YOUR HEALTH Dr James Le Fanu: 12 July
Thursday, 11 July 2013

Dr James Le Fanu: 12 July

When getting the giggles can be a pain, how to ease the sensation of burning in the mouth, and a natural way of preventing hay fever

Written by Dr James Le Fanu
The drawback of any illness, whether a bout of flu or something more serious, is that it can be a bore – seriously interfering with one’s appreciation of the simple pleasures of life.

Still, some wit never comes amiss for, as the great Hippocrates remarked, ‘Dourness is unattractive for both the healthy and the sick.’

It must, however, be the right sort of wit – as suggested by a contribution to the Archives of Internal Medicine ‘Humour in the physician-patient encounter’.

Consider the not unusual situation of expressing one’s disapproval when the doctor is late, yet again, for the consultation. Here, ‘I was just about to send out a search party for you’ with its subtle reversal of roles – the patient concerned about the doctor’s welfare – is preferable to the sarcastic stereotyping of ‘So you’ve been out on the golf course again!’

Next, a humorous comment can express sympathy for the patient’s plight, as with the doctor who responded to an obese patient’s query ‘How do you stay so thin?’ with the not necessarily truthful ‘My wife can’t cook’ – that does at least convey the sense that no one’s life is perfect.


This leads to the observation that in medicine, as in life, the right sort of wit goes a long way. The possible exception might be those medical conditions that are precipitated by humour. These include enuresis risoria – an involuntary loss of bladder control owing to suppressed laughter, more commonly known as giggle micturition. This can be distressing but treatable with a form of behavioural therapy that involves selfadministering a harmless electric shock to the back of the hand when laughing.

This is then replaced by an ‘imaginary shock’ where the patient just thinks about the sensation of the real shock. This seems to do the trick. It’s a funny old world.

This week’s medical query comes courtesy of a reader from Manchester who reports soreness of the tongue and upper and lower palate just behind her teeth that lasts from lunchtime until bedtime. ‘It feels as if I’d drunk a hot cup of tea and burnt my mouth,’ she says.

There’s nothing abnormal to see and her dentist isn’t too bothered about it. It’s been going on for eight months. It sounds like type 1 burning mouth syndrome – that’s not present on waking but gets more severe throughout the day and is due to abnormal functioning of the sensory nerves. Exacerbating factors may include certain toothpaste brands, and glasses washed in dishwashers. There‘s no speciŽfic cure, but drugs prescribed for similar types of neuropathic pain, such as amitriptyline, may be of help.



The preventive measure against hay fever of ‘desensitisation’ – exposing the patient to small doses of the pollen during the winter months – is no longer recommended. But the same e‡ffect can, perhaps surprisingly, be achieved by taking regular doses of honey.

A reader from Lancashire provides the details: ‘Starting in early January you should take one dessert spoon full of local honey each day and thus build up a resistance to the local pollen. I tried this with initial great success and repeated it for three years – and now only get very minor attacks of hay fever when the pollen counts are extremely high.’

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