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Evaluation and management of the comatose patient
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About 50 million Americans suffer from some form of arthritis, 30 million people suffer from low back pain, millions suffer from arthritic neck pains, and 200,000 children are affected by the juvenile form of arthritis. Once any of these conditions establishes in an individual, it becomes a sentence for suffering during the rest of the individual's life—unless the simplicity of the root-cause of the problem is fully understood.

Initially, rheumatoid arthritic joints and their pain are to be viewed as indicators of water deficiency in the affected joint cartilage surfaces. Arthritis pain is another of the regional thirst signals of the body. In some arthritis pains, salt shortage may be a contributing factor.

The cartilage surfaces of bones in a joint contain much water. The lubricating property of this 'held water' is utilized in the cartilage allowing the two opposing surfaces to freely glide over one another during joint movement.

Whereas the bone cells are immersed in calcium deposits, the cartilage cells are immersed in a matrix containing much water.

As the cartilage surfaces glide over one another, some exposed cells die and peel away. New cells take their place from the growing ends that are attached to the bone surfaces on the two sides. In a well-hydrated cartilage, the rate of friction damage is minimal. In a dehydrated cartilage, the rate of 'abrasive' damage is increased. The ratio between the rate of regeneration of cartilage cells to their 'abrasive peel' is the index of joint efficiency.

Actively growing blood cells in the bone marrow take priority over the cartilage for the available water that goes through the bone structure. In the process of dilating the blood vessels to bring more circulation to the area, it is possible that the branch that goes through a tight hole in the bone cannot expand adequately enough to cope; the cells that depend on these vessels for an increased water and nutrient supply are under a physically imposed rationing control. Under such circumstances, and unless there is blood dilution to carry more water, the 'serum' requirements of the cartilage will have to be satisfied from the blood vessels that feed the capsule of the joint. The nerve regulated shunting mechanisms (to all the joints) also produce signals of pain.

Initially, this pain is an indication that the joint is not fully prepared to endure pressure until it is fully hydrated. This type of pain has to be treated with a regular increase in water intake to produce some dilution of blood that is circulating to the area until the cartilage is fully hydrated and repaired from its base attachment to the bone—the normal bone route of serum diffusion to the cartilage. A look at Figures and 7 will help make the points clear.

It is my assumption that the swelling and pain in the capsule of the joint is an indication there is dilation and edema from the vessels that furnish circulation to the capsule of the joint. Joint surfaces have nerve endings that regulate all functions. When they place a demand for more blood circulation to the area to pick up water from the serum, the compensatory vascular expansion in the capsule is supposed to make up for the inefficiency of circulation from the bone route of supply.

Because dehydration in the joint surfaces will eventually cause severe damage—to the point of making the bone surfaces bare and exposed until osteoarthritis becomes established—the tissue damage will trigger a mechanism for remodeling of the joint There are hormone-secreting cells in the capsule of the joint. When there is damage (also from dehydration), injured tissue has to be repaired. These 'local remodeling hormones' take over and restructure the joint surfaces. It seems that they cater to the lines of force and pressure that the joints have to endure.

Unfortunately, the repair process seems to produce a deviation of the joints. To avoid such disfigurement, one should take the very initial pain seriously and begin a strict attention to daily intake of water. Initially, this pain should be recognized as a sign of local dehydration. If it does not disappear after a few days of water intake and repeated gentle bending of the joints to bring more circulation to the area, one should then consult a professional practitioner of medicine.

You have nothing to lose and everything to gain by recognizing the pain and the non-infectious inflammation of a rheumatoid joint as a thirst signal in your body. You are probably showing other signals for water shortage in your body, but this particular site is indicating predisposition to a more severe local damage.

If we understand the body to have difficulty in recognizing its thirst state, it is possible that this lower state of alertness is also inheritable by a child. It is possible that dehydration in a rapidly growing child might also indicate its presence by the pain felt in the joints as well as it can be felt in heartburn. The mode of signal production that would denote thirst might naturally be the same in the young, as well as in older people. It is therefore recommended that juvenile arthritis should also be treated with an increase in daily water intake.

As you can see, Dr. Laurence Malone, whose letter is published below, is an experienced medical doctor and an educator. His observations on the effect of water in rheumatoid joint pains in himself shows that our other colleagues in the medical profession

should begin to notice the medicinal values of water in disease prevention.

Politica de confidentialitate



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