Because the brain closely fills the tight compartment of the rigid skull, any added substance inside the skull cavity, be it a hemorrhage, an infection of the brain (encephalitis), or the covers of the brain (meningitis), or increase in blood circulation, or swelling of the brain (edema) due to an allergy or brain in jury, or a new growth in the brain (brain tumor), will cause severe and constant headache until the increase in intracranial (intra-skull) pressure is relieved by spinal puncture (which removes fluid from the brain), by brain surgery, by drugs, or by the natural course of events.

Because of the important centers located in the brain and because of the fixed space inside the skull, any tumor or growth in the brain, whether benign or malignant, has to be considered malignant, since prolonged continuation of the increased intracranial pressure can produce blindness, or paralysis of one side of the body, convulsions, severe head­ache and vomiting.

It is therefore important that any sudden and persistent headache should obtain the early study and attention of a neurologist. Of course, some common sense has to be employed in such decisions, since every headache does not warrant an urgent rush to a neurologist, any more than every pimple or spot on the skin means cancer and a rush for a biopsy. When in doubt, however, it is wisest to consult a responsible authority on the subject.

Types of Brain Tumor

There are many types of brain tumor. Some are easy to reach, especially if they are located near the skull, and may be removed completely. Others are deep seated in the brain and invade large areas of its substance, so that complete removal could only be accomplished at the risk of causing further damaging symptoms, paralysis, or even death. In such situations, a small portion of the brain tumor is removed to allow for the release of the increased intracranial pressure and the temporary easing of the symptoms, with the full understanding that the unremoved parts will continue to grow and lead to paralysis, numbness, blindness, vomiting, wasting of the body and ultimate death. Deep x-ray treatment into the brain can sometimes retard the speed of growth of special types of tumor. Certain tumors such as a glioma grow very slowly and, if situated in a so-called “silent area” of the brain, may not disable the patient severely for many years. When I was 15 years of age, an older brother of a friend had a glioma removed from the cerebellum part of the brain and continued to conduct his small business. When I was 25 years of age, he had a second operation for the removal of a remnant of the same tumor, which in the course of years had grown to large size. When I was 35, he had the third operation for the same regrown tumor, following which he became totally disabled. Research is continuing in many medical centers of the country for better methods of destroying brain tumors without injury to the patient.

Almost every physical disorder has some connection with emotional factors. Even accidental injuries such as broken bones seem to happen more often to children with disturbed home backgrounds than to others. A psychosomatic disease, sometimes called a psychogenic disease, is one in which emotional factors are not merely present, but are dominant. This appears to be the case, for example, in many skin disorders, migraine, some types of asthma, and some gastrointestinal disorders.The term “psychosomatic” should not be used in a derogatory sense, with the suggestion that psychosomatic illnesses are imaginary. They are not. They are real physical conditions. Imaginary physical disorders that are caused entirely by mental illness are called hysteria.

You know from experience that your state of mind affects your body. For instance, your heart beats faster when you are excited or frightened, a stomachache often follows an emotional scene, fear can make you sweat, and so on. These are simple examples of the interaction of the body with the mind under stress. There are far more complex links known, such as one between chronic anxiety and duodenal ulcers, though the mechanism of the linkage is not clearly understood.

There is much to be learned about psychosomatic illnesses. It may be that emotional stress is a final factor or “last straw” in precipitating health problems in people who have some genetic susceptibility to a disease already. Significantly, a tendency to develop disorders such as asthma, eczema, irritable colon, or migraine under stress seems to run in families.

What is The Treatment?

If you develop an illness that is known to have a psychosomatic element, your physician may ask questions about your lifestyle. If straightforward medical treatment does not relieve your symptoms, he or she may begin to concentrate on helping you to handle the stresses of your day-to-day life. The knowledge that you can probably avoid or lessen certain symptoms by avoiding certain emotional strains may be helpful. For example, relaxation exercises, together with a change or two in your daily routine, can be particularly helpful in treating vascular, or circulatory, disorders such as some types of high blood pressure.

What is this Condition?

Peritonitis is an acute or chronic inflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the abdominal organs. The inflammation may extend throughout the peritoneum or may create an abscess in one spot.

Peritonitis commonly decreases the intestine’s action and causes it to bulge with gas. The death rate is 10%. Mortality was much higher before the advent of antibiotics.

What Causes it?

In peritonitis, bacteria invade the peritoneal membrane. The bacteria typically come from the digestive tract during traumatic disorders such as appendicitis, diverticulitis, peptic ulcer, ulcerative colitis, volvulus, strangulated bowel obstruction, an abdominal tumor, or a stab wound. Peritonitis can also be a chemical inflammation. This can follow rupture of a fallopian tube, ovarian tube, or the bladder. Other possible causes include perforation of a gastric ulcer or release of pancreatic enzymes. In both types of inflammation, accumulated fluids containing proteins and electrolytes make the normally transparent peritoneum red, inflamed, and swollen.

What are its Symptoms?

The person with peritonitis feels sudden, severe, and widespread abdominal pain that tends to intensify and localize in the area of the underlying infection. For instance, if appendicitis causes the rupture, pain focuses in the lower right abdomen.

The person is often weak, pale, sweating, and has cold skin due to excessive loss of fluid, electrolytes, and protein into the abdominal cavity. Intestinal muscles stop working and the resulting obstruction causes nausea, vomiting, and abdominal rigidity.

Other symptoms include light-headedness, irregular heartbeat, signs of dehydration (thirst, dry swollen tongue, pinched skin), acutely tender abdomen, and a fever. Inflammation of the peritoneum around the diaphragm may cause shoulder pain and hiccups. Abdominal pressure can interfere with breathing. Typically, the person with peritonitis tends to breathe shallowly and move as little as possible to minimize pain.

How is it Diagnosed?

Severe abdominal pain in a person with tenderness suggests peritonitis. The doctor will use abdominal X-rays to confirm that the small and large bowels are distended. If the person has perforation of a visceral organ, the X-ray shows air in the abdominal cavity. Other tests that may provide information include chest X-ray, blood studies, paracentesis, and laparotomy.

How is it Treated?

The doctor will try to treat any digestive tract inflammations early enough to prevent peritonitis. After peritonitis develops, however, the doctor will take emergency measures to combat infection, restore intestinal activity, and replace fluids and electrolytes.

Massive antibiotic therapy usually includes administration of Mefoxin with an aminoglycoside or Bicillin L-A and Cleocin with an aminoglycoside, depending on the infecting organisms. To decrease muscle movement and prevent perforation, the person should receive nothing by mouth, but should receive supportive fluids and electrolytes intravenously.

Surgical Treatment

When peritonitis is caused by perforation, surgery is necessary as soon as the persons condition is stable enough to tolerate it. To prepare the person for surgery, the doctor will give pain relievers and use a nasal tube to relieve pressure in the bowel and, possibly, a rectal tube to help the person pass gas.

The surgeon’s job is to eliminate the source of infection by evacuating the spilled contents and inserting drains. Occasionally, a tube is used to remove accumulated fluid. Irrigation of the abdominal cavity with antibiotic solutions during surgery may be appropriate in some cases.