The Old Prescription

 

Medicine and healthcare are now way ahead of their times.  For this reason it is right and just to attempt a retrospective of health care in the days before the advent of penicillin and micro-specialisation.

 My early memories of healthcare revolve round our doctor who had a Licentiate in Medicine and practised in Calicut. When he placed his stethoscope on a patient’s body, he was never far from his oath to practice medicine honestly. He looked for the symptoms and an effective cure and never bothered about the tax status of the patient, his standing in society, his religion and least of all his ability to pay. In those days doctors divided their time between their pharmacies and home visits. The mid-century pharmacy had a few basic amenities like an X-Ray machine, a surgery for dressing minor injuries and in some cases, a few rooms for patients from out of town.

 A home visit from the doctor was an occasion for everyone to congregate in the drawing room. The children hung around the door while the doctor examined the patient with the help of a torchlight. The healing began with a finger on the pulse, a look at the tongue, an examination of the throat and the inevitable instruction to breathe deeply. Then there were questions about when the symptoms surfaced, how well the daily routines were going and whether there were other issues like a headache, body pain, or a cough.

 There were few pathology labs and digital readers to let you into the deepest secrets of the human body.  All the same, ailments from chicken pox to pemphigus were diagnosed within minutes and there was never the need to wait half a day of one’s life to see a specialist. The doctor simply read the signs, analysed the symptoms, listened to the patient, then smiled reassuringly and said: “Am sure you will be back in school in two days.” He was a dietician as well. At the end of the visit he would issue the negative list and an advisory for the next few days: “No mangoes, no oily foods, just kanji[i] or rice and buttermilk cooked with turmeric.”

 He then wrote an elaborate prescription which the compounder in his pharmacy deciphered and prepared. Most medicines of the era seemed related to the carminative and were a bright red in colour. Quinine which was still in use was a deceptive pink and topped the international levels for bitterness. After compounding, the mixture was poured into thick glass bottles with a label on one side and a paper-cut measure on the other. Back home the instructions were followed like religious rituals:  ‘shake the bottle before use; take three or four times a day before, or after food.’

 Cuts and bruises were treated with a tincture of iodine and a home-made bandage. There was a litany of poultices for every part of the anatomy.  Rigorous salt water gargles were always in fashion and every home owned an eye glass to clean the eyes of dust and dirt. Castor oil, Epsom salts, glycerine-tannic acid, gentian violet and Mendel’s solution were permanent fixtures on the medicine shelf. Turmeric, ginger, garlic, cumin and half the ingredients in the pantry were also used as remedies to complement the red and pink mixtures.

 Some members of the community placed their trust in Ayurveda and some in homeopathy. The aryavaidyasala[ii] in our town at that time had no chrome and glass, but dispensed powders, medicines and mixes for various ailments.  The patient came home with a bundle of dried roots and medicinal plants all wrapped up in an old issue of the Mathrubhoomi[iii]. The decoction was then prepared at home just as the vaidyar[iv] instructed. Often, the ingredients had to be boiled for hours with lots of water and slowly reduced from maybe a pint to an ounce or two. The end result was bitter and had to be gulped down in the best way possible and then repeated every day for as long as the treatment lasted. The list of dietary restrictions was long and varied, but at the end of the treatment the patient usually hurried to offer oblations to Lord Dhanvantari[v].  

 There were short comings and limitations. When all of the above did not work, the wealthy took the Mangalore Mail to Madras or Vellore for the next level of care. The rest of the community re-imposed their trust in the Licentiate in Medicine, the print-wrapped bundle of herbs and their own destinies.

                        

[i] Gruel made with broken rice

[ii] The medicine shop

[iii] The local daily

[iv]  A doctor of indigenous medicine

[v] The deity for healthcare