Parents should expect the child to be distressed at these times — this is perfectly normal. In most instances, if properly handled, the distress will quickly dissipate and will become less frequent and less intense as the child becomes more familiar with the new surroundings, and more comfortable with his new care-givers, and as he becomes more confident with experience that the parent will indeed return.

The situation is often made worse by the parents’ own ambivalence about the separation. The mother and/or father may have all sorts of mixed feelings about leaving their child — ambivalence about a child growing up too quickly, anxiety about the child’s safety and so on — that are transmitted to the child. While such feelings are only too normal and often understandable, they may develop into an overprotective attitude towards the child which serves to hinder his development. This may also manifest itself in other ways, such as a reluctance to set consistent limits, and so on. Ultimately this may lead to a child who is reluctant to participate fully in the various experiences of life, who is overdependent on adults, and who reacts to any anxiety or stress by turning these feelings inwards so they are expressed as somatic symptoms such as abdominal pain, sleep problems and nightmares, and headaches.

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Where a patient has specific symptoms for which a doctor cannot find enough evidence to make a diagnosis, he should carry out specific tests, usually one or two at a time, to find out what is going on. Ordering a whole battery of tests may save time but often means many are ordered unnecessarily and this may be expensive.

The Australian Medical Association has recently reaffirmed its policy that multiphasic health screening of healthy persons should not attract a subsidy from the Government or the health funds but the cost of it should be totally borne by the individual.

This opinion is not shared by all doctors and some are wholeheartedly in favor of screening of healthy people and believe early disease may thus be detected before symptoms make themselves known.

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Those that occur in the second trimester or between three to six months, usually are due to dilatation or opening of the cervix or neck of the womb.

This may happen as the result of a previous injury to the muscles of the cervix, during childbirth, or from stretching of these muscles during a curette or induced abortion.

If trouble is recognised early, or as a preventive measure with a subsequent pregnancy, a firm suture or stitch can be put in the cervix early in the pregnancy, and this may enable the pregnancy to continue to full term.

Why should a woman miscarry?

Unfortunately, in most instances, we doctors just do not know the reason, although some doctors tell their patients it’s nature’s way of ensuring that most babies born are normal — thereby assuming that a pregnancy that miscarried is abnormal.

This probably is just speculation.

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In years past, this was common with tuberculosis, and fluid or pus would frequently collect between the lungs and the lung cage.

This was called effusion and empyema. This is seldom seen today, particularly as tuberculosis is far less common.

Treatment

Medical attention as early as practical is recommended with symptoms of this nature. Antibiotics are usually extremely quick and effective in killing the germs. A large range of organisms may be responsible, but many are amenable to treatment, and often a rapid cure is readily forthcoming.

Plenty of fluids, bed rest for a few days, linctuses for coughs, analgesics and antipyretics for pain relief, and to reduce elevated temperatures, may be given as necessary. Paracetamol elixir for children under the age of six years is effective in the latter case, or paracetamol or aspirin tablets for those in the 6-12 age group. Dosage varies with age—check the label, which usually lists the dose for each age. Check the details given earlier for the common cold, for the advice is similar.

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Treatment

It is often possible to modify the aggressive response. Give the child the opportunity to let off steam on a regular basis. It is fruitless to try to coop a child up at all times and force acceptance of every rigid restriction you suggest. It will not work in the long term.

Make opportunities where your child’s energies and frustrations can be redirected. Hobbies offer unlimited scope for this, especially those you know the child will do well. Success usually breeds success, and pride of achievement is a good way to get rid of pent-up emotions; it also dissipates energy extremely well. Punishment, sometimes essential, is not the cure in most cases. It will only tend to worsen the situation and make an aggressive bully an even worse one.

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When this muscle gets too slack and flabby as you get older or after childbirth, your pelvic organs can sag (prolapse) and you might experience problems such as stress incontinence (leaking of urine if you laugh or cough — see Bladder) and constipation. If the vagina becomes loose and weak it can lead to less sensation during sexual intercourse, and it may allow the bladder to sagdownwards, creating an increased risk of urinary infection.

Whatever age you are, you can tone up your pelvic floor muscles with simple exercises, sometimes called Kegel exercises, which you can do anywhere — in the office, on the phone, in a movie, waiting for a bus — wherever. No one will notice a thing. First get the feeling of which muscles they are, by concentrating on trying to stop the flow intermittently when urinating. You may not be able to do this completely, but the aim at this stage is just to feel the pelvic floor muscles working.

Once you can identify the muscles, you’re ready to start exercising. Tighten up the whole pelvic floor and hold for around three seconds, then relax for three seconds. Repeat five or six times. You should try and do at least 10 sets of these exercises a day — preferably more like 20. But don’t do too much too fast — work up to it gradually.

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Conjunctivitis is highly contagious. It is spread by contact with discharge from the eye or by contact with objects (hands, facecloths, toys, handkerchiefs) that have touched the infected eyes or that the child with conjunctivitis has handled. Symptoms of conjunctivitis may develop within one to three days after contact with the infection. Conjunctivitis usually spreads quickly to the other eye.

Conjunctivitis may exist alone. It may also develop as a complication of sore throat, tonsillitis, earache, or sinusitis.

Signs and symptoms

Conjunctivitis causes redness of the entire white of the eye. There is a buildup of yellow pus. The eyelids may swell and redden. There is a burning sensation in the eye. Vision is always normal, and light rarely bothers the eye.

Conjunctivitis is different from other conditions that also cause reddened eyes. Eye allergies cause itching and tearing but never pain or pus. Viruses cause pain and tearing but no pus. Foreign bodies in the eye cause pain, sensitivity to light, and tearing, but no pus; redness caused by a foreign body usually appears in only one part of the white of the eye. Glaucoma causes pain, enlargement of the pupil, tearing, and sensitivity to light, but no pus. If your child has reddened eyes, remember to consider these other possible causes besides conjunctivitis.

Home care

If you suspect that your child has conjunctivitis, call your doctor. Your doctor may wish to see the child; however, if your description of the symptoms is detailed and accurate, the doctor may decide to prescribe antibiotic eye drops or ointment over the telephone.

Place the antibiotic eye drops or ointment into the eyes as frequently as directed. Treat both eyes even if only one eye seems to be affected. Continue treatment for 24 hours after the eyes appear normal. Since conjunctivitis is so contagious, isolate your child from other people. Watch other members of the family for possible symptoms.

Precautions

• With medication, the eyes should improve quickly-usually within 24 hours. If eyes don’t begin clearing in that time, call your doctor.

• If eye ointments are used, vision will be blurred for a few minutes after each application. Any other vision problems should be reported promptly to your doctor.

• Be certain to notify your doctor of any other signs of illness, such as a head cold, nasal discharge, sore throat, earache, fever, or sore glands. Conjunctivitis may be a complication of another disease.

Medical treatment

The doctor will carefully examine the outside and inside of the eyeball, including looking under the eyelids for hidden foreign bodies. Your doctor may stain the eyeball with special drops to look for injuries or ulcers (scratches on the surface of the eye). The doctor may also culture any discharge from the eye, nose, or throat. Antibiotics taken by mouth might be prescribed. If necessary, your doctor may consult an ophthalmologist (a specialist in eye diseases).

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To head off future health woes, doctors recommend getting the following tests starting when you’re in your twenties.

History and physical: See your doctor for a history and physical every three years until you turn 40, suggests Dr. Goldberg. Then switch to every two years until you are 50, when you should start getting them annually. It’s here that your physician learns all about you and your family history: health problems dating back to childhood; any current medical conditions such as allergies, diseases, or medications; lifestyle factors, such as whether you drink or smoke; and any other pertinent information.

Blood pressure: Have your blood pressure checked every three years until you turn 40; then switch to every two years, says John Coulehan, M.D., professor of medicine and preventive medicine at the State University of New York at Stony Brook School of Medicine. “This might be one of the most important screenings you can have done,” Dr. Coulehan says. “There are absolutely no symptoms to high blood pressure. Untreated, it can lead to heart attack, stroke, kidney failure, and many other problems.” To refresh your memory, blood pressure is read in two numbers, the top number being systolic; the bottom, diastolic. Systolic pressure measures the force of blood flow at its peak. Diastolic measures blood pressure at its lowest point. A normal reading is around 120/80 millimeters of mercury. Consistent readings above 140/90 are high.

Blood count: Have your blood count done every three years, until you reach 40; then have it tested every two years, suggests Dr. Coulehan. This test measures the quality of your blood and the levels of three types of blood cells needed for optimum health: red cells, which carry oxygen; white cells, which fight infection; and platelets, which help with blood clotting. Low levels of red blood cells can be a sign of anemia, a major cause of fatigue.

Urinalysis: Have a urine test done every three years until you reach 40; then switch to every two years, says Dr. Goldberg. Give your doctor a paper cup with a small urine sample, and he can tell you how well your kidneys function, whether you’re drinking enough water, whether you have any kidney stones or prostate or urinary tract infections, and even if you have diabetes or some cancers.

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The simplest piece of biofeedback equipment (it can be bought from good chemist shops and specialist health and sports stores) is a simple skin resistance meter. Pads attached to the fingers detect the level of sweat production-which relates fairly closely to the level of activity of the flight-or-fight stress system of the body. The machine produces a noise, and the idea is to use your mind to silence the noise produced by the machine. How you do this is up to you. Some people think of pleasant, calming scenes. Others imagine a favourite pursuit. Others just gaze at a beautiful picture or object. As sweat production falls, the skin resistance falls and the machine stops making a noise. Such equipment is available, but there is also much more sophisticated and expensive biofeedback equipment on the market. Perhaps the most complex device is the ‘mind mirror’, a type of electroencephalograph which displays twelve printouts of brain waves.

Whichever method is used, the idea-just as with relaxation exercises-is that one recalls the method when the situation gets stressful. Many thousands of people have used relaxation exercises or biofeedback to relieve themselves of stage fright, nerves before exams or a job interview, etc. What you learn at home is put into use whenever you need it.

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Zea mays

Combined with agrimony and made into a tea it is used to treat bed-wetting; alone it treats cystitis.

COUCH GRASS

Agropyron repens

Possessing antibiotic qualities, it acts as an antiseptic diuretic.

CRANESBILL (AMERICAN)

Geranium maculatum

Useful in cases of diarrhoea, haemorrhoids, peptic ulcers, and haemorrhaging in the digestive tract. It can be used as a mouthwash for mouth ulcers and sore throats. It is also used in treatment of thrush.

DANDELION

Taraxum officinale

Dandelion affects the kidneys, gallbladder, liver, pancreas and blood and contains the actives taraxcin, the monohydric alcohols taraxasterol and homotaraxasterol, fatty acid, sugar and insulin.

Dandelion would be one of the most prescribed herbs today, and its main use would be for liver complaints or as a diuretic. Dandelion stimulates the liver increasing its detoxifying action. Because of this action Dandelion is a valuable blood purifying herb and may be used in some skin diseases. Dandelion is also a very useful diuretic being much safer than juniper berry as it is non-irritant to the kidneys. The dandelion leaves can be eaten as part of a salad and will help prevent liver problems and gallstones. The dried roots are used to make a coffee substitute.

DEVIL’S CLAW

Harpagophytum procumbens

Devil’s Claw in used to treat inflammation of joints, as in arthritis, and also for mild analgesic properties. It is used to treat tennis elbow and when anti-inflammatory medicine is needed.

DILL

Anethum graveolens

Used fresh as a flavouring with potatoes, eggs, chicken, and fish, the seeds can be made into a tea to ease indigestion and in particular babies’ colic.

DONG QUAI

Angelica sinensis

Dong quai can be used in the treatment of most female gynaecological ailments, in particular menstrual cramps, irregularity, a delayed flow during menstrual period. It also can be successfully used to treat hot flushes that often accompany menopause. It is nourishing to the blood, being rich in vitamin E and vitamin B12 and is also useful in the treatment of anaemia as well as being a valuable blood purifier.

Dong quai is also very useful in combination with other herbs such as black cohosh, queen of the meadow, red raspberry and bless thistle. I have found this combination excellent in the treatment of hormone imbalance and menopause problems.

ECHINACEA

Echinacea augustifolia

This herb is used both internally and externally, for boils, acne, abscesses, severe bites, septicaemia, fevers, and in some cases it has been used to treat cancer. A dilator of peripheral blood vessels, it can also be used in prevention of viruses.

ELDER FLOWER

Sambuccus nigra

The flowers of the black elder are used as an ingredient in eye lotion and for skin complaints. They are mainly used to treat colds, sinus, chronic nasal catarrh with deafness, throat infections, and in combination with other herbs, it is used to treat constipation, diarrhoea, bronchitis, cystitis, and fluid retention.

EPHEDRA

Ephedra silica

Used in bronchial asthma, hayfever, skin complaints, purifying the blood, urticaria. It contains the alkaloid ephedrine.

EUCALYPTUS

Eucalyptus globulus

The Tasnunian blue gum’s oil is used externally for burns, cuts, ulcers, and sores. Inhaled, it clears the nose and lungs, aids bronchitis and asthma, and as a lozenge it relieves sore throats. It has a strong aroma, and acts as an antiseptic and disinfectart.

EUPHORBIA

Euphorbiahirta

Relaxes the bronchi and is used to treat asthma. The latex is used to treat warts.

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