Friday 14 December 2012

The Chinese delicacy of hairy crabs


Hairy crabs are the great autumn delicacy of eastern China, and an obsession for those who can afford to eat them. The female crabs ripen in the ninth lunar month, the males in the tenth, and from then until the end of the year they are almost inescapable.
A pair of crabs crouched on my plate, eyeballing each other like adversaries, their legs spiky with yellow hair.
The male was big and beefy, the colour of a mandarin, with claws bedded in dark mossy fur. The female was smaller, its shell a less flamboyant shade of orange.
Steam drifted up from both of them. I took a deep breath and prepared for the attack.
Eating hairy crabs is a wild and messy business. You must pull off the legs and claws, prise open the shells and scrape, pick, suck and crunch until you have extracted every last, delicious morsel.
The pale, silken flesh of the crab legs is delectable enough, but their shells contain the real treasures: the golden, voluptuous semen of the males and the bright orange roe of the females, sprawled lazily atop a custardy mess of meat.
Of course, for those who find eating whole crabs a hassle, restaurants offer seasonal menus of dishes made with meat that has been painstakingly excavated from the shells.
You might try the legs stir-fried with asparagus, the luscious shell-meat and roe on a dishful of quivering tofu, or a hairy crab version of Shanghai's most famous steamed dumpling, the xiao long bao.
The crabs have long inspired passion in their devotees. The 17th Century playwright Li Yu wrote that his heart lusted after them, and there was not a day in his life when he had not thought of them.
I had not intended to eat hairy crab every day during my recent stay in Shanghai, but they seemed to greet me everywhere I went.

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And although I had always considered myself to be a competent crab-picker, I found myself taking what seemed to be an advanced course in the art of crab-eating, because everyone I met offered me a new piece of advice.
My friend Jason's mother told me to leave two legs attached to each half of the body like a handle, so I could raise it to my lips and chomp out the strandy white flesh at the sides.
The uncle of another friend, Rose, taught me how to stick parts of both claws together so they looked like a butterfly.
And most intriguingly, he showed me how to turn the stomach inside out to reveal a tiny knobbly appendage that resembled the head of an ancient monk, complete with wizened face and long, straggly beard.
There was plenty of medical advice too, because eating hairy crabs is a dangerous game, as any Shanghainese can tell you.
According to Chinese medicine, their flesh is perilously cold, and must be balanced with warming foods, which is why they are always served with vinegar and ginger, and sometimes a flask of Shaoxing rice wine.
And crabs should never be eaten with "cold" persimmon, because it is thought to be a toxic combination.
Then there are the parts of the crab that must be avoided. The pillowy, finger-like lungs and plasticky pyramid of the stomach should be discarded, said another friend, Haichen.
After a couple of weeks of excessive crab-eating, despite my delight, I was becoming paranoid.And do not, whatever you do, eat the heart, she added - it is a sinister grey flap of rubbery flesh tucked away inside the body, which is even colder than the meat and should never be eaten. Smaller than a SIM card, it is easily overlooked.
Haichen had warned me that for women especially, crabs should be eaten in extreme moderation, but I could not seem to escape them.

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I was ambushed by crabs at what was supposed to be simple lunches at the homes of friends, surprised by crab dishes on every dinner table.
Even after a wine-and-food pairing event when I had been tasting crab all day long, the
piece de resistance at the judges' banquet was... crabmeat on a bed of eggwhite custard.
Despite my diligent consumption of ginger and wine, would I succumb to the symptoms of cold - stomach-ache and vomiting?
And just how soon after eating a crab was it safe to consume persimmons, which were also perfectly in season and quite irresistible?
I recalled, with a shudder, that I must have eaten a few of the flabby grey hearts before I had learned to pick them out.
For a few days I walked around in a state of unease, waiting for the crabs' revenge. But I am pleased to report that I survived the experience in robust good health.
And I cannot wait to go to Shanghai next autumn for more.

Is miscarriage care insensitive?


Imagine being in hospital with the knowledge you've just miscarried and lost your baby. But at the same time you're being kept on a ward where you can hear women going through labour and life entering the world.
It happened during Julie Orford's first miscarriage and was just one instance of what she describes as "insensitive care" during a "really, really frightening" time.
"I found it quite distressing that I was in the process of losing my baby, when I could hear others actually having their baby downstairs," she told the BBC.
Julie, 40, from Suffolk, miscarried - as happens in one in five pregnancies in the UK - in 2008, when 11 weeks pregnant.
After she was told her baby had no heartbeat, she said she felt like she was left on a hospital "conveyor belt" and her treatment was "very insensitive".
One of the issues was language. She said she felt like she was losing a baby, but doctors would only refer to "pregnancy tissue".
"It's very common for a miscarriage to happen - you very much just become part of the process.
"Perhaps you're not treated sensitively and spoken to in a way that would help you through that difficult time.
"I felt it was more like a medical procedure, there was never any talk of a baby or losing babies."
New rules
Experiences like Julie's are why the National Institute of Health and Clinical Excellence (NICE) has published new guidelines for England and Wales, on dealing with women who miscarry or have an ectopic pregnancy (when a fertilised egg implants outside the womb).
The NICE panel highlighted huge differences in pregnancy services across the country, with some available seven days a week, while others operated only for three mornings.
One of the recommendations was to set up dedicated early pregnancy assessment services. These would include a 24-hour contact number for women who have problems during their pregnancy.
Prof Mark Baker, director of the centre for clinical practice at NICE, said: "It's vital that women and their families receive good, consistent, timely and effective care and support that addresses their needs and enables them to make informed decisions.
"We know that not every woman is receiving this level of treatment at the moment, but this guideline will address that inconsistence and ensure all women receive excellent care, no matter where they live."
He added: "It's not rocket science to separate people who are losing a baby from people who are having a baby."
Mary Ann Lumsden, a professor of gynaecology and medical education at Glasgow University who led the panel, said it was about creating "a pivotal central point in the care of these women.
"It's an excellent opportunity for all the care to be in one place."
She also stressed that it was important that women were treated sensitively: "It doesn't cost a great deal to be sympathetic.
"For each woman it is a unique event and we must recognise people's distress.
"Most healthcare professionals do a pretty good job and try to be compassionate, but there are examples of bad practice."
Jacqui Clinton, of the baby charity Tommy's, said women who lost a child due to an ectopic pregnancy often struggled to cope without seeking help.
"No matter how early on your experience, the loss of a baby can feel like a bereavement. We therefore welcome these guidelines, and any initiatives, to provide the best possible care and support for women and their babies."
Jane Munro, of the Royal College of Midwives, said the guidelines should help ensure standardised and consistent care for women.
"The focus on emotional support and information giving is important, so that women can be clear about their choices and make informed decisions," she said.

Winter vomiting bug

Birmingham's City Hospital, Maidstone Hospital in Kent, and George Eliot Hospital in Nuneaton, Warwickshire, all have patients with the infection.
At Southampton more than 400 virus-infected passengers disembarked from a cruise ship.
The Health Protection Agency has said a 72% rise in cases was unexplained.
In its latest weekly report, it said there had been 2,630 confirmed laboratory reports of norovirus - up from 1,533 cases reported in the same period last season.
"There are no indications as to why activity is higher this year," it said.
Norovirus is highly contagious, and involves a sudden onset of vomiting and diarrhoea, with possible temperature, headache and stomach cramps. The illness usually lasts one or two days and there are no long-term effects.
The HPA said that lab reports represent only a small proportion of the actual amount of norovirus activity, as most infected people do not go to a doctor for treatment.
"It has been estimated that for every confirmed case there are around 288 unreported cases," the HPA said.
The figures for the number of hospital outbreaks showed that there were 45 hospital outbreaks during the last two weeks up to 9 December, which was similar to the previous fortnight to 2 December.
The HPA advices infected people not to visit friends or relatives in hospitals or residential care homes while ill, to avoid spreading the virus.
Cruise ship illness
Southampton's port health authority confirmed that 417 infected passengers disembarked on Friday after a 10-day Baltic cruise with P&O Cruises.
The cruise company apologised to passengers on Oriana who suffered diarrhoea and vomiting.
At City Hospital in Birmingham four wards were closed to visitors as a precautionary measure to stop the spread ahead of Christmas. Officials hoped to re-open within a week.
In Kent, three wards at Maidstone Hospital were closed to new admissions and family and friends of patients have been told to stay away.
Maidstone and Tunbridge Wells NHS Trust said 27 patients had norovirus.
Four wards have also been closed at The Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate because of the bug.
NHS Tayside reopened two wards on Friday that were closed to new admissions following an outbreak of norovirus.
The wards were at Crieff Community Hospital and Dundee's Royal Victoria Hospital.
In Wales, visitors have been urged to stay away from five hospitals - Ysbyty Gwynedd, Dolgellau, Colwyn Bay, Glan Clwyd and Wrexham Maelor - to prevent the spread of the infection.

Monday 10 December 2012

'Fat' drug could treat epilepsy


A substance made by the body when it uses fat as fuel could provide a new way of treating epilepsy, experts hope.
Researchers in London who have been carrying out preliminary tests of the fatty acid treatment, report their findings in Neuropharmacology journal.
They came up with the idea because of a special diet used by some children with severe, drug resistant epilepsy to help manage their condition.
The ketogenic diet is high in fat and low in carbohydrate.
The high fat, low carbohydrate diet is thought to mimic aspects of starvation by forcing the body to burn fats rather than carbohydrates.

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Although often effective, the diet has attracted criticism, as side-effects can be significant and potentially lead to constipation, hypoglycaemia, retarded growth and bone fractures.
By pinpointing fatty acids in the ketogenic diet that are effective in controlling epilepsy, researchers hope they can develop a pill for children and adults that could provide similar epilepsy control without the side-effects.
In early trials, the scientists, from Royal Holloway and University College London, say they have identified fatty acids that look like good candidates for the job.
They found that not only did some of the fatty acids outperform a regular epilepsy medication called valproate in controlling seizures in animals, they also had fewer side-effects.

But many more tests are needed to determine if the treatment would be safe and effective in humans.
Prof Matthew Walker, from the Institute of Neurology, University College London, said: "Epilepsy affects over 50 million people worldwide and approximately a third of these people have epilepsy that is not adequately controlled by our present treatments.
"This discovery offers a whole new approach to the treatment of drug-resistant epilepsies in children and adults."
Simon Wigglesworth, deputy chief executive at Epilepsy Action, said: "We know the ketogenic diet can be a highly effective treatment for children with difficult to control epilepsy and it is starting to be used for adults.
"The diet is high in fats and low in carbohydrates and the balance of the diet needs to be carefully worked out for each child. Although some children manage the diet very well, others find the diet unpleasant and difficult to follow. Children can also experience side-effects including constipation and weight loss.
"The identification of these fatty acids is an exciting breakthrough. The research means that children and adults with epilepsy could potentially benefit from the science behind the ketogenic diet without dramatically altering their eating habits or experiencing unpleasant side-effects.
"We look forward to seeing how this research progresses."