The average three-year old child should have twenty deciduousor baby teeth. He should have six teeth at the end of his first year, twelve when eighteen months old, sixteen when he is two, and all twenty by the time he is two and half years of age.

If during pregnancy his mother’s diet lack calcium, there may be some delay in this time that his teeth push their way through the gums. Disease such as syphilis will also interfere with the normal development and appearance of teeth.

In adult there are thirty-two permanent teeth. The first of these begin to come through when a child is six or seven years old. This permanent teeth, growing in from below, usually push out the decidouous or baby teeth. By the time person is twenty five he should have all his teeth.

How good this teeth are will largely depend on his diet. Also, how much sugar he has been allowed to have, and the kind of care he has given the teeth during his growing years are of great importance.

Pancreatitis means inflammation of the pancreas. In some cases in some cases it maybe rather mild, but in others very severe. Most pancreatitis seems to be related some condition involving the bile ducts leading from the liver. A stone from the gallbladder may block the mouth of the pancreatic duct and cause pancreatitis. It is surprising how may of these people are alcoholics. Others may have suffered injuries, and still others have pancreatitis because of some peptic ulcer penetrating into pancreas from the stomach or duodenum. In a few cases the pancreatitis may follow some infectious disease, such as mumps.

Patients with pancreatitis usually complain of sudden pains in the upper part of the abdomen. These may be steady and severe, but at time also dull and cramp-like. The patient may have fever from 100° to 102°F., as well as tenderness in the upper abdomen, and even jaundice if the bile ducts have been partially or completely blocked.

Many of these cases come to surgery simply because the diagnosis has not been confirmed. The serum amylase test is used to differentiate this condition from other similar problems within the abdomen.

Pancreatitis Treatment will vary according to the seriousness of the condition. During the acute stage the patient is feed intravenously. Later he may take some solid food, but only in small quantities and without any mixtures. He should not take alcohol in any form, for this may only aggravate the condition. From henceforth he must live on a simple program, avoiding all stress as far as possible.

The gallbladder is a small, pear-shaped, muscular organ closely attached to the under surface of the liver.  Its only function is to store and concentrate the bile between meals so there will be a plentiful supply when needed. Bile from the liver is clear, golden color when formed, but after being concentrated in the gallbladder it turns a deep green.

This concentrating process sometimes results in the formation on stones forming the gallbladder, particularly in women following pregnancy. Most of these patients are overweight. Stones may form in other parts as well as the gallbladder, but these are relatively rare.

Many people with gallstones seem to have no problem at all, especially if there is one large stone. But when a number of smaller stones are present in the gallbladder, the patient may feel sharp, cramp like pains all over upper abdomen. These come on an hour or two after meals. The condition is more likely to occur at night, and may produce nausea and vomiting, as well as a rapid hear t and tenderness in the right upper part of the abdomen.

Many of these patients complain of gas and distention of the abdomen especially after eating fried foods, fat, and green vegetables. If the stone completely blocks the common bile duct, jaundice will result and the skin will become a yellow and very itchy. This is a serious condition that should be relieved at once, if at all possible.

Most gallstones can be seen by X-ray, using certain contrast dyes to outline the stones. In the more severe states the patient has fever, cramp like pain in the abdomen, as well as gas and general discomfort. This condition may resemble peptic ulcer, coronary artery disease, acute appendicitis, and even shingles.

A correct diagnosis is therefore important, for delay could be dangerous in so serious a condition. Women are more likely to be affected particularly during the later years.

Any condition interfering with normal flow of blood to the heart may cause an enlargement of the vessels in the liver. This is part of the serious condition known as chronic passive congestion.

It is the most commonly seen when th heart itself is failing. The patient suffers from shortness if breath, and his liver may be enlarged and very tender. Fluid often gathers in the abdomen as well as in the extremeties. The treatment is the same as for the congestive heart failure.

There are several different forms of cirrhosis. The most common is portal cirrhosis, also known as Laennec’s cirrhosis. which is most often associated with alcoholism. It is usually seen in men in later life. Poor nutrition seems to be partly responsible for this condition and may account for its prevalence among alcoholics. In some cases chronic poisoning with industrial fluids, such as carbon tetrachloride, may also play a part.

In the early stages of the disease there may be nothing more than frequent attacks of gas and indegestion, with occasional nausea and vomiting, and perhaps some abdominal pain and weight loss. As the condition advances, the patient begins to run a low grade fever. He has a foul breath, juandice skin, and distented veins on the abdomen. So-called “spiders” are seen on the face, neck, arms and trunk. These are hairlike, reddish markings in the skin somewhat resembling small spider. As the disease continues, the abdomen becomes bloated and swollen, the mind is clouded, and there may be considerable bleeding from the stomach.

Cirrhosis of the Liver Treatment:

During the severe stage keep the patient in bed. He must avoid the use of alcohol in any form. His diet should be rich in protein and moderately low in carbohydrates and fat. If possible he should have atleast a quart of milk a day as well as extra vitamins in the form of Brewer’s yeast and B12 injection weekly. Salt should be restricted, particularly if there is swelling in the legs or abdomen. If massive bleeding occurs, the patient should be rushed to hospital and remain there until the hemorrhage is brought under control.

Amebic Hepatitis is more prevalent in the tropics but is also found in temperate areas as well. Amebic parasites find their way into the body through contaminated food and water. Within the digestive system they multiply rapidly. Some of them are transported through the bloodstream to the liver, where they lodge in the capillaries and envade the nearby tissues producing a typical picture if hepatitis similar to those described above.

Fatty liver is due to excessive amounts of fat being deposited in the liver cells. This occurs most frequently in overweight persons and in usually due to excessive intake of food, particularly fats. Certain intoxicants such as alcohol, carbon tetrachloride, and chloroform,  may also produce a fatty liver. It may occur in certain cases of tuberculosis, diabetes, anemia and in deficiency condition, such as pellagra.

The liver is enlarged and tender, and there may be jaundice, fluid in the abdomen, excessive bleeding, and other evidence of liver failure. The patient should be given a high protein, low-fat diet, and two or three teaspoons of dried yeast powder in milk twice daily between meals, or two yeast tablets two or three times a day as needed. He should be placed on a reducing diet and avoid the use of alcohol in any form – permanently.

Serum Hepatitis is also due to a virus, but it is different from the infectious hepatitis described in the last posst. This particular virus seems to be transmitted either by blood transfusion or through the use of unsterile dental drills. This condition takes from two to five months to develop so that the true cause is iften hard to trace down. The onset is moe gradual than is the case of infectious heapatitis.

Infectious hepatitis occurs more commonly in children and young adults, while serum hepatitis more frequently occurs in people who are over thirty years of age. The treatment is similar to that just described for infectious hepatitis.

Hepatitis is an acute inflammation of the liver cause by some infectious or toxic agent. The skin may discolor and the whites of the eye turn yellow. Usually there is some tenderness over the liver in the upper part of the abdomen. Most of these patients have fever, and  many of them are very ill during the acute stages of the disease.

Various substance and organism may be responsible for hepatitis, including germs, viruses, toxic agent, such as carbon tetrachloride, chlorpromazine, and many other substances used either as medicines or in modern industry.

Infectious hepatitis often occurs in epidermics. It is caused by certain viruses which are introduced into the body mainly through contaminated food or water. Young people are most frequently affected, Epidemics of inefctious hepatitis are more common in wartime.  Crowding, poor sanitation, and malnutrition all play their part in this disease. In many cases it seems to take from to six weeks for the disease to develop.

This more common type of jaundice usually begins abruptly with nausea, vomiting, fever, general weakness, and loss of appetite. The liver is tender to the touch. In more severe cases jaundice may be quite noticeable, but in milder cases there may be no jaundice. This continue for ten days to two weeks and then tens to disappear. In some cases the spleen is enlarged and there is often considerable itching in the skin, as well as intermitent diarrhea. Bile may also be seen in the urine, particularly during the early phases of the disease.

Most cases recover after six to eight weeks, but relaps are fairly common in people who go back to work soon. Those who have to subsist on a poor diet, or who use alcohol, are likely to have a longer period of illness. The patient should be under medical observation for several months even after he feels he has recovered.

Hepatitis is a highly infectious disease. The patient should be strictly isolated during the active phase. Gamma globulin may be given to those exposed to hepatitis in the hope of  preventing the disease.

Hepatitis Treatment:

Keep the patient in bed as long as there is any sign of jaundice, abdominal pain, or tenderness over the liver. At least three weeks in bed is advisable. The patient may get up to go the bathroom, but otherwise should remain in bed. His diet should be rich in protien and carbohydrates, but low in fats. He should also be given vitamin B complex to help restore hist lost appetite and to help heal the liver. He should be careful not to overexert himself.

Any tendency to fever may indicate a relapse. The patient should then remain several more weeks in bed until he has made a complete recovery.

Jaundice means a yellow discoloration in the skin or the whites of the eyes. This is due to excessive amounts of bile in the blood stream.

Jaundice may arise from a number of different causes. Some types of Jaundice arise from the condition outside the liver. In some causes the patient may have Jaundice in sub clinical form. The bile pigment may be elevated but not sufficiently to actually discolor the skin.

Normally there is a certain rate at which the red blood cells are broken down and destroyed in the body. The average life of red cell is about four months or 120 days. But certain disease conditions may cause an excessive breakdown of red cells and this increases the bile pigment in the blood. Such as rapid breakdown of cells may be seen in hemolytic anemia, sickle cell anemia, pernicious anemia, and jaundice of newborn, as well as in malaria, pneumonia, yellow fever, and certain bacteria infections of the blood.

Obstructive Jaundice means that the bile is backing up into the blood stream because of some obstruction involving the larger bile ducts. The normal liver produces about pint of bile every twenty four hours. This bile is transported either to the gallbladder where it is concentrated and becomes green, or else passes directly to the small intestine where it acts as a lubricant.

Bile gives color to the feces. When bile is absent, the stools become every light, almost white in color. Anything that obstructs the flow of bile to the intestine will not only produce light colored stools but ma also result in jaundice. The obstruction may be due to a stone or stricture in the bile ducts, or perhaps to hepatitis or cirrhosis of fever, even cancer in the head of pancreas.

Stones in the common duct are a frequent cause of jaundice. The patients notes a sharp, sudden pain in the upper part of the abdomen near the mid line. Fever soon develops, and after few hours of days, jaundice will usually appear. It is first seen in the whites of the eyes, later spreading to all the skin and mucous membranes of the body.

Jaundice is particularly common in middle aged ladies who have several children. Jaundice due to cancer comes on more slowly and there is little or no pain at the beginning. In either case the jaundice will continue until the obstruction is removed, and may last for weeks or months, depending on the patient’s general condition. In acute hepatitis, on the other hand, the jaundice appears quickly but usually subsides within a week or ten days.

Jaundice Treatment:

One must first find the cause of the jaundice. If the trouble is due to some parasites, such as malaria, suitable medications may soon bring the condition under control. If the jaundice is due to presence of a stone or other obstruction, surgery will be needed for relief and cure. The sooner the obstruction is relieved the less liver damage. The patient should kept in a low fat diet. Seriously ill patient should always be treated in hospital where they can be fed intravenously if needed. In cases of serious bleeding, vitamin K should administered, preferably by injection during the acute phase of the disease, and later in the form or tablets.

The liver has another important function that detoxifying or destroy many harmful poisons and even certain medicines that are taken into the body for other purposes. When the liver is sick these numerous activities are impaired, and soon the whole body suffers. All this endless activity means that the liver cells eventually become worn out and must be replaced. In most people the breaking down and building up process continues without any apparent difficulty. In fact, radioactive studies have demonstrated that all the protein in the liver is changed every few weeks.

Not only the does the liver store food materials, it also produces bile, a golden yellowish liquid that is needed for the absorption of fat from the intestine. Bile is another laxative. It actually prevent us from being poisoned by  absorbing the by-products of our digestion. Should the bile channels become blocked, a serious condition known as juandice will develop.

Another substance produced into the bile. It may even from stones in the bile ducts and gallbladder under certain conditions. Another substance is prothrombin, so essential in the clotting of blood. Urea, an important component of urine, is also produced within the liver. The production of all these substance may be changed under certain disease conditions.

If vitamin K is not present, or is interfered with through action of certain anticoagulant medicines, the level of prothrombin in the blood will fall. Under certain conditions vitamin K may not be absorbed to well from the intestine so that there of the body. In such a case, bleeding may occur in various parts of the body. Bile salts must also be present in the intestine to allow vitamin K to be absorbed. Hence, anything that hinders the normal flow of bile into the intestine will greatly the function of the liver.