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MEDICAL AND PUBLIC HEALTH SERVICES
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INTRODUCTION
IN THE PAST, DISEASES WERE RARELY ATTRIBUTED TO THE PHYSIOLOGICAL DISORDER. Many a times they were ascribed to some evil influence which was propitiated by some sacrifice. In such cases of illness the people hankered after magic and such magical practices as bhanamati, saifi amal and alvil atrial. In most of the cases, the treatment was so severe that there was little hope of the survival of the patient. At present the people in the rural areas are sometimes the victims of such beliefs and ideas.
The vaidyas, vaidus and hakims played an important part in the medicinal practices of the past. Although the knowledge of such persons was mainly based on the indigenous system of medicine, they made full use of local plants and herbs. The vaidus moved from one place to another treating the people, especially residing in the rural areas. They sometimes treated the live-stock also, when veterinary doctors were not available. The treatment given by vaidyas was according to the ayurvedic system of medicine. Their knowledge represented a combination of what they inherited from their fore-fathers and the practical experience obtained during their medical practice. The system of diagnosis by vaidus and hakims did not essentially differ from the ayurvedic system of medicine. But the psychological impression created by them was very important.
As regards maternity homes, the maternity and child care was in the hands of experienced and elderly ladies in the joint families.
Majority of the population regarded the propagation of male off-spring as a religious duty and barrenness was considered as a terrible punishment for crimes committed in a former birth. A move in the direction of birth-control was, therefore, unconceiv-ed of. All these beliefs and views regarding particular illness were replaced by the development in medical science and spread of education amongst people. Today hospitals and dispensaries are doing well in treating the patients with modern medicines and doctors well trained in medical sciences are replacing the persons practising the traditional system of medicines.
The Gazetteer of Buldhana, published in the year 1910, gives an interesting account of public health in the past which is reproduced below: -
"Up to June 1897 the District was much healthier than in the previous two years, but the consumption of jungle vegetables during the rains produced a voilent epidemic of cholera in July, August and September, and diarrhoea and dysentery carried off many victims. For the year ending 31st August, 1897, the death-rate was 41.91 per mille as against 46.05 in the previous year, the highest figure being reached in August with a rate of 11.62 per mille. The next month September was also a very unhealthy month with a death-rate of 11.52 per mille. The birth-rate up to 31st August 1897 does not appear to have been affected by the famine as it was 44.80 per mille as against 42.13 in the previous year and slightly exceeded the average mean of the preceding ten years. " [ Gazetteer of Buldhana, 1910, p. 315.]
"The district has suffered greatly from cholera, no less than eleven severe epidemics having occurred since 1869. In 1878. a year of distress, 7,414 deaths were recorded. For three consecutive years, 1895, 1896 and 1897, cholera raged and in 1906 a very severe epidemic took place, 5,277 deaths or a rate of 8.59 per mille of the population being returned. The infection is said to be introduced generally from some sacred centre of pilgrimage, especially Pandharpur in the Sholapur District of the Bombay Presidency. During the epidemic of 1906 efforts were made to purify the water-supply by permanganate of potash and 8,358 wells were thus disinfected. At first the attitude of the people towards the measures was distinctly suspicious, but underwent a marked change when it was seen what benefits resulted in villages where the wells were properly treated. Plague appeared in the District in 1902, and has prevailed every year since, the total number of deaths from that year to 1906 being over 16,000. The worst epidemic occurred in 1903 when the mortality was 5,282 or 8.44 per mille of the population. The town of Khamgaon especially suffered severely in 1902 and 1905, when 1,179 and 872 deaths were recorded. The type of plague usually observed was the bubonic, and the percentage of deaths to persons attacked was over 75, though in some villages it reached the appalling figure of 90. The attitude of the people towards plague measures is slowly undergoing a change, and evacuation is freely resorted to. Small-pox is always present. The worst epidemic occurred in 1877, when 2,682 people died, and in 1905, when the mortality was 1,483. The District is fairly protected by vaccination, about 24,000 persons being vaccinated annually. But the severe epidemic of 1905 is partly attributed to the fact that in the previous year children had not been adequately protected, two or three indifferent scars being very often found. Four scars are now the minimum number permitted. Fever which is a wide term covering pneumonia and inflammation of the brain and other organs, is responsible for about one-third of the total mortality of the District. The type of malarial fever usually seen is the benign tertian though occasional cases of ague are met with." [ Gazetteer of Buldhana, 1910, pp. 65-66.]
The following account, reproduced from the old Gazetteer describes vaccination in the district as under: -
" The Municipal towns of Buldana, Khamgaon, and Shegaon are the only places where compulsory vaccination is permissible. The ratio of persons protected against small-pox is about 80 per cent, of the population, in recent years owing to the prevalence of plague during the winter months, when vaccination is in full swing, the work of protection has suffered to a certain extent, and very recently the Sanitary Commissioner has pointed out the insufficiency of the protection afforded by one or two marks; an order has been lately issued to produce tour scars, this being considered by the Metropolitan Asylums Board to be the minimum number requisite to produce efficient protection." [Gazetteer of Buldhana, p. 393.]
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