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Whooping cough

Whooping cough, also known as pertussis, is a highly contagious disease that causes classic spasms (paroxysms) of uncontrollable coughing, followed by a sharp, high-pitched intake of air, which creates the characteristic whoop of the disease’s name.

Whooping cough is caused by a bacterium called Bordetella pertussis. B. pertussis causes its most severe symptoms by attaching itself to those cells in the respiratory tract that have cilia.

Cilia are small, hair-like projections that beat continuously, and serve to constantly sweep the respiratory tract clean of such debris as mucus, bacteria, viruses, and dead cells.

When B. pertussis interferes with this normal, janitorial function, mucus and cellular debris accumulate and cause constant irritation to the respiratory tract, triggering coughing and increasing further mucus production.


Whooping cough is a disease that exists throughout the world. While persons of any age can contract whooping cough, children under the age of two are at the highest risk for both the disease and for serious complications including death.

Apparently, exposure to B. pertussis bacteria earlier in life gives a person some, but not complete, immunity against infection with it later on. Subsequent infections resemble the common cold.

It is estimated that as many as 120,000 persons in the United States get whooping cough each year. The number of cases has been increasing, with the largest increases found in older children and adults. Between 1993 and 1996, the number of cases increased by 40% in five-to nine-year-old children, 106% in 10–19 year olds, and 93% for persons aged 20 years and older.

Causes and symptoms

Whooping cough has four stages that partially overlap: incubation, catarrhal stage, paroxysmal stage, and convalescent stage.

A person usually acquires B. pertussis by inhaling droplets carrying the bacteria that were coughed into the air by someone already suffering with the infection. Incubation is the symptomless period of seven to 14 days after breathing in the B. pertussis bacteria, and during which the bacteria multiply and penetrate the lining tissues of the entire respiratory tract.

The catarrhal stage is often mistaken for an exceedingly heavy cold. The patient has teary eyes, sneezing, fatigue, poor appetite, and an extremely runny nose (rhinorrhea). This stage lasts about 10–14 days.

The paroxysmal stage, lasting two to four weeks, begins with the development of the characteristic whooping cough. Spasms of uncontrollable coughing, the whooping sound of the sharp inspiration of air, and vomiting are all hallmarks of this stage.

The whoop is believed to occur due to inflammation and mucus that narrow the breathing tubes, causing the patient to struggle to get air into his/her lungs; the effort results in intense exhaustion. The paroxysms (spasms) can be induced by overactivity, feeding, crying, or even overhearing someone else cough.

The mucus that is produced during the paroxysmal stage is thicker and more difficult to clear than the more watery mucus of the catarrhal stage, and the patient becomes increasingly exhausted attempting to clear the respiratory tract through coughing. Severely ill children may have great difficult, maintaining the normal level of oxygen in their systems, and may appear somewhat blue after a paroxysm of coughing, due to the low oxygen content of their blood.

Such children may also suffer from swelling and degeneration of the brain (encephalopathy), which is believed to be caused both by lack of oxygen to the brain during paroxysms, and also by bleeding into the brain caused by increased pressure during coughing. Seizures may result from decreased oxygen to the brain.

Some children have such greatly increased abdominal pressure during coughing that hernias result (hernias are the gila protrusion of a loop of intestine through a weak area of muscle). Another complicating factor during this phase is the development of pneumonia from infection with another bacterial agent, which takes hold due to the patient’s weakened condition.

If the patient survives the paroxysmal stage, recovery occurs gradually during the convalescent stage, usually taking about three to four weeks. However, spasms of coughing may continue to occur over a period of months, especially when a patient contracts a cold, or other respiratory infection.

Diagnosis

Diagnosis based only on the patient’s symptoms is not particularly accurate, as the catarrhal stage may appear to be a heavy cold, a case of the flu, or a simple bronchitis.

Other viruses and tuberculosis infections can cause symptoms similar to those found during the paroxysmal stage. The presence of a pertussis-like cough along with an increase of certain specific white blood cells (lymphocytes) is suggestive of pertussis (whooping cough). However, cough can occur from pertussis-like viruses.

The most accurate method of diagnosis is to culture (grow in the laboratory) the organisms obtained from swabbing mucus out of the nasopharynx (the breathing tube continuous with the nose). B. pertussis can then be identified by examining the culture under a microscope.

Researchers believe that as many as 90% of the cases are not diagnosed, mainly because of the nonspecific symptoms displayed by adults. An adult who has been coughing for months may have whooping cough.

Recent advances in the accuracy of diagnostic tests based on polymerase chain reactions (PCR) are now being applied to whooping cough. Researchers in Seattle are presently working on a PCR-based test for Bordetella pertussis that will improve the speed as well as the accuracy of diagnosing whooping cough.

Treatment

Whooping cough should always be treated with antibiotics and never with only alternative therapies. The following complementary therapies may reduce symptoms and speed recovery. Supportive treatment involves careful monitoring of fluids to prevent dehydration, rest in a quiet, dark room to decrease paroxysms, and suctioning of mucus. Sitting up during coughing attacks may help.

Herbals

The following herbal remedies may help to support antibiotic treatment of whooping cough:

• bryonia (Bryonia alba) tea: spasmodic coughing
• butterbur (Pinguicula vulgaris) infusion: infection and spasms
• evening primrose (Oenothera biennis) oil
• jamaican dogwood (Piscidia erythrina) root or bark: spasms
• lobelia (Lobelia inflata) tea or tincture: spasmodic coughing
• pansy (Viola tricolor) tea or tincture: spasms
• red clover (Trifolium pratense) tea
• santonica (Artemisia cina) powder, tablets, or lozenges
• sea holly (Eryngium planum) infusion: infection and spasms
• skunk cabbage (Symplocarpus foetidus) powder, extract, or tincture
• sundew (Drosera rotundifolia) infusion: infection and spasms
• thyme (Thymus vulgaris) infusion: infection and spasms
• wild cherry (Prunus serotina) bark infusion or syrup: infection, and spasmodic coughing

Homeopathy

Homeopathic remedies are chosen based upon the family of symptoms displayed by each patient. Remedies for symptom families include:

• Drosera: dry and tickly feeling in throat; violent coughing that induces vomiting; symptoms worse after midnight.
• Kali carbonicum: dry, hard, hacking cough at 3 A.M.; puffy eyelids; exhaustion; chilly feeling.
• Coccus: coughing worse when warm; drinking cold water brings relief; vomiting stringy, transparent mucus.
• Cuprum: coughing spasms cause breathlessness and exhaustion; blue lips; toe and finger cramping; drinking cold water brings relief.
• Kali bichromicum: coughing up yellow, stringy mucus.
• Belladonna: stomach pain before coughing; coughing worse at night; retching with coughing attacks; red face; puffy eyelids.
• Ipecac: sick feeling most of the time; paleness, rigidity, breathlessness, and then relaxation precede vomiting.

Chinese medicine

Traditional Chinese medicine (TCM) practitioners use a combination of herbals, acupuncture, and ear acupuncture to treat whooping cough during each stage. Yi Zhi Huang Hua (Herba solidaginis) decoction or a decoction of Bai Mao Gen (Rhizoma imperatae), Lu Gen (Rhizoma phragmitis), and Si Gua Gen (Radix vascularis luffae) may be taken for the early stage of whooping cough. Gasping cough can be treated with a mixture of Wu Gong (Scolopendra) and Gan Cao (Radix glycyrrhizae).

Other remedies

Other remedies may assist in the treatment of whooping cough.

• Dietary supplements include vitamins A and C, beta carotene, acidophilus, lung glandulars, garlic, and zinc.
• Dietary changes include drinking plenty of fluids, eating fruits, vegetables, brown rice, whole grain toast, vegetable broth, and potatoes, and avoiding dairy products.
• Juice therapists recommend orange and lemon juice or carrot and watercress juice.
• Hydrotherapy treatment consists of wet clothes or other material applied to the head or chest to relieve congestion.
• Aromatherapy uses essential oils of tea tree, chamomile, basil, camphor, eucalyptus, lavender, peppermint, or thyme.
• Osteopathic manipulation can reduce cough severity and make the patient feel more comfortable.

Allopathic treatment

Treatment with the antibiotic erythromycin is clearly helpful only in the very early stages of whooping cough, during incubation and early in the catarrhal stage.

In general, however, physicians have used this antibiotic both for treatment of whooping cough itself and to prevent its spread to others in the patient’s community. This type of preventive measure is known as prophylaxis.

Unfortunately, the benefits of antibiotic prophylaxis and treatment for whooping cough are limited because erythromycin-resistant strains of B. pertussis have spread throughout the United States since the first case of erythromycin resistance was identified in Arizona in 1994.

Although erythromycin is still used as of 2003 for both treatment and prophylaxis of whooping cough, the Centers for Disease Control (CDC) is monitoring the five resistant strains of B. pertussis that have been identified so far.

Expected results

Just under 1% of all cases of whooping cough cause death; in 2000, only two deaths from whooping cough were reported in the United States. Children who die of whooping cough usually have one or more of the following three conditions:

• Severe pneumonia, perhaps with accompanying encephalopathy.
• Extreme weight loss, weakness, and metabolic abnormalities due to persistent vomiting during paroxysms of coughing.
• Other preexisting conditions, so that the patient is already in a relatively weak, vulnerable state (such conditions may include low-birth-weight babies, poor nutrition, infection with the measles virus, presence of other respiratory or gastrointestinal infections or diseases).

Prevention

The mainstay of prevention lies in the immunization program. In the United States, inoculations begin at two months of age. The pertussis vaccine, most often given as one immunization together with diphtheria and tetanus (called DTP), has greatly reduced the incidence of whooping cough. With one shot backed with a 70% immunization rate, two shots increase it to 75–80%, and three to only 85%, it is not a guarantee.

A new formulation of the pertussis vaccine is available. Unlike DTP, which is composed of dead bacterial cells, the newer acellular pertussis vaccine is made up of two to five chemical components of the B. pertussis bacteria. The acellular pertussis vaccine (called DTaP; when combined with diphtheria and tetanus vaccines) greatly reduces the risk of unpleasant reactions, including high fever and discomfort at the injection site.

Because adults are the primary source of infection for children, there has been some talk in the medical community about vaccinating or giving booster vaccinations to adults. A recent increase of pertussis cases among adults in France has led several French medical schools to recommend booster doses of vaccine for adults.

Wigmore diet

The Wigmore diet is named for its creator, Ann Wigmore. She devised a nutritional system called the Living Foods Program, based on a combination of wheatgrass juice, live sprouts, and fresh raw foods. It is thought that this dietary regimen, which is sometimes called raw nutrition, detoxifies and rebuilds the body.

Persons following the Wigmore diet also avoid using denatured processed commercial foods or anything containing chemicals, especially pesticides. Although the Wigmore diet is essentially a vegetarian diet, its distinctive feature is its emphasis on eating foods in their uncooked state.

Origins

The Wigmore diet was developed during the 1960s by Ann Wigmore, a woman who was born in Eastern Europe in 1909 and emigrated to the United States after World War I. She credited her grandmother with teaching her natural healing methods.


She did not, however, use this folk wisdom immediately but returned to it after years of ill health that included colitis, headaches, and arthritis. When she finally learned that she had cancer, she returned to her grandmother’s healing methods in order to regain her health.

After testing the results of a diet based on sprouts and wheat grass juice in her own life, she wanted others to benefit from what she had learned. Ann Wigmore founded the Hippocrates Health Institute in Boston in 1963, which still teaches her methods of self-healing through a live-foods diet.

Although Ann Wigmore died in a fire in 1993, her diet still attracts new followers. In recent years, the Hippocrates Institute has opened branches in southern California and Florida.

Benefits

The Wigmore diet is based on the assumption that the high levels of living enzymes in fresh raw foods, particularly wheat grass juice and fresh sprouts, provide the body with substances needed to detoxify and regenerate it.

In addition to increased vitality and a strengthened immune system, the Wigmore regimen is thought to help individuals overcome some serious diseases, including arthritis, digestive tract problems, allergies, and even cancer.

Description

Sprouts

Perhaps the essence of what she taught could best be described by Ann Wigmore herself: “Live foods nutrition is super nutrition because it recognizes and appreciates the differences between raw and cooked foods and between natural and synthetic nutrients.

In the conventional nutrition-school curriculum there is little room for a discussion of either the value of enzymes and life forces in foods, or the merits of live (raw) versus cooked foods. Yet the difference, when translated into health terms, is the difference between being vitally healthy and alive, and just breathing.”

The Wigmore diet classifies foods into four major groups: living foods, which include sprout mixtures, sunflower and buckwheat baby greens, living sauerkraut, and the fresh juices of wheat grass and barley; raw foods, which include fresh organic vegetables and ripe fruit, spices, herbs, and raw nuts; whole cooked foods, which include steamed or boiled vegetables, cooked whole grains, and baked root vegetables; and processed fast foods, which include all forms of “junk foods.” People following the Wigmore diet believe that most human diseases are caused when a person’s diet contains mostly foods in the last two groups.

Practitioners of the Wigmore diet encourage people to think of enzyme and oxygen levels as “bank accounts.” The more oxygen and enzymes that can be stored in the cells, the healthier one feels. It has been shown that eating certain foods will maintain enzymes and oxygen at optimal preferred levels.

Other notable features of the Wigmore diet include its emphasis on wheat grass as a “living food medicine” and food combining as a key to good digestion. Wheat grass has been credited with more healings than any other factor in the kegiatan because it is supposed to be rich in over 90 enzymes and minerals that are needed to build up the blood and immune system.

wheatgrass juice

People following the Wigmore diet are encouraged to drink at least two 2-ounce servings of wheat grass juice every day. In addition, wheat grass enemas of 4–8 ounces can be taken “as often as possible” for best results during the detoxification process.

Food combining in the Wigmore diet is based on the assumption that certain food combinations cause stomach cramps, indigestion, bad breath, intestinal gas,or lowered energy levels.

Foods are divided into nine groups: proteins (poultry, fish, dairy products, miso, and yeast); pre-digested proteins (nuts and seeds); starches; vegetables; acid fruits (citrus fruits and sour fruits); subacid fruits (apples, apricots, most berries, and peaches); sweet fruits (bananas, dates, and all dried fruits); melons; and neutral foods (avocados and lemons). Melons are to be eaten alone. While meals made up of foods from any one category are a good combination, for example, fruit and starch are a bad combination.

Another important point in the Wigmore diet is drinking water. Tap water is considered unsuitable, and some form of filter should be used. Distilled water or spring water are preferred.

Preparations

Preparations for the Wigmore diet include a gradual departure from less healthy foods; cleansing the digestive tract with aloe vera or similar products; and encouraging good digestion by eating food at room temperature as often as possible and eating raw or living foods before any cooked foods.

It is thought that the cooked foods hold up the digestion of raw and living foods, causing intestinal gas. Ann Wigmore’s The Sprouting Book discusses the proper preparation of the sprouts that play such a prominent role in her diet.

Precautions

Like all natural therapies, the Wigmore diet will be more effective if environmental as well as nutritional pollution of all types is avoided, and if a generally healthy lifestyle is followed. Such spiritual practices as meditation, visualization, and joining or starting a Living Foods support group are considered important features of a healthy lifestyle.

Side effects

Practitioners of the Wigmore diet warn people to expect certain side effects from detoxification, which is considered a key principle in the Living Foods lifestyle. The diet is believed to clear toxins from the body that have accumulated over years of poor nutritional habits. These toxins are released into the bloodstream and lymphatic system for eventual excretion.

During the detoxification process, the dieter may feel less energetic and uncomfortable in their body. The kegiatan recommends daily non-strenuous exercise, high fiber intake to cleanse the colon, daily dry skin brushing over the entire body, and the use of spirulina (blue-green algae) products to ease the side effects of the detoxification process.

As the Wigmore diet is a purely organic regimen, and avoids the use of medications and all chemicals, the risk of other side effects is minimal. Nevertheless, some individuals will be unable to tolerate this diet, and others may be allergic to the foods that are prescribed.

Research and general acceptance

As with many holistic therapies, the Wigmore diet is met with skepticism from allopathic physicians. On the other hand, there are many clinical cases and testimonials consistent with Ann Wigmore’s predicted benefits.

Wintergreen

Though several different plants are called by this name, true wintergreen is Gaultheria procumbens, a lowgrowing species of shrub common in sandy coastal regions and woodlands of eastern North America from Georgia to New Foundland.

It is a member of the heath, or Ericaceae, family. Other names by which wintergreen is known include aromatic wintergreen, boxberry, Canada tea, checkerberry, deerberry, ground berry, mountain tea, partidgeberry, spice berry, teaberry, and wax cluster.

Wintergreen plants have creeping underground stems from which small reddish stalks grow, normally less than 6 in (15 cm) high. Wintergreen leaves are spoon-shaped and less than 0.5 in (1 cm) in length. They are bright green, shiny, and have a leathery appearance. They are attached in tufts near the tip of a rigid, slender stalk.


In June or July, wintergreen plants produce tiny wax-like, urn-shaped flowers, which are either white or pink in color. These unusual flowers are often difficult to find because the plant’s leaves and other ground covers on the forest floor hide them so well.

The fruit of the wintergreen, a startlingly brilliant red berry, appears in late autumn through the winter, and is much more visible than the wintergreen flower. Wintergreen is an evergreen plant, and even beneath deep snow it retains its shiny green leaves and scarlet berries.

Wintergreen leaves and berries are edible. In their natural state they have no particularly noticeable odor. The leaves have a tart, spicy, astringent taste, while the berries are sweet, with a unique, pleasant taste, which is often used in flavorings.

Wintergreen leaves were formerly carried in the United States Pharmacopoeia,but now only the oil distilled from them is listed. But in many countries the whole plant is still used.

When wintergreen leaves are distilled, they impart an oil, which is made up of 99% methyl salicylate, the chemical compound upon which all aspirin products are based. Before being distilled, wintergreen leaves have to be steeped in water for nearly a day before the oil will develop through fermentation.

It is only after this fermentation and the chemical reaction of water and one component, gaultherin, that wintergreen emits its characteristic, pleasant aroma. Chemists have learned how to synthetically produce an oil with many of the same properties and a very similar product, also called oil of wintergreen, is extracted from the sweet birch tree, Betula lenta.

Wintergreen flowers

The name wintergreen is also sometimes applied to two other members of the genus Gaultheria, as well as three other unrelated plants:

• Gaultheria hispidula is also called wintergreen. It is supposed to remove the predisposition to cancer from the body.
• Gaultheria shallon, sallol, is found in northwest America. Its berries are edible and quite tasty.
• Pytola rotundiflora is also known as false wintergreen or British wintergreen. It was formerly used as a vulnerary.
• Chimophila umbellata and Maculata are both called by a variety of names: bitter wintergreen, rheumatism weed, spotted wintergreen, or pipsissewa. North American natives used these two herbs for the treatment of indigestion, rheumatism, scrofula, and as a diuretic.
• Trientalis europaea, or chickweed wintergreen, is native to England and was used in the past externally in an ointment used in healing wounds, and internally as a tea to treat blood-poisoning and eczema.

General use

Wintergreen oil is used as flavoring for candies, chewing gum, and medicines. With eucalyptus or menthol, it is often used to flavor toothpaste and other dental products. The berry, often called checkerberry, is used for flavoring candies. It is sometimes used as a tea by itself, or combined with tea as a flavoring; hence its name teaberry.

Medicinally, wintergreen leaves are taken internally as a decoction to treat nephritis and bladder problems. It is used as a diuretic, for the treatment of neuralgia, as a systemic tonic, to stimulate menses, and to aid in bringing on lactation after childbirth. It has also been used to relieve children’s headaches. Leaves have also been used for headaches and other pains, and as a gargle for a sore throat and mouth.

Externally, oil of wintergreen is widely used in liniments for the relief of muscular-skeletal pain, both from sports injuries and arthritis. Because of its aromatic and pain-relieving qualities, the oil is used in a number of products in aromatherapy, including stress-reducing pulse point creams, foot scrubs, and balms.

Preparations

Wintergreen leaves can actually be picked at any time of year, but summer is the most opportune time for gathering them. They must be dried in the shade to prevent loss of the volatile oil contained in the leaves, and should be stored in an airtight container in a dark, cool place.

A decoction can be made by mixing 1 c (240 ml) of boiling water with 1 tsp (1.5 g) of the dried wintergreen leaves and allowing the mixture to steep for 15 minutes. This tea may be taken up to three times per day.

Wintergreen and its parts

Oil of wintergreen, as noted previously, is made by first steeping wintergreen leaves in water for at least 24 hours, and then allowing this mixture to ferment and release its oil. Fermentation is known to have occurred when the characteristic wintergreen aroma is released.

This oil is sometimes used externally in dilute solutions in combination with other products such as aloe and lanolin to produce ointments, but either the oil extracted from sweet birch or the synthetic version are more apt to be used.

Precautions

Oil of wintergreen should not be taken internally. In the past, it has been given in a capsule form to treat rheumatism, but excessive doses of it have actually caused death due to severe inflammation of the stomach and gastrointestinal hemorrhage.

Side effects

True oil of wintergreen, distilled from wintergreen leaves, is very rapidly absorbed by the skin and often causes severe skin irritation and painful, hive-like skin eruptions.

Wild oat

Wild oat (Avena sativa) is a member of the grass family native to Scotland. There are approximately 25 varieties of the oat plants, and oat is now grown throughout the world.

Avena sativa is the species that is used in herbal remedies. The mature seed of the oat plant is used as a cereal grain. However, much of the plant is used to maintain good health and to remedy disease conditions.

Before maturity oat seeds are in a liquid phase, and they are collected for use in tonics that treat nervous conditions. Wild oat is usually in this stage for two weeks during August.


The seeds mature in the late summer and early fall. If harvested then, the seeds are rolled or ground into oatmeal. If the seeds aren’t harvested at that time, they are referred to as groats.

Once the seeds are harvested, the straw from the plant can be cut up and brewed as oatstraw tea. And the husks surrounding the seeds are used as oat bran.

The only part of this grain that is not used in alternative medicine is the root.

Wild oat is also known as oat, groats, oatstraw, and straw.

General use

Avena sativa is Latin for wild oat, a name that does not provide the complete picture of this grain’s use in alternative and conventional medicine. The old saying “sowing your wild oats” is based on the observation that stallions given wild oat experienced greater sex drives.

wild oat ilustration

Wild oat was thought to have the same effect on men, although that has never been scientifically proven. Nevertheless, dietary supplements containing wild oats are still advertised and sold as boosting the male sex drive.

Wild oat may not be an aphrodisiac or a means of promoting fertility, but the grain has numerous other health benefits.

In the past, people recovering from illnesses ate oatmeal because it was easily digested. Doctors advised overworked people to drink a beverage consisting of wine and oats. The drink was said to restore nervous energy. Oatmeal also served as a treatment for skin conditions.

In contemporary times, oatmeal is acknowledged as a rich source of bran and fiber. The grain is associated with treating high cholesterol . Whole oat products with at least 0.02 oz (0.75 g) of soluble fiber in each serving can reduce the risk of heart disease.

The U.S. Food and Drug Administration allowed manufacturers to make that statement, and add that the fiber product must be part of a diet that is low in cholesterol and saturated fat. A study published in the summer of 2002 reported that oat cereal is superior to wheat cereal in lowering LDL cholesterol levels in adult males.

A new use for the beta-glucans (complex carbohydrates) contained in oats is in the manufacture of functional foods for the management of Type 2 (adult-onset) diabetes. Functional foods are a relatively recent category of foods.

They are not currently defined by any government regulatory body, but are commonly understood to be any potentially healthful food or food ingredient that may provide health benefits beyond the traditional nutrients it contains. Functional foods are sometimes called nutraceuticals.

Oat fiber is also used as a substrate, or growing medium, for Lactobacillus and other bacteria that are introduced into the digestive tract of patients suffering from severe infections of the pancreas.

The “good” bacteria in the intestines help the body to fight off infections elsewhere in the digestive system. The oat fiber provides the bacteria with nourishment without causing any side effects to the patient.

Furthermore, pregnant women can benefit from the calcium and other trace nutrients found in oat straw.

Wild oat is recognized as a natural antidepressant and a mild sedative. It acts like a tonic to the nervous system, providing both nourishment and balance. Oat tea or an oat Bach flower remedy is used as a nervine (preparation given to calm the nerves).

In these capacities, wild oat can be used to treat conditions including headaches, depression, tension, insomnia, anxiety, and feelings of sadness. Wild oat is also a remedy for nerve pain and chronic fatigue.

Oatstraw can be used to ease emotional anxieties and to treat skin conditions such as rashes, psoriasis, burns, eczema, warts, and insect bites.

An oatmeal pack may be used to treat skin conditions. The oatmeal facial is a popular treatment for promoting smoother skin because the textured oat sloughs off dead skin when used as a mask or scrub. An oatstraw bath can provide more relief for skin conditions and neuralgia.

Wild oat is also believed to help with nicotine withdrawal, a remedy recommended by German doctors. The wild oat extract is said to be effective when used for this purpose, and oat cereal is also said to be helpful.

Preparations

Wild oat is available in various forms and is used in various alternative medicine traditions such as homeopathy. Commercial preparations include oatstraw tea, tincture, and the wild oat Bach flower remedy (a liquid concentrate called a stock). The packaged oatmeal sold in the grocery store can also be used for treatments.

Wild oat tea, which is also known as an infusion, is made by pouring 1 c (240 ml) of boiling water over 1–3 tsp (1.5–3 g) of the dried straw. The mixture is steeped for 10–15 minutes and then strained. Wild oat tea should be drunk three times a day.

When wild oat tincture is used, the dosage is 1 oz (1 mL) taken three times a day.

Wild oat can be combined with skullcap and mugwort to provide relief from depression and to improve sleep.

A flower remedy

Flower remedies are liquid concentrates made by soaking flowers in spring water. Also known as flower essences, 38 remedies were developed by homeopathic physician Edward Bach during the 1930s. Bach’s wild oat remedy is taken to resolve conditions such as career anxiety and uneasiness about a lack of direction or commitment.

The daily dosage of the Bach wild oat flower remedy is 2–4 drops (1/8–1/4 ml) taken four times each day. The drops can be placed under the tongue or added to a glass of water. Another remedy is to add some stock to the bath water.

Oat baths

An oatstraw bath can provide relief for irritated skin and neuralgia. A bath is prepared by boiling 1 lb (500 g) of shredded oatstraw in 2 qt (0.95 L) of water. After boiling for 20 minutes, this mixture is strained and used in the bath. Another option is to place cooked rolled oats in a bag and the bag is put in the bath.

Precautions

Wild oat has not been associated with any health risks when taken in proper dosages, according to Physician’s Desk Reference for Herbal Medicines, the 1998 book based on the findings of Germany’s Commission E. The commission is the German counterpart of the U.S. Food and Drug Administration (FDA). The European group’s findings about herbal remedies were published in a 1997 monograph.

However, people diagnosed with gluten sensitivity ( celiac disease) should consult with a doctor or health practitioner to determine if they can safely take wild oat internally.

Side effects

There are no known side effects associated with designated dosages of wild oat.

Interactions

There are no known interactions associated with the use of wild oat and other medications or herbs.

White willow (Salix alba)

White willow (Salix alba) is a large tree that grows in Central and Southern Europe, Asia, and North America.

Also known as European willow or baywillow, this tree prefers to root near streams and rivers and grows to a height of 35–75 ft (11–25 m). In the spring, the slender branches first sprout tiny, yellow flowers and then long, thin green leaves.

White willow belongs to the Salicaceae family. There are over 300 species of willow, but only several species are used medicinally: white willow (S. alba), purple willow (S. purpurea), violet willow (S. daphnoides), and crack willow (S. fragilis).


General use

White willow is the oldest recorded analgesic, or painkiller, in human history. Chinese physicians have used white willow since 500 B.C. to relieve pain and lower fevers. White willow was also used in ancient Assyrian, Egyptian, and Greek medicine as well. The Greek physicians Dioscorides, Hippocrates, and Galen recommended white willow to remedy fevers and pain.

Native American tribes, including the Cherokee, Blackfoot, Iroquois, and Eskimo peoples, created a tea from closely related species of the bark to relieve headaches, fever, sore muscles, chills, rheumatism, and general aches and pains. White willow was used in Europe to stop vomiting, remove warts, and suppress sexual desire in addition to treating fevers and pains.

In the mid-1700s, white willow was used in Britain as a remedy for malaria since the bark was similar to cinchona bark, a South American bark used to treat malaria. In 1828, European chemists extracted the constituent salicin from white willow bark and converted it to salicylic acid.

At the end of the nineteenth century, acetylsalicylic acid was synthetically produced and aspirin was born. Due to the cheap and easy production of aspirin, white willow eventually lost its popularity as a pain and fever reliever.

In modern times, however, white willow is being recalled as nature’s aspirin and gaining popularity around the world as an alternative treatment for fevers and inflammatory and painful conditions such as bursitis, tendinitis, headaches, rheumatoid arthritis, back pain, osteoarthritis, menstrual cramps, and muscle aches. White willow has been approved by the German Commission E for treating fevers, rheumatic ailments, and headaches.

In France, white willow is used to remedy headaches, toothache pain, tendinitis, and muscle sprains. The British Herbal Compendium has administered white willow as a treatment for rheumatic and arthritic conditions, colds, and influenza.

How white willow works

The inner bark contains tannins, flavonoids, phenolic glycosides, and anti-inflammatory and fever-reducing salicylates. The high concentration of tannins may be responsible for relieving gastrointestinal disturbances and reducing tumors of the esophagus, stomach, colon, and rectum.

White willow’s analgesic effect works to inhibit the production of prostaglandins, a hormone-like chemical that is produced by the body in response to injury and causes aches, pains, and inflammation.

Thus, white willow is beneficial in treating acute and chronic pain and inflammation in conditions such as painful menstruation, arthritis, and neuralgia. White willow is best when used over long periods of time and can take days to improve conditions.

The active ingredient in white willow is salicin. Salicin is gradually converted along with other compounds in white willow into salicylic acid in the intestine and liver.

Because of this conversion process, white willow generally takes longer to act than aspirin, but the effects may last for an extended period of time. As a result, white willow is mild on the stomach and usually does not cause bleeding or other gastrointestinal discomfort that often occurs with aspirin usage.

White willow vs. aspirin

White willow bark

Herbalists claim that white willow can sometimes be used in the same conditions as aspirin. One benefit to white willow use is that the natural salicylic acid present in white willow reportedly produces fewer side effects than the synthetically produced acetylsalicylic acid of aspirin.

Aspirin has been recommended as a treatment to reduce the risk of heart attacks and stroke by lessening the chance of internal blood clots. Preventative benefits of white willow in these cases have not been determined, primarily because the salicin content of the bark varies. Herbal experts believe that most willow bark samples contain enough salicin to have a similar effect.

Preparations

The bark of young tree branches (two or three years old) is harvested during the early spring. The grayish bark is separated from the tree, then either dried or used fresh. White willow is commercially available in tincture, tablet, capsule, powder, or tea forms. When choosing a commercial preparation, it is recommended to use a standard product that contains 200–250 mg of white willow per dose.

The recommended daily dosage is 100–250 mg of white willow every four hours. To relieve arthritic, back, and muscle aches and pains, the recommended dosage is 225 mg of white willow bark four times daily.

A decoction made from willow bark is used both internally and externally. To make a decoction, combine 1 tsp chopped or powdered white willow bark with 8–10 oz of water.

Bring to a boil, then simmer for five minutes. Drink three or four times daily. This mixture can also be gargled to help inflamed gums and tonsils. Cooled and applied externally, the decoction helps aid healing of sores, burns, or cuts.

Tincture dosage: 2 ml three times daily.

Precautions

Persons with tinnitus should not take white willow.

Pregnant or breastfeeding women should consult their healthcare practitioner before taking white willow.

Persons who are sensitive to aspirin should use caution when taking white willow as it may irritate their stomachs.

Administration of aspirin to children under the age of 16 to relieve symptoms of cold, flu, or chickenpox may cause a rare condition called Reye’s syndrome. Reye’s syndrome is characterized by vomiting, swelling of the brain, and liver damage; and may be fatal.

Reye’s syndrome is a medical emergency and requires immediate treatment by qualified medical professionals. The toll-free hot line number of the National Reye’s Syndrome Foundation is listed below.

While white willow is metabolized differently from aspirin, there is still a similarity between the two, and it is recommended that white willow not be given in these situations.

Persons with a bleeding disorder, ulcer, colitis, Crohn’s disease, kidney or liver disease, or diabetes should not take this herb.

Children over 12 and persons over 65 should take white willow in low initial doses. Children under the age of 12 should not use white willow at all.

Side effects

Excessive doses of white willow may cause stomach upset, diarrhea, nausea, or ringing in the ears. If this occurs, should be stopped white willow.

Interactions

White willow bark ilustration

In general, persons considering taking white willow preparations should first consult a physician or registered pharmacist, as white willow interacts with a number of nonprescription as well as prescription medications.

Persons who are allergic to aspirin should not use white willow.

White willow should not be taken in combination with aspirin or such nonsteroidal anti-inflammatory drugs (NSAIDs) as ibuprofen or naproxen, alcohol, or blood-thinning medications.

White willow has been reported to have adverse interactions with bismuth subsalicylate (Pepto-Bismol), celecoxib (Celebrex), repaglinide (Prandin), and ticlopidine (Ticlid). It increases the action of metaclopramide (Reglan), but reduces the effectiveness of diclofenac (Voltaren, Cataflam), ketoprofen (Orudis), and nadolol (Corgard).

Wasabi

Wasabi (Wasabia japonica) is an edible plant member of the Cruciferae family, which includes cabbage, turnips, and mustard. Wasabi shares the anticancer benefits of this family.

Native to Japan where it has been cultivated since the tenth century, it is still considered a staple condiment in that country. Traditional preparation involves using a sharkskin grater called an oroshi.

Wasabi’s culinary popularity and chemical bioactivity make it valuable medicinally and industrially. Demand for wasabi has created a relatively short supply, higher prices, and new commercial opportunities.


These new opportunities include research and development of cultivation technologies, particularly in Canada, and exportation from Japan of seiyo wasabi, or Western wasabi—imitations made of horseradish (Cochlearia armoracia). Western and Japanese wasabi are both highly prized.

Wasabi is a perennial, root-like rhizome that is cylindrical in shape. A brownish-green skin covers its pale green flesh. The plant grows to about 18 in (46 cm) in height and produces leaves on long stems from the crown of the plant. As the plant ages, the leaves fall off and a rhizome, or creeping underground stem, is formed, from which new buds arise as modified stems.

The modified stem is the part of the plant that is used. The highest quality wasabi, whose translated name is mountain hollyhock (also known as sawa wasabi), thrives on cool water. It grows along the edges of cold mountain streams.

When cultivated, rather than wild-crafted (harvested randomly from its natural growing places), it is grown on treeshaded, terraced gravel beds covered by a thin layer of cool running mountain water or on artificially shaded gravel ridges formed in larger river beds. A lower quality wasabi (oka wasabi) is grown in fields.

There are two varieties of wasabi, Daruma—considered to have a more attractive appearance—and Mazuma—considered to have more heat. Wasabi is described as being “hot and fiery without burning,” which changes to a sweetness that lingers in the mouth.

General use

Historically, wasabi has been consumed as a condiment, used similarly to horseradish or mustard. Its pungent flavor and aroma may add a piquant flavor to sushi, marinades or sauces, and rice, noodle, and fish dishes. In Japanese restaurants across North America, sashimi and sushi may be served with a small mound of grated wasabi or wasabi paste.

Nontraditional uses include adding wasabi to mashed potatoes, tuna sandwiches, or blending it with soy sauce. One source included it in a recipe for a unique Bloody Mary. Wasabi leaves marinated in sake, brine, or soy sauce, are eaten with a bowl of rice.

In addition to its flavor, wasabi has another benefit. Traditional Japanese cuisine includes raw fish, which is a potential source of parasites and bacteria. Wasabi’s antiparasitic, antimicrobial, and antibiotic abilities may be preventive against food poisoning. One source points specifically to wasabi’s effectiveness against the Anisakis parasite.

Another study, comparing the antibacterial activity of different foods against Escherichia coli (E. coli) and Staphylococcus bacteria, found that cruciferous plants possess antibacterial activity, with the highest activity found in wasabi (rhizome).

Other studies found that wasabi may be effective against the tooth-adhering ability of the bacteria Streptococcus mutans, thus inhibiting dental plaque and decay. Of special note are the numerous studies demonstrating wasabi’s effectiveness against stomach cancer cells.

One study found the induction of stomach cancer in rats was suppressed when they were given wasabi. The risk of hormone-related malignancies, such as breast and prostate cancer, may also be lowered.

Some researchers believe that the cruciferous vegetables help the body eliminate excess endogenous (produced from within) and exogenous (produced from without but ingested or absorbed) hormones, such as estrogen. This action may be a result of wasabi’s ability to stimulate the liver and gallbladder, aiding in the digestion of fatty foods and the processing of food nutrients.

wasabi field

Other medicinal benefits attributed to wasabi include its effectiveness against diarrhea, blood clots, inflammation, and asthma. Its pungent aroma may help relieve sinusitis and bronchitis. Although the amounts absorbed from culinary use may be negligible, wasabi reportedly also contains potassium, calcium, and vitamin C.

Industrial applications of wasabi under investigation include its usefulness in the development of other antibiotics, due to its own antibiotic qualities; its effectiveness as a fungicide against the blackleg fungus that threatens plants commercially valued for their oil, such as rapeseed and canola; and its possible use as an effective alternative to chemically toxic wood preservatives.

Preparations

Wasabi is most commonly found in powder or paste form. However, due to the scarcity and price of high quality wasabi, many of these preparations—including imports from Japan for retail sale and those served in Japanese restaurants—are imitations made of horseradish, mustard, a starchy binder, and coloring. Wasabi paste may be made from a powdered wasabi by adding water, and letting it stand 10 minutes to allow the flavor and heat to develop.

One source noted that the powder may be safely stored in a cupboard, but recommended refrigerating the paste. A salad dressing may be made by combining 3 tablespoons of rice wine vinegar, 1 tablespoon honey, 1 teaspoon wasabi paste, 1 teaspoon soy sauce, and 1/2 teaspoon sesame oil.

Traditional wasabi is prepared freshly for each use, as its volatile oils are quickly dissipated. It is recommended that individuals select a fresh, cool, and succulent rhizome with nice color. It should be rinsed under cool water with a vegetable brush, cutting a fresh surface below or above the leaf node (a distinctive ridge as on bamboo stems).

While maintaining a 90-degree angle to the grating surface, the wasabi should be grated in a circular motion against a traditional sharkskin, ceramic, or stainless steel grater. (It is not necessary to peel the wasabi rhizome before grating it.) Then it is gathered into a ball and allowed to sit momentarily at room temperature. It is best used within 15 to 20 minutes.

One source notes that wasabi products are often found in large grocery stores that sell Asian food products and ethnic condiments; Asian markets; fish markets; gourmet shops; and other alternative marketplaces. Prices are similar to other specialty condiments of equal quality.

Precautions

Growing wasabi

Wasabi should not come into contact with the eyes or nasal passages.

Due to its anti-inflammatory, antibiotic, antibacterial, antiparasitic, anticoagulant, and anti-asthmatic effects, the use of wasabi may magnify the effects of certain pharmaceutical drugs used for similar purposes.

People with ulcers, esophageal reflux, kidney disorders, gastrointestinal disease, or those using hormone replacement therapy, are advised to consult with a healthcare professional before using wasabi.

Side effects

Due to its liver and gallbladder stimulating effects,eating wasabi may cause gastrointestinal disturbances, including diarrhea and nausea.

Interactions

One source notes that wasabi has possible interactions with anti-inflammatory analgesics, anesthetics, thyroid medications, corticosteroids, diuretics, and high blood pressure medications. This may be due in part to confusion with horseradish species. No other Wasabia japonica-drug interaction references are noted.

Warts, also called verrucae, are small benign growths usually caused by a viral infection of the skin or mucous membrane. The virus infects the surface layer of skin. The viruses that cause warts are members of the human papilloma virus (HPV) family, of which there are many different strains.

Warts are not cancerous but some strains of HPV, usually not associated with warts, have been linked with cancer formation. Warts are contagious from person to person and from one area of the body to another on the same person.

Particularly common among children, young adults, and women, warts are a masalah for 7–10% of the population. There are close to 60 types of HPV that cause warts, each preferring a specific skin location.

For instance, some types of HPV cause warts to grow on the skin, others cause them to grow inside the mouth, while still others cause them to grow on the genital and rectal areas.


However, most can be active anywhere on the body. The virus enters through the skin and produces new warts after an incubation period of one to eight months. Warts are usually skin colored and feel rough to the touch, but they also can be dark, flat, and smooth.

Warts are passed from person to person, directly and indirectly. Some people are continually susceptible to warts, while others are more resistant to HPV and seldom get them.

The virus takes hold more readily when the skin has been damaged in some way, which may explain why children who bite their nails tend to have warts located on their fingers. People who take a medication to suppress their immune system or are on long-term steroid use are also prone to a wart virus infection. The same is true for patients with AIDS.

The main categories of warts are common warts (face and hands), plantar warts (feet), and venereal warts. Hand warts (verruca vulgaris) can grow anywhere on the hands, but usually occur where skin has been damaged in some way (e.g. picking or nail biting). This is a rough horny lesion varying in size from 1 mm–2cm in diameter.

Foot warts (verruca plantaris) known as plantar warts, are the most painful type of wart, due to the pressure exerted on them. They are most common in children and young adults, since they are often contracted in locker rooms and swimming pool areas.

If left untreated, they can grow to an inch or more in circumference and spread into clusters. Those suffering from diabetes are more likely to suffer from plantar warts, and may also suffer complications due to the reduced potential for their bodies to heal themselves.

Flat warts tend to grow in great numbers and are smaller and smoother than other warts. They can erupt anywhere, appearing more frequently on the legs of women, the neck and dorsum of the hands, the faces of children, and on the areas of the face that are shaved by young adult males.

Genital warts, also called condylomata acuminata, moist warts, fig warts, or venereal warts, are one of the most common sexually transmitted diseases (STDs). Genital warts are more contagious than other types of warts.

Approximately one million new cases of genital warts are diagnosed in the United States every year. It is estimated that two-thirds of persons coming into contact with genital warts will develop symptoms within three months.

Genital warts tend to be small flat bumps or they may be thin and pointed in shape. They are usually soft, moist, pink to red in color, occurring as a single lesion or in clusters that resemble a cauliflower, and not scaly like other warts. In women, genital warts appear on the external genitalia, within the vagina, on the cervix, and around the anus or within the rectum.

In men, genital warts usually appear on the tip of the penis but may also be found on the scrotum or around the anus. Genital warts can also develop in the mouth of a person who has had oral sexual contact with an infected person. They may also appear, less often, between the toes.

Filiform wart is a long, horny, finger-like projection that is usually found in multiples. Seen most commonly in adult males, they occur in the bearded area of the face or on the eyelids and neck.

Causes and symptoms

Since warts are caused by a virus, they can only be caught by contact with a source of infection. This can be direct physical contact, or secondary contact with the shed skin of a wart (through a floor or a towel for example). As the incubation period for warts is quite long, it is often difficult to pinpoint sources of infection.

Individuals whose immune systems are deficient most often contract warts. AIDS patients commonly suffer from warts, and it is not uncommon for warts to appear at the site of a syok (burns, cuts or abrasions.)

Diagnosis

Common warts are rough, irregular, skin colored or brownish. Warts that are brownish in color, or that do not respond to treatment, should be checked by a physician to exclude the possibility that they may be malignant growths.

Treatment

Warts may need no treatment at all, since a large proportion of them (67% over a two-year period) disappear spontaneously. This is particularly so in the case of flat warts.

However, a wart that appears unusual in any way should be checked by a physician, as a small proportion can become malignant. Generally, the main criterion for treatment of warts is a cosmetic one, if it is found to be embarrassing by the sufferer, or unpleasant to others.

Acupuncture

The aim with acupuncture will be to raise the general well-being of the patient, improve the functioning of the immune system, and free blockages of “chi” or life force. Warts and other health problems will be less likely to occur as general health and resistance are improved.

Aromatherapy

Since warts are caused by viral infections, the aim of an aromatherapy treatment would be to kill the virus with the application of an appropriate essential oil. There are many oils that have antiviral properties, so the therapist will also endeavor to choose oils that are appropriate for the patient.

Onion and garlic oils both have powerful antiviral properties, but perhaps tea tree oil, which also possesses remarkable anti-viral properties, might be more acceptable as far as smell is concerned.

Colloidal silver

The use of colloidal silver against viruses of all kinds has proved very successful. It should be topically applied to the wart, but can be taken internally to promote functioning of the immune system, and thus prevent warts from occurring.

Herbal medicine

Herbal remedies for genital warts and other STDs have attracted considerable recent attention because of the epidemic spread of these diseases in developing countries where most people cannot afford allopathic treatments.

One traditional herbal remedy from Colombia that is being studied is extracts of plants belonging to the Euphorbia family. These compounds have been used to treat ulcers, tumors, and warts for generations, and some of them appear to be effective in treating genital warts.

Before applying any herbal cure to a wart, as much of the wart as possible should be removed, in order to give the cure a head start.

Apple juice: Apply the juice of a sour apple. Action is due to the magnesium in the juice.
Banana skin: First the wart should be rubbed with an abrader, and a fresh banana skin (immediately after opening) should be applied and left overnight.
Cabbage: Apply fresh juice from a white cabbage.
Chickweed: Apply the juice to the wart.
Dandelion: The juice of the dandelion is a very old English cure for warts.
Garlic: Rub a raw clove on the wart every night until it disappears.
Green figs: The white milk from a green fig is excellent at removing warts.
House leek: This is a plant commonly found in rock gardens. It has thick fleshy leaves and its juice is rich in supermalate of calcium, which will destroy warts.
Pineapple: Cotton wool should be soaked in the fresh juice of a pineapple. The enzymes of the pineapple will dissolve the wart.
Rubber plant: If the stem of a leaf from a rubber plant is broken, white liquid will ooze out. If this is applied to the wart over a period of two to three days, the wart should disappear.

Naturopathy

Naturopathy, in common with many alternative therapies, works on the principle that given the right circumstances, such as pure air, pure water, and first class nutrition, the body will heal itself and become extremely resistant to illness. Naturopaths believe that such symptoms as warts are the result of toxins in the body, and an immune system that is not running efficiently.

They may prescribe treatments such as colonic irrigation, alongside a aktivitas of healthy eating to raise the general level of health. A naturopath may suggest a paste made with vitamin C, applied to the wart daily for a period of a few weeks.

Visualization

This method, also known as creative imagery, has skeptically been described as “willing yourself well,” but practically it has been found to be very effective for a range of conditions, both physical and emotional.

The patient is required to sit in a relaxed state, breathing evenly, and visualize the self in the condition he or she would like to be. In this case, perhaps he or she visualizes the body overcoming the warts and absorbing them, leaving behind healthy skin. This method has been found particularly suitable for children, as it has no side effects and therapists claim it has a good success rate.

Folk remedies

There are many remedies for warts that have been handed down from generation to generation all over the world. The following remedies have excellent track records.

Thread: a length of thread should be tied around the wart, and tightened every day until the wart drops off.
Human saliva: the sufferer applies his or her saliva to the wart first thing every morning.

Allopathic treatment

Warts may be self-treated by a number of allopathic remedies, but care should be taken as they are fairly strong chemicals (usually salicylic acid).

Those suffering from diabetes, heart disease or circulation problems, or any degree of peripheral neuropathy, should not attempt to treat themselves with any of these preparations, because of the risk of damage to tissue, and because of their increased susceptibility to infection.

In addition, the face and mucous membranes may scar, so it may be preferable to seek professional advice.

A physician may use cautery (use of heat) or cryosurgery (use of extreme cold, usually in the form of liquid nitrogen) to remove warts. These are processes that require precision, and therefore are highly skilled procedures.

Another drawback is that they can be painful. Increasingly, laser treatments are also being used to treat warts, whereby the laser beam vaporizes the wart tissue. Pulsed laser treatments appear to be particularly effective in treating warts in the anogenital region of children.

A newer allopathic medication that shows promise in the treatment of resistant viral facial warts is diphencyprone (DPC), a drug that was developed to treat a type of hair loss known as alopecia areata. DPC has shown effectiveness in removing facial warts that were resistant to both cryosurgery and other topical drugs.

Expected results

Allopathic methods for the treatment of warts are generally successful, but they carry more risk of scarring than natural methods.

More than one alternative method may have to be tried before success is achieved, but they carry the added bonus of adding to the well-being of the patient, and not harming the body. Allopathic treatments involve the use of strong chemicals, which carry risks and are not compatible with body chemistry.

Usually, warts either disappear spontaneously or are treated successfully with no scarring or lasting effects. However, occasionally, what appears to be a wart is the beginning of a type of cancer, so those that are resistant to treatment should be seen by a physician.

Recurrent genital warts are a serious personal and public health concern. Even though genital warts may be removed, the virus itself continues to live. Certain types of HPV can cause tissue changes in the cervix of women with recurrent infection that may lead to cervical cancer.

The general recommendation for women who have a history of genital warts is to see their doctors every six months for Pap smears to monitor any changes that may occur.

Prevention

To avoid foot warts, footwear should always be worn in public places and feet should be kept clean and dry. In general, warts should not be picked, to avoid cross infection, and any patch of damaged skin should be protected. Every effort should be made to keep the immune system in peak working condition.

Genital warts can be prevented by using condoms and avoiding unprotected sexual contact. Barrier protection will not, however, prevent the spread of wart-causing HPV to such uncovered areas as the pubis and upper thighs.

Although vaccines to prevent the spread of human papilloma virus are under investigation as of 2002, they will not be available for general use for at least several years.