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Back Diseases Daily Fitness Tips

10 Best Exercise for Back Cauda Equina at Home

Here we explain 10 exercise that you can try at home to strengthen your Lower, Middle, Upper Back and also for Cauda Equina. Here’s a look at some top exercises to build your back strength while helping support your overall daily movement.

Best Exercises for Back at Home

In this post, we will discuss how you can strengthen Back using natural exercise. Don’t forget to breathe normally through all the exercises and try to propel yourself each and every time!

  • Bridge stretch
  • Knee-to-Chest Stretches
  • Lower Back Rotational Stretches
  • Draw-in Maneuvers
  • Pelvic Tilts
  • Lying Lateral Leg Lifts
  • Cat Stretches
  • Superman Stretch
  • Seated Lower Back Rotational Stretches
  • Partial Curl up

1. Bridge stretch

Bridge works an individual’s gluteus maximus, which is the enormous muscle of the buttocks. Individuals connect with this muscle when they move their hips, especially when they twist into a squat. Bust out this exercises for a Cauda Equina Syndrome.

The gluteus maximus is one of the most significant muscles in the body, and keeping it solid can help support the lower back.

To play out a bridge stretch at home:

  • Lie on the ground and twist the knees, putting the feet level on the floor hip-width separated.
  • Press the feet into the floor, keeping the arms by the sides.
  • Raise the posterior off the ground until the body shapes a straight line from the shoulders to the knees.
  • Squeeze the buttocks with the shoulders staying on the floor.
  • Lower the buttocks to the ground and rest for a couple of moments.
  • Repeat 15 times and afterward rest for 1 moment.
  • Do 3 sets of 15 redundancies.

2. Knee-to-chest stretches

Doing a knee-to-chest stretch can help lengthen the lower back, mitigating strain and pain. Bust out this exercises for a Cauda Equina.

To play out the knee-to-chest stretch at home:

  • Lie on the back on the floor.
  • Bend the knees, keeping the two feet level on the floor.
  • Use hands to pull one knee in toward the chest.
  • Hold the knee against the chest for 5 seconds, keeping the abs tight and squeezing the spine into the floor.
  • Return to the beginning position.
  • Repeat with the contrary leg.
  • Repeat with every leg 2–3 times two times per day.

3. Lower back rotational stretches

The lower back rotational stretch can help assuage strain in the lower back and trunk. It additionally tenderly works the center muscles to improve security. Bust out this exercises for a Lower Back.

To play out the lower back rotational stretch at home at home:

  • Lie back on the floor with twisted knees and feet level on the ground.
  • Keeping the shoulders solidly on the floor, tenderly turn both twisted knees over to the other side.
  • Hold the situation for 5–10 seconds.
  • Return to the beginning position.
  • Gently turn the bowed knees over to the contrary side, hold, and afterward come back to the beginning position.
  • Repeat 2–3 times on each side two times per day.

4. Draw-in maneuvers

The draw-in maneuver works the transversus abdominis. This muscle is on the front and side of the belly, settling the spine and lower back district. Bust out this exercises for a Upper Back.

To play out the attract move at home:

  • Lie back on the floor with knees bowed and feet level, keeping the arms by the sides.
  • Breathe in profoundly.
  • While breathing out, pull the bellybutton toward the spine, fixing the stomach muscles and keeping the hips still.
  • Hold the situation for 5 seconds.
  • Repeat multiple times (10 times).

5. Pelvic tilts

The pelvic tilt exercise can release tight back muscles and keep them adaptable. Bust out this exercises for a Cauda Equina Syndrome.

To play out this lower back adaptability work out at home:

  • Lie back on the floor with knees twisted and feet level, keeping the arms by the sides.
  • Gently curve the lower back and drive the stomach out.
  • Hold for 5 seconds, at that point unwind.
  • Flatten the back and pull the bellybutton in toward the floor.
  • Hold for 5 seconds, at that point unwind.
  • Increase the quantity of reiterations day by day, developing to 30.

6. Lying lateral leg lifts

Lying horizontal leg lifts work the hip abductor muscles. These muscles support the pelvis and can help lessen strain on the back. Keeping these muscles solid is fundamental, as they help an individual keep up their balamce and can influence portability. Bust out this exercises for a Cauda Equina.

To perform lying sidelong leg lifts at home:

  • Lie on one side with the legs together.
  • Keep the lower leg somewhat bowed.
  • Draw the bellybutton into the spine to connect with the center muscles.
  • Raise the top leg around 18 inches, keeping it straight and expanded.
  • Hold the situation for 2 seconds.
  • Repeat multiple times (10 times).
  • Turn onto the opposite side of the body and repeat, lifting the other leg.
  • Perform 3 sets on each side.

7. Cat stretches

The cat stretch can help extend the back, make it more grounded, and straightforwardness strain in the muscles. Bust out this exercises for a Lower Back.

To play out the cat/feline stretch at home:

  • Get onto the hands and knees with the knees hip-width separated.
  • Arch the back, pulling the bellybutton up toward the spine.
  • Slowly loosen up the muscles and enable the abdomen to hang toward the floor.
  • Return to the beginning position.
  • Repeat 3–5 times two times every day.

8. Superman Stretch

A person needs solid back extensors to keep up great stance. These muscles run along either side of the spine. Frail back extensors can diminish spinal and pelvic help, however doing an activity called a “Superman” can help. Bust out this exercises for a Upper Back.

To play out a Superman at home:

  • Lie face down on the ground and stretch the two arms out before the body, keeping the legs loosened up and flat on the ground.
  • Raise both the hands and feet, meaning to make a hole of around 6 crawls among them and the floor.
  • Try to pull in the bellybutton, lifting it off the floor to connect with the core muscles.
  • Keep the head straight and take a gander at the floor to maintain a strategic distance from neck damage.
  • Stretch the hands and feet outward quite far.
  • Hold the situation for 2 seconds.
  • Return to the beginning position.
  • Repeat multiple times (10 times)

9. Seated lower back rotational stretches

Individual situated on seat at exercise work area doing back wind extends. The situated lower back rotational stretch calms torment, working the core muscles and reinforcing the lower back. Bust out this exercises for a Cauda Equina Syndrome.

To perform the seated lower back rotational stretch at home:

  • Sit on a stool or seat without arms, keeping the feet level on the floor.
  • Twist at the core to one side, keeping the hips square and the spine tall.
  • Position the hands behind the head or place the left hand on the correct knee to help the stretch.
  • Hold the situation for 10 seconds.
  • Repeat the activity on the left-hand side.
  • Repeat on each side 3–5 times two times every day.

10. Partial Curls up

Solid stomach muscles assume a huge job in supporting the spine and can also help keep the hips appropriately adjusted. Feeble abs can bring about poor core quality and absence of security, which can cause lower back agony. Curls and Partial Curls help to build a solid core. Bust out this exercises for a Cauda Equina.

To perform partial curls up at home:

  • Lie back on the floor and curve the knees, keeping the feet level and hip-width separated.
  • Cross the hands over the chest.
  • Breathe in profoundly.
  • On the breath out, connect with the muscular strength by pulling in the stomach.
  • Gently raise the head and shoulders 2 creeps off the ground while keeping the neck in accordance with the spine.
  • Hold for 5 seconds at that point comes back to the beginning position.
  • Repeat the activity multiple times (minimum 10 times).
  • Perform 3 sets.

These all exercises surely helpful for all diseases of a Upper Back, Middle Back, Lower Back and Cauda Equina Syndrome.

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Back Diseases

Cauda Equina Syndrome – Symptoms, Causes, Diagnosis, Red Flags and Treatments

What is Cauda Equina Syndrome ?

Low back pain influences a large number of individuals consistently. Cauda equina disorder is a condition which happens when the nerves at the base of the spinal cord are crushed together.

Cauda equina syndrome (CES) is a rare. CES is not related to gender or race. CES can influence both physically and inwardly, especially on the off chance that it is chronic. Cauda equina disorder is a clinical region that pulls in a high danger of suit.

CES affects a heap of nerve roots called cauda equina (Latin for horse’s tail). Cauda equina syndrome occurs when the nerve roots of the cauda equina are compress and disrupt motor and sensory function to the lower extremities and bladder. Nerve roots that control the capacity of the bladder and entrail are particularly powerless against harm.

Keep reading to learn what symptoms the condition causes, how it’s managed, and more.

Alternative Names

  • Cauda Equina Syndrome is some time knows as CES Disease and Cauda Equina Disorder

Which Age Group Affect Cauda Equina Syndrome Disease?

It occurs primarily in adults, although trauma-related CES can affect people of all ages.

  • Teen Boy and Girl, Man, Women, Old Man and Women

Cauda Equina Syndrome Sign and Symptoms

Cauda Equina Disorder symptoms can set aside a long effort to create and may fluctuate in severity. CES can cause an assortment of symptoms, including:

  • Severe low back pain
  • weakness, pain, or a loss of sensation in one or both legs (such as a loss of motor function in legs or difficulty in walking)
  • bowel incontinence (such as a loss of control)
  • loss of reflexes in your lower limbs
  • Powerlessness to feel anything in the body regions that would sit on a saddle
  • Sexual dysfunction that has gone ahead abruptly
  • loss or reduction of reflexes
  • Inability to urinate, or to hold urine or feces

Medical history implications:

  • A history of cancer
  • Recent violent injury to the back
  • Current severe infection
  • Recent lumbar spine surgery

Causes of Cauda Equina Syndrome

Cauda equina Syndrome is most usually caused by a gigantic disc herniation in the lumbar spine (low back). Symptoms vary and may come on slowly. There are various conditions that can cause Cauda equina syndrome. A common cause of CES is injury of a spinal disc on the nerve roots.

The following are possible potential causes of Cauda equina Syndrome that describe red flags:

  • Severe low back pain
  • Numbness, weakness, or Pain in one or both legs
  • Lesions or tumors on your lower spine
  • Narrowing of the spinal canal
  • Spinal infections or inflammation
  • Lumbar disc herniation (most commonly in L4/5 and L5/S1)
  • Sexual dysfunction
  • Lumbar spinal canal stenosis
  • Spinal anesthesia (trouble feeling anything in the areas of your body that would sit in a saddle)
  • Arteriovenous malformation
  • Birth abnormalities or birth defects
  • Spondylolisthesis
  • Tarlov cysts
  • Facet joint cysts
  • Spinal fracture or dislocation
  • Accident that crushes the spine, such as a car accident or fall
  • Tuberculosis (Pott disease)
  • Lymphoma
  • Spinal hemorrhages or fractures
  • Metastases
  • Primary CNS malignancies
  • Aortic dissection

Cauda Equina Syndrome Red Flags

Risk factors for developing Cauda Equina Syndrome include:

  • Individuals with a history of spinal conditions (that cause back pain), such as lumbar spinal stenosis
  • Degenerative disc disease
  • Infection of the spine
  • A history of cancer
  • Individuals with a history of spinal surgery
  • Degenerative joint disease (osteoarthritis)
  • Having a genetic predisposition for a herniated disk
  • Paget disease
  • Spina bifida (Birth defects, such as a narrow spinal canal)
  • Instability or deformity of the spine
  • Spinal surgery or spinal anesthesia
  • Hemorrhages affecting the spinal cord
  • Spinal arteriovenous malformations
  • Coagulopathy (easy bleeding), which is a bleeding disorder that decreases the body’s ability to form blood clots (or coagulates)
  • In rare cases, spinal manipulation of the lower back
  • Lesion or tumor affecting the spinal bones, spinal nerve roots, or cerebrospinal fluid (CSF)

Cauda Equina Syndrome can develop suddenly even without these risk factors.

How is Cauda Equina Syndrome Diagnosed?

Your doctor will want a detailed list of all your symptoms, including when they started and their severity and Medical history. Your doctor will do a physical examination. They will test the stability, strength, alignment, and reflexes of your legs and feet.

Magnetic resonance imaging (MRI):

  • You may be advised to have an MRI scan of your lower back.
  • An MRI uses magnetic fields to help produce produces images of the spinal cord, nerve roots and surrounding areas.
  • MRI scan will give a more detailed look at the spinal cord and the structures surrounding it.

Myleogram:

  • A myelogram is an X-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces.
  • Myelogram test is a special dye is injected into the tissue surrounding your spine.
  • It can show displacement on the spinal nerves due to herniated discs, bone spurs, tumors, etc.

Cauda Equina Syndrome Treatments

The surgery prevents pressure on the nerves from reaching the point at which damage is irreversible. Surgery help prevent the permanent damage such as paralysis of the leg, loss of bowel and bladder control, sexual function or other problems. Talk with your doctor about the best therapy plan for you.

Treatment options include the following:

Discectomy

Discectomy is the surgery in which the compressed nerves are removed from the portion of the disc. To remove part of an intervertebral disc that is putting pressure on the spinal cord or. To expel some portion of an intervertebral disc that is putting pressure on the nerve root or spinal cord. The window of bone is removed to uncover the nerve root and plate. The part of the cracked disc compacting the spinal nerves is deliberately removed.

Radiation therapy

If CES is due to cancer, radiation therapy may be an option. Your doctor may also treat the underlying cause of CES.

Spinal decompression

Spinal decompression for stenosis removes the bone spurs and ligaments compressing the nerves. The surgeon removes the bone that forms the roof of the spinal canal. Tumors and other lesions can also be removed.

Laminectomy

Laminectomy is one of the most common back surgeries. Most laminectomies are fulfilling with general anesthesia and mechanical ventilation. Laminectomy is a surgery in which a surgeon removes portion or all of the vertebral bone (lamina).

For long-term treatment,

your doctor may prescribe drugs such as,

  • Pain relievers after surgery such as oxycodone (OxyContin)
  • Over-the-counter pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol), can be used for daily pain relief.
  • Corticosteroids are prescribed to reduce the inflammation and swelling around the spine
  • Hyoscyamine (Levsin), tolterodine (Detrol) and oxybutynin (Ditropan) for better bladder and bowel control

What you should do in Cauda Equina Syndrome?

  • Get regular exercise for cauda equina syndrome. Exercise build-up the muscles that support your back and helps keep your spine flexible.
  • To become familiar with everything you can about dealing with the condition
  • You may want to join a cauda equina syndrome – CES support group.
  • You may want to get help from an occupational therapist, social worker, continence advisor, or sex therapist.
  • Involve your family in your care.

Is surgery required for Cauda Equina Syndrome?

The time of onset of symptoms is difficult to specify. Thus it is difficult to define the delay between symptoms and surgery. When there is pressure on the cauda equina causing loss of sphincter control it would be understandable to think that the ideal treatment would be to remove the pressure as soon as possible with surgery.

The surgery should be done within 24 or 48 hours of the onset of serious symptoms. A CES diagnosis is usually follow by surgery to relieve pressure on the nerves. But, Cauda equina syndrome is a medical emergency that calls for urgent surgical intercession.

What treatment options are there after surgery?

After surgery, your doctor will see you periodically to check on your recovery. Full recovery from any CES difficulty is possible. If you continue to have symptoms, be sure to tell your doctor.

  • A physical therapist can help you regain your strength and give you exercises to help improve your stride.
  • An occupational therapist may also be helpful if everyday activities, such as getting dressed, are affected by CES.
  • Specialists to help with incontinence and sexual dysfunction may also be part of your recovery team.

Managing Bladder and Bowel and Sexual Function

Bladder and bowel task is automatic, yet the parts under deliberate control might be lost in the event that you have Cauda Equina Syndrome.

Cauda Equina Syndrome can cause pain in the lower back or between the legs, bladder or bowel control and sexual function.

Therefore, Here some guidelines for managing bladder and bowel dysfunction:

  • Empty the bladder completely with a catheter 3-4 times each day.
  • Drink plenty of fluids and practice regular personal hygiene to prevent urinary tract infection.
  • Check for the presence of waste regularly and clear the bowels with gloved hands.
  • Use protective pads and pants to prevent leaks.

Complications of Cauda Equina Disorder

If the primary treatment is delay, the following complications may arise such as:

  • Bladder, sexual and bowel dysfunction
  • Paralysis
  • Abnormalities in sensory systems

Home Treatments for Cauda Equina Syndrome

Some home remedies like an ice sack, warming pad, rub or massage or a long hot shower can help you.

The nutritional supplements glucosamine and chondroitin have been recommended as nutritional supplements. But, There is no perfect home remedy or treatment available at that time.

Cauda Equina Syndrome Prevention

Cauda Equina Syndrome is a rare complication. Prevention of Cauda Equina Syndrome is focuse on early diagnosis by identifying the symptoms described in this article. But, averting infections and injury is a lot of fundamental to maintain a strategic distance from these reasons for Cauda Equina Syndrome. Therefore, There are no present rules to counteract CES.

Conclusion

Cauda equina syndrome is a surgical emergency. Cauda equina syndrome is a hazy area and there is no agreement on which signs and side effects ought to be followed up on.

If you have cauda equina syndrome, you may need urgent surgery to remove the material that is pressing on the nerves. An understanding of cauda equina syndrome is important not only to orthopedic surgeons and neurosurgeons.

Categories
Child Diseases Mental Disease

Depression in Children Symptoms, Causes and Treatment

Do you have a question related to Depression in Children? Today i’m going to share symptoms, causes and treatment of depressed child.

Let’s get stared about Depression in Children.!

Look around!! You will see many quiet and sad faces lost somewhere. Sometimes you find mood swings of your friends and dear ones. You may take it lightly, but maybe this is a symptom of depression.

Depression is a common and serious medical illness that negatively affects how you feel, the way you think and how you act.

Depression makes a person lose his interest in his regular activities. A depressed person normally seems distracted. There are also many physical changes during the state of depression.

Depression in Children

Mostly, middle aged are more affected by depression. Yet here the children aren’t spared by this mental illness. According, to a study in 2014, 33% of children were suffering through severe depression condition.

When can you say that a child is depressed?

It’s always that depression is loneliness and sadness. This feelings are situational.

You can certainly say that a children is depress when he/she continuously feels helpless, hopeless, alone all the time. At this time he mostly underestimates his capabilities and also may be scare to open up.

Causes of Depression in Children

The causes of depression in Children are rather similar with those of the rest of the age groups. These are the some of the reasons why depression is common among children :-

  • The environment he/she is brought under his school, family, friends and the other regular activities.
  • Some specific life events which affects his thoughts.
  • The past life
  • Some biochemical disturbance
  • Genetic Vulnerability

Signs and Symptoms of Child Depression

  • Extreme feelings of sadness, emptiness and hopelessness.
  • Too anxious and agitation
  • Restlessness and too tensed
  • Reduced concentration
  • Loss of thinking ability
  • Reduced or increased weight or appetite.
  • Slower pace of daily activities
  • Loss of interest
  • Increased thoughts of suicide, deaths and suicide attempts.
  • Causing physical injury to oneself.

How to treat depression among children?

Before treating depression among your child you have to be first be sure on how to take care of your child. Plan out some time from your schedule and talk to them about their and your day. Also, know about their problem and guide them. Don’t force them upon any anything, let them make a perfect choice their way.

Depression can be treated at several levels- At home, A consultant and Medications.

At Home 

Family members and friends can promote good mental health. They can gently encourage him or her to have a healthy lifestyle. Also, encourage the child to maintain a healthy diet, including adequate water intake.

Also, get enough sleep, exercise regularly. Apart from this they should remain socially active, and to engage in healthy stress-management activities.

Research that analyzed the results of several studies (meta-analysis) has found that the positive impact of exercise on mood is even more than assumed due to its being part of a healthy lifestyle.

Parents and other loved ones can also be helpful to the depressed child by discouraging him or her from engaging in risky behaviours.

A Consultant for Depressed Child 

Most mental health professionals will continue treatment of major depression for six months to a year to prevent a reoccurrence of symptoms.

‘Psychotherapy’ is working with trained mental therapist and to figure out ways to solve problems and cope depression.

Two major kinds of psychotherapy commonly treat childhood depression: interpersonal psychotherapy and cognitive behavioural therapy.

However, Interpersonal form of psychotherapy seeks to alleviate depressive symptoms by helping child with depression develop more effective skills for coping with their emotions and relationships.

Cognitive approach to psychotherapy helps to decrease depression and the likelihood it will come back by helping the child change his or her way of thinking about certain issues.

Medications or Treatment

Under, severe cases medicines can be taken with the prescription of the doctor.

The most commonly used group of antidepressant medications prescribed for children is the selective serotonin reuptake inhibitors (SSRIs).

SSRI medications influence the levels of serotonin in the brain. For many prescribing professionals, these medications are the first choice because of the significant degree of effectiveness and safety of this group of medicines.

However About 60% of children who take antidepressant medication improve. It may take anywhere from one to six weeks of taking medication at its effective dose to start feeling better.

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Ayurvedic

Before Buying Herbal Medicines – You Should Know

Herbal medicines are one type of dietary supplement. They are sold as tablets, capsules, powders, teas, extricates, and new or dried plants. Individuals utilize herbal prescriptions to attempt to keep up or improve their health.

People believe that products labeled “natural” are always safe and good for them. People accept that Herbal items labeled “natural” are constantly sheltered and good for them. Herbal medicine has its origins in ancient cultures. It includes the medicinal utilization of plants to treat malady and upgrade general health and prosperity.

You Should know Before Buying Herbal Medicines

What should you look for when buying herbal medicines? It is usually most convenient to buy capsules, tablets, essential oils, pessaries, and perhaps tinctures, and to make up your own infusions, decoctions, and syrups.

Buy from a respectable herb store, staffed by individual’s proficient about herbal meds. Only purchase herbs online from set up herbal providers. Buy natural herbs and items where accessible.

Buying Dried Herbs

Dried herbs are generally available from herbal suppliers. Buying from shops is preferable to buying online because the herbs can be examined before purchasing. However, it is conceivable some online organizations may supply fresher herbs because of higher turnover.

To pick up the best medicinal impact, great quality produce is basic. Shop around and remember the accompanying focuses before purchasing:

  • Herbs should not be stored in clear glass jars or in direct sunlight, as this causes oxidation, which affects their efficacy.
  • Good-quality fragrant herbs ought to have an unmistakable aroma and taste.
  • Check for signs of infestation due to poor drying techniques, or adulteration. This can sometimes be recognized by the presence of dried grass or other non-medicinal material in the jar.
  • Herbs lose their color as they age. Look for bright material that has been well dried and stored, and that is not too old.
  • Calendula flowers that are a vivid yellow/orange color are likely to make good medicine. If they have been sitting on a shelf for 18 months, they will probably look drab and pale.

Buying Herbal Products

When purchasing products, for example, capsules, tablets, fundamental oils, pessaries, and tinctures, consistently check the mark on the jar or packet.

If it does not do the following, do not buy it:

  • Name all constituents of the product
  • State the recommended daily dosage
  • Express the heaviness of each capsule or tablet, or volume of bottle
  • List the heaviness of every constituent of a capsule, tablet, and so on.
  • List the proportion of herb in the item (for instance, 1:3, which means 1 section herb to 3 sections fluid).

Who should avoid herbal medicines?

Taking herbal medicine may not be suitable for:

  • People taking other medicines
  • Individuals with genuine health conditions, for example, liver or kidney ailment
  • Individuals who will have medical procedure
  • Pregnant or breastfeeding women
  • The elderly
  • Children – as with all medicines, herbal medicines should be kept out of the sight and reach of children

Talk to your Doctor about Herbal Medicine you are taking

If you are thinking about using an herbal medicine, first get information on it from dependable sources. Make a point to educate your health care supplier concerning any herbal prescriptions you are taking.

Obvious-but too many people skip this step. Ask your doctor about any new supplements you plan on taking, especially if you’re on other meds. Indeed, even plant-determined pills can connect with different medications, and can be perilous in case you’re pregnant.

The best supplements aren’t always the ones from the ground. Follow these expert suggestions next time you’re in the market for an herbal boost in pill form something about herbal medicines seems unthreatening. After all, they’re made from plants.

Herbal medications are those with dynamic fixings produced using plant parts, for example, leaves, roots or blooms. However, being “natural” doesn’t really mean they’re ok for you to take.

Medicinal Herbs & Big Business

The major pharmaceutical companies have realized that rainforests, grasslands, and even along roads and fields are sources of potentially invaluable medicines. As a result, the industry has invested vast resources into screening the active constituents of medicinal plants from all over the world.

The drug taxol, first extracted from the Pacific yew (Taxus brevifolia), and one of the most effective treatments for breast cancer, was developed in this way. There is a key problem to this approach, for it is geared to the production of isolated plant chemicals which can then be synthesized and patented. With a patent, a company can make a profit, recouping the massive investment required to research and develop new medicines.

Herbs, however, are whole naturally occurring remedies. They cannot and should not be patented. Even if the major pharmaceutical companies were able to find an herb such as St. John’s wort, which proved to be more effective and safer than conventional medicines, they would prefer to develop synthetic chemical drugs rather than plant medicines.