Sibling rivalry may be worsened by family stresses and tension , or by changes in the family such as separation or moving house. Sometimes conflict between siblings may be worse when one sibling has a chronic medical condition or a disability or learning problem, which necessitates additional parental attention.

The best way for parents to manage sibling rivalry and conflict is generally to keep out of it. Some rivalry is inevitable, and not necessarily a bad thing. The situation is often made worse by parents buying into the argument. Most of the time it is best left to the children to sort things out themselves. Parents should rather establish clear guidelines and set limits on what is acceptable behaviour, and handle it in the way they would handle any aggressive or inappropriate behaviour.

Parents can minimise sibling rivalry by addressing the following issues:

• inform other children of the imminent arrival of a new baby;

• involve other children in helping to care for the new arrival, strongly praising appropriate behaviour, and attempting to ignore behaviour that is inappropriate;

• try to set aside time for each child each day (‘special time’);

• demonstrate to each child the very special individual attributes they alone have; encourage individual activities and interests; allow them to have different activities, appropriate to their ages, such as different bedtimes.

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There are many factors which can lead to the formation of atheroma. These are:

Heredity — a history of heart attacks at an early age in parents or grandparents

High levels of blood fats (lipids) — cholesterol and triglycerides

High blood pressure

Obesity

Cigarette smoking — this increases the risk four to six times

Nervous tension

Lack of physical exercise

Most of these factors are reversible and there is no doubt that high fat levels are a cause. What is debated is whether you can do anything about changing the level of fat in the blood.

A diet high in animal fat tends to increase the amount of cholesterol and a high intake of refined carbohydrate increases the level of triglyceride. Changing the diet may reduce this factor and so reduce the risk.

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Incomplete abortion means that some placental tissue has been retained within the uterus or womb.

This miscarriage is usually associated with bleeding which may be heavy, and pain, backache or lower abdominal cramp, just like a mini-labor.

Very few miscarriages are complete — that is, all the products of conception completely discharged.

Most doctors would consider that all cases of miscarriage require the operation of D and Ñ — dilatation and curettage — to remove the products of conception.

If the womb is not completely emptied, then the retained placental tissue may cause infection or, later on, heavy or irregular periods.

A missed abortion is where death of the foetus has occurred. The symptoms of pregnancy disappear, but there may be no bleeding.

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During its journey around the body, all blood regularly pays a visit to the kidneys. There it is filtered in a rapid and wondrous manner through the renal network. Impurities the body wishes to eliminate are rapidly shed. If the blood is overloaded with certain products it has no use for, these are also tossed out by the kidneys. The balance of chemicals, hormones and minerals needed by the body is kept normal by the balancing-out capacity of the kidneys.

Chemicals are filtered out in a fluid form, and collected in the central part of the kidneys. From there they are channelled by tubes, called ureters, which lead to the bladder. There the fluid is stored until a convenient time, when it is voided by another single tube called the urethra.

There is an important outlet valve at the lower end of the bladder. It takes babies many months before they have complete control over this valve. But eventually each one succeeds and is then capable of passing urine at a suitable time and place.

Some children do not gain this control for some years, and continue to pass their urine at night. Bed-wetting is an embarrassing problem, but in most cases it overcomes itself and it is uncommon after the age of 12 years. But it sometimes persists into the late teens or twenties, when it may become a social embarrassment. Treatment today is usually successful.

The kidney is probably the most common organ of the body to suffer from congenital malformations, though these are fortunately not frequent. Sometimes cysts, occasionally many in number, may damage the kidney structure. In other cases structural abnormalities may occur. Some of these are apparent from an early age and will be automatically cared for by doctors soon after birth.

Infections of the bladder and lower tracts of the urinary system are common. These usually respond well to prompt treatment.

More seriously, the kidneys may be affected by an infection that takes place in some other part of the body. This is believed to be an allergic type of reaction and it may produce serious symptoms.

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Often the child’s tantrums are a direct reflection of upbringing. In families with a high level of emotional disturbance, where fighting and personality clashes are the rule, the child is more likely to reflect this by being involved in rages far more often. A child who normally lives in a calm, relatively serene atmosphere will lend to reflect this and be much less likely to be involved in temper tantrums, breath-holding bouts, sulky periods and similar emotional states.

Treatment

Children are usually the product of their environment and upbringing. A serene home life will invariably produce a child with a calm mental outlook and a tendency to fly into rages far less often than one who lives in a family ridden with mental stress and turmoil.

Children live by example. If parents only realized this, it would greatly ease the burden of treatment. Yelling, screaming and shouting, hurling abuse and chastizing verbally or physically will seldom do much good for frayed tempers. Indeed, it will tend to worsen the situation. Bribery will be equally disastrous, for the child may soon learn the pecuniary value of temper tantrums, and lack of self-control will be inevitable.

Self-control by parents is the best example. Adults are able to do this, and in so doing they will inevitably benefit their children and their children’s attitudes. Being neither overindulgent nor over-strict is also good admonition.

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Normally the pleura move smoothly against one another as the lungs expand and contract during breathing. A thin film of fluid lubricates the membranes. When an infection is present, the pleural fluid becomes sticky and the pleura rub against one another. This ‘pleural rub’ can be heard clearly through a stethoscope. Sometimes an excess of pleural fluid is produced, protecting the inflamed membranes from friction. This pleural effusion can be detected when a dull note is produced by tapping the chest wall. A raised temperature and general feeling of unwellness is a further symptom.

Pleurisy is generally a minor illness. However in some cases it may be a sign of a more serious disease such as pneumonia, a blood clot in the lung, lung cancer or tuberculosis. It is therefore imperative that a doctor be consulted before undertaking any form of complementary treatment.

Homeopathic remedies can be used to treat pleurisy. Chest and back compresses can help reduce internal inflammation. Large doses of Vitamin C and Vitamin A may be recommended by a naturopath.

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Any other material discharging from the ear canal signals a potentially serious condition. It may be a symptom of a middle ear infection; a boil in the ear canal; swimmer’s ear (infection of the ear canal); rupture (break or tear) of the eardrum by injury or infection; a foreign object in the ear canal; tumour of the middle ear (cholesteatoma); or fracture of the base of the skull.

Signs and symptoms

Abnormal discharge from the ear may be thin and watery, bloody, odorous, cheesy, green, yellow, or white.

Home care

Any drainage from the ear canal (except typical earwax) should be considered abnormal. Do not try to treat a draining ear at home. It should be promptly seen by a physician.

While waiting to see the doctor, pain accompanying a draining ear may be temporarily treated with aspirin or paracetamol pain relievers.

Precautions

• A draining ear should be examined by a doctor within 12 to 24 hours.

• Do not pack cotton into a draining ear. Packing the canal may force the discharge back into the middle ear.

• Do not use a cotton swab or any other instrument to remove material still in the canal.

• Do not attempt to wash out a draining ear since the eardrum may be broken or torn.

Medical treatment

Your doctor will gently clean your child’s ear, inspect it, and diagnose the cause. Depending on what is found in the ear canal, treatment may require oral antibiotics, medicated ear drops, removing a foreign body, an X ray of the child’s skull or mastoid bone, or surgery for cholesteatoma (tumour of the middle ear). In the case of a ruptured eardrum, antibiotics may be required for a long time, until the eardrum is healed and hearing returns to normal.

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Age 40 is when it’s time to step up your tests, generally getting them every other year instead of every three. It’s also time to start tending to your lower half. Your risk for colon cancer rises sharply when you hit your mid-forties, and your risk for prostate cancer increases as well. In addition to the other aforementioned tests, get this test now, suggests Dr. Goldberg. He also notes that race and personal or family history of illness can change the timing and frequency of medical tests.

Rectal exam: Nobody wants one. Every 40-plus man needs one every year, says

Dr. Goldberg. A digital rectal exam (DRE) – in which your doctor inserts a gloved, lubricated finger into your rectum to feel your prostate-is your best line of defense against prostate cancer.

Your Fifties and beyond

Not much changes between 40 and 50, so long as you’re continuing your regular tests about every two years. At age 50, start getting physicals annually and continue getting the DREs you started getting in your forties. Just add a couple more tests, and you’re set for life, says Dr. Goldberg.

Stool sample: During a DRE, the doctor will also take a tiny sample of stool to test for any traces of blood-a sign of cancer growth or development. Like DREs, this should be done every year, says Dr. Coulehan.

Sigmoidoscopy: Your 50th birthday is a good time to start having this test and then get it done every five years thereafter, says Dr. Goldberg. A sigmoidoscope is a thin, flexible, lighted instrument that actually lets the doctor look into your rectum and large intestine for polyps, or growths that might signal cancer. The test takes just a few minutes. And don’t worry. The sigmoidoscope is so thin and flexible, doctors say that although the test is uncomfortable, it is not painful. If you are at higher risk because of family or personal history, your doctor may recommend more inclusive tests such as colonoscopy or a barium enema at an earlier age.

PSA screening: PSA (prostate-specific antigen) screening is a blood test that checks for a compound that is produced exclusively by the prostate gland. Significant increases in this compound can indicate a problem, such as prostate cancer. You should have this test done every year starting at age 50, says Dr. Goldberg, unless you are at high risk because of your family history or if you are an African-American.

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At first, the suggestion that it is our western lifestyle that causes many of our major diseases seems quite ridiculous, but the pioneering work of a group of doctors who spent decades in non-westernized parts of the world must make us think again. They noticed that certain non-infective diseases were very much less common in traditional societies than they were in the West. They wondered at first what to call these diseases. ‘Diseases of civilization’ (meaning modern, western civilization) is not quite right because evidence suggests that some of them were around but uncommon in the ancient civilizations of Egypt, Greece, Rome, India and China. Given that the conditions they found to be so common were now mainly seen in communities that had adopted our western, technological way of life, they decided to call them ‘western diseases’.

The first two criticisms that are immediately thrown at such a suggestion are, first, that people in the Third World tend not to live to be old enough to get ‘our’ diseases, and second that their medical systems are so poor that they simply do not diagnose the conditions even when they are present. Neither of these criticisms stands up when examined in depth, and studies which show that migrant populations (originally without western diseases) adopt the diseases of their westernized brothers in their new country, prove without doubt that it is not simply that whole populations in the non-industrialized world are somehow immune to westernized diseases. It is also impressive (if depressing) to watch peoples with traditional lifestyles take on our disease pattern as they adopt our way of life.

So what could possibly be causing these western diseases? Obviously motor-car accidents can only occur where there are motor cars, and pollution from industrial effluent or cigarette smoke is only found where these two abound, but these are not the diseases I mean when I refer to western diseases. The conditions in question are such disorders as: high blood pressure, obesity, diabetes, heart disease, appendicitis, piles, varicose veins, gall-stones, kidney stones and cancer.

Of course, any of many changes in western lifestyle in recent years could account for the frequency of all these conditions today and their virtual absence until the last century in the West and in most of the world today, but because many of them seem to affect the digestive system it makes sense to start looking for clues in the food we eat. Modern technology has radically altered the production and preparation of food and it now seems that food changes are at the heart of many of these ‘new’ western diseases.

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Humulus lupulus

Used as a soporific to treat insomnia, anxiety, indigestion, and also for the relief of menstrual pain and neuralgia.

HOREHOUND Marrubium vulgare

Beneficial for disorders of the gall bladder and the stomach, it can also be used to treat menstrual pain. It is specifically of use in bronchial disorders.

HORSERADISH

Cochlearia armoracia

Eaten raw, it stimulates digestion and treats bronchial disorders. It clears the head and relieves congestion and sinusitis and the related pain.

HORSETAIL

Equisitum arvense

Having a high silica content, horsetail can be used to clean pewter. A potent diuretic, it can be drunk as a tea to remove gall or kidney stones. It promotes coagulation and corpuscle growth, reducing internal and external bleeding.

IRISH MOSS

Chondrus crispus

Known as carrageen, Irish moss is a gelatin derived from seaweed and is used in pharmaceutical products. Its soothing properties are useful for bronchial and digestive irritations, and it is also nutritious and used for treating convalescents.

JUNIPER

Juniperus communis

Used internally as a urinary antiseptic and to stimulate appetite. The oil can be used in a vaporiser for bronchial infections. It is a diuretic which stimulates the kidneys.

KELP

Fucus vesiculosus

Kelp is used in the treatment of disorders of the thyroid gland and to treat overweight people; it contains iodine.

KOLA Cola nitida

Kola is a heart stimulant and is high in caffeine. It is used to treat headaches, migraine and depression.

LIME FLOWERS

Tillia cordata

In combination with hawthorn and mistletoe, the flower can be used to treat hypertension, cardiac disease and high blood pressure.

LIQUORICE

Glycyrrhiza glabra

Liquorice root can be used as an expectorant in respiratory complaints, and it is well-known for its laxative properties. It is also used as an anti-inflammatory drug, possessing similar qualities to prednizone.

MILK THISTLE

Silybum marianum

Used as an appetite stimulant and an aid to digestion, the powdered seeds can be used in certain cardiovascular disorders. This herb has also been used to treat leg ulcers and varicose veins. It protects the liver from toxins and is used to treat hepatitis.

MULLEIN

Verbascum thapsus

Specifically used for respiratory disorders, working as an expectorant and a sedative. Externally an oil from the flowers can treat haemorrhoids, bruises, nappy rash and warts.

OATS

Avena saliva

Oats are nutritious and soothe the intestinal tract. The seeds are good for the heart and relieve nervous anxiety. The oatmeal is used for skin disorders and the dried straw is used as tea for chest complaints.

OLIVE OIL

Olea europaea

Apart from its culinary delights it has laxative properties, relieves ulcers, and it is believed to reduce cholesterol. Externally the oil is used on bruises, burns and bites, and softens dry skin and hair. Eating this flavoursome oil can enrich dry skin, relieve itchy scalp, add lustre to the hair.

The mucilage on the seed swells when ingested and is effective for constipation, and also diarrohea. It helps lower blood cholesterol. Its most effective use is for Irritable

Bowel syndrome and in cases of colitis. It is sometimes used to treat cystitis

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