THE INDIAN MEDICAL GAZETTE.
50
TOO MANY COOKS. We have been
favoured by a respectable native practitioner of this town?an L.M. S.?with a history of a case of " Bard wan fever assuming features which appertain to typhoid." The patient was "a Hindoo gentleman, aged 33 years, of opulence and strong
build,"
a
pleader
took him to Burdwan
days, returning
High Court. Professional in September last; he remained
business
of the
to Calcutta in the first
his return he felt out of sorts,
there 25
week of October.
On
the
7tb, decided symptoms of fever set in. On the 8th, he called in a plucked student of the Medical College," who treated him for ague with diaphoretic mixture." On the 10th, he became delirious ; the reporter and,
on
"
"
was
summoned and instructed to call in consultation Calomel
leading European practitioners. were
ordered.
The bowels were moved and
some
of the
one
and James'
powder
reduction of
temperature obtained. Quinine was then exhibited. On the 12th, becoming more violent, another leading European practitioner was called in, and the dose of quinine was increased, digitalis being given in the intervals and strong liquid On the same day, the patient having now nutrients prescribed. become partially unconscious and refusing medicine, the services of a native kobiraj were obtained. The kobiraj administered a preparation of mercury, arsenic and musk and a milk diet. Daring the night convulsions supervened with aggravated delirium, sweating, weak pulse and cold extremities. On the 13th The patient was now speechless, a. homoeopath was sent for. almost unconscious, and evidently sinking. During the 14th, he the delirium
continued to sink, and his
case
was
left in the hands
of the
reporter, who ordered stimulants (ether, ammonia and brandy) ; some rose colored spots disappearing on pressure were noticed on
the chest and arms
died about half
on
the forenoon of this
four
the
day.
The
patient
of the loth.
The
morning past evidently a severe and rapid example of malarious " ?fever, presenting a continued type and terminating in a typhof fatal exhaustion. Such cases ous" condition, the concomitant were described as very common during the prevalence of the Burdwan fever," which has attracted so much attention. Our object in briefly stating the facts which we have gathered from our correspondent's communication is not to discuss the nature case
on
was
"
or
type of the case, but to offer
some
comments upon the mea-
adopted for the relief of the patient. The duration of the illness wa3 7 days, and within that period no fewer than six medical practitioners?" a plucked student of the Medical College," an L. M. S., two European doctors (Government medical officers, in leading practice), a kobiraj, and a homoeopath? were summoned by the father to treat the unfortunate man. The narrative is, we fear, a very common one in native society. As long as the illness is trivial a cheap, unqualified and ignorant native practitioner is employed. Becoming more serious, a qualified man is called in, and, alarming symptoms occurring, the best available advice is sought. When this measure does not appear to procure immediate and striking advantage, resort is had to irregular professors of the healing art, and, when the case is hopeless, and despair supervenes on anxiety, the original attendant is permitted to do his best. A system of this sort depends on thoughtlessness and ignorance, an imperfect appreciation of duty and want of faith in medicine. We are not about to institute a comparison between the relative merits of the three therapeutical systems, the ministers of which were successively employed to treat this man ; but it is quite certain that nothing sures
which were
[February 1,
1878,
bat harm could come of six different persons, and three different systems of healing being brought to bear upon the case of one individual within the space of one week. "We can sympathise with the agitation and anxiety of friends determined to leave no
stone unturned to retain
dear and valued
life; we can prefers the Icoiiraj and his prejudice empirical system to the practitioner of rational medicine ; and there can be no denying that the pretentious professors and the transcendental doctrines of homoeopathy command the conscientious adherence of many thoughtful and intelligent persons even
allow for the
a
which
in this and other countries ; but we cannot understand the
shifty, unreasoning
resort
to
or
approve
after
another, which we know to be so common in native society. The successful handling of any disease necessarily presupposes an intelligent knowledge of its nature, history and progress, if not also of the constitution and family history of its subject. These data demand observation, and, in most instances, contiWe do not in these days attach so much nuous observation. did our as forefathers, to the effect of drugs, nor importance, expect that by means of medicines we can attack and vanquish Our strength lies a disease as if it were a tangible entity. in our knowledge of the causation and course of diseases and in the adaptation of means to aid nature's efforts towards recovery, to remove painful symptoms and avert unfavourable consequences. We are in the position of the commander of a ship in a storm, watching and acting according to our previous knowledge and skill and present circumstances. Quite apart from the comparative merits of therapeutical theories nothing can be so incompatible with the intelligent grasp of a case as a frequent change of doctors. However clever each successive man may be, one
system
he cannot obtain from others the same kind or amount of know-
ledge
of the
case as
if he had been in attendance from the
and when every new actor comes
on
first;
the scene without communi-
those who have gone before, which must occur irregular practitioners are called in to supersede regular, the difficulty of properly apprehending and intelligently managing the case is increased. Besides, every plan of treatment requires time for its employment and the development of its effect, and nothing but mischief can arise from a mixture of plans, each of which might possibly, if pursued consistently, quietly and intelligently, be productive of advantage. Every new man brought 011 the scene is compelled, by the circumstances of the case, to do something, and the severer the case the stronger that something is likely to be. Tbe effect on the patient of these repeated efforts
cation with when
cannot be otherwise than harmful. We believe that an incalculable amount of mischief is done by the practice against which would most we are now raising our voice, and we
earnestly
recommend the adoption of cedure in
doctor,
cases
whose
of sickness.
a
more
The
knowledge, character,
rational and sensible pro* employment of a family and skill reliance is
placed management of the sick is the system which all civilized and intelligent communities have adopted. A conscientious man will not only himself do what he knows to be best for his patient, but will, when circumstances arise to necessitate it, summon to his aid the best knowledge and skill which can be obtained when he is in difficulty or doitbt. It will readily be conceded that it would be the height of folly, capriciously and suddenly, to transfer a lawsuit from one lawyer to another, or from one court to another ; and the folly is even greater in the case of disease, where the conand the
on
implicit committal
to him of the
Eebeuaby 1,
ditions are issues
more
more
1878.] complex,
THE RECENT APPOINTMENT TO THE EYE INFIRMARY. the interests more
difficult to foresee and control.
stirring, and the would, with all
We
native friends the
earnestness and
on
immense
the errors, which we have
sincerity, impress importance of avoiding
our
endeavoured to expose, and we appeal to those native practitioners, who may read these lines, to exert themselves to correct a habit in dealing with sickness as absurd as it is dangernow
ous.
51
50
TOO MANY COOKS. We have been
favoured by a respectable native practitioner of this town?an L.M. S.?with a history of a case of " Bard wan fever assuming features which appertain to typhoid." The patient was "a Hindoo gentleman, aged 33 years, of opulence and strong
build,"
a
pleader
took him to Burdwan
days, returning
High Court. Professional in September last; he remained
business
of the
to Calcutta in the first
his return he felt out of sorts,
there 25
week of October.
On
the
7tb, decided symptoms of fever set in. On the 8th, he called in a plucked student of the Medical College," who treated him for ague with diaphoretic mixture." On the 10th, he became delirious ; the reporter and,
on
"
"
was
summoned and instructed to call in consultation Calomel
leading European practitioners. were
ordered.
The bowels were moved and
some
of the
one
and James'
powder
reduction of
temperature obtained. Quinine was then exhibited. On the 12th, becoming more violent, another leading European practitioner was called in, and the dose of quinine was increased, digitalis being given in the intervals and strong liquid On the same day, the patient having now nutrients prescribed. become partially unconscious and refusing medicine, the services of a native kobiraj were obtained. The kobiraj administered a preparation of mercury, arsenic and musk and a milk diet. Daring the night convulsions supervened with aggravated delirium, sweating, weak pulse and cold extremities. On the 13th The patient was now speechless, a. homoeopath was sent for. almost unconscious, and evidently sinking. During the 14th, he the delirium
continued to sink, and his
case
was
left in the hands
of the
reporter, who ordered stimulants (ether, ammonia and brandy) ; some rose colored spots disappearing on pressure were noticed on
the chest and arms
died about half
on
the forenoon of this
four
the
day.
The
patient
of the loth.
The
morning past evidently a severe and rapid example of malarious " ?fever, presenting a continued type and terminating in a typhof fatal exhaustion. Such cases ous" condition, the concomitant were described as very common during the prevalence of the Burdwan fever," which has attracted so much attention. Our object in briefly stating the facts which we have gathered from our correspondent's communication is not to discuss the nature case
on
was
"
or
type of the case, but to offer
some
comments upon the mea-
adopted for the relief of the patient. The duration of the illness wa3 7 days, and within that period no fewer than six medical practitioners?" a plucked student of the Medical College," an L. M. S., two European doctors (Government medical officers, in leading practice), a kobiraj, and a homoeopath? were summoned by the father to treat the unfortunate man. The narrative is, we fear, a very common one in native society. As long as the illness is trivial a cheap, unqualified and ignorant native practitioner is employed. Becoming more serious, a qualified man is called in, and, alarming symptoms occurring, the best available advice is sought. When this measure does not appear to procure immediate and striking advantage, resort is had to irregular professors of the healing art, and, when the case is hopeless, and despair supervenes on anxiety, the original attendant is permitted to do his best. A system of this sort depends on thoughtlessness and ignorance, an imperfect appreciation of duty and want of faith in medicine. We are not about to institute a comparison between the relative merits of the three therapeutical systems, the ministers of which were successively employed to treat this man ; but it is quite certain that nothing sures
which were
[February 1,
1878,
bat harm could come of six different persons, and three different systems of healing being brought to bear upon the case of one individual within the space of one week. "We can sympathise with the agitation and anxiety of friends determined to leave no
stone unturned to retain
dear and valued
life; we can prefers the Icoiiraj and his prejudice empirical system to the practitioner of rational medicine ; and there can be no denying that the pretentious professors and the transcendental doctrines of homoeopathy command the conscientious adherence of many thoughtful and intelligent persons even
allow for the
a
which
in this and other countries ; but we cannot understand the
shifty, unreasoning
resort
to
or
approve
after
another, which we know to be so common in native society. The successful handling of any disease necessarily presupposes an intelligent knowledge of its nature, history and progress, if not also of the constitution and family history of its subject. These data demand observation, and, in most instances, contiWe do not in these days attach so much nuous observation. did our as forefathers, to the effect of drugs, nor importance, expect that by means of medicines we can attack and vanquish Our strength lies a disease as if it were a tangible entity. in our knowledge of the causation and course of diseases and in the adaptation of means to aid nature's efforts towards recovery, to remove painful symptoms and avert unfavourable consequences. We are in the position of the commander of a ship in a storm, watching and acting according to our previous knowledge and skill and present circumstances. Quite apart from the comparative merits of therapeutical theories nothing can be so incompatible with the intelligent grasp of a case as a frequent change of doctors. However clever each successive man may be, one
system
he cannot obtain from others the same kind or amount of know-
ledge
of the
case as
if he had been in attendance from the
and when every new actor comes
on
first;
the scene without communi-
those who have gone before, which must occur irregular practitioners are called in to supersede regular, the difficulty of properly apprehending and intelligently managing the case is increased. Besides, every plan of treatment requires time for its employment and the development of its effect, and nothing but mischief can arise from a mixture of plans, each of which might possibly, if pursued consistently, quietly and intelligently, be productive of advantage. Every new man brought 011 the scene is compelled, by the circumstances of the case, to do something, and the severer the case the stronger that something is likely to be. Tbe effect on the patient of these repeated efforts
cation with when
cannot be otherwise than harmful. We believe that an incalculable amount of mischief is done by the practice against which would most we are now raising our voice, and we
earnestly
recommend the adoption of cedure in
doctor,
cases
whose
of sickness.
a
more
The
knowledge, character,
rational and sensible pro* employment of a family and skill reliance is
placed management of the sick is the system which all civilized and intelligent communities have adopted. A conscientious man will not only himself do what he knows to be best for his patient, but will, when circumstances arise to necessitate it, summon to his aid the best knowledge and skill which can be obtained when he is in difficulty or doitbt. It will readily be conceded that it would be the height of folly, capriciously and suddenly, to transfer a lawsuit from one lawyer to another, or from one court to another ; and the folly is even greater in the case of disease, where the conand the
on
implicit committal
to him of the
Eebeuaby 1,
ditions are issues
more
more
1878.] complex,
THE RECENT APPOINTMENT TO THE EYE INFIRMARY. the interests more
difficult to foresee and control.
stirring, and the would, with all
We
native friends the
earnestness and
on
immense
the errors, which we have
sincerity, impress importance of avoiding
our
endeavoured to expose, and we appeal to those native practitioners, who may read these lines, to exert themselves to correct a habit in dealing with sickness as absurd as it is dangernow
ous.
51
