Office of the Chief Rabbi


By L. Varek. Saint Leo University. 2019.

Until the development and acceptance of theory about germs in the nine- teenth century erectafil 20 mg lowest price, folk medicine and orthodox medicine again shared similar or the same conceptions of contagion and how to deal with it buy erectafil 20mg online. One significant difference between the two, however, concerned the folk medical notion that some diseases could not be destroyed and so cures could be achieved only by ritually transferring the illness to someone or something else. In the early seventeenth century Issobell Haldane explained how she cured a child by washing its shirt in some water in the name of the Trinity. On the way, however, she was cross with herself for having spilt some of the water because, if anyone passed over it, the disease would be transferred to them rather than being washed away in the stream. Here hepatitis is known as the mal d’arco or ‘rainbow illness’ and is thought to be contracted by looking at a rainbow while urinating outdoors, or by walking along a crossroad contaminated with the disease. It is cured by the patient urinating for several nights in a pot containing the plant common rue (Ruta graveolens). Ancient Greek physicians believed that health was governed by the balance of four substances or humours, namely yellow bile, black bile, blood and phlegm. Illnesses were caused by the imbalance of these substances, which Traditional European folk medicine | 29 led to excessive heat/cold, moistness/dryness in the body. Cures required the ingestion of foods, liquids or herbs that had hot/cold, wet/dry properties, which counteracted the identified imbalance, or methods such as bleeding, which reduced humoral excesses. In European popular culture people did not necessarily conceptualise health in humoral terms, but their practices and aeti- ologies were based on the theory as much as legitimatised medicine. Once the European medical community had rejected it by the end of the eighteenth century, however, its continued influence became a marker of scientific back- wardness. In its myriad manifestations it had its own distinct identity in local, regional and national contexts. Influence of religion Many aspects of folk medicine were and are inseparable from popular or practical religion. The sacrament of ordination was thought to imbue the Catholic priesthood with the healing power of God’s grace, while in Protes- tant communities ministers and pastors continued to play an important role as healers, using prayer and their literary knowledge of medicine.

Berkeley Wellness recently summarized the meditation data: “Subjecting meditation to scientific testing is a challenge buy erectafil 20mg without a prescription. And other forms of relaxation training (for instance order 20mg erectafil overnight delivery, progressive muscle relaxation, biofeedback, and stress management) may be just as useful. Still, research over the past 30 years suggests that mindfulness meditation may help in conditions such as insomnia, chronic pain, psoriasis, fibromyalgia, and some psychiatric disorders. It has been shown to alter aspects of the immune, nervous, and endocrine system and produce changes in areas of the brain associated with memory, learning, and emotion. Research suggests it may be particularly useful in helping people adhere to medical treatment and cope with pain, as well as reduce anxiety and depression 33 associated with illness. According to Gordon, when your belly is soft, all of the other muscles in your body begin to relax as well. Thus, “soft belly can help quiet the mental and physical agitation, the persistent fight-or-flight response, and the chronic stress, [as well as the] exhaustion, hopelessness, and self-condemnation, when we 34 are depressed. Deeply relax all your muscles, beginning at your feet and progressing up to your face. When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes opened. Do not worry about whether you are successful in achieving a deep level of relaxation. When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating “one. Practice the technique once or twice daily, but not within two hours after any meal, since the digestive processes seem to interfere with the elicitation of the relaxation response. Coining the term “relaxation response,” which the Mayo Clinic calls the “rest and digest” response, Benson identified the body’s physiological reaction that is the exact opposite of, and necessary complement to, the stress (fight-or-flight) response.

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This is because reflects distribution from the central to the peripheral com- most drugs are used therapeutically at doses that give rise to partment discount 20 mg erectafil with amex. Drugs that show non-linear kinetics in the therapeutic range include heparin cheap erectafil 20mg amex, phenytoin and ethanol. Implications of non-linear pharmacokinetics include: Although many drugs are eliminated at a rate that is approxi- mately proportional to their concentration (‘first-order’ kinet- 1. Instead, elimination Consider a drug that is eliminated by conversion to an inactive metabolite by an enzyme. The drug concentration and reac- 100 tion velocity are related by the Michaelis–Menten equation (Figure 3. At low concentrations, the rate is linearly related Blood sample 10 Drug Central Peripheral (tissue) compartment compartment 1 Elimination Time Figure 3. The time required to eliminate 50% of a dose increases A young man develops idiopathic epilepsy and treatment is started with phenytoin, 200mg daily, given as a single with increasing dose, so half-life is not constant. A modest increase in dose of such a drug disproportionately phenytoin concentration is 25μmol/L. This is very week later he is complaining of unsteadiness, there is nys- important clinically when using plasma concentrations of, tagmus and the serum concentration is 125μmol/L. Comment Key points Phenytoin shows dose-dependent kinetics; the serum con- centration at the lower dose was below the therapeutic • Two-compartment model. Despite the apparently plasma concentration falls bi-exponentially, instead modest increase (to 150% of the original dose), the plasma of a single exponential as in the one-compartment concentration rose disproportionately, causing symptoms model. In: Clinical pharmacoki- Consequently, increasing the dose causes a netics: concepts and applications, 3rd edn. These are permeable to lipid-soluble drugs, whilst pre- senting a barrier to more water-soluble drugs. The most convenient route of drug administration is usually by mouth, and absorption processes in the gastro-intestinal tract are among the best understood. Unless administered intravenously, most drugs are in gut wall absorbed incompletely (Figure 4.

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Although these individuals may be subjected to stereotyping and stigma buy cheap erectafil 20 mg on line, society provides treatment and support and attempts to integrate them into the rest of the population order erectafil 20 mg free shipping. It is possible, however, that screening for such disorders would lead to terminations of pregnancy and a reduction in this stigmatized population. Although this would lead to fewer individuals with these disorders (this may be a positive consequence, as no one wants to suffer from sickle-cell anaemia) the individuals who are born with these problems may face increased stigma as they would be part of a greatly reduced minority existing in a world with reduced social provisions for support and treatment. Autonomy – the patient has a right to choose The third ethical principle is that of autonomy. This is based on the view that ‘mentally competent and mature individuals should make decisions about their own future, subject to the constraints required to ensure social order’ (Burke 1992). Proponents of screening argue that screening is central to promoting autonomy in that the individual has a right to have access to information about their health status. According to this model of screening, the doctor is the patient’s gatekeeper to relevant information. However, screening may also undermine an individual’s autonomy if it is construed as a form of social control and doctors are seen as ‘lifestyle police’. Justice – the equal distribution of resources The fourth ethical principle of justice refers to the need for an equal distribution of resources. In addition, the ‘inverse care law’ (Hart 1971), which suggests that those who seek out tests most frequently are often those who need them the least, when applied to screening, highlights a shifting of finances to the most healthy individuals in society. A cost-effectiveness analysis involves assessing either how to achieve a set objective at minimum cost or how to use a fixed resource to produce the best output. In terms of screening, this raises issues about the objectives of screening (to detect asymptomatic illness, which can be treated) and the degree of resources required to achieve these objectives (minimum interventions such as opportunistic weighing versus expensive interventions such as breast screening clinics). The economic considerations of screening have been analysed for different pol- icies for cervical screening (Smith and Chamberlain 1987).

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