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A few excerpts from
Fascinating Health Secrets

Want to avoid the flu?  (and who doesn't?)  Click here for some tips on staying healthy.Scents and sexual attraction.
What Tylenol commercials will never tell you.
What aspirin commercials will never tell you.
What not to take with acetaminophen.
Take a peek into the future of analgesia.
How the success of dieters is often sabotaged by food cravings.
Fun facts to know & tell about mad cow disease.
Simple cures for flatulence.
Like chewable vitamin C tablets?  Like your teeth?  Then read this.
What's best for you:  fresh, frozen, or canned foods?  You might be surprised.
Fun facts to know and tell about dreams.
What is the explanation for superhuman feats of strength?
Do you eat liver?  You might stop after you read this.
Want to be a genius?
Interesting—and useful—trivia about liquor.
Getting high on garlic?
An amusing discourse on a serious topic:  self-defense against animals.
Whooping cough:  it's not a disease of the past, and it's not just a childhood disease.
Contact lenses bothering you?
Rosebushes, barberry bushes, sphagnum moss and other mulches:  what you don't know can hurt you.
Reducing your risk of infection after exposure to germs (subtitled, how to tell if your doctor is an idiot).
If you want to avoid coming down with the flu, anthrax, AIDS, herpes, or just a cold, it is important to know that you won't necessarily contract an infection just because you're exposed to germs.  In other words, germ exposure is not synonymous with infection.  Here's what you can do to stay healthy.
Useful information about douching.
If you are troubled by recurrent vaginal yeast infections, read this section.
Libido and prolactin.
How an allergy drug can spice up your sex life.
Why Robitussin might make you into a parent.
How Norplant and Depo-Provera can ruin your sex life, figure, and health.
A better life in a bottle?  Yes!
The best condom tip ever:  how to make a tip condom.
What's a subcondom?  Probably the best invention since sliced bread.
Trivia time.  What do graham crackers and corn flakes have to do with sex?

If you subscribe to the credo that "all is fair in love and war," you will quite likely appreciate the following tip, which adds a new twist to the term "love potion."  Researchers have found that most people tend to be attracted to individuals who possess body odors which are unlike their own natural smell.  As it turns out, a person's natural scent is influenced by the major histocompatibility complex (MHC) genes, which code for markers that tag your cells as "self," enabling your immune system to identify—and destroy—"nonself" stuff (such as bacteria) that happens to get into your body.  Pilots will readily appreciate that this is a biological analogy to the IFF (Identification, Friend or Foe) system used in military aircraft, which allows pilots to determine if other aircraft in their vicinity are "friend" or "foe."

The innate preference for a partner with a different scent is thought to be advantageous because this is correlated with a more varied set of MHC genes (and, consequently, enhanced immunity) in the resultant offspring.  If you are wondering about the real-world relevance of this seemingly arcane info, you should wonder no longer.  Harken, ye friends, and feast your eyes upon these pragmatic postulates:

    1. If your natural scent is substantially different than that of a potential mate, your chance of dating/mating success with this person will be enhanced if you do not embellish yourself with cologne, perfume, scented soaps and detergents, etc.  Such added scents merely camouflage your own natural odor, obscuring perception of the olfactory match.
    2. Conversely, if your odors are similar, you will find that your best friend is an olfactory smokescreen, such as perfume or cologne.
    3. Granted, you're probably not in the habit of sniffing potential mates in order to determine if you should be, odoriferously speaking, au naturel, or artificially scented.  The safest course of action in such an eventuality is to forgo the added scents and see if the chemistry is strong between you and your partner.  If things are progressing well, skip the Madison Avenue love potions, and relish your natural odor.  On the other hand, if the chemistry just doesn't seem to be working, splash on some scent, and look forward to a rekindled reciprocity of ardor.  Trust me.  I speak from experience.
    4. Given the accomplishments of the marketing folks on Madison Avenue, most people suffer from the delusion that commercial scents are vital to success in the dating world.  Billions of dollars have been spent on such advertising, inculcating the notion that intersexual appeal is readily amenable to enhancement by the application of sundry scents.  As we've seen, such added scents can help—or hurt—a particular relationship, depending upon the extant MHC/scent compatibility.  From an evolutionary perspective, however, such obscuration of genetic variation is functionally tantamount to a neglect of familial proximity in the choice of a marital partner.  To put it succinctly, inbreeding ain't a good idea.  While the results of the relative MHC inbreeding, fostered by the use of various scents, might seem minor in comparison to the genetic clash of, say, cousins, it is nevertheless true that such inbreeding can produce offspring with suboptimal immunity.  Conceivably, this may be a contributing factor in the problem that we are now experiencing with a variety of infectious diseases—it's not that the germs are strong so much as it is that our immune systems are weak.  Just something to mull over the next time you dab on some perfume.
    5. It seems that every rule has an inevitable exception.  Did you honestly believe that anything which dealt with romance could be straightforward?  It has been found that women on the Pill prefer similarly scented mates.  This could contribute to the aforementioned genetic disaster discussed immediately above, were it not for the fact that women on the Pill usually do not become pregnant.
    This exception is not mere trivia; it has practical utility in the wild and wacky world of dating.  Let's assume you're a love-smitten young man whose brain has been addled by a surfeit of testosterone.  Let's further assume you're longing for the affections of a pulchritudinous woman who, alas, enjoys your company as a friend but does not manifest a burning desire for intimacy.  Sound familiar?  If Dear Abby can't help you, you can either move on to greener pastures, or try the following tip.  If your semi-girlfriend is not on the Pill, encourage her to begin using it; if she is on it, encourage her to discontinue it.  Given the plethora of information—both pro and con—that is available on the Pill's effects, it is easy to build a logical case for either option.  Obviously, for this to be ethically justifiable, you must do nothing except to present accepted facts, leaving her to make the ultimate decision.  It sure beats trying to get her drunk!  Assuming that her Pill status changes, her scent preference will also change, perhaps making you a lucky man.  And perhaps not.  Clearly, scent is not the principle determinant of intersexual attraction.  Most people have a list of desirable characteristics imprinted in their mind, which allows them to rapidly determine if someone is suitable for dating.  Unless you're a fairly close match for this preformed mental love map, you don't stand a chance anyway.  But if the "missing link" was just a bit of chemistry, you're in luck.
Before leaving this topic, I should mention that there is some concern about the safety of colognes and perfumes when they are applied to the skin.  Some of their constituents are absorbed and, as you can probably guess, they're not good for you.  If you use them, apply them to your clothing instead of your body.

Most people, including physicians, reflexively treat fever with aspirin or acetaminophen (Tylenol) without considering the deleterious effect of lowering body temperature.  Your body's immune system works better with at least a moderate fever, so by lowering your temperature you may feel better temporarily, but inadvertently prolong the illness.  Avoid treating a fever less than 102° unless there is a good reason for so doing—such as in an elderly patient with significant heart disease or in a child prone to febrile seizures.  Another indication for reducing fever is to help in the evaluation of a febrile child.  If the child is not seriously ill, he will usually become almost normally active.  If he does not, a physician should be contacted.

Did you know that a person with a viral illness who is taking aspirin is more likely to transmit the disease to others?  This is true because aspirin increases viral shedding.  Although this fact is of enormous importance from a public health standpoint, it has never been adequately disseminated.  Most doctors don't know this.

Avoid consuming carbohydrates along with acetaminophen, as they decrease the effect of the acetaminophen.

Let's take a peek into the future, and see what analgesics might be available to your children or grandchildren.  Lurking in the depths of the oceans are creatures called cone snails, which have a certain fondness for eating flesh.  Flesh, however, does not like to be eaten.  What's a hungry cone snail, bereft of food stamps, to do?  Answer:  make conotoxins, which paralyze their prey, making the clumsy cone snails into a potent adversary.  One of the conotoxins (omega-conotoxin) has been shown to be nontoxic, but is hundreds of times better than morphine in relieving pain, and it doesn't cause numbness or the pleasant buzz that causes addicts to flock into emergency rooms, feigning a bad back or a migraine headache.  Animal protectionists will be heartened by the news that scientists have devised a way to make synthetic conotoxins, thus averting a 21st century cone snail massacre.  The first synthetic conotoxin, named SNX-111, is effective only when it is delivered directly to the spinal cord.  If you think a shot in the butt is unpopular, think about the terror you'll experience when the nurse chases after you with a 3- or 4-inch spinal needle!  People who are needle-phobic, including myself, can console themselves with the fact that someone in search of wealth will almost undoubtedly conceive of a related drug that can be administered by a more pleasant route.  Still want to limit the profits of pharmaceutical companies?

The success of dieters is often sabotaged by food cravings.  Once you understand why you crave certain types of foods, it becomes easier to control the cravings.  Ultimately, all cravings are rooted in biochemistry.  Your desire for certain foods rises and falls in synch with the levels of various chemicals in your body.  These chemicals create a desire for a certain type of food, like fat or carbohydrate.  Individual preferences then mold this urge into a craving for a specific food.  This is analogous to sexual attraction in that biochemistry creates a desire for another person, but it does not cause a longing for a specific mate.

Neurotransmitters are chemicals that transmit nerve signals from one nerve cell to the next.  There are several neurotransmitters that influence appetite.  Serotonin is a neurotransmitter with numerous functions, one of which is the regulation of desire to ingest carbohydrates.  As brain serotonin levels rise, there is a decrease in carbohydrate craving.  The amount of serotonin in the brain is dependent upon the brain's tryptophan level, and the availability of vitamins (B6, B12, and folic acid) that help convert tryptophan to serotonin.  Tryptophan is one of the many amino acids that are the building blocks of proteins.  The brain's tryptophan level is dependent upon the tryptophan level in the blood, and the presence of other amino acids that inhibit the passage of tryptophan from the bloodstream into the brain.  A meal rich in carbohydrates and low in protein stimulates the pancreas to secrete insulin, a hormone that lowers blood levels of sugar and amino acids—except tryptophan—by forcing these substances into cells.  When such a meal is consumed, there are less amino acids in the blood to hinder tryptophan transport into the brain.  What this boils down to is:

  • High-carbohydrate, low-protein meals increase brain serotonin, thereby temporarily decreasing the desire to ingest carbohydrates.
  • High-protein meals lower brain serotonin, which creates a preference for carbohydrates in the next meal.
  • Deficiencies of vitamins B6, B12, and folic acid can impair the conversion of tryptophan to serotonin, and hence create a craving for carbohydrates even when their intake is adequate.
The type of carbohydrate ingested can influence the serotonin level, and therefore influence the desire for more carbohydrates.  Rapidly absorbed sugars cause a short burst of insulin secretion.  This results in only a short-term increase in brain serotonin levels.  The serotonin level soon falls, and the desire to ingest carbohydrates returns.  Consequently, eating a candy bar is not a good way to suppress carbohydrate cravings.  Starches cause a prolonged secretion of insulin, which keeps the brain serotonin level high for a much longer time.  This holds the carbohydrate craving in check for several hours.

Some people crave carbohydrates because they have inherently low levels of serotonin, not because they lack willpower.  These people are especially apt to benefit from therapies that increase serotonin, such as supplementation with tryptophan or the use of drugs such as Prozac.

Carbohydrate desire is fueled by another neurotransmitter named neuropeptide Y (NPY).  When the blood sugar level is low, NPY increases, which stimulates your appetite for carbohydrates (incidentally, it also decreases the libido in women).  The ingestion of carbohydrates raises the blood sugar level, which lowers the level of NPY.  The NPY level can also be increased by stress.  NPY levels peak in the morning, which explains why many people prefer carbohydrate-rich foods for breakfast.

Galanin is a neurotransmitter that stimulates the desire to ingest fat.  Apart from its role in creating an appetite for fat, galanin also influences how much dietary fat is stored as body fat.  The galanin level is increased by estrogen, endorphins, and the breakdown of body fat.  Galanin levels peak in the evening.  When people are placed on a low-fat diet, they normally crave fat.  This occurs because galanin levels rise in an attempt to induce fat intake.  However, this craving subsides after three months of adherence to the diet.  In effect, the body becomes frustrated by the repeated failure of galanin to stimulate fat intake, and simply gives up.

Think you're safe from mad cow disease just because you've never scarfed down a British hamburger? I wish that I could share your sense of safety, but I can't. Before I present the evidence which substantiates such a gloomy perspective, let's take a look at mad cow disease and its cousins. Collectively, these diseases are called transmissible spongiform encephalopathies, or TSEs for short. TSE is a fancy way of saying "a degenerative disease of the brain that can be spread to other animals, which causes microscopic changes reminiscent of a sponge."

Bovine spongiform encephalopathy (BSE), a.k.a. mad cow disease, is a fatal disease that affects the brain and spinal cord of cattle. It is believed to be caused by a prion, which is a self-replicating, aberrant conformation of a normal protein that is present on nerve cell membranes. Prions are not destroyed by cooking or by ordinary means of food sterilization. BSE first appeared in Great Britain in 1985, and it has since spread to over 166,000 cattle. Affected animals may exhibit nervousness or aggression, incoordination and abnormal posture, decreased milk production, and body wasting. Other signs include itching, heightened sensory perception, excessive licking, and a high-stepping gait.

Emergence of BSE in cattle is thought to have resulted from the use of cattle feed which contained meat and bone meal derived from sheep that is presumed to have been infected with scrapie, another TSE. Scrapie also affects goats (thought you might want to know that in case there's ever a TSE category on Jeopardy . . . "I'll take TSEs for $500, Alex."). Other TSEs include kuru, Creutzfeldt-Jakob disease, chronic wasting disease (CWD) of mule deer and Rocky Mountain elk*, feline spongiform encephalopathy, transmissible mink encephalopathy, Fatal Familial Insomnia (I kid you not), and Gerstmann-Sträussler-Scheinker syndrome. If your family doctor can name more than four TSEs, it's a good bet that his personal life is rather dull . . . I speak from experience.

* If you're a deer hunter, you are probably hungry for more information, which I am happy to provide. CWD has occurred in only limited areas of the western U.S., affecting relatively small numbers of the aforementioned species, as well as both white-tailed and black-tailed deer. There has been no known transmission of this TSE to humans, but as they say, there's always a first time. It is thought that contaminated skin can be disinfected by soaking for ten minutes in a 4% sodium hydroxide solution, followed by copious washing with water.

Unless you're a British rancher or a mink farmer, none of the foregoing should be of much concern to you. Now for the human connection. Pop a couple Valiums and speed-dial your therapist, 'cause you're about to have a new worry to add to your list of concerns. It's called Creutzfeldt-Jakob disease, which I've previously listed, although I neglected to mention its merciful acronym, CJD. CJD may be inherited or acquired. Since you can't pick your parents, there is no use worrying about the former. Acquired CJD is, as its name so aptly suggests, acquired from something, such as a BSE-infected cow. It can also result from eating human brains, a cannibalistic practice once popular among the Fore natives of the New Guinea highlands which resulted in a disease known as kuru.

If you're curious—and have a strong stomach, and haven't eaten in the past six hours—read on. The "cannibalistic practice" involved grinding brain matter into a pale gray soup, which was then heated and eaten. Somehow, I'm sensing that the phrase "soup is good food" may need some qualification.

Acquired CJD has also resulted from the use of growth hormone derived from human cadavers, and from corneal transplantation. CJD cannot be transmitted sexually, so you can cross this one off your list of pre-coital interrogatives.

While there are a whole lot of people in Britain who will eventually wish that they had been vegetarians, there is no proof that mad cow disease has yet struck American cattle. However, there is certainly cause for concern. To begin with, American cattle ranchers commonly utilize the same feeding practices that resulted in the British BSE epidemic. Play with fire long enough, and you're going to get burned. Worry #2: some U.S. sheep have scrapie, and other TSEs have been proven or highly suspected in a variety of wild and domestic animals, including pigs. Worry #3: after being fed cow meat, several ranch-raised mink died of TSEs. While the Mink-Chow** had been deemed unfit for human consumption, this makes me nervous . . . really nervous. Is it proof? No, but it's highly suspicious. Worry #4: studies of people with CJD have shown that they were more likely than other folks to have eaten lamb, certain types of pork, or pig brains. Hence, there may be a TSE in these species that is infecting humans.

** The diversity of products being what they are, I feel compelled to issue the following legal disclaimer to any company that actually manufactures something called Mink-Chow (I wouldn't be surprised), and all other interested parties: I am using "Mink-Chow" in a generic sense to indicate feed that is given to minks. If you manufacture it, I am not referring to your Mink-Chow®; if I were, I would have written Mink-Chow®, not Mink-Chow.

Some people are genetically immune to CJD. In case you are curious, heterozygosity at codon 129 confers immunity. However, it's not likely that you will know if you're one of the lucky ones. Heck, even O.J., who had his DNA splattered across a few hundred million television sets, probably hasn't the faintest idea of what's lurking at codon 129. On to more practical info . . .

Clearly, the greatest risk is from consuming infected brain, spinal cord, or retinal tissue. However, prions have been found in nerves, which run throughout the body—including muscle (meat), and in other organs, such as the spleen. Having little nerve tissue, whole cuts of meat are relatively safe. On the other hand, sausage and hot dogs can contain organ meat and spinal cord. On occasion, even hamburger contains parts of spinal cord, even though it should not. Poultry and fish are apparently not susceptible to any TSE, and TSEs are not believed to be transmissible via milk or dairy products.

As a former emergency doctor who has a soft spot in his heart for his colleagues still toiling in ERs, I feel compelled to mention that there is no lab test which detects CJD during life. Having seen plenty of people visit ERs for reasons which are even more ludicrous, I'm sure that the notion of coming to an ER for a "CJD checkup" has crossed the minds of more than a few individuals.

Notwithstanding the absence of an ante mortem lab test, there are some signs and symptoms which may indicate CJD, including apathy, irritability, self-neglect, dementia, fatigue, insomnia, lethargy, disorientation, dyslexia, hyperreflexia, muscle atrophy, tremor, double vision, blurring or dimness of vision, and a number of other manifestations. Obviously, these clues are nonspecific and may occur in a number of other more common disorders. The possibility of CJD should be seriously considered when a rapidly progressive dementia develops before or during mid-life, especially when accompanied by myoclonus (a shock-like contraction of a muscle). There is no treatment, and death typically ensues within a year.

Shy people tend to have low levels of dopamine in their brains. Some physicians are using monoamine oxidase inhibitors (MAO) to increase their dopamine levels. MAO inhibitors can help in this condition, but these drugs have very serious potential side effects. Before resorting to MAO inhibitor use, a trial of tyrosine (an amino acid) therapy may be indicated. This is a more natural, and far safer, approach. However, any such therapy—tyrosine or MAO inhibitor use—is simply an adjunct to the requisite psychological transformation that must occur in a shy person before their problem can be overcome. A new medical treatment of shyness involves the use of Zoloft® (sertraline), which is usually used in depression. Curiously, there is a biological component to shyness, and certain traits (blue eyes, narrow faces, and higher heart rates) are associated with shyness.

Before any treatment of shyness is undertaken, one should ascertain that the problem is simply shyness and not something more serious that may manifest as shyness. For example, chronic mercury poisoning can cause a condition known as erethism. The term erethism also refers to excessive irritability or sensibility to stimulation, especially in regard to the sexual organs but including any part of the body., a state of shyness, easy embarrassment, withdrawal, apprehension, irritability, emotional instability, depression, and fatigue. When confronted with a patient with the above problems, most psychiatrists would not consider erethism, and reflexively prescribe Prozac or some similar drug.

In addition to erethism, chronic mercury poisoning can cause diarrhea, stomatitis (inflammation of the lining of the mouth), increased salivation, incoordination, impaired articulation of speech, and tremors of the tongue, lips, and extremities. Besides avoiding sources of mercury (industrial exposures, some vaginal douches, dental amalgams [metallic tooth fillings], thimerosal [an anti-infective agent used in some contact lens solutions], Merthiolate® [a trademark for preparations of thimerosal], and mercury-tainted fish*), treatment includes the use of penicillamine, a chelating drug that increases the excretion of mercury from the body.

* Since mercury is stored in the muscle tissue of fish, trimming fat is not effective in reducing mercury exposure, although it does minimize the levels of PCBs and many other contaminants.

Trivia time. Women in ancient China sometimes swallowed mercury, heated in oil, as a means of contraception. Yucch. Makes you appreciate technological advancement, doesn't it?

Tragically, Karen Wetterhahn, a chemistry professor at Dartmouth College who investigated how toxic metals inhibit repair of DNA, died in 1997 of poisoning after two drops of dimethylmercury splashed onto her latex gloves.

Most people dread passing gas in social situations.  Wafting some of your personal supply of methane gas toward your date is certain to make a lasting impression, albeit a bad one.  Well, I'm here to tell you that if we can put a man on the moon, science can alleviate your gas problem to some extent.  One answer to this age-old malady is a product called Beano, a product intended primarily to reduce the gas resulting from beans but actually useful in controlling gas from a variety of other sources as well.  It is available at many health food and drug stores, and even many supermarkets.  A decidedly low-tech, but nevertheless effective additional cure, is to have a bowel movement beforehand.  This is effective because the gas you expel is actually created by the bacteria which comprise the bulk of your stool.  With less stool inside, you'll make less gas.  It's not rocket science, but it works.

Chewable vitamin C tablets taste great, but can damage tooth enamel.  Stick to the ordinary pills that are swallowed.

It is a myth that canned or frozen fruits or vegetables are nutritionally inferior to their fresh counterparts.  In truth, they are often more nutritious, unless the fresh items are grown in your garden (or some other local garden).  Almost all commercially available fresh fruit and vegetables are picked before they are fully ripe, so that they are not rotten by the time you purchase them.  Produce selected for commercial freezing or canning is, understandably, allowed to fully ripen before being picked.  This ensures that the nutrient content of the food is as high as possible.  Since some canned foods are contaminated with lead, the best choice is frozen food (unless you have your own garden).

It is possible to program the content of your dreams to some extent.  The low-tech approach simply involves a conscious reminder, issued immediately prior to sleeping, in which you concentrate upon the desired subject.  Simple, but surprisingly effective.  The high-tech approach to interactive dreaming requires a machine that detects REM sleep, then plays one or more programmed sounds (e.g., a whistle of a train, the crowing of a rooster, the cheering of a stadium crowd, or the theme song to Gilligan's Island—whatever floats your boat). Researchers have found that the brain often accepts the "suggestions" that are implied by these sounds, with the result that these sounds and their accompanying themes are often incorporated into the ongoing dreams.

The next topic about dreams in the "fun facts to know and tell" series is that the content and outcome of one dream usually affects the subject of subsequent dreams.  However, your brain—acting in the manner of a hard-nosed television executive—will often decide to "cancel" a series for unfathomable reasons.  The next execration that occurs is reruns.  No, reruns are not just limited to network television and HBO.  They occur, or should I say reoccur, in your dream life, too.  And, to complete the television analogy, it's often the worst stuff that is replayed.  Go figure.

The maximum force of contraction exerted by a muscle is controlled by the Golgi tendon organ (GTO), which is a receptor found in the muscle-tendon unit whose function is to limit the tension developed by the muscle.  If you did not have GTOs, you would be considerably stronger, but also at increased risk for ripping tendons from bone.  When the GTO senses a tension that it considers to be dangerous, it causes a reflexive inhibition of muscle contraction (engineers might recognize this as being analogous to a negative feedback loop).  In most people, though, the GTO is too sensitive and inhibits the muscle before there is any real danger of injury.  As a result, strength is needlessly limited.

An interesting sidelight to this topic is that the GTO inhibition of strength can itself be inhibited.  This is the primary means by which ordinary individuals can exhibit extraordinary strength in certain dire crises.  For example, most people have heard of the case in which a mother lifted a car that had fallen on her son.  There are several other stories, many of which are documented.*  The manner in which the GTO is inhibited is not known, but it must involve the central nervous system.

While there is no known conscious method of inhibiting the GTO to allow superhuman feats of strength to be performed at will, the GTO can be desensitized over time to allow some increase in strength independent of muscle growth.  This is accomplished by performing jerky movements against resistance, performing the same or similar movement in which increased strength is desired.  There is some attendant risk of straining muscles or tendons with this technique, and it is certainly not intended for beginners.  For an advanced athlete looking for a competitive edge, it may be the difference between winning and losing, and thus may be worth the risk.

Although this should be fairly obvious, it is worth mentioning that strength increases resulting from GTO inhibition will do nothing to augment muscle size.  Since most people who work out with weights do so for cosmetic reasons (i.e., to appear stronger or to lose weight), GTO inhibition is of no use to them.

* I didn't mention this in the book, but I had such an experience.  If you're curious, send me an e-mail message and I'll tell you about it.

Have you heard of Kupffer cells?  Probably not, but if you eat liver, you should.  Kupffer cells are liver cells whose function it is to devour toxins and other material that is indigestible.  If the body has no way to process something, it uses its Kupffer cells as microscopic vacuum cleaners, sucking up the garbage.  Unlike vacuum cleaners, however, Kupffer cells have no way to "empty their bag," so to speak.  The material ingested by Kupffer cells is permanently stored in them.  When you eat liver, you are also eating Kupffer cells and the residue they contain.  Since most people do not crave liver as they would pizza or a Big Mac, giving up liver is generally easy.  If you want to continue eating liver, though, you can minimize your risk by eating calves' liver rather than the liver from a mature animal.  Older animals have had more exposure to various toxins, and therefore have more highly contaminated Kupffer cells.

Now that I'm on the subject of yucky stuff in liver, I'll mention lobster tomalleys.  Tomalleys are the mushy green liver in the lobster's body.  Believe it or not, but some people actually eat this stuff.  Aside from its unappealing color and consistency, it is advisable to avoid the tomalleys, as they may contain substances that can cause paralytic shellfish poisoning.  In the summer, lobsters, clams, mussels, oysters, and scallops may ingest a poisonous dinoflagellate (have you heard of the "red tide"?) that produces a neurotoxin that is not inactivated by cooking.  This neurotoxin causes numbness and tingling around the mouth shortly after consumption, followed by nausea, vomiting, abdominal cramps, weakness, dizziness, headache, paralysis, and even respiratory failure.  I've had a craving to eat at a Red Lobster restaurant for the past few years, but now that I think of it, I think I'll stick to chicken.

Most physicians would be shocked to learn that Dilantin (a drug used to control seizures) can improve cognitive ability.  The average I.Q. of people taking Dilantin is certainly less than average.  This fact leads most physicians to the conclusion that Dilantin lowers intelligence.  In reality, the primary reason why epileptics have subnormal IQs is because of their preexisting brain lesions and the fact that repeated, prolonged seizures can result in progressive degeneration of the brain.  In high doses, as is true with Inderal, Dilantin can lower intellectual performance.  In contrast, low-dose Dilantin (25 to 50 mg per day) has been shown to increase Wechsler IQ test scores, and to improve verbal performance, long-term memory, and concentration.  Dilantin's utility is especially pronounced in those whose concentration is impeded by obsessive thoughts, anger, or fear.  When used in violent criminals, Dilantin reduces the rate of recidivism.  It won't turn an axe murderer into a desirable date, but it is statistically useful in reducing the risk of repeat offenses.  Dilantin has more of a normalizing effect than a "downer" effect, though.  For example, when people who are too passive are treated with Dilantin, they become more assertive and outgoing.

Why does aged alcohol taste better than freshly distilled spirits?  The barrels in which alcohol is aged are made of wood (usually oak), which contains hemicellulose, tannins, and lignin.  With aging, the hemicellulose forms sugars such as xylose, fructose, arabinose, and glucose.  Ethyl alcohol extracts tannins and lignin from the wood.  Tannins are oxidized into several different flavorful compounds.  One of the final degradation products of lignin is vanillin, which is the principle aromatic molecule of vanilla.  Vanilla flavor is present in old rums, whiskeys, and cognacs.  While the taste of inexpensive spirits can be improved by the addition of a small amount of vanilla to partially duplicate the results of aging, manufacturers are generally prohibited by law from doing this—although there is no reason why you can't do it.  If you're going to drink, you might as well enjoy it!

Now this is strange. It may not qualify for inclusion in Ripley's Believe It Or Not!, but it's an oddity nonetheless. In the process of evaluating the effects of garlic on blood clotting and cholesterol, researchers noted that garlic seemed to function as a mood elevator. Garlic eaters reported greater feelings of well-being, and experienced less fatigue, irritability, agitation, and anxiety.

In my experience, there is definitely something in garlic that affects mood. Whenever I feel a cold developing I'll chew a clove of garlic. In doing so, I've noticed that I get anywhere from a mild boost in mood to an oh-my-God, what-an-incredible-buzz euphoria that lasts for several hours. I don't know if the variation in response is attributable to variations in the garlic (which is certainly possible) or to a variation in how my mind is "primed" (so to speak) to respond to the garlic.

If you try this, here are a few tips you should keep in mind:

  • Chew the garlic thoroughly before swallowing. You can think of the active chemicals in garlic as being analogous to the chemicals in a two-part epoxy, which do nothing until they're mixed together.
  • Unless you have a very strong stomach limit yourself to one clove of garlic at a time. Stupidly, I once chewed three large cloves in succession and then spent the next few hours howling about how my stomach felt as if it were on fire.
  • If you're taking the garlic for its euphoric effect, it's better to chew it on an empty stomach. I think that some of the induced euphoria arises as a reflexive response to gastrointestinal irritation. Dilute that with food, and you'll also limit the "high."  Incidentally, the garlic buzz is very similar to the so-called "runner's high" (which can develop after any prolonged strenuous exertion) but the garlic high can be even more pronounced and it requires no effort. I've never tried combining garlic with vigorous exercise to see if I obtain an off-the-scale nirvana, but I'll try it sometime and report back when I do.
  • Ginger is another natural substance with a euphoric effect, but garlic is considerably more potent. I have a lot more about this topic and ways of potentiating euphoria in my book (remember, these are just excerpts).

Now that I'm on the subject of the usage of firearms for self-defense (trust me, I was in the book), it's appropriate to discuss another related application:  self-defense against dangerous animals. In sharp contrast to the amicable, cuddly image of wild animals as depicted by Walt Disney and other cartoonists, wild animals are just that—wild. I've watched chipmunks go berserk, chasing people with a ferocity that must be seen to be believed. If I didn't know better, I'd swear the little chippy had taken amphetamines, LSD, about 10 cups too many of coffee, and was in what bodybuilders experienced in steroid use affectionately refer to as "a 'roid rage." And this, mind you, was from a chipmunk, whose capacity for the infliction of harm relative to that of other animals is about as impressive as would be a slingshot in a thermonuclear war. Take mountain lions, for example. Lately, they have been snacking on California citizens at an alarming rate, no doubt appreciative of the fact that the ever health-conscious residents of the Golden State make tempting low-fat meals.

In North America, the undisputed heavyweight champions in the consumption of humans are bears. Black, brown, grizzly, polar, whatever—if it's a bear and if it has penciled you in on its menu for its next meal, you're in a heap of trouble. If you like, you can file an injunction with the bear, pleading that his behavior is inconsistent with the aphorism that "bears won't bother you if you don't bother them." However, bear temperament is characteristically mercurial, and they seemingly bask in the knowledge that they're judge, jury, and executioner. My introduction to Bear Psychology 101 was given to me by a park ranger, who related how a couple of teenage women made the mistake of camping in bear territory and wound up becoming McCamper. It's hard to imagine how those two girls, snoozing in their sleeping bags, "bothered" the bear. Maybe they were snoring too loudly? The ranger speculated they may have been menstruating; that, apparently, is as enticing to a bear as the smell of a baking apple pie is to a human. Regardless of the perceived offense, the bear decided that it was a capital crime, for which the teenagers were summarily executed. Both of them. My, aren't we hungry? Perhaps we should consider spiking the bear's water supply with an appetite suppressant? Another horrible end to a vacation came when a man returned to the cabin he had rented in Alaska, only to find a bear consuming his erstwhile spouse. That was, I'm sure, good for a few thousand nightmares. Still think that I'm just bearanoid?

I'll be the first to admit that any weapon short of a bazooka or howitzer is unlikely to stop a bear in its tracks unless the shot is well-placed, striking the brain, spinal cord, or a bone vital to locomotion. However, given that bears do not subscribe to the notion that the pen is mightier than the sword, people who attempt to influence bear behavior solely by appealing for mercy with tips culled from a bear manual are at a distinct risk of acquiring an intimate knowledge of ursine dentition. Your average bear has read very few of these manuals, and doubtless feels no compulsion to abide by the rules of engagement. Consequently, it may become necessary to attempt dissuasion with something more convincing, say a .338 Winchester Magnum. One problem with such an approach is that Conservation Officers label such people as "hunters," insisting they confine their activities to a circumscribed period of the year called "bear season." Fearing that my massive 150-pound body might somehow be mistaken for that of a bear, I make it a habit to shun forested areas during hunting season, confining my forays into the wilderness to other times. Furthermore, if you have any knowledge of guns, you will know that a .338 Mag is a rather bulky instrument. I'd prefer to have both hands free to play with my chainsaw or, preferably, girlfriend—if I had one, anyway. Still, I'd like to have some means of avoiding a bear's gastrointestinal tract. I thought of a device that might occupy a bear's mind while I make a hasty retreat, skedaddling to the confines of civilization. I'm itching to test this idea. If you have ready access to bears and are interested in a joint research project, please contact me.

Given that children are routinely vaccinated against whooping cough (a.k.a., pertussis), most people—and even most doctors—assume that the disease is a thing of the past.  Not true.  A recent study found that 12 percent of people with a cough lasting longer than 2 weeks had pertussis.  People with whooping cough characteristically have a spasmodic, paroxysmal, or convulsive cough in which there are 5 to 15 (or more) rapidly consecutive coughs, sometimes followed by a whoop (many patients never whoop).  The whoop, if present, results from a deep, hurried inspiration.  After a few relatively normal breaths, another paroxysm may start.  Infants may experience choking spells instead of the whoops.  Incidentally, "pertussis" means violent cough.

Whooping cough is a bacterial disease, caused by infection with Bordetella pertussis.  Transmission is primarily by inhalation, not contact.  It can occur at any age, but it is most common in children less than 2 years old.  Infection does not confer lifetime immunity, although subsequent attacks are usually mild.  Epidemics occur in a given locality every 2 to 4 years.  The illness lasts 3 weeks to 3 months, averaging 7 weeks.  Initially, there is sneezing, watery eyes, lethargy, loss of appetite, and a nighttime cough.  Fever is unusual.  The cough becomes more troublesome during the day, often with 40 to 50 paroxysms daily.  Initially, the mucus is thin, becoming tenacious and viscid.  The antibiotic erythromycin may abort infection if given during the incubation phase, and treatment of household contacts is recommended.  Erythromycin may be of some benefit if given soon after the onset of recognizable disease, but it is unlikely to alter the course of the illness after the paroxysms have begun.  Even months after the disease has resolved, paroxysmal coughing may recur, usually in response to a respiratory irritant or an unrelated upper respiratory infection.

Contact lens wearers can develop eye irritation as a result of applying hand lotion.  This is true even if the eyes are not directly touched.  Why does this occur?  Hand lotions give off a steady stream of vapor, to a variable extent, depending upon their composition.  This is a slow process and is, of course, invisible to the unaided eye.  Nevertheless, molecules from the lotion continually fly off in all directions, and some end up being deposited on the surface of the eye.  These molecules tend to be hydrophobic (meaning they don't mix well with water), and they often act as a direct chemical irritant.  Those who wear contact lenses have eyes that are often partially irritated to begin with, making them more susceptible to other irritants.  Most hand lotions are not too offensive in this regard, but there are some that are very bothersome.

Rosebushes.  Barberry bushes.  Sphagnum moss and other mulches.  What sort of thoughts do you conjure up when you hear such words?  The outdoors.  Fresh air.  A beautiful yard.  Health.  I'd agree with all of the associations, except the latter.  The aforementioned plants often harbor the fungus Sporothrix schenckii, which causes the disease sporotrichosis.  The fungus enters through tiny nicks or cuts in the skin (usually on the hand), producing a nontender subcutaneous (below the skin) nodule that eventually ulcerates.  Other similar nodules appear days or weeks later, developing further up the arm.  The incubation period ranges from 1 to 12 weeks, with most cases becoming apparent 3 weeks after exposure.  Inhalation of the fungus can cause pneumonia or cavitation (the formation of a cavity) of the lung.  Yuck.  Sporothrix can also spread through the bloodstream, taking up residence in your bones and joints.  Aren't you darn glad there are doctors in this world?

Given the increasing popularity of gardening, the incidence of sporotrichosis is increasing.  Fortunately, the disease can be treated.  In the early stages, it readily responds to oral potassium iodide, which can cause the worst case of zits you could possibly imagine, and assorted rashes, red eyes, laryngitis, and bronchitis.  In short, you'll be great dating material.  But, as your mother might rationalize, think of the character you will develop.  As is true for most diseases—but especially for this one—the best treatment is obviously prevention.  The obvious solution is gloves, or—if you buy into the blatant decadence depicted in the recent Visa commercials in which it is suggested that it is more "rewarding" to pay someone else to do your yard work for you—hire someone to do the dirty work.  In the yucky stages (to use precise medical terminology), intravenous amphotericin B may help.  When I was in medical school, we called amphotericin B "ampho-terrible," since it was almost as toxic to humans as it was to fungi.  Another antifungal drug, itraconazole (Sporanox), shows promise in the treatment of this disease.

If you have been exposed to the HIV virus (or any other infectious disease), there are additional measures you can take to further reduce your risk of becoming infected.  You may not be aware of the fact your body is constantly being exposed to germs, but infection rarely occurs because your immune system is able to annihilate the germs before they are able to take hold.  Once they are established, it is far more difficult to eradicate them.  This is analogous to assassinating some intransigent political figure before his power base is cemented.  For example, if Adolph Hitler was killed after making his first speech, World War II could have been prevented at a cost of less than 10 cents.  Since this did not happen, the cost of stopping him was over a trillion-fold greater (which you are still paying for, in terms of higher taxes).

If your immune system is strong, it is more able to kill the germs before they can cause disease.  It is best if your immune system is fortified before exposure, but there is a period after exposure—but before recognizable disease develops—when a battle is occurring in your body between the germs and your immune system.  Strengthening your immune system at this point is analogous to sending reinforcements into a battle, which increases the likelihood of success by the side that has been augmented.

There are several things that you can do to bolster your immune function, including:

  • Consuming yogurt with live active cultures has been shown to increase the activity of natural killer cells (which destroy cancer cells, and virus-infected cells), and to stimulate antibody and gamma-interferon production.  Interferons are natural proteins that are manufactured and released by cells in response to viral, certain bacterial (staphylococcal, streptococcal, pneumococcal), and certain parasitic infections.  Interferons act by binding to cells, stimulating or "revving them up" so that they are better able to resist infection.  Different types of interferon (alpha, beta, and gamma) exist.  The antiviral activity of interferon is especially important in the early stages of infection.
  • Shiitake mushrooms (those large, beefy, brown Asian mushrooms that are becoming increasingly available in American supermarkets) contain the immunostimulant lentinan, which possesses antiviral activity.  Maitake mushrooms also stimulate the immune system, enhancing the activity of macrophages and natural killer cells.
  • Consider using real licorice, which may stimulate interferon production.  The distinction between real licorice and fake licorice, as well as important precautions, are discussed elsewhere in Fascinating Health Secrets.
  • Consume a flavorful diet, which may increase levels of certain immune cells.  This is thought to result from the fact that the area of the brain which processes smell (which is involved in the perception of taste) influences the thymus and lymph system.
  • Garlic enhances T-lymphocyte and macrophage activity.  The garlic I'd recommend is plain ol' garlic from the vegetable isle, not garlic pills. The latter are typically an extract of one of the constituents of garlic, and it is not yet resolved if that single chemical is responsible for the much-touted cholesterol lowering effect of garlic, let alone responsible for the myriad other benefits of garlic. Also, another pertinent caveat:  crush the garlic before swallowing it. You can think of garlic as being somewhat analogous to two-part epoxies which do nothing until they are mixed together.
  • Supplement your diet as directed in the nutritional section of Fascinating Health Secrets.  As an example of the importance of nutrition, there is good evidence that daily supplementation with 200 mg of vitamin E can reverse the age-related decline in immunity that makes elderly people more prone to both bacterial and viral infections.  Research has also shown that people with low protein intakes are more susceptible to tuberculosis (and, most likely, a variety of other infections).  A vitamin A deficiency lowers resistance to respiratory and gastrointestinal infections.

Nutrition is not just an individual concern; it may impact others around you.  A study demonstrated that a deficiency of vitamin E or selenium in an animal infected with a certain virus (coxsackie 3B) resulted in mutation of the virus to a more virulent type that causes cardiomyopathy.  Once formed, these more virulent viruses can be spread to others, inducing potentially serious infections in them.

  • Reduce your intake of fat, in particular the omega-6 fats found in such vegetable oils like safflower, corn, and sunflower seed oils.  These can inhibit lymphocyte (a type of white blood cell) formation and natural killer cell (an important constituent of the immune system) activity.  Omega-3 fats from fish oil do not seem to cause the same problem; they may actually enhance immunity.
  • Reduce sugar intake.  Evidence suggests that it may lower immunity by interfering with the ability of white blood cells to ingest and destroy germs.
  • Avoid junk food.  While the constituents of such products are often detrimental in and of themselves, there is another problem associated with the ingestion of junk food:  the empty calories in junk food discourages the consumption of healthy foods.  I've met several people who drank enough Coke or Pepsi so that more than half of their daily caloric intake was provided by their soft drinks!  Not surprisingly, each one of these people was also a patient.
  • Avoid excessive alcohol, which also depresses the immune system.  One or two drinks per day, though, may actually lessen the chance of acquiring an infection by limiting viral replication and ameliorating stress.  Also, alcohol has been shown to minimize the chance of acquiring food-borne infections.
  • Avoid exposure to cigarette smoke, which impairs respiratory system immunity.
  • Drink plenty of water.  Optimal hydration enhances both nasal filtration (important for trapping airborne germs and particles [some of which may cause secondary problems of their own]) and reduces the risk of urinary tract infections.
  • Avoid aspirin and similar drugs, which interfere with certain aspects of the immune response.  Furthermore, aspirin increases viral shedding so that a person with a viral illness who is taking aspirin is more likely to transmit the disease to others.
  • Be judicious in the use of antipyretics (fever-reducing medications).  There is evidence that fever is an adaptive and beneficial response, not just an annoyance to be hastily suppressed. Viewed from an evolutionary perspective, I find it difficult to believe that millions of years of genetic honing has resulted in the body mounting a maladaptive response to infection, which surely has been one of the primary evolutionary pressures shaping our development.  Long before the advent of Tylenol, cute drug reps, and a Rite Aid drug store on every corner, our only hope for survival was natural immunity and its frequent concomitant, fever.  Physicians who throw a monkey wrench into a tried-and-true system of immunity had better well have some unequivocal justification for their action, yet they robotically advise the use of Tylenol in almost every febrile patient without a shred of evidence that their action is beneficial.  There are some patients in which the use of antipyretics is justified (such as a patient whose heart might be excessively strained by the extra workload imposed by the fever), but routine use of antipyretics for mild to moderate fevers is a practice that physicians cannot justify except by saying that it makes people feel better.  This temporary amelioration in symptoms, however, may occur at the expense of a prolongation of the infection.
  • Increase your intake of lysine, and decrease your intake of arginine.  These amino acids influence the degree to which you are susceptible to certain viral infections.
  • Take Echinacea, a herb that has been found to stimulate the immune system (especially the T-cells).
  • Quercetin, discussed elsewhere in this book, may limit the ability of certain viruses to cause an infection.  Quercetin is available in supplement form and in several foods.  Natural sources of quercetin include grapefruit (especially the white pulp), apples, berries, shallots, yellow squash, red grapes, broccoli, red wine, black tea, and red and yellow (but not white) onions. Onions also contain another substance, diphenylthiosulfinate, which has potent anti-inflammatory activity and therefore may be beneficial to people with asthma and other diseases rooted in inflammation.  Diphenylthiosulfinate is inactivated by the heat of cooking, but quercetin is not.
  • Limit zinc intake to 50 mg per day, or less.  High zinc intake can suppress the immune system.  Ensure that your copper intake is adequate, as a copper deficiency reduces the white blood cell count, thus increasing susceptibility to infection.  Also, there is preliminary evidence that a deficiency of selenium encourages HIV growth.
  • Although it may seem trite, ensure that you receive adequate sleep, rest, and relaxation.  Avoid worrying and stress as much as possible.  When stressed, your body produces more cortisol, which impairs immunity.  Research has shown that immunity increases in people who have undergone stressful experiences when they write about the events.  Stress can also be defused by taking positive action; your body is programmed to want to do something when stressed.  Simply being in a good mood enhances immune response.  The immune system can also be suppressed by failure to express feelings such as anger and grief.  Laughing can increase immune function and speed healing; some hospitals now give their patients humorous books and movies.  Music, touch, and a pleasant environment help, too.  Even something as simple as a pleasurable dinner with a friend has been shown to boost immune function for up to 72 hours.  Becoming involved in an enjoyable hobby can also improve immunity.  The adage about "all work and no play" making a person "dull" can be extended to "dull and sick".  Even if you are lucky enough to love your work, the stress of keeping mentally focused for prolonged periods of time can wreak havoc with your immunity—not to mention reducing your ability to concentrate.  Your mind, and body, requires time to recuperate from exertion.  No matter what you term it—R&R, "chilling out," "vegging out," "taking it easy"—it is an essential precondition for mental and physical health.  Sleep helps, but it is not the sole answer, especially in regard to mental refreshment.  You simply can't run at peak efficiency for 16 hours a day, 7 days a week.  If you think you can, you're deluding yourself.
  • Wear comfortable clothes that feel great on your body.  This form of tactile pleasure, which enhances immunity by decreasing stress, is especially important for those people without partners to provide a loving touch.  I enjoy the softness of a new sweatshirt.  You?
  • According to research done in Japan, lemon scent minimizes the effect of stress upon the immune system, and thus may be a useful adjunct.  I think that any aroma that you particularly enjoy would do the same thing.  When I was in college at Michigan State University, for a time I lived in a nearby town called Haslett.  There was a hardware store in Haslett that had what was for me an incredibly appealing almond-like scent.  This didn't just smell good; it made me feel successful, intelligent, confident, peaceful, happy, and productive.  Sometimes I'd go into the store just to smell that wonderful aroma.  I'm sure the scent was purposely introduced to make the customers of the store feel good about going there, as I can think of no other reason why a hardware store should have an intense almond scent.  While you may not experience the same reaction to that scent, it is likely that there is some other scent that elicits a similar response from you.  Even if these scents do not have a direct effect upon the immune system, it is indisputable that they can help immunity by mitigating the effects of stress.  Pheromone-containing colognes (Realm®), discussed in great deal elsewhere in this book as adjuncts for enhancing intersexual attraction, can also alleviate stress.
  • Be assertive.  Several studies have shown that people who are assertive have stronger immunity.  I realize that some people think of assertiveness as a synonym for bitchiness, but the two words are not interchangeable.  Assertive people stand up for their rights and refuse to take unwarranted abuse.  The correlation of assertiveness with heightened immunity is not surprising, since assertiveness reduces stress, which is one of the primary suppressors of immunity.
  • Avoid prolonged exposure to either very hot or very cold weather.  This stresses your body, which reduces immunity.
  • Avoid the sun, and other sources of ultraviolet (UV) radiation.  The skin contains cells called Langerhan's cells that detect germs, initiating an immune response to them.  UV radiation can impair Langerhan's cell function.  UV radiation can also activate certain white blood cells (suppressor T cells) which interfere with the immune response.  If you must go in the sun, apply topical vitamin C beforehand (as mentioned elsewhere in Fascinating Health Secrets) and wear a sunscreen with a sun protection factor (SPF) of 15 or more.  However, traditional sunscreens, for reasons that are not clear, are only partially effective in the prevention of UV immunosuppression.
  • Avoid caffeine if it makes you tense or irritable, for reasons that should now be obvious.
  • Avoid loud noise—another stressor.
  • Don't diet.  Many constituents of the immune system are proteins, the production of which can be reduced by severe dieting.  However, on a long-term basis, it is advantageous to avoid obesity, which is associated with impaired immunologic function.
  • Have sex.  This increases the levels of IgA antibodies (that are your first line of defense against germs) and also stimulates the T-cells and natural killer cells of the immune system, reducing your risk of infection and cancer.  Most of the things you have to do to reduce your risk of cancer are unpleasant; here's one that isn't.  For the sake of your partners, you should obviously inform them of your status and use a condom, if you have been exposed to HIV.
  • Whenever possible, stay away from others who are ill.  If you contract their illness, your ability to combat other germs is reduced.  When you are around others who may be ill, follow the advice given in the section in Fascinating Health Secrets on disease prevention, and don't neglect common sense measures such as frequent hand washing.
  • Postpone nonessential vaccinations.  When your immune system is distracted, so to speak, by other germs or by a vaccine, its ability to deal with the primary infection is reduced.  Incidentally, the beneficial increase in antibodies which results from vaccines is greater when the recipient is not under unusual physical or mental stress.  Research has shown that people given the tetanus vaccine are much more susceptible to HIV infection.  If you sustain a cut that was contaminated by HIV-infected blood, and you're due for a tetanus shot, I'd advise you to skip the vaccine.  To begin with, most people have an overblown fear of tetanus.  I've never seen a patient with tetanus, and I've never even heard of anyone who contracted that disease.  Sure, it's a nasty illness, but it is not very prevalent.  I'd bet that your chance of dying as a result of an accident sustained while driving to the ER for a tetanus shot is greater than your chance of dying as a result of tetanus.  Secondly, there is an alternative to the tetanus vaccine that does not stress your immune system.  Hyper-Tet® (tetanus immune globulin) supplies preformed antibodies to tetanus, which minimizes the risk of tetanus acquisition.  Quite likely, you will need to mention this to your doctor, as most physicians have a foggy understanding of Hyper-Tet® and usually neglect to use it, even when its use is clearly indicated in textbook cases.
  • Don't eat out.  It's simply human nature:  compared to you, restaurant workers are less likely to be meticulous with food hygiene.  Working in the ER of a tourist town (and therefore seeing many patients who have eaten restaurant food) has convinced me that the incidence of gastroenteritis or food poisoning is remarkably greater in people who eat out than in people who eat at home.  Contracting such a problem can stress your immune system, lessening its ability to deal with other infections.  If you're lucky, you'll witness the hygienic faux pas and thus be able to avoid the contaminated food, but most likely you will savor every germ as you unwittingly infect yourself.  I once ate at a popular fast-food Mexican restaurant in which most food preparation is done at a counter directly in front of the customer.  The teenie bopper who was preparing my burrito had what was obviously a whopper of a cold (pun intended).  She blocked a couple of wet, slimy sneezes with one of her hands, and then resumed working on my burrito, pawing the tortilla with her well-lubricated hand.  Even if nasal effluence (a.k.a., snot) were devoid of germs, I'd be less than enthused about wrapping my lips around such slime.  Common sense should dictate the advisability of washing her hands after the sneeze, but when I suggested that she do that after discarding the burrito, she looked at me as if she were truly mystified and offended by such a request.  Her countenance said it all.  Such temerity!  Such insolence!  How dare you suggest such a thing?  Well, I wouldn't eat food peppered with the nasal discharge of someone as delectable as Mimi Rogers, and I certainly wouldn't bite into the effluvium of a burrito bimbo.  I never ate there again.
    Having treated innumerable injured restaurant workers in the ER, and having noticed that many of them have obvious infectious diseases, I've come to the conclusion that most restaurant managers don't care if your food is inoculated with a germ-laden "Special Sauce" contributed by an infected employee.  Most of the resultant infections will cause no more than a few days of misery (as if that weren't bad enough), but there are some truly nasty germs lurking inside a disproportionately high number of food-service workers.  Consider cooks and chefs.  One of their occupational hazards is sustaining a hand cut.  Do you think the contaminated work surfaces and utensils are completely disinfected before your next burger is made?  Do you think that any contaminated food is discarded?  Dream on.  A former employee at a popular restaurant in my childhood hometown revealed that it was common practice for their cooks to spit on a steak that had been sent back for additional cooking.  With such an attitude, it is difficult to believe that they would be more careful with food that was otherwise tainted.  Professionals, they're not.  And now for my politically incorrect observation of the day.  Most likely, you will not see the person who cooks your food in a restaurant.  When they're injured, I see them in the ER—and I see that a noticeably higher percentage of them are sickly, scrawny people who look as if they're in the latter stages of hepatitis or AIDS.  I'll bet that their emaciated appearance does not result from a lack of food, either, which leaves chronic disease as the next-most-likely condition to cause such a problem.  Many of them have told me that they're intravenous drug abusers (which, of course, is a major risk factor in the acquisition of the germs which cause hepatitis or AIDS).  Are you appetized yet?  Furthermore, some restaurants (and, disgustingly, most hospitals) seem constitutionally unable to provide truly clean dinnerware and utensils.  The telltale adherent food particles says it all:  if bits of the last meal are clinging to your fork, how clean is it?  Not very, I'd wager.  If you have the runs a few days later, my mouth will not be hanging open in disbelief.
    If you are going to eat in a restaurant anyway, your best defense is to dine in an expensive, classy establishment.  Odds are, their chef and workers will be less likely to be infested, and less apt to engage in behaviors that might transmit germs to you.  And if you're pleasant and a decent tipper, they'll likely return the favor by being careful with your food.  Hold the pickles, hold the lettuce, special orders might upset us . . .
  • Avoid prolonged, very strenuous exercise, which may cause a temporary decrement in immune function.  Marathon runners have a higher incidence of infectious illness after completing a marathon.  Granted, it's unlikely that you would exert yourself to the same extent, but they are far more accustomed to such events than you would be, given their preparatory training.  You might experience the same degree of immune suppression just by running one mile.  Mild exercise, in contrast, increases natural killer cell activity, which can speed recovery.
  • Fall in love.  If that is not possible, watch a movie about love.  Some researchers have found that people who watched such movies had increased levels of immunoglobulin-A (IgA) in their saliva (presumably, a similar increase would also be present elsewhere).  IgA is a component of the immune system that is present in saliva, tears, colostrum, and respiratory, genital, urinary, and intestinal secretions.  IgA provides an early antiviral and antibacterial response.
After reading this list you'll realize how pathetically inept your doctor is when you see him for a viral infection and his only advice is to drink plenty of fluids and take Tylenol.

Women who douche more than once a week have an increased risk of cervical cancer.  This effect seems to occur, regardless of the type of fluid used for the douche.

On the positive side, douching can reduce the risk of acquiring certain STDs.  In the past, douching was often employed as a desperate means of contraception, and its marginal effectiveness resulted in its being viewed with askance.  However, this negativistic perception is overly inclusive.  Certainly, it is not a reliable means of contraception.  However, it can flush out semen and cellular debris abraded from the penis during intercourse, and therefore minimize the chance of infection.  Functionally, this is analogous to hand washing.  Let's say that you have a hand cut, and a rabid dog licks your wound (OK, a rabid dog would probably do more than lick your wound, but this is beside the point!).  As a result, some nasty germs are deposited in the cut.  What would you do:  wash the cut, or leave the wound alone so that the germs can soak in?  Why, you would wash the cut, of course!  Wound cleansing is the most basic and effective means available to reduce the probability of infection.  If you had a cut that was contaminated by dirt and germs, and a doctor was given the choice of either cleansing it or giving you antibiotics, he would invariably choose cleansing as the most desirable option.  The effectiveness of antibiotics pales in comparison to the effectiveness of cleansing in reducing the odds of wound infection.  Of course, cleansing cannot eliminate the risk of infection, but what is better:  some reduction in risk, or no reduction in risk?

If you are troubled by recurrent vaginal yeast infections, read this section.  The organism responsible for most of these infections is Candida albicans, which can attach to your underwear and survive washing.  To eliminate the yeast, put your panties in boiling water for 30 minutes, wash them in hot water twice with unscented detergent (the first time using two to three times the normal amount of detergent; the second time using a standard detergent dose), then dry.  After drying, iron them (the heat from the iron kills the few remaining yeast).  Or, you could always buy new underwear every day.

Pregnant women afflicted with either yeast or non-yeast bacterial vaginal infections can often be cured by applying a tablespoon of acidophilus-containing (a.k.a., active-culture) yogurt into the vagina each day.  Of course, use plain yogurt—not the sweetened and flavored varieties!  If you dislike the idea of instilling yogurt into your vagina, eat yogurt beforehand.  Your risk of acquiring a vaginal infection can be decreased by eating eight ounces of active-culture yogurt daily.

If you have a yeast infection that does not respond to traditional anti-fungal medicines, you may have an infection that is not caused by Candida albicans.  When physicians think of vaginal yeast infections, they assume that Candida is the responsible agent.  However, a small percentage of chronic yeast infections are caused by Saccharomyces cerevisiae, a.k.a. baker's yeast.  If you or your sexual partner bake with yeast, you may be infected with this organism, which does not respond to Monistat and similar antifungal drugs.  A vaginitis caused by Saccharomyces can be treated with suppositories that contain 600 mg of boric acid, placed intravaginally for two weeks.  Please note that it is not the baked goods per se which causes this infection, since baking kills the yeast.  Rather, it is contact with the dough, small amounts of which are often trapped under the fingernails.  This infection can be prevented by thorough hand washing, and scrubbing under the nails, after contact with yeast doughs.  If your doctor wishes to verify the presence of Saccharomyces, it will be necessary to perform a culture, as a standard microscope smear may not differentiate this from Candida.  Furthermore, it is not possible to differentiate based upon the symptoms and signs of the infection, as both yeasts present with an identical clinical picture.

Another possible cause of recurrent vaginal yeast infections is oral sex.  Since 40% of adults harbor yeast in their mouth, women who receive oral sex can be infected from their partner.  If this is suspected, oral swabs or cultures can determine if the partner is indeed infected.  Now, on to the next topic . . .

Another cause** of decreased libido is excessive prolactin.  Prolactin is a hormone which stimulates lactation (milk production), if present in sufficient amounts for prolonged periods.  Surprisingly, prolactin is present in both women and men.  Prolactin can impair libido, even if its concentration is not high enough to induce lactation.  There are numerous causes of hyperprolactinemia (increased blood prolactin), including stress, certain drugs (oral contraceptives, Aldomet, tricyclic antidepressants, phenothiazines, Reglan, Compazine, Phenergan, Tagamet, and Haldol), hypoglycemia, and nipple stimulation in both women and men.  Apparently bizarre causes of hyperprolactinemia are certain chest wall lesions, including neoplasms of the chest wall, herpes zoster (shingles), and surgical scars or trauma affecting the chest wall.

Ginseng's reputed aphrodisiac effect has a scientific basis, because ginseng can depress blood prolactin levels.  This effect is more pronounced with repeated use.

Prolactin can also contribute to obesity, since it can stimulate appetite and promote fat storage.  Parlodel (bromocriptine) is a drug that can reduce prolactin secretion.  It can therefore promote fat loss.  Parlodel can improve libido, especially in people with high prolactin levels, and it may increase sexual pleasure, too.  One of the unique properties of Parlodel is its ability to increase sexual desire while postponing ejaculation.  Sounds to me like a recipe for fun.
** Trust me, I was on this topic in the book—these are just excerpts!

The adage about how it is often not desirable to have too much of a good thing is applicable to vaginal secretions in some women.  For optimal female and male pleasure, vaginal secretions should have a certain viscosity and volume.  Most women form reasonable quantities of a pleasingly viscous fluid, but a few women produce copious amounts of a watery secretion that is too slippery.  Sexual sensations are dependent upon friction, and the excessive reduction in friction which results from these secretions can impair pleasure.  This problem can be mitigated with Periactin (cyproheptadine), which has antihistamine and antiserotonergic effects.  You are probably familiar with antihistamines such as Benadryl, which can cause a dry mouth.  They also increase the viscosity, and decrease the volume, of vaginal secretions.  Periactin is better than Benadryl for this, because it also has an antiserotonergic action (that is, it inhibits serotonin).  Because serotonin inhibits sexual pleasure, drugs with an antiserotonergic effect—like Periactin—can intensify pleasure.

On the other end of the spectrum, vaginal secretions that are too viscous can result from inadequate fluid intake or the action of numerous drugs.  This problem can be controlled by addressing the root cause, or by using a vaginal lubricant.

This will sound goofy, but it's true.  Robitussin, and anything else which contains guaifenesin, increases a woman's chance of conceiving by thinning the cervical mucus.  Guaifenesin is by far the most common expectorant used in the United States.  It can also thin semen to some extent, making it easier for sperm to swim (it's easier to swim through liquids that are less viscous).  If you are taking any sort of expectorant medicine, it is virtually certain that it will contain guaifenesin.  The efficacy of most hormonally-based contraceptives is dependent to some extent on their thickening of the cervical mucus, making it more difficult for sperm to pass.  If you are on such a contraceptive (like Norplant or the Pill), you could be in for a big (well, 7½ pounds!) surprise.

Now that I am on the subject of Norplant, let me take this opportunity to blast it and its cousin Depo-Provera.  While both are effective in preventing pregnancy, they reduce a woman's estrogen and testosterone levels.  The reduction in testosterone lowers libido, and the reduction in estrogen lessens the sensate qualities of a woman's vagina as well as contributing to depression and anorgasmia (failure to achieve orgasm).

Norplant and Depo-Provera can also increase the risk of a woman acquiring HIV through vaginal intercourse.  These drugs thin the vaginal walls, making them more susceptible to viral penetration.  Vaginal thinning can be controlled by the concomitant use of estrogen vaginal cream, since estrogen thickens the vagina.  Estrogen vaginal cream can also thicken the vaginal walls of women who are not receiving Depo-Provera or Norplant, further reducing the likelihood of HIV acquisition.  As a secondary benefit, the thickened vaginal wall enhances male pleasure during intercourse, producing sensory delights that are not possible with a "standard," unenhanced vagina.  Estrogens increase the risk of cancer of the uterus in women beyond the age of menopause, but a) uterine cancer is something that can be screened for, and b) if detected, it can be treated, and c) many postmenopausal women have had a hysterectomy and thus have no uterus.

Depo-Provera and Norplant can also make women chubby.  For example, the manufacturer of Depo-Provera reports women receiving that drug gain an average of 5.4, 8.1, 13.8, and 16.5 pounds after 1, 2, 4, and 6 years of therapy, respectively.

In a dose of 50 to 150 mg 20 minutes before sex, niacin has been reputed to enhance vaginal lubrication, sexual flush, and orgasm intensity.  The first two are quite possible, but I have my doubts about the latter point.  Some people have attempted to form a logical nexus between something which is a manifestation of sexual excitement (the sexual flush) and orgasm quality.  While there are a number of factors which contribute to the intensity of orgasm, and sexual excitement is one of them, the augmentation of indices of sexual excitement (such as flushing, sweating, and heart rate) cannot enhance sexual pleasure.

This physiological malapropism reminds me of the pheromone-containing colognes that were marketed in the late 1970s.  Pheromones are hormones produced by animals that stimulate a response in other animals of the same species.  In this case, scientists had identified a pheromone that caused the recipient's heart to beat faster and more forcefully.  In a wild and unjustifiable extrapolation of logic, incorporation of this pheromone into men's colognes was supposed to make the hearts of nearby women beat faster and more strongly.  And that it did.  Since forceful beating of the heart is one of the things people experience when they are falling in love with a person of the opposite sex, this stimulation of the heart was supposed to make the pheromone recipient believe that they were falling in love with a certain person just because their heart went into overdrive when that person was around.  Ha!  We're not talking about moths or birds, we're talking about women!  I don't think that anyone is so "cerebrally challenged" as to mistake an increase in heart rate with feelings of love.  In medical school, my heart rate must have doubled whenever I saw a certain Professor of Surgery, yet the thought of love never crossed my mind in any manner that may have been associated with her.  Far from it.

While that pheromone may have been a dud, there are pheromones that play some role in sexual attraction.  Sooner or later, these are bound to be exploited commercially.  A pheromone (copulin) has been identified in vaginal secretions just before ovulation, which is thought to play a role in stimulating the sexual interest of males.  Since women are most apt to become pregnant around ovulation, it is not surprising that nature has contrived a means to facilitate intercourse at that time.  Pheromones are also present in sweat.  Men produce more sweat—and more pheromones—than women.  The pheromone content of sweat may be one reason why women find sweat to be a turn on, especially in certain circumstances.  For example, a few years ago I had a relationship with a woman who derived a great deal of pleasure from prolonged intercourse—often an hour or more.  Given that I was the one doing most of the work, so to speak, it is not surprising that I became literally soaked with sweat.  Having been raised in an American culture that often defines sweat as being offensive, I was actually apologetic to my girlfriend for my sweatiness.  Her response shocked me.  Not only did she not mind the sweat, she exclaimed, "I love it!"  Now, this should not be interpreted by men as a license to become a perpetual sweat hog, as it is one thing to be clean and sweaty, and something else altogether different to reek of B.O.  Pheromones or not, offensive odor can negate the otherwise positive effect of sweat.

A new cologne, called Realm, contains a "feel-good" pheromone that enhances one's sense of well-being.  Realm comes in two types:  one intended for application on men, and another intended for application on women.  The men's version enhances male well-being; the woman's version enhances female well-being.  Seems strange, doesn't it?  The purpose of wearing the cologne is, after all, the attraction of a mate, so it seems logical to assume that the male version would enhance a female's sense of well-being, so that women who are in proximity to a pheromonally supplemented man would feel good while they're in his presence.  The pheromone colognes of the 1970s may have been duds, but it doesn't take a rocket scientist to realize that a man could apply Realm for Women and increase his success in dating.  The people who manufacture Realm are certainly bright enough to realize that, so why don't they just do the apparently logical thing and have the male version attract women, and vice versa?  Repeat after me, attorneys.  Repeat after me, lawsuits.  Yes, folks, we live in America, the land where manufacturers of lawn mowers get sued if they don't emblazon their mowers with a half-dozen stickers warning there is actually a moving blade beneath the mower deck, and this moving blade is potentially dangerous.  No kidding?  So that's what cuts the grass, eh?  The manufacturer of Realm is worried that the same type of attorneys who sue lawn mower manufacturers who secretly hide dangerous rotating blades will sue them, alleging their client never would have fallen for the con man, mass-murderer, or VD-infested scumbag, were it not for the overwhelming attraction elicited by the pheromone.  Hence, by labeling the male "feel-good" version for use on males, the manufacturer can honestly claim that Megan's attraction for Steve had nothing to do with their product.  Of course, they know you're smart enough to figure out which version you'd like to wear, but they didn't tell you that, right?

If you would like to expand your knowledge of fun facts to know and tell about pheromones, read on.  The organ responsible for pheromone detection is the vomeronasal organ (VNO), which is bilaterally located on the floor of the nose.  The VNO was once thought to be vestigial, but several independent researchers have unequivocally demonstrated that it is functional, providing a true "sixth sense."  Pheromone response is to some degree, but certainly not absolutely, gender-specific.  Realm for Women contains the pheromone androstadienone, and Realm for Men contains estratetraenol.  Male VNO response to Realm for Women is approximately 40% of the female response, and female response to Realm for Men is about 40% of the male response.  Got that?  This blurring of gender specificity no doubt proves to be unsettling to Erox, the manufacturer of Realm, for the reason mentioned above.  Notwithstanding any corporate paranoia over liability and their attempted mitigation of this problem by obfuscating the obvious gender utilization of their products, though, Erox should be justifiably proud of their accomplishments.  In fact, if my vote means anything, I'll even go so far as to nominate them for a Nobel Prize.  Intelligently used, pheromones are far more than a somewhat underhanded means of increasing intersexual attraction.  They can enhance the perception of well-being, making the recipient feel more cheerful, less irritable, less depressed, and imparting a feeling of a perpetual internal smile—at least until the cologne wears off.  If they don't believe this already, it can make a person feel that life is indeed worth living.  By reducing stress, pheromones can indirectly improve immune function, help build muscle, reduce cardiovascular risk, and even combat skin diseases such as acne, eczema, and psoriasis.

Before leaving this subject, I have a few more pragmatic tips on the use of Realm:

  • Don't expect to apply Realm and then walk by a person of the opposite sex, having them decide that you are, after all, the one for them.  Pheromones can induce a feeling of pleasure in the recipient, but this perception may or may not be attributed to your presence.  According to the tenets of contemporary psychology, the attribution of a recognized nexus between you and the perception of happiness is more likely to develop in the pheromone recipient as the number of these exposures increases, enhancing the development of a learned response.  Furthermore, the chance that an effect will be elicited on any occasion is improved when the pheromone emitter is close to the recipient, and this proximity is maintained for at least several minutes.  Obviously, it helps to choose a location without strong air currents.  Having dinner together in a restaurant, or watching a movie while sitting side-by-side, would be ideal circumstances in which to employ pheromonal attraction.
  • Given the lack of absolute gender specificity discussed earlier, it is reasonable to expect that concomitant use of Realm for Men and Realm for Women would evoke a response that is greater than that which could be achieved by the use of just one pheromone cologne.
  • Consider, if you will, the ethics of the enhancement of intersexual attraction.  On the face of it, it may seem that such a technique is underhanded, and it smacks of fraudulent deception.  Hmmm . . .  That was my initial impression, too, but the more I thought about this matter, the more I realized this was no different in intent than make-up, a pair of nice jeans, or a Wonder Bra.
  • At the time of this writing, the price for a bottle of Realm is $60.  Before you gasp and go into cardiac arrest, let me assure you that a little of this stuff goes a long way.  The $60, I figure, will buy you one heck of a good year, or about as much improvement as can be reasonably expected from the marvels of modern chemistry.  By the way, ol' Pezzi doesn't have the slightest financial interest in Erox; I'm touting their products because they made a believer out of me.

It's a fact:  the average couple begins having sex after three dates.  If unprotected heterosexual intercourse were an efficient means of transmitting the HIV virus, heterosexuals would be dropping like flies.  Some people use condoms, but most don't.  Even in those who do initially use condoms, most soon forgo such usage.  Consequently, the majority of heterosexual intercourse is done without a condom, and I need not remind you about the prevalence of sex.  If unprotected heterosexual intercourse were the risky Russian roulette that it's made out to be, there wouldn't be enough people left for you to even find a person to date!  Nevertheless, most people have a morbid fear of acquiring AIDS and give some thought to the use of a condom.

Instead of giving you a lecture on remaining celibate until you're married, or giving you in-one-ear, and-out-the-other advice on wearing a condom, I'll give you some tips on a type of condom you've probably never heard of before:  the tip condom.  This condom minimizes the loss of sensation that causes most people to avoid condoms, and it is an effective barrier to the transmission of HIV.

Q:  What's a tip condom?
A:  A condom that covers only the tip of the penis.

Q:  I've never seen them in stores.  Where can you buy them?  And why should I use one?
A:  I don't know of anyone who sells them, but it is easy to make them.  (I'll give details below.)  As long as both partners have no sexually transmitted diseases, the only reason for using a condom is to prevent pregnancy.  The tip condom does this just as well as a standard condom.

Q:  What about AIDS?
A:  First of all, the HIV subtype that's prevalent in our country is very difficult to transmit through vaginal intercourse.  In fact, some researchers think it is next to impossible as long as there are no open sores or lesions on the penis or vagina.  I heard one expert discussing this on the radio, and he said that he believes the vast majority of heterosexual transmission of HIV is not due to vaginal intercourse, but rather to anal sex, which some heterosexuals engage in.  I don't think vaginal intercourse is perfectly safe, since small tears can develop in the vagina or penis during sex if lubrication is inadequate or if the man has a large penis.  Still, I think the risk of transmission in heterosexuals who avoid anal sex is way overblown.  As an example, consider the case of Paul Michael Glaser.

Q:  Who is he?
A:  He's a Hollywood actor whose wife was infected with HIV, and she and her husband were together for several years before she was diagnosed.  However, he never acquired the infection.  There are plenty of other cases, too, but he's the most famous one.  So why all the hoopla about AIDS in heterosexuals?  More than a few people suspect that Puritanical forces have capitalized upon the AIDS epidemic as a means of enforcing their agenda.  There are even more politically incorrect explanations, none of which I care to speculate about in print.

Q:  So you don't think there is a reason for heterosexuals to use condoms if they don't have anal sex?
A:  I'm not saying they're worthless, but the media have totally twisted the facts about condoms.  They want you to believe that condom usage is the most important factor in reducing the risk of transmitting HIV through sex.  That's a fallacy.  The most important factor is selection of a partner.  HIV is far less likely to be transmitted if you don't use a condom and have vaginal intercourse with a person from a low-risk group than if you do use a condom and have sex with a person from a high-risk group.  Condoms can always be used to reduce risk, but anyone who relies upon them as their primary tool for preventing the spread of HIV is putting their eggs in the wrong basket.

While I'm on the subject of how the media have distorted facts about AIDS, it's pertinent to note that some scientists do not believe that HIV is the cause of AIDS.  Since almost everyone seems to "know" that AIDS is caused by HIV, it is tempting to dismiss these naysayers as being foolishly ignorant.  However, before we label these folks as being backwater kooks, it's worthwhile to know who they are.  Perhaps the foremost scientist who favors a reappraisal of the HIV/AIDS hypothesis is Dr. Kary Mullis, who won the Nobel Prize in Chemistry for inventing the polymerase chain reaction (PCR), a technique which amplifies DNA and is arguably one of the most important discoveries in the history of science.  If he's a backwater kook, then Albert Einstein was just a guy with a slide rule.  There's no doubt that Mullis is a genius, and 99.9% of the scientists in the world can only wish that they were as gifted as he.  However, these other scientists—trying to make do with a lot less brainpower—haven't been the least bit shy in jumping on the "HIV causes AIDS" bandwagon, and mainstream journalists with even less on the ball have swallowed this hypothesis hook, line, and sinker and promulgate it as if it were God's Given Truth.

Q:  How does the tip condom compare with a standard condom in terms of preventing the spread of HIV?
A:  The primary means by which it is transmitted to a woman is through the man's semen, and in the case of a woman transmitting the disease to a man the primary route is through the woman's secretions entering the man's urethra.  The tip condom is as effective as the standard condom in preventing both of these routes.  A standard condom would be more effective than a tip condom if there were open sores or wounds on the penis or vagina, but overall I think the risk of transmission would be reduced if every condom sold were a tip condom.

Q:  I'm not sure I follow you.
A:  What I just said seems to be a paradox, but it's true.  Since sex with a tip condom is almost as pleasurable as sex without a condom, people would be far more likely to use a tip condom than a standard condom.  A standard condom would be somewhat better if people used them, but they dull sensation so much that men find a million reasons not to use them.  In that case, they're totally worthless, and a tip condom is infinitely superior.  When used for oral sex, tip condoms can reduce the risk of HIV transmission and also eliminate the perennial problem of what to do when the man climaxes.

Q:  Does sex with a tip condom really feel almost as good as sex without a condom?
A:  While it does reduce sensation somewhat, it doesn't necessarily decrease overall pleasure.  The neural pathways that trigger sexual pleasure and orgasm are complex, and decreasing the stimuli from the tip of the penis can sometimes enhance pleasure.  In fact, the most intense orgasm I ever had occurred while I was wearing a tip condom.

Q:  How do I make a tip condom?
A:  Such a condom is easily fashioned by cutting a standard non-lubricated condom so that it ends just beyond the penile sulcus (depression) and placing a small rubber band over the condom as it passes over the sulcus.  It may be further secured by applying tincture of benzoin (available at any drug store) into the sulcus and allowing it to dry a few moments until tacky before the condom is applied.  Also, don't fit the condom snugly to the tip of the penis; it is a good idea to leave a bit of slack there to provide for expansion during ejaculation.  As you are securing the tip condom, express any air that's trapped in the tip.

Q:  Can I use a sexual lubricant with a tip condom?
A:  That's a good idea, especially if the woman's natural lubrication is inadequate.  Using a sexual lubricant like Astroglide or Wet can essentially eliminate the small chance of a genital abrasion or tear developing during coitus, which could allow transmission of the virus.  (Remember, AIDS cannot pass through intact skin.)  Furthermore, they can significantly enhance sexual sensations; their efficacy in that regard makes K-Y Jelly and Vaseline pale in comparison.

    Trivia time:  Astroglide was developed by a NASA chemist working on the Space Shuttle project (hmmm . . . makes you wonder what they're doing in the Space Shuttle, doesn't it?  "Uh, Houston, this is Discovery.  We have lift-off . . .").
Q:  Does the tip condom protect against other sexually transmitted diseases?
A:  It protects against those diseases that are transmitted through the man's urethra (such as gonorrhea and similar diseases), but it does not protect against diseases that are transmitted by skin contact (such as venereal warts, herpes, or syphilis).

The latest birth control device is the female condom. Like the male condom, it imposes a barrier between the penis and the vagina. The primary drawback to condoms is that they reduce sexual pleasure, no matter how thin the barrier. Working on an unrelated topic a few years ago, I discovered a polymer that could be used to construct a female condom that is vastly superior to existing devices in terms of durability, venereal disease protection, and especially sensation. Since all condoms are reasonably durable and provide good protection from VD, I believe the latter characteristic (sensation) is the most important aspect of a condom because research has shown that most people will not use them because they do reduce pleasure. People spend more time talking about condoms than they do using them.

In 1990, I was doing research on polymers that might be applied to the back of a picture to prevent the picture from tilting (exciting life, eh?). Tired of constantly straightening my pictures, and dissatisfied with the existing "rubber bumpers" often used for this purpose, I set off to discover a better material. I found that a simple alteration to an existing polymer made it feel incredibly like a vagina, in terms of texture, consistency, and resiliency. While I had no intention of working on an artificial vagina, when I touched the material, I immediately recognized the similarity between this and a real vagina. Showing it to my girlfriend a year later, she exclaimed, "It feels better than mine!" I wouldn't go that far, but there is indeed a remarkable similarity.

Although I had made an interesting discovery, I was leery of proceeding with this idea. Frankly, I did not want to be known as the inventor of an artificial vagina. While virtually everyone masturbates at some time in their life, this topic remains somewhat taboo. Sex (both heterosexual and homosexual), birth control, abortion, rape, and incest are covered so frequently in books, magazines, and radio and television broadcasts that these topics are blasé. Mention them and no one bats an eye. The public discussion of masturbation has yet to achieve this degree of acceptance. President Clinton allowed his Surgeon General to publicly discuss condoms for a couple of years, but when Dr. Joycelyn Elders mentioned masturbation, he fired her. The prestigious journal The Lancet referred to this incident as "a bizarre example of the triumph of politics and prejudice over common sense."  (And how ironic, given that masturbation is downright respectable compared with some of the things Clinton has done while in office . . . literally.)

Until recently, I was reluctant to develop this idea because I felt it might undermine my credibility on other paths of research. My opinion changed when I read a book on medical ethics, which said that a physician has a duty and an obligation to the public to reveal advances that might prevent diseases. Indeed, not to do this is unethical, not merely a neutral omission. Since my discovery could also be used to construct a female condom that more people would use (see below), it would of course prevent many diseases. While I do not believe that heterosexual transmission of AIDS is much of a problem, it is indisputable that many other diseases are sexually transmitted. By preventing the spread of these diseases, my innovation would have a legitimate, laudable medical use. Hence, I decided to proceed.

Since the above-mentioned polymer feels similar to a vagina, it is obvious why men would find this to be preferable to a traditional condom. But what about a woman's pleasure? Let's analyze this to see how a female condom fashioned of this polymer would allow women to experience the same degree of pleasure—or even heightened pleasure—as they would during intercourse without a condom.

Apart from the emotional component, a woman's sexual pleasure is derived from three factors. First, male thrusting indirectly stimulates the clitoris. Second, the penis applies pressure and tension to the vagina, including the G-spot, and the labia minora (the sensitive inner lips of the vagina). Third, the texture of penile skin (which improves when moistened) stimulates the outer third of the vagina and the labia minora. A female condom made of this special polymer would likely provide enhanced pleasure to a woman for several reasons. The texture of the polymer is superior to that of penile skin; tactile sensation is therefore improved. Next, the pressure the device applies to the vagina, G-spot, and labia minora increases because the thickness of the condom effectively increases penile diameter. In contrast to traditional male or female condoms, increasing the thickness of the condom wall will increase both male and female pleasure. Finally, the device could be molded so as to provide direct clitoral stimulation. Thus, women who have difficulty reaching orgasm via traditional intercourse would be more likely to experience an orgasm.

Another use of this material would be in the construction of a subcondom. A what, you ask? OK, I realize that I'm heading off into uncharted territory, so an explanation is in order. A subcondom is a device placed on the penis, beneath a condom. Why would anyone want to do that, you ask? There are several reasons, including:

w The subcondom provides an additional barrier to prevent the transmission of sexually transmitted diseases (STDs).

w The subcondom provides an additional barrier to prevent insemination, if the condom breaks.

w A subcondom, constructed of the polymer alluded to above, would provide much greater pleasure to the man during intercourse (since the texture of the material is similar to that of a vagina). The woman's pleasure would not change appreciably, although it would be possible to use the subcondom as the only condom. If this were done, a woman's pleasure could also be enhanced, since the texture of the polymer is far superior to that of latex rubber.

Since it is well-known that condom usage is limited by the fact that condoms reduce pleasure, subcondoms—by enhancing pleasure—would make condom use much more acceptable. This would result in increased use of condoms, which would limit STDs and unwanted pregnancies.

Trivia time. Graham crackers were invented by Sylvester Graham (1794-1851), who intended them as a means of curbing what was then called "self-abuse"—what we now call masturbation. Not surprisingly, graham crackers have no such effect. Graham was also a proponent of daily tooth brushing, an idea that was considered radical at the time (I'm glad I wasn't dating back then!). The inspiration for Graham's tooth brushing idea is not known, but I'd wager a bet that it had something to do with the pasty goo that is deposited between teeth when graham crackers are eaten.

Similarly, Kellogg's Corn Flakes® were developed by Dr. John Kellogg, who intended them as a food that would curb the urge to masturbate. Strange, but true. Perhaps even stranger is that there is a grain of truth in this (pun intended), if the corn flakes are eaten instead of meat. Compared with those who eat meat, vegetarians have lower testosterone levels. Testosterone is known to be the primary hormonal regulator of libido in both sexes.

Ol' Doc Kellogg had a real fixation about masturbation and he apparently felt that the anti-masturbation effect of Corn Flakes left something to be desired, so he advocated circumcision without anesthesia as another way of curbing self-abuse.  When I toured the Kellogg's cereal factory years ago, the revisionist tour guide neglected to mention how the inventor of Corn Flakes played a small but important role in the history of sex.

 Thank you for reading these excerpts from my book!


All material Copyright © 2000 by Kevin Pezzi, M.D. All rights reserved.  Reproduction or publication of the content in any manner, without express permission of the publisher, is prohibited. No liability is assumed with respect to the use of the information herein. You should consult with, and obtain the approval of, your personal physician before instituting any of the measures presented. No book intended for the general population can attempt to treat specific individuals, and no material in this book should be construed as offering individual medical advice. Given the innate variability of people, it is critical that your physician approves the adoption of any information herein contained as being safe and effective for you. A physician's circumspection is his—and your—greatest asset.

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