Strokes

A stroke is a condition where a blood clot or ruptured artery or blood vessel interrupts blood flow to an area of the brain. A lack of oxygen and glucose (sugar), flowing to the brain, leads to the death of brain cells and brain damage, often resulting in an impairment in speech, movement, and memory. The two main types of stroke include ischemic stroke and hemorrhagic stroke. Ischemic stroke accounts for about 75% of all strokes and occurs when a blood clot, or thrombus, forms that blocks blood flow to part of the brain. If a blood clot forms somewhere in the body and breaks off to become free-floating, it is called an embolus. This wandering clot may be carried through the bloodstream to the brain where it can cause ischemic stroke. A hemorrhagic stroke occurs when a blood vessel on the brain's surface ruptures and fills the space between the brain and skull with blood (subarachnoid haemorrhage) or when a defective artery in the brain bursts and fills the surrounding tissue with blood (cerebral haemorrhage). Both result in a lack of blood flow to the brain and a build-up of blood that puts too much pressure on the brain.

The outcome after a stroke depends on where the stroke occurs and how much of the brain is affected. Smaller strokes may result in minor problems, such as weakness in an arm or leg. Larger strokes may lead to paralysis or death. Many stroke patients are left with weakness on one side of the body, difficulty in speaking, incontinence, and bladder problems.

Within a few minutes of having a stroke, brain cells begin to die and symptoms can become present. It is important to recognize symptoms, as prompt treatment is crucial to recovery. Common symptoms include: dizziness, trouble walking, loss of balance and coordination, speech problems, numbness, weakness, or paralysis on one side of the body, blurred, blackened, or double vision, sudden severe headache.

Smaller strokes (or silent strokes), however, may not cause any symptoms, but can still damage brain tissue.

A possible sign that a stroke is about to occur is called a transient ischemic attack - a temporary interruption in blood flow to part of the brain.

The primary goal in treating ischemic stroke is to restore blood flow to the brain. This will be attempted using blood clot-busting drugs such as aspirin, heparin, or tissue plasminogen activators that must be administered within three hours of the stroke. In addition, surgical procedures may be performed that can open up or widen arteries. These include carotid endarterectomy (removal of plaque and widening of the carotid artery) and angioplasty (a balloon that widens the carotid artery and is held open with a metallic mesh tube called a stent).

Strokes may be prevented by lowering blood pressure, quitting smoking, beginning or increasing exercise, controlling medical problems with medications (i.e., atrial fibrillation requires anticoagulants), maintaining optimal weight, and eating a diet high in fruits and vegetables.

Eye and Vision disorders

Blindness. This is the loss of useful sight. Blindness can be temporary or permanent and it has many causes. Birth defects or damage to any portion of the eye, the optic nerve, or the area of the brain responsible for vision can lead to blindness. The visual impairment cannot be corrected with surgery or corrective lenses, and the condition can make it difficult to perform everyday activities.

Cataracts. Some children are born with cataracts, a cloudiness of the eye's lenses that prevent images from being seen clearly or at all. But cataracts are much more prevalent in the elderly among whom surgery to remove cataracts and correct vision is common.

Colour blindness. Colour blindness is caused by problems in the pigments of the cones in the retina. Most people who are colour-blind can see some colours. In most cases, someone who is colour-blind confuses some colours with others, usually red and green. People can be born colour-blind or they may develop the condition over time. The most common form of colour blindness is an inherited condition that affects boys much more often than girls. Colour blindness cannot be corrected.

Conjunctivitis. Conjunctivitis refers to inflammation (redness, pain, and swelling) of the conjunctiva. One type of conjunctivitis is called pinkeye, a common contagious infection in which the eyes become pinkish red and watery, and pus may form. Pinkeye is usually treated with eye drops. Conjunctivitis may also occur due to allergies or from a scratch on the surface of the eye.

Eye injuries. Injuries to the eye are one of the most common preventable causes of blindness. Eye injuries may be caused by irritants such as sand, dirt, or other foreign bodies on the eye's surface. Chemicals or foreign bodies that become embedded in the eye can also cause pain and loss of vision. Forceful blows to the eye can cause bleeding inside the eye and damage to the cornea, retina, and other important eye structures.

Glaucoma. One of the leading causes of blindness, glaucoma, is a disorder that causes fluid pressure to build up inside the eye, potentially causing damage to the optic nerve. Although it can occur in infants and children, it is much more common among older adults.

Macular degeneration is an eye disease that mainly affects older people. But sometimes infants and children can develop it, too. When someone has macular degeneration, the middle area of the retina becomes scarred. This causes eyesight to deteriorate over many years. The cause of macular degeneration is unknown in most cases, but it tends to run in families, which indicates that genes and heredity are involved.

Strabismus. A condition in which the eyes appear crossed, strabismus is usually caused by a defect in the balance of the pull exerted by the muscles that help the eyes stay straight and move together properly. Surgery on the eye muscles can help realign the eyes. Permanent vision loss in the less-used eye can occur if the condition is not treated in early childhood.

Sty. A sty is an infection of one of the follicles from which the eyelashes grow. Sties are treated by applying warm compresses and using antibiotics.

Ear diseases

Ear disease is a subfield of otolaryngology addressing the pathology of the ear.

There are many different types of ear problems. For example, ear pain may be caused by infections of the tonsils, jaw or sinuses. Chronic infection, for example, glue ear, can cause hearing loss that can affect learning and lifestyle, and exposure to loud noise can also damage hearing. As well as infection, the ears can also suffer from dermatitis reactions to topical medicines, wearing jewellery, cosmetics or methacrylate ear plugs.

Otitis media is inflammation of the middle ear, causing a build-up of fluid, with or without an infection. If there is an infection, it is often viral. Many children will have several bouts of otitis media before they are 7 years old. Symptoms include crying, ear pulling, mild fever and irritability.

Glue ear is a type of chronic otitis media. Long term build-up of thick or 'sticky' fluid in the middle ear, behind the eardrum, causes hearing loss. This makes socializing and learning very difficult, especially if hearing loss is not recognized in early childhood.

Ear wax in the ear is normal and protects the ear. However, a build-up of wax may be a problem in some adults. This may require wax-softening ear drops, and sometimes the ears may also need to be syringed clean by a doctor. Impacted ear wax rarely causes an ear discharge or pain, but it may cause hearing impairment.

Swimmer's ear develops when humidity, heat and moisture cause the skin layer inside the ear to swell. The addition of further water, for example, through swimming, makes the skin lining the ear canal even softer and liable to infection. Attempts to remove the water with cotton buds or other objects may make the condition worse, causing pain and itching.

The word "vertigo" means the kind of giddiness in which things actually seem to spin round you. It is often due to problems in the balance mechanisms of the inner part of the ear. Possible causes include labyrinthitis and Meniere's disease. There is also something called "Benign Positional Vertigo", which often develops in the second half of life. What happens is that you move your head - and then you suddenly feel awfully giddy. The cause is believed to be tiny "stones" in the fluid of the inner part of your ear. Fortunately, surgeons have developed a way of curing the condition by carrying out a manipulation called "Particle Reposition Manoeuvre".

Catarrh in the back of the throat is notorious for causing all sorts of symptoms in the ears; deafness, "popping", discomfort and sometimes slight giddiness. The commonest cause is smoking. Catarrh can't be treated with ear drops -because they wouldn't get through the ear drum. So the most common way of treating it is with nose drops.

Dermatitis

Dermatitis is a general term that describes an inflammation of the skin. There are different types of dermatitis, including seborrheic dermatitis and atopic dermatitis (eczema). Although the disorder can have many causes and occur in many forms, it usually involves swollen, reddened and itchy skin.

There are several types of dermatitis, including: contact dermatitis, a rash that results from either repeated contact with irritants or contact with allergy-producing substances, such as poison ivy; neurodermatitis, a chronic itchy skin condition localized to certain areas of the skin; seborrheic dermatitis, a common scalp and facial condition that often causes dandruff; stasis dermatitis, a skin condition that's caused by a build-up of fluid under the skin of the legs; atopic dermatitis, more commonly known as just eczema or atopic eczema, a chronic itchy rash that tends to come and go; perioral dermatitis, a bumpy rash around the mouth.

Each has distinct signs and symptoms. Common signs and symptoms include: redness, swelling, itching, skin lesions.

Contact dermatitis results from direct contact with one of many irritants or allergens. Common irritants include: laundry soap, skin soaps or detergents, cleaning products. It takes a greater amount of contact with an irritant over a longer time to cause dermatitis than it takes for an allergen. Once you're sensitized to an allergen, just brief exposure to a small amount of it can cause dermatitis. Once you develop sensitivity to an allergen, you typically have it for life.

Neurodermatitis typically develops when something has created an itchy sensation in a specific area of your skin. This irritation may lead you to rub or scratch your skin repeatedly in that area. Common locations include ankles, wrist, outer forearm or arm, and the back of your neck. Possible causes include: dry skin, chronic irritation, eczema, psoriasis.

Seborrheic dermatitis causes a red rash with yellowish and somewhat "oily" scales, usually on the scalp. It's common in people with oily skin or hair, and it may come and go depending on the season of the year. It's likely that hereditary factors play a role in this condition.

Stasis dermatitis can occur when fluid accumulates in the tissues just beneath the skin - typically on your lower legs - due to a sluggish return of blood from the leg veins back to the heart. The extra fluid interferes with your blood's ability to nourish your skin and places extra pressure against your skin from underneath.

Atopic dermatitis often occurs with allergies and frequently runs in families in which members have asthma or hay fever. It usually begins in infancy and may vary in severity during childhood and adolescence. It tends to become less of a problem in adulthood, unless you're exposed to allergens or irritants in the workplace.

Perioral dermatitis may be a form of the skin disorder rosacea, adult acne or seborrheic dermatitis, involving the skin around the mouth or nose.

Infertility

Infertility is when a couple can not conceive (get pregnant) despite having regular unprotected sex. Around one in six or seven couples may have difficulty conceiving. A couple will only be diagnosed as being infertile if they have not managed to have a baby after two years of trying. There are two types of infertility:

• Primary infertility, where someone who has never conceived a child in the past has difficulty conceiving.

• Secondary infertility, where a person has had one or more babies in the past, but is having difficulty conceiving again.

The cause of infertility in women usually involves problems with ovulation. Signs of ovulation difficulties include non-existent or irregular menstrual cycles. Other causes of female infertility include birth defects within the uterus, uterine fibroids, and blocked fallopian tubes. For a woman to be fertile, the ovaries must release healthy eggs regularly, and her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes to become fertilized by a sperm. Her reproductive organs must be healthy and functional.

The cause of infertility in men can usually be traced to problems with the production of sperm. Men who produce no sperm suffer from a condition called azoospermia, and those with a low sperm count suffer from oligospermia. In addition, blocked reproductive tracts, malformed sperm, or inactive sperm can be a cause of male infertility. For a man to be fertile, the testicles must produce enough healthy sperm, and the sperm must be ejaculated effectively into the woman's vagina. Tests for male infertility attempt to determine whether any of these processes are impaired.

Treatment of infertility depends on the cause, how long the person has been infertile, the age of the partners and many personal preferences. Some causes of infertility can't be corrected. However, a woman can still become pregnant with assisted reproductive technology or other procedures to restore fertility.

Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. If the sperm are of good quality, and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring) physicians may start by prescribing a course of ovarian stimulating medication.

Injectable fertility drugs increase the chance of multiple births. Oral fertility drugs such as Clomid increase the chance of multiple births but at a much lower rate. The use of these drugs requires careful monitoring using blood tests, hormone tests and ultrasound measurement of ovarian follicle size. Generally, the greater the number of foetuses is the higher the risk of premature labour. Babies born prematurely are at increased risk of health and developmental problems. These risks are greater for triplets than for twins or single pregnancies.

If conservative medical treatments fail to achieve a full term pregnancy, the physician may suggest the patient undergo in vitro fertilization. There are also a number of alternative fertility treatments that have been found to be affective, both on their own and as a complementary treatment to traditional infertility solutions.

Child Development

Child development refers to the biological and psychological changes that occur in human beings between birth and the end of adolescence, as the individual progresses from dependency to increasing autonomy. Because these developmental changes may be strongly influenced by genetic factors and events during prenatal life, genetics and prenatal development are usually included as part of the study of child development. Related terms include developmental psychology, referring to development throughout the lifespan, and paediatrics, the branch of medicine relating to the care of children. Developmental change may occur as a result of genetically-controlled processes known as maturation, or as a result of environmental factors and learning, but most commonly involves an interaction between the two.

Some age-related development periods and examples of defined intervals are: newborn (ages 0-1 month); infant (ages 1 month - 1 year); toddler (ages 1-3 years); preschooler (ages 4-6 years); school-aged child (ages 6-13 years); adolescent (ages 13-20). However, organizations like Zero to Three and the World Association for Infant Mental Health use the term infant as a broad category, including children from birth to age 3, a logical decision considering that the Latin derivation of the word infant refers to those who have no speech.

The optimal development of children is considered vital to society and so it is important to understand the social, cognitive, emotional, and educational development of children. Increased research and interest in this field has resulted in new theories and strategies, with specific regard to practice that promotes development within the school system. In addition there are also some theories that seek to describe a sequence of states that comprise child development.

Pediatrics is the branch of medicine dedicated to the attainment of the best physical, emotional, and social health for infants, children, and young people generally. Pediatrics became a specialty in 1930 when the American Academy of Pediatrics was founded with the idea that children have special developmental and health-care needs. Pediatricians devote much of their time to regular health examinations, as well as to preventive medicine and health practices. They routinely immunize children against such infectious diseases as influenza, meningitis, measles, mumps, and chicken pox. In addition to their immediate health-care duties, pediatricians act as advocates for children in endorsing public education, access to health care, and services to children. These measures have led to better development and health of young people as well as a dwindling of morbidity and mortality rates. The American Academy of Pediatrics maintains 41 sections consisting of members who have interests in specialized areas of pediatrics such as immunology, adolescent health, cardiology, emergency medicine, surgery and diseases of special organs and systems. A number of surgeons specialize in pediatric surgery, and pediatricians known as neonatologists specialize in the care of premature babies, critically ill children, and those with congenital malformations.

Common Infectious Diseases in Children

Seasonal flu

Seasonal flu (or influenza) is caused by various strains of the influenza virus. The usual symptoms are fever, headache, muscle aches, severe tiredness, sore throat and cough. Sickness and diarrhoea can occur, especially in children. It is sometimes accompanied or followed by chest infections that can be severe. It often occurs in epidemics, most commonly in the winter,

Flu is spread from person to person by cough and sneeze. It can spread rapidly within families and schools where there are many people living close together. Flu can be passed on to other people for 3-5 days after symptoms start.

There is no specific treatment but there are many remedies available from pharmacists to ease the symptoms. Children should not be given any preparations containing aspirin. If you are in any doubt about the contents of a "flu" remedy, please check with the pharmacist. Children affected by influenza should be encouraged to rest and drink plenty of water or other fluids. They should be encouraged to cover their mouths when coughing and use paper tissues when sneezing. Hand washing needs to be encouraged, and supervised for younger children.

Each year vaccines against the likely common types of the virus are prepared and should be given to people at risk, particularly the elderly and those with chronic heart, chest or kidney diseases. Healthy children and adults do not need immunisation, although children with asthma should be protected.

Whooping Cough

Whooping cough - or pertussis - is an infection of the respiratory system caused by the bacterium Bordetella pertussis (or B. pertussis). It's characterized by severe coughing fits that end in a "whooping" sound when the person breathes in.

The first symptoms of whooping cough are similar to those of a common

cold:

• runny nose

• sneezing

• mild cough

• low-grade fever

After about 1 to 2 weeks, the dry, irritating cough evolves into coughing fits. During the attack of coughing, which can last for more than a minute, the child may turn red or purple. At the end of a fit, the child may make a characteristic whooping sound when breathing in or may vomit. Between attacks, the child usually feels well.

Although it's likely that infants and younger children who become infected with B. pertussis will develop the characteristic coughing episodes with their accompanying whoop, not everyone will. However, sometimes infants don't cough or whoop as older kids do. They may look as if they are gasping for air with a reddened face and may actually stop breathing for a few seconds during particularly bad fits.

Pertussis is highly contagious. The bacteria spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Others then can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses.

The bacteria thrive in the respiratory passages where they produce toxins that damage the tiny hairs (cilia). This results in an increased inflammation of the respiratory passages, and the typical cough which is the hallmark of the infection

Infected people are most contagious during the earliest stages of the illness up to about 2 weeks after the cough begins. Antibiotics shorten the period of contagiousness to 5 days following the start of antibiotic treatment.

Whooping cough can be prevented with the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization.

Experts believe that up to 80% of non-immunized family members will develop whooping cough if they live in the same house as someone who has the infection. For this reason, anyone who comes into close contact with someone who has pertussis should receive antibiotics to prevent spread of the disease. Young kids who have not received all five doses of the vaccine may require a booster dose if exposed to an infected family member.

The incubation period (the time between infection and the onset of symptoms) for whooping cough is usually 7 to 10 days, but can be as long as 21 days. Pertussis can cause prolonged symptoms. The child usually has 1 to 2 weeks of common cold symptoms, followed by approximately 2 to 4 weeks of severe coughing, though the coughing attacks can sometimes last even longer. The last stage consists of another several weeks of recovery with gradual resolution of symptoms. In some children, the recovery period may last for months.

To make a diagnosis of whooping cough, the doctor will take a medical history, do a thorough physical exam, and take nose and throat mucus samples that will be examined and cultured for B. pertussis bacteria. Blood tests and a chest X-ray may also be done.

If the child has whooping cough, it will be treated with antibiotics, usually for 2 weeks. Many experts believe that the medication is most effective in shortening the infection when it's given in the first stage of the illness, before coughing fits begin. But even if antibiotics are started later, they are still important because they can stop the spread of the pertussis infection to others.

Some kids with whooping cough need to be treated in a hospital. Infants and younger children are more likely to be hospitalized because they are at greater risk for complications such as pneumonia, which occurs in about 1 in 5 children under the age of 1 year who have pertussis.

While in the hospital, a child may need suctioning of thick respiratory secretions. Breathing will be monitored and oxygen given, if needed. Intravenous fluids might be required if the child shows signs of dehydration or has difficulty eating. Precautions will be taken to prevent the infection from spreading to other patients, hospital staff, and visitors.

Chickenpox

Chickenpox is a common infectious disease. It is caused by a virus called varicella zoster and is spread by sneezing and coughing or direct contact with broken chickenpox blisters. It is much more severe in adults than in children and can be a particular problem in pregnancy. Shingles (also known as herpes zoster) is a reactivation of the virus and will only develop in a person who has previously had chickenpox.

Chickenpox is like a mild case of flu with an itchy rash. The rash is the most noticeable feature and starts out as crops of raised red spots. These develop into small blisters which eventually scab over in 3-4 days. Chickenpox is mainly a disease of children and is usually, but not always, a mild illness.

Chickenpox is highly infectious and is usually spread from person to person by cough and sneeze. The incubation period is two to three weeks. Children with chickenpox can pass it to others from 1-2 days before the rash appears until 5 days after the rash has started. A child who has had chickenpox will be immune for life. Because it is the reactivation of a virus, you cannot catch shingles. However, fluid from the blisters can spread the virus to other people, who will develop chickenpox if they have never had it before. The rash should be covered with a dry dressing until the blisters have dried up.

Chickenpox is highly infectious and it is very difficult to prevent it spreading from person to person. Getting the child to cough into a tissue and keeping them away from susceptible people should help prevent transmission of Chickenpox.

Mumps

Mumps is an infectious viral disease caused by the paramyxovirus. It mainly affects the salivary glands, but sometimes other parts of the body are affected. Mumps usually affects children but can affect any age group.

Mumps usually begins with 2 or 3 days of discomfort and an increasing temperature. This is followed by the onset of discomfort and swelling of the parotid glands, which are situated below the ears and normally cannot be felt. The swelling can be in both glands or just one side and can cause the earlobes to stick out and the face to appear swollen. The mouth may feel dry and swallowing can be painful. Symptoms usually last for 3 or 4 days but can last for more than a week. The mumps virus is a common cause of viral meningitis, which is usually very mild and has no after effects.

Mumps is usually spread from person to person by cough and sneeze. Less often, it may be spread by direct contact with the saliva of someone with mumps. People with mumps can pass it to others from shortly before the symptoms start until just after the swelling has gone.

The only effective way to prevent mumps is to immunise all children against it with the MMR vaccine as part of the routine programme of childhood immunisation.

Scarlet fever

Scarlet fever (also known as Scarlatina) is caused by the bacterium Streptococcus A. It often affects children between the ages of 2 and 10 years.

The illness usually begins with a sore throat, headache and fever. The rash normally breaks out on the second day and lasts between 3 and 6 days. The rash often starts with a mass of tiny bright red spots on the neck and chest and will usually spread over the body. The rash normally does not appear on the face but the cheeks will look very flushed. The rash goes white if you press on it. The skin often peels, especially on the hands, feet and groins. The tongue often has a thick white coating that peels after four or five days producing a strawberry like appearance.

Scarlet fever is infectious, especially in the home environment. The infection is spread person to person by touching or through cough and sneeze. The incubation period is short, between 1 and 3 days and people do not remain infectious for long once antibiotic treatment is prescribed.

Children with scarlet fever should be treated with antibiotics. After 48 hours of treatment, they will no longer be infectious. There is no immunisation available against the infection.

To prevent spread of the infection until 24 hours after starting antibiotics, the child's drinking glasses, eating utensils, sheets and towels should be kept separate from those belonging to other family members. These items should then be washed with hot soapy water.

Measles

Measles, also called rubeola, is a highly contagious respiratory infection that is caused by a virus. It causes a total-body skin rash and flu-like symptoms, including a fever, cough, and runny nose. Since measles is caused by a virus, there is no specific medical treatment and the virus has to run its course. But a child who is sick should be sure to receive plenty of fluids and rest, and be kept from spreading the infection to others.

While measles is probably best known for the full-body rash it causes, the first symptoms of the infection are usually a hacking cough, runny nose, high fever, and red eyes. A characteristic marker of measles are Koplik's spots, small red spots with blue-white centres that appear inside the mouth.

The measles rash typically has a red or reddish brown blotchy appearance, and first usually shows up on the forehead, then spreads downward over the face, neck, and body, then down to the arms and feet.

Infants are generally protected from measles for 6 months after birth due to immunity passed on from their mothers. Older kids are usually immunized against measles according to state and school health regulations.

For most kids, the measles vaccine is part of the measles-mumps-rubella immunizations (MMR) or measles-mumps-rubella-varicella immunization (MMRV) given at 12 to 15 months of age and again at 4 to 6 years of age.

Measles vaccine is not usually given to infants younger than 12 months old. But if there is a measles outbreak, the vaccine may be given when a child is 6-11months old, followed by the usual MMR immunization at 12-15 months and 4-6 years.

There is no specific medical treatment for measles. To help manage symptoms, which usually last for about 2 weeks, the child is given plenty of fluids and encourage extra rest. Kids with measles should be closely monitored. In some cases, measles can lead to other complications, such as otitis media, croup, diarrhoea, pneumonia, and encephalitis (a serious brain infection), which may require antibiotics or hospitalization.

Medical Specialists

Medical specialists are experts in certain fields of medicine. They either treat specific parts of the body, such as the back or the brain, or they specialize in certain diseases, such as cancer. Family doctors keep a list of local specialists and can help patients choose the right specialist for each medical issue. In many cases specialists require a referral from a family doctor before they will see a patient. Here is a list of the most common types of specialists.

allergist: specializes in determining food and environmental

allergies

anesthesiologist: specializes in pain prevention during surgery

cardiologist: heart specialist

dentist: tooth specialist

dermatologist: skin specialist

fertility specialist: helps people who have difficulty getting pregnant

gynecologist: specializes in women's needs

massage therapist: specializes in muscle relaxation

midwife: helps women deliver babies in a natural way

naturopath: specializes in natural cures and remedies

neurologist: brain specialist

obstetrician: specialist for pregnant women

occupational therapist: specializes in workplace health
oncologist: tumour specialist, including cancer

ophthalmologist: specializes in eye diseases

pediatrician: specialist for babies and children

physical therapist: specializes in the body's movement

podiatrist: foot specialist

psychiatrist: specialist in mental health

radiologist: specializes in imaging tests

Quotations and Phrases

Taken from Original Texts

1. "Time: that which man is always trying to kill, but which ends in killing him". (Herbert Spenser)

2. "I recommend you to take care of the minutes: for hours will take care of themselves". (Lord Chesterfield)

3. "Language is a uniquely human characteristic. Each person has programmed into his genes a faculty called universal grammar". (Noam Chomsky)

4. "One of the difficulties in the language is that all our words from loose using have lost their edge". (Ernest Hemingway)

5. "Custom, then, is a great guide of human life". (David Hume)

6. "The deposition of custom is everywhere the standing hindrance to human advancement". (John Stuart Mill)

7. "Literature is the ochestration of platitudes". (Thomas Wilder)

8. "Great literature is simple language charged with meaning to the utmost possible degree". (E. Pound)

9. "Literature flourishes best when it is half a trade and half an art". (W.R. Inge)

10."Art is man added to nature". (Francis Bacon)

11."Art is skill, that is the first meaning of the word". (Eric Gill)

12."Art is a lie that makes us realize the truth". (Pablo Picasso)

13."My doctor gave me six months to live but when I couldn't pay the bill he gave me six months more". (Walter Matthau)

14."One finger in the throat and one in the rectum make a good diagnosti­cian". (Sir William Osier)

15. "Cured yesterday of my disease I died last night of my physician". (Mathew Prior)

16."Either the soul is immortal and we shall not die then that we are dead. Live, then as if you were eternal". (A. Marois)

17. "The miserable have no other medicine but only hope". (W. Shakespeare)

18."Whoever shed man's blood, by man his blood shall be shed". (Holy Script)

19."I have no desire to lay bare my heart and I put limits to the intimacy..." (S. Maugham)

20. "A heart has its own reasons of which human reason doesn't know any­thing". (S. Maugham)

21."He has a heart as sound as a bell and his tongue is a clapper, for what his heart thinks, his tongue speaks". (W. Shakespeare)

22."Far from within, out of the heart of men, proceed the evil thoughts, forni­cations, thefts, murders, adulteries". (Holy Script; Mark 7:21)

23."Half of the modern drugs could well be thrown out except that the birds might eat them". (M.H. Fisher)

24."And put a knife to your throat if you are a man of great appetite". (Holy Script Prov. 23:2)

25."I have finally come to conclusion that good reliable set of bowels is worth more to a man than any quantity of brain". (J. Billings)

26."There is no love sincerer than the love of food". (George B.Shaw)

27."No longer drink water exclusively, but use a little wine for the sake of your stomach, and your frequent ailment". (Holy Script)

28."The desire to make medicine is perhaps the greatest feature which distin­guishes man from animals". (W. Osier)

29."Death that hath suck'd the honey on thy breath, hath had no power yet upon the beauty". (W. Shakespeare)

30."Away with Systems! Away with a corrupt world! Let us breathe the air of the Enchanted Island". (George Meredith)

31."Then the Lord God formed man of dust from the ground, and breathe into his nostrils the breathe of life, and man became a living being". (Holy Script; Gen. 2:7)

32."If prolonged it (illness) cannot be severe; and if severe, it cannot be pro­longed". (Seneca)

33."Love is like the measles, we all have to go through it". (K. Jerome)

34."And in this harsh world draw thy breath in pain, to tell my story". (W. Shakespeare)

35."Medicine is a collection of uncertain prescriptions, the results of which, taken collectively, are more fatal than usual to mankind. Water, air and cleanliness are the chief articles in my pharmacopoeia". (N. Bonaparte)

36."It is his reasonable conversation which mostly frightens us in a mad man". (Anatole France)

37."In the past men created witches: now they create mental patients". (T. Shass)

38."Illness is the doctor to whom we pay most heed; to kindness, to knowl­edge, to make promise only, pain we obey". (Marcel Proust)

39."I wasn't driven into medicine by a social conscience but by rampant cu­riosity". (Jonathen Miller)

40."Living is sickness from which sleep provides relief every sixteen hours. It is palliative. The remedy is death". (Nickolas S. Chamfort)

41."God heals and doctor takes the fee". (Benjamin Franklin)

42. "Drink is a great provoker of three things... nose-painting, sleep and urine". (W. Shakespeare, "Macbeth")

43. "Patience is the virtue of an ass, than trots beneath his burden, and is quiet". (Lord Lansdowns)

44. "Suffering does not ennoble. It makes man petty, querulous and selfish". (S. Maugham, "Sanatorium")

45. "The aim of medicine is to prevent disease and prolong life; the ideal of medicine is to eliminate the need of a physician". (William J. Maya)

46. "All that lives must die, passing through nature to eternity". (W. Shake­speare)

47. "It is not those who are healthy that need of physician, but those who are sick". (Holy Script; Matt. 9:12)

48. "The art of medicine consists of amusing the patient while Nature cures the disease". (Voltaire)

49. "For man is born for trouble, as sparks fly upward". (Holy Script; Job. 5:7)

50. "It (a drink) provokes the desire, but it takes away the performance". (W. Shakespeare, "Macbeth")

51. "You should commit errors in youth in order to have something to regret in old age". (S. Maugham, "His Excellency")

52. "Do not lead us into temptation". (Matt. 6:13)

53. "Passion is all very well, but it is not a proper foundation for marriage".
(S. Maugham)

54. "A wondrous moment! There before me.
A radiant, fleeting dream you stood,

A vision fancy fashioned for me

A glimpse of perfect womanhood". (A. Pushkin)

55. "For we are born in other's pain and perish in our own". (Francis Thompson)

56."He had much experience of physicians and said the only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not". (Mark Twain)

57."We want far better reasons for having children that not knowing how to prevent them". (Dora Russel)

58."And maiden virtue rudely trumpeted". (W. Shakespeare)

59."The reproduction of mankind is a great marvel and mystery. Had God consulted me in the matter I should have advised him to continue the generation of the species by fashioning them of clay". (Martin Luter)

60."Before undergoing a surgical operation arrange your temporal affairs. You may live". (Ambrose Bierce)

61."To survive it is often necessary to light, and to fight you have to dirty yourself. (George Orwell)

62."One man's poison is another man's drag". (Ronald Knox)

63."The lesson of anatomy applies: there is nothing so rare as the normal". (Somerset Maugham)

64."For the arms of the wicked will be broken". (Holy Script; Ps. 37:17)

65."In anatomy it is better to have learned and lost than never to have learned at all". (Somerset Maugham)

66."Accidents will occur in the best regulated families". (Charles Dickens)

67."A comfortable house is a great source of happiness. It ranks immediately after health and good conscience". (Sydney Smith)

68."My father taught me to work; he didn't teach to love it". (A. Linkoln)

69."Nothing dignifies human labour so much as the saving of it". (John Rod-gers)

70."The preservation of health is a duty. Few seem conscious that there is such a thing as physical morality". (Herbert Spenser)

71."Exercise is bunk. If you are healthy you don't need it, if you are sick you shouldn't take it". (Henry Ford)

72."There is really no such thing as bad weather, only different kinds of good weather". (John Ruskin)

73."Everyone talks about the weather, but no one ever does anything about it". (Charles D. Warner)

74."Patriotism is your conviction that this country is superior to all other". (George B. Shaw)

75."Where liberty dwells there is my country". (Thomas Jefferson)

76."Workers of England be wise, and then you must be free for you will be fit to be free". (Charles Kingsley)

77."The beauty of Scotland is that it is big enough to be important in the UK and small enough for everyone else". (George Younger)

78."The Irish are a fair people, they never speak well of one another" (Dr. S. Johnson)

79."Not only England, but every Englishman is an island". (Friedrich von Hardenberg)

80."The business of America is business". (Calvin Coolidge)

Proverbs

1. Every family has a skeleton in the cupboard.

2. Men make houses, women homes.

3. Charity begins at home.

4. Many hands make light work.

5. Early to bed, early to rise makes a man healthy, wealthy and wise

6. After rain comes fair weather.

7. So many countries, so many customs.

8. Dry bread at home is better than roast meat abroad.

9. Health is better than wealth.

10.Time is the great healer.

11.Footprints on the sands of time are not made by sitting down.

12.Procrastination is the thief of time.

13.What is bred in the bone will come out in the flesh.

14.What the eyes do not see the heart does not grieve ever.

15.He that has not silver in his purse must have silk in his tongue.

16.A still tongue makes a wise head.

17.If it were not for hope, the heart would break.

18.Water is a boom in the desert, but the drowning man curses it.

19.Idle folk has the least leisure.

20.Business first, pleasure afterwards.

21.Customs make all things easy.

22.So many countries, so many customs.

23.It's pretty, but is it art.

24.Man does not live by bread alone.

25.Ninety per cent of inspiration is perspiration.

26.The purse of the patient protracts the disease.

27. While the doctors consult, the patient dies.

28. What can't be cured must be endured.

29. Death is the great leveller.

30. While there is life there is hope.

31. Desperate diseases must have desperate remedies.

32. The remedy may be worse than the disease.

33. Hard words break no bones.

34. Two dogs fight for a bone, and a third runs away with it.

35.One foot is better than two crutches.

36. Many physicians have killed the king.

37.The town for wealth, the country for health.

38.Absence makes the heart grow fonder.

39.A honey tongue, a heart of gall.

40.A fair face may hide a foul heart.

41.It is a poor heart that never rejoices.

42.The heart that once truly loves never forgets.

43.Kind hearts are more than coronets.

44.Paint heart never won fair lady.

45.The belly is not filled with fair words.

46.A closed mouth catches no flies.

47.Now drink and be merry, for tomorrow you die.

48.The tongue ever turns to the aching tooth.

49.If the doctor cures, the sun sees it, but if he kills, the earth hides.

50.Who shall decide if doctors disagree?

51.Diet cures more than doctors.

52.The evil wound may be cured but not the evil name.

53.He who pleased everybody died before he was born.

54.Laughter is the best medicine.

55.Conscience does make cowards of us.

56.An idle brain is the devil's workshop.

57.Time and thinking tame the strongest grief.

58.There is no medicine to cure stupidity.

59.A good surgeon must have: an eagle's eye, a lion's heart, and hand.

60.Cheerfulness is the best medicine a family can keep.

61.An ounce of preventation is worth a pound of cure.

62.Patience is virtue.

63.Even if a doctor is good, he is best seen departing.

64.He that fears death lives not.

65.As the man lives so shall he die.

66.It's an ill bird that fouls its own nest.

67.If the pills were pleasant they would not be gilded.

68.The course of true love never did run smooth.

69.He knows not what love is that has no children.

70.No herb will cure love.

71.Prettiness dies first.

72.Love lives in cottages as well as in courts.

73.Love and cough can not be hidden.

74.All is fair in love and war.

75.You must learn to creep before you walk.

76. It is love that makes the world go round.