Friday, September 28, 2007

"The Pills"

Mrs Antrobus has the gout. She had it a few months ago and hobbled along to see Dr Neighbour. He, quite rightly, gave her Indocid (a shiny new Non-Steroidal Anti-inflammatory Drug – NSAID for short). Of course, by new here I mean invented during the latter half of the last century, but in overall terms that’s quite new really.

It worked like a charm for the gout. Only problem, it made poor Mrs A feel terrible: queasy, giddy, sore-tummied, tight-chested, in short pretty much all the listed side effects short of massive and life threatening gastrointestinal haemorrhage. She almost preferred having the gout.

This is a shame, because, and I can speak here from personal experience, when it works and is tolerated Indocid can be a great help. Still it appears Mrs A is particularly sensitive to the side effects of NSAIDs and so we perhaps should avoid them for the future. But Mrs A has the gout. Again. It’s time, to coin a phrase, to “get mediaeval on it’s a**e”. No more Dr Nice-Jest!

You see, for all our modern sophisticated scientific method, sometimes you just have to go the apothecary route. It’s time to wheel out the Autumn Crocus. More properly, time to wheel out that extract of the aforementioned known to our ancestors as colchicine. It’s a difficult drug to use because it can be quite toxic, causing vomiting and diarrhoea. Indeed the dosing instructions contain the comforting advice “take Ye until ye paine hath abayted or peradventure it happeneth that ye patient vomiteth or suffereth an flux of ye bowelf, prithee”, or words to that effect. It’s also a bit of a pain having to go back to prescribing in grains and drachms, but, for all that, it can and often does work every bit as well as the shiny new drugs, and is often better tolerated.

I have this mental image that the drug is prepared by tonsured and habited apothecary friars sequestered in sheds at the bottom of monastery gardens, dispensing antique wisdom and solving the odd ecclesiastical murder. Somehow I suspect this is no longer the case, but it suits my fancy to continue in my delusion, and to delight in turning the clock back a few centuries once in a while.



Z said...

You get gout, Dr J? Ow.

Nutty said...

Things just aren't what they used to be. My mother was of the generation of pharmacists that ground up beetles as ingredients and could identify the origin of three or more different types of cloves. As a student, she made cocoa butter suppositories to throw at ceilings (they stick up there at room temperature and fall off on people's heads as the lights warm them). Now it's all pills in packets.

Elaine said...

Methinks thou hast done well, Dr Jest.

orchidea said...

Ooh, I've never told you about "The Cure": It's my French neighbour's grandma's recipe to ward off a pending bout of [insert applicable lurgy here]. I might have blogged about it en passant, if so, I'll come back and post a link. I'm convinced it contains la fée verte i.e. absinthe, but she's not telling. One thing I can tell you though is that it seems to work! Natural remedies are very much en vogue again here, in fact I think they never went out of fashion.

As for "The Pill": I couldn't take the side effects - the lack of a natural female cycle turned me into a wailing banshee once a month. I cured that one myself by growing a baby. ;-)

Shinga said...

Drachms, grains, minims, scruples - lovely words even though they must be a fiddle to prescribe and dispense.

I'm sure that a version of Dr Jest, ably assisted by Tarantino, would cut through morning surgery like the proverbial hot knife through butter.

orchidea said...

PS. Dr J, I tried to email you a response to your comment on my blog last week, but it keeps getting bounced back to me, marked undeliverable.

Doctor Jest said...

z-- indeed :-(

nutty-- hee hee, what larks! No chance of that in todays "fitness to practice" over regulated training environment ;-)

elaine-- Prithee twas but an trifle.

orchidea-- "The Cure" sounds fascinating. Do tell. As for the title, it harks back to teh quondam days when patients had the decency to get their ailments one at a time and so were dispensed all meds in tiny cardboard boxes with helpull but beuatifully hand written instructions as above, commencing "The Pills tobe taken.....".

You girls and your hormones... truly one of lifes enduring mysteries ;-)

As for your PS I wondered why all the spam had stopped! I'll have to look into it.Thanks for the heads up.

shinga-- I can live with the switch to S>I> (like I'm really old enough to have known otherwise-- not). It's the dumbing down to mcg for microgrammes that really bugs. And yes I'm sure Mr T and I could sort out all the ills of the world in three hours of tightly plotted mayhem!