CALORIE CONTENT OF FOODS AND BEVERAGES - Weight Control - Weight Loss

FOODS AND BEVERAGES 1000S

 Soup Bouillon or consommé Cream soups Split-pea soup Vegetable-beef or chicken Tomato Chicken noodle Clam chowder Meat and fish Beef steak Roast beef Ground beef Roast leg of lamb Rib lamb chop Loin pork chop Ham, smoked or boiled Bacon frankfurter Tongue, kidney Chicken Turkey Salami Bologna Veal cutlet (un-breaded) Hamburger patty (regular ground beef) Beef liver, fried Bluefish, baked Fish sticks, breaded (including fat for frying) Tuna fish, canned, drained Salmon, drained Sardines, drained Shrimp, canned Trout Fish (cod, haddock, mackerel, halibut, whitefish, broiled or baked)

 Whole lobster Vegetables Asparagus Beans, green kidney lima Beets Broccoli Cabbage, raw cooked Carrots, sweet white potato chips Radishes Spinach Squash, summer winter Tomatoes, raw canned or cooked fruits Apple Applesauce, unsweetened sweetened Apricot, raw canned or dried Avocado Banana Cantaloupe Cherries, fresh canned, syrup Cranberry sauce Fruit cocktail, canned Grapefruit Olives Orange Peach, fresh canned, syrup Pear, fresh canned, syrup Pineapple, canned (with syrup) Plums, fresh canned, syrup Prunes, cooked with sugar Raisins, dried Tangerine cereal, bread, and crackers.  

      

 Building general Health as Preventive Therapy Weight Control

CALORIE CONTENT OF FOODS AND BEVERAGES 

Cereal, bread, and crackers Farina, cooked Oatmeal, cooked Rice, cooked Macaroni or spaghetti, cooked Egg noodles, cooked Flour Bread, white, rye, or whole wheat Ry-Krisp Saltine Ritz cracker Biscuit Hard roll Pancakes Waffles Bun-cinnamon with raisins Danish pastry Muffin Dairy products Whole milk Evaporated milk Skim milk Buttermilk (from skim milk) Light cream, sweet or sour 

Heavy cream Yoghurt Whipped cream Ice cream Cottage cheese Cheese Butter Egg, plain fried or scrambled Cake and other desserts Chocolate layer cake Angel cake Sponge cake Fruit pie Cream pie Lemon meringue pie Chocolate pudding  Fruit ice Doughnut, plain Brownie Cookie.

CALORIE COUNT - Weight Control - What Food to take? How ?Much Food to take?

Weight Control  

 CALORIE COUNT 

How do you determine the proper calorie level per day for you? Your physician can help, taking into account your present weight, desired weight, state of health, and normal activities. He may suggest perhaps as few as 1,200 calories per day if you are an adult woman, 1,500 to 1,800 if you are an adult man. These levels are about half those of non-dieters. 

Within these limits, you can diet reasonably happily on a wide variety of foods and obtain all essential nutrients. Or your physician may suggest a reduction of intake level by as little as 300 or 400 calories. It is usually not considered wise to depend upon a reduction of less than 300 or 400, since one or two miscalculations or indulgences may mean no weight loss at all.

Remember that the objective is permanent weight loss, not a flashy quick cut down, promptly followed by a return of the excess pounds. So what if it takes several months or even a year to reach your ideal weight -as long as you will be using a tolerable diet, one you can sustain, retraining you’re eating habits so you can enjoy the new habits and the desired weight level for the rest of your life. 

Always remember that only one-half pound of weight loss per week means 26 pounds for the year, and 1 pound a week means over 50 pounds lost. In setting up your diet, your physician most likely will move in the direction of a little of everything, to assure balance and variety.

He will make certain you get something from each of the four basic food groups (see page 49). He will be thinking in terms not merely of reducing but of general health, of reducing without risk of malnutrition or risk of fomenting heart disease. 

As an example, sample menus for 1,200 calories a day diet might go like this: 

Breakfast: 1/2 small grapefruit; 1 poached egg; 1 slice of toast; 1 small pat of butter or margarine; coffee or tea. 

Lunch: A 3-ounce cooked serving of lean meat, poultry, or fish; 1 serving of vegetable; 1 serving of fruit; 1 slice of bread; 1 small pat of butter or margarine; 1 glass of skim milk. 

Dinner: A large broiled beef patty; 1/2 cup of asparagus; 1/2 to 1 cup of tossed green salad with vinegar dressing; 1 slice of bread; 1 small pat of butter or margarine; 1/2 cup of pineapple; 1 glass of skim milk. Snacks, if desired, may consist of bouillon or consommé, tomato juice, raw vegetables, coffee or tea, or food saved from meals. 

You may find it convenient to use a mini-pocketbook calorie counter available in pharmacies and food stores. 

For your general guidance, the table lists the calorie content of many commonly used foods   

Exercises for weight control

THE EXERCISE FACTOR

 For years, the role of exercise in reducing has been misinterpreted. Today, regular exercise is known to be essential for maintaining good health and preventing many diseases as well as being a vital adjunct to dirt for weight control. As some put it, diet is half the battle for weight control; it helps you on your way. Exercise provides the vitality and the drive; it helps take you where you want to go. There are still two widely prevalent misconceptions about exercise and weight control.

 One is that it takes great amounts of time and effort to use up enough calories to affect weight significantly. The other is that exercise increases the appetite and the end result is increase, not decrease, in weight. The misconception about time and effort stems from the impression that any exercise has to be accomplished in a single uninterrupted session. To be sure, it takes an hour's jogging to use up 900 calories, but one does not have to do all the jogging in one stretch. 

One must walk 35 miles to lose a pound of fat, but walking an additional mile a day for 35 days will take off the pound.

One can lose 10 pounds in a year by walking an extra mile a day. In one dramatic demonstration of the value of exercise, the daily food intake of a group of university students was doubled, from 3,000 calories daily to 6,000. At the same time, exercise each day was stepped up. 

There was no gain in weight. 68 / Building General Health as Preventive Therapy Another fact about exercise that deserves consideration: Body weight affects the amount of energy expended whatever the activity may be -walking, jogging, tennis playing, or anything else. For example, a 100- pound individual walking 3 miles per hour will burn about 50 calories in 15 minutes; someone weighing 200 pounds would use up as many as 80 calories in the same period. 

Weight reduction

IS A DOCTOR NECESSARY? 

Weight reduction on a sound basis calls for the special knowledge of a physician. He will make certain that you do not lose your health while losing excess weight; that you do not reduce too rapidly and thereby put a strain on your heart and circulation; that you do not find yourself with a cosmetic problem because you have lost weight but have not regained skin tone and end up with flabby masses of pendulous skin. He will suggest proper exercise. 

He will also prescribe vitamins, minerals, and other substances, if necessary, to prevent weakening of bones and organs and to maintain resistance to disease. For example, if you use a "no-calorie" salad dressing made of mineral oil, your doctor may want you to take some vitamins, because mineral oil lends to prevent adequate absorption of some of the vitamins your diet would ordinarily provide. Moreover, it helps considerably if you can have your diet suitably adjusted to your eating habits.

You may be one of those who will be miserable if deprived of a bedtime snack. You may prefer a substantial dinner and be willing to cut down on lunch to have it. A physician can help you establish a sound diet and one best suited to your needs. He may, if necessary, prescribe sedatives for your use during the toughest phase of dieting; the psychological aspects of a relationship with a sympathetic, encouraging physician also can be of great importance during dieting and later on in maintaining low weight. A doctor's encouragement and praise of a patient's efforts in reducing, we have found, can be of major value.

PILLS AS PROPS

 Should you take drugs to reduce? Without a doctor's supervision, never. If, in an individual case, a physician feels that an anti-appetite drug as a temporary prop is justifiable, he will prescribe it-and it should be taken exactly as prescribed. Most physicians, however, prefer to have a patient Weight Control / 67 rely on willpower and determination rather than on drugs and to adjust the diet so this is feasible. In the past, medicines for weight reduction generally were based on amphetamine and so stimulated patients that physicians were reluctant to use them. Now, a number of appetite-reducing agents are available, free of the side effect of overstimulation.

These apparently safer agents are available only on prescription. Over-the-counter reducing preparations are big business. At worst, they can be risky business because of the possibility of side effects; at best, the money is foolishly spent because in and of them the medicines are not to be relied upon for effective permanent weight reduction. The problem with even safe reducing agents is that they are only supports that help temporarily. 

It makes much more sense-s-and has far greater chance of permanent success-to regulate your diet by a healthy change in eating habits which, once desired weight reduction is achieved, can be continued with some upward shift in calorie intake, to maintain you at proper weight. 

DOES THIS MEAN YOU? 

By definition, an obese person is anyone who weighs 30 percent or more over what he or she should weigh. Even if you are not that much over- weight, it can be important to lose the first 10 pounds or so of excess, because the chances are that if you are overweight at all, you will gain Weight Control / 6 more in the future, and it is easier to lose 10 pounds than 20, 30, 50, or 100. Usually, your mirror provides you with a fairly good clue about whether you are too heavy. You can consult the accompanying table to determine whether your eyes have deceived you.

DESIRABLE WEIGHTS FOR MEN AND WOMEN    

Weight in pounds, according to frame, as ordinarily dressed, including shoes

HEIGHT                                                                

(WITH SHOES ON)                                                           

FT. IN.   SMALL FRAME                   MEDIUM FRAME              LARGE FRAME

                                                Men                     

5              2              116-125                                124-133                131-142

5              3              119-128                                127-136                133-144

5              4              122-132                                130-140                137-149

5              5              126-136                                134-144                141-153

5              6              129-139                                137-147                145-157

5              7              133-143                                141-151                149-162

5              8              136-147                                145-160                153-166

5              9              140-151                                149-160                157-170

5              10           144-155                                153-164                161-175

5              11           148-164                                157-168                165-180

6              0              152-164                                161-173                169-185

6              1              157-169                                166-178                174-190

6              2              163-175                                171-184                179-196

6              3              168-180                                176-189                184-202

                                                Women                               

4              11           104-111                                110-118                117-127

5              0              105-113                                112-120                119-129

5              1              107-115                                114-122                121-131

5              2              110-118                                117-125                124-135

5              3              113-121                                120-128                127-138

5              4              116-125                                124-132                131-142

5              5              119-128                                127-135                133-145

5              6              123-132                                130-140                138-150

5              7              126-136                                134-144                142-154

5              8              129-139                                137-147                145-158

5              9              133-143                                141-151                149-162

5              10           136-147                                145-155                152-166

5              11           139-150                                148-158                155-169

You will note that this table, unlike some others, gives desirable rather than average weights. Average people tend to become fat with the passing of the years, and this is not desirable. Average weight tables reflect the fatties who make up the upper part of the average. Note that in each ural weight group there is an allowance or range of about 10 pounds. If you have lost or gained a few pounds outside the limits for your height and frame, discuss the matter with your physician at the next visit.

 If you vary 15 or more pounds from the limits, make an appointment for an immediate checkup. There are several simple tests, too, by which you can assess your actual fatness. One, the ruler test, is based on the fact that if there is no excess of fat, the abdominal surface between the flare of the ribs and front of the pelvis normally is flat. If you lie flat on your back and place a ruler on the abdomen, along the midline of the body, it should not point upward at the midsection. 

If it does, you need to slim down. The skinfold, or pinch, test simply calls for grasping a "pinch" of skin with thumb and forefinger-at your waist, stomach, upper arm, but- tocks, and calf. At least half of body fat is directly under the skin. Generally, the layer beneath the skin-which is what you measure with the pinch since only the fat, not muscle, pinches-should be between one-fourth and one-half inch. Since, with your pinch, you are getting a double thickness, it normally should be one-half to one inch.

A fold much greater than one inch indicates excess body fatness- one much thinner than half an inch indicates abnormal thinness.

GLANDULAR VERSUS ORDINARY OVERWEIGHT Some 50 years ago, when hormones were discovered, there was a common notion that obesity must be due to some hormone problem. When this turned out to be rarely the case, there was a shift to the idea that obesity is never due to hormonal disturbances but is always the result of overeating. Today, some physicians think that the reasonable view is that to become obese it is always necessary to eat more than you need for the energy you expend, and how often this may be due to some shift in hormone functioning, even within the so-called normal range of such functioning, is simply unknown.

What is known is that in those relatively few cases where a hormone problem can be detected and corrected, it is most commonly the thyroid gland that is at fault. Located at the side and in front of the windpipe, just below the" Adam's apple," the one-ounce thyroid gland acts some- what like a thermostat, regulating the rate at which body organs function and the speed with which the body uses food. With an overactive thyroid, body functions speed up noticeably. 

There may be a perceptibly faster heartbeat, nervousness, difficulty in sleeping at night, and weight loss. With an underactive thyroid producing inadequate amounts of thyroid hormone, there is a tendency to be lethargic and to gain weight. When thyroid dysfunction is suspected in an overweight person (or anyone else, there are tests-basal metabolism and others-that can determine whether, in fact, there is a problem. If under activity is established

VEGETARIAN DIETS AND NATURAL FOODS

VEGETARIAN DIETS 

There are three types. The strictest excludes all animal products as well  animal flesh and organs. The second allows use of such animal produce milk, cheese, and eggs. The mildest allows fish and shellfish in.

Some people adhere to them and may be lean, but there is no scientifically discernible special virtue in vegetarian diets. There are vegetarians who attribute their long life and healthy old age to their diet, but there are equally healthy old people who credit daily meat eating. One possible hazard in vegetarian diets, particularly the strictest, may be lack of sufficient protein. We learned recently of a 78-year-old physician-patient who developed a huge enlargement of the liver, estimated to weigh 15 pounds instead of the usual 3. Biopsy showed cirrhosis.

 He had never used alcohol but from the age of 10 had never eaten meat and had reduced other sources of the complete proteins (see page 49). Specialists in liver disease who were called in finally concluded that the many years of a diet inadequate in rich, complete proteins had caused damage to the liver. The prescription: beefsteaks, filet mignonette, roast beef. The patient is having the time of his life at meals.

NATURAL FOODS 

Many health food and natural food stores in the country offer a wide range of "unprocessed" or "organic" foods. The foods, for the most part, are good and nutritious. They often cost more than foods available at regular food stores and supermarkets. Claims made in their behalf are that they are grown in soil that has not been impoverished and they are not spoiled by processing. As arguing against the idea, that generally available foods are grown in poor soil. nutritionists’ note that commercial agriculture in this country treats soil as a precious commodity and keeps it rich through crop rotation and fertilization.

Even if soils were widely impoverished, they add, this would not necessarily mean that foods grown in them would be nutritionally inferior. Infertile soil may lead to reduced yield per acre but no inferiority in the makeup of the plant grown. Many nutritionists also observe that the nutritive value of a given crop, such as corn or wheat, is influenced more by the kind of seed planted than by the fertility of the soil. 

Thus, corn can be bred to contain more niacin or more starch, tomatoes to contain more vitamin A or vitamin C, through development of new strains and seeds. As for food processing, leading nutritionists argue that commercially canned and frozen foods-in terms of practical nutrition if not of taste -are not inferior to fresh. 

Penicillin overdose side effects! How to avoid it?

A Special Word about Medicine Taking of many people that if a little is good, more is better. With potent agents, excessive dosage can produce real trouble. Similarly, under dosage can cause problems. Inadequate antibiotic dos- age, for example, carries its own risk. One common example is the patient with a "strep" throat who takes penicillin, improves, stops treatment, then gets the sore throat back again.

Once more, he takes some penicillin but not the full prescribed amount. Again the sore throat dis- appears only to recur after a short time. And so a disease that can be eradicated by continued administration of penicillin for eight to ten days is converted into one that drags on with repeated remissions and relapses. Physicians have, in fact, long suspected that many failures of anti- biotic treatment stem simply from failure of patients to keep taking medication as prescribed. A recent study uncovered disturbing evidence that many parents may be risking their children's health by failing to make certain they take their medication as long as necessary.

Actually, in acute "strep" infections, penicillin treatment for 10 days is considered essential to prevent rheumatic fever. Yet in a follow-up of 59 children for whom a 10-day course of penicillin had been prescribed, investigators found that 56 percent of the youngsters had stopped taking the drug by the third day, 71 percent by the sixth day, and 82 percent by the ninth day. When a doctor prescribes medication, the first thing to do is to get the prescription filled immediately. The value may be lessened, or even lost completely, if you delay.

Then follow directions of the doctor to the letter. If you are not certain you understand them, ask him for clarification-even for instructions in writing as to exactly what you are to do. Take all the medicine pre- scribed, not some amount you arbitrarily settle on. Don't decide, if you begin to feel better, that you can stop or reduce dosage. Sometimes, illnesses require several prescriptions. Very much worth noting here is an old principle taught to nurses: read every label three times. You can use that principle to advantage at home. 

How to manage Infections, overdoses, side effects in modern medicine

Friendly bacteria keep under control harmful organisms that also are natives of the digestive tract. When friendly bacteria are killed off in large numbers, there is less competition for the harmful residents and they have a chance to multiply. The result may be super infection-a new and different infection that develops as a result of another's being treated. Again, the super infection is often mild and disappears once antibiotic treatment stops. 

But super infection sometimes can be severe.

What it comes down to is this: use of potent modern medications, not only antibiotics but many others, involves a calculated risk and alertness. Ideally, the physician uses them after careful consideration and upon arriving at the decision that the good to be gained outweighs any risks along the way-and uses them with caution, keeping alert to the earliest indications of any new trouble from the drugs which he may be able to overcome by change of dosage, switch of medication, addition of other medication, or when necessary discontinuance of treatment.

One of the major problems, though, has been the insistence of many patients upon willy-nilly prescription of medication. They may demand penicillin, for example, for a cold or any fever. They have the feeling that a visit to the doctor is not complete unless the doctor "gives" them something. Too often, this has put physicians on the spot; and to please patients, some have prescribed medication against their better judgment.

So far as your own health is concerned, you can do much to preserve it not just by seeking timely medical advice but by taking it-by avoiding insistence upon medications, by indicating to your physician that you are aware of the values and also limitations of medications, the need to use them wisely not indiscriminately, to use them when they are required and not otherwise.

DOSAGE PROBLEMS

A man who took double the prescribed dose of an anticoagulant-a drug that, in effect, acts to thin the blood to prevent clot formation-found himself in the hospital a few days later with severe nosebleedsand vomiting of blood.

 A woman with bronchial asthma was admitted to the hospital with heart palpitations after she had used, contrary to instructions, an isoprenaline (isoproterenol) spray repeatedly for several hours. Another patient, a 29-year-old man, who had decided to take 50 percent' more than his prescribed dose of a cortisone like drug, came- to the hospital with changed personality, considerable weight gain from fluid retention, and other effects. 

How often periodic medical checkups should be carried out?

How often periodic medical checkups should be carried out is best determined by the physician on the basis of what is most suitable for you as an individual rather than on the basis of a general rule. Age is one determinant. The elderly and the very young generally need more frequent examinations than those in between. But other factors must be considered-present state of health, past medical history, family medical history, occupational hazards if any, etc. Your physician will take these into account in deciding what is most appropriate for you -a checkup once a year, or twice a year, or perhaps once in two years.

BETWEEN CHECKUPS Manifestations of illness or impending illness take the form of signs or symptoms, or both. Signs are objective evidence: for example, a change in skin color or the swelling of a body part. Symptoms are subjective: for example, nausea or pain.

They can vary greatly, of course, from mild' and fleeting to severe and persistent. All deserve attention, though it is likely that if they are mild and transient the reason for them is inconsequential. Any persistentor recurring sign or symptom deserves action. Even if mild it should not be ignored. Passing it off as something not worth notice except by a hypochondriac is dangerous.

 You may become so habituated to its presence that you regard it as something "normal" for you-until the underlying problem reaches a stage where it is irreversible or leads to serious consequences. The following discussion is intended to help you interpret the significance of signs andsymptoms that may appear between checkups, as a guide to when to consult your physician without delay. 

How AUTOMATED MULTI-PHASE SCREENING helps to check diseases in health care

One of the relatively recent developments that is almost certain to bring striking changes in the practice of medicine, adding further to the emphasis on and practicality of preventive medicine, is automated multi- phase screening. The idea is to link electronic detection devices, large numbers of chemical tests, and computer science together to screen or check, at low cost, large numbers of apparently healthy people, looking for the most subtle signs of early disease and even of pre-disease states, doing far more routine testing than physicians have time for, providing them with the results of the tests, and giving them more opportunity to counsel patients and practice preventive medicine.

In a periodic checkup that may run two to three hours, a patient moves from one station to another for checks of hearing, visual acuity, respiration rate, lung capacity. An electrocardiogram is made; a measurement of pressure within the eye is quickly made for detection of glaucoma, a major cause of blindness. A chest x-ray is taken and, in the case of women, a three-dimensional breast photograph (mammography). Pulse and blood pressuremeasurements are included. The patient answers a self-administered questionnaire on health history. And blood and urine samples are taken and automatically checked for indications of infection, gout, diabetes, and other diseases and also for a variety of biochemical values that may give some indications of pre disease changes. A computer summarizes the findings and produces a printed record for the patient's personal physician to evaluate. Automated multiphase screening is moving rapidly out of the experimental phase. Much of the pioneering work in its development was done by physicians at the Kaiser Foundation Health Plan in northern California with some financial assistance from the U.S.Public Health Service

The Public Health Service has awarded funds to set up pilot programs in Milwaukee, New Orleans, Brooklyn, and Providence-some affiliated with health centers in poverty areas, others with universities, and still others with city health departments. Already, some large industries are planning automated multiphase screening facilities as part of their occupational health programs. And there are plans for forming medically directed private companies which would provide automated screening service for patients referred by physicians.

Automated screening facilities may not be available in your community yet. Ask your doctor about them. Tell him you are interested. If the facilities are not available, you will be doing a public service by encouraging your doctor to push for their establishment in the near future.

YOUR ROLE

You AS the patient in preventive medicine have a role to play that goes far beyond cooperating in regular checkups. You can build and maintain your health, taking advantage of the latest knowledge in such areas as nutrition, weight control, physical activity, rest and relaxation (to be covered in later sections of this posts). You can be alert, too, between checkups for any danger signals.

How Blood Pressure Determination helps to find and Prevent diseases?

 

Measuring blood pressure is an even more important part of the medical check today than it was in the past. For one thing, we know now how common elevated pressure is, affecting at least 17 million Americans. For another thing, we know now that high blood pressure, or hypertension, is an important factor in stroke, heart disease, and kidney disease. And best of all, hypertension today almost invariably can be controlled. Blood pressure is simply the push of blood against the walls of the arteries. It is highest when the heart contracts and pumps blood into the arteries and this peak pressure is called systolic. It is lowest when the heart relaxes between beats, and this lower pressure is the diastolic.

To measure pressure, a basically simple, though not simply named, device, the sphygmomanometer, is used. It's an inflatable cuff attached to mercury or other type of meter. When the cuff is wrapped around the arm above the elbow and inflated, the inflation does two things: it drives the mercury column up to near the top of the gauge and it compresses an artery in the arm so no blood flows through. With his stethoscope placed on the artery, the physician listens as he gradually lets air out of the cuff. At some point, as the air is released, the pressure of blood in the artery will begin to exceed the pressure of air in the cuff, and the blood will begin to flow again in the artery.

The beginning of flow produces a thudding sound the physician can hear through the stethoscope, and at this point the mercury gauge shows what the systolic pressure is. Then, as more air is released from the cuff there comes a point when the thudding sound no longer can be heard, and at this point the mercury gauge shows the diastolic pressure. It is normal for pressure to vary somewhat from day to day, even minute to minute. It goes up with excitement, which is why in an examination a physician may wish to take your pressure several times. In some people, however, the blood pressure is nearly always higher than it should be. 

Patient History and Physical Examination can be Physician’s tool to Prevent Diseases

Patient History and Physical Examination can be Physician’s tool to Prevent Diseases

One patient who experienced a slight change in urination-dribbling a little during the night- passed it off as a joke, kidding with his wife that somehow, though he was still a young and vigorous man, he had entered second childhood. He had actually developed an enlargement of the prostate gland. A year of delay made the operation he needed more difficult and led to a complication, kidney infection, caused by backing up of urine. In reporting symptoms to the doctor, don't grope for medical words; use simple English. Many diseases have strong psychological aspects, and symptoms may recede the moment you are in the doctor's office. Still, tell the doctor you have the symptoms even though it may seem silly to talk about them when they are not immediately present. You can be certain the doctor will understand the phenomenon.

THE PHYSICAL EXAMINATION 'Even as he shakes hands with you, an alert physician may pick up some clues. Are your hands warm and moist, with a fine tremor? These characteristics may suggest over activity of the thyroidgland. If the hands are cold and the skin is coarse and puffy, the thyroid could be under- active. Red fingertips may signal some abnormal flow of blood in the heart; flushing of the nail beds in time with the heartbeat may indicate another type of heart problem called aortic regurgitation. As he observes the body, the physician can learn a great deal. The color of lips and ears may indicate possible anemia.

The Promise and Nature of Preventive Medicine

 One leg is slightly shorter than the other-enough in some cases to account for a backache problem. He may note leg swellings traceable to a heart problem, and any enlarged glands, tumors, or abnormal pigmentation resulting from internal disease. In his examination, the physician will be looking to see if the body is symmetrical. Lack of symmetry is almost always a sign of some dis- ability or disease. If the left side of the neck looks different from the right, it may be because of a tumor which is pushing out on that side. If the thyroid is not symmetrical, it may be because of a benign tumor which has enlarged one lobe ofthe gland. In the retina at the back of the eyes, small blood vessels-arteries and veins-lie are almost naked, devoid of covering material.

And there, very quickly, with an instrument called the Ophthal-mo-scope, the physician by looking through the pupil of the eye can detect any blood vessel changes which may provide clues to diabetes or kidneydisease. Women need a breast examination for any tenderness, abnormal lump, or nipple discharge. During a vaginal examination, a smear of cells for the "Pap" test is usually taken; this is a test to detect early cancer in the area. Both men and women should have a rectal examination to detect any local disturbances. With an instrument, the Sigmoido-Scope, the physician can see and check the lower portion of the colon for any growths.

As a patient, you can help greatly by insisting that the physician do a thorough inspection, by reassuring him that you have no squeamishness. Some doctors feel that patients’ are resistant to rectal andgenital examination and omit these vitally important checks. 

How a Patient History Can be used in Preventive Health Care? follow 1000 posts

It is not essential that you have a detailed knowledge of modern examining and testing procedures. But some awareness of the basic, long-established methods and tests and the newest x-ray and laboratory tools, and what they can do, will be useful.

THE CASE HISTORY

The patient's history, always an invaluable guide in disease diagnosis, is equally valuable in prevention. We have mentioned earlier, in passing, some of the reasons. Occupational data-facts about the work you do and possibly the circumstances under which you do it-may reveal some hazards, physical or psychological, to which you are exposed. An account of family health-the illnesses of parents and grandparents, their longevity, the state of health of brothers and sisters-can provide clues to hereditary strengths and weaknesses.

Your own past illnesses are 'an. important part of the record. Some childhood episodes of illness, if severe, may have left a mark. Rheumatic fever, for example, may strike a child at 15 or earlier and may produce some heart damage. Yet, very often, the effects of the heart damage are not felt until age 35, 40, or even later. A record of the rheumatic fever incident may be of vital importance in accurate diagnosis of a heart condition. 

The case history-which includes what the patient reports about present problems-sometimes, provides the first indication of onset of a serious illness. For example, angina pectoris (chest pain) is associated with coronary heart disease. In coronary heart disease, the coronary arteries feeding the heart muscle become narrowed. There are sophisticated techniques now-including x-ray movies of the coronary arteries -to show up the narrowing. But in some early cases, angina may occur before there are sufficient changes to show up on the x-ray studies.

If in taking the history the physician determines that there have been angina episodes-perhaps after some sudden unusual exertion, perhaps upon leaving the house on a particularly cold morning-he can confirm the anginadiagnosis by giving the patient some nitroglycerin tablets to take when the next incident occurs; and if there is immediate relief of pain, the diagnosis is virtually 99.9 percent certain. During history taking, be accurate, don't make wild guesses, but do report things you may think are only minor, like a sense of just not feeling well. It's important to indicate any change because it may be an early warning of something potentially serious. 

DISEASE SCENARIOS in body care, and how to cure or prevent it? 1000 posts following

Bacterial diseases and preventive medical care

In Preventive medical care new discoveries and inventions make great changes in the human life.
Another important development has been the discovery that death is really a slow intruder, that diseases do not suddenly spring up full-blown but often have long scenarios. In the Korean War, autopsies of young American soldiers revealed that in 54 percent of these youths, many of whom had only very recently attained manhood, coronary heart disease was already starting. We see- of the disease germinate in the early years and the ultimate heart attack is the end result of a long process in time, then here is a problem that can be combatted, for there is time to combat it. And there is evidence of what factors are involved, there are mere to fight; to retard, and perhaps even to prevent it from getting started Some of the most impressive preventive work recently has been the result of advances in the understanding of body chemistry-and of chemical abnormalities that may be inborn. It has now become possible to detect early in life, even almost immediately after birth, such inborn errors as phenylketonuria and galactosemia.

Detection of diseases

They involve inability to properly handle certain specific food elements, and simply by avoiding such elements it has become possible to prevent development of mental retardation, growth failure, and other serious problems. Understanding of the chemistry of disease is expanding rapidly, and there is growing confidence that the principles of early detection and treatment of diseases due to inborn chemical errors can be extended to many common chronic diseases. That 'can make it possible for the doctor in his practice to have to deal less-with severe complications triggered while a disease smoulders under the surface before calling attention to itself with obvious symptoms, and he can be concerned instead with The early detection of the still symptom-free but predisposed patient and correction of the basic problem before complications have a chance to Develop..

Already, for example, promising work is being done in detecting people with prediabetes-those who have no symptoms of diabetes but do have changes in body chemistry that may forecast eventual onset of overt diabetes. Early results of treating such patients with antidiabetic agents are regarded by some investigators as promising, suggesting it may be possible to prevent the development of diabetes and such complications as visual disturbances, circulatory disturbances, and increased risk of coronary heart disease. As we have noted earlier, kidney machines can be lifesavers for pa- tients with kidney failure-but it would be far 'better to prevent the failure. And there is growing hope now that in many cases failure may be prevented by attention to asymptomatic bacteria.

Bacteria detection

Asymptomatic bacteria simply means the presence of sizable numbers' of bacteria in the urine without causing symptoms. The condition may occur at any age and in either sex but is especially frequent in females, affecting 1.2 percent of schoolgirls and 6 percent of pregnant women. There is ovi- dence that if left untreated bacteria may eventually cause the kidney disease pyelonephritis, which in turn may result in kidney failure. Bacteria can be treated effectively once detected, and newer tests now make its detection simpler and more practical. Today, as the next chapter will show, many testing procedures are available to make it possible for the physician increasingly to anticipate and prevent disca rather than wait for it to appear.