YOUR HEALTH Dr James Le Fanu: predisposed to illness
Thursday, 22 November 2012

Dr James Le Fanu: 23 November

How some people are simply predisposed to illness, which blood pressure gauge is more reliable, and a suggested remedy for a dominant taste

Written by Dr James Le Fanu
Some people undoubtedly have more than their fair share of bad luck. Recently, when searching through the medical notes of a man in his early 30s, I discovered he had been involved in a serious traffic accident at the age of four and then, a year later, almost died from peritonitis from a ruptured appendix. He went on to develop asthma, was found to have an undescended testicle requiring operation and, while still a teenager, developed kidney stones.

Now he might just be a statistical quirk as, by the law of averages, some will have more illnesses than others. But there is a general impression that a small amount of people are fated from birth to draw the short straw in the lottery of life. When the distinguished medical statistician, Major Greenwood, examined the incidence of accidents among female munition workers during the First World War, he found they were not randomly distributed, but rather tended to befall the same small group of women. Similarly, a study of car drivers in Connecticut found that just five per cent was responsible for more than a third of the accidents over a six-year period. The simple explanation might be that the accident-prone are just less dexterous than others.

With children it is different, as they are particularly vulnerable to potential dangers in their immediate environment. Indeed, childhood accidents dwarf all other causes of untimely death with an enormous gradient between the social classes. Clearly, a childhood spent on a dismal housing estate bordering a main road is a lot riskier than one spent in the leafy suburbs.

The significance of childhood accidents is that frequently something can be done to prevent them. Thus the introduction in the 1960s of child-resistant containers, which reduced the rate of accidental poisoning by drugs by an astonishing 75 per cent and the protective benefit of child restraints in cars is enormous. There is still, no doubt, much more that can be done.

This week’s medical problem comes courtesy of a lady from Watford with raised blood pressure, apparently well controlled with the drug ramipril. She finds, however, there is a consistent discrepancy between the pressure as measured by the practice nurse with an automatic digital device, which is always higher than that recorded by her family doctor with his ‘oldfashioned’ sphygmomanometer. Which, she wonders, is correct?

The simple answer, as so often, is that old-fashioned is best – the ‘sphyg’ being the more accurate of the two methods of measurement. This has obviously important implications where, for example, any proposal to increase medication on the basis of a raised reading obtained with an automatic machine should preferably be checked against that obtained by the ‘sphyg’.


There are several types of taste buds attuned to detecting the sweet, the sour and the salty. For reasons unknown, one can come to dominate the others, leading to an unpleasant salty or sweet taste in the mouth. There is regrettably no effective treatment, though it does tend to improve with time.

A reader proposes this remedy. ‘Dissolve three teaspoonfuls of salt in a cup of hot water and swill it around the mouth. Hold it in the mouth until the salt solution cools down, then spit it out. This should be done two or three times a day.’

This remedy must presumably work because the salty solution neutralises the abnormal sensation from the salt-detecting taste buds.

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