Obesity in US

July 21st, 2008

Fact about obesity in US, from yahoo health news. The scorring from Body mass index is calculated by dividing a person’s weight in kilos by his or her height squared in meters.

WASHINGTON (AFP) - Obesity continued to creep up in the United States last year and now affects more than one in four US adults, a US government report showed Friday
In 2005, 23.9 percent of adults in the United States were obese, or had a body mass index greater than 30, while in 2007, the percentage had grown to 25.6 percent, data issued by the Centers for Disease Control (CDC) showed.

More from yahoo

Healthy Food Choices

July 17th, 2008

Eating healthy is something we all would like to do,

although it can be hard. In order to eat healthy, you

must first make the right food choices. Eating healthy

is all about what you eat, which makes the choices very

crucial to your results.

Grains

You should consume 6 ounces of grains per day. To do this,

you can eat 3 ounces of whole grain cereals, breads, rice,

crackers, or pasta. You can get an ounce of grains in

a single slice of bread, or 1 cut of cereal.

Vegetables

These should be varied, as you should eat 2 1/2 cups of

them each day. You should start eating more of the dark

vegetables, such as broccili and spinach. Carrots and

sweet potatoes are good as well. You should also eat

more dry beans such as peas, pinto beans, and even kidney

beans.

Fruits

Fruits are very important. You should try to eat 2 cups

of them each day. Focus on eating a variety, such as

fresh, frozen, canned, or even dried fruit. You can

drink fruit juices as well, although you should use

moderation when doing so.

Milk

Milk is your calcium rich friend. For adults, 3 cups

is the ideal goal. For kids 2 - 8, 2 cups is where you

want to be. When choosing milk products or yogurt, you

should go for fat-free or low-fat. Those of you who

don’t like milk or can’t have it, should go for lactose

free products or other sources of calcium such as fortified

foods and beverages.

Meat and beans

Eating 5 ounces a day is the ideal goal, as you should go

lean with your protein. When eating meat, always bake it,

grill it, or broil it, as this will prevent grease from

adding to the equation. You should vary your protein

as well, with more fish, beans, peas, and nuts.

When cooking your food, you should also limit solid fats

such as butter, margarine, shortening, and lard. These

foods may add flavor to your dishes, although they can

also help raise your cholesterol as well. Therefore, you

should try to add these foods and any foods that happen

to contain them.

To help keep your saturated fat, trans fat, and sodium low,

you can check the nutrition facts label. This label can

be found on the food package and will tell you all the

information you need to know about the food item.

By picking your foods wisely and watching what you eat,

you’ll help control your lifestyle. Exercise is great as

well, as it goes along perfect with a healthy eating

lifestyle. No matter what your age may be, eating healthy

will help you keep your active lifestyle for years and

years - even help you and your health in the long run

as well.

www.generalspaintball.com Receive Your Articles

July 16th, 2008

www.generalspaintball.com receive your articles, topic about health, sport, food, lifestyle. Just submit or email us at outsourcemedia at yahoo.com. Thanks

NAILS IN HEALTH AND DISEASE

July 15th, 2008

Introduction:

The nails are present at the end of each finger tip on the dorsal surface.The main function of nail is protection and it also helps for a firm grip for holding articles.It consists of a strong relatively flexible keratinous nail plate originating from the nail matrix. Under the nail plate there is a soft tissue called nail bed.Between the skin and nail plate there is a nail fold or cuticle.Normal healthy nail is slight pink in colour and the surface is convex from side to side.Finger nails grow 1 cm in three months and toe nails take 24 months for the same.

Importance of nails in disease diagnosis:

The colour ,appearance,shape and nature of the nails give some information about the general health and hygiene of a person . Nails are examined as a routine by all doctors to get some clues about underlying diseases.Just looking at nails we can makeout the hygiene of a person.The abnormal nail may be congenital or due to some diseases.The cause for changes in the nail extend from simple reasons to life threatening diseases.Hence the examination by a doctor is essential for diagnosis .Some abnormal findings with probable causes are discussed here for general awareness.

1) Hygiene:-

We can make out an unhygienic nail very easily .Deposition of dirt under the distal end of nail plate can make a chance for ingestion of pathogens while eating.If nail cutting is not done properly it can result in worm troubles in children.When the worms crawl in the anal orifice children will scratch which lodges the ova of worms under the nails and will be taken in while eating.Prominent nail can also complicate a skin disease by habitual scratching.Sharp nails in small kids cause small wounds when they do feet kicking or hand waving.

2) Colour of the nails:-

a) Nails become pale in anaemia.

b) Opaque white discolouration(leuconychia) is seen in chronic renal failure and nephrotic syndrome.

c) Whitening is also seen in hypoalbuminaemia as in cirrhosis and kidney disorders.

d) Drugs like sulpha group,anti malarial and antibiotics ect can produce discolouration in the nails.

e) Fungal infection causes black discolouration.

f) In pseudomonas infection nails become black or green.

g) Nail bed infarction occures in vasculitis especially in SLE and polyarteritis.

h) Red dots are seen in nails due to splinter haemorrhages in subacute bacterial endo carditis, rheumatoid arthritis, trauma, collagen vascular diseases.

i) Blunt injury produces haemorrhage and causes blue/black discolouration.

j) Nails become brown in kidney diseases and in decreased adrenal activity.

k) In wilsons disease blue colour in semicircle appears in the nail.

l) When the blood supply decreases nail become yellow .In jaundice and psoriasis also nail become yellowish.

m) In yellow nail syndrome all nails become yellowish with pleural effusion.

3) Shape of nails:-

a) Clubbing: Here tissues at the base of nails are thickened and the angle between the nail base and the skin is obliterated. The nail becomes more convex and the finger tip becomes bulbous and looks like an end of a drumstick. When the condition becomes worse the nail looks like a parrot beak.

Causes of clubbing:-

Congenital Injuries

Severe chronic cyanosis

Lung diseases like empyema,bronchiactesis,carcinoma of bronchus and pulmonary tuberculosis.

Abdominal diseases like crohn’s disease,polyposis of colon,ulcerative colitis,liver cirrhosis ect…

Heart diseases like fallot’s tetralogy,subacute bacterial endocarditis and ect..

b) Koilonychia:-

Here the nails become concave like a spoon.This condition is seen in iron deficiency anaemia.In this condition the nails become thin,soft and brittle.The normal convexity will be replaced by concavity.

c) Longitudinal ridging is seen in raynaud’s disease.

d) Cuticle becomes ragged in dermatomyositis.

e) Nail fold telangiectasia is a sign in dermatomyositis ,systemic sclerosis and SLE.

4) Structure and consistancy:-

a) Fungal infection of nail causes discolouration,deformity,hypertrophy and abnormal brittleness.

b) Thimble pitting of nail is charecteristic of psoriasis ,acute eczema and alopecia aereata.

c) The inflamation of cuticle or nail fold is called paronychia.

d) Onycholysis is the seperation of nail bed seen in psoriasis,infection and after taking tetracyclines.

e) Destruction of nail is seen in lichen planus,epidermolysis bullosa.

f) Missing nail is seen in nail patella syndrome.It is a hereditary disease.

g) Nails become brittle in raynauds disease and gangrene.

h) Falling of nail is seen in fungal infection,psoriasis and thyroid diseases.

5) Growth:-

Reduction in blood supply affects the growth of nails. Nail growth is also affected in severe ilness. when the disease disappears the growth starts again resulting in formation of transverse ridges.These lines are called Beau’s lines and are healpful to date the onset of illness.

BRIEF IDEA ABOUT PILES (Hemorrhoids)

July 15th, 2008

What is piles ?

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

Depending upon the situation there are two types of piles.

1) External piles. 2) Internal piles.

1) External piles:-

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

2) Internal piles:-

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

Some times internal and external piles occure in same individual.

Factors responsible for piles:–

1) This is a familial disease.

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

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

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

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

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

Signs and symptoms of piles:–

1) Pain:-

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

2) Bleeding:-

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

3) Protruding mass:-

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

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

Complications of piles:–

1,Infection: The infection can spread to deep veins resulting in septicaemia.

2,Fibrosis: Here the piles become fibrosed with hardening of anal orifice.

3,Thrombosis: Here the blood inside the piles will form clots and can obstruct blood flow.

4,Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood supply.

5,Suppuration: When the piles suppurate it can produce abscess with discharge of pus.

Treatment of piles:–

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

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

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

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

4) Cryosurgery is very effective.

5) Anal dilatation can reduce constipation and pain.

6) Haemorrhoidectomy is the surgical removal of piles.

How to prevent piles?

1) Eat plenty of fruits and vegetables.

2) Take fibrous food.

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

4) Keep a regular timing for food.

6) Drink sufficient quantity of water.

7) Keep a regularity in bowel habits.

8) Take treatment for constipation.

PROSTATE CANCER

July 15th, 2008

Introduction:-

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

Diseases of the prostate gland:-

1) Prostatitis:-

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

2) Benign enlargement of the prostate:-

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

Cancer of the prostate.

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

Site of tumour:-

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

Changes in the gland in cancer:-

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

Growth :-

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

Spread of tumour:-

Metastasis in cancer of prostate is very early.

1) Local spread:-

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

2) Lymphatic spread:-

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

3) Spread through the blood:-

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

Signs and symptoms of prostate cancer:–

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

1) No symptoms:-

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

2) Slight difficulty in urination:-

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

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

4) Retention of urine:-

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

5) Signs of metastasis:-

Some patients come with the signs and symptoms of metastasis.

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

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

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

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

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

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

Clinical examination :-

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

Investigations:-

1) Complete blood investigations;-

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

2) Urine analysis:-

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

3) Renal function tests:-

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

4) Serum acid phosphatase:-

Increased in cancer of prostate.

5) x-ray of the spine:-

To detect any tumour or fracture.

6) Ultra sonography;-

Gives idea about prostate,bladder,kidney ect.

7) C T scan:-

More detailed information about organs and tumour.

8) MRI of the spine:-

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

9) Lymphangiography:-

Gives idea about lymphatic spread of cancer.

10) Biopsy to confirm cancer:-

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

Treatment:-

1) If there is retention of urine catheterisation is needed.

2) Dialysis if kidney failure.

3) If there is coma monitoring of all vital functions along with parentral nutrition and electolyte supply.

4) Specific treatment is prostatectomy(removal of prostate)

Partial prostatectomy :-

Here only the affected lobe is removed.

Radical prostatectomy :-

Total removal of prostate along with nearby lymphnodes.

5, Hormone therapy :-

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

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

7) Radiotherapy is also done for some cases.

8) Homoeopathy:-

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

9) Yoga and meditation is also healpful.

THE GROWTH AND POWER OF APPETITE

July 15th, 2008

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

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

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

No man safe who drinks. ———————-

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

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

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

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

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

TONGUE IN DISEASE DIAGNOSIS:

July 15th, 2008

Introduction:

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

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

Appearance of tongue in some abnormal conditions:-

1) Movements of the tongue:-

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

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

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

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

2) Moistness of the tongue:-

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

Dryness of the tongue is seen in following conditions.

a) Diarrhoea

b) Later stages of severe illness

c) Advanced uraemia

d) Hypovolumic shock

e) Heat exhaustion

f) Hyponatraemia

g) Acute intestinal obstruction

h) Starvation

i) Prlonged fasting.

3) Change in colour of tongue:-

a) Central cyanosis:-

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

b) Jaundice:-

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

c) Advanced uremia:-

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

d) Keto acidosis:-

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

e) Riboflavin deficiency:-

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

f) Niacin deficiency:-

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

g) Anaemia:-

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

4) Coating on the tongue:-

a) Bad breath:-

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

b) Typhoid fever:-

In typhoid fever tongue becomes white coared like a fur.

c) Candidiasis;-

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

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

e) Secondary syphilis:-

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

f) Leokoplakia:-

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

g) AIDS:-

In these patients hairy leukoplakia is seen.

h) Peritonitis:-

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

i) Acute illness:-

Furring is also seen in some acute diseases.

5) Papillae:-

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

a) Hairy tongue:-

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

b) Geographic tongue:-

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

c) Median rhomboid glossitis:-

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

d) Nutritional deficiency:-

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

e) Benign migratory glossitis:-

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

f) Thiamine and riboflavin deficiency:-

Deficiency of these vitamins cause hypertrophied filiform and fungiform papillae.

g) Niacin and iron deficiency:-

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

h) Vitamin A deficiency:-

This causes furrowed tongue.

i) In nutritional megaloblastic anaemia tongue becomes smooth.

j) Folic acid deficiency:-

Here macrocytic megaloblastic anaemia with glossitis is seen.

k) Cyano coblamine deficiency:-

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

l) Scarlet fever;-

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

6) Ulcers on the tongue:–

a) Apthous ulcer:-

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

b) Herpes simplex:-

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

c) Ulcer in cancer:-

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

d) Syphilitic ulcers:-

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

e) Dental ulcers:-

These ulcers are produced by sharp edges of carious teeth.

HOW ALCOHOL CAUSES MENTAL AND MORAL CHANGES

July 15th, 2008

The transforming power or alcohol is marvelous, and often appalling. It seems to open a way of entrance into the soul for all classes of foolish, insane or malignant spirits, who, so long as it remains in contact with the brain, are able to hold possession. Men of the kindest nature when sober, act often like fiends when drunk. Crimes and outrages are committed, which shock and shame the perpetrators when the excitement of inebriation has passed away. Referring to this subject, Dr. Henry Munroe says:

“It appears from the experience of Mr. Fletcher, who has paid much attention to the cases of drunkards, from the remarks of Mr. Dunn, in his ‘Medical Psychology,’ and from observations of my own, that there is some analogy between our physical and psychical natures; for, as the physical part of us, when its power is at a low ebb, becomes susceptible of morbid influences which, in full vigor, would pass over it without effect, so when the psychical (synonymous with the moral ) part of the brain has its healthy function disturbed and deranged by the introduction of a morbid poison like alcohol, the individual so circumstanced sinks in depravity, and “becomes the helpless subject of the forces of evil, “which are powerless against a nature free from the morbid influences of alcohol.”

Different persons are affected in different ways by the same poison. Indulgence in alcoholic drinks may act upon one or more of the cerebral organs; and, as its necessary consequence, the manifestations of functional disturbance will follow in such of the mental powers as these organs subserve. If the indulgence be continued, then, either from deranged nutrition or organic lesion, manifestations formerly developed only during a fit of intoxication may become permanent , and terminate in insanity or dypso-mania. M. Flourens first pointed out the fact that certain morbific agents, when introduced into the current of the circulation, tend to act primarily and specially on one nervous centre in preference to that of another, by virtue of some special elective affinity between such morbific agents and certain ganglia. Thus, in the tottering gait of the tipsy man, we see the influence of alcohol upon the functions of the cerebellum in the impairment of its power of co-ordinating the muscles.

Certain writers on diseases of the mind make especial allusion to that form of insanity termed ‘dypsomania’, in which a person has an unquenchable thirst for alcoholic drinks a tendency as decidedly maniacal as that of homicidal mania ; or the uncontrollable desire to burn, termed pyromania ; or to steal, called kleptomania.

Homicidal mania.

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The different tendencies of homicidal mania in different individuals are often only nursed into action when the current of the blood has been poisoned with alcohol. I had a case of a person who, whenever his brain was so excited, told me that he experienced a most uncontrollable desire to kill or injure some one; so much so, that he could at times hardly restrain himself from the action, and was obliged to refrain from all stimulants, lest, in an unlucky moment, he might commit himself. Townley, who murdered the young lady of his affections, for which he was sentenced to be imprisoned in a lunatic asylum for life, poisoned his brain with brandy and soda-water before he committed the rash act. The brandy stimulated into action certain portions of the brain, which acquired such a power as to subjugate his will, and hurry him to the performance of a frightful deed, opposed alike to his better judgment and his ordinary desires.

As to pyromania , some years ago I knew a laboring man in a country village, who, whenever he had had a few glasses of ale at the public-house, would chuckle with delight at the thought of firing certain gentlemen’s stacks. Yet, when his brain was free from the poison, a quieter, better-disposed man could not be. Unfortunately, he became addicted to habits of intoxication; and, one night, under alcoholic excitement, fired some stacks belonging to his employers, for which, he was sentenced for fifteen years to a penal settlement, where his brain would never again be alcoholically excited.

Kleptomania.

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Next, I will give an example of kleptomania . I knew, many years ago, a very clever, industrious and talented young man, who told me that whenever he had been drinking, he could hardly withstand, the temptation of stealing anything that came in his way; but that these feelings never troubled him at other times. One afternoon, after he had been indulging with his fellow-workmen in drink, his will, unfortunately, was overpowered, and he took from the mansion where he was working some articles of worth, for which he was accused, and afterwards sentenced to a term of imprisonment. When set at liberty he had the good fortune to be placed among some kind-hearted persons, vulgarly called teetotallers ; and, from conscientious motives, signed the PLEDGE, now above twenty years ago. From that time to the present moment he has never experienced the overmastering desire which so often beset him in his drinking days to take that which was not his own. Moreover, no pretext on earth could now entice him to taste of any liquor containing alcohol, feeling that, under its influence, he might again fall its victim. He holds an influential position in the town where he resides.

I have known some ladies of good position in society, who, after a dinner or supper-party, and after having taken sundry glasses of wine, could not withstand the temptation of taking home any little article not their own, when the opportunity offered; and who, in their sober moments, have returned them, as if taken by mistake. We have many instances recorded in our police reports of gentlemen of position, under the influence of drink, committing thefts of the most paltry articles, afterwards returned to the owners by their friends, which can only be accounted for, psychologically, by the fact that the will had been for the time completely overpowered by the subtle influence of alcohol.

Loss of mental clearness.

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Alcohol, whether taken in large or small doses, immediately disturbs the natural functions of the mind and body, is now conceded by the most eminent physiologists. Dr. Brinton says: ‘Mental acuteness, accuracy of conception, and delicacy of the senses, are all so far opposed by the action of alcohol, as that the maximum efforts of each are incompatible with the ingestion of any moderate quantity of fermented liquid. Indeed, there is scarcely any calling which demands skillful and exact effort of mind and body, or which requires the balanced exercise of many faculties, that does not illustrate this rule. The mathematician, the gambler, the metaphysician, the billiard-player, the author, the artist, the physician, would, if they could analyze their experience aright, generally concur in the statement, that a single glass will often suffice to take , so to speak, the edge off both mind and body , and to reduce their capacity to something below what is relatively their perfection of work.

A train was driven carelessly into one of the principal London stations, running into another train, killing, by the collision, six or seven persons, and injuring many others. From the evidence at the inquest, it appeared that the guard was reckoned sober, only he had had two glasses of ale with a friend at a previous station. Now, reasoning psychologically, these two glasses of ale had probably been instrumental in taking off the edge from his perceptions and prudence, and producing a carelessness or boldness of action which would not have occurred under the cooling, temperate influence of a beverage free from alcohol. Many persons have admitted to me that they were not the same after taking even one glass of ale or wine that they were before, and could not thoroughly trust themselves after they had taken this single glass.

Impairment of memory.

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An impairment of the memory is among the early symptoms of alcoholic derangement.

“This,” says Dr. Richardson, “extends even to forgetfulness of the commonest things; to names of familiar persons, to dates, to duties of daily life. Strangely, too,” he adds, “this failure, like that which indicates, in the aged, the era of second childishness and mere oblivion, does not extend to the things of the past, but is confined to events that are passing. On old memories the mind retains its power; on new ones it requires constant prompting and sustainment.”

In this failure of memory nature gives a solemn warning that imminent peril is at hand. Well for the habitual drinker if he heed the warning. Should he not do so, symptoms of a more serious character will, in time, develop themselves, as the brain becomes more and more diseased, ending, it may be, in permanent insanity.

Mental and moral diseases.

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Of the mental and moral diseases which too often follow the regular drinking of alcohol, we have painful records in asylum reports, in medical testimony and in our daily observation and experience. These are so full and varied, and thrust so constantly on our attention, that the wonder is that men are not afraid to run the terrible risks involved even in what is called the moderate use of alcoholic beverages.

In 1872, a select committee of the House of Commons, appointed “to consider the best plan for the control and management of habitual drunkards,” called upon some of the most eminent medical men in Great Britain to give their testimony in answer to a large number of questions, embracing every topic within the range of inquiry, from the pathology of inebriation to the practical usefulness of prohibitory laws. In this testimony much was said about the effect of alcoholic stimulation on the mental condition and moral character. One physician, Dr. James Crichton Brown, who, in ten years’ experience as superintendent of lunatic asylums, has paid special attention to the relations of habitual drunkenness to insanity, having carefully examined five hundred cases, testified that alcohol, taken in excess, produced different forms of mental disease, of which he mentioned four classes: 1. Mania a potu , or alcoholic mania. 2. The monomania of suspicion. 3. Chronic alcoholism, characterized by failure of the memory and power of judgment, with partial paralysis generally ending fatally. 4. Dypsomania, or an irresistible craving for alcoholic stimulants, occuring very frequently, paroxysmally, and with constant liability to periodical exacerbations, when the craving becomes altogether uncontrollable. Of this latter form of disease, he says: “This is invariably associated with a certain impairment of the intellect, and of the affections and the moral powers .”

Dr. Alexander Peddie, a physician of over thirty-seven years’ practice in Edinburgh, gave, in his evidence, many remarkable instances of the moral perversions that followed continued drinking.

Relation between insanity and drunkenness.

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Dr. John Nugent said that his experience of twenty-six years among lunatics, led him to believe that there is a very close relation between the results of the abuse of alcohol and insanity. The population of Ireland had decreased, he said, two millions in twenty-five years, but there was the same amount of insanity now that there was before. He attributed this, in a great measure, to indulgence in drink.

Dr. Arthur Mitchell, Commissioner of Lunacy for Scotland, testified that the excessive use of alcohol caused a large amount of the lunacy, crime and pauperism of that country. In some men, he said, habitual drinking leads to other diseases than insanity, because the effect is always in the direction of the proclivity, but it is certain that there are many in whom there is a clear proclivity to insanity, who would escape that dreadful consummation but for drinking; excessive drinking in many persons determining the insanity to which they are, at any rate, predisposed . The children of drunkards, he further said, are in a larger proportion idiotic than other children, and in a larger proportion become themselves drunkards; they are also in a larger proportion liable to the ordinary forms of acquired insanity.

Dr. Winslow Forbes believed that in the habitual drunkard the whole nervous structure, and the brain especially, became poisoned by alcohol. All the mental symptoms which you see accompanying ordinary intoxication, he remarks, result from the poisonous effects of alcohol on the brain. It is the brain which is mainly effected. In temporary drunkenness, the brain becomes in an abnormal state of alimentation, and if this habit is persisted in for years, the nervous tissue itself becomes permeated with alcohol, and organic changes take place in the nervous tissues of the brain, producing that frightful and dreadful chronic insanity which we see in lunatic asylums, traceable entirely to habits of intoxication . A large percentage of frightful mental and brain disturbances can, he declared, be traced to the drunkenness of parents.

Dr. D.G. Dodge, late of the New York State Inebriate Asylum, who, with. Dr. Joseph Parrish, gave testimony before the committee of the House of Commons, said, in one of his answers: “With the excessive use of alcohol, functional disorder will invariably appear, and no organ will be more seriously affected, and possibly impaired, than the brain. This is shown in the inebriate by a weakened intellect, a general debility of the mental faculties , a partial or total loss of self-respect, and a departure of the power of self-command; all of which, acting together, place the victim at the mercy of a depraved and morbid appetite, and make him utterly powerless, by his own unaided efforts, to secure his recovery from the disease which is destroying him.” And he adds: “I am of opinion that there is a “great similarity between inebriety and insanity.

“I am decidedly of opinion that the former has taken its place in the family of diseases as prominently as its twin-brother insanity; and, in my opinion, the day is not far distant when the pathology of the former will be as fully understood and as successfully treated as the latter, and even more successfully, since it is more within the reach and bounds of human control, which, wisely exercised and scientifically administered, may prevent curable inebriation from verging into possible incurable insanity.”

General impairment of the faculties.

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Dr. Richardson, speaking of the action of alcohol on the mind, gives the following sad picture of its ravages:

“An analysis of the condition of the mind induced and maintained by the free daily use of alcohol as a drink, reveals a singular order of facts. The manifestation fails altogether to reveal the exaltation of any reasoning power in a useful or satisfactory direction. I have never met with an instance in which such a claim for alcohol has been made. On the contrary, confirmed alcoholics constantly say that for this or that work, requiring thought and attention, it is necessary to forego some of the usual potations in order to have a cool head for hard work.

“On the other side, the experience is overwhelmingly in favor of the observation that the use of “alcohol sells the reasoning powers, “make weak men and women the easy prey of the wicked and strong, and leads men and women who should know better into every grade of misery and vice. If, then, alcohol enfeebles the reason, what part of the mental constitution does it exalt and excite? It excites and exalts those animal, organic, emotional centres of mind which, in the dual nature of man, so often cross and oppose that pure and abstract reasoning nature which lifts man above the lower animals, and rightly exercised, little lower than the angels.

It excites man’s worst passions.

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Exciting these animal centres, it lets loose all the passions, and gives them more or less of unlicensed dominion over the man. It excites anger, and when it does not lead to this extreme, it keeps the mind fretful, irritable, dissatisfied and captious…. And if I were to take you through all the passions, love, hate, lust, envy, avarice and pride, I should but show you that alcohol ministers to them all; that, paralyzing the reason, it takes from off these passions that fine adjustment of reason, which places man above the lower animals. From the beginning to the end of its influence it subdues reason and sets the passions free. The analogies, physical and mental, are perfect. That which loosens the tension of the vessels which feed the body with due order and precision, and, thereby, lets loose the heart to violent excess and unbridled motion, loosens, also, the reason and lets loose the passion. In both instances, heart and head are, for a time, out of harmony; their balance broken. The man descends closer and closer to the lower animals. From the angels he glides farther and farther away.

A sad and terrible picture.

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The destructive effects of alcohol on the human mind present, finally, the saddest picture of its influence. The most aesthetic artist can find no angel here. All is animal, and animal of the worst type. Memory irretrievably lost, words and very elements of speech forgotten or words displaced to have no meaning in them. Rage and anger persistent and mischievous, or remittent and impotent. Fear at every corner of life, distrust on every side, grief merged into blank despair, hopelessness into permanent melancholy. Surely no Pandemonium that ever poet dreamt of could equal that which would exist if all the drunkards of the world were driven into one mortal sphere.

As I have moved among those who are physically stricken with alcohol, and have detected under the various disguises of name the fatal diseases, the pains and penalties it imposes on the body, the picture has been sufficiently cruel. But even that picture pales, as I conjure up, without any stretch of imagination, the devastations which the same agent inflicts on the mind. Forty per cent., the learned Superintendent of Colney Hatch, Dr. Sheppard, tells us, of those who were brought into that asylum in 1876, were so brought because of the direct or indirect effects of alcohol. If the facts of all the asylums were collected with equal care, the same tale would, I fear, be told. What need we further to show the destructive action on the human mind? The Pandemonium of drunkards; the grand transformation scene of that pantomime of drink which commences with, moderation! Let it never more be forgotten by those who love their fellow-men until, through their efforts, it is closed forever.”

HOW ALCOHOL AFFECTS THE BRAIN

July 15th, 2008

I once had the unusual, though unhappy, opportunity of observing the same phenomenon in the brain structure of a man, who, in a paroxysm of alcoholic excitement, decapitated himself under the wheel of a railway carriage, and whose brain was instantaneously evolved from the skull by the crash. The brain itself, entire, was before me within three minutes after the death. It exhaled the odor of spirit most distinctly, and its membranes and minute structures were vascular in the extreme. It looked as if it had been recently injected with vermilion. The white matter of the cerebrum, studded with red points, could scarcely be distinguished, when it was incised, by its natural whiteness; and the pia-mater, or internal vascular membrane covering the brain, resembled a delicate web of coagulated red blood, so tensely were its fine vessels engorged.

I should add that this condition extended through both the larger and the smaller brain, the cerebrum and cerebellum, but was not so marked in the medulla or commencing portion of the spinal cord.

The spinal cord and nerves.

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The action of alcohol continued beyond the first stage, the function of the spinal cord is influenced. Through this part of the nervous system we are accustomed, in health, to perform automatic acts of a mechanical kind, which proceed systematically even when we are thinking or speaking on other subjects. Thus a skilled workman will continue his mechanical work perfectly, while his mind is bent on some other subject; and thus we all perform various acts in a purely automatic way, without calling in the aid of the higher centres, except something more than ordinary occurs to demand their service, upon which we think before we perform. Under alcohol, as the spinal centres become influenced, these pure automatic acts cease to be correctly carried on. That the hand may reach any object, or the foot be correctly planted, the higher intellectual centre must be invoked to make the proceeding secure. There follows quickly upon this a deficient power of co-ordination of muscular movement. The nervous control of certain of the muscles is lost, and the nervous stimulus is more or less enfeebled. The muscles of the lower lip in the human subject usually fail first of all, then the muscles of the lower limbs, and it is worthy of remark that the extensor muscles give way earlier than the flexors. The muscles themselves, by this time, are also failing in power; they respond more feebly than is natural to the nervous stimulus; they, too, are coming under the depressing influence of the paralyzing agent, their structure is temporarily deranged, and their contractile power reduced.

This modification of the animal functions under alcohol, marks the second degree of its action. In young subjects, there is now, usually, vomiting with faintness, followed by gradual relief from the burden of the poison.

Effect on the brain centres.

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The alcoholic spirit carried yet a further degree, the cerebral or brain centres become influenced; they are reduced in power, and the controlling influences of will and of judgment are lost. As these centres are unbalanced and thrown into chaos, the rational part of the nature of the man gives way before the emotional, passional or organic part. The reason is now off duty, or is fooling with duty, and all the mere animal instincts and sentiments are laid atrociously bare. The coward shows up more craven, the braggart more boastful, the cruel more merciless, the untruthful more false, the carnal more degraded. ‘ In vino veritas ‘ expresses, even, indeed, to physiological accuracy, the true condition. The reason, the emotions, the instincts, are all in a state of carnival, and in chaotic feebleness.

Finally, the action of the alcohol still extending, the superior brain centres are overpowered; the senses are beclouded, the voluntary muscular prostration is perfected, sensibility is lost, and the body lies a mere log, dead by all but one-fourth, on which alone its life hangs. The heart still remains true to its duty, and while it just lives it feeds the breathing power. And so the circulation and the respiration, in the otherwise inert mass, keeps the mass within the bare domain of life until the poison begins to pass away and the nervous centres to revive again. It is happy for the inebriate that, as a rule, the brain fails so long before the heart that he has neither the power nor the sense to continue his process of destruction up to the act of death of his circulation. Therefore he lives to die another day.