MEDICAL AND PUBLIC HEALTH SERVICES

HISTORICAL BACKGROUND

THE GROWTH OF MEDICAL AND PUBLIC HEALTH CONSCIOUSNESS is a recent phenomenon. It was brought about by the spread of Western education coupled with the progress made in the field of scientific research. During the old days, the ailment was generally ascribed to the evil influence when the general masses lacking in education were under the spell of orthodox thought and as such the remedies thought fit for curing physical disorders were propitiating the evil influence through sacrifices rather than medical treatment.

Even then the people had the knowledge of anatomy and the vaidyas used to treat patients under the ayurvedic system of medicines based upon the use of different medicinal herbs and minerals. The reference to different kinds of rasas and bhasmas in the early Sanskrit treatises like the Sushruta, Ashtangahridaya, Charak, etc., bears sufficient testimony to the knowledge of the vaidyas in respect of chemistry and different minerals. The system of diagnosis of the vaidyas was generally through the reading of pulses (nadi pariksha).

The advent of the Muslim rule in the country witnessed the spread of a system of medicine that had its origin in Arabia and that was in vogue in the neighbouring countries known as the unani system of medicine. The method of diagnosis and treatment of the hakims following this system of medicine did not differ much from the one followed by the vaidyas. Besides the vaidyas and hakims, the third class of people engaged in providing medical assistance were known as the vaidus. They had a very good knowledge of the rich medicinal properties of the different herbs. However, they lacked in the knowledge of human anatomy and they were not able to read the pulse, though exceptions were not unknown, and hence their diagnosis was mainly based upon the symptoms of the disease as narrated by the patient or his close associates. They also used to treat sick animals in the absence of any veterinary medical system. They used to move from place to place.

In the absence of the specialised knowledge of gynaecology and obstetrics the experience of the elderly ladies in the joint family was of immense help in respect of anti-natal and post-natal care of expectant mothers as the deliveries generally used to take place at the residence rather than at the existing maternity hospitals as the people were under the obsession of the orthodox views. The elderly ladies in the family also used to treat the minor: ailments with a small stock of medicine which they always preserved in what was known as ajibaicha batva and which could be well compared with the stock of patent medicines maintained at homes in recent times.

Modern Trends.— The spread of Western education and the strides made in the field of scientific research made a large percentage of the population health conscious. Hence it will be interesting to know the ' medical relief' provided at the time the old Bhandara District Gazetteer was published in 1908. The account pertaining to it is reproduced below:

"The  District  has  altogether  10  dispensaries,  four at head-quarters including the

 40 in-patients, the Bhandara main dispensary containing 16 beds. The police dispensary contains accommodation for 10 patients. The daily average number of in-door patients at the public dispensaries during the decade ending 1901 was 10 and that of out-door patients 517. The number of patients treated at the public dispensaries during the years 1901 to 1905 averaged 89,000 annually. The mission hospital was started in 1889 by the United Free Church Mission. In 1895 the present hospital blocks comprising male and female wards, operation rooms, two private wards, hospital assistant's quarters, and store rooms, were erected as a memorial to the late Revd. Robert Barbour of Bonskeiel, Scotland, who left funds for the salary of the Medical Missionary. During 1905-06 the operation room was reconstructed and equipped with the most modern surgical appliances. An additional piece of land was purchased and added to the compound, on which new sanitary arrangements and a shelter for the open air treatment of consumptives are to be erected. The income of the public dispensaries in 1905 was Rs. 14,500, of which the greater part was provided from Provincial and local funds. The principal diseases treated were malarial fevers and bowel and chest complaints. The number of operations performed annually during the decade ending 1901 approximated to 1,600. A midwife is employed at the main dispensary and one at the branch dispensary, Gondia."

"Vaccination is only compulsory in the municipal towns of Bhandara, Tumsar and Pauni, but is carried on throughout the district from October to March yearly. In towns 10 to 13 per cent of the population have been vaccinated annually during the last few years. Taking the district as a whole, 26,114 people were vaccinated during 1904-05; the cost per successful case was Rs. 0-1-9, and the total rate per mile of population was 39 in this year, the percentage of successful primary vaccinations being 99. Over 96 per cent of the children born and surviving to one year of age have been vaccinated since 1891. The number of revaccinations has been about 800 annually from 1901 to 1905. The staff employed during 1904-05 consisted of one native Superintendent and 14 vaccinators. The cost of the operations in 1904-05 was Rs. 2,500." [Central Provinces District Gazetteers, Bhandara, District 1908, pp. 174-75.]

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