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By P. Dan. University of Maryland at College Park.

It stands to reason himcolin 30 gm online, therefore himcolin 30 gm for sale, that some medical education might be useful in times of trouble. Almost all handbooks (some quite good) on wilderness or third world medicine will usually end a section with: “Go to the hospital immediately”. Although this is excellent advice for modern times, it won’t be very helpful in an uncertain future when the hospitals might all be out of commission. We only have to look at Hurricane Katrina in 2005 to know that even modern medical facilities may be useless if they are understaffed, under-supplied, and overcrowded. Unwittingly, the majority of the citizens in New Orleans became their own medical care providers in the aftermath of the storm. With medical assistance teams overwhelmed, no one was coming to the aid of one injured or ill individual when thousands needed help at once. If you become the end of the line with regards to the medical well- being of your family or group, there are certain adjustments that have to be made. These medical supplies and skills must then be adjusted to fit the mindset that you must adopt in a collapse: That things have changed for the long term, and that you are the sole medical resource when it comes to keeping your people healthy. Many, when confronted, will decide that they cannot bear the burden of being in charge of the medical care of others. Others, however, will find the fortitude to grit their teeth and wear the badge of survival “medic”. If this reality first becomes apparent when a loved one becomes deathly ill, the likelihood that you will have the training and supplies needed to be an effective medical provider will be close to zero. This volume is meant to educate and prepare those who want to ensure the health of their loved ones. If you can absorb the information here, you will be better equipped to handle 90% of the emergencies that you will see in a power-down scenario. As well, you will have a realistic view of what medical issues are survivable without modern facilities. With this book, we hope to give you the tools to arrive at choices that will increase your chances of successfully treating injuries and disease. All the information contained in this book is meant for use in a post- apocalyptic setting, when modern medicine no longer exists. If your leg is broken in five places, it stands to reason that you’ll do better in an orthopedic hospital ward than with a splint made out of two sticks and strips of a T-shirt. The strategies discussed here are not the most effective means of taking care of certain medical problems. They adhere to the philosophy that something is better than nothing; in a survival situation, that “something” might just get you through the storm. As Theodore Roosevelt once said, “You must do what you can, with what you have, where you are”. If we never encounter a long-term survival situation, this book will still have its uses. These events are inevitable at one point or another, and will tax even the most advanced medical delivery systems. Medical personnel will be unlikely to be readily available to help you if they are overwhelmed by mass casualties. The information provided here will be valuable while you are waiting for help to arrive. With some medical knowledge and supplies, you may gain precious time for an injured loved one and aid in their recovery. An important caveat: In most locales, the practice of medicine or dentistry without a license is against the law. None of the recommendations in this book will protect you from liability if you implement them where there is a functioning government and legal system. Consider obtaining formal medical education if you want to become a healthcare provider in a pre-collapse society. Although you will not be a physician after reading this volume, you will certainly be more of a medical asset to your family, group, or community than you were before. Among other things, you will have: Learned to think about what to do when you become the end of the line in terms of your family’s medical well-being. Put together a medical kit which, along with standard equipment, includes traditional medications and natural remedies. Most importantly, you will have become medically prepared to face the very uncertain future; and after all, isn’t that what you wanted to accomplish when you first picked up this book? The first part of this preface described this and other books that might be helpful in scenarios that might occur as a result of the aftermath of a major disaster or long-term catastrophe. It might also be helpful in a remote setting for those who have to fend for themselves for long periods of time. If you are already a doctor or formally-trained medical professional, you will feel that some of the information in this book is below your pay grade. It is meant for the non-medical professional who is concerned about keeping their family healthy when trained personnel, such as yourself, are no longer around. In a long-term survival situation, medical personnel will not have the luxury of “Stabilize and Transport” and will have to adjust their mindset.

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There is not to be perceived cheap himcolin 30 gm amex, indeed purchase himcolin 30 gm on-line, any morbid transmutation in that spot during the first days, but the specific venereal transformation takes place in the internal of the body irresistibly, from the first moment of infection until syphilis has developed itself throughout the whole body, and only then (not before), nature, loaded down by the internal malady, brings forth the local symptom peculiar to this malady, the chancre, usually in the place first infected; and this symptom is intended by nature to soothe the internal completed malady. Therefore also, the cure of the venereal disease is effected most easily and in the most convincing manner, so long as the chancre (the bubo) has not yet been driven, out by local applications, so long as the chancre (the bubo) still remains unchanged, as a vicarious symptom of the internal syphilis. In this state, and especially when it is not yet complicated with psora, it may be asserted from manifold experience and with good reason, that there is on earth no chronic miasma, no chronic disease springing from a miasma, which is more curable and more easily curable than this. In a few days after taking such a dose of mercury, the chancre (without any external application) becomes a clean sore with a little mild pus, and heals of itself - as a convincing proof, that the venereal malady is also fully extinguished within; and it does not leave behind the least scar, or the least spot, showing any other color than the other healthy skin. But the chancre, which is not treated with external application, would never heal, if the internal syphilis had not been already annihilated and extinguished by the dose of mercury; for so long as it exists in its place, it is the natural and unmistakable proof of even the least remainder of an existing syphilis. I have, indeed in the second edition of the first part of Materia Medica Pura (Dresden, 1822), described the preparation of the pure semi-oxide of mercury, and I still consider this to be one of the most excellent anti-syphilitic medicines; but it is difficult to prepare it in sufficient purity. In order, therefore, to reach this wished for goal in a still simpler manner, free from all detours, and yet just as perfectly (for in the preparation of medicines we cannot proceed in too simple a manner), it is best to proceed in the way given below, so that one grain of quite pure running quick-silver is triturated three times, with 100 grains of sugar of milk each time, up to the millionth attenuation, in three hours, and one grain of this third trituration is dissolved, and then potentized through twenty-seven diluting phials up to (x) the decillionth degree, as is taught at the end of this volume, with respect to the dynamization of the other dry medicines. I formerly used the billionth dynamization (ii) of this preparation in I, 2 or 3 fine pellets moistened with this dilution, as a dose, and this was done successfully for such cures; although the preparation of the higher potencies (iv, vi, viii), and finally the decillionth potency (x), show some advantages, in their quick, penetrating and yet mild action for this purpose; but in cases where a second or third dose (however seldom needed) should be found necessary, a lower potency may then be taken. But just as incontrovertibly does it follow that every disappearance of the chancre (or the bubo) owing to a mere local destruction, since it was no real cure founded on the extirpation of the internal venereal disease through the internally given appropriate mercury medicine, leaves to us the certainty that the syphilis remains behind; and every one who supposes himself healed by any such merely local, pretended cure, is to be, considered as much venereally diseased as he was before the destruction of the chancre. The second state in which, as mentioned above, syphilis may have to be treated, is the rare case when an otherwise healthy person, affected with no other chronic disease (and thus without any developed psora), has experienced this injudicious driving away of the chancre through local applications, effected by an ordinary physician in a short time and without attacking the organism overmuch with internal and external remedies. Even in such a case, - as we have not as yet to combat any complication with psora - all outbreaks of the secondary venereal disease may be avoided, and the man may be freed from every trace of the venereal miasma through the before-mentioned simple internal cure effected by a like dose of the above mentioned mercurial medicine - although the certainty of his cure can no more be so manifestly proved as if the chancre had still been in existence during this internal cure, and as if it had become a mild ulcer simply through this internal remedy, and had been thus manifestly cured of itself. But here also there may be found a sign of the non- completed as well as of the completed cure of the internal syphilis which has not yet broken out into the venereal disease; but this sign will only manifest itself to an exact observer. In case the chancre has been driven out through local application, even if the remedies used had not been very acrid, there will always remain in the place where it stood, as a sign of the unextinguished internal syphilis, a discolored, reddish, red or blue scar; while on the contrary, when the cure of the whole venereal disease has been effected by the internal remedy, and if thus the chancre heals of itself without the action of an external application, and when it disappears because it is no more needed as a substitute and alleviator of an internal venereal disorder which now has ceased, then the spot of the former chancre can no more be recognized, for the skin covering that place will be just as smooth and of the same color as the rest, so that no trace can be discerned of the spot where the chancre had stood. Even when, after the expulsion of the chancre by local applications, the bubo has already broken out but the patient is not yet seized with any other chronic disease, and consequently the internal syphilis is not yet complicated with a developed psora (which is nevertheless a rare case), the same treatment will also here, while the bubo is only developing, produce a cure; and its completion will be recognized by the same signs. In both cases, if they have been rightly treated, the cure is a complete one, and no outbreak of the venereal disease need any more be apprehended. The most difficult of all these cases, the third, is still to be treated: when the man at the time of the syphilitic infection was already laboring under a chronic disease, so that his syphilis was complicated with psora, even while the chancre yet existed, or when, even while there was no chronic disease in the body at the outbreak of the chancre, and the indwelling psora could only be recognized by its tokens, an allopathic physician has, nevertheless, destroyed the local symptom, not only slowly and with very painful external applications, but has also subjected him for a long time to an internal treatment, weakening and strongly affecting him so that the general health has been undermined and the psora which had as yet been latent within him has been brought to its development and has broken out into chronic ailments, and these irrepressibly combine with the internal syphilis, the local symptom, of which had been at the same time destroyed in such an irrational manner. Psora can only be complicated with the venereal disease when it has been developed and when it has ultimated itself in a manifest chronic disease; but not when it is as yet latent and slumbering. By the latter the cure of syphilis is not obstructed, but when complicated with developed psora, it is impossible to cure the venereal disease alone. By means of friction with mercury, large doses of calomel, corrosive sublimate and similar acrid mercurial remedies, (which originate fever, dysenteric abdominal ailments, chronic exhausting salivation, pains in the limbs, sleeplessness, etc. There arises in this manner and through this combination what is called a masked, spurious syphilis, and in England pseudo syphilis, a monster of a double disease,* which no physician hitherto has been able to cure, because no physician hitherto has been acquainted with the psora in its great extent and its nature, neither in its latent nor its developed state; and no one suspected this dreadful combination with syphilis, much less perceived it. No one, therefore, could heal the developed psora, the only cause of the uncurableness of this bastard syphilis, - nor could they in consequence free the syphilis from this horrible combination so as to make it curable, just as the psora remains incurable if the syphilis has not been extirpated. In order to reach this so-called masked venereal disease successfully, the following rule must serve the homoeopathic physician: After removing all hurtful influences that affect the patients from without and after settling on a light and yet nourishing and strengthening diet for the patient, let him first give the anti-psoric medicine which is homoeopathically the best fitting to the then prevailing state of disease, as will be shown below; and when this medicine has completed its action, also probably a second, most suitable to the still prominent psora symptoms, and these should be allowed to act against the psora, until they have effected all that can be at present done against it - then should be given the dose above described of the best mercurial preparation to act against the venereal disease for three, five to seven weeks; i. In inveterate and difficult cases, however, this first course will hardly accomplish all that is desired. There usually still remain some ailments and disorders, which cannot be definitely classed as purely psoric, and others which cannot be classed as definitely syphilitic, and these require yet some additional aid. But since these secondary venereal symptoms are so changeable that their temporary disappearance gives no certainty of their complete extinction, we must also wait for that more conclusive sign of the complete extirpation of the venereal miasm afforded by the return of the healthy color and the entire disappearance of the discoloration found in the scar which remains after the extirpation of the chancre by local, corrosive applications. The remaining psoric symptoms had then still to be combated with suitable remedies, and then lastly what there yet remained of sycosis or syphilis, by means of the remedies given above. I would also remark that the complete cure of sycosis which has taken possession of the whole organism before the outbreak of its local symptoms is demonstrated, like that of the chancre miasma, by the complete disappearance of the discoloration on the spot of the skin, which discoloration remains after every merely local destruction of the figwart as a sign of the unextirpated sycosis. The anti-psoric remedies improved the ulcers up to a certain degree: they healed the ulcer on the leg, they took away the burning pain and most of the fetid smell of the nose; also the remedies given to cure the sycosis caused some improvement - but as to the sum total nothing further was effected until he received a small dose of protoxide of mercury, after which everything was fully healed and he was restored to full health, excepting the irreparable loss of his nose. I think it necessary before proceeding to the doctrine of the third chronic miasma, the most important of all, psora, to premise the following general remark: For the infection with the only three known chronic miasmatic diseases there is usually needed but one moment; but the development of this tinder of infection, so that it becomes a general disease of the entire organism, needs a longer time. Not until a certain number of days have elapsed, when the miasmatic disease has received its complete internal development in the whole man - not until then, from the fullness of internal suffering, the local symptom breaks forth, destined by a kind nature to take upon itself in a certain sense the internal disease, and in so far to divert it in a palliative manner and to soothe it, so that it may not be able to injure and endanger the vital economy too much. The local symptom has its place on the least dangerous part of the body, the external skin, and, indeed, on that part of the skin where during the infection, the miasma had touched the nearest nerves. This process of nature, which repeats itself continually and evermore in the same manner in chronic miasmata, aye, - even in those which are acute and constant, - ought not to have escaped the penetration of physicians, at least not in venereal diseases, to the treatment of which they have applied themselves now for more than three hundred years; and then they could not have avoided drawing a conclusion as to the process of nature in the other two chronic miasmata. It was, therefore, irrational and unpardonably thoughtless of them to suppose that every chancre evolved by the organism after several days, often after quite a number of days, as the result of the completed internal malady, was a thing merely adventitious from without and situated on the skin without any internal connection, so that it might be simply removed by cauterizing, Ò so as to prevent the poison from the chancre (scilicet) from being absorbed into the internal parts, and thus from causing man to be afflicted with the venereal disease. This has been the case in several hundred thousands of cases these last three centuries. Just as irrational and thoughtless is the notion of physicians of the old school, even of the most modern times, that itch is merely a disease of the skin, in which the internal portion of the body takes no part. According to this groundless supposition, therefore, nothing better can be done than to remove this ailment from the surface of the skin, although the extirpation of the internal psora disease which causes the cutaneous eruption is necessary as an aid, and when this is cured also the cutaneous ailment, being the necessary consequence of the internal disease, will naturally disappear - cessante causa, cessat effectus.

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It will be hard to do much about those clogged coronary arteries; there won’t be many cardiac bypasses performed himcolin 30gm visa. However buy cheap himcolin 30 gm on-line, by eating healthily and getting good nutrition, you will give yourself the best chance to minimize some major medical issues. In a survival situation, an ounce of prevention is worth, not a pound, but a ton of cure. I’m not asking you to do anything that your great-grandparents didn’t do as part of their strategy to succeed in life. I won’t dwell too much on natural remedies in this chapter, as there are chapters devoted to the subject in other parts of this manual. Some members of my family wonder why I spend all my time trying to prepare people medically for a major disaster. Despite history teaching us otherwise, they are totally certain that there is no scenario that would take away, even for a while, the wonders of high technology. They see the hospital on their way to work and they have health insurance, what could happen? No, there’s too much to learn in one lifetime; even as a physician, I often come across things I’m not sure about. That’s what medical books are for, so make sure that you put together a survival library. I firmly believe that, even if you have not undergone a formal medical education, you can learn how to treat the majority of problems you will encounter in a grid-down situation. You can, if you absolutely have to, be the end of the line with regards to the medical well-being of your people. If you can absorb the information I’ll provide in this handbook, you will be in a position to help when the worst happens. Maybe, one day, you might even save a life; if that happens just once, my mission will have been a success. Both of these professionals have much to offer in terms of maintaining our medical well-being. This makes little sense to me, and certainly would be detrimental in a survival situation. Having an inflexible attitude towards one branch of medicine or another is harmful to your family or survival group. As such, this book is not just geared towards standard medical treatment, but includes other natural healing options. Those of you that are wholly against one or the other will probably be unhappy with it. I have also heard an herbalist challenge the benefits of the vaccine that eliminated Smallpox from the world. In each case, no amount of evidence would budge either practitioner from their notion that any discipline but their own had any place in the treatment of patients. This intransigence is akin to entering a fistfight with one hand tied behind your back. We must integrate the practice of medicine to include all methods if we are serious about maintaining the health of our people. Your approach to a patient can change, based upon what the problem is how serious it is. If you break your arm, for example, you will first turn to traditional medicine to set the bone and splint it. Afterwards, however, you might add other approaches to strengthen your immune system to speed the healing process. In holistic medicine, we emphasize the need to look at multiple aspects of health, including the physical, nutritional, emotional, lifestyle and social. This practice helps you recover from the mental stress associated with your injury as well as the physical. Don’t forget the part that spirituality plays in the recovery from an injury or illness. For many, it is an important component to the support necessary to foster the healing process. Studies show that those cancer patients with a positive attitude obtained through spiritual means survive longer and have a better quality of life. Never underestimate the power of positive thinking and spiritual peace when considering the health of your loved ones. Remember that you, as the medical caregiver, will be in charge of their emotional well-being as well as their physical health. I say this not to endorse a specific religion, philosophy or ritual, but to encourage you to reach inside yourself. If you have what it takes to be an effective medic, it will be most apparent in a crisis. Unless we have the skill and equipment to distill essential oils from plants, they will run out also. Only by applying ourselves to the practice of integrated medicine, incorporating all of the various healing options available to us, will we be likely to weather the aftermath of a societal storm.

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Management Management Surgery is indicated in boys and young males with asym- 1 Anysecondary cause should be identified and treated proven 30 gm himcolin. Aspiration should not be attempted as there is a tile men with a varicocele discount himcolin 30gm free shipping, surgery has not been shown risk of infection and bleeding. Ligation of the spermatic 3 If the hydrocele fluid becomes infected or contains vein can be either by open or laparoscopic surgery. In blood, incision and drainage of pus are necessary, and older males who no longer wish to have more children, examination of the scrotal contents to exclude an un- treatment with scrotal support and analgesia may be derlying tumour may be performed at that time. Aetiology/pathophysiology Clinical features Normally the foreskin does not retract at birth and it Aswelling in the scrotum located above and behind the may be months to years before it becomes retractile. In testes, thus some patients attend saying they have devel- congenital phimosis, the orifice is too small from birth oped a third testis. Surgery to remove the cyst(s) risks damaging the sper- Clinical features matic pathway, such that bilateral operations can cause r Ayoung child with congenital phymosis may have dif- sterility, and more conservative removal often leads to ficulty with micturition, with ballooning of the pre- recurrence. Definition Inability to achieve or sustain a sufficiently rigid erection Complications r in order to have sexual intercourse. Occasional episodes Recurrent balanitis may occur due to secretions col- of impotence are considered normal, but if erectile dys- lecting under a poorly retractile foreskin. Balanitis function precludes more than 75% of attempted inter- causes pain and a purulent discharge. Also called male If apoorly retracting foreskin remains retracted after sexual dysfunction. Incidence/prevalence r Phimosis increases the rate of penile cancer by at least This has been underestimated in the past, due to the 10-fold. With Management greater understanding, increased availability of treat- Symptomatic phimosis is treated by elective circum- ment and more widespread discussion of the problem, cision. Circumcision is not required in asymptomatic 40% of men aged 40 are recognised to have some degree young children, unless for religious reasons. In cases of of sexual dysfunction, increasing by approximately 10% acute paraphimosis, the band is excised under general with each decade. Aetiology The cause is pyschogenic in 25% of cases, drugs (25%) and endocrine abnormalities (25%). The other 25% are Epididymal cysts caused by diabetes, neurological and urological/pelvic Definition disease. Epididymalcystsarefluidfilledswellingsconnectedwith Psychogenic causes can be divided into following: the epididymis that occur in males. If the fluid contains r Depression, causing loss of libido and erectile dys- sperm, it is called a spermatocele. Chapter 6: Genitourinary oncology 275 r Performance anxiety occurs in men who, after one Investigations or more episodes of erectile dysfunction, become so Simple hormonal tests for prolactin levels, thyroid func- anxious that subsequent attempts at intercourse fail, tion tests, testosterone levels are sometimes useful. Barbiturates, corticosteroids, phenothiazines 5phosphodiesterase), so increasing the ability to gen- and spironolactone may reduce libido. Recreational drugs such as co- 1 hour before sex, and its effects last for 4 hours. Its caine and hallucinogenic drugs can cause impotence vasodilation effects can cause headache, dizziness, a with long-term use. Auto- r Penile self-injection with vasoactive drugs such as pa- nomic neuropathy is also an important factor. There r Vacuum devices can be used to ‘suck’ blood into the isalsoareflexarcatS2–S4whichmeansthatgenitalstim- penis and then a ring is applied at its base to main- ulation increases vascular flow. Ejaculation is not possible with these any level can therefore interfere with sexual function. Clinical features r Psychological counselling is useful for those with a Some features in the sexual history, medical history or psychological cause. Completelossof erections, including nocturnal erections, suggests a neu- rological or vascular cause. Sudden loss of sexual func- Genitourinary oncology tion without any previous history of problems, or major genital surgery, suggests performance anxiety, stress or Kidney tumours loss of interest in the sexual partner. Ability to generate an erection, but then inability to sustain it may be due Benign tumours are commonly found incidentally at to anxiety or to a problem with vascular supply, or nitric post-mortems or on imaging. It is important to r Renal adenomas are derived from renal tubular ep- take a drug history and enquire about possible features ithelium. Tumours less than 3 cm in diameter are ar- of depression, smoking, alcohol or drug abuse. Microscopically they giomyolipomas, but there is also an increased risk of contain only large well-differentiated cells with papillary renal cell carcinoma.