Right and Wrong use of modern medicine. Lesson from Book "Where there is no doctor"

Hesperian Health Guides (Where There Is No Doctor)

Hesperian

Werner, David

Document text

| COMMUNITY HEALTH CSL. al 
47/1, (First Floor) St. Marks Road, “aes — 
Rangalore - 560 001, aes . | 


RIGHT AND WRONG USES 
OF MODERN MEDICINES — 


YS 
. 


53 
ons os 
wen es 

" et 
as, | 
: ted) 
=. 3 
a's, 
Lora 


_ This is a reprint from 


4 here if Ss No Doctor 


_ (Indian adaptation ) 


ae 
> 
Me 
2 
! Seat 
~e 
aor 
= 


published by the 


Voluntary Health Association of India 
C-14 Community Centre 
Safdarjung Development Area 
New Delhi 110016 


61 
COM Me ALT 


- 


CHAPTER 


RIGHT AND WRONG USES 
OF MODERN MEDICINES 


Some medicines sold in pharmacies or village stores can be very useful. Others 
are of no value. Also, people sometimes use the best medicines in the wrong way, 
so that they do more harm than good. To be helpful, medicine must be used 
correctly. 


Many people, including most doctors and health workers, prescribe far more 
medicines than are needed—and by so doing cause much needless sickness and 
death. | 


There is some danger in the use of any medicine. 


Some medicines are much more dangerous than others. Unfortunately, people 
sometimes use very dangerous medicines for mild sicknesses. (| have seen a baby 
die because his mother gave him a dangerous medicine, chloramphenicol, for a 
cold.) Never use a dangerous medicine for a mild illness. 


~- — ~- 
ae corel tD e — 
on: — pant ie 


Guidelines for the use of medicine: 


1. Use medicines only when necessary. 


2. Know the correct use and precautions for any medicine you use (see the 
_ GREEN PAGES). os 


3. Be sure to use the right dose. 
4. |f the medicine does not help, or causes problems, Stop using it. 


5. When in doubt, seek the advice of a health worker. 


6. Always check the expiry date (\ast date before which to use) of the medicine. If 
the medicine is given after this date, it may do more harm than good. 


Note: Some health workers and many doctors give medicines when none is 
needed, often because they think patients expect medicine and will not be 
satisfied unless they get some. Tell your doctor or health worker you only want 


62 


medicine if it is definitely needed. This will save you money and be safer for your 
health. 


Only use a medicine when you are sure it is needed 


and when you are sure how to use it. 


THE MOST CANGEROUS MISUSE OF MEDICINE 


Here is a list of the most cornmon and dangerous errors people make in using 
modern medicines. The improper use of the following medicines causes many 
deaths each year. BE CAREFUL! 


1. Chloramphenicol (Ch/ioromycetin) (p. 401) 


The popular use of this medicine for simple diarrhea and other 
mild sicknesses is extremely unfortunate, because it is so risky. 
Use chloramphenicol only. for very severe illnesses, like typhoid 
(see p. 229). Never give it to newborn infants. 


2. Oxytocin (Pitocin), Pituitrin, and Ergonovine (Ergotrate) (p. 424) 


Unfortunately, some midwives use these medicines to speed up 
childbirth or ‘give strength’ to the mother in labor. This practice 
is very dangerous. It can kill the mother or the child. Use these 
medicines only to control bleeding after the child is born (see 
0.312). 


3. Injections of any medicine 


The common belief that injections are usually better than 
medicine taken by mouth is not true. Many times 


medicines taken by mouth work as well as or better than 
injections. Also, most medicine is more dangerous 
injected than when taken by mouth. Use of injections 


should be very limited (read Chapter 9 care 


4. Penicillin 


Penicillin works against only certain types of infections. Frequent use of penicillin 


for sprains, bruises, or any pain or fever is a great mistake. As a general rule, injuries 
that do not break the skin, even if they make large bruises, have no danger of 
infection; they do not need to be treated with penicillin or any other antibiotic. 


Penicillin ointment or powder used.on the skin can make the person sensitive to 
penicillin. 


Penicillin is dangerous for some people. Before using it, know its risks and 


precautions you must take (see p. 70 } 


63 


5.__Injections of penicillin with streptomycin (p. 400). 
a Pen streptomycin 


here are many familiar brands names. 
These medicines are used too much and often for the wrong 
reason. They should not be used for colds for two reasons 


la. They do not work against colds and flu.. 
1b. They can cause serious problems, sometimes deafness 
or death. 


2. Give streptomycin for treatment of tuberculosis only. 
If you give it for any other disease, the person may 
become resistant to streptomycin, and then will have 
to take more expensive medicines to cure tuberculosis. 
Do not give this medicine for any other disease. 


6. Vitamin B72 and liver extract (p. 425) 


These medicines do not help anemia or ‘weakness’ except in 

rare cases. Also, they have certain risks when injected. They 

should only be used when a health worker has prescribed them 
>.< after testing the blood. |n nearly every case of anemia, iron pills 
fo) will do more good (see p. 147)* 


7. Other vitamins (0.424) 


As a general rule, DO NOT INJECT VITAMINS. Injections are more dangerous, 
more expensive, and usually no more effective than pills. 


Unfortunately, many people waste their money on syrups, tonics, and ‘elixirs’ 
that contain vitamins. Many lack the most important vitamins (see p.139'). But 
even when they contain them, it is wiser to buy more and better food. Body- 
building and protective foods like beans, vegetables, fruits,e€99S, and meat. 
are rich in vitamins and other nutrients (see p.129 -131). Giving a thin, weak 
person good food more often will usually help him far more than giving him 
vitamin and mineral supplements. 


A person who eats well does not need extra vitamins. 


THE BEST WAY TO GET VITAMINS: 


2 2 


CS) am These CAL) pein These b Aem™ This 
are Y are is 
Dee ad G) better better better 
than than than 
Am / these. a this. emer” this. mF 


ex | 


be) 


64 


For more information about vitamins, when they are necessary, and the foods | 
that have them, read Chapter 11, especially pages 129 and 138 


8. Calcium 
Injecting calcium into a vein can be extremely dangerous. It can — 
‘oe quickly kill someone if not injected very slowly. Injecting 


SS calcium into the buttocks sometimes causes very serious 
abscesses or infections. ; 


Never inject calcium without first seeking medical advice! 


| Note: !n countries where people eat a lot of corn or 
other foods prepared with lime, it is foolish to use calcium injections or tonics (as 
is often done to ‘give strength’ or ‘help children grow’). The body gets all the 
calcium it needs from the lime. 


9. ‘Feeding’ through the veins (Intravenous or ‘I.V.’ solutions) 


In some areas, persons who are anemic or very weak spend their last paise, to 
have a liter of |.V. solution put into their veins. They believe that this will make 
them stronger or their blood richer. But they are wrong! 


Intravenous solution is nothing more than pure water with some salt or sugar in 
it. It gives less energy than a large candy bar and makes the blood thinner, not 
richer. It does not help anemia or make the weak-stronger. | 


Also when a person who is not well trained puts the |.V. solution into a vein, 
there is danger of an infection entering the blood. This can kill the sick person. 


Intravenous solution should be used only when a person can take nothing by 
mouth, or when he is badly dehydrated (see p.183). 


Only a trained health worker should give these solutions. 


If the sick person can swallow, give him a liter of water with a little sugar and 
salt (see Rehydration Drink, p.182). It will do as much for him as injecting a liter 
of |.V. solution. 


For people who are able to eat, nutritious foods do more to 
strengthen them than any type of I.V. fluid. 


65 


If a sick person is able to swallow and keep down liquids... 


me — This 
is ne is 
better = 4 better 
than ES 4 than 
this. ‘Cn this. 
Ter bee: a 
xO d 
Ww “ 
i. 4 ¢ 


10. Laxatives and Purges (p. 417) 


It is always dangerous to give a laxative or purge to a baby or 
to anyone who Is very weak, dehydrated, or has severe pain 
in his belly. Unfortunately, people often believe that purges 
bring back health or clean the bad things out of the body. In 
Chapter 1 it is explained that purges or strong laxatives 
nearly always do more harm than good. 


To learn the correct uses of laxatives and enemas, see p. 21. 


WHAT TO EAT WHEN TAKING MEDICINES 


Many people believe that they should avoid eating certain foods like brinjal 
tomato, curds, oranges, guavas, eggs, meat and cooking oil when they take any 
medicine. They think all medicines will do harm if they are taken with these foods. 
This is not true ! No medicines causes harm juat because it is taken with these foods. 

But in case of some illnesses, certain foods can make the illness more severe 
because the body cannot digest these foods: | 3 


PM ici tcev nc «5.s00s0sdaccemceae see p 149 

UEC OIOIIIG, 6.5. ..5:10cvsherkseectes see p. 371 

high blood pressure..............00cc00., see p.148 

gall bladder problems...........ccccccccccccs, see p.375 
stomach ulcers and heart burn..............0....... see p.150 
urinary tract infection in children........... see p. 357° 


Certain foods can cause serious damage in these illnesses, whether or not any 
medicine is being taken. Certain medicines will cause bad reactions if a person 
takes alcohol (see metronidazole, page 407 


66 


WHEN SHOULD MEDICINE NOT BE TAKEN? 


There are situations when, without a doubt, it is best not to use certain 
medicines: 


1. Pregnant women or women who are breast feeding should 
avoid all medicines that are not absolutely necessary. 
(However, they can take vitamins or iron pills without 
danger.) 


2. With newborn children, be very careful when using 
medicines. Whenever possible look for medical help before 
giving them any type of medicine. Be sure not to give too 
much. : 


3. A person who has ever had any sort of allergic reaction— 
hives, itching, etc.—after taking penicillin, ampicillin, a 
sulfonamide, or other medicines, should never use that 
medicine again for the rest of his life because it would be 
dangerous (see Dangerous reactions from injections of 
certain medicines, p. 83). 


4. Persons who have ulcers or heartburn should avoid 
medicines that contain aspirin. 


5. There are specific medicines that are harmful or dangerous 
to take when you have certain illnesses. For example, persons 
with hepatitis should not be treated with antibiotics or other 
strong medicines, because their liver js damaged, and the 
medicines are more likely to poison the body (see p.210). 


6. Persons who are dehydrated or have disease of the kidneys should be especially 
careful with medicines they take. Do not give more than one dose of a medicine 
that could poison the body unless (or until) the person is urinating normally. For 
example, if a child has high fever and is dehydrated (see p.88), do not give him 
more than one dose of aspirin until he begins to urinate, Néver give sulfa to a 
person who is dehydrated. 


The book Where There I $s No Doctor is available 
at Rs 29/- plus postage. Multiple copies of reprints 
of various chapters are also available, | 


Please write to: 


Publications Officer 

Voluntary Health Association of India 
C-14 Community Centre : 
Safdarjung Development A rea 


lhi 110016 
New Delhi Re. 2.50