Cause

The conjunctiva, or lining over the eyeball and inside the eyelids, can easily become infected by a germ (bacterium) or a virus. Infection is more common after initial irritation of the eye due either to an object or chemical that has entered the eye, or to an allergic reaction. Sometimes the child develops conjunctivitis as part of a cold.

Clinical features

Your child’s eye will be red and teary, and will be sore or itchy. Sometimes there will be a greenish, sticky discharge in the eye, which cakes the lids together after sleep. The skin around the eyes may look puffy.

Treatment

Keep the eye clean by washing it gently several times a day with cotton wool soaked in tepid water. See your doctor for the appropriate treatment. If an infection due to a germ is suspected, your doctor may suggest doing an eye swab (see p. 48) in for several days. You may need help in administering these — your doctor or nurse may be able to give you some helpful suggestions.

Conjunctivitis is very contagious, so always wash your hands after touching your child’s eyes, and provide a separate towel for his use only. Wash his hands frequently too, and discourage him from rubbing his eyes. Keep him at home until the infection has cleared up completely.

When to see your doctor

It is wise to consult your doctor whenever you suspect that your child has an eye infection. You should definitely see your doctor if

• the infection does not clear up after 3-4 days, despite treatment;

• your child is also generally unwell.

*263\90\8*

A real fox. But she didn’t get it on or like that. I did all the stuff,

and she was like nothing’, man. She said I didn’t know how to do

it. I felt like a jerk.

FOURTEEN-YEAR-OLD BOY

There is one magical way to turn a girl on. Only one person in the whole world knows this magical way. I’ll let you in on the secret. The person who knows is the person herself. There isn’t any one way that is the right way. Everyone is different. Getting turned on is something two people do together. Boys don’t turn girls on and girl don’t turn boys on. Even though the books and some of the guys or girls might brag that there are certain ways to do it, they are just plain wrong. Remember, anybody except your parents or the boy or girl you love who is telling you about what they do in sex is either lying, bragging, or covering up their own ignorance. Talk to your parents. They have proven they know at least a little bit of what they are doing, because you are sitting here talking very maturely about sex. They must have done something right.

*299\97\8*

HUSBAND

Most couples have sex at night, after the house is straightened up, the cat let in, the kids asleep, and everything else is out of the way. Neurohormonally, the best time for sexual interaction is sometime in the late-morning hours when the sex hormones are at their peak. Of course, there is much more to sex than the hormones, but we are more rested and energized in the morning hours.

The argument for having sex at night is difficult to accept. Turning in for a night’s sleep is hardly the time when we are the most rested anyway. Sometimes sex can be energizing, something to share when you are tired, and this would be a good reason to have sex in the morning. Many people have fallen into a pattern of sleeping after sex, resulting in a conditioning process of kiss, hold, have intercourse, go to sleep. After a time, sex means sleep. Wouldn’t it be nice if awakening meant sexuality rather than the obligation to go to work? Wouldn’t it be nice if we could replace the alarm clock with a sexual clock signaling us to intimacy-rather than calling us to the day’s starting line?

One man in the clinic stated, “I never like to have sex in the morning. It gets me tired, and anyway, you never know who else you might meet during the day.” Although he laughed as he shared this idea, it was apparent that he felt sex was de-energizing, a discharge of energy, and he did not want to waste his vital fluids. He also assumed that new or different partners demand more energy than familiar partners. If we view sexual interaction as dependent upon some predetermined amount of available sex energy, our intimacy is determined by a sense of strength and weakness rather than awareness and responsiveness.

The couples who visited the Masters and Johnson Clinic in St. Louis reported an invigoration of their sex life. They stayed in a hotel room, were not working or parenting, and made love at various times of the day. They communicated about sex almost continually. It became, at least for two weeks, a major part of their life-style. I have found that just changing “when” couples relate sexually has major impact on their IQ, their Intimacy Quotient. One wife reported, “I don’t know what it would be like to make love when the sun is out.” Sex may have come out of the dark ages, but still has a long way to go before it comes out of dark bedrooms.

*126\97\8*

1. Prepare the equipment for performing the enema. The best units available are types used in hospitals, with a large capacity (2-3 litres) gravity tank, flexible hose and a nozzle to be inserted in the anus. Consult a friendly nurse if in doubt. Other units (enema syringe, see Fig. 1 below) have a simple hand pump which is used to pump water from any container into the flexible hose with a nozzle at the end.

2. Prepare about 5 to 6 litres of water. Use lukewarm (body temperature) water (preferably pure or filtered) for performing the enema. Avoid unspecified chemicals, chlorine, detergents or soap etc. in the solution. If available, add a few drops (3-5) of 3% hydrogen peroxide for every litre of water, (equivalent to 1 drop of 30% of hydrogen peroxide per 2 litres of water). Be very careful not to exceed the specified concentration of hydrogen peroxide. Similar concentrations of hydrogen peroxide occur naturally in the rain water high in the mountains and in some springs (Lourdes, France). Hydrogen peroxide inside your bowel breaks down into pure water and pure oxygen. Extra oxygen is then used to oxidise toxins directly and serves as a safe antiseptic. Some of the free oxygen enters the bloodstream right in the bowel, assisting greatly the surrounding cells in excreting toxins. Never use any chemicals, soap or detergents in the water for enema. The reason is simple: anything you put in will be immediately absorbed into your bloodstream. For example, if you make enema with a wine, you will immediately become drunk. Adding chemicals, soap or detergents to your enema water makes all procedure useless from the point of view of the detoxification: you just add more toxins.

3. Insert the nozzle into your anus and let the water flow in (or pump it in). Try to allow as much water as you can, without causing any excessive discomfort or pain. If you feel pain, stop the flow of water immediately.

4. Try to hold the water inside your bowels for at least a few seconds. It would be best if you could do few steps, jumps and perhaps a few sit-ups whilst still holding the water inside you. But do not force yourself. Do whatever comes easy.

5. Sit on the toilet and let go of the water slowly. Do not try to accelerate the flow of whatever comes out by excessive pressure. You may cause yourself unnecessary discomfort. Do not rush. Let the body take its time to perform the cleansing. To assist your intestines in the transportation and excretion of waste, you can gently massage your stomach with your hands. Wait until all activity in the bowel stops, and you do not feel any reason to sit on the toilet. Clean yourself with a tissue.

6. Repeat the sequence of steps 3-5 two or three times, until clean water comes out from your bowel. Congratulations. You have just relieved your body from the extra burden: a few kilograms of toxic waste. You should find, that you have used most of the water.

The above procedure takes approximately one hour.

*25\96\8*

It is wise to have mosquito netting on the doors and windows of houses and hotels, netting over the bed and to use insect repellent on exposed skin.

Most of these need to be replenished every two to three hours. Long sleeves and trousers should be worn and it is also advisable to stay indoors at night as the mosquito bites only at night.

There are several drugs which can be taken regularly while in the malarious area and these should prevent the disease in most cases.

Chloroquine is the most widely used drug for the prophylaxis of malaria. Two tablets are taken on one day each week and this is continued all the time in the malarious area and for four weeks on leaving the area.

Unfortunately, the falciparum strain of Plasmodium has developed resistance to chloroquine in some countries. This has happened in some parts of Africa, and in most parts of the Pacific and Papua New Guinea and other drugs for prevention may now be required.

*493/71/1*

Cancer cells which are dividing rapidly are therefore more likely to be damaged by these drugs than the normal body cells which divide much less frequently. Nevertheless the drugs do damage normal body tissues. To further the analogy, the few remaining cells which haven’t been killed by the machinegunning effect of the drugs may later be picked off by the sniper type effect of the body’s own defence mechanisms.

Immunotherapy may also be employed in the treatment of cancer. This involves improving the body’s own immune system of defence so as to attack the foreign cancer cells.

The idea of meditation in improving the treatment of cancer lies in the theory that this improves the body’s immune response.

*237/71/1*

His letter is a touching one. It is a love note for Elizabeth as well as a sad tale of all-too-common experiences with misdiagnosis and improper treatment of the “career woman’s disease.” It goes, in part, this way:

“I’m writing at a point of desperation in my wife’s life. She has learned after five years of pain that she has endometriosis. Elizabeth has seen twenty doctors since 1982, when they began having chronic pain in her vulva following an abortion. Doctors couldn’t find any condition that corresponded to her pain and either dismissed her as neurotic or prescribed creams that irritated the area.

“Then, a few months ago, a general practitioner diagnosed endometriosis based on her symptoms: painful urination, history of bad menstrual cramps, and abdominal pain. We heard that Danocrine would help over other treatments, but he insisted she take Norlutin. A synthetic progesterone, which created terrible side effects. Elizabeth then went to a top gynecologist on whom she’d pinned all her hopes. He told her that she had problems ‘accepting a normal sex life’ (we’ve been unable to make love for months because intercourse was so painful for Elizabeth) and that nothing else was wrong with her!

“I’m not a doctor, but I think I’ve unearthed every available medical journal on endometriosis. I feel pretty confident that Elizabeth has this disease and no other.

“I never would have believed how a woman can suffer and still be ignored by those with the power to heal if 1 had not seen it myself. This is why I’m writing a letter like this. Please give our problem your attention. We trust your opinion and hope you can answer us, no matter how briefly. What should we do next?”

Endometriosis can dramatically alter the daily rhythms of a woman’s life, and Elizabeth is a good example of this. Often, intimate relationships change when pain becomes a demanding third party. In these cases, coping with the disease not only requires fortitude of spirit but needs the understanding of others.

Of the many points Jonathan raised in Elizabeth’s case, the most significant was his description of two of the three symptoms (the “triad”) that most typify endometriosis: a history of bad menstrual cramps and dyspareunia (or painful intercourse). The third, infertility! is, in my opinion, a good probability for Elizabeth, although getting pregnant is not relevant to her now. Although a laparoscopy; or “Band-Aid procedure,” performed by a good diagnostician can help reveal the truth about Elizabeth’s condition, it’s a fairly good bet based on her symptoms that she has endometriosis and that a laparoscopy is not necessary in her case. As mentioned earlier, a standard suction abortion is rarely responsible for the onset of the disease. A badly performed abortion, however, may have caused some damage to the uterus. The doctor might have accidentally wrenched it in some way, tearing it slightly so that endometriotic tissue spread to the cervix and vagina. It is worth noting that the disease very rarely implants itself and grows in the vagina. However, during an internal examination a doctor can see very small brown-black (“powder burn”) spots of endometriosis on the cervix.

Unless there were actual lesions or indication of infection, we would say that the pain an Elizabeth’s vulva was not due to a localized problem, but radiated down from another source. Most likely, the pain originated in pelvic organs inflamed with actively growing endometriotic tissue. Such growths would alto account for frequent urination, since the bladder is commonly involved in this “glue-stick” disease.

Partnership of any kind, but especially partnership in health care, requires harmonious goals. You and your doctor must be able to exchange information freely and decide on the wisest course of action.

*63\43\4*

Although itching has been extensively studied, its causes are ill understood. However any discussion of itching must refer to the physiology, so that the limitations of treatment may be understood. Itching, then, is a disagreeable sensation produced by the action of stimuli of a harmful nature on the skin surface. It is a signal of actual or potential danger to the skin. The purpose of the reflex action of scratching is to remove the causative agent from the body surface.

It is thought that a wide variety of stimuli and noxious agents may liberate chemicals in the skin which then act on peripheral nerves, eliciting the itch sensation. These chemicals include histamine, bradykine, protease, and prostaglandins. Throughout the skin there are many itch receptors. On the forearm these points lie approximately one millimetre apart. However they are more closely set in areas about orifices such as the mouth or anus. The small skin nerves then carry the impulses to the spinal cord, from where they are transmitted via the pain fibres to the brain. It is not yet understood how scratching relieves itching, but possibly it disturbs the rhythm of the impulses travelling towards the spinal cord. Scratching may also simply damage the nerve fibres which are conveying the itch.

Possible causes of itching.

1. Physical and chemical spicules, e.g. fibre glass, wool, detergent, proteases, e.g. nettles, Rhus tree drugs, e.g. opiates, quinidine.

2. Skin diseases Obvious e.g. eczema, tinea, bites. Not obvious e.g. scabies, hives, winter itch, parasitophobia.

3. Internal diseases or conditions.

Metabolic disorders, e.g. diabetes, thyroid disorders, liver disorders, kidney disorders, blood disorders, pregnancy, cancer, parasitic infestation iron deficiency.

4. Psychological disorders. Primary, secondary.

*90\44\4*

Talking about the menopause is something that most women have just never done. We talk about other aspects of our lives, but not this one. As a result, a conspiracy of shame and silence has drifted down the generations, expressed in such phrases as: ‘It’s her time of life’, ‘She’s going through the Change, poor old thing’, ‘Take no notice of her, she’s just having a hot flush’. Say no more, nudge nudge, wink wink.

Now, however, at last, compared with their predecessors, women reaching the menopause could be the lucky ones, the ones who know about it and are well informed. They can recognise hot flushes and other symptoms for what they are: the body’s response to a fall in the level of the female hormone oestrogen – simply that. They are not something shameful; nor do they mean we are suddenly old. After all, who wants to feel old at 50? It will be another 30 years before you need even to start worrying about that, so don t wish it on yourself now.

Part of the problem is that, until fairly recently, the majority of women didn’t live long enough to experience the menopause. Until reliable birth control became readily available, women who bore children tended to spend the majority of their married lives in a state of pregnancy or breast-feeding until their early forties. A combination of continuing pregnancies and the hazards of childbirth, as well as poor sanitation and inadequate health care, meant that, even at the start of the twentieth century, most women were dead by about fifty. So it is hardly surprising that so little was known about the menopause, let alone talked about.

Those who did survive to the menopause never made much of a fuss about it. They used a bit of self-medication, herbal remedies handed down through the generations, or exciting dietary supplements like ‘two sheep’s ovaries a day sandwiched between unleavened bread’, or ‘one tankard dairy of the urine of a she-goat’, and waited for it to pass.

Today, we often feel the menopause is just another illness to be treated by visits to the doctor and by medication. We hear the term ‘deficiency disease’, that is we are deficient in oestrogen. Yet most women still don’t really know what the menopause is, when it might happen, what to expect, and what can be done to ease their passage through it.

*1\42\4*

Cervical cancer is diagnosed in about 1100 Australian women each year. Although most diagnoses are made in women aged over fifty-five, it seems that increasing numbers of women in their twenties and thirties are now being affected. Tell-tale signs include bleeding between periods in pre-menopausal women, bleeding after sexual intercourse or at any time after menopause, and a smelly vaginal discharge.

Screening for cervical cell abnormalities that could develop into cancer is available using the Pap smear technique. A small sample or biopsy of cells from the cervix is obtained using a special brush and a fine wooden spatula. The cells are smeared onto a piece of glass and then sent to a laboratory for examination. From the appearance of the cells, it is possible to identify cancer at a stage early enough to permit its complete removal and cure. Australian health authorities recommend a Pap smear every second year from the time women start to be sexually active.

Over 400000 women in the State of Victoria, Australia, had a Pap smear during 1990, but seven out of ten women considered to be most at risk of cervical cancer did not come forward for testing. Of every ten smears done, eight were completely normal or showed insignificant changes. Less than four in every 100 smears showed CIN changes and only one in every 2000 was suggestive of possible cancer. If the results of a Pap smear raise concerns or if a woman experiences any unusual bleeding or cervical discharge, the cervix is examined for suspicious-looking tissue using a magnifying instrument called a colposcopy. A biopsy is usually taken and the tissue sample removed from the cervix is sent to a laboratory for microscopic examination. If the examination indicates severe CIN or pre-invasive cancer, any areas of the cervix which look abnormal are treated by cryosurgery (which destroys tissue by freezing), diathermy (which achieves the same end using an electric current), or else by heat or by laser. Diathermy or electrocoagulation entails using an electric current to produce points, loops or small balls of heat that burn the tissue while also closing blood vessels. Lasers are high-density beams of light energy that can cut tissue precisely and, at the same time, close off blood vessels. All these techniques have a high cure rate, and they do not interfere with a woman’s sex life or prevent her from having children in the future. Occasionally, a procedure called conisation is performed in which a cone-shaped sample of tissue about a centimetre thick is removed from the cervix using a scalpel, diathermy or laser. Once again, it is rare for the technique to damage a woman’s sex life or impair her ability to have children. If, however, there is any evidence that the disease has spread inside or beyond the cervix, a hysterectomy should be discussed. Radiation therapy or chemotherapy may also be suggested in a bid to ensure the complete destruction of cancer cells.

Although scientists do not know the exact cause of cervical cancer, there appears to be an association with sexual activity. Research suggests that certain strains of the human papilloma virus (HPV), which may be transferred during sexual contact, are involved in the disease process.

*16\198\4*