24. Village Health and Hygeine

In a well-ordered society the citizens know and observe the laws of health and hygiene. It is established beyond doubt that ignorance and neglect of the laws of health and hygiene are responsible for the majority of diseases to which mankind is heir. The very high death rate among us is no doubt due largely to our gnawing poverty, but it could be mitigated if the people were properly educated about health and hygiene.

Mens sana in corpore sano is perhaps the first law for humanity. A healthy mind in a healthy body is a self-evident truth. There is an inevitable connection between mind and body. If we were in possession of healthy minds, we would shed all violence and, naturally obeying the laws of health, we would have healthy bodies without an effort.

Constructive Programme, 1961, p.21

It is necessary to understand the meaning of the word health. Health means body ease. He is a healthy man whose body is free from all disease; he carries on his normal activities without fatigue. Such a man should be able with ease to walk ten to twelve miles a day, and perform ordinary physical labour without getting tired. He can digest ordinary simple food. His mind and his senses are in a state of harmony and poise.

Key to Health, 1960, p.3

The fundamental laws of health and hygiene are simple and easily learnt. The difficulty is about their observance. Here are some:

Think the purest thoughts and banish all idle and impure thoughts.

Breathe the freshest air day and night.

Establish a balance between bodily and mental work.

Stand erect, sit erect, and be neat and clean in every one of your acts, and let these be an expression of your inner condition.

Eat to live for service of fellowmen. Do not live for indulging yourselves. Hence your food must be just enough to keep your mind and body in good order. Man becomes what he eats.

Your water, food and air must be clean, and you will not be satisfied with mere personal cleanliness, but you will infect your surroundings with the same threefold cleanliness that you will desire for yourselves.

Constructive Programme, 1961, p.22

Nature Cure for Disease

The practice of nature cure does not require high academic qualifications or much erudition. Simplicity is the essence of universality. Nothing that is meant for the benefit of the millions requires much erudition. The latter can be acquired only by the few and therefore can benefit the rich only. But India lives in her seven lakhs of villages-obscure, tiny, out-of-the-way villages, where the population in some cases hardly exceeds a few hundred, very often not even a few score. I would like to go and settle down in some such village. That is real India, my India, for which I live. You cannot take to these humble people the paraphernalia of highly qualified doctors and hospital equipment. In simple natural remedies and Ramanama lies their only hope.

H., 7-4-'46, p.69

I hold that where the rules of personal, domestic and public sanitation are strictly observed and due care is taken in the matter of diet and exercise, there should be no occasion for illness or disease. Where there is absolute purity, inner and outer, illness becomes impossible. If the village people could but understand this, they would not need doctors, hakims or vaidyas.

Nature cure implies an ideal mode of life and that in its turn presupposes ideal living conditions in towns and villages. The name of God is, of course, the hub round which the nature cure system revolves.

H., 26-5-'46, p.153

Nature cure implies that the treatment should be the. cheapest and the simplest possible. The ideal is that such treatment should be carried out in the villages. The villagers should be able to provide the necessary means and equipment. What cannot be had in the villages should be procured. Nature cure does mean a change for the better in one's outlook on life itself. It means regulation of one's life in accordance with the laws of health. It is not a matter of taking the free medicine from the hospital or for fees. A man who takes free treatment from the hospital accepts charity. The man who accepts nature cure never begs. Self-help enhances self-respect. He takes steps to cure himself by eliminating poisons from the system and takes precautions against falling ill in the future.

Right diet and balanced diet are necessary. Today our villages are as bankrupt as we are ourselves. To produce enough vegetables, fruits and milk in the villages, is an essential part of the nature cure scheme. Time spent on this should not be considered a waste. It is bound to benefit all the villagers and ultimately the whole of India.

H., 2-6-'46, p.165

The nature cure of my conception for the villagers is limited to rendering such aid as can be given to them through what can be procured in the village. For example, I would not need either electricity or ice for them. Such work can only be for those like me who have become village-minded.

H., 11-8-'46, p.257

My nature cure is designed solely for villagers and villages. Therefore, there is no place in it for the microscope, X-rays and similar things. Nor is there room in nature cure for medicines, such as quinine, emetin and penicillin. Personal hygiene and healthy living are of primary importance. And these should suffice. If everyone could achieve perfection in this art, there could be no disease. And, while obeying all the laws of nature in order to cure illness, if it does come, the sovereign remedy ever lies in Ramanama. But this cure through Ramanama cannot become universal in the twinkling of an eye. To carry conviction to the patient, the physician has to be a living embodiment of the power of Ramanama. Meantime, all that Can possibly be had from the five agencies of nature must be taken and used. They are earth, water, ether, fire and wind. This, to my mind, is the limit of nature cure. Therefore, my experiment in Uruli Kanchan consists in teaching the villagers how to live clean and healthy lives and in trying to cure the sick through the proper use of the five agencies. If necessary, curative herbs that grow locally, may be used. Wholesome and balanced diet is, of course, an indispensable part of nature cure.

H., 11-8-'46, p.260

The science of natural therapeutics is based on a use, in the treatment of disease, of the same five elements which constitute the human body.

Key to Health., 1960, p.57

Earth

Just lays great emphasis on the use of earth. I felt that I ought to give it a trial. For constipation, Just advises cold mud poultice on the lower abdo-men. I made a mud poultice by mixing clean dry earth with water, packed it in a piece of thin cloth and kept it on the abdomen throughout the night. The result was most satisfactory.

Key to Health, 1960, p. 58-59

The mud poultice should be 3 inches broad, 6 inches long and £ inch thick.

Key to Health, 1960, p.59

It is my experience that a mud poultice applied to the head, relieves headache in most cases. I have tried it in hundreds of cases. Headache may be due to several causes, but whatever the cause, as a general rule, an application of mud poultice relieves it for the time being.

Mud poultices cure ordinary boils. I have applied mud to discharging abscesses as well. For these cases I prepare the poultice by packing the mud in a clean piece of cloth dipped in potassium permanganate lotion, and apply it to the abscess after washing it clean with permanganate lotion. In the majority of cases this treatment results in complete cure. I do not remember a single case in which it has failed me. Mud application immediately relieves the pain of a wasp sting. I have used it in many cases of scorpion bite, though with much less success.

Key to Health, 1960, p. 59-60

In high fever, an application of mud poultice on the head and abdomen is very useful. Although it does not always bring down the temperature, it does invariably soothe the patient and make him feel better so that the patients themselves ask for these applications.

I have used it in several cases of typhoid fever. The fever no doubt runs its own course but mud applications seem to relieve restlessness and abate the suffering.

Key to Health, 1960, p.60

In Sevagram we have made free use of hot mud poultices as a substitute for antiphlogistine. A little oil and salt is added to the mud and it is heated suffi-ciently long to ensure sterilization.

Key to Health, 1960, p.61

It is safe to use soft alluvial clay, which is neither gritty nor sticky. One should never use earth taken from manured soil. Earth should be dried, pounded, and passed through a fine sieve. If there is any doubt as to its cleanliness, it should be well heated and thus sterilized.

Key to Health, 1960, p.61

Just writes that clean earth may be eaten in order to overcome constipation. Five to ten grams is the maximum dose. The rationale is said to be this. Earth is not digested. It acts as roughage and must pass out. The peirstalsis thus stimulated pushes out the faecal matter as well. I have not tried it myself. Therefore those who wish to do so, should try it on their own responsibility. I am inclined to think that a trial or two is not likely to harm anyone.

Key to Health, 1960, p.62

Water

Hip bath and sitz bath are the most important of Kuhne's contributions to hydro-therapy. He has devised a special tub for use though one can do with-out it. Any tub thirty to thirty-six inches long according to the patient's height generally serves the purpose. Experience will indicate the proper size. The tub should be filled with fresh cold water so that it does not overflow when the patient sits in it. In summer the water may be iced, if it is not cold enough, to give a gentle shock to the patient. Generally, water kept in earthen jars overnight ans-wers the purpose. Water can also be cooled by putting a piece of cloth on the surface of the water and then fanning it vigorously. The tub should be kept against the bathroom wall and a plank put in the tub to serve as back rest. The patient should sit in the tub keeping his feet outside. Portions of the body outside water should be kept well covered so that the patient does not feel cold. After the patient is comfortably seated in the tub, gentle friction should be applied to his abdomen with a soft towel. This bath can be taken for five to thirty minutes. When it is over, the body should be rubbed dry and the patient put to bed.

Hip bath brings down the temperature in high fever and given in the manner described above it never does any harm, and may do much good. It relieves constipation and improves digestion. The patient feels fresh and active after it. In cases of constipation, Kuhne advises a brisk walk for half an hour immediately after the bath. It should never be given on a full stomach.

I have tried hip baths on a fairly large scale. They have proved efficacious in more than 75 cases out of 100. In cases of hyperpyrexia, if the patient's condition permits of his being seated in the tub, the temperature immediately invariably falls at least by two to three degrees, and the onset of delirium is averted.

Key to Health, 1960, p.63-65

Now about the sitz or friction bath. The organ of reproduction is one of the most sensitive parts of the body. There is something illusive about the sensitiveness of the glans penis and the foreskin. Anyway, I know not how to describe it. Kuhne has made use of this knowledge for therapeutic purposes. He advises application of gentle friction to the outer end of the external sexual organ by means of a soft wet piece of cloth, while cold water is being poured. In the case of the male the glans penis should be covered with the foreskin before applying friction. The method advised by Kuhne is this. A stool should be placed in a tub of cold water so that the seat is just about the level of the water in the tub. The patient should sit on the stool with his feet outside the tub and apply gentle friction to the sexual organ which just touches the surface of the water in the tub. This friction should never cause pain. On the contrary the patient should find it pleasant and feel rested and peaceful at the end of the bath. Whatever the ailment, the sitz bath makes the patient feel better for the time being. Kuhne places sitz baths higher than hip baths. I have had much less experience of the former than of the latter. The blame, I think, lies mostly with myself. I have been lax. Those whom I advised sitz baths, have not been patient with the experiment, so that I cannot express an opinion on the efficacy of these baths, based on personal experience. It is worth a trial by everyone. If there is any difficulty about finding a tub, it is possible to pour water from a jug or a lota and take the friction bath. It is bound to make the patient feel rested and peaceful. As a general rule, people pay scant atten-ion to the cleansing of the sexual organ. The friction bath will easily achieve that end. Unless one is particularly careful, dirt accumulates between the foreskin and the glans penis. This must be removed. Insistence on keeping the sexual organ clean and patiently following the treatment outlined above will make the observance of Brahmacharya comparatively easier. It will result in making the local nerve endings less sensitive and unwanted seminal emissions less likely. To say the least, it is very unclean to allow seminal emissions to occur. Greater insistence on cleanliness should and will cause a feeling of revulsion against the process and make one much more particular than otherwise in taking all the precautions to avoid them.

Key to Health, 1960, p.67-69

Wet sheet packs are also useful in the treatment of prickly heat, urticaria, other forms of skin irritation, measles, smallpox etc. I have tried them on a fairly large scale for these ailments. For smallpox and measles cases, I added enough potassium permanganate to the water to give it a light pink colour. The sheet used for these patients, should afterwards be sterilized by soaking in it boiling water and leaving it in it till it cools down sufficiently and then washed with soap and water.

In cases where circulation has become sluggish, the leg muscles feel sore and there is a peculiar ache and feelings of discomfort in the legs, an ice massage does a lot of good. This treatment is more effective in summer months. Massaging a weak patient with ice in winter might prove a risky affair.

Now a few words about the therapeutics of hot water. An intelligent use of hot water gives relief in many cases. Application of iodine is a very popular remedy for all sorts of injuries and the like. Application of hot water will prove equally effective in most of these cases. Tincture of iodine is applied on swollen and bruised areas. Hot water fomentations are likely to give equal relief, if not more. Again, iodine drops are used in cases of earache. Irrigation of the ear with warm water is. likely to relieve the pain in most of these cases. The use of iodine is attended with certain risks. The patient may have allergy towards the drug. Iodine mistaken for something else and taken internally might prove disastrous. But there is no risk whatsoever in using hot water. Boiling water is as good a disinfectant as tincture of iodine. I do not mean to belittle the usefulness of iodine or suggest that hot water can replace it in all cases. Iodine is one of the few drugs which I regard most useful and necessary, but it is an expensive thing. The poor cannot afford to buy it and more-over its use cannot be safely entrusted to everybody. But water is available everywhere. We may not despise its therapeutic value because it is obtained so easily. Knowledge of common household remedies often proves a godsend in many a crisis.

Key to Health, 1960, p.71-72

Steam is a more valuable therapeutic agent. It can be used to make the patient sweat. Steam baths are most useful in cases of rheumatism and other joint-pains. The easiest as well as the oldest method of taking steam bath is this. Spread a blanket or two on a sparsely but tightly woven cot and put one or two covered vessels full with boiling water under it. Make the patient lie flat on the cot and cover him up in such a way that the ends of the covering blankets touch the .ground and thus prevent the steam from escaping and the outside, air from getting in. After arranging everything as above, the lid from the vessels containing boiling water is removed and steam soon gets on to the patient lying between the blankets. It may be necessary to change the water once or twice. Usually in India people keep an angithi under the pots to keep the water boiling. This ensures continuous discharge of steam, but is attended with risk of accidents. A single spark might set fire to the blankets or to the cot and endanger the patient's life. Therefore, it is advisable to use the method described by me even though it might seem slow and tedious.

Some people add neem leaves or other herbs to the water used for generating steam. I do not know if such an addition increases the efficiency of steam. The object is to induce sweat and that is attained by mere steam.

In cases of cold feet or aching of legs, the patient should be made to sit with his feet and legs immersed up to the knees in as hot water as he can bear. A little mustard powder can be added to the water. The foot bath should not last for more than fifteen minutes. This treatment improves the local circulation and gives immediate relief.

In cases of common cold and sore throat a steam kettle which is very much like an ordinary tea kettle with a long nozzle can be used for applying steam to the nose or throat. A rubber tube of required length can be attached to any ordinary kettle for this purpose.

Key to Health, 1960, p.73-75

Akash

Akash might be taken for the empty space sur-rounding the earth and the atmosphere round it.

Key to Health, 1960, p.75

Sky or the ether is the abode of the atmosphere. One can pump out air say from an empty bottle and create a vacuum, but who can pump out the vacuum itself? That is akash.

This akash we have to make use of to maintain or to regain health.

Key to Health, 1960, p.76

The more we utilize this great element akash the healthier we will be. The first lesson to be learnt is this, that we should not put any partition between ourselves and the sky - the infinite - which is very near and yet very far away. If our bodies could be in contact with the sky without the intervention of houses, roofs and even clothes, we are likely to enjoy the maximum amount of health. This is not possible for everyone. But all can and should accept the validity of the statement and adapt life accordingly. To the extent that we are able to approach the state in practice, we will enjoy content-ment and peace of mind.

Key to Health, 1960, p.77

This train of thought will make the thinker keep his surroundings as open as possible. He will not fill the house with unnecessary furniture and will use the minimum of clothes that are necessary. Many households are so packed with all sorts of unnecessary decorations and furniture which one can very well do without, that a simple living man will feel suffocated in those surroundings. They are nothing but means of harbouring dust, bacteria and insects.

Key to Health, 1960, p.78

One should make it a point to sleep in the open. Sufficient covering should be used to protect oneself against the inclemencies of the weather - against cold and dew. In rainy season an umbrella-like roof without walls should be used for keeping the rain out. For the rest, the starlit blue canopy should form the roof, so that whenever one opens one's eyes, he or she can feast them on the ever changing beautiful panorama of the heavens. He will never tire of the scene and it will not dazzle or hurt his eyes. On the contrary, it will have a soothing effect on him. To watch the different starry constellations floating in their majesty is a feast for the eyes. One who establishes contact with the stars as living witnesses to all his thoughts will never allow any evil or impurity to enter his mind and will enjoy peaceful, refreshing sleep.

Let us descend from the akash above to the akash within and immediately about us. Thus the skin has millions of pores. If we fill up the empty space within these pores, we simply die. Any clogging of the pores therefore must interfere with the even flow of health. Similarly we must not fill up the digestive tract with unnecessary foodstuffs. We should eat only as much as we need and no more. Often one overeats or eats indigestible things without being aware of it. An occasional fast, say once a week or once a fortnight, will enable one to keep the balance even. If one is unable to fast for the whole day, one should miss one or more meals during the day. Nature abhors a vacuum is only partially true. Nature constantly demands a vacuum. The vast space surrounding us is the standing testimony of the truth.

Key to Health, 1960, p.79-81

Sun

Sunbath is as useful as ordinary water bath though the two cannot replace one another. In cases of debility and slow circulation, exposure of the uncovered body to the morning sun acts as an all-round general tonic and accelerates the metabolism. The morning sun has the largest amount of ultra-violet rays which are a most effective component of the sun's rays. If the patient feels cold, he should lie in the sun covered up and gradually expose more and more of his body as he gets used to it. One can also take the sunbath pacing up and down in the sun without any clothes on, in a private enclosure or in any other place away from public gaze. If such a place is not within easy reach, one can just cover up the private parts by tying up a piece of cloth or a langoti and expose the rest of his body to the sun.

Key to Health, 1960, p.81-82

I know of many persons who have been benefited by sunbaths. It is a well-known treatment for tuberculosis.

Key to Health, 1960, p.82

Sun treatment often results in the cure of intractable ulcers.

Key to Health, 1960, p.82

Air

This fifth element is as important as the four already discussed in the foregoing pages. The human body which is composed of the five elements cannot do without any one of them. Therefore no one should be afraid of air. Generally, wherever our people go, they make devices to keep out the sun and the air and thus jeopardize their health. If one cultivates the habit of living in the open in the midst of plenty of fresh air, right from childhood, the body will become hardened and he or she will never suffer from cold in the head and the like ailments.

Key to Health, 1960, p.83

The Extent of Medical Aid

With the commencement of the activities of the A.I.V.I.A., medical aid finds a prominent, if not almost an exclusive, place on the programme of many workers. The aid consists in distributing among the villagers free medicines, Allopathic, Ayurvedic, Unani or Homeopathic, or all combined. Druggists selling these medicines are quite ready to oblige workers approaching them for a few medicines, which co£t them a trifle and which, in their opinion, may, if they look at the gift selfishly, bring them more buyers. The poor patients become the victims of well-intentioned, but ill-informed or over-enthusiastic, workers. More than three-fourths of these drugs are not only useless but imperceptibly, if not perceptibly, harmful to the bodies into which they are put. Where they do bring some temporary relief to the patients, their substitutes are as a rule to be found in the village bazaar.

Therefore, A.I.V.I.A. is leaving medical relief of the kind I have described severely alone. Its primary care is educative in matters of health as well as of economy. Are not both inter-related? Does not health mean wealth for the millions? Their bodies, not their intellect, are the primary instruments of wealth. The Association, therefore, seeks to teach people how to prevent disease. It is well known that the food of the millions is very deficient in its nourishing value. What they do eat they misuse. Their knowledge of hygiene is practically nil. Village sanitation is as bad as it well can be. If, therefore, these defects can be put right and the people imbibe the simple rules of hygiene, most of the ailments they suffer from must disappear without further effort or any outlay of money. Hence the Association does not contemplate opening dispensaries. Investigations are now being made to find out what the villages can supply in the shape of drugs. Satish Babu's. cheap remedies* are an effort in that direction. But incredi-bly simple though they are, he is experimenting with a view to making drastic reduction in the number of these remedies, without diminishing their efficacy. He is studying the bazaar drugs and testing them and comparing them with the corresponding drugs in the British pharmacopoeia. The desire is to wean the simple villagers from the awe of mysterious pills and infusions.

Key to Health, 1960, p.59

Where cases of fever, constipation or such common diseases come to village workers for help they will certainly have to render such help as they can. Where one is certain of the diagnosis, there is no doubt that the village bazaar medicine is the cheapest and best. If one must stock drugs, castor oil, quinine and boiling water are the best medical agents. Castor oil may be locally procurable. The senna leaf may serve the same purpose. Quinine I should use sparingly. Every fever does not require quinine treatment. Nor does every fever yield to quinine. Most fevers will disappear after a fast or a semifast. Abstention from cereals, pulses and milk, and taking fruit juices or boiling raisin water, even boiling gud water with fresh lemon juice or tamarind, is a semifast. Boiling water is a most powerful medical agent. It may move the bowels, it will induce perspiration and therefore abate fever; it is the safest and cheapest disinfectant. In every case where it is required to be drunk, the water must be allowed to cool till it is fairly bearable to the skin. Boiling does not mean mere heating. The water begins to bubble and evaporate after it is on the boil.

Where the workers do not know for certain what to do, they must allow the local vaidya to have full sway. Where he is non-existent or unreliable and the workers know a philanthropic doctor nearby, they may invoke his assistance.

But they will find that the most effective way of dealing even with disease is to attend to sanitation. Let them remember that nature is the finest physician. They may be sure that nature is repairing what man has damaged. She appears to have become powerless when man continuously hampers her. Then she sends death - her last and peremptory agent to destroy what is beyond repair - and provides a fresh garment for the wearer. Sanitary and hygienic workers are therefore the best helpers or the best physicians every person has, whether he knows it or not.

H., 5-4-'35, p. 59

Medical relief as part of village work or social service plays an important part in many reports I receive from numerous organizations. This relief consists of medicines supplied to patients who from far and near flock to any person who advertises himself as distributor of such relief. It means no trouble on the part of the medicine man. He need not have much or any knowledge of diseases and the symptoms. Medicines he often receives free from obliging chemists. Donations are always to be had from indiscriminate donors whose conscience is satisfied if they can distribute their charity in aid of suffering humanity.

This social service has appeared to me to be the laziest form of service and often even mischievous. It works mischief when the patient is expected to do nothing save to swallow the drug given to him. He is none the wiser for having received the medicine. If anything he is worse off than before. The knowledge that he can get for nothing or for a trifle, a pill or a potion that will correct certain irregularities will tempt him to repeat them. The fact that he gets such aid free of charge will undermine his self-respect which should disdain to receive anything for nothing.

There is another type of medical relief which is a boon. It is given by those who know the nature of diseases, who will tell the patients why they have their particular complaints and will also tell them how to avoid them. Such servants will rush to assist at all odd hours of the day or night. Such discriminating relief is an education in hygiene, teaching the people how to observe cleanliness and to gain health. But such service is rare. In the majority of cases mention of medical relief in reports is a piece of adver-tisement leading to donations for other activities requiring perhaps as little exertion or knowledge as medical relief. I would therefore urge all workers in the social field, whether urban or rural, to treat their medical activity as the least important item of service. It would be better to avoid all mention of such relief. Workers would do well to adopt measures that would prevent disease in their localities. Their stock of medicines should be as small as possible. They should study the bazaar medicines available in their villages, know their reputed properties, and use them as far as possible. They will find as we are finding in Sindi (a village near Wardha) that hot water, sunshine, clean salt and soda with an occasional use of castor oil or quinine answer most purposes. We make it a point to send all serious cases to the Civil Hospital. Patients flock to Mirabahen and receive lessons in hygiene and prevention of diseases. They do not resent this method of approach instead of simply being given a powder or a mixture.

H., 9-11-'35, p.308

* Home and Village Doctor, By Satish Chandra Das Gupta, Khadi Pratishthan, 15, College Square, Calcutta.