The invasion of Singapore and Malaya was delayed because of the reduction in the period of service in the Far East. The atom bombs were then dropped and plans for all services including medical ones had to be altered, their main aim becoming the treatment and repatriation of surviving prisoners of war. The ending of the war did not occur abruptly on V-J day; many Japanese troops had to be convinced that the war was over. Meantime the treatment of diseases in British and other service men continued; reference is made to some experiences in Rangoon. The morale of personnel who now were anxious to return to their homes was low and efforts were made to raise their spirits. In India it was accepted that the days of British rule were over.
Semai descriptions of their beliefs about health and disease vary from person to person. Moreover, at different times the same person expresses mutually incongruent beliefs. This amorphousness and fluidity merit analysis rather than neatening. This paper details Semai beliefs, loose ends and all, and suggests that their formal peculiarities are due to the prevalence of synecdoche in conceptual organization. Their inconsistency and fluidity may stem from individualistic egalitarianism within Semai society and powerlessness in the face of nonSemai attack. Finally, it is suggested that construing indigenous medicine as a crude form of Western medicine leads to overtidiness and consequent error.
In comparing shamanistic healing with Western psychotherapy, the principal distinctions advanced by psychiatrists and psychologists have been: (1) that the shaman's patients receive 'remission without insight' while Western psychotherapy provides patients with a learning experience; and (2) that Western psychotherapy is based upon rational theory, whereas psychotherapeutic elements in shamanistic rituals are by-products of irrational magical activity. Anthropologists, on the other hand, have demonstrated the logic behind the shaman's seance, and its uses as a projective system which locates the patient's problems in external entities rather than within his own psyche. An investigation of the Malay shamanistic ritual (Main Peteri) expands the scope of discussion, since it reveals that embedded within this exorcistic spirit-raising seance is a nonprojective indigenous theory of psychic functioning, employing symbols internal to the patient, which is comparable to, and no more nor less rational than, mainstream Western theories.
A random sample of 102 hypertensives out of a total of 347 in the Malaysian Armed Forces were studied with regard to patient education, knowledge of hypertension and therapy compliance. It was found that for 53 percent, patient education was unsatisfactory and as a result 67 percent had inadequate knowledge of hypertension. Adherance to therapy - drug intake, weight reduction and cessation of smoking - was poor (more than 59 percent, 96 percent and 70 percent failure respectively). There was no significant difference between asymptomatically and symptomatically detected hypertensives.
The University Science Malaysia, Penang, the third medical school in Malaysia, is following an integrated curriculum. In this curriculum, the students are taught the subject of otolaryngology from the second year of their course unlike the traditional schools where they are taught in the fourth or fifth year. This paper describes how otolaryngology is introduced in this integrated, problem-based curriculum.
In his article, 'The Effectiveness of Symbols,' Lévi-Strauss contends that the details of a Cuna birth incantation evoke specific physiological responses from parturient women, aiding them through difficult labors. His argument, which analyzes the incantation as a text divorced from its social setting, has drawn criticism from students of Cuna society on a number of substantive points, primarily centering around the difficulties that the special linguistic form of ritual language would present to a non-adept. If the patient lacks a thorough comprehension of the mythic details, how can the incantation change her physiological processes? In an attempt to evaluate the effect of myth upon a woman in labor, this article calls upon Cuna and Malay ethnographic data, and presents a Malay birth incantation as interpreted by the ritual practitioner who recited it. Following a discussion of the non-semantic aspects of the incantation and the extent to which the patient shares the interpretation of the healer in both the Malay and Cuna societies, recent biomedical studies are cited in support of hypotheses concerning the physiological and biochemical effects of myth in the management of childbirth.
279 cases of pulmonary tuberculosis were diagnosed during a 10 year period from 1969 to 1978. 60% as a result of self-referral and 40% from mass miniature radiography of the chest. For every case of pulmonary tuberculosis picked up, the number of MMRs required has been steadily rising from 1 in 1900 to 1 in 6700. Using South Korea study figures, it costs US$42600 for a case of pulmonary tuberculosis detected by MMR. Besides being not cost effective, there is little advantage in early detection with regard to prognosis, in preventing subsequent cases and in picking up other lung or cardiac abnormalities. Unnecessary radiation results from frequent MMR whose dosage is 10 or more times greater than standard chest X-rays. MMR should be limited to. contact tracing, prior to overseas courses and on termination of service.
Study site: medical boards submitted to Medical Directorate, Ministry of Defence, Malaysia
The rapid increase in the use of helicopters for hospital transport during the 1980s is the culmination of several hundred years of military medical innovation. Mass battefield casualties spurred both technologic and medical changes necessary for today's sophisticated helicopter systems in use worldwide, particularly in the United States. The Napoleonic Era and the American Civil War provided the framework for the evolution of today's state-of-the-art emergency medical techniques. The use of airplanes to evacuate the wounded eventually led to using helicopters for rescue missions in World War II. The combat experiences of the United States in Korea, the British in Malaya, and the French in Indochina proved that rotary-wing aircraft were invaluable in reducing battlefield death rates. Any skepticism about the efficacy of helicopter medical evacuation was erased during the Vietnam conflict. As an integral part of the modern battlefield, these specialized aircraft became a necessity. The observations and experience of American servicemen and medical personnel in Vietnam established the foundation for the acceptance of helicopter transport in modern hospital systems.
Malaysian, British and New Zealand soldiers were tested for evidence of infection with Rickettsia tsutsugamushi after several weeks' exposure to the infection during field exercises in Malaysia. 39 (5.0%) of 787 British and New Zealand soldiers developed immunofluorescent antibody (IFA) to R. tsutsugamushi to a titre of 1:50 and two (0.3%) to a titre of 1:100. 11 (1.5%) of 751 Malaysian soldiers also developed low titres less than or equal to 1:100. These low antibody levels were not correlated with clinical disease, and their significance is unknown. Seven (0.9%) of the Malaysians showed an IFA rise to greater than or equal to 1:200, and three of these experienced febrile illnesses, one lasting two weeks. An additional eight Malaysian soldiers had an IFA titre of greater than or equal to 1:400 when first tested and six of these also had a Proteus OXK agglutinin titre of greater than or equal to 1:160, indicating infection shortly before the study.
Studies carried out on the occupational exposure to paraquat of plantation workers in Malaysia comprised quantitative estimates of dermal and respiratory exposure of knapsack spray operators, carriers, and rubber tappers operating under their normal working conditions. Spray operators have been shown to be dermally exposed to paraquat by walking through recently sprayed vegetation and into their own spray, regular adjustment and unblocking of spray nozzles and leakage, and overfilling of knapsack spray tanks. Carriers also received measurable dermal exposure from walking through recently sprayed vegetation and accidental spillage when carrying and loading. The infrequent and negligible dermal exposure of tappers resulted from walking through recently sprayed vegetation. Determinations of the total airborne paraquat concentrations in the breathing zone show that spray operators and carriers are exposed to an order of 1% or less of the current TLV for respirable paraquat. No paraquat was detected in the breathing zones of tappers working in simultaneously sprayed blocks. The calculated ranges of dermal and respiratory exposures, when compared with published data on both the exposure to, and the toxicity of, paraquat, indicate that there should be no toxicological risk to any of the three groups studied as a result of using paraquat.
Malaya, an ancient crossroads of trade, was the recipient of Chinese and Ayurvedic humoral ideas and, later, those of medieval Islam. These ideas were readily accepted by Malays, since they are highly congruent with pre-existing notions among aboriginal peoples of Malaya involving a hot-cold opposition in the material and spiritual universe and its effects upon human health. Islamic Malays have adapted these aboriginal beliefs to correspond to the Greek-Arabic humoral model in matters concerning foods, diseases, and medicines. Although Malay theories of disease causation include such concepts as soul loss and spirit attack, along with 'naturalistic' ideas such as dietary imbalance and systemic reactions to foods, all of these theories can either be reinterpreted in humoral terms, or, at least, are congruent with the basic tenets of Islamic humoral pathology. Behaviors and beliefs regarding human reproduction, however, while essentially following a humoral pattern, diverge from Islamic, as well as traditional Chinese and Indian Ayurvedic, humoral theories. Unlike any other major humoral doctrine, Malay reproductive theory (like that of non-Islamic aboriginal peoples of Malaya) equates coldness with health and fertility and heat with disease and sterility. These ideas, in turn, are related to beliefs regarding the nature of the spirit world: the destructiveness of spiritual heat and the efficacy of cooling prayer.
A case of tetanus occurring after induced abortion is reported. The patient gave a history of low grade fever with chill and rigors, headache, neck pain and Trismus. She subsequently developed respiratory distress. However, incorrect information from the patient resulted in the delay to locate and eradicate the source of infection. Early referral to an intensive care unit for ventilatory assistance was the most appropriate step to save the patient. Complications which occurred during the course of the disease were sometimes difficult to overcome. These complications were probably related to the duration of stay in the intensive care unit. Their incidence could be reduced by more meticulous patient care.
The case histories of two patients healed by animist treatment in the Iban tradition are reviewed by two psychiatrists. Both psychiatrists point to the difficulties in the evaluation of the background of the disease and of the mechanisms of its treatment by people not aware of the cultural and sociological aspects of eastern civilisation. The diagnostic classification of both patients by means of western medicine and the possible treatment of their disease are discussed. The failure of western medicine to understand the psychiatrical aspects of animist religions in the pathogenesis of diseases raises the question whether western medicine will be able to cope with the health problems of Iban (and other animists) sufficiently when their animist tradition will be replaced by western civilisation.
Matched MeSH terms: Medicine, East Asian Traditional*
Traditional methods of treatment are extremely popular with Malaysians especially for psychiatric illnesses. Those who seek such treatment come from all cultures, social classes and different educational levels in this country. In one hospital as much as 49% of psychiatric patients had been to traditional healers . Some receive simultaneously traditional and modern modes of treatment. While many reports have been written on traditional healers such as the bomoh and spirit mediums, relatively less is written about Christian healers who practise exorcism. This paper describes two patients who had received psychiatric diagnoses of major illnesses, and who subsequently underwent Christian exorcism. The process of exorcism and the short-term and long-term outcome are reported.
Details of curing rituals symbolize social traumas. Western based psychiatrists are often not very successful in treating Malay patients because of the difficulty of understanding the ritual signs. This paper focusses upon cultural details as they relate to a curer. The paper begins by discussing 'medical pluralism' and proceeds to a consideration of one local healer.
The 1980 malaria notifications in Malaysian soldiers are analysed. The number of new cases notified was 964, giving an annual incidence of11.81/1000 soldiers. Sixty-three percent were falciparum and 36 percent were vivax infections. There were 48 relapses and recrudescences. Twenty-three carriers were detected on mass screening. The yield from mass screening was very low - 5.09/1000 screened. The current practice of chemotherapy, though generally acceptable, was unsuitable for a number of patients. Recommended regimens are not being adhered to. There were two cases ofcerebral malaria, one of whom died.