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About sunset he became distressed, talked at random and this was followed by a bad night. Tenth day: in the morning, he lost his voice, became very chilled, had high fever with much sweating and died. He had severe fever accompanied by shivering and continuous sweating of the whole body. The urine was thin and contained a small amount of scattered particles suspended in it, but did not sediment. Second day: he was voiceless in the morning; fever high, sweating without remission. The patient became somewhat distressed and did not sleep; the extremities were cold. First day: epistaxis from the left nostril; the fever however increased considerably. Third day: the fever became less and he passed a large quantity of ripe urine with a lot of sediment. Fourth day: about noon he had a warm sweat involving the whole body, the fever left him and he reached the crisis. The urine, though thin, was of good colour and there was no trouble with the bowels. The deafness cleared up and, although pain in the feet re mained, in other respects the final crisis was reached. There was continuous aching in the right side and a dry cough, but no spitting in the first few days. He suffered from thirst and insomnia, but the urine was copious, thin and of good colour. Eighth day: I bled him at the elbow; there was a large flow of blood as there should be. There was slight sweat ing about the head, while the cough and the sputum from the lungs were moister. Seventeenth day: began to expectorate a small quantity of ripe sputum and his condition improved. After the crisis he was thirsty and the matter evacuated from the lungs was not good. At first he vomited much bilious matter and suffered from thirst and much distress. His urine was thin and dark; sometimes, but not always, it contained suspended matter. The fever showed paroxysms at varying intervals, for the most part quite irregular. About the fourteenth day, he complained of deafness and the fever increased; the urine remained as before.
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Plan supplementary foods to meet the additional needs of pregnancy during the last trimester. Compare and contrast the nutritional needs of a child in first year of life with those of an adult. How does the change affect the nutritional intake of Senior Citizens (those abovse 60 years of age)? For example, rice is grown in certain parts of our country and it forms the staple in those regions; similarly wheat, jowar, bajra, makka (corn) and ragi are used as staples, where these are the major crops. Secondly, the amounts and kinds of foods we eat is affected by the money that can be spent for food. Thirdly, our family’s meal pattern is dictated by the geographic region, religion, community and family practices developed over several generations. The dals, the vegetables and fruits, which we habitually include in our menu, are mainly those, which were a part of our regional meal pattern. Even when we move to other regions for work or business, we tend to retain a large part of our food heritage. For example, Punjabis residing in Bombay or Calcutta, retain their food pattern, which includes wheat parantha, rajmah, palak, and peas, etc. A Tamilian in similar situation would include, rice, sambar made from tur dal and vegetables such as ash gourd and amaranth. As you know, it makes little difference whether the leafy vegetable used is amaranth or palak from the nutritional point of view, for both provide pro-vitamin A in substantial amount. Thus the regional patterns can meet the nutritional needs of people, if sufficient food from each of the five groups is included; the particular food chosen from each group and the way it is prepared is a matter of individual choice. In addition to these regional variations in food acceptance pattern, two major patterns are prevalent in the world—the vegetarian and the non-vegetarian dietary. It is good to remember that in India, vegetarians include milk and milk products such as curds, lassi, paneer, cheese, buttermilk, etc. Let us understand the historical basis of evolution of the Indian dietary before discussion its nutritional aspects. Evolution of the Vegetarian Dietary Pattern1 Before the advent of Jainism, there appears to have been no restriction in the food acceptance of our people, except on an individual voluntary basis. The philosophy of non-violence, which was preached by the prophets of Jainism had a profound influence on the dietary practices of their followers. Not only did he become a vegetarian, but he refrained from hunting and banned it in his kingdom. One of the reasons for abstaining from flesh foods was the belief in the transmigration of souls between living beings, which, included animals. Thus Vegetarianism represents a conscious choice with respect to one’s diet, which is quite different from foregoing meat because it is expensive. Thus it does not connote a dietary practice only, but is a way of life that has cultural and spiritual implications.
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Transmission of ionic charge between two acupuncture points has been demonstrated (Mussat, 1974). Acupuncture needles with one metal for the shaft and a different metal for the handle form tiny batteries. Some schools of acupuncture use additional electrical stimula tion applied to the needles. From an electrical perspective, each organ in the body is a like a battery contained in a sac of electrolytes, with a positive potential on the surface of the sac that is the aggregate result of electrical processes in the tissues of the organ. The normal functions of an organ can be expected to generate stronger and smoother electrical effects than an organ in distress or disorder. Electrical cur rent and ionic fows are postulated to move along the fascia, providing electrical con nections from the organs to the skin surface. Acupuncture points form inter connecting nodes in connective tissues among all of the circulatory and regulatory Energy Medicine 249 Surface Depression Dense Connective Tissue Loose Connective Tissue Capillaries Arteriole Myelinated Nerve Unmyelinated Nerve Fibers Myelinated Nerve Vein Arteriole Lymphatic Trunk Superficial Fascia figuRe 7. Each point is situated below the skin in a tube of connective tissue that is less dense than the sheath of denser, and electrically less conductive, tissue that surrounds it. At the core of this tube is a bundle of fuid vessels composed of a lymphatic trunk, entwined with an arteriole and an associated vein. The vessels are surrounded by webs of unmyelinated cholinergic nerve fbers from the autonomic nervous system. Other myelinated nerves weave in close proximity with the blood and lymph ves sels but are not entangled with them. From a mechanical perspective, the column is an elastic system that absorbs jolts and pressure. The vascular bundle also provides interaction between the vasomotor system and temperature regulation (Helms, 1995; Auzeich, 1984; Bossy and Sambuc, 1989; Senelar, 1979; Terral, 1988). Senelar and Auzeich found that 80% of the points examined showed this combination (Senelar and Auzeich, 1989). Heine described this columnar arrangement in similar terms, emphasizing the high-speed electrical transmission functions of the proteoglycans in the loose connective tissues that pass through the fascia with the vessels and nerves. The proteoglycan network responds to electromagnetic and magnetic stimuli, eas ily depolarizing, and transmitting these electrical potentials over long distances as chain reactions in tissue matrix (Heine, 1988a, 1988b, 1990). A modern acupuncture needle is made with a steel shaft and a handle of a dissimi lar metal—copper, silver, bronze or an alloy, wound around the upper half to one quarter of the shaft. Three different electrical phenomena arise when an acupuncture needle is inserted in the tissue. A thermoelectric potential develops along the shaft 250 the Scientifc Basis of Integrative Medicine because of a temperature gradient. The tip in the tissue becomes warmer than the handle, and the larger surface area of the handle prolongs this effect by acting as a radiator in contact with air. The tip of the needle develops a positive potential via the Seebeck effect of the temperature gradient.
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The ‘ constitutions’ that accompany the case histories suggest general conclusions concerning the periodi cities of crises, notably concerning the regular occurrence of paroxysms and crises on either the odd, or the even,* days as numbered from the outset of the disease. But these descriptions clearly reflect the writers’ theoretical assumptions and interests, and not surprisingly modern clinicians have, in many cases, found it impossible to identify, on the basis of these accounts, what the patients were suffering from. My father tells me that as a medical student at St Bartholemew’s in the early 1920s he was taught to watch for the crisis in pneumonia on the uneven days, especially the seventh, and in the sixteenth edition of William Osier’s the Principles and Practice of Medicine (ed. The commonest theory, derived no doubt from popular beliefs but expressed as a general dodtrine in several Hippocratic texts, is that opposites are a cure for opposites. Diseases caused by exertion are cured by rest; those caused by indolence are cured by exertion. To put it briefly; the physician should treat disease by the principle of opposition to the cause of the disease according to its form, its seasonal and age incidence, countering tenseness by relaxation and vice versa. This will bring the patient most relief and seems to me to be the principle of healing. The writer of Tradition in Medicine attacks those who based their theories on hot, cold, dry and wet particularly on this score. In chapter 13 he suggests that they should consider the case of a man of weak constitution who has fallen sick through eating unsuitable food such as uncooked wheat and meat. It must obviously be one of them because these are the causes of disease, and the remedy lies in the application of the opposite principle according to their theory. As these examples show, some theories of treatment were highly schematic and dogmatic. Once again, however, we must do justice to the variety of different points of view represented among the Hippocratic writers. The difficulty of effecting a cure, indeed the helplessness of the doctor, are often expressed. Yet none the less, if they get another wound of the same sort, they use the same treatment, for they do not suppose that the outside bandaging and exposure of the wound is to blame, but some mishap. For many practitioners cauterize shoulders liable to dislocation at the top and in front where the head of the humerus forms a prominence, and behind a little away from the top of the shoulder. Now these cauteriza tions rather bring it about than prevent it, for they shut out the head of the humerus from the space above it’ (ch. In practice, the methods of treatment mentioned in the Hippocratic Corpus consist of a very few general types. The most important are surgery (especially the treatment of fractures and dislocations, but including also the use of the knife, trephining and cautery), blood-letting, the administra tion of purges, emetics and suppositories, baths, fomentations, ointments and plasters, and, especially, the control of regimen diet and exercise. On the other hand certain de velopments did, it seems, take place in the fifth and fourth centuries in both surgery and dietetics. Most patients and all bed-ridden cases were treated in their own homes, cared for by their relatives.
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