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Morning sickness is characterised by nausea and vomiting during pregnancy. It usually occurs during the early months. About 60% of pregnant women suffer from morning sickness at some stage of their pregnancies, and some actually vomit. Morning sickness is most common between weeks 5 and 8 of pregnancy, but can persist to week 16.

Morning sickness gained its name because the most common symptom is a feeling of nausea upon arising. There are no established causes of the illness, although many believe that hunger makes a significant contribution. Metabolic changes resulting from pregnancy have also been suggested as causal factors. In unusual cases pernicious vomiting can develop in pregnancy and should not be confused with the relatively mild symptoms of morning sickness. Although this affects only one woman in 200, it can cause dehydration and weight loss and treatment for it must be sought.

The treatment of morning sickness involves a number of approaches. A cup of tea and a slice of toast eaten in bed before arising is sufficient to allay the symptoms in many women. Peppermint or raspberry tea are also recommended. Raspberry tablets can be substituted if preferred. Most effective of all is ginger, either fresh or in tablet form, but it should not be taken in the last few months of pregnancy as it may cause colic in the unborn child.

*10\69\2*

The anxious patient cannot sit still. He fidgets and wriggles about. He cannot settle to the task in hand; he starts one job but feels uncomfortable, leaves it and starts something else. He is less restless when there is something definite that he has to do, so he is more comfortable at work than at home. On weekends, in spite of happy relations with his family, it is common for him to wish for Monday so that he can go back to the fixed routine of work.

Sometimes people feel that they will be better if they take a holiday and have a good rest. Of course, these patients are at their worst in such circumstances because they have lost the ability to relax and take it easy. Other people with anxiety are benefited by such a holiday, but when restlessness is a feature the anxious patient only returns more tense and frustrated than ever.

A forty-seven-year-old foreman wrote for an appointment, and described his restlessness in these terms.

“I have an inability to relax, nervous tension, anxiety complex and constant apprehension, I cannot sit [without a flush of anxiety] in meetings, church, theatre, dentist’s chair, barber’s chair, public transport, or as a passenger in a motor car . . . My flush of nervous tension makes me leave whatever I am attending . . .”

*13\57\2*

If you want to feel what a muscle is like when it’s relaxed, start by recognizing what it’s like when it’s tense. Probably the easiest muscles to tense and relax are the muscles in your hands, so that’s where we’ll start.

Relaxing your hands, arms and shoulders-Clench both your fists as hard as you can, holding them up in the air. Now you’re ready to relax. Keep up the tension in your hands as hard as you can while you take a deep breath through your nose, counting to three slowly. Now blow out your breath through your mouth as though you were blowing out three candles, set one behind the other in front of you. As you blow, release the tension and let your fists drop and your hands fall back on the bed (or the sofa, or the floor or wherever you are). It will be a great relief to be without all those tight sensations in your hands and wrists. Lie still and check that all the tight, aching feelings have gone or are going. If they’re still there after a couple of minutes, clench your fists again and repeat the process. Then get your friend to check how relaxed you are. A really relaxed hand is absolutely floppy. The fingers curl into a natural curve. If you are on your own, prop up a mirror so you can see yourself and check on the position of your hands. After a while, your hands, lying on the bed, will begin to feel quite heavy.

Now relax your arms. Lift your hands and arms off the bed and tense them right up to the shoulders. You will feel the tension in your elbows, which will seem to be trying to push their way through from the outside to the inside of your arms. You’ll probably ache along the inside of your upper arms, too, and across your shoulders. Take your deep breath, blow out your three candles and let all the tension in your arms go so that they drop back heavily onto the bed. If you’re really relaxed all the tight aching sensations should soon start to melt away. Get your friend to check that your arms are relaxed by gently lifting them up and supporting them with both hands. A relaxed arm is floppy and quite heavy to lift. Lie quietly and check that there isn’t any tight, uncomfortable feeling anywhere along the length of either arm.

At this stage, tackle your shoulders. Most of us hunch our shoulders just a little bit, most of the time. It’s a sure sign of tension, but we don’t usually recognize what we’re doing. If you now hunch your shoulders right up into your neck as far as you can, you’ll feel tension in the back of your neck, under your chin, and down your back along both shoulder blades. Once again take a deep breath, tensing your shoulders as much as you can, and then breathe out, blowing through your mouth. Let your shoulders drop as though your arms were falling out of their sockets. Now drop them a bit further still.

You might well find that you’re not comfortable on your pillows now, and you’ll need to get your friend to readjust them. You may need to wriggle around a little until you’re comfortable again. When you’re settled, check that your hands and arms and shoulders are still relaxed.

*8\177\2*

In the mid-1950s, William Petersen came to me as a patient, complaining that eating a single commercial apple would cause him to have a severe headache. Petersen was fed on apples twice in my office after having avoided this food for a week, and on both occasions was struck with searing attacks of head pain. I naturally diagnosed him as allergic to apples.

Petersen was an inquisitive man, with a determination to understand why he reacted in the way he did. He lived in a nearby state which had a large fruit-producing belt. Upon returning home, working on a hunch, he slipped into an abandoned orchard and gathered some apples from the trees. These apples had not been sprayed or cared for in years. He picked about half a peck of sound ones and took them home. Surprisingly, he was able to eat these unsprayed, untreated apples with complete abandon: he ate three or four of them at a time, every day for a week. He had no headache or any other reaction whatsoever. He then reported the result of his experiment to me.

I therefore obtained my own source of unsprayed apples and tested Petersen on these in my office. Again, he had no reaction to unsprayed apples but responded with a severe headache to any commercial variety. Petersen went on to eat apples thereafter, provided he obtained them from uncontaminated sources. He didn’t have an apple allergy at all; he had something else, something which still did not have a name.

To extend this observation, in 1953 I obtained samples of apples sprayed with several major pesticides from the horticulture department of the College of Agriculture of the University of Illinois. By using these apples, as well as completely unsprayed and untreated ones, the problem of the “multiple fruit sensitivity” was finally worked out. The majority of the patients who reacted to these fruits were usually not allergic to fruit at all. What they were susceptibile to was the chemical pollution of fruit. The unsprayed fruit could be tolerated quite well, but the commercially available varieties, such as are obtained in supermarkets and fruit stores, caused chronic health problems such as arthritis, colitis, nervousness, and depression.

This observation raised a host of questions about health and sickness, questions which struck at the basis of much of Western technology.

How safe is our present chemical environment? To what extent does it contribute to chronic illness? How much do we know about the long-term effects of such by-products of “progress” as the chemical pollutants in the air of our homes and cities, chemical additives and contaminants in our foods, water, cosmetics, and drugs?

Supposedly these environmental chemicals had been tested and found safe.

However, there were serious questions to be asked about the validity of long-term toxicity studies carried out by government or industry. If only a minority of rats responded adversely to a chemical, were these results averaged out in the final report? What about the minority of people who are similarly afflicted? Were they being similarly ignored or lost in our statistical studies? These were important questions, since even if only one or two percent of the population were made chronically ill by daily exposure to such chemicals, this would still amount to two to four million people in the United States alone, enough to keep all our physicians busy for a long time. We doctors were the ones who had to deal with the unusual reactions, yet the medical profession seemed completely unaware of the potential danger.

Many of the chemicals in common use had become “profitable ventures” by the time anyone began to suspect that they were harmful. They thus became the focal point, individually and collectively, of defensive public relations operations by giant companies.

Indeed, some of the most troublesome chemical exposures have not been adequately described, and there is still no general knowledge of their potential hazards. The chief reason for this is that these materials have become integral parts of our current existence. Since they are so common, they are not usually suspected. Not being suspected, they are not usually avoided deliberately. Thus, not being eliminated either by chance or design, certain common chemical exposures remain unsuspected causes of chronic physical and “mental” illnesses.

There is an element of addiction to some of these chemicals, as well. Even though certain chemical exposures may be suspected of causing harm, avoidance is not only inconvenient, and sometimes expensive, but, because of the addictionlike responses that may be involved, sometimes the victims do not even wish to avoid exposure to the chemicals. Thus, understanding of this problem has been obstructed both by the constant nature of the chemical exposure and the self-perpetuation of the process.

I called this the chemical susceptibility problem, instead of the chemical allergy or sensitivity problem, to avoid prolonged and pointless debates over whether such small doses could cause classic allergic reactions. Whatever their name, such reactions were real and increasingly common, as many cases were to show.

*9\110\2*

Colic is any cramp-like, recurring abdominal pain. Colic has a variety of causes and may occur at any age. Most often, however, people use the term to refer to colic that occurs in infants.

Infantile colic, or “three-month” colic, is a specific problem that bothers 10 to 20 percent of babies. Colic is far more common in bottle-fed babies than in breast-fed babies. Colic starts during the first few weeks of life and lasts one to six months (an average of three months).

Signs and symptoms

The signs of colic are seen in the typical behavior of colicky infants. A baby with colic cries for hours a day, particularly in the late afternoon and evening. The child pulls the legs up, clenches the fists, screams, and turns red. The child may feed briefly but soon stops feeding and returns to crying. Rocking and cuddling also stop the cries only briefly. In other respects, the infant is normal; the baby gains weight well, has normal bowel movements, and doesn’t spit up any more than most infants do.

A variation of this classical form of colic is the infant past two weeks of age who wakes frequently (every two hours or so), cries fretfully, takes one to two ounces of formula or a few minutes at the mother’s breast, falls into a fitful sleep, and wakens later to repeat this pattern.

Home care

First check for obvious causes of crying and discomfort other than colic. Look for diarrhea or constipation; loose nappy pins; severe nappy rash; a trapped arm or leg; whether the baby is too hot or too cold; or signs of illness – fever, nasal discharge, cough, reddened eyes, vomiting, hernia (a lump in the groin), or sores on the body. See whether your baby responds promptly to talking and cuddling and remains comfortable. A baby in pain can be distracted, but only temporarily. If breast-feeding, check that the mother’s nipples are not bleeding. Swallowed blood causes cramps. If a breast-feeding mother drinks too much cow’s milk, this can also cause cramps in the infant.

Offer your baby a feeding. If your baby drinks generously and falls asleep comfortably for several hours, the child was hungry, not colicky. Keep the baby partially upright in an infant carrier between feedings to be sure the baby is not regurgitating food in the oesophagus.

If colic still seems likely, applying gentle heat to the abdomen temporarily relieves the pain. First place a cloth nappy over the infant’s abdomen. Then place a heating pad (turned to “low”) on top of the nappy. Giving the child a pacifier may help. Also try inserting a glycerin suppository or lubricated thermometer to induce a bowel movement.

Precautions

• Make sure the formula is properly prepared.

• When bottle-feeding your baby, be sure that the nipple is kept full; this keeps your baby from swallowing too much air.

• Make sure the bottle’s nipple hole is large enough so that the baby can finish feeding in a reasonable time.

• Carefully burp the baby in different positions after each feeding.

Medical treatment

Your doctor will check for signs of illness, such as sores in the mouth or urinary tract problems. A urinalysis may be ordered. Your doctor also may recommend a change in formula to investigate the possibility that the child is allergic to the formula. A breast-feeding mother may need to eliminate all milk products from her diet to see if this is what is affecting her child. The doctor may also temporarily stop any solids already started to determine if the child may be allergic to certain foods.

*35/84/5*

• The prostate is part of the sexual apparatus of a man so it is only sensible to look at sexual activity as a cause of prostatic problems. Clearly a man’s sexual habits must influence the workings of his prostate.

The prostate produces fluid all the time which, having built up, needs to be discharged by ejaculation. The build-up appears to take approximately three days in the average young and middle-aged man and longer in the older man.

Finding that younger men are experiencing prostate problems which in the past were confined to the elderly has led various experts in the field to suggest that prolonged sexual excitement without ejaculation is bad for the gland. This is rather akin to the pelvic congestion that occurs in women who are aroused repeatedly but don’t have an orgasm-they too suffer from all kinds of pelvic and lower-back symptoms. Also, it is proposed that when such a man does ejaculate his prostatic contractions are poor and that he has a poor-quality orgasm with incomplete emptying of the gland.

Residual fluids degenerate in the gland and cause inflammation and need more muscle power to expel them next time.

No single type of sexual activity necessarily produces prostatic damage, but both excessive masturbation or intercourse and too little could do so. The answer must be to find your own sexual rhythm and be guided by how you feel. Certainly, long periods of abstinence from sex may produce prostatic fullness, tenderness and eventually infection which can be difficult to treat. Zinc supplements and regular emptying of the prostate both help.

• Many animal experiments show that vitamin E deficiency causes all kinds of abnormalities and problems in the sexual life and reproduction of animals. It therefore makes sense to eat foods rich in the vitamin.

• Natural substances occurring in wheat germ oil have proved valuable in animal experiments. It is an old belief among the peasants of the Balkans of Eastern Europe that pumpkin seeds are of value for prostatic well-being. Analysis of these seeds shows that they are rich in all the nutrients known to be of value to prostatic health. Other valuable seeds are those of the sunflower. These seeds contain the amino-acids glycine, alanine and glutamic acid. A study in the US of forty men with benign prostate troubles found that in 32 per cent of them their prostates shrank to normal size and there was some reduction in size in 92 per cent when they were given these amino-acids. The need to get up at night was reduced or eliminated in 72 per cent and urgent urination was relieved in 81 per cent. Men who received placebo capsules had no similar improvements. This study, rather than stimulating further research, has been largely ignored. Foods that are especially rich in these amino-acids are brewers’ yeast, milk, eggs, beef, liver, lentils, nuts and corn.

• Unsaturated fatty acids have been shown to be of value in benign prostatic enlargement. In a study of nineteen men with this condition who were fed unsaturated fatty acids, all had less residual urine at the end of the treatment and twelve of them had none. For thirteen of the nineteen the dietary change meant they no longer wanted to get up at night to urinate. Cystitis cleared up. Dribbling was eliminated in eighteen of them and in nineteen the size of the prostate gland went down. Lecithin is a good source of unsaturated fatty acids.

*7/72/5*

Correct, deep, belly breathing, says Dr. Hendricks, has been shown to:

•     Melt tension. It counters the shallow tight breaths produced by the instinctive fight-or-flight response that we find ourselves kicked into frequently.

•     Clarify and focus the mind.

•     Increase energy and endurance.

•     Clear unpleasant emotions. Two or three big breaths at the onset of an injurious emotion such as fear, anxiety, or depression are often enough to move it out of the body.

•     Help manage pain. (This is why it is taught in natural childbirth classes.) Do not hold your breath when in pain or anticipating pain. Instead, breathe – calmly, deeply.

•     Improve athletic performance.

•     Significantly lower blood pressure.

Deep breathing and breathing in general help in treating many modern-day maladies. “Breathing exercises are a major emphasis of the yoga classes I teach in Hawaii,” says Arthur Brownstein, M.D., medical director of the Princeville Medical Clinic and clinical instructor of medicine at the University of Hawaii John A. Burns School of Medicine in Honolulu. Breathing exercises are also a major component of the stress-management program taught to heart patients during the highly touted programs conducted by the Preventive Medicine Research Institute in Sausalito, California.

Breathing exercises

The following are the basics of Breathing 101, as taught by Dr. Hendricks as well as Barbara Lang, who teaches Yogic breathing in an intensive medically supervised program for people with heart problems and other degenerative diseases.

Get past tense. Tense your abdomen. Relax your abdomen. Tense your abdomen. Relax your abdomen. Do this maybe a dozen times, until you are well aware of how a relaxed abdomen feels.

Give yourself a hand. Put your hand on your abdomen. Breathe slowly, comfortably, deeply enough to make your hand rise with each inhalation and fall with each exhalation.

Go for ribs. Keep breathing slowly, comfortably and into your belly. If you are truly breathing correctly, you will feel your rib cage expand to the side with each inhalation.

Move your spine. “Babies can lie in a crib all day without getting a backache because they move their spines with each breath,” says Dr. Hendricks. “We tend to hold ourselves more stiffly as we age.” With each in-breath, let your spine move away from the chair back (if you’re sitting) or away from the floor (if you’re lying on your back). On each out-breath, let it flatten against the chair or floor.

That’s your basic, healthy breathing. To remember to do it, associate the term breathe with normal everyday activities such as standing, sitting, or turning, says Larry J.

Feldman, Ph.D., director of the Pain and Stress Rehabilitation Center in New Castle, Delaware. Then, he says, taking healthy, deep breaths at intervals throughout your day will be as natural as, well, breathing.

*41/36/5*

Most breast cancers arise from the epithelia in the breast, and these are known as carcinomas. In-situ carcinoma is the term used for a carcinoma which remains in the position in which it developed, with no sign of invasion into the surrounding tissues. Sarcomas – tumours arising from the connective tissue -are rare in the breast.

Some 90 per cent of breast cancers develop within the epithelial lining of the ducts. Of the remainder, about 5 per cent occur within the lobules of the breast, and these are likely to be associated with second tumours in the same or the other breast. The remaining 5 per cent are a combination of ductal and lobular cancers. There are variant forms of most types of breast cancer, sometimes with a different prognosis from that of the tumours they resemble.

Different names are used to identify the same cancers in different countries, and by different doctors within a country. Confusion is therefore rife – not least amongst the medical profession itself.

Ductal tumours

Scirrhous/non-specific ductal carcinoma

This is the most common form of ductal breast cancer, which usually develops as a hard, painless swelling in women near their menopause. It often occurs in the upper outer quadrant of the breast and may spread into the surrounding fat. Malignant cells may also be present in nearby lymph vessels and blood capillaries. A scirrhous carcinoma that has invaded the lymph nodes or the lymph vessels near the skin is likely to have a worse prognosis.

Atrophic scirrhous carcinoma

This is a very slow-growing tumour which may cause contraction and deformity of the breast in elderly women. It is often only found during routine medical examination and can remain localized in the breast for many years.

Medullary carcinoma

Also called lymphocytic or encephaloid carcinoma, this is a softer, more rapidly growing tumour than the scirrhous. It is said to have a better prognosis, even when spread has occurred to the lymph nodes in the armpits. If the body launches a strong defensive response itself, the prognosis can be even better. There is less fibrous reaction (unlike with the scirrhous type), and many disease-fighting lymphocytes are seen within the cancer.

There is also a variant of this type of cancer which is known as atypical medullary carcinoma. This is an intermediate form combining characteristics of a medullary and a scirrhous carcinoma.

Inflammatory carcinoma/carcinoma of pregnancy and lactation

These tumours may resemble a breast abscess. They grow rapidly and may cause the breast to become hot and tender. They do not normally become apparent until it is too late for them to be treated successfully.

Papillary carcinoma

Papillary carcinomas are a rare variant of the non-specific ductal form, with a good prognosis. They develop as a mass of cells within the lumen of a duct, and they present early with bloody nipple discharge.

Cystic carcinoma

Cystic carcinomas are rare (only about 1 per cent of all breast cancers), but they have a poor prognosis. When aspirated, the fluid they contain is bloody, and malignant cells can be seen within it when it is examined under a microscope.

Lobular tumours

Cancers in the lobules of the breast are 10 to 20 times less common than ductal tumours. The prognoses are similar, but lobular tumours are more likely to occur in both breasts, Sometimes several being present at the same time.

*20/39/5*

Screening procedures that are definitely not worth doing routinely are barium enemas; barium meals; looking for cells in the sputum (spit); stress testing; lung-function tests; and biopsies of the lining of the uterus. All of these are, of course, useful diagnostic procedures in specific individuals.

Screening can be carried out in the community in general or it can be focused on specific sub-groups who are thought to be ‘at risk’. As we have seen, when screening for cervical cancer, money is best spent on screening women from lower down the socio-economic scale because it is much more common in this group.

Families are population sub-groups ripe for screening. The predisposition for many diseases (as well as truly hereditary disease, of course) runs in families. Common examples are breast cancer, diabetes, asthma and high blood pressure. Doctors have always considered screening families in the context of infectious diseases in the past but few do this kind î intra-family screening for chronic conditions.

Screening, especially the sort that involves paying a fixed sum for a batch of tests and examinations, is currently enjoying something of a revival. One of the attractions of screening programmes is that the; can often be inexpensive and can be implemented by relatively low grade personnel rather than doctors. But as the price has come down, fewer questions tend to be asked and screening is now-with the coming interactive computer systems-set become even more popular, after decade of apathy and serious questioning of its worth. Another reason for an increased interest in screening recently is that, with the setting-up of new health maintenance and prevention-orientated medical organizations, screening equipment and personnel can be used with the curative staff on hand. A major criticism of screening centers in the past has been that they left the patient high and dry with his or her findings from the screening. These new ways numbers of false positives that occur of working enable responsible follow- with certain screening procedures, up to be a part of the whole picture. This is essential in the light of the Much more research needs to be done before we can be absolutely sure just how valuable many screening procedures are. What looks like commonsense preventive medicine is often not so on deeper analysis. The danger with the coming of cheaper and easier screening methods is that society might ask fewer questions, not more.

*35/72/5*

When Dave Venne moved in with some of his buddies, he was looking forward to the companionship and fun. What he didn’t expect was a 15-pound weight gain.

“Those guys ate all the time, and I was right there with them,” says the 25-year-old landscaping-design supervisor from Tempe, Arizona. “Still, I couldn’t believe how quickly the pounds piled up. I went from 225 to 240 in 12 weeks. More than a pound a week!”

At 6-foot-4, Dave carried the extra weight well. But it made him feel heavy and uncomfortable. “I work outside in the heat, and I felt miserable,” he says. “Plus, I wasn’t running as fast or jumping as high when I played basketball, one of my favorite pastimes.

“My roommates and I would play basketball or do something else for a couple of hours practically every night,” he continues. “By the time we finished, we’d be so hungry that we’d eat just about anything that we could get our hands on.” Their foods of choice were pizza, burgers, and Mexican takeout, all washed down with copious quantities of soda and beer. “Sometimes, I’d eat an entire pizza and drink three or four beers, plus a couple of Cokes, before going to bed,” Dave says. “And that was on top of eating a sandwich or something else when I got home from work.”

Feeling out of shape and overweight, Dave decided his late-night eating habits had to go. “I figured that if I ate a good dinner, I wouldn’t get hungry later that night,” he says. “I’m not much of a cook, but even I can heat up a can of soup and put together a turkey sandwich.”

As he began paying more attention to his food choices, his other meals became healthier, too. He traded in his usual sausage-egg-and-cheese breakfast sandwich for a bowl of cereal, a glass of orange juice, and sometimes toast. For lunch, he still favored fast-food restaurants, but he replaced his bacon double cheeseburgers with grilled chicken sandwiches. And he carried bottles of water with him everywhere. “I have to drink a lot while I’m working,” he explains. “I used to down seven or eight sodas a day. I think that switching to water helped me lose weight.”

Indeed, Dave got rid of those 15 extra pounds, plus 8 more, in about 6 months. He has held steady at 217 pounds, a comfortable weight for his size, since 1998.

These days, Dave seldom eats after 8 o’clock at night. If he feels hungry after a couple of hours of shooting hoops, he’ll eat fruit or fat-free frozen yogurt. When his roommates order out, he helps himself to a healthy snack or goes to bed instead.

“Being around junk food and not eating any of it was hard at first,” Dave admits. “But now I feel so much better about myself that I don’t even miss that stuff.”

*29\89\8*