Regular readers will recall my piece about chilblains, and the traditional remedy of easing discomfort that involved soaking them in tepid urine. Well, an extraordinary letter arrived on my desk afterwards from a British army veteran of the Malayan Emergency in the late 1940s and early 1950s. Without going into too much military detail, his mission was to flush communist terrorists out of their secret camps using patrols into heavily forested jungles.
"Creepy-crawly nasties", as he puts it, were everywhere. Leeches were a big problem, and the humid conditions meant that a severe dose of tinea fungal infection (ringworm) was common in the men's groins. Army-issue treatment at the time was the application of a brightly coloured cure-all called Mercurochrome. But the patrols used native people as trackers in the jungle – folk who had originated from the head-hunting tribes of Borneo. They had a great knowledge of jungle pharmaceuticals and the preparation of potions. They advised the use of copious amounts of one's own urine to cure "jock itch", and my war correspondent tells me it worked a treat, without scarring. Now I'm not advising this at home, or, indeed, in your local forest. Your neighbourhood chemist stocks antifungal creams far better and safer than Mercurochrome, and, I dare say, a lot more agreeable than a bucket of warm pee.
It's a while since we had our Ailment of the Week slot, so I thought we'd return today with a short dissertation on upper-wind problems. Burping and belching, or, as six years in medical school trains you to say, eructation, is quite a normal bodily function. It tends not to be a gaseous by-product of fermentation in the stomach, as most folk think, but, in most cases, is simply swallowed air. If you eat too quickly, drink too quickly, or do both too quickly together, the alimentary canal will be quick to tell you it has surplus amounts of air. In some people, air swallowing can be a kind of nervous tic at times of anxiety. Doctors have even invented a term for the swallowing of too much air – aerophagy. Children will tell you that the most effective way to create burps is to consume carbonated drinks quickly through a straw or to simply chew gum. The actual sound of burping is caused by vibration of a muscular valve, or sphincter, in the upper oesophagus or gullet. Excessive upper wind, especially if associated with other symptoms, like pain, nausea or swallowing difficulties, should be mentioned to your doctor. Some rarer stomach conditions can cause belching to have a particularly foul smell, or even be flammable. It's also important to consider if a supplement or medicine could be responsible. Multivitamins, iron pills, anti-inflammatories, narcotics and antacids are potential culprits. We might cover the other end of the wind tunnel next week.
As I write, all of your local hospitals are being neatly poached, sliced and scrambled up into a new health service omelette known as Hospital Groups. With the exception of the private ones, that is – they have more important things to worry about, like death-inducing bank loans. If you find it difficult, as patients, to navigate Irish healthcare, you won't be reassured that doctors on the ground are even more confused. It's becoming increasingly difficult for GPs to find out which doctors are working in which hospitals. Recently, I went looking for some simple information about six hospitals in the mid-west of the country. What I wanted to know – so that I could pass the information on to GPs – was quite simple: which consultants worked in which hospitals. Alas, this was not now possible. You see, they all work in one enormous conglomerate, with a single contact address miles away from where many of them treat patients. Each of these Hospital Groups is now tied for life to a medical school (of which we have five too many on this island already), but that's another story. As far as I can see, all the very same mistakes that were made when they merged eight health boards into the HSE are now being replicated in this rush to merge hospitals. There will be winners. Those who hold high office will have less mouths looking for feed. And parish medical schools have secured a permanent lifeline without any consideration being given to a proposal to merge them. But scant regard is being paid to those at the coalface. When the doctors don't know what the hell is going on, it's time for patients to get worried.
Somebody has asked me for my view on artificial sweeteners. Personally, I wouldn't use them, though I am coming over to today's medically popular viewpoint that sugar, in its various guises, is a much bigger baddy than we suspected in the early days of supermarkets. If you have a sweet tooth, why not dice some fresh fruit every morning and keep in the fridge instead? I know a lot of older people who have taken sweeteners for years. Whilst they don't seem to have done them any harm to their longevity, I always advise people who report insomnia to come off all these products to see if their sleep improves. And, you know what, sometimes it does.
I'm coming down heavily with medical malapropisms, and thank you to everyone who got in touch with theirs. A vet, who spent 20 years in bovine practice in the south of the country, told me that he, too, was asked one night to "come out and seduce me cow". She was a few days overdue and must have got an awful fright at the induction! And Margaret wrote to me about her grand-aunt, who said her husband had broken a bone in his pelmet (pelvis). She would also go to the doctor to have her pulpes taken (pulse). Jim tells me that a retired teacher of his acquaintance once received a sick note from a mother saying, "My Tommy can't go to school today because he has an abbess under his arm (abscess)."
Sunday Indo Life Magazine