It is important to remember that if a person is sexually active then he or she can get venereal disease. It doesn’t matter how clean or how well brought up you may be, it is not confined to any one socio-economic group.

If you think you might have acquired one of these infections, then immediately seek professional help. You may see your local doctor, the Out-patient clinic of a public hospital, or one of the Government clinics set up to deal with VD.

The Government clinics are listed in the telephone books under the Health Department section of The State Government.

There is no need to be frightened that someone will come to call on you or hound your sexual contacts if you seek treatment. Naturally you will be urged to let your partners know if it is shown you have VD, but that is only acting responsibly.

Remember that most venereal diseases can now be quickly and completely cured.

*602/71/1*



While most eye inflammations lead to an increased production of tears with watering of the eyes, sometimes the reverse, with dry eyes resulting, can be an annoyance.

There are a few rare conditions where the production of tears by the lacrimal glands is reduced but the problem can occur in the elderly as tear glands age and so produce less tears.

Failure to blink frequently may also be a cause of drying of the eyes.

Artificial tears are available in drop form and may be prescribed although some are available from the chemist without prescription.

These drops are a lubricant, contain no active drugs and may be used frequently without risk to the eyes.

*345/71/1*



Modern cancer specialists believe in scientifically-tested treatments which work in a way that makes sense to their scientifically-trained minds. The ‘best’ treatments are those which have been scientifically shown to produce the greatest proportion of remissions and the greatest average length of life, almost regardless of any other consideration. The ‘best’ treatments are those that are best at shrinking cancers and delaying death. They are not the treatments that make people feel best, nor are they the treatments that are most convenient and pleasant. A treatment which has any chance at all, however small, of temporarily making cancer growths smaller is ‘better’ than treatment aimed at simply relieving symptoms and making people feel better. A treatment which, on average, extends patients lives by three months is ‘better’ than no anti-cancer treatment. These treatments are considered better even though they may mean frequent injections, blood tests, hospital visits, weakness, nausea and vomiting and other unpleasant side effects. Doctors have set recommendations for each type of cancer. All that your doctor needs to know about you is the type of cancer you have, its extent and possibly your age. The same sorts of statements could be made about practitioners other than doctors.

*125/40/1*



Thus, surgery has a good chance of curing some types of cancer, but only those which are usually still confined to the primary site at the time of diagnosis. Cancers which tend to release cells into the bloodstream or lymphatic system before they are diagnosed are unlikely to be cured by surgery. Other types of cancer are extremely sensitive to radiation treatment, so sensitive that they can be cured by it even when secondary growths have formed. There are also some types of cancer which are very sensitive to certain chemotherapy drugs, and these particular types can be cured even when they have spread extensively. There are some cancers which are verySensMve to the balance of various hormones in the body. These cancers can remain dormant for long periods of time if the hormone balance is changed (by taking pills or injections or by removing the glands which produce certain hormones). I will be discussing these treatments and the particular types of cancer against which they are effective in later chapters.

*119/40/1*



For some babies, the process of normal childbirth presents a great hazard, with the risk of death or severe brain damage. Our grandparents knew and accepted this. Today, you and I are just not prepared for our babies to run these risks.

Generations of medical students have been taught that, in labor and childbirth, they need to consider the three Ps — the passage, the passenger and the power (which pushes the baby through the passage).

Delayed delivery which might lead to foetal or maternal distress could usually be assisted by means of forceps and the skill of the obstetrician usually lay in his ability to manage difficult births and extract the baby with forceps.

Now the pressure is on the doctor not to risk the baby with a difficult forceps delivery but to go straight to a caesarean section.

This operation carries with it a small risk to the mother, but modern anaesthetics, improved surgical techniques and the availability of blood from the blood bank make this risk very small.

*95/71/1*



A common guiding principle of ethical decision-making is to ‘do no harm’, Fat-reduction methods have a number of risks that should be balanced against the potential benefits for each client.

For some people, for example those with diabetes or heart disease, the need to lose fat is paramount and the ethical balance is dearly in favour of attempting fat loss. Conversely, for some people the risks of losing fat, especially by dieting, are so great mat the ethical balance is usually in favour of discouraging fat loss (for example, people with anorexia nervosa, binge-eating disorder or a history of cyclical dieting).

The decision will not be so obvious in most cases and you will need a good knowledge of the potential risks and benefits of your approach to fat loss methods as well as carrying out a careful assessment of each individual client.

The treatment resources available.

Ethical decisions need to be realistic. That means they have to fit the actual circumstances rather than ideal circumstances. You need to take into account the actual treatment resources available, even if these differ from what would ideally be the case.

What treatment can you offer? This goes beyond consideration of your particular expertise and takes account of what you usually offer or any constraints imposed by the organisation for which you work.

What resources can you refer to? The ethics of offering help may differ according to the alternatives available. In circumstances where few other resources are available or your skills, however limited, exceed those of the available alternatives, it may be unethical not to offer help even though in the context of a richer range of alternatives, it would be ethical for you to refer on.

*233\186\4*



Carbohydrate foods that break down quickly during digestion have the highest G.I. factors. The blood sugar response is fast and high. In other words the glucose (or sugar) in the bloodstream increases rapidly: Conversely, carbohydrates which break down slowly, releasing glucose gradually into the bloodstream have low G.I. factors. An analogy might be the popular fable of the tortoise and the hare. The hare, just like high G.I. foods, speeds away full steam ahead but loses the race to the tortoise with his slow and steady pace. Similarly, the slow and steady low G.I. foods produce a smooth blood sugar curve without wild fluctuations.

For most people most of the time, the foods with low G.I. factors have advantages over those with high G.I. values. But there are some athletes who can benefit from the use of high G.I. foods during and after competition. The substance which produces the greatest rise in blood sugar levels is pure glucose itself. All other foods have less effect when fed in equal amounts of carbohydrate. The G.I. factor of pure glucose is set at 100 and every other food is ranked on a scale from 0 to 100 according to its actual effect on blood sugar levels.

The G.I. factor of a food cannot be predicted from its composition or the G.I. factor of related foods. To test the G.I. factor, you need real people and real foods. There is no easy, inexpensive substitute test Standardised methods are always followed so that results from one group of people can be directly compared with those of another group.

The G.I factor is a clinically proven tool in its applications to diabetes, appetite control and reducing the risk of heart disease.

*23\33\4*



Fringe benefits which come unasked as a result of these relaxing mental exercises. These were matters that were easy to discuss and record—better sleep; greater ease at work; less tension in the home; better sexual response; and improved responses, both mental and physical, in many other aspects of our life.

But there is something else, something much more elusive, something much more significant. I have experienced it. I also know that others have experienced it, although they have rarely told me so.

You may easily think to yourself, “Well, how does he know?” I know in the same way as you will know when it comes to you.

When I was asking him about the nature of meditation, the yogi saint of Katmandu told me, “You can show a child a banana, but you cannot tell him how it tastes.” Taste the flavour of your relaxing mental exercises. Taste it deeply. And you will know what I mean. This that is greater than all the rest.

I have tried to write as if I were talking with you in my consulting room. If you were here with me, I would ask you to drop me a note just to let me know how things have gone with you.

As a doctor I want to know the result of my treatment. If the treatment is not quite orthodox, it is all the more important that we know the result. Please, if you have had help from this let me know. What was your trouble? How long had you had it? Then these ideas can be put to others with the additional weight of your own experience.

*149\57\2*



On the whole, these deformations consist of localised flattenings and bulgings of the margin of the pupil. In this case one should note whether these distortions appear in the right or left eye, and whether they are found in the upper, lower, nasal or temporal sectors. A sunken condition of a flattened segment leads to inward bulging, corresponding to an increase of all symptoms.

All asymmetrical deformations of the pupil are reliable indications for assessing the condition of the nervous system, as well as to imply a disease condition of those organs whose areas are localised in the sector corresponding to the flattened segment. This second point is very important.

Flattening of the left pupil margin in the upper sector indicates psychic disturbances. Flattening of the lower sector of both pupils indicates severe muscle weakness affecting the legs.

Flattening of the pupil margin in the nasal sector indicates disturbance arising from the spinal cord and its nerve trunks, and includes physical and mental conditions. Temporal flattening corresponds more with hormone disturbances. From cerebellum to gonads, including suprarenale, pancreas and heart, these organs stand in close hormonal relationship. From this arises the clinical picture of vegetative dystony.

Flattening of the pupil margin in the upper sector of the right iris is more often seen in conditions associated with hysteria, whereas involvement of the same sector of the left iris indicates a predominance of melancholic states (see also right iris: Uterus-Cerebellum line, and left iris: Rectum-Cerebellum line).

Right temporal sector flattening suggests disturbance of the liver and consequent effects. In this case, the patients are suffering from liver encumbrance arising from hereditary preconditions caused by faulty nutrition and mode of life

*41\78\2*



There are two drugs that doctors at St Thomas’ Hospital are using to cut back the amount of prolactin their patients produce during the last half of the month. One is Vitamin B6, or pyridoxine, which they estimate helps nearly sixty per cent of patients whose symptoms are depression, headaches or breast swelling (at the time of going to press the results of a properly controlled trial of pyridoxine has not yet been published). This vitamin had already been used successfully to treat some women on the Pill who developed depression and headaches. Taking the Pill can sometimes cause a shortage of Vitamin B6 and when this happens, your brain can’t make enough of a substance called 5-hydroxy-tryptamine, and when that happens you get depressed. Some doctors treat the depression by giving their patients more Vitamin B6. Others, who seem to me to have rather more sense, advise their patients that the Pill doesn’t suit them and persuade them to try some other form of contraception that doesn’t have side-effects. A leaflet on Vitamin B6 treatment can be obtained by sending a stamped, addressed envelope to PMT Clinic, Gynaecology Department, St Thomas’ Hospital, Lambeth Palace Road, London SE1. Pyridoxine is obtainable off prescription (as ‘Comploment’, which contains 100 mg of pyridoxine) but as the daily starting dose used at St Thomas’ is considerably lower it is obviously sensible to follow the recommendations given in this leaflet, if you decide to try it for yourself.

*85\177\2*



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