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• Pick a room for time-out. Usually the child’s bedroom is used, though it can be any room where he will be safe. Sometimes you can use the time-out technique in a chair in the corner of the room, although this is more difficult and used more in older children.

• If your child is doing something of which you disapprove, warn him that if he doesn’t stop immediately, you will put him in his room.

• Only warn him once — then act. Never warn and then fail to act on your warning. This undermines your whole strategy by creating uncertainty as to whether you are serious.

• If he does not stop after the warning, take him to his room immediately. Do not explain to him why you are doing this — explanation at this time is a form of reinforcement.

• Leave him there for 5 minutes, then go and tell him he can come out of his room. Treat him normally after the time-out — do not talk to him about the event.

Time-out is especially effective for aggressive behaviour such as hitting or biting.

Have appropriate expectations that are relevant to the age of the child, and remember that children differ from each other in temperament. Some children will inevitably be more active and curious than others, and may be more likely to test limits more often.

Do not blame yourself for your child’s behaviour. While it is true that some parenting practices may reinforce undesirable behaviour, parents do not cause a child’s behaviour problems.

Behaviour is always more difficult to manage when you are not in your home. Parents often report that their child plays up when they are visiting friends and relatives, or out shopping, for example in the supermarket. The principles of behaviour management are exactly the same as outlined above, although it is much more difficult to carry them out consistently. It is understandable that parents may feel embarrassed in front of friends or strangers, and be reluctant to maintain the principles of behaviour modification.

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Some headaches can all be classified and singled out as having a specific name, such as migraine.

There is often an overlap between the different types and sometimes two or three different forms may be present in the one individual.

Many headaches are caused by stimulation of the pain-sensitive nerves in the wall of the blood vessels both inside the brain and in the scalp.

These are vascular headaches and include migraine, cluster headache, the headache due to a hangover and even that associated with toxic states, such as fever.

Some are due to muscle contraction and this includes the common tension headache and the very rare headache due to eye strain.

It also includes pains around the temple due to spasms of the masseter muscle which moves the jaw when we chew and is caused by an imbalance of the bite.

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So let’s consider exactly what this function is, and the parts of the body involved.

The organs concerned with menstruation are the womb, the ovaries, and the fallopian tubes.

The womb, or uterus, is a pearshaped organ roughly 7.6 cm (3 inch) long and 3.8 cm (IVi inch) wide, and it lies low down in the pelvis.

The womb is mostly thick muscle, but it is lined with several layers of cells known as endometrium.

The ovaries are two almond-shaped organs lying either side of the womb about 5 cm (2 inch) away. The fallopian tubes connect to the top of the womb, and their open outer ends lie very close to and partly enclose the ovaries.

The womb thins down to a narrow neck, the cervix, and sits on top of and projects into the vagina.

The beginning of a woman’s menstrual cycle really begins at the end of menstruation, or bleeding.

A hormone, oestrogen, is produced by the ovaries and causes the lining of the womb to thicken, to become soft and spongy.

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Older children tend to develop a cough and bring up large quantities of foul-smelling sputum. Often there is a mild fever which waxes and wanes. In long-standing cases the doctor notices that the fingers become clubbed. (This means the normal ends of the fingers are more rounded.) Many children become anaemic, pale and obviously in deteriorating health.

Treatment

Most doctors believe that bronchiectasis can usually be prevented by adequate treatment of any respiratory disorder. Upper respiratory tract infections, bouts of the flu, coughs and colds, bronchitis, pneumonia, removal of foreign bodies—whatever the cause and nature of the respiratory disorder—if this is treated adequately and completely until a full recovery has taken place, then the risk of this hapless and debilitating chronic disease is not nearly so high. It is salutary advice which parents would do well to follow.

Treatment must be under the proper care of a doctor or hospital where full facilities are available, and where ongoing care and advice can be offered. Lengthy hospitalization is usually not needed, and much of the care can be given at home by the parents.

In the early acute stages, when diagnosis is being established, hospital care may be needed. Antibiotics, aerosol bronchodilators, postural drainage and breathing exercises all form an important part of treatment. Adequate nutrition is also important. Sometimes diseased tonsils or adenoids may require surgical removal, or sinus drainage undertaken. In severe cases, when the disease is confined to a particular lobe of the lung, removal of the lobe may be advisable.

The crux of ongoing home treatment is the postural drainage and breathing exercises routine. This is aimed at removing as much debris from the lungs as possible, and opening up the air passageways to enable as much oxygenation as possible of the lung tissues. The routine may be continued for many months, for years, or possibly for a lifetime.

There is often no simple do-it-yourself cure for bronchiectasis. It usually is diagnosed in hospital, and treatment and ongoing care must often continue for a considerable period of time. Parents should make certain they carry out full instructions to the best of their ability. They should also explain to all their children (especially older ones) the nature of the problem and the need for continual co-operation. Without this, it becomes an even more difficult medical problem.

In early stages, moderate bronchiectasis is often completely curable. However, some cases continue for many years and require ongoing management under the experts.

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Occasionally there may be a question of normal mental development, but this can usually be quickly evaluated. In most cases, this is not the cause. A changed attitude by the parents and their efforts at helping the child speak normally often helps, with avoidance of baby talk as the child gets older. Stuttering often starts in the 3-6 age group when the child is often subjected to emotional stresses or tensions.

Treatment

Like most other anxiety-induced symptoms, eliminating the cause, as much as possible, as early as possible, is the ideal. Special anxiety-producing situations and circumstances must be carefully sought out. It may take time to do this, for situations that are of little importance to a parent may be major to a child. A sense of being wanted, of security, warmth and affection, is important. Instilling confidence into the little person, reducing fears and dreads and removing frightening situations all assist. Stuttering and stammering in the older child and adult are often very difficult to treat. In recent years, considerable success has been achieved in older children with the use of medical hypnotherapy. This again indicates the emotional nature of the disability.

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Oestrogen is secreted by the follicles in the ovaries, one of which develops each month in sexually mature women to contain an unfertilised egg. Under direction itself from hormones released by the pituitary gland at the base of the brain, the follicle bursts and releases the egg into the woman’s fallopian tube for fertilisation by the male sperm. Throughout the egg’s development, the follicle has secreted oestrogen to direct the uterus to prepare a blood enriched lining ready for the egg to implant in once fertilised. If fertilisation does not take place, the follicle, now emptied of the egg and known as the corpus luteum, secretes a second hormone, progesterone, which will cause the uterus to shed its lining, a process familiar to most people as the monthly or menstrual period.

The enormous influence of oestrogen on many aspects of women’s health is often only fully appreciated after menopause, when the menstrual cycle ceases and the body’s production of oestrogen reduces dramatically. All kinds of side effects can result. The hot flushes, insomnia and mood swings experienced by many women during menopause are related to the fall in oestrogen levels, as are the more permanent conditions such as thinning hair and loss of skin elasticity. Similar side effects can accompany the surgical removal of the ovaries in younger women.

More serious is the increase in the risk of coronary heart disease experienced by post-menopausal women: an increase up to ten times greater than that of women just prior to menopause. Oestrogen, it seems, helps to limit fatty deposits in the arteries and relaxes the blood vessel walls to increase blood flow.

Receiving particular attention in the 1990s is the role oestrogen plays in the maintenance of bone mass and bone strength. Osteoporosis is caused when calcium leaches from the bone, leaving it porous and brittle. The condition is known to be accelerated by decreasing levels of oestrogen in the body, suggesting that oestrogen helps the cells maintain their calcium content.

To avoid this and other unpleasant and even dangerous conditions associated with aging, many women are turning to Hormone Replacement Therapy, a program whereby synthesised, plant or animal oestrogens and some progesterone supplements are taken regularly from the onset of menopause onward. While many women find that HRT removes all unwanted symptoms of the change of

life, it makes other women sick and may have serious side effects.

Oestrogens are powerful substances, particularly many of the synthesised forms, and they are far from fully understood. Oestrogen is now thought to play a significant role in the development of several kinds of cancer in women, including breast cancer, and in triggering conditions like thrombosis or blood clots in the veins. It is also believed that synthetic oestrogen given to women in the 1950s and 1960s to prevent miscarriage is responsible for a higher than normal incidence of rare cancers in their offspring. Naturopaths may suggest herbal alternatives to hormone replacement therapy. For example, the Chinese herb Dong quai contains plant oestrogens and can actually help to balance the body’s oestrogen levels by adding oestrogen to the system when concentrations are low and inhibiting oestrogen action when the levels are too high, competing as it does with the oestrogen molecule for binding sites. In China it has been used for centuries to treat menopausal symptoms and menstrual problems in women and dong quai is now gaining respect in the West.

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Diarrhea in children over the age of five differs in several ways from diarrhea in infants and younger children. Diarrhea is less likely to cause dehydration (a serious loss of body fluids) in older children. The older and large the child becomes, the smaller the chances of dehydration. Serious dehydration is unlikely past six years of age-unless diarrhea is combined with vomiting, which keeps the child from drinking enough liquids.

Viruses in the intestine are the most common cause of diarrhea in older children. Dysentery bacteria and parasites in the intestine are the next most common causes. Respiratory viruses and reactions to certain foods are the least likely cause of diarrhea in older children.

Other diseases may cause long-term, frequent diarrhea in older children (though they are rare or unknown in infants). Ulcerative colitis is a condition in which ulcers frequently appear in the colon (large intestine). Regional enteritis (Crohn’s disease) is a recurring inflammation in the small intestine. The cause of these two diseases is not known. Cystic fibrosis is an inherited disease that affects the lungs, pancreas, sweat glands, and sometimes the liver and other organs. It often causes frequent diarrhea with foul-smelling stools.

Signs and symptoms

Loose, watery stools are the major symptom. There may be mucus or flecks of red blood in the stools. The child may have cramps. There may also be fever, loss of appetite, vomiting, and weight loss, depending on the cause of the diarrhea.

Home care

If the child has both diarrhea and vomiting, treat vomiting first by restricting the child’s diet to clear liquids only. Once the vomiting stops treat the diarrhea by limiting or not reintroducing solid foods – especially those with roughage, fruits (except bananas and apples), vegetables, butter, fatty meats, and peanut butter. Do not give the child milk, since milk may further aggravate diarrhea.

Encourage the child to drink plenty of clear liquids: tea, water, flavored gelatin water, and commercial mineral and electrolyte mixtures.

Precautions

• Do not give anti-diarrheal medications to children, since side effects are common and can be dangerous.

• Isolate an infant from children who are ill with vomiting and diarrhea.

• If there is blood in the stools, high fever, prostration (extreme weakness or collapse), or severe or prolonged diarrhea (more than two to three days), call your doctor. Dysentery may be the cause.

• Report frequent, repeated diarrhea to your doctors. Frequent diarrhea may be a symptom of colitis, enteritis, or cystic fibrosis, especially if there is weight loss.

Medical treatment

Your doctor’s treatment will be the same as home treatment. If necessary, the doctor may request blood tests, X rays of the large and small intestines, and sigmoidoscopy (an examination of the large intestine). In severe cases, hospitalization may be ordered.

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For the best results, take ginkgo in a 50-to-1 extract, says Dr. Willard. That means the label should say that it contains 24 percent flavonoid glycosides – the active ingredient that increases blood flow.

It’s best not to exceed 240 milligrams daily, warns botanist and herbalist James Duke, Ph.D., of Washington, D.C., in his book The Green Pharmacy. Higher doses can cause diarrhea and irritability.

Shrinking an enlarged prostate. Saw palmetto helps, Dr. Tyler says. However, he warns that we should not self-diagnose prostate problems. Let the doctor do that, then discuss alternative treatments, he advises. If the problem is enlarged prostate, then consider the herb. In Germany, doctors prescribe saw palmetto and other herbal remedies nearly 90 percent of the time to relieve enlarged prostates.

Read saw palmetto labels carefully, Dr. Tyler advises, and purchase a brand that contains 85 to 95 percent fatty acids and sterols. The fatty acids and sterols contain the plant medicine that benefits prostate tissue, so you want to be sure that you’re getting a potent percentage of that. A usual dose is 80 to l60 milligrams twice daily, says Dr. Tyler.

Coping with depression. Several active principles in the herbal remedy Saint-John’s-wort are proving to be effective antidepressants for mild to moderate depression. It doesn’t work instantly, though. Although it can be taken as a tea, it is best consumed in capsule or tablet form, standardized on the basis of hypericin, a marker, not necessarily an active component, advises Dr. Tyler. Follow label dosage directions carefully. The antidepressant effect should be evident within six weeks.

Solving stomach upset. Ginger, the cooking spice and the flavor in real ginger ale, is a great stomach-soother and a pleasant motion-sickness preventive, says Dr. Tyler. This root can stop nausea quickly. You can make a tea with 1/2 to 1 teaspoon grated fresh ginger, or with 1 teaspoon ground ginger.

Warning: It does have a pepper-like bite. If you prefer, you can eat some crystallized ginger candy. Or drink real ginger ale (not “artificially flavored”). For motion-sickness prevention, take the cure 20 to 25 minutes before you take off, of course.

Sleeping easier. Valerian is a mild tranquilizer that has been shown to help people fall asleep. And it doesn’t leave you with the morning hangover associated with other sleeping pills, Dr. Tyler says. Valerian smells terrible, so it is better taken in capsule form than in a tea. Follow the instructions on the label, advises Dr. Tyler.

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