Cholera is caused by a short, curved, rod-shaped germ known as vibrio cholerae. The germ produces a powerful poison or endotoxin. It is spread by files and water contaminated by the germs. The real cause of this disease, however, is the toxic and devitalized condition of the system brought about by incorrect feeding habits and faulty style of living. This condition facilitates invasion of cholera germs.
The treatment in the beginning should aim at combating the loss of fluids and salts from the body. To allay thirst, water or soda water or tender coconut water should be given for sipping, although, these may be thrown out by vomiting. Therefore, only small quantities of water should be given repeatedly, as these may remain for sometime within the stomach and a stay of every one minute means some absorption. The patient may require five or more litres of water a day, however, care should be taken to avoid waterlogging the patient. Potassium may be added to the infused fluid.
After the acute stage of cholera is over, the patient may be given tender coconut water and barley water in a very thin form. When the stools begin to form, he should be given buttermilk. As he progresses towards recovery, rice softened to semi-solid form mixed with curd may be given. However, the patient should not be given solid food till he has fully recovered. Liquid and blant foods, which the patient can ingest without endangering a reoccurence of the malady, are the best.
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Cholera is one of the most severe diseases of the intestines. It is a serious affliction, involving the lower part of the small bowel. It is a waterborne disease and is common during the monsoon period. The mortality rate for this disease has been quite high.
The disease strikes suddenly and fills the intestinal canal with bacilli which die rapidly and leave the person quickly, alive or dead. It comes as a fell epidemic and creates havoc but subsides quickly in the locality. Those who are susceptible to it are carried away and those who are left alive are immuned to it. Thus after an epidemic in a non-endemic area, there is no re-visitation in the locality for two or three years.
The original home of cholera is West Bengal in India. It spread from this country during the 19th century in a series of epidemics along the trade routes. It reached Japan and Russia in 1817. The disease then spread to Moscow in 1826, Berlin in 1831 and Paris in 1832. Subsequently, it spread to Canada and several countries in Europe. However, by 1895, cholera had disappeared from Europe.
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There are few enzymes whose names have been established by long usage such as ptyalin, trypsin and erepsin. Apart from these, enzymes are usually named by adding the suffixes to the main part of the name of the substrate upon which they act . Thus amylases act upon starch (amylum), lactase acts upon lactose, lipases act upon lipids, maltase acts upon maltose and protesses act upon proteins. There are, however, several enzymes which act upon many substances in different ways. These enzymes are named by their functions rather than substrates. Thus, an enzyme which causes deaminations is called a deaminase and oxidising enzyme an oxidase.
Enzymes play a decisive role in the digestion of food as they are responsible for the chemical changes which the food undergoes during digestion. The chemical changes comprise the breaking up of the large molecules of carbohydrates, fats and proteins into smaller ones or conversion of complex substances into simple ones which can be absorbed by the intestines. They also control the numerous reactions by which these simple substances are utilized in the body for building up new tissues and producing energy. The enzymes themselves are not broken down or changed in the process. They remain as powerful at the end of a reaction as they were at the beginning. Moreover, very small amounts can convert large amounts of material. They are thus true catalysts.
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Enzymes are chemical substances produced in the living organism. It has been estimated that there are over 20,000 enzymes in the human body. This estimate is based on the number of bodily processes that seem to require action. However, so far only about 1,000 enzymes have been identified. But their great role in nutrition and other living processes has been firmly established. They are protein molecules made up of chains of amino acids. They play a vital role and work more efficiently than any reagent concocted by chemists. Thus for instance, a chemist can separate proteins into their component amino acids by boiling them at 166 degree celsius for over 18 hours in a strong solution of hydrochloric acid, but the enzymes of small intestines can do so in less than three hours at body temperature in a neutral medium.
A feature which distinguishes enzymes from inorganic catalysts is that they are absolutely specific in their actions. This means that a particular enzyme can cause reactions involving only a particular type of substance or a group of closely related substances. The substance on which the enzyme acts is known as “substrate”. The specificity of an enzyme is, however, related to the formation of the enzyme-substrate complex which requires that the appropriate groupings of both substrate and enzyme should be in correct relative position. Enzymes which are used in cells which make them are called intracellular enzymes. Enzymes which are produced in cells which secrete them to other parts of the body are known as extracellular enzymes. Digestive juices are an example of the latter type.
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As dermatitis may appear due to varied causes, treatment also varies accordingly. If, however, the trouble is constitutional arising from internal causes, the patient should commence the treatment by adopting an all-fruit diet for at least a week. In this regimen, he should take three meals a day of juicy fruits such as orange, grapes, apple, pineapple and papaya at five hourly intervals.
After an exclusive fruit diet, the patient may adopt a restricted diet for 10 days. In this regimen, breakfast may consist of orange juice or grapefruit. Raw salad, consisting of vegetables available in season, with raisins, figs or dates may be taken for lunch and dinner may consist of steamed vegetables such as spinach, cabbage, carrots, turnips, cauliflower, along with a few nuts or fresh fruit. Milk puddings and desserts such as jellies, jams and pastries, all condiments, spices, white sugar, white flour products, tea, coffee and other stimulating drinks should be avoided.
After the restricted diet, the patient should gradually embark upon a well-balanced diet, consisting of seeds, nuts and grains, vegetables and fruits. The emphasis should be on fresh fruits and raw vegetables. In case of a severe condition, the patient should undertake a fast on fruit or vegetable juices for three to five days. This may be followed by a restricted diet for 10 to 15 days. Further fasts and a period on restricted diet at intervals may be adopted after the resumption of a normal diet.
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Inflammation of both internal and external skin is known as Dermatitis. Therefore, chemical substances usually give rise to dermatitis. They may reach the skin from outside or from inside through the bloodstream. About 100 different plants are known to be capable of causing dermatitis in susceptible persons. The onset is usually acute and begins an hour or two after contact. Dermatitis may be caused by external contact with mineral irritants. This includes most cases of industrial dermatitis which arise on the hands or forearms which actually come in contact with the irritant.
Certain drugs applied externally such as atropine, belladona, carbolic acid, iodine, mercury, penicillin, sulphonamides, sulphurs, tars and turpentine sometimes cause dermatitis. Other substances causing this disease include hair dyes, bleaches, skin tonics, nail polish, perfume, wool, silk, nylon, floor-wax and various detergents. Other causes of this disease are indiscretion in diet, deficiency of vitamine A, pantothenic acid, nervous and emotional strains.
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To begin with, the patient should adopt an exclusive diet of fresh fruits for five days. In this regimen, he should take three meals a day of juice fruits, such as apple, pear, peach, grapes, pineapple and papaya at five-hourly intervals. He should take warm water enema during this period to cleanse the bowels. Thereafter, he may adopt a restricted diet. In this regimen, the breakfast may consist of a glass of fresh juice of lemon or apple or grapes and the lunch may comprise one or two potatoes cooked with their skins. French beans as often as possible, a mixed salad of raw vegetable with lemon juice and olive oil dressing, one or two whole wheat bread or chappatis, and a little cottage cheese. The dinner may be a repitition of the lunch meal.
After the restricted diet, the patient may gradually embark upon a well-balanced diet, with emphasis on fresh fruits and raw vegetables. A hot water bath taken daily will be beneficial in the treatment of dropsy. Certain home remedies have been found beneficial in the treatment of dropsy. Of these, the use of pineapple is very effective. It contains sufficient chlorine which stimulates the activity of the kidneys and helps remove much of the waste products from the body. It also relieves the body of a water-logged condition. Also, the use of garlic is another effective remedy for this disease as two or three cloves of this vegetable should be chewed early in the morning. This will bring good results. The juice of bitter gourd can also be taken, with beneficial results.
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