Infections which occur in the bladder, and which spread into the narrow tubes leading to the kidney (called the ureters) are common during pregnancy, particularly after the twentieth week.

Because of increased amounts of hormone in the bloodstream, the ureters tend to dilate, and this may encourage germs to travel from the bladder into the cavities of the kidney.

Due to changes occurring in the pelvis, complete emptying of the bladder is often difficult. Small amounts of urine are left, forming a reservoir for proliferating germs. Here they multiply rapidly. Frequently, no symptoms occur, and the infection simply smoulders on silently.

But when the germs commence moving into the ureters and on into the kidneys, symptoms can suddenly flare. Elevated temperatures, chills, fevers, aches in the lower back region, aches and pains all over, frequency of urination, the desire to empty the bladder a short time after this has already been done, with little satisfaction, all become commonplace symptoms. Vomiting and a high pulse-rate might also occur.

These demands prompt medical attention. The doctor will probably order a laboratory test on the urine. In this manner the organism producing the infection can be isolated, and the antibiotic to which it is most responsive determined. Treatment is usually commenced at once. Bed rest and lots of fluid are essential.

Women’s Health

Jake is a 29 year-old freelance writer and health food shop owner, who is currently trying to write and sell screenplays. He has suffered from feelings of sadness, fatigue and anxiety off and on since the age of three when his parents got divorced. He remembers being sick a lot as a child and getting into many fights at school. He was the class clown and was often in trouble with teachers.

Jake’s depressions went undiagnosed until age 22, by which point he felt extremely sad and dejected. He had recently completed his university course but didn’t know what he wanted to do with his life. He was working as a fund-raiser for disadvantaged children, but was tired much of the time and had a hard time performing his tasks. When he consulted me that autumn, he had quit work and was home sleeping for most of the time.

Jake had previously been treated with Prozac, but it didn’t help his lack of energy, which was one of his main symptoms, and made him feel ‘spacey’. I then treated him with another SSRI in high dosages. Although the drug made him feel more energetic and less down-in-the-dumps, it also made him angry and irritable and he developed a nasty edge in his dealings with other people that was quite uncharacteristic for him. To combat these unwelcome effects, I added a second mood-regulating drug, lithium carbonate. In addition, he also received psychotherapy and light therapy. This combination of treatments was quite effective and by the new year Jake had enough energy to acquire two part-time jobs and felt about as good as he could remember ever feeling. He was bothered, however, by medication side-effects such as sleep disturbance and continued aggressive feelings despite the placating effects of lithium.

After several years on this combination, Jake stopped his medications because he wanted to see how he would do without them. He felt fine until he moved to a new city with his girlfriend. He had always had difficulties with transitions and he felt the old familiar fatigue and anxiety coming back to him and consulted a GP, who restarted Jake on anti-depressants. Once again, he began to feel unpleasantly edgy. At Jake’s request, the GP prescribed a different anti-depressant, Lustral, which helped his mood somewhat but decreased his sex drive a great deal. Not only was he less interested in sex, but also had difficulty with erections and orgasms. He began to avoid sex because it was uncomfortable for him not to be able to perform and affected his self-esteem.

Jake read about St John’s Wort in the popular press and coinci-dentally, I had just begun to treat his mother with the herbal extract with excellent results. Since he is interested in alternative medicines, he put himself on St John’s Wort, 300 mg three times a day, and gradually phased out the Lustral. His sex drive, mood and energy improved markedly following the introduction of St John’s Wort. The only side-effect was mild indigestion, which responded readily to antacids and was in any case short-lived.

Jake’s mood and energy levels are as good as they have ever been and he finally feels ‘like a normal person’. He is grateful to the herbal remedy for helping him so much, even though he recognizes that he has also worked very hard to feel better about himself and his life. This work has involved therapy and self-reflection, regular exercise and actively avoiding toxic influences and negative attitudes. He plans to move to Los Angeles where he is more likely to succeed as a screenwriter, and feels optimistic even though his chosen course is a difficult and risky one and he has recently broken up with his girlfriend, with whom he was deeply in love.

Although Jake shifted from Lustral to St John’s Wort on his own, it is certainly better to make such changes under a doctor’s supervision. But Jake had clearly learned some of the key principles of anti-depressant management during his years of psychiatric care and did a good job with juggling his own medications. He recalled, for example, that you should try not to stop an antidepressant abruptly if at all possible. To do so is to court withdrawal side-effects, such as dizziness, sleep disruption and flu-like symptoms, to name just a few. Also there can be a rapid decline back into depression again. So Jake was wise to taper his Lustral gradually. In addition, Jake recognized that finding the right antidepressant is only one aspect of the treatment of depression. He is combining the herbal remedy with other healthy activities, such as therapy, self-reflection, exercise and the avoidance of negative influences. His move to Los Angeles also promises to be a healthy choice for him as it is more likely to offer him the career opportunities he needs in order to feel professionally fulfilled.

*16/75/2*

Anti Depressants

This condition can develop when babies drink allergen-containing breast milk. These babies become very colicky and often pass blood through the bowel and whereas the amount passed is seldom ever a threat to the baby it is an accurate barometer of just how inflamed and painful the lining of the baby’s bowel is.

Some authorities claim that milk and wheat are the only causes of breast milk colitis. My experience is that this isn’t so. Any food can do it. It all depends what the mother is specifically allergic to and not all mothers are allergic to milk and wheat. Don’t take yourself off these foods unless allergy tests have proved your sensitivity to them. They are nutritious foods and going off them could reduce the nutritional value of your milk. For the same reason don’t attempt to test for allergies by the elimination diet method. Go to an allergist and have the blood and skin tests.

The only exception to this rule is for those people of Mediterranean, Asian and African extraction. These people lack the enzymes needed to digest cow’s milk properly and invariably have a sensitivity to it. This sensitivity is often carried through their breast milk to the baby. If you belong to one of these ethnic groups and your baby’s breast milk colitis isn’t responding to treatment go off milk for a trial period. Milk could be the culprit. Going off milk means going off all those foods that are made from milk or contain milk in their manufacture.

*16\18\9*

Allergies

A logical question arises: how is it possible for all those nasty things to enter our bodies ? Where do they come from? It is certainly not our intention to ingest any of them in any concentration whatsoever.

Common products which could have propyl alcohol in them include cosmetics, perfumes, deodorants, shampoo, hair spray, mouthwash, body lotions, vegetable oils, antiseptics, shaving creams and rubbing alcohol. Propyl alcohol is also listed on the product labels as propanol or isopropanol. Any compound having a “prop” sequence in their name should raise your suspicion.

Benzene is so deadly, that it should be totally absent from our environment. Yet, traces of it can be found in many products ranging from bottled water to toothpaste and chewing gum. Benzene is not added intentionally in any food product. However, it is used in the process of extracting food additives, flavours and as a cleaning agent. Most products containing added flavours or extracts potentially contain traces of benzene. A typical example is a mint extract from mint leaves which is used in toothpaste, chewing gum and confectionery. Any product containing any food extracts and/or flavours potentially contains traces of benzene. Simple logic tells us that we should avoid such foods. Benzene is also added to unleaded petrol (gasoline).

Xylene, toluene and other solvents are used in paints, cleaning agents, petrol (gasoline), colour pen markers and other consumer products. Of course, you do not eat such products, but you can breathe the solvents into your lungs. It is quite logical, that you should avoid inhaling any solvents.

For further examples, go to the library and inspect Chemical Dictionary. Look up the solvents listed above and read in what quantities they are manufactured and how they are used in the food industry. Prepare yourself for a shock.

Mercury is one of the most toxic metals to our body. It directly affects most of the functions of the brain. Yet, it has been used for decades in the form of dental amalgam fillings.

As the mercury is slowly released from the amalgam – such fillings act basically like toxic time bombs. See the References for more details.

Fluoride is very toxic and for years has been used as a rat poison. Yet, most of the municipal water in the USA, Australia and many other countries is poisoned with it. The only large city in Australia having fluoride-free water is Brisbane, and interestingly enough, children in Brisbane have the healthiest teeth in the country.

It is little known, that in 1990-91 forty US dentists sued the American Dentist Association for misinforming the public and the dental profession about the effects and extent of amalgam and fluoride poisoning (NEXUS Vol 2 No 2 February 1991).

From just the few examples listed above, it becomes quite clear that it may be quite difficult, if not impossible, to avoid toxins completely.

However, it is quite possible for us to take precautions and to change our lifestyle to:

• minimise the intake of poisons

• assist our body in its natural purification processes

In the following chapters I will show you how you can do this.

*15/96/8*

General health

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.

*15/78/2*

General health

The conditions present while going to sleep are called “sleep associations” They are the things, events, people, and anything else that might surround induce sleep.

We all tend to look forward to, and even depend on, the same, or a a similar set of sleep conditions being there for us each time we want l asleep. These are different and personal for each of us. They usually ir things like a dark room, a favorite side of the bed, or that special pillow.

Sleep associations help us get to sleep. Routines and rituals ã important part of most people’s lives—but nowhere are they more common, and more important, than when they center around sleep. They seem to help bridge the gap between day and night, wakeful activity and the unknowns of sleep. Even as adults—logical, rational, and usually wanting more sleep—we go through certain steps to be sure everything is “right” for sleep.

I can’t go to sleep without reading for a while.

I set a glass of water on the nightstand, plump up my pillow, check the alarm twice, and then relax.

Children learn to go to sleep in the conditions that their parents set up.

They learn to expect that old blanket, the night light, the music box, or their special pillow.

Kevin was always rocked to sleep. We made sure that he was fast asleep when we laid him down; otherwise he would cry. If he woke up later, he would cry until we rocked him again.

Since adults are generally in charge of their own lives, they are, theoretically, also in charge of their own sleeping conditions. Imagine what would happen if they were not. Suppose that the parent noted above, when awakened by a windstorm, was all out of water—or, worse yet, discovered someone had hidden her alarm clock. How could she possibly get back to sleep worrying that she might not wake up on time?

Children often find themselves in such frustrating situations. They wake during the night to find that the conditions they went to sleep with somehow changed during the night.

Remember that arousals are a normal part of sleep cycles—a time when we check to be sure everything is as it should be before we fall back to sleep. How lonely a child who has fallen asleep at the breast must feel to discover that it is no longer nearby! The bed must certainly feel less comfortable than Daddy’s arms or the rocking chair. Certainly calling out or crying is a logical, understandable, reaction—an attempt to regain the conditions favorable to sleep.

Difficulty falling asleep and frequent waking are common sleep problems. They may be connected. When a child cannot get to sleep, he will also not be able to get back to sleep. His sleep associations can be the root of it all. Even if you do not suspect this to be your child’s problem, it is important to look at it. Developing independent sleep associations is also a preventive measure.

*15/67/8*

Anti Depressants

Q. What about side effects? We seem to read about adverse conditions occurring from time to time. Are these serious?

A. I suppose every known drug has an adverse side effect on somebody somewhere. It is a fact of life. Why, even most foods can be found to disagree with somebody. Considering that by 1984 around 30 million patients are said to have been treated with cimetidine, the number of adverse side effects is surprisingly small. Certainly researchers will dig up a wide range of symptoms which are claimed to have been produced by cimetidine, but in the total picture, these are very small and probably of little consequence.

The same doctors will also point out that simple, old fashioned aspirin, which has been around for nearly 100 years, may cause allergy reactions, asthma, bleeding from the stomach and bowel, nausea and vomiting, diarrhoea, and many other symptoms. But this does not preclude it from being one of the most valuable and widely prescribed drugs of all time.

If adverse side effects occur, then appropriate steps can be taken at once. On the other hand, if they are minimal, then the benefits of treatment will often outweigh any problems.

Q. Are other drugs in this family available, or is cimetidine the only one?

A. In 1982, another drug called ranitidine became available in Australia. Like cimetidine, it is a product of original research in Britain. It is marginally different, works in a similar manner, is claimed to have certain benefits, as all new drugs claim. Time, however, will show if this is really the case. Some major British trials have indicated that it may be of special benefit in the few cases in which cimetidine therapy fails to work. No drug will be effective 100% of times and a related drug may prove effective, this appears to be the case with ranitidine. Another preparation is a drug called oxmetidine, which is also similar in activity. Yet another named omeprazole has also been developed. How these will compare to the others, time will tell. It has all been succinctly put by a Sydney gastro-enterologist who recently wrote in an Australian medical magazine: “It is difficult to envisage that these drugs will be any safer or more effective than cimetidine in equipotent dosage.”

Q. Can the patient still take other medication with cimetidine if necessary?

A. The most likely medication will be antacids, and this is often taken in the early days along with cimetidine. It does little more than reduce pain. As pain disappears, most will cease using antacids, but they may be taken if desired. Often the decision is left with the patient.

It is pointed out that the doctor will be careful in prescribing other non-ulcer type drugs in the event of high dosage levels being required. Sometimes, in severely ill patients, cimetidine is given by injection, either directly into the blood stream (intravenous) or the muscle (intramuscular injection). This helps it work more rapidly.

In ageing patients, when the liver and kidney are not working as efficiently as in younger days, the drug may further reduce their working efficiency, and drugs such as warfarin, phenytoin, theophylline, which go to the liver also, must be taken with care. Nevertheless, this is the doctor’s concern. He is well aware of these special circumstances in certain patients and will offer the appropriate advice.

*15/61/2*

Gastrointestinal

Key to maintaining good health, nutrition refers to the relationship between the food we eat and our bodies’ needs. While there are hard and fast rules about the things our bodies require to operate efficiently, confusion often arises from the fact that nutritional needs vary from person to person as a result of physiological and environmental differences. Commercial interests may also exploit our desire for good health and seek to mislead us with exaggerated or even false claims about goodness or dangers of certain foods. A thorough understanding of the essential food groups and their sources, your daily requirements and the pressures of your environment and lifestyle will help you on the road to good nutrition. It is also recommended that any symptoms of dietary deficiency, which can range from marks on the fingernail to lethargy and more serious illnesses, be considered from a nutritional perspective. Your natural health practitioner will be able to help you identify and rectify problems with your diet.

Our basic nutritional requirements divide into five categories: water, carbohydrates, proteins, fats or lipids, vitamins and minerals.

Water makes up about 70% of our body mass. While it is often said that water has no nutritional value, it is essential for cell function, nutrient absorption, temperature control and waste elimination. Most people will die within days if water is withheld.

Starches and sugars are known as carbohydrates. Both are broken down into simple sugars called monosaccharides and stored in the muscles and liver. Providing our most immediate source of energy and assisting with the body’s uptake of nutrients, carbohydrates should comprise about 60% of a normally active person’s diet. Starches are complex carbohydrates and are found in grain foods such as breads and rice, pasta, peas and potatoes. Bulky and often high in fibre, vitamins and minerals, complex carbohydrates are the better source of carbohydrate in the diet. Sugars, particularly refined sugars, have less nutrient value and, because they contain less bulk than starches, are easily overconsumed, resulting in obesity. They are also a major cause of tooth decay. Refined white flour may contain similar levels of carbohydrate to wholemeal flour, but it is low in fibre and therefore of less benefit to your general health.

Proteins are responsible for growth and development and for the repair of body tissue. Made of amino acids, they also form the enzymes and hormones which regulate the body’s chemistry and function. You will obtain protein from meat, fish, eggs, dairy products such as milk, yoghurt and cheese, nuts and beans such as soya beans, lentils and haricots. The amount of protein required by the body is a matter of some controversy. Generally, it is thought that 40-60 grams a day is sufficient. Excess protein can be converted and stored as fat.

It may sound like a dirty word, but fat is an essential element of any healthy diet. Also known as lipids, fats allow you to absorb the fat soluble vitamins such as A, D, E, and K. Fat provides protection for the abdominal organs and nerve fibres, conditions the hair and skin and helps to keep the body warm. The issue, of course, is what kind of fat you eat and how much. Excess fat or too much of what are known as saturated fats, as opposed to polyunsaturated fats, contain high levels of cholesterol, leading to gallstones, obesity, blocking of the arteries, heart attack and stroke. Saturated fats generally come from animal products such as meat, eggs and dairy foods but beware: palm and coconut oils are also high in saturates. Polyunsaturated fats are mostly derived from vegetable sources like maize, sunflower, sesame and rape seed, and oily fish such as tuna, salmon or trout. Olive oil and some fish oils are known as mono-unsaturated and are better for your health than animal fats.

Under increasing scrutiny is the process of hydrogenation, a food industry technique which saturates polyunsaturated oils with hydrogen usually in the presence of a metal catalyst such as nickel. Normally liquid, the unsaturated oils become solid when hydrogenised: for example, sunflower oil becomes margarine. The process creates non-natural fat substances which are now thought to act like saturated fats, depositing fatty substances on the organs and making the blood cells sticky. Don’t be fooled by clever marketing. Keep your intake of hydrogenised fats to a minimum.

Although required in tiny quantities, vitamins and minerals are essential for food absorption and body function and deficiencies will affect a person’s health. (For information on specific vitamins and minerals, see individual entries). There are 13 major vitamins, only two of which are produced by the body: Vitamin D is made by the action of sunlight on the skin and Vitamin K is a byproduct of the activity of bacteria in the large bowel. All other vitamins must be ingested and, fortunately, most are readily available in fresh food. Supplementation in the form of tablets is rarely necessary. Remember, however, that the recommended daily allowance (RDA) for each vitamin and mineral is calculated as the minimum requirement for health in ideal conditions. Such conditions rarely exist.

The following is a list of just some of the factors, physiological, environmental and behavioural, which can affect your daily requirements: alcohol, caffiene, smoking, allergies, oral contraceptives, reliance on convenience foods, pollution, pregnancy and lactation, stress, antibiotics and other medication, certain medical conditions, menopause and old age. For these reasons, among others, your medical practitioner may recommend you adjust your diet or supplement your vitamin intake with tablets or tonics from time to time.

Fibre is the next important consideration in your diet. It has no real nutritional value as it cannot be absorbed by the body. Instead it passes through our digestive system as roughage, pushing through waste products and keeping the digestive tract healthy. Both constipation and cancer of the bowel can be avoided with a high fibre diet. Most unrefined cereals and plant foods contain fibre. Eat plenty of unrefined grains and raw or lightly cooked fruit and vegetables. Those who suffer from irritable bowel complaints should choose a source of fibre which will not scour the bowel, such as oatbran.

While you may think you need a chemistry degree to eat well, good basic nutrition comes down to common sense. Make sure you eat at least four serves a day of breads, rice, pasta or potatoes and four serves of fresh fruit or vegetables, including green and yellow/orange vegetables. Eat three serves a day of meat, fish, poultry, nuts, beans, peas or lentils. Have one serve of milk, cheese or yoghurt and keep additional fats, oil and salt to a minimum. The fat and sodium you need should be available from other foods in a balanced diet.

Whenever possible, eat fruit and vegetables raw. If cooking, opt for a technique which preserves the nutritional value of food or uses minimal fat such as steaming, grilling, roasting, stir frying and stewing. Western style frying of foods should be avoided.

Finally, eat three meals a day, vary your diet regularly, keep tabs on your general health to pinpoint any deficiencies and try to eat when relaxed. Fifteen minutes of relaxation before eating will aid digestion and increase your absorption of nutrients.

*23/69/2*

General health

The answer lies in the very nature of the addictive process. If we make repeated contact with a substance that disagrees with us we can, in time, get used to it and learn to live with it. So used to it can we get that if we no longer make contact with if we start, to experience withdrawal symptoms. These withdrawal or hangover symptoms are usually the same symptoms we experienced on first contact with the substance and can be stopped immediately we make contact with it again.

Former smokers (and drug addicts) are familiar with this pattern. As beginner smokers, many of them found their first cigarette unpleasant and even disagreeable. Peer pressure forced them to continue smoking and in time cigarettes started to agree with them, indeed they found they needed them to cope with life’s daily stresses and to relax. When they finally decided to give them up they went through withdrawal symptoms that often left them tired, cranky, irritable and depressed.

Over-exposure to any substance, even those that don’t give us an initial bad reaction, can give rise to an eventual addiction to that substance. This happens as readily to foods and common environmental and food chemicals as to cigarettes and other drugs.

Certain people come into the world with a genetic predisposition to allergy. Lowered resistance due to stress and insufficient nutrients in the diet triggers the tendency to react allergically to things we are over-exposed to. (It’s important to note that those who don’t carry this genetic predisposition can expose themselves to foods and chemicals with impunity for many years—even a lifetime.)

*23/18/9*

Allergies

Bacterial meningitis can damage the brain at any age from the newborn period to old age. Vigorous and early treatment with antibiotics and corticosteroid drugs nearly always prevents damage to the cortex, which lies immediately under the meningeal covering of the brain. However, if the treatment is delayed, or the organism is resistant to the antibiotic chosen, the damaged cortical cells may act as seizure foci in subsequent years. Meningitis due to tuberculosis is particularly likely to result in later epilepsy.

A bacterial brain abscess usually now results from blood-borne bacteria which are deposited in the cerebral hemispheres in a patient who is acutely ill with septicaemia. However, most blood-borne bacteria from an infection are filtered out from venous blood as this passes through the capillaries of the lungs. An exception occurs if there is a hole between right and left sides of the heart. Some bacteria may then pass directly from the venous circulation into the left ventricle and into the cerebral circulation. This accounts for the high incidence of cerebral abscess in those with these types of congenital heart disease.

An abscess may also form by direct extension into the brain from a local infection—for example, severe middle ear suppuration or frontal sinusitis may cause abscesses respectively in the temporal or frontal lobes of the brain.

Acute abscesses can certainly cause epileptic seizures, but, even if successfully treated by drainage and by antibiotics, further seizures may arise from the scar. In an attempt to avoid this, many surgeons now excise totally the capsule of the abscess rather than simply aspirate the pus.

Viral meningitis is a self-limiting illness, and epilepsy does not occur after this. Sometimes, however, the viruses are present within the substance of the brain, rather than remaining confined to the surface. This is called encephalitis, and seizures may result. Two of the more common viruses causing seizures in this way are the herpes and cytomegaloviruses. Cytomegalovirus usually affects the fetal (unborn baby’s) brain, and the herpes virus usually affects infants, young children, and adults. The HIV virus can also cause seizures, either by itself or, through depressing the immune system, allowing invasion of the brain by other viruses, and often by a small organism known as Toxoplasma.

Some viruses behave in a very strange way in the brain. Measles, for example, is an illness which affects nearly all children without significant late effects. The illness is terminated by the production of antibodies. A tiny number of children, however, do not succeed in eradicating the virus from their brains, and, some years later a new measles-related illness begins—sub-acute sclerosing pan-encephalitis—in which seizures and mental deterioration are prominent. Fortunately this is now becoming very rare with the wider use of measles vaccine.

Parasites can also cause epilepsy. The pork tapeworm Taenia solium may cause epilepsy if the cystic stage of the tapeworm, usually found in pigs, occurs in the muscles and brain of man. In developing countries, calcified cysts are found in the brains of many of the rural population and this disorder, cysticercosis, and tuberculosis accounts for a lot of the greater incidence of epilepsy in such populations. The dog tapeworm Toxocara has also been incriminated in the development of epilepsy, though with less certain evidence. Toxoplasmosis, possibly acquired through infection in utero from domestic animals is certainly associated with seizures.

Creutzfeldt-Jakob disease is a rare disorder caused by an infectious agent which is not a bacteria or a virus. One route of transmission is through surgical instruments (ordinary sterilization does not kill it) or through tissue transplantation (for example, corneal transplantation). It is related to ‘mad-cow, disease (BSE, bovine spongiform encephalopathy). Affected adults may have seizures as part of the serious neurological illness.

*22/188/2*

Epilepsy