Infections and preventive methods

All fruits and vegetables should be washed and scrubbed. In suspect areas, travelers should eat only cooked foods and use only milk known to be pasteurized. You may be asking, "Why all this fuss about a disease I have hardly heard about?" Consider this one fact about amebiasis: in some forms, it has a fatality rate of 40 percent. 

Your life, if you become infected, is only as good as a 6 to 4 bet; not very good odds. In addition, if an acute attack is survived, there may be serious, chronic complications. Fortunately, treatment has been improving, and today, when the best available treatment is applied promptly and vigorously, the fatality rate can be reduced to less than 5 percent. How is the disease recognized? In the tropics, it will usually start as full- blown amebic dysentery, with up to 25 bowel movements a day, and with stools often containing blood and bits of mucus.

The patient may feel slightly feverish and will soon be weakened by the abdominal distress and dehydration. In this country and other temperate zone countries, there is rarely such extreme diarrhea; and the combination of abdominal distress, diarrhea alternating with constipation, fatigue, slight fever, and vague aches and pains throughout the body may be passed off as "colitis," "irritable colon," or "upset stomach." In some persons, symptoms are so mild that they do not see a doctor for treatment and unknowingly become carriers of the amebic organisms.

Another problem in diagnosing the disease arises from the increasing numbers of Americans who take short winter vacations in semitropical and tropical countries. If a vacationer develops diarrhea and other intestinal symptoms, he is not eager to consult a doctor in a strange country. He also does not want to interrupt his brief holiday. So he doses himself with Lomotil, paregoric, or anything else he has brought along for "tourists' diarrhea." When he returns home, he plunges into work. Thus, the diagnosis of amebiasis may be missed, and the best time to treat it lost; later, there may be dangerous spread of infection in the body, making for treatment problems.

To be sure, most cases of diarrhea during vacations are the relatively harmless tourists' diarrhea. But we strongly advise anyone who develops diarrhea in a semitropical or tropical country to tell his physician about it promptly upon return home or, if the stay is to be more than the usual brief vacation, to consult a local doctor (you can usually find a competent physician by calling the nearest American consul and asking for the name of his doctor). 

When there are symptoms suggestive of amebiasis, your physician will rarely start treatment until a precise diagnosis is made. That means finding the amebic organisms in the stool. Unfortunately, locating the organisms is not always simple; and some physicians who have devoted themselves to the study of this disease will not exclude the diagnosis of amebiasis until six stools, including one passed after a saline purge, have been judged negative by a competent diagnostic laboratory. 

Infections and diseases through Cuts, Wounds, and Scratches

Cuts, Wounds, and Scratches

Because these are potential portals -of entry for infectious organisms, they should be washed promptly with soap and water and covered with sterile gauze; a Band-Aid will do if the cut is small. Any cut that penetrates deeply may heal better if sewn together. If in doubt, let your doctor or the nearest hospital emergency room decides for you; otherwise you may blame yourself later for an unsightly scar. 

A serious danger from wounds and deep scratches is tetanus, or lock- jaw. The tetanus germ is commonly found in soil and wherever there are horses, cattle, and manure. It is also found in the dust of city streets. A deep puncture by a nail can be serious. Although many people think it is the rust on a nail that may cause trouble, this is not true; it's the germs on the nail that constitute the danger. The best preventive measure for tetanus is immunization.

Tetanus toxoid provides immunity for several years. For anyone who has not been so immunized, a deep wound or scratch calls for use of tetanus anti- toxin (TAT) as an emergency measure to prevent tetanus. It is available in hospital emergency rooms, infirmaries, and first-aid stations. While T AT provides protection, it does cause unpleasant reactions in some people, and doctors will test the patient for possible sensitivity to the horse serum with which TAT is made.

Tetanus toxoid does not produce unpleasant reactions, another reason why you should take this important safety measure in advance of any possible accident. Take Reasonable Precautions We hope that this chapter motivates you-through understanding rather than just admonition-to take sensible precautions against infection. Make it a way of life simply not to drink out of glasses, eat out of dishes, or use the towels that others have used; to stay, as much as possible, away from sneezers and coughers; and to keep yourself and your home fastidiously clean. 

There is no need to go to extremes, to become a fanatic on the subject of germs. Some people do, devoting themselves to almost constant scrubbing, boiling, sterilizing of food, home, and their own person. They spray their noses and throats and the air about them with antiseptics, shun others, wage a constant battle against contamination. This is neither necessary nor effective. It is unnecessary because, where germs are concerned, the odds favor us. Most organisms are harmless. 

Insect Bites - Animal Bites causes infections and diseases

Insect Bites

An insect bite produces a small puncture in the skin, and infection may be introduced when the insect carries organisms in its mouth or excrement. Tick fever, or Rocky Mountain spotted fever, which is similar to European typhus fever, is transmitted by the bites of ticks. In Mexico and southern United States, a type more closely related to European typhus is transmitted by lice, ticks, and mites living on rats. 

Malaria and yellow fever are carried by certain mosquitoes. While most of the United States is free of malaria, in parts of the South it has not yet been eliminated completely through destruction of mosquitoes chemically or elimination of stagnant ponds and other places where the mosquitoes breed. If you live in or visit such areas where malaria may be a threat, protect yourself against mosquitoes with a repellent salve, make certain that screening is adequate, and if necessary use mosquito netting over the bed at night. 

You can be immunized against yellow fever, and although the disease has been eliminated in much of the world, immunization is worthwhile if, for example, you travel to parts of South America or Africa which are near jungles where the yellow fever mosquito still flourishes.

 Animal Bites

Any animal bite that penetrates the skin should be thoroughly washed with soap and water and treated by a physician. Rabies, or hydrophobia, a viral disease affecting brain and nervous system, is transmitted by the bite of dogs and other domestic and wild animals harboring the virus in saliva. If possible, a biting dog should be caught and studied by the health department.

 If the dog is infected, or if it dies within 10 to 14 days, the bitten person must receive Pasteur treatment or the new serum to prevent rabies, which is a 100 percent fatal disease. If the bite is on the head, neck, or face, treatment should be started at once, without waiting to see if the dog dies, since the virus, when introduced at these sites, can reach the brain quickly.

The rabies virus travels along nerves to the brain, so the farther away the bite the longer the trip to the brain. In bites on the foot, it has taken as long as a year for rabies to develop. Unless the dog is caught and found to be free from the disease, Pasteur treatment or the new serum must be given. All warm-blooded pets-cats, dogs, monkeys-now can be vaccinated periodically against rabies by a veterinarian. 

No pet owner should neglect this precautionary measure. If a dog must be shot because of viciousness, it should be shot in the body so the undamaged brain can be studied in a health department or police laboratory. Any dog that is acting queerly should be examined by a veterinarian. 

sulfa medicines- infections- medication

 Another major development was the introduction of sulfa medicines, powerful anti-germ agents. The first of the modern antibiotic compounds, penicillin, came into general use only after World War II. Today, available antibiotics include more than half a dozen types of penicillin plus streptomycin, neomycin, bacitracin, and erythromycin- all considered "specific-target" in the sense that they have powerful effects against a limited range of disease-causing organisms. 

In addition, there are broad-spectrum antibiotics, so called because they combat a wide range of bacteria. Broad-spectrum agents include chloramphenicol, chlortetracycline, tetracycline, and oxytetracycline.

Antibiotics work in two ways. Some, like penicillin, actually destroy organisms. Others are bacteriostatic; they hold bacteria in check without actually killing them. The bacteriostatic compounds prevent the entrance of some essential element, such as iron, into the metabolic processes that maintain growth and reproduction of bacterial cells. 

The bacteria do not die, but they no longer divide and multiply. If antibiotic treatment is stopped too soon, organisms may resume growth and reproduction. A single bacterium, unchecked, can produce a billion descendants in 24 hours. The bacteriostatic antibiotics are valuable in that, as they hold bacterial populations in check, they give body defenses time to muster and to destroy the germs.

 It's important to understand that different germs may produce similar symptoms-and a boil or sore throat or finger infection that earlier yielded to one kind of antibiotic may, another time, come from another type of bacteria and require another type of antibiotic.

 Clearly, you should not try to medicate yourself. Let your doctor treat the infections in your family, and respect him if he is not in a rush to use an antibiotic. He may judge it wiser to give the body a chance to throw off an infection, as it often can, or to wait until he can establish exactly what the problem is and then pick the right antibiotic for it. Indiscriminate use of antibiotics, like indiscriminate use of any potent medication, can be dangerous, leading to undesirable side effects and to failure to hit the actual germs causing trouble, thus adding to problems of body defenses.

When your physician does prescribe medication, follow his directions exactly. 

Remember that just because you begin to feel better does not mean that the medication should be discontinued or the dosage reduced unless your physician specifically so directs. A few more days of treatment, or even just one more day, may be essential to control infection. When your physician suggests that treatment stop, then stop, and do not use any remaining pills except under his advice. In most cases, leftover medication is best thrown away. When antibiotics are thoughtfully prescribed and intelligently taken, you need have no fear of using them. 50 used, when they really need to be used, these substances often turn out to be wonder workers indeed. 

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 PHARYNX (THROAT)- THE LARYNX

THE PHARYNX (THROAT)

From the nasal cavity, air moves into the pharynx, or throat, which ranks as one of the most complex parts of the human body. Seven tubes enter the pharynx: the two from the nasal cavity, called the internal nares; the Eustachian tubes which lead to the ears; the mouth cavity; the opening of the esophagus; and the glottis, the opening of the windpipe. Traffic in the pharynx becomes complex during the eating process. Food and water go down one opening; air must pass through another. 

Fortunately, the traffic control is automatic and things usually go where they should. Tonsils, masses of soft tissue, are located on each side of the pharynx, behind the mouth cavity.

There is also tonsil tissue at the base of the tongue. And adenoids are tonsil-like masses of tissue that grow on the back wall of the pharynx behind the internal nares. It appears that the function of tonsil tissue is to trap and destroy disease organisms, helping to guard the body against infections that may develop from germs entering through the nose or mouth. 

Tonsils become infected rather easily. In some cases, the tonsils may become so diseased that tonsillitis, sore throat, and other respiratory infections become frequent. Then a physician may recommend tonsil removal, although such removal, once extremely popular, today is not done on a routine basis, but only where there is strict need. Mere enlargement of tonsils is no reason for removal. Tonsils are normally larger in children than in adults. Only when they interfere with breathing and swallowing may it be necessary to remove them because of size.

 Enlarged adenoids may block the openings of the Eustachian tubes and interfere with normal pressure changes in the middle ears, causing dis- comfort and hearing impairment. When enlarged adenoids happen to block the internal nares, they force mouth breathing. Fortunately, adenoid removal, when necessary, is a simple operation.

THE LARYNX 

The larynx, or voice box, is at the top of the windpipe, or trachea, which takes air to the lungs. But while incoming air passes through the boxlike larynx, it is actually air expelled from the lungs that makes voice sounds. In the front of the larynx, two folds of membranes, the vocal cords, areattached and held by tiny cartilages. Muscles attached to the cartilages move the vocal cords, which are made to vibrate by air exhaled from the lungs. 

The vibrations are carried through the air upward into the pharynx, mouth, nasal cavities, and sinuses, which serve as resonating chambers. The greater the force and amount of air from the lungs, the louder the voice. Pitch differences result from variations in the tension on the cords.

The larger the larynx and the longer the cords, the deeper the voice

 The average man's vocal cords are about three fourths of an inch long. Shorter vocal cords give women higher-pitched voices. 

Infections and Radiation Hazards prevention for Industrial workers

Infections

Workers handling cattle may be exposed to undulant fever (brucellosis). Those handling hides may develop anthrax. Slaughter- house workers, as well as farmers, have to guard against tetanus. Dog- pound workers must be wary of rabies. Barbers and beauticians have to guard against ringworm (fungus infection). These are just a few of many infections that may be acquired in various occupations. 

Frequent washing of exposed body areas and the use of gloves provide valuable protection. Cuts, even slight ones, should be washed immediately with soap and water, then treated with the mild form of tincture of iodine or other safe antiseptics. If your job involves the handling of living or dead animals, it is wise to get your physician's advice on the best precautions against specific infections you may face. 

RADIATION HAZARDS

Devices and materials that give off potentially harmful radiation are in increasing use. Fortunately, increasingly effective controls have been developed so workers can be protected. One type of irradiation, x-ray, has been used for years in medicine for viewing internal body structures and more recently for treating cancer and certain other problems. The same rays, however, if absorbed in excessive dosage, can cause cancer. In industry and in scientific laboratories, where x-rays may be used for quality control and other purposes, they must be carefully monitored and controlled; so, too, other types of radiation which can be harmful. It is possible for an individual to receive an excessive amount of radiation, as from atomic fallout, without being aware of it for years.

Effect On Genes

The effects on his genes, which control heredity, may not affect him at all but may seriously damage his children. X-rays, radium, and other radioactive substances emit different types of radiation which require different types of protection. These are some of the ways you can be protected if your job requires working with or near radioactive materials: Film badge: This widely used personal protective device measures the amount of radiation to which you are exposed. It is developed regularly and the type and energy of the radiating source can be determined. Dosimeter: Of the many kinds of dosimeters, the most common is a pocket-type device about the size and shape of a fountain pen. It can be held up to the light, and the user at any time can determine whether he has received a sudden or heavy dose of radiation or is getting close to his maximum allowable exposure. 

THE IRON-DEFICIENCY PROBLEM And the Causes in Our Body system

THE IRON-DEFICIENCY PROBLEM

 A deficiency of iron in the diets of young girls and women is a cause of growing concern. Iron deficiency can produce anemia, and the need for iron is universal. Generally, there is no problem in men, who require only 10 milligrams (1/3,000 of an ounce) of iron a day to maintain adequate body stores. 

But menstruating and pregnant women require 18 milligrams a day, and dietary analyses indicate that many adolescent girls and menstruating women have an iron intake of only 10 milligrams a day. Some studies reveal iron-deficiency anemia in as many as 60 percent of pregnant women. The problem centers around the fact, that overall iron content of foods on the market runs around 10 milligrams for every 2,000 calories.

Thus, unless she is paying particular attention to iron, a woman consuming 2,000 calories a day will not be getting adequate amounts of the mineral. The fact is that 50 to 60 percent of iron in the diet comes from cereals and meats, with nearly equal contributions from each, but the proportion of cereals and meats consumed by women varies widely. 

Whenever weight is a problem, too, the tendency is to reduce consumption of cereal products. Most meats provide 2 to 3 milligrams of iron per 3-ounce serving. Dry beans and nuts provide about 5 milligrams per cup. Most leafy green vegetables contain from 1 to 4 milligrams per cup.

Egg yolk, whole grain and enriched bread, potatoes, oysters, dried fruits, and peas are other good sources. There are on the market a number of prepared breakfast foods fortified with high levels of iron; some provide 8 to 10 milligrams per one-ounce serving. The use of iron-fortified food items when necessary to achieve adequate iron intake can be an important aid to health. For some women with high iron requirements-during pregnancy or because of abnormal menstrual losses-physicians may need to prescribe supplemental iron preparations.

HOW MUCH TO EAT - A word about food

FOOD CAUSES

It is better to eat no more than eighty per cent of your capacity. A Japanese proverb has it that eight parts of a full stomach  ache sustain the man; the other two sustain the doctor."

So one of the Zen masters is quoted in the book Three Pillars of Zen (Beacon Press, Boston, 1967)

The advice is relevant. That Americans generally consume too many calories for the amount of physical energy they expend is a matter of record and of increasing concern as the energy expenditure tapers off even more. Every five years, the National Research Council, which serves as scientific adviser to the United States government, publishes recommended dietary allowances.

After recommending, in 1963, a cut of 100 calories per day for men and women, it recommended another 100-calorie reduction in 1968. In its calculations, the Council uses a "reference" man and woman-each 22 years old, weighing 154 pounds and 127 pounds respectively, living in a mean temperature of 68 degrees, and engaging in light physical activity. 

Such a man, the Council now figures, needs 2,800 calories a day; the woman 2,000. The Council also recommends that caloric intake be cut below these levels with age-by 5 percent between ages 22 and 35, by 3 percent in each decade between 35 and 55, and by 5 percent per decade from 55 to 75.

This brings the figure for the woman, for example, to 1,900 by age 35, to 1,843 by age 45, to 1,788 by age 55, to 1,699 at 65 and to 1,614 at 75. These, of course, are general guidelines, leaving room for individual variations, and your physician may well have suggestions of value for you. It is a measure of good health, and a contribution toward maintaining it, to reach and keep a desirable weight. 

For that, an effective balance between food intake and energy output is needed. If you are currently at ideal weight (see table on page 61), your intake and output are in balance---which is fine if you are getting adequate amounts of exercise. Exercise, of right kind and in adequate amounts, is a vital element in health for many reasons (see Chapter 8). If you should need to increase your physical activity, you will need to increase intake to maintain desirable weight.

Administering Drugs with care - Preventive adverse and side effects

First read the label when you take the drug container from the medicine cabinet; read it again when you take the drug itself; and finally, read the label a third time when you put the container away. That last reading is an extra check to make certain you read the label properly the first two times. If you did happen to make a mistake, you have a chance to do something about it at once.

  

TRICKS FOR PROPER DOSAGE made by machines that produce attractive roundedness

 For the most part, are more attractive-looking and less expensive than those that were made individually by a druggist to a special prescription of a physician. The trouble with machine-made articles of medicine, as with mass- produced clothes, is that tailoring to each individual's needs cannot be built in. Thus, it's known that the amount of medicine required varies almost directly with the weight of a person.

Most machine-made capsules and pills are made for a standard person of about 150 pounds so they are apt to contain just a bit too much for most women, a bit too little for most men. Doctors have learned how to adjust dosages even with the limitations of machine-made medicines. For example, consider pills of phenobarbital often prescribed for nervousness, tension, headaches with a psychogenic component. Phenobarbital is commonly available in 1/8, 1/4, and 1/2 grain sizes. Suppose phenobarbital in 1/4 grain dosage is prescribed for a woman and it helps her tension but makes her just a bit too forgetful and drowsy to do her work properly.

The doctor tries 1/8 grain, but that doesn't help her tension enough. The solution lies in going back to the 1/4 grain dosage and proper use of a fingernail file. The patient is instructed to consider a tablet as a circle, and to gently file away one fourth of the circle, to get a tablet that is just halfway between 1/8 and 1/4 grain sizes. 

Usually, the patient "plays around" a bit and finds just the right tailor made size for her needs. When it comes to capsules-especially of sleeping medicines such as Nembutal, Seconal, and Amy talit's a help to learn how to take apart a capsule gently and pour out a portion to adjust the dosage to individual needs, then rejoin the capsule.

 Many people find a standard 1-1/2 grain capsule ineffective; on the other hand, when they take two capsules, they may experience hangovers. One full capsule and half of another may be the right dosage. 

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.