Medical Articles, Medicine Information.

Have you ever had a sharp, stabbing pain somewhere and then, when it came back at other times, it caused worry that there was something really wrong with you?

These pains may occur in the chest or back muscles, are sharp and stabbing and usually shortlived, even if severe. They are usually muscular and the underlying cause is usually nervous tension.

Attacks of severe pain in the rectum which occur at irregular intervals and are fleeting or last only a few minutes are similar.

This condition is called proctalgia fugax. The pain may occur at night or following straining at stool or after ejaculation. Examination shows things to be normal and no organic cause can be found.

The pain is thought to arise from a cramp-like spasm of one of the muscles in the pelvic floor and so is similar to the muscle pains. Some researchers believe it is a variant of the irritable bowel syndrome.

The condition may improve with psychotherapy, with tranquillisers or with drugs designed to relieve the muscle spasm.

A full explanation of the benign nature of the disorder may be sufficient to relieve the patient’s anxiety and so relieve the condition.

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Masked depression may show itself as other symptoms such as chronic fatigue, bowel disorders, indigestion or headaches.

Pessimism, despair and withdrawal are usually characteristic of all depressed states.

A reactive depression may last for six to 12 months and then spontaneously lift or the depression may persist for many years, varying a little up or down.

Not only does depression interfere with a patient’s life, taking away his enjoyment and affecting his efficiency and work output, it also has its effect on those around him, particularly his immediate family.

It is important for the doctor, for those who counsel people and for those who work and live with a depressed person to recognise that any depression may lead to suicide if the person feels hopeless.

Other treatment is ineffective unless the correct diagnosis is made.

Anxiety may be associated with depression and may mask it. Only the anxiety may be seen and a tranquilliser prescribed. Most tranquillisers do nothing for the underlying depression. The anxiety state calms down but this allows the depression to well up.

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Whooping cough is much less dangerous in the older child and so immunisation with a high risk of reaction is not warranted.

Diphtheria is due to a bacterium, not a virus, and has a short incubation period of about three days.

The disease may be mild and produce little more than a mild sore throat and a “cold” type illness, but it may cause a severe infection with a high temperature, muscle weakness, aches and pains, confusion and delirium.

When the throat is affected, a typical pearl-grey exudate or membrane may appear on the tonsils or back of the throat.

The affected larynx or voice box may swell and lead to obstruction of breathing. It may be necessary to make an opening in the windpipe or trachea (a tracheotomy) to enable the child to breath.

The heart may be affected by toxins or poisons produced by the germ and lead to heart failure and death. Sometimes the nervous system is affected and this can lead to paralysis of muscles.

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Just as we cannot exactly predict for any individual what organ will be affected by secondary growths, so we cannot exactly predict what will eventually cause death. Most causes of death from cancer fall into one of the two following groups. Firstly, cancer may destroy so much of a vital organ (such as the liver, brain or lungs) that it can no longer carry out its normal function. Secondly, cancer can weaken the body and immune system so much that infections such as pneumonia are fatal. These causes all act gradually. Less commonly, cancer causes death through haemorrhage, blood clots or other more sudden processes.

The ‘natural history’ of an illness means what happens if there is no treatment. It is important’ to have some idea of how your cancer might behave without any treatment before you decide what, if any, treatment to have. Of course, cancer behaves in exactly the same way if it is not sensitive to the treatment chosen. Unless you are cured, your cancer will behave like this sooner or later.

As we have learnt, a cancer starts with one or a few cells. These have to double (each one split into two) about thirty times for the cancer to reach the size of a 1cm cube. It is unusual to detect a cancer smaller than this. This means that by the time a cancer is diagnosed, even when it is very tiny, it has actually been there for quite a while. It would be at least a few weeks even in the case of very rapidly-growing cancers and many months or even years for some of the slower-growing types.

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There is a list of relative contraindications to HRT, that is those conditions in which you and your doctor will need to consider the balance between the risks and the benefits:

• Endometriosis can lead to a difficult decision having to be made. If you had an oophorectomy, then you will probably have particularly troublesome hot flushes, and if you had the operation before about the age of 45 you will be at a much greater risk of developing osteoporosis, so HRT would seem an important treatment for you. However, the excess tissue that built up in endometriosis may get worse on HRT, even many years after the menopause, suggesting that you should not use this form of treatment. This is obviously something you should talk over with your doctor.

• If you have a family history of cancer of the breast or uterus, your doctor will want to consider what your chances are of developing either of these diseases if you take HRT. Once again, only you can decide by weighing the relative risks against the relative benefits. Benign breast disease needs careful monitoring, but HRT needn’t always be ruled out.

• Fibroids tend to get worse in the presence of oestrogen, and may enlarge if you take HRT. But this doesn’t usually cause extra problems and most women with fibroids who are on HRT find they just have heavier periods.

• The presence of gallstones means HRT has to be prescribed with caution, as it can lead to an increased risk of this condition becoming worse. A non-oral route, such as the patch or implant, avoids the digestive system, so may be acceptable. Oestrogen can make gallbladder disease worse.

• High blood pressure should be investigated before starting on HRT, but once it has been brought under control, your doctor will probably feel it is alright for you to be on HRT. High blood pressure is not in itself a contraindication.

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The preceding discussion has assumed heterosexual sexual behaviour. However, not everyone is primarily attracted to members of the opposite sex; some people, both males and females, are aroused by and form homosexual relationships with members of their own sex. Research on the effects of hysterectomy on the sexual relationships of lesbian women is extremely limited and deserves more attention.

Another area in which knowledge is limited is the previously mentioned role of the uterus in sexual response. Direct stimulation of the cervix during sexual intercourse also seems to have a role in the sexual response of some women and men.

More information exists about the effects of changes in hormone production after hysterectomy. Even when the ovaries are retained, oestrogen levels seem to be affected by hysterectomy in some women. About a quarter of women whose ovaries remain after hysterectomy experience early loss of ovarian function (on average four to five years earlier than in comparable women who have not had a hysterectomy) which can lead to vaginal dryness and hot flushes. In a bid to prevent or overcome these problems, many women with indications of low oestrogen levels are prescribed oestrogen therapy after a hysterectomy whether or not their ovaries have been removed.

A woman’s attitudes — and those of her partner — can be an extremely important influence on sexual relations after hysterectomy. In the aftermath of her hysterectomy, Kay was already questioning her femininity and attractiveness. She had regarded her main role in life as childbearing and suddenly, without the ability to do this, her life lost meaning. But her agitation grew when Kevin failed to respond to her attempts to arouse him sexually. She worried that she was now less attractive to him and new tensions entered their relationship. This unfortunate chain of events continued until the couple sat down and communicated their feelings and fears; Kevin explaining that he was worried about causing Kay pain when they made love, Kay coming to grips with the reasons why Kevin and others valued her.

In the case of Vin, talking did not help a great deal. He thought his wife Mary was less of a woman after undergoing hysterectomy but found it difficult to say exactly why. He understood that Mary had tried many other approaches to resolving her medical problems without success, and that something had to be done to relieve her pain and bleeding. In cases such as this, it can be helpful if a spouse or partner is involved in the decision-making

process, thus providing opportunities to discuss any concerns with the doctor. It may also alert women to the need for a concerted effort on all sides to overcome unforeseen barriers to reestablishing a satisfactory sexual relationship.

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One of the commonest causes of insomnia is stress.

The Oxford Dictionary defines ‘stress’ as a force, an effort, a demand upon physical or mental energy. We use the word ‘stress’ very often, but what is stress, what is it doing to us, and how do we react to stress and cope with it? Stress can be compared to a mechanical force or pressure exerted on an object To understand the relationship between stress and the object under stress, let us look at a simple example, such as what happens when pressure is exerted on a piece of fruit.

If you put a lot of apples in a bag, the apples exert pressure on each other, and each apple is subject to pressure from surrounding apples. This is a normal level of pressure and stress. However, if you take an apple out of the bag and drop it to the floor, the apple is bruised. If you accidentally step on this apple, you leave a big scar on it Dropping the apple and stepping on it are both extraordinary stresses not normally exerted on apples.

Hence, to put it in plain language, there are two kinds of stresses in our lives: ordinary stress, which most of us experience every day, as in the example of the apples in the bag, and extraordinary stress, comparable to dropping the apple or stepping on it, which we only experience once or twice in our lives, and which some of us may never have to face at all.

However, we are not all apples. Some of us may be stronger, like a coconut, which when dropped on the floor will not be harmed as it takes a few strokes of a hammer to crack it. Or some of us may be weak, like a ripe tomato, that even ordinary pressure can bruise. People come in all shapes and sizes and possess different inner strengths and energies. Some of us may be like coconuts, some like apples, and some like ripe tomatoes. We have no choice as to what we are, as part of this is our inheritance from our parents and part is based on our life experience, just as an apple cannot change into a coconut, and a tomato cannot change into an apple. However, with some help we can strengthen ourselves a lot more and can deal with stress a lot better. Einstein reminded us that we use only 10 per cent of our potential, and there is a lot of strength inside us that we have not recognized.

Hence there are two factors in stress. The first factor is the kind of stress, whether it is ordinary stress or extraordinary stress. The other factor is how tough the person is. Some of us may not be able to face up to ordinary stress, just as the ripe tomato. But some of us may be extremely tough and need a hammer to crack us, like the coconut.

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A man of twenty-two came to see me in great distress. He quite openly said that he was a homosexual. He had been caught by the police picking up another homosexual in a public bar. The police had been very considerate and had made no charge against him, but had advised him to seek the help of a psychiatrist, and to report back to them in a month.

In spite of his distress he kept saying that he was glad he had been, caught. He described his furtive sexual life with casual men. He said he had been actively homosexual since aged twelve or thirteen. On one occasion four years ago, by great act of will he had had no homosexual experience for a month. On further questioning it became clear that he did not really enjoy these experiences. In a way he hated them. But he was so lonely, and so timid toward girls that this type of human contact was preferable to utter loneliness and isolation.

I explained to him that he had been driven to this form of sexual experience by his own introvert nature and not by true homosexuality. He learned to do the relaxing mental exercises. As his anxiety abated, he gradually became friendly with various girls. He found that he could like them and enjoy their company. It soon came about that he was talking of love, and he told me he was having normal sexual intercourse with the girl of his choice. With this there was a remarkable change in his personality.

This man had believed that he was destined to live a life in the shadows as a homosexual. Something happened to him beyond his wildest dreams. It is well to remember that there are many like him.

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Most people will say that they are all right, their bowels move once a day. Many are satisfied when they evacuate only once every two or three days. If your bowels move only once in two or three days you are badly constipated, even if you don’t feel pain or discomfort at present. Such delayed evacuation will eventually, more likely than not, lead to serious illnesses. But even if your bowels move once every day, intestinal sluggishness is definitely indicated.

People living under natural, primitive conditions move their bowels after each meal. Most animals do the same. Healthy infants follow the same pattern. Adults, too, should do likewise. They should at least evacuate twice a day, morning and evening.

Constipation can be corrected only by adopting a sound, commonsense program of natural foods, proper eating habits, plenty of exercise, plenty of liquids, and establishing a habit of regular routine. Laxatives will never solve this colossal health problem. They only weaken the natural functions of the intestines and ultimately cause more harm than good.

The sufferers of arthritis who avail themselves of biological treatments as outlined in this book, will have their constipation problems automatically solved. Fasting, enemas, and “eliminative diets” of raw foods will effectively rebuild and restore the normal function of the intestinal organs and bring about good elimination.

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The understanding and treatment of epilepsy has improved considerably over the past fifty years. Most of this improvement has resulted from basic scientific research into how and why epileptic seizures start, and from the development of safer and more effective anti-epileptic drugs by the pharmaceutical industry. However, there is still much work which needs to be carried out, not just to improve our understanding and knowledge, but to improve the quality of life of a child or man or woman with epilepsy.

It is unlikely that a single ‘cure’ for all epileptic seizures and epilepsies will be found, due to the fact that there are so many different causes and types of epilepsy. It is also very unlikely that epilepsies will ever be completely prevented from occurring in the first place. A proportion of the epilepsies are inherited. It is improbable that much can be done to prevent these epilepsies, and it may not be possible (or appropriate) to remove these abnormal genes by ‘genetic engineering’ techniques. However, improved medical care should reduce the numbers of patients who develop epilepsy after meningitis or encephalitis. Improved safety measures on the roads, in cars, and the wider use of cycle helmets and protective head gear on industrial sites should reduce the incidence of posttraumatic epilepsy. In developing countries, better obstetric care and public health measures to eradicate parasitic diseases, (particularly cysticercosis) and bacterial diseases (particularly tuberculosis and other causes of meningitis) will play a part.

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