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Patients and their surgeons may be so overwhelmed by the unremitting domination of serious pain that they seek a fundamental answer by surgery, aiming to cut completely the pathway that transmits the message or to destroy the hypothetical pain centre. If the ventral-lateral quadrant of the spinal cord is cut on one side, a clear analgesia appears on the opposite side of the body below the level of the cut. This loss of pain lasts for weeks and months but is replaced by even more unpleasant pains as nerve cells ahead of the cut build up their excitability. This operation is now rarely done except in some cases where cancer patients have only a short time to live. The very large improvement in the understanding of narcotic therapy for cancer pain means this has replaced the surgical attempt to cut the messages off from their destination.In intractable cases where pain fails to respond to narcotics, neurosurgeons have made lesions in many locations which were believed to be candidates for the ‘pain centre’ or for being major message-carrying bundles. The results are remarkably similar no matter where the lesion is made. Initially there is a gratifying relief from pain but, within days, weeks or months, pain returns, often with additional unpleasant characteristics. Another target of attack has been in parts of the brain classically assigned to ‘thinking’ in the old dualistic scheme. The result, as in the case of frontal lobotomy, is a patient who has considerable cognitive deficits, particularly in holding attention. These patients may appear somewhat better, even though they report that the pain is as bad as ever, because their attention, normally rivetted by their pain, drifts away onto other topics. Patients and relatives do not consider this relief worth the price.Legitimate research continues to locate cells in the brain that are firing off in abnormal patterns and creating false signals. Such cells exist in the spinal cord when motorcycle crashes rip the entering roots from the spinal cord, leaving a numb, paralyzed arm and ongoing pain generated by the spontaneous discharge of spinal-cord cells attempting to compensate for their loss of input. The problem with an operation to remove the spinal-cord cells is that, after a period of relief, cells further down the line react to the loss of input created by the surgery and take up the pain-producing activity.Other therapeutic methodsThere remain huge numbers of other methods, many of ancient origin, almost none of which have been subjected to rigorous trial and yet which retain enthusiastic advocates who proclaim their effectiveness.*57\219\2*

DiverticulitisWhen the muscles of the colon wall have to work overtime to deal with hard stools or lack of bulk in the diet, they become weakened and lose their elasticity. This causes pouches called Diverticula. The food trapped in these pockets makes wonderful breeding ground for bacteria. The result can be Diverticulitis, an infection where there is often a fever and acute abdominal pain. This condition needs medical help.Diverticula Disease/Irritable Bowel SyndromeWhere symptoms are not severe and are treated by the GP these two diagnoses are often interchangeable. Men are more likely to be told they have diverticula problems, women are more likely to be told they have Irritable Bowel Syndrome.Spring Cleaning the BowelWhen they become aware of the dangers of a dirty colon, some people become too enthusiastic and embark on drastic colon cleansing programmes which can result in poisons pouring into the bloodstream and although the final result is very beneficial the process can make the sufferer feel wretched. The experience of detoxification can entail:• migraine• blinding headaches• nausea• flu-like symptoms• aches and pains• fever• exhaustion• anxiety• panic attacks• irritability• weepiness• sometimes quite profound depression.This can be avoided by taking it slowly, flushing the poisons out a little at a time.*52\326\8*

The next step is a full physical examination to assess his asthma and to make sure that there is nothing else affecting the child. Many people believe that a doctor can tell all that is required of the child’s condition simply by taking his pulse, the respiration rate, or listening to his chest. In case of asthma, nothing could not be further from truth.The physical examination focuses on skin, eyes, ears, nose, throat, and chest. The doctor will look for signs of eczema or hives on the skin. Inflammation in the ears or eyes may be due to an underlying allergy. Dark circles under the eyes, or a swelling in the nose, are signs of allergic rhinitis, or hay fever, both associated with asthma. The doctor would also examine the throat, the tonsils, the abdomen for spleen and the liver. Occasionally, what appears to be asthma turns out to be something else. One of the chief functions of the examination is to make sure that other conditions do not escape unnoticed.The chest examination is the most important part of the physical examination. Using a stethoscope, the doctor will try to detect wheezing sound, if any. The doctor would also attempt to determine whether the air movement in and out of the chest is unhindered, or whether there is any airway obstruction, and the effect it may be having on the child’s health. The doctor may even ask the child to do light exercise to make it easier to detect the wheezing sound. Chronic and severe asthma in children tends to cause some loss of normal growth and the child should be weighed and measured regularly, and at each physical examination, to monitor normal growth.*47\260\8*