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HEALTHY EYES: MACULAR DEGENERATION
The retina is capable of two kinds of vision: central and peripheral. With central vision you distinguish detail at close range as in reading and sewing, and at a distance as with following road signs. Peripheral vision allows you perception of your surroundings including objects and movement not in the direct line of sight. Peripheral vision prevents collisions with others when walking or driving.
Central vision is performed by the macula, the tiny spot in the center of each retina. In macular degeneration it is this minute area which deteriorates, gradually blurring and eliminating central vision but leaving most of the peripheral vision intact. The deterioration is most common in the aged from hardening of the arteries. Thus, macular degeneration is partial or total loss of the sensitive macula area in the retina providing sight and color vision resulting in a reduced ability to see.
Sometimes macular degeneration occurs prior to old age, from hereditary or other causes not yet understood by medical science. If the disease is limited to one eye, the patient may continue to function normally. Where the condition occurs in both eyes, functioning is altered and a reorientation of goals and work must be undertaken.
Treatment of macular degeneration is administered with new technology using a focused laser beam. The treatment is not uncomfortable to the patient and often doesn’t even require hospitalization. Optical devices known as low-vision aids also are used for macular degeneration. These are various types of magnifying lenses which provide enlarged images for the victim of macular degeneration.
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A FEW WORDS ABOUT BACTERIA
Bacteria appeared early in the evolutionary scheme of things, arriving on the planetary scene about 4,000,000,000 years ago. Today bacteria support all of the earth’s ecosystems. Life on earth may survive without trees; but it can never survive without bacteria. Of the three groups of bacteria important to the planetary ecosystem, two take up residence within and upon the human body. One group consumes organic material fuelled by oxygen producing carbon dioxide and water. Members of this group live on the skin and some parts of the gut. Fermenters form the other group of bacteria and live deep within the bowel. The ecosystem of the colon is akin to a primeval swamp. There the Fermenters consume organic material converting it into methane and carbon dioxide.
Nor have the animal cells that compose human bodies evolved independently of bacteria. There is striking evidence that animal cells are a symbiotic association of various bacterial entities. According to microbiologist, Lyn Margulis, Mitochondria – the power houses of animal cells – are bacteria that have come to reside within the cell walls of their animal hosts. Such ideas lead to the notion that each human is the sum of billions of micro organisms each working together for the good of the greater whole. Some how, out of this complex arrangement of wheels within microbiological wheels, each human has developed both mind and a biological soul.
Not all bacterial relations are friendly and right until the middle of this century; bacteria were mankind’s greatest predators. This human prey has turned the tables on its bacterial hunters over the last hundred years largely through the separation of sewerage from the water supply. Good hygiene and the maintenance of high nutritional standards throughout the developed world have also played their part in the never-ending war against one of mankind’s smallest enemies.
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FOOD AND NUTRITION: DIGESTIBILITY OF FOOD
By digestibility is meant the completeness of digestion and also the ease or speed of digestion. The efficiency of digestion is remarkably high. Based upon the typical American diet, 98 per cent of the carbohydrate, 95 per cent of the fat, and 92 per cent of the protein in the food eaten is digested and absorbed.
Fibers and seeds are not digested. Therefore, a diet made up of many fruits, vegetables, and whole-grain products could have a digestibility of carbohydrate of only 85 per cent. The completeness of digestion is greatly reduced in some disorders of the gastrointestinal tract such as severe diarrhea. In some hereditary diseases such as celiac disease, cystic fibrosis of the pancreas, and lactose intolerance, the enzymes for the digestion of fats and carbohydrates may be missing, so that much fat or starch is eliminated in the feces.
The speed of digestion varies widely according to the size of the meal and the composition of the diet and also depends upon certain psychologic factors. As little as 9 hours or as much as 48 hours may elapse from the time food is eaten until the wastes are eliminated. Small meals will remain in the stomach for a far shorter time than will large meals. Foods that are poorly chewed are likely to require a longer time for digestion.
Foods are sometimes said to “stick to the ribs.” In other words, they stay in the stomach longer, so that they delay hunger contractions and are therefore more satisfying. They are said to have high satiety value. A breakfast of juice and dry toast, being chiefly carbohydrate, has little satiety value. But a breakfast of juice, toast, eggs, and bacon also contains proteins and fats. Because the digestion takes somewhat longer in the stomach, this meal would be more satisfying. An excessive amount of fat, especially in the form of fried foods, slows up digestion so much that discomfort sometimes results.
Extractives in meat increase the flow of digestive juices. A cup of broth or bouillon is sometimes used at the beginning of a meal to stimulate the appetite and to increase the digestive action. The secretion of digestive juices is also increased by the pleasant sight, smell, and taste of food. On the other hand, the secretion is likely to be decreased when foods are unattractively served or when the surroundings are unpleasant. An individual who is excessively tired or who is under emotional stress such as fear, grief, or anger often experiences digestive upsets or may be unable to take food.
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ECZEMA IN ADULTS AND EVENING PRIMROSE OIL
More and more studies from around the world are confirming that evening primrose oil can help adults with atopic eczema. The first trial, at Bristol Royal Infirmary, showed that evening primrose oil worked best in higher doses, and when it had been taken for several months. The most effective dose was eight to 12 capsules of 500mg (4 to 6g) evening primrose oil taken for longer than 12 weeks.
Other trials on adults with eczema during the 1980s have tended to confirm that large oral doses (4 or 6g a day) of evening primrose oil produce the best results. They also confirm that the longer the patient takes evening primrose oil, the better the results.
In a multi-centre study involving 13 hospitals in England, Scotland, Denmark and Finland, the doctors found that evening primrose oil produced excellent results in a very difficult group of patients, who all had a prolonged history of eczema, mostly starting in infancy or early childhood. On average, the patients had suffered from eczema for 17 years without having found any effective treatment.
Nearly all the patients reported improvement from the evening primrose oil treatment in every symptom of eczema – redness, dryness, scaling, itch, and swelling. Fifty-three out of 54 patients suffering from moderately severe eczema and 58 out of 59 patients with severe eczema reported an improvement in their overall condition.
During the treatment with Efamol many patients were able to reduce or stop altogether their use of antihistamines, antibiotics, systemic steroids and the most potent grade of topical steroids. After treatment with evening primrose oil, some patients could halve their doses of potent and moderate topical steroids, and could cut down on their use of antihistamines by a quarter, and of antibiotics by about a sixth. Apart from the use of emollients, they could dramatically reduce all their usual medication.
Nearly all the 116 patients (71%) in this multi-centre study chose to keep on taking Efamol. For some, this has run into several years. The average time for taking it was 11 months. Fifteen patients who stopped taking Efamol noted a relapse of their eczema.
A double-blind trial in Finland in 1987 showed that evening primrose oil had a significant effect on patients with atopic eczema. The overall severity was reduced, there was less inflammation, there was a reduction in the percentage of the body surface covered by eczema, and the patients suffered from less dryness and less itching. The dose in this trial was eight capsules (four capsules twice a day) for 12 weeks.
In this trial, patients were allowed to use emollient creams at the same time if they wanted to. They were also allowed to use a mild topical corticosteroid cream or oral antihistamine, or both, during the trial if they had severe skin symptoms. Interestingly, three times as much topical steroid was used by patients in the placebo group than in the group taking evening primrose oil. This suggests that the evening primrose oil was working much better than the placebo.
The doctors conducting the trial came to the conclusion that evening primrose oil was an adjunct to the existing treatment for atopic eczema, and could be safely used alongside steroids and other creams.
Evening primrose oil as a treatment works best in cases of moderate or severe atopic eczema. It has not been found to work well in cases of very mild eczema, where there is no family history of atopic disorders, and where the essential fatty acid levels in the blood were normal to start with. Epogam, made by Scotia Pharmaceuticals, is available on prescription for atopic eczema.
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OBSTRUCTIVE SLEEP APNOEA: ASSESSMENT, OXYGEN SATURATION AND SLEEP STATES
Assessment
Although a physical examination and detailed medical history can tell a great deal about the likelihood of OSA, confirmation of the syndrome can only be done in properly equipped sleep laboratories which are now established in many large public hospitals and some private institutions. Formal sleep studies (technically referred to as polysomnography) make it possible to observe the patient in a clinical setting under the supervision of trained personnel.
Many of the functional and physiological changes mentioned previously, such as airway obstruction, hypoxaemia and irregularities of heart rate, are monitored during the study, giving investigators enough information to decide on the best course of action for the hapless snorer. Most people are apprehensive about the need for hospital admission and comprehensive testing procedures, and it is important that they be informed and reassured of the non invasive nature of these procedures. A nervous patient is likely to have a poor night’s sleep from which little useful information can be extracted.
Oxygen saturation
Probably the single most important measure of the severity of OSA is the level to which blood oxygen falls. Blood oxygen concentration, or saturation, can be estimated quite accurately by attaching a probe to either a finger or ear lobe. A special light emitted from the probe is able to detect oxygen saturation in the blood supply of the site to which it is attached, which in turn reflects the circulating oxygen level.
Sleep states
Airway obstruction is more pronounced in deep sleep, particularly during REM, and it is therefore important to document sleep stages to confirm that the patient slept soundly, preferably with several episodes of REM. Sleep states are monitored via several electrodes which are glued to various sites on the head which detect electrical activity of the brain, eye movements and muscle tone, all of which help to define sleep states.
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FOOD AND NUTRITION: ROLE OF DIGESTIVE ORGANS
Digestion in the month. The digestion of food begins in the mouth with the chewing of food and its mixing with saliva. Chewing is important because it increases the surface area of the food particles for later digestive action. Saliva contains amylase, a starch-splitting enzyme, but food remains in the mouth for such a short time that only a small amount of starch can be broken down to dextrins and maltose.
Digestion in the stomach. Food passes from the esophagus into the stomach by relaxation of the cardiac sphincter. Following the entrance of food into the stomach the sphincter closes, thus preventing the regurgitation of food. The stomach serves as a temporary storehouse for food, brings about partial digestion of protein, and prepares food for further digestion in the small intestine. The food is continually churned and mixed with gastric juice until it reaches a liquid consistency known as chyme. Rhythmic contractions move the chyme toward the pylorus where small portions are gradually released through the pyloric sphincter into the duodenum.
Gastric juice contains hydrochloric acid, pepsin, rennin, mucin, and other substances. Hydrochloric acid has several important functions: (1) it swells the proteins so as to make them more easily attacked by the enzymes; (2) it provides the acid medium necessary for the action of pepsin; (3) it increases the solubility of calcium and iron salts so that they are more readily absorbed; and (4) it reduces the activity of harmful bacteria that may have been present in the food.
Pepsin, a protease, splits proteins into smaller molecules called proteoses and polypeptides. Very little digestion of carbohydrates and fats occurs in the stomach. In the upper (cardiac) portion of the stomach the salivary amylase continues to act upon starch to change it to dextrins and maltose. As soon as the food mass is mixed with hydrochloric acid this action ceases. Lipase in the stomach has some effect on emulsified fats as in milk, cream, butter, and egg yolk, but most of the hydrolysis of fats takes place in the small intestine.
Digestion in the small intestine. Most of the digestive activity takes place in the small intestine, which includes the duodenum, the jejunum, and the ileum. Bile, manufactured by the liver and stored in the gall bladder, is essential for fat digestion. As soon as fats enter the duodenum the secretion of a hormone, chokcystokinin, is stimulated. Cholecystokinin causes the gallbladder to contract and to release bile into the duodenum. Bile emulsifies the fats, that is, breaks them down into tiny globules so that the fat-splitting enzymes have greater contact with the fat molecules. Bile, being highly alkaline, neutralizes the acid chyme and provides the alkaline reaction necessary for the action of the intestinal enzymes.
As soon as acid chyme enters the duodenum, two hormones, secretin and pancreozymin are produced. They are carried by the bloodstream to the pancreas where they stimulate the secretion of pancreatic juice. The pancreas also pours its secretions into the duodenum. Pancreatic amylase splits starch to maltose; a protease, trypsin, breaks down proteins and polypeptides to much smaller molecules; and lipase, steapsin, completes the digestion of fats to fatty acids and glycerol.
A hormone, cnterociinin, stimulates the flow of intestinal juice from glands in the walls of the small intestine. The intestinal juice contains protein and sugar-splitting enzymes. Lactase splits lactose to the simple sugars glucose and galactose; maltase acts on the maltose molecule to yield glucose; and sucrase brings about the hydrolysis of sucrose to glucose and fructose. A group of enzymes known as peptidases completes the breakdown of proteins and polypeptides to amino acids.
Function of the large intestine. The large intestine includes the cecum, colon, rectum, and anal canal. Digestion and the absorption of nutrients have been essentially completed by the time the food mass reaches the large intestine, but much water and digestive juices are reabsorbed so that the intestinal contents gradually take on a solid consistency. The feces contain the fibers of food, small amounts of undigested food, bile salts, cholesterol, mucus, bacteria, and broken-down cellular wastes.
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CHILDREN WITH ECZEMA
Atopic eczema can show in infants as young as only a few months old. It sometimes appears for the first time when a baby is weaned off breast milk.
Recent research done in Italy and Sweden shows that most children with eczema can improve considerably on evening primrose oil. Only a few years ago, it was thought that children with eczema did not respond as well as adults, but this may have been because they were not given a high enough dose. It is known that growing animals have far higher essential fatty acid requirements than fully grown adults and the same probably applies to humans. Now we know that children do in fact respond very well indeed.
In Bologna, Italy, Dr Alessandra Bordoni studied 24 children with atopic eczema. Twelve of them were treated with evening primrose oil and 12 with a placebo. The group treated with evening primrose oil (Efamol) significantly improved compared with the placebo group. 65% of the group taking evening primrose oil showed significant improvement after just four weeks of therapy. The dose was 3g a day (i.e. six capsules of 500mg). It is not yet understood why some children did not respond. There is also a small percentage of adults with atopic eczema who do not respond to evening primrose oil treatment. Perhaps this is because there is no essential fatty acid abnormality in these cases.
Evening primrose oil can safely be given to babies and very young children. If they are too young to take the capsules by mouth the oil can be taken out of the capsules by pricking the gelatin shell. The oil can then be rubbed into the soft parts of the skin, like inside the thighs and on the tummy. The oil penetrates the skin very quickly. Contrary to what you might expect, you should rub the oil into the healthy skin and not the areas affected by eczema. However, for children old enough, it is better to take the evening primrose oil by mouth as the conversion process is more efficient. The oil is available in bottles so it can be spoon-fed. Epogam Pediatric is capsules in which one end can be snipped off and the oil put in a spoon or over food. It is available on prescription.
Breastfeeding is able to protect against the development of atopic conditions, including atopic eczema. Human breast milk, unlike cow’s milk, is rich in gammalinolenic acid, dihomogammalinolenic acid, and arachidonic acid. As a matter of interest, a six-month-old, fully breast-fed baby is getting the equivalent amount of GLA to about three 500mg capsules of evening primrose oil a day.
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NATURAL TREATMENT FOR GLAUCOMA AND CATARACT PREVENTION
Laser surgery thrust cataract and glaucoma treatment into the twenty-first century with the use of an instrument that seems more at home in a science fiction novel than an eye doctor’s office.
But as strides in technology are made, the more simple and natural treatments should not be overlooked. Herbalists and homeopathic specialists recommend several natural alternatives in the prevention and treatment of glaucoma and cataracts.
Herbs, used singly or in blends, may provide relief from these conditions. The Greater Celadine, for example, has historically been associated with the treatment of cataracts. In medieval times, juice from the Greater Celadine was used as eye drops for the removal of cataracts.
Today, herbalists say the juice of this slender plant, when applied to the outside of the eyelid, may gradually fade cataracts and spots on the cornea. Experts emphasize, however, the juice should not be dropped directly into the eye.
Herbalists, also note that a steam bath for the eyes, made of a blend of herbs has positive effects on cataracts and glaucoma.
Another special combination of herbs, called Samst’s Swedish Bitters, is all but unknown in the United States. It’s popular in Europe for its powers of curing and alleviating the symptoms of a variety of ailments, including cataracts.
When brushed across the eyelids, Swedish Bitters is said to be an effective treatment for cataracts. It should be noted, though, that the herbal blend is highly astringent and precautions, such as coating the skin with Calendula ointment, should be taken.
Glaucoma is caused, assert many herbalists, by a problem with the body’s kidneys. The next two remedies are said to ease the symptoms of the eye condition, by alleviating the kidney problems.
The first is a tea made of an herbal blend (and containing a small amount of Swedish Bitters). When a glaucoma sufferer drinks several cups of this beverage daily, the symptoms of the condition may soon disappear.
The second glaucoma treatment aimed at healing the ailing kidneys to relieve eye pressure is the Horsetail Sitz Bath. It is so beneficial that many people report the pressure is taken off the eyes during the bath itself. When taking the bath, the water should cover the kidney area, but not the heart region.
Recent research in nutrition, moreover, indicates that Vitamin may provide protection from cataracts. Researchers at the USA’s Human Nutrition Research Center fed guinea pigs large doses of Vitamin C, which resulted, the studies showed, in three to five times the usual concentration of the vitamin in the eyes.
These pigs were exposed to ultraviolet light of the type we encounter on a sunny day, and which is responsible for causing cataracts in the eyes. The pigs given the high dosage showed considerable less damage than those which were not.
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SPECIFICS OF ACUTE CONFUSION TREATMENT
It may be necessary to give some calming medication at the beginning of treatment when a person is excessively agitated. It is best not to use the drugs known as benzodiazepines (Valium/ diazepam, Mogadon/nitrazepam, etc.) as these may have the opposite effect and, by removing all inhibitions, cause the person to be even more disturbed.
If drugs need to be used then the ones with the least side-effects should be tried first. One drug used widely in elderly people for its calming effects in confusional states is Melleril (thioridazine). It can be given in small doses, e.g. 10 mg, and the dose increased until the desired effect is achieved. This should be a lessening of agitation and not a very sleepy or stuporose person liable to fall or be incontinent because of the drowsiness. Other drugs are stronger and can cause more side-effects, though occasionally they are needed, e.g. Largactil/chlorpromazine and Haldol or Serenace/ haloperidol. This latter drug can be very helpful when the confusional state is accompanied by either severe paranoia (fear of being harmed) or aggression. All of these drugs have some side-effects the most serious being stiffness and immobility – a form of Parkinson’s disease called Parkinsonism. The drugs may have to be given by injection if the person is very disturbed or is unable to take medication by mouth. Once the underlying cause has responded to treatment the calming medication can be stopped as most people will return to normal. The medication should not be carried on just in case.
Prompt recognition by carers and prompt diagnosis and action by GPs are the cornerstones of effective treatment.
*14/128/5*

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HOW TO SURVIVE YOUR DOCTOR: APHRODISIACS, APPENDECTOMY
Aphrodisiacs
There are no drugs that reliably increase the sexual appetite and function of both male and female humans. The male sex hormone, testosterone, increases the sexual appetite of some women. The female sex hormone, progesterone that has some testosterone like side effects, also increases the female sexual appetite in a cyclical fashion. Women using high doses of progesterone or Danazol in the treatment of endometriosis often comment on the marked increase in their sexual appetite. The response of these ladies sexual partners is variable. Some men request that doctors cease the prescription of libido enhancing medication to their partners on the grounds of sexual exhaustion.
Home Remedies
The closest domestic activity that comes close to having the properties of an aphrodisiac is watching blue movies. Where possible, couples should take this medicine together, jointly aware of the expected outcome.
Appendectomy
Many people think the removal of an inflamed appendix is a life saving event. This thought is far from the truth. Many appendixes have absolutely nothing wrong with them at the time of operation. Fee for item of service medicine relates to the high miss rate of Australian surgeons. In countries with salaried medical practitioners, far more appendixes stay inside their owners? bellies. The reluctance of salaried surgeons to launch their sharp instruments into the abdomens of suffering patients does not appear to cause any untoward side effects. With the recent introduction of endoscopic appendectomy, fewer Australian surgeons will perform unnecessary appendectomies. Through the new technology they will look before they eviscerate.
Home Remedies
Avoid elective surgery. Ask the surgeon to look before he leaps.
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