The BMA family doctor home adviser

319 Pages·2001·17.06 MB·English

by  Tony Smith

The British
Medical Association
FAMILY
W
E
N
DOCTOR
HOME ADVI SER
Medical Editors
D T S & D S D
R ONY MITH R UE AVIDSON
A Dorling Kindersley Book

LONDON,NEWYORK,MUNICH,MELBOURNE,DELHI
BRITISH MEDICAL ASSOCIATION
CHAIRMANOFTHECOUNCIL Dr Ian Bogle
TREASURER Dr W J Appleyard
CHAIRMANOFTHEJOURNALCOMMITTEE Sir Anthony Grabham
MEDICAL EDITORS AND CONSULTANTS
MEDICALEDITORS
Tony Smith MABMBCH, Sue Davidson MBBSMRCPMRCGPDRCOG
MEDICALCONSULTANTS
Sir Peter Beale KBEFRCPFFCMFFOMDTM&H, Peter Cantillon MSc MRCGP,
Mark Furman MRCPCH, Stephen Hughes MRCPCH, Warren Hyer MBChBMRCPMRCPCH,
Penny Preston MBChBMRCGP, Andrew Shennan MBBSMRCOGMD,
Frances Williams MAMBBChirMRCPDTM&HMRCPCH
DORLING KINDERSLEY
EDITORIALMANAGER Andrea Bagg
SENIORARTEDITOR Marianne Markham
SENIOREDITORS Mary Atkinson, Nicki Lampon, Andrew Macintyre
EDITORS Jolyon Goddard, Katie John, Janet Mohun, Teresa Pritlove, Hazel Richardson
ARTEDITORS Janice English, Chris Walker DESIGNASSISTANCE Sara Freeman DTP DESIGNERS Julian Dams, John Goldsmid,
Jason Little, Louise Paddick PICTURERESEARCHASSISTANT Marie Osborn PRODUCTIONMANAGER Michelle Thomas
OUT-OF-HOUSETECHNICALSERVICESMANAGER Nicola Erdpresser
SENIORMANAGINGEDITOR Martyn Page
MANAGINGARTEDITOR Louise Dick
ARTDIRECTOR Bryn Walls
DK INDIA
MANAGINGEDITOR Prita Maitra
MANAGINGARTEDITOR Shuka Jain
PROJECTEDITOR Atanu Raychaudhuri EDITORS Chandana Chandra, Sudhanshu Gupta
PROJECTDESIGNER Sabyasachi Kundu DESIGNER Sukanto Bhattacharjya
DTP COORDINATORANDSOFTWARETRAINER Jacob Joshua DTPDESIGNER Shailesh Sharma
HEADOFPUBLISHING Anita Roy
The British Medical Association New Family Doctor Home Adviser is not a substitute for medical diagnosis.
You are advised always to consult your doctor for specific information on personal health matters.
The naming of any organization, product, or alternative therapy in this book does not imply BMA endorsement;
the omission of any such names does not indicate BMA disapproval.
First published in Great Britain in 1986 by Dorling Kindersley Limited, London
First published in paperback in 1989, reprinted 1990
Second edition 1992, reprinted 1992, 1994, 1995, 1996, 1997
Third edition 2001
Published in the United Kingdom by Dorling Kindersley Limited
80 Strand, London WC2R 0RL
A Penguin Company
4 6 8 10 9 7 5 3
Copyright © 1986, 1992, 2001 Dorling Kindersley Limited, London
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted in any form or by any means, electronic, mechanical, photocopying, recording,
or otherwise, without the prior written permission of the copyright owner.
A CIP catalogue record for this book is available from the British Library.
ISBN 0-7513-2168-0
Colour reproduction by Colourscan, Singapore
Printed and bound in Spain by AGT, Toledo
see our complete catalogue at
www.dk.com
F
OREWORD
Attitudes to illness have changed enormously in recent years. People now
expect that treatment of even the most serious disorders is likely to be
successful. In general, people are more knowledgable about health. When
they or their children become ill, they want to know the likely cause of
their symptoms and how quickly they may expect to get better.
At the same time, we are now more self-reliant. Most of us realize that
the majority of common, minor illnesses such as a cold or an attack
of diarrhoea do not need expert medical assessment or complex drug
treatments. These disorders are self-limiting – we can expect to get
better, even if no treatment is given.
The problem for people without medical training is that some symptoms
such as a headache or a cough may be the first warning of a serious illness.
Few events can be more alarming or make a parent feel more helpless than
the sudden illness of a child – especially in children too young to describe
their symptoms clearly. For how long does a sensible person deal with
the problem at home? When should you call your doctor or talk to an
information service such as NHS Direct? And when do you need to make
an urgent visit to the hospital’s accident and emergency department?
Following the easy-to-read charts in this book will help you to tell the
difference between minor problems and conditions that need immediate
medical attention. No book can teach you how to make a medical
diagnosis, and this is not a guide to being your own doctor. What it does
do, however, is to tell you when and for how long you may safely wait for
things to get better naturally. It gives practical advice on the use of home
remedies and over-the-counter drugs and so encourages self-reliance when
that makes sense. If you do need to see a doctor, the charts tell you whether
you need emergency help, an urgent appointment, an appointment within
24 hours, or just a routine one. This book will give you the information
you need to make the best use of your doctor.
The charts in this book have been developed by doctors and reviewed
by medical experts. We hope that this book will make an important
contribution to giving people more control over their own health.
DR TONY SMITH & DR SUE DAVIDSON
MEDICAL EDITORS
CONTENTS
C
ONTENTS
HOW TO USE THIS BOOK.........................8 30 Hearing problems..........................104
SYMPTOM CHARTS
31 Runny or blocked nose...............106
43–288
32 Sore throat.........................................107
YOUR BODY AND HEALTH 33 Coughing...........................................108
9–42 HOW TO USE THE CHARTS..................44 34 Breathing problems.......................110
System-by-system chartfinder..................46
35 Mouth problems.............................112
YOUR BODY...................................................10 Symptom-by-symptom chartfinder.......48 36 Teeth problems................................114
Skeleton..............................................................10 37 Eating problems..............................116
Muscles...............................................................11 CHARTS FOR CHILDREN 38 Vomiting in children.....................118
49–144
Cardiovascular system................................12 39 Abdominal pain..............................120
Respiratory system.......................................13 Contents.............................................................49 40 Diarrhoea in children...................122
Nervous system..............................................14 CHILDREN: BABIES 41 Constipation.....................................124
The senses.........................................................15 UNDER ONE...........................................50–65 42 Abnormal-looking faeces...........125
Digestive system.............................................16 1 Sleeping problems in babies........50 43 Urinary problems...........................126
Endocrine system..........................................17 2 Excessive crying................................52 44 Toilet-training problems.............128
Lymphatic system..........................................17 3 Fever in babies...................................54 45 Genital problems in boys...........130
Urinary system................................................18 4 Vomiting in babies...........................56 46 Genital problems in girls............132
Male reproductive system.........................19 5 Diarrhoea in babies.........................58 47 Painful arm or leg..........................133
Female reproductive system.....................20 6 Feeding problems..............................60 48 Joint and back problems............134
Conception and pregnancy.......................21 7 Slow weight gain...............................62 49 Foot problems.................................136
The newborn baby.......................................23 8 Skin problems in babies.................64 50 Limping..............................................138
TGhroe wgrtho wchinagr tcsh...i.l..d....................................................................................2246 CHILDREN: ALL AGES....................66–138 CHILDREN: ADOLESCENTS.......139–144
9 Feeling generally unwell................66 51 Adolescent weight problems.....139
HEALTHY LIVING........................................28 10 Tiredness...............................................68 52 Adolescent behaviour
A healthy diet..................................................28 11 Sleeping problems in children....70 problems.............................................140
53 Problems with puberty
Exercise..............................................................29 12 Growth problems.............................72 in boys.................................................142
Alcohol...............................................................30 13 Excessive weight gain.....................74 54 Problems with puberty
Tobacco..............................................................31 14 Fever in children...............................76 in girls..................................................143
Drugs...................................................................31 15 Rash with fever.................................78 55 Adolescent skin problems..........144
Sex and health................................................32 16 Skin problems in children............80
Stress...................................................................32 17 Hair, scalp, and nail problems...82
GENERAL CHARTS FOR ADULTS
Safety and health...........................................33 18 Itching....................................................84 145–240
19 Lumps and swellings.......................85
PROFESSIONAL HEALTHCARE..............35 20 Dizziness, fainting, and Contents..........................................................145
Healthcare throughout life.......................35 seizures..................................................86 56 Feeling unwell..................................146
Visiting your doctor.....................................35 21 Headache..............................................88 57 Tiredness............................................147
Health checks and screening...................36 22 Confusion and/or drowsiness.....90 58 Loss of weight.................................148
Immunization..................................................37 23 Clumsiness...........................................92 59 Overweight........................................150
24 Speech difficulties.............................93 60 Difficulty in sleeping....................152
MEDICAL TESTS..........................................38 25 Behaviour problems........................94 61 Fever.....................................................154
Testing samples..............................................38 26 School difficulties.............................96 62 Excessive sweating.........................156
Physiological tests.........................................39 27 Eye problems......................................98 63 Headache...........................................158
Imaging tests....................................................39 28 Disturbed or impaired vision...100 64 Feeling faint and passing out...160
Endoscopy.........................................................42 29 Painful or irritated ear.................102 65 Dizziness............................................162
6
CONTENTS
66 Numbness and/or tingling.........163 110 Painful joints....................................228 142 Weight problems and
67 Forgetfulness and/or 111 Painful shoulder.............................230 pregnancy..........................................279
confusion............................................164 112 Painful arm.......................................231 143 Vaginal bleeding in
68 Twitching and/ortrembling......166 113 Painful leg..........................................232 pregnancy..........................................280
69 Pain in the face................................167 114 Painful knee......................................234 144 Abdominal pain in
70 Difficulty in speaking...................168 115 Swollen ankles.................................235 pregnancy..........................................281
71 Disturbing thoughts and 116 Foot problems.................................236 145 Skin changes in pregnancy........282
feelings.................................................169 117 Back pain...........................................238 146 Swollen ankles in pregnancy....283
72 Depression.........................................170 118 Painful or stiff neck......................240 147 Back pain in pregnancy..............284
73 Anxiety................................................172 148 Recognizing the onset of
74 Lumps and swellings....................174 labour..................................................285
149 Breast problems and
75 Itching.................................................175 CHARTS FOR MEN
pregnancy..........................................286
76 Hair and scalp problems............176 241–254
150 Depression after childbirth.......288
77 General skin problems................178 Contents..........................................................241
78 Skin problems affecting 119 Bladder control problems
the face................................................180 in men..................................................242 FIRST AID
79 Skin discoloration and 120 Problems with the penis.............244 289–302
moles....................................................182 121 Erection difficulties.......................246
80 Rash with fever...............................184 122 Ejaculation problems...................247 FIRST AID......................................................290
81 Nail problems..................................185 123 Testes and scrotum ABC of resuscitation.................................290
82 Painful or irritated eye................186 problems............................................248 Action in an emergency...........................291
83 Disturbed or impaired 124 Painful intercourse in men........249 Recovery position.......................................292
vision...................................................188 125 Low sex drive in men..................250 Artificial respiration..................................293
84 Hearing problems..........................190 126 Fertility problems in men..........252 Choking..........................................................294
85 Noises in the ear............................192 127 Contraception choices Cardiopulmonary resuscitation
86 Earache...............................................193 for men................................................254 (CPR)............................................................296
87 Runny or blocked nose...............194 Shock................................................................298
88 Sore throat........................................195 Anaphylactic shock...................................298
89 Hoarseness or loss of voice.......196 CHARTS FOR WOMEN Severe bleeding............................................299
255–288
90 Wheezing............................................197 Severe burns..................................................299
91 Coughing............................................198 Contents..........................................................255 Unconsciousness..........................................300
92 Shortness of breath.......................200 128 Breast problems..............................256 Major seizures..............................................300
93 Chest pain.........................................202 129 Bladder control problems Spinal injury..................................................301
94 Palpitations.......................................204 in women...........................................258 Fractures.........................................................301
95 Teeth problems...............................206 130 Absent periods................................260 Swallowed poisons.................................... 302
96 Mouth problems............................208 131 Heavy periods..................................262 Bites and stings............................................302
97 Difficulty in swallowing.............209 132 Painful periods................................263
98 Vomiting............................................210 133 Irregular vaginal bleeding..........264 DRUGS GUIDE AND
99 Recurrent vomiting.......................212 134 Abnormal vaginal discharge.....266 USEFUL ADDRESSES
100 Abdominal pain..............................214 135 Genital irritation............................268 303–313
136 Lower abdominal pain
101 Recurrent abdominal pain........216
in women...........................................269
102 Swollen abdomen..........................218 DRUGS GUIDE.............................................304
137 Painful intercourse in
103 Wind....................................................219 women.................................................270 How drugs affect you...............................304
104 Diarrhoea..........................................220 138 Low sex drive in women............272 Using drugs safely.......................................304
105 Constipation....................................221 139 Fertility problems in women....274 A–Z of drugs.................................................305
106 Abnormal-looking faeces...........222 140 Contraception choices USEFUL ADDRESSES.................................311
107 Anal problems.................................223 for women.........................................276
108 General urinary problems.........224 141 Nausea and vomiting
109 Painful urination............................226 in pregnancy.....................................278 INDEX & ACKNOWLEDGMENTS.....314
7
HOW TO USE THIS BOOK
H
OW TO USE THIS BOOK
The major part of this book consists of 150 question-and- healthy precedes the charts, and, after them, you can find
answer symptom charts, which help you determine the information on dealing with major emergencies. The book
possible cause of a symptom and what to do. Background concludes with useful information on drugs and how to
information on how the body works and how to keep it contact support groups or find further health information.
Your body and health
YOUR BODY AND HEALTH YOUR BODY AND HEALTH YOUR BODY AND HEALTH YOUR BODY AND HEALTH
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10 11 34 35
Symptom charts
ADULTS: GENERAL ADULTS: GENERAL ADULTS: WOMEN ADULTS: WOMEN
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First aid Finding information
FIRST AID FIRST AID
Recovery position Artificial respiration
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292 293 CHARTFINDERS The system-by-system
chartfinder (pp.46–47) groups the charts by
Drugs guide and DRUGS GUIDE USEFUL ADDRESSES body system or process, and the symptom-
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8
YOUR BODY AND HEALTH
Y B
OUR ODY
& H
EALTH
Understanding how your body works and
how to look after yourself are essential if you
want to stay healthy. This section starts by
explaining the structure and function of the
major body systems. It then looks at how you
can modify your lifestyle to prevent health
problems from developing. The final parts of
the section describe how you can make the
best use of the help that health professionals
offer and how medical problems are
investigated should they occur.
9
YOUR BODY AND HEALTH
Y
OUR BODY
Skeleton Types of joint
Joints are formed where two or more bones meet. Different types
The skeleton provides form, support, and protection for the
of joint allow for differing degrees of movement. A few joints, such
body. It consists of 206 bones, with further support from as those in the skull, are fixed. Semimovable joints, such as those
cartilage (a tough, fibrous material). The axial skeleton – the in the spine, provide stability and some flexibility. The majority of
skull, spine, and ribcage – consists of 80 bones and protects joints, known as synovial joints, move freely. The main types of
the brain, spinal cord, heart, and lungs. The appendicular synovial joint, and their planes of movement, are illustrated below.
skeleton has 126 bones and consists of the limb bones,
collarbones, shoulder blades, and bones of the pelvis. All
bones are living tissue with cells that are constantly replacing
old bone with new material. Bones
contain a soft, fatty material Skull
called bone marrow; this is PIVOT JOINT
Jawbone BALL-AND-
surrounded by spongy bone, (mandible) SOCKET JOINT
which is in turn surrounded by
denser compact bone. The
Collarbone
marrow in the bones of the (clavicle)
spine, skull, ribs, and pelvis
manufactures blood cells.
Shoulder blade ELLIPSOIDAL JOINT
SADDLE JOINT
(scapula)
Breastbone (sternum)
Humerus
Rib
PLANE JOINT HINGE JOINT
Spine The spine
Cervical
The spine, also known as the vertebral
Ulna vertebrae
column, maintains the body in an
(7 bones)
upright position, supports the head, and
Radius
encloses and protects the spinal cord. It
consists of 33 bones called vertebrae.
Wrist bones
(carpals) Joints and discs of fibrous tissue between
most of the vertebrae make the spine
Hand bones flexible, while ligaments and muscles
(metacarpals) Thoracic stabilize it and control movement.
vertebrae
Finger bones (12 bones)
(phalanges) Pelvis
Kneecap
(patella)
Femur Soft Fibrous
core covering
Lumbar
Compact Spongy Bone Fibula vertebrae SECTION OF INTERVERTEBRAL DISC
bone bone marrow (5 bones)
Tibia Intervertebral disc
Vertebra
Ankle bones
(tarsals)
Areas
where ribs
Foot bones are attached
(metatarsals)
Sacrum
(5 fused
bones) Ligaments
Toe bones Coccyx THORACIC
STRUCTURE OF BONE (phalanges) (4 fused bones) VERTEBRAE
10
YOUR BODY AND HEALTH
Muscles Types of muscle
The three types of muscle are skeletal muscle, which covers and
Muscles are fibrous bundles of tissue that move the body,
moves the skeleton; cardiacmuscle, which forms the walls of the
maintain its posture, and work internal organs such as
heart; and smooth muscle, found in the walls of the digestive tract,
the heart, intestines, and bladder. These functions are the blood vessels, and the genital and urinary tracts. Each type of
performed by three different types of muscle (right), of muscle has a different function and consists of fibres of a particular
which skeletal muscle makes up the greatest bulk. shape. Skeletal muscle, which moves the limbs and body, is formed
Muscles are controlled by signals from the nervous system. of long, strong, parallel fibres. This type of muscle is able to contract
quickly and powerfully, but can
Skeletal muscle can be controlled consciously, while the other Long, parallel fibres
work at maximum strength only
types work automatically. Most skeletal muscles connect
for short periods of time. Heart
two adjacent bones. One end of the muscle is attached by
muscle pumps blood around
a flexible cord of fibrous tissue called a tendon; the other is
the body. It comprises short,
attached by a tendon or by a sheet of connective tissue. The branching, interlinked fibres that
skeletal muscles not only move parts of the body but also form a network within the walls
help to maintain the posture when a person is standing, of the heart. This type of muscle
sitting, or lying down. The names of some muscles suggest can work continually without
their functions. Extensors straighten joints, flexors bend tiring. Smooth muscle carries
out functions such as moving
joints, adductors move limbs towards the body, abductors
food through the digestive tract.
pull limbs outwards, and erectors raise or hold up parts of
It is composed of short, spindle-
the body. Some of the main skeletal muscles are illustrated
shaped fibres that are connected
below. Deeper muscles are shown on the left of each image to form sheets, and can work for
and the more superficial muscles are shown on the right. SKELETAL MUSCLE prolonged periods.
Occipitofrontal Temporoparietal Temporoparietal
How muscles work
Splenius
Orbicular of mouth
Orbicular of eye of head Semispinalis of head
Smaller pectoral Movement occurs when signals
Greater pectoral Erector Trapezius from the nervous system cause
Internal of spine
muscles to contract. Conscious
intercostal
Deltoid Deltoid movements of the body are
External produced by the interaction of
Latissimus
intercostal
dorsi skeletal muscles, bones, and
joints. Most muscles connect one
Biceps
of arm bone to another and cross a joint.
When a muscle contracts, it pulls
Deep Triceps
flexor of of arm on the bones to move them.
fingers Many muscles are found in pairs,
Extensor one on each side of a joint, and
of fingers produce opposing movements.
Gluteus For example, in the upper arm the
minimus
triceps contracts to pull
Ulnar
Quadrate the arm straight and
extensor
of thigh the biceps contracts
of wrist
to bend the arm.
Triceps contracts
Internal
oblique of Biceps relaxes
abdomen
Abductor
of finger Gluteus
Long maximus
adductor
of thigh Sartorius
Biceps STRAIGHTENING THE ARM
Popliteal of thigh
Gracilis Rectus
of thigh Gastrocnemius Triceps relaxes
Gastrocnemius
Anterior Soleus
tibial Posterior
Long extensor tibial Achilles
of toes tendon
Long
Short extensor Short
flexor of
of big toe extensor
big toe
of toes Biceps contracts
Abductor
of big toe BENDING THE ARM
FRONT VIEW BACK VIEW
11