Older hospital patients benefit from specialists in 'care of the elderly'

There are, it would seem, two possible explanations for the gentleman from Armagh who wakes around 5am every day with a “feeling of tension” in his stomach that persists until breakfast, before “gradually ebbing away”.

The first is morning anxiety syndrome, a variation of the early-morning blues that can, of course, be a feature of a depressive illness. But when this occurs as an isolated phenomenon, it may be due, it is suggested, to the daily variation in the production of cortisol, the flight-or-fight hormone that peaks in the early hours and may, in turn, be associated with a (relatively) low blood sugar level.

This may be mitigated by a small snack on waking, and countering the feelings of anxiety with positive thoughts along the lines of “I have been through this before; it will get better”.

The further possibility, whereby the stomach tension takes the form of a physical gut ache or colicky pains, suggests a form of the early-morning version of irritable bowel syndrome – but without the usual repetitive bouts of diarrhoea. This may be helped by antispasmodic drugs, but as one long-term sufferer puts it: “I now just live with it; other people have worse.”

'Sunburnt' skin

This week’s medical mystery comes courtesy of Mr R M from Leeds, now in his mid-fifties and “plagued” with a general soreness of the skin of both legs, “as if they were sunburnt”. This is triggered by heavy or tight clothing, is (rather bizarrely) worse after eating, and may be relieved by exercise. Neither antihistamines nor steroid creams bring relief, and he is desperate for any other suggestions.

'Folk' remedies

Finally, further to the fascinating phenomenon whereby the same natural “folk” remedies are known to diverse cultures – such as the marsh plant bulrush being useful for minimising bleeding and promoting wound healing – Dianne Simpson writes to tell of her experience as a young girl in the Fifties, when she lived on a small island off the east coast of Canada.

When scalded down her back by boiling water, an old nurse living nearby advised covering the burns with a paste made from the fluff of the bulrush plant. “She told my parents this would ensure there would be no scars – and she was right.”

Online clinic

The Mary Portas-style makeover of this column is an opportunity to extend its scope to include an online clinic for readers seeking advice on all types of medical problems. Those with a query should send it to This e-mail address is being protected from spambots. You need JavaScript enabled to view it to reach me by 5pm on Thursday; responses can be viewed from 10am the following morning on the Telegraph website, at www.telegraph.co.uk/drjames.

Your comments, opinions on the column and any “mystery syndromes” remain most welcome, and should be directed to This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Or write to Dr James LeFanu, c/o Features, Daily Telegraph, 111 Buckingham Palace Road, London SW1W 0DT.

James Le Fanu’s 'The Rise and Fall of Modern Medicine’ is available from Telegraph Books for £14.99 plus £1.25 p&p. To order, call 0844 871 1515 or visit books.telegraph.co.uk