EFFECT OF ALCOHOL ON THE MEMBRANES.

The parts which first suffer from alcohol are those expansions of the body which the anatomists call the membranes. "The skin is a membranous envelope. Through the whole of the alimentary surface, from the lips downward, and through the bronchial passages to their minutest ramifications, extends the mucous membrane. The lungs, the heart, the liver, the kidneys are folded in delicate membranes, which can be stripped easily from these parts. If you take a portion of bone, you will find it easy to strip off from it a membranous sheath or covering; if you examine a joint, you will find both the head and the socket lined with membranes. The whole of the intestines are enveloped in a fine membrane called  peritoneum . All the muscles are enveloped in membranes, and the fasciculi, or bundles and fibres of muscles, have their membranous sheathing. The brain and spinal cord are enveloped in three membranes; one nearest to themselves, a pure vascular structure, a network of blood-vessels; another, a thin serous structure; a third, a strong fibrous structure. The eyeball is a structure of colloidal humors and membranes, and of nothing else. To complete the description, the minute structures of the vital organs are enrolled in membranous matter."

These membranes are the filters of the body. "In their absence there could be no building of structure, no solidification of tissue, nor organic mechanism. Passive themselves, they, nevertheless, separate all structures into their respective positions and adaptations."

Membranous deteriorations.
-------------------------

In order to make perfectly clear to your mind the action and use of these membranous expansions, and the way in which alcohol deteriorates them, and obstructs their work, we quote again from Dr. Richardson:

"The animal receives from the vegetable world and from the earth the food and drink it requires for its sustenance and motion. It receives colloidal food for its muscles: combustible food for its motion; water for the solution of its various parts; salt for constructive and other physical purposes. These have all to be arranged in the body; and they are arranged by means of the membranous envelopes. Through these membranes nothing can pass that is not, for the time, in a state of aqueous solution, like water or soluble salts. Water passes freely through them, salts pass freely through them, but the constructive matter of the active parts that is colloidal does not pass; it is retained in them until it is chemically decomposed into the soluble type of matter. When we take for our food a portion of animal flesh, it is first resolved, in digestion, into a soluble fluid before it can be absorbed; in the blood it is resolved into the fluid colloidal condition; in the solids it is laid down within the membranes into new structure, and when it has played its part, it is digested again, if I may so say, into a crystalloidal soluble substance, ready to be carried away and replaced by addition of new matter, then it is dialysed or passed through, the membranes into the blood, and is disposed of in the excretions.

"See, then, what an all-important part these membranous structures play in the animal life. Upon their integrity all the silent work of the building up of the body depends. If these membranes are rendered too porous, and let out the colloidal fluids of the blood the albumen, for example the body so circumstanced, dies; dies as if it were slowly bled to death. If, on the contrary, they become condensed or thickened, or loaded with foreign material, then they fail to allow the natural fluids to pass through them. They fail to dialyse, and the result is, either an accumulation of the fluid in a closed cavity, or contraction of the substance inclosed within the membrane, or dryness of membrane in surfaces that ought to be freely lubricated and kept apart. In old age we see the effects of modification of membrane naturally induced; we see the fixed joint, the shrunken and feeble muscle, the dimmed eye, the deaf ear, the enfeebled nervous function.

"It may possibly seem, at first sight, that I am leading immediately away from the subject of the secondary action of alcohol. It is not so. I am leading directly to it. Upon all these membranous structures alcohol exerts a direct perversion of action. It produces in them a thickening, a shrinking and an inactivity that reduces their functional power. That they may work rapidly and equally, they require to be at all times charged with water to saturation. If, into contact with them, any agent is brought that deprives them of water, then is their work interfered with; they cease to separate the saline constituents properly; and, if the evil that is thus started, be allowed to continue, they contract upon their contained matter in whatever organ it may be situated, and condense it.

"In brief, under the prolonged influence of alcohol those changes which take place from it in the blood corpuscles, extend to the other organic parts, involving them in structural deteriorations, which are always dangerous, and are often ultimately fatal."

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EFFECT OF ALCOHOL ON THE BLOOD.

Dr. Richardson, in his lectures on alcohol, given both in England and America, speaking of the action of this substance on the blood after passing from the stomach, says:

"Suppose, then, a certain measure of alcohol be taken into the stomach, it will be absorbed there, but, previous to absorption, it will have to undergo a proper degree of dilution with water, for there is this peculiarity respecting alcohol when it is separated by an animal membrane from a watery fluid like the blood, that it will not pass through the membrane until it has become charged, to a given point of dilution, with water. It is itself, in fact,  so greedy for water, it will pick it up from watery textures, and deprive them of it until, by its saturation, its power of reception is exhausted , after which it will diffuse into the current of circulating fluid."

It is this power of absorbing water from every texture with which alcoholic spirits comes in contact, that creates the burning thirst of those who freely indulge in its use. Its effect, when it reaches the circulation, is thus described by Dr. Richardson:

"As it passes through the circulation of the lungs it is exposed to the air, and some little of it, raised into vapor by the natural heat, is thrown off in expiration. If the quantity of it be large, this loss may be considerable, and the odor of the spirit may be detected in the expired breath. If the quantity be small, the loss will be comparatively little, as the spirit will be held in solution by the water in the blood. After it has passed through the lungs, and has been driven by the left heart over the arterial circuit, it passes into what is called the minute circulation, or the structural circulation of the organism. The arteries here extend into very small vessels, which are called arterioles, and from these infinitely small vessels spring the equally minute radicals or roots of the veins, which are ultimately to become the great rivers bearing the blood back to the heart. In its passage through this minute circulation the alcohol finds its way to every organ. To this brain, to these muscles, to these secreting or excreting organs, nay, even into this bony structure itself, it moves with the blood. In some of these parts which are not excreting, it remains for a time diffused, and in those parts where there is a large percentage of water, it remains longer than in other parts. From some organs which have an open tube for conveying fluids away, as the liver and kidneys, it is thrown out or eliminated, and in this way a portion of it is ultimately removed from the body. The rest passing round and round with the circulation, is probably decomposed and carried off in new forms of matter.

"When we know the course which the alcohol takes in its passage through the body, from the period of its absorption to that of its elimination, we are the better able to judge what physical changes it induces in the different organs and structures with which it comes in contact. It first reaches the blood; but, as a rule, the quantity of it that enters is insufficient to produce any material effect on that fluid. If, however, the dose taken be poisonous or semi-poisonous, then even the blood, rich as it is in water and it contains seven hundred and ninety parts in a thousand is affected. The alcohol is diffused through this water, and there it comes in contact with the other constituent parts, with the fibrine, that plastic substance which, when blood is drawn, clots and coagulates, and which is present in the proportion of from two to three parts in a thousand; with the albumen which exists in the proportion of seventy parts; with the salts which yield about ten parts; with the fatty matters; and lastly, with those minute, round bodies which float in myriads in the blood (which were discovered by the Dutch philosopher, Leuwenhock, as one of the first results of microscopical observation, about the middle of the seventeenth century), and which are called the blood globules or corpuscles. These last-named bodies are, in fact, cells; their discs, when natural, have a smooth outline, they are depressed in the centre, and they are red in color; the color of the blood being derived from them. We have discovered that there exist other corpuscles or cells in the blood in much smaller quantity, which are called white cells, and these different cells float in the blood-stream within the vessels. The red take the centre of the stream; the white lie externally near the sides of the vessels, moving less quickly. Our business is mainly with the red corpuscles. They perform the most important functions in the economy; they absorb, in great part, the oxygen which we inhale in breathing, and carry it to the extreme tissues of the body; they absorb, in great part, the carbonic acid gas which is produced in the combustion of the body in the extreme tissues, and bring that gas back to the lungs to be exchanged for oxygen there; in short, they are the vital instruments of the circulation.

"With all these parts of the blood, with the water, fibrine, albumen, salts, fatty matter and corpuscles, the alcohol comes in contact when it enters the blood, and, if it be in sufficient quantity, it produces disturbing action. I have watched this disturbance very carefully on the blood corpuscles; for, in some animals we can see these floating along during life, and we can also observe them from men who are under the effects of alcohol, by removing a speck of blood, and examining it with the microscope. The action of the alcohol, when it is observable, is varied. It may cause the corpuscles to run too closely together, and to adhere in rolls; it may modify their outline, making the clear-defined, smooth, outer edge irregular or crenate, or even starlike; it may change the round corpuscle into the oval form, or, in very extreme cases, it may produce what I may call a truncated form of corpuscles, in which the change is so great that if we did not trace it through all its stages, we should be puzzled to know whether the object looked at were indeed a blood-cell. All these changes are due to the action of the spirit upon the water contained in the corpuscles; upon the capacity of the spirit to extract water from them. During every stage of modification of corpuscles thus described, their function to absorb and fix gases is impaired, and when the aggregation of the cells, in masses, is great, other difficulties arise, for the cells, united together, pass less easily than they should through the minute vessels of the lungs and of the general circulation, and impede the current, by which local injury is produced.

"A further action upon the blood, instituted by alcohol in excess, is upon the fibrine or the plastic colloidal matter. On this the spirit may act in two different ways, according to the degree in which it affects the water that holds the fibrine in solution. It may fix the water with the fibrine, and thus destroy the power of coagulation; or it may extract the water so determinately as to produce coagulation."

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Precautions to be taken while combing hair

Hair combing is a routine activity of almost all people.Some people keep a particular hair style throughout their life and some especially younger generation adopt new styles according to new trends and fashion.Hair styles has got close relation with the personality of a person.The hair of an unhygeinic person is usually tangled and dirty because of lack of washing and combing.To have a healthy scalp hair proper nutrition is needed.General health has got direct relation with the quality and quantity of hair.Regular washing,use of hair oil,proper combing ect are also needed to make the hair beautiful.General hints for combing is discussed here.

1) Different varieties of combs are available in the market.The best comb is selected by considering the nature of hair(hard or soft,long or short) ,style and convenience.
 
2) Combing should be done with utmost care and concentration.Some people especially gents think about some other matters and comb without any care which may be harmful to the hairs.

3) Combing should be gentle .A vigorous combing can increase hairfalling.

4) Do not comb if the hair is wet.  First dry it with a towel and then put some oil and gently massage it.Now the combing will be easy and harmless.

5) Should not be combed in the opposite direction of hairs.This can increase hair falling.

6) Vigorous combing in backward direction can produce traction baldness.

7) Frequent combing can damage the scalp and the hair follicles.Those who carry pocket comb use it frequently and make it a habit.Combing two or three times in a day is sufficient.

8) The tooth of the comb should not be sharp and it should not be pressed too tightly on the scalp.

9) Always clean the comb before and after use because hair and dirt deposited in the gap will make combing diffucult and painful.

10) Others comb should not be used.This helps to prevent fungal and bacterial infections.Head lice can also spread from one person to other by sharing the combs.

11) Combing the tangled hair is difficult and painful.Hence use some shampoo for cleaning and after drying  put oil and make the hairs free for an easy combing.

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CEREBRAL PALSY

It is a non progressive neuromuscular disorder causing mild to severe disabilities throughout life.This condition is manifested as a group of persisting qualitative motor disorders which appear in young children due to damage to the brain during delivery or due to some pathological conditions in the intrauterine life.The neuroligical problems are multiple but non progressive in nature.Approximately 2 per 100 live birth is having this problem.This disease is having no hereditary tendency.

Causes of cerebral palsy:

1) Injury to the brain during delivery.

2) As a complication of forceps delivery.

3) Lack of oxygen supply to the baby during delivery.

4) Infections during delivery.

Signs and symptoms of cerebral palsy:--

The signs and symptoms may not be similar in all babies affected.Depending upon the damage to the brain there may be mild to severe lesions.

Mild cases:- 20% children will have mild disability.

Moderate cases:-50% cases are having moderate disability.The affected children require self help for assisting their impaired ambulation capacity.

Severe cases:-About 30% of the affected children are totally incapacited and bedridden and they allways need care from others.

Abnormal findings in cerebral palsy:-

1,Abnormal neonatal reflexes.

2,Stiffness of all muscles with awkward motion.
3,Extention of extremities on vertical suspension of the infant.

4,Scissoring of the lower limbs due to spasm of the adductor muscles of the thigh.

5,In severe cases the back bend backwards like and arch.

6,May have total or partial paralysis.

7,Arrest of neurological and behavioral developement.

8,Swallowing may be difficult in some cases.

9,Drooling of saliva.

10,Mild to severe mental retardations.

11,Abnormal movements are seen in some cases.

12,Tremors with typical movements.

13,If cerebellum is affected there will be loss of muscle tone with difficulty in walking.

14,Complete or partial loss of hearing.

15,Speech may be affected.

16,Squint and other visual problems may be associated.

17,Convulsions may be seen in some children.

Cerebral palsy is diagnosed by detailed clinical examination and by eliminating other similar diseases like brain tumour, progressive atrophy ect.All investigations like CT scan,MRI and routine investigations are needed to ruleout other diseases.

Management of carebral palsy:--

General management:

This includes proper nutrition and personal care.  Symptomatic medicines are needed to reduce convulsions and muscle stiffness.  Diazepam can reduce spasticity and athetosis.
Dantrolene sodium helps to relax skeletal muscles.

Physiotherapy:

Here massage,exercise, hydrotherapy and ect are needed.Special training is given to train walking,swallowing and talking.The affected children are also trained to hold articles for routine activities.

Rehabilitation:

Moral and social support should be given to these children.They should be send to special schools where special training can be given by trained staff.Mentally retarded children need special training.Depending up on the disabitity special instruments and machines are given for locomotion and to assist their daytoday activities.

Occupational therapy:

This is given by occupational therapists.They train the disabled people to do some suitable works so that these people can have their own income.

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Aspen Nightlife

Finding things to do in Aspen, Colorado during the 

day isn’t difficult – get out on the slopes and ski or 

enjoy one of the other winter sports that you love. 

At night, however, Aspen really comes to life with 

Aspen nightlife! No matter how old or young you are, 

there is something to do in Aspen twenty-four hours 

a day, seven days a week.

Music and dancing are the biggest Aspen nightlife 

attractions, but there is more to do than just that – 

so if you aren’t quite old enough to get into the 

various bars and clubs in the area, don’t think that 

you will be bored at night – you won’t be! Start by 

finding out what activities are planned for the 

evening at your lodge or hotel. Most lodges and 

hotels have events planned throughout the season 

– and this is a good place to start finding things to 

do after the slopes have closed for the day.

Shopping in Aspen is another highlight. There are 

many galleries and specialty shops that you won’t 

find in your own hometown. Take advantage of this. 

Most shops are open after the slopes have closed 

for the day, and many stay open late because they 

understand that you want to spend your daylight 

hours out on the slopes.

If you aren’t old enough for the club scene, take 

advantage of the teen nights that are offered by many 

of the resorts. These are safe fun nights for teens, 

which parents will approve of.  Teens also enjoy the 

offerings at many of the spas. Spas aren’t just for 

adults. Enjoy the skin treatments, massages, 

saunas, and hot tubs. Some resorts also have game 

rooms for the teens and younger kids.

If you are old enough for the bars and clubs – finding 

something to do won’t be hard at all. Again, find out 

what is happening in the evening at your lodge or 

hotel first. If you aren’t interested, hit the streets. 

Almost everything is within walking distance in Aspen, 

and anything that is out of walking distance is 

accessible by bus or taxi. If you will be drinking, 

do not drive your car to the bar or club – find 

alternate transportation.

The Aspen Recreation center has many planned 

events throughout the season that are appropriate for 

adults and kids. However, if you are planning to bring 

the kids, but you want to enjoy some adult Aspen 

nightlife as well, child care may be available through 

your lodge or hotel. 

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Homoeopathy for bad breath

Offenssive smell from the mouth is a common complaint in the day to day medical practice.It mainly affects those who mingle with others very closely. Bad breath is noticed mainly by the friends & family members or some times person himself feel it and come to the doctor.Many badbreathers develop depression which forces them to be away from the society which in turn hampers their activities.
                               
The protein in the food debris are degraded by the anaerobic bacteria present in the mouth.Offenssive odor is produced due to release of  some gases like hydrogen sulphide,skatol ect due to bacterial activity.Formation of a thin sticky membrane on the tongue favoures bacterial growth.Bactrera are also seen in the crypts of tonsils ,dental caries,dental pockets ect.Bad breath is associated with oral hygiene,caries,gingivitis,tonsillitis,tonsillar plaques,food habits,water intake ,tobacco chewing,stomach and liver diseases and ect.

Homoeopathy is a system of medicine introduced by a german physician Dr Samuel Hahnemann.Homoeopathy treats the diseased individual as a whole rather than treating diseased parts or organs.The physical,mental,emotional,social spheres of a person is considered for a permanent cure.This system believes that the diseases are caused due to the derangement of vital force which is an invisible power in every individual.In a healthy state the vital force maintains the equilibrium of mind body and soul .During this man will have normal sensations and functions.When the vital force gets affected there will be external manifestations in the form of signs and symptoms.The imbalance in the body functions makes a shelter for forign organisms(bacteria,viruses,fungi,protozoa ect) and allow them to proliferate &produce so called diseases.Homoeopathy believes thet the real desease comes before the bacteria & viruses,hence the root cause of the disease has to be treated for a permenent cure.The antibacterial and antiviral agents only remove the secondary causes mentioned above.

Diseases are produced by noxious morbific agents called Miasms which are dynamic influences which affect the vital force.There are mainly three miasms PSORA ,SYPHILIS&SYCOSIS. These three causes are accepted by other schools of medicine but called by different names. Psora causes functional disturbances, syphilis cause structural changes in the form of destructions and sycosis causes changes in the form of overgrowth.These three miasms can act individually or in combined form producing different disease conditions.

To treat bad breath with homoeopathic medicine is easy if correct remedy in suitable dose is given. In the homoeopathic medical repertory by Dr Robin Murphy there are 140 homoeopathic drugs mentioned for bad breath.So just giving one drug for bad breath may not give good result.To come to a correct remedial diagnosis we should have the symptomatology of the person .It is the total symptoms of a person which includes mental generals,physical generals,particular symptoms ect.Bad breath is considered as a physical general symptom .Eventhough it comes only from a part of the body it affects the whole individual.

Symptoms related with appetite,thirst,bowels ect are included in physical generals.
All signs and symptoms (mental&physical)of the person is taken in detail.Knowledge about past illneses,family history of diseases,food & bowel habits,relation to climatic changes and constitution ect are noted down in a systematic order.

Mental symptoms:

example: fear,anxiety,depression,anger,jealousy and ect....

Physical symptoms:

example: Body makeup,appetite,thirst,desires,aversions,bowels,urination,sleep,taste, nature of smell,discharges any abnormal sensations like pain, burning ,climatic changes,thermal relations, and ect....

Peculiar uncommon symptoms:

This is the speciality of homoeopathic system of medicine.For the selection of a suitable remedy these symptoms are very important.common symptoms which are seen almost in all patients are least important.

particular/local signs&symptoms:

This include signs &symptoms related to body parts &organs.

example: Coating on the tongue,nature of mucus membrane of  oral cavity, tonsils, gums, teeth, ulcers, discolourations ect are considered here.

Systemic & general physical examination:-

Bad breath can be due to various systemic and disorders.Hence all systems ( respiratory system ,digestive system,nervous system, cardio vascular system and ect )and parts from head to foot should be examined.

provisional disease diagnosis;  Here probable diseases are diagnosed. In homoeopathy disease diagnosis is not that much important for the selection of a  remedy,but needed for general management and to know the prognosis.

Investigations:

This includes lab investigations and other methods to find  out any other major illnesses.
                                                                                                                         
Final disease diagnosis:

After doing all investigations the disease is diagnosed.

Remedial diagnosis:

This is the most importnant part as far as homoeopathy is concerned. For this the selected symptoms are arranged in a systematic order on the basis of importance.                            
symptoms are analysed to find out the importance of each symptom for the selection of a remedy.Remedies are selected on the basis of similarity.[the basic principle of homoeopathy is 'similia similibus curenter' means like cures like.A medicine which can produce some symptoms in a healthy man can be used as a remedy to trea the similar symptoms in a diseased person.Each homoeopathic drug is proved on healthy human beings and the symptoms collected by this process(drug proving) is written in meteria medica.]

Suitable remedies are diagnosed by a process called repertorisation. Here books called repertories are used. Repertory is the index of symptoms of materia medica(books which  contain the symptoms of drugs).Nowadays computer softwares are used for repertorisalion.By this process we will get the remedies covering  maximum important symptom of the patient.

Amoung this group of remedies  the most suitable remedy is selected by referring various books and history of the patient..The selected medicine is given in suitable potency & dose.

ANTI MIASMATIC TREATMENT:

The root cause of disease is miasms which should be eradicated using suitable anti miasmatic drugs.Every drug can eradicate the miasm if there is symptom similarity.there are anti psoric drugs,anti syphilitic drugs and anti sycotic drugs.After diagnosing the miasm suitable anti miasmatic drug has to be given to complete the cure.

[In homoeopathy medicines are prepared from different sources like minerals, plants, animals, toxins, diseased parts ect. Medicines are prepared from these substances by a special process called potentisation.Here the soluble  substances are potentised by diluting with spirit and insoluble substances by grinding with sugar of milk.The crude drug substance is first mixed with a calculated quantity of spirit and water and kept for few days .From this mixture extract is taken and is called mother tincture(denoted as Q).From this mother tincture dilutions are prepared by potentisation.Potentisation is a mathematical process by which the quantity of original drug substance reduces but medicinal power increases. Depending upon the ratio of quantity of drug substance and vehicle(spirit or sugar of milk)there are different scales for this process.Each scale has got different potencies which indicate power of medicine.Example in decimal scale 3x,6x.12x ect.in centisimal scale there is 30c,200c ect,in LM poteny there are 0/1,0/2,0/3 ect.potency is written after the name of every medicine]

Same medicine is available in different potencies. Suitable potency is selected according to so many facters like sevearity,depth of disease,condition of the patient ,nature of disease ,type of symptoms,age of patient and ect.

Some useful homoeo drugs for bad breath.

Arnica montana, Antim crude, Ars alb, Asafoetida, Aurum met, Baptisia,    Bryonia,Borax,Calc carb, Carbo veg, Cinchona, Chelidonium, Graphites,  Kali bich ,Kreosotum, Lachesis, Lycopodium, Merc sol, Natrum mur,  Nitricum acidum, Nux vomica, Plantago, Pulsatilla, Phos, Pyrogen, Sulphur etc.

1) Arnica montana:

This medicine is useful for fetid breath.Mouth is very dry with thirst for water.Bad breath associated with fever.There is bleeding from the gum,may be after tooth extraction or after injury.Offenssive gas pass upwards and downwards from stomach.Petient is very sensitive to touch with sore and bruised feeling allover the body.

2) Antim crude:

Useful for bad breath with gastric complaints and coated tongue.This medicine act mainly on filthy persons with aversion to bathing.Tongue is coated white like fur.Nostrils and lips are cracked .Eructations are putrid.Very useful for badbreath in children


3) Ars alb:

All discharges are having cadeveric smell.Saliva is bloody with bad odor.Thirst for  warm water is well marked. This medicine act well in debilitated and emaciated persons.Bad  breath associated with gastric disorders.Vomiting from slightest food or drink and intolerance of  vegetables and watery fruits.Mentally these patients are fastidious with an insecurity  feeling.They are having fear of death or serious disease with restlessness and anxiety.

4) Asafoetida:

Useful for bad breath associated with eructations.Great distension of abdomen with sensation of a ball rising in throat.All discharges are offenssive.Reverse peristalsis with loud eructations.This medicine act well on hysterical persons.

5) Aurum met:

Useful for bad breath in girls at puberty. There is ulceration in gums with putrid or bitter taste. Destruction in body tissues like bone is noticed in these patients.This medicine act well on persons who are tired of life with suicidal thoughts.They also have a feeling that they have done an unpardonable crime.


6) Baptisia:

Breath fetid with bitter taste.Gums sore and ulcerated.Yellowish brown coating on centre of tongue with glistening edges.Surface of the tongue is cracked.These patients feel difficult to swallow solid food.Tonsils are enlarged without pain.Useful for painless tonsillitis &   pharyngitis with putrid smell.All discharges are offenssive.This medicine act well on persons having besoted look.There is a tendency for stupor and delirium in these persons.
                                       
7) Borax:

Useful for bad  breath associated with apthous ulcer in the mouth.Also effective for fungal infection of the mouth.Mouth is very hot and tender.Ulcers bleed on touch.Very useful for  bad breath in children with ulcers in the mouth.Child is having fear of doward motion.

8) Bryonia:

Irritable persons who always talk about business.Lips parched dry and   cracked.Tongue coated dark brown with bitter taste in the mouth.Thirst for large quantity of  cold  water is well marked.Heaviness in abdomen after eating.Usually constipated with hard  dry  stools.


9) Calcarea fluor:

Plugs of mucus are continually forming in the crypts of the tonsils.Unnatural looseness of the teeth with or without pain.Prone to get caries with discolouration.Tonsils are    enlarged with recurrent infection.


10) Carbo veg:

These patients are weak and debilitated .All body discharges are profuse with   cadeveric smell.Gums are retracted and bleed easily.Frequent putrid eructations with distention   of  abdomen.Complaints ameliorted by passing flatus.Can't tolerate meat and fat.Involuntary    diarrhoea at night.Wants to be fanned from a close distance.


11) Chelidonium:

Tongue yellow with imprint of teeth.Bad odor with bitter taste in the  mouth.Useful for bad breath with liver complaints.Thirst for hot liquids.Patient feels better by eating.  Constipation with hard round stools.Constipation alternating with diarrhoea.

12) Graphites:

This medicine act well on obese patients with skin troubles.Breath smells like urine.Rotten odor with salivation and blisters in the mouth.Sour eructations with gastric complaints.Skin complaints with sticky discharges.Gastric pain ameliorated by eating .

13) kali bich:

Bad breath with gastric ulcer.There are round ulcers in the mouth.Saliva viscid.  Vomiting with bitter taste.Tongue is smooth .Craves bear.Gastric complaints alternating with rheumatism.

14) kreosotum:

Teeth dark and crumbly.Bitter taste in the mouth with putrid odour.Very rapid decay of teeth.All discharges are very offenssive.Gums spongy and bleed easily.Bad breath associated with caries and gastric complaints.

15) Lachesis:

This medicine act on dark restless patients with jelousy.Tongue is black  coloured.   Complaints are aggravated during sleep.Wants fanning from a long distance.Cannot tolerate tight cloathing around body.Complaints aggravated in hot climate.

16) Lycopodium:

Act well on intelligent people who are physically weak.They have lack of self confidence.Useful for badbreath associated with sour eructations with burning in throat.  Teeth excessively painful to touch.There are blisters on the tongue.Wants warm food and drinks.These   people are usually constipated .Craving for sweets well marked.

17) Merc sol:

Sweetish metallic taste in the mouth with bloody viscid saliva. Gum is spongy and  bleed easily.Mouth is moist with increased thirst.Teeth indented. Crown of the teeth decay.Fetid odor from the mouth can be felt all over the room.Ulcerations in the mouth with bleeding.All body discharges are offenssive.All complaints are aggravated at night.

18) Nux vomica:

This medicine act well on people who lead a sedentery life.They are very short tempered and become angry very easily.They are very busy in their occupation and enjoy modern civilised life with all types of food and drink.Bad breath is more after meals and in the morning. Posterior part of the tongue is coated and anterior part is clean.Sour taste in the mouth with nausea in the morning.They have got frequent urge for stool.Heavy feeling in abdomen after food is noticed.

19) Plantago:

Dental caries with severe toothache.Pain better by eating.Salivation is better by eating.  Toothache with swelling of gums.Gargling plantago Q is useful to get relief from   toothache due to caries.

20) Pulsatilla:

Act well on mild and gentle ladies with a yielding disposition.Patient is very timid with a weeping tendency.Bad breath is noticed mainly in the morning.Mouth is very dry but dosn't want to drink water.  Yellow or white tongue covered with a  tenacious mucus.Taste is altered.Taste of food remains in the mouth for a long  time.Patient wash the mouth frequently.

21) Psorinum:

Act well on unclean patients with bad odor.  Hawking up of cheesy, pea like balls of   disgusting smell and taste is the main cause for bad breath in these patients.Tonsils are swollen with profuse offenssive saliva.Quinsy with tough mucus in throat.All body secretions are filthy.Eructations taste like bad eggs.Very hungry and getup even at midnight for food.Swallowing is painful with pain in ears.

22) Pyrogen:

Bad breath of septic origin is cured with this medicine.Taste terribly fetid with horrible breath,tongue red ,dry ,smooth asif varnished.Bad breath associated with high fever and   coffeground vomiting. In general patients body is very sensitive to touch,can't rest on bed because of bruinsed pain.All discharges are offenssive.  

23) Sulphur:

This medicine act best on dirty & filthy people with offenssive odor and a tendecy for skin diseases.Lips dry bright red with burning sensation..Tongue white with red tip & borders.Bitter taste in the morning. Eructations are putrid.Burning in all parts of the body. Aversion to bathing  is well marked.Not bothered about hygiene ,still they believe that they are having superhuman powers.  These individuals are very selfish.

Some homoeo mother tinctures (Q) useful for bad breath.

[mother tincture should not be taken directly because it can produce burning sensation,hence 10 drops should be mixed in half glass of water and taken internally or used for gargling]


1) Cinnamon  Q : This mother tincture can be used for gragling after diluting with  water.Also useful for bleeding from gums.

2) Eucalyptus  Q : This tincture can be used as a mouth wash after mixing with water.Internal use of this medicine can remove mucus from the respiratory tract.Also useful for cold and coryza.
 
3) Zingiber  Q : Useful for bad breath associated with gastric complaints.  This medicine can improve digestion.Also used for gargling.

4) Rhus glabra Q : Gargling of this tincture is very useful for ulcerative lesions in the mouth like aphthous ulcer.Internal use of this tincture can reduce the bad smell of stool & flatus.

5) Oleum caryophyllum Q : Gargling of this tincture can reduce toothache.Due to it's fregrant quality very useful to reduce bad breath.

6) Balsamum peru Q : This medicine can remove the mucus from respiratory tract hence very useful in chronic bronchitis and lung abscess.Can heal the ulcers in the mouth by gargling  this tincture,it can also produce pleasent smell from the mouth.

7) Menthol Q  : This is a main ingradient in tonics and syrups.Gargling of this tincture reduces  bad breath.
 
               

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TONGUE IN DISEASE DIAGNOSIS:

Introduction:

Tongue is a muscular organ associated with the function of deglutition,taste and speech.It acts as an easily accessible organ for the assessment of  health of an individual and shows the state of hydration of the body.It is said that tongue is the mirror of the gastrointestinal system and any abnormal functioning of the stomach and intestines will be reflected on the tongue.

Some characteristic changes occur in the tongue in some particular diseases.That is why the examination of the tongue is very essential and will give some clues for diagnosis.All doctors examine the tongue and they consider the changes in size,shape,,colour,moisture,coating,nature of papillae and movements ect.

Appearance of tongue in some abnormal conditions:-

1) Movements of the tongue:-

a) In one sided paralysis of the body(hemiplegia)tongue moves towards the parylised side when protruded.  

b) Tremulus movement of the tongue is seen in diseases like thyrotoxicosis,delirium tremens and parkinsonisum.Tremor is also seen in nervous patients.

c) In progressive bulbar palsy there will be wasting and paralysis of the tongue with fibrillation.Eventually the tongue gets shrivelled and lies functionless in the floor of the mouth.This condition is associated with dribbling of saliva and loss of speech.

d) In chorea(involuntary rhythmic movements) the patient may not be able to keep the protruded tongue in rest,it will be moving involuntarily.

2) Moistness of the tongue:-

The moistness of the tongue gives some indication about the state of hydration of the body.Water volume depletion leads to peripheral circulatory failure characterised by weakness,thirst,restlessness,anorexia,nausea,vomiting ,dry and parched tongue.

Dryness of the tongue is seen in following conditions.

a) Diarrhoea
b) Later stages of severe illness
c) Advanced uraemia
d) Hypovolumic shock
e) Heat exhaustion
f) Hyponatraemia
g) Acute intestinal obstruction
h) Starvation
i) Prlonged fasting.

3) Change in colour of tongue:-

a) Central cyanosis:-

Cyanosis is the bluish discolouration of the mucus membrane due to decrease in the amount of oxygen in the blood.This is seen in heart failure,respiratory failure and in anoxia.In cyanosis tongue,lips ect becomes pale bluish.

b) Jaundice:-

This is the yellowish discolouration of all mucus surfaces of the body (including tongue)due to increase of bilirubin in the blood.Jaundice is seen in hepatitis,bile duct obstruction,increased destruction of RBCs and ect...

c) Advanced uremia:-

This is the increase of urea and other nitrogenous waste products in the blood due to kidney failure.Here the tongue become brown in colour.

d) Keto acidosis:-

This is the acidosis with accumulation of ketone bodies seen mainly in diabetes mellitus.Here the tongue become brown with a typical ketone smell from the mouth.

e) Riboflavin deficiency:-

Deficiency of this vitamin (vitamin B2) produces megenta colour of the tongue with soreness and fissures of lips.    

f) Niacin deficiency:-

Deficiency of niacin (vitamin B3)and some other B complex vitamins results in bright scarlet or beefy red tongue.

g) Anaemia:-

It is the decrease in haemoglobin percentage of the blood.In severe anaemia tongue becomes pale.

4) Coating on the tongue:-

a) Bad breath:-

The main cause for bad breath is formation of a pasty coating(bio film) on the tongue which lodges thousands of anaerobic bacteria resulting in the production of offenssive gases.Those who complain about bad breath may have thick coating on the posterior part of the tongue.

b) Typhoid fever:-

In typhoid fever tongue becomes white coared like a fur.

c) Candidiasis;-

It is a fungal infection which affects the mucus surfaces of the body.On the tongue there will be sloughing white lesions.

d) In diabetes and hypoadrenalism there will be sloughing white lesions.

e) Secondary syphilis:-

Syphilis is a sexually transmitted diseased caused by trepenoma pallidum infection.In secondary stage of this disease we can see mucous patches which are painless,smooth white glystening opalescent plaques which can not be scraped off easily.

f) Leokoplakia:-

Here white keratotic patches are seen on the tongue and oral cavity.This is a precancerous condition.

g) AIDS:-

In these patients hairy leukoplakia is seen.

h) Peritonitis:-

It is the inflammation of the peritonium(inner covering of abdominal cavity which also covers the intestines and keep them in position) in this condition there is white furring of the tongue.

i) Acute illness:-

Furring is also seen in some acute diseases.

5) Papillae:-

These are small projections on the rongue associated with taste.There are different type of papillae on the healthy tongue.In some diseases there are some abnormal changes which are following.

a) Hairy tongue:-

This condition is due to elongation of filiform papillae seen in poor oral hygeine ,general debility and indigestion.

b) Geographic tongue:-

Here irregular red and white patches appear on the tongue.These lesions looks like a geographic map.The excact cause is not known.

c) Median rhomboid glossitis:-

In this condition there is smooth nodular red area in the posterior mid line of the tongue.This is a congenital condition.

d) Nutritional deficiency:-

In nutrional deficiency there is glossitis(inflammation of tongue) leading to papillary hypertrophy followed by atrophy.    

e) Benign migratory glossitis:-

It is an inflamatory condition of the tongue where multiple annular areas of desquamation of papillae appear on the tongue which shift from area to area in few days.

f) Thiamine and riboflavin deficiency:-

Deficiency of these vitamins cause hypertrophied filiform and fungiform papillae.

g) Niacin and iron deficiency:-

In this condition there is atrophy of papillae.Smooth tongue is encountered in iron deficiency.

h) Vitamin A deficiency:-

This causes furrowed tongue.

i) In nutritional megaloblastic anaemia tongue becomes smooth.

j) Folic acid deficiency:-

Here macrocytic megaloblastic anaemia with glossitis is seen.

k) Cyano coblamine deficiency:-

Here glossitis with macrocytic megaloblastic anaemia and peripheral neuropathy is encountered.  

l) Scarlet fever;-

In this streptococcal infection there is bright red papillae standing out of a thick white fur ,later the white coat disappear leaving enlarged papillae on the bright red surface and is called strawberry tongue.

6) Ulcers on the tongue:--

a) Apthous ulcer:-

These are round painful ulcers appear in stressed individuals frequently. May be associated with food allergy.Usual sites are tongue,lips,oral mucosa and ect.

b) Herpes simplex:-

It is an acute vesicular eruptions produced by herpes simplex virus.When these vesicles rupture it forms ulcers.

c) Ulcer in cancer:-

Cancerous ulcers are having everted edges with hard base.Bleeding is also seen.Cancer of the tongue is common in tobacco chewers.

d) Syphilitic ulcers:-

Syphilitic fissures are longitudinal in direction.In primary syphilis extra genital chancre is seen on the tongue.In secondary syphilis multiple shallow ulcers are seen on the under surface and sides of the tongue.In tertiary syphilis gumma may be seen on the midline of the dorsum of the tongue.

e) Dental ulcers:-

These ulcers are produced by sharp edges of carious teeth.

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CURE OF BAD BREATH

Bad breath is a common health problem in the society.Offenssive smell from the mouth may be due to various reasons.The main reason is the presence of anaerobic bacteria in the biofilm formed on the tongue .These bacteria degrades the proteins present in the food resulting in the production of some offenssive gases like hydrogen sulphide,skatol ect.

Bad odor from the mouth in the early morning is seen in almost all individuals.This can be controlled by maintaining oral hygiene.Even after cleaning the mouth some individuals may suffer from bad breath due to some problem in the mouth or in the nearby areas.Some general disease condition can also produce bad breath.Exact cause has to be identified and should be treated accordingly.Some common measures to cure or reduce bad breath are discussed here.

1) Oral hygiene:

Mouth should be kept clean every time to reduce the bacterial action.After food gargling with lukewarm water is very essential.Even after small food articles like snacks,sweets,buscuits cleaning with water is needed.Brushing should be done twice daily.It is said that early morning brushing is for beauty and bed time brushing is for good health.

2) Brushing techniques:

Normal brushing technique should be followed for better result.Many people brush vigorously causing damage to the gums.Brushing after every food and drink can damage the enamel .Bristles of the tooth brush should be smooth but hard enough to remove the food particles from the gaps.The direction of brushing is the most important thing.The upper teeth should be brushed in a downward direction and the lower in upward direction.This is applicable to both inner and outer surfaces.Next comes the crown of the teeth;here brushing is done in anterior and posterior direction keeping the brush in same direction.This applicable to both upper and lower set of teeth.

3) Tongue cleaning:

White or yellowish coating on the tongue can cause bad breath.This is more well marked in the morning and should be removed twice daily with the healp of a tongue cleaner.  Tongue cleaner must be used gently without damaging the taste buds on the tongue.

4) Tooth pick:

Tooth pick is a small strip of wood or plastic with a pointed end.This is used to remove food particles lodged between the gaps.Very useful after eating meat and fish.Should be used gently to avoid damage to gums.

5) Gargling:

After every meal gargling with lukewarm water is useful.For better result little common salt is dissolved in the lukewarm water .Different types of mouth wash is available in the market in different trade names.Gargling with mouth wash can also reduce bad breath.

6) Food habits:

Protein containing food articles are known to produce bad breath.  Example; meat, milk, fish, egg etc.  If these food articles are taken proper cleaning is essential.Some food articles are known to produce particular smell which may be unpleasent for others.  Raw onion is the best example.It is said that an apple a day keeps the doctor away and a raw onion a day keep every body away.Small food articles taken in between can also cause bad smell(nuts,fried items etc).Maintaining regularity in food timing is the most important thing.

7) Water intake:

Dryness in the mouth can make a favourable condition for the bacterial activity resulting in bad odor.saliva is needed to keep the mouth moist and to reduce the bacterial proliferation.Production of saliva is closely related with water balance of the body and hence sufficient quantity of water should be taken to maintain the production of saliva.

8) Mouth freshners:

Natural and artificial mouth freshners can reduce the intensity of bad breath to some extent.Spicy articles are commonly used for this purpose.Chewing spices like clove,cumin seed,cardomom,cinnamon,ginger ect are useful. All citrus fruits can reduce bad odor.Mouth freshners and chewing gums are available in the market.these products are also helpful ,but some may cause damage hence should be used with caution.

If the above things doesn't work then what to do ?

Consider the following:-
     
1) Remove the cause:

Bad breath is common in some general and systemic diseases like  diabetes,fevers,gastric disorders,liver diseases and ect.By removing or reducing the primary  cause the bad breath will go automatically.

2) Modern medicine:

If bad breath is due to any infection suitable antibiotics,anti fungal or anti  viral medicines will help.If it is due to any autoimmune or chronic inflamatory conditions steroids   may also be used.Saliva producing tablets can also be used.
                           
3) Dental cleaning:

Dental cleaning done by a dentist can remove the dental plaques and tartar. This can reduce the severity of bad breath.Visit your dentist atleast once in a year.

4) Filling of caries:

Since caries are one of the main cause for bad breath it should be filled by a dentist.Earlier silver amalgam was used ,nowadays it is replaced by synthetic materials.If the pulp cavity is affected by the caries root canal treatment can be done.

5) Tooth extraction:

If caries are deep with destruction of teeth with bad smell extraction is the better choice and a dental implant can be kept in the gap.

6) Tonsillectomy:

Patients with recurrent tonsillitis can have bad breath due to offenssive discharges and release of pasty materials from the crypts of tonsils.Such patients get great relief after tonsillectomy(removal of tonsils).

7) Psychological counselling:

Those who suffer from bad breath may be very much depressed and they be away from the public .This isolation hampers their daytoday activities.Such people should understand the fact that all humanbeings are having bad breath, but with slight differences in intensities.Mostly all people control it by taking personal care.Every human body has got it's own smell,that may or may not be tolerable for others.They should be adviced to do all hygienic meashures to reduce the intensity of smell.Improving the quality of life by all possible means can also help.Moral support from friends and family members are needed for such people.

Some individuals visit the doctor for bad breath without any real problem.It is included under somatisation disorder.They usually complain about pain, breathlessness,abdominal discomfort,bad smell ect.proper diagnosis is needed to rule out any real causes.These patients should be managed with a psychological approach.

8) Homoeopathy:

In Homoeopathy medicines are selected on the basis of physical ,mental,emotional,and social aspects of the diseased person.Considering the whole aspects a constitutional homoeopathic medicine is selected and given in suitable potency and dose.By this all health related problems including bad breath will be solved.On the basis of coating on the tongue,type of smell,cause for bad breath,and other associated complaints a medicine can be given to get relief from bad breath.In the homoeopathic medical repertory by Dr Robin Murphy there are 140 homoeopathic drugs mentioned for bad breath.On the basis of signs and symptoms of the individual a suitable medicine is given.Commonly used drugs are arnica, antim crud, pulsatilla, sulphur, psorinum, nux vomica, ars alb, merc sol, kreosot, hekla lava, silicea, asafoitida, graphites, kali bich, acid nitric etc.

Homoeopathic mother tinctures like cinnamon Q,kreosot Q,zingiber Q,rhus glabra Q,menthol Q  and ect can be used  for gargling after diluting in water.

[POINTS MENTIONED IN THIS ARTICLE IS FOR GENERAL AWARENESS.  ANY BODY SUFFERING FROM BAD BREATH SHOULD CONSULT A DOCTOR.]


               






                                 

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THE GROWTH AND POWER OF APPETITE.

 One fact attendant on habitual drinking stands out so prominently that none can call it in question. It is that of the steady growth of appetite. There are exceptions, as in the action of nearly every rule; but the almost invariable result of the habit we have mentioned, is, as we have said, a steady growth of appetite for the stimulant imbibed. That this is in consequence of certain morbid changes in the physical condition produced by the alcohol itself, will hardly be questioned by any one who has made himself acquainted with the various functional and organic derangements which invariably follow the continued introduction of this substance into the body.

But it is to the fact itself, not to its cause, that we now wish to direct your attention. The man who is satisfied at first with a single glass of wine at dinner, finds, after awhile, that appetite asks for a little more; and, in time, a second glass is conceded. The increase of desire may be very slow, but it goes on surely until, in the end, a whole bottle will scarcely suffice, with far too many, to meet its imperious demands. It is the same in regard to the use of every other form of alcoholic drink.

Now, there are men so constituted that they are able, for a long series of years, or even for a whole lifetime, to hold this appetite within a certain limit of indulgence. To say "So far, and no farther." They suffer ultimately from physical ailments, which surely follow the prolonged contact of alcoholic poison with the delicate structures of the body, many of a painful character, and shorten the term of their natural lives; but still they are able to drink without an increase of appetite so great as to reach an overmastering degree. They do not become abandoned drunkards.

 No man safe who drinks. ----------------------

 But no man who begins the use of alcohol in any form can tell what, in the end, is going to be its effect on his body or mind. Thousands and tens of thousands, once wholly unconscious of danger from this source, go down yearly into drunkards' graves. There is no standard by which any one can measure the latent evil forces in his inherited nature. He may have from ancestors, near or remote, an unhealthy moral tendency, or physical diathesis, to which the peculiarly disturbing influence of alcohol will give the morbid condition in which it will find its disastrous life. That such results follow the use of alcohol in a large number of cases, is now a well-known fact in the history of inebriation. The subject of alcoholism, with the mental and moral causes leading thereto, have attracted a great deal of earnest attention. Physicians, superintendents of inebriate and lunatic asylums, prison-keepers, legislators and philanthropists have been observing and studying its many sad and terrible phases, and recording results and opinions. While differences are held on some points, as, for instance, whether drunkenness is a disease for which, after it has been established, the individual ceases to be responsible, and should be subject to restraint and treatment, as for lunacy or fever; a crime to be punished; or a sin to be repented of and healed by the Physician of souls, all agree that there is an inherited or acquired mental and nervous condition with many, which renders any use of alcohol exceedingly dangerous.

The point we wish to make with you is, that no man can possibly know, until he has used alcoholic drinks for a certain period of time, whether he has or has not this hereditary or acquired physical or mental condition; and that, if it should exist, a discovery of the fact may come too late.

Dr. D.G. Dodge, late Superintendent of the New York State Inebriate Asylum, speaking of the causes leading to intemperance, after stating his belief that it is a transmissible disease, like "scrofula, gout or consumption," says:

"There are men who have an organization, which may be termed an alcoholic idiosyncrasy; with them the latent desire for stimulants, if indulged, soon leads to habits of intemperance, and eventually to a morbid appetite, which has all the characteristics of a diseased condition of the system, which the patient, unassisted, is powerless to relieve since the weakness of the will that led to the disease obstructs its removal.

"Again, we find in another class of persons, those who have had healthy parents, and have been educated and accustomed to good social influences, moral and social, but whose temperament and physical constitution are such, that, when they once indulge in the use of stimulants, which they find pleasurable, they continue to habitually indulge till they cease to be moderate, and become excessive drinkers. A depraved appetite is established, that leads them on slowly, but surely, to destruction."

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PROSTATE CANCER

Introduction:-

Prostate is a glandular organ present only in males.  It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,two lateral and a median lobe.Since  the first part of the urethra pass through it any lesion in the prostate will produce difficulty in passing urine.

Diseases of the prostate gland:-

1) Prostatitis:-

This is the inflamation of the prostate gland due to bacterial infection.

2) Benign enlargement of the prostate:-

This is a non cancerous tumour of  the prostate seen after the age of 50.  3,Cancer of the prostate:-This is the 4th most common cause of death from malignant diseases in males.

Cancer of the prostate.

Cancer of the prostate is directly linked with the male sex hormones(androgens).If the levels of sex hormone increases the growth rate of cancer also increases.It is found that after the removel of testes there is marked reduction in the size of tumour.

Site of tumour:-

Prostate cancer is seen mainly in the posterior lobe.Non cancerous enlargement is seen in other lobes.

Changes in the gland in cancer:-

The gland becomes hard with irregular surface with loss of normal lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)

Growth :-

Growth rate is very fast in prostate cancer .The tumour compresses the urethra and produce difficulty in urination.

Spread of tumour:-

Metastasis in cancer of prostate is very early.

1) Local spread:-

From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles.Tumour cells also move to the neck and base of the urinary bladder.

2) Lymphatic spread:-

Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(in the chest)

3) Spread through the blood:-

Spread of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.

Signs and symptoms of prostate cancer:--

Signs and symptoms depend upon the stage of the cancer. The following symptoms may be seen.

1) No symptoms:-

Tumour is small and only in the posterior lobe.  This is diagnosed accidentely.

2) Slight difficulty in urination:-

Here the tumour is enlarged and urethra is slightly compressed.Shortly there will be frequent urge for urination with difficult urination.

3) When the tumour spread to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.

4) Retention of urine:-

When the urethra is completely compressed there will be retention of urine.This can lead to hydronephrosis, renal failure ect.In this condition patient may get convulsions due to renal failure and finally coma.

5) Signs of metastasis:-

Some patients come with the signs and symptoms of metastasis.

a) Lumbo sacral pain due to spread of cancer cells to lumbar and sacral vertebrae.

b) Fracture of spine due to cancerous growth in the spine.

c) Swelling, pain and fluid collection in the abdomen due to lesion in the abdomen.

d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.

e) General weakness due to spread of cancer to different parts of the body.

f) Anaemia due to involment of bone marrow and increased destruction of RBCs.

Clinical examination :-

Includes per rectal examination to feel the prostate gland,palpation of abdomen to feel the swelling in kidneys and any tumours.Patient is examined from head to foot to find out any lesions.

Investigations:-

1) Complete blood investigations;-

RBC,WBC,Platlets,ESR,bleeding time ,clotting time ect.

2) Urine analysis:-

Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.

3) Renal function tests:-

Blood urea level,serum creatinine level,electrolyte level ect.

4) Serum acid phosphatase:-

Increased in cancer of prostate.

5) x-ray of the spine:-

To detect any tumour or fracture.

6) Ultra sonography;-

Gives idea about prostate,bladder,kidney ect.

7) C T scan:-

More detailed information about organs and tumour.

8) MRI of the spine:-

Gives detailed information about spine ,disc and nearby soft tissues.

9) Lymphangiography:-

Gives idea about lymphatic spread of cancer.

10) Biopsy to confirm cancer:-

Biopsy is taken from the tumour and is send for histopathological examination under the microscope.This will detect the presence of cancer cells.

Treatment:-

1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there is coma monitoring of all vital functions along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)

Partial prostatectomy :-

Here only the affected lobe is removed.

Radical prostatectomy :-

Total removal of prostate along with nearby lymphnodes.

5, Hormone therapy :-

Stilbestrol is given to reduce tumour growth.Since this treatement increases the chance for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.

6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.

7) Radiotherapy is also done for some cases.

8) Homoeopathy:-

Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect can be given according to symptoms.Constitutional homoeopathic medicine will give great relief and can increase the life span.

9) Yoga and meditation is also healpful.

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BAD BREATH

Causes of bad breath ?

Bad breath is a common health problem which greately affects the daytoday activities of somany people. The offenssive odor from the mouth is unpleasent to those who come in close contact with bad breathers. The problem will be doubled by psychological trauma leading to depression. The sufferers from this problem wil be isolated from the society. This can even lead to marital disharmony.

Literally speaking all humanbeings are badbreathres. Oral cavity contains millions  of  anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrifies them. This process results in the formation of offenssive gases like hydrogen sulphide,methyl mescaptan,cadaverin,skatol,putrescine ect causing bad odor. If oral hygiene is not maintained properly all will suffer from  bad breath. Most of us control this by regular brushing,tongue cleaning and gargling. Even after maintining cleanliness in the mouth some individuals suffer from offenssive smell due to various causes which has to be diagnosed and treated properly.

Some common causes of bad breath.

1) Poor oral hygiene:

If oral hygiene is not maintained properly the mouth becomes the seat for millions of bacteria which produce offenssive gases by degrading the food debris. Bad breath is severe in those who do not brush their teeth regularly and clean their mouth after every food. Snacks taken inbetween meals can also produce bad breath because of improper cleaning.
Badbreath is common in almost all people in the morning on waking. During sleep there is less production of saliva .Saliva  has got some antibacterial properties which help to keep the mouth clean. Saliva conains oxygen molecules which is needed to make oral cavity aerobic. So the reduction in it's quantity during sleep makes a favourable condition for anaerobic bacteria.

2) Food habits:

The main cause of bad smell is due to degradation of protein by the bacteria and hence all food products rich in protein favours bad breath. Meat,fish,milk products, eggs,cakes,nuts,pear and ect can cause bad breath. Some food articles can produce particular type of smell which may be unpleasent. Raw onion can produce typical bad smell. It is said that an apple a day keeps the doctor away,a raw onion a day keeps everybody away. Eating groundnuts can also produce bad smell. However if proper cleaning is done smell can be reduced irrespective of the nature of food.  Irregularity in timing of food can also produce bad breath. Small food articles taken in between the meals can also produce bad smell.

3) Biofilm:

There is formation of a thin sticky coating  called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where millions of gram negative bacteriae are seen .The thick coating on the tongue is always associated with badbreath. Even a  thin biofilm can make anaerobic condition favourable for bacterial proliferation.

4) Dental caries:

This is a destructive process causing decalcification with distruction of enamel and dentine resulting in cavitisation of the tooth. These are produced mainly by the lactobacilli . Food particles are deposited inside these cavities and are putrified by the anaerobic bacteria producing bad smell. Normal brushing will not remove the food debris easily and hence they are putrified completely. Caries are common in schoolgoing children and in those who donot maintain proper oral hygiene .Calcium and vitamin deficiency can also predispose caries.

5) Gingivitis:

Gum is a mucus membrane with supporting connective tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is the inflammation of the gum .Due to various causes gum tissue get infected resulting in swelling,pain and discharge. If the condition become worse the infection spread towards peridontal area leading to continuous discharge called pyorrhoea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis.All these conditions can produce offenssive smell.

6) Gum retraction:

When the gums retract from the teeth a gap is developed which will lodge food particles and cause bad breath.

7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly in the gaps  between the teeth and gum. This will provide shelter for the food debris and bacteria causing  bad breath.

8) Ulcerative lesions& coatings:

Almost all ulcerative lesions of the mouth are associated with bad breath. These lesions may be caused by bacteria,viruses,food allergies or due to autoimmune disorders. Apthous ulcer is the commonest amoung ulcerative lesions. Others are herpes,fungal infections,vincents angina,infectious mononucleosis,scarlet fever,diphtheria,drug reactions  and ect. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating(candidiasis). Leucoplakia is a white thick patch on the mucus membrane of the mouth & tongue. It is considered as a precancerous condition. Offenssive breath is associated with these conditions.

9) Diseases of the salivary glands:

Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and make an aerobic condition which is unfavourable for the bacteria .Any condition which reduces the production of saliva can increase bacterial activity.  Some times the salivary duct is obstructed by stones or tumors.Cancer of the salivary gland is associated with offenssive odor. In suppurative parotitis purulant dischrge in to the mouth causes bad breath.

10) Tonsillitis:

Tonsils are a pair of lymphoid tissue situated  in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.

11) Tonsillar plaques & tonsillar fluid:

If bad breath persists even after maintaining proper oral hygeine there is possibility of this condition. Serous fluid secreated from the folds of tonsil is very offenssive. Some patients complain that they hawk some cheesy materials from the throat;which are very offenssive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteriae. In such conditions tonsillectomy gives noticiable relief from bad breath.              

12) Pharyngitis& pharyngial abscess:

Pharynx is a fibromuscular tube which forms the upper part of the digestive & respiratory tract. Inflmmation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offenssive discharge of pus in to the throat.

13) Dentures:

Denture users may complain about bad smell due to lodgement of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.

14) Tobacco:

Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasent for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhoea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these causes offenssive smell.

15) Smoking:

Smokers always have  bad smell. It can also produce lesions in the mouth & lungs causing bad breath.Smoking increases carbon dioxide in the oral cavity & reduces oxygen level,causing a favourable condition for bacteria. Smoking reduses appetite & thirst hence acid peptic disease is common in chain smokers.

16) Lesions in the nose & ear:

Bad breath is occasionally seen in sinusitis(infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the eustachian tube(passage from middle ear to the throat)can also cause offenssive odor. Chronic rhinitis(infection of mucus membrane of nose) and forign bodies in the nose can also produce bad smell in the expired air.

17) Diabetes mellitus:

Mostly all diabetic patients suffer from bad breath. Coated tongue,ulcers &coatings in the mouth ,increased sugar level in tissues ect are responsible for bad breath.Bacterial growth in diabetic patient is very faster than non diabetic individuals.

18) Fevers:

Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis , AIDS ect produce bad smell.
 
19) Fasting & dehydration:

Dry mouth favours bacterial activity. So any condition which produce dryness in the mouth makes the breath offenssive. Eventhough the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.

20) Bedridden patients:

Bedridden patients suffer from offenssive breath due to thick coating on the tongue. water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favours anaerobic bacteria to become active.

21) Diseases of stomach & esophagus:

Eructation of gas and food produce unpleasent smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis,gastric ulcer and cancer of stomach.

22) Intestinal diseases:

Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative collitis..Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis ect.

23) Diseases of lungs:

Lung diseases like pneumonia, lung abscess,chronic bronchitis,bronchiectasis,tuberculosis, lung cancer ect can produce bad odor during expiration.

24) Liver disorders:

Liver diseases like hepatitis, cirrhosis,can  cause bad breath.Gall bladder diseases with vomiting also causes unpleasent odor.    

25) Psychiatric  patients:

Bad breath is common in psychotic patients due to poor hygiene,irregular food habits,less water intake and ect.


26) Somatisation disorder:

This is a psychiatric disorder charecterised by the presence of a physical symptom that suggest a medical illness .These patients come with physical complaints like pain,nausea difficult respiration, bad smell ect. This condition is diagnosed after detailed examination of the patient with all investigations.Since this is a psychiatric disorder it has to be managed with a psychological approach.

[ THE POINTS MENTIONED IN THIS ARTICLE IS FOR GENERAL INFORMATION. ANY PERSON HAVING BAD BREATH SHOULD CONSULT  A QUALIFIED DOCTOR ]

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BRIEF IDEA ABOUT PILES (Hemorrhoids)

What is piles ?
 
Dilatation of radicles of rectal veins within the anal canal is called piles.The medical term for piles is hemorrhoids.Compared to arteries veins are weak due to thin walls and hence any backpressure in the veins can make them tortuous.There are three rectal veins namely superior, middle and inferior rectal veins.Any obstructions or increase of pressure in these veins can predispose piles.

Depending upon the situation there are two types of piles.

1) External piles.         2) Internal piles.

1) External piles:-

This type of piles is seen outside the anal opening and is covered by skin.It is black or brown in colour.This type of piles is very painful due to rich nerve supply in this area.

2) Internal piles:-

It is inside the anal canal and internal to the anal orifice.It is covered by mucous membrane and is red or purple in colour.These piles are painless.

Some times internal and external piles occure in same individual.

Factors responsible for piles:--

1) This is a familial disease.

2) Piles is seen only in animals maintain an erect posture. This is due to congestion in the rectal veins due to the effect of gravity.

3) It is common in individuals having chronic constipation.Those who have a habit of visiting the toilet due to frequent urge for stool may develop piles in future.

4) Piles is common in those who take excess of chicken, prawns, spicy food ect.Those who take vegetables and fibrous food are rarely affected.

5) Some ladies get piles during pregnancy due to compression of rectal veins by the uterus.

6) Cancerous lesions in the rectum can obstruct blood flow and result in piles.

Signs and symptoms of piles:--

1) Pain:-

Pain is common in external piles which will be worse while straining at stool.

2) Bleeding:-

Bleeding comes in splashes while pressing for stool.Bleeding may be profuse in some cases.

3) Protruding mass:-

In external piles the swelling can be felt around the anal orifice.In case of internal piles initially it can not be felt.When the disease progresses the piles protrude during stool and will go inside automatically.When the condition becomes worse the protruded piles will not go back in to the anus.

4) In some cases there will be discharge of mucus with itching around the anal orifice.

Complications of piles:--

1,Infection: The infection can spread to deep veins resulting in septicaemia.
2,Fibrosis: Here the piles become fibrosed with hardening of anal orifice.
3,Thrombosis: Here the blood inside the piles will form clots and can obstruct blood flow.
4,Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood supply.
5,Suppuration: When the piles suppurate it can produce abscess with discharge of pus.

Treatment of piles:--

Initially it is treated on the basis of symptoms.Constipation should be treated.If there is anaemia iron should be give.Homoeopathic medicines can give good results. If medicinal treatment is not giving any result the following can be tried.

1) The thrombosed external pile is excised under local anaesthesia.

2) Sclerosant injection therapy can reduce the size of piles.

3) Rubber band ligation around the neck of piles is useful in some cases.

4) Cryosurgery is very effective.

5) Anal dilatation can reduce constipation and pain.

6) Haemorrhoidectomy is the surgical removal of piles.


How to prevent piles?

1) Eat plenty of fruits and vegetables.

2) Take fibrous food.

3) Avoid excess intake of meat,prawns,crabs ect.

4) Keep a regular timing for food.

6) Drink sufficient quantity of water.

7) Keep a regularity in bowel habits.

8) Take treatment for constipation.

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CAUSES OF LOW BACK PAIN.

 
Low back pain is a usual symptom among the modern civilized people.It affects mainly the middle aged and young adults of both sexes.People who work on the chair with out exercise and those who carry heavy loads regularly are prone to get this complaint.We can hardly find a person who has not suffered from back pain at least once in life.The causes of  low back pain ranges from simple reasons like muscular strain to cancer of spine and hence backache should not be ignored.The pain is felt in lumbar and sacral region and may radiate to nearby sites.

The following are some causes for backache.

1) Backache due to diseases in the back.

2) Backache due to gynecological problems.

3) Backache due to problems in other parts of the body.


1) Backache due to diseases in the back:--
                           
a) Injuries :-

     1) Compression fracture of the vertebral column.
     2) Rupture of intervertebral discs.
     3) Injuries to ligaments and muscles of back.
     4) Lumbosacral strain.
     5) Intervertebral joint injuries.
     6) Fracture of processes of vertebra.

b) Functional backache due to imbalance:-

     1) During pregnancy.
     2) Pot belly.
     3) Diseases of the hip joint.
     4) Curvature in the spine due to congenital defect.
     5) Short leg in one side.
 
c) Backache due to inflammatory conditions:-

     1) Infection of the bone due to bacteria.
     2) Tuberculosis of the spine.
     3) Arthritis.
     4) Brucellosis.
     5) Lumbago or fibrositis.
     6) Inflamation of the muscles.
     7) Anchylosing spondylitis.

d) Backache due to degenerative diseases in the back.

     1) Osteoarthritis.
     2) Osteoporosis in old people.
     3) Degenaration of the intervertebral disc.

e) Tumour in the spine:--

     1) Primory tumour of the bones in the spine.
     2) Metastatic tumours from other sites like prostate,lungs,kidneys,intestine ect.

2) Backache due to gynaecological problems:-

     a) After childbirth.
     b) After gynaecological operations.
     c) Prolapse of the uterus.
     d) Pelvic inflammatory diseases.
     e) Cancerous lesions of the pelvic organs.
     f) Endometriosis.

3) Backache due to problems in other parts of the body.

     a) Renal stones.
     b) Ureteric stone.
     c) Cancer of prostate.
     d) Pancreatitis.
     e) Biliary stones.
     f) Peptic ulcer.
     g) Inflammations of pelvic organs.
     h) Occlusion of aorta and illiac arteries.


Investigation of a case of backache:-

1) Complete blood count.

2) Routine urine examination.

3) Ultrasonography of the abdomen and pelvis.

4) X-ray of the lumbar and sacral region.

5) MRI of the spine.

5) CT scan of abdomen and pelvic region.

6) Examination of rectum,prostate,genito urinary organs.


Treatment of back ache:-

1) Removing the cause for backache.

2) Symptomatic treatement.

2) Back exercises.

3) Traction.

3) Yoga.

5) Surgery.

7) Homoeopathy.

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ALCOHOL HAS NO FOOD VALUE.

 Alcohol has no food value and is exceedingly limited in its action as a remedial agent. Dr. Henry Monroe says, "every kind of substance employed by man as food consists of sugar, starch, oil and glutinous matter mingled together in various proportions. These are designed for the support of the animal frame. The glutinous principles of food fibrine, albumen and casein are employed to build up the structure while the oil, starch and sugar are chiefly used to generate heat in the body".

Now it is clear that if alcohol is a food, it will be found to contain one or more of these substances. There must be in it either the nitrogenous elements found chiefly in meats, eggs, milk, vegetables and seeds, out of which animal tissue is built and waste repaired or the carbonaceous elements found in fat, starch and sugar, in the consumption of which heat and force are evolved.

"The distinctness of these groups of foods," says Dr. Hunt, "and their relations to the tissue-producing and heat-evolving capacities of man, are so definite and so confirmed by experiments on animals and by manifold tests of scientific, physiological and clinical experience, that no attempt to discard the classification has prevailed. To draw so straight a line of demarcation as to limit the one entirely to tissue or cell production and the other to heat and force production through ordinary combustion and to deny any power of interchangeability under special demands or amid defective supply of one variety is, indeed, untenable. This does not in the least invalidate the fact that we are able to use these as ascertained landmarks".

How these substances when taken into the body, are assimilated and how they generate force, are well known to the chemist and physiologist, who is able, in the light of well-ascertained laws, to determine whether alcohol does or does not possess a food value. For years, the ablest men in the medical profession have given this subject the most careful study, and have subjected alcohol to every known test and experiment, and the result is that it has been, by common consent, excluded from the class of tissue-building foods. "We have never," says Dr. Hunt, "seen but a single suggestion that it could so act, and this a promiscuous guess. One writer (Hammond) thinks it possible that it may 'somehow' enter into combination with the products of decay in tissues, and 'under certain circumstances might yield their nitrogen to the construction of new tissues.' No parallel in organic chemistry, nor any evidence in animal chemistry, can be found to surround this guess with the areola of a possible hypothesis".

Dr. Richardson says: "Alcohol contains no nitrogen; it has none of the qualities of structure-building foods; it is incapable of being transformed into any of them; it is, therefore, not a food in any sense of its being a constructive agent in building up the body." Dr. W.B. Carpenter says: "Alcohol cannot supply anything which is essential to the true nutrition of the tissues." Dr. Liebig says: "Beer, wine, spirits, etc., furnish no element capable of entering into the composition of the blood, muscular fibre, or any part which is the seat of the principle of life." Dr. Hammond, in his Tribune Lectures, in which he advocates the use of alcohol in certain cases, says: "It is not demonstrable that alcohol undergoes conversion into tissue." Cameron, in his Manuel of Hygiene, says: "There is nothing in alcohol with which any part of the body can be nourished." Dr. E. Smith, F.R.S., says: "Alcohol is not a true food. It interferes with alimentation." Dr. T.K. Chambers says: "It is clear that we must cease to regard alcohol, as in any sense, a food".

"Not detecting in this substance," says Dr. Hunt, "any tissue-making ingredients, nor in its breaking up any combinations, such as we are able to trace in the cell foods, nor any evidence either in the experience of physiologists or the trials of alimentarians, it is not wonderful that in it we should find neither the expectancy nor the realization of constructive power."

Not finding in alcohol anything out of which the body can be built up or its waste supplied, it is next to be examined as to its heat-producing quality.

Production of heat.
------------------          

"The first usual test for a force-producing food," says Dr. Hunt, "and that to which other foods of that class respond, is the production of heat in the combination of oxygen therewith. This heat means vital force, and is, in no small degree, a measure of the comparative value of the so-called respiratory foods. If we examine the fats, the starches and the sugars, we can trace and estimate the processes by which they evolve heat and are changed into vital force, and can weigh the capacities of different foods. We find that the consumption of carbon by union with oxygen is the law, that heat is the product, and that the legitimate result is force, while the result of the union of the hydrogen of the foods with oxygen is water. If alcohol comes at all under this class of foods, we rightly expect to find some of the evidences which attach to the hydrocarbons."

What, then, is the result of experiments in this direction? They have been conducted through long periods and with the greatest care, by men of the highest attainments in chemistry and physiology, and the result is given in these few words, by Dr. H.R. Wood, Jr., in his Materia Medica. "No one has been able to detect in the blood any of the ordinary results of its oxidation." That is, no one has been able to find that alcohol has undergone combustion, like fat, or starch, or sugar, and so given heat to the body.

Alcohol and reduction of temperature.
------------------------------------                  

instead of increasing it; and it has even been used in fevers as an anti-pyretic. So uniform has been the testimony of physicians in Europe and America as to the cooling effects of alcohol, that Dr. Wood says, in his Materia Medica, "that it does not seem worth while to occupy space with a discussion of the subject." Liebermeister, one of the most learned contributors to Zeimssen's Cyclopaedia of the Practice of Medicine, 1875, says: "I long since convinced myself, by direct experiments, that alcohol, even in comparatively large doses, does not elevate the temperature of the body in either well or sick people." So well had this become known to Arctic voyagers, that, even before physiologists had demonstrated the fact that alcohol reduced, instead of increasing, the temperature of the body, they had learned that spirits lessened their power to withstand extreme cold. "In the Northern regions," says Edward Smith, "it was proved that the entire exclusion of spirits was necessary, in order to retain heat under these unfavorable conditions."

Alcohol does not make you strong.
--------------------------------                

If alcohol does not contain tissue-building material, nor give heat to the body, it cannot possibly add to its strength. "Every kind of power an animal can generate," says Dr. G. Budd, F.R.S., "the mechanical power of the muscles, the chemical (or digestive) power of the stomach, the intellectual power of the brain accumulates through the nutrition of the organ on which it depends." Dr. F.R. Lees, of Edinburgh, after discussing the question, and educing evidence, remarks: "From the very nature of things, it will now be seen how impossible it is that alcohol can be strengthening food of either kind. Since it cannot become a part of the body, it cannot consequently contribute to its cohesive, organic strength, or fixed power; and, since it comes out of the body just as it went in, it cannot, by its decomposition, generate heat force."

Sir Benjamin Brodie says: "Stimulants do not create nervous power; they merely enable you, as it were, to  use up  that which is left, and then they leave you more in need of rest than before."

Baron Liebig, so far back as 1843, in his "Animal Chemistry," pointed out the fallacy of alcohol generating power. He says: "The circulation will appear accelerated at the expense of the force available for voluntary motion, but without the production of a greater amount of mechanical force." In his later "Letters," he again says: "Wine is quite superfluous to man, it is constantly followed by the expenditure of power" whereas, the real function of food is to give power. He adds: "These drinks promote the change of matter in the body, and are, consequently, attended by an inward loss of power, which ceases to be productive, because it is not employed in overcoming outward difficulties i.e., in working." In other words, this great chemist asserts that alcohol abstracts the power of the system from doing useful work in the field or workshop, in order to cleanse the house from the defilement of alcohol itself.

The late Dr. W. Brinton, Physician to St. Thomas', in his great work on Dietetics, says: "Careful observation leaves little doubt that a moderate dose of beer or wine would, in most cases, at once diminish the maximum weight which a healthy person could lift. Mental acuteness, accuracy of perception and delicacy of the senses are all so far opposed by alcohol, as that the maximum efforts of each are incompatible with the ingestion of any moderate quantity of fermented liquid. A single glass will often suffice to take the edge off both mind and body, and to reduce their capacity to something below their perfection of work."

Dr. F.R. Lees, F.S.A., writing on the subject of alcohol as a food, makes the following quotation from an essay on "Stimulating Drinks," published by Dr. H.R. Madden, as long ago as 1847: "Alcohol is not the natural stimulus to any of our organs, and hence, functions performed in consequence of its application, tend to debilitate the organ acted upon.

Alcohol is incapable of being assimilated or converted into any organic proximate principle, and hence, cannot be considered nutritious.

The strength experienced after the use of alcohol is not new strength added to the system, but is manifested by calling into exercise the nervous energy pre-existing.

The ultimate exhausting effects of alcohol, owing to its stimulant properties, produce an unnatural susceptibility to morbid action in all the organs, and this, with the plethora superinduced, becomes a fertile source of disease.

A person who habitually exerts himself to such an extent as to require the daily use of stimulants to ward off exhaustion, may be compared to a machine working under high pressure. He will become much more obnoxious to the causes of disease, and will certainly break down sooner than he would have done under more favorable circumstances.

The more frequently alcohol is had recourse to for the purpose of overcoming feelings of debility, the more it will be required, and by constant repetition a period is at length reached when it cannot be foregone, unless reaction is simultaneously brought about by a temporary total change of the habits of life.

Driven to the wall.
------------------

Not finding that alcohol possesses any direct alimentary value, the medical advocates of its use have been driven to the assumption that it is a kind of secondary food, in that it has the power to delay the metamorphosis of tissue. "By the metamorphosis of tissue is meant," says Dr. Hunt, "that change which is constantly going on in the system which involves a constant disintegration of material; a breaking up and avoiding of that which is no longer aliment, making room for that new supply which is to sustain life." Another medical writer, in referring to this metamorphosis, says: "The importance of this process to the maintenance of life is readily shown by the injurious effects which follow upon its disturbance. If the discharge of the excrementitious substances be in any way impeded or suspended, these substances accumulate either in the blood or tissues, or both. In consequence of this retention and accumulation they become poisonous, and rapidly produce a derangement of the vital functions. Their influence is principally exerted upon the nervous system, through which they produce most frequent irritability, disturbance of the special senses, delirium, insensibility, coma, and finally, death."

"This description," remarks Dr. Hunt, "seems almost intended for alcohol." He then says: "To claim alcohol as a food because it delays the metamorphosis of tissue, is to claim that it in some way suspends the normal conduct of the laws of assimilation and nutrition, of waste and repair. A leading advocate of alcohol (Hammond) thus illustrates it: 'Alcohol retards the destruction of the tissues. By this destruction, force is generated, muscles contract, thoughts are developed, organs secrete and excrete.' In other words, alcohol interferes with all these. No wonder the author 'is not clear' how it does this, and we are not clear how such delayed metamorphosis recuperates.

Not an originator of vital force.
--------------------------------

which is not known to have any of the usual power of foods, and use it on the double assumption that it delays metamorphosis of tissue, and that such delay is conservative of health, is to pass outside of the bounds of science into the land of remote possibilities, and confer the title of adjuster upon an agent whose agency is itself doubtful.

Having failed to identify alcohol as a nitrogenous or non-nitrogenous food, not having found it amenable to any of the evidences by which the food-force of aliments is generally measured, it will not do for us to talk of benefit by delay of regressive metamorphosis unless such process is accompanied with something evidential of the fact something scientifically descriptive of its mode of accomplishment in the case at hand, and unless it is shown to be practically desirable for alimentation.

There can be no doubt that alcohol does cause  defects  in the processes of elimination which are natural to the healthy body and which even in disease are often conservative of health.

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