Tuesday, 5 February 2013

The Hot Toddy

Well it’s that time of year again when almost everyone around has been struck down by the dreaded seasonal flu or common cold. You know how debilitating the relatively minor classic symptoms (headache, runny nose, sore throat, productive cough, general aches and pains and fatigue) can be. But in our moment of suffering and desperation, which remedies do we depend on to ease our suffering?

There are lots of remedies about both old and new. Depending on who you listen to (the advert on the TV or your mother), some will say plenty of rest, lots of fluids, vitamin C, or an antipyretic such as paracetamol. I discussed this with one of my students recently. She is studying medicine in Poznan and she strongly recommended a shot of vodka with lemon and other interesting ingredients mixed in. This reminded me of when i was sick as a child and my mother would give me a hot toddy. She would prepare a mug of hot water mixed with a wee dram of whiskey, honey and some form of soluble aspirin or paracetamol and I remember how it made me feel safe, warm and cared for. Interestingly enough my student said that she would use a hot toddy to treat herself, but wouldn't prescribe such treatment for her future patients. There are ethical issues here of course, even if prescribing alcohol is for ‘medicinal purposes’. According to the American Lung Association you should “avoid any drinks that contain alcohol.” Alcohol causes dehydration which can delay the healing process.

Why does a hot toddy seem effective?

As far as we know there is no medical research to support the benefits of a hot toddy. If you know of any then please feel free to share it. But so many people claim that it works for them (lots of anecdotal evidence).  But nowadays if it isn't ‘evidence based medicine', then it shouldn’t be used. Felicity Cloake, a writer for the Guardian, who specialises in food and drink describes the hot toddy as a wonder drug, stating, "The heat, spice and sweet and sour flavours apparently encourage mucus production, discouraging the advance of those pesky bacteria and viruses, while the booze helps you sleep. (In moderation, of course. All things in moderation.)"

Just like it made me feel warm and cared for, it's probably more likely to be linked to the phenomenon that is known as the placebo effect. Simply put, if you believe something will help you then there is a strong chance that you will feel some positive effects. It is all linked to your beliefs and expectations, which can be strongly influenced by things like the environment in which the treatment is given and even the manner of the person who is administering it. My mother always had (still does) a wonderful bedside manner. For more reading into the powerful world of the placebo effect, a field of medicine which is generating a lot of solid research to confirm it’s power and reality, check out Dr Kaptchuk and his team in America. It's fascinating stuff. We’ll look at the placebo effect and related groundbreaking research in a later post.  Until then 'bottoms up!'.

Did you know?
  • Adults get an average of two to four colds per year, mostly between September and May.
  • Young children suffer from an average of six to eight colds per year.

Medical Vocab Builder

  • struck down (phrasal verb) = to develop an illness/disease/sickness
  • debilitating  (adjective) = when something stops a person from performing regular everyday activities
  • antipyretic (noun) = medication which reduces a high temperature/pyrexia/fever
  • hot toddy (noun) = check out wikipedia's explanation
  • soluble (adjective) = a substance which dissolves in water
  • medicinal purposes (common phrase) = something which is said to help an illness, but this expression is more often used when a person is jokingly looking for an excuse to drink alcohol
  • evidence based medicine (medical jargon) = treatment which has been proven by testing, clinical trials and research
  • anecdotal evidence (common phrase) = when the experience of a person indicates to them personally that something is true
  • pesky (adjective) = annoying
  • booze (noun) = colloquial word for alcohol
  • bedside manner (common phrase) = when a person is good at making a patient feel better by the way they act
  • bottoms up (common phrase) = colloquial expression used by people sharing a drink of alcohol, 'cheers' or 'good health' are also sometimes used

Now take the quiz below to check your understanding:
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