Heat rash takes the form of tiny blebs (or blisters) which appear in newborn babies.

Sweat glands are not fully developed in babies, and can become blocked if the baby is too hot. This is why miliaria is commonly seen in newborn babies during summer. It may also appear during a fever, or simply when a baby has been overdressed.

Clinical features

Pinkish blebs or small blisters usually appear over the face, neck and in skin folds, especially in the nappy area. If infected, they may become pus-filled.

Treatment

A tepid bath, light clothing and some fresh air is usually all that is needed for miliaria to disappear. The rash should disappear in 2-3 days. If your baby is scratching the spots, try applying some calamine lotion. Other creams or ointments are useless, and may in fact worsen the rash.

When to see your doctor

• if the spots become red or pus-filled (green). This means that they have become infected, and need treatment;

• if the rash lasts more than 2-3 days;

• if in addition to having a rash, your baby is generally unwell, has a fever or is not feeding well.

Complications

Infection (see above). ,

Prevention

Try not to overdress your baby. Carefully dry all skin folds after each bath.

Don’t dismiss every rash as ‘just a heat rash’. If in doubt, check with your health professional.

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Health issues are often covered in newspapers and magazines, and on radio and television. The coverage of health issues in the media tends to be simplistic, and reports of new findings or new treatments are often sensationalised. Ask your doctor for information on issues of interest to you, as you are much more likely to obtain accurate and appropriate information.

Hospitalisation is a major stress for the child, and usually for the parents and the rest of the family too. Many parents find the hospital environment impersonal and a little intimidating. It is sometimes disconcerting to have to relate to different health professionals, to have to repeat the medical history a number of times, and to have your child disturbed frequently by repeated examinations or tests. Nurses and doctors may change according to their rosters, so discontinuity of care is the rule rather than the exception. All this can exacerbate your understandable anxiety about the health of your child. The child himself experiences major changes to his routine, a new and sometimes threatening environment, and often pain and a loss of physical well-being. There are a number of things that parents can do to make this time easier for the child and for themselves.

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ABSENCE OF ORGASMIC CONTRACTIONS: I can enjoy the whole thing, but I do not come. I can go on and on, but I will not, I cannot come.

It gets so bad that I am actually screaming inside at myself to come, come, come. My partner says it. Come, come, come. I can’t, can’t, can’t.

Guess again which report belongs to which gender. The first is a wife, the second a husband. The similarity of sexual response and problems seems clear. Both genders reported problems with orgasmic contractions. One hundred fifty-five husbands and 344 wives reported such problems. When this problem occurred, it took with it in many cases the possibility of psychasm, for these people were taught that orgasm was the ultimate goal, the only goal of the sexual encounter. Without pelvic contractions, there could be no “fulfillment.” This is not true, and, in fact, these spouses learned to enjoy psychasm independent of contractions. When this happened, and the defeated, angry orientation at the center of this problem was removed, orgasmic contractions returned.

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The super marriage can expand and contract, allow closeness without crowding and distance without diffuseness. A super

marriage is a super system that flows between neguentropy and entropy in an intimate rhythm of life and growth for both partners, a universal dance of intimacy, a Tao of sexuality.

The husband in our example reported, “I really cannot imagine life without her. We just are like one in a strange sort of way. A dance with no song.”

The wife added, “Well, he is not a part of me, I mean a part of me like my, I mean our, children are. I have become a part of him, an extension, sucked into his life. It’s the way a black hole must be, a spiral, with me going down further and further into him.”

This same compensated pattern was reported in the bedroom. “The more things change, the more they stay the same,” said the husband. “We just repeat the same things in the same way. We could practically just call out the numbers or use hand signals. I lie on my right side, stimulate her, then we do it. That only changed once when I broke my right arm in a softball game. I was on her left side then, and it was like making it with a different woman.”

“It’s like a merry-go-round without the merry,” added the wife. “He sort of works on me. He wants me to suck him after I come because that’s the only time I can force myself to do it. Then he goes in, does it, the end.”

Each time this couple makes love, the neguentropy, the merging, becomes stronger. They do not become more intimate, they become more trapped, stuck with each other and suffering together. They crash rather then merge. They have a type of marital implosion.

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Even when the diagnosis appears certain, it may be necessary for the doctor to carry out a number of specific tests, such as a cardiograph, X-rays or blood examinations, to convince both the patient and himself that there is no underlying organic cause.

It is important for the doctor to give his patient a full explanation of how the symptoms have come about. If the doctor merely tells his patient that the problem is due to “nerves” and gives him a prescription for a tranquilliser, the patient will go away unconvinced.

The doctor should treat these patients with sympathy and understanding. He should not make value judgments about their ability to cope with their stresses. They are suffering from a real illness, even if it tests his ability in diagnosis and treatment.

Teaching the person how to relax and come to terms with the stresses of life is also important.

It may be necessary to use drugs to modify the response of the various organs to these nervous influences. Antispasmodic drugs may stop the overactivity of the bowel in nervous diarrhoea or other drugs slow the heart’s action.

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Depression can happen to anyone but is more likely in those with certain personalities.The over-conscientious or the compulsive-obsessive personality are more prone.

The house-proud housewife who is a perfectionist in her outlook falls into this category.

The woman who washes on a certain day, shops on another and who must stick to her routine, no matter what, is often deeply anxious and can only cope with her anxieties by adhering to a routine. If this routine is upset and she loses control of it, she may slip into depression.

The same may apply to the male clerk or executive who has a fixed routine and high expectations of his own efficiency.

He is critical of his own work and that of others and cannot delegate responsibility, nor can he accept his own ‘weaknesses’ if he becomes emotionally ill. These people often exhibit what is called masked depression.

Heredity may play a part in depression, as it appears to run in families. There is also the environmental influence of the family.

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Cystic fibrosis is a common childhood disorder, yet few people know about it.

In Australia, one child in 2500 is born with it, and one person in 25 carries the recessive gene which causes it.

Eighty children with this disease will be born each year in Australia.

Cystic fibrosis (CF for short) is a genetic disorder. Because it is caused by a recessive gene it will develop only if a child receives two recessive genes, one from each parent.

If he has only one such gene, the disease does not develop. That person, however, is a carrier.

If one child in a family has the disease, then each subsequent child will have a risk of one in four of having the same disease.

The basic problem in cystic fibrosis is that there is a widespread disorder of mucus-secreting glands.

It particularly affects the lungs and the pancreas which lies high up on the back wall of the abdomen behind the stomach.

It has two main functions. One is to produce enzymes, and this is the part affected in cystic fibrosis, which pass along a small duct to the first part of the small bowel. These enzymes are necessary for the proper digestion of fat and protein.

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Body odor is a common, distressing, and embarrassing problem that is not always easy to prevent, correspondence in the Western Journal of Medicine (146:367) reports.

In one case, an extremely foul body odor had suddenly developed and had persisted in spite of all attempts to control it with special soaps, extra bathing, and frequent changes of antiperspirant and deodorant.

On carefully reviewing this man’s routine, his doctor discovered that he had recently started using Fresh Start laundry detergent, and suggested that he try another one. The man did so and was pleased to find that his odor problem immediately went away. Furthermore, now that he understood the problem, he was able to explain why his body odor returned not long after he had put on clothing which had been laundered with Fresh Start.

Obviously, the odor was produced by some kind of reaction occurring between his skin chemistry and the detergent residue in his clothes. Others with stubborn cases of B.O. might also wish to try using another detergent brand.

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