eChapters

17.1. Introduction

Throughout human history, the coastal plains and Lowland River valleys have usually been the most populated areas over the world (Wolanski et al., 2004). At present, about 60% of the world’s population live along the estuaries and the coast (Lindeboom, 2002). This is degrading estuarine and coastal waters through pollution, eutrophication, increased turbidity, overfishing and habitat destruction. The pollutant supply does not just include nutrients; it also includes mud from eroded soil, heavy metals, radionuclides, hydrocarbons, and a number of chemicals including new synthetic products.

The impact on estuaries is commonly still ignored when dams and irrigation farming are proposed on rivers. In addition, estuaries are often regarded as sites for future development and expansion, and have been increasingly canalized and dyked for flood protection, and their wetlands infilled for residential areas.

All these factors impact on the biodiversity and productivity and hence, the overall health of estuaries and the ecosystem services they provide to humans. They increasingly lead humans away from the possibility of ecologically sustainable development of the coastal zone. Integrated coastal zone management plans are drawn up worldwide but, in the presence of significant river input, most are bound to fail because they commonly deal only with local, coastal issues, and do not consider the whole river catchment as the fundamental planning unit. It is as if the land, the river, the estuary, and the sea were not part of the same system. When dealing with estuaries and coastal waters, in most countries land-use managers, water-resources managers, and coastal and fisheries managers do not cooperate effectively due to administrative, economic and political constraints, and the absence of a forum where their ideas and approaches are shared and discussed (Wolanski et al., 2004). 

18.1 Introduction

The commercially available water quality simulation models with various dimensions (1D, 2D and 3D) and database software designed to quantify movement and concentration of contaminants in lakes, streams, estuaries, and marine environments. The following water quality models were described below (Table 18.1).

18.2 Environmental Fluid Dynamics Code

The Environmental Fluid Dynamics Code (EFDC) is a multifunctional surface water modeling system, which includes hydrodynamic, sediment-contaminant, and eutrophication components. It has been applied to over 100 water bodies including rivers, lakes, reservoirs, wetlands, estuaries, and coastal ocean regions in support of environmental assessment and management and regulatory requirements. IT is a state-of-the-art hydrodynamic model that can be used to simulate aquatic systems in one, two, and three dimensions. It has evolved over the past two decades to become one of the most widely used and technically defensible hydrodynamic models in the world. It uses stretched or sigma vertical coordinates and Cartesian or curvilinear, orthogonal horizontal coordinates to represent the physical characteristics of a waterbody. It solves three-dimensional, vertically hydrostatic, free surface, turbulent averaged equations of motion for a variable-density fluid. Dynamically-coupled transport equations for turbulent kinetic energy, turbulent length scale, salinity and temperature are also solved. The model allows for drying and wetting in shallow areas by a mass conservation scheme.

The homoeopathic system of medicine is one of the finest systems of cure available in the world. It achieves in totality the ideal laid down by its founder, Dr. Samuel Hahnemann:

"The highest ideal of cure is rapid, gentle and permanent restoration of the health, or removal and annihilation oftlie disease in its whole extent, in the shortest, most reliable, and most harmless way, on easily compreltensible principles".

In homoeopathy, not a single drug is used without knowing its effect on healthy human beings. Hence there is no shooting in the dark. The system operates, by and large, without laboratory tests and other expensive means of diagnosis, which are being used when not needed and that too, unfortunately on patients who can hardly afford the expenses.

Cost wise, there is no medical system in tlie world, which is as inexpensive as homoeopathy. No patient who requires a speedy cure without side effects can ignore homoeopathy; no doctor who has nothing but the good of his patient at heart can overlook the utility and effectiveness of homoeopathy and no Government which has to balance its budget can afford not to use homoeopathy in hospitals and other institutions run for the health and care of the sick and thus it is the most cost effective treatment

The discovery of homoeopathic system of medicine makes a fascinating story.

Dr. Samuel Hahnemann laid down the fundamentals of the then new doctrine of homoeopathy in organon of medicine. As observed by him in the 'Introduction⁷ to this work, till then no one had ever taught this homoeopathic mode of cure, no one had carried it out in practice.

Dr. Hahnemann was of the view that the art of the medical practice "should. Rapidly and mildly, effect an unalloyed and permanent cure, and restore to health by means of the smallest doses of a few simple medicines carefully selected according to their proved effect, by the only therapeutic law comfortable to nature, that is Similia Similibus Curentur".

Homoeopathy is based on the following principles:

"The physicians high and only mission is to restore the sick to health, to cure, as it is termed"

The highest ideal of cure is rapid, gentle and permanent restoration of health or removal and annihilation of the disease in its whole extent in the shortest, most reliable and most harmless way on easily comprehensible principles.

Unprejudiced observer of a sick person takes note of nothing in every individuars disease except the changes in the health of the body and of the mind, which can be perceived externally by means of the senses. "All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease"

This individualizing examination of a case of disease, for which Dr. Hahnemann give general directions, of which the practitioner will bear in mind only what is applicable for each individual case, demands of the physician nothing but freedom from prejudice and sound senses, attention in observing and fidelity in tracing the picture of the disease.

The patient details the history of his sufferings; those about him tell what they heard him complain of, how he has behaved and what they have noticed in him; the physician sees, hears, and remarks by his other senses what there is of an altered or unusual character about him. He writes down accurately all that the patient and his friends have told him in the very expressions used by them. Keeping silence himself, he allows them to say all they have to say, and refrains from interrupting them (every interruption breaks the train of thought of the narrators, and all they would have said at first does not again occur to them in precisely the same manner after that.) unless they wander off to other matters. The physician advises them at the beginning of the examination to speak slowly, in order that he may take down in writing the important parts of what the speaker says.

He begins a fresh line with every new circumstance mentioned by the patient or his friends, so that the symptoms shall be all ranged separately one below the other. He can thus add to any one that may at first have been related in too vague a manner but subsequently more explicitly explained.

Homoeopathic treatment is based on an overall understanding of the symptoms in the body and mind created by a sickness. Dr. Samuel Hahnemann, the founder of the homoeopathic science of healing, after years of experiment and trial, came to finding that symptom - similarity is the curative method of medically curable diseases. In paragraph 25 of the 'Organon of Medicine⁷, he formulated the principle of 'like cures like' in these words: " Now, however, in all careful trials, pure experience, the sole and infallible oracle of the healing art, teaches us that actually that medicine which, in its action on the healthy human body, has demonstrated its power of producing the greatest number of symptoms similar to those observable in the case of disease under treatment, does also, rapidly, radically and permanently remove the totality of the symptoms of this morbid state, that is to say, the whole disease present, and change it into health; and that all medicines cure, without exception, those diseases whose symptoms most really resemble their own, and leave none of them uncured."

The aforesaid indicates the importance of symptoms in the diagnosis and treatment in homoeopathy. If a drug creates a symptom during the course of proving, then it can be cured by a potencised dose of the drug; whatever may be the name of the disease. For instance, in proving GLONOINE produces a bursting, throbbing sensation in the head in a healthy person. Conversely any surging of the blood to the head requires GLONOINE. This can happen in a sun - stroke, in high blood pressure, in cerebro - spinal meningitis. KALI BICROMICUM produces in proving, a tough, stringy discharge of mucus. In homoeopathy, KALI BICROMICUM cures a similar discharge whether from the nose inwards from mouth, from fauces, from pharynx, from larynx, trachea, bronchi, vagina, and uterus or from any mucus membrane. CACTUSGRANDIFLORUS produces in pure form and gross doses, constriction of the heat and a constriction, anywhere in the body, which is like an iron band being tightened. The same sensation of constriction leads us to the use of CACTUS in a homoeopathic dose and it need not be confined to the heart. There can be constriction of the scalp, in the oesophagus, in the chest, in the abdomen, bladder, uterus, vagina or rectum.

The homoeopathic materia medica consists of around 1000 drugs, the characteristics of which have been verified or proved. Homoeopathy is unique in that it uses no drug, which has not been proved. The proving has been done by administering pure medicines to healthy human beings and recording in minute detail the effects, mostly adverse, produced by such administration. The tests were conducted on men and women who were mostly medical people and students who were not sick. The drugs were administered in doses consisting of crude drugs or homoeopathic potencies. These volunteers were then asked to describe the effects of the drugs in their own words. These descriptions were noted down by the doctors conducting the experiments and were carefully recorded. Hundreds of thousands of such symptoms were recorded while proving the homoeopathic drugs and the materia medica forms a record of the best proving along with other data collected as a result of laboratory tests and experiments.

In paragraph 25 of the 'Organon of medicine', Dr.Samuel Hahnemann the founder of the system laid down the basis of homoeopathy in the following words: "Now, however, in all careful trials, pure experience, the sole and infallible oracle qi healing art, teaches us that medicine which, in its action on the healthy human body, has demonstrated its power of producing the greatest number of symptoms similar to those observable in the case of disease under treatment, does also, in doses of suitable potency and attenuation, rapidly, radically and permanently remove the totality of the symptoms of this morbid state, that is to say the whole disease present, and change it into health; and that all medicines cure, without exception, those diseases whose symptoms most nearly resemble their own, and leave none of them uncured."

Homoeopathy system of medicine is the system of healing suited to all the young, and the old, the rich and the poor, the people in the developed as well as the underdeveloped countries and for persons in any place or climate. This is not to take away from the value and utility of the other prevalent systems of medicine. The aim of every science of healing is the relief of sick. Every system is successful in its own fashion. Homoeopathy too fights sickness and does so with remarkable results. Additionally the cost of diagnosis in this system is negligible because the diagnosis is by and large symptomatic. The medicine itself is inexpensive. Notable efficacy and low costs are the strong points of homoeopathic medicine. There are no toxic effects of the drugs, no side effects. The time taken for the medicine to show improvement is not long. Homoeopathic medicines are easy to store and have a long life.

Homoeopathy has been attacked again and again on the ground that the potencised drugs cannot be tested in a laboratory. But that way a number of phenomenon is still outside the pale of conventional science. However, laboratory tests have been going in many countries and certain phenomenon not acceptable to conventional scientific beliefs have been observed.

The homoeopathic system of medicine develops for its special use, the inner medicinal powers of the crude substances by means of a process peculiar to it and which has never been tried, whereby they only all become immeasurably and penetratingly efficacious and remedial. Even those that in the crude state give no evidence of the slightest medicinal power on the human body.

This remarkable change in the qualities of natural bodies develops the latent, hidden powers, which influence the body, change the well-being. This is affected by mechanical action upon their smallest particles by means of rubbing and shaking and through the addition of an indifferent substance, dry or fluid. This process is called dynamization; potencizing and the products are dynamizations or potencies in different degrees.

This chapter provides a readily available means of reference for helping in life threatening emergencies, accidents and for providing first aid, where any delay caused by the lack of medication or non-availability of the doctor can have serious consequences either in terms of life or in terms of resulting serious sickness.

As soon as possible competent medical help should be availed of in emergencies and accidents. In the meanwhile the homoeopathic medicines suggested hereafter would provide relief, would halt deterioration in most cases and may save life in many instances.

Emergencies can be life threatening. One of these can be severe haemorrhage, where copious bleeding can lead to death. Obstruction of breathing for different reasons is a matter for concern. Serious accidents are life threatening because there may be unmanageable bleeding, shock and pain.

Below, a list of few medicines and other items required for first aid in emergencies has been given. This can be helpful in homes, in factories and offices.

Pimples are very common in young people during their teen years. This condition, which is also known as acne, is apparently due to certain hormone changes in the body. It is particularly prevalent during early adolescence, from 12 to 16 years of age, and is more likely to occur in those who have an oily skin. In the early stages a blackhead or comedone blocks the outlet of an oil gland within the skin. This is not a serious problem, for it leaves no permanent effect.

If the sebaceous duct ruptures and the oily material ooze out between the layers of the skin instead of coming to the surface, there may be a cyst or swelling known as a sebaceous cyst. These are somewhat disfiguring, but not harmless unless they become infected and form small abscesses. When these heal they may leave ugly scars. Severe acne may occur on the shoulders, the back and chest, as well as the face and neck.

Effects of diet: Acne is not caused by diet, but certain foods definitely aggravate this condition, especially in some patients. Rich foods, such as chocolate, nuts, cola drinks, ice-cream, fatty meats, and excessive amount of sugar, all seem to aggravate this condition. Certain drugs, such as those containing bromides and iodides, may also play a part in some people.

Some girls develop one to two pimples just before menstruation. These only last a day or two and are of no consequence. But when acne continues over months or years, it is very distressing, especially to a young woman, and something should definitely be done to clear up the condition. Nervous tension due to family trouble may also play a part in continuing this difficult problem. Even in its mildest form, acne usually persists for a year or more until the hormone system of the body has become fully adjusted.

For ages, man has consumed alcohol to forget his sorrows, to lead him into the realm of happiness. John Keats (1795 -1821), the great romantic English poet, listened to the full-throated music of a nightingale and wanted to become one with that moment of happiness. He thought of taking 'a beaker full of the warm south, of vintage, that has been cooled a long age in the deep delved earth⁷, drinking which he could ' leave the world unseen', and fade away into the dim forest with the singing bird. But Keats was romanticizing the effect of wine on the human mind. A moment later, he decided to give up the idea of taking the assistance of Bacchus and his leopards and switched over to reaching the bird and its music on 'the viewless wings of poesy⁷. This was definitely a wise decision because the alleged euphoric effect on alcohol is a myth. In fact alcohol dulls the brain and retards its activity.

Alcohol is basically a drug. Man consumes it more than any other drug. No form of alcohol, however mild, whether wine or beer or cider, can do good to the human system and health.

It is fallacy to believe that alcohol stimulates the brain. In reality, alcohol depressed the brain. It slows down various centers of control. When alcohol is swallowed, it goes into the stomach where a fraction of the dose enters the blood stream through the blood vessels of the stomach walls. From the stomach, alcohol has to pass into the small intestine. The carbon dioxide in soda water accelerates this flow of alcohol from the stomach into the intestines. This is what makes whisky and soda more dangerous than whisky and water.

Asthma is a condition of sudden paroxysmal, expiratory, wheezing dyspnoea caused by an abnormal response of the respiratory center to stimulus causing hyperactivity of the vagal endings in the broncho-constricting muscles resulting in bronchial spasm; with it, hyperaemia oftlte mucous membrane followed by excessive bronchial secretion is associated.

This is true spasmodic asthma and in this other conditions of periodic expiratory dyspnoea with a different primary factor should not be included.

The disease has in most a family history and is more common in males; sometimes found in young children but more frequently begins in early adult life. Some of these have definite bronchitis also but in the most, the main is paroxysmal bronchospasm no physical sign obtained in the lungs.

The factors concerned in asthma are (i) bronchospasm from causes central and peripheral, (ii) oedema of the bronchial mucous membrane from allergy. Neuropathic predisposition.

The more immediate causes are (i) allergy, (ii) peripheral stimuli from their site of production, grouped as (a) naso-pharyngeal, (b) alimentary, (c) endocrine (d) broncho-pulmonary (iii) constitutional disturbances.

Partial or complete loss of hair on the scalp is rather common among them. This is more or less to be expected in the female. Premature baldness is a tendency in certain families. Thinning of the hair is often seen in older women, but complete baldness in the female is fortunately rare. Temporary baldness may occur following a fever or some prolonged illness. The hair usually returns after the patient has recovered from the illness.

Sudden loss of the hair in certain areas, a condition called alopecia areata, may sometimes follows extreme nervous shock. This may clear up in a few weeks, although sometimes it will recur. In females excessive hair loss is seen after delivery and during lactation. This is only due to hormonal changes in the body and due to suckling of the milk by the child. This disappears after the child stops weaning. It is not a permanent problem. In children falling of hair occurs due to many reasons such as severe headache, dim eyesight, after a prolonged illness, use of different shampoos and soaps, after a severe head injury and a familial tendency. Generally it is observed that if the parents have thin hair and early loss of hair in their life so is their children.

Many people use various shampoos and creams to prevent hair loss but with no gain. Homoeopathy has a very good treatment for hair loss. Some of the important medicines indicated in the hair loss are given below:

By the time a child reaches the age of two he can usually keep himself dry during the day. However, it may be another year or more before he can keep dry all through the night. Even then, the best-trained child may fail to live up to expectations on certain occasions when he is highly excited.

Older boys and girls may also have occasional problems at night, especially when sleeping in a strange bed after a highly exciting evening.

The bladder is emptied unconsciously especially during sleep at night; may be associated with enlarged tonsils, thyroid deficiency, phimosis, intestinal worms, blanitis or vulvitis also sometimes pyelitis, cystitis, oxaluria even minor epilepsy.

There are many causes for this condition, ranging all the way from simple neglect of the calls of nature to degenerative changes in the spinal cord. The condition is found in all classes and at all ages. Nocturnal bedwetting is very common in weak, neurotic children. The next most numerous class is that of women who have born children and who have passed the fiftieth milestone. A laugh, a sneeze, a fright and the urine spurt from the bladder. Probably this is want of proper adjustment of the function of the nervous mechanism of the sphincter and the detrusor and the former fails to inhibit the later.

Bronchitis may be defined as a distressing and often serious type of inflammation affecting the windpipe, or bronchial tubes, in the chest. There are two types of bronchitis:

1. Acute Bronchitis
2. Chronic Bronchitis

Acute bronchitis: In acute bronchitis the larynx, trachea and bronchial tubes are acutely inflamed. The tissues are swollen because of irritation; large amount of mucus is secreted and poured into the bronchial tubes to protect the inflamed mucous membrane. Unless this thick, sticky material is removed, it may obstruct the windpipe, causing more severe diseases like atelactasis and pneumonia. The common cold is probably the most frequent cause of acute bronchitis.

During the acute stage of bronchitis there is usually a high fever and some difficulty in breathing. There is a constant cough. Hoarseness may also be present and some pain in the chest. Difficulty in breathing continues until the inflammation has decreased. And thick secretions have removed. Chilliness is present with internal coldness, also cold hands and feet, rawness beneath the sternum, some tightness and oppression of the chest, cough may be dry, hard, ringing, expulsive, paroxysmal, tearing which leaves great soreness under the sternum. After few days the cough, which was at first dry, becomes moist and is accompanied by slight expectoration of mucus and occasionally some blood. As the amount of expectoration increases all the other symptoms decreases, and then in turn abnormal secretion and expectoration also decreases at the end of 7 to 10 days.

It may be defined as a chronic condition of the liver in which there is an increase of the connective tissue, a decrease in its size, and a degeneration of the parenchyma.

Alcohol is the most common cause of the cirrhosis of liver. Alcohol reaches the liver through blood stream. Other causes may include improperly prepared foods, poisonous substances, drugs like arsenic, phosphorus, the infectious diseases like syphilis and obstruction of the bile ducts.

Cirrhosis of the liver produced by alcohol abuse is known as portal cirrhosis where as cirrhosis caused by some obstruction such as a stone in the common duct or some narrowing of the bile duct leading from the liver to the small intestine is called as Biliary cirrhosis.

Although the common cold affects all parts of the body, it usually begins in the nose and throat. Colds are so common we hardly give them a second thought, yet they can be rather serious. Most colds are due to virus infections of one type or another. Unfortunately, none of these viruses are susceptible to our present antibiotic medicines. Adenoviruses produce the more serious type of colds, and they are often followed by tonsillitis and sore throat even virus pneumonia, particularly in children. Sometimes the membranes of the eyes are also involved.

The common cold is the most prevalent of all diseases known to man. The average person seems to have two or three colds a year. The condition is highly contagious. When one member of the family has a cold, the others are very likely to have one within a few days.

What makes a person susceptible to a cold? Probably his lowered resistance is a chief factor. Allergic disorders of the nose and throat also make a person more susceptible to colds and other virus infections. Chilling of the body does seem to play a part, particularly in those whose resistance is already weak. Lack of sleep may be another factor.

Any person may carry the cold virus. However, children under six years of age seem readily to pass the infection from one to another, and soon all the family is involved. Colds are always more serious in the younger children.

Constipation means difficult or infrequent passage of the feces. In some cases it is due to mechanical obstruction of the intestines, such as cancer, diverticulitis, or perhaps to some functional cause, such as an irritable colon discussed above. In most cases there is no actual obstruction.

Many elderly people suffer from constipation; probably they do not take sufficient fluid. They may think they are drinking enough, but careful observation may reveal that they are having only two or three glasses of liquid a day. For normal bowel habits, one should drink from six to eight glasses of fluid each day.

Sometimes constipation results from ignoring the normal call of nature. Many people suffering from constipation become dependent upon laxatives in early childhood. This is most unfortunate, for it means that the child may be dependent on drugs for the rest of his life. As far as possible do not use an enema on a child unless absolutely necessary. Laxatives and enemas are only for unusual conditions. Nature will provide for the normal needs of the body.

This is the commonest symptom of nearly all respiratory diseases and is indicative of an effort to expel a foreign substance causing irritation on any place in the cough reflex path.

The center is in the medulla close to the respiratory centers. This is activated reflexly by the afferent impulses traveling up mostly along the vagus and to a less extent, the vagus and the phrenic (to bronchi and diaphragm), the spinal accessory, intercostals and other nerves supplying the accessory muscles of respiration. The peripheral fibres of the vagus and the phrenic are also sometimes directly affected causing cough reflex.

The medullary center itself may also be excited or restrained by impulses from superior cerebella centers, so that cough may be induced or controlled by voluntary efforts.

The term dandruff includes several different conditions of the scalp. There is scaling in which the entire scalp may be covered with loose dry scales. When the hair is combed or brushed, or when the scalp is scratched, these scales fall like snow on the shoulders. Often there is itching, as well, and the scalp may be red from scratching.

What is at first thought to be dandruff may later prove to be some other conditions, such as. seborrhoeic dermatitis, or worse still psoriasis and even neurodermatitis.

Neurodermatitis : It is a chronic type of itching and inflammation of the skin. The itching area may be in some localized spot or it may extend over large areas of the body. The condition may even develop in infants. It may disappear after the age of two and return in the early teens of later. The condition is more often seen in those who suffer from fever, hives and asthma. True cause is not known for most of the people are allergic to many things. Many of them are tense and restless and are troubled with a dry skin. They are hypersensitive and are often given to itching, especially in the bend of elbow or behind the knee. The constant scratching leaves deep scratch marks and causes thickening and furrowing of the skin.

Individuals suffering from the more pronounced types of mental disorder are sometimes said to be insane, but the term insanity is a legal one, not a medical term. An insane person is one who cannot distinguish right from wrong or assume responsibilities for his own actions. In the case of a psychotic patient the whole personality is involved. And he is completely out of touch with real world around. Not so the neurotic patient. Only a small part of his personality is involved. Psychotic patients often require hospitalization; neurotic patients rarely do, unless they have some additional physical problem.

Another distinction between these two major groups is that his friends usually bring the psychotic patient to the doctor, while the neurotic comes of his own accord. He knows he is sick, and he usually wants help. Most often he is suffering from a nervous depression.

Eczema is a troublesome skin condition characterized by redness, cracking, oozing and scaling of the skin. Extremes of heat and cold and even emotional stress seem to play a part in this condition. The patient usually complains of itching and burning in the skin, especially at the night. Sores appear on various parts of the body, but most often on the hands, feet, ears and legs. Eczema may come on at any time of life and in either sex. The commoner manifestations are erythema changing to papule, vesicle, crust, scale and fissure, with serous exudation. In chronic cases, thick scales accumulate.

This is the effect of local irritation by chemical, thermal, actinic or mechanical agents in a hypersensitive individual, subject of an allergy or constitutional disabilities such as gout, chronic nephritis, rheumatism, local sepsis, dyspepsia, alcoholism, uterine disturbances also teething. In some cases heredity may be found.

Papules, vesicles and pustules with some degree of local oedema are found; exudation, crusting and scaling with inflammation of varying severity may be present. These tend to spread to the contiguous areas.

One or both cheeks of an infant or the ear, limbs or trunk are occasionally involved. In adults also similar papulo- vesicular eruptions appear. Sensations of burning, smarting, throbbing or itching are present, according to the acuteness of the process and severity of the inflammation.

The gall bladder is a small/pear shaped, muscular organ closely attached to the under surface of the liver. Its only function is to store and concentrate the bile between meals so there will be a plentiful supply when needed. Bile from the liver is a clear, golden colour when formed, but after being concentrated in the gall bladder it turns a deep green. This concentrating process sometimes results in the formation of stones in the gall bladder, particularly following pregnancy in commonly over weight women. Many people with gallstones seem to have no problem at all, especially if there is one large stone. But when a number of smaller stones are present in the gall bladder, the patient may feel sharp, cramp like pains all over the upper abdomen.

The predisposing causes are stagnation of bile, due to an excessive diet of starch and fat, constipation, obesity, pregnancy, tight lacing or other obstruction to the flow of bile.

The exciting causes are catarrhal and infective inflammation of the gall bladder, like sepsis, typhoid etc., and tumors. Old patients and women are most susceptible.

Gastric Ulcer a well defined ulcer involving the mucous membrane of the stomach with a tendency to progressive destruction, beginning in the mucosa and sometimes extending to and even through the deeper layers of the walls of the stomach.

We have not been able to name a definite cause. "Altered composition of the blood and the resulting insufficient nourishment of the cells'⁷. Riegel says the ulcer is due "to a self-digestion of the stomach at the limited spot." He calls attention to the fact that the gastric juice is always hyperacid in these cases and thinks it is more than a mere coincidence. Virchow says the cause is emboli or thrombi, which form in the nutrient gastric arteries, which have lost their tonicity. He claims that an ulcer forms at the point of obstruction.

Gastric ulcers occur most frequently between twenty and thirty years of age. This is an average, which we arrive at from the fact that in females it is from fifteen to thirty and in males from forty to forty-five. The predominance of women over men as shown by clinical statistics is two to one, but pathologically the numbers are about equal in two sexes.

No occupation seems to grant exemption. Cooks seems to be more predisposed. Next come metal workers in those factories where there is much dust. Some claim that shoemakers and tailors are also prone to the condition.

Inflammation of the mucous membrane of the stomach, sometimes accompanied by more or less severe constitutional manifestations.

Headache is the most common of all nervous complaints. The causes are varied and so also its mode of onset, duration, intensity and other conditions associated with it.

Structures of the head, which are sensitive to pain, are:

Cholesterol is present in the diet of all people, and it can be absorbed slowly from the gastrointestinal tract into the intestinal lymph. It is highly fat soluble but only slightly soluble in water and is capable of forming esters with fatty acids.

Many thousands of people today are heavy smokers, not by choice, but because they have found no way of escape. They are caught in the grip of a habit developed during their teen-age years when so many young people think it is 'smart' to smoke.

The strange thing is that most of these people never wanted to smoke in the first place. There was only doing what they thought everyone else was doing at the time. Yet there is another odd thing. Smoking in not a normal habit. A person has to learn to smoke.

Smoking is by and large, an acquired habit. People start smoking because they think it is fashionable to do so or because their friends and companions are able to persuade them to start smoking. Some smokers feel that they look more attractive to the opposite sex when they are smoking. Others hold that a social gathering becomes more intimate if people are smoking. In reality all this is a product of smokers imagination. Because he wants to justify his habit, he invents enough reasons for it.

It is a contagious, infectious disease. It is of short duration usually sporadic, characterized by malaise, headache, severe pain in the body and catarrh of the respiratory passage.

Metrological conditions are predisposing causes. The bacillus of Pfeiffer is generally acknowledged to be the exciting cause. The bacilli enter the system through respiratory organs.

The disease is highly infectious. Incubation period is 1 or 2 days and one attack does not give any immunity, rather increases the susceptibility.

There is much discrepancy and disagreement among over authorities on the question. In a case of simple uncomplicated flu, but find no characteristic anatomical lesions other than congestion and catarrhal secretions of the mucous membranes of the respiratory and alimentary systems. Death is usually caused by some complication and post-mortems show all the changes found in the complicating diseases.

Inability to go to sleep or to get sleep for a period insufficient for the needs of an individual is known as insomnia. Chronic inability to sleep.

None of us can do without sleep. An infant sleeps 14 to 18 hours a day. This period is slowly reduced. An adult may be happy with 7 to 8 hours of sleep every night. There are people who require 5 hours or even 4 hours of sleep in 24 hours.

Sleep has a definite purpose and that is why all mammals sleep. Lack of sleep apparently does not cause any physical harm. But anyone who gets less than his normal sleep experiences a decrease of efficiency and concentration.

Worms and other intestinal parasites are found in every part of the world. They are more common in tropical and sub tropical areas and are more common during the rainy season. Most of these worms and parasites enter in the human body either through the mouth or through the skin of the feet.

Round worms, are the giant worms present in the intestines that cause the disease kwon as ascariasis. It is found in almost all the countries. These worms are off-white in colour, are long and thick and are most frequently seen in children. Eggs produced by them are passed in stools. When children play in the soil contaminated with the eggs, particularly children living under unhygienic conditions easily transfer them to the mouth via dirty fingers.

Roundworm eggs may remain alive in the soil for many months. There is always greater danger of contamination where human wastes are used in fertilizing vegetables. Great care must be taken to be sure all foods are thoroughly cleansed and sterilized by cooking before being used.

Jaundice is a disease marked by a yellow discoloration in the skin, or in the whites of the eyes. This is due to excessive amounts of bile in the blood stream. Jaundice may arise from a number of different causes. Some types of jaundice arise from conditions outside the liver. Also in some cases the patient may have jaundice in a sub clinical form. That is, the bile pigment may be elevated but not sufficiently to actually discolour the skin.

Normally there is a certain rate at which the red blood cell are broken down and destroyed in the body. The average life of a red cell is about four months. But certain disease conditions may cause an excessive breakdown of red cells and this increases the bile pigment in the blood. Such a rapid breakdown of cells may be seen in haemolytic anaemia, sickle cell anaemia, pernicious anaemia, jaundice of the newborn child, as well as in malaria, pneumonia, yellow fever and certain bacterial infections of the blood.

Obstructive jaundice means that the bile is backing up into the blood stream because of some obstruction involving the larger bile ducts. The normal liver produces one pint of bile every twenty-four hours. This is transported to the gall bladder where it is concentrated and becomes green, or else passes directly to the small intestine where it acts as a lubricant. Bile is also necessary for the absorption of fats and for its laxative effect in the large intestine.

The common stones found in the kidneys are of calcium oxalate, uric acid, urates, triple phosphates or a combination of these.

The patients are often males between 30 to 50 years.

Most backaches seem to begin while bending forward to pick up some object from the floor. The pain usually comes on suddenly without warning, and it may be very difficult to straighten up to a standing position again. In most cases it is felt either in the middle of the back or lower down on one side. If a spinal disc is involved, the pain may radiate down the thigh and leg along the sciatic nerve on that side. The most common cause of backache probably arises from failure to get enough exercise to keep the muscles of the back strong and healthy. Flabby muscles then produce a wobbly spine, followed by pain, spasm and misery especially if a disc is ruptured.

Low blood pressure or hypotension is far less common than hypertension or high blood pressure. Sometimes the pressure falls rapidly because of hemorrhage or loss of blood. Low blood pressure may also come on gradually because of slow bleeding in the gastrointestinal tract or through the kidneys or bladder.

Any lack of normal protein in the diet may also lower the pressure because of malnutrition or actual starvation or because of some endocrine disturbance, such as hypothyroidism. In rare cases an islet cell tumor may form in the pancreas producing an excessive amount of insulin and lowering the blood sugar level. Such patients always tend to feel tired and worn out.

Emotional problems are a far more frequent cause of low blood pressure. For instance, some people will fall into a dead faint on hearing bad news. This shock like state is probably brought on by temporary disturbance in the vasomotor system, causing the patient to collapse. To a lesser degree, prolonged disappointment and frustration may also result in a subnormal blood pressure. Relieving the chronic stress of mind may be all that is needed to bring the blood pressure back to normal. One should also add a little more protein to the diet, and be sure to take sufficient rest and exercise.

Homoeopathic treatment for low blood pressure is given below:

A neurotic headache, usually reflex in origin and paroxysmal in character.

The causes are many and varying in kind, making both the diagnosis and treatment the most difficult the general practioner encounters,

Migraine is clearly a hereditary condition, and the inheritance is passed down through the females rather than the males. Nervous abnormalities of the female generative organs are the most frequent of the exciting causes. Eye strain; shock; grief; worry; gastro-intestinal irregularities; mental emotions, i.e., anger, fear, love, jealously and remorse may cause migraine at one time and hysteria at another.

Many patients have lived, to suffer from the disease, for fifty years. On the other hand, many are permanently cured. The time needed to complete the cure will depend upon your ability to determine the tissue or organ, which is the cause of the disease, and the faithfulness with which the patient will follow directions.

Next to epilepsy, no disease so frequently presents premonitory symptoms as Hemicrania. These may be blurring of visions, flashes of light, balls of fire, etc.; chilliness; flashes of heat; dizziness; depression or excitation; confusion of ideas; numbness, etc. then comes the pain which is usually one sided, and may be any or all sensations, sharp or dull, continuous or intermittent, etc. There may or may not be tenderness of the affected part.

It is an acute specific infection of the salivary glands especially of the parotids sometimes submandibular and sublingual glands also; occasionally the latter glands are affected first.

The most affected are the children or young adults of both sexes often living in a school or a barrack and the disease spreads rapidly from one person to another in close contact by droplets. This virus reaches the salivary glands by bloody or lymphatic because mumps is a systemic disease and may cause in addition, inflammation of the meninges, brain, pancreas and the gonads. The disease is more prevalent in winter and spring months. The incubation period is about 3 weeks.

The affected parotid glands and the surrounding tissues become hyperaemic and oedematous, the acinar cells disintegrate with round cell infiltration but later on, heal completely without any scarring.

Testes when involved have much oedema, perivascular infiltration with lymphocytes, localized haemorrhage, destruction of the germinal epithelia and blocking of the tubules with cellular debris. Only certain localized areas are affected, other parts remain unaffected.

An inflammation of the muscular substance of the heart. The condition may be acute or chronic. Acute myocarditis may be sub-divided into three varieties:

1. Acute Parenchyma.
2. Acute Diffuse Interstitial.
3. Acute Circumscribed.

In the first of three classes, there is a glandular degeneration of the muscular fibres of the parenchyma of the heart and an increase in the number of their nuclei. Severe cases of this class often terminate in fatty degeneration.

In the second class, we have round-cell infiltration of connective tissue of the myocardium.

It is very important to watch weight, not allowing oneself to become too thin or too fat, but trying to remain neat ideal. Most youngsters in their teens, if they are healthy and active, are fairly close to the ideal weight for their size and age. Changes often come in the late twenties, reducing a person's physical fitness. Sluggish habits begin to develop as the individual loses his skill in running, swimming or healthy activities.

When greater quantities of energy (in the form of food) enter the body than are expended, the body weight increases. Therefore, obesity is caused by excess energy input over energy output. In other words, extra weight is due to extra eating. For each 9.3 Calories of excess energy that enters the body, one gram of fat is stored.

Excess energy input occurs only during the development phase of obesity. Once a person has become obese, all that is required to remain obese so that the energy input equals the energy output. For a person to reduce in weight, the input must be less than the output. People with large bones and well-developed muscles may seem somewhat overweigh compared with those of lighter build. But actually the lighter person may carry around more fat. His muscles may be weak and underdeveloped.

Haemorrhoids or piles are due to swelling or enlargement of the veins that supply the rectal outlet of the body. Localized inflammation and bleeding, and also thrombosis in many cases often complicate this painful condition. People who suffer from constipation and other bowel disorders are more likely to develop haemorrhoids. Piles are also more common in pregnancy, and in conditions affecting the liver and upper bowel.

Pneumonia was once one of the most dreaded diseases known to man. It is no longer so. But pneumonia is still a serious disease. Germs causing pneumonia re of various types, such as streptococcus, staphylococcus, and pneumococcus varieties. Certain viruses are also responsible at times.

Pneumonia may be defined as an acute infectious disease of the lung, caused by the micrococcus lanceoaltus affecting principally the parenchyma.