THE DIARY OF A DOCTOR WHO TELLS

Evening Star, Issue 24292, 5 September 1942, Page 3

THE DIARY OF A DOCTOR WHO TELLS

DOCTORS AMD MEDICINE Monday, August 31, I was reproved to-day for lotting Wendy continue coughing without doing anything about u. she picked up a cold at scnool last week. “ It’s always the same in a doctor's house,” 1 was told. “ You have to be just about dead before anyone takes any notice of you.” How many doctors have heard that one ? It is not so much disregard for their own kith and kin as disbelief in the efficacy of much medicine that prevents a doctor rushing to the dispensary when a member of his household has a trilling ailment. Over a hundred years ago one Charles Colton wrote: “ N*i men despise physic so much as physicians, because no men so thoroughly understand how little it performs.” And there is that famous saying of Ambroise Pare: “ I dressed his wounds; God healed him.” Many people ask for a bottle of medicine when they really want a bottle of magic, A man will come into the surgery after having indulged himself to the full for 40 years, and, with child-like faith, ask for a bottle of medicine to wipe away the wear and strain of a lifetime. The trouble is that the doctor and the -patient approach a “ cure ” from different angles. The patient has a pain or feels discomfort in some form or other. He goes to the doctor to get the matter fixed up, rather than in any spirit of seeking return to some academic condition called ‘‘health.’ The doctor merely sees the pain and discomfort as indications pointing to a particular disease, and considers it his job to launch an attack on the disease rather than the symptoms. It has been well put by someone who compared the doctor to the captain of a ship in a stormy sea. His job is not to calm the storm, but to use his seamanship to bring his vessel safely through it. , It must not'be thought that doctors regard all medicines as merely a frill in treatment. Who would want _to treat certain heart disease without digitalis or something lifke it ? _ Malaria without quinine or its companions? Intense pain without opium? Many infections without one of the sulphanilamides? There are medicines that save, medicines that help. And there are the other sorts of medicines. Tuesday, September 1. “ I know what my trouble is, of course,” said Norman Nillson, “ I’ve got too much acid in my system.” “What makes you think so?” I asked, and was told that Norman suffered from “ acid,” eructations after meals, and a nasty taste in the mouth. “ Sorry,” I said, “ but that’s got nothing to do with too much acid in the system.” “ Well, how do you know when you’ve got much acid?” asked Norman. “ There’s a fair amount of confusion on this acid question,” I replied. “ In the first place, there is acid in the stomach and there is a possibility of acid accumulation in the system. They’ve got practically nothing to do with one another. It’s perfectly normal and eminently desirable to have acid in the stomach. You don’t digest your food properly -if you haven’t; “ Acid in the system is a different thing and quite rare in that the normal reaction of the blood and tissues is slightly alkaline. It’s a delicate balance, and there is a special centre in the brain that regulates our breathing in regard to.it.” “ What’s breathing got to do with it?” demanded Norman. “ You probably know that we breathe in oxygen and breathe out carbonic acid gas,” I said, “ the accent being on the acid. If this centre in the brain thinks the balance is being weighed a. little too much one way, all it has to do is to make us breathe faster —if we want to get rid of more acid—or slower if it wants to improve the alkaline side.” My late . respected professor of physiology might have frowned severely at this description as an inadequate unravelling of a highly technical mystery, but it at least relieved Norman’s mind of misconceptions. , Body chemistry is a difficult subject which takes medical students much study to grasp. It is not to be explained in a dozen lines. Incidentally, Norman’s eructations and nasty-taste-in-the-mouth were eventually traced to excess alcohol plus the absence of a toothbrush. Wednesday, September 2. “ Just put her on a light diet for two or three days,” I said to Mrs Evans, after paying another visit to her daughter Ethel, who is recovering from pneumonia. “ Just exactly what is a light diet?” was the common-sense reply. “ I>o you mean steamed fish or something like that?” “As a matter of fact,” I said, “I suppose I really mean that she can have a little of almost anything.” Steamed fish, brains, tripe, and so on seem to have led the “ light diet ” field for many years, and I can’t claim to know why. I see no reason why convalescents can’t have their fish grilled if they like it. I see no reason why they can’t have meat other than chicken if they feel like it. 1 see no reason why they can't have their eggs poached or scrambled if they/prefer it. A convalescent person’s appetite is often a very good guide as to what he may safely eat. Thursday, September 3. William Halls had had a heavy lunch. The day being cold, he put up the windows of his sedan car as he got in to drive off. An ambulance brought him to the hospital still unconscious, and now his fractured arm is set. When I called this evening he told me that he felt himself going off to sleep and strove desperately to overcome the feeling. He was thinking of stopping for a while, but the thought came too late. Many motorists know the drowsy feeling that comes over the driver at times. There is only one thing to do, and that is to stop at once and perhaps have a few minutes’ snooze. Otherwise you may find yourself repeating this story I heard in verse: Here lies, till Gabriel’s trumpets peal, The bones of Shelby Sharp. He dozed while holding a steering wheel And woke up holding a harp. Friday, September 4. “ How’s Tom?” 1 asked Horace Gadsen. whose son is overseas. “ He’s had malaria,” said Horace. “ Fortunately the benign _ sort. He won’t he handicapped all his life with it. will he?” “ No,” 1 said; “ he should get it out of his svstem soon.”

“ It’s a mosquito disease, isn’t it?” ho said. “ Why don’t we get it in epidemic form here?” “We’ve been lucky with our mosquitoes in the past,” I replied. “ But we can’t back our luck indefinitely. We’ll have to do something about mosquitoes ” The mosquito is a dangerous animal and a far greater enemy of mankind than the lion or the tiger. The mosquito also carries yellow fever. It’s not a special form of mosquito, but the ordinary domestic brand. Incidentally, man’s nearest relation, the Rhesus monkey, gets the disease, and gets it so badly that only about one in JO infected monkeys survive. The mosquito carries another tropical disease called filariasis. The “ filaria parasite lives in the lymph areas of the human, and its embryos get into the blood. By day they hide in the deep vessels of the lungs and the thorax. At night .time they make their way to the surface blood vessels of the skin, mainly the arms and legs. By some extraordinary instinct the mosquito knows this, and ho pounces on the infected human and actually sucks the embryos out of the blood. For 10 to 40 days the filaria embryo develops in his temporary host, and then gets into the mosquito’s proboscis. Comes the night when his host bites deep at another human, and the proboscis carries the filaria back again into the human. Dengue is another mosquito disease. One assumes that at least after the war. if not before, we shall 'be prepared to spend some money lighting our insect enemies. Names in this diary are fictitious. (Copyright.)