The Health Blog

Patients may have continuing problems of which the doctor is aware, and which may or may not be relevant to refer to in a particular consultation. An example would be a relationship difficulty which might itself need attention in its own right or because of its direct bearing on the presenting problem, for instance a request for a change of method of contraception.

Risk factors can be assessed, in particular noting any new ones since the last attendance. Opportunistic health promotion is the other item which comes from the Stott and Davis model (1979). This may be irrelevant on some occasions, for example, a request for emergency contraception. The term includes screening (cervical cytology, rubella immune status and blood pressure checks for those using non-hormonal methods) and positive health promotion (help with giving up smoking, dietary advice, suggestions for improving relationships with the patient’s partner and raising the question of safer sex and reducing risk of sexually transmitted diseases, including HIV infection).

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Others at this stage in their emotional development are still trying to assert their individuality and establish themselves as adults in the eyes of authority (parents and other parental figures such as teachers and social workers). The irony is that they do so in an irresponsible way, demonstrating to the parental figures that they cannot be relied upon to be sensible and adult. For this group, becoming pregnant is often a subconscious way of proving to the parent that they are old enough to be treated as an adult, so they forget their Pills and fail to turn up for their repeat appointments.

Peer group pressure may make some girls attend for contraception when they do not need any. Their regular attendance and acceptance of packets of Pills may hide a hidden desperation that they are not like other girls.

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New-found independence, which often comes when there has been a final acceptance that the child-bearing days are over, provides freedom to enjoy life as a couple again. In the same way a new job or entry into training for a new career makes the need to avoid pregnancy or prime importance, so couples may need to reconsider their contraceptive method.

At this stage in life a late period can be a cause of great alarm. Pregnancy must be excluded, for an assumption that the patient is menopausal is unhelpful and may give a sense of false security which is disastrously dispelled if a pregnancy is later confirmed. If the woman has been using the rhythm method or the safe period, with or without the intermittent use of a barrier method, explanation is necessary: now that she is peri-menopausal she cannot rely on the safe period as her menstrual cycle will be irregular. Women who have continued to use natural family planning or a combination of those methods with a barrier method may need a lot of education and support, as well as an examination of their fears if they are to be helped to use a safer method such as the IUCD or hormonal contraception. The fact that they have not chosen those methods before may tell doctors something about their feelings towards them.

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Certain clinical problems arise in contraceptive practice that are general to transcultural medicine. The clinician needs to be aware of symptoms and signs that indicate a disease more prevalent in such patients than in the ethnic majority. The problems of rickets, tuberculosis and diabetes in Asian patients, and hypertension in Afro-Caribbeans are widely discussed. More particular to patients in the child-bearing age group is the issue of preconception counselling and genetic disease. Recent immigrants from rural areas are less likely to have had rubella immunization. Higher rates of consanguinity in Asian couples, haemoglobinopathies and hepatitis  carriage in those from the Far East, are all problems that require the practitioner to be aware, or the record system to be arranged so as to prompt the doctor, to check for these risks.

Training for staff to use different naming systems is available in some areas where local courses are held. Birth dates may be unknown to patients from areas where birth registers are not used, and those given on passports should not always be considered reliable data.

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For the doctor, it can be an advantage to have an interest in the subject of disability because of the awareness, insight and expertise that can be provided, although comfort with questions of sexuality and counselling skills are without doubt the most important aspects of the care that can be provided. Doctors trained in psychosexual medicine develop individual styles, but there is a common pattern of a patient-centred and listening approach which gives a framework to their work, and the security of what is familiar. When trying to help a person with a disability some change in technique may be needed if the real person within is to be reached. For instance, speech difficulties due to neurological disease make it difficult for the patient if the doctor merely listens and encourages the patient to do all the talking. The physical exhaustion and strain of speaking, especially about stressful things, takes too high a toll. The doctor must therefore adapt his technique.

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Herbs seldom suffer from fungus diseases if the soil is properly drained and adequately limed (or dolomited) and sufficient organic compost is put into the ground, in which live the “helpers” as well as the predators. Many types of microorganisms found in natural compost kill off the mildew and fungus-producing spores living in poor soil. Lime or dolomite is necessary in the soil not only as a direct plant food (I say that with the backing of an agronomist in high places), but also to kill off many of the disease-producing elements. I have grown sage plants under controlled conditions, one section with dolomite in the container and one without. During the very wet summer that ensued, the dolomited plants sailed through unscathed, while the others dropped their yellowed leaves and eventually succumbed completely to root-rot.

If you do suspect a plant of having a fungous or root disease, one effective ground spray is the following: Obtain if you can the leaves of Equisetum arvense, Horsetail, or Mare’s Tail, from your nursery, or the dried leaves through your natureopathic physician. Boil 1 part equisetum to 50 parts of water for 15 to 20 minutes. Do not make the solution any stronger, as the herb is a very potent one. Water this around the base of the affected plants (not on the foliage) on soil which has been soaked well the previous day. Equisetum has a very high silica content.

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As yet, treatment from a natureopath is not recognized as treatment by a “qualified” medical practitioner; and this has reduced the ranks (and the incomes) of many men and women dedicated to healing. It has also reduced the numbers of their patients, as many who would like to have the benefit of this type of medicine cannot afford to pay the costs. Surely, these are two branches of the same science and should be recognized as such; one using artificial means and one natural means.

Theoretically (and logically) those using artificial methods should be tagged as “witch doctors” if that title is to be placed anywhere. Please don’t think I have any grudge against medical practitioners. I believe only that they have been misled by the man-made “wonder drugs” of the last half-century, and by their patients’ demand that the symptoms of illness should be cured as quickly as possible. Suppressing the symptoms only aggravates the body’s inability to expel any disease-caused poisons. A runny nose is not pleasant, but it is the body’s way of freeing swollen tissues from the waste matter accumulated in them.

Perhaps we ourselves are to blame. No one likes to be sick, and if illness strikes we would all like a magical potion to make us instantly well again. Tackle it from the other angle: use the goodness of herbs and natural foods to build up resistance and vital health, and disease will have trouble gaining a foothold. If it does lay you low, try rest, patience and Nature’s remedies, and the cause of the illness should soon disappear.

On the lighter side, herbs can be fun. If you like to practise oneupmanship, do it with a drop of this and a sprig of that in your food when friends and relatives come for a meal. Keep them guessing, and surprise them with your skill.

So all I can add now is the phrase with which I ended my Introduction to these pages about the fascinating world of over twenty centuries of herbal lore:

Bon appetit, good health, and happiness!

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Ruta graveolens RUTACEAE

Rue is a herb that today means to many of us only a plant carried by Hamlets Ophelia, and therefore signifying sorrow and dire misfortune. Early herb writers revelled in the knowledge we have now lost of its amazingly strong powers, in particular those affecting eyesight and counteracting poisons. Present-day crime has veered away from poison as a means of settling a score or removing a political enemy; but in the Greek and Roman Empires, a knowledge of antidotes often meant life itself. Rue had an almost magical reputation for warding off or counteracting evil, and even long before this it was known to the Druids and the ancient Saxons as a holy herb and strewn in homes and public places. Later, Christian churches used it too, the twigs for sprinkling Holy Water being taken from the bush. Dioscorides noted that a weasel, when going out snake-hunting for food, often ate rue first, and from this observation came later experiments using it as a poison antidote. It was the principal ingredient in mithridate, the legendary antidote for all poisons ever concocted, and was the plant given by Mercury to Ulysses to overcome the poisons (both physical and mental) of Circe. Dioscorides also noted another peculiarity of rue: it can raise a nasty inflammation when handled by some people with sensitive skins. So if you wish to grow it, treat it with suitable care.

Rue was much in demand amongst the artisans, craftsmen, sculptors and painters of the Renaissance period as a strengthener of eyesight. A weak tea was brewed from the leaves and taken inwardly, and the eyes were bathed each day with a similar solution. The herb is a very powerful one, so be careful if you wish to follow in the steps of Leonardo and Michelangelo, who both used it, claiming it gave them not only strengthened and improved vision but inner sight and creativity as well.

The seeds germinate slowly, and when finally through the soil they appear to be crawling about all over the seed box with downy little feelers. Sow them in the spring, and trans¬plant when the seedlings are big enough to handle. You should not need gloves at this early stage of their growth.

A border of rue can be very effective, as its greyish-blue foliage makes delicate counterpoint with the true greens more common in the flower garden. For a striking ribbon of colour around formal beds, plant rue all along the edge, santolina (a grey feathery-soft plant with brilliant yellow flower-cushions in spring) inside it, then balance these two with another planting of blue rosemary behind. As a border for a large rose-garden, this tri-coloured hedge can be quite spectacular.

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2 oz. fresh horehound

1 1/2 cups water

1 3/4 lb. brown sugar

1/4 cup corn syrup

Cook the horehound slowly in water for 15 minutes, if possible in a stainless steel or heavy saucepan with the lid on. Then let stand for one hour. Remove the horehound (tip it on the compost heap), then add the sugar and syrup to the liquid and boil to “hard-crack” stage (300 degrees F. on a candy thermometer). Pour into a greased shallow pan, and mark into squares.

The botanical name comes from the Hebrew marrob, a bitter juice, and the herb is certainly not a pleasant-tasting one in its raw state. It is a native of Europe, North Africa and Central Asia, and has naturalized in many parts of the world including Britain and North America, where in some states it is a declared noxious weed! How true is that definition of a weed “a plant whose uses to man have not yet been appreciated”!

The plant is ungainly and perhaps even untidy, the white downy stems and woolly leaves trailing along in all directions. In summer white whorls of flowers appear at the leaf axils, but these, too, are neither attractive nor showy. If ever an ugly duckling had a hidden swanlike soul it is horehound. It grows best in poor soil; my own horehound plants have the rockiest, most difficult corner in the garden.

Check with your Department of Agriculture before starting off a paddock of horehound to cure the world’s ills. In your area it may be a declared weed.

Bill Wannan, in his entertaining book Folk Medicine, tells of horehound’s role in the early Australian goldrush days. In the 1890s at Kalgoorlie, Chinese (clever, as always) who had come to work as cheap labour on the goldfields went away somewhat richer because of their knowledge of vitamin-rich horehound. The dried leaves were sold at steadily inflating prices to miners to brew a tonic tea. Old-timers swore by its efficacy. Horehound poultices were often used as a remedy for the “Barcoo rot”, a skin disease caused by over-exposure to the dry heat of the inland together with vitamin deficiencies in the diet. The herb’s reputation grew as one boundary rider passed on the good word to the next. Barcoo rot is seldom encountered now that more is known about diet, but horehound’s praises are still sung on many outback stations by those old enough to remember.

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Sow the tiny seed of catnip in the autumn, give the plant room to grow, with sunlight and light soil, and keep a watchful eye out for caterpillars or grasshoppers.

There is also a garden variety of catmint (Nepeta mussini) with quite a different form of growth. It is a small rockery or edging plant, with grey-green foliage and lavender-coloured spikes of flowers. It grows in a dense little clump and can be very decorative in a pathway or warm sunny corner near a wall.

This plant has some of the medicinal value, but not all, of the other variety, and Nepeta cataria is the more valuable. Try planting this garden variety over your spring bulbs, then when the daffodils and hyacinths are flowering they will have a soft supporting carpet of green and mauve. When they die down, the catmint will still be there instead of just a bare space.

Nepeta mussini must also be cut back after flowering. The plant will grow somewhat straggly and wilted, and then the new growth will commence again from the centre. As soon as this is under way, cut off all the last season’s old spent stems. You will probably find quite a few snails and slugs are thus deprived of a favourite haunt.

Try a vase of Nepeta cataria when it is in flower on your dining-room table. The delicate perfume will fill the room.

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