Scarlet fever does not occur often nowadays, and is a much milder illness than it used to be, for reasons not well understood.

Cause

Scarlet fever is caused by a Streptococcus germ, spread by sneezing and coughing.

Clinical features

Symptoms of scarlet fever vary greatly between children. The commonest symptoms are a mildly sore throat, swollen, tender lymph glands in the neck, a mild fever, and a characteristic rash. The rash covers the whole body and consists of tiny red spots. The tongue may be bright red (strawberry tongue). Nowadays complications of scarlet fever are very rare, due to effective treatment with antibiotics. Rheumatic fever used to be a serious complication, but is rarely seen in association with scarlet fever now.

Treatment

Scarlet fever can be treated effectively with antibiotics of the penicillin group. (If your child is allergic to penicillin, other antibiotics can be used.)

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“Why would a woman let a man put his thing in her?”

When you grow up and can take care yourself and others, there times when a woman wants to love, to hold, and to kiss and touch a man, and a man wants to do the same thing. Sometimes, but not every time, the man and woman want to join together and have the penis inside the vagina. This is one of the most important things to do in all the world, and a baby can start to grow when the sperm goes with the egg. It is a way of loving, a very special grown-up way of sharing yourself with someone, so it should only happen when you are married and going to be together forever.

    ”How can a baby eat in there?”

The baby is inside something like a space capsule, and food and other things needed to live are brought in from the mother. There is a special capsule filter that only lets in what the baby needs to live. The baby grows in this capsule and gets food through a cord attached at her or his belly button. The mother and baby are a team and are living together making each other healthier.

“Why doesn’t the baby drown in the water in the sac?”

You are very smart. Yes, there is something like water made by the mother that the baby floats in inside the uterus. It keeps the baby from getting hurt and keeps the baby safe and healthy. The baby can’t drown because he or she does not breathe through the mouth until he or she comes out. It’s just like a person in space, with all the food and even their oxygen coming in through that special cord.

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I hate those X-rated videotapes. They are disgusting. A bunch of naked bodies humping each other. I like the parts where you can see some feeling, but that almost never happens.

WIFE WITH HUSBAND PRESENT

I get turned on a lot with those tapes. I feel guilty, but I got one out to look at while he was at work and I masturbated. I know it’s filth, but some parts turn me on.

WIFE IN PRIVATE INTERVIEW

The early perspectives assumed that men looked and women felt. I did not find this assumption to be the case with the couples \ interviewed. Women were aroused by visual stimulation, and sometimes were quite specific in their report. “I love the turn in the shoulders by a man’s neck, sort of the neck and shoulder area. I love to sort of smooth out his suit coat or jacket by running both my hands out from that turn on both sides of his neck to his outer shoulders. I love to look at men in the theater from behind and look at their shoulders.” This wife’s report illustrates a strong visual reaction, and other examples were similar.

The individual love maps of men and women, not their gender, determine what stimuli will elicit a sexual response at any given time. If we tell women that they do not respond visually, then they are likely to report that they do not. If we ask open questions without gender bias, we get the same range of responses in husbands and wives.

Talk together about your reactions to erotica and you will discover that both of you are turned on and off to various visual cues. Asking whether or not a woman is turned on to X-rated material is like asking if someone is turned on to books. It depends! And remember, the sexual-response system is not a closed energy system with an on-and-off switch. It is a flowing, ever-changing system. We do not really get turned on or off, we respond to varying degrees.

When we free our relationship from the mechanical orientation of the early sex perspectives, we learn that we we always “on,” and in control of our response through our selection, sharing, and awareness of our love maps and the variables that determined it.

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I suppose to you this will sound perverted. We have done almost everything together. We haven’t missed a posture. But we never seem to experience anything together. We sleep next to each other, but not with each other. Our sex life is like masturbating, like using each other to masturbate. You might say we are the founders of the term “completing the act.”

WIFE

Super Marital Sex Rule: Any part of the marriage that is ignored will disappear, and this rule is particularly true for sex. For most couples, the amount of enjoyment they derive from their sexual relationship corresponds with the amount of attention they pay to their sexual interaction. The sexual return from a marriage will usually match the intimacy investment. The following are ten areas in which the couples failed to invest appropriately or enough.

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In obsessional-compulsive disorder, there may be recurrent ideas or images entering the mind, such as phrases, pictures and disagreeable ideas, often obscene.

There may be aggressive impulses to hit or injure someone, suicidal thoughts, a desire to swear in church or to take off one’s clothes.

With phobias, there may be extreme anxiety and an unreasonable fear of an object or a situation. These are regarded by the sufferer as groundless and irrational but he cannot control them.

Some phobias are clear-cut, and psychotherapy can often reveal the repressed anxiety that caused the fear of the phobic situation. The connection may be subtle but easy to recognise.

In other cases, there is no clear connection between what caused the repressed fear or anxiety and the resulting phobia.

In treating phobias, behavior modification and learning techniques may be required. Another method is desensitisation.

In this, the person is exposed, initially in thought, to the situation which he most fears. He starts by thinking of himself in that situation in a mild way, then mentally removes himself before the anxiety is severe. This goes on until he imagines himself in the worst possible situation, without anxiety.

Next, he is placed in the real situation, for a short time and removed as soon as he shows anxiety. Finally, he can be fully exposed and able to cope without anxiety.

Another technique is implosion, the reverse of the slow process of desensitisation.

Here the person is placed, at once, into the worst possible situation he can imagine. This creates extreme anxiety and it is believed the shock is so great that the anxiety disappears.

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A further operation is lumbar sympathectomy, which involves cutting the sympathetic nervous chain in the lower back. This chain controls the tone in the arterial wall. When the nerves are cut, the arteries permanently dilate and blood flow can increase. Sometimes both operations are combined.

The bypass operation is the same principle as in coronary bypass surgery, where atheroma blocks one of the coronary arteries and a vein is used to bypass the obstruction.

There is no doubt about the marvels of modern medicine, but how can we convince our patients to avoid the bad habits that lead to many of these problems?

Changing our diet and avoiding smoking would reduce the incidence of atheroma.

The diagnosis of intermittent claudication can be made on the history alone. When the doctor examines the legs, he may be unable to feel the pulses in the feet. This indicates obstruction to blood flow.

In the past, various drugs were used in an effort to dilate the narrowed arteries and improve the blood flow. Unfortunately, these have proved disappointing.

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The more severe cases will require admission to hospital. They are perhaps better in a psychiatric ward or hospital rather than a general hospital. Most will respond to encouragement and supervision of meals rather than to forced feeding. However if the weight loss is extreme and the general physical condition is poor then intravenous feeding may be necessary.

Apart from the attention to the physical state, the emotional side of this disorder needs treatment. The girl herself may need intensive psychotherapy. Often the family, especially the parents, may also need counselling, and it may be better in these cases for parents to have a different therapist to the girl herself.

Anorexia nervosa rarely results in death now unless as a result of suicide, but associated depression is not unusual.

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Symptoms: discolored urine, puffy eyes, headache and high blood pressure.

Home care:

Most cases of nephritis are mild and pass unnoticed. If the symptoms are marked enough to be recognizable, the child requires medical attention.

Precautions

-    If the child’s eyes are puffy, or the urine is scanty and dark, the child may have nephritis.

-    If symptoms of nephritis are pronounced enough to be noticed, take the child to the doctor.

-    Nephritis usually follows a strep infection. Watch for the condition to follow a strep throat or impetigo, even if the infection is being treated with antibiotics.

There are many forms of nephritis, or inflammation of the kidneys, but the form that is most common in children usually follows a streptococcal infection such as strep throat, scarlet fever, or streptococcal impetigo. The first symptoms of nephritis develop one to three weeks after the onset of a strep infection, and these symptoms are usually mild. In fact, most cases of nephritis probably go unnoticed (or undiagnosed) and pass without treatment. Occasionally, however, nephritis starts abruptly and the illness is severe. Most children recover completely from nephritis, but a few develop chronic kidney disease.

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Chromium is a trace mineral increasingly thought to be vital in the production of diabetes, but

so far the work has mostly been done on Type 2 diabetes. Early research in rats found that

abnormal glucose metabolism could be corrected by adding chromium (as brewer’s yeast) to the

diet.

The biological significance of this trace element has only recently been recognized, but now that it has been there are signs that many people are short of it. Chromium is physiologically active in the body in only one inorganic form (the trivalent form). This inorganic (non-living) type of chromium is very inactive in the body compared with another chromium-containing compound-the organic complex called the glucose tolerance factor (GTF). It is not known exactly what this is but it appears that animals have only a limited ability to produce it themselves and so need external sources. GFT is the only known form in which chromium can cross the placenta. When trivalent chromium is given orally less than 1 per cent is absorbed.

Chromium’s main function is to help insulin control the body’s sugar levels. Experiments with

animals have found that glucose (sugar) metabolism is quickly impaired if the animals are fed

diets poor in chromium and that giving the element soon returns the situation to normal.

Because animal work has found that chromium-deficient animals develop diabetes-like

symptoms, it was natural to ask whether a similar mechanism could be at fault in human

diabetics. Several reports have suggested that giving chromium has had beneficial effects on

diabetics and in one study four out of six maturity -onset diabetics improved with a dose of 250 micrograms of chromium a day. Other studies have found that diabetics put out more chromium in their urine than do non-diabetics. Studies of poorly-nourished children in Jordan, Turkey and Nigeria found that they grew faster when given extra chromium. In spite of this circumstantial evidence there are no definite indications that diabetes is caused by a deficiency of chromium, and it is certain that many diabetics will not be improved simply by taking chromium.

Unfortunately, the refining of foods removes a very substantial part of their chromium. Blackstrap molasses, honey and raw sugar are rich in chromium but white sugar has almost none. This is especially unfortunate since chromium is needed if the body is to handle sugar effectively, as we have seen. White bread contains only one third of the chromium of the original whole wheat and this, of course, goes for anything made from white flour.

The food richest in chromium is brewer’s yeast but whole-grain bread, nuts, shellfish, liver, kidneys, grape juice, beef and beer are also rich sources.

As with many other trace elements, absorption is very poor, especially from tablets. Overall, only about 3 per cent of the chromium in our food is absorbed, so with our relatively chromium-deficient diet there is not much of a safety margin.

The recommended daily intake of chromium varies from 5 to 100 micrograms a day. Given that the body needs to absorb about 10 micrograms a day and that only 3 per cent is absorbed, perhaps the amount we consume should be even higher than 100 micrograms.

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Indigestion is a vague term used to describe pains or discomfort in the abdomen after eating or drinking. Dyspepsia is a discomfort in the uppermost part of the abdomen after food. Some people’s indigestion is caused by a peptic ulcer.

What causes it?

• Peptic ulcer.

• Smoking.

• Alcohol, tea and coffee.

• Specific foods (often spicy ones or sugar).

• Fatty foods.

• Stress.

• Too little gastric acid.

• Hypoglycemia.

• Thrush.

• Reflux oesophagitis or hiatus hernia.

• Irritable bowel syndrome.

• Gall-bladder problems.

• Angina.

Prevention

• Smoking stimulates the production of gastric acid and can cause quite severe indigestion in some people. Smoking also reduces the efficiency of the valve of the top of the stomach, so allowing acid stomach contents to flow into the lower end of the gullet (oesophagus) and cause pain there. Other substances that do this are chocolate, alcohol, spearmint, and peppermint. Stopping smoking brings relief in days to many people with indigestion. Any treatment being given for indigestion is made less effective in someone who continues to smoke.

• Alcohol, tea and coffee stimulate gastric-acid production. Experiment with leaving out all of these for a few days and see the results. If the indigestion goes completely reintroduce one drink at a time (weak if it is tea or coffee, and infrequently in the case of alcohol) and stop as soon as you get indigestion again. It may be that there is one (or more) of them that you will never be able to drink without feeling ill.

• Research has found that certain individuals improve when they go on to a low-carbohydrate diet. Sucrose increases pepsin secretion by the stomach by 200 per cent. The same study found that eight out of nine people with hiatus hernia did better when they went on a similar diet, low in refined carbohydrates. Five out of eight people with duodenal ulcer also improved.

• Fatty foods often produce pain or discomfort in the upper abdomen (if the individual’s gall-bladder is not working well) partly because of gall-stones. If fatty foods regularly bring on your indigestion, see your doctor.

• Stress is a potent stimulant to gastric acid, and many people complain of odd discomforts and uneasiness in the stomach when they are stressed. Stress also affects the rate at which the stomach digests food and passes it on to the intestine, and this can cause indigestion as well.

• Although many people with indigestion have too much gastric acid and improve when taking antacids, some do not. These people have too little acid in their stomachs and the antacids òàê them worse. Prevention here involves taking pepsin and hydrochloric acid supplements regularly. A good way to take hydrochloric acid is in the form of 1-3 tablets of betaine hydrochloride before each meal

• The yeast Candida albicans, which causes thrush, can infect the stomach and produce a sense î burning after the ingestion of food. This type of indigestion can only be cleared up by treating the infection.

• In the irritable bowel syndrome the colon (large bowel) goes into spasm after food. The middle part of the colon lies in the upper abdomen very near the stomach and this pain can be mistaken for indigestion.

• Angina pectoris can often mimic indigestion. If you have any history of heart disease in your family or have any of the risk factors known to be important in heart disease always take ‘indigestion’ seriously. The prevention of indigestion in your case might be to treat your angina.

• If you have indigestion don’t take a sloppy diet or drink lots of milk as neither have been proven to reduce indigestion, except temporarily. Unfortunately, they often worsen it because milk produces a rebound overproduction of acid once its initial buffering effect has passed.

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