Supreme Court Judgement and After
Mazumdar K P.
In the recent Supreme court judgement, of a case where a Homoeopathic Physician, not having studied Allopathic system of medicine treated a patient with allopathic medicine and the patient died, the Supreme Court held him guilty of negligence under sec. 15(3) of the Indian Medical Council act 1956,Bombay Homoeopathic Practitioners Act 1959, sec 2(8), 2(12),14 A, 20(12)(a), 23 and 28 - Maharashtra medical council Act 1956, sec 2(d).
The implication of this judgement is that a person who does not have knowledge of a particular system of Medicine but practices in that system is a Quack and a mere pretender to medical knowledge and skill. Homoeopathic physician will also be considered a quack if he practices allopathic medicine.
Although in the present case the expert in allopathic system of medicine had corroborated that the treatment accorded to the unfortunate patient was the one that would have been given in any similar case. If the treatment would have been given in any similar case. If the treatment would have been given by an allopathic physician then probably nothing would have happened and the chapter would have been closed.
Every system of medicine has its scope and limitations. Homoeopathy has its own limitations also. All of us will agree that Homoeopathy has very little to offer in cases of emergencies such as Status asthmaticus, Acute myocardial infarction, Cerebrovascular accidents, strepto-coccal or bacterial infection progressing rapidly to a situation characterised by a total failure of the mechanism of homoeostasis, Dehydration with severe electrolytic imbalance, Burns, Acute and chronic renal failure,Acute pains, Severe haemorrhage, Terminal cases of cancer etc., As long as Homoeopathic physician cannot handle these cases of emergencies our insistence on their appointment at the rural PHCs as a third physician is unjustified.
Hahnemann in the footnote of aphorism 67 of the VIth edition of Organon of medicine, instructs to deal with emergent and life threatening cases by antipathic or substitution or palliative measures. But he hastens to caution that such measures be adopted judiciously only to remove suppression or obstruction or to replace the lost fluids,to thereby release the endangered vital force. That means that the Homoeopathic physicians can make use of ancillary methods which do not run contrary to the principles of Homoeopathic practice. Thus the replacement therapy like blood transfusion in severe cases of blood loss and anaemia,intravenous fluids in a case of severe dehydration and judicious employment of minor surgical means, suturing of gaping wounds, after administering local anaesthesia, antibacterial therapy in cases of severe life threatening bacterial infection, to tide over the crisis will be quite in order for him. Since Hahnemannian days, there have been many changes in human susceptibility, the types of diseases and their expressions and development of new investigative techniques that would pinpoint the diagnosis, new therapeutic methods,including transplants and implants have come in vogue. Unless the Homoeopathic physician learns to apply these methods judiciously in practice he will be practicing only the science of therapeutic and not a system of medicine. I know many of my brother practitioners will like to condemn this view but the facts is that they should ask their own conscience as to what they would do in such cases, how often they have referred their cases to Homoeopathic hospitals ? Or to allopathic hospitals? And with what results ! In bye gone days Homoeopathy was taken as a profession by matriculates or even by postal tuitions where no clinical material was seen by them; then there was a class like retired lawyers, judges,police officers who were logical in their thinking and it was this class which kept Homoeopathy alive. But the times have changed: we get very good students to pursue this science; they are more mature, knowledgeable and hard working.
When I was asked to present amendments to the existing BHMS course of studies I had suggested teaching of modern pharmacology, but wisdom did not prevail at that time and the real amended course of studied never saw the light of the day.
Practising Homoeopathy in the rural set up and urban set up are two different entities. In metro or mega cities or urban areas the practitioner has many other sources of help in emergencies. He has hospitals, nursing home and even consultants of other schools to help him in the hour of need. But in rural areas he has to fight a lone battle even at the risk of his life against all odds. He is forced to use the few emergency methods at his disposal. It is understood here that he should not make this practice of using allopathic drugs a routine. If he does this as a routine practice and if a mishap takes place, he has to face dire consequences in a court of law.
Bulk of the rural practices is carried out by these practitioners of Ayurveda, Homoeopathy, Unani and Sidha. Supreme Court judgement will prohibit these practitioners from using other form of medication or techniques. During the times of crisis of epidemics, floods and natural calamities these practitioners bear the burn to ease the burden on the healthcare system and now their existence is at stake.
The CCH must take action on a war footing by.
- Formulating courses of studies in modern pharmacology of emergency drugs and in emergency medicine for fourth year students of BHMS.
- Make it mandatory to start Casualty department in all Degree college hospitals recognised by CCH,. .
- Start Continuing Medical Education in collaboration with Ministry of Health with an arrangement to issue certificates after successful completion of their courses to the satisfaction of the examining body.
Will the CCH move ?
