How an African slave helped Boston fight smallpox

How an African slave helped Boston fight smallpox

Centuries before Ebola, Cotton Mather faced down another global epidemic with a health tactic from abroad

By Ted Widmer | OCTOBER 17, 2014

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Cotton Mather’s successful smallpox campaign was based on inoculation advice he received from a slave named Onesimus.
UNIVERSAL HISTORY ARCHIVE/GETTY

THE SPREAD of Ebola has added a scary twist to one of the clichés of our age: that we live in a world of shrinking distances. Boston isn’t one of the five US airports where officials will aim an infrared thermometer gun at anyone coming off a plane from West Africa. But passengers who reached Logan Airport with flu-like symptoms last week were escorted to hospitals by a team in hazmat suits, and our eyes now scan the horizon nervously, wondering about every new arrival.

New as it might seem, this anxiety about our hyperconnectivity has a long lineage: In the 17th and 18th centuries, Bostonians felt a similar terror. The ships that streamed into Boston Harbor from around the Atlantic world carried a vital lifeblood—the commerce that built Boston—but they also carried the microbes of infectious disease.
The most fearsome of all was smallpox, the disease that wiped out so many Native Americans at the time of European settlement, and that also killed large numbers of the English. A terrible epidemic came in 1721, infecting roughly half of Boston’s 11,000 residents. But Boston’s approach to public health changed that year, thanks to an experimental strategy for inoculating citizens with small traces of the disease.

The idea behind this radical new treatment came from Africa, specifically from a slave named Onesimus, who shared his knowledge with Cotton Mather, the town’s leading minister and his legal owner. Boston still suffered dreadfully, but thanks to Onesimus and Mather, the terror linked to smallpox began to recede after Africans rolled up their sleeves—literally—to show Boston how inoculation worked. The story of how Boston began to overcome smallpox illustrates the strife that epidemics can cause, but also the encouraging notion that humans can communicate remedies as quickly as they communicate germs—and that the solutions we most need often come from the places we least expect to find them.

TO EARLY New Englanders, smallpox was one of life’s many imponderables. No one really knew where the disease came from. Was it carried by bad air, or sent as a form of divine retribution for personal failings? Boston had plenty to fear on both counts—one observer described the town at low tide as “a very stinking puddle.” Medical knowledge was still primitive; a learned scientist, John Winthrop Jr., kept what he thought was a unicorn horn in his cabinet. For most, the first line of defense was the prayer book.

Disease was an inseparable part of the New England story from the beginning. It arrived wirh the Great Migration of the 1630s, aboard the very ships that brought so many families to New England. It returned in 1666, and again in 1678, when an epidemic killed 340 Bostonians. A young Cotton Mather wrote, “Boston burying-places never filled so fast.” With time, local leaders began to develop crude public health policies—burying the dead quickly, flying red flags over houses affected, and requiring ships with sick sailors to stop at Spectacle Island in Boston Harbor. But as Bostonians knew, the next epidemic was always just over the horizon. In 1721, on April 22, the HMS Seahorse arrived from the West Indies with smallpox on board, and despite precautions, a full-blown epidemic started.

This time, however, the city was better prepared, thanks to several unlikely heroes. Cotton Mather is not always the easiest figure to admire. The scion of a dynasty of ministers, he fought a lengthy rear-guard action against time, trying to stanch the ebbing of power among the city’s religious authorities. But he was surprisingly modern in some ways, and paid attention to the new forms of knowledge coming in on those ships. Another contradiction lay in his racial attitudes—his writings suggest that, more than most of his contemporaries, he admired Africans, but he also accepted slavery, and had raised no objections when his congregation presented him with a young slave in 1706. He named him Onesimus, after a slave belonging to St. Paul.

Mather had come close to choosing a career in medicine, and devoured the scientific publications of the Royal Society in London. As the society began to turn its attention to inoculation practices around the world, Mather realized that he had an extraordinary expert living in his household. Onesimus was a “pretty Intelligent Fellow,” it had become clear to him. When asked if he’d ever had smallpox, Onesimus answered “Yes and No,” explaining that he had been inoculated with a small amount of smallpox, which had left him immune to the disease. Fascinated, Mather asked for details, which Onesimus provided, and showed him his scar. We can almost hear Onesimus speaking in Mather’s accounts, for Mather took the unusual step of writing out his words with the African accent included—the key phrase was, “People take Juice of Small-Pox; and Cutty-skin, and Putt in a Drop.”

Excited, he investigated among other Africans in Boston and realized that it was a widespread practice; indeed, a slave could be expected to fetch a higher price with a scar on his arm, indicating that he was immune. Mather sent the Royal Society his own reports from the wilds of America, eager to prove the relevance of Boston (and by extension, Cotton Mather) to the global crusade against infectious disease. His interviews with Onesimus were crucial. In 1716, writing to an English friend, he promised that he would be ready to promote inoculation if smallpox ever visited the city again.

When it did, Mather pursued a determined course of action, asking doctors to inoculate their patients and ministers to support the plan. His call was answered by only one person, an apothecary named Zabdiel Boylston, who began by inoculating his 6-year-old son, Thomas, and two slaves.

As word spread of the new medicine, the people of Boston were terrified and angry. According to Mather, they “raised an horrid Clamour.” Their rage came from many sources; fear that inoculation might spread smallpox further; knowledge that the bubonic plague was on the rise in France; and a righteous fury that it was immoral to tamper with God’s judgment in this way. There was a racial tone to their response as well, as they rebelled against an idea that was not only foreign, but African (one critic, an eminent doctor, attacked Mather for his “Negroish” thinking). Some of Mather’s opponents compared inoculation to what we would now call terrorism—as if “a man should willfully throw a Bomb into a Town.” Indeed, one local terrorist did exactly that, throwing a bomb through Mather’s window, with a note that read, “COTTON MATHER, You Dog, Dam You; I’l inoculate you with this, with a Pox to you.”

Another attack came from the New-England Courant, a newspaper that debuted on Aug. 7, as smallpox raged. The brainchild of a satirical editor, James Franklin, it was unlike anything Boston had seen before, ridiculing an older generation perennially telling everyone else how to behave. Inevitably, it jumped right into the inoculation debate, finding its fattest target in the prig who was always lecturing Bostonians—the Very Rev. Cotton Mather, D.D. At 58, he was the last avatar of a worldview that had exhausted itself in the 17th century, particularly during the Salem witchcraft crisis of 1692, which he had helped to bring about. It must have seemed as if the entire town was against him.

But in this instance, he knew what he was talking about. Through all of the opposition, he and Zabdiel Boylston persevered in their efforts to “Conquer the Dragon.” As the dreadful year continued and smallpox took its toll, the results began to tell. Inoculation was not perfect, but it was a far more effective response than doing nothing at all. When the epidemic had run its course, 5,889 people had contracted the disease (roughly half the town), and 844 people had died, or one in seven. Of the 242 who had been inoculated, only six had died–one in 40.

In the aftermath, Mather and Boylston were lionized for their courage, and Boylston was received with accolades in London, where he went for a long visit. Little is known about the fate of Onesimus, though Mather recorded that he was able to buy his freedom.

GOD KNOWS that Cotton Mather could be hard to take—one reason the New-England Courant found an immediate audience by attacking him. But in his openness to science and evidence, and his willingness to listen to an African living in his household, he showed a capacity for self-correction that redeemed some of his earlier failings. We will never know if he found redemption in the sense of the word he understood; but he found a meaningful second chance in 1721, and embraced it.

Boston was not quite out of the woods—other epidemics would come, often during wars that we remember with more clarity. But a smallpox vaccine, safer than amateur inoculation, was invented in 1796. Nearly 200 years later, in 1979, the World Health Organization declared that smallpox had been eradicated. That immense victory, which took centuries to consummate, was brought closer by the knowledge that an African-Bostonian brought to a city where he was held in slavery at the beginning of the 18th century.

The episode is also fascinating for one final aftereffect. An important witness to the debate over inoculation was a 15-year-old boy, the younger brother of Cotton Mather’s chief tormentor in the Courant. Perhaps the most famous Bostonian of all time, Benjamin Franklin made his fortune, of course, by fleeing the city and its theological disputes for Philadelphia. As an adult, possibly with some acknowledgment that he and James had been too quick to ridicule an elderly minister trying to use science on behalf of humanity, Franklin would become an important advocate of inoculation, especially after his own son died of smallpox.

Franklin also had a personal encounter with Zabdiel Boylston in London, not long after the smallpox crisis, that changed his life. The young Franklin had run out of money and options, and Boylston helped him with a crucial loan of 20 guineas, despite the fact that Franklin and his brother had attacked his medical efforts throughout 1721. As an old man in Paris, Franklin met a young relative of Boylston’s and told him that he could never repay what that loan had meant to him at a low moment. “I owe everything I am to him,” he confided, before asking the young man what he could do for him.

Today, as anxiety leads many to see all of Africa as a potential source of infection, it may be time to revive a similar feeling of reciprocity—and an appreciation for what African medical knowledge meant to Boston during the most serious health crisis of its early history.

Ted Widmer is assistant to the president for special projects at Brown University and a senior research fellow with the New America Foundation. He is an Ideas columnist.

http://www.bostonglobe.com/ideas/2014/10/17/how-african-slave-helped-boston-fight-smallpox/XFhsMMvTGCeV62YP0XhhZI/story.html?p1=Article_Trending_Most_Viewed

10 Things to Know About Thyroid Disease and Fatigue

10 Things to Know About Thyroid Disease and Fatigue<!–

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1. Fatigue and Hypothyroidism

Fatigue is a very common symptom of hypothyroidism – an underactive or low thyroid — in many patients. When the treatment for hypothyroidism is optimized , many patients report that their fatigue is lessened or even fully resolved.

2. Fatigue and Hyperthyroidism

Fatigue is a symptom of hyperthyroidism — an overactive or high thyroid — in some patients. In some cases, fatigue is present even after you’ve gotten a sufficient amount of sleep. In other cases, fatigue in hyperthyroidism may result from insomnia, anxiety, or disrupted sleep patterns. Typically, appropriate treatment for Graves’ disease and hyperthyroidism will help resolve fatigue associated with an overactive thyroid.

3. Fatigue and Autoimmune Thyroid Disease

Even when thyroid function tests show that the thyroid is “normal” and hormone levels fall within the reference range, the presence of elevated thyroid antibodies indicative of autoimmune Hashimoto’s disease or Graves’ disease can cause fatigue as a symptom in some patients.

4. Dietary Changes

Some thyroid patients — including those who do not have celiac disease or gluten intolerance — have reported a reduction in fatigue when they switch to a gluten-free diet , free of wheat and gluten products. Others have reported similar effects by eliminating sugar, or other inflammatory foods from the diet.

5. Unrefreshing Sleep

Some people experience fatigue due to what’s known as unrefreshing sleep. This means you’ve had enough sleep — usually seven or more hours — but you wake up and still feel tired, because the sleep was of poor quality, interrupted, or did not reach restorative levels. Unrefreshing sleep may be associated with adrenal dysfunction, as well as chronic fatigue syndrome and fibromyalgia .

6. Iron

Some thyroid patients experiencing fatigue may be low in iron, in particular, the stored form of iron known as ferritin. It’s worth having ferritin levels checked by your physician, and if they are not optimal, talk to your doctor about supplementing with iron, or adding more iron to your diet through foods.An excess of iron, in particular a hereditary condition known as hemachromatosis, can also be associated with fatigue.

7. Chronic Fatigue Syndrome and Fibromyalgia

If you have long-term, debilitating fatigue, and the fatigue is accompanied by other symptoms such as enlarged lymph nodes, a chronic sore throat, and/or body/muscle aches pains, you may have other conditions, known as Chronic Fatigue Syndrome and/or fibromyalgia . these conditions are more common in thyroid patients than in the general population.

8. T3 and Natural Thyroid

Some thyroid patients on thyroid hormone replacement have reported an improvement in their fatigue levels when switching from a T4 only treatment (i.e., levothyroxine), to a T4/T3 treatment–for example, the addition of synthetic T3–or use of a natural desiccated thyroid drug .

9. Sleep Apnea

Thyroid patients are at greater risk of sleep apnea , where breathing stops for short periods during sleep. Sleep apnea can contribute greatly to fatigue. Thyroid patients experiencing fatigue should talk to a physician about having a sleep study or evaluation done to determine if sleep abnormalities — including apnea — may be contributing to the fatigue.

10. You Can Get Better Sleep

In addition to making sure you get optimal thyroid treatment for your condition, and address any sleep disorders , food sensitivities, and imbalances in iron levels, there are many other ways to ensure that you get sufficient sleep.But first, how much sleep do you need? According to the National Sleep Foundation most adults need a minimum of seven to eight hours per night, and a substantial percentage of us are not getting this amount of sleep on a regular basis.

Here are some tips to get to sleep, and get better sleep:

  • Try to keep the same sleep schedule weekdays and weekends
  • Keep your bedroom cool
  • Don’t watch television or work in your bedroom
  • Avoid caffeine and alcohol in the afternoon, and before bedtime
  • Don’t take naps.
  • Don’t exercise after dinner time
  • Take a hot shower or bath before bedtime
  • Use a sound conditioner or earplugs to block noise
  • Avoid large meals before bedtime
  • Increase light exposure during the day
  • Minimize light in your bedroom — Use blinds or blackout curtains, turn off television and computer at night, avoid illuminated clocks, and don’t read from backlit devices at night
  • Listen to relaxation or guided imagery tapes to help fall asleep
  • Don’t drink too much liquid in the evening
  • Limit changes in your work shifts
  • Drink an herbal or relaxation tea at bedtime
  • Have a bedtime snack with protein

Home to world’s smallest and biggest eggs

China: Home to world’s smallest and biggest eggs – Home – ShortList Magazine

China: Home to world’s smallest and biggest eggs

Insert egg-pun here

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A farmer was surprised to collect a super small egg from the chicken pen at their home in Yangzhou, eastern China’s Jiangsu Province. The tiny egg is just 2.5cm long and weighs 5 grams, equivalent to a 10 cent Chinese coin.

This comes two months after a farmer from Shuangliu in southwest China found that one of her chickens laid a huge 250g egg. Wang Yongbi said: “I’ve been raising chickens for more than 30 years but it’s the first time I’ve seen such a huge egg.” Wang said she fed the chickens no special food, but grains, maize and vegetable leaves. She added: “Normally the eggs are small”.

Which is interesting.

http://www.shortlist.com/home/china-home-to-worlds-smallest-and-biggest-eggs

Cricket snack bars and love bug salads

Cricket snack bars and love bug salads

It’s apparently the next big food trend in the western world. Eating insects may be good for our health and the environment, but do they taste good?

Jacky Chung, co-founder of Ento, can foresee a time when hungry office workers regularly reach for one of his company’s ready-made bento boxes for lunch, or dip into one of its healthy, protein-rich snacks during long afternoons. He realises that some of us might take some persuading, but he’s certain that the health benefits, and most importantly the taste, of Ento’s food cubes, pâtés, seasonings and more will win many of us round eventually.

“We want to be very honest with our foods to consumers in that they are predominantly made from insects, but we try to present it to them in a way that is culturally acceptable in the western diet, thereby redefining insects as a food and not as an animal,” says Chung.

Eat insects, save the planet

It seems that the idea of eating insects is creeping up on western society like a mosquito in the night. Many societies around the world eat insects as a matter of course, but westerners have long had a squeamishness about consuming anything they’d normally shoo out of the window. It’s a squeamishness we may have to get over, if a growing band of experts are to be believed. In the not-too-distant future it may be a case of eating insects or eschewing meat altogether.

We may be well advised to get over our distaste for creepy crawlies sooner rather than later, says Pat Crowley of Chapul, an American company that makes a range of snack bars based on a protein-rich flour milled from crickets.

“The majority of our freshwater resources worldwide go to agriculture, with the majority of that used for livestock production. Insects, however, are incredibly efficient at converting plant matter into a very healthy source of protein for humans, while emitting very few greenhouse gases and not requiring nearly as much land resources.”

And closer to home, Bug Grub is a UK site that sells specialised snacks, bars, dips and flour in its quest to get us eating insects.

Let’s be clear. This isn’t just the view of extremists and cranks. Last year the United Nations’ Food and Agriculture Organisation weighed into the debate in a comprehensive 200-page report.

“It is widely accepted that by 2050 the world will host nine billion people. To accommodate this number, current food production will need to almost double,” reads the report.”We need to find new ways of growing food.”

The report estimates that insects already form an important part of the diets of two billion people worldwide. There are very good reasons to believe that they will have to form part of the diet of many more in the next few decades.

Insects are good for us

One reason is that it takes 10lbs of feed to produce 1lb of beef, and the same amount of feed to produce 8lbs of edible crickets. In an increasingly thirsty world, it’s also worth noting that 100 gallons of water produces 19g of protein from chicken, and 71g from crickets.

On top of that, insects may not be appealing, but they are healthy. They tend to be low in fat, high in protein and a good source of vitamins and minerals. Put it all together and it’s hard to avoid the conclusion that insects would be a very good food source indeed, if they weren’t – well – insects.

Which is where companies like Ento and Chapul come in. They’re not simply trying to get us to fight back the gag reflex and swallow crickets, beetles and meal worms as a kind of personal and environmental medicine. They’re convinced the little blighters can be made to taste nice, too.

A marketing problem

In fact, Chung believes that the problem is one of marketing and packaging as much as anything else. Britons have learned to love sushi, after all, and 30 years ago eating raw fish wrapped in seaweed was seen as a similarly exotic foreign eccentricity that would never catch on.

“Insects are delicious, with each insect possessing their own unique flavours. For example, honey caterpillars taste like a combination of milk and pistachio nuts when roasted,” says Chung. “From a culinary standpoint we believe insects offer many new and exciting opportunities – it’s just a matter of making this more accessible and approachable for people so that they can begin to appreciate these excellent ingredients.”

Insects are also starting to creep and crawl onto restaurant menus. Archipelago in London has been serving them for a number of years. The restaurant’s Love Bug Salad features pan-fried locusts and crickets seasoned with chilli and garlic. Its Bushman’s Cavi-Err dessert includes caramel encrusted mealworms.

Meanwhile, the fashion for insect cooking is catching on in the home of gastronomy. Le Festin Nu in food-loving Paris offers palm weevils with beetroot and truffle oil, water scorpion with preserved peppers and black garlic, and grasshopper with quail eggs. The menu of Aphrodite in Nice features mealworm and crickets.

In fact, in terms of flavour, texture and cooking there is no reason not to enjoy insects, say those in the know. Grasshoppers and crickets are said to impart a satisfying crunch, and are great for taking on flavour when roasted with garlic, lime juice, chilli and salt. Witchetty grubs – a favourite torture for jungle-bound celebrities – actually taste like almonds, while their skin when cooked takes on the texture of roast chicken. Termites can be enjoyed steamed, smoked or sun-dried. Mealworms are comparable to beef in terms of protein content, but have a greater number of healthy, polyunsaturated fats.

If you’re still not convinced, the good news is that you don’t have to eat them whole. Like Chapul bars and Ento grasshopper pâté, it could be that our first introduction to insect eating will come in heavily disguised form. The consensus, though, is that whether whole, powdered or in some other way processed, eating insects may soon be all but unavoidable.

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http://food.uk.msn.com/food/cricket-snack-bars-and-love-bug-salads

What is temporomandibular joint (TMJ)?

Temporomandibular joint (TMJ) disorders facts

  • The temporomandibular joint (TMJ) is the site where the upper jaw (maxilla) and lower jaw (mandible) temporomandibular joint meet.
  • TMJ disorders are a group of complex problems with many possible causes.
  • Symptoms of TMJ disorders include headache, ear pain, dizziness, and fullness or ringing in the ear.
  • There are many treatment options for TMJ disorders.

What is the temporomandibular joint?

The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ, there are moving parts that allow the upper jaw to close on the lower jaw. This joint is a typical sliding “ball and socket” that has a disc sandwiched between it. The TMJ is used throughout the day to move the jaw, especially in biting and chewing, talking, and yawning. It is one of the most frequently used joints of the body.

The temporomandibular joints are complex and are composed of muscles, tendons, and bones. Each component contributes to the smooth operation of the TMJ. When the muscles are relaxed and balanced and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without pain.

We can locate the TMJ by putting a finger on the triangular structure in front of the ear. The finger is moved just slightly forward and pressed firmly while opening the jaw. The motion felt is from the TMJ. We can also feel the joint motion if we put a little finger against the inside front part of the ear canal. These maneuvers can cause considerable discomfort to a person who is experiencing TMJ difficulty, and doctors use them for making the diagnosis.

What are TMJ disorders, and what are causes of TMJ disorders?

 

TMJ disorders are a group of complex problems of the jaw joint. TMJ disorders are also sometimes referred to as myofascial pain dysfunction and Costen’s syndrome. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws. The following are behaviors or conditions that can lead to TMJ disorders.

  1. Teeth grinding and teeth clenching (bruxism) increase the wear on the cartilage lining of the TMJ. Those who grind or clench their teeth may be unaware of this behavior unless they are told by someone observing this pattern while sleeping or by a dental professional noticing telltale signs of wear and tear on the teeth. Many patients awaken in the morning with jaw or ear pain.
  2. Habitual gum chewing or fingernail biting
  3. Dental problems and misalignment of the teeth (malocclusion). Patients may complain that it is difficult to find a comfortable bite or that the way their teeth fit together has changed. Chewing on only one side of the jaw can lead to or be a result of TMJ problems.
  4. Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.
  5. Stress frequently leads to unreleased nervous energy. It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding and clenching their teeth.
  6. Occupational tasks or habits such as holding the telephone between the head and shoulder may contribute to TMJ disorders.

What are common TMJ symptoms?

 

TMJ pain disorders usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. Symptoms tend to be chronic, and treatment is aimed at eliminating the precipitating factors. Many symptoms may not appear related to the TMJ itself. The following are common symptoms.

Headache: Approximately 80% of patients with a TMJ disorder complain of headache, and 40% report facial pain. Pain is often made worse while opening and closing the jaw. Exposure to cold weather or air-conditioned air may increase muscle contraction and facial pain.

Ear pain: About 50% of patients with a TMJ disorder notice ear pain and do not have signs of ear infection. The ear pain is usually described as being in front of or below the ear. Often, patients are treated multiple times for a presumed ear infection, which can often be distinguished from TMJ disorder by an associated hearing loss or ear drainage (which would be expected if there really was an ear infection). Because ear pain occurs so commonly, ear specialists are frequently called on to make the diagnosis of a TMJ disorder.

Sounds: Grinding, crunching, clicking, or popping sounds, medically termed crepitus, are common for patients with a TMJ disorder. These sounds may or may not be accompanied by increased pain.

Dizziness: Of patients with a TMJ disorder, 40% report a vague sense of dizziness or imbalance (usually not a spinning type vertigo). The cause of this type of dizziness is not well understood.

Fullness of the ear: About 33% of patients with a TMJ disorder describe muffled, clogged, or full ears. They may notice ear fullness and pain during airplane takeoffs and landings. These symptoms are usually caused by eustachian-tube dysfunction, the structure responsible for the regulation of pressure in the middle ear. It is thought that patients with TMJ disorders have hyperactivity (spasms) of the muscles responsible for regulating the opening and closing of the eustachian tube.

Ringing in the ear (tinnitus): For unknown reasons, 33% of patients with a TMJ disorder experience noise or ringing in the ears (tinnitus). Of those patients, half will have resolution of their tinnitus after successful treatment of their TMJ disorder.

What is the treatment for TMJ disorders?

 

The mainstay of treatment for acute TMJ pain is heat and ice, soft diet, and anti-inflammatory medications.

1. Jaw rest: It can be beneficial to keep the teeth apart as much as possible. It is also important to recognize when tooth grinding is occurring and devise methods to cease this activity. Patients are advised to avoid chewing gum or eating hard, chewy, or crunchy foods such as raw vegetables, candy, or nuts. Foods that require opening the mouth widely, such as a big hamburger, are also not recommended.

2. Heat and ice therapy: These assist in reducing muscle tension and spasm. However, immediately after an injury to the TMJ, treatment with cold applications is best. Cold packs can be helpful for relieving pain.

3. Medications: Anti-inflammatory medications such as aspirin, ibuprofen (Advil and others), naproxen (Aleve and others), or steroids can help control inflammation. Muscle relaxants, such as diazepam (Valium), aid in decreasing muscle spasms. In certain situations, local injection of cortisone preparations (methylprednisolone [Depo-Medrol], triamcinolone [Kenalog], Celestone) into the TMJ may be helpful.

4. Physical therapy: Passively opening and closing the jaw, massage, and electrical stimulation help to decrease pain and increase the range of motion and strength of the joint.

5. Stress management: Stress support groups, psychological counseling, and medications can also assist in reducing muscle tension. Biofeedback helps people recognize times of increased muscle activity and spasm and provides methods to help control them.

6. Occlusal therapy: A custom-made acrylic appliance (mouth guard) that fits over the teeth is commonly prescribed for night but may be required throughout the day. It acts to balance the bite and reduce or eliminate teeth grinding or clenching (bruxism).

7. Correction of bite abnormalities: Corrective dental therapy, such as orthodontics, may be required to correct an abnormal bite. Dental restorations assist in creating a more stable bite. Adjustments of bridges or crowns act to ensure proper alignment of the teeth.

8. Surgery: Surgery is indicated in those situations in which medical therapy has failed. It is done as a last resort. TMJ arthroscopy, ligament tightening, joint restructuring, and joint replacement are considered in the most severe cases of joint damage or deterioration.

 

What is the prognosis (outlook) of TMJ disorder?

The outlook of TMJ disorder depends on its particular cause. Sometimes simple stress management and jaw rest lead to recovery within days. More serious TMJ problems can require corrective orthodontics and surgery.

Can TMJ problems be prevented?

Yes. TMJ problems can often be prevented by using simple nighttime mouth guards. The dentist is the first line of defense in this setting.

REFERENCES:

Klippel, John H., et al., eds. Primer on the Rheumatic Diseases. New York: Springer and Arthritis Foundation, 2008.

http://www.onhealth.com/temporomandibular_joint__disorder/page4.htm

Ruddy, Shaun, et al., eds. Kelley’s Textbook of Rheumatology, 6th ed. Philadelphia: Saunders, 2001.

Did you know the benefits of Ginger?

Did you know the benefits of Ginger?

Ginger is one of the world’s seven most potent disease-fighting spices.

 

Ginger has been used for its health benefits for over 5000 years and is a favorite medicinal as well as culinary herb. rhizome by Crystl.

 

 

Unlike most spices, the part that has the most medicinal value grows under ground. Often mistakenly called “ginger root” this is actually the rhizome of the plant which is more of a subterranean stem than a root. Although you can use dried ginger and powdered ginger for health benefits, fresh ginger is preferred.

Roots by 
Amontillada.

 

 

The intake of ginger helps stimulate the secretion of mucus, quieting your cough and soothing any scratchiness in your throat.

 

Ginger has been proven (in multiple studies) to treat feelings of nausea, particularly in the form of seasickness, morning sickness, motion sickness and as a side effect of chemotherapy.

Ginger by 
FotoosVanRobin.

 

 

In pregnancy is to be extra careful!! Never use any herb, including ginger, without first discussing it with your doctor!! As for those suffering from ulcer, or other very serious gastric problems, they should also consult their doctor.
Doctor Hand by Truthout.org.

 

 

Ginger contains anti viral, anti toxic, and anti fungal properties, and is used for the prevention of and treatment against the common cold.

Honey Lime 
Ginger Drink by Nags The Cook.

 

 

Ginger acts as an antihistamine and

aids in the treatment of allergies.

Giant Ginger 
Root by Damian Cugley.

 

 

Ginger displays anti inflammatory properties and can be used to treat rheumatoid arthritis, osteoarthritis, and various other muscular disorders.

Ginger Study (1)
 by Ida Christine Kvisgaard.

 

 

The chemical components of the root are instrumental in inhibiting the biosynthesis of prostaglandins which are responsible for causing inflammation.

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Thus the root has proven to be a highly effective form of treatment, in some cases, even more so than the NSAID’s that are traditionally prescribed.

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Chewing on fresh ginger,,
can help freshen the breath.
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Being a warming herb, ginger can help knock out a fever. This property also makes it effective in stimulating circulation of the blood.

Ginger Root by 
J. Pollack Photography.

 

It can also help relax muscles around the blood vessels and is said to help prevent blood clots from forming. The warming effects make it a natural decongestant as well as an antihistamine, making it the perfect remedy for colds.

Lemon and Ginger
 Drink by Red Snapper9.

 

Some studies show that it can even help inhibit

the replication of the herpes simplex virus.

a ginger root by
 left-handed.

 

Recent studies show that ginger might also have a role in lowering LDL cholesterol because the spice can help reduce the amount of cholesterol that is absorbed.

Curry with 
Zucchini by Jernej K.

 

It has also been shown in animal trials to help slow

or even prevent cancerous tumor growth.

Is it safe to fly during pregnancy?

Is it safe to fly during pregnancy?

Answers from Roger W. Harms, M.D.

 

Generally, commercial air travel during pregnancy is considered safe for women who have healthy pregnancies. Still, if you’re pregnant, it’s best to check with your health care provider before you fly.

Your health care provider might caution against air travel if your pregnancy is considered high risk or you’re at risk of preterm labor. Similarly, your health care provider might restrict travel of any type after 36 weeks of pregnancy.

If your health care provider approves air travel and you have flexibility in your travel plans, the best time to fly might be in the middle of your pregnancy — about weeks 14 to 28. This is when you’re likely to feel your best, and the risks of miscarriage and premature labor are the lowest.

When you fly:

  • Check the airline’s policy about air travel during pregnancy. Guidelines for pregnant women might vary by carrier and destination.
  • Choose your seat carefully. For the most space and comfort, consider requesting an aisle seat.
  • Buckle up. During the trip, fasten the lap belt under your abdomen.
  • Promote circulation. If possible, take occasional walks up and down the aisle. If you must remain seated, flex and extend your ankles often.
  • Drink plenty of fluids. Low humidity in the cabin can lead to dehydration.

Decreased air pressure during flight can slightly reduce the amount of oxygen in your blood, but this doesn’t pose risks if you’re otherwise healthy.

Likewise, the radiation exposure associated with air travel at high altitudes isn’t thought to be problematic for most business or leisure travelers who fly during pregnancy.

There’s a caveat for frequent fliers, though.

Pilots, flight attendants and others who fly steadily might be exposed to a level of cosmic radiation that raises questions during pregnancy. If you must fly frequently during your pregnancy, discuss it with your health care provider. He or she might limit your total flight time during pregnancy.

http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/expert-answers/air-travel-during-pregnancy/faq-20058087