Gum disease progresses in stages-pyorrhea-Plaque

Gum disease progresses in stages

 It starts with gingivitis, in which the gums become inflamed, swollen, and tender. Left uncontrolled, the inflammation advances and the gums begin to stand away from the teeth so that pockets are formed which harbor bacteria and pus. 

This ispyorrhea. As pyorrhea progresses, fibers holding the teeth in their sockets weaken and gradually the bone supporting the teeth is destroyed, and the teeth become loose and are lost. What starts the process?.There is now evidence-thanks to the brilliant work of many investigators, notably Dr. Sumter Arnim of the University of Texas, Houston- that, just as in tooth decay, bacteria are involved.

Clinging to the teeth and working on food particles to produce acid, bacteria also produce a material-a film called plaque-that covers them over, allowing them to work undisturbed. Plaque not only furthers decay; it triggers the formation of tartar, or calculus. 

And it is calculus that, spreading down below the gum line, irritates the gums, starts up inflammation and gingivitis, and opens the way for pyorrhea and gum disease progression. "Calculus cannot form unless plaque is present," says Dr. Irving Glick- man, Chairman of the Department of Periodontology at Tufts University School of Dental Medicine. "It's important for a dentist to remove calculus once formed; but it's also vital for the individual to minimize formation. In no other field of medicine can the patient so effectively assist in preventing and reducing the severity of disease.

Other factors may enter into decay and gum disease. In some caries- rampant individuals-those with far more even than the bad-enough average of decay-poor nutrition or faulty saliva flow may play a role; dentists can correct both. Faulty bite may help foster gum trouble; this can be corrected. But it is now clear that against both decay and periodontal disease, effective home care to prevent plaque formation is a prime weapon of prevention.

And more and more dentists are taking time to educate patients in proper home care methods. Recently, one of us spent two and a half months visiting such men in and around more than a dozen cities and in small communities. It was gratifying to see them lift bits of plaque from patients' teeth and place them under special microscopes so the patients could see for themselves the teeming colonies of bacteria in the plaque. 

Plaque on the teeth is invisible, but these dentists reveal it to patients graphically with a simple tool, a disclosing wafer. It's a small tablet containing a harmless vegetable dye. Chewed up, it stains the teeth temporarily, but only where the plaque is. 

Eye sight and Television viewing - How it affects?

Television Viewing

Television will not hurt the eyes if you have a fairly large screen, do not keep the room in total darkness, do not sit too close to the set or at an angle, and do not watch steadily for extended periods. It can be wise to be arbitrary about children's viewing, setting an hour as the limit for Swimming Rarely does swimming cause ear trouble unless there is a nose, sinus, or throat infection. Learning how to breathe in through the mouth and out through the nose during swimming is a helpful preventive measure. In the case of a perforated eardrum, however, you should have your doctor's permission and advice before going swimming. 

Once in a while, an eardrum may be perforated by the pressure of high diving; pain, and sometimes bleeding, will result. If you see a doctor immediately, there will probably be no permanent harm from such an accident. Deafness There are many degrees of hearing impairment. Mild hearing loss may go unnoticed. When the loss is great enough to produce some difficulty in communication, the condition is commonly called "hard of hearing." When so much hearing ability is lost that a loud voice, even a voice amplified by a hearing aid, cannot be heard, the condition is called deafness. 

Hearing impairment may stem from an inner ear problem; essentially, this is nervedeafness. Often, the impairment is of the conductive type in which there is no nerve involvement but rather some defect in the conduction of sound waves in the outer ear canal or the middle ear. An infection, injury, or congenital deformity may close the ear canal, and the canal may need surgical reconstruction. If an eardrum has been partially destroyed by infection, plastic surgery may repair it. If the middle ear bones are damaged by infection, corrective surgery may help.

Otosclerosis, a common form of impairment, involves the stapes, one of the middle ear bones. Because of overgrowth of bone, the stapes cannot vibrate properly and so is unable to transmit sound waves. An operation to mobilize the stapes has restored hearing for many people. And other surgery may be used when the mobilization operation is not suitable. 

Many types of hearing impairment can be overcome to a marked degree, even almost completely, with hearing aids. It is tragic to think of all the people who lead handicapped lives because they believe that others will make fun of them if they wear an aid. If this was ever true -and we doubt it-it is certainly no longer true with aids that bear no resemblance to trumpets. 

Modern devices are well designed and effective when properly chosen. Since various hearing impairments differ, it is important to find an instrument suited to the wearer's specific needs. A specialist, not a salesman, can give you the right advice.  Consist of having your own and your children's hearing tested at regular intervals and of seeing your doctor the moment you or a child feel any pain, note any ear discharge, experience any unusual buzzing, ringing, or pressure in the ear, or become aware of any seeming diminution of hearing acuity. 

Eye

Eye 

In one experiment, when subjects were asked to estimate the size of coins and cardboard disks that were exactly the same size, they guessed, on the average, that the coins were one-fourth larger than the disks-and the poorer off financially a subject was, the more he overestimated coin size. The eyes even serve a purpose beyond seeing. 

They have a marked effect on taste, as shown by studies at a U.S. Air Force medical laboratory where volunteers were fed in a completely darkened room. Unable to see the food, they could detect no difference in taste between white and whole-wheat bread or between various canned foods. Eye Problems and Their Prevention Defects and diseases to which the eyes are susceptible account, in part, for the fact that there are nearly half a million people in the United States who are totally blind and two million more who are partially blind. 

But in part, too, this unpleasant fact is the result of misunderstanding, neglect, and delay in seeking aid, for many potentially blinding disorders can be prevented, or arrested, or even cured with prompt attention. In addition, of course, about 40 percent of the population wears glasses, indicating that the vision of almost one of every two people leaves something to be desired.

Three common eye defects-farsightedness, nearsightedness, and astigmatism-are the result of simple optical aberrations in the eye. If the lens is to focus light rays directly on the retina, it must be at the proper distance. When the eyeball is too short, the lens will be too close;  Prevention: Body conversely, if the eyeball is elongated, the lens will be too far away. Moreover, to accommodate to both near and far objects, the lens must change its curvature to maintain proper focus. At birth, the average baby has foreshortened eyeballs and is far- sighted. 

From about age 6 to age 20, the eyeballs elongate. After about age 45, people tend to become farsighted again because the lens, going through a normal hardening process, loses some of its ability to change curvature to focus on near objects.

Nearsightedness is usually due to a lengthening of the eyeball, an increase in curvature of the cornea, or a change in refraction of the lens. Astigmatism is usually caused by an irregularity of the shape of the cornea. When the cornea does not have a perfect curve, images is distorted. The effect can be similar to that of looking through a dirt- streaked pane of glass. 

Fortunately, nearsightedness, farsightedness, and astigmatism are readily corrected with eyeglasses. And it is important that these conditions be corrected, for both comfort and good eye health. If, for example, one eye is more effective than the other, the good eye may do all the work, which could be bad for it and also for the one that is not being used.

This is why children's eyes should be checked at an early age, even before school, and why you should mind your own eyesight, remembering that changes do occur with time. Have your eyes examined as soon as you find yourself holding things off at a distance to see them, or when you notice that you no longer see as well as you once did in poor light. 

Always have an eye doctor examine your eyes and prescribe any necessary lenses. It is true, of course, that eyeglasses are an expense and possibly a bit of a nuisance. But what a joy it is to see properly and to know you are protecting your precioussight. 

Peripheral nerves

Peripheral nerves may be cut, bruised, or torn by fractured bones or blows. A torn or cut nerve should be treated by a specialist in such work. If your doctor advises it, by all means go even hundreds of miles for such treatment as a means of preventing permanent paralysis and other serious consequences of nerve injuries. 

It will be apparent that you can do much to help guard the health of your nervous system by observing commonsense precautions to avoid accidents and injuries and by following suggestions made in many pages of this book about maintaining general good health. 

In addition, you can best influence the nervous system, including the autonomic, to exercise effective control over body functions by maintaining good mental health and by making use of suggestions given in the next section of this book on coping with the tension and stresses that all of us must expect to encounter.

Parkinsonism- Nervous system- thallium toxicity- spinal cord

The nerves extending out from the system go to glands such as salivary, sweat, liver, and pancreas, and to muscles such as those in the iris of the eyes, heart, stomach, intestines, and bladder. They also go to muscles in the walls of blood vessels. 

The parasympathetic system consists of two major nerves. One, the vagus, comes from the medulla and sends branches through the chest and abdomen. The other, the pelvic, arises from the spinalcord in the area of the hip and sends branches to organs in the lower part of the body. As examples of how the two systems work: The sympathetic dilates the pupil of the eye, while the parasympathetic constricts the pupil. Sympatheticnerves speed up the heartbeat; parasympathetic slows it down.

The sympathetic constricts blood vessels and raises blood pressure; the parasympathetic expands the vessels and lowers pressure. The autonomic nervous system is influenced strongly by emotions. For example, when you experience a dry mouth and goose pimples because of fear, the sympathetic system is at work. Preventing Nervous System Damage Diseases such as multiple sclerosis and Parkinsonism affect the brain and/ or spinal cord. These are discussed elsewhere in this book. 

Other maladies affect the peripheral nerves which connect the brain and spinal cord with the muscles, organs, skin, eyes, etc. When a peripheral nerve is affected, the condition is called neuritis or neuralgia. And since a peripheral nerve usually contains both pain and motor fibers, painful symptoms plus some paralysis of muscle power may occur. Certain toxic materials such as lead, arsenic, and mercury may pro- duce a generalized poisoning of the peripheral nerves, with pain, tender- ness, and paralysis of the limbs.

There are many other causes of generalized neuritis, including alcoholism, vitamin deficiencies, some types of allergy, diabetes, severe vomiting of pregnancy, thallium toxicity, and some viral and bacterial infections. While some attacks of generalized neuritis begin with fever and other symptoms of acute illness, on the other hand, neuritis caused by lead and alcohol toxicity comes on very slowly over a Course of weeks or months. In most instances, an attack of generalized neuritis will subside when the toxic substance is eliminated. 

Rest and good diet containing extra vitamins, especially of the B group, are helpful. Physiotherapy may relieve the pain or paralysis. Effective prevention of generalized neuritis is based on knowledge of the danger of poor nutrition, chronic alcoholism, industrial hazards, and infections-all discussed elsewhere in this book. Frequently, instead of a generalized irritation of the nerves, only one nerve is afflicted. 

For example, if you sleep in a cold draft which blows on one side of the face, next morning the facial nerve on that side may be temporarily paralyzed. When produced by drafts, the paralysis clears up after some days or weeks. After such an episode revealing your sensitivity to drafts, you will want to take steps, of course, to avoid recurrence. 

The central nervous system

The central nervous system works in more than one way. There are simple reflex actions and there are reactions at higher levels. Consider, for example, what happens when you unexpectedly touch a hot object. Instantly, your hand is jerked away. The pain stimulated the receptor endings in a sensory nerve in the skin. Nerve impulses immediately flowed along a fiber, passed through a sensory branch of a spinal nerve and into the cord. 

There then followed a quick transfer across a synap of a central nerve in the cord, another transfer across another synapse t a motor nerve, which then passed impulses out of the cord and along a motor fiber of a spinal nerve through the body to the muscles. The muscles reacted; your hand was jerked away. It took just a fraction of a second for the entire reflex-an involuntary process, requiring n thought, assuring immediate helpful action.

 But there was another reaction, too-at higher levels. Although you were not consciously aware of the reflex as it happened, you very quickly learned about it through another transfer in the cord.

The areas sent messages to your muscles, and you moved to the tap. And, as you probably realize, while all this was going on, your emotional centers entered the picture and you had some feelings-perhaps of anger, or disgust, or both-about the event. 

The Autonomic Nervous System A second nervous system, the autonomic, provides for control, on an automatic basis, of vital internal organs. The autonomic system has two nicely balanced parts-the sympathetic and the parasympathetic-which oppose each other, much like accelerator and brake of a car. In so doing, they make possible a precise balance. The sympathetic system begins at the base of the brain and runs along both sides of the spinal column. 

Human nervous system - Central Nervous System

Nerve cells are so specialized that they have lost the ability to repro- duce themselves. When a neuron dies, it cannot be replaced. However, when an axon is damaged, if the damage is at some distance from the cell body, the neuron will not wither away. The damaged section of theaxon may perish but often the remaining section will grow.

 The growth may be slow, although studies in some animals show a growth rate as fast as an inch a week. Even when a neuron is completely destroyed, all is not necessarily lost; sometimes other pathways may' come into use to serve the function of the destroyed unit. " Man's endowment of neurons is vast. For example, the ant, often considered to be a remarkably wise little insect, capable of constructing cunning houses and leading a relatively complex social life, has some 250 neurons.

 Man has billions, and the number can be looked upon as The Brain and Nervous System I 243 an indication of his tremendous potential if he chooses to use them all, and wisely. Actually, man has two nervous systems, not just one.

The Central Nervous System The central nervous system includes the brain and spinal cord. The spinal cord is suspended in a cylinder formed by the bones of the spine. The meninges, which cover the brain, also continue down to serve as protective coverings for the cord. And cerebrospinal fluid, between mid- dle and inner membranes, cushions the cord, just as it does the brain, from shock. 

The central nervous system connects to every part of the body by means of 43 pairs of nerves. Twelve of these, the cranial nerves, go to the eyes and other sense organs, the heart, and other internal organs. They are called olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, auditory, glossopharyngeal, vagus, accessory, and hypoglossal.

The 31 other nervepairs go to skeletal muscles throughout the body. 

They branch off the cord between the bones of the spine. One of a pair goes to the right side of the body, the other to the left. Outside the cord, each nerve splits. One branch carries sensory-type fibers-for incoming messages-to the cord; the other carries motor-type fibers. 

THE NERVOUS SYSTEM

THE NERVOUS SYSTEM

The brain is likened to a control center, then the nervous system can be thought of as a two-way communications network through which informational messages flow to the control center and command messages are transmitted from the center. The informational, or sensory, messages come from the outside world through the sense organs (eyes, ears, etc.); they also come from within the body itself-there are billions of receptors all over the body concerned with various functions. 

The nervous system is organized to give you essential voluntary control over many actions. It is also set up to relieve you of concern with routine matters. Thus, for example, you eat dinner and decide whether you like or dislike a certain dish and wish to finish it.

On the other hand, you walk along, stumble on an object; without thought on your part, the muscles of the legs are automatically commanded to react, and one leg is extended and the other flexed so you maintain your balance. How Nerves Work Messages travel along nerves, at speeds of as much as 250 miles an hour, as the result of both electrical and chemical action. 

A nerve cell, or neuron, when viewed under a microscope, looks like a tiny blob, rounded or irregular in shape, with one or more threads extending from it. The blob is the actual nerve cell body; the threads are nerve fibers. Shorter fibers, called dendrites, bring messages to the cell body; they may range from a very small fraction of an inch to several feet in length.

One fiber, longer than the others and called the axon, transmits messages away from the cell body. A nerve impulse, going through the nerve network, travels over the fibers of many cells. As it reaches the end of one fiber, it jumps a gap, called a synapse, to the next fiber. Chemicals produced and stored around synapses can help the impulse to jump the gaps or can block the impulse. Some drugs that act in the nervous system-some of those for high blood pressure, for example-accomplish their tasks by affecting the chemicals at the synapses. 

The Brain and Nervous system

The pons, a saddle-like mass of coarse fibers, connects the medulla with the higher brain centers. The medulla, or spinalbulb, just below the pons and at the upper end of the spinal cord, is a switching center for nerve impulses to and from higher brain centers.

 It also contains centers which, as we will see, work through the autonomic nervous system to control heart action, changes in artery walls, breathing, and other activities that go on without our conscious effort. The cerebellum, or little brain, is divided into hemispheres like the cerebrum. The front and back areas control muscle tone. Equilibrium is the concern of an area behind the back lobe. The two main hemispheres coordinate voluntary movements.

It is characteristic of the intricate organization of brain and nervous system that the cerebellum receives nervous messages from the balance mechanism of the inner ears, from the muscles and joints, and from centers deep in the brain, and then sends impulses to the muscles adjusting their tone and coordinating their action. Are you able, with eyes closed, to touch the tip of your nose? Can you both rub your stomach and pat your head simultaneously? Then your cerebellum is still at work.

Protection for the Brain

The brain is an excellent example of built-in protection provided by nature for a vital organ, Despiteprocesses in the brain, brain tissue itself is quite sturdy stuff, tough and resilient. It is protected against injury in a number of ways. A tough bony cage, the skull, surrounds the brain completely. It takes a very strong blow to break the skull. The skull itself is protected by the scalp, which can absorb some tough blows. The scalp is made up of five layers which medical students remember by an acrostic: S is for skin (and hair in which in women constitutes considerable protection), and the skin of the scalp is the thickest in the body; C is for the cutaneous tissue, a layer under the skin; A is for the aponeurosis, a tough layer of fibrous tissue which helps the scalp slide around; L is for some loose tissue;

Still more protection is provided

 Inside the brain are four reservoirs, the ventricles, which contain cerebrospinal fluid. This fluid circulates around the brain. Thus, the brain practically floats on and in fluid. And engineers will tell you that this is an ideal "shock absorber" system. Finally, inside the bone of the skull the brain is wrapped in layers of tissue. One of these layers, the dura mater, is particularly tough and helps protect the brain against blows. But nature cannot provide infinite protection, and it has not foreseen the demands of modern society. It did not anticipate that man would ride motorcycles at 100 miles an hour, and might hurtle over the handle-bars.

Or that children would go out on hard turf and play football. Or those workmen would walk under skyscraper construction projects where a bolt falling from the fortieth floor would develop the speed of anartillery projectile. So we need additional protection: adequate helmets for motorcyclists and athletes, steel hats for workmen exposed to possible head injuries. Parents must realize, too, that babies fall off beds and, at some stage, jump out of cribs. These must be guarded against and a baby doctor can advise. Beyond protecting the brain from injuries, you can protect it so there is no interference with its efficient operation. 

THE BRAIN AND NERVOUS SYSTEM

THE BRAIN AND NERVOUS SYSTEM 

EVERYTHING YOU does in, and every awareness and impression you have of, life is the result of activity in the brain and nervous system. To call it a remarkable system is to understate the obvious. It is so complex that scientists are only making a beginning at penetrating its mysteries. And yet enough has been determined, and it is now possible to understand sufficiently the broad outlines of the makeup and functioning of the system in health and disease, to permit you to do much to preserve its health.

THE BRAIN 

Of all things known in the universe, the human brain is, by far, the most intricate. Although it weighs only about 12 ounces on the average at birth and in an adult only about 3 pounds, its storage capacity is phenomenal. It has been estimated that the brain can store more facts, impressions, and total information than are contained in all the 9 million volumes in the Library of Congress. It's another indication of the brain's complex organization that, if necessary, you can get along with only half of it. The fact is that after removal of much of one side of the brain because of tumor, doctors, lawyers, and others have been able to carryon with their regular work.

And in one study with 62 soldiers who suffered penetrating head wounds during World War II, the men, upon being retested for intelligence, showed little or no change in scores they had made in the Army General Classification Test upon first entering service. Although at various times there has been some belief that the brain is compartmentalized, with specific areas for specific functions, the evidencemany studies is that when some brain area is damaged, another area may be able to take over its functions. 

The brain has 15 billion nerve units which permit storage of memory images and all the learning we accumulate. In addition, it has huge numbers of connections which control the more than 600 muscles in the body. Other connections into the brain from the eyes, ears, and nerves in the skin permit us to record and remember what we see, hear, feel, smell, and taste.

The brain is made up of several parts. 

The cerebrum, largest and most familiar, takes the form of two hemispheres divided by a groove. The surface, or cortex, of the cerebrum is the gray matter we hear about, formed by the cell bodies of nerve cells. Fibers from these bodies lead inward and form the white matter of the cerebrum. Some of these fibers lead to the center of the brain; others extend from front to back and from side to side; and deep in the brain, complicated junctions are formed.

 Actually, most of the fibers cross over so that one entering the brain from the left side of the body crosses to the right side of the brain, which is why the right lobe of the cerebrum controls most of the left side of the body, while the left lobe controls the right side. At the base of the cerebrum are three structures: pons, medulla, and cerebellum. 

Gonorrhea and preventive care and cure

Gonorrhea is a common venereal disease. Prior to the development of effective antibacterial agents, it was a serious problem. Now it can usually be cured with one injection of penicillin. Every person, female as well as male, should read the section on gonorrhea. Even children are susceptible. Gonorrhea can be transmitted in ways other than sexual contact. 

If you understand the facts thoroughly, you will know how to prevent gonorrhea. The other venereal diseasesless common and less importantare chancroid, lymphogranulomainguinale, and veneral warts. These are made evident in men by sores on the penis or enlarged lymph nodes in the groin. (Women, too, may contract these diseases.)

They respond to treatment while in early stages and no time should be lost in consulting your physician. Venereal diseases can be prevented. The simplest and most effective prophylactic is the condom, or rubber sheath. Some men think this diminishes the pleasure of intercourse. 

But anyone who has seen really severe cases of venereal disease comes away convinced that if a man must expose himself to the dangers of VD, he can well afford to reduce slightly the physical pleasure in return for protection and freedom from worry. 

The testicles are not often affected by disease. They are not, however, immune to involvement and may be affected by mumps, undulant fever, or gonorrhea. The cord that supports them may be invaded by an extension of a hernia, or there may be enlarged veins. The epididymis may become diseased. If you notice a swelling, lump, or congestion of the scrotum or testicles, be sure to see your physician as soon as possible.

Syphilis cure and male genital system routine care

 Routine Care

The genitals should be kept clean, free from infection. For this, an uncircumcised male can gently pull back the foreskin and wash off any hellions with soap and water as often as required to keep the penis cle.in. The genitals should be protected from blows and other injuries during football and other strenuous sports. No special food is needed for health. No medicines arc required, and non" Venereal Disease should be taken except under a doctor's orders.

 Masturbation causes no organic damage or harm; it may, however, give rise-because of feelings of guilt often associated with this practice-to emotional conflicts which may lead to phobias about syphilis or to impotence. Five venereal diseases may affect the male genital system. Syphilis is the most serious.

 Syphilis can be cured, and we urge you to read the section on this disease so you will not fail to seek medical advice if you have any reason to suspect you may have contracted syphilis. (Women, too, should understand venereal diseases.) No one except a competent physician is capable of treating the disease properly. You would be running grave risk if you depended upon a quack to even diagnose the condition. 

The fact that syphilis can be cured is no reason for carelessness, smugness, or delay. Syphilis cases in the United States and in many other countries have been increasing rapidly. One reason seems to be that many people assume they have nothing to worry about-but, left to smoulder, syphilis can have serious consequences. 

CARE OF THE URINARY SYSTEM

CARE OF THE URINARY SYSTEM 

Your kidneys do not require "flushing," "stimulation," or any of the things that patent medicines may claim to achieve. Kidney disorder may produce low back pain, and this symptom, together with any changes in the urine, should always be reported immediately to your doctor. 

Contrary to claims made for certain "kidney medicines," they cannot cure 232 / Preventive Body Care chronic pain in the back, which is seldom caused by a kidney disorder. Don't take any medication for your kidneys except on a doctor's orders. Some causes of kidney stones (renal calculi) are beyond control.

 But prevention or prompt treatment of infection is helpful in avoiding stone formation. Another important preventive measure is maintenance of adequate urine flow. When the urine becomes highly concentrated be- cause of excessive perspiration during hot weather or exertion, there is increased tendency to form stones and to develop infection. Drink plenty of water if you perspire heavily.

 A floating (movable) kidney is usually not serious, although it may cause discomfort. Bright's disease (also called nephritis) is a potentially serious illness (page 601). Whenever the urine appears bloody, wine- colored, smoky, or at all unusual, it may be a sign of Bright's disease which, as a rule, causes no pain. Always see your doctor immediately if you notice any such urine changes. 

See him immediately, too, if the urine should appear to be cloudy or pus-laden. Inflammation of the kidneys is called pyelitis. If treated early, this and many other kidney disorders can be completely cured. If not cured, kidney infections can slowly damage these vital organs, leading to high blood pressure and uremic poisoning. 

The bladder is subject to infection (cystitis) and inflammation. These conditions usually yield to treatment with a suitable antibiotic prescribed by your physician.

 Never use a "bladder pacifier" or other home remedy. Infections can be the cause of incontinence, the inability to control urination. Frequency of urination can be a symptom of a disorder such as diabetes. Difficult urination may be caused by a urethral stricture or narrowing. Always consult a physician if you experience frequent, difficult, or painful urination; don't attempt to treat the condition yourself. It often is traceable to an easily cured inflammation, but it may stern from a dis- ease such as prostate gland enlargement in men (page 639). Stones can also form in the urinary bladder; never take any home remedy to "dis- solve" them. If necessary, stones can be removed by surgery. 

Urinary Bladder

THE BLADDER

 A tube, or ureter, leads from each kidney to the urinary bladder. The bladder empties through the urethra, a tube leading to an external open- ing called the meatus. The bladder, which functions as a collecting and temporary storage point for urine, expands to accommodate increasing amounts. With the accumulation of about half a pint, reflex contractions lead to a desire to urinate, or micturate. 

The contractions stimulate pressure receptors in the muscles of the bladder wall, from which nervous impulses go to the brain. When it is convenient to urinate, the brain sends out signals which cause the bladder's external sphincter to relax.

The signals also set up a whole series of other events, including holding of the breath, forcing of the diaphragm down, and contraction of the abdominal wall, which in- crease pressure on the bladder and help it void its accumulated urine. Such is the complexity of the process that it is hardly any wonder that most children are walking before they become able to urinate with con- trolled competence. 

Normal daily production of urine may range from two to three pints. In some diseases, such as diabetes insipidus, the quantity is increased; in others, fever and diarrhea decrease it. Tea, coffee, alcohol, excitement, and nervousness increase urine output; hot water decreases it. Whatever the actual liquid output, a day's urine generally contains about two ounces of solids. 

THE GENITOURINARY SYSTEM

THE GENITOURINARY SYSTEM

EVERY BODY cell not only must build its substance and obtain its energy from nutrients supplied in the food you eat; it must get rid of wastes. And all cells deliver their waste products continuously to the blood. In turn, the blood carries them to various centers for excretion. 

Thus, carbon dioxide and some water in the form of vapor are removed from the blood in the lungs. Salts and additional water pour out through the skin's sweat glands. Other wastes, including water, salt, urea, and uric acid-leave the blood in the kidneys. Blood enters the kidneys through the renal arteries and leaves through the renal veins and, in circulating within the two kidneys, goes through a fabulous filtering system. 

The kidneys-each about 4-1/2" long, 2-1/2" wide, 1-1/2" thick, and weighing 5 ounces-are located deep in the abdomen at about the level of the lowest ("floating") ribs. Essentially, they are filters containing intricate plumbing-a system of tiny tubes called nephrons whose combined length in each kidney is about 140 miles. To the naked eye, a single nephron would resemble a grain of sand. Under a microscope, it has the look of a twisted worm with a huge head. The head, called the glomerulus, is covered with a network of capillaries that carry blood continuously into the glomerulus. 

The tail is the tubule. In a healthy kidney, as blood enters a glomerulus, a fluid is separated from it. The fluid contains neither red, nor white blood cells nor only a trace of large protein molecules. The fluid passes along the tubule, and about 99 percent of the water, amino acids, proteins, glucose, and minerals needed by the body are returned to the bloodstream. The remaining fluid, with its content of waste materials, is eliminated from the body as urine. Every 24 hours, the kidneys filter about 200 quarts of fluid and salts.

One or two quarts of the waste go to the bladder and are flushed out of the body. Actually, the kidneys have a tremendous reserve capacity; they could clean nine times more fluid than they are called upon to do, and for this reason one healthy kidney can readily serve the body's needs. The kidneys function to maintain the correct balance between the salts and water of the body, to get rid of any toxic substances, and to keep the body in correct mineral balance. For example, too much potassium in the blood could stop the heart quite as effectively as a bullet. 

Stomach and digestive problems and preventive care

 1. LUMINATION

 Choose a time, shortly to defecate whether or not you have "the urge." Allow ten minutes. Relax, be comfortable, read if you like-the important thing is not to feel tense or hurried. Prop your feet on a footstool so your knees are close to your chest. If you choose to go before breakfast, it will help to drink a glass or two of fluid upon getting out of bed; it can be warm or cool water, fruit juice, tea, or coffee. Teaching your bowels to move regularly is a little like training yourself to wake up at a given hour every morning; it can be done, with patience, and once acquired the habit persists.

 2. DIET. 

The residue of foods you eat is easier to eliminate if it contains some roughage in the form of fibers, lubricants in the form of fats or oils, and fluid. These should be included in the diet of healthy people. (In some disease states, there may be an inability to tolerate roughage; in such cases, a physician will so advise.) To cure or prevent constipation, make certain your diet includes: For breakfast: 1/2 to 1 glass of tomato, grapefruit, prune, or orange juice. 

Also include one item from each of the following, (a) through (e): (a) Mixed dried or stewed fruits-prunes, apricots, figs (b) Cooked, whole-grain cereals with milk-barley, brown rice, oats, wheat (c) Margarine (d) Whole-grain bread (e) Beverage For lunch, dinner or supper, some of the following: Green leafy vegetable--beet greens, spinach, escarole, lettuce, turnip greens, dandelion greens, mustard greens Baked potatoes (eat the skins) Margarine, salad oils Dried or stewed fruits-especially for dessert at evening meal Take two glasses of fluid between meals and at least eight all told during the day. 

Drink an extra amount of water in summer because part of it is lost in perspiration.

3. EXERCISE. 

Strong abdominal muscles help elimination. If you do not have a firm, well-toned abdominal wall, start the exercises described on page 89. If your job requires much sitting and very little physical activity, you should indulge in regular sports or other forms of exercise. You will feel better generally as well as have fewer tendencies toward constipation.

 4. LIVE SENSIBLY. 

Try as much as you can to avoid the stresses and strains of modern living. Get relaxation to help temper those stresses and strains. Don't worry about constipation. If your physician gives you a clean bill of health on your regular visits, and you follow our suggestions for home checkups (page 33), constipation is not going to harm your health. Usually, these suggestions are enough to prevent or cure constipation. If they are not, and failure to move the bowels causes real discomfort, you may:

5. TAKE AN ENEMA. 

Use a pint of warm water containing a level tea- spoonful of table salt. If you use an enema bag, hold it about two feet above the toilet seat; if you use a bulb, do not press it too hard-the water should flow under gentle pressure. This should help soften the stool so it can be passed easily. You may take an enema every day-but remember that this is a crutch and the sooner you discard it, the better. If an enema does not help, your physician can show you how to insert olive oil into the rectum at night through a catheter, which will soften the stool and make it easier to pass in the morning.

6. LAXATIVES. 

If you cannot take an enema, use a mild laxative such as petrolatum and agar, aromatic cascara sagrada, or milk of magnesia. Do not do this until you have given your bowels a chance to work by themselves. An important step in curing constipation may be to stop taking all laxatives and cathartics. Strange as it seems, laxatives are frequently the cause of constipation and seldom are necessary in its cure. As noted above, mineral oil may be of value. A final warning: Don't give a laxative to a child, and don't take one yourself, if there is any fever, nausea, pain, or general feeling of illness associated with the constipation. It can cause fatal consequences if the condition is caused by appendicitis.

Definition of constipation

Here is the medical definition of real constipation:

A person has constipation when bowel movements are too hard to pass easily or are so infrequent that uncomfortable symptoms result. Constipation does not mean failure to pass a stool daily; this may be imaginary constipation. Hard movements that require straining can bring about rectal troubles such as hemorrhoids and fissures or may aggravate a hernia or the tendency to hernia. Constipation may cause uncomfortable symptoms such as nausea, heartburn, headache, or distress in the rectum or intestines, continuing until the stool is passed. 

Notice that we say uncomfortable rather than harmful symptoms; that are because these symptoms stem from nerve impulses to various parts of the body when the rectum is distended by retained fecal matter. They are not due to "autointoxication," or absorption of poisons from the fecal matter. It has actually been established that similar symptoms can be brought on when cotton is placed in the rectum after all fecal matter has been removed. Some people suffer more than others from these symptoms, not because of their imagination but because they are actually more sensitive. 

In imaginary constipation, the bowel movements are not difficult to pass; they cause no unpleasant symptoms; they simply do not take place as often as the individual thinks they should. Often, it is a mother or other relative who insists the movements should be more frequent. The fact is that bowel movements can be normal without being "average." While the "average person" has a movement daily, usually immediately after breakfast, countless people are normal even though they have more than one movement a day, or a movement only every second day, or every third, fourth, fifth, or even eighth day. 

People vary markedly in body makeup, type of intestine, eating habits, physical activity, and custom. By self-induced constipation, we mean the kind caused by one or more of the following: improper diet (eating the wrong things or eating too little); the use (that is, abuse) of laxatives, cathartics, etc.; irregularity in habits of elimination.

Modern living, with its strains, stresses, and sedentary habits, helps promote constipation; indeed, in some primitive languages there is no word such as constipation because the need for it does not exist. Functional constipation can also be caused by "sluggishness." As we have seen, after food has been digested in the stomach and intestines, the residue, a watery material, enters the colon. Water is absorbed in the colon; that is why the feces may become hard and difficult to pass if they remain too long in the colon. The stools are propelled along by a series of wavelike, peristaltic movements. Usually the waves are strongest in the morning, which is why it may be easiest to have a bowel movement before or just after breakfast. In some people, peristalsis is weak. 

This may happen with increased age, and some elderly people may require an aid to elimination. Mineral oil is the best remedy. But we think it wise to accept as helpful virtually any method that an elderly person has long used and found satisfactory -whether it is hot lemon water early in the morning or the enema that some elderly people believe has magical virtues. In such cases, the important thing is to watch for any sudden change in established bowel habits. How to Cure-and Prevent-Functional Constipation If you now do have constipation, there are certain things you can do to Cure it, and these same methods will also prevent you from becoming constipated. 

Stomach distress

This can be alleviated by a teaspoonful of bicarbonate of soda in water or by use of a buffered type of aspirin. If you are truly sensitive to aspirin, you may find Tylenol a useful substitute. If you are occasionally, not habitually, constipated, it is safe to take a mild laxative such as a teaspoonful or two of milk of magnesia. 

Avoid regular dosing with any laxative or cathartic. Be certain to see your physician if you find yourself beginning to suffer persistently or repeatedly from any of the following symptoms: nausea, vomiting, excessive belching, fullness or burning sensations in the abdomen, cramps, constipation, or diarrhea. Be certain to see him immediately if you pass stools that are blood-streaked, blackish, colorless, or foul- smelling. The liver in a healthy body requires no particular care.

 It certainly does not need to be "stimulated" by such medicines as those claiming to "increase the flow of bile." But there are several things you can do to prevent damage to the liver. You can protect it from the harm that can result from excessive intake of alcoholic beverages and from poisons such as carbon tetrachloride to which you may be exposed at work or in the course of hobbies requiring use of solvents. Remember that glue sniffing, engaged in by youngsters seeking a "thrill," can harm the liver. 

Both normal weight and balanced diet are necessary to keep the liver healthy. Liver damage, such as that from a virus infection, may produce jaundice-a yellowing of the skin and particularly of the whites of the eyes. Jaundice should be reported immediately to your physician. Some viruses that cause liver infection are transmitted by blood on syringes or needles. That is why drug addicts who share equipment have a high rate of liver disease. Alcohol and ordinary boiling do not kill the viruses; the very high temperature of an autoclave type of sterilizer is needed. 

Do not use someone else's injection equipment in administering insulin, for example. Other viruses affecting the liver are transmitted hand to mouth, and so it is vital to wash hands with soap and water after passing a stool, before each meal, and after trips and contacts on buses, trains, and other public conveyances and places. Infection may affect the gallbladder. Gallstones sometimes cause considerable pain and may block the flow of bile, leading to jaundice and infer lion of the liver and gallbladder.

Examine the stomach with an instrument called the gastro scope

 Examine the stomach with an instrument called the gastro scope

Such tests, and others that sometimes may be needed, are well worthwhile. Almost every disturbance of the gastrointestinal tract that makes itself known by indigestion can be helped if identified in time. It is reassuring to know that tumors are rather rare causes of the tremendous number of cases of chronic indigestion. On the other hand, a disease can progress to a serious, even fatal stage while you are engaged in "treating" your indigestion-for example, if you take a cathartic for indigestion which is caused by appendicitis. 

Let your physician decide whether or not you should take any medicine. Realistically, we know that few people will consult a physician for every mild stomach upset.

If it is, indeed, only a mild upset, we recommend one of the following remedies: a level teaspoonful of bicarbonate of soda in water or, if you prefer, in fruit juice; or 10 to 20 drops of essence of peppermint taken either on a lump of sugar or in a teaspoonful of sugar, and chewed slowly; or a teaspoonful or two of iced creme de men the, or other liqueur or brandy, sipped slowly; or a little wine such as sherry. 

For nausea or cramping, tincture of belladonna is helpful. Adults require 15 to 20 drops in water. Each person must find his proper dosage. Usually, an effective amount will cause some dryness of the mouth or slight blurring of vision. The dosage can be repeated in four to six hours. For more intense abdominal cramps, one to two teaspoonsful of paregoric may be used (see Appendicitis, page 531). 

Lomotil, two tablets four times a day, is prescribed by many physicians for tourist cramps and other gastrointestinal complaints. A persistent "nervous" stomach may be helped by mild sedatives such as phenobarbital, especially if given in combination with tincture of belladonna. However, this medication should be prescribed only by a physician. Aspirin, taken for headache, cold, or rheumatism, sometimes produces stomach distress. 

Stomach and health problems- Digestive system

The one problem:

The stomach wound refused to heal completely. St. Martin refused any kind of operation that might close the stomach wall, preferring instead to get along with bandages in place of an intact wall. He did get along remarkably well, and cooperated with Beaumont, who decided to take advantage of the unfortunate situation to make some observations. It was this work that led to the isolation of hydro- chloric acid in the stomach. And from it came many other findings. Beaumont was able to note, for example, that the stomach became flushed with blood when St. Martin became angry and that it also moved about with considerable energy during anger.

Organic diseases-including ulcer, cancer, virus infection, food poisoning, and many otherscan, of course, affect the digestive system. You can protect the digestive system by taking many simple, sensible pre- cautions. For one thing, you can be sensible about the food you eat. If you know that some particular food does not agree with you, you should avoid it. If you happen to be a person with a sensitive colon, it may be that raw vegetables or fresh fruits trouble you. Some people are bothered unduly by such gas-forming foods as radishes, cabbage, cucumbers, and eggs. 

Alcoholic beverages may cause great difficulties for some sensitive people, leading to diarrhea or cramps in some and belching in others. Excessive smoking can upset the stomach.

The list of possible trouble- makers is long; individual sensitivities vary greatly. You need to, and can, be your own "alimentary tract detective." You should, of course, eat a balanced diet. Since such a diet will contain well-proportioned amounts of proteins, carbohydrates, and fats, without an excess of any, it will put less of a strain on anyone particular digestive function. 

Avoid rapid eating; the stomach works overtime in trying to handle a meal you did not take time to eat properly-and it may start sending out distress signals. None of us can be entirely free of tension. We're all subject on occasion to "nerves." But we can see to it that we make mealtime a reason- ably pleasant, relaxed time, as an aid to both enjoyment of food and its better digestion.