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I remember clearly, when I was still quite young, my first encounter with parasitic infections, although at the time the word meant nothing to me. We were awakened in the middle of the night by the doorbell. A caller at that time of the night is most unusual at any time, but this was during the war years, so we were especially wary. Half-curious and half-frightened I crept behind my mother when she opened the door and outside stood a man wearing a shoe on one foot and a clog on the other. At that time my mother had people hidden in our house from the Germans, and when our visitor told her that he had escaped from one of the ships that would have taken him on his way to a concentration camp in Germany, she quickly pulled him inside. His presence in the house endangered all our lives but, at least inside he had a measure of safety, certainly more so than walking the streets. My mother, however, was faced with a considerable dilemma. She soon discovered that it would be irresponsible to let him mix with the other people in hiding, because our latest guest had scabies. This condition was more common during the war years, and it was fortunate that my mother, although not professionally trained, was very knowledgeable about homoeopathic and naturopathic remedies. She explained that if the house were to be searched she could not let him hide under the floor with the others because of the infectiousness of his condition, and she would have to treat him. The man was covered from top to toe in ointment, so that, if need be, he could also hide out in the space cleared under the floor.

Scabies is a highly contagious, parasitic skin disease, and its many eruptions cause intense itching. It is caused by the so-called itch mite and I have been told that it is enough to drive one mad. The treatment is basically external and sulphur echtiol, the cream used by my mother, is one of the best methods for treating a person with this disease. However, as the itch can become unbearable, it may be necessary to prescribe something for internal use as well. I have great faith in the Bioforce remedy, Boldocynara, which helps to ease the itching condition. This remedy is a fresh herbal preparation and should be taken three times a day, ten to fifteen drops in a little water.

Another parasitic infection, fortunately less and less common nowadays, is Pediculosis, which is also a lice infestation. This condition was also common during the war years and I remember that eventually we just shrugged our shoulders when, at school, we heard that someone would be absent for a few days because that usually meant they had been infested with lice and taken into hospital. Yet, prior to the war and since, there was a tremendous stigma attached to such conditions.

The Pediculus capitis, a head louse, is usually limited to the scalp, while the Pediculus corporis inhabits the seams of clothing worn next to the skin, and feeds on the skin covered by clothes. Usually the condition can be treated externally, but if it is persistent internal treatment may also be necessary. In days gone by, the old-fashioned remedy DDT was often used. Nowadays it is recognised that this poisonous substance can have very considerable after-effects. Although it was effective, there are natural treatment methods that are equally good, e.g. stinging nettle extract.

There are some very good ointments available for scabious conditions, one of which is a garlic ointment. Although smelly, it is quite effective, even for the condition of Pediculosis pubis, where the crab louse infests the hairs of the genital region. Occasionally it is also found in the eyebrows, eyelashes, beard or sometimes on the body surface.

These conditions are extremely unpleasant and socially embarrassing. Thanks to better hygiene standards, these conditions are nowhere near as common as they were during the traumatic war years. However, if they do occur, immediate treatment should be sought.

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During the asymptomatic period, your physician will probably keep track of the progress of the infection by physical examinations and with two principal tests. One test is to count, at regular intervals, the number of CD4 cells in the blood. The normal count is between 700 and 1,300 CD4 cells per milliliter of blood (five milliliters is one teaspoon). The average person has a CD4 count of about 1,000. People’s CD4 counts vary for several reasons. One reason is that different laboratories, counting CD4 cells in the same person or the same blood sample on the same day, can get counts that differ by as much as 20 percent. Another reason is that the CD4 count naturally varies in any one person over time, for reasons that are independent of HIV infection but are poorly understood. Consequently, a CD4 count of 500 one time may be 400 or 600 the next time; this is considered a normal variation. Because of this normal variability in the counts, a test showing a dramatic change in the count might need to be repeated.

In a person with HIV infection, the CD4 count decreases, on average, by 85 to 100 cells per year. Most people do not develop symptoms until their CD4 counts are below 300, and the average CD4 count for a person with an AIDS-defining diagnosis is 50—100. At a decrease of about 100 CD4 cells a year, the person who starts with a count of about 1,000 will develop symptoms after five to eight years, and will develop AIDS two or three years after that. The CD4 counts in some people fall more rapidly, while the CD4 counts in other people stabilize for several years. The CD4 count is the best measure of the progress of the infection. Physicians also use the CD4 count to determine what sorts of treatment will be helpful and to determine the benefit of the treatments used.

A second method for keeping track of the infection is through blood counts. Blood counts are counts of the numbers of the different kinds of cells in the blood: red cells, white cells, and platelets. Red blood cells deliver oxygen to the rest of the body; without enough oxygen, the

person loses energy, is tired much of the time. A low count of red blood cells is called anemia. White blood cells (the CD4 cell is only one kind of white blood cell) are part of the immune system’s defense against certain types of infection. A low count of white blood cells is called leukopenia. Platelets are cells that are critical in the process of blood clotting; a low number of platelets may result in excessive bleeding. During the asymptomatic period, the blood counts, like the CD4 counts, may also fall. That means that the body has progressively fewer red blood cells, fewer white blood cells, and/or fewer platelets. The body, however, has a great reserve, a large overabundance, of all three kinds of blood cells. The blood count must be lowered severely before symptoms occur.

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Type II diabetes occurs in both sexes, but women who have had a lot of children and those who have had unusually large babies seem to face a special risk. People who have relatives with diabetes (especially Type II diabetes) have a greater chance of developing the disease themselves.

Diabetes affects all the peoples of the earth, with a few exceptions: It is extremely rare among Eskimos, for example. In the United States, minority groups seem to be especially hard hit: Type II diabetes, the more common form, occurs about 60 percent more often in blacks than in whites, and its prevalence is also very high among Hispanic populations and certain Native American tribes such as the Pimas and Papagos.

The probability of getting Type II diabetes increases with age. The risk also increases with the amount of excess weight. At least three-quarters of the people who develop diabetes in middle or old age are overweight. Yet not all (or even most) overweight people develop diabetes.

What Goes Wrong

Although Type I diabetes is caused by damage to the beta cells of the pancreas, so that they cannot secrete enough insulin, some people with very serious cases of diabetes have beta cells that look perfectly normal. Tests of their blood show plenty of insulin—more than enough, it would seem, to keep the sugar metabolism running smoothly. Yet they too suffer from hyperglycemia.

High blood sugar could result if the pancreas is producing normal amounts of insulin, but the body’s needs for the hormone become far higher than normal and the gland cannot keep up. This might happen when people overeat to an extreme degree, flooding their bodies with more carbohydrates than their system can handle. (In general, any diet that results in a gain in weight will increase one’s chances of developing diabetes. A diet that causes weight reduction will decrease one’s chance of developing diabetes, or, if it is already present, will make it less severe.)

In some cases of diabetes, the insulin that the pancreas produces does not work properly. This may happen for several reasons. For example, the body normally produces a chemical called insulinase, which breaks down excess insulin when its job is done. If too much insulinase is produced, the insulin will be destroyed before it has had a chance to lower the body’s blood sugar level. Sometimes the body produces antibodies against insulin, in much the same way it makes them against disease germs. These anti-insulin antibodies may attack insulin or attach themselves to its molecules so that the hormone cannot work on the cells. Certain drugs, including cortisone, prednisone, contraceptive pills, nicotinic acid, and some diuretics (drugs that are used to rid the body of excess fluids), can interfere with the action of insulin.

Diabetes may also result from hormone disorders, in which the body produces too much glucagon or too much of another pancreatic hormone called somatostatin. This hormone, secreted by the delta cells in the islets, helps to regulate the secretion of both glucagon and insulin.

In non-insulin-dependent diabetes, insulin may not be able to allow glucose to pass into the cells effectively because something is wrong with the outer surface of the cells. Researchers have found that insulin normally reacts with specific chemicals, called receptors, on the cells’ outer membranes. If there are not enough of these receptors, or if they become less receptive to insulin, the hormone will not be able to help glucose get into the cells. This condition is called insulin resistance.

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