What ails the present medical care?

In spite of the vast amount of medical data at our disposal, there are limitations and drawbacks of medical care. This is due to the defective medical knowledge - the restricted narrow concepts of human being, illness, etiology and treatment. This has resulted in undue emphasis on physical aspect of human existence ignoring the mental and spiritual aspects in understanding the illness and treating them. There isa) Unnecessary medicalisation while the other methods of treatment remain underused.b) Only symptomatic relief, rather than a cure by removal of the cause, with likelihood of recurrence or syndrome shift.c) Incompleteness of treatment which tackles only the external cause without rectifying the inherent susceptibility leaving the possibility of recurrence.d) Overspecialization and unnecessary referrals, and non-individualisation of treatment causing avoidable side-effects.

Totalistic and integrated approach to health - a proposal.

In an earlier article the authors had traced the defects in medical practice to the flaws in the medical knowledge. In the present paper they propose a plan for the rectification of these defects.As the current medical research is unsuited for this purpose there is a need to adopt an alternative method of research, consisting of three phases viz.a) Formulation of hypothesisb) Development of tools of assessment andc) Experimental verification of the hypothesis using the instruments of assessment.This method must be used to revise the concepts of human being, illness, etiology and treatment. The first topic that must be taken up for such consideration is the concept of human being. An outline of the various constituents of human being is given. Also the factors that account for individual difference s among human beings, are enumerated. Subsequent research aimed at revision of concepts of illness, etiology and treatment should be based upon such a totalistic and integrated concept of human being.

Need for an integrated system of medicine-a proposal for its attainment.

Integration of various systems of medicine is in the best interest of all concerned. It enables the physician to provide the best available therapeutic care to the patient without undue delay, making way for a better prognosis. It also makes available to him a greater variety of treatment measures hitherto restricted to one or the other system. Integration must be achieved at the theoretical level first by pooling together the facts available in the existing systems. From this pooled data must be formulated newer integrated concepts of human being, illness, etiology and treatment. It is not difficult to achieve such integrations for their already exist certain similarities among the prevalent systems of medicine. This will help to translate ancient wisdom into practice and find proper orientation to modern discoveries. Therefore the adherents of various systems must sink their differences and strive to develop an integrated system of medicineThe entire world is the teacher to the intelligent and the foe to the unintelligent. Caraka Vimana 8/14.

Penfluridol in chronic schizophrenia.

Twenty-eight male chronic schizophrenic patients completed a 6 month treatment with a single weekly dose of 20 to 120 mg penfluridol, a new long- acting oral neuroleptic. Twenty-four patients showed significant improvement at the end of the trial period. Significant reduction in scores could be demonstrated in 21 out of 26 symptom variables. Central side-effects, reported by 19 patients, were mild and transient except in one patient who was withdrawn from the trial. Laboratory investigations and vital signs remained within normal limits.

Effects of intravenous metoclopramide in 81 patients with tardive dyskinesia.

We compared acute effects of single intravenous administrations of metoclopramide (40 mg) and placebo in a double-blind crossover study involving 81 patients with tardive dyskinesia. Metoclopramide produced significantly greater reduction in mean total Abnormal Involuntary Movement Scale score as well as in ratings for six of the seven body areas, when compared with placebo. On adjusting each patient's metoclopramide response for his or her placebo response, we found that 35 of the 81 patients had 50% or greater placebo-corrected improvement. There were no apparent clinical differences between metoclopramide responders and nonresponders. Administration of 60 mg of metoclopramide to 15 patients produced greater improvement in tardive dyskinesia as compared with 40 mg; the incidence of acute dystonia, however, jumped from 10% with 40 mg to 33% with 60 mg.