DEAR DR. DONOHUE: I have a fungal infection in the nail of my big toe. My sister tells me she got rid of hers by soaking her foot in vinegar. Would that work? What would? I want to wear sandals, but I’m not showing this gross toenail to anyone. – R.F.

ANSWER: There are innumerable folk remedies for toenail fungus. None has been proven to work. Some are dangerous. Vinegar soaks are probably not harmful, but don’t waste your time trying to cure the fungus with them.

Prescription medicines do work for toenail fungus. Oral Lamisil (terbinafine) and oral Sporanox (itraconazole) must be taken for three months. Both infiltrate the nail. Results aren’t seen until much later, since it takes a full year to a year and a half for a toenail to grow from the base to its tip. Both these medicines have the potential for liver damage, so tests of liver function are performed while they’re being taken. The medicines are stopped if there is any sign of liver involvement so permanent damage can be avoided. Please note that Lamisil also comes as a cream and an ointment, and the liver warning does not apply to those preparations.

Griseofulvin is another oral medicine that has a credible record for treating toenail fungus.

Penlac nail lacquer is a liquid applied directly to the nail daily for a full year. It can sometimes effect a cure.

All of these medicines are relatively expensive.

You need confirmation that the changes you see in the nail are due to a fungal infection. There are look-alike conditions – trauma to the nail, nail psoriasis and eczema. Your doctor can provide that confirmation.

DEAR DR. DONOHUE: “History of diverticulitis.” What does that statement actually mean? “History” to me means a long time ago. Not once has any of my doctors said the word “diverticulitis” to me. I am 79 years old. – M.M.

ANSWER: A diverticulum is a pea-sized pouch that forms on the outer surface of the colon. It’s actually the colon lining bulging through the muscular colon wall. Diverticulosis is a colon with many diverticula, and most often it causes no pain and no problems. It’s discovered on X-rays or during a scope examination of the colon.

Diverticulitis is a painful inflammation of diverticula. The pain is often so severe that hospitalization is required. An episode of diverticulitis is something no one ever forgets unless it was so mild that it was mistaken for something else.

“History of diverticulitis” means that a person has had at least one attack of diverticulitis. Of all the people on this planet, you are the one who would know if you have a history of it.

The diverticulosis booklet spells out the signs, symptoms and treatment of this common condition. To order a copy, write: Dr. Donohue – No. 502, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: What does “vasovagal” mean? My doctor tells me that’s what I had. I thought I had fainted. – G.P.

ANSWER: Vasovagal syncope (SIN-coe-pea) is the common faint. It also goes by the name neurocardiogenic syncope. It’s a brief loss of consciousness due to a sudden drop-off in blood flow to the brain. Standing in place for a long time, an overheated room, profound fatigue, skipping meals or an emotionally stressful situation can cause blood vessels to dilate (the “vaso” part). Ordinarily the heart speeds up to maintain blood pressure. When the vagus nerve (the “vagal” part) inappropriately gets into the act, the heart slows and blood pressure drops lower, and the faint occurs. The horizontal position restores blood pressure, and the person wakens.

Usually a single fainting spell in an otherwise healthy person is not a sign of a serious health problem. Your doctor has given you a clean bill of health, so you can forget what happened.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.