(a) Nose—Left iris 52′, right iris 8′ approx.

(b) Throat and larynx—Left iris 45′-47′, right iris l3′-15′.

(c) Trachea—Right iris 12′-14′ only.

(d) Bronchi—Left iris 15′-17′, right iris 43′-45′.

(e) Lungs—Left iris 10′-15′, right iris 45′-50′ respectively, from the muscle zone outwards.

(f) Pleurae—Left iris and right iris, 15′-19′, 41′-45′- (Strictly speaking, the pleurae do not belong to the respiratory organs, but as is well known, are often disturbed together with the lungs, thus requiring them to be mentioned here.)

1. Inflammation of the upper respiratory passages ((a) to (c)): as may occur especially in the form of mucous membrane catarrh following chill—shows as white flakes or clouds in the specified areas. White wisps, running outwards to the iris margin, indicate an acute catarrhal discharge.

2. Chronic catarrh of the upper respiratory organs: is shown by dark grey wisp-signs.

3. Lacunae = weakness-signs: in the area for the upper respiratory passages, indicate a weakness of these organs and permanent catarrhal tendencies. More important than the signs in the areas for the upper respiratory passages are those which show in the area for bronchi, lungs and pleurae.

The bronchi very often became involved together with disturbances of the upper respiratory organ, in which case, the signs described above are also found in the bronchial areas.

*22\78\2*

TROUBLESOME MISERIES-CLUMSINESS

If you suffer from the aching miseries, then life at school can frequently be very difficult. To be suddenly and inexplicably clumsy can have dire results, especially if you are usually neat and deft. Your handwriting may degenerate, no matter how hard you try to keep it tidy, with the result that you get lower grades and teachers disapprove. You may be suddenly unco-ordinated, so that you walk into desks instead of round them, or do badly at games, or you become a menace in the science labs. That doesn’t improve your popularity either, which in its turn will make you feel even more upset and vulnerable and off-balance.

If you’re clumsy like this, one trick is to try to do everything slowly. Breathe in a lower, deeper gear as described and take a few minutes to relax as much of your body as you can. You’ll find the more relaxed you are, the less clumsy you are likely to be. Try to make a joke of your clumsiness if you can. But above all, keep that chart going, so that you can predict your clumsy times and try to avoid some of the more tricky situations. Obviously it’s a good idea to keep out of harm’s way as much as you can. It’s not a good time of the month to be working backstage, or putting in overtime in the labs or shifting PE equipment about. But most important of all, let your ally on the staff know what you’re doing. Show her the chart. She could be the one who will explain to your other teachers that you are not being lazy or bolshie, or going out of your way to produce poor work, or letting the side down, or whatever it is.

*66\177\2*

Laboratory tests are used by doctors to help identify illnesses, to determine what particular type of infectious organism is causing a problem, and to learn how serious a disease may be. Some procedures can be performed right in the doctor’s surgery, others must be done in a laboratory where more complex equipment is available. Some common tests and procedures are described here.

Urinalysis means analysis of a specimen of urine, the liquid form of body waste. Urine tests can reveal infections in the kidneys, the bladder, and the rest of the urinary tract. The chemical and cell content of urine can also show how well the digestive system is working.

Urine can be tested in four different ways. First, it can be examined visually for color and texture. Normal urine is a clear yellow; if it is cloudy, reddish, or some other color, an infection or an injury may be present in the body. Second, the water content of the urine can be measured. This shows how well the kidneys are doing their job of filtering the body’s wastes. Third, the chemical content of the urine can be analyzed, to find out if the body is discarding necessary chemicals that should be retained. Finally, the urine can be examined under a microscope to find out what cells, bacteria, and other material are present. This is done to identify an infection or disease more exactly.

Chemical analysis of urine is often used as a screening test for diabetes, a disease in which the body does not properly use the carbohydrates (sugars and starches) that are its chief sources of energy. To test for diabetes, the amount of glucose (a form of sugar) in the urine is measured by dipping a chemically treated stick in the urine and comparing the color of the stick with a color chart. If the glucose is above a certain level, diabetes may be the cause. Additional blood tests are then done to verify the diagnosis.

*268/84/5*

Blisters are a buildup of clear or almost clear fluid between layers of the skin. They may be caused by heat burns; chemical burns; rubbing (friction); infection by bacteria; viruses; hand, foot, and mouth disease; funguses; allergy to insect bites; or allergy to certain plants. Blisters range from the size of a pinhead to several centimeters across.

Signs and symptoms

Blisters are obvious from their typical appearance – a raised bubble of skin containing clear fluid. The cause of blisters is sometimes determined by their location. When blisters appear on the palms or heels, they are usually due to rubbing; most blisters of the feet are caused by ill-fitting shoes or by not wearing socks. Blisters on the soles and toes may be caused by a fungus. Blisters on the cuticles or backs of fingers almost always mean an infection.

Home care

Do not break open blisters caused by rubbing or by burns. Protect them with gauze and bandages. If a blister is accidentally opened, trim away the major portion of loose skin, cleanse with soap and water, and bandage. If the blister becomes infected (redness and increasing tenderness are signs of infection), it should be soaked in an Epsom salts solution. An infected blister should be checked by a doctor.

Precautions

• Red streaks spreading from a blister indicate spreading infection. If red streaks appear, see your doctor.

• Soaking unbroken blisters in too weak a solution causes marked enlargement of the blisters (suggested Epsom salts solution is at least 110 grams salts to a liter of water).

Medical treatment

Your doctor will determine the cause of the blister and look for signs of possible infection. Infected blisters are opened and the fluid cultured to determine the type of infection. Soaks or oral antibiotics may be prescribed individually or in combination.

*22/84/5*

Refined carbohydrate foods

These foods include sugar and foods with very high sugar content, and are unsuitable to include in the diet.

Sugar – White, brown, raw, icing, castor, coffee crystals etc.

Commercial flavoured milks – e.g. Big ‘M’

Flavoured mineral water

Glucose Powder

Jam, marmalade, lemon butter, sweet spreads

Honey, Golden syrup, treacle

Lollies, chocolates, toffee etc.

Powdered drinks, e.g. Fruit Saline, Tang

Sauces e.g. tomato, mint, barbecue

Soft drinks and cordials (ordinary sweetened)

Sugar coated breakfast cereals

Sweet desserts, jelly crystals

Sweetened condensed milk

Sweetened tinned fruits, glace fruit

Sweet Sherry, liqueurs, port, stout, sweet wines

Tonic water

Toppings and syrups

Sweetening agents & dietary products

Excessive use of any type of sweetening agent is unnecessary and not recommended. Try to educate your child to prefer less sweet foods. Why not learn to have unsweetened tea and coffee? Sweetening agents can be divided into two (2) groups.

1. Energy – Free Sweeteners

These sweeteners do not provide any energy (kjoules/calories) and include agents such as saccharin and cyclamate. They are usually purchased in liquid or tablet form – e.g. Sugarine, Sucaryl, Hermesetas, Nutrasweet, Equal.

Saccharin and Cyclamate are frequently used in the manufacture of low calorie or low joule dietary products which are suitable for people with diabetes.

Aspartame also has very low energy content.

2. Energy Providing

These sweeteners provide the same amount of energy (kjoules/calories) per gram as sugar (sucrose). However they do not influence blood glucose levels in the same way.

Those commonly used in the manufacture of dietary products include fructose, sorbitol, and mannitol.

Products prepared with these sweetening agents are often labeled ‘Carbohydrate Modified’.

The use of products containing fructose, sorbitol, mannitol in the diet must be limited for the following reasons:

a. When taken in excess fructose, sorbitol, mannitol may cause diarrhea.

b. Excessive intake may interfere with glucose metabolism.

c. Many carbohydrate modified products are high in fat – e.g. chocolate and should be only used occasionally.

d. The total energy content is often very similar to products prepared with sugar (these products are not low in energy [kjoules/calories] and are not recommended for use by the overweight diabetic).

Examples of products sweetened with fructose, sorbitol or mannitol include:

(Ingredients are generally printed on the label.)

Carbohydrate Modified Jams e.g. Mrs. Trewins

Diabetic Chocolate

Blizzards or SL’s – all flavours

Sugarless Chewing Gum

Diabetic/Carbohydrate Modified Biscuits

Carbohydrate Modified Ice-cream

The carbohydrate exchange list provides information for the inclusion of a variety of normal biscuits and ice-cream, making these products unnecessary.

Note: A small range of powdered sweeteners using a combination of mannitol and cyclamate is available e.g. Sweetaddin and Slim Line. In moderation they are suitable for use in cooking except where weight control may be a problem. A substitution of 1/3-1/2 cup for 1 cup sugar is generally satisfactory.

*107/54/5*

Close to 95,000 men a year die of lung cancer, compared to 66,000 women. Nearly twice as many men as women die of cirrhosis of the liver. And males are three times as likely to be killed in accidents. The reasons are obvious. Men smoke more, drink more, and take more unnecessary risks than women.

“Add to that the fact that men eat more meat, fat, dairy products, eggs, and high-calorie foods than women, while women eat more fruits, vegetables, whole grains, and low-calorie foods,” says Dr. Crose. “It’s small wonder that men’s lives are cut short.”

And cut is exactly the word to describe the often sudden ends that men come to, says Dr. Kawachi. “The biggest killer of men in their prime is heart attack. Men also die of sudden death more frequently than women. They have no inkling that they have heart disease, and then they get ventricular fibrillation and drop dead,” he says.

One way to avoid getting stopped in your tracks is to have annual physicals. Another is to make small lifestyle adjustments to keep healthier and safer. Here are doctors’ top tips.

Terminate tobacco. Whether you chew it or smoke it, tobacco use dramatically raises your risk for cancer, Dr. Goldberg says. Chewing tobacco causes oral cancer. Smoking is responsible for almost 90 percent of lung cancers among men and significantly raises a person’s risk for developing cancer of the pancreas, kidney, bladder, and esophagus.

“People tire of hearing it, but quitting smoking is the best thing you can do for yourself,” Dr. Kawachi says. “If you’re a lifetime smoker, you have a one in four chance of dying from a disease related to that habit, especially before age 65.” No matter how old you are when you quit, you lower your risk of cancer and heart disease almost immediately, Dr. Kawachi says. Research shows that your risk of having a heart attack drops within the first 24 hours. And within the first five years, your risk of dying from lung cancer is cut in half.

Drink, but think. Once you have a few, you’re well past the point of thinking about your drinking. So try doing what women-who are frequently designated drivers-do. Before you start, think about what you’re going to drink and what you’re going to do afterward. Then limit yourself to just a couple. “While there’s evidence that moderate drinking may be good for the heart, excessive booze is bad for it. Plus it increases your risk for cancer and cirrhosis of the liver,” Dr. Goldberg says. Booze is partly to blame for five times as many men as women drowning, though more men know how to swim, and for men being almost 2H times more likely to die in a car accident than women, he says.

Flip-flop fiber and fat. Most men eat more fat than they should, and they’re often eating more than they realize. To get less artery-clogging fat in your diet, make a point to choose fibrous foods over fatty foods whenever possible, says Dr. Kawachi. That means if there’s a choice between a baked potato and fries, go with the baked potato.

“This is often harder for men than for women,” Dr. Crose says. “Women become concerned about food at an early age, which is a problem regarding eating disorders, but it can be helpful in preventing chronic diseases later in life.” By keeping this rule in mind, you’ll almost automatically eat more fruits, vegetables, and grains and less processed high-fat foods.

*17/36/5*

A study published in the Annuals of Internal Medicine compared the effect on weight loss and hyperlipidaemia (elevated blood fats) of a low carbohydrate ketogenic diet and a low fat diet. A ketogenic diet is where carbohydrate intake is severely restricted to between 20 and 40 grams per day; this means the diet is mainly composed of lean meat, fish, chicken and eggs, with small amounts of salad vegetables. In this study participants on the low carbohydrate diet kept carbohydrate intake to less than 20 grams per day; the low fat group kept fat intake to below 30% of calories, (this equates to less than 67 grams of fat per day for the average person who consumes 2000 calories per day). The low fat diet group had to eat less than 300mg of cholesterol daily, and both groups participated in exercise.

The results showed that a greater number of people in the low carbohydrate group stuck with the diet than people in the low fat group (76%o versus 57%). After 24 weeks, weight loss was greater in the low carbohydrate group than the low fat group (average weight loss of 12.9% versus 6.7% of body weight). The interesting point is that triglycerides came down by 0.84mmol/L in the low carbohydrate group, and only 0.31mmol/L in the low fat group, and HDL cholesterol increased by an average of 0.14mmol/L in the low carbohydrate group, and actually decreased by 0.04mmol/L in the low fat group.

In basic terms, triglycerides decreased more, and HDL increased more in the low carbohydrate group compared to the low fat group. The low carbohydrate diet used here was quite extreme; it is not necessary to lower carbohydrate intake so severely to obtain good results. Another study published in the Journal of the American Medical Association compared a low glycaemic diet with a low fat diet. In the study 39 overweight or obese patients between the ages of 18 and 40 participated. Weight loss results were similar in this study; however participants in the low glycaemic group experienced less hunger, less insulin resistance, lower triglycerides, lower C-reactive protein and lower blood pressure than those on the low fat diet. Clearly lowering the amount of carbohydrate you eat can help you to feel less hungry, lose weight and improve your blood fats.

The effect carbohydrates have on liver function

Eating more carbohydrate than we need results in its storage as body fat. The liver is the main fat metabolizing organ in the body, and excess carbohydrates are converted into fat in the liver; you will remember that most cholesterol in our body is manufactured in the liver. Over time, a high carbohydrate diet clogs our liver with fat and we can develop what is known as fatty liver disease; also known as non-alcoholic steatohepatitis. This is an extremely common condition, and affects an average of 20 percent of the population. Most people do not develop a fatty liver because they eat too much fat, they get it from eating too much sugar, bread, pasta, cereals, soft drinks, and other foods high in sugar which their liver turns into fat. Hydrogenated vegetable oil, which contains trans fatty acids also contributes to the development of fatty liver.

When we develop a fatty liver, it often causes us to have raised liver enzymes; this indicates that there is inflammation occurring in our liver. C-reactive protein is manufactured in the liver in response to inflammation, and it promotes further inflammation in the rest of our body, including our artery walls.

*20/53/5*

Our fear of death and the great beyond has fueled a seemingly endless supply of myths and lore, not to mention bad B-movies. Here are a few of our favorites.

Count on “the count.” With Tom Cruise’s portrayal of the Vampire Lestat in Interview with the Vampire, the world marked nearly 1,000 years of vampire lore. Popularized in the late 1800s with the publication of Bram Stoker’s novel Dracula, the notion of vampires first appeared in 1047, when someone referred to a Russian prince as “Upir Lichy” or wicked vampire. Vampire hysteria ran rampant from 1600 through the 1700s. Things got so bad in Romania that they developed “automatic vampire-piercing devices”-sharpened stakes driven into the grave so that if the body tried to leave, the vampire would be pierced instantly.

Essentially, vampires are thought to be folks who have died before their time, often violently, who have come back to kill their family and friends. Telltale signs of vampires are needle-sharp incisors used to suck blood from their prey. A wooden stake through the heart, cutting off the head, or burning the body to ashes is the best-known ways to bring one down for good.

Do the zombie. Countless cult classics like Night of the Living Dead show once-dead and buried folks clawing their way from their earthly tombs and oozing into nearby neighborhoods to wreak havoc among once-happy, unsuspecting citizens. Though nobody can say for certain where the concept of so-called zombies came from, it’s one we clearly dread-and one that may be more reality-based than you think.

Reportedly, Haitians schooled in the science of voodoo could administer a fish poison known as tetrodotoxin that would induce a state just inches from death. The victim would then be buried and, provided the voodoo maker had administered just the right dose, could later be “resurrected” to terrorize the living.

Tell it to your mummy. Ancient Egyptians believed that they were “magically resuscitated” after they died. To help the dead along, they would first embalm the corpse to mummify it. Then they’d bury it in an elaborate tomb, equipped with furnishings and toilet facilities so that the mummy could live comfortably once he came back to life. Somewhere along the way, people began to worry that maybe the mummy would wake up not in the Egyptian afterlife but in his tomb, mad as hell, and with a hankering to take his anger out on the living.

Today, we’re less nervous about that possibility but just as fascinated with mummies. More than 100,000 people a year travel to Kampehl, Germany, to view the remains of Christian Friedrich von Kahlbutz, a seventeenth-century count who was found naturally mummified in his crypt.

*27/36/5*

Preventive medicine is probably imbued with more rhetoric and noble ideas than any other medical speciality, but amongst all the high-flown talk one assertion stands out-that people ought to be more responsible for their own Health. This argument suggests that if we were all more ‘responsible’ and ‘pulled ourselves together’ we could prevent much illness both in ourselves and others. I personally find this a naive and unhelpful way of looking at prevention because it puts too great a burden of responsibility on millions who can’t cope with it. If they then ‘fail’ they are double losers-not only do they have the health problems to deal with but they are deemed to have brought them upon themselves.

The idea that personal lifestyle has implications for health is very old indeed. It underlines many of the injunctions of the Old Testament. The golden rule formulated by Juvenal (a healthy mind in a healthy body) was intended to achieve both physical and psychological well-being simultaneously. Even during the eighteenth and nineteenth centuries when real strides were being made in preventive public health Measures, novels of the day suggested that it was the responsibility of individuals to look to their own well-being.

The idea that an individual can prevent the occurrence of illness is not new, then. What we now understand better is that human behaviour is not simply a matter of what people can will themselves to do-it is the combined result of forces acting from within (many of which are unconscious) and without. So today we can look in a very different way at how human behaviour affects health. No longer can we condemn people on ‘moral’ grounds for their lack of control, or whatever, and punish them, however unconsciously, with ill health. Also, the almost total control of mass infectious illnesses and the increase of chronic diseases as a cause of death makes the whole business of prevention even more important because the latter are so difficult or even impossible to cure.

This has all led to a generally held assumption that the next great milestone in medical advances will be a wholesale change in personal health-related behaviour brought about by a better understanding of human beings as a result of the behavioural sciences. If this is so and if it is to form the basis of preventive medicine for the future we ought to look at it more closely.

We have looked at health and illness behaviour in some detail already. Obviously an understanding of the subject is crucial if we are really to make any progress in preventing anything. The key study in this area has resulted in the Health Belief Model which attempted to explain how and why people used preventive services such as ÒÂ screening, dental check-ups and vaccinations. Since this model was first developed in the US in the 1950s numerous studies have classified areas touched on by the Model.

The Health Belief Model, simply stated, proposed that in the presence of certain triggers to take health action the likelihood of action actually being taken depends on the person’s belief about the seriousness of the health condition, his or her susceptibility to it, the efficiency of the proposed action and the difficulties he or she might encounter in attempting to carry out the action. This, then, is a rational model of human behaviour in which people respond to given situations with thought and with some knowledge.

Unfortunately, even this simple analysis of what happens is fraught with problems, and when we look at a specific example it begins to fall apart. For example, studies have found that women who are relatively young and well educated and have higher incomes are more likely to hold beliefs that are appropriate to taking action to have a cervical smear test than are women with less education and lower incomes. It is obviously not satisfactory to rely on any particular group’s own perception of health risks and the advisability of preventive action. The facts, alas, are often that the very groups who are least able to perceive the value of a preventive measure are those most at risk.

The next challenge then is to understand why people believe what they do and to try to find out how their attitudes can be changed to their advantage. In a free society this is a complex business because the people concerned have first to be convinced that a particular health goal is worth achieving. Many approaches are possible and an oblique one often works better than a full-frontal one. For example, many men happily take exercise because it makes them feel good yet they are blissfully unaware of the positive health benefits of their actions. These are purely a bonus to their sporting activities.

*22/72/5*

Linda O’Hanlon used a measuring cup to lose 57 pounds.

Overweight since she was a child, Linda, of Maspefh, New York, never developed that “I’m full” signal that makes most people push away their plates after eating a serving or two. “When I sat down for a spaghetti dinner, I didn’t get up until every last strand of pasta in the pot was gone,” she recalls.

Over the years, as her weight crept upward, Linda invested thousands of dollars in fad diets with hopes of slimming down. But they didn’t help. “I’d lose 5 pounds and go off the diet,” she explains. “Then I’d gain back the 5 pounds, plus another 5.”

By the time Linda reached 208 pounds, she gave up trying to lose weight, resolving to accept herself as she was. But that changed in August 1997, when she went with a friend to Weight Watchers. Through the program’s meetings, she learned how to make healthful food choices and control her portion sizes. “The lesson was that if you put junk in your body, you’ll feel like junk,” she says.

She took that lesson to heart. Realizing that she had a natural tendency to overeat, Linda became extra-vigilant about her portion sizes. When she’d sit down for pasta, she’d pull out her trusty “|measuring cup and carefully measure out 1 cup of spaghetti, 1 cup of cooked vegetables, and 1 cup of garden salad. She’d eat that and no more.

Over time, Linda became adept at eyeballing her portion sizes. By relying on her brain instead of her stomach to say “when,” she dropped three pants sizes in 7 months. Two years later, at age 30, she’s holding steady at 151 pounds. “My clothes fit great, and I’m bursting with energy,” she says.

WINNING ACTION

Learn to recognize portion sizes. For foods that are easy to overdo, especially pasta, cereal, and ice cream, measure out one serving and transfer it into the bowl you would normally use. Make a mental note of how it looks (it’s probably a lot smaller than you’re used to seeing). You’ll need some time to retrain your brain, but eventually, the smaller portions will seem normal.

*16\89\8*