Medical Self-Care issue # 1, 1976


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This is the first issue of Medical Self-Care magazine, created and published by Tom Ferguson, while he was a 4th year medical student at Yale, in 1976.

Tom Ferguson, MD then spent his life studying the transformation of the patient role and promoting the concepts of self-care, activated & empowered patients. He invented the term e-patients to describe the evolution of the patients following the arrival of the internet.

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Medical Self-Care issue # 1, 1976

  1. 1. , -=-116 --- --, Medical Self-Care Access to Medical Tools NUMBER 1/ $2.50 ,'----=- / .^;Fr Y
  2. 2. Editor's Page Welcome to our fhst issue. Her€'s the kind of iDfoirnation we'I Reviews of the best popular modical books. try to provide: 1 2 A.ticles t€aching basic paramedical clhical skils-how to take a blood Dressure, examine a sore thoat, listen to a friend's luDss. 3 Sources for hard-to-s€t rnedical equipment. 4 Access to the "nedical literaturc"-nedicd textbook, joulrrls, bookstor$, rd libraries. Accounts of the smwing health corsuner/patient education moveEert trking plfte both inside and ourside the health professioo. Future issues witl be loDsei, coDtain a good deal of rcade! Ieedbeck, and hopetu y be less of a one-man show. We welcome your sugsestions, oiticisN, and advice. I never planned to edit a nasuine. I'n a 4th tea! medicel studert planninA to becon€ a 5 family praetitioner. But doring my tilst yeel on the hospihl wads, I wB cortinually amazed by how little responsibility nost patients took for theb os''r health. About ha.l{ the patienh I s&w that year had a preventable ilness. Evory time I saw s snoker vith lung cancer oI eDphysema, a heara drbher with liver disee€e, a fet, sedentary businessnaD with a heart atiack, or a woman who'd oDly come to the doctor whon her breast carcer wd loDg past any chance of cule, I rcalized that nedical carc i! not somethiDa to be left to docto$ and other health workeB. This rnagazine is dedicated to those patients, and to those of oui reedsrs who wil profit by their example and avoid becomins patieDts at aI. Torn Ferg$on Yaie Medical School June 15, 19?6 Asea,^t Editt Lee A@Nkm E.dth Jdra rz€a Wonen s Medical Constrn.rism A Dnecdon,Ilyout m S'?tr & Cdve! D€sUn Illust arions on FFs 3 & I Typesetiing and Printing The A.looete Pre.s, New E@n
  3. 3. Contents Medical Self-Care 4 6 6 ? Suhder l9?6 8 I B€in8 Your 0w[ Prralnedic How to Be Your Own Doctor (Sometimes) The WeI Body Book A Beef@t Ddtor's Meual Medic8.l Passport/You Health Cue and How to Manase It Your Bblk Blg Tweezers/Thermometer/Stethoscope/Tone!€Blades Blood Pre$ur€ Cuff/Tlashlight/Otoscope Vaginal Speculum/R€flex Hammer Bedside Diasnostic Examination 10 OuI Bodies, Olrselves/heast Cancer 11 For Yourse[: The Fuli msnt of lemale Sexuality The Monthly Exhact/Liberating Masturbation Mer's H€rlth 12 Man's Body/Type A Behavior and voul Hoat E.tir8 13 The Anerican Heart Association C@k Book One Bowl A Sinple Concept for Contrcliing Body Weight Aembics/The New Ae.obics Aembics lor Wonen/The Zen of Rundina Kids 14 Teaching Medicine to Kids/Yosa for Children 15 T.A. lor Tots/Between Parcnt & Child Hor l.oDA W You Live 16 How to Practice Pr$pective Medicine/How to Save YouI Life On Snokins D.og" 1? The Medicine Show/Offthe Sauce The New Handbook of Prescription Ditgs Cop'ns 18 19 How to Be Your Own Best Friend/Stress without Dishess The Relaxation Response/How to Get Conhol of Your Time and LiIe Madn€ss Net ork News Reader The Medi.rl Lirersturo 20 The Merck Manual/Medieal Libraries/The White Shop C.oss-Cultud Medicire 21 Roling Thunder/AFay with A[ Pests DodinS rith Doctors 22 MenaaiDs You. Docior/Finding Medlcal Sell Crre MageiDe A non p.ofit n.saine publish€d lour tin€s rombd,t Frdftnriar offic* Box 31 9 San Franckco CA 94131 Additmnil dpieolrhisi$lcll Eehinns subsc.ipiions a rou 126 Sushinng $bscnplions tl00 (NMes ol rebi.ina &d susidninq sub$ribers will b. pdnt€d uhle$ requesidd oth€rwi5e) CopFisht O 19?3 by M€dical SeII CN Mi8ain€ a Doct ./On Workins with Docto.s Modical Cl$ss Io. LryPeople 23 List ofPeople Teaching Classes/Ihe Activated Patient Wouldn't you Like to Have a Doctor Like Watr Stol % Foedb&L
  4. 4. enjouabla, h;shlv reallobla u@k tlnt takes U& salelg m$ into tetitory Uou nAv h@e thousht ol u lor d.octns onh. Hh sexetu-page chaptet caAod, "A Note to Being Your Own Paramedic Phusiciatlt" d.$eru6 to be ,erored @d. sent to erery d.octt lou |autu. Irr. Sehnert lbit$ that a paperb@k edition uiA be out thh sLrntuer. -TF Bow To B€ Yorr own Do.t r Many of my patients already are their owr doctors-sometines. They've Iearned to hardle mino. illne$es d lsoE.drcsl Keith W Sehnzrt wilh goiltwtl Ehenoerg ernergencies witnout help, and majo! ones without panic. They have "blact bags" of thei. own, with ever)'thing Imn stetho' scope to sphygmornanorneter in them. They ex&mire their yougsters' eal3 i.ith otoscopes when thsy complain of earaches. They check hwbands' ed wives' heertbeale and neishbors' blood pres- Strang€ bwiness? Yes, they are nen' bers of thet blard'Dew beed, the Acti- vrted Patient-a kind of heady hybrid who is patient and onequarter physician. They've leamed to Tal{e the sphy8momanometer, for ex- ample-another instruDert that no hone should be without. When I gave then t patients in my m$tly black class et Northeast-Georgetown Medical Cent€! ir Washington, I knew they'd turn up pledty of hyperteNion, because it runs rampant in the conrnunity. So that wa! Iny honework assiSrment: "Take thes blood Try thent out on Iarily n€Dbers, ftiends, acqraintancssprsssure cuffs hoDe. each oI you check a mininum of haff dozen peoplo." Natunly, statistics high blood pressule are 60,6 ! oD for whites and four times that for bla.ks, butreted a! they are by inne! city stresses ald tensioDs. My students exceeded natioml figures. A startling 300,6 of thos€ exanined had this aptly naDed "silent disease" hypeltensioD-lnd rnost didnt BI-OOO PRE€iSJRE TOOI S lpeak the doctor's own lan8llag€, and ask him questions rathe! thar passively sit, honor and obey. They've leamed to check vital si8ns, the fbst si8Ds of r @mnary, and how to tel whether a siDN problein is m atlergy o. a eonunon cold by the color ol the mucous membrane of the noso. They've learned Body Talk-that special laDSl]ase oI synptoms th&t embles them to ktrow what ar ache or pah is $ying. And they a.e playing an important and needed role in a health parinership with 1916; 3&9 p38€3 110.70 postpaid lrord From p€rsonal medical experience, 20 teI you thet lor the busy doctor, theE s rothing wol8e than the years of it, I c{n Gmsset & Dunlap, Inc Bo: 941 Madison Squarc Strtion N€w York NY 10010 Ih;s book tuAs !o1t hou to so abdrt bec@tins &ltr oun par$ned,h. Probablu the b6t sinstz r$ource aao rhl.e for foths sharlns the soah of thit "ns@i@. Keith Sehnzrt has been tea.hins med.iclr.a to wtients sirce 1970. The lint sexenreen chapteft of thit book pr4ent hit coru:ept of the "@tiaateil patipnt," a hupenon trained, in batia clinbd shi0t ad, capablp ol padnipatins ,n the n&t asement of hb ,y her olrm care. The rest of the booh-128 blue wses in buh-cwbts of the SeV-EeIp Medig calc1ti.l,e, the textbook Dr. S. llf€s the ir. patient who cslls atrd say8 rvith pinpoint inaccuEcy, "I ache aI over." Or equany helpful, "I feel !o siek." A phone cr llom a patient who knows how to take vital signs-pulss, rcspiration, tempelatur€, blood pressure-and to leport relevart obseflations lite inflaned thuts o! reddened eardrums is fai more meaningful. I can make a judg€nent on whether the patient ought to come into the ofice, or go straight to a hospital. I can usualy Fescribe confidently on the phone. I seamed her hea.lth history and looked up. "A@oding to this, Nancy," I said, Hishly salted foods like dehydrated soups and bouilons, pretzels and potato chips should be less hequent visitors to Take the sugar bowl and saltshaker off th€ table. Use some selt in cookins, but cut down the uourt the recipe cals for. Nore should be routinely added when the meal is served-consciously tly to use "you're 39 years old." She lo8t her sef-assurance: "Oh, there covte lor pation*. It stua datailed, directions lot dodins Dith the n6t cotnnon ilbwsses, Mci.Ienk, trnd enet nust b€ some mistake. I'n only 34." "Therc's no mistake," I said, "Yoor Difren fM inet rned,ical suidebooks in that it a$und the reader ia capabl2 ol kannns sone basic c4ni.ol me,l.icine. An aging faster than you are. chm.olosical ase is 34. What I'n talking about is you rca.l ag€, ba-sed on your lile-style and body condition. Your body is Sell.Cre. Sumne. 19?6
  5. 5. aeins You.0*D It. patches on WoI Body Book tum)l'b, MD ,t'd Ed Bm@tt Mike Clothes to @ttre hone to. Tight clothes not only can ch"Je and upset the nornal bala&e ol your skin, they also slow down tbe ciculation of blood in your body by pressina eaai$t and constricting, sna blood vessels ad capilalies. It's a Sood idsa, if you hsve to we{ tishi clothes or you! job durins the day, or fo! other sial .*soDs, to have loo8e litting cloth€s to to. ff yo'tE . naD, take off your neckti€ &Dd loosen your belt; if come homs Pesnedic the tonsils. Record in 5 the Physical Oxamination Report. Th€ pharynx is the fleshy area that you wil see turthest to the bsck of the thoat. l,ike other mucffal tbsue, it should be noist and pink. Note anything here that looks .ed, oI swouen, or any white or yelow patches, Mucous draining doi'n along the pharrrx wi usualy appea! whitish to yelowish, in the fo.n of a thin mating; you miaht al-so describe it as stlingy or veiny. Record your obsoIvations in th€ Physicat ExadriDatior Repod. youte e woman, remove your girdle il you wear oDe. Fird something that realy feets good next to yolrr skin, clothes that are Ioose and which please you aesthoticaly. THE WELL BODY BOOK 1973; 350 paAe! 17.75 postpaid lrom ReDdoD House 20r E 50th Stieet New York NY 10022 Alreoty udels kraun d,n eA be. loved, thit beaut;l1rlu d,es;sned, book ht8 becw so pory)4r its easg to ouerbok hoto sood,;t reau! Check the cufis of your sleeves. ff you can slide two fingers betveen the doth and your skin, they are okry. ff not, they ale tight enough to causo skin initation aDdlo. restrict the cncdation of blood t and lrom yollr hsnds. Check for elastic nalks amund the t ps o{ your so.ks, waist, and the le8s, armholes, and neck of underweer. Ifyou see any mark8 on your skin ftom the pressure oI tho elastic, that |!e& is plom to rash and lest ct€d blood Breasts: The b. Conbiws a deep emphaAit t . the feehns t;de ol thinssseri,s;tir;tv, coping, coi.nuai@tim - uit h exceuznt sectiora on prerenthe medic;ne ad, d,iosrwsis aon ueatnent. Thei, sec. t;on on the eran,imtion b the Mike Samueb W$t Coast peoplz, pftctia* medbhe at sides, brealts utrcovered. Study hor slightly larger than the other-which mry or Day not be immodiately perceptibl€. In spite of the size ditrer€nces they wil b€ shaped about the sa[le, one side matchina the other even thoush differcnt in size. That'! the synnetry you w&[t to look for. a med,icine Lack of symmetry ![ea[s dimples or There ere common medical compkints that doctoB see every day which cen very olten be baced to clothing: heat rashes from dothes that !E too hot; alergies ielrted t the fab c the clothes are rnado oi alergies related to the detersEnh l€ft in the clothes hom washins; nechanical ir clothi[si ':ock rot" Irom wearing pants that are t o tight aDd {abric! thet dor't b.erthe; vaginal infections frord wesring dylon uderyrrts that dort breathe; ralhes md chafing fmn eoa$e-textured clothes on dolicate skin sudaces such a3 the genital areas, mderarms, bleasts and neck; fungus infections ol the feet from wearins non'brathing 8ho€s; blisteft and inlections bliste* on the leet as a r€sult ol badly-desisDed tt the othe!. Note sym[lotly and lsylrr, metry. Most wonen have one breast ne^, colnr heal4rc, tuui 3 LLD.'g." .TF chafing flom tight clothes or the elastic exam breasts lor e moment, comparing ore lree cttnie stalfed bs "inssase fuith heolers, In'lian fbst pa.t of this is visual. Have the pemon sit faciDa you with her arrns harsiDs loossly at her or il-fittirs bulges which sppeu in one brea€t but not Now cxahine the tltmet. Have the peBon open their mouth $'ide and sey "ahhh!" If necessuy, take your butte. knile and we the flat lide of the blade as a tongue depr$ser to press down the back ol the tonpe so that you car see int Tonsils are masses oI lymphoid tbsue which in childhood probably help protect the body frotrt irjection. Their size vuies, but the color is pink Iike other healthy mucosa. II a person ha-! had theb tonsils removed, you won't, oI course, see the tonsils. Also, in adults, tonsils [lay be norroalty sh.udker ud difficult to see. Note red, swolen, or white to yeuow in the other. Note these and write them dom iD the Physical Exuinstion Report. White the person is sittina up, elarunc he. nipples elose up. Nipples vuy in shape, size and coloration hom persor to person. The color ol the nipples, as wel as the size of the breasts, may changE during neNtruation. Tenderness oI the bre3ets may eko occur. Note ed record any redness, dischargs, or sores.
  6. 6. 6 B€ns You Own PlEnedic A Bs€loot Doctor'! Mrlud Instihtte of Traditnlnnl Chtnese Med,n inz ol Hinw. Poat6e, Peode's newbue of Chi,ur 4 between the second htercostal space. Ove! the bicuspid valve: located slightly to the risht of the lower sterDub. The solrds provided by the punpiDg ol ({led the ,eart somd!. The lbst heart sound is caused by codraction of the heart chanber whers the heA't ,re the tricuspid &Dd bicuspid valves suddenty dose add nus.Ies oI the left and right ventricle contract. At the apex of the h€art, on€ ean he a "tury-tuDg" soud. The second healt sound is produced by vibration rssulting lrorD venhicular dia' stolo md sudden closue of the ptllnonlfy fnd aortic valves. At the b8se ol the heart, that is, over the pulmonary aortic valve and the aoriic valve, one can hear a Seven'Lealed Lotus lch'iyeh Lien) Properties and, ortrbar Warm-natured, tastes bitter sweet. Relax$ muscles tnd aciivat$ sinews, reduc$ sweling and Corditiom used most lor: I Rheumatoid arthralsiai 2 tEumatic damaAe 3 wound caused bleediDs. Prepmtion:Stems and leav$ Ior n€dicinal use, 5 ch'ien to 1 Iiang each tim€, prepared aB decoction. For external us€, crush fresh leaves for poultice to be applied over afiected parh. The interval between the fbst and second hea{ sounds is conparatively short. Fron the second heart sound to the eppeaEnce of the first head sound the Heart souDds of a nolnat Person are reSrlar, head at the rate of 60-80 times per rninute in an adult. In ilness, nulrnurs may be heard during dialtole or 1974; 960 paSes i9.75 postpsid fron Superirtendent of Documents US Govemnent hi[thg Office WashirstoD DC 20402 This phon2book-sized, treature bbrAa oru?ltvture wul tn/ttsase Dith clalfinl Chinpse, heftol, Mn Westm oeproacheg to med&:he. Sectit?ls ol Undzntandrnq th2 Elri.on Bodu, Huqk u, Dhernstia ann Iher&pelttic Tectuicw, Mh Cot- bol" rreatflent of Coflnon llhtesses, ann we of Chinzse a 400'pa4e sednm orl the Medici,,nl Plants. Treatment se.ti0a$ acwuntture, hetbd' ud Wetten Ibt rene- d,ia for eqah iuness. Soltg ot the methodt and. rndern* lpea.h kenels, ltiol2u, roaated cTocodilz, aAktoorn cocolmtl Eolntd Wttg erotio. ow wova ol med,icinz ,|,1tt hokjuAt at arbitrary ann uhinricol 1,Ia*ea you redize 'lF Social Facto$ Pube Diagrosis The pulse is senerally felt at the "ts' uD k'ou" (over the radial dtery at tle wfist.i Different pube findings supplernenting data obtained by other diagmstic techniques, may uncover the nature of pathologic chanse in the hffoan body, and help make a proper diagrosis. Techniqg: Beiore the patient's pube is checked, the patieni should be restins, and the phFician should be.elaxed. During the pulse taking, the patient's wrist is placed resting on its side, r'hile the physician plac$ htu index, middle and Thb i! an important tschnique wed in examining for heart ailmsnt8. It is gpner3Iy performed over four areas: ring fingers over the "ts'un-k'ou," ieeling first tle "kuan-mai" site on the inner aspect of the bony proninence (tle ulrar proninence) with his niddle finger. Then he places the other two lingers over the bicwpid valve: locatsd at the anterior and Aus.ultation of the Heart 1 Over the apex oI the hoart. 2 Over the aotic v&lve: loceted alons the right bord€r of the sternun between the s€cond i.t€rcostal sPace. 3 Over the pulraonlry ao.tic vltve: loc{t€d along the left border oI the stemurn "tsun" .rd "chih" sites, posierior to the middle fhs€r. If the patient's dms are sho.t, placenent of the three finge.s should be adjusted, but tle same amount of pres8ure (light, nedium, heavy) is used to detect pulse conditions over the ts'un, kuan, and c)'ih sites Differences in the sociel system often have a 8reat etrect on the incideDce a[d eliniDation of certair diseas$. Chitra ha! ehninated cholera, smallpox, vere.erl disease, plasue, etc. With respect to certain diseases with more serious cors€quences, such a! malaria, schistosomi$i!, etc., better preventioD and trsrtm€nt trteasues have g"eatly reduced the disease incidence. Therefore, wheD causeg of disea-le a.e analyzed, s"eat emphali! must be given to the social systen. Promotins Late Mar.iase Il the young people talk about love, aDd havirF children et too eally malriase an as€, thei ener8:ies affectins theb work will be dissipated, od theb study. Furtherno.e, ihe standpoint of physieal developnent, roost youDg people do not attain all .ound matu ty until sfier 25 years oI age. Prenatue narriage and Ioi the Medical Sell Cee- Snnner 1S76 procreation are not beDeficid young and succeeding geneHtion.
  7. 7. Beins Your O*n You H€rlth C&. &d Eor I$!,reneLWeedMD Use of Condons A contracsptive d€vice used [lale, it b simple by the to use, with good results. Its selectior depends on the size of the e.ect p€nis. B€fole inte.cou$e, the coDdob should be blown up to tsst for le3ks. Th6n eii at tho tip should bs expeled b€fore fitting it on the peni!. Alt€r ejrculation, and befole the penis b€com6 conpletely soft, the condom should b€ r€moved by pdling at the operirs, to prevent its retention in the vasina. Wash ard cloan after ws. Dry, lDd check lor ble!k!. Dust with talc, wrap and put aw3y€r u.e. To It YOUR HEATTH CARE and HOW To Manage It P!..medic ? lrou to doiDg some oI thern at aI. Ii ij t, hrve e physician who may rememter less, but who looks thinF up in time and always sets th€ dght thing dono in one way or another. Isn't that e'ht patients want? So patierb must denlld evidence that a docto. pey'ou5 vell, Dot jwt that he rememberu wel. b€tter A superb specialkt becene t taly pleoccupied with an exelert piec€ of vdula. surge.y on a blood vessel in a pstient's lsg, and ind€ed did .elieve the patient'! cunent symptom. He kept no ti!t, and a nodule in a prostat€ on an admi$ion complet€ problen d€t€ct€d phFie-al examination was never stated as a problem and no plar was formulated, Mqlicd Htstory B@Llct Two ye8rs hter th€ patiedt died of clrtinoma of the pmstate. There is no a$llrance that earlier detection would 32.00 have prolon8€d his life-but it could have. The patient hrd no way of knowing the Medidl Pi3sFrt $4.00 The Medical Passpo( Foundrtion P O Box 820 Dehnd rh S2?m T ete peopb pet ottt tuo tshabb o'!ds lor n dicat sell-care: I A sef-adninbtered medical history 2 physiciaD's lack of system, and may havo 1976; 191 pase! $3.80 postpaid fiom A"medical passport"-s waltet-sized, pl8tic-covemd booktet ir phich you ed your doct r relord yolll @npl€t€ rnedic3l history, physi$l firdings, lab .esolts. and a liletime historical and diagrostic suMa.y. 1he mediaal hbtoty lonn E3'3 ol1 the of hea].th care suest jltg lo1tr should, atk in the coltne of o complete "rotaer phw;cal Fiuinlt it out uowselJ util she yo a sood, sente ol vow present heolth t lor teu hou compre. he6ive the med;cal carc vtu Me receix;ns status a,ul iU help Pr$entins the completed, histuv lom at sov rleat olfue aisit mau yrooid,e uour drctt tith u)ubb intonnat{an-and, h;s M her red.t;e uiu ceddinl! gfue !o1t some in3ight into lotr .Ioctt. me medi- cal paJspoft @s'ff6 Uolr of cortiruitu of nnd,ieal care uhib trawlins, ot ih emer- beer Dde. the iEpression that someone ws takina totel car€ of him. Often petients believe care is complete, wheir in reality it rargly is. PROMIS Lsbo.rrory Unive.sity of VermoDt Burlinsto. VT 06401 O,tz ol the ,eal eye-opeien in soins throxsh tuedAd tchool has been the uau medial reco A are kept. Ou-Jaahnned bctort wed, to keep all then recodt an their hean^, and nwq yesent records are kept in tuh d ung that 01 u the dnctor bho urote them con teL uhot they sag. I hereb! @iiate Di. Lalnetue Weed, lM a NobeL Prize tn nled,icitlz Jot dzub?ins the Probtzm Oriented, Medical Recod IPOM&) Svstem, o staul4rdized, Jonnat lor keepins nedicol recoTl' bhi.h i't l'.d$ the roce$ of th;nking lour d.o.ttr 906 through in ftaching a dbgnosi6 anl, cmvit g otut treatment. In this booh, Dr. Weed. etplaiB hou lou cM leam to url,erstand that thought yoc*s ad chech it 16 m b! keepins copiet of uour otn nedia.l rec(td Patients de beginning to realize that the fact that lheb physician happeDed to sraduate {bst in his class at nedical college and wrote b.iliantly on his exams do€sn't 8larantee that he will give them cee. Hlving a good lneDory and answeri.g medical questio.s cor, .€ctly on pape. is as different fron top'notch .TF actualy listening to a heari or examinins ears, a! taking you. w tten driver's test is actually d.iving through tBtrie. It do€s tle patient little aood ifthe physician knows ihe riAhr thinAs but is extrebely inefficient in doinS ihed, or do€sn r sei ln a routioe history the patient told the house office! at the hospital that he had had a chanse in his bowel habits and some bl@d in his stools. The sp*ialist in chalse put down onty tle ploblem fioh hi3 specialty und€r his "impression." Tll€re wa! no complet€ problein list. The syrnptoms trom the bowel were forgotten. A carcinona of the colon was rnissed and pieked up later under condit ns which wer€ not advantageous to the pati€nt. Another instance of avoidable sufieling and percious tine lost because someone had the ilusion that it was rnore efficient to pmceed without aI thc fact€.
  8. 8. that the tips poini toward the ftont. fhe sp ng connecting the two edpieces cu be beni in or out to make tle earpiec$ fit Your Black Bag snuAly but comfortably. Good for ljstenins to heads, lungs, abdomens, and takins blood pressures. Ask a medical worker friend to slow you how, o. consuli one ofthe b@ks.eviewed check blood pressuEs on your Liends, you ll be pretty certain to be doirg sone of A booklet on taking a blood pr$sure is available from your local A.nedcan Heari Association, or from the NatioDal Office at 44 East 23rd Street, New York, NY 10010. The most lrequentiy used item in my black bas. Both ol our kids seem to attract splinte$. Get a Aood pair and don't use them Ior tiahtening soews, etc. Theres rothing more infuriaiing tlan havins a sobbing cbild siretched out agoss thecouch with a splinterin his or her foot, and thai you. tweeze$ dont quite come it dry and in its case. For tiny splinteB I use a pocket toAether. Keep m&glifier I bought in a photo shop for 75c. Tweeze.s are available in nost drug- Tonsue BLd6E At About $2 in any drug store Always it. Oral for inlants and child.en, rectal Io. iniants. (Always use a lubricant wiih a clean wiih cold water, as hot may break hospital supply stores. Usually it's not necessary to use anything to hold the tongue down at all. Try askin8 the pe.son to open his o. her mouih wide and pant in In a pinch, use the handle of a clean rcctalihe.momeier.) You. iempeFture goes up after exercising and immedistely after a woman Penlights are more convenient to carry, and for eheckirs pupil size, but the big oDes last lorger and can do double duty around the house or when you so cam- pins. They'rc better fo. t@kins into throats, the thing they'll p.obably be usd ovulates-a handy way to det€rmine when you'rc fedile (see Our Aodt€s, Amebes, p.10). Oral the.mometer sbould be placed urde. the tongue ior at least minutes. The person shouldni have just lad anythinA to eat or drink. Most docto$ don't consider a temper ature under 1000 F- a fever. Flssldisht Useful too for examinins noses, looking in eyes for fo.eign matter, providirg light while .emoving splinters, dd fi.ding d.opped contact lerses. (Turn the room liglts o and shine ibe flashlight across the floor. The lens will make a tiny Blood Pressue Cufi dnllin4*F{.T'wre Theserun about $25 and up. A few drug stores are bealnnins to cany kits with slethoscopes d,, blood p.essure cuffs. (You need both to take a blood pressue.) Stetho3cope column and dial (shown). Tlre mercury Five dollars ard up ftom your local or medical supply store, Seals, wards, your local ned school b@kstore, or ih.ough your local druggest, or the hospital Whiie Shop (seep. 20). Edmund Scientific is a.other good mail-order sou.ce (Bai' rinston, New Je.sey 08007). Get one wiih a diaphragm-a .ound. ilrt disk on the end. which is more useful thaD the hoUow, bell shaped chestpiece. The ea.piece of most stethoscopes are sei at sn angle. Put them in your ears so Cxffs come in two types-me.cury nodels unnecessuily cumbersome and expensive. The dial nodels are handier and work fine-thoush you should check them against your doctor's for Emotional facto.s (1ike beirs at the d@tor's office) can cause your blood pressure to shoot up, so bl@d pressures should always be taken when theperson is comlortable and .elaxed. 1506 of the population has hish blood pressure. Il you buy a cuff and routinely Recommended for homes with children, or adults with recuning ear infections. The veU Bod,s Book recommends a 50c ear speculum wiih a tushlisht, but I have a ha time seeins an)'thing ilis way. A battery in the'handle model cGts $30 or This is an inst.ument to be used people yrith steady hands. cdeluly by Medical SelI Ca.., Sumn.r 1376
  9. 9. I d reconmend learnhg to use ons fron a to about 90". With th€ hip B€ituid€ Dirsro.tic Etldtn tior Elner L Decou,ha MD Rbh$d, L DeGol,ia MD 513.80, postpaid lrom innmobils, attenpt to eneDd the knee. In nenills€al iritation, this atternpt is r$isted and ceuses pain in the hemstri!8E. Bruilrbski'! sig[. With the patient The White Shop 4:l Colego Streot New Eaver CT 06510 M! laoorite nled,bal booh the B;bL ol phyticol ercniwtion, freqv,entlry 6een in supine &Dd the linbs extended, prssively flex the necki this produces fleE m ol the Jtlbs, r sign oi n€ning€al initetior (Fig. u39). the uhite coat pockek of rned;cal students ard, thtems. Cbinnd ne.licine o"shized by the partu ol the bod,y. Briel, terse, atd, to the p,rint. YouA n ed a nad.i'ol Ihe?e's a ph'[te heqtehtls heo"d, amons bwv howe offi.ers on the uvds, It meant quit tpeainting, theoreiizal Stieh to the ba*ia, "cut the neat." d!'Ll thit Vigilll Spocdu Used increasingly by y"onen examination with a be so hand for book c-*ts the neat. .TF t Fia. 11-39. Brudzinski's sign. With the patient supbe and the chost held firrnly to the bed, attenpt to f,ex th€ n€ck. In meningeal initation, this maneuvor causes involuntary flenon oI the hips. soE- rnimr. Ask your nuBe or midwife to show you how. O! make an educational appointment with your gynecologist-go with a friond &nd have the doctor show you how to do a Sigrls oI MeniDseal Irritation pelvic exan on each other. Meninsitis, meninsismw, subarechloid hemonhase, posterior lossa tlmorst and the Esults of increased intlacanial pre!sue eaw€ rbnorrnal spasrns oI various Cons]']t Ov Bod;es, O1LneI06. Whttever you do, us this (and all the instru- specjal physical si8a3. Available at hGpital and medical supply houses, or lor $2 pNtpaid lron New Moon Communicatiom, Box 3488, Ridgeway Station, Stanjod, CT 06905. mus.Ie 8"oups which are appalert as Nuchd Rtidity. The patient c&mot place the chin upon his chest. Passive fleiion of the neck is liEited by involuntary mNcle spasm. Testing ths pa$ive flexion induces involuntary hip tlexion (Brudzinski's !isn). Spilsl RiSldity. Movemenb of tho spine are limited by spasns of the Drect r Spinae. In €xtreme ca*s, ths spiral muscles are iD tetanic conbaction, pro ducins risid hyperext€nisor of the ent e spinei the head is forced backward, tho tiunk forward; the condition is termed Kcrds's Sig[. With the patient supine, passively flex the hip to 90o (Fi8. lrfg). With the hip kept in flexion, attempts to enend the knee prodces poin in the hanrsl,lhr$ and resbtMe to tutthet extension. This is a reliable si$ of menin' g€al initationi but it may occur with her' niated disc or tumols o{ the cauda equina. BlDn€r Rarely nedicaly n€fl€x necessary-uDless ir your household has e neulolo' gical disease-but lots of tur Dd highly educationsl to use. About 35 at msdical soneone Fig. 11{A: Xemis's si8n. With tho patient supine, flex the hip and knee each Fig. 7-1. Precordial projections of the onterior surface of the heart. Note the entie area of the p*eordiun is the proiection of the right ventricle. The left bolder and apex are fomed by the left vertriclei the risht at.ium coDstitutes the risht boder.
  10. 10. not pe.missible to lind out ioo much. The taboos were strongest in the area of rcproduction and sex. which is why our Women's Health book concentrates on them. Oui Bodies. Ou.€lves second edition B6ton lvonen s Hedth Book Collectioe oUR B0D|ES. OURSETVES A BOOK BYAND UN/IE FOR WOMEN 'Wlen someone fbst said to me two yea$ aao, "You can feel the ead ol your own cenix with your finger," I w3 interested but flustered. I had hardly eve. put my finger in my vagina at all, and felt squeanish about touching myself there, in that place "resened" for lovers and doctors. It took ne two nonths to get up my neNe to tly it, and then one altem@n, pretty nervously, I squatted dom in tle bathroom and put ny li.8€r in deep, back into my vlgina. Thele it wa! (!), feeling slippery and rounded, with an indentation atthe center th.ougb which, I realized, my menst.ual flow came. lt was both very exciting and beautifuly ordin ary at the same time. Last we€k I bought a plastic speculum so I can l@k at my cervix. Will it take as long this tilne? Bimanurl Pelvic Exam FEliTfi Til slhost as soon a5 th.t treatment was started), over the weeks of tleatnent I was involved in every aspect of planning but the caE. X rays wele with me, and I was also helped to giv€ certaiD parls of the treatment to myself between vi!it.s-! form of seu-help-and to recognize my body. The whole encounter wa5 so difierent f.on the usual medieal experience, where passive dependercy snd drugs are encou.saed rnd you aE rlno€t never beated tike ad dult. Thele w.s ! deep respect for power of the body to he it3ell; it helpd me to evsluate other types lDvortiSltiv€ R€port 19?5; 400 prges $10.00 postpaid ftom Harcourt, Brace, Jovuovich 757 3rd Avenue New York NY 1001? Sinon &nd Schuster R6e Kuhtur New Yo.k NY 10020 Jound, a ht np in her tte brcast in J1me, 1974. Ttis book telb storl! of her er:peAewea up to ond fo ouins the remooal ol her breatt. Ms. Kuhn2r it a medicd rqeDcher. k som M .he h4d. recol)ered h@t her mortectmy, she 6et hereelf the tath o! uttiting a book tho.t uollld. explnrc the Va.ticol. su;ile to uonens medici'tz. Th;s ww edit;on k tirtv pages Lmger and. Me that ha$ Mu. Ex"adad eectiN on Setldita, Tak;ng CMe oJ Ouftelau, Birth Control, Menop@se, Paftnthood, reon/rble, and. Women atut Health Care. F@hnl inlollnLtion is ;tupeccably acartute ard complete. ControuersioJ med.i.d xws treo,tnent ol breast cancer o.nd abrnrnal pap smearcl ate .laarly i'lenti like dis$sed. Treats uonen as uhola bein$ daer- Jied and thoroushly ..)ins of personali.ed care. .JK Recmmenned. reodins in the sV2colosu rotation at Yole Medical SchooL .TF Until ee beaan to prepar€ this material for a course for women, many ol us didn t know lhe nanes oI parts of our anatomy. Some ol us had learned bits and pieces of inforrnation aboui specilic body functions {menstruation, for to be both helpful and interested. The most inpressive paft of ihe experience was not thal the pain went away (it did Br€..t A Pssoml Xitt ry .rd TET#YIFIT' 1976; 383 pages $5.45 (clinic copies available at dilcount) A I had sufieled from lower back pain lor years. Most docto$ to whom I mentioned it weren't interested, so I rlways assumed nothins could be done. WheD I conphined of lny discontort to a lriend, she s&v€ rne the nane of a chiloprsctor who tuned out exuple), but it The other day I was iaking a bath with my almost-three-year-old dauglter. I we! lying down and sle was sitting b€iween my less, which wele sprcad apart. She said, "Momhy, you don't have a penis." I said, "That's right, nen have penises and women have clitorises. All calm and fine-then, "Mommy, wbere is your clito s?" Okay, Dow what was I going to do? I took s deep heath {fo. courrse or something), tried not to blush. spread ny mediea sociol econonic, a pychowical atpects ol breoat ccn er. The book interuearet her our. eryeri. encu as a potient uith the redt ol her feseafch. The ftsult it a cof,wsioate, objectbe rnrftthe that shoad gtlid.e other bomen tttuxsh the confsing jt',tgI2 ol fa.ts ann rejud,;ces she etuolrhtered in her olrn search lot help. .TF vulva apad, and showed her my clitoris. It didn't feel so bad. "Do you want to see you.s?" I asked. Yes." That was quite a tlick to get he. to look over her fat stomach and see he.s, especialy when she staded laughing as I first put my fiDS€r and then beB on her clitoris. was Medical sellod€, Sunn€r 1976
  11. 11. lhG ftltilE.nt olFon l€ Soiudity v"W* elttality As idt t o attieLi 4!'aen... -A ru-ltklht bu,k thnt b.tadnotrrrrnn tt 4t t'rt Lt th.) !,r .8 Nhrnkl th rc,;t,ht n; y 'Barbqi:h 19?6; 191 paSes (paperback) t1.?6 pastpaid ftom N€w ADerican Library P 0 Box 999 B€r8enfield NJ 0?621 La'm;e Eatboah co-lzadt s"o1'ps lor y*org,umi. uonen at the Un vertita ol Calilottrh edicol Schoot in San Ftun. chco. This book adrbesses both the "hout to" and the 'thy bothet" ol lenule A wry at"pott;xe booh cined ar feart and utuieties our cltlt@e hu inposed on uomen and, their se?u. dity. Lamb l|{t hes.d aA the m!th., han 'eat4l beha"ior cornet ,nh!ftltu,, to "rer i& auvcesstr lot uunzn as it it lor ngn " a^d, carefi!,llu, gentlu ditpel! the Encouaget unnerr to tahe olter re.partulit's Jor their oum bodias by the oPetL ad hee eqnesrion ol thzn oun .JK uorkho u a set tbercDiJt belore start;no med schooL This is tho be.t book on ser themp! he seen. Spenl a Vear .'1,F It 8€erbs only natual that we shoutd itnqine the illicit durinS sexual Ianrasy, for hasn t with ser fantasies. Try enjoying the flnta5y IuIy a[d heely ed see iI anything cblrg€s lor you. AIso, Ietasies chang€ ove. tiEe. Whrt is exciting this month may beode rnundene a-e new snd different sexull tun-ons arc eiplored. FaDtesy is clearly on€ of the ways you can eide. your serual €).periences without actualy iDdulgins iD acts thrt may te unacceptable to you. lt is also a vory positive way to locus your mind during sexual activity so thst you LibsstilA M.ltulbrtlo! Bettu Dodtal can concentrate completely on serual pleasures. Not al of us have th€ ability to fantrsize with ease at the besinning, and Iew of us wil eve! expe.ience an orgasm by lantaly alor€, but you rnay be ebl€ to develop the abilitr to fantaliz€ which nay 8reltly enhance you! lerual feelin8!. n T'oruti,r: Garfleld, .d.ins Why don't we stop psychoan&lyzing our sex and everythihs associated alwrys bee! somehow illicii? Malters and Johnson found thst the orgasms produced by mastubatioD occuned mo.e dependably, noro repidly, ed w€re of sreater intensiiy then those achieved th.oush stimulation by a pa.tner. Coropee this situation to eating. Someiirnes you [lay b€ hunSrr when your partn€r bn't around; you night preler to eat with hirn, but you wouldn't consider stNing just so you could eat togethe!. You can satisfy your buD8€r for food by you.self with a me8l or a snack and you can still join your pariner later on if you like. This is also true of sexuat hunS€r. Some wonen pr€fe! diroct rnd hed stinulation of the glans ol the or the sunounding area, while others find this kind of stimulation irit&ting and erioy a lishter touch. Prelererces for timing and sequence, for setting and Elood also vsry woftan to woman. As my co-worke. Leah Potts puts it, "Il you want t balrc beautilul rnusic with m€, you'I hrve to lerrn my song." 1974; 60 plg€s 13.60 postplid from BodFsx DosiSrs 121 Madison Avenue New York NY 10016 A slim, cirty.pase 'tneditatiotu on $U- Iow." Ollers the same messace oa Fot lolurcelh that nathtbatkm is an impot tmt ua!! tor both men ddimmen to bafl about the;ro mbod;4s. Dodtolit orti.ti.flamboyan, EaAt Cotst, self+ebualh oricnted. Barbo.h is bu.keyed scbntitu, W$t Coatt, hetero.emalh ^ienteil n@tmted bith jiftan erq'ititeU d,ran genital po'''lnts of uomen in her Bod,uter vrotkshops. JK She wr! sixtr,eight, Iiving llone, a widow oI s€velal year5. I str.ted right off Ite MoDtl'ly with, "Mother, aie you masturbating to orgsn?" There $a! a sputt€ring psuse Extn t and th€n she caEe riaht back with, "Why, $5.50 per year (birnonthly) from New Moon Communications Bor 3488 Betty Ann, of courso not. that sort of thina." I'n too old lor Ou n€xt conve$ation-some two bte!-was b€auiitul, Y€sl shs had succ€gsfuly ard very sa3ily n$turbat€d weeks Ridgewar Station Stanford CT 06905 CalTies infotlt@t*,a neus, and etuourasened lor uo@'s .elf-beta ctini$ and ssrDcotosiad sev-carc. Inlnnal arn poit;cal. uith lnts of thaftd er periedc$ hom reoders. -TF to orgasm, and it was extremely pleasant. She lelt lhs had slepi nor€ loundly sfter,
  12. 12. Men's Health c An individual act of will and selfassertion. Probably the best way to a Fe'arrangEd day or on the spur ol the monent. Which of these three methods would be best for You depends or your personality and on whether you smoke for supPort in sive up on Mar'i Body: Ar Own€!'E M.!ud The Diasran Group moments oI ltress: out of habit; fo. physical gratification; to prcmote re- laxation; or bectuse you a.e trulY addicted. Effecte of Givins Up Withh ten yeals of giving up the tile expectancy of an ex srooker (up to 19 cisa' rettes a day) is the sa]ne as that of a nor-snoke.. But the beneficial etrects can be seen within two weeksr no nde cough: better taste and smell; increased vitality; and nore money to spare. hin. sive confidence and security to him, rather than to goad, iEitate, and infurilte as with the Type A nan. we have .epeatedly advised our olfn Type A patient! to atteinpt reading houst's seven-volune Do'iel The Renumb@e ol Thinss PMt, not because it i3 one of the Sreat mode.n clatsics (which it is), but beceuse the authm reeds several chapters to deseibe an event that most Type A snbjects would h|ve handled in a sentence or two. houst cannot be hur' ried. When a Type A attempts to !kim, he is likely to fiDd hinser totaly lost in 3 pageful of Proustia.n pmse. lt is only by deliberate acquieseence io Ploust'! pace that the reader can uDderstand and enjoy the novel, and it is this acquiescence that mak* such readins a dri[. Eating Typo A Behrvior ud Your H€.rt Meyer Frie&tu,a MD ann nav H R6ennan, Ml) 1974i 3rg pages (paperback) $2.30 pGtpaid fron Mail Order Department ra$cett Publications. Inc 1976; 256 pa8€s 16.96 postpaid f.orn Greenwich CT 06830 The Paddington Press Two Continents Publishins Group 30 E 42nd Street New York NY 100r? F@t-phlced erclclaped,in on the nutlz Tlo Amortc.n Helft The ax,thors present elriileroe that speeil!, inpo.ttent, highlu competitiDe men l:Ivpe At @e at irctea:ed, rbk fot heart d.i.seose, then tel aou hou to 3lo1x do1/n, becme bs conpetithe anl leam body. Lots of sood, siraphs ann pbt@6. Briel caputa sutmnries o,t a ui.le ranse of topiu Jron ohc$ses ro ue ab fewr. Eiahlv reuhblz, thtttgh i$ stri.ct aootdtnre of personal o? poUt;ca.l .omftnt siaes it a certcin school-booh qaalitv. Good lo teerls ot fie-teew oJ both sex4, ot es a,refercnae booh. Are there ar! mens groury @t thera uo,hins a,, o, nulz wrsi@ o/ Ol1I Bodies, Ourse]jes? we Med one, and thh ;n t it. .TF Ways of Civins a Up Snoking Group sessions, wheE the new ex' snoker gives and Eceives suppot i. his attempt to stop. Somo groups are olganized on a volurtary basis. Others are operated by rnedical and health orsanizations. A doctor, libruy or local infomation service caD advise you on b Individual nedica.l care, in which the ex-smoker receives the personal attention ed help oI a physician. Arloci,rthn CooLbook 1975; 403 pag€s (paperback) $2.?5 postpaid fron Balantine Cash Sales P O Box 505 Westminister MD 2115? Good health! reciPizs Type A Behavior Patterr is an action' emotior cornplex that can be observed in any peBon who i! ogg'rsdo€ry irvolved i^ a .b@i, irgessont sttuggle to achieve moE and mo.e in less and leg3 tine, and iI -TF Eat before shopping. ff you go to th€ store hunsry, you are likely to make unnecessa.y pu.chases. .equired to do so, agdnst the opposils efforts of other thinSs o. other pelsons. The Dersotr with TYPe B Bel'avior PatteD is the exact oppcjte of the TJT€ A subject. He, unlike the Type A permn, is .arely har.ied by desies to obtain a wildly inoealing nuErber of things or participate in an endlessly srowing seri€F ot events in an ever dec.easing amouDt of tine. His intelis€nce may be a! good as or eveD better than that ol the Type A snbjeet. Sinilarlu, hb gftat ot anbitim n?nu be at el)en gredter thm that of h;s Twe A co!.nterpqt. He n]ay also have a corside.sble ainount ol "drive," but its character is such that it s€ems to steady Buy polyunsatumted vegetable oils and use them for cooking. Safilower oil is the most polyunsaturated with soybean, sun- flower, corn, cottonseed and sesane oils folowins in descendins order. Sell.Cue. Snnher 1976 I I
  13. 13. One Bowt A Simple Corcept lor CoDtrolitrs Body Weight tl.*tMce, d ueU oa nec*sar! saJetu yecautiom. hpecialls sood Jor uonen Exercise haliing tronble gettrng into erercLs$ bho Just Io& week I JoMn atuther book ne in a d.eeper. nore irdivinw.L poeti ua!. It's collzd'fhe Zen of Rundina. It d$cribes the uEiter's erpeierces in f:nd.ins his o,rn, M,;ryA wau of rutmins lhou and uhere-in the co1lnhv, barefoot on the be@hl @ul encoumges the read,er to awroorh runnins aA a Epi*ual e,ercise. Ih|tmted, bu photu of the author rwtuins thfush in' s pirins Cal,iforn;a. hntu cap a. whirh speaks to Kemeth H Cooper, MD, MPE 1968; 182 pages lpaperboakl $2.0a p$twid Kerneth 1I Cooper, MD, WE pagd IpaperbtEkl 82.25 p6tpai.l Aembics lor wpE€D Miwred, Cooper anl Kenneth H MD 1970i 191 Cooper, 19?2; 160 pages lpaperbaek) $2.00 postpaid from The Zer of Rurning Bantarn Books, Inc 414 East Cu{ Road Des Moines lll 60016 Tella hou to test uour Wesent lzbel ol phvsicol fit@ss lby seeins hob l@ uou can tun in tNoehe minut6l, then help ?tou plan a tailor-nurne erercise Foyam that i6htle rumins, lLvl,kins, auintuins, lwnins, h@td,bdl, or sqwh. Letuhica yesents the bd,eic pros'{r'i" The New Aercbies add,t more can bihins, statiorery 1974; 56 pages (pape.back) $2.00 postpaid f.on Random House contplete .hArts, oAJ ional infonnqtim, tip, ad. safetu precau*na. Best books aroLnn m getting, and 201 E 50ih Street New York NY 10022 A be@tifuI At e book abtut setthq ;n to@h 1,ith food.-feeL;nss. Eatins aa medi tat;on. Pag in g at t entiol, What is the distance yoo can cover in 12 .TF . ,.eating besins with the very ftst tiny vib tion of hunger inside ne-a vibation that Srows until I an set into notion, huntins food. I see that eatins includes deciding what food I want to eet, the way I preparc it, under what cbcum stances I eat it. how fast or slow I chew and swallow, and the process of disestion and assimilation that goes on without my conscious diection durirs and after the Eat whenever you are hungry, as often as you are hunSry, but stop the rninute When you get hunSry, nake a seafth to lind just the right {ood you want to eat If you coos nile miles rnil$ miles more less than 1.0 1.0 to 1.24 1.26 to 1.49 1.50 to 1.?4 1.?5 nile! or Fitn63 catesory Ve'Y Poor Foor Fair Good Excelent 1974i ?8 pages $4.45 postpaid 201 E 0! R|uits I'd tzter fron Random House sfth Strcet New York NY 10022 trie,l. rwtuins unt;l a leu ueelcs aso, bhen Tom conuitu:ed me to come dnn to the trark with him. I uaa in no tine. CL@l! dmcins't entltgh "uffins to keep me in shape. Soon aftetuvd, a hiend, Ioaned, me a .ops ol M;l'lred. Coop€rb Aerobics lor Wonen. Sre tdhs about her oM ann other bonens elperiewes in ruming. I md e@h'rasins. It saw mE M idea o! dhtan et ad, tinet aprornie b n! ase ani bbel ol Jitnqs. There are tabbs thd &A you hou tutLy caLni4 uou blrn w nnning a giuen folnrd, it uery prat:tical "I advocate the iife-style oI th€ marathon runner aDd moDito. sutopsi€s oD distance NnneB in an effort to b.hg the lons€vity of the Hunza into our nodern cities. Thus Iar. I have lound no reports oi death due to (cororary artery disease, enphysena, or cirhosis) uons those who have covered 42 kn (26 iniles) on f@t at any tirne in their life." Dr. fhon&-s J. Bc'$lzr, M;ting in the 1976 i$ue of the Wettem Med,ical, &riL
  14. 14. able-"Thrt's Kids it a good qusstioD. Lot's wlitt lule to !!l tlle vet visit th€ ldrnd ho3pitd," do{,n so *e'I bo when wo We wero ro.€sulld by ![ Yosr lo. Chldrcn Eoe Dbhln ths qu€stions ws codd sftwer. This c,a! one of ou! Isvoritesr'Adolesc€Dce ilnt lonsthi4 you hsv€ to go t th€ doctor Io!, i! it?" T@hitrs M€dlcino t l(ldg Tot Fersatat ad Lee Ammidol MakinS Your Puls€ Go Faster This i,s a! lctive €rercire belt done d the end of a claslloom s€lsion, The children count theb pubes fo! tweDty TEACIIING MEDICINE &e DiC<in socon&, lnd mcord th€ r€sult, thon 80 to the nealest open sp!!e rld cxercb€ vigoE sly for 9-5 mbut?s. (We hld them run arcund the buildinS.) then thsy court I'O KII'S thei! puls$ &gein. StetholcoD€s A stothos.op€ cobblncs . powerful imese, & valuable nedicat tool, snd s favoite toy. hovidina st€tholcope! for youl childr€n's use wil alow ttem to Ssther a 8r€at deal ot iDtornatior about thsir own and each other's bodid. Abo Sood tor listeDing t reiiSsrrto! motors, conversation! ir th€ Deti rcom, rnd puFing c!ts. J€ny Rol 1976 {papsrbrck) $8.00 postpaid Hsff'hou videotape: lent $35, buy t75 hon 1976; m8 p!8p! (pap€rback) 44.22 pogtpdd hon ItrdeD€ld€nt Nel's Co Inc ?5 Rocketel€r Phrr:r Nev York ltY 10019 Au of the thirgt we leerred. tea.hins nedbi^. to hat,@?[ hopm@h they looed tuhts Uogi" Eat! tte?-bg-ttep dircdnn toith bts ol pirures, .TT Medical Sell-Cale MaSaziDe P O Box 31549 Sm lrancisco CA 94181 Lee a d I uorked uith a croa9 o! fiitt and second. srodera lor aisht ueekt, trVing to ligltre ou, how uou llotild, oo ab@t teaatin4 mEdnine ,o ki.h, The vidzotape shou. uhat happerAd. in that gttup. me nm1nl, Eltggestt bays uou can tea.h lNils ned.icine in yow homa or ctatroom, @d conUtins or. swtdei r.$L4e.l'hlA.!.,{h.h!.4' bibuosnryhs of child"en'. booht on heddn and mo nedid aitwcts. Me, Teach Medicine? That's whet we wondered beforo st&!' ting this ploject. Whst if they a8ked questioD q,e couLln't lnsw€r? We ne€dn't h&ve worfi€d. We t'ust never pretended to be exporis. W6 lealned to sly, "I don't know. How do you suppN we would 80 about linding out?" We help€d the kids us€ the libriry to answer iheir own questioDs, Iorrned to m&tch qudtions to the resoorcos avail- r M.iliol S.lf Ce, Suber rsr6
  15. 15. I{is T.A. lor Tots Abw M Freed PhD a loi. of of boys and girls are frightened by thinas. Did you know that? Lots of grown'ups too. ;t1"'/r'l/ I often feel ftigltened. about the personality of the child. People a.e frightened about being left alone or beins alone in the dark. or a.lone (".'".'t,',,,,ky|ll Consturctive c ticism confires itseu to pointing out how to do what has to be done, entirely omitting neaative .enark! with peopl€ they don't know, o. being jumped out at. Tlese are sca.y feelings. I guess you can see that the things we are afraid ol most ue being alone and not One way to get over leelinS afraid is to .- The reed.for individuality and uniqueness rnay push a clild into lailure, resa.dless of pa.enial plessu.e and pun' one chiid said, "They can take away the TV 4.nd the alowance, but they ' atnnot take away ny failing srades." .6hhent. As to people you leel care aboui you and who give you good strokes. Tellthemyour Ao lears and ther you will not feel alone 19?3; 232 pages {paperback) 16.55 postpaid fion Spanking relieves suilt too easily: the -ahild, havins paid for hb misbehavior, feels to rcpeat it. JALMAR Press, lnc 391 Munro€ Street Saoanento CA 95825 '. Betw@D Parert & Child Hahn G Ginott b. How ce you set a wa.m fuzzy? One way is to ask for one. SaY, "Monny, please hold me. I want a lr,or,n ''Please rub my back." i?z?," Bedtime for older children should be flexible: "Berdtirne is between eight and nine (or nine a'd ien). You decide exactly wlen you wana to be in bed." To p.event unnecessary grilt, p4rents should deal witi clildren's transsressions the way a good mecnanic deals wiih a car that b.eaks down. He does not shame the owner; he points out what has io be or, Have you ever done something to aet a cow z bad stroke? Did vou get sDanked or yelled at or hit? IIow did that "rickle, hippen? Talk about that llow did vou feel? Tell what bappened. 19?2; 223 pages (paperback) $1.?5 postpaid Mail orde. Department f 55th St New York NY 10019 250 How to tdk l&m/tneL! to ch;Aren. Since d.iscorerins this book, I haw been able to han e ahnost dl the conhontario6 that the! argu,e, w ;n?d8e duals u.sed to be to either sto? the Mswent or tr! to settlz it. Nou I help tlLem uork out the# oun solution. Itg anazins the elfect one senterce can haw-it twns a bitter, resentful arsu- j- i @ise. When Sometimes you get ang"y. Your enger is real. You have a right to Jeel ansry and to tetl other people about it. Talkingaboutit helps you be less angry and to be happier afterwads. ment into a shting er?erience -' t.i
  16. 16. roake it up at dinner. The stimuli are very How Long lVill You Live Ade.iGcleroiic kelrr Dis€ase High lat diel, no exercis€ Risk oldeaih wnhin r0 yers Viso.ous exeRise, low Ia1 di€! Bisk oldedh wiihin strons. At the sight of the colned beef, I can aciua.lly feel ny jaw working. My habit tu very deep indeed. And then aD inage of my father's face as I last saw it flalhes before me. I arn appal€d. I try to turn off the pictue by moving away fton the hot table. I take a selad. The picture retums. I shout silently to trtyseli Stopl I t.y to think ol something pl€asant: my Iorthcomins trip to Europe, a happy 10 yeais afternoon with lty littlo daughter. . .arythins to get that hospital sceDe otr th€ Hor to Prsctice Prospestive Mdicile Lebb C nobbins soeen of my mind. But note: How to Ssve You Lilo E@l (IbeU l9?0; 100 paaes U2.50 postpaid Infornation. free Health ltazard Appraisal Methodist Hospital of Indiana 16{X North Capito! Avenue Indianapoltu, Indiana 46202 I ended up with the salad rathe! than the corDsd beeI. And it happened day afte. day. In one study of dietins rnetr, the nost lor not foloi'ing a pr€scribed diet was that the wile lailed to pitch in and hslp. the dtirnnre refeftNe n'wal fot ?retentbe meilithlz. Lk'l the fulrteen nost Ukalu catses ol death for your ase, ser, and rare. reus uhieh ol the lourteen vou can rcdure by ch$ging vtur beha' vior. AU'ws aot to Jisure v@r ritk with behal,ior, u,n IBI nodified IAI "resenl Or SdoHry Some of the new "low nicotin€" ci8!rettes may be mo'e dang€rous to your health than the reerrlar khd, accoiding to an atide in the M&y, 19?6 issuo of Conslsnat Repo?tt. SiDce a si8lificent prcpoltion oI lmokers 8le addicted to 'rF 10 Year Deaths Pe. 100,000 whfte r Malsnani Ncoprssd ol brelst 2 Art€ oscl.Elt.Dis. ind Chr. Endddd 3 Vasculu Lesions Afie.tina CNS 4 Maliqnant Neoplsh oI Ulerus 5 Chonic Rheudalic Hcei Dhea* 6 Ci..hosis ol Liv* ? Mal. Neop. oI Inle ines and Feciun 3 Molor Vehicle Accidents 10 11 l2 nicotine, they'I need ,?tt€ cigalettes ard thus inhale s'edtet quantiti$ of tar and rdje- &€ r'o Mlliprn! Noplasnofl,uDgs Pneuncnia Hypcflensiv? H€art D'sease u oir'*". 351 carbon nonoxide 29? 200 13r 133 133 109 103 i.2n 1973; 308 pas€s (pap€rback) $2.75 postpaid hom Penguin B@ks, Inc. 239 239 I Olher Hype.rensiv€ Dis.iss The author's father, a lat, sedent l! smoher m a h;sh-lat d,iet, d,ied, oJ a heart att6k o,t o,se forty-four. Thb ;t the atorv ol EorI Ubeu's surcush eflorts to ch@se h;t Ufestslz so as to aooid a sinilt fate. r93 Weu.documented 4?9 399 193 10 orhe. Diseases of th€ H€ari 11 Nephlilis and Neph.cis r4 t47 Mal. N€o. of Ini.siines aDd Reciun 126 1r3 16 Moior vchicle Arciderls 1? Chronic Rheumaiic Hea.r Disease Total Colses 1la 2.42) irui altogether. The article is ca ed "Ciga*ttes: l,es! Tar, Less Nicotine-Is That Good?" ne' prints ue available ftom Consaarcr Re- New York NY 10011 Malisnant N.oplsm ot Urerus Mdisrant Neoplasn of Brelst than 0.3 mg), you'le rcally otr youl way to reducing your Dicotin€ intako and irnproving your chances of quitting Sa.r?rs (less 72 5th Avenue Arledosd. H.i, Dis. andChr. Endd.rd. Va*llar i,esions Atlectitrs CNS Hrp.rt€Nive Hea DG$se nicotine' Tlere is hope, though. IJ you 6n narase to do leith one of the "super-lo$' ricotin€" brands like Cdt ton 70b or Kins 9r 60 60 49 with "low brands like Dordt or ?"ae than *,ith theit regdar brands (and pay more to do it). hie htu readnblz. .TF ports, 256 WashinSton Street, Mt. VernoD NY 10550. 'Nonn Silber Num Silber, a consdtMt to Contumer Reports, is 11'titins his PhD thetb on the medknl, conswr morernerd. Lunchtine. A cafeteria. The salad counter. The hot tabte with corned beef, hankfulters. French-fried potato$. Like ar addict, I an drawn to the hot table. I a.toaly hear the rationalization in my mind: WeI, it d@sn't matter today. I've been good so far. . .only 300 cslo.ies. I'I M€disl S€llcue, Sume. 1976
  17. 17. l7 e ptions such as nosquito ckly heat, or poison ivy. mild skin Ilrugs bites, p he d@sn't sco.e. Don't laugh! It could ,{,fir€prtc (see Chapier 2). Deconsestant isee Chzprer 2). I,@oroe (see Chapter 8). The best way to stay sober is to attend A.A. neetinss resdely. Noi so nuch for what you hea. as for what you /eel there. When I walk into that smoky L-shaped Ofi the S6uce The Medicire Show B!! the editon oJ room we rent from the Knishts oI Columbus I leel the way a pe$on is supposed to feei when he walks iDto a g"eat c{thedral. Somethiry bisser thsn rne is ia that roorn, and while I an there I Conxtner Repc'tts arn a part of that biglless. Tho New HEdb@k ol Po$.rtptior Dru83 Richtrd. Burork, MD with Fftd J Fox, MD 1975; 4() pases (paperback) $2.45 postpaid hom BalentiDe Book! 201 E 50th Street New York NY 10022 LEWIS MEYER ExpLtitts wr"osd, sine elfects, and altemI;Des to the most comrtuMlU-yesfiibed nediadt;o6. Good treatment of plutnureutinl a&)ertitins ann the drus conpad6'roh in keepins dr,ts "ricet h;sh. .TF The imnensity ofthis advertising effod is best appreciated by considering that it co8ts the drug industry 1974; 384 pages (paperbaekl i4.00 postpaid from Pantheon B@ks, Inc 201 E 50th Street New York NY 10022 1967; 1Zd paaes tpape.Dack, $2.45 postpaid Lom Colier B@ks Drugs to Keep on Hand Atal,s$ia/Antiwrctic lsee Chapter 1). Buy the least costly aspi n tablets you Ant@id. (see Chapter 7). Sodiun bicd is useful fo. the treatment of heartbun o. other symptoms of simpte indigesiior except for those on bonate occasiona.l Antid,iMhed Rened?l lsee Chafiet a) Antiprbitic see Chapter 13). Ordinary calanine lotion can be used fo. the .elief of le&st thrce thousand advertiling dollars 866 3rd Avenue Maids non?retcription dnss. Ctap. ten m6pirh, eUewhes, colds, cwghs, sttre thrcah, ;nd.igqtioa Mrlvith, dntzdfl,fr. &efu|, prutiaal infomtun. You can set th;t book hee bith a subcaiptiotu to Consuner neporfi. .TF at 1600 million annually. Since there are apFoxi' mately 200,000 presoibins d@to.s, the drus companies are spending nore than each year on each docto!! New York NY 10022 A tough, horcet littk book about ad stauins sober. Aboho|es Atmryna$ lron the in"tide. -7Y d,rinkins It is time to remind medical students. doctors-in-training, and all oI tle concerned public th&t the aims of the dns manuJacturers ue ditrerent from the aims Sudden sobriety is a sho.k to a man's slands, hormones, and libido. After years of Don Juanins it at baE and over highbaus, he's sober. He goes to meetinss, he d@s twellth step work, he makes his fbst closed meetins talk. His skin's clearer, lis eyes a.e brighter, hi! breath is sweeter, his digestion'8 peachy, his snile's s€nuine-but he's sexualy ftushated. He's Old I'umble Fh8€rs and he can't get started. He used to score aI the time when he could use the exeuse: l{oDey, we we.e tisht. Now he hasn't sot that excuse and he hasn't got a l{orey and Valiun (di@pm) is a beModiazepino sedative, best known 6 a 't.anquilizer," and is ,n€ most prescibed drua in the U.S. for several years nning...thevast ndket lor 'tranquilize.s" that haa developed in reent yeals seems disproportionate to the ned. Indeed, the Eannbook leek that this ma.ket developed laryely in response to rnassive advertisins on the part oI Roche and othem.
  18. 18. wher they'€ hun8ry and when they hurt. Coping Eow t Be Your But when we'E smal, othe. P€oPle's voiees are so rnuch louder and surer thaD our own. It's easiest to ao along with whst On Beet Fri€nd others say. They've 8ot it a.I fig!rcd out already, and we're just starting to put the pieces tog€ther. Besides, it's their side the bread is buttered on. ff we listen to them, we get room and board. What can we ofier ourselves to conpete with that? It's another story of what we had to do to survive as children, but we dont Deed t keep on doing those same thirss anY long€r. Tunins in ag€in takes practice; we have to encou.age ourselves to speak up. ff we've stopped listening to our own voicss ior a long time, that voice m&y be vsry faint; it nay have hall giveD up. It mey also be prctty angry for having beer shut up so lors. Stro3, without Dtutrd8 Eans seUe cations eams as much 8@dwill and love as pompous artilicielity eans disiike. On the train ove. the Andes, between Mendora and Santiago, I set talking to a adlivien fdmer. and asked him whether he utilized node fediMeE to inclease hi! haNests. "Oh, no," he said, "that would odly cleate dissatisfaction in rny neishbols. I prefer a nodest harvest to be on good terrns with them." You rnay say he eamed the love of his neishbors by not trying to be t@ eflicient. Flolu the point of view oI its stlessprcducins or stressor activity,;t i8 it t tu, terill tuhether the ogent ot sit ntion ue that laie ;s plea.tant @ lotplzasant; ^ll counts is the intensity oI the denand fo! readjustment or adaptation. The noth€! who i! told that her odly son di€d in battle sufiels a tenible nentat shock; if years later it turns out that the news was fslse and the son uDexpectedly walks into her room alive and s,ell, sne experiences extreme joy. The specific Esults oI tbe two events, sorfow and joy, arc cou'' pletely different, in fact, opposit€ to each other, yet thei. stressor etrect-the ron' specific denand to readjust h€rseff t an entirely nsw situation-may be the sam€. helpless drunk qho showcrs you wiih in6ulcs but is obviowlv auite unable io do you harm, mthing witl happen if you iake a "synhoxic atti' tude-so past and isbore hiD. However' iI you respond catetoxically and fight' or lf you ms€t a 1971; 96 pssps (paperback), $2.00 postpaid from Balentine Cash sales P O Box 505 westninbter Marylaid 21157 :Iakins r*pu,.ribiutu for even only prepare io uo11r oun neNous system will become alarmed and tense in preparation lor combat. ff you happen to be a coronarY candi' ,TF date (because of age, arteriosclerosis, obesity, a high blood'cholesterol level), the result may be a frtal brain homoFhag€ or head attack. In ihtu case, One fundemental thing, for exanple, i3 to meet yolr own expectations. If you h3ve housevork or hoin€work o! somo other work to do, end you are ternpted to tet it slide. ask youlsell how you will feel iI you put it off. Il you senss.ihat you i/il be a little disgusted with yeutsetl, thon go ahead and do the job, and let yourseu savo. the feeli4 you 8€t flom having doDe it. Enjoy the experlence oI boins ir charge oI youlsell. It's qdte eihil&reting. 1974; 171 pages $7.45 postpaid frorn J B Lippincott Company E washinston Square Philadelphia PA 19105 impodant ouselves. Most to lean to listen to of us le8rn to tune oui clear;,babies k[ow ourselves out. We start out Fceiving nessases loud ad who was the murderer? The druD} didrt even touch you. This is biolosical suicide! Death is caused by choosins the wrona Scientifu ann perso,nl, conchtsions bu the pkneer It's fight, the result mav be tmsic. You will discharge adleD.lintype hormones, which i.$€ase blood pressure and pulse rate, shile your Pholo ol strc9t rc|earch. "TF Do not under€stimate the delisht of real sinplicity in your life style. Avoidance of all a.trectations and unnecessary compli- M.di.rl Sell.Cue. Snnn€r 19'6
  19. 19. Tho R€luation Rolponse Eerbert BeNo4 MI) repeating "ONE." with practice, the lespons€ should come with little etrolt. or twice daily, but not within ts,o hours alter Practice the tehnique oDce any meal, sirce the dig$tive processes sern to interfere with the elicitation ol the Relrxation Response. Hor t G€t CoDtrol Alnt laLein oI Your TlDs lld l,trs Makirs "nistakes" can be a Feat tine'saver. You find out what work8 by tryins. You g€t rid of umealistic goals by h.ving tried and failed to accomplisl M.d&ss Network News Rasder Shera! Eircch et o) MADNESS 9Ncts or.k Ne s s ltcurle r 19?5; 158 pa8€! t6.45 postpaid from William Monow & C{ 105 Madison Avenue New York NY 10016 Meditation in pltin, .bar lans'nse. Itt hirtor!, hol to do it, uhnt it does for vou. b. BenAon b a hwertetlsion specidist at Emanl, Med,iaal, School. .TF 1974; 194 pages $s.95 postpaid Irom Glide Publications 1 Sit quietly in a comforiable position. 3 Deeply rclax atl you. muscles, besinning at your feet and Fogressing up to your lace. Keep them *laxed. 4 Breathe through your nose. Become awarc of your breathing. As you brcethe out, say the word, "ONE," silently to yourslef. For example, breathe IN.. .OUT, "ONE'; IN.. . OUT, "ONE"; etc. Breatle easily and 5 Continue for 10 to 20 minutes You may ope. your eyes to check the time, brt do not use an alarm. lvhen you finish, sit quietly for several ninutes, at fusi with your eyes closed and l&ter with your eyes opened. Do not stand up for 6 Do not worry about whether you are successful in achievins e deep level of relaxation. a passive attitude and permit .elaxation to occur at its own pace. When distractina thoushts occu., try to i8!o.e them by not dwelins upon them and Etu.n to 3i]0 Ellis Sheet SaD Franci€co CA 99102 1973i lttu pst€! 12.00 pGtpaid from New American Libmry Inc 1301 Averue ol the Ane.icrq New York I.IY 10019 Best book Ibe teen on getting organlsussested b! Lebis Engetl M.dnosd Network News $4.00 pe! year (6 issues) 2150 Market Street San Francisco CA 94114 A neuspaper bU ex-psy.h;atrb patientt trying to nnke Bone chmges. AngW. Eishtfinh so. .rF .TF I I build Miss Huey began Save Time on success. How to talk in a 1ow, tle salve on my temptes and fitting the smau €lectric soothing voice. smoothing I don't wast€ my tine leeling grilty about buttons on eitler side oi my head. "You'li time tor the inportaut things. If it's inpoltmt I'll make the tine to do it." Ig€tup at5 a.m. during the week (and go down, and darkness wiped me out like what I don't do. I rcmind myseltr "There is alway! enoush to bed errly). I hlvo a light lunch so I dor't set sl€epy in be perlectly all right, you won't leel a thins, just bite down. . ." And sh€ set somethina on my tonsle and in panic I bit chalk on a blackboard.
  20. 20. a relaxing €nvironrnsnt. Smokirg imme- The Medical diately b€for€ meab should be probibittd, tood should bc elt€ll in mod€rate smourts, mal following r merl, th€ ptient should avoid excitsmsnt. Literoture Its Merck Mrnud ltc!ryy tsefth of DLgnosb rrd edition Da)id N Holuey, MD Edito" An @ute lnfednm of the aIoeoLD o/tne &rng. Involv6m6nt of ,n entire lobe ia ca]Jed bbar pEw.o b; of plris of the lobe only, bddar lot cew.zntal) ?ie1lrn'dr When the irfoction is lestricted to alveoli contiSuous t! blonchi, it i! cdled It is probrbly most useful to speak of the dtuease as brcterial bn nthopnewwia. o! nonbacterial pn6umod!, or, wh6n the etiologic ag€nt is kDown, to refer t it accordinAty {e.g- pneuEonococcal pneumoni!, friedllnder's pDeumoni!, mycoplalm8l prcumonh,vbrlpn6umoni&). Prenelstrud Tension A condiiion charactorized by n€lvousness, irritabililty, omotional imtability, deple$ion, frequent h€adaches, g€neralized edena, and mastalgtu, $hich occurs periodicrly and cyclicaly duriry the ? to i! applied. In male!, !I 8€ne! oD ths X chromosome, whether lec€sive or dominmt, aI€ explessedi hence th€ pre- zsgor.r donin&nce of nsles in X-linked coditions. An affscted lemale must be honorySous lor the mutant alleloi i.e., it must be present in both ol her X chronoGones. Thi! can heppen oDly if her fsih€r i! atfected &d her mother is either hetsrozygous or elss homozygous for the nutent allsle. Since rnost X-lhked mutarts 316 !lr€, afiected f€males ale very rare. P€di8re€s todl larse famili€s with xlinked rec€ssiv€ trsiL! hav€ shoea lh!t, on the average, sbout on€.half of the mrternal uncld of the proband wiu be affecied; sincs one-half of the mat€lml suDts b€ ctl!ie6, some of th€ probsnd's male mstemal filst cousiDs wil abo be aff€cted. sil On occaiion, females known to b€ heterozygous for X-linLed mutstiors shoe vsrying d€gre6 of expr€$rion, but rarely a! s€ver€ly as the atrected (herdizrgpus) (se ma Lton Ewottesi.t helow, nndet Se, Chromosone Abermtiottl. male 10 days prior to m€nstruatior but dis' appsarc s few hours afts! the onset ol M.di(d Librrd€. X-Link€d B€c€ssivs Inhe;tarce $?2: Ir senersl, the lollowing rules applyl 1 Ne$ly !U atrected pelsoDs a!€ fttles, 2 Th€ trait is ali,ay3 treDsmitted thlougn 1964 p!8eg $.m postpaid lron Tho Whit€ Shop the heterozyaous mother, who i! phen' typic6lly normal. 3 An aff€cted male n€vsl transmik the 43 Colese Sheet New Haven CT 06510 TLb tlene, pocket$ized .,ned;cd tert@ Bibb papa bs the booh is Merck Pharnaoeutiaol Conpanu oa a hno"vbli.hed. intiod?l A typictl p€digee is shown in FiA. 41. set"viae to the ned,bol yol$- s;on. Ihev uon't seu to laweople d,irect, but uour bcal medical school bookatte lor the White thop - see bettrul till be hA?U 4 Th€ crrrier femsl€ irrnsmits th€ trait to oI her sons. Non€ of her daughters wil Ehow the hait, but oneone-hslf half will be carrie$. 5 AI daught€rs of an &ffected dtal€ vil be A q&rter ol the price oJ malru ned,iral tertbooh. Eosier to reui th'n nttt, thoesh !tu noy sti[ neetl a,ned.icol dictioncg 6 d relentue. lron siains taupeopb nadbd Worndnm lot lear ;t m;sht be a patient gsllaring evidzn e trr a ndpra.tbe t!,it. The rab Medicd Libraru, lihe those of nost prhate nedicoJ schook, h clated, to the |rs wblic. State med,icol, Bchool Ubmrios tend to be a Uttla morc opeL Antotu lclow ol rcd.icol Abr$ics thst uebome lqrfiopb? Anu ned;cal Ubrv. io.ns out there have anU &gg$tbns? .TT Thc Whit! Shop Thir;s uhere I b{v Mst ol rry nedhal hmn)hs -rp boohs @ul equipment. TheUU be m$t of the books in thl;s issvz. Ab FreeieL Dyspepsia-"Indig€stion" A symptorn complex ircluding Daus€a, h€aftbun, upp€r abdorninal pair, tbt!lence aDd .uctrtion, a sense of fullne$, and a Ieeling of abdominsl distention, occmiDg during o! alter the ing€stion of tood. Treatnent: The patient should normal balanc€d diet, without Otz of the Yalz medical l;brarnht, Irto uants to stav orlonw A, bo,t bu:ing ne that med;csl Ubrcricw uere diacowased hste st ! and in 'xeLones nuiL ordets d,td -1:F More tlan 60 t!3its. nost ol which are diseales (€.8.. inborn eFo.s of m€tabolism), lre a rcsult oI mutant senes on the X chromosome. Since the human male has The White Shop 43 Colese Street N€w Haven CT 06510 only one X chmmosome, tho tetm tumi- Medicrl s.ll.Ce. Sunmer rY|6
  21. 21. Cross-Cultural Medicine Ifyou have a sense oi opposition-tlat is, iI you leel contempt for others-you're in a perfect position to receive their contempt. The idea is not to be a receiver. You people have such d8€. Dd fee ed contempt for your so'called crininals that c me rate goes up snd up. Your societt has a high crime rate because it is in a perlect position to receive crime. You should be worki.a urti- these people, not in opposition lo them. The idea is to have coniempt for c me, not for people. your Rolllla Dous t bed, readi.g newspapeB t them, keoping thsm company and becoming lanilia! with their rledicll aDd social prcbleG. I couduct a wa.d round i. a diffe.ent wa sach day lnd es I do s,I confined Ttudor W Rolling, Thunder,like Swami Rama and perhaps all "medicine people," sives first p.iority to the capacity to @rtrol the attention, to maintain "one-pointedness of mind." There can be no healing, no meditation, no nearinsful spiritual erperiente without that highesi of disciplines. "It's noi like an organization. It's not a resimented or aD organized thing. This is the way IndiDs do things: It's meant to be, it happens. and that's it." usually collect a.etinue ol patients who go with ne, look and listen ald oft?n volunteer information. At first I thought this wa! m intrusioD on th€ patient's privacy, but later I discov€red thrt they accompanied ne not out ol idle curiosity but because of a genuine concein for their fellow patients and thrt it often help€d t put me fuly in ths pictu€. I recently visited a coal-mine in Shanli piovince where I pas t ld ihat the min€!! objected to having to obt&in a doctor'3 certificate ir order to so or sick leave, They said that this obsolete Egdrtion reflected distrust of the wolkels. Accor' dingly, it was abolish€d snd ths inter- estins thing is thst since then, the runb€r of workers absent for health reasors h.r falen sharply. Those senior nurses who are selected lo! training as doctors are lelieved of !I otle. duti€s for at least six morths |nd go throuah an iDtensive cru8e of rnedicrl Aw.y with AI P€.t6 Dr. Jostua S Horn The former head rurse in our hed 1969; 192 paaes $2.95 postpaid florn Monthly Review Press 116 W 14th Street N€w York NY 10011 1974: ?7:l p!8!s $3.95 postpaid DeI Publishing Co often ask hor que€tions and she impresses A lo1,ins, pqtasan a.count ol Chiwse mediciw onn Ufe sinre the reoolution b! d Britkh sDseonuho Awd there fot Jifteen O.e Das HammaNkjold Plaza New Yolk NY 1001? Dds-to-da! Ule uith a contemporary Anedcan Innhn hedar, rich in patie6e arn ud,ersta"l.ins, neftaes to neke seprutions betueea medici@ dnd. rcA.TF When you come to people who a.€ happy and who laugh, join with them. that's the only Dedicine. There are surg€.y ward lsussested ba JeM Anne8on) .TF I had not been lons at work before it became clear that meetinss, big dd small, played a very important prrl h the lje of t;e hospital staff. Some we.e eonfined to a siDsle wa!d, others involved everyone in the hospital, from the di.ectorc to the leund.y workerE. a lot of dcto$-medical d@tors and psychiat.ists, especially the youns ores and the new ones-who e thinking in new ways, entirely dilfe.enl Irom the old establishn€nt. Some of our The patients olten sel€ct representatives to convey theb opinions and sugge!tions to teams of docto.s, and orderli$ who have dsy to-day .esponsibi' dd they'll patients. These teams meet daily to plan tle day'swo.k. Ambulant patients play an active pa.l in ward affairs. They take people will be workins with tlese people b€ coopelating with us. A! I ssid befo.e, we have knowledge and capabilities that they de going to need, tley have some abilities and techniques that we could learn about, too. and Iity in relation to specilied sroups of thei. meals in the wed diniDs roon ad many oI them help patients who are hs.s now become a doctor in the same ward. During ward routin$, ne with her 8tasp of the I conplicated anstony and physiolo8y of the hnd. She assists othe. su.geons in ditricult op€rations and chey assist he! ir simple or€s. She is mod$t, keen to l€am &nd dex' terous, and I m sure that within & few years she wil become a codp€ient surgeon in tlis field.
  22. 22. Dealing with Doctors because we don'i wani anybody ln io tell us libla.y belore pu.chasing one, since they den't very inter health. They'.e much more doctors ested in inte.ested in illness, lor their traininA and practic€ ue in the cure of disease. . . .now you musi fird out if there's a proper fit between You and the new MDiging Your Doctor Dr ArtLnr S Fre6e docto.. Areyou both in aseement that Ie is to lun the slow and you don't want io be involved in any decisions? 0r do you wani to share responsibility lor your h€alt} care ed ior all necessary decisions with your new doctor? And does the doctor aglee to your involvement? Whenany nor-ladiologist wants to take ofyou-your G.P. or intemist or an x ray whatever-ssk iI CIBN he's had special training Need d doctar but dan t knou hau ta sa abo t findins one? CoI the emergekc! rcon oJ Aow local hospito.l atul. 6h to speak to the intem an d.utv. The best time to call is betueen 8 and 1A AM- tllell ll be hethly rested. md nol too busu. IThat's the best time ta 9o to an emergerlcA roam too.l TeU the arn ask Ior intem bh! lo nee.I d doctor d coryle al tumes. InLem see .l.octors at theb best md. borst, md the! lrnou uho the sood an.s are. Thes'U olaa be so Jltttered that louI set a lood recomnetulation. Nobod! erer 6ks an in radiolosy and whether he has a radio' logist check on his inrerpretation, to make sure nothins is missed. If his answers a.en't "yes," you a.e beins subjected to radiation unnec€ssarily. with Docior6 Docto$ are treate.l wrv cviouslv in this tultue. Theare lored Md respected OD Working To cope with d@tors, you mDst be pre pared io check on the nedical jargon, the term!, the vagre comments they make, and tbis can be done only by accumulatinA a lib.ary of your own. Then the.e are othe. b@ks which you should at least look over and become faniliar wiur, so ihat you can use them if the occasion a.ises. Laier you may want to buy some of these if you find you are comfortable with ihem and 19?5; 191 pag€s $8.45 posipaid lrom Stein and Day Briarcliff Manor NY Let's start firsi with the basic books 10510 MiAIs nucktukins book about fitutins .TF Only when doctors evahateone anotier *ill healtl-cflre quality'cont.ol eve. be attained-and the medical p.ofession is lightins hard to prevent it. Wher you hea. about peer .eview or PSRO (holessional Standads Review Orsanization) this refers to the p.oposal ihat otler doctors check on the private praciitjone.. One G.P., who sees some sixty patients a day, became hysterical when dis' cussing this idea. "Filling out lorns just like in tle }ospitat, thai's wlat PSRO is all aboui. we have to fight these things. I don't want to lill out more than one record just like I've been doins. Everybody in our medical society voted to fisht ii tlat you should own. The Stein a.d Day International Medical Encyclopedia JACBT1M New York: Stein and Day, 1972 Ladies' Home Journal Medical Guide A E NoMse New York: Harper ard Row, 1973 Book ol Hea]th Third edition RLCL-kandRWCuntea New York: Van Nost.andReinhold Conpany, 19?3 These books are excelteni and autho.i trtive, witi broad coveraqe. The Book oJ, is a little mo.e scientific, perhaps, with more history, while the others may put slightly more €mphasis on newer nedical problems such as sbo ion. Its best to compa.e them in the bookstore or @ri feved. ann hatud. Theule a|eruorked, orerpaid, aul nol alabed ta Doctors h@e L'een tredted as gods lar a tine. Thdt stbting to change nau, and. it s jusr 6 htd lor dacta,s to adfust to the change 6 it is for pattentslong Lalpeople Mil doctors htue to h.lp ea.h othcr co.r.l)). into ,.,) rol.s i, which the lalperson cm lnau a little mare nedicine. @..1 the d.octor can be a IJ aot'd be interested. in shorikg Aout etperiences bith tl.octors-gaod at bad-ue d, be glo1l to he@ th.m.
  23. 23. Medical Classes for Loypeople Wonldn't You Like to H6ve s D@tor Wslt lile Dear Tom, Thanks fo. askina about our patient My office provides each new Patient with a set of ielephone triage sheets so as to save time on tle ielephone by thei. knowing what information to hale ready belore they call in. I also make audiovisual Eere a Ust oJ people teothing or plmnins @urses in nedicine lot lnspeot b. Il uou hear oJ others, Iet us k@uPublic Health Department seli-instnctional proSlams for my pa_ One.oon in my office is equipped with simple diasnostic tools (which we teach pstients to use) so they can Aather more valid obs€.vations before decidins whe Minneapolis, Minn 55415 ther to interact with our stafl. Fo! example, a mother miglt brina her clild Keith Sehneft. M.D. ad Fourih Streei 250 South Box 7268 Arlinston, VA 2220? Dr. Eva Salber Duke Unive.sity 615 Chapel Drive Durham, NC 2??06 Ceol Thomas, R.N. Unive.sity of Utah Division of Continuins Education University & South Second Streets Sali Lske City, Utah 84u2 Walt Stoll. M.D. 805 South Limestone Lexine:ion, KY 40506 in to look inio }is ear or listen to his cbest tnez decide whether he needs to be seen by the nurse, P.A., or M D, or if sinple symptomatic reliel is indicated for a few nore days. This se.vice is to the patient and requies only thai they dictat€ their visit io. their own lecords. We also provide each patient with a .unning copy of his o. hq clart for thei. infornation and as a cleck on o'f accu ncy in observins and recordin8 Tlis has been invaluable as a tool of conrnunica tion. Patients can lill out their own insurance iorms too-the advantages go Please keep in touch. I think what you are doins could be an important step towald the day when everyone realizes a tull)ow important the patient, ^s fledsed nenber, is in the health care Walt Stoll, MD Lexington, KY Health Services Unive$itY of Nevada Reno, NV 89507 Chsrles Whitfield Southen Illinois University Scbool ol Medicine The Activsted PstieDt: A Coule Guid€ Box 3926 Ke;th W Sehnert MD linois 62?08 $15.00 postpaid lrom Center fo. Contiruins Health Education Ked College of New JeEey GeorAetown Unive.sity Box ?268 Wood-Ridse NJ 0?083 Arlington VA 2220? Edward Saitz Westen Pennsylvaria Regional ned.icine Medical Pro$an 200 Meyran Avenue Pittsburg PA Ma$hall w 15213 Kreuter PhD Division of Health Sciences UniveBity of Utah Salt Lake City 84112 Session4: Should a PatieDt Take His OM Ston? Course suid.e to the 16-session cL$ in for b,weoplz tfught b! Dr. Keith SehtErt at Georgetom Uniuer- situ's Center Jor Contituins Eedth Ed,uco.ti.n. H.tnd.outs diltributed to students at eoth cl./rss Me iwlud,ed. Should be useful either in orsanizins a ct As in uou connnuit! or l$ er-saltu. 1:F Des$iption: This p.esents a rcview of hypeftension dd of the anatomy of tle cardiovascular system. An initial demoD stration session is held in which blmd pressures are taken by patients and brief use made of the stetloscope ir] checking sross head and lung sou.ds. The dass iben does a home project in which the blood pressure of family, friends and neiglbors a.e tested. Denowtration: This portion is added to sive ile beneiit of hdds on" experience for the students. By now, in tle fourth week of classes, the siudents know e&I other and can approach such a demonstlation with mutual interests. The class is divided into seveEl groops and the mdiments of usina the splygmo' manometer and stethoscope arc demon' strated by the physicians, nurses, a'dlo. physician's assistanis ieaching the ses The students ihen leam to take eacl other's bl@d pressure and to count tie heart .ate and listen to breathing sounds. The total demonshation time is 45 min_ Tley a.e then asked to take the appa.atus home to test the blood of family, friends, dd neiglbors, while keepins a rcco.d of pdsibb nyperiensives they locate. Reconmended Non Presc.iption D.ugs
  24. 24. Feedback Ow job is to InoDide aon uith qrc6' to med.;cal toolA and inJomation vou coh help ba checkins the topits bhih woulll be oJ m6t interest to Uou A btter uould, be eoen tuicer. Medical SeU-Care Magazine Box 717 Invemers, CA 94937 tr tr tr Alcoholisrn n Appendieitis n tuthritis ! ! ! . ! ! ! ! Backache n Being you ow! paranedic ! Btth conhoi pi1ls . Bladder infections ! Bloody nose ! Broken w st i Brcrchitis ! Burns D Bursitis ! Careers in medicine E tr ! ! ! C D Chest pai! D Conmon gynecologicel problens n ! Conhaception D Convulsions D Coping Cuts tr Earache Death and dying Druss objeci in eye Occupational health Old sge Parenthood Physical examination Pink eye Poisoning P.epaid health plans Rurnins Senility Sex n n Empiysema tr Findins a docior tr Fbst aid tr Healtl insurance Vaginal discharge Vitamins n C Eatins ! Nutrition n Sex tlempy ! Shock . Splinte.s n Stonach fl! ! Stuffy nose ! Teachins nedicine to kids n Teachina our doctors Colds n tr tr Menop.use Men's health Mental health Yosa ! You. black bas D Hea.t attack ! ! n Hish blood pressure Home deliveries How lona wiu you live? Tl IIow d..rtors arc l.ained ! How to take a blood pressure ! Insect bites ard stings n Inegrlar heaftbeat n Kids ! Keeping your own nedical rccords n I su8gest you review the folowing tr,Learning ftom illness tr tr ! ! yonie imited, to become a charter subsd;ber to Med.icd Sell-Care Maltozi@ . Medical classes for laypeople Medicai lite.ature Medical schools Medical traditions in otler cultureg M€dical Sell-Care Magazine Box ?17 Invemess, Enclosed b CA 94937 $?. Plea!€ si8! me up as a charter subsc.ibel. Stleet Ciiy State zip