Toys are an important part of childhood. Children (and adults) can choose from a bewildering array of toys, simple or incredibly complex, cheap or expensive. It is often said that play is the work of childhood, and children use toys to play, to learn, and to fertilise their imagination.

There is pressure on both children and parents to purchase certain types of toys. Many parents at some level feel better if they are able to provide a large quantity and variety of toys for their children. There is peer and advertising pressure on children to have certain toys — just look at the saturation advertising on afternoon television which is directed at children. This pressure is often difficult to resist.

Expensive toys are not necessarily better than cheap ones, and there is nothing wrong with toys that are hand-me-downs, provided they are sturdy and still in reasonable condition. It is often a very old soft toy that a child becomes most attached to. Children have very vivid imaginations and rich fantasy lives, and they improvise readily. Anything can be a toy — not necessarily something that is bought from a toy shop. Improvised toys (such as the lid of a saucepan or empty containers) stimulate the child’s creativity.

Let the child choose the toys if possible — they should not be a realisation of parents’ fantasies. However, it is important that you set clear limits in advance on such issues as cost and safety. Toys and play are an important way that parents and children can communicate with each other. They create the opportunity to share quality time together and stimulate the child’s learning and creativity.

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“Ever since the heart attack, he seems to be trying too hard. 1 mean, he wants to please me, prove something, I think.” The wife described her feelings about the impact of a life-threatening disease on her husband and her marital sex. “He used to really enjoy me, but now he seems to be worried that I will see or think that he is fragile or something.” With catastrophic illnesses, some patients adopt styles that prevent a mutually pleasing sexual interaction. Here are some of the styles, based on my interviews.

The Accepter: This person acts as if the disease is deserved, another negative in a disappointing life. There is little effort to fight back, to change, to adapt, to protect sexuality. Rather, there is surrender and sacrifice of sexuality to the disease process. “The doctor told me that diabetes could cause impotence. He said it, and he was right. So I don’t know why you are asking me about our sex life. I can’t have one,” said the husband. When I asked how his wife felt about that, he responded, “She has no more choice than I do. It is just in the cards. A bad deal, a rotten deal. ” When I suggested that there was no erection at all, the man responded, “Look, you learn to live with what you are given.” To paraphrase T.S. Eliot, if you fail to look inside for the strength to grow at times of crisis, then you must accept whatever life gives you. As this chapter continues, remember one basic principle: No disease prevents sexuality. The Accepter has forgotten this fact.

The Denier: This patients minimizes all illness, indeed all negative events, and in the process sexuality leaves the marriage. This minimizing interferes with sex because the maintenance of intimacy depends first on acknowledging any blocks to that intimacy. “No stroke is going to bother me. It didn’t even faze me, really. We just keep going,” reported the husband. “No way that’s true, Dave,” said his wife. “Can’t you see that we haven’t had sex in months?” The husband could not believe his ears. “It could not have been that long. I’m just as sexy as ever.” He laughed and pinched his wife’s thigh. She slapped his hand and he continued to laugh. “It’s not funny.” She began to cry. “You’re either a liar or a fool. I cannot live this way.”

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OF EXPRESSION?

Are you a talker, a toucher, a shower, a feeler, a senser, a listener? How do you best express yourself?

One husband said, “I’m a man of few words. My wife has all merest.”

The wife responded, “Oh really? Your few words are worth hundreds of mine, because you never listen anyway. I have to send ten for one to be heard.”

Styles of communication are as different as the people who use them. Try now to identify your basic style: quiet, reflective, passive, active—how do you send your signals?

“I don’t talk about love,” said the man. “I show it, I give it, I demonstrate it.”

“Then I must be blind,” answered the wife. “So try talking a little more. I listen better then I see.”

When you really want to be heard and understood, how do you send your message? How do you communicate, show the road signs along your love map?

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Gonorrhoea or “clap” is an ancient disease and has been around at least since Biblical times. This is caused by a rounded bacterium, the gonococcus or neisseria gonorrhoea.

The incubation period is shorter than syphilis, being around two to eight days. In men, it usually causes an acute inflammation in the urethra or tube which carries the urine from the bladder to the outside. There is a discharge, often thick and yellow, and considerable pain on passing urine. These symptoms are usually so marked as to make the sufferer seek medical attention quickly.

But, in perhaps 10 per cent of cases, there are no symptoms and so the man may be unaware he has an infection and pass it on to others.

In women, at least 80 per cent have no symptoms and so are more likely to spread the disease. It is uncommon to involve the urethra so there are no symptoms related to passing urine.

It may involve the vagina or cervix and may cause a mild discharge. If the infection ascends and involves the fallopian tubes there may be severe abdominal pain and this infection may block the tubes, leading to sterility.

In both sexes, the mouth, throat or rectum may be involved.

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There are some simple rules of which we should all be aware if we are called on to render first aid to someone having an epileptic fit.

There is no need to move the person unless he is in danger from a hazard such as traffic or moving machinery.

Do not restrain the convulsive movements. Move furniture, if possible, away from the person.

Do not put your fingers in the mouth of the person, trying to remove dentures or stop him biting his tongue — you may have your fingers severely bitten. Most people feel they should place something in the mouth of the convulsing person to stop the tongue being bitten. Hard objects like spoons or pieces of wood are more likely to break the teeth. A bitten tongue will heal but a knocked-out tooth is gone for ever.

In my experience, it is difficult to insert a soft object such as a rolled handkerchief or a cloth-covered piece of wood, so it is better not to try.

When the convulsion has stopped, the person should be rolled on to the front with head to the side — the coma position — so that saliva or vomit will not be inhaled.

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It is important not to leave undescended testes, presuming they will come down at puberty. In the past, operation was often delayed until after puberty or male hormones were given just before puberty to try to promote normal descent.

Ectopic or abnormally placed testes are prone to several complications. Function may be impaired in both the production of the male hormone testosterone and also the reduction of sperm.

Testes lying in the groin are prone to injury and are more likely to twist on themselves and this torsion can cut off the blood supply. There is also a higher risk of cancer developing in testes which are not normally lying in the scrotum.

In about 70 per cent of cases the mal-descended testes are associated with hernia and this, in itself, may require operation.

Operation is the treatment of choice and most surgeons prefer to operate before the age of six.

The testes are brought down into the scrotum and anchored there by means of stitches. Late operation, that is, around puberty and particularly after puberty, is associated with a high risk of failure of function of these organs.

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SCLEROSIS-DISPLACEMENT OF THE UTERUS

Is recognised by the fact that the iris fibres in the uterus-area run in large strongly curved arcs enclosing dark lines. The iris fibres then reach as far as the kidney area. With a uterus displaced towards the rectum (retroversion) there is a displacement of the iris fibres from

22′ to 20′—therefore to the low back area, and since there is often pressure upon the rectum, the above signs may also be seen in the left iris in the rectum area. Where there is prolapse the dark uterus sign extends lower and often reaches as far as the iris-rim.

Uterine neoplasms are recognisable in the early stages often only by changes in the iris wreath. Therefore it is absolutely essential to observe any deviation of the wreath upwards, since with all new formations in the abdominal cavity, especially of the larger kind, such as ovarian cysts and uterine fibroids, an indentation of the iris-wreath develops, even when no true sign of swelling has yet appeared. In the subsequent development of the disease, the typical widthwise dark tumour-sign forms in the affected organ area.

In contrast to the large tumours, the uterine carcinoma shows at first only in the form of very small, somewhat pin-head size dark points, around which the iris fibres separate. Only if the condition deteriorates, and disturbs the normal body tissues do these points become black.

Small black points with small white transverse lines in the area for uterus are generally the consequence of difficult childbirth (lesions of the cervix).

If cramp-rings are found which interrupt in the uterus area, the patient complains of painful cramps during the menstrual period.

In the iris, the cerebellum lies opposite the uterus (cerebellum-uterus line), and both these organs have a close relation to one another. Patients in whom the cerebellum-uterus line is indicated tend towards hysteria—they are noisy and talk too much. On the other hand, patients showing the cerebellum-rectum line (left iris) tend to hypochondria. Patients with such signs are silent, say almost nothing, and bear their sorrows without much complaint.

The appearance of the uterus sign in the left iris is very much disputed. On this point I cite Phil. Jung: ‘Since both vagina and penis as single organs are found in both irides, why should the uterus be an exception?’ Jung found that with severe genital conditions the uterus signs appear in both irides, whereas in slighter conditions only the right iris shows the sign, and, as he says, this may have its origin in the strong ‘positivity’ of the uterus as a developed organ.

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Signs and symptoms

The signs are obvious, and diagnosis of the cause of abnormal vaginal bleeding often can be made by inspecting the vaginal area. The inspection should determine whether blood is coming from the vaginal opening, the urethra, a laceration of the surrounding tissues, or the rectum.

Home care

Unless they are extensive or due to sexual molestation, bruises and lacerations of the vagina and the surrounding area usually can be treated at home. No antiseptic is necessary, and burning on urination can be minimized by having the child urinate while in a bathtub or water. All other causes of vaginal bleeding require your doctor’s attention.

Precautions

• If a girl is less than nine or ten years old and has vaginal bleeding with or without breast development, she should be seen by a doctor.

• If there is any suspicion of sexual molestation, contact your doctor immediately.

• Girls whose mothers received the drug diethylstilbestrol (DES) during pregnancy may have a deformity of the vagina (adenosis) that causes bleeding. Whether or not they have vaginal bleeding, all girls whose mothers took DES should be examined by an experienced gynecologist (a specialist in the diseases and health of women) at the beginning of puberty. Although the medical profession originally overestimated the chances of a girl whose mother took DES getting cancer, the possibility does exist; all girls with adenosis of the vagina should be carefully monitored.

Medical treatment

Treatment of vaginal bleeding depends upon its cause. Your doctor will determine what is causing vaginal bleeding by performing a careful examination, sometimes involving the rectum. Your doctor may require a culture of any vaginal discharge or an X ray of the pelvis. A girl whose mother received DES will be referred to a gynecologist. A prolapsed urethra requires surgical correction.

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