Anaphylactic Shock

Anaphylactic shock is a highly dangerous allergic manifestation that occurs when an individual has an immediate life-threatening reaction to contact, ingestion, or injection of an allergen. This rarely occurs with food allergy, but is most commonly associated with drugs. Penicillin injections have periodically produced this severe type of anaphylactic shock.
Stings from hornets, honey bees, bumblebees, and yellow jackets in sensitized individuals can provoke anaphylactic reactions. Even inhalation of allergens, such as antibiotic powder, or caster bean flour, may cause anaphylaxis.
Symptoms occur within seconds to minutes after the substance enters into the body, when precipitous drop in blood pressure occurs. Frequently there is difficulty breathing, profuse sweating, and sudden generalized vascular relaxation that causes faintness. In fatal cases stoppage of the heart or respiration follows.
Prompt emergency resuscitative measures are necessary to save the life of a victim in anaphylactic shock. Subcutaneous injection of adrenalin in the appropriate dosage (based on body size) is life saving in such a situation, while general first aid measures involving adequate airway, artificial respiration, and closed chest cardiac massage are instituted. Increasing
anaphylactic cases of this nature has brought physicians to adopt a more conservative attitude in the administration of antibiotics by injection. Bee sting allergy kits are available for those sensitized individuals who live with this ever present threat of danger.

Food Allergies

There is probably no area more controversial and perplexing as suspected allergies connected with food. These range from sensitivity to food additives, such as coloring, preservatives, and other foreign chemicals, to plant sources, to actual hypersensitivity to protein and other constituents of fruits, grains, nuts, vegetables, or animal foods. Careful detective work and long-term adherence to dietary regimens are frequently necessary to first diagnose and then live with food allergies.
It is my belief that the stage is set for many food allergies by feeding patterns in infancy, such as the early introduction of solid foods, the widespread use of cow’s s milk in prepared formulas, and the relative lack of mother interest in prolonged breast feeding. Maternal use of drugs which
sensitize the babies in utero or during the breast-feeding period can also prepare the way for allergic responses to develop.
The most common allergy that occurs in infancy is a sensitivity to cow’s milk. This is often manifested in diarrhea, unusual regurgitation, excessive gas or colic, or a “failure to thrive.” Usually a change to soymilk formula if breast feeding is not available will stabilize the situation, although rarely more restricted and specific formulas have to be devised.
A majority of the black and oriental races and lesser percentages of Caucasians are sensitive to cow’s s milk even in adult life. This, however, is due to the deficiency of lactase, an enzyme which helps to split milk sugar (lactose) and render it available for absorption. Diarrhea, excessive gas, and an acid stool are produced. Simply abstaining from milk is curative. You must always suspect the diagnosis in order to apply the proper remedy at once, thus removing the cause.
Other people are truly allergic to the proteins of cow’s milk and find unpleasant symptoms, such as frequent sinus or nasal congestion, related to the intake of milk. Please note, however, that skin scratch tests for food allergies are notoriously unreliable as indicators of an individual’s s sensitivity to the eating of these foods. It appears that the skin is just not a parallel indicator with the gastrointestinal tract. The only way to be certain in diagnosing food allergies is through trying an elimination diet.
Next to milk as a cause of allergy, chocolate and wheat lead the list. Usually the grains are less common allergens, but berries (such as strawberries), nuts, shellfish, eggs, and many other foods can produce similar symptoms. It is believed by some that symptoms resembling hypoglycemia,
such as episodic weakness and certain mental aberrations (anxiety, panic attacks, depression, etc.) may be related to food allergies. It must be acknowledged, though, full proof is lacking to completely confirm this theory as yet. Nevertheless, eliminating the offending food, then gradually progressing from a limited diet to a more liberal intake of varied foods will help bring a return of health and strength, with fewer physical symptoms and more emotional stability.
Sulfites are added to foods to serve a variety of purposes. They preserve food by killing bacteria and yeasts. They retain color and apparent freshness by acting as antioxidant. They may also be used to sterilize containers and arrest fermentation in alcoholic drinks. The label may contain any of the following listings, all various types of sulfites: sulfur dioxide, sodium sulfite, sodium bisulfite, potassium bisulfite, sodium metabisulfite and potassium metabisulfite. Many people are allergic to sulfites, reacting with skin rash or asthmatic wheezing.
Carefully test for allergies with a medically approved method. RAST (Radio Allergo Sorbent Test) testing offers an easy way to evaluate the blood for immediate immune reactive (IgE) factors. The more definitive, though expensive, ELISA/ACT TM (Enzyme Linked Immune Sorbent Assay / Advanced Cell Test) measures both immediate and delayed responsiveness to over 300 foods and environmental chemicals. Additional detailed evaluations, however, may require a period of observation and careful dietary therapy in a sanitarium or preventive lifestyle institution to isolate specific factors or undertake dietary trials.

Hives, or urticaria, is a very common manifestation of hypersensitivity

The disease itself is manifested by the sudden appearance of reddened areas, which rapidly become welts, being distributed generally over the body or localized to the face, neck’s or extremities. Intense itching is usually present. The lesions often migrate and change their appearance rapidly. The rash, however, usually does not blister or weep unless scratching has abraded the skin and allowed the entrance of germs.
Food allergies can sometimes cause hives. Very frequently an allergy to strawberries, shellfish, or some less common food can trigger a sudden onset of this rash. Reaction to substances such as wheat, milk, or eggs is more rare. It is necessary to avoid the food if one wishes to eliminate the symptom.
Several drugs can also cause hives. This condition is usually termed a drug allergy. The most common producers of this drug reaction are Penicillin and related antibiotics. Sulfa drugs and pharmaceuticals from nearly every major class of medicinal agent can produce an urticarial reaction in the sensitized individual. Babies seldom get hives unless a drug has been present in the milk or they have had previous exposure. But it is frequently seen in children and adults
with no particular preference as to age, sex, or race. The result of stress at both conscious and subconscious levels may trigger a sudden onset of urticaria. However, in up to 50% of the cases the exact source cannot be detected with certainty. It is very worthwhile to look for the cause, however, and consider any substance that is inhaled, ingested, or contacted by the skin
as a possible factor to exclude.
Treatment of hives should first begin with reassurance. This condition is self-limited and is usually neither life threatening nor contagious. The intense itching can be relieved considerably by cool baths with the addition of one cup starch or oatmeal powder (Aveeno), or alternately using 1/2 cup baking soda. Lotions may be helpful to reduce the symptoms. Try ice packs for local lesions. Antihistamines seem to counteract the reaction, but usually are not necessary as the condition commonly disappears within hours.
An exception to this may occur with bee sting allergy. If an individual is highly allergic to the sting of a honey bee, wasp, hornet, or yellow jacket, the reaction with hives will be immediate and generalized. Not only should ice and/ or moistened charcoal be applied to the site of the sting, but in emergencies the administration of adrenalin or a similar substance is necessary to prevent rapid progression into the swelling of the respiratory passages or the sudden development of shock. Since bee sting hypersensitivity can be lethal, careful diagnosis and prompt treatment is essential. Moreover, in such cases, desensitization injections can permit greater freedom in outdoor life and remove the fear that often grips parents as well as children who live with this threat of danger.

Hay fever or allergic rhinitis is a hypersensitivity disease involving the nose and sinuses

Hay fever or allergic rhinitis is a hypersensitivity disease involving the nose and sinuses, The mucous membrane becomes inflamed in response to an allergic substance and produces a watery, profuse discharge associated with increased tearing, itching of the eyes, and sneezing. This condition is usually seasonal, with the peak incidence corresponding to the presence of the offending allergenic inhalants. Pollens of trees, grasses, wildflowers, and other weeds are the most common culprits in producing this allergy. Some people are affected by danders, the particles produced from the skin of animals or hair from cats, dogs, horses, etc. House dust, molds, feathers, and even certain foods can produce hay fever. The appearance of the inner mucous lining of the nose is usually pale and thin, as opposed to upper respiratory infections where the mucus becomes thick, and the mucous membrane reddened and swollen.
Usually it is quite helpful for the allergy sufferer to know and identify the offenders. Scratch tests are usually helpful in evaluating the type of sensitivity. Intradermal injections are more commonly done by ear, nose, and throat specialists or allergists. However, the simpler and less expensive scratch tests are usually sufficient to establish the cause and initiate desensitization therapy. Recent advances in the use of allergy shots have allowed a more rapid desensitization procedure that is replacing the traditional year-round technique. The hay fever sufferer will find relief from the plentiful use of tissues, by placing cool compresses over the nose and sinus areas. Frequent nasal irrigation with cool saline (sniffing or spraying the salty solution) will help remove entrapped pollens and other particles, and clear the nasal passages of the allergy—producing substances. When the allergy is due to Bermuda grass or ragweed, activities outdoors such as yard work and lawn mowing may require the use of a mask. An appropriate respiratory filter can trap these pollens and minimize the symptoms, while still allowing work outside. Botanical identification of certain plants, such as ragweed, goldenrod, and various trees, grasses, and wildflowers will interest the pursuit of further nature study, while cautiously avoiding fields and forests where the prime offenders abound.
The chronic use of antihistamines and nasal sprays is to be discouraged, as side effects are frequent and troublesome. Excessive drowsiness, disturbance of digestive secretions, and the “rebound phenomenon” associated with nasal reaction to decongestants are all avoidable with this emphasis on natural remedies. Further attention to the diet, or in unusual cases, the relocation to a different climate may be necessary to bring hay fever and its troublesome symptoms under control.

Asthma,This allergic disease of the respiratory system primarily affects the lungs

This allergic disease of the respiratory system primarily affects the lungs. At the end of each tiny air tube that reaches the lung is the alveolus, where gas exchange occurs. Here oxygen enters the red blood cells to be exchanged for carbon dioxide, which is then exhaled. The bronchial tubes that form the large and small air passages have a smooth specialized muscle in them that constricts under certain conditions. In contrast, with the smooth muscle of the artery walls, these bronchial muscles dilate in response to adrenalin and constrict in the presence of histamine as well as other chemical mediators of allergies. A condition described as bronchial asthma occurs when there is spasm of the bronchial tubes, leading to obstruction in the airway. Usually there is also excess mucus accumulation and thickening of the mucus’s making it more tenacious and difficult to clear.
The asthmatic patient, then, primarily has an air hunger, with musical wheezes in the lung. These can be heard easily with a stethoscope over the chest and in more severe asthmatic crises becomes audible to the unaided ear. A number of conditions can produce these symptoms. There are certain drugs that can create an allergic reaction, as well as many industrial inhalants that irritate the lungs. A few people react to food allergies with the production of asthma’s though this is less common. Most frequently, the asthmatic sufferer reacts to inhaled particles in the air, called allergens, which may be of a biologic nature or inanimate particles. House dust is an example of the latter. Danders from cats, dogs, horses, feathers, or down also can produce wheezing. Commonly seen in the spring, summer, and fall are allergies to various inhaled pollens. Although some people primarily suffer from hay fever, others are affected in their lungs. The inhalation of pollens, such as those from pine trees in the spring, wildflowers in the summertime,
ragweed or goldenrod in the fall, may produce characteristic responses. These are related to the number of particles inhaled and the efficiency of the nasal filtering mechanism. Emotions can also trigger allergies. I remember vividly the experience of a teenage girl who suffered a violent asthma attack in a hospital when she remembered with nostalgia her dear pet cat at home alone! Moreover, numerous infections in the lung are seen in conjunction with asthma. These are usually termed asthmatic bronchitis. Frequently seen in childhood, they are often associated with an upper respiratory infection. A physiologic approach to asthma then involves several factors. The secretions should be thinned with a copious fluid intake’s preferably by the oral route. Inhalations of cool moist air can often help in the clearing of secretions and the thinning of this very sticky mucous material. Gentle coughing assists in expelling of the mucous plugs, but this should be done in combination with the inhalation of humidified cool air. The use of a stem vaporizer is to be discouraged, as this often adds to the swelling and edema formation in the bronchial tubes. Hydrotherapy is important in the treatment of asthma. Often the adrenal glands can be stimulated early in the disease by a quick ice rub to the spine in the upper back, associated with brisk tapping (percussion) over the adrenal area. This stimulation of the sympathetic nervous system results in the discharge of enough adrenalin to counteract the acute effects in beginning stages, as well as induce dilation of the bronchial tubes.
Prolonged hot packs to the chest can sometimes be effective in relaxing both the respiratory muscles and the patient’s s nerves. This must be repeated several times, and will often abort the acute asthmatic attack and eliminate the need for medication. Inhalation therapy with the use of bronchial dilators and theophylline derivatives are often used in a hospital setting. Sometimes mullein tea or other teas containing theophylline can be used with some effectiveness to further aid in combating the bronchial spasm. As in any disease, a thorough attempt to discover the cause’s then as far as possible eliminate it’s will reward the asthmatic sufferer with an increase of comfort and removal of those conditions that progresses in the advanced case too often leading to emphysema.

Evidence on the Role of the Mediterranean Diet as a Whole in Longevity

In a study undertaken in Greece, an overall nutritional score describing the traditional Mediterranean Diet and particularly the Greek version of it, and based on the eight characteristics of this diet, was a priori defined. The investigators reported that adherence to the traditional diet, as reflected by the nutritional score, favorably affected life expectancy among elderly people. Furthermore, when the individual components of this score were examined, they had weak and generally nonsignificant associations with survival, in contrast to the overall score, which had a substantial and significant effect. The favorable effect of the Mediterranean Diet on the survival of the elderly, assessed again through a score based on the eight characteristics of
this diet, was also shown in a study conducted in Spain.
Results of studies of the Mediterranean Diet in Mediterranean populations, however, may be confounded by the likely association of adult diet with early life nutritional patterns and culture-specific psychosocial variables such as social support. A study performed in Denmark, however, provided similar results, and so did a study examining the diets of Greek-Australians and Anglo-Celt Australians.

Fish , Cereal and Legumes on mediterranean Diet

Fish

Though fish consumption varied widely both between and within Mediterranean countries, fish was by far preferred over meat in the traditional Mediterranean Diet. Fish consumption is associated with reduced coronary heart and cerebrovascular mortality, though a recent review of cohort studies suggests that the effect is more evident among high-risk groups only.A possible mechanism is the beneficial role of n-3 fatty acids on blood clotting and triglyceride levels.

Cereals and legumes
Cereals form the basis of the Mediterranean Diet pyramid and legumes are listed among the important compounds of diet in the Mediterranean region. Overall, there is substantial epidemiologic evidence that whole grains are associated with decreased risk of coronary artery disease and some cancers. The role of legumes in these diseases appears promising, but is as yet inconclusive, although it appears that frequent consumption of legumes and derivatives is associated with reduced levels of LDL cholesterol in the blood. Complex carbohydrates derived from whole wheat bread, other cereal products, and legumes, which are plentiful in the Mediterranean Diet, are only weakly conducive to postprandial hyperglycemia, which could be
important in the pathogenesis of metabolic and other diseases.

Olive oil ON mediterranean diet

By definition, olive oil is a central component of the diet in the Mediterranean basin. The Greek version of the Mediterranean Diet and, to a lesser extent, the other versions of this diet, are dominated by the consumption of olive oil. Olive oil is the only vegetable oil obtained from whole fruit rather than from seeds. As compared with other vegetable oils, olive oil has a peculiar fatty acid composition (percentage (mol/mol) of methyl esters): oleic acid (56.0–83.0), palmitic acid (7.5–20.0), linoleic acid (3.5–20.0), stearic acid (0.5–3.5), palmitoleic acid (0.3–3.5), linolenic acid (0.0–1.5), myristic acid (0.0–0.05), and other fatty acids in minute amounts. Olive oil also contains, in total concentration of about 2% of the oil, several other minor compounds, among which tocopherols, carotenoids, and phenolic compounds have powerful antioxidant properties.Extra virgin olive oil is particularly rich in phenols.The exact mechanism of action of flavonoids and other polyphenols has not been established, but they are believed to act as free radical scavengers that may play a role in forfeiting some early steps in the carcinogenic process.
There is converging evidence that olive oil conveys some form of protection against breast cancer as well as data suggesting that olive oil may reduce the risk of endometrial and ovarian cancers.A recent report indicates that monounsaturated lipids, mostly from olive oil, is associated with a statistically significant decrease in the risk of sporadic colorectal cancer with wild-type ki-ras genotype. With respect to cardiovascular diseases, it has been established that monounsaturated lipids, the main type of lipid in olive oil, affect HDL cholesterol more favorably
than do polyunsaturated lipids, and substantially more favorably than do carbohydrates, making olive oil an optimal energy-generating nutrient.Furthermore, vitamin E, which exists in olive oil, has been reported to reduce the risk of CHD.
The antioxidant activity of olive oil has been clearly demonstrated in vitro and it is likely that the responsible compounds also block oxidation of low density lipoprotein (LDL) cholesterol, the preeminent risk factor for atherosclerosis. Finally, with respect to other chronic conditions, a study from Greece suggests that consumption of olive oil-derived monounsaturated lipids may increase bone mineral density and reduce the risk of osteoporosis.

Vegetables and fruits oN the Mediterranean Diet

Consumption of vegetables and fruits has been systematically found to reduce the risk of most forms of cancer, although the responsible compounds or processes have not yet been established. High consumption of vegetables and fruits is typical among Mediterraneans and helps explain the relatively low incidence of several forms of cancer in the region. Some of the earliest studies demonstrating this inverse association have been reported from Mediterranean countries, particularly from Greece, where the consumption of vegetables has been and remains exceptionally high. Thus, in 1983, it was reported that high consumption of vegetables and, independently, low consumption of red meat substantially reduce the risk for cancer of the large bowel. Two years later, the results of another study indicated that individuals consuming high quantities of raw vegetables and citrus fruits, as well as whole-grain bread, were less likely to be affected by cancer of the stomach. Another study from Greece21 was the first to point out that consumption of vegetables was inversely associated with breast cancer risk, an association that was later confirmed by several researchers. The connection was also noticed in a larger investigation in Greece.A protective effect of vegetables and fruits against cancer of various sites
has been documented in a number of epidemiological studies in the Greek population.
An effect of fruits was more evident with respect to lung cancer,whereas crude fiber, mostly from vegetables, was the discriminatory protective agent in studies of ovarian and pancreatic cancers.Fruits and vegetables were also the only food groups inversely associated with cancer of the endometrium and adenocarcinoma of the esophagus, although these associations were not always significant. It should be pointed out that, in most of the previously mentioned studies,
the associations with particular micronutrients, including ß-carotene and vitamin C, were generally not as strong as those with vegetables and fruits as a whole. The protective effect of vegetables and fruits against malignancies of various sites has also been documented in a series of case-control studies conducted in Italy. The results of these studies are summarized in a review by La Vecchia and Tavani,who point out that the association is generally most marked for epithelial cancers, apparently stronger for those of the digestive and respiratory tracts, and somewhat weaker for hormone-related cancers. Studies conducted in other parts of the world have also supported a protective role of fruits and vegetables against different forms of cancer.
In fact, such associations represent the main thrust of nutritional epidemiology of cancer.
With respect to cardiovascular diseases, studies in Greece have also provided evidence that high intake of total carbohydrates and crude fiber, reflecting a high intake of vegetables and fruits, is beneficial against atherosclerosis, as manifested in peripheral arterial occlusive disease and CHD.These findings have been supported by the results of other large and sophisticated investigations, and are compatible with a generalized beneficial effect of a diet rich in antioxidant substances.
They could, however, also be explained in terms of the homocysteine hypothesis. Recently, accumulated evidence on the deleterious role of plasma homocysteine levels on CHD risk, provides solid biologic foundation for the inverse association between consumption of vegetables on the one hand, and CHD and peripheral arterial disease on the other, as homocysteine levels are reduced by folic acid, which is found mainly in vegetables.

Musculoskeletal Pain

Pain involving the ligaments and muscles is often seen in athletic injuries. When the ligament is torn, the injury is called a sprain. This often occurs in the ankle, the knee, the low back, or shoulder. Muscles that are bruised often become painful and when the injury is considerable, that is called a strain. These small ligaments and muscle fibers may actually be torn, but heal without any residual weakness, after a short period of rest. Inflammation of the bursa (bursitis) may occur as the result of trauma, arthritis, infection or other disorders. Common locations include the shoulder, hip, knee, elbow and heel. Severe local pain and tenderness is often present. Sometimes calcium deposits are seen on x-ray. Immediate application of cold in the form of snow or an ice bag is one of the most helpful remedies, followed by mild exercise and gentle hot and cold compresses, after the acute inflammation subsides.
The tendon sheath of the hand or wrist may become inflamed, Some of these are due to constriction of tendons or nerves, and may require surgery. In the wrist this is called carpal tunnel syndrome. Others are seen in conjunction with rheumatoid arthritis, discussed in chapter five. A number of metabolic problems can produce skeletal pain, muscle cramps, or deep visceral pain. The sudden restriction of oxygen supply, disorders of the adrenal glands, and the so-called autoimmune diseases, may produce severe weakness or muscle pain.
Three forms of vascular obstruction particularly deserve mention. Arteriosclerosis of the large and medium sized arteries is the most common vascular disease of man. This often leads to pain in the muscles, particularly in the legs induced by exercise (intermittent claudication). Diabetic patients are particularly susceptible. Often the pulses in the lower extremities are reduced.
Changes occur in the skin with hair loss, deterioration of the nails, and even gangrene. Buerger’s disease (thromboangiitis obliterans) is a disease of young and middle-aged male cigarette smokers. This hypersensitivity to tobacco produces spasm in the small vessels of the hands and feet. Sometimes a smoker is so addicted to nicotine, that he continues to pursue the habit, in
spite of progressive gangrene and amputation of fingers, feet, legs, and even hands. I have often seen these unnecessarily handicapped patients suffering the terrible sequels of nicotine addiction. Raynaud’s disease is often caused by cold. Women are most commonly afflicted. With exposure to cold, their fingers become white, then blue, and finally red. Pain and tingling are common during this crisis, due to the lack of blood supply. Exercising by whirling the arm in a windmill motion can help to bring blood to the involved areas. Another occupational complication of a similar nature may produce ulceration in fingertips or toes. These are more commonly seen in smokers and those with auto-immune disorders. Obstruction of the lymphatic return may produce a type of edema, associated with pain. Also, thrombosis of the veins is usually painful,
involving the overlying skin with redness and swelling. When larger veins are involved, the muscle and entire extremity is very painful. Most of these pain syndromes can be approached effectively by the intelligent home health observer. With a knowledge of anatomy and
physiology, and a few simple remedies, they can bring relief to many cases. It is important first to ascertain the cause of these pain responses. Wrong habits may need to be corrected. Then nature is assisted in her efforts to restore right conditions within the nerves, muscles, and other involved organs. The relief of pain will always evoke profound gratitude from chronic sufferers. Its study can challenge the layman or specialist for at least a lifetime.

BACK PAIN

Pain in the lower back, as well as the neck is very common in America. Many related, but distinct conditions can produce discomfort here. Disease of the spine, although less common than other problems, is often related to injury. An auto accident or sudden fall, causing acute flexion of the back, may compress and fracture one of the vertebral bodies. It may be an early sign of osteoporosis, thinning of the bones due to calcium deficiency. X-ray is often necessary to diagnose this condition accurately. Immobilization on a straight board, with the avoidance of any flexion, standing, or walking is extremely important First Aid in dealing with these acute injuries. Braces, which keep the back in extension, are often worn for several months in the treatment of a fractured spine.
Local pain in the low back can be caused by any process, which irritates nerve endings. Straining of the muscles, protrusion of a disc, rupture of a ligament, and many less common problems can injure the tissues and aggravate this pain. Tenderness is usually found upon pressure in the region involved. Associated muscle spasm may produce pain around the involved area. At times, the pain may be referred or projected into regions lying in the area of the associated nerve roots. For example, pain produced by diseases in the upper part of the lumbar spine is usually referred to the front of the thighs and legs. That from the lower part of the lumbar spine, is referred to the buttocks, posterior thighs, and calves. Radicular or root pain has some similar characteristics, but usually is much more intense and is often aggravated by a cough, sneeze, or strain. Any motion, which stretches the nerve, such as straight leg raising, may have a similar effect.
Proper examination of the back is an art requiring considerable knowledge of muscle, nerve and skeletal anatomy. Often tenderness over the lumbosacral junction, the sacroiliac joint, the costovertebral angle over the kidneys, or a specific vertebra can help the examiner in accurate diagnosis. The usual testing of the blood, urine, and x-rays of the back are often adjuncts in understanding the cause. Appropriate exercises may then be used, together with rest or the use of moist heat in bringing relief to all but the most stubborn condition. Special problems may be treated effectively in a lifestyle center.

ABDOMINAL PAIN

The correct interpretation of acute abdominal pain is one of the most challenging demands made of any physician. Sometimes proper therapy requires urgent action. A great deal of experience and judgment is needed to elucidate the cause.
A number of mechanisms can produce abdominal pain. Inflammation of the lining of the abdomen (peritoneum) can produce pain of steady, aching character. This pain is usually located directly over the inflamed area and the area will also be quite tender. Release of a small amount of stomach acid will cause much more pain than even contaminated intestinal contents will when
the appendix ruptures.
Another type of pain occurs in the distention or obstruction of hollow organs. This is usually intermittent or cramping in nature. Colic in the abdomen can be produced from obstruction of bile duct, the gallbladder, the ureters, or the intestines. Since all of these may cause vomiting, the location of the pain and other related symptoms must be considered in arriving at a rapid diagnosis. Finally, it is important to consider the blood vessels in the abdomen as causes of potential pain. An out pouching of the aorta (aneurysm) may produce pain, developing slowly, increasing gradually, or in a sudden rupture, may become quite catastrophic. Abdominal angina occurs when the vascular supply to the intestines becomes clogged with cholesterol deposits and this pain, similar to the angina pectoris of the heart, occurs following a heavy meal.
Referred pain from the chest, the spine, or the pelvic organs, may also make diagnosis difficult. Compression or irritation of nerve roots in the spine is usually intensified by coughing, sneezing, or straining. Pressure on the genital organs will usually be very painful and show the origin immediately of this referred pain. Respiratory origin is usually indicated by obvious interference with breathing.
It is important to become acquainted with the clinical pictures of these various abdominal problems. Knowledge of anatomy of abdominal organs, as well as their function is essential in understanding abdominal pain. Some types can be treated safely at home. In these cases, moist heat and temporary abstinence from food is often helpful. There are conditions requiring surgical
intervention. Basically keeping in mind these possibilities will help an individual to seek a physician promptly at the appropriate time while avoiding unnecessary dependence on drugs or expensive diagnostic testing in the more self-limited and trivial conditions.

CHEST PAIN

There is very little parallel between the severity of chest pain and the seriousness of its cause. A frequent problem exists in distinguishing trivial disorders from coronary artery disease or other serious health hazards. It is important to avoid the long tradition now shown to be myth, that pain beneath the left breast or radiating into the left arm is always of cardiac origin.
Such pain is often observed in patients who are tense, easily fatigued, or anxious.
Oxygen deficiency of the heart muscle can produce pain. This is the syndrome medically termed angina pectoris. When the oxygen supply is deficient in relation to the need, pain will develop in the heart muscle. This may be aggravated by exercise, or occur during a stressful situation, or after a heavy meal. Atherosclerosis (narrowing) of the coronary arteries is the most common cause. Spasms of the small cardiac vessels may also trigger this pain (angina), which usually subsides with a short rest.
Pain in the esophagus usually results from acid irritation of the lining (mucous membrane) of the esophagus. Spasm of the swallowing muscles or the presence of obstruction can also produce this deep chest pain. Accompanying symptoms of difficult swallowing, regurgitation, and weight loss direct attention to the esophagus. Pain in the pleura or the lining of the lung is very common. It results from stretching of the inflamed membrane and occurs in viral, as well as bacterial, pneumonia. Sometimes air in the chest cavity (pneumothorax) and tumors can mimic this type of pain. Inflammation of the outer covering of the heart (pericarditis) can also produce it. It is usually aggravated by coughing or deep breathing. Sometimes swallowing or a change in bodily position produces the same type of pain, Applications of moist heat and rest are important in the relief of these deeper pains.
Tension is also a common cause of chest wall pain. Usually the discomfort is experienced as a sense of tightness, sometimes called aching. It may occur on various occasions and in different areas of the chest, and is usually associated with fatigue or emotional strain. It is important to distinguish these and the above categories of chest pain from various abdominal problems,
some of which are described below.

TENSION HEADACHE

This type of headache usually occurs over both sides of the head and often settles at the base of the neck. A fullness, tightness, or pressure is often described. Sometimes these headaches show the peculiarity of being continuous day and night for long periods of time. Sustained muscle tension, as well as vascular changes may be involved. Sometimes a similar headache may follow injury (auto accidents, head trauma) and gradually resolves over many months.
Simple remedies may be used with success in the treatment of headache. A person should lie down in a quiet area, apply a cold compress to the head, and seek to put the mind at rest. Often a drink of water or mild nerve-calming tea such as catnip or chamomile tea can relax the person until the headache passes. More severe types of headaches can be treated with the hot foot bath.
This is described in the section on hydrotherapy. Adding mustard to the foot bath may also bring relief through acting as a counterirritant as well as pulling blood to the lower extremities (called derivation) to relieve congestion in the head. Extra hours for sleep, daily nature walks, or a change of pace may be needed. General hygienic recommendations for a more healthful diet, systematic exercise, and improved stress control are valuable preventives.

MIGRAINE

The term migraine refers to periodic, throbbing headaches on one side of the head, which usually begins in childhood or adolescence, and occur with diminishing frequency during advancing years. Sometimes, along with the headache, nausea and vomiting may actually disable the affected individual for several hours each time the migraine occurs. Some variations are seen. Many are forced to lie down and to shun light and noise for what they call a “sick headache.” Other milder forms do not require withdrawal from accustomed activities. Between attacks the migraine sufferer is essentially normal. In fact, the headache seems to be brought on during the “let down” period after many days of hard work or stress. Spasm in the blood vessels has been implicated
and many powerful hormones are often released that perpetuate discomfort
for several hours.

HEADACHE

The term headache encompasses all aches and pains associated in the head. Along with fatigue, hunger, and thirst, headache represents man’s most frequent discomfort. It must always be kept in mind that headache is a symptom, not a disease, and its cause should always be ascertained. Some types of headaches are quite easy to diagnose. Infection or blockage of sinuses is usually accompanied by pain over the sinus area and in the forehead. It is often associated with tenderness of the skin in the same area.
Sometimes the head seems to throb. Often headaches tend to return at the same hour of the day. Headache originating in the eye is usually located near the eye or in the forehead. It is of steady, aching type and tends to follow prolonged use of the eyes in close work. Muscle imbalance is often involved. A careful examination of the eyes by your doctor is recommended.
Headaches accompanying diseases of the ligaments, muscles, and joints in the upper spine are usually referred to the back of the head and nap of the neck. Later in life, these pains are seen frequently in arthritis and also tend to occur after whiplash injuries. Massage very deeply in the area and you may disclose the presence of tender nodules near the insertion of the neck muscles.
Moist heat, as well as skillfully performed massage is particularly helpful in relieving this type of pain.
The headache of irritation in the meninges or coverings of the brain, is usually of an acute onset and becomes severe, deep seated, and constant. Usually this occurs in conjunction with fever. Whenever the neck becomes stiff, immediate consultation with a physician is recommended. Both meningeal infections or brain hemorrhages can cause this type of pain. Lumbar puncture in about 20% of normal patients may produce a transient headache. Usually this is relieved in the lying position and subsides after a few days.

LABORATORY TESTING

Most laboratories today require requisitions from a physician to run various tests. New self-care home kits are now available for many screening tests, which can be done at home. Some of these are as follows: pregnancy test, blood cholesterol, blood glucose, and stool testing for occult blood. The latter is useful to periodically evaluate possible blood loss, as well as causes for anemia. Urine testing for protein or sugar, and fasting blood sugar measurements, are good screening tests for diabetes. These tests can be done on a group basis at health fairs, and for a considerably reduced cost.
Cholesterol and triglyceride evaluations are periodically performed in coronary screening programs, and occasionally, it is possible to secure chest x-rays, electrocardiograms, and even treadmill tests from public health groups or private groups screening for cardiovascular disease. Sometimes the YMCA, religious camp meetings, or special health fairs in shopping centers will provide these tests at a very reasonable cost. Cooperative physicians may provide other laboratory determinations in the case of acute disease.

How The Skin Works

The largest organ of the body is the skin. Some writers have called it “keyboard of the hydrotherapist.” Through the numerous blood vessels and nerves of our skin, and their reflex connections with the internal organs, practically every organ of the body can be influenced by applications of heat or cold to the skin surface. Small muscle bundles are found in the dermis, connected with the hair follicles. Contraction of these arrectores pilorum muscles cause the hair to stand erect, producing a peculiar roughness of the skin known as “goose flesh.” Applications of cold or sensations of chilliness can bring this condition. With cold, the skin also becomes blanched, as blood squeezes out of the vessels by this muscular contraction. An enormous network of lymphatic vessels, veins, and capillaries is present. These tiny tubes that constantly convey fluid back to the heart contain thousands of valves and nerve fibers. This gives them the ability to
shift blood flow from one area to another.
Several times a minute, changes occur in the diameter of our blood vessels. As they contract and become smaller, blood is forced onward. During the relaxing or dilating phase, they fill with blood. This “pumping” action is another powerful factor in the circulation of these vital fluids. It is sometimes called the “peripheral heart.” Circulation slows when the nerve control of these vessels is interfered with, and the extremity becomes dusky in color and cold. Paralysis succeeding a stroke, infectious diseases, and even emotional problems can alter the flow of blood in the skin. This adds to the burden on our heart, making it work under a disadvantage. Contrasting temperatures of hydrotherapy treatments produce powerful circulatory reactions, which enhance these rhythmic changes and alternating contractions in the blood vessels of the skin. Massage also aids the return of lymph to the heart, and briefly empties the veins when it is done properly. Movement of a limb by active exercise likewise enhances the circulation. Since the body weight is 1/13 blood and about1/4 lymph (interstitial fluid), a large amount of fluid can be affected when hydrotherapy applications are given. Results are seen in the body as a whole.
Sweat glands are found throughout the entire skin, but are especially numerous in the underarms (axillae), the palms, and the soles. It is estimated that 1 square cm. of skin on the palm may have about 3,000 of these tiny “mouths.” Estimating the total surface of their ducts at 11,000 square feet, it appears obvious that this secretory function is of considerable importance.
Sweat is about 98% water, but contains small traces of impurities, which are thrown off from the skin. It also contains assorted salts, such as sodium chloride. About twice as much water is excreted by the skin as the lungs give off each day! When the excretory function of the kidneys is diseased, the sweat becomes loaded with toxins. Unfortunately, the sweat glands may also be diseased when kidney afflictions are of long duration. To encourage free perspiration during a hydrotherapy treatment, it is appropriate to drink water before and during the applications. Hot drinks are very helpful. An environment that is warm, comfortable, quiet, and free of stress is likewise beneficial.
Certain diseases produce such alteration in the ability of sweat glands to eliminate heat that extreme precautions must be made in giving these treatments. Extensive burns may destroy the skin nerves and abolish normal reflexes that occur in response to temperature. Alcohol intoxication may obliterate the response to heat, making heat stroke a distinct possibility if appropriate precautions are not taken. Reflex effects on distant organs are also influenced by damage to nerve endings in the skin. The perception of heat and cold, our control of circulation, and the beneficial effect derived from hydrotherapy treatments may be compromised in numerous diseases. Careful observation and study are essential, along with medical consultation
where indicated.

TYPES OF THERAPY

In the privacy of your home, there are several types of therapy that deserve particular attention. Naturally, it is our instinctive tendency to look for the simplest way of getting well. Often people resort to drugs in an attempt to cure themselves, only to find that the drug has changed the form and location the disease, producing new symptoms or complications that might even be worse than the original disease. Furthermore, the expense of drugs, together with their long term risk are reason for great caution in their use by the home health practitioner.
Diet is an extremely important type of home treatment. In case of illness, the patient’s diet should be simpler than is usually eaten. Sometimes a fruit fast for a few days will help a person recover without a grain of medicine.
Juices have a more limited place. Sometimes skipping a meal and drinking water or fruit juice will allow nature a chance to build up defenses against the invader. This should be done at mealtimes, not drinking juices all through the day.
Herb teas have a valued place in healing. Hence, a special chapter is being devoted to their use. Medicinal teas are usually prepared by mixing one teaspoon of the herb in a cup of boiling water and allowing it to steep for three to five minutes, until the tea is ready. The herb is strained out before drinking. Other herbal beverages made with parsley or comfrey, create the so called “green drink,” which is popular in health food stores today. There are many common symptoms that can be treated safely with herbs, making it unnecessary to consult a physician nearly as often as we do these days.
Hydrotherapy seems to be the most neglected home remedy. These treatments involve the use of water, and include such remedies as the hot half bath, cold shower, cold mitten friction, contrast bath, the heating compress, and other therapies discussed in chapters devoted to the specific treatments. Hydrotherapy offers a powerful technique of shifting the circulation in your
body. Its purpose is to decongest certain areas, then improve the ability of an organ to fight infection and overcome any invasion of germs. Perfect health depends upon perfect circulation. Water therapy is one of the most valuable ways to achieve this goal.
Exercise is also a valuable remedy in the treatment of many diseases, particularly those of degenerative nature. The chapters on heart disease, vascular disease, respiratory problems, and nervous disorders will particularly contain advice in regard to therapeutic exercise.
Sunlight, fresh air, abstinence from harmful substances, rest, and the mind healing influence of trusting in Divine power are also powerful remedies that one can use in the home to combat disease and restore right conditions within the system. We will apply these in the next chapter to approach the subject of pain, one of the most common symptoms that afflicts mankind.

RATIONAL APPROACHES to ILLNESS

In dealing with any disease, the first step toward diagnosis is found in the health history and its interpretation. All facts of significance in the lifestyle of the individual up to the time of illness should be evaluated as possible contributors to the present problem. Allergies to drugs, foods, or
environmental factors should also be evaluated in the face of present illness. Second, the careful analysis of the illness under question with all of its various symptoms, including other factors that have ensued from the first onset to the present need to be considered. Most diseases fit certain patterns. As organ systems and their disorders are discussed, these patterns will become obvious. Thus, the intelligent interpretation of a medical history provides one of the most valuable clues to understand illness and its proper diagnosis.
Remember this one caution in the proper interpretation of health history. Accurate recall for the patient is very important. However, most sick individuals color their subjective awareness of symptoms with substantial concern over the consequences of illness to their families. Fear of disease, disability, and even death may affect the person’s response to the otherwise clear question or stimulus. Although the story of every illness is extremely important, in most cases, it is not definitive, but rather narrows the number of diagnostic possibilities, and thus guides any subsequent investigation. A physician’s skill, knowledge, wisdom, and experience are most clearly evidenced in his history taking. Likewise, the thorough analysis of symptoms in home health care will provide your best clues toward understanding disease.