Tag: doctor

Grief : Death of AIIMS Covid warrior; raises questions


What happened to my father shouldn’t happen to anyone: Son of deceased AIIMS sanitation chief

 

Two days after his father, senior sanitation supervisor at AIIMS New Delhi, died of COVID-19 at the institute’s trauma centre, his son is still in shock.

Amid conflicting versions from the family and the institute administration, it’s unclear where the truth lies. What’s clear is, COVID warriors remain vulnerable to the disease and must do all they can to protect themselves.

The complexity associated spread and treatment  with Covid-19, is beyond the present day medical science. Although global efforts are being done on war footing, but it may take few months or a year to have some reasonable control over virus.

 

“My father got the infection on May 15 and passed away on May 24, within nine days.He was still on duty when he first developed uneasiness and illness. Routine checks were done at AIIMS on the morning of May 15. COVID test was not done and the doctors on duty suggested that my father should return for a COVID test after he develops symptoms. By the time visible symptoms developed around May 19, my father was already in need of a ventilator,” says his son urging asymptomatic people to get tested as soon as possible.

Every day is crucial in the fight against this disease as it doesn’t give you any time to respond, says the young man who, like his father, is a permanent staffer at AIIMS.

The son  also raises the question of quality of protective gear available to sanitation staff, cleaners, sweepers, ward boys and other workers at the institute.

While acknowledging the pressures of COVID management on AIIMS, the distraught son says that the N-95 masks provided to the sanitation workers at AIIMS were of low quality.

“We are all given four N-95 masks with four envelopes for 15 days and we a supposed to use one each day, store the others and then repeat the cycle. Since the COVID outbreak, I’ve only received eight masks till now. My father also had the same mask and its quality is very low as compared to the quality of filter N-95 masks you get in the markets. We do not get gloves. Sanitizers are also not freely available and we are mostly encouraged to use soap and water. But because the sanitation staffers’ job is prone to infection they should get the best quality masks, head caps, gloves and full disinfection kits. What happened to my father should not happen to anyone,” he  said, urging the government to increase testing of asymptomatic people.

Sudden demise of the front warrior has now brought the lens on the safety of cleaners and ward boys across top COVID hospitals.

Questions also arise on whether he had received Hydroxychloroquine preventive drug against COVID considering

ICMR recently revised its HCQ guidelines to include asymptotic COVID warriors in containment zones.

When contacted, AIIMS medical superintendent ruled out laxity on the part of AIIMS in handling the the case.

AIIMS medical superintendent also said AIIMS had issued HCQ for all its COVID warriors much in advance of ICMR’s revised guidelines covering all frontline staffers in containment areas and provided its staffers with all the necessary protection.

“Why wouldn’t we care for our own staff? We managed the case  the moment he came to us,” said  AIIMS medical superintendent

Amid conflicting versions from the family and the institute administration, it’s unclear where the truth lies.

What’s clear is, COVID warriors remain vulnerable to the disease and must do all they can to protect themselves.

21 occupational risk to doctor and nurses

covid 19 unmasks risk to health workers, administrators refrain

disbelief to grief

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Corona Virus unmasks danger to nurses and doctors, which administrators prefer to refrain or oppress


 

Working of a doctor and nurses has never free from risk to themselves. The risk is generally underestimated, although it often involves major  risk  to their  life. Problem is that  majority of people, society, governing bodies  and even doctors themselves do not perceive or acknowledge  many times  the risks seriously.  Deadly Corona virus has unmasked and unveiled the danger to nurses and doctors,  the topic often suppressed, shunned by administrators and those who govern.

    An extreme example is the Chinese doctor, who was reprimanded, humiliated and made to apologize for doing right.  But this one example  is tip of the iceberg, for the Global phenomenon, where risk to front line workers is ignored routinely. They are just taken as  the routine workers, who have consented to be sacrificed. Chinese doctor Li Wenliang, one of the eight whistle-blowers who warned other medics of the coronavirus outbreak but were reprimanded by the police, died of the epidemic on Thursday,

 

  As per reports, 40 staff members of Wuhan hospital are  infected with Virus.

    Administrators and regulators refrain to study data that would establish and quantify the occupational hazards of being a doctor and nurses. Some of these hazards may be known, but there is no comprehensive analysis of workplace risk for physicians and nurses, like those that have been done for other professions. As physicians, we have a sense of the risk, and yet we remain engaged, continuing to care for our patients as we know  “these things” happen. Perhaps society prefers to remain blissfully ignorant of the sacrifice and risk their doctors  and nurses take on, comforted by the fantasy of the serene  hospital. Perhaps we  all despise to let reality and data shatter the illusion.

   But since  these risks are increasing exponentially every day, because of unknown and mutated germs (bacteria and viruses),  awareness is needed.  There are lesser set procedures, lack of awareness, not protective equipment or supportive society, governance and  laws, at most of  the places globally.  doctors  and nurses continue to work  in danger zones. These risks can be of varied types and contracting the diseases is just one of them.

Patients carrying specially unknown germs are  handled by doctor and nurses, who have no clue, what they are dealing with.   Time gap in such  patients coming to the  hospital  and  the exact diagnosis of finding a dreaded disease, may be  quite dangerous to doctors and nurses. To add to the problem, In  large number of patients, exact viruses cannot be diagnosed or even suspected. In many cases of ARDS, the causative organism cannot be  isolated or identified.  It is important for  doctors and nurses  to take universal precautions at every level. There can be many more viruses or germs which are yet to be discovered or mutated ones that  are unknown.

H1N1, Zika,  Ebola,  SARS  are few examples,  just to imagine that they existed and handled by health workers as unknown germs, till they were discovered.

Worst part is that our systems are not defined to prevent, treat or compensate or even acknowledge for these big disasters, if it happens to healers. These problems are not known to students, when they decide to take medicine, nor they are taught in medical school. Most of the time they have to fend for themselves, if problems occur.

Everyday globally, the doctors and the nurses  greet the new day and return to their work of taking care of their patients, knowing well the risk  involved.

Maybe it is time that we are little more aware  and acknowledge that even doing everything in best manner and honestly, they are in a  conflict zone and  are all in harm’s way. Just be careful and be mindful that  doctors, nurses, and healthcare workers,  may get  sickened, injured, disabled even  as they care for their patients in best manner.

21 occupational hazards to nurses and doctors

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Leopard tortoise designed pill to administer insulin in diabetes


The discovery  has a potential to  transform  lives of millions of patients with diabetics.  It can  counter the availability and cost of insulin in future.  If successful , the new technology can even change the  delivery of other  drugs as well.

Scientists have developed a “needle pill” that could allow diabetics to take insulin without the need for daily injections.

The pea-sized capsule contains a small needle made of solid, compressed insulin, which is injected into the stomach wall after the capsule has been swallowed.

When tested in pigs, the device worked consistently and was able to deliver equivalent doses of insulin to those required by someone with diabetes.

Giovanni Traverso, an assistant professor at Harvard Medical School affiliated Brigham and Women’s hospital and a co-author of the study, said: “Our motivation is to make it easier for patients to take medication, particularly medications that require an injection. The classic one is insulin, but there are many others.”

Injections can be painful, cause injuries and be a barrier to people taking medication, he added.

The shape of the capsule is inspired by the leopard tortoise, found in Africa, which has a steep, domed shell that allows it to right itself if it rolls onto its back. In the case of the capsule, the domed shape ensures that the needle is continually reoriented towards the stomach wall. The needle is attached to a compressed spring that is restrained by a disk made from sugar. When the capsule is swallowed, water in the stomach dissolves the disk, releasing the spring and injecting the needle into the stomach wall.

The stomach wall does not have pain receptors, so it is unlikely that this would cause any discomfort. The insulin needle takes about an hour to dissolve into the bloodstream. In tests in pigs, the researchers said they were able to deliver five milligrams of insulin – comparable to the amount that a patient with type 2 diabetes would need to inject.

The metal spring and rest of the capsule passed through the digestive system, without seeming to cause any problems.

The team are now carrying out further tests in pigs and dogs and hope to start the first human trials within three years.

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Silence of lords is a death sentence to the medical profession:#Doctor’s assaults


 

      Every one when sick, always seeks help of a doctor and invariably help is provided. But strangely, when a doctor needs help, there is no one. Even those people, whose life had been saved, have not returned the favor.  A   strange phenomenon has happened in few years of accusing the doctors for all the ills in society and holding them responsible, without even looking at the root cause.  Everyone has found an easy scapegoat to blame.   Human rights of medical community has been grossly violated by physical assaults. More painful is to see the authorities  who are  supposed to take action have maintained a silence in all these years about this issue.  There has been countless incidences, recent being in Kalyan and Jaipur.

 

If this trend is not checked in an effective manner, it will be difficult to even treat a single patient in coming times. The way media and prominent people have put all doctors in bad light, it seems that a normal and good advice is also not taken in a correct perspective. Even patients do not understand, that this advice is for the  their betterment only.  It is because of prejudiced minds against doctors. Our films and film stars have shown in films that it is okay to assault and bully the doctor to get treatment  in an effort  to impress the gullible masses and make some money. They may be successful in making some money, but by creating mistrust they have put the lives of gullible people on risk. The media should have a more sensible approach and do some basic research before highlighting sensational news against doctors, hospitals and healthcare professionals.

Just imagine, what that gynecologist did to the patient to  earn a slap, for no reason. In this  manner, forget about serious patients and surgeries, doctors will be afraid to do even routine surgeries as well. Here the situation is that even before surgery, doctor was slapped. Imagine, if a complication happens during or after surgery, doctor would have been killed. But strangely our government, human right commissions, police and courts have behaved as if they do not exist to help the doctor, but they expect the doctor to help everyone. This kind of inaction and  silence of  authorities is appalling.

       Obviously good doctors will try to shun the system. Government, human right commissions, police and courts, media have done their contribution to kill a profession, which was of great help to them.  I am sure we are civilized and wisened up enough to recognize these flaws in the society and have some corrective measures before it is too late………….too late to change the perceptions which will settle in the young impressionable minds of the children who till now think of it as their dream career. Otherwise no brilliant child would ever like to enter this profession out of their fear. Nor the parents would like their children to be working for uncivilized society.  The government needs to enact reasonable laws to use  healthcare systems,  to the best interest of people  instead of  unfairly victimize the doctors, just to impress the gullible masses.

It is not a doctor, which was assaulted. Silence of lords is a death sentence to the medical  profession as a whole. One person may realize the folly, but if we wait for realization to come to  whole civilization, it may be too late.

Again I will request the people to introspect, who rue the scarcity of good doctors “ do they deserve to have good doctors?”

 

 

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Future medicine is beyond human limits: robots as doctor, till then human docs with robot like activity:


 

         The adage “To err is human” probably does not apply to the doctors. Doctors are definitely regarded different from rest of the humans and are not supposed to have privileges that other persons of humankind are guaranteed. Hence they are harassed often for any adverse clinical outcome even though it may be because of poor prognosis of patient. They work under continuous fear and stress and are punished for each small or big error. Then what are they? Modern slaves or human docs with robot like activity?

With advances in medical science, simultaneously there has been aberrant evolution of medical profession, education, regulation and medical industry. By provoking controversy about doctors for varied reasons, medical industry and law has intruded between the doctor patient relationship to take a centrestage in health care. Till now, doctor patient interaction was the central point of the health industry, a core around which medical industry revolved. Except this interaction, rest almost everything is controlled by industry.  If this interaction too is replaced by robotic machines, the control of medical industry over business of health will be almost complete. With the evolution of robotic technology and artificial intelligence, the dream of industry to have full control over health care business has become a realistic possibility.  There have been technical advancements to promote better treatment and diagnosis but these, at the same time, increase the cost of treatment and involvement and hence dependence on investors and industry. Complexity of medical science, industry, legalities and medical regulation has been multiplying everyday beyond human limits for doctors, at least in some specialties. Long years of training, Dealing and working with all complexities of medical system, all time retrospective analysis of their work by patients and lawyers, complex documentations, social media mudslinging, extensive and complex communication, technical advancements and legal interactions has taken a toll on the doctors and they are gradually ceasing to be normal human beings. They are slowly being converted to humans with robot like activity.

Also there is a thought whether doctors can be replaced by robots, completely or partly. Such talk of having machines is not without basis as all the stakeholders are feeling the need for a drastic change to have better and better medical care .

 

Future of medical profession: Robots as doctor:

  1. Usually doctors have to carry huge burden of expectation of society and patient. People want quick and effective treatment, without human faults, with an up-to-date medical knowledge delivered within moments. Unrealistic expectations are getting beyond human limits and these can be fulfilled only by robots.
  2. Since well trained doctors are lesser in number, they are expected to deliver a curative treatment with excellent accuracy with perfect documentation even when load of patients is extraordinarily high.
  3. Even in presence of extraordinary work load and difficult circumstances, doctor are supposed to maintain perfect documentation to save himself. Because later, any case can be subjected to legal scrutiny in future. Lawyers and courts will analyze retrospectively for years, with wisdom of hindsight and luxury of time, to find the faults and may punish the savior.
  4. Nobody wants to die. Even somebody with severe disease, with poor prognosis, have tendency to blame doctors for his illness, if he has contacted    Such incidences occurring too frequently cause feeling of hurt to doctors. Verbal and physical assaults is a routine. Robots will be immune to such painful thoughts and will not be affected mentally and continue to work perfectly in such circumstances.
  1. Training to be a Doctors are expensive and takes years. It takes painful long years and time. Human life span is limited. Therefore training a doctor and paying him life long, a bad business idea for industry and society. That is reason of unwillingness to pay even the rightful to the doctors. Robots will be a onetime investment. Life is one and span is less. Studies and gaining experience takes away good part of doctor’s life.  People from strong financial backgrounds avoid becoming doctors. Although they may opt for becoming health managers or investors.
  1. Human limitations, like tiredness, mood variation, feeling hurt, family issues, failure to apologize always in all situations (especially if doctor is not at fault), diagnostic  bias, limited knowledge   are various human factors with doctors, which are undesirable  for being a doctor and can be rectified easily with Robots.
  1. Available medical information is like a sea, that cannot be held in a hand. However brilliant doctor may be, he will know fraction of available knowledge. The moment we pass our exams, we start becoming out of date.
  2. Human bias always plays a role, because medical science is far from complete. Moreover rapid change in technology makes all knowledge and experience of a doctor redundant. Robots can be easily updated.

 Present medicine: human docs with Robot like activity:

As humans, doctors can make errors, get demoralized or dragged to courts or subjected to verbal or physical abuse, their mood and enthusiasm may be spoiled and may make more errors in other patients as well.  But they have to continue to perform as due to nature of their work does not allow them to have time to cool their mind. Repeated incidents make doctors immune to such mudslinging. Their reaction to these insults and distressing situations becomes blunt and reactions are subdued like that of a Robot.  Doctors themselves are slowly being converted to Robots like creatures.

  • Doctors do not react to unjustified verbal assaults of a patient, same as machine do.
  • They do not get demoralized easily because of moral assassination by media, calling them thieves, thugs and dacoits, even doing most helpful job in the entire society, saving lives. Now there is no reaction from doctors, when an uncommon or single stray incidence of adverse kind is used to portray all doctors in same light. This unwavering sanity looks like as if there have no apperception to perception of such poignant thoughts, same as Robots.
  • Many of them tirelessly work day and night without rest and food, along with verbal and physical assaults, accomplish arduous tasks like a machine.
  • Medicine is very complex and far from complete, still the precision executed by this wonderful community is no less than great machine “robot”. They executing all theory, practical and experience, application with in a trice. There personal emotions get a machine like toughness. They look like tough ship in such tornado, like a tough machine with no human weakness.
  • There is many things going in a doctor’s life, on professional and personal front. For example, care of sick, difficult family communication, perfect documentation, complaints, ongoing, court cases, declaring deaths, data maintenance, treatment and prevention of infections, nosocomial infections, medico legal suits, iatrogenic complications or simply genuine poor prognostic patients, unforeseen complications, unnecessary mudslinging by media and social media along with newer advances to cope with. There can be personal and own family issues as well. For a simple human being, it is difficult to accomplish all this complexities   immaculately and at the same time, while handling the ongoing patient load.
  • Doctors continue to work unaffected by continuous retrospective analysis and afflictive comments from practically every side, patients, administration and courts. All of them acquire wisdom off hindsight and have luxury of time to make an analysis.

 

Present and Future of medical profession:

Robots will be immune from errors and mood swings, tiredness and human limitations, hurt feelings, (will apologize always even if it is not their fault). And therefore legalities in the profession will be minimized.  No breach of protocol is possible. No questions or room for mistrust. Robots can do duties all seven days a week and 365 days a year. Public, Governments and medical industry will be happy. With Artificial intelligence and rapid advancement in robotics, doctors will have very little role in medical industry. Best part is that, it will be a onetime investment.

 

          Minor disadvantage:  Only things Robots lack human touch and feelings and will not be going extra mile for patient as compared to human doctors. Robots will just complete protocols. But with time, these   qualities will not be required anymore. There will be no humans to blame for the suffering of diseased, or to vent anger at. No human scapegoat will be there for physical or legal revenge. But till the time human doctors are   completely replaced by machine robots, ordinary mortals have to fill in and they will be human Docs with robots like activity (HUDOROLA).

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National Doctor’s Day: India, USA


India

Also celebrated on July 1 all across India to honor the legendary physician and the second Chief Minister of West Bengal, Dr Bidhan Chandra Roy. He was born on July 1, 1882 and died on the same date in 1962, aged 80 years. Dr Roy was honored with the country’s highest civilian award, Bharat Ratna on February 4, 1961. The Doctor’s Day is observed today to lay emphasis on the value of doctors in our lives. It is an occasion to give them their due respect through commemorating one of their greatest representatives. India has shown remarkable improvements in the medical field and July 1 pays a perfect tribute to all the doctors who have made relentless efforts towards achieving this goal irrespective of the odds.

 

United States

In the United States, National Doctors’ Day is a day on which the service of physicians to the nation is recognized annually. The idea came from Eudora Brown Almond, wife of Dr. Charles B. Almond, and the date chosen was the anniversary of the first use of general anesthesia in surgery. On March 30, 1842, in Jefferson, Georgia, Dr Crawford Long used ether used to anesthetize a patient, James Venable, and painlessly excised a tumor from his neck.

The first Doctors’ Day observance was March 30th, 1933, in Winder, Georgia. This first observance included the mailing of cards to the physicians and their wives, flowers placed on graves of deceased doctors, including Dr. Long, and a formal dinner in the home of Dr. and Mrs. William T. Randolph. After the Barrow County Alliance adopted Mrs. Almond’s resolution to pay tribute to the doctors, the plan was presented to the Georgia State Medical Alliance in 1933 by Mrs. E. R. Harris of Winder, president of the Barrow County Alliance. On May 10, 1934, the resolution was adopted at the annual state meeting in Augusta, Georgia. The resolution was introduced to the Women’s Alliance of the Southern Medical Association at its 29th annual meeting held in St. Louis, Missouri, November 19-22, 1935, by the Alliance president, Mrs. J. Bonar White. Since then, Doctors’ Day has become an integral part of and synonymous with, the Southern Medical Association Alliance. Through the years, the red carnation has been used as the symbol of Doctors’ Day.

 

Permanent link: https://en.wikipedia.org/w/index.php?title=National_Doctors%27_Day&oldid=785811878

https://en.wikipedia.org/wiki/National_Doctors%27_Day

India

Also celebrated on July 1 all across India to honor the legendary physician and the second Chief Minister of West Bengal, Dr Bidhan Chandra Roy. He was born on July 1, 1882 and died on the same date in 1962, aged 80 years. Dr Roy was honored with the country’s highest civilian award, Bharat Ratna on February 4, 1961. The Doctor’s Day is observed today to lay emphasis on the value of doctors in our lives. It is an occasion to give them their due respect through commemorating one of their greatest representatives. India has shown remarkable improvements in the medical field and July 1 pays a perfect tribute to all the doctors who have made relentless efforts towards achieving this goal irrespective of the odds.

But in recent times, sadly “ Happy Doctor’s Day” is just a Tokenism, a hollow slogan”.

United States

In the United States, National Doctors’ Day is a day on which the service of physicians to the nation is recognized annually. The idea came from Eudora Brown Almond, wife of Dr. Charles B. Almond, and the date chosen was the anniversary of the first use of general anesthesia in surgery. On March 30, 1842, in Jefferson, Georgia, Dr Crawford Long used ether used to anesthetize a patient, James Venable, and painlessly excised a tumor from his neck.

The first Doctors’ Day observance was March 30th, 1933, in Winder, Georgia. This first observance included the mailing of cards to the physicians and their wives, flowers placed on graves of deceased doctors, including Dr. Long, and a formal dinner in the home of Dr. and Mrs. William T. Randolph. After the Barrow County Alliance adopted Mrs. Almond’s resolution to pay tribute to the doctors, the plan was presented to the Georgia State Medical Alliance in 1933 by Mrs. E. R. Harris of Winder, president of the Barrow County Alliance. On May 10, 1934, the resolution was adopted at the annual state meeting in Augusta, Georgia. The resolution was introduced to the Women’s Alliance of the Southern Medical Association at its 29th annual meeting held in St. Louis, Missouri, November 19-22, 1935, by the Alliance president, Mrs. J. Bonar White. Since then, Doctors’ Day has become an integral part of and synonymous with, the Southern Medical Association Alliance. Through the years, the red carnation has been used as the symbol of Doctors’ Day.

 

 

Permanent link: https://en.wikipedia.org/w/index.php?title=National_Doctors%27_Day&oldid=785811878

https://en.wikipedia.org/wiki/National_Doctors%27_Day

 

 

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Death declaration by doctor: complex communication skill. “No negligence in alive baby declared dead: hospital “

The death pronouncement is one of the most sensitive and complex part of communication in

The death pronouncement is one of the most sensitive and complex part of communication in and out of hospital, intensive care. It comprises more than the actual declaration of death. It may be a relatively straight forward when the death is expected and the family is mentally prepared and accepting the outcome. However, when the doctor is interacting with a grief-stricken family, dealing with the death of a child, or coming to terms with the death of a personal patient, a death pronouncement becomes complex. Problem is compounded often in presence of violent relatives, non acceptance of death, medico legal cases and   especially in cases of unnatural causes for the death. Relatives often refuse to accept death and within no time mobs swell in number, threatening of physical and verbal assaults and revenge against the doctor in various forms. Although there can be specific protocols and hospital policies, it will still depend upon the timely thoughts and skills of the doctor, how to handle the situation. Doctors should be better trained for handling of death as it can put them in risky situation, because of following reasons.

  1. Death itself is a complex issue. Even today modern science has not reached scientifically at the bottom of life and death.
  2. Communication of death is complex. It varies with each patient, type of relatives, place, country and every situation in same hospital is different.
  3. Declaration of death is a legal matter. How a doctor verifies death, communicates and documents death, it can create legal and other problems for doctor.

Any problem related to declaration of death is immediately picked by media and the initial reaction is to blame the doctors. The doctors in such cases are projected as incompetent and callous, and that makes a media news. Invariably one stray incidence is used as to project whole medical community in negative manner. Later inquiries and further inquiring continue, and even later truth emerges, that is not enough to bring back the lost prestige for medical profession.

Take for example the latest news of “ Alive Baby declared dead.”

http://timesofindia.indiatimes.com/city/delhi/alive-newborn-declared-dead/articleshow/59208765.cms

Later after two days, news was “ hospital enquiry claims No negligence in alive baby declared dead”

link   http://www.dnaindia.com/india/report-no-medical-negligence-in-case-where-newborn-was-declared-dead-2479826

Above news just conveys the complexity of situation, doctors often face. My aim here is to convey  that communication of death is a very complex subject. Ironically no structured training of emotional, communicative and legal issues is imparted to medical students. But they are supposed to face the situation everyday, when they function as doctors.

 

Most legal determinations of death are certified by medical professionals who pronounce death when specific criteria are met. Two categories of legal death are death determined by irreversible cessation of heartbeat and breathing (cardiopulmonary death), and death determined by irreversible cessation of functions of the brain (brain death).

Especially new doctors need to realize that the structure of modern society is to make life and death, medical and then legal matters, and to subject the most basic elements of our existence to professional authority. The birth certificate and the death certificate are signed by doctors, and then registered by the civil authorities.  Because of all  these sensitive issues, emotional aspects and legal dimensions of death being  huge, so need more attention. .

In remote areas doctors are totally alone and helpless, so security issues will remain. There is no solution in sight for these problems. Already I have written about a “real story of female doctor assault”.

Problem is that doctors during training days or residency are not trained in such kind of communication. Although while doing their duties they observe seniors and learn how they are communicating. But still when actual situations arise, which can be diverse, complex and challenging, and everyday getting more demanding. In view of current scenario against doctors, they need better training on these issues. Basic question is, if doctor needs help, where can he turn to for help or information. The resources, other staff and the setup is not of much help in difficult scenarios.  It is not uncommon that doctors are left to themselves, if a difficult situation arises. Medical education and Hospital systems need to be better equipped to provide more support to doctors in present era. For doctors, if they make a mistake, there is no one to support them or save them from verbal, physical assaults, law and medico legal cases.

Harassment is tremendous. Therefore   doctors, be careful – save the patient, but save yourself also.

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Ancient traditional Chinese medicine


Assorted  plant and animal parts used in traditional Chinese medicines: dried Lingzhi, ginseng, Luo Han Guo, turtle shell underbelly, and dried curled snakes.

China also developed a large body of traditional medicine. Much of the philosophy of  traditional Chinese medicine derived from empirical observations of disease and illness.  and reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales. These causative principles, whether material, essential, or mystical, correlate as the expression of the natural order of the universe.

The foundational text of Chinese medicine is the Huangdi neijing , written 5th century to 3rd century BCE.  Near the end of the 2nd century AD, during the Han dynasty, Zhang Zhongjing, wrote a  Treatise on cold damage, which contains the earliest known reference to the Neijing Suwen. The Jin Dynasty practitioner and advocate of acupuncture and moxibustion, Huangfu Mi (215-282), also quotes the Yellow Emperor in his Jiayi jing, c. 265. During the Tang dynasty, the Suwen was expanded and revised, and is now the best extant representation of the foundational roots of traditional Chinese medicine. Traditional Chinese medicine that is based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years.

In the 18th century, during the Qing dynasty, there was a proliferation of popular books on traditional medicine. Jesuit missionaries introduced Western science and medicine to the royal court, the Chinese physicians ignored them.

Finally in the 19th century, Western medicine was introduced at the local level by Christian medical missionaries from the London Missionary Society (Britain), the Methodist Church (Britain)

Because of the social custom that men and women should not be near to one another, the women of China were reluctant to be treated by male doctors. The missionaries sent women doctors such as Dr.  Mary Hannah Fulton (1854–1927). Supported by the Foreign Missions Board of the Presbyterian Church (USA) she in 1902 founded the first medical college for women in China, the Hackett Medical College for Women, in Guangzhou.

 

Link    https://en.wikipedia.org/wiki/History_of_medicine

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Ancient Indian medicine


Ancient Indian medicine

The Atharvaveda, a sacred text of Hinduism  dating from the Early Iron age, is one of the first Indian text dealing with medicine. The Atharvaveda also contain prescriptions of herbs for various ailments. The knowledge to use of herbs to treat ailments later formed bases for the large part of Ayurveda.

Ayurveda, means  the complete knowledge for long life is another medical system of India. Its two most famous texts belong to the schools of Charaka and Sushruta. The earliest foundations of Ayurveda were built on a synthesis of traditional herbal practices and  theoretical conceptualizations.  There after new  therapies dating from about 600 BCE onwards, and coming out of the communities of thinkers who included the Buddha and others.

According to the compendium of Charaka and  the Charakasamhita , health and disease are not predetermined and life may be prolonged by human effort. The compendium of Susruta, the Susrutasamhita, defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life. Both these ancient compendia include details of the examination, diagnosis, treatment, and prognosis of numerous ailments. The Susrutasamhita is notable for describing procedures on various forms of  surgery, including  rhinoplasty, the repair of torn ear lobes, perineal lithotomy, cataract surgery, and several other excisions and other surgical procedures. Most remarkable is Sushruta’s penchant for scientific classification: His medical treatise consists of 184 chapters, 1,120 conditions are listed, including injuries and illnesses relating to aging and mental illness. The Sushruta Samhita describe 125 surgical instrument, 300 surgical procedures and classifies human surgery in 8 categories.

The Ayurvedic classics mention eight branches of medicine: kayacikitsa (Internal medicine), salyacikitsa  (surgery including anatomy), salakyacikitsa  (eye, ear, nose, and throat diseases), kaumarabhrtya  (pediatrics), bhutavidya  (spirit medicine), and agada tantra (toxicology), rasayana (science of rejuvenation), and vajikarana (Aphrodisiac). Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalies. The teaching of various subjects was done during the instruction of relevant clinical subjects. The normal length of the student’s training appears to have been seven years. But the physician was to continue to learn.

As an alternative form of medicine in India, Unani medicine got deep roots and royal patronage during medieval times. It progressed during Indian sultanate and Mughal periods. Unani medicine is  similar to  Ayurveda. Both are based on theory of the presence of the elements (in Unani, they are considered to be fire, water, earth and air) in the human body. According to followers of Unani medicine, these elements are present in different fluids and their balance leads to health and their imbalance leads to illness.

By the 18th century A.D., Sanskrit medical wisdom still dominated. Muslim rulers built large hospitals in 1595 in Hyderabad, and in Delhi in 1719.

 

Link    https://en.wikipedia.org/wiki/History_of_medicine

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Evolution of medical science


 

The   practice of medicine  by trained professionals has been ever evolving  in its approach to   illness and disease, from ancient times to the present.

Early medical traditions evolved in  Babylon, China, Egypt, and India. The Greeks  pioneered the art of   medical diagnosis, prognosis, and advanced medical ethics. The Hippocratic Oath, still taken  by doctors up to today, was written in Greece in the 5th century BCE. In the medieval age, advances in  surgical practices were made and  systematized in Rogerius’s,  The Practice of Surgery. Systematic training of physicians was  started in universities around the years 1220 in Italy.  During the Renaissance,  significant advances were made with invention of microscope and  better understanding of anatomy.   The germ theory of disease in the 19th century led to cures for many infectious diseases. Military doctors advanced the methods of trauma treatment and surgery. Systematic sanitary measures and public health measures  made significant improvement . Advanced research centers opened in the early 20th century, often connected with major hospitals.  Discovery of antibiotics  was major invention in the mid-20th century.. These advancements, along with developments in chemistry, genetics, and lab technology such as the X-ray, was recognized as   modern medicine. Medicine was heavily professionalized in the 20th century, and new careers opened to women as nurses from the 1870s.

 

Link    https://en.wikipedia.org/wiki/History_of_medicine

 

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