Thursday, February 28, 2008

Symptoms, Diagnosis and Treatment of Lymphoma

Symptoms, Diagnosis and Treatment of Lymphoma by Jeremy Parker

Would you know if you had lymphoma? Do you even know what to look for? Below is a short description of lymphoma and information on the symptoms to look for, how the doctor will diagnose it and the possible treatments available today.

What is lymphoma?Lymphoma is a type of cancer that affects the lymphocyte cells of the immune system. It generally originates in one or more of the lymph glands and causes them to swell to the point that they become uncomfortable although not painful. The common lymph glands that are first affected include those in the neck, in the armpit area and in the groin. Unfortunately the cancerous lymphocytes can break away from the main growth in the lymph glands and travel around the body in the lymphatic system and in the blood. This means that lymphoma often affects the entire body and causes symptoms in areas far from the original site of growth.

What are the common symptoms of lymphoma? There are a number of common signs and symptoms that are associated with lymphoma however it must be pointed out that these symptoms can also be caused by numerous, less severe conditions and so anyone suffering with any of the following symptoms should not self-diagnose lymphoma. The common symptoms include:

Swollen lymph glands – although these often develop in the neck, armpit and groin areas they can also develop in the chest and these lymph glands can not be felt externally. This means that they can be swollen for some time without causing any external swelling that can be felt with the fingers.

Fever and night sweats – because cancerous cells are present in the body the immune system launches an attack and this causes the body’s internal temperature to rise, which is felt as a fever.

Unexplained weight loss - lymphoma can affect any system within the body and occasionally it affects the digestive system which then fails to function at its best. This means that food is not absorbed properly and the body begins to lose weight.

Tiredness and fatigue – again this can occur when the digestive system is affected and the impaired food absorption leaves the body with little energy. It also occurs because the body is constantly trying to fight the spread and development of cancerous cells.

How is lymphoma diagnosed? Usually the doctor will have an idea of the diagnosis from your description of the symptoms and from performing a physical examination i.e. to feel for swelling in the lymph glands. From here he/she will refer you to the hospital for further tests which may include x-rays, CT and MRI scans to see how far the cancerous cells have spread, blood tests and even bone marrow biopsies. These tests will be able to confirm the presence of lymphoma and they will pinpoint exactly what type of lymphoma you have and how far it has progressed.

How is lymphoma treated? There are a number of ways that lymphoma can be treated however the exact course of treatment will depend on a number of factors including what type of lymphoma is present, how far it has spread, how fast it is growing and your general state of health. The options include chemotherapy, radiotherapy and bone marrow transplants however every case is different and your course of therapy will be individual to your illness so that you have the best chance of recovery possible

Myth of the Sword

Myth of the Sword

Nearly all cultures throughout history have been subject to the myth of the all-powerful sword. China's history is filled with legendary swords and swordsmen some of whom even rose to the levels of gods. The Japanese have the legendary Samurai with their world famous katana, often referred to as the Samurai sword. Cossack, Moor, and other Muslim cultures are often remembered as mounted, saber-wielding warriors. In Western Europe the medieval knights were in no way an exception to the sword culture. The sword's symbolic connection to the heraldic nobility remains to this day, although in ceremonial form only. For most cultures around the world, the sword still holds a position of reverence.

I have dueled and sparred with and against swords for many years and yet I am still amazed when the first words out of almost every new student are, 'I want to learn how to fight with a sword.' I explain that unless your armored and riding a horse whenever the sword is pitted against nearly any other ancient weapon of equal length or longer inevitability it comes up wanting. However, the invincible sword myth is so deeply ingrained in human culture that such warnings are rarely heeded, and predictably, the sword becomes most students' first focus.
The sword's true combat nature can only be revealed through the handling of the real thing, authentic replicas, and precise training weapons that are meticulously designed for proper accuracy and use. With the aide of such training tools the myth of the sword can be unlocked, not just from a historical approach but from a hands-on approach as well. Sadly, often schools do not follow an accuracy policy with training weapons or when sparring with weapons. This is one reason why there are so many misconceptions about genuine sword combat.

The Japanese sport of kendo is commonly believed to be a martial art based on dueling with katanas. Nothing could be further from the truth. The two are as different as kickball and baseball. The kendo sparring sword called a shinai is a straight sparring sword meant to be a safe representation of the katana. This very light weapon averages anywhere from 35" to 47" in length and is made of several straight strips of bamboo bound together with leather. With the exception of the lengths, the balance and design of this sparring tool from its tip to handle holds absolutely nothing in common with the Samurai's curved katana. The shinai blade is straight and its handle is long, round, and wrapped in a soft leather sheath. The katana blade is curved and its handle is long and somewhat egg shaped but a little more flat along the sides, and it is braided. The hits and points scored in sport kendo have more in common with European cudgel play or fencing than with a katana duel.

Points are most often scored with snapping hits as opposed to the drawing cuts that come naturally with a curved blade. Though snap cuts are also a part of the katana's arsenal they are not a staple of attack as in kendo. A closer representation would be sparring with curved wooden bokkens, which are considerably more accurate reproductions of the katana and were the traditional training weapon of the classical Bushi. The bokken offers a close though not completely accurate representation of a bladed katana duel and was often used for dueling as a replacement for real swords.

Miyamoto Musashi, arguably one of the greatest swordsmen in Japanese history, by his own account won several duels against katanas with a bokken. As with shinais, the same problem arises from modern and the ancient western forms of cudgel play. The rattan or other wooden forms of broadswords are bulkier, unbalanced, poorly weighted, and often have no obvious flat side to parry with. Because of these design flaws cudgel play can only be considered a sport not a form of combat. One should not compare these sport-related styles of combat to the real thing. A comparison cannot accurately be made if for no other reason than the sparring weapons are so dramatically removed in weight, shape, and design from the weapons they are supposed to replicate.

When a student reaches a high enough sword skill to spar against other types of weapons, the design flaws of the sword as a singly competitive weapon become painfully obvious. It is not long after this realization that the sword student fades out of the picture along with dreams of becoming an invincible swordsman. The few persistent sword students who remain quickly find the value of an added weapon to their free hand. Shields, maces, flails, daggers, or other swords become the new order of training. With a little more sparring, the student begins to see the ultimate truth behind the myth of the sword. Even with the aid of another weapon, it is a very difficult task for a swordsman to defeat longer-reaching weapons. When a swordsman is matched up against a weapon that is longer and therefore holds greater reach capabilities that swordsman's chance of survival drops dramatically. Without the aid of a companion weapon, even a highly skilled swordsman finds it difficult to defeat lesser skilled opponents with longer- reaching weapons.

The sword master Miyamoto Musashi, victor of sixty life-and-death encounters, was in a famous duel of record against the long-swordsman, Sasaki Kojiro. Kojiro called his sword 'clothes pole' because of its unique design: a long, straight, blade quite the contrary to its contemporary, the curved katana. When Musashi dueled Kojiro, he was not wielding a curved katana of his own or even using his famous two-sword style. Instead he wisely used a large, carved boat oar to defeat his opponent. This boat oar gave Musashi two very important advantages: first he did not have to concern himself with the angles of his cuts, and second, he did not have to worry about parrying with his sword and having it destroyed by a big boat oar. It is no mystery why Musashi won this duel.

When two duelers meet and are equal or even close to equal in skills, the odds go to the dueler with the technological advantage. I know the entertainment industry would have us believe otherwise, but when it comes to sparring or dueling with weapons, you can't change the math behind the design of the weapon, techniques, and the movement the weapon's nature requires. George Silver, an accomplished dueler and prizefighter who wrote two treatises on combat in 1599, Brief Instructions and Paradoxes of Defense pointed out in his works, and I paraphrase, "He who moves in the least amount of space and time, moves ahead of his opponent and so stays out of harm while being able to inflect harm." To make Silver's point consider the story of David and Goliath. Goliath is unrivaled on the battlefield and no Israelite can stand against him in single combat.

He holds several advantages over his opponents: he is stronger and so can attack and defend with more power than his opponent; he is taller which gives him the ability to both outreach and outstride his opponents; and he is undefeated, which gives him a psychological advantage over his opponents. Goliath would likely have been armored and have the contemporary weapons of the times, bronze or leather armor, a bronze or wicker shield, spear, and according to legend a great sword.

On the other side of the dueling scale is the boy, David. David is a mere sheep-herding child, not even a warrior in the traditional sense. David's only weapon is a sling. It would appear that the scales tip heavily in favor of Goliath, but a more detailed look reveals the opposite. The sling is a formidable weapon in this realm of single combat, especially single combat on an open battlefield that offers room to maneuver. Bearing in mind the nature of the ground in the Middle East, David also had plenty of rocks to choose from while maneuvering. Out of necessity as a sheepherder, he would have been a well-practiced slinger and skilled at keeping predators away from the herd with endless days to spend flinging rocks with his sling to pass the time away.

With those skills he could have continually launched a rock at Goliath for every other step Goliath did or did not take, all the while staying out of reach of Goliath's weapons; thus fulfilling Silvers' recipe for victory. Due to its translation through time, the story has led us to believe that David's sling was both laughable and ultimately a shock to Goliath. Neither would be true, the sling has been around for a long time and was a commonplace weapon in early biblical warfare. It is reasonable to believe that Goliath was defeated because of the nature of the weapon's reach, the terrain conditions, and the psychological effects of the whole scheme of things, i.e., the undefeated war giant versus a sheep-herding boy with everybody watching.

How much time would Goliath spend hiding behind his shield from a boy while the Philistine and Israeli armies watched? Let us assume that Goliath, like every other solider during biblical warfare, has seen a sling in action before, as opposed to the common belief that he thought it laughable and fell victim to his overconfidence. Goliath could hide behind his shield and try to close within sword range, but in order to hit David he has to be able to see him. When Goliath exposes his face to look, David only needs to time his next rock for impact into that exposed moment. It is nearly impossible to successfully time a parry against a missile weapon launched at close range. The smaller the projectile, David's rock, the more difficult it is to see, calculate its speed, and accurately react to defending the target area of its destination.

Also added to David's advantages is he can launch his rocks continually. With the sling David can follow a familiar formula: he can attack repeatedly while remaining out of reach of his opponent's assaults. At best Goliath would have had the opportunity for one spear throw at David, but again at the cost of over exposing himself to David's faster sling attacks. After that spear throw its back to sword range. Whatever tactic Goliath used we all know the result of it.

Musashi used a similar technique to David's against the chain and sickle fighter Shishido Baiken. Again, rather than use his sword and face the extra challenges that comes with it, Musashi opts to make a close range throw of his tanto, a Japanese dagger which hits and kills his unsuspecting opponent. In the West, one seldom hears of duels pitting a sword against another type of weapon. In Europe it was considered an unfair advantage to mix weapons during duels. The European duel was as often a matter of righting wrongs and maintaining honor as it was about issues of martial skills. In the East reasons for dueling ranged from matters of honor to testing martial skills. One dueled with whatever weapon one specialized in, and it was believed if you were a warrior you should be able to defend yourself with your weapon regardless of what your opponent was using, the only true rule was to win. This is a much harder test of skills than to be protected by the equality of weapons. Knowing this, one must question why dueling with the katana did not reach its peak until after the age of elite Samurai warriors.

After the dismantling of the Samurai class, an action that turned the once proud warrior class into living archives of an age gone for good. During this later era, most Japanese field weapons became obsolete and where impractical to carry in public. With a major decline in the use of most battlefield weapons, the time for the sword to shine was at hand. The katana became the Samurai's last symbolic hold on an ancient warrior system soon to be completely outdated by cheaper and more efficient guns.

The replacement of the elite warrior class by the gun was not a phenomenon known only to the Japanese. The gun in its own time systematically brought about the dismantling of the elite warrior classes worldwide. The Chinese Boxers, the Scots Highlanders, the Zulu, the Aborigines, and the American Indians were among the last holdouts of the warrior elite, and they all fell victim to the gun. For most of these warrior cultures the sword became a symbolic relic of an age far more romantic then it actually was. Since the end of the elite warrior classes the facts regarding the sword and its value as a weapon have been exaggerated far and away beyond its real functions as an instrument of war.

The sword has several weaknesses as a combat weapon. Due to its limited reach or in the case of the great sword, excessive length; one has less time for reaction to an opponent's attack. The sword's edge is fragile and easily damaged so parries need to be made with the flat of the blade, making defense both complicated and cumbersome. The tang of the sword, the blade's extension into the handle, receives most of the impact when parrying and can be prone to breaking. Many styles of the sword offered little hand protection and so the hand of a swordsman was a primary target. To counter this, some swords were built with elaborate basket-like guards to protect the hand. There are accounts of the basket-hilt broadsword of Scottish highlander fame having to be pried off of the Highlander's hand after battle due to its collapsing under the pressure of enemy blows.

The sword is complicated to learn, time consuming to make, and generally an expensive arm. In medieval Europe, a single-handed broadsword could cost as much as 25,000 dollars by today's standards. The Japanese katana was, in its own fashion, an equally high-priced weapon. One can see the obvious reasons why, during Eastern and Western sword histories, the weapon was really more of a class and power symbol than a mainstream weapon for war. There is a Japanese house code that states "Do not yearn for katanas and tantos created by famous masters. A katana or tanto worth 10,000 pieces can be defeated by 100 yari (spears) each costing a 100 pieces. It is better to purchase 100 spears and arm 100 spearmen, in this way you can defended yourself in time of war." (Toshikage Jushichikajo, 1480)

Today the sword and Samurai have nearly become the same word. Yet during the height of the age of the Samurai, the bow, naginata, and spear were the main focus for war. The bow is found in the earliest history of Samurai warfare and the Yari-Samurai, elite spearmen, mounted or on foot, were among the highest valued warriors in a warlord's army. The katana was more often used as a backup weapon and for personal ritualized dueling. In most cultures during the age of battlefield dueling, duels were fought on horseback with bows or lances. If the warrior lost either of those weapons, he then used his sword as a last ditch effort to save or take his life. Around the same time the drafted peasant soldier of the late nineteenth century came into full force, the sword, due to its impractical functions on the battlefield, was eventually reduced to an ornamental symbol of authority. During the Second World War the ancient Samurai sword that was made using the secrets of a holy swordsmith still remained among the upper class, but the sword for the average officer was a 1933 mass-produced weapon.

This 1933 version was designed so that the older traditional katana blade could fit into the handle and replace the standard contemporary blade.

Because of the entertainment industry from ancient times to the present, the myth of the swordsman's abilities has always been far beyond any true feat of real swordsmanship. The western broadsword has followed the same path as the eastern swords, only it has been even further reduced into a simplistic, shining hip-hanger used only for parade. The Chinese straight sword has not escaped this symbolism either. It has been reduced to a lightweight flimsy show piece far more suitable for fast acrobatic Wu-Su routines then actual combat. What the general public has been led to believe almost entirely through the media is that the sword was the most powerful dueling weapon of all times. There are many reasons why the sword could not actually hold this title. First as mentioned is reach; second, arch versus thrust; third and most important, exposure.

To better explain the realities of sword combat and the troubles a swordsman would have, consider facing a spearman with a sword. To start the swordsman's troubles, the spearman need only keep the swordsman the distance of a spear thrust away. In doing so, the swordsman is put in danger of spear attacks while his target, the spearman, remains out of reach. Being out of reach of the attacks of his opponent, the spearman has many advantages added to his hopes of self-preservation. A spear, or even a lance of ten feet or less, can both cut and thrust like a sword and so deliver a variety of attacks without fear of immediate counterattack. For the swordsman to survive, he needs to close the distance on his opponent while trying to ward off thrusts and cuts from the attacking spear. The spearman need only keep attacking while retreating or circling a few steps if necessary. This is comparable to a man with an empty eighteenth-century musket fighting a ten-pace duel against a man with a colt revolver. Unless an act of God occurs, the musketeer is in for hard times.

The next problem is the issue of arch versus thrust. Everyone has seen a movie where the hapless spearman comes charging in with a stiff-armed thrust at the hero, who is always a swordsman, who jumps to the side and chops the oncoming spear in two. This is a perfect example of the mythological power of the arching sword stroke in its full absurdity. If the swordsman were to attempt a wasted motion like trying to cut the assaulting spear in two, it would be an ill-fated move for two reasons: it seriously exposes the swordsman to a counterattack, and it is an almost impossible cut to make. It is one thing to cut in two a shaft stuck firmly in the ground, it is another thing entirely to try and cut in two a free-floating shaft that deflects on impact.

Try hanging a spear-like shaft in the air by attaching a rope to the butt of the shaft and attaching another rope at a halfway point. Then try to chop that shaft in two with a single or several strokes. When you are through shaking your head, all those great movies will be ruined forever. The easily imagined results of this simple test are exactly like the real results of such a cut. The reader can see just how unlikely performing that cut actually is. Some Arthurian legends claimed the sword, Excalibur, could cut a boulder in two as though the rock was made of butter. Strangely, no sword culture can deny having myths of an equal nature to that of Excalibur's. There is also a Japanese legend of a katana so sharp that when it was left stuck in a stream, floating leaves were not sliced in-two by it but actually purposely avoided the sword's edge. Legends of this nature have always led the populous into believing that in the realm of edged weapons, the sword holds full royalties on slicing and chopping abilities. This is simply not true regarding personal combat.

All of the elite warrior-based cultures knew and used the advantages of thrusting and slicing with a spear as well as other long-reaching weapons. The difficulties of getting past that deadly reaching spear would be no small task for a swordsman. In addition to this reach advantage, even a moderately skilled spear fighter can deliver several thrusts or cuts to an oncoming swordsman before that sword can reach its target. History has shown us that one of those many spear cuts would be to either to the swordsman's lead knee, hand, arm, or foot. A good hit to any of these areas would end the swordsman's attack promptly.

A common misjudgment is that a large portion of a weapon's edge needs to strike the surface to do any real damage. An edge need only penetrate the depth of three fingers in the right areas of the human anatomy to be a fatal hit or lead to one. Though the stroke to the knee is not a fatal blow, worldwide archaeological finds from battle sites involving ancient weapons have consistently shown that such a wound led to a final lethal blow. In these archaeological digs, large percentages of the fallen were first struck at the bend of the knee, or other exposed appendages, and then delivered a fatal blow while they lay prostrate from the first injury. By studying the results of many years of full-contact dueling with training and blunted weapons, I have rarely found this cut to a charging opponent's knee, ankle or foot to fail. An equally successful tactic is thrusting into the opponent's oncoming feet.

When infantry used swords and shields against lance-carrying cavalry, the results nearly always ended in disaster for the foot soldier. When foot soldiers replaced swords with spears and lances, the disaster fell on the heavy cavalry. It was so effective that infantry pike units became the standard for hundreds of years. Pike units were not removed from the battlefield until the advent of efficient firearms sporting bayonets, which was not the demise of the pole weapon but rather a merger of pike and gun. When the sword is pitted against a spear, the swordsman also has to overcome the issue of too much exposure. Combat manuscripts of old break the sword down into sections depending on the type of sword.

The first third of the blade from its tip down was for cutting, the next third was for soft parries, and the final third above the hand guard was for heavy parries and coming to grips with your opponent. The old masters from the East and West also wrote that the preferred method of defense with a sword was simply to avoid your opponent's attacks physically and through footwork. This method was preferred over jeopardizing your sword's cutting edge and its structural integrity by using it to fend off blows from other weapons. With exceptions, the sword length averages from 20 to 42 inches. On the contrary, the smallest battlefield spear is around six feet in length with a shaft designed for warding off blows from other weapons. The swordsman must also overcome the limited range of his defense, referring not only to the sword's reach but also the axis with which one can parry and so defend the body.

Take into account the mechanics of the human body and the length, manner, and design of the weapon being used. The nature of the sword creates a problem when defending above or below the waist. The problem is to defend one's body above or below one must, by the nature of the sword, expose the opposite of what is defended. This is true with all weapons but to a higher degree with sword and similar weapons. The pole arm offers considerably more options. By tipping the weapon vertically, horizontally, or diagonally out from the body, one can readily defend and strike from any axis of the body. The pole arm fighter does not even have to resort to this guard until the swordsman gets in close enough to be a threat. The swordsman, on trying to close, has to defend too much exposed area and so is subject to attack at several areas on his body. To a large degree this is why the shield was developed. In most cultures, the shield was developed for war and not dueling.

The shield was designed to be part of a wall of shields used as a defensive battle tactic as demonstrated by the front lines of a Greek phalanx, the Roman turtle formation, and the Viking shield wall. In a duel or single combat, the shield is used in a considerably different manner than in a melee or mass melee. Regardless of how it is used, the shield can only effectively protect one side of the body during a charge and so forces the wielder to defend his opposite side with the sword. Because of the leverage that can be placed behind a thrusting or sweeping pole attack, the sword and its wielding arm cannot compete with the impact of an oncoming pole weapon As mentioned earlier, this is especially true when a sweeping spear cut or a thrust is delivered to the swordsman's stressed knee, ankle, or foot. Such an attack forces the swordsman to bring the tip of his sword down; the arm position would be the equivalent of completely emptying a drinking mug gripped in your hand. Doing this simple motion the reader can see how the position is both awkward and weak; furthermore, the position also exposes the upper torso. The lower guard that could be used exposes even more of the swordsman's body. A high or low, well-timed thrust or cut to this weak side will put an end to the charging swordsman.

Though I have used the spear here as the swordsman's nemesis, one can see that any weapon of greater length or weight would prove technologically superior. It becomes obvious why the swordsman's survival is so unlikely. The sword has come to stand on a solid throne where its powers are more mythical than the sword-wielding heroes themselves. We have come to believe the sword and its powers as the staple of all the classical warrior societies. Swords have been given names and positions of power; some were even believed to be magical. The right person with the right sword could smite injustice, slay the wicked, and restore kingdoms, assuming that is no one else shows up with a spear, halberd, pole-flail, rake, pitchfork, or sling. The entertainment industry may keep the sword on a throne of power and awe, but for those who have fought with and against the sword in all its manifestations, it's a translucent and mythological throne.