European Stars And Stripes (Newspaper) - January 24, 1989, Darmstadt, Hesse                                To your health by Janet d Agostino medical writer in West Germany Low blood pressure is seen Asan ailment that needs some kind of treatment often with  the United states and other european countries Low blood pressure is not generally considered a disorder and instead a sign of Long life. This difference in attitude towards Low blood pressure can be explained by the Way culture philosophy and National character influence medical practice according to a recently published Book titled Medicine & culture varieties of treatment in the United states England West Germany and France. In fact author Lynn payer found during ten years of research that medical treatment can vary from country to country just As language food and customs do. Payer a medical journalist chose to compare the United states England France and West Germany because they have the greatest influence on Western Medicine and because their populations have similar life expectancy and infant and maternal mortality rates. In the beginning payer As Many americans probably do assumed Medicine to be a science with a right and a wrong Way to treat a disease and any deviation from the american Norm to be wrong " but during her research she began to realize that the european methods of treatment were also valid and useful american Medicine payer wrote is characterized by its aggressiveness and the belief that it is better to do something than nothing. In England France and West Germany doctors Are More Likely to wait and watch rather than to take the offensive in certain situations. Payer said that american doctors perform More diagnostic tests and examinations will More often choose surgery Over drug treatment and when they do prescribe drugs favor higher doses. American doctors operate More often and do More complicated surgery an american woman has two to three times the Chance of having a Hysterectomy As her counterpart in England France or West Germany and cardiac bypass operations Are performed six times More often than in England. This medical aggressiveness reflects an aggressiveness of the american character that has often been attributed to the effect the vast Frontier had on the people who came to Settle it payer wrote. This contrasts with the value the French place on thinking rather than doing. French Medicine emphasizes strengthening a person s Constitution or resistance to disease through tonics vitamins rest and health spas rather than cutting out the problem or treating it immediately with drugs payer wrote. The French tradition of Fine dining May explain Why in the past the French have associated Many illnesses from fatigue to painful menstruation with their livers she wrote. The English and american saying that cleanliness is next to godliness is not shared by the French who have a greater respect for dirt. The French payer wrote Are Quick to Point out the health advantages of dirt or at least the health advantages of tolerating  the French prefer a form of natural vaccination through exposure to certain germs Over Man s vaccinations. The american obsession for cleanliness can be explained by the belief that disease must be caused by something in the environment probably a germ. Most foreigners find amusing the lengths americans go to keeping themselves and everything around them clean payer wrote. In Germany the heart and poor circulation Are often blamed for illness. West germans use about six times the amount of heart drugs per capita As do the French and English and not because there s More heart disease in the country payer wrote. However the West germans do not Necesse warily operate More often on the heart.  roughly translated cardiac insufficiency is a diagnosis commonly made by West German doctors for a wide variety of complaints but not used in the same Way in the other three countries. Payer links this emphasis on the heart to lingering influences of German romanticism a literary philosophical and musical movement of the 19th Century that valued feelings rather than thought. This led to the concept of the heart As being More than just a pump but an Organ with a life of its own. Germans like the French place a greater emphasis on the patient s resistance than the germ and Are less Liberal in their use of antibiotics. While West German doctors use the most modern High tech medical equipment the medical system also values natural Healing remedies such As Massage herbal teas homeopathy and health spas. Of the English payer wrote the most striking characteristic of British Medicine is its Economy. The British do less of nearly  the British doctor is much less Likely to do routine examinations than his colleagues in France or America. He also orders fewer a rays operates less often and prescribes fewer drugs. While american doctors advocate Early treatment and frequent screening of High blood pressure in England the recommendation is that an adult should have his blood pressure taken once every five years. And the numbers which define when High blood pressure should be treated Are somewhat higher in England than the United states payer wrote. This tendency to do less is attributed to the National health service s need to save Money and to the British character of maintaining a stiff upper lip payer wrote. Unlike the French and West germans British doctors pay less heed to building up resistance use More antibiotics and like the americans turn their noses up at health spas and other fringe medicines. Payer Points out that there Are merits to the different medical practices in each country and that we could learn from each other. For example cleanliness does reduce disease but too much cleaning can cause other medical problems and the restrictive use of antibiotics would Lessen the development of Antibiotic resistant bacteria that have caused a number of serious infections. However payer also wrote that doctors usually read Only the medical literature from their own country and Are not aware of medical treatments being used outside their Borders. The Book makes Clear that there May be valid types of treatment for a patient s condition that Are not for whatever reason recommended by his doctor. The treatment recommended by the doctor May or May not be Best suited for the patient depending upon the lifestyle and desires of that patient. In the end Only the patient is really competent to decide the Best course of treatment for himself payer wrote. Medicine & culture published by Henry Holt and company of new York is not available in stars and stripes bookstores Page 16 the stars and stripes tuesday january 24,1989 Likely biochemical basis for stuttering is found by Thomas h. Maugh ii los Angeles times the first evidence that stuttering and second speech disorder called spasmodic dysphonia Are caused by biochemical abnormalities rather than by emotional disturbances was presented in san Francisco this month by University of Texas researchers. Stuttering affects one in every 100 people in the United states and spasmodic dysphonia in which the Larynx spasms to choke off words affects perhaps one tenth As Many. The new discoveries presented at a meeting of the american association for the advancement of science should remove much of the stigma and guilt associated with the disorders because of the belief that they were psychological in origin. The findings also provide new techniques for therapies that already Are being used on an experimental basis. Overall i am very impressed with their study said audiologist Robert g. Turner of the University of California san Francisco head of the scientific affairs committee of the american speech language and hearing association. It s a very difficult problem to study,.and their research strategy is very Well designed. What s really significant is that they have shown the occurrence of a biochemical abnormality using a variety of  everyone knows someone who stutters hesitating at the beginning of some words and saying the first sound repeatedly until the entire word comes out. What has confused researchers is the fact that stutterers do not stutter All the time. Country Singer Mel Tillis for example stutters when he Speaks but not when he sings. Because of this variability Many psychiatrists believe that the disorder was caused by psychological trauma in childhood and have made parents feel unnecessarily guilty according to speech scientist Frances j. Freeman of the Dallas Center for vocal motor control of the University of Texas one of the researchers on the project. Spasmodic dysphonia typically develops in the 30s and 40s, but it can begin As Early As the teen years or As late As the 60s. Most often the Larynx spasms closed so that words Are Cut off but in some patients the Larynx Muscles completely relax so that sounds cannot be made. The disorder is usually progressive so that the victim eventually loses speech entirely. The discoveries of a biochemical link were made possible by the innovative combined use of several new techniques for imaging the brain and measuring metabolic activity and blood flow. The combination of these techniques provides a unique window into the brain said Freeman. We can say with great Confidence the 84 percent of the people we have studied with these two disorders have a neurological defect of the Central nervous system that causes the disorder said radiologist Terese Finitzo the project director. The affected areas Are not the same in the disorders but they Are close enough together to suggest that both impairments might be subtly different manifestations of similar underlying damage she said. As for the other 16 percent failure to find neurological dysfunction does not preclude its existence. It just Means that our techniques Aren t sophisticated enough yet to see  the discoveries have suggested new avenues for treatment. The Center now makes extensive use of conventional speech therapy for spasmodic dysphonia a treatment approach that was ignored when the cause of the disease was thought to be psychological. The discovery of impaired blood flow to some regions of the brain is also prompting use of conventional drugs that dilate blood vessels and increase blood flow. They Are also using drugs that Are normally used to treat movement disorders caused by impairments in the same Region of the brain. It is too Early to Tell if any of these approaches Are working Finitzo said but the team has great Confidence that one or More of the approaches will prove successful