Saturday, November 7, 2009

Chronic cough and Alternative medicine

"Doctor, He is coughing badly for the last 4 months."

A man in his mid 20s was saying about his thin and frail looking father who was sitting slumped on my patient's chair.

"4 months!!! You did not take him to any doctor?" was my angry question.

Son: "Yes, he was under a doctor's treatment for 4 months".

Me: "Were any blood tests done or any sputum or X ray examination done?'

Son: 'One blood test was done long back, which was normal.'

Me: 'Who was the doctor who treated him?' [I was curious].

Son: 'Father does not like strong modern medicines, so he was under the care of a

Homeopathic doctor'.

Me: 'Then why have you brought him here?'

Son: 'He is becoming weak day by day, lost weight and is not eating anything'.

I was almost sure of the diagnosis before I examined him. There were nothing obvious in his clinical exam except some altered breath sounds and pallor. So I asked him to take an X ray film of the Chest without wasting anymore time.

In an hour's time the Son came in to my room with the X ray. Yes as I suspected the X ray showed tell tale signs of Tuberculosis of the Lungs.

"It is TB". I offered him reference to the Government Health Center [for confirming the diagnosis by sputum examination and for free medicines]. He, as I guessed took the offer as he was not that well off.

Few days ago I had another man of about 65 years with almost similar history. Cough for 3 to 4 months and homeopathy treatment. He also turned to be suffering from sputum positive Tuberculosis.

Why these doctors are not thinking about TB? Are they taught the signs and symptoms of Lung TB? Can they treat Tuberculosis?
Only modern anti tuberculous antibiotics can cure a patient of TB, not homeopathic or ayurvedic medicines.

I know many homeopathic and Ayurvedic doctors who refer patients to Modern Medicine doctors as soon as they realise they cannot help the patient. But some never do, may be fearing they will be considered incompetent or due to sheer lack of knowledge.

I know all doctors can make mistakes. I have made many mistakes too. But if you find a patient is not getting better, a doctor should re-think the diagnosis, do further tests or refer to some one else better equipped to deal with the illness. I always do that.



Both the above patients must have spread the tuberculosis bacteria around their house and surroundings in the 3 to 4 months they were coughing out sputum.

If the situation is like this how can we ever eradicate or control TB?

9 comments:

Anonymous said...

:) I understand what you say..

To my understanding,homeopathy works only for tose diseases that are mild and it is effective only to those people have immense faith,as like to that of God,in both homoe medicine and the doctor..

Don't think that i am making a vague statement..I have taken lot of auyrvedic and homoe medicines for my allergic problems..But nothing happened,just that a temporary relief is attained. Again,its all the same old story.That said,i won't say that alopathy is an all-cure system.It has lot of side-effects,but others branches of medicine have the least.. So its all a visious cycle. Either you do it or even if you don't do it,yiu are damned :) I am reffering to illness like cold,atopy,asthma and like cases.

And in other cases of illness like TB or Leukamia,i know that only alopathy works,but at what cost? Maybe my kidney or my liver will be fused oof by the ime the main illness is cured..Such is the side-effect of modern medicine.

what did i say?did i make any sense?I don't know...

Bindhu Unny said...

My view is that practitioners all streams of medicine should aim at curing the patient fast than holding on to their systems. No system can cure all illnesses.
Btw, I've personal experiences of wrong diagnosis by Modern Medicine doctors: minor cut on toe as psoriasis; watering eyes as glaucoma; skin allergy as lichen planus. Worst was when my sister-in-law was prescribed heavy-dose medicines for elephantiasis, when the swollen joint was due to arthritis.
I've decided that all doctors are human beings and they make mistakes. So don't have blind faith in anyone.

An off-topic one: The super specialist who treats my sis-in-law refuses to look at her other ailments, possibly arising due to the medicines she take for arthritis. He asks her to find another doctor to treat this as he's specialised in treating arthritis only. I don't find this approach very professional. Is this what we have to expect in the future? Like to know your views on this.
Apologies if I misused the comment option. :)

Anonymous said...

Sad. TB is serious and the doctor should have realised what he was ignoring!

Arun.N.M. said...

Nimmy as you said homeopathy involves lot of faith in the system and the practioner,some sort of a placebo effect.So it wont work universally and will not work in serious infections.
What I find fault with many homeopathic practioners is despite the limitation of their system they try thier medicines in almost all illnesses,that too for a prolong period. We see the very serious after effects of such treatments. These are not side effects but complications of not giving proper treatment at proper time.
Any medicine with some good effect will have side effects. The art and science of medicine is to give maximum relief with minimum side effects.

Arun.N.M. said...

Bindu Unny,
As I said in my post all make mistakes and one should try to learn from the mistakes. Science of medicine is one of the most imperfect one. That's why ppl still believe in different systems of medicines.In a perfect scenario there should be only one system of scientific medicine. As we do not have different systems in Physics, Chemistry or Biology, Medicine should have only one system.For that we will have to wait for few more decades or centuries.

My feeling is all patients should try to reach a diagnosis by investigating under modern medicine,look at the options of treatment and if found unsatisfactory only should consider alternative medicine.

As the science and practise of medicine becomes more and more complex,specialisation is neccessary. Actually they should be called sub-specialsits and not super-specialsits, as they know more and more about less and less.The sub-specialist you mentioned actually do not know how to deal with a problem which is beyond his speciality. That's why he is referring to someone else.

In an ideal situation the patient should approach a primary care physician first,try to arrive at a provisional diagnosis, and if needed that physician should refer to a sub specialist. The sub specialist should confirm the diagnosis and plan the treatment after discussing with the primary care physician.If needed another sub specialist also should be consulted.If any complications occur the patient first approaches the primary care physician and after discussing with the sub specialists concerned a solution can be arrived at.
In a fully commercialised health care system like ours with a huge patient load this ideal situation is difficult to achieve.

Arun.N.M. said...

IHM,
Many old people going on ooughing for months in well to do homes have TB. They are termed as having Asthma or something like that and is never taken to a doctor. In this 2 cases the families were not guilty as they took them to doctors and was undergoing treatment for almost 4 months. I think homeopaths also should be taught in detail abt TB

hadikaljouhar said...

Do homeopaths believe in disease causing microorganisms or are they having any other theories?

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