Ailments

Strictly speaking, an addiction is a compelling physical and psychological need for a habit-forming chemical substance, without regard for destructive consequences. In recent years, this definition has been expanded to include practically any compulsive behavior, ranging from overexercise and compulsive gambling to shoplifting and sex. There are now more than 200 such addictions that are being addressed by 12-step groups modeled on Alcoholics Anonymous.

An allergy is an exaggerated response by the body's immune system against a normally harmless substance, or allergen. Almost anything can trigger an allergic reaction. Some common allergens are molds, tobacco smoke, certain foods and food additives, insect venom, and chemicals in plants, cosmetics, perfumes, detergents, and soaps.

(Aplastic, hemolytic, iron deficiency, and pernicious anemias)

There are many forms of anemia, the most common blood disorder. All are marked by abnormalities in the number or function of red blood cells, or erythrocytes. These blood cells get their red color from hemoglobin, an iron-rich substance that carries oxygen.

(Abdominal, aortic, and dissecting aneurysms)

An aneurysm is a bulging in the wall of a weakened segment of a blood vessel. The aorta, the body's largest artery, is most often affected, although aneurysms develop also in arteries at the base of the brain and in some of the smaller vessels within the brain.

(Angina pectoris, chest pain, coronary artery disease)

Angina is recurrent chest pain that originates under the breastbone (sternum), often spreading to the neck, jaw, arms, and upper back. The nature of the pain varies, but it is usually described as a sensation of pressure, tightness, heaviness, or choking, and it is often accompanied by shortness of breath. Severe angina may feel like a heart attack, but it is a temporary condition that does not cause permanent damage. It does, however, signal an increased risk of a heart attack.

The appendix is a small, pouch-shaped organ located in the lower right side of the abdomen, where the small intestine empties into the colon. In humans, the appendix has no known function, and generally does not cause problems unless it becomes inflamed, enlarged, and filled with pus -- a condition referred to as appendicitis.

(Infantile autism, pervasive developmental disorder)

Autism is a complex syndrome of childhood in which intellectual growth is uneven and social development is impaired. Common characteristics include unresponsiveness, inability to speak or communicate and understand, refusal to seek or accept physical comforting, and an unusual insistence upon routines. For example, autistic children often make repetitive body movements, and even the most trivial change in their physical environment or routine can provoke rage or extreme anxiety. Some autistic children mimic sounds or develop intelligible speech patterns, and some are mute. About 20 to 40 percent have seizures.

(Backache, back strain, piriformis syndrome, sciatica)

At least 80 percent of all Americans suffer an occasional backache, and for 15 percent, the problem is chronic. The majority of backaches originate in the lumbar spine, between the waist and tailbone, the cervical spine (neck) is the second most common source of pain. Depending upon the cause, the pain may be constant, dull, and centered in one area; or it may be acute or stabbing, and spread from the lower back to the buttocks and legs or from the neck to the jaw and arms.

(Fetororis, halitosis)

Most people cannot smell their own bad breath, but it is all too apparent to others. Among the main causes of unpleasant breath odor, smoking, eating certain foods, and poor denial hygiene are the most common.

Foods and drinks affect the breath either directly or indirectly through the rungs and digestive system. Wine, beer, and other alcoholic beverages leave a residue in the mouth that alters breath odor, and the digestive process produces a somewhat different, sour smell. Foods with relatively high sulfur -- garlic, onions, fish, and meat, for example -- can create a lingering breath odor because, as they are digested, sulfur compounds enter the bloodstream, travel to the lungs, and are exhaled. As the body metabolizes these compounds (in about 12 to 24 hours) the odor disappears.

(Alopecia)

Baldness involves the complete or partial loss of hair, usually on the scalp, but sometimes other places as well. Normally, we shed 50 to 100 hairs every day as part of natural a growth, resting, and renewal process. When a hair is in the resting stage, it loosens gradually from its root and is shed. A few months later, a new hair begins to grow in its place.

(Decubitus Ulcers, Pressure Sores, Trophic Ulcers)

These painful ulcers are a potentially serious problem for anyone who is bedridden, confined to a wheelchair, or lacks sensation because of paralysis or some other condition. If a person does not change position every few hours, either independently or with help, blood flow is reduced wherever there is unrelieved pressure. The result is cell death, skin deterioration, and eventually, the development of pressure sores. Places where bone is close to the skin, such as the heels, hips, and base of the spine, are particularly vulnerable.

Diagnostic Studies and Procedures

A bedsore is usually diagnosed by observation. The first warning sign is an area of redness over a pressure point. The skin there gradually thickens and swells, leading to blisters and open sores. Finally, skin ulcerations develop, sometimes becoming progressively deeper until the bone is exposed. At this stage, osteomyelitis, a serious bone inflammation, is likely to develop.

Medical Treatments

If the source of pressure is identified and corrected at an early stage, bedsores can be treated with special gels, creams, and antibiotics.

More advanced bedsores require debridement to remove the dead tissue. Special gels or 1.5 percent hydrogen peroxide may be applied to speed sloughing, so that the diseased tissue can be lifted away with forceps. Deeper sores require surgical removal of damaged tissue and bone. Skin grafts may be needed to cover large areas.

Alternative Therapies

Severe bedsores always require medical treatment. For milder cases, certain homemade remedies can be used, but special care must be taken to avoid infecting open wounds.

Herbal Medicine. Many herbalists recommend myrrh for bedsores i because of its astringent and antiseptic properties. Before use, however, it should be tested on a small area of skin to make sure that it does not cause further irritation, and it should never be applied to an open sore.

Hydrotherapy. Wet dressings and special whirlpool baths promote the sloughing of dead tissue. Whirlpool baths also facilitate healing by increasing blood flow to the skin.

Naturopathy. Poultices of certain natural substances are recommended for the treatment of weeping sores, but if a wound is deep or infected, a health professional should be consulted. A poultice made of raw, unprocessed honey is said to promote healing. So too is a dressing of papaya pulp or a poultice of grated raw or mashed cooked carrots placed on the sore and changed every two to three hours.

Self-Treatment

To prevent bedsores from developing or from progressing past the initial stages, self-care is fundamental.
If you are the patient, shift positions frequently and be alert to any red or sore spots. If feasible, exercise in bed to maintain muscle tone and good circulation. This helps to prevent not only bedsores but also the formation of clots that can lead to phlebitis, a pulmonary embolism, or other serious complications.

Periodically lift each foot, one at a time, move it in a circle, and flex it I up and down. Then lift each leg in turn, without bending your knee, and hold it up for a count of 10 seconds. As strength increases, hold the legs up for longer periods.

Knee bends can also be performed while lying in bed, by lifting each leg in turn and flexing and straightening the j knee joint. Try to do all of the above exercises four or five times a day, gradually increasing the number of repetitions during each session.

In a wheelchair, use a foam rubber cushion covered with sheepskin and raise your buttocks off the seat periodically. Do not sit for extended periods in the same position.

If you are caring for someone who is unable to move himself, shift the patient every few hours. Keep the skin, clean and dry by washing it thoroughly at least once a day, or more often if the patient is incontinent. Avoid rubbing harshly; gentle sponging with a small amount of soap is best. Pat the skin dry with a soft towel and apply talcum powder where needed. Use a moisturizing lotion to prevent dryness.

Change sheets every day or two, or whenever they are soiled or damp. If the patient eats in bed, make sure that all crumbs and food particles are carefully removed after each meal.

An egg-carton-type of foam rubber pad under the bottom sheet can help relieve pressure. A water bed also can help distribute the body's weight more evenly. Consider using a bed cradle that will keep the covers away from the knees, toes, and heels. For extra protection, sheepskin pads can be used to cushion the heels and elbows, and a larger sheepskin mat can be placed under the buttocks to cushion the hip.

Other Causes of Skin Ulcers

Bacterial infections can lead to skin ulcers, as can varicose veins and other circulatory problems in the legs.

Bell's palsy is a paralysis of the facial muscles that control movement and expression. Each year, about 40.000 Americans develop the condition; most are over 40, although the disorder can occur at any age.
Paralysis, which occurs on one side of the face, is usually temporary. The symptoms include an inability to close one eye plus weakness and lack of muscle tone on the affected side. The face may feel as if it is twisted, and speaking and eating may become difficult. In some cases, one side of the mouth droops and the senses of taste and hearing are impaired. The eye may also become abnormally dry.

(Insect, marine, and snake)

Consequences of venom from poisonous insects, spiders, marine life, and snakes range from minor to life-threatening; anyone who spends time outdoors should be aware of the hazards.

A bleeding emergency, or hemorrhage, is a crisis in which steps must be taken promptly to stop loss of blood before it becomes life threatening. On average, an adult has about 10.5 pints of blood; the loss of even two pints can be fatal.

The body exudes many odors, some of them tolerable, perhaps even agreeable, and others unpleasant. For example, the smell of fresh perspiration usually is not offensive. (That of stale perspireation is, however, because bacteria that live on the skin create malodorous substances in sweat.) Menstrual blood develops a disagreeable odor when exposed to air, and certain foods, especially onions and garlic, as well as alcoholic beverages, can produce a strong and distinctive body odor.

At birth, all babies are somewhat bow-legged because, within the cramped space in the uterus, the legs are likely to fold over each other. This condition is referred to as genu varum in medical parlance. (In Latin, genu means knees and varum means inwardly curved.) In the simplest terms, legs are defined as bowed if, when the ankles touch each other, the unbent knees do not.

(Cystic mastitis, breast syndrome, fibroadenoma, lipoma)

Although women often react with alarm to any change in their breasts, especially the appearance of a lump, most breast problems are benign disorders. Indeed, more than 80 percent of all breast lumps that appear before menopause are not cancerous. Fibrocystic breast syndrome is the most common cause of breast lumps. Some doctors refer to it as a disease, but most now consider it a normal variation of breast tissue that makes it appear lumpy. The condition seems to be an exaggeration of changes that normally occur in the breast each month, due to fluctuations in the female hormones. These changing hormone levels prepare the breasts for milk production by increasing fluid and blood flow.

A bunion is a deformity, or protrusion, of the joint at the base of the big toe, in which there is usually pain, inflammation, and swelling. The big toe appears to be turned inward and may overlap the second toe, and sometimes the third toe as well. The condition is almost always accompanied by inflammation of the nearby bursa, the fluid-filled sac that acts as a cushion between the tendons and bones.

Bursitis is a rheumatic condition that occurs when a bursa becomes inflamed and painful. The bursae are small sacs or pouches at the ends of bones that act as cushions between the bones and muscles, tendons, or skin. They contain a lubricating fluid to eliminate joint friction and maintain smooth movement of muscles over the bones.

(Bradycardia, fibrillation, palpitations, and tachycardia)

Cardiac arrhythmias are characterized by an abnormal series of heartbeats, classified as bradycardia (too slow), tachycardia (too fast), or irregular (erratic). During bradycardia, fainting may occur because the brain does not get enough oxygen. In some forms of tachycardia, such as fibrillation, the rhythm is lost entirely, dissolving into quivering of the heart muscle.

A cavity is an area of decay in a tooth resulting from the interaction between oral bacteria and sugar and other carbohydrates in the mouth. In the course of metabolizing the sugars (and starches transformed into sugar by saliva), the bacteria create an acid that becomes part of a sticky substance known as dental plaque. Plaque clings to the tooth and begins to erode the enamel, producing holes, or cavities. Tooth enamel is the strongest material in the body, but it does not renew itself. As bacteria and the acids they form further penetrate the damaged tooth surface, a cavity enlarges to the point where it invades the dentin -- the bony material inside a tooth.

Chickenpox is a highly contagious childhood disease. About 95 percent of all children have been infected with it before adolescence, most commonly between ages three and nine.

Cholera is an acute intestinal illness caused by a particular strain of the Vibrio cholerae bacterium. Usually, the disorder is mild, but in approximately one case in 10 cholera produces profuse watery diarrhea, vomiting, and leg cramps. These, in turn, cause a rapid loss of body fluids and salts and result in dehydration and shock that, if left untreated, can be fatal.

(Alcoholic, hepatic, and other forms of cirrhosis)

Cirrhosis refers to progressive scarring of the liver, in which fibrous bands and hard nodules replace healthy tissue and reduce normal liver function. This organ, which filters toxic substances from the blood and performs numerous other chemical and metabolic tasks, can function even when a large number of its cells are destroyed, but unchecked cirrhosis is eventually fatal.

A clubfoot is a deformity of the lower leg and foot that occurs during fetal development. Twice as common in males as in females, the abnormality may affect one or both feet. In most cases, the front of the foot turns down and in, and the heel also turns inward. The arch is abnormally high, the ankle joint may be rigid or stiff, and the calf is abnormally small.

Cold sores appear as small, painful blisters around the mouth. They occur usually in groups, with a red ring surrounding each blister, and last for one to three weeks. During this period, the sores fill with fluid, and then crust over, dry up, and disappear.

Colic is a self-limiting condition in which an otherwise healthy baby cries inconsolably for several hours at a time. No one can say with certainty what causes colic, but about 10 percent of all infants develop it. The prolonged crying usually begins a few days after birth, tapers off at two months, and comes to an end at about three months. Crying episodes occur most commonly in the early evening, but they may also take place at other times of the day.

Colon polyps are small benign tumors that grow on the inside walls of the large intestine, usually in or near the rectum. They range in size from a tiny grape to a small plum. Some, known as familial polyposis, are inherited, but the cause of most colon polyps is unknown. They become more common after age 40; most adults eventually develop them.

Conjunctivitis is an inflammation of the conjunctiva, the thin membranes that line the inner surface of the eyelid and cover part of the eyeball. It is commonly known as pink eye because the most obvious symptom is reddening of the affected eye. In addition, the eye usually feels gritty and has a runny discharge. During sleep, the discharge may make the eyelids stick together. Some people also experience intense itching or sensitivity to bright light.

Constipation is a condition marked by infrequent bowel movements of hard feces that are difficult to pass. Straining, rectal bleeding, and a sensation of fullness are common. In some cases, the constipation alternates with diarrhea and it may be accompanied by abdominal cramps, bloating, and gassiness.

Cystic fibrosis, or CF, is an incurable genetic disease characterized by abnormalities of the exocrine and eccrine glands, which secrete sweat, mucus, digestive juices, and other substances. The abnormal glands produce large amounts of thick, sticky mucus that can clog airways, intestines, and other passageways, Progressive blockage of the bronchial lubes often leads to infection, respiratory failure, and death.

Cystitis is an inflammation of the urinary bladder, most often due to a bacterial infection. The irritation of cystitis prompts the bladder nerves to signal a sudden and urgent need to urinate, even though the bladder may be relatively empty. Urination is accompanied often by pain or a burning sensation, and if the infection is severe, only small amounts of urine may pass, usually containing blood. Other possible symptoms include a low-grade fever and pain in the pubic area. Most bladder infections are caused by Escherichia coli, bacteria that normally live in the intestines Chlamydia, a sexually transmitted organism, also causes cystitis. These can invade the bladder through the urethra -- the tube through which urine leaves the body.

If a retina becomes detached from the tissue at the back of the eyeball, it is deprived of its blood supply which is carrying essential oxygen and nutrients. It must be reattached as soon as possible to prevent irreversible loss of sight. Fortunately, advances in repairing minor retinal tears have been preventing the more serious eventuality of complete retinal detachment.

(Diabetes mellitus; Type 1 and Type 2 diabetes)

Diabetes is a chronic metabolic disease in which the body either does not produce or does not fully utilize insulin. As a result, it cannot properly metabolize carbohydrates and, to a lesser extent, protein and fat. Glucose (sugar) builds up in the blood; to rid the body of the excess, the kidneys begin to excrete it in the urine.

Diarrhea, the frequent passage of very loose or watery bowel movements, is a symptom of an underlying disorder, which may have been caused by stress, dietary indiscretion, travelers diarrhea, flu, food poisoning, or any one of numerous conditions. Although most episodes are minor and temporary, a prolonged bout can lead to dehydration and an upset in body chemistry that could be life threatening, especially in children and the elderly.

(vertigo, disequilibrium, lightheadedness)

Vision, touch, hearing, the vestibular system in the inner ear, and multiple areas of the brain all contribute to helping maintain balance and orientation in space. Damage to any of these senses or areas can cause dizziness.

Dry mouth describes any condition in which reduced secretion of the salivary glands results in inadequate saliva, and the saliva that is produced is thicker than normal. Depending on the severity of the problem, a person may have not only dryness in the mouth, but also increased thirst, dry lips, or, in the worst cases, difficulty chewing and swallowing. Taste and smell may be impaired. Because mouth dryness permits more rapid bacterial growth, tooth decay and gum disease are more likely to occur.

Earwax, or cerumen, normally lines the ear canal, a narrow tunnel about one inch long that extends from the outer ear to the eardrum. (This tunnel contains many nerve endings, so that even the slightest touch or pressure can cause discomfort.) Earwax, which is produced by glands in the canal, protects the inside of the ear especially against water. When too much wax accumulates, however, it can cause pain, itching, ringing in the ears (tinnitus), and temporary loss of hearing.

An abnormal accumulation of fluid in body tissues causes a type of swelling called edema. This swelling may be localized, as with ascites (the distended abdomen that develops in cases of liver disease and some types of cancer), or generalized, occurring throughout the body, as with progressive kidney failure. In the early stages of generalized edema, the swelling may not be obvious, but a rapid, seemingly mysterious weight gain may take place.

(Acute and subacute bacterial endocarditis, non-bacterial thrombotic endocarditis)

Endocarditis is an inflammation or infection of the endocardium, the inner lining of the heart valves and chambers, and most often occurs in the valves.

Failure to thrive refers to abnormally slow growth in infants and young children. In general, it describes a child under two years of age who weighs less than 80 percent of the average for children with the same birth weight. The child may also lag in other aspects of development, including speech and motor control. The cause might be organic or nonorganic, but more often it is a mixture of the two.

Fainting is a sudden loss of consciousness, usually brief and preceded by a sense of lightheadedness or dizziness. It represents the body's way of protecting the brain's oxygen supply. When you faint, you involuntarily fall, allowing more blood to flow to the brain.

The human foot is an engineering marvel, made up of 26 bones, 33 joints. 19 muscles, and more than 100 ligaments. Two arches -- a longitudinal one in the midfoot and a short one in the forefoot -- act as bony bridges to support the foot and function as shock absorbers.

Gastroenteritis, the medical term for food poisoning, covers a number of intestinal disorders contracted from contaminated food. Symptoms usually appear within one to six hours after eating, and include nausea, vomiting, abdominal cramps, and diarrhea. The cause can be a bacterium, protozoan, or toxin. This last may occur naturally in certain plants, mushrooms, fish, or shellfish, or it may be a byproduct of improper canning techniques. Outbreaks of food poisoning often happen among people who have eaten contaminated food in a restaurant or at a party or picnic. Staphylococcus or salmonella is frequently the culprit.

A ganglion cyst is a harmless, although annoying, non-cancerous growth that forms directly under the skin. Ganglia usually occur in clusters, on or near tendon sheaths and joint capsules. (These benign growths should not be confused with the cluster of nerve cells that is also referred to as a ganglion.) Formed of the same jellylike substances found in fibrous tissue, ganglia may feel either hard or soft to the touch. A typical ganglion is the size of a pea, but some grow as large as a walnut, especially if they become inflamed.

Aging is the most common cause of hearing loss, but the degree of deficiency varies greatly from person to person and affects men more than women. Presbycusis, a type of sensory-neural hearing loss that is particularly prevalent in the elderly, is due to deterioration of the tiny hair cells that line the cochlea in the inner ear. These cells send electrical sound impulses to the part of the brain where sounds are received and processed. Accidents and exposure to excessive noise can also damage these cells.

Heat exhaustion and heatstroke are medical emergencies brought on by exposure to more heat and humidity than the body can adapt to. Although the two terms are sometimes used interchangeably, they are distinctly different conditions.

Heat exhaustion is caused by dehydration, usually the result of sweating heavily and not consuming adequate replacement fluids. Warning signs include increasing fatigue, weakness, and feelings of anxiety, along with a drenching sweat. As the condition worsens, blood pressure drops, the pulse slows, and the skin becomes pale and clammy. The person could be confused and might faint.

Hemorrhoids are varicose veins in the anal area that cause pain, itching, and bleeding. The three veins that serve the anal area normally expand, or dilate, during bowel movements and shrink afterward. Repeated straining to pass hard stools can result in permanent swelling. The enlarged veins then press on surrounding nerves, thus producing the itchiness and discomfort. They may be located inside or outside the anal opening. External ones tend to be more painful and the internal type bleed more easily. Usually, hemorrhoids are uncomfortable and annoying but not serious. For some people, however, they can cause extreme pain, particularly when defecating. The swollen veins may also rupture and bleed.

Hirsutism is the medical term for excessive hair, or hairiness, particularly in women. When a woman grows hair on her face, trunk, and limbs that is similar to a man's, the condition is called male-pattern hirsutism. Humans appear to be fairly hairless, but in reality we have as many hair follicles as apes. However, most human follicles produce velius hair, which is colorless and fine. Some velius hair, though, is convened into the coarser, more visible terminal hair during puberty, when testosterone -- a male sex hormone -- stimulates its growth. Males produce more testosterone than females, thus, men normally have more visible facial and body hair.

Hypothermia is a life-threatening drop in the body's internal temperature to below 95°F (35°C). this occurs when the body loses heat faster than it can generate it. Although hypothermia is associated usually with prolonged exposure to very cold weather outdoors, most cases actually occur indoors with room temperatures ranging from 50° to 60°F (10° to 15.6°C).

Incontinence, the inability to control the flow of urine, affects about 10 million Americans. Between 10 and 30 percent of people over the age of 65 who are living independently are incontinent, as are more than 50 percent of those who live in nursing homes and other long-term care institutions. The problem, which is more common in women, may be transient or chronic, depending upon its cause.

Indigestion is the general term for an upset stomach that stems from no identifiable cause or physical abnormality. Symptoms typically develop during or soon after eating or drinking, with the most common complaints being stomach pain, a sensation of fullness or bloating in the upper abdomen, gas, and possibly belching. Some people also experience mild nausea and heartburn, a burning sensation accompanied by an acid taste in the mouth.

An ingrown toenail occurs when one side at the top of a nail turns under and cuts into the skin that surrounds it, causing the area to become very sensitive to pressure from a shoe. The nail of the big toe is the one affected most often. If untreated, the tissue around the ingrown nail becomes swollen and inflamed. Continued pressure may also cause small, painful corns to develop in the groove of the nail.

People who are lactose intolerant are unable to digest milk and milk products because they have insufficient amounts of lactase, the enzyme needed for digesting lactose, or milk sugar. Instead of being broken down and converted into glucose, or blood sugar, the lactose remains intact in the intestines, absorbing large amounts of water. This accumulation of fluid stimulates peristalsis, the rhythmic intestinal contractions that move material through the intestines, and results in gas, cramps, and diarrhea. In addition, certain bacteria that inhabit the colon ferment the lactose, leading to an even greater buildup of gas, and the passage of watery, acidic stools.

Laryngitis is an inflammation of the larynx, or voice box, that interferes with speech. Early symptoms include a tickling dry cough, hoarseness, and a sore throat. In more serious cases, a person may have no voice at all, and both swallowing and breathing may also be difficult.

Lead interferes with several viral enzyme activities if it is chronically inhaled or ingested in sufficient quantity to accumulate in the blood Developing fetuses, infants, and young children are most vulnerable to damage from lead; even small amounts can cause harm. Some 2 million preschool children are afflicted by varying degrees of lead poisoning in the United States each year.

Lice are tiny parasitic insects that live on blood. In humans, they infest primarily the scalp, hair, and genital area, but also other parts of the body. The most common types are:

• Head lice (Pedtculus humanus capitis), usually less than 1/8th of an inch long and almost as wide. They are most often spread through direct contact, but can also be picked up by sharing brushes, combs, and other head gear. Schools are a common source of outbreaks because lice spread easily on hats, scarves, and jackets in coat closets.
• Pubic lice (Phfhirus pubis), shorter and fatter than head lice. Their resemblance to tiny crabs, complete with claws, has given rise to their popular name, "crabs." They are usually transmitted by sexual contact.
• Body lice (Pcdiculus human us corporis), longer and thinner than pubic lice. Infestation is common among people who live in crowded, unsanitary conditions.

Macular degeneration entails gradual destruction of the macula, the tissue that makes up the central portion of the retina. It generally strikes the elderly, and among older Americans, it is one of the most common causes of legal blindness.

Malaria is an infectious disease caused by any of four strains -- P. falciparum, P. malariae, P. vivax. and P. ovale -- of the Plasmodium protozoan, a single-cell parasite. Once the parasites enter the body, they travel via the bloodstream to the liver, where they multiply rapidly. After an incubation of one to two weeks, thousands of parasites re-enter the blood, where they destroy red cells. The parasites then invade and destroy red blood cells in regular cycles.

Mastitis is an inflammation of the breast that occurs primarily in nursing mothers, although it can develop as a result of a breast injury. The condition is usually caused by Staphylococcus aureus bacteria, which are ubiquitous in our environment. In healthy people, they generally cause no problems, so long as they remain on the skin. But these organisms can start an infection when they enter the breasts through tiny skin cracks or fissures. Nursing mothers are susceptible because cracked nipples are common during the first month of breast-feeding. Improper nursing techniques or the use of a breast pump increases the risk.

Measles is a highly contagious disease caused by a paramyxovirus. Medically known as rubeola, in the past it was referred to as nine-day measles to distinguish it from the milder, three-day German measles, or rubella. Measles was once exceedingly common during childhood, occurring often in local epidemics. Today, it is rare in most industrialized countries, thanks to widespread immunization during infancy.

(Click Murmur, Floppy Valve, or Balloon Mitral Syndrome)

Mitral valve prolapse is a minor heart defect that prevents the valve linking the two left chambers -- the atrium and ventricle -- from closing properly. After blood receives fresh oxygen in the lungs, it passes into the left atrium, through the mitral valve (shaped like a bishop's miter), into the left ventricle, which pumps it out of the heart into the aorta. In mitral valve prolapse, one or both leaflets -- the flaps that open and close to form the valve -- bulge into the atrium during each heartbeat, and a little blood heading for the ventricle may leak (regurgitate) back into the atrium.

Mononucleosis is a highly contagious disease that strikes mostly adolescents and young adults. It is sometimes called the kissing disease, because it is transmitted by direct contact with saliva or nasal secretions infected with the causative organism -- the Epstein-Barr virus (EBV). However, kissing an infected person is not necessary; mononucleosis is easily transmitted by sharing personal items such as a drinking glass eating utensils, or a toothbrush.

(High-Altitude Sickness; Arebral and Pulmonary Edema)

Mountain sickness develops when the body is unable to adapt to an abrupt increase in altitude. Atmospheric pressure declines with increasing altitude; though the percentage of oxygen in the air remains constant, less oxygen enters the bloodstream through the lungs, to compensate, the heart and lungs work harder and the body gives off more carbon dioxide, which can upset its biochemical balance and cause fluid to accumulate between cells. Symptoms include headache, fatigue, nausea, rapid heartbeat, and breathlessness.

A muscle cramp is a sudden, sharp pain caused by involuntary muscle spasms. These spasms happen most often in the limbs, but they also occur in certain internal organs. Among the more common causes are:

• Inadequate flow of blood to muscles, often resulting from hardening of the arteries (arteriosclerosis).
• Exhaustion and cold, which cause the type of cramps suffered by swimmers.
• Minor muscle injuries that cause spasmodic contractions. Athletes are especially vulnerable.
• Poor posture that strains specific muscles. People who work at poorly designed computer work stations frequently experience muscle cramps in their hands, arms, neck, and shoulders.
• Chronic overuse of certain muscles, such as those of the hand that produce a writer's or tailor's cramp.
• Excessive loss of sodium and perhaps potassium and magnesium.
• Heat cramps caused by profuse sweating during vigorous exercise in hot, humid weather are the most common.
• Unaccustomed pressure on back and leg muscles during pregnancy.
• Pains may also be caused by spasms of the tiny muscles in internal organs. Examples include menstrual cramps, angina due to coronary artery spasms, and cramps related to a spastic colon.

Fingernails and toenails can speak volumes about the state of your health. Inspecting them, a doctor can find important clues to many diseases. Nails themselves also are vulnerable to a host of common, albeit minor, problems -- splitting, hangnails, discoloration, ingrown toenails, and infections, among others. Healthy nails are smooth, shiny, and a somewhat translucent pink. (The visible nail plate is composed of keratin, a hard protein formed in the matrix, which is protected from infection and damage by the cuticle.) The pink color comes from blood vessels in the underlying nail bed; a bluish color indicates inadequate oxygen in the blood.

Nausea and vomiting -- a feeling of queasiness followed by the forcible ejection of the contents of the stomach -- are not themselves disorders, but rather are common symptoms that may signal anything from pregnancy or overindulgence in food or alcohol to poisoning or a life-threatening disease. The two usually, but not always, occur together.

Neck pain, ranging from a steady, dull ache to incapacitating spasms, is a very common complaint, with many causes and manifestations. The pain may originate in any of the neck structures; muscles, ligaments, tendons, and the disks that cushion the seven cervical vertebrae, as well as bony overgrowths and spurs. Or it can originate elsewhere; for example, the shoulders or the temporomandibular joint (TMJ) of the jaw—and radiate to the neck along nerve pathways that serve both areas.

Ovarian cysts are benign growths that form on the ovaries, the two small, almond-shaped organs located on either side of the uterus. There are many different types, but the most common are functional cysts, which develop in the following way:

During the first half of a woman's menstrual cycle, the ovaries increase estrogen secretion, which in turn signals the pituitary gland to release FSH and LH hormones that stimulate the ovaries to ripen one or more eggs. The eggs mature in tiny sacs called follicles, which grow to a size of 1/2 to 1 inch in diameter. During ovulation, the mature egg bursts from its follicle, which is then replaced by the corpus luleum, a structure that secretes the hormone progesterone. Sometimes the egg is not released from the follicle, which then thickens to form a cyst that continues to pump out estrogen.

A cyst may grow as large as an orange, possibly rupture, and cause severe hemorrhaging and pain. More often, the woman experiences abdominal pain and irregular or abnormally heavy menstruation for a few cycles, but the cyst disappears in time, and normal periods resume.

In the case of polycystic ovaries, multiple cysts have developed, causing the ovaries to enlarge. This condition is associated with failure to ovulate and women who have polycystic ovaries typically experience menstrual abnormalities and infertility.

Women with endometriosis may develop ovarian chocolate cysts, or endometnomas, which form when tissue similar to the lining of the uterus attaches to the ovaries.

Diagnostic Studies and Procedures

Most ovarian cysts are found when a doctor palpates the ovaries during a pelvic examination. Blood tests may be ordered to measure hormone levels. Ultrasound can determine whether the growth is solid or filled with fluid. For some cases, laparoscopy may be ordered, especially if the cyst appears to be solid. In this procedure, a viewing tube is inserted into the pelvic cavity through a small incision near the navel. The examination is usually done under general anesthesia in a hospital setting.

Medical Treatments

Treatment depends on symptoms, the size and type of cyst, and the woman's age and overall health. A young women with a small functional cyst and no symptoms will probably be told to wait for two or three menstrual cycles to see whether the cyst disappears on its own.

Hormones may be prescribed to stimulate ovulation, especially if the woman wants to conceive. If these do not work, surgery may be performed to remove the cystic portion of the ovary. Surgery may also be advised if the cyst is large or has ruptured, if there is severe pain or bleeding, or if the cyst becomes twisted, cutting off circulation.

It is possible sometimes to remove the cyst while leaving the ovary intact, but in other cases, one or both ovaries may have to be removed completely.

Alternative Therapies

Alternative therapies are not effective in treating ovarian cysts, although acupuncture may alleviate pain.

Self-Treatment

Self-care cannot eliminate an ovarian cyst. If you develop menstrual irregularity or are having trouble conceiving, a home ovulation test can determine if you are ovulating normally. Should symptoms persist for more than three menstrual cycles, see your doctor.

Other Causes of Pelvic Pain

Endometriosis, menstrual cramps, tubal pregnancy, and pelvic inflammatory disease can cause symptoms similar to those of ovarian cysts. Ovarian cancer should be ruled out, especially if the cyst is solid. An adrenal tumor or hormonal disorder should also be investigated as a possible cause of menstrual abnormalities or other symptoms linked to ovarian cysts, particularly if masculinization develops.

When the pancreas, a digestive organ situated behind the stomach, becomes inflamed, the condition is referred to as pancreatitis. The inflammation may be acute or chronic, and is thought to result from an abnormal activation of certain digestive enzymes produced by the pancreas. Instead of waiting until they teach the small intestine to begin their digestive functions, the enzymes start working in the pancreas itself, leading to swelling, bleeding, inflammation, and sometimes tissue death.

Most poisoning emergencies result from ingesting a toxic substance; less common are poisonings caused by inhaling gases, such as exhaust fumes; absorbing chemicals through the skin; or injecting drugs into the body.
More than 75 percent of poisonings reported in the United States each year are of children under age five who have swallowed toxic substances ranging from excessive doses of vitamins and medications to household cleaners. Another high-risk group is the elderly, who accidentally (or intentionally) take an overdose of a drug or other toxic substance.

Postpartum depression, or the baby blues, is a feeling of sadness and/or despair that appears shortly after giving birth The symptoms range from mild to incapacitating, but are usually short-lived. The cause is probably a combination of factors. Sudden hormonal changes at the time of childbirth play a major role, as does the mother's realization that she is now responsible for a tiny, helpless person who requires 24-hour care. Fatigue is also involved. Childbirth itself is often painful and exhausting, and newborns demand to be fed every two hours or so. The result is that most new mothers fail to get adequate rest until the baby's routine stabilizes, which may not happen until six weeks to two months after birth.

About one-third of all men over age 50 experience noncancerous enlargement of the prostate gland, the result of a gradual process that can eventually cause severe obstruction of urinary flow. The prostate gland surrounds the neck of the male bladder and the urethra, the tube that carries urine from the bladder during voiding. Why it enlarges with age is not completely understood. Some theorize that chronic inflammation of the prostate may cause the enlargement; others suggest nutritional or metabolic factors play a role.

(Acute or Chronic Bacterial Prostatitis; Chronic Non-Bacterial Prostatitis)

Prostatitis is an infection or inflammation of the prostate. This is the plum-shaped gland that surrounds the neck of the male bladder and urethra, the tube that transports urine during voiding.

Symptoms of prostatitis include low back pain and an urgent and frequent need to urinate, even during the night, with difficulty in starting the urine flow and in emptying the bladder completely. Urination and ejaculation often produce pain or burning; there also may be blood and bacteria in the urine. Acute bacterial prostatitis is often accompanied by chills, fever, and achy joints and muscles.

Caused by protozoa, a class of single-cell parasites, protozoal infections are common in rural areas of underdeveloped countries in Africa, Asia, and South America. They are relatively rare in the United States and other industrialized nations, but do occur among Western travelers to Third World countries.

A pulmonary embolism occurs when an artery in the lung becomes obstructed, usually by a clot, or embolus. Most often, the clot forms in a deep vein of the leg or pelvic area and a piece breaks away, traveling through the venous system and heart and into the lungs. Less commonly, the obstruction may be due to a globule of fat that enters the bloodstream following a fracture.

Rabies, or hydrophobia, is an acute, highly lethal viral disease that can affect the central nervous system of any warm-blooded animal, including humans. It is almost always transmitted through the bite of a rabid animal, although it can also be contracted if saliva containing the virus enters the body through an open sore, the eyes, or the mucous membranes of the mouth.

Ringing in the ears is a general term to describe a condition in which a person perceives sounds that have no acoustic origin. Although tinnitus, the medical name for the condition, comes from the Latin term "to ring," the noises can take many forms -- whistling, buzzing, humming, or roaring -- and range from a soft hum to a high-pitched squeak. Some people hear the sounds constantly in one or both ears, while others hear them only intermittently. Sometimes the sounds pulsate, synchronizing with the heartbeat.

Scabies is an intensely itchy, highly infectious parasitic skin disease caused by the Sarcoptes scabiei itch mite. The mile is usually transferred from one person to another by direct skin contact, especially during sexual activity or while sharing a bed. Far less often it is spread by indirect contact, such as sharing a towel or clothing. This is not typical because the mites do not survive long when not on a human body.

(Inflammatory Dandruff; Seborrheic Dermatitis; Seborrheic Eczema)

Seborrhea, a common chronic skin disorder, is characterized by rough, dry, inflamed skin that gives off yellowish scales. There may be itching, and when it develops in skin folds, these areas are often red and sore. The term seborrhea is misleading because the scaling has little or nothing to do with the production of sebum, the waxy substance secreted by the skin's sebaceous glands; instead, the scales are dead cells shed by the epidermis layer. Seborrhea can develop at any age, but occurs most often in young adults.

Shingles is almost always an adulthood recurrence of chickenpox, but differs from the original disease in that it involves inflammation of a peripheral sensory nerve that originates in the spinal cord.

The varicella zoster virus, which causes chickenpox and shingles, is related to herpes simplex, the virus that produces cold sores and genital herpes. As with these herpes infections, the varicella virus remains in the body after chickenpox clears up, taking refuge in certain nerve cells. Thus, shingles is characterized by nerve pain and the eruption of painful blisters along the pathway of a root nerve. (The varicella virus can be transmitted from someone who has shingles and become the cause of chickenpox.)

(Hypovolemic Shock; Traumatic Hemorrhagic Shock)

Shock is a life-threatening emergency in which insufficient oxygenated blood reaches vital body organs and tissues because of extremely low blood pressure. One type, traumatic hemorrhagic, or hypovolemic shock, results from a severe loss of blood. Typical causes range from a major accident to a ruptured tubal pregnancy, a perforated intestinal ulcer, or ruptured aneurysm. Other types of shock may be due to serious illnesses (see Other Causes). For example, septic shock occurs when bacteria multiply in the bloodstream and then release toxins. Whatever the type of shock, emergency first aid calls for similar procedures.

(Central, Mixed, or Obstructive Apnea)

While breathing is an automatic function that most people take for granted, persons who have sleep apnea stop breathing repeatedly for anywhere from 10 seconds to 2 or 3 minutes during sleep. The majority of these persons are unaware of such episodes, although their bed partners may complain of their loud snoring and fitfulness.

Snoring, a very common occurrence, affects some 100 million Americans, mostly older adults. Why so many snore is unknown, but the source of the noise is clear. When these people sleep, their throat muscles relax, and as air passes over the uvula (the pendant of flesh that hangs down at the back of the mouth), it causes vibrations similar to those produced when someone plays a woodwind instrument. Instead of musical tones, however, snoring creates harsh, rasping noises. These sounds are more disturbing to sleeping partners than to the snorers themselves, who are usually unaware of the problem until someone complains of the noise.

Because speech is essential to human communication, anything that interferes with it can be isolating and emotionally distressing. Primary mutism, in which a person cannot speak due to absent vocal cords or another structural defect, is rare. More commonly, difficulty speaking is secondary to other conditions, including paralysis, deafness, retardation or other mental disorders, and larynx cancer. In certain cases, a person knows how to speak but has difficulty forming words.

Outbreaks of a deadly streptococcal infection that results in toxic shock and the rapid destruction of muscle and flesh have raised concern among scientists that a strain of strep A, the bacterium involved, is re-emerglng as a major health threat. According to the Centers for Disease Control and Prevention, the current wave of invasive strep A infections began in the late 1980s, and by 1990, about 10,000 to 15,000 cases were being reported in the United States each year. Although this is less common than other bacterial infections, it is of concern because of the rapidity with which strep A can maim and kill.

Increasingly, doctors are recognizing that too much stress, or an inability to cope with it, is a serious health threat. Although many people think of stress as a modern phenomenon, humans have never lived in a stress-free environment. Indeed, many experts contend that our prehistoric ancestors, in their quest for food, shelter, and safety, faced stressors much worse than those of the 20th century. Still, the way in which our bodies respond to stress is a holdover from our earliest forebears.

(Cerebral Embolism, Hemorrhage, or Thrombosis; Cerebrovascular Accident; Subarachnoid Hemorrhage)

A stroke occurs when a portion of the brain is deprived of blood, resulting in ischemia or even tissue death. More than 500,000 Americans suffer a stroke each year, about one every minute. Although the stroke death rate has been cut in half over the last 25 years, the affliction still claims 144,000 lives annually, making it the third leading cause of death in the United States (after heart attacks and cancer). Strokes are also a major cause of serious disabilities, which include varying degrees of paralysis, speech problems, visual disturbances, and impaired memory.

A sty develops when a pimple-like abscess forms in one or more of the specialized oil glands that line the eyelid. The term sty (or stye, as it is sometimes spelled) derives from the old English word stigend, which means "to rise." Hordeolum, the medical term for a sty, is Latin for "a small grain of barley," which describes its appearance.

Tetanus is an acute infectious disease of the nervous system caused by a microorganism that usually enters the body through an open wound or cut. The infectious agent, Clostridium tetani, is a type of bacterium, or bacillus, that reproduces by forming spores. These spores are found almost everywhere, but especially in soil, dust, and the manure of cows, horses, and other plant-eating animals.

(Cooley's Anemia; Mediterranean Anemia; Thalassemia Major and Minor)

Thalassemia refers to a group of inherited blood disorders in which the body's bone marrow is unable to form normal amounts of hemoglobin, the oxygen-carrying pigment in red blood cells. People of Mediterranean, African, and Southeast Asian origin are most commonly affected.

Thrush, or oral candidiasis, is a common yeast infection that develops in and around the mouth. It usually appears as a heavy, whitish coating on the tongue and as creamy patches that resemble milk curds on the mucous membranes of the mouth. The patches may spread to the gums, lips, throat, and skin. In severe cases, thrush may progress to the esophagus, which results in pain and difficulty swallowing. In rare instances, it enters the bloodstream and may affect various organs throughout the body; this serious complication develops mostly in patients with AIDS, cancer, or other disorders marked by reduced immunity.

The tonsils, a pair of lymph nodes at the back of the throat, are part of the body's defense system against bacteria and other harmful organisms entering through the nose and throat. Sometimes the tonsils become enlarged and inflamed. This condition, called tonsillitis, is especially common in children.
Both viruses and bacteria can cause tonsillitis, with strains of streptococcus -- the bacteria responsible for strep throat and other common infections -- the most common culprit.

Although pain of a toothache originates in part of the tooth, the surrounding soft tissue, or underlying bone, it can radiate up and down and extend from the forehead to under the jaw.

Most toothaches result from caries, or dental decay, triggered by bacteria that live in the mouth. These bacteria give off acids that can erode tooth enamel, allowing organisms to invade the underlying dentin -- the beginning of a cavity.

Toxoplasmosis, a parasitic disease, occurs worldwide in nearly all warmblooded animals, including humans. It is caused by a single-celled (protozoan) parasite called Toxoplasma gondii, an organism usually contracted by eating undercooked meat from infected animals. Cats are often wrongly blamed as the major source of infection. Because the parasite produces eggs only in cats, they are the definitive .T gondii host. However, humans can acquire toxoplasmosis from them only by direct contact with cat feces containing T. gondii eggs. A cat may eat infected mice or raw meat containing cysts of T. gondii. The protozoan then reproduces sexually in the cat's small intestine, and one to four weeks later, its eggs are excreted.

Traveler's diarrhea is characterized by the passage of four or five loose, watery stools a day, usually for two to four days. Studies show that 20 to 50 percent of travelers develop diarrhea, but the incidence varies greatly according to destination. For Americans, the developing countries of Latin America, Africa, the Middle East, and Asia pose the greatest risk. But travelers who go any place where their intestinal tracts encounter unfamiliar micro-organisms can acquire diarrhea. For example, Mexicans often develop the problem when visiting the United States.

Trichinosis, a parasitic infection, occurs worldwide and affects people of all ages. The parasite, Trichinella spiralis, forms cysts in the flesh of pigs, bears, some marine animals, and certain wild scavengers. In the United States, pigs fed garbage that contains raw meat scraps are the most common trichinosis carriers. Humans typically contract the disease by eating raw or undercooked pork, especially ready-to-eat sausages.

A tubal, or ectopic, pregnancy occurs when a fertilized egg becomes implanted in one of the fallopian tubes (or less commonly, elsewhere in the pelvic cavity) rather than in the uterus. Normally, an egg enters a fallopian tube after it is released from an ovary during ovulation. When conception takes place, it usually does so within the tube and the fertilized egg then proceeds to the uterus. If all goes well, pregnancy is established. In about 1 in 80 pregnancies in the United States, however, something goes wrong; the fertilized egg fails to reach the uterus and develops instead in the tube.

Tuberculosis is an ancient disease that remains one of the leading causes of death. According to one estimate, about half of the world's population is infected with Mycobacterium tuberculosis, the major causative organism. Of these, 30 million have active tuberculosis, with 10 million new cases and 3 million deaths each year.

Although this infectious disease is commonly referred to as rabbit fever, it is carried by some 100 other species of wild animals as well as sheep, cattle, cats, and at least six other species of domestic animals. Tularemia is spread to humans by handling infected animals, eating their meat, drinking contaminated water, inhaling contaminated particles, or being bitten by ticks, deer flies, or other insects carrying the causative Franrisella tularensis bacterium.
Until recently, tularemia was considered a rare disease, confined mostly to hunters, trappers, and fur handlers.

Small, open craters or sores that develop in the lining of the stomach or small intestine are commonly referred to as ulcers. (Less often, ulcers form in the esophagus, especially in the lower portion that may be exposed to stomach acids.) Technically, however, those that develop in the stomach are gastric ulcers, and those that form in the section of small intestine just below the stomach are duodenal ulcers. Doctors usually add the term peptic because such ulcers develop only in the areas of the digestive system that come in contact with pepsin, an enzyme that breaks down proteins.

Varicose veins -- which are widened and twisted -- develop when the tiny one way valves within the vessels malfunction and allow some blood to seep backwards. The most familiar are those in the lower legs, which appear bluish and bulging, but they also form in the anal area (see hemorrhoids). Less often, veins in the esophagus become varicosed; this condition, usually linked to liver disease, can cause serious intestinal bleeding.

Any condition in which blood leaks out of the vessels that normally contain it constitutes vascular bleeding. If the leaking blood invades skin tissue, it shows up as bruises, ranging from tiny reddish-brown or purple dots, called petechiae, to larger patches, referred to as purpura.

Viruses, the smallest of all parasites, can live, grow, and reproduce only within the living cells of a host organism, which may be any plant or animal, including human beings. The world is populated by many billions of viruses; most are harmless, but others are the sources of our most persistent and even deadly diseases -- everything from the common cold to AIDS.

(Acquired immune deficiency syndrome) AIDS, first described in 1981, is not a single disease, but rather, an increasing vulnerability to many disorders, especially infections. These result from the progressive destruction of the immune system by the human immunodeficiency virus (HIV).

(Focal Dysionia / Spasmodic Torticollis)

Wryneck and torticollis are characterized by painful spasms in the neck. A wryneck usually occurs suddenly and is self-limited, often vanishing mysteriously. In contrast, torticollis comes on gradually; at first it is intermittent, but it keeps worsening until affected muscles are chronically contracted and the neck posture remains abnormal more or less permanently. Wryneck and torticollis are relatively common, affecting about 1 in 10,000 people, with women slightly outnumbering men.