HUMAN DISEASES (Part 4 of 7)

Other Growth Changes

Some alterations in tissue growth are not cancerous. Atrophy, for example, is a lessening in size. It is the shrinking of cells or tissues for various reasons. Starvation, for instance, causes atrophy of the adipose, or fatty, tissues. Disuse of a body part may also lead to atrophy. When a fractured arm is placed in a cast, the arm's muscles decrease in size from lack of use.

Compensatory hypertrophy, in medicine, condition that results when one of a paired set of organs, such as a kidney or a lung, is removed and the remaining organ increases in size.

Hypertrophy is an increase in size of individual cells or fibres It results in an enlargement of the body part containing these muscles or fibres Hypertrophy of the heart has already been discussed. Compensatory hypertrophy is best seen in paired organs. When a diseased kidney is removed from the body, the remaining kidney grows larger because it now must do the work of two kidneys.

RESPIRATORY SYSTEM DISEASES

The lungs are spongy organs through which vital oxygen enters the body and needless carbon dioxide exits. Oxygen and carbon dioxide are exchanged in and out of capillaries in the many tiny air sac's, or alveoli, in the lungs. Although the breathing passages have defences against invading germs and irritants, the lungs can be stricken by a number of serious diseases.

Chronic bronchitis is a disease that results from infection of the air passages by bacteria or viruses. It is marked by cough and increased production of sputum, an accumulation of saliva, mucus, and pus. Air pollution and cigarette smoking both can aggravate the malady.

Tuberculosis, bacterial disease most frequently affecting lungs; associated with fever and loss of weight; commonly transmitted through the air (droplet infection) but also from drinking unpasteurized milk obtained from infected cows.

Tuberculosis is a complicated disease that most often strikes the lungs. The bacilli that cause it grow from place to place in the lung, leaving cavities in the unoccupied sites.

Symptoms of tuberculosis may include weight loss, fever, chest pain, cough, and sputum. After the active infection is arrested, a period follows when the disease may break out again. Tuberculosis is treated with isoniazid and other drugs.

Pneumonia, or acute infection of the lungs, may occur suddenly in a seemingly healthy person. It is usually marked by fever, cough, and chest pain. Lung X rays show patches of inflammation. Though once quite fatal, the threat of pneumonia has been reduced as a result of antibiotic treatment.

Pleurisy, an inflammation of the pleura; caused by infection, injury, or other chest diseases.

Pleura, the serous membrane that covers the lungs, lines the walls of the thorax, and is reflected upon the diaphragm.

Pleurisy is severe chest pain accompanying each deep breath in a person with an inflamed pleura, the twin membrane around each lung and lining the chest cavity. Pleurisy can attend pneumonia or result from direct infection of the pleura.

Emphysema is a serious lung disease that follows destruction of the elastic and connective tissue fibres supporting the lung. It is linked with advancing age. Certain forms of emphysema are inherited. Heavy cigarette smoking and long exposure to air pollutants seem to encourage the disease. A person with emphysema, lacking sufficient lung elasticity, wheezes and has trouble breathing. Furthermore, air movement in the lungs is reduced and the patient is easily fatigued because he fails to get enough oxygen or get rid of enough carbon dioxide.

Asthma is the wheezing or whistling sound that accompanies each breath when the air passages contain too much mucus. It may follow lung infection or result from an allergic reaction that causes muscle spasms and swelling in the air passages.

Acute pulmonary oedema results when fluid quickly accumulates in the lungs and fills the alveoli. The fluid build-up is caused by heart trouble that, in turn, produces back pressure in the pulmonary veins and the left atrium of the heart to which they carry oxygen-rich blood from the lungs. A person suffering acute pulmonary oedema is suddenly breathless and turns blue because of oxygen-poor blood. The condition is treated with oxygen, digitalis to strengthen heart action, and diuretics to speed fluid removal by the kidneys.

Pneumothorax, presence of air in the usually air-free pleural space between the lungs and chest walls.

Pneumothorax occurs when air gets into the chest between the pleural lining. The lung then collapses. A collapsed lung may occur when the chest is pierced in some way or when an abnormal bleb, or blister, on the lung surface bursts.

Lung abscess is an accumulation of a mass of pus inside the lung. A lung abscess can increase the seriousness of pneumonia and other lung infections, especially in chronically ill persons.

Hyaline membrane disease is a disorder of some prematurely born infants. The alveoli of afflicted babies are lined with a protein material, limiting the amount of oxygen their blood can receive. The disease is often fatal.

Histoplasmosis is a fungus infection of the lungs. Fungi lodge in the lungs and multiply until body defences wall them off. In some areas it was once called "summer flu" because its symptoms resemble those of influenza. Serious cases involve weight loss and a long convalescent period.

Silicosis, disease of the lungs, caused by inhaling tiny sharp particles of stone dust; fibrous tissue forming around particles causes cough, shortness of breath, and weakness.

Pneumoconiosis means "dust disease." It can strike miners and industrial workers who inhale damaging amounts of dust. One of the most serious is silicosis, which results from inhaling quartz dust. Another, anthracosilicosis, arises from inhalation of coal and quartz dust.

SKIN DISEASES

Because of its location the skin is perhaps more susceptible to disease than any other body organ. Even so, it is marvellously designed for its particular jobs of protecting the inner body against harm from the outside surroundings, receiving clues about what is happening externally, and keeping the body cool by means of the evaporation of sweat produced by its sweat glands. The skin is thick, leathery, and tough enough to prevent mechanical injury to the body. It is also covered with a barrier of dead cells that block harmful chemicals from getting into the body.

The skin is richly supplied with nerves that enable the perception of pain, touch, heat, and cold. Blood vessels in the skin can either contract or expand in response to nerve signals.

A person's emotional state can often be observed through changes in skin colour Shame or rage reddens the skin; fear blanches it. The skin may react to disease in a great many ways including formation of blisters, pimples, ulcers, tumours, and by haemorrhage

Blackheads are an accumulation of a horny material in special follicles of the face. The characteristic black dots in blackheads are not dirt but melanin, the pigment responsible for skin colour

Acne is an outcropping of blackheads or pimples on the face of an adolescent. It is brought on by hormonal changes that accompany sexual maturity. It is not caused by food, emotions, or uncleanliness. Antibiotics are available for the treatment of severe acne, but most cases respond well to local application of a peeling agent.

Warts are horny growths caused by virus infection. They are spread from person to person. Although warts cannot be prevented, they can be burned away with an electric needle or a caustic chemical such as nitric acid.

Hives, or urticaria, are itchy, whitish elevations of the skin. They appear and disappear rapidly. Hives are often the result of an allergic reaction to certain foods or medicines.

Persons who suffer severe cases of hives can receive a series of desensitizing shots. Antihistamine drugs sometimes can relieve a bout of hives.

Birthmark, a skin blemish, result of an overgrowth of blood vessels.

Birthmarks are the result of an overgrowth of blood vessels. They usually show up after birth as port-wine-coloured stains or strawberry-coloured marks. The strawberry marks may eventually disappear but at times can be destroyed quickly by the application of extreme cold. Port-wine stains and other long-lasting skin blemishes can be concealed by special cosmetics.

Eczema, or dermatitis, is a superficial inflammation of the skin. It can be an allergic reaction to poison ivy, dyes, or drugs. It can be provoked by such irritants as acids, solvents, or excessive use of soap or detergents. Sunburn can also cause eczema. Some forms of it, such as infantile eczema and seborrhoeic dermatitis, stem from an unknown cause. Nonetheless, nearly all types of eczema can be relieved by the application of corticosteroid creams.

Athlete's foot is a fungus infection of the skin between the toes. The infected area is scaly, moist, and itchy. It usually has a disagreeable smell. Athlete's foot can be relieved when anti fungal drugs are applied to the infected skin each day. Fungus infections that cause a loss of hair or nails must be treated with griseofulvin, an antibiotic.

Bacterial infections such as the psoriasis caused by "staphylococci" germs are rare because of modern standards of hygiene and sanitation. However, the bacterial disease gonorrhoea, which passes between the skin of the sex organs, has risen to epidemic proportions among teenagers in recent years. This and other bacterial infections of the skin are remedied with antibiotics.

NERVOUS SYSTEM DISEASES

The nervous system is the quick communication system of the body. Information from the outside world enters the body through the sense organs and is sent to the spinal cord for instant response or is relayed to the brain for further processing.

Nerves and the membranes that protect portions of the nervous system are susceptible to breakdown or infection. Sometimes, the organisms that cause such diseases as mumps or infectious hepatitis can infect the nervous system, too.

Nervous System Infections

Meningitis is an inflammation of the meninges, or membranes around the brain and spinal cord. It can occur through viruses, bacteria, fungi, or yeasts that get into the nervous system. Meningitis is a serious disease and can be fatal.

Shingles, inflammation of certain nerve tissue caused by virus herpes zoster.

Shingles, or herpes zoster, is a virus-caused inflammation of certain nerve tissue. Painful skin bumps occur over the line of the inflamed nerve or its branches. Shingles and chicken pox are both caused by the same virus.

HUMAN DISEASES (Part 5 of 7)

Non-infectious Nerve Disorders

Neuritis, disease of the nerves causing pain, abnormal circulation, and reflex action; differs from neuralgia because of inflammation; treatment includes heat, proper nutrition, physical therapy, and medication.

Neuritis is the degeneration of one or more nerves. It is often marked by a pins-and-needles feeling, a burning sensation, or a stabbing pain. Neuritis can result from infection, especially of the facial nerve, hard body blows, or bone fracture causing nerve injury.

Everyday hard grasping of tools and activities requiring cramped body positions can also trigger neuritis.

Neuralgia, severe, stabbing pain along course of nerve; not associated with nerve damage; attacks often triggered by infection, malnutrition, chilling, or fatigue; sometimes is symptom of organic disease; trigeminal neuralgia, popularly called tic douloureux, affects main sensory nerve of face and is treated by local anaesthetic or cutting of nerve roots.

Neuralgia is often confused with neuritis but is a distinct problem. Neuralgia is characterized by sudden, sharp bursts of pain along any of the sensory nerves near the body surface.

Sciatica is severe leg pain resulting from an inflamed sciatic nerve or its branches. A ruptured, or "slipped," disk one of the pads between the vertebra of the spine often causes sciatica.

Tics are usually habitual muscle twitches in the face or neck that seem to serve no purpose. A tic is generally intensified by an emotional situation or by fatigue.

Vertigo, a severe form of dizziness resulting from the inability of the body to adapt to abrupt or unexpected motion.

Vertigo is a dizziness or disorientation that occurs when something is wrong with the body's balancing system, part of which is located in the inner ear. The sufferer feels as though he is falling through space.

Parkinson's disease (or paralysis agitans, or Parkinsonism), chronic disorder of nervous system, manifest by tremors and muscle weakness, accompanied by changes in pigmented cells of brain stem; strikes in middle or late life; treated with drugs and sometimes by brain surgery; named for James Parkinson (1755-1824), British physician who identified it in 1817.

Parkinsonism, or Parkinson's disease, is thought to stem from changes in brain chemistry. Victims of the disorder walk with a slow, shuffling gait, have a wide-eyed, unblinking facial look, and experience muscle tremors, or shakes. They also have trouble speaking and swallowing. Parkinsonism can be treated with a drug called levodopa, or L-dopa.

Multiple sclerosis (MS), chronic disease of the nervous system; cause unknown; leads to disturbances of vision, speech, coordination, and bodily functions.

Multiple sclerosis is a slow-developing disease that eventually involves the entire brain and spinal cord. Its cause is not yet known, but the disease eats away the fatty myelin sheath around many nerves. As a result, it interferes with proper nerve-signal transmission to muscles and organs. Muscle control, vision, mental abilities, and many other body functions are eventually impaired. Physical therapy is often required because the limbs of victims become weak and they are easily tired doing ordinary tasks.

Stroke

Stroke (or cardiovascular accident), common term for cerebral thrombosis (a blood clot that interrupts the blood supply of the brain) and for cerebral haemorrhage (a rupture in a blood vessel that allows blood to escape into the brain tissue); both can cause brain damage with resulting paralysis or death.

A stroke, or cardiovascular accident, occurs when blood can no longer nourish brain tissue and key nerve cells are thereby destroyed. A blood clot in one of the brain's blood vessels, haemorrhage from a broken blood vessel there, or hardening of a brain artery can cause a stroke.

Depending upon the brain area affected, a stroke can culminate in loss of limb use particularly the arms speech difficulties, and partial blindness. In time, victims of relatively non severe strokes often regain most or all of the impaired body functions. In more severe cases, extensive physical or speech therapy is needed for partial rehabilitation of the stroke victim.

Epilepsy

Epilepsy, disease of the nervous system, frequently from subtle brain damage, less often from injury; characterized by sudden, recurrent seizures with loss of consciousness and severe convulsions (grand mal), or in mild form by brief blackouts and fainting spells (petit mal).

Epilepsy is a brain disorder in which nerve signals "fire" abnormally and cause convulsive seizures, or alternating muscle contractions and relaxations. Scar tissue in the brain can provoke some seizures. In many cases, however, doctors cannot pinpoint the reason for an epileptic attack. Someone might have a seizure once and never again. If someone has more than one seizure, the second and any that may follow are officially called epileptic attacks.

Doctors generally recognize several types of epilepsy, including grand mal, petit mal, and infantile spasms. A grand mal attack is usually marked by rigidly contracted muscles, loss of consciousness, and collapse. The attack may last from two to five minutes, followed by deep sleep.

A petit mal attack usually comes as a lapse of awareness for less than a minute. The victim then resumes whatever activity he was engaged in before the attack without realizing anything out of the ordinary took place. Infants under the age of three sometimes have infantile spasms during which sharp muscle contractions force the body to jackknife for a few seconds. Anti convulsive drugs are used to treat and prevent all such attacks.

METABOLIC AND DEFICIENCY DISEASES

Disease can sometimes follow from alterations in normal body metabolism caused by deficiencies in diet, hormones, and vitamins. It can also stem from malfunctions in the body's immunity system.

Malnutrition and Vitamin Deficiencies

Malnutrition can be either over nutrition or under nutrition Obesity resulting from overeating can lead to high blood pressure, heart disease, and diabetes. Under eating can stifle the development of body and mind.

Marasmus is the condition that results when a child's diet lacks both total calories and protein. A child with marasmus is always hungry and wastes away. Kwashiorkor is a protein deficiency that saps a child's strength even though his diet contains enough calories. A child with kwashiorkor lacks an appetite and is sullen. Both conditions occur in underdeveloped nations.

Vitamin deficiencies are uncommon among people in the world's richer nations, except in the cases of pregnant women and those who breast-feed their babies. Since ample vitamins are in the general diet in those lands, there is no medical justification for daily doses of multivitamins to stimulate vigour or prevent colds or infections.

Iron, silver-grey, hard, brittle, fusible element that is the cheapest and most used of all metals. In pure form it is very reactive chemically and rapidly corrodes in moist air and warm temperatures. Iron is often alloyed with other metals to make it tough yet malleable. Pig iron is used to produce steel. The use of iron is prehistoric

Properties of Iron

Symbol Fe

Atomic number 26

Atomic weight 55.8

Group in periodic table VIII

Boiling point 4,982 F (2,750 C)

Melting point 2,795 F (1,535 C)

Specific gravity 7.874

Mineral deficiencies can also produce body disorders. Iron is indispensable for the prevention of anaemia Magnesium is a cofactor in many enzymes. Deficiency of it causes dizziness, weakness, and convulsions. Iodine is a major part of the thyroid hormones.

Without it a person can develop a goitre Fluorine is not considered essential, but it plays a great part in minimizing dental caries, or cavities. Trace elements, such as chromium, cobalt, and manganese are also needed for a healthy body.

Hormone Deficiencies

The body's endocrine system produces a variety of hormones. When the endocrine glands are not working properly, certain disease processes can begin.

Abnormal output of growth hormone from the pituitary gland early in life can result in one of two disorders dwarfism if there is too little or gigantism if there is too much. Abnormal output of certain hormones from the adrenal glands causes irregular regulation of the body's water balance and disturbs the normal retention and excretion of salts. Malfunction in sex hormone production can stem sexual activity, as well as produce excessive hair growth and distribution. Malfunction of the thyroid gland affects the rate at which food is burned for energy, causing the metabolic rate to run too fast or too slow for everyday needs. When part of the pancreas breaks down, diabetes develops.

1921: Insulin found to treat diabetes. In 1921, at the University of Toronto, Frederick Grant Banting and Charles H. Best conducted experiments that successfully isolated the hormone insulin. This hormone is used to control the disease diabetes. The name of the hormone is derived from the Latin word for island, insula, because the hormone is produced in the part of the pancreas called the Islets of Langerhans.

Although it had been known for some time that the pancreas made the enzymes responsible for digesting proteins, it had not been possible to isolate insulin. Insulin is a protein and is digested by the enzymes. Banting and Best used animal experiments to extract insulin and demonstrated that it stopped symptoms of diabetes. Commercial production of insulin uses pigs, oxen, and sheep as sources for the hormone.

Diabetes Mellitus

Diabetes mellitus, a fairly common disease, is caused by lack of biologically active insulin, a hormone secreted by the pancreas. Without insulin the body cannot use sugars and starches in the food. It must then rely upon its stored fat for energy. This storehouse is soon exhausted, however, because without insulin the body can no longer make and store fat. In addition, protein is no longer manufactured and the muscle mass of the body dwindles. The effect of growth hormone is reduced too. All this adds up to a rise in the level of blood sugar and increased urination, which, in turn, dehydrates the body and makes the diabetic thirsty. The sufferer loses weight, experiences muscle cramps, and has an itchy skin. If diabetes is not treated, sodium and potassium are lost in the urine and the products of fat breakdown, called ketones, build up in dangerous proportions in the blood.

The blood also becomes increasingly acid and body dehydration reaches a dangerous level.

Finally, the untreated diabetic goes into a potentially fatal coma.

Diabetes is treated by limiting the patient's diet and injecting him with insulin derived from cattle or hog pancreases. This treatment was pioneered by the Canadian physicians Frederick G. Banting and Charles H. Best in the 1920s.

Recently, an oral medication has proved capable of lowering the blood sugar of diabetics who develop a mild form of the disease after they reach adulthood. These tablets do not contain insulin but are helpful as long as the pancreas of the diabetic still produces some insulin.

Long-term diabetes is often associated with blood vessel degeneration. When this complication occurs, the diabetic can suffer heart disease, stroke, eye haemorrhage and blindness, kidney failure, gangrene of the feet, and serious neuritis.

The normal blood-sugar level ranges between 60 and 100 milligrams per 100 cubic centimetres of blood. It rises slightly higher after a meal. When the level falls below normal, a person has hypoglycaemia and may develop headache, irritability, sweatiness, and other symptoms. Later, the patient has trouble keeping balance, speaks incoherently, and may even become violent or act listless and withdrawn. Finally, the hypoglycaemic person falls into a coma and may have convulsions.

A diabetic may experience hypoglycaemia when he gets an excessive dose of insulin or oral medication. Hypoglycaemia can also result from diseases of the adrenal, pituitary, and pancreas glands, as well as from starvation, liver damage, and alcohol intake. Moreover, some otherwise healthy persons, especially those under too much stress, can suffer mild hypoglycaemia In an emergency, a health care provider may administer sugar, either orally or by intravenous injection. Glucagon, a pancreatic hormone that raises the blood-sugar level, can also be injected. Long-range treatment involves correcting the disorder engendering the low blood sugar. People suffering from hypoglycaemia often respond very favourably to a change in diet that balances sugar and other nutrients.

HUMAN DISEASES (Part 6 of 7)

Other Metabolic Diseases

Gout is faulty metabolism of purine, an amino acid, resulting in the accumulation of uric acid in the blood and urate salts in the tissues, especially the joints where they cause painful arthritis. It may stem from an inborn error of metabolism or from other diseases. It usually strikes middle-aged men. The joint at the base of the big toe is the typical site of a sudden acute attack of gout. The affected joint becomes red, hot, swollen, and painful.

Fever accompanies the attack. Joints of other limbs might become similarly affected.

Attacks of gout recur, but the sufferer enjoys complete relief in between them. Some patients develop chronic arthritis from gout. Gout is treated with low-purine foods and such drugs as allopurinol that lower the uric acid level of the blood.

Cystic fibrosis, an inherited disease in which the pancreas fails to provide secretions necessary for normal digestion of food; commonly associated with chronic lung disease.

Cystic fibrosis is a genetic disorder involving the pancreas and the lungs. It appears during the first 10 years of life, although sometimes it is not discovered until later. Certain glands of the pancreas become plugged by thick mucus, which bottles important digestive enzymes. Intestinal troubles result.

Furthermore, the lungs suffer scarring, infection, and eventual emphysema. Cystic fibrosis is treated with substitute pancreatic enzymes, vitamins, and a high-calorie diet. Antibiotics are given to fight the lung troubles.

Other metabolic disorders include phenylketonuria (PKU) and galactosemia. PKU is an inherited inability to metabolize phenylalanine, an amino acid. Galactosemia is an inherited inability to change galactose, one type of sugar, into sucrose, another, because a necessary enzyme is missing. Both diseases can result in mental retardation of children if not corrected in time.

Arthritis and Lupus

Rheumatoid arthritis (RA), chronic disease of the connective tissue, causing painful sensations in joints and muscles.

When the body fails to recognize itself, it makes antibodies against its own tissues.

Rheumatoid arthritis and systemic lupus erythematosus are two among a rising number of such autoimmune diseases.

Rheumatoid arthritis is a chronic crippling disease that deforms bone joints and their adjacent tissues. It can strike nearly anyone. Although arthritis is not especially prevalent in damp climates, its symptoms are more bothersome there. It is marked by inflammation of an entire joint, including its synovial lining. Tendon coverings and bursas, or fluid-filled cushions, can become inflamed too. Cartilage in the joint and adjacent bone are destroyed, causing painful stiffness and eventual ankylosis, or "freezing," of the joint. Skin over the joint is taut, shiny, and clammy. Arthritics often suffer aches and pains. The rheumatoid factor, a large protein molecule, is present in the blood of so many adult patients that it aids in the diagnosis of the disease. Rheumatoid arthritis is usually treated with rest, physical therapy, and aspirin and other salicylates.

Systemic lupus erythematosus (SLE), or lupus, is a serious degenerative disease that can strike one or many body systems over a period of years. The blood serum of afflicted persons contains a number of peculiar proteins, including the so-called L.E. factor, the antibody characteristic of the disease. Symptoms of SLE resemble other diseases, including cancer and tuberculosis, but lesions around the nail beds and fingertips that destroy the skin in those areas earmark lupus. In addition, the spleen and lymph glands of the neck and armpits may enlarge. The pericardium and heart valves are affected too. The kidneys and portions of the central nervous system may also become damaged. Although anyone may be affected, females between the ages of 20 and 40 years most often develop this incurable disease.

Osteoarthritis is a painfully disabling disease of the spine and other weight-bearing joints. Cartilage in the joint is destroyed, followed by overgrowth of nearby bone. The incurable but non deforming disease develops with advancing age.

Ankylosing spondylitis is a disabling and deforming disease of the spine, sacroiliac joints, and sometimes the shoulders, hips, and knees. The synovial lining of the affected joint becomes inflamed, the bone is weakened by loss of calcium, and the spine is bent forward.

Eventually, the spinal vertebrae fuse and the spine becomes locked in the deformed position.

KIDNEY AND GENITAL DISEASES

Disease can affect any of the parts of the closely related urinary and genital systems. Both can be infected or malfunction because of a shortcoming in development.

Kidney Inflammations

Kidney disease, commonly result of inflammation or damage to blood vessels of kidneys; severe forms lead to breakdown of normal elimination of waste products.

Glomerulonephritis is a serious inflammatory disease of the kidneys. It usually is triggered by a prior infection, often by streptococcal bacteria, which inflames the glomeruli, the tiny tufts through which blood is filtered. The inflammation may go away after a few weeks or may slowly destroy all the glomeruli. In the early stages, the inflammation may reduce filtration enough to cause blood to retain some excess fluid, salts, and wastes. Blood pressure might also rise. If the inflammation persists, the glomeruli are destroyed, blood pressure soars, and urine formation may stop. Mechanical means must be taken to cleanse the blood.

Pyelonephritis, bacterial infection of the inner portions of the kidneys and the urine.

Pyelonephritis is a bacterial infection of the inner portions of the kidneys and the urine. If quickly treated, the infection can be cured. If untreated, however, the infection may scar and eventually destroy kidney tubules, resulting in a need for mechanical cleansing of the blood. Once damaged by a bout of pyelonephritis, the kidneys are easily reinfected.

Toxaemia of pregnancy is a disorder stemming from other kidney problems experienced by some women in the last half of pregnancy. During a pregnancy, the kidneys must work more than usual. However, a woman entering pregnancy with a kidney disease such as Glomerulonephritis may not be able to step up kidney function enough to meet the new demands. In severe cases of toxaemia, the foetus may die or have to be aborted to save the mother's life. In lesser cases, however, medical treatment poses little risk to either life. Once a woman develops toxaemia, she is likely to develop it again in later pregnancies.

Calculi and Other Urinary Disorders

Calculus disease, condition that occurs when certain substances in urine crystallize into compact stones.

Calculus disease occurs when certain substances in urine crystallize into compact stones called calculi. A stone may be formed within a kidney and become swept by urine into the ureters and the bladder. It may cause pain, obstruct urine flow, or grow large enough to damage the kidney or bladder. Small calculi may be passed in urine, and large ones can be pulverized without surgery by means of energetic sound waves. Calculi can consist of calcium, urates, cystine, or other crystals. The tendency to form kidney stones sometimes runs in families.

Polycystic disease, an inherited failure of normal kidney development, strikes infants as well as adults. Many fluid-filled cysts spring up throughout the kidneys and cause them to malfunction. Polycystic disease sufferers eventually become uraemic

Uraemia means "urine in blood." It describes the condition in which the kidneys almost totally fail to operate. The blood then retains the nitrogenous products of protein metabolism instead of having them removed by the kidneys. Also, the concentration of many of the electrolytes, or salts, in the blood rises too high. The breath or perspiration of affected persons smells of urine. Each of the previously mentioned kidney ailments could cause uraemia Artificial kidneys have been developed to cleanse the blood of uraemic patients. In some cases, patients with destroyed kidneys can receive a human kidney transplant.

Genital Disorders

Sometimes portions of the genital system fail to develop normally. In some rare cases, the gonads male testes and female ovaries or other sex structures fail to develop at all. Without gonads, a person neither achieves puberty nor develops secondary sexual characteristics, such as breasts and uterus growth in females and penis growth and muscle development in males.

Infections such as gonorrhoea can cause sterility by blocking the oviducts, or egg passages, of females or the vas deferens, or sperm passages, of males. In males, gonorrhoea may also interfere with urination.

The prostate gland at the neck of the bladder in males enlarges slowly with age. It eventually may hamper urination and need surgical correction.

REHABILITATION

Rehabilitation is a fairly new medical speciality, although the notion of helping someone cope with a disabling disease or disorder is an old one. As an increasing number of people become disabled by stroke, paraplegia (paralysis of the lower body), limb losses, and many chronic nervous system and other physical disorders, it has been shown that medical rehabilitation can help many of them live a reasonably normal life. This is true even when the handicapping problem is not medically correctable.

Rehabilitation means getting utmost use from the limbs, senses, or other body systems that remain in operation after a chronic disability. Its goal is to help the patient become as independently active as possible. The disabling condition might result from a disease, birth defect, or severe accident. Sometimes rehabilitation involves fitting an amputee with an artificial limb, fitting a lame person with a brace, or teaching a paraplegic how to manoeuvre a wheelchair. Sometimes it only involves counselling and other psychological techniques for persons who are mentally disabled.

In its early days medical rehabilitation concentrated on helping people who had walking and other movement problems. The advances made in rehabilitating them sparked efforts to aid people who were stricken by stroke, chronic arthritis, and spinal cord disease and other chronic nervous system disorders. Afterwards, it was learned that rehabilitation could also help patients with heart disease, chronic lung disease, and a variety of conditions that slowed recovery from surgery. Bio engineers have been successful in devising artificial limbs and other life support structures that function so much like natural ones that recipients no longer suffer a disabling handicap.

Rehabilitation is a team effort. It requires the work and dedication of physicians, physical therapists, occupational therapists, psychologists, social workers, and vocational counsellors The doctor and the physical and occupational therapists work to restore those body functions impaired by the disability. The psychologist, social workers, and vocational counsellor help the patient get a mental grip on himself to better deal with the emotional and social problems brought on by the disability. Members of a coordinated rehabilitative team can do wonders in restoring a handicapped person to a functional life.

In addition, the rehabilitative team works with a disabled person to prevent the physical deterioration that takes place when muscles are not used. Furthermore, the team aims at getting the maximum output from the patient's remaining body functions. Exercises and other means are used to develop fully the remaining physical reserves because disabled persons expend more energy and need more stamina to do ordinary things than do non disabled persons.

Teaching new tasks to the disabled is an integral part of physical rehabilitation. For example, a crippled person may be trained to use a wheelchair or other motive device well enough to manage into the driver's seat of an auto mobile and thus achieve a measure of independence, the important goal of the entire rehabilitative process.

A chronically disabled person often suffers mental depression. The rehabilitation team tries to restore that person's confidence so that he can take an optimistic view on resuming daily activities. Positive attitudes of patient, friends, and family toward any disability are important factors in the success of rehabilitation. During rehabilitation the patient is encouraged to find meaning in life, overcome feelings of being a "permanent patient," and resume his place as an active member of society. Counselling is also important in rehabilitating alcoholics and the mentally ill.

Treatment for the disabled is given at special rehabilitation centres or in the rehabilitation departments of some hospitals. Rehabilitation units are designed so that patients can do many things by themselves; the quarters are built to simulate conditions the patients will encounter when discharged. As a consequence, patients get practice in dealing with such problems as opening and closing doors, going up and down stairs, and a host of other environmental situations that they will face when the rehabilitation program is over.

HUMAN DISEASES (Part 7 of 7)

RESEARCH AGAINST DISEASE

Although medical science has made great strides to eradicate disease, a number of ailments remain to be conquered. Medical scientists have not yet discovered what causes muscular dystrophy, an inherited disorder that strikes nerve tissue and cripples its victim. Nor do they know what causes sudden death syndrome, or crib death, a disease that fatally strikes infants less than a year old. Nevertheless, research is under way against these and other baffling diseases in the hope that someday they will be wiped out or at least made manageable.

Medical scientists perform many kinds of experiments when they are on a research adventure. They may grow tiny cells in test tubes, infect them with the germs or chemicals they think might cause the disease, and watch the after effects Or they might infect a laboratory animal with a disease and observe how its body fights off or succumbs to the ailment. At other times medical scientists test the effects of a drug, a pathological environment, or a possible disease organism on human volunteers. However, before human experimentation ethically can be permitted, the volunteers must give their informed consent to any unconventional treatment. That is, they must be fully aware of the harmful as well as helpful consequences possible before taking part in the research. Also, prior experiments should have been made on laboratory animals to establish some idea of the project's safety.

Medical research is an ongoing endeavour at many laboratories and scientific institutions throughout the world. Medical schools and major hospitals maintain research programs for the benefit of their patients with unchecked or rare diseases. Research programs are also undertaken at many universities where scientists divide their time between teaching and laboratory study. Government agencies such as the National Institutes of Health also engage in research against disease.

Research programs are delving into the problems of ageing As more and more is learned about the biochemical changes that go on in the body as it grows older, scientists may someday be able to modify those changes to ensure better health for the aged. The biochemical basis of certain forms of mental illness are being explored, too, as are the causes and possible remedies of drug abuse.

Some physical disorders still require surgery for correction. As a result, there has been research into improving surgical techniques and into devising artificial parts for the body.

Surgeons, for example, have been trying to improve their ability to rejoin severed limbs. Bio engineers have designed heart pacemakers, sensory aids for the blind, and many other spare parts for the body.

The very foundations of life are being explored in genetic engineering. This recent endeavour is an attempt to alter the genetic make-up of developing embryos in the hope that inborn errors of metabolism can be corrected.

Although some scientists doubt that genetic engineering will ever be practical, if it became so, the ability to alter mistaken genes in unborn children would open a remarkable medical frontier. In the meantime, doctors have encouraged genetic counselling, in which couples planning marriage can learn of the possible consequences of childbearing when they are the carriers of certain inherited disorders, such as Down's syndrome, also called mongolism, or sickle-cell anaemia

Assisted by Theodore R. Van Dellen, M.S., M.D., late Associate Professor of Medicine, Northwestern University, and syndicated medical columnist; Thomas Killip, M.D., Chief of Cardiology and Attending Physician, The New York Hospital; Albert M. Kligman, M.D., Ph.D., Professor of Dermatology, Hospital of the University of Pennsylvania, Philadelphia; William C. Thomas, Jr., M.D., Professor of Medicine, University of Florida College of Medicine; Bernard S. Leibel, M.D., Associate Professor of Medicine, University of Toronto; and Daniel J. Feldman, M.D., former Adjunct Professor, College of Medicine, University of California at Irvine.

BIBLIOGRAPHY FOR DISEASE

Berger, Melvin. Germs Make Me Sick! (Harper Junior, 1987).

Berkow, Robert, ed. Merck Manual: General Medicine (Merck, 1987).

Brown, Fern. Hereditary Disease (Watts, 1987).

Eagles, Douglas. Nutritional Diseases (Watts, 1987).

Hansherr, Rosmarie. Children and the AIDS Virus (Ticknor and Fields, 1989).

Hughes, Barbara. Drug Related Diseases (Watts, 1987).

McKeown, Thomas. The Origins of Human Disease (Basil Blackwell, 1988).

Metos, T.H. Communicable Diseases (Watts, 1987).

Zinsser, Hans. Rats, Lice, and History (Little, 1984).

HUMAN RIGHTS (Part 1 of 2)

Universal Declaration of Human Rights

(Adopted by the United Nations General Assembly, Dec. 10, 1948)

Preamble

Whereas recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world,

Whereas disregard and contempt for human rights have resulted in barbarous acts which have outraged the conscience of mankind, and the advent of a world in which human beings shall enjoy freedom of speech and belief and freedom from fear and want has been proclaimed as the highest aspiration of the common people,

Whereas it is essential, if man is not to be compelled to have recourse, as a last resort, to rebellion against tyranny and oppression, that human rights should be protected by the rule of law,

Whereas it is essential to promote the development of friendly relations between nations,

Whereas the peoples of the United Nations have in the Charter reaffirmed their faith in fundamental human rights, in the dignity and worth of the human person and in the equal rights of men and women and have determined to promote social progress and better standards of life in larger freedom,

Whereas Member States have pledged themselves to achieve, in co-operation with the United Nations, the promotion of universal respect for and observance of human rights and fundamental freedoms,

Whereas a common understanding of these rights and freedoms is of the greatest importance for the full realization of this pledge,

Now, therefore,

The General Assembly

Proclaims this Universal Declaration of Human Rights as a common standard of achievement for all peoples and all nations, to the end that every individual and every organ of society, keeping this Declaration constantly in mind, shall strive by teaching and education to promote respect for these rights and freedoms and by progressive measures, national and international, to secure their universal and effective recognition and observance, both among the peoples of Member States themselves and among the peoples of territories under their jurisdiction.

Article 1

All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

Article 2

Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.

Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.

Article 3

Everyone has the right to life, liberty and the security of person.

Article 4

No one shall be held in slavery or servitude; slavery and the slave trade shall be prohibited in all their forms.

Article 5

No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.

Article 6

Everyone has the right to recognition everywhere as a person before the law.

Article 7

All are equal before the law and are entitled without any discrimination to equal protection of the law. All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.

Article 8

Everyone has the right to an effective remedy by the competent national tribunals for acts violating the fundamental rights granted him by the constitution or by law.

Article 9

No one shall be subjected to arbitrary arrest, detention or exile.

Article 10

Everyone is entitled in full equality to a fair, and public hearing by an independent and impartial tribunal, in the determination of his rights and obligations and of any criminal charge against him.

Article 11

1. Everyone charged with a penal offence has the right to be presumed innocent until proved guilty according to law in a public trial at which he has had all the guarantees necessary for his defence.

2. No one shall be held guilty of any penal offence on account of any act or omission which did not constitute a penal offence, under national or international law, at the time when it was committed. Nor shall a heavier penalty be imposed than the one that was applicable at the time the penal offence was committed.

Article 12

No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honour and reputation. Everyone has the right to the protection of the law against such interference or attacks.

Article 13

1. Everyone has the right to freedom of movement and residence within the borders of each State.

2. Everyone has the right to leave any country, including his own, and to return to his country.

Article 14

1. Everyone has the right to seek and to enjoy in other countries asylum from persecution.

2. This right may not be invoked in the case of prosecutions genuinely arising from non-political crimes or from acts contrary to the purposes and principles of the United Nations.

Article 15

1. Everyone has the right to a nationality.

2. No one shall be arbitrarily deprived of his nationality nor denied the right to change his nationality.

Article 16

1. Men and women of full age, without any limitation due to race, nationality or religion, have the right to marry and to found a family. They are entitled to equal rights as to marriage, during marriage and at its dissolution.

2. Marriage shall be entered into only with the free and full consent of the intending spouses.

3. The family is the natural and fundamental group unit of society and is entitled to protection by society and the State.

Article 17

1. Everyone has the right to own property alone as well as in association with others.

2. No one shall be arbitrarily deprived of his property.

Article 18

Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief, and freedom, either alone or in community with others and in public or private, to manifest his religion or belief in teaching, practice, worship and observance.

Article 19

Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.

Article 20

1. Everyone has the right to freedom of peaceful assembly and association.

2. No one may be compelled to belong to an association.

Article 21

1. Everyone has the right to take part in the government of his country, directly or through freely chosen representatives.

2. Everyone has the right of equal access to public service in his country.

3. The will of the people shall be the basis of the authority of government; this will shall be expressed in periodic and genuine elections which shall be by universal and equal suffrage and shall be held by secret vote or by equivalent free voting procedures.

Article 22

Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality.

Article 23

1. Everyone has the right to work, to free choice of employment, to just and favourable conditions of work and to protection against unemployment.

2. Everyone, without any discrimination, has the right to equal pay for equal work.

3. Everyone who works has the right to just and favourable remuneration ensuring for himself and his family an existence worthy of human dignity, and supplemented, if necessary, by other means of social protection.

4. Everyone has the right to form and to join trade unions for the protection of his interests.

Article 24

Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay.

Article 25

1. Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

2. Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

Article 26

1. Everyone has the right to education. Education shall be free, at least in the elementary and fundamental stages. Elementary education shall be compulsory. Technical and professional education shall be made generally available and higher education shall be equally accessible to all on the basis of merit.

2. Education shall be directed to the full development of the human personality and to the strengthening of respect for human rights and fundamental freedoms. It shall promote understanding, tolerance and friendship among all nations, racial or religious groups, and shall further the activities of the United Nations for the maintenance of peace.

3. Parents have a prior right to choose the kind of education that shall be given to their children.

Article 27

1. Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits.

2. Everyone has the right to the protection of the moral and material interests resulting from any scientific, literary or artistic production of which he is the author.

Article 28

Everyone is entitled to a social and international order in which the rights and freedoms set forth in this Declaration can be fully realized.

Article 29

1. Everyone has duties to the community in which alone the free and full development of his personality is possible.

2. In the exercise of his rights and freedoms, everyone shall be subject only to such limitations as are determined by law solely for the purpose of securing due recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order and the general welfare in a democratic society.

3. These rights and freedoms may in no case be exercised contrary to the purposes and principles of the United Nations.

Article 30

Nothing in this Declaration may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms set forth herein.