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Stomach and intestines have their iris positions in the first major zone, directly around the pupil. In contrast to the other organs they are concentrically arranged, and take in a third of the iris.

When looking at an iris, attention is first directed to the stomach and intestinal zones. In health the stomach and intestinal zones are of equal size. They take in a third of the iris and do not differ in essential colour and structure from each other. This normal form of the first major zone is very seldom found in these days.

A. Stomach zone:

1. Hyperacidity: The stomach zone is lighter than its surroundings, almost white and elevated. The patient complains of heartburn. If the stomach zone is circular and with a sharply marked outer circumference, then there is swelling and cramp of the stomach. Such patients have a constant sense of pressure in the stomach with cramp, associated with eructations.

2. Gastric insufficiency: The stomach zone becomes dark grey and sinks inwardly. There may appear black lines deeply furrowed in the stomach area, in which case there will be functional deficiency of the mucous membrane. These patients also complain of heartburn, which is in this case a false indication of acidity (= lactic acid). If with these signs the stomach zone is too small, then that is a sign of induration/sclerosis.

3. Inflammation of the mucous membranes = Gastritis: In this condition one finds small white flakes lying directly against the pupillary margin, especially when viewed with side floodlighting.

4. Inflammation of the stomach muscle layer: This is of a rheumatic nature, and shows small white flakes or clouds in the outer rim of the stomach zone (therefore on the boundary with the intestinal zone). Patients with these signs cannot tolerate cold food or drink—they have the feeling of ‘a cold lump in the stomach’.

5. Gastric ulcer: (Ulcus ventriculi et duodeni). The ulcer shows itself in the stomach zone as a black point, and is most frequently found in the posterior wall of the stomach (right iris about 20′, left iris about 40′), and in the pylorus. In the pyloric area the signs are more oblong than round, and usually extend over into the intestinal zone (ulcus duodeni). An open ulcer is a black point or line which is accompanied by a small white cloud (black point or line loss of substance, white cloud -= tissue inflammation, therefore the pain). When the ulcer has healed, the black spot becomes surrounded by a fine white closed ring (healing ring).

6. Gastric carcinoma: Cancer signs are small putty-like steel-grey signs which shine out from the depths of the iris. The iris appears putty-like and ’smudged’. Not infrequently a stomach cancer develops, especially a scirrhous cancer, from the so-called Ulcus callosum. This is shown in the iris in the form of several serrated black spots which overlap each other. The iris is then seen to be flattened in the outer rim.

7. ‘Nervous, stomach: A red-brown stomach zone points to a toxic poisoning of the gastric nerves ( = the so-called ‘nervous’ stomach). In most cases this colour change also extends over to the intestinal zone. Often also, radiations extend over the brain areas—an indication that any headaches have their origin in the stomach.

8. Dropped-stomach = Gastroptosis: When through over-contraction of the pylorus the muscle layer of the stomach weakens (= dilatation of the stomach), or when through general slackening of the abdominal muscles there arises a ptosis of the stomach, then this condition will be recognised in the iris by an expansion of the stomach zone—from 30′-45′ in the right iris, and from 15-30′ in the left iris. If the stomach zone areas—right iris 45′-60′, left iris 60′-15′—are enlarged, then that is a sign of gastric enlargement/dilatation. The reason for this is the accumulation of gas in the stomach.

One also finds patients with an enlarged stomach zone—from 15′-30′ in the right iris, or from 30′-45′ in the left iris. Here it is the posterior wall of the stomach which is relaxed and which gives rise to the ptosis.

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Babies and small children can be a real joy when you are fit and well and on top of the world. But if you’re below par, they can change almost immediately into fiends. And if that happens, your feelings towards them can change just as abruptly. It was no surprise to me to read in Dr Dalton’s book Once a Month that so many babies are battered when their mothers are suffering from the aching miseries. There are lots of difficult and involved reasons for this horrible experience. One of the most powerful seems to be that the parents had the baby in the first place so that it could love them. Another is that they don’t understand why their baby cries and the crying makes them angry. Another could be that they’re completely out of gear because they haven’t had enough sleep for far too long. A baby who cries night after night for months on end can reduce even the most patient mother to a shred of her former self, and break down even the most loving self control. I don’t believe premenstrual tension causes women to batter their children, but the miseries could be the final straw that makes you take violent action.

If you find that you are far more severe, or even unkind, with your children during the days when your period is on the way, you really do need an extra pair of hands to help you.

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Despite the availability of vaccines that effectively protect children against diseases that can be killers, surveys repeatedly indicate that many Australian children are inadequately protected against these diseases.

The seven potentially devastating diseases against which all children can and should be properly immunized are: diphtheria, tetanus, whooping cough (pertussis), polio, measles, mumps, and German measles (rubella).

There are two reasons why so many children go unprotected against these diseases. First, many parents believe that polio, diphtheria, and whooping cough no longer exist. Second, people don’t realize how dangerous these and the other four diseases are. Children die or are permanently disabled each year as a result of these preventable diseases. The statistics prove that children are in danger from these diseases, and without immunization your child is also at risk.

Doctors use two types of immunization:

Active (live) immunization is done by injecting a weakened or killed virus or bacterium into the body. This stimulates the body’s natural defense system. The body produces substances known as antibodies, carried in the bloodstream, which are tailor-made to fight the invading organisms. The antibodies remain in the body for years, sometimes a lifetime, to protect it against that particular disease.

Passive (dead) immunization involves injecting ready-made antibodies – usually extracted from the blood of animals that have been immunized for the purpose of producing antibodies to be used in passive immunization. Passive immunization is only temporary but serves to protect a person who may already be infected until the body has time to create its own antibodies.

The following sections explain how you can protect your child against these diseases.

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Home care

An anorexic child should be under a doctor’s care. The doctor will tell you how to take care of the child at home.

Precaution

If the condition is not controlled, the anorexic may starve herself to death.

Medical treatment

The doctor will first attempt to rule out any physical cause of the child’s extreme weight loss, such as cancer, infectious disease, disorders in the digestive organs, or problems in absorbing the nutrients from food. If the patient has lost more than 25 percent of her original body weight, if she displays the classic behavior, and if the onset of symptoms occurs before the age of 25, a diagnosis of anorexia is usually warranted.

An anorexic may require hospitalization and forced feeding if her disease has led to severe malnutrition. However, most anorexics can be treated on an outpatient basis by a family physician, a psychiatrist, or a specialist in eating disorders.

The psychological problems that underlie the anorexic behavior should be exposed and resolved. In the meantime, however, the youngster must be convinced that she must gain weight and reassured that her doctor and parents will not allow her to become overweight. Healthy attitudes toward body weight and normal eating patterns must be restored.

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Does diabetes affect your sex life?

The short answer to this is no, it need not do so, and certainly not when you are young. Sex development in both boys and girls, men and women, is not affected by diabetes. Sexual feelings are just the same whether you have diabetes or not. The ability to enjoy sexual relationships and to have children is the same for people with diabetes also. The risk of pregnancy after intercourse is just the same as for people without diabetes, and those with diabetes need to take the same responsibility and precautions to prevent unwanted pregnancy as other people.

Young men may hear that impotence can be a problem for people with diabetes in later life. Impotence means difficulty or inability for a man to have or to maintain an erection. This may occur in some people after many years and may be a greater risk if diabetic control is poor. There are a number of possible causes for this apart from it being a complication of diabetes, and there are forms of treatment that may help if it does occur. It is another good reason of course to aim for careful control of your diabetes if you are a boy.

Can I have the pill?

Yes, but you should of course discuss this with your physician. There is no evidence that the contraceptive pill causes more problems in women with diabetes than in others, and the pill should not upset diabetic control. You will of course have a low-dose pill and have regular checks with your doctor while you are having it.

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Contrary to what you might think, life expectancy charts don’t tell you much about how long you, specifically, have to live. They predict how long you, your next-door neighbor, the president, Larry Bird, and a million other men have to live-72.4 years-but that’s only on average.

Your life span, meanwhile, is how long you actually live-and that could be anywhere from 60 to 120 years. And if you’re in much better physical shape than the average Joe your age, chances are that your life span will be higher than the life expectancy. “The life span of an individual may turn out to be very different from the life expectancy. You may die tomorrow, or you could live to be more than 100 years old,” says Dr. David Smith of Northwestern University Medical School. “At times when life spans are changing rapidly, life expectancies have little predictive value for the life span of an individual. Life expectancies are a prediction of what is to occur in the distant future yet are based on data from people who have recently died, so they are not very relevant to people living or being born today,” explains Dr. Smith. In other words, just because the chart says 72 doesn’t mean that you should schedule yourself to die then.

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Aspirin is a non-steroidal ant-inflammatory drug. It is in a class of drugs called salicylates, and works by inhibiting the release of chemicals in the body that cause pain aid inflammation. In addition to its use for acute conditions such as headache, fever or period pain, small doses of aspirin are often used to prevent heart attacks and strokes in high risk individuals. Aspirin has a blood thinning effect, and in this way may reduce the chance of a blood clot blocking a blood vessel and causing a heart attack or stroke. For this purpose aspirin is taken in a smaller dose, usually l00 mg. Popular brands include Astrix, Cartia and Cardiprin.

However, aspirin is not without potential side effects, and there are questions as to whether it really reduces the risk of heart attack and stroke at all. Possible side effects of aspirin include upset stomach, abdominal cramps, skin rash, allergic skin reactions, and it contributes to the development of leaky gut syndrome; making food allergies more likely to develop. A potential serious side effect of aspirin is gastrointestinal bleeding. According to Dr John Reckless, chairman of Heart UK, “If you put the average older patient on aspirin in one year, one person in 262 would have a significant gastrointestinal bleed in that one year”. One possible symptom of gastrointestinal bleeding is black or bloody stools. If you experience this symptom it is vital you see your doctor as soon as possible.

The Women’s Health Study, which ran for ten years found that regular use of low dose aspirin does not prevent first heart attacks in women younger than 65. The group of women who took 100 milligrams of aspirin every other day was no less likely to have a heart attack than the group taking a placebo. Each group had approximately 20, 000 participants. Most previous studies showing aspirin to reduce the risk of heart attacks and strokes were done on men. The women in the study who took aspirin had a forty percent greater chance of suffering severe gastrointestinal bleeding, and they also experienced more minor bleeding and bruising. Interestingly, the incidence of hemorrhagic stroke was greater in the women who took aspirin. This is the type of stroke caused by bleeding, not blockage due to a blood clot. This makes sense since aspirin reduces the ability of the blood to clot. Therefore, if you are a woman without significant risk of heart disease, it is not recommended you take aspirin as a preventative.

An interesting study called “The warfarin/aspirin study in heart failure” was published in the American Heart Journal. Patients with congestive heart failure are considered to be at increased risk of suffering a heart attack or stroke. This particular study involved 279 patients who were diagnosed with heart failure that required medication with diuretics. The patients were divided into three groups, aspirin therapy, warfarin therapy, and no blood thinning therapy. The results of the study showed no health benefits from aspirin or warfarin to these patients; there was no difference in deaths, or non-fatal heart attacks or strokes. Significantly more patients taking aspirin were hospitalized because of worsening heart failure. The conclusion of this study was “Antithrombotic therapy in patients with heart failure is not evidence based but commonly contributes to polypharmacy “. This means that there are no proven benefits to taking blood thinning medications in patients with heart failure, and they increase the risk of side effects from adverse drug interactions.

A daily aspirin may reduce the risk of heart attacks and strokes in some individuals. However there are much safer and healthier ways to thin your blood. The omega 3 fats found in fish oil, flaxseed oil and walnuts have a powerful blood thinning effect. All antioxidants help to thin the blood; you can obtain these through regularly consuming raw vegetable juices and garlic, and taking supplements of vitamin E. Do not take vitamin E, garlic or ginkgo biloba supplements if you are on blood thinning medication without consulting your doctor.

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One of the physician’s tasks in the sleep disorders clinic is to distinguish between patients with potential sleep apnoea and those with other complaints which adversely affect the quality of sleep. Stress related insomnia, for example, has no place in the laboratory dedicated to sleep related breathing disorders. The following case studies are fairly typical of patient histories which warrant complete evaluation of their symptoms. While they do not accurately reflect the incidence of snoring or OSA in any particular age group or sex, they have been included to demonstrate a diversity of presentations.

Case 1

A 38 year old travelling salesman had been a heavy snorer for years, aggravated to some extent by the consequences of a broken nose. He was a restless sleeper and often awoke in the morning with a headache. Daytime drowsiness was beginning to affect his attention span and driving competence which eventually led to his falling asleep while driving the car on a long business trip. He was not seriously hurt but the incident prompted investigation of his daytime sleepiness. Examination by his local doctor found him to be moderately overweight for his height and it was noted that he enjoyed five or six cans of beer at night. The doctor advised that his long working hours and drinking habits could explain the worsening symptoms and suggested he lose some weight and take time off for a holiday. Some weeks later he was involved in another near miss driving incident, prompting him to seek advice from another practitioner who referred him to a sleep disorders clinic. Overnight studies confirmed OSA and he began a trial of nasal CPAP which he tolerated well. His quality of sleep and daytime alertness were improved to the extent that he purchased his own CPAP equipment for use both at home and in motel rooms when required to sleep away from home. Weight loss and reduction of alcohol intake improved his condition slightly but not enough to eliminate his dependence on nightly CPAP, a situation he has come to accept as necessary for his wellbeing in the foreseeable future.

Comment: An example of OSA as it is most commonly seen. The patient is middle aged, male, overweight, drinks alcohol at night and has a predisposing factor to airway obstruction (a broken nose). For those who have suffered the symptoms of OSA for years, CPAP offers remarkable relief, an advantage which clearly outweighs the disadvantages and inconvenience associated with its use.

Case 2

A 32 year old woman enjoyed good health and led a particularly busy life with three young children and a part time job. She and her husband heard a discussion about snoring and OSA on a late night variety show on television which they viewed with mild amusement until some of the more serious aspects of the syndrome were aired. The wife was in fact a snorer but it rarely disturbed her husband as he was a very sound sleeper. Some months later she had reason to see her doctor on an unrelated matter and although rather embarrassed, she brought up the subject of her snoring. On examination she was found to have excessive fleshy tissue associated with the soft palate at the back of her throat, narrowing the entrance to the upper airway. There was no history of daytime breathing difficulty and no evidence of underlying disease. Referral to a sleep disorders unit confirmed her husband’s account of nocturnal snoring but there were no episodes of complete airway obstruction and none of the measurable features of OSA. Surgery to remove tissue from the throat was an option but as neither the patient nor her husband was particularly disturbed by the snoring, they chose not to intervene.

Comment: This woman’s state of health and level of physical activity makes the diagnosis of OSA extremely unlikely. The exclusion of underlying sleep disorders is reassuring for both doctor and patient and should never be considered a waste of time.

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Preventive medicine is very difficult to define and today it is no longer acceptable to think simply in terms of preventing the occurrence of specific disease processes. With current trends to whole-person health there is a more holistic approach which involves a more positive approach to preventive health care. Most people understand preventive medicine in terms of public health activities such as immunization for children, the control of fresh water supplies, safe sewage disposal, an assurance that foods and drugs are safe and the detection and control of infectious diseases. These activities are routinely and effectively carried out by local health authorities in most western countries, and we tend to take them for granted. Today we face new problems of prevention, with chronic diseases and self-induced environmental hazards causing a substantial proportion of all illnesses and deaths.

Partly because of the way that preventive medicine has grown out of public health and sanitation and partly because of the way that health care is centered on after-the-fact Procedures, preventive medicine is poorly regarded within medical and health circles and most doctors simply pay lip-service to the concept. This statement is borne out by the fact that only 4 per cent of the total US medical expenditure goes on prevention and only 1.5 per cent of all that country’s doctors are involved in full-time preventive medicine! The figures are not much better in other western countries. The influence of preventive medicine is also obstructed by the fact that it needs little that modern technology has to offer and therefore appears to be outdated and simplistic. All of this limits its appeal to those doctors and other health-care professionals who are looking for drama in medicine rather than what is best for society as a whole.

Unfortunately, prevention also tends to be handicapped in another way. Because of the difficulties already mentioned those who do go into it become so frustrated at the small resources and slow progress that they tend to become somewhat evangelical in their zeal to get things changed, so that they alienate even some potential allies. As one expert put it: ‘If there is one thing more difficult than submitting oneself to a regime, it is refraining from imposing it on other people’

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If one person on a weight-loss program is good, then one person with a partner must be better, right? In most cases, the answer is yes.

A buddy can be an encourager, a confidante, a co-conspirator, and a calming influence. She can persuade you to put on your walking shoes and go for a stroll when you’d rather be vegging out in front of the TV or pigging out at the mall. She’ll listen attentively when you confess to eating a whole bag of chocolate-chip cookies, then suggest that the two of you play a couple of sets of tennis that afternoon.

So how do you go about recruiting someone for this all-important position? Use some common sense, and trust your instincts. If you run into trouble every morning at the office when the pastry cart comes around, consider asking the person in the next cubicle to be your morale booster. If you need someone to coax you out of bed for your 6:00 A.M. workout, maybe your spouse is the weight-loss partner for you.

Nobody at home with you? Look on the Internet. There are all kinds of weight-loss chat rooms, including those connected with the Web sites of organizations like Weight Watchers and Jenny Craig.

Once you think that you’ve found your weight-loss buddy, tell that person what you expect. Are you looking for moral support? A workout partner? Somebody to talk to when the going gets rough? Make your wants and needs clear. That’s the only way that your buddy can help you.

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