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By: Q. Rufus, M.B. B.A.O., M.B.B.Ch., Ph.D.
Assistant Professor, Northeast Ohio Medical University College of Medicine
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For example, during pregnancy, employment position obstetricians promote a healthy lifestyle. They provide screening services related to blood pressure assess Source: American Medical Association ment, Papanicolaou smear, breast exami nation and review of the breast self-exam ination, and referral for mammography or other specialized services. They spend time discussing work-related health risks, smoking, seat belt use, safe sex and sexually transmitted disease prevention, and genetic screening for family planning. Fol lowing delivery, the obstetrician holds a responsibility to the mother for at least 6 weeks. The physician must continue to evaluate not only her anatomy, but also her psychological well-being. Most patients of gynecologists are either initially transferred from their obstetric clinic or referred from nurse practitioners or in ternists. Thus, patient relationships may be as short as one delivery or continue long after menopause. Because of the thrilling rush of the operating room experience, some obste trician-gynecologists like the surgical aspect of their specialty the best. Caesarean delivery has become the most common hospital-based operative procedure in the United States and now accounts for about 23. One academic physician stated “in most cases, my surgical efforts cure prob lems, usually with good outcomes. The manual dexterity required for obstetric or gynecologic surgery may not approach that of, for example, neurosurgery or otolaryngology. Despite the reduction in operating room time due to new primary care educational requirements, gradu ating residents in this specialty are still well-trained, competent surgeons of the abdomen and pelvis. In a way, obstetrician-gynecologists have much more in common with their colleagues in ophthalmology, a surgical specialty that also has significant medical and primary care components. Medical students should disregard condescending comments made by other surgical subspecialists. Some obstetrician-gynecologists take the initiative of completing a 1-year fellowship in pelvic surgery as a junior attending to gain additional surgical experience. There is little room for indecisiveness, meekness, or timidity within this specialty. Because gy necologic surgeries start quite early in the morning and deliveries or ruptured ec topic pregnancies can occur during the middle of the night, you must be able to function at all times of day or night. Your common sense and experience are calming and reassuring for an ex pectant mother about to deliver her first child, a preoperative gynecologic patient, and a woman struggling with the loss of a pregnancy.
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The Ayurvedic medicine “chiretta,” as gentian was called in English, was the only known remedy against malarial fevers until the discovery of quinine-yielding Cinchona trees in central South America. Extracts from this shrub with its square stems and purple flowers are an important ingredient in a well-known Indian fever powder called “Sadurashan-Churan” sold widely in Indian bazaars. A bitter Indian gentian tonic is used to stimulate sluggish livers and to treat gout. As the plant also yields a powerful vermifuge, it is a common prescription for children suffering from worms or other stomach ailments. Liquoriorce (Glycerrrhiza glabra) Family: Papilionaceae Sanskrit name: Yastimadhu Hindi name: Mulethi If equal quantities of clarified butter, sugar and liquorice, be mixed with fennel-juice and milk, the nectar like composition is said to be holy, provocative of sexual vigor, a preservative of life, and sweet to the taste. Ayurvedic medicine recommends the root of this graceful plant with its light, feathery foliage, as beneficial in the treatment of coughs, colds, and other bronchial irritations. Sweet-tasting dried liquorice roots are sold in every Indian bazaar, to be sucked as throat lozenges, to relieve hoarseness and coughs. Such is the fame or liquorice as the curative of sore throats that it remains popular as a lozenge for singers and declaimers in our own times, as it was in Charaka’s day. Powdered liquorice is also considered by Ayurvedic medicine as an excellent remedy for Hyperacidity, and clinical tests by Dr. Keith conclude that “for relieving pain, discomfort and other symptoms caused by acid matter in the stomach, it is wonderful. Dioscorides, the Greek physician who authored De Materia Medica, recommended liquorice juice for hoarseness and for heartburn, while in an assessment independent or the Kama Sutra, Chinese medicine praises liquorice for “rejuvenating those who consume it for a long time. Vasaka (Adhatoda vasica) Family: Acanthaceae Sanskrit name: Vasaka Hindi name: Adusa As a hawk on its cord is held in flight, so life bonded by energy is held by breath. D 1100} Ayurveda produced the concept or “life breath," which was later used by the practitioners of yoga and kundalini yoga. Its earliest physicians established the close connection between oxygen inhalation, and the neurological system, evolving various pranayamas, or breathing techniques, which could be used to improve the nervous system and increase mental faculties such as memory and alertness, so necessary for forestalling the body’s decay. But in order to practice such techniques the human lungs had to be healthy, and for this Ayurvedic physicians used the plant vasaka. In Ayurvedic pharmacology the main action of the vasaka is as a bronchodilator and an expectorant. Honored for its strength, in Sanskrit botany this modest shrub is named Lion’s Muzzle and Stallion’s Tooth after the shape and color of its flowers. But its antiseptic and pesticidal qualities justify the popular name or vasaka, which means “Little Dweller," or "protector’ of the dwelling place. More recently, Ayurvedic science has extracted drugs from vasaka which regulate excessive menstrual flow, and Ayurvedic physicians now regard vasaka as the rival of the asoka tree in its value to women. Chebulic Myrobalan (Terminalia chebula) Family: Combretaceae Sanskrit name: Haritaki Hindi name: Harad As a tonic for promoting strength and preventing the effects of age, cherubulic myrobalan should be taken every morning with salt during the rainy season, with sugar in me autumn, with ginger in the first half of winter, with long pepper in the second half of winter, with honey in the spring, and with treacle in the hot months. Ayurvedic prescription Chebulic myrobalan, together with the emblic and belleric myrobalans, form the legendary Three Fruits of Ayurveda— a vitamin-rich, combination used in all its basic health tonics. Because or their astringent and antiseptic properties, this combination is also used on surgical dressings.
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Its nutriment is neither the solid food nor the drink which comes from the belly, but a pure and luminous sub stance which is refined out of the blood. It conveys this nutri ment out of the neighbouring blood receptacle by trans mitting its rays, deriving it from there as though from the belly and intestines, which of course it does not do in reality. Now to avoid any disturbance from the confused movement of the food in the great artery [i. For the great artery feeds from the belly and intestines and is laden with food not fit for the ruling principle. It is obvious that the left cavity is not nourished by visible blood: if you kill an animal by cutting its throat and open up the left chamber, you will find it quite empty apart from some serum and bile, and the membranes which I have described. As for the vessel which comes from the right chamber, this too is closed off by the membranes meeting together. It opens towards the lung to provide blood for the lung’s nutriment, while to wards the heart it is closed, but not hermetically, so that air can enter it, though only in a very small quantity. Contrary to the general opinion, blood is in fact not a hot thing by nature, any more than any other fluid; though it may be made hot. In Greek medical writers this word generally means ‘ blood-vessel ’, which includes both the vein and the artery of modern anatomy. After the distinction had been made, phleps approximated to the sense in which the modern anatomist uses ‘ vein’. Yet even the author of the Heart, who is aware of the distinction, in one passage (ch. However, in the Nature of the Child, phleps is used for the author’s peculiar hypothesis that the body is a network of communicating vessels which convey all sorts of fluid: sperm, milk, the ‘hu ours’, as well as blood. In fact phleps for this author simply means any vessel in the body which conveys fluid. I have therefore preferred the translation ‘ vein’ to ‘ blood-vessel’, which has the further advantage that ‘ vein’ may also be applied to porosities in other substances. There is a similar difficulty with this word, which cannot simply be translated as ‘ nerve,’ since before the discovery of the nervous system the word was much more likely to signify what we should call tendons and liga ments. Yet it may also refer, anatomically if not physiological ly, to what the modern anatomist would recognize as nerves. Since English has no word which covers all three meanings, it is not possible to give a consistent translation here. In the Heart it is tempting to translate these as ‘ auricle’ and ‘ ventricle’ respectively, since the words con tain the metaphor from which the modern terminology origi nated. But ‘ auricle’ would be definitely misleading, since the author clearly includes in the ‘ ears’ of the heart the atria, while ‘ ventricle’ implies the modern distinction between ventricle and atrium.
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In such a case, the healer chalks these potential medicines off the list, and moves on to the next. The data of ethnopharmacology may not be systemati cally or even consciously acquired. Absolutely essen tial, life-saving information can be acquired from folk medicine and in no other way. But it does not follow that the shamans of such cultures are able to predict the weather in Paris or Tokyo, much less the global climate. It is certainly true that all beliefs and all myths are worthy of a respectful hearing. Science, and aca demic scholarship in general, the contention these days goes, is too subjective. From this doleful fact, some have gone so far as to conclude that there is no such thing as history, no possibility of reconstructing the actual events; that all we have are biased self-justifications; and that this conclusion stretches from history to all of knowledge, science included. It is the responsibility of those historians with integrity to try to reconstruct that actual sequence of events, however disappointing or alarming it may be. They recognize that accounts of events have passed through biased human filters, and that historians themselves have biases. Those who want to know what actually happened will become fully conversant with the views of histori ans in other, once adversary, nations. All that can be hoped for is a set of successive approximations: by slow steps, and through improving self-knowledge, our understanding of historical events improves. But it is also scientists who, in most such cases, have blown the whistle alerting us to the danger. It has an overwhelming advantage over history, because in science we can do experiments. If you are unsure of the negotiations leading to the Treaty of Paris in 1814-15, replaying the events is an unavailable option. But for many questions in science, you can rerun the event as many times as you like, examine it in new ways, test a wide range of alternative hypotheses. The American revolutionary, Ethan Allen leader of the Green Mountain Boys in their capture of Fort Ticonderoga had some words on this subject: Those who invalidate reason ought seriously to consider whether they argue against reason with or without reason; if with reason, then they establish the principle that they are laboring to dethrone: but if they argue without reason (which, in order to be consistent with themselves they must do), they are out of reach of rational conviction, nor do they deserve a rational argument. There are always a few driven by simple wonder and great integrity, or by frustration with the inad equacies of existing knowledge, or simply upset with themselves for their imagined inability to understand what everyone else can who proceed to ask the devastating key questions. A few saintly person alities stand out amidst a roiling sea of jealousies, ambition, backbit ing, suppression of dissent, and absurd conceits. I think all that social turmoil and human weakness aids the enterprise of science. There is an established framework in which any scientist can prove another wrong and make sure everyone else knows about it. Urey once confided to me that as he got older (he was then in his seventies), he experienced increasingly concerted efforts to prove him wrong. One of the most productive astrophysicists of our time has been Fred Hoyle, responsible for monumental contribu tions to our understanding of the evolution of stars, the synthesis of the chemical elements, cosmology and much else.
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