eChapters

6.1 Designing primers

Designing correct primers are very important to get the expected result in PCR experiment. There are two primers (Forward & Reverse) required for the amplification of the desired DNA fragment. One primer should anneal to the sense strand (oriented to the 5'→3' direction) and another primer should complement the antisense strand (oriented in the 5'→3' direction).

There are various characteristics to be considered to design a good primer including Tm, length, GC content, secondary structure and specificity.

There are commercially available softwares besides free online tools at NCBI (primer blast) for designing PCR primers. In addition, primer sequences published in peer reviewed literature can also be used.

For RT-PCR, the extracted total RNA is first reverse transcribed to cDNA using reverse transcriptase enzyme. Following are the protocols for cDNA sysnthesis and RT-PCR.

Note: cDNA synthesis and RT-PCR can be performed according to the manufacturer protocol from where the specific reagents for the above methodologies are purchased.

8.1 Purpose

To lay down a uniform protocol for the synthesis of c-DNA from total RNA

8.2 Scope

The scope of this Standard Operating Procedure is to lay down a standard procedure for the synthesis of c-DNA from total RNA

9.1 Purpose

To lay down a standard protocol to perform RT-PCR for quantitative analysis of target RNA.

9.2 Principle

RT-PCR technology is used to amplify a specific RNA sequence (target sequence) to measure its expression inside the cell. RT-PCR follows the same principle as of normal PCR, but instead of DNA here cDNA is used as template for amplification. Extracted RNA is reverse transcribed to cDNA with the help of reverse transcription enzyme. The cDNA is then subjected for PCR amplification with the help of DNA polymerase, target specific primers, nucleotides and reaction buffer. In molecular diagnosis, RT-PCR is used to detect the expression of oncogenes at the time of diagnosis. It is also used to detect minimal residual disease during treatment

10.1 Purpose

To lay down a standard protocol to perform qPCR for quantitative analysis of target genomic sequence.

10.2 Principle

qPCR or quantitative polymerase chain reaction or real-time polymerase chain reaction, is a molecular biology technique to amplify and at a time quantify a targeted DNA molecule and based on the polymerase chain reaction (PCR). It is called real time as the amplified DNA is detected as the reaction progresses and holds an advantage over standard PCR where the reaction is detected at its end. There are two common methods in quantitative PCR to detect the products i) non-specific fluorescent dyes which intercalates with any double stranded DNA ii) sequence-specific DNA probes labeled with a fluorescent reporter consisting oligonucleotides. This reporters helps in detection of the complementary hybridization of the probe and quantifies amount of DNA in cells or tissues.

11.1 Principle

In situ hybridization techniques involve detection of specific nucleic acid sequences to in morphologically preserved chromosomes, cells or tissue sections. Along with immunocytochemistry, in situ hybridization can correlate microscopic topological information to gene activity at the level of DNA, mRNA or protein. The FISH protocol involves 1) denaturation and hybridisation performed on Day 1 and 2) washing and detection performed on Day 2. DNA of the chromosomes and the probes are denatured and allowed to hybridize overnight on the first day. On day 2, slides are washed to remove unbound DNA sequences followed by detection, counterstaining and mounting of the slides.

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.

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.

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.

The testis is composed of up to 900-coiled seminiferous tubules, each averaging more than 0.5 meter long, in which the sperm are formed. The sperm than empty in to the epididymitis, another coiled tube about 6 meters long. The epididymis leads into the vas deferens, which enlarges in to the ampulla of the vas deferens immediately before the vas enters the body of the prostrate gland. A seminal vesicle, one located on each side of the prostrate, empties into the prostatic end of the ampulla, and the contents from both the ampulla and the seminal vesicle pass into an ejaculatory duct leading through the body of the prostrate gland to empty from the prostrate gland into the ejaculatory duct. Finally the urethra is the last connecting link from the testis to the exterior.

The prostrate gland secretes a thin, milky fluid that contains citrate ion, calcium, phosphate ion, a clotting enzyme, and a profibrinolysin. During emission, the capsule of the prostrate gland contracts simultaneously with the contractions of the vas deferens so that the thin, milky fluid of the prostrate glands adds further to the bulk of the semen. Slightly characteristic of the prostatic fluid may be quite important for successful fertilization of the ovum because the fluid of the vas deferens is relatively acidic owing to the presence of citric acid and metabolic end products of the sperm and consequently, helps to inhibit sperm fertility. The vaginal secretions of the female are acidic. Sperm do not become optimally motile until the pH of the surrounding fluids rises to about 6.5. Consequently, it is probable the prostatic fluid helps to neutralize the acidity of these other fluids after ejaculation and thus enhances the motility and fertility of the sperm.

This is characterized by formation of erythematous papules or patches with clear margins and covered with white scales, in different parts of the body without any constitutional disturbances.

It is more common among young adults of either sex and occasionally a family history is present. This has a seasonal prevalence often appearing in winter and clearing up in summer.

The course in chronic is very obstinate and tends to recur after an apparent cure. It disappears without leaving scars or pigmentation. It is not infectious.

The epithelial layer is thickened and intercappilary processes and papillae are elongated, the horny layer is defective and there is cellular infiltration between the horny cells and blood vessels.

It is a constitutional disease of infancy and childhood, characterized by impairment of the general health, and arrested growth, abnormal proliferation of the developing bone.

Heredity is a frequent predisposing cause. Poor nutrition, poor housing facilities, want of cleanliness, want of sun light are both predisposing and exciting causes. Age plays a great part. Climate also has its influence, more prevalent in moist than in dry climates. Diathesis influences are second only to heredity.

Hyperemia of all the structures of the bone, periosteum, osseous tissue, cartilage and marrow, is the first step in the development of the rachitic lesion. As a result, we have proliferation of cartilage cells, retarded and irregular development of bone, softening of matrix, undue vascularity of the cancellous tissues, and weakness and deformity of the bones in various parts of the body. The weight of the bones is lessened. The vascularity of the bones is increased. In some cases the blue discoloration is due to the increased vascularity may be seen even through the thick scalp. Outside of the bones they may find blurring of striation of muscles, excessive fat in connective tissue between the muscle fibre and rare cases of fatty degeneration of the muscle fibres themselves. The liver is occasionally enlarged the spleen more rarely so.

It is an inflammatory condition that mainly affects the children and young people in their teens. It is considered to be an allergic condition that mainly attacks the connective tissues of the body, causing joint pains and St. Vitus' dance due to central nervous irritation and skin lesions. The most serious damage that this disease brings is the damage to the valves does the heart. Certain streptococcus germs present in the throat are sometimes responsible.

It is caused by the entry of the bacteria in to the blood.

The pathogenetic bacteria or their products usually enter the blood through some break in the skin or mucous membrane. Although sepsis may be more easily traced to infection through tears in the parturient canal and other wounds, yet many cases have their origin in the respiratory organs, digestive tract including the teeth and other organs or tissues. Suppuration in any part of the body like otitis, dental or rectal fistula may give rise to sepsis. Gonorrhea or the infections may be directly the cause of sepsis or indirectly by leaving channels for the invading organisms. The most frequent organisms are the staphylococci, although ten or twelve others have been found. Sepsis affects both sexes and all ages.

In the pyemic cases, the abscesses, emboli, thrombi, degeneration of the surrounding tissues, etc., were found most frequently in the lungs then kidneys, spleen and liver. Changes found: blood dark and disintegrated; spleen large and soft; fatty degeneration of the heart; kidney large, pale with prechynmatous changes; liver large with fatty degeneration.

MALE STERLITY, or failure to fertilize female egg cells, may be due to several causes. In some cases the trouble is due to an emotional factor, such as a mental block. It may be caused by an absence or atrophy of the testes, or perhaps by some obstruction in the male genital organs. Infections involving the 'genital organs may result in the production of unhealthy or even dead sperm cells. In such cases special tests may locate the seat of the trouble, which may be treated surgically.

FEMALE STERLITY, or failure to have children may arise from several different causes. Sometimes the trouble is due to the husband.

The ovum remains viable and capable of being fertilized after it is expelled from the ovary probably no longer than 24 hours. Therefore, sperm must be available soon after ovulation if fertilization is to take place. On the other hand, a few sperm can remain fertile in the female reproductive tract for up to 72 hours, although most of them for not more than 24 hours. Therefore fertilization to take place, intercourse usually must occur sometime between 1 to 2 days before ovulation and up to 1 day after ovulation

Sinusitis or accessory sinus suppuration is bacterial inflammation of the nasal and contiguous sinuses following acute rhinitis especially streptococci. Sometimes the infection travels from the second bicuspid and first two molar teeth whose roots are near to the antral floor. Sinusitis is an important etiological factor in the causation of many diseases of the lower respiratory tract.

Inflammation of the paranasal sinuses often follows the common cold, influenza, and other general infections. Germs that would normally be eliminated from the body may sometimes find their way into these little sinuses or chambers on each side of the nasal passages. Trouble may be due to inadequate drainage resulting from a deviated septum, or perhaps to the presence of polyps. Any chronic infection within the nose may lead to sinuses.

Acute Sinusitis is characterized by moderate degree of fever and local pain. The latter depends on the site affected: if frontal sinus, forehead; antrum, on one cheek: sphenoidal sinus, deep-seated headache. Headache is more marked in the afternoon.

The pharynx, or back of the throat, frequently becomes inflamed when a person has a cold or an attack of influenza. This inflammation may also involve the tonsils and adenoids if these have not already been removed.

This is due to many causes:

i) Inflammation of thefauces, soft palate and uvula.

Sunstroke results from direct heat rays of the sun. The victim may be mentally confused and complain of a bad headache. He may become delirious. His blood pressure may fall to a low level and the pulse become rapid and weak. An abnormal condition due to exposure to excessive heat.

The predisposing cause is anything, which lowers normal resistance; the chief of which are worry, excitement, mental or physical fatigue, alcoholic excesses, and lack of nourishment etc.

The exciting causes are prolonged exposure under the direct rays of the sun, unusual exertion in a hot, moist, sultry, breezeless atmosphere. The occupations, which furnish most of the cases, are breakers, boiler tenders, soldiers on the march, masons etc.

Different stages, or forms or different degrees of severity of the same condition have produced different results and been given different names, viz., heatstroke, sunstroke, heat exhaustion, insulation, thermic fever, heat prostration.

Tetanus is a specific infectious disease caused by the exotoxin of tetanus bacilli, usually growing in necrosed tissues, absorbed by the motor end plates of the peripheral nerves, carried to the central nervous system and manifested as lockjaw and paroxysmal spasmodic contraction of other muscles.

Tetanus bacilli present in the soil especially one contaminated by faeces of a horse or of a similar animal, enters through some skin abrasions and remain localized at the site. These are thereafter removed by phagocytes but if any lacerated tissue is present, more so if contaminated by pyogenic bacteria, these multiply and manufacture a highly potent exotoxin which is absorbed through the motor nerve end-plates in the muscles carried to the motor cells of the central nervous system, the sensory ones not being affected.

The posterior root ganglia act as filter preventing the toxin from entering into the spinal cord, the anterior root is thus only affected.