kidney failure. Chronic kidney failure may progress over months or years towards end-stage kidney failure, which is life-threatening. At this stage, longterm dialysis or a kidney transplant is the only effective treatment.... kidney disorders
FAMILY: Zingiberaceae
SYNONYMS: C. domestica, Amomoum curcuma, curcuma, Indian saffron, Indian yellow root, curmuma (oil).
GENERAL DESCRIPTION: A perennial tropical herb up to 1 metre high, with a thick rhizome root, deep orange inside, lanceolate root leaves tapering at each end, and dull yellow flowers.
DISTRIBUTION: Native to southern Asia; extensively cultivated in India, China, Indonesia, Jamaica and Haiti. The oil is mainly distilled in India, China and Japan. Some roots are imported to Europe and the USA for distillation.
OTHER SPECIES: Closely related to the common ginger (Zingiber officinale). Not to be confused with the Indian turmeric or American yellow root (Hydrastis canadensis).
HERBAL/FOLK TRADITION: A common household spice, especially for curry powder. It is high in minerals and vitamins, especially vitamin C. It is also used extensively as a local home medicine.
In Chinese herbalism it is used for bruises, sores, ringworm, toothache, chest pains, colic and menstrual problems, usually in combination with remedies. It was once used as a cure for jaundice.
ACTIONS: Analgesic, anti-arthritic, anti inflammatory, anti-oxidant, bactericidal, cholagogue, digestive, diuretic, hypotensive, insecticidal, laxative, rubefacient, stimulant.
EXTRACTION: Essential oil by steam distillation from the ‘cured’ rhizome – boiled, cleaned and sun-dried. (An oleoresin, absolute and concrete are also produced by solvent extraction.)
CHARACTERISTICS: A yellowy-orange liquid with a faint blue fluorescence and a fresh spicy woody odour. It blends well with cananga, labdanum, elecampane, ginger, orris, cassie, clary sage and mimosa.
PRINCIPAL CONSTITUENTS: Mainly tumerone (60 per cent), with ar-tumerone, atlantones, zingiberene, cineol, borneol, sabinene and phellandrene, among others.
SAFETY DATA: The ketone ‘tumerone’ is moderately toxic and irritant in high concentration. Possible sensitization problems. ‘The essential oil of turmeric must be used in moderation and with care for a fairly limited period.’.
AROMATHERAPY/HOME: USE
Circulation muscles and joints: Arthritis, muscular aches and pains, rheumatism.
Digestive system: Anorexia, sluggish digestion, liver congestion.
OTHER USES: Employed in perfumery work, for oriental and fantasy-type fragrances. The oleoresin is used as a flavour ingredient in some foods, mainly curries, meat products and condiments.... turmeric
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