The exact proportion of cancers that are caused by exposure to environmental chemicals is the subject of considerable debate. Estimates vary from 1 to 3 per cent of all cases. Cancer mortality in England and Wales is 24 per cent higher in manual than in non-manual workers but it is thought that as much as 90 per cent of this larger risk is accounted for by factors like cigarette smoking rather than dangers associated with actual occupation. There are about forty chemicals and processes that are either known to cause cancer in humans or are suspected of doing so. Most of the known carcinogens have been withdrawn or controlled but many of the suspected ones have not. The most common environmental hazards are: vinyl chloride (liver, lung and brain cancers); some chemical dyes (bladder); some compounds of arsenic, chrome and nickel (skin, lung and nose); some wood dusts (nose); some types of tar and soot (skin); and radiation (many types of cancer). Your employer has, by law, to tell you of any known toxic or cancer-producing hazards, and you should tell him or her if you are worried about anything at your place of work. Your union safety representative could be helpful too.

*120/72/5*

In addition to causing pain, hemorrhoids can bleed enough to produce anemia, which, in turn, may put enough strain upon an elderly person’s heart to throw it into failure, Geriatrics (39#8:89) reports. In younger people whose hearts are stronger, this anemia may nevertheless help to cause angina (pain or a feeling of tightness in the chest, originating in the heart, and brought on by exercise or emotion).

When an elderly person has both heart failure and bleeding hemorrhoids, it can be dangerous to stop the bleeding by conventional means since such patients cannot easily withstand an anesthetic or the trauma of surgery. Now, however, with the new and much safer procedure known as cryosurgery, which involves freezing the unwanted tissues with an extremely cold (minus 70 degrees C) nitrous oxide probe, the risk has virtually been eliminated. Patients treated in this way rarely require anesthesia and are free of pain immediately after the procedure. Cryosurgery is safely performed in a doctor’s office, and has even been used successfully in 80-year-olds with heart failure caused by massive rectal bleeding. Since cryosurgery destroys any sensory nerves frozen by the probe, the postoperative course is painless. Not yet available widely, cryosurgery should catch on very quickly if this initial experience can be confirmed.

*153\143\2*

If detected early enough, senile macular degeneration (SMD), the leading cause of blindness in the elderly, can be treated quite easily in the eye specialist’s office with a laser beam. Treatment delayed for longer than two weeks after the first symptoms appear helps only about 10 percent of patients, Geriatrics (37#12:21) reports, whereas treatment started earlier prevents progression of SMD in over 80 percent.

So important is early detection and treatment that it is a good idea for the elderly to check their vision daily for this potential problem. The test can be quickly performed without anybody’s help or any special equipment. Merely stare, one eye at a time (covering the other with your hand), at a long straight line, such as a door frame. If, to either eye, the line appears bent or twisted, or if a black spot gets in the way, tell an ophthalmologist about it right away.

*122\143\2*

University of Oregon researchers have shown that fish oil is better than vegetable oil at reducing high levels of lipid (fat and cholesterol) in the blood. Given as a supplement to people with hyperlipidemia (high blood lipids), the quantity of oil used was equivalent to eating about a pound of fish every day. This research, according to Medical World News (23#2:97), was prompted by the observation that Eskimos, who live largely on fish, almost never suffer from coronary heart disease.

Salmon oil (that can be taken as Maxepa capsules) is now widely accepted as a dietary means of both lowering the cholesterol blood level and preventing hardening of the arteries, thereby lowering the risks of heart attack and stroke. Each Maxepa capsule, according to the Medical Letter (24:99), contains 180 mg of the unsaturated fatty acid known as EPA (eicosapentaenoic acid), which is about one-tenth of the amount taken daily by people in research that demonstrated a beneficial effect. It remains to be seen, though, whether this much Maxepa (10 capsules a day, or a total of 1,800 mg daily), taken indefinitely, will prove to be safe. Since this substance is technically a “food,” it has escaped the usual safety testing that the FDA requires for all new drugs.

In addition, it has been found, the active chemicals in salmon oil also slightly reduce the blood’s ability to clot, correspondence in the New England Journal of Medicine (315:892) reports. However, with usual doses, this effect is not enough, by itself, to produce dangerous bleeding. Actually, the prolongation of the “bleeding time” test (following a finger prick) that occurs after large doses are taken daily for a month is smaller than occurs in response to treatment with one aspirin tablet.

Nevertheless, this cannot be ignored since, should both aspirin and salmon oil be taken together, their combined prolonging effect on bleeding might under certain circumstances be dangerous. Furthermore, as with aspirin, it would be wise to stop taking salmon oil two days or more prior to surgery.

The next article points out facts about other fish oil products.

*89\143\2*

Among 200 normal adults studied at the University of California while taking ginseng daily for long periods, 22 (10 percent) developed hypertension, nervousness, insomnia, rashes, and diarrhea. According to the Journal of the American Medical Association, both men and women experienced these side effects in response to the American and foreign varieties of ginseng.

The hypertension was particularly significant in that the average blood pressure of the 22 people involved rose from 125/78 immediately before they started using ginseng to 150/ 96 13 weeks later. This much hypertension, if continued, is likely to shorten life. Ginseng, taken as tea, capsules, or tablets, is gaining ever wider usage nowadays because many people believe it preserves youth and increases sexual potency. There is no scientific evidence that this is so. Although heavy users may enjoy a feeling of euphoria, the risk of hypertension clearly outweighs the benefits.

*58\143\2*

Alzheimer’s disease (once called senile dementia), is a dreaded condition that afflicts about one in three people in their 80s. The gradual accumulation of aluminum in the brain over a lifetime has been thought by many experts to be a contributory cause to the disease, if not the main one.

That view has not been universal, however. Other experts have argued that there is no relationship between the amount of aluminum in the brain and the degree of the dementia. Their objection is now weakened by research reported in the Lancet (1:354) that used the newest and most refined method (nuclear magnetic resonance) for studying the chemistry of the brain.

The research consistently showed a minute deposit of aluminum in the very center of each and every nerve cell “tangle,” the characteristic lesion of the brain in all cases of Alzheimer’s. This presence of aluminum at the center of every tangle strongly suggests that it is involved in the initiation of the Alzheimer’s patient’s brain damage.

Though some experts believe that the aluminum found in these brain lesions has merely settled out of the blood stream into tissues that already have been damaged by something else, there is evidence that points to the contrary. It has been shown that aluminum inhibits the enzyme in our tissues (called choline esterase) that is known to be responsible for maintaining normal functioning of the brain. Thus, far from being merely a “passive marker” that settles out of the blood into damaged parts of the brain, aluminum could be the cause of the damage as well.

Furthermore, there is current news of a dementia that is similar to that of Alzheimer’s, but accelerated, that has been occurring in kidney failure patients undergoing dialysis when the dialysis fluid is made from water containing a lot of aluminum. This development gives even more credibility to the theory that aluminum is related to Alzheimer’s disease. According to one story in Lancet (2:116), a 44-year-old man who received kidney dialysis in an area where the tap water had a high content of aluminum developed almost complete memory loss during the time of treatment. However, he became able to remember normally again after 259 mg of aluminum was removed from his body. (See the next article, “Aluminum in Our Water,” for more information.)

Of additional interest, scientists have found that animals fed aluminum for several months eventually die with brain damage similar to that found in humans with Alzheimer’s disease. Also, medical researchers have discovered that brain tissue from people dying with Alzheimer’s contains much higher levels of aluminum than the brain tissue of mentally normal people of the same age who die from other causes.

In view of all this, a physician writing to the editor of the New England Journal of Medicine (303:164) suggests that gradual build-up of aluminum in the brain may well account for the gross loss of memory and judgment characteristic of Alzheimer’s.

The reason why the onset of the disease is delayed in most cases until the age of about 80, however, has never been plausibly explained. At last, though, in light of research reported in the Lancet (2:1227), we may be closer to the answer.

Aluminum, it was found, not only damages the brain directly, but also harms it by lowering the effectiveness of the blood brain barrier (BBB), a layer of tissue that normally acts as a protective coating between the bloodstream and the brain’s nerve tissues. Normally, the BBB keeps toxic body waste products from getting out of the blood into the nervous system. When the kidneys age and become less efficient at ridding the body of waste products, particularly those derived from protein breakdown, the concentration of these substances in the bloodstream increases, and, if the BBB is no longer intact, they are able to get into the brain and poison it.

Significantly, it was discovered that one of these toxic waste products causes memory loss and selectively damages parts of the brain that are most affected by Alzheimer’s disease. Thus, aided and abetted by the aging of the kidneys, aluminum helps to bring on Alzheimer’s in two ways: by directly poisoning the brain, and by injuring the BBB so that other poisons can damage the brain as well.

*27\143\2*

If your own doctor carries out the total care of the confinement himself, he will no doubt perform a complete examination at the first visit. Or if you are referred to the obstetrician, he will most likely perform the full routine on the first occasion.

This is what you could expect to take place:

(1) History of the Present Pregnancy. The doctor will check your L.M.P. He will ask about details of symptoms you may be experiencing, in an effort to pinpoint whether you are or are not pregnant. In many cases it is quite clear and fairly obvious that you are pregnant.

(2) History of Previous Pregnancies. The doctor will be interested to know about previous pregnancies, whether they proceeded to full term, or ended up as miscarriages or abortions. He will want to know about any special difficulties that occurred during the pregnancy, or afterwards. Also, if the babies were normal, weighed the normal weight, and the approximate duration of each labour. All this will assist him when it comes to assessing the present case. He will also question you about blood transfusions.

(3) History of Past Illnesses. As certain diseases may be of significance, he will query you on past and present illnesses. Diabetes, heart and kidney disorders may be very important.

(4) Physical Examination. The doctor will then carry out a full physical examination. Each system is checked. The heart, lungs and intestinal system are examined, as well as each other system in brief. The breasts and nipples are checked. The doctor will be keen to know your average weight before you became pregnant. He will weigh you, check your height and blood pressure. In fact, the regular blood pressure readings form one of the most important checks thereafter. It is essential that the doctor have a “base-line” reading with which he can later compare subsequent readings.

(5) Pelvic Examination. The doctor will insert an instrument called a speculum into the vagina. This gives him an excellent view of the vaginal passageways, and the cervix, the part of the womb that juts into the upper part of the vagina.

He will inspect each part thoroughly. If there are discharges, he will probably take a specimen for pathological examination.

A cervical smear test will probably also be done, and this too will be later sent to the pathological laboratory for examination.

This is followed by a manual examination. In this way, the womb can be felt by the examining fingers. Abnormalities may be detected which could play an important part later on in the pregnancy. The size and position of the womb is felt and recorded.

(6) Laboratory Tests. Besides the tests already mentioned, the doctor will arrange for certain important tests to be carried out. These will usually include various blood tests. A hemoglobin estimation is performed. This indicates the quality of the blood. If reduced, it may require treatment.

The blood group must be known, for this could be vital later on in the event of abnormal bleeding. It is called the “ABO” grouping. In addition, the Rh (or Rhesus) factor must be known. This is also very important for all women, but especially in the cases of mothers pregnant for the first time. Today, it is possible to prevent many of the disasters of yesteryear when serious complications occurred due to this blood factor. Modern medical progress has now virtually eliminated these serious problems from arising by treatment before they occur. More will be told about this later on. The key factor is the need to know the patient’s Rh factor.

The Wasserman or Kahn test (to check against venereal disease) is performed, and a urinalysis carried out. This is a simple urine test for certain elements that could adversely affect the pregnancy (mainly albumen and sugar). Sometimes a special culture of the urine may be ordered if the doctor has any suspicion that infection is present in the urinary tract.

Some of these tests will be carried out at the doctor’s office. Others may necessitate a visit to the pathology department of the hospital or to the rooms of a private pathologist. Sometimes the doctor may take the blood sample himself and have these sent to the pathologist.

If there is any doubt about pregnancy, the pregnancy test may be carried out as well. This is the check for H.C.G., which has already been explained.

(7) The Next Visit. An appointment will be made for your next visit which will be in four weeks’ time. Subsequent visits will be quite a deal briefer than the initial one.

They will chiefly entail a check on the blood pressure, a urine check (mainly for the presence of albumen, which if present is an indication of abnormal kidney function), and weight gain.

The mother-to-be will have the opportunity of telling the doctor of any abnormality that she has noted. He will offer appropriate advice.

After the twenty-eighth week, examinations tend to be more comprehensive. The doctor will carry out an abdominal check as well as the foregoing procedures. He will assess the height of the fundus, and this gives a good indication of the rate at which the infant is growing.

He will also check the position of the foetus as it lies in the womb. He can readily work out where each part of the body is, where the head is located, the back, and breech (or rump). He will listen for the foetal heart sounds through a special obstetrical stethoscope, and check on its degree of activity. All these are important features, and variations from the normal may need to be followed through with other investigations.

Every doctor, of course, sticks to the routine he has found most practical over the years. So if your doctor has a routine which differs from this one, do not be alarmed. There is little doubt that all the important features will be covered bit by bit. He may elect to carry out certain examinations earlier or later. It depends on his individual feelings at the time, so go along with his suggestions at all times.

Later on, certain additional blood tests may be ordered. If the blood count or haemoglobin levels were unsatisfactory at the first assessment, then it is certain these will be rechecked once or twice later on.

If there is any question about Rh factor problems, later checks may be required for this as the pregnancy moves on.

*63/76/5*

In males, an operation known as vasectomy is available, and has become popular in recent times. It involves cutting and ligating the vas, the tube that conveys the male seminal cells from the testes in the scrotum where they are manufactured. This operation, too, is successful, but it should be regarded as being permanent.

Both of these operations are straightforward. However, in some there are psychological side-effects, largely related to the mental problem that pregnancy thereafter is impossible and this can adversely affect some men and women. Before the operation is done, a very full appreciation of all the factors, both for and against, must be clearly considered. Many younger women who have had this done in their twenties regret it later on. Particularly is this likely if children or partner are killed or die, or if separations or divorces occur and a new partner enters the scene, and they wish to procreate again. Many situations such as this are on record, so that careful appraisal is imperative.

It should be clearly pointed out that these operations are intended for permanency. As it so happens, up to 5 per cent of women want to have the operation reversed within a few years of it being carried out! Sometimes this is possible, but often the results are unsuccessful, even with the skillful use of modern microsurgery. So, think well before you make the decision and opt for surgical sterility. Certain operations are more readily reversed, but the main objective is permanency. Please keep this well in mind!

In considering any form of contraception, whether it is for temporary, long-term or permanent reasons, it is worth discussing it all very fully with your family doctor or gynaecologist. It goes without saying that there must be complete unity within the family circle about whatever practices and methods are decided upon.

*48/76/5*

There are many factors which will spoil the delights of sexual intercourse. I shall outline them briefly, and will not comment too much upon them. Most of them will need nothing more than a mention. The chief are:

a. Your state of health and that of your partner.

b. The use of certain drugs, even the “popular” drugs which are known as sedatives and tranquillizers. These suppress normal sexual responses. Certain drugs used for the treatment of high blood pressure often reduce the libido, and in males can reduce potency and the ability to gain satisfactory penile erection.

c. Alcohol and alcohol-based beverages may inhibit sexual performance and/or satisfaction. (In the early stages of alcohol consumption, desire is often increased, but rarely, if ever, will it increase performance.)

d. Certain diseases affect sexual desire and performance. Diabetes is perhaps the best known and the most common one, and it may affect quite young people. If you are in this group, a frank discussion with your doctor could help greatly. However, it is often the case with the diabetic, unfortunately, that treatment is not always satisfactory.

e. Overwork, increasing worries with work situations, long hours with inadequate sleep and rest, domestic tension, are also barriers to achieving full sexual response and satisfaction.

f. Impotence. This may be due to psychological factors as well as to physical. If this is your problem, you should see your doctor; he may be able to help. Often what seems to be a physical cause is psychological – e.g., a sense of guilt – which will somehow interfere with the body’s internal programming and the result is the inability to achieve success in this important area of marital relationships.

If there are any difficulties in a marriage because of what appears to be, for want of a better name, sexual incompatibility, I would urge a visit to a marriage counselor, your family doctor or to a psychologist trained in this field. Go to your doctor first, and it is likely that he will refer you to a psychologist or a counselor.

*34/76/5*

The fact remains that home ownership is still the dream of most, and if it is at all possible, the idea should be encouraged. Rentals paid to landlords are never retrievable. It is “dead money.” Certainly the landlord has every right to get a percentage on his invested funds, so don’t blame him for making life hard.

The majority of couples, even in these days of high-priced housing, should make plans as early as possible to purchase their own bit of real estate. As I watch couples marry, I find it most stimulating to see a given proportion, even in these days of astronomical prices, still purchasing (and paying off) their own homes in the early days of their marriage.

It is possible. But it must be planned for. Many sensible couples work hard before marriage, and accumulate a nest-egg at the bank. When they marry, they pool the funds, and this is often adequate for a deposit on a modest dwelling.

Once the deposit is paid, everything thereafter is payment off the principal (and the interest), but inevitably the principal sum is being gradually whittled down.

Generally speaking, in times of inflation, it is in the buyer’s own interest to purchase and pay off. You buy today at whatever the going rate is, just suppose it to be $85,000. But you are paying it off in terms of money values over the next ten or twenty years. By then, if inflation keeps going (and it seems this way, despite what the pundits say), you are paying it off in money of tomorrow’s value. In short, your income is greater, and it may take a lot less time to pay off the total principal than you had imagined. What is more, your house tends to keep pace in value with the inflationary spiral.

It is worth bearing this in mind. A smart real estate man told me a long time ago: “The best time to buy (or build) your house is today.” Sure, yesterday or last year or ten years ago would have been better, but that is gone and dead and buried. Tomorrow’s prices will be significantly more. Today is the time. Get the message, young couple, unsure of making a decision?

If you do not take the step, in twenty years’ time you will still be wishing you had. By then rentals will have tripled, as well as the price of houses, and you still own nothing.

However, you must put the cost of housing well up in the list of regular “outgoings,” for it is basic.

Today, every young couple seems to want the lot, as far as everyday domestic conveniences are concerned, right from the start. There is no harm in wanting.

*19/76/5*