Dr James Le Fanu: 12 April
There were, at last count, more than a hundred cures for hiccups, including the following passed on several years ago by a consultant physician who, in turn, had learned of it from Lord Rosenheim, Professor of Medicine at University College Hospital.
Soon after becoming Professor, Lord Rosenheim admitted into his care the Director of the Medical Research Council in West Africa, who had been flown back to Britain incapacitated by intractable hiccups. After a fortnight in hospital, the hiccups were as bad as ever – and Lord Rosenheim was embarrassed by his failure to effect a cure.
One evening, his patient told the ward sister that his hiccups seemed less severe on a full stomach. She gave him methylcellulose, which when taken with water expands to fill the stomach. The hiccups promptly ceased.
This and the many other remedies for hiccups illustrate the point that in medicine, as in life, there may be more than one way to skin the proverbial cat. Hiccups are due to the uncoordinated contraction of the muscles of the diaphragm squeezing air out of the lungs.
Hence any manoeuvre that dampens down the contractions is likely to help – and here there are several possibilities.
The first is to try to physically suppress the contractions by, for example, holding one’s breath. Similarly the methylcellulose remedy presumably worked by filling the stomach and thus acting as a splint against the diaphragm above it.
The second possibility is to force the diaphragm to make an unusual movement in the hope this will override its contractions – best achieved by the technique of drinking water from the wrong side of a glass.
Finally, the contractions can be restored to normal by stimulating the nerves to the diaphragm. This can be achieved by rubbing the side of the neck or stimulating the uvula at the back of the throat by swallowing dry granulated sugar.
So, the abundance of hiccup remedies is perhaps not surprising and should encourage an openminded view of what might work.
THIS WEEK’S MEDICAL QUERY comes courtesy of a lady from Kent, suffering from a spotty, swollen and very tender tongue. Her doctor diagnosed glossitis (inflammation of the tongue) and advised her to dissolve 300mg of aspirin in water and swill it round her mouth three times a day. It has, however, left her with a very salty taste in her mouth and on her lips. ‘I cannot enjoy food, and wine is undrinkable,’ she writes.
Possible causes of glossitis include an allergic reaction (eg, to toothpaste) and the fungal infection candida, but in this case it is almost certainly due to a viral infection.
The salty taste is caused by damage to the salt-sensitive buds on the tongue, which should, with luck, resolve spontaneously – although this can take time.
In the meantime, it can help (paradoxically) to wash the mouth out with a salty solution several times a day. This ‘overwhelms’ the nerve impulses from the saltsensitive taste buds – resulting in a gratifying, if transient, reduction in the intensity of the salty sensation.
drjames@lady.co.uk
‘Some years ago my husband discovered that onions were having quite lethal effects on his digestive system, resulting in extreme biliousness, a swollen mouth and headaches,’ she writes. ‘Looking back to his childhood, he realises that onion-based soups and stews were the likely cause of many digestive discomforts which at times left him feeling really ill.’
Soon after becoming Professor, Lord Rosenheim admitted into his care the Director of the Medical Research Council in West Africa, who had been flown back to Britain incapacitated by intractable hiccups. After a fortnight in hospital, the hiccups were as bad as ever – and Lord Rosenheim was embarrassed by his failure to effect a cure.
One evening, his patient told the ward sister that his hiccups seemed less severe on a full stomach. She gave him methylcellulose, which when taken with water expands to fill the stomach. The hiccups promptly ceased.
This and the many other remedies for hiccups illustrate the point that in medicine, as in life, there may be more than one way to skin the proverbial cat. Hiccups are due to the uncoordinated contraction of the muscles of the diaphragm squeezing air out of the lungs.
Hence any manoeuvre that dampens down the contractions is likely to help – and here there are several possibilities.
The first is to try to physically suppress the contractions by, for example, holding one’s breath. Similarly the methylcellulose remedy presumably worked by filling the stomach and thus acting as a splint against the diaphragm above it.
The second possibility is to force the diaphragm to make an unusual movement in the hope this will override its contractions – best achieved by the technique of drinking water from the wrong side of a glass.
Finally, the contractions can be restored to normal by stimulating the nerves to the diaphragm. This can be achieved by rubbing the side of the neck or stimulating the uvula at the back of the throat by swallowing dry granulated sugar.
So, the abundance of hiccup remedies is perhaps not surprising and should encourage an openminded view of what might work.
THIS WEEK’S MEDICAL QUERY comes courtesy of a lady from Kent, suffering from a spotty, swollen and very tender tongue. Her doctor diagnosed glossitis (inflammation of the tongue) and advised her to dissolve 300mg of aspirin in water and swill it round her mouth three times a day. It has, however, left her with a very salty taste in her mouth and on her lips. ‘I cannot enjoy food, and wine is undrinkable,’ she writes.
Possible causes of glossitis include an allergic reaction (eg, to toothpaste) and the fungal infection candida, but in this case it is almost certainly due to a viral infection.
The salty taste is caused by damage to the salt-sensitive buds on the tongue, which should, with luck, resolve spontaneously – although this can take time.
In the meantime, it can help (paradoxically) to wash the mouth out with a salty solution several times a day. This ‘overwhelms’ the nerve impulses from the saltsensitive taste buds – resulting in a gratifying, if transient, reduction in the intensity of the salty sensation.
drjames@lady.co.uk
KNOW YOUR ONIONS
While acute indigestion is usually due to a tummy bug or food poisoning, it may in some people be caused by a sensitivity to components of their diet – peppers, chocolate, melon or, as a reader from Middlesex reports, in her husband’s case, onions.‘Some years ago my husband discovered that onions were having quite lethal effects on his digestive system, resulting in extreme biliousness, a swollen mouth and headaches,’ she writes. ‘Looking back to his childhood, he realises that onion-based soups and stews were the likely cause of many digestive discomforts which at times left him feeling really ill.’