Monthly Archives: April 2011

ADJUNCTIVE THERAPY FOR ACUTE BACTERIAL MENINGITIS

Steroid UseGiven that many of the damaging sequelae of acute bacterial meninges are due to the host’s inflammatory response, several studies have looked at the role of steroids as an adjunctive measure. Many of the studies have been done in children, and steroids have been shown to decrease the incidence of hearing loss in cases of H. influenzae meningitis in this population. Corroborating retrospective studies, a recent randomized double-blinded study from the Netherlands found significant mortality and morbidity benefit with the use of dexamethasone during the first 4 days of therapy for acute bacterial meningitis, convincingly for pneumococcal meningitis. The authors used doses of 10 mg IV every 6 hours for 4 days, commencing before or concomitant with the first dose of antibiotics. While they did not demonstrate better outcomes with steroids for non-pneumococcal meningitides, the number of non-pneumococcal cases was too small to reach a conclusion. Early steroid use should strongly be considered when the clinical picture with or without CSF data points to bacterial meningitis.
Supportive CareEach patient’s neurologic status should be monitored closely and vigilantly for clinical deterioration, and, if this occurs, the practitioner should consider prompt reimaging, the use of modalities to lower intracranial pressure, and neurosurgical consultation for placement of a ventricular shunt or other neurosurgical intervention. While debate has surrounded intravenous fluid administration and cerebral edema, it is now generally accepted that fluids are often needed to maintain an adequate mean arterial pressure to provide sufficient cerebral perfusion pressure.*7/348/5*

THE PAYOFF FROM MEDICINE

Medical research is consuming far more funds than it was when the health sciences were making breathtaking advancements in the quality and quantity of human life. We spend billions of tax dollars, for instance, on the budget of the National Institutes of Health every year. When it comes to the control of disease, medicine gave us much less for much more money as the twentieth century progressed. It is true to some extent that the problems faced now are harder to solve, but it is also true that medical research is stuck in a rut. We can be confident only that the problems of the present are harder to solve using the approaches of the past. Little in the control of disease during the last half of the twentieth century involved fundamentally new approaches, in the same way that antibiotics are fundamentally different from vaccination, which is fundamentally different from hygienic improvements, which is fundamentally different from surgical removal of diseased tissue. Rather we are recycling each of these solutions. The major advances during this period were vaccines and antibiotics. The payoffs from vaccination dwindled from the successes against polio, measles, whooping cough, and mumps during the 1950s and 1960s to the more sporadic successes of the subsequent three decades. The generation of new antibiotics struggled to stay ahead of antibiotic resistance. The antibiotic strategy was broadened to encompass antiviral and antiprotozoal drugs, but these applications never generated the magic bullets that were anticipated from the successes of the 1940s. The positive effects of antivirals on AIDS, and antimalarials on malaria, never came close to the effects of penicillin on streptococcal pneumonia. When confronted with problems such as influenza, AIDS, and malaria, researchers kept applying the solutions that worked for other diseases, hoping that improved technology would improve the results of these marginally effective strategies. They did not use technology to generate any fundamentally different approaches.     In spite of this declining return on investment, one fact stands out. Though there has been much investment in studies of genetic causation of disease, the most significant returns were generated on the investments in studies of infectious diseases. Polio, measles, hepatitis, liver cancer, ulcers, and cervical cancer were all controlled or shown to be controllable during the last half of the twentieth century through the control of infectious agents. This track record provides a sense of how to invest in our future: focus on the germs.     The Human Genome Project serves as a test case. Many medical experts believe that the Human Genome Project will accomplish much of what the last half century of medical genetics failed to do: identify the genetic causes of the major diseases so that the harm from these diseases can be ameliorated. The genome project will surely illuminate genetic causes of disease, but evolutionary principles suggest that the most important disease-causing genes will belong not to the humans but to the pathogens. Human genes will become relevant not so much because they cause disease but rather because they protect or fail to protect against pathogen genes.     Specifically, analysis of the human genome should foster the discovery of genetic sequences that seem out of place in the human genome. These stretches will seem out of place because they are out of place, being viral rather than human. By facilitating an improved understanding of infectious agents in the human genome, these studies will help unmask potential agents of human diseases.*28\225\2*

ABSCESSES AND FASTING

An effective method to quickly remove the toxins from the body is a period of fasting on a grape diet, which means what it says, i.e. no other food than grapes should pass the lips. This diet should not be followed for longer than four days. An even more foolproof way to rid the body of toxins is by colonic irrigation. As more and more people begin to feel the benefits of colonic irrigation, it is becoming better known and more widely accepted as a therapeutic procedure. Yet, many people still know relatively little about this treatment method, so I will explain how and why the treatment is given, and what should or should not be done in colonic irrigation. A good friend of mine runs a clinic in Toronto, Canada, which specialises in colonic irrigation treatments, called Resto-Clean. Most of the following information is based on the procedures followed in that clinic.Colonic irrigation is a means of restoring the colon to a healthy state so that it can perform its function properly. It involves a hygienic cleansing of the lower bowel, or large intestine, using water. The modern diet, on the whole, is too full of refined foods, saturated oils and chemical substances, which puts a strain on the whole body. Besides this, the stress of modern living and the environment in which we live, are conducive to creating disorders which place a great burden on the whole elimination system. This creates abnormal conditions which prevent the colon from working properly. A colon irrigation is done to clean it and restore it to its proper function.The colon’s main functions are to continue digestion of food started in the small intestine, to remove water for use by the body, and to convey waste and toxic material outside the body. It does the latter by means of waves of muscle contraction in the wall of the colon, called peristalsis. It also holds bacteria which begins the process of breaking down the waste into its components, thus preventing a toxic condition in the body. It should take no more than twenty-four hours for food to move through the digestive system. However, the colon handles more than the food we eat; it also expels the dead cells from the body. In other words, the colon is the body’s sewage system.Two common symptoms of colon trouble are constipation and diarrhoea. But there are many conditions which an unhealthy colon will produce, which appear to be unrelated to the colon. Since the colon is the whole body’s sewage system, any problems which cause it to malfunction will have effects elsewhere. If waste builds up through constipation, a general condition which affects the whole body, called toxaemia, can occur, in which poisons from the colon are circulated through the bloodstream, giving rise to serious problems in several organs. Generally speaking though, problems in the colon show up in the digestive system first. Colon irrigation will help any condition which is caused by a back-up of poisons in the body. Since every organ throws off waste material, usually through the blood, an inability to dispose of the waste will poison the entire body.As to the question of who should have colonic irrigation, it would be too easy to say ‘Everyone’. Certainly anyone who has chronic problems in the digestive and/or elimination system should begin a series of treatments. They are not normally needed for small children, but treatment can be given to children over six years of age. The average person in our society, including children, has a diet which creates problems in the colon, whether or not he or she is aware of it. Even in a ‘healthy’ person, the walls of the colon become impacted with waste matter which builds up over a number of years. This prevents the efficient functioning of the colon. Any person with this condition will benefit from this treatment therapy.A person with a colon which functions normally, should have about as many bowel movements per day as he or she had meals the previous day. There should be no constipation or diarrhoea. These things would seem to indicate a healthy colon. However, because the body organs are designed to function normally under some level of stress, the appearance of a healthy colon may mask a growing problem in the digestive, system. Therefore, it is a good preventive measure to remove poisons and wastes and maintain good health by means of a cleansing of the lower bowel.Ideally, colonics should be done by trained colon therapists, who have a good knowledge of the anatomy and physiology of the digestive system. A trained nurse is best. People who are untrained in colon therapy should be avoided.There are different ways of performing colon irrigation. In this age of machinery one would expect that there is a machine to do the work, and indeed there is. But machines, even sophisticated ones, are not very sensitive to the human condition. These machines pump water into the bowel and let it drain several times. This is called a pressure method since the machine relies on an increase of pressure in the bowel to make it drain the water. A better method involves using gravity, rather than pressure. Gravity and the continuous and active involvement of a trained colon specialist makes this a gentler and far superior method of irrigation. In the gravity method, a tank of water located at a certain height above the patient (12-18 inches) provides adequate pressure through gravity and the manual control of the water allows a more individual treatment.Colonics are done in a room housing a padded table for the patient to lie on, the colonic irrigation apparatus and a chair for the therapist. The therapist talks to new patients to explain the procedure and notes down a short medical history. Anyone who has not been referred by a physician, chiropractor or naturopath, will be asked to contact their doctor to determine whether there is any reason why colonic irrigation should not take place. If desired, the therapist may approach the doctor on behalf of the patient.Patients are asked to empty the bladder prior to the treatment, because the bowel will be massaged. Setting up the equipment involves filling a five-gallon tank with water, taking the proctoscope from the steriliser, attaching the tubes to the proctoscope and lubricating it. Clients are asked to lie on their sides for the initial part of the irrigation and then on their backs. The water is set to a certain temperature, usually between 80 and 96 degrees Fahrenheit or 27 to 35 degrees Celsius, depending upon the condition of the bowel, and allowed to flow into the colon through a quarter-inch tube. By blocking the large exit tube, the therapist prevents water from flowing out and puts a little water into the colon. By releasing the exit tube, they allow the water to drain, carrying with it toxins, fecal matter, mucus, and fermentation and other debris from the colon. This is carried directly into the sewage system. By filling up the colon more and more on successive cycles, the whole colon is eventually cleaned. The therapist massages the colon upon releasing the water in order to encourage the expulsion of toxic waste. Often the colon will help in this by producing waves of muscle contractions, which is quite normal. The site of many toxins is the caecum at the end of the colon closest to the small intestine. One of the goals of the treatment is to irrigate this portion well and rid it of toxic waste. This is not always possible at first, depending upon the condition of, and blockage in, the bowel, but after a number of irrigation treatments all parts of the bowel are cleaned.After going through this, ‘fill, release, massage, empty’ procedure several times and using about fifteen gallons of water, the treatment will be finished. It will have taken from half-an-hour to an hour. At the end of the treatment the proctoscope is removed and the client goes to the toilet to discharge any water left in the colon.After colonic irrigation the patient should take acidophilus (yoghurt culture) capsules or tablets in order to ensure that the intestinal flora in the colon are replaced. If the patient has been referred by a chiropractor, naturopath or physician, the colon therapist’s report to him, or her, may lead to a prescription for further herbal or drug treatments.If we have a normally healthy colon, a series of twelve to sixteen irrigation treatments should be enough to bring it to a high level of efficiency. In the case of toxic colons, a longer series of treatment may be required.A good diet and effort to eliminate or control stress and fatigue will keep us generally healthy, and good health means a well-functioning colon. Under these conditions colonic irrigation every three to six months will ensure that the body as a whole is kept clean and vital.*32\147\2*