By Dr. Billy Goldberg and Mark Leyner

We hope that those of you who share our insatiable appetite for pungent biomedical fodder heard about a health clinic in Arkansas that was evacuated recently after more than 30 people were sickened. The staffers and some patients were hit with symptoms that included nausea, dizziness and uncontrollable drooling. A hazmat unit from the National Guard ran precautionary tests, and health officials are looking into whether the outbreak might be connected to an exterminator's visit.

msnbc.com

Uncontrollable drooling?! Surely there's a disaster film in the making here. Imagine scores of hapless villagers borne away on a tsunami of drool!!

It makes good sense that a hazmat unit was called in because the toxic effects of pesticides – and nerve gasses, for that matter – may include excess salivation with drooling.

But before we tackle the fascinating subject of excessive drooling, which in polite society is more properly known as sialorrhea, how about a quick tutorial about saliva? Drool School.

Spit is one of those disreputable, often reviled bodily fluids that doctors – like chivalrous knights on charging steeds – feel an obligation to rescue from misperception.

Saliva is a clear, viscous fluid secreted from the mucous glands of the mouth. What a magical fluid! The WD-40 of our squeaking bodies.

It contains two major types of protein secretions aiding in digestion and lubrication, as well as several antimicrobial components. Our salivary glands produce about 2 to 4 pints of drool a day. 

All babies drool, especially when teething. But as children get older they usually learn to control their saliva and most kids beyond 4 years of age stop their drooling. Children who suffer from disabilities that impair the nerves or muscles in their throats and mouths may continue to drool past this age and may require treatment which can include speech therapy, biofeedback, medication and even surgery.

Pregnant women can also become big-time droolers. Their salivary glands may become swollen, their cheeks puff up and they can have difficulty swallowing and speaking. Sometimes they even have to constantly wipe their mouths to prevent saliva from dribbling down their chins. Ah, the blissful indignities of impending motherhood!

Breathing through the mouth while sleeping also can result in drooling, especially after a few alcoholic drinks.  

Not having enough spit can be equally uncomfortable. There are over 1,800 drugs that can make your mouth feel dry. Eighty percent of the top 10 drugs may cause oral dryness, including drugs prescribed for high blood pressure, anxiety, depression, allergies, weight loss or pain.

If a patient complains of sialorrhea – excessive drooling  –  various associated signs and symptoms need to be explored. Is there also a sore throat, difficulty swallowing, chewing, and speaking? Does the patient have pain or stiffness in the neck or muscle weakness in the face?  Has there been any exposure to pesticides? Are there bite marks?  (Excessive drooling can result from rabies.) 

Why so many questions about too much drool?

In the presence of other symptoms, it can be a sign of trouble. Drooling with fever may indicate abscesses in the head and neck area, tonsillitis, mononucleosis, strep throat or epiglottitis. If accompanied by dysphagia (difficulty swallowing), weight loss or facial weakness, persistent drooling can point to an esophageal tumor, Ludwig's angina or myotonic dystrophy. With Bell's Palsy, for instance, drooling often accompanies the gradual onset of facial hemiplegia (partial paralysis).  And drooling is a common complication of Parkinson's disease.

Now that you're slobber-savvy, you can meditate upon several saliva conundrums. Did you ever wonder where all that excess saliva that's sucked out of people's mouths at dentists' offices around the country ends up? If your suspicion is that tens of billions of barrels of frozen saliva is being stored in top-secret tanks under the Antarctic Ocean, awaiting the development of cars that can run on saliva — thus freeing us from the yoke of foreign oil dependence— you  might be on to something. 

What about kissing? Isn't it strange that for all the derisive things people say about spit, sharing it with other people is considered one of the sublime pleasures in life? 

A study recently conducted at the State University of New York at Albany found that men prefer wetter kisses. The authors of the study hypothesize that "kissing styles that maximize salivary exchange provide subtle information about a female's reproductive status since saliva and breath odor changes across the menstrual cycles."  The scientists speculate that "male preference for salivary exchange could function to introduce substances such as hormones or proteins into women's mouths that may influence their mating psychology, and even make them more sexually receptive."

So, in the end – as ruthless as it may sound – romance may all boil down to the Saliva of the Fittest.

Want more weird health news? Find The Body Odd on Facebook.

By Diane Mapes

You might not think President George W. Bush and Amy Winehouse have much in common, but they've both succumbed to episodes of syncope, a medical term derived from an ancient Greek word that means "to interrupt."

Evening Standard / Getty Images

In other words, they've both fainted.

Bush passed out while eating pretzels and watching TV on his couch back in 2002; Winehouse lost consciousness last Monday after signing autographs for a group of fans outside her home.

According to the experts, fainting isn't as freakish as you might think. Caused by a decrease in the flow of blood (and oxygen) to the brain, syncope is actually fairly common, says Dr. Blair P. Grubb, professor of cardiovascular medicine and pediatrics at The University of Toledo Medical Center. About 19 percent of all adults will experience at least one episode of it in their life. The tricky part is figuring out why.

"Syncope may be benign and it may be the warning sign of something more serious," says Grubb, author of "The Fainting Phenomenon: Understanding Why People Faint and What to do About It."  "One of the difficulties is that there are many things that can cause it."

On the serious end of the scale is cardiovascular syncope, which is often the only warning sign before a sudden death due to some form of heart complication or congenital anomaly. Basketball player Reggie Lewis experienced an episode of cardiovascular syncope before he collapsed and died of hypertrophic cardiomyopathy in 1993.

"You may only have one warning before a tragedy," says Grubb. "If you faint, it could be due to a serious problem. Whenever there's a question, it's best to go ask your doctor."

Non-cardiac syncope is far more prevalent and far less indicative of a serious illness. But its causes are legion.

Alcohol and certain drugs can cause blood pressure to drop which can then trigger an episode of syncope; starving yourself or becoming dehydrated can have the same effect. High gravitational forces can also cause fainting, which is why the Air Force commonly screens people for the condition. A hot, crowded setting such as a political rally or rock concert can also bring on a black out.

Historically, constraining corsets may have been responsible for fainting spells in women, although Grubb says the practice known as swooning might also be attributed to bad health (tuberculosis and other common diseases of the day), toxic make-up (arsenic and mercury were popular ingredients) or good old-fashioned deceit.

"In those days it was a learned behavior," he says. "Some people would do it as a put-on; it became the social norm."

Most people who faint don't need to fake it, though; they're predisposed to the condition thanks to their off-kilter autonomic nervous system (ANS), the set-up that controls the body's involuntary functions -- i.e., the regulation of blood pressure, body temperature, sweating, digestion, etc.

"About 10 percent of the population has poor autonomic tone," says Grubb. "If given the right set of stresses and strains, they'll pass out."

The ANS can short circuit in a variety of ways. In neurocardiogenic or vasovagal syncope (also known as the "common faint"), the heart mistakenly sends a signal to the brain that the body is experiencing an episode of hypertension, even though the blood pressure may be quite low. The brain responds by causing the blood pressure and heart rate to plummet, which then results in a lack of blood to the brain.

Boom. You're on the floor.

Some folks will pass out when they stand for too long in the same lock-kneed position.

Others will faint at the sight of blood (or even the thought of it).

"People will pass out laughing, coughing, sneezing, and having orgasms," says Grubb. "If you have an enlarged prostate and you have to strain to urinate, you can pass out from that. If you're really constipated and you strain really hard, you can faint on the toilet. That's called defecation syncope."

While most people are able to take evasive action (i.e., get flat) when they feel a faint coming on (symptoms usually include light-headedness, blurred vision, shakiness, and "spots before your eyes"), those who suffer from refractory recurrent syncope aren't as fortunate.

"These people have no warning whatsoever," says Grubb. "They'll wake up on the floor in a pool of blood with a broken jaw. Their lives are ruined by this."

According to Grubb, syncope accounts for 3 percent of all emergency room visits and up to 6 percent of all hospital admissions.

The famously bee-hived British singer Amy Winehouse is one of them, although her fainting spell seems connected to a more serious problem. Doctors have determined that she has early stage emphysema and an irregular heartbeat caused by smoking crack cocaine and cigarettes. 

Given her love of back-combing, though, it's surprising she hasn't fainted before.

"Some people will pass out when getting their hair done," says Grubb. "It's called hair grooming syncope. If you yank on the hair of people who are predisposed to this, they can pass out."

Want more weird health news? Find The Body Odd on Facebook.

"For each ailment that doctors cure with medications (as I am told they do occasionally succeed in doing) they produce 10 others in healthy individuals by inoculating them with that pathogenic agent 1000 times more virulent than all the microbes - -the idea that they are ill."?
-- Marcel Proust, "The Guermantes Way"

Dr. Billy Goldberg:
This quote came to mind after a particularly grueling weekend in the ER.  You see, I am just getting over a brief yet vicious bout of nosophobia. Nosophobia refers to a morbid fear of contracting a disease. In my case, I was terrified of about 37 different ailments that might strike me or one of my family members down.  It didn't help that when I got home from the hospital I had to spend an hour convincing my sister that she didn't have thyroid disease, liver failure or metastatic cervical cancer.  My sister and I both share a genetic predisposition towards worrying that isn't exactly helped by my practice of medicine.

Surprisingly, most doctors aren't hypochondriacs.  But medical students often go through a phase of thinking they have everything they learn about in school. I can recall sitting in a genetics lecture with a pregnant friend and watching her cringe and rub her belly as we learned about every horrendous ailment that might affect her unborn child. This condition has been called "medical student's disease," "hypochondriasis of medical students" – and best of all, "medical studentitis." 

Some studies suggest that as many as 80 percent of med students suffer from unfounded fears of illness. The prevalence of true psychiatric hypochondriasis among regular folks has been estimated to be as high as 10.7 percent. This number strikes me as low, probably because it doesn't include people like me who have occasional episodes of hyponchondriacal thought.

Most medical students recover from their "medical studentitis" and join the legions of doctors who ignore their own medical illnesses and scoff at their patients who have unfounded fears. Unfortunately, I am prone to relapse.  Where does all this leave me? I have no idea, but I sure would like to forget my sister's fears, that 5-year-old who came into the ER with newly diagnosed leukemia and that funny lump that I have on my own leg.

Mark Leyner:
Hypochondria is a Möbius strip to me.  I can't tell where it begins or ends, or, conceptually, what's the inside and what's the outside of it. So, it produces a kind of vertigo. Or maybe I just think I have vertigo.

Isn't there a profound truth to thinking that we're sick all the time? The reality is that once we've outlived our prime procreative days, we begin to inexorably degrade. Our very bodies become constant reminders of our own mortality.

Isn't hypochondria, actually and paradoxically, an illness in and of itself?  It's included in the category of somatoform disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the reference handbook used by clinicians to guide the diagnosis of mental disorders. Some experts argue that hypochondriasis shares many features with obsessive-compulsive disorder or panic disorder and would be more appropriately classified with the anxiety disorders.

So, thinking you're sick when you're not is … sick.  Hmm.

Our society's ingrained hostility to hypochondriacs clearly demonstrates how arbitrary cultural judgments can be. Certain delusions are more disreputable than others. We denigrate hypochondria – the delusion of being ill when one is well. But we laud sick people who think they're well – it's evidence of a brave and gritty optimism. Stupid people who maintain the delusion that they are smart tend to be intolerable. But smart people who insist that they are stupid display wonderful humility and charm. And even in the pecking order of bogus invalids, hypochondriacs rank above the malingerers, who knowingly feign illness or other incapacities in order to avoid work.

As a child, I was elaborately schooled in the fine art of hypochondria.  Hypochondria was to my family what skiing or folk-dancing was to other families – a traditional pastime that stretched back for generations. Dinner conversation inevitably turned to someone's bloody sputum or lumpy testicle. It was like a never-ending borscht-belt production of Munchausen syndrome (the epic Wagnerian version of hypochondria).

Here are some of the conditions, diseases and tumors I've thought I've had just over the past two months:  oligodendroglioma, arrhythmia, bladder cancer, skin cancer, cirrhosis of the liver, syphilis, Crimean-Congo hemorrhagic fever, Creutzfeldt-Jakob disease, anaphylactic shock from dust-mite allergies, some teratological malformation of the alveolar ridge, and bronchiolitis obliterans (Popcorn Worker's Lung Disease).

The consummate achievement in the art of hypochondria goes considerably beyond merely thinking that you're sick. The ultimate form of hypochondria is thinking you're dead. A person who thinks he's dead, but consents to a sort of feigned life is to be enormously admired.

Here we can see how this ultimate hypochondria can be a profound expression of bushido – the traditional code of the Japanese samurai.

This is how Yamamoto Tsunetomo, a 17th-century samurai retainer of the Nabeshima Clan, described the proper attitude of a warrior: "Every day without fail one should consider himself as dead. There is a saying of the elders that goes, 'Step from under the eaves and you're a dead man. Leave the gate and the enemy is waiting.' This is not a matter of being careful. It is to consider oneself as dead beforehand."

Now there's an eminently healthy attitude, if I ever heard one.

Are you a hypochondriac? Take our poll.

Want more weird health news? Find The Body Odd on Facebook.