Children’s dermatitis or infantile eczema is a distressing condition, since it is not only a strain on the child, but also on the parents, due to the constant extra care and attention the child has to receive.

In 1964, at the Convention of the German Society for Child Therapy held in Munich, Dr Holt, an American paediatrician at New York University, presented the viewpoint that the ‘tar therapy’ was still the best method for the treatment of infantile eczema and that using tar extract of 5 per cent was also more economical than treating with steroid ointments. Also of considerable interest was Dr Holt’s concession that infantile eczema is much easier to suppress than it is to cure.

With the help of the ‘tar therapy’ it is relatively easy to reduce the severity of the condition from degree IV to degree I, but Dr Holt admitted that this therapy is not enough to effect a complete cure. What was not mentioned was the fact that once the tar therapy is discontinued the little patient will quickly experience a worsening of the condition. Neither was there any mention that tar, with its eleven hydrocarbons, including napthalene, has been recognised as a carcinogenic – cancer-producing – substance.

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The inability to have children is often connected with a hormone deficiency. In such cases there are two possibilities that can be pursued. First, the body may be stimulated in such a way that its own production of hormones is improved. On the one hand, this can be achieved through hydrotheraphy, by means of sitz baths (hip baths), alternating hot and cold baths, the Kuhne treatment and similar methods. On the other hand, stimulation of the circulatory system will boost the supply of blood to the abdomen, which in turn will step up the production of hormones and may eventually lead to pregnancy.

For stimulating the circulation remedies such as Aesculaforce, Aesculus hippocastanum and Urticalcin can be of great benefit, especially when supplemented by wheat germ or wheat germ oil (capsules). Although outdoor exercise and deep-breathing in the open air are necessary for the natural regeneration of the body, sporting activities should not be overdone. Rather, one’s whole way of life should be normal and balanced. This is the natural and safe course of action to take first of all.

There are many side-effects to orthodox medical treatment that can be relieved by complementary therapies. Radiotherapy often causes itching skin, soreness around the area being treated, and a general feeling of tiredness. Cystitis, diarrhoea and fear, are also common symptoms. Chemotherapy can cause nausea, loss of appetite, hair loss and soreness of the digestive system (ulcers and lesions). The trauma involved with all of this, as well as the general debilitating effects on the system, can cause headaches as well.

While complementary therapies do not (or at least should not) claim to cure cancer, certain therapies can help the body fight the disease, and recover from orthodox treatment. It is important to talk to your doctor and your complementary therapist about all the treatments you are undergoing. In disease as serious as cancer, mismatched treatments can be fatal.

Aromatherapy is an excellent way to relax and recover, but should never be undertaken immediately after chemotherapy. Bathing and massage can often irritate sore skin. ‘The best means of using the oils is inhalation – a vapouriser or a gentle bath blend – perhaps rose and geranium, which may help fight fear and depression, and fennel to help with nausea. Niaouli and tea tree have been used in Europe to reduce surface burning during radiation treatment, and lavender has been used to treat radiation bums. Rosemary is said to stimulate re-growth of hair. Lavender applied to the nostrils or in the bath with camomile, can reduce the headaches linked with brain cancers.

Acupuncture is valuable when dealing with the side-effects of cancers, as listed above, and will help to relieve pain and depression. There are, controversially, reports from China that indicate that acupuncture stimulates our body’s anti-cancer substances. Chinese acupuncturists also claim that it boosts the body’s immune system.

A homoeopath will prepare a package of remedies individually suited to your symptoms. ‘These might include galium album, clematis and echinacea.

Medical herbalism can relieve some of the symptoms of cancer, and encourage the immune system to work against it. All treatment must he tailored to complement the orthodox treatments being received. There will be options for pain relief, depression (St John’s wort) and nausea (ginger, peppermint or fennel), and calendula promotes healing of skin. Echinacea and garlic, taken internally, improve resistance to secondary infections. ‘There are many many options to help your body deal with the cancer and the side-effects of treatment – both of which can cause headaches.

Nutrition is particularly important in cancer. A strong, healthy constitution is much more likely to have a. fighting chance, and to respond better to treatment. Pain can be kept at bay by daily doses of phenylalanine, Supplementation of selenium may also help, under the guidance of a clinical nutritionalist. Some research suggests that it affects enzymatic processes that may inhibit the activation of some cancer cells. There is no doubt that it does have some anti-cancer properties. A good B-vitamin supplement will also help deal with the feeling of malaise, and Vitamin D is said to be useful. Sensible eating, perhaps a macrobiotic diet, is beneficial to some cancer patients.

Reflexology can help deal with the emotional repercussions of cancer, and speed up recovery after an operation.

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Three important questions need to be answered following any head injury.

Has there been concussion or any other form of brain damage?

Is there any bleeding in or around the brain?

Is there a neck injury as well?

As far as the direct head injury is concerned, the following facts are important to take into consideration.

If the victim has been knocked out, or cannot remember the exact incident or the few seconds leading up to it, then he needs to be admitted to hospital for at least twenty-four hours observation. .

An injury from a blunt object (either one that hits you or one that you fall on) that has caused a cut in the skin may have been sufficient to break the skull as well. You will need an X-ray to show whether there is a skull fracture underneath the cut.

If any of the following occur in the first twenty-four hours after a head injury, the injury to the brain may be more severe than previously thought, or there may be internal bleeding. The symptoms are: severe, increasing headache; vomiting; double vision; incoordination; drowsiness. (There’s a great difference between drowsiness and sleepiness: when you feel sleepy you want to sleep, but can be roused to full consciousness. When you’re drowsy, you can’t be roused properly.)

If any of these occur; if there is any odd behaviour; if there is a general deterioration of the patient’s condition; or if there is anything else that is causing concern, you should go to Casualty immediately.

Usually the above symptoms occur within the first twenty-four hours, but in some cases they can occur much later, perhaps over ten days. This is particularly

the case with sub-dural haemorrhages in older people. Even when the injury is several days old, if the patient starts showing some of these symptoms, they should see a doctor immediately.

The only reason why patients are admitted to hospital following a head injury is to be certain that they do not have any hidden bleeding inside the skull causing pressure on the brain, or else swelling of the brain substance itself. Any extra pressure needs to be relieved as soon as possible, whether caused by stoved-in bones in the skull; from high-pressure bleeding; or from slow low-pressure bleeding, as in a sub-dural haemorrhage. An urgent operation may be necessary to elevate stoved-in bones and suck out any blood clots: swelling of the brain substance itself can be treated with steroids.

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Estimates vary as to the proportion of people who get migraines, but figures of between eight and twelve per cent are commonly quoted. There is no racial difference. Migraine affects women more than men.

The number of attacks varies in frequency from sufferer to sufferer, with some people having only one or two attacks a year: others less fortunate may have more than three a week.

It’s difficult to get an ‘average’ picture, because only those patients with symptoms bad enough to consult their doctor get counted! At one of the UK migraine clinics, nearly one in ten patients were having more than three attacks a week; a quarter were having more than one attack per week, and nearly half had more than one attack per month.

Migraine generally starts before the age of forty, and most frequently begins in the twenty to thirty age group, though figures vary. Interestingly, migraine often occurs in childhood; a fifth of migraineurs began having attacks before the age of ten.

It is possible to have true migraines which start above the age of forty, but it’s unusual; above the age of fifty it may well be associated with some other more serious abnormalities such as a tumour. Migraines which start after the age of fifty need full investigation by your doctor.

Migraine is not necessarily for life – about half of sufferers no longer have attacks twenty years later, and migraine is relatively uncommon over the age of sixty-five. Reassuringly, when attacks continue, their intensity usually reduces. We used to think that attacks dropped off after the menopause in women, but we now know that some women improve at the menopause and some get worse; some even have their first attack at this time.

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Infections fall into two main groups – those caused by bacteria, and those caused by viruses. Bacteria arc relatively large’ organisms, existing outside the body cells, while viruses are much smaller, and need to get inside the body’s cells in order to multiply. Viruses are responsible for many of the major infective illnesses that still trouble us in the West – the common cold, influenza, chickenpox, measles, German measles, hepatitis, and, of course, AIDS.

Unfortunately, the only way lo stop most viral infections is by preventing them from occurring in the first place through immunisation. Immunisation, however, has to be carried out disease- by disease – a separate immunisation is required for polio, influenza, German measles, and so on, even though sometimes the inoculations can be mixed in one injection. The point of immunisation is to expose the body lo each type of virus, but in a safe, inactive form. This activates the immune .system, which remembers the chemical shape of the outside coal of the virus. Then, if any of the ‘real’ viruses invade in the future, the body quickly recognises them and mobilises the immune system lo destroy them before they can do any damage.

Bacterial infections include most of the infections that produce pus or boils; in addition, such infections as typhoid, gonorrhoea, diphtheria and whooping cough are all bacterial infections. The body’s immune system will fight bacteria, but nowadays bacteria can also be killed off by antibiotics – at least, in most cases. Bacteria are usually quick to succumb once a suitable antibiotic has been given, but sometimes an infection gets too tenacious a hold for antibiotics to do any good, and on other occasions bacteria tan develop resistance to particular antibiotics.

As well as bacteria and viruses there are other groups of infective agents, such as spirochaetes (which in this country cause syphilis and the water-borne Weil’s disease). In tropical climates, infections by worms and other parasites can be common; these include malaria, which is a small parasitic organism that lives in the red blood cells and the liver, and is transmitted by the bite of an infected mosquito.

The characteristic sign of an infection (other than very minor ones) is a raised temperature. The temperature rise varies according to your age, and the diseaseitself; as a rough rule of thumb, anything above 101°F is likely to be a viral infection (with the exception of urinary infection, malaria and septicaemia, Commonly known as blood poisoning). Smaller rises in temperature are usually associated with bacterial infections.

The age of the patient has an important bearing on the temperature, too. By comparison with adults, children produce much higher temperatures: in an adult, a minor infection which causes a temperature of 99.5°F may produce a raging temperature of 102°F in a child. In the same way, the temperature rise is usually much smaller in the elderly, in comparison to the middle-aged adult.

often children don’t complain of headaches when they have infections, but perceive the pain to be in their abdomens. ‘I’ve got a tummyache, Mummy’ is the childhood equivalent of the adult’s ‘I’ve got a headache’.

It’s generally true that any illness that produces a fever can produce a headache; it,, headache is worse in the earliest and middle parts of the infection, and usually dies down as the fever starts to wane.

In the specifically childhood diseases – chickenpox, measles, and so on – it is often only when the rash comes out that the parents realise their child is suffering In ‘in something other than a heavy cold or a dose of flu, as intrinsically, there is little difference between the infection caused by influenza and that caused by chicken pox. It really doesn’t matter, anyway, because once a viral infection has taken hold there’s very little we can do except treat the symptoms as they arise, using extra fluids, paracetamol for the temperature (aspirin can be used for adults) and bed rest. For uncomplicated viral infections, ordinary antibiotics are useless and there is no point in prescribing them.

Sometimes a simple viral infection becomes more complex: perhaps a secondary Infection such as a bacterial chest infection develops in a patient who started off With flu. Often it’s obvious what has happened – such as when the patient starts coughing up coloured sputum. In children, a viral infection of the nose and throat can sometimes be followed by an ear infection. Most secondary infections are caused by bacteria, so in these cases the doctor will want to prescribe an antibiotic. Although the primary cause of the illness (the virus) won’t respond to an antibiotic, the secondary (bacterial) infection will.

In a bacterial infection, a headache usually comes on only if there is quite extensive infection. The two bacterial infections most likely to do this are a urinary tract infection, and a chest infection.

However, infections in the face, head and neck areas can produce headaches directly. Sinus infections produce headaches through pressure on the facial bones, dental infections can also produce headaches, and viral infections which affect the lymphatic glands in the neck can cause muscle spasm of the neck muscles.

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Migraine is a syndrome which involves a lot more than just the brain. One of the things it does is stop the absorption of substances from the stomach (in addition to making the patient nauseous and sick). Anything that is in the stomach that isn’t vomited up is likely to stay there unabsorbed for a long time.

Now we’ve found that we can reverse this with certain types of anti-vomiling drugs. Metoclopramide is one, domperidone is another. These are anti-nausea drugs that also stabilise the muscle activity within the gut, on which it can have a most dramatic effect. Giving a small dose of metoclopramide together with paracetamol or aspirin, allows the pain-killer to be absorbed across the stomach wall and – hey, presto! – in many cases the migraine attack is aborted. Metoclopramide and domperidone also have the extra advantage of being anti-vomiting agenls, damping down the vomiting centre and reducing what is probably the second most unpleasant aspect of migraine, after the headache.

The use of metoclopramide and similar drugs has revolutionised many aspects of migraine therapy, and has certainly reduced the need for the heavy morphine-based drugs. At the first sign of an attack a sufferer may take a tablet of metoclopramide together with a couple of tablets of paracetamol or aspirin (or, a combination drug combining both of them) and, with a bit of luck, the attack may be halted.

Migraleve Pink tablets contain an anti-vomiting agent of a different type: Migraleve Yellow tablets (the follow-on tablets) don’t contain painkillers.

The most important aspect of treating an attack is to start taking the medicines early. Nipping it in the bud is one of the most effective ways of dealing with an impending attack; leaving it for several hours may be too late.

There is a wide variety of drugs to select from, and different doctors will have different ideas about the relative importance of each group. Not all drugs are safe to use for children.

The five groups of drugs used to treat an attack are: analgesics, anti-vomiting agents, ergotamine, sedatives and the 5-HT stimulants.

• Analgesics. There’s no great virtue in taking strong analgesics when simple ones will do, and often paracetamol and/or aspirin are perfectly acceptable, provided that they are absorbed into the bloodstream. Aspirin has the additional advantage that it helps to reduce the stickiness of platelets in the blood; and, as these may have a role in the migraine attack, aspirin may be of added benefit. Don’t give aspirin to children, and don’t use it in pregnancy, nor if you have stomach ulcers or are on anticoagulants or steroids.

If simple analgesics like these don’t work your doctor may well prescribe something stronger, such as codeine, dihydrocodeine or coproxamol: in the last resort it may still be necessary to use pethidine, morphine, diamorphine, or pentazocine. Where you are continuing to vomit it may be necessary to give these very strong drugs by injection.

Anti-vomiting Drugs. We’ve already dealt with the anti-nausea drugs. These have two effects: reducing vomiting and nausea, and allowing the absorption of other drugs. Obviously, if there is vomiting already then these agents won’t work and will need to be given by injection or suppository.

Ergotamine. Ergotamine is a potent vaso-constrictor (causing blood vessels to clamp tip tightly) which, bearing in mind that in migraine the blood vessels are often dilated, may be the reason why it helps. However more recent work suggests that its action on blood vessels is a lot more complex than this. Ergotamine isn’t absorbed very well in tablet form so it’s often used as a suppository, taken under the tongue or inhaled, using a pressurised inhaler. Caffeine helps the absorption of ergotamine, and is often combined with it. The big problem with the use of ergotamine is that the effective dose is very near the toxic dose. Do not increase the dose of ergolamine beyond what your doctor has prescribed, or you could lose the blood supply to your extremities, causing gangrene.

Also, ergotamine must neverhe given to a pregnant woman because it can cause the most violent contractions in the womb, leading either to a premature delivery or to suffocation of the baby within the womb. Ergotamine should also not be used in those with heart disease or circulation problems. Ergotamine mustn’t be used too regularly – there is an crgotamine-abuse syndrome, in which the ergotamine itself causes headaches. Ergotamine headaches are unlike migraines, being more of a generalised dull headache.

•    Sedatives. Sedatives are sometimes useful in aborting an attack early on. If you are able to relax and go to sleep you may wake up headache-free, and this is particularly useful when stress is a triggering factor. Common sedatives include the benzodiazepine tranquillisers: diazepam, chlordizepoxide etc. but there are others, such as chlorpromazine.

However, many anti-migraine drugs contain caffeine, which will have the opposite effect! It may be better to avoid caffeine-containing drugs if your migraines are linked to stress or anxiety.

•    5-HT Stimulants (agonists). Transmitter chemicals allow messages to pass from nerve to nerve in the body. One of these chemicals is a substance called 5-HT, otherwise known as serotonin. 5-HT seems to have an important part to play in the workings of the brain, though the exact relationship between 5-HT levels and problems such as anxiety, depression, eating and migraines is anything but simple. However, we do know that 5-HT seems to be reduced in those suffering from depression, and that it is intimately bound up with eating and appetite, and in migraine. There are three different types of 5-HT receptors, and the ones involved in depression are probably not the same type as the ones involved in migraine.

There are various ways to interfere with the workings of these brain chemicals. They can be blocked or their effects can be increased. One particular group of drugs seems to be able to help in the established attack of migraine. These are called 5-HT agonists or stimulants, and they stimulate the 5-HT receptors, just like 5-HT does in its natural role.

However, it isn’t a question of simply giving extra 5-HT and thereby preventing migraines; rather, we actually prevent the onset of migraine attacks by using 5-HT blocker drugs, such as pizotifen. It seems that to prevents migraine you need to block the effect of 5-HT, whereas to treat a migraine you need to have more of it.

5-HT agonists are one of the most recent developments in the treatment of migraine. Sumatriptan has recently been introduced and it seems to be highly effective in the treatment of the established attack. As with many of the other antimigraine drugs, it is important to give it as early in the attack as possible, and injecting it makes sure that it gets into the bloodstream quickly. There is an ingenious plastic device called an auto-injector, which allows you to give your own injection safely and simply, without the need for professional help.

Sumatriptan is also available in tablet form for those in whom vomiting or poor absorption is not a problem. The efficacy is similar, but the onset of action is slightly slower. The only drawback to Sumatriptan is that it is expensive to make.

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