[CHAPTER LXIX.]
The Care of the Sick.
The tending of sick persons is a task assigned to women in Tibet, and the peculiar notions prevailing about the treatment of patients makes this task doubly onerous. Tibetan doctors strictly forbid their patients to sleep in the day-time, and so those who tend them have to follow this injunction of the doctors and keep the unfortunate patients awake. The patients are not allowed to lie in bed but are made to remain leaning upon some supports specially prepared for them. One or more nurses sit by their sides to give them any help they need, and above all to prevent them from going to sleep. These nurses cannot long stand the strain of constant watching, and therefore they are relieved in turn, to resume the task after they have taken more or less rest. The nurses faithfully attend to their duty, are very quiet so as not to annoy the patients, wakeful as they are, and above all to satisfy any of their wants, to comfort and humor them, and also to keep the rooms clean. This cleaning must be judged strictly by a Tibetan standard, for viewed from the Japanese standpoint it hardly deserves the name. The patients are also kept comparatively clean, considering the general filthy habits of the Tibetans. The effect of this insanitary condition at once makes itself felt to the olfactory sense of a foreigner who is accustomed to more perfect arrangements at home, for as soon as he enters the room a peculiar offensive smell greets his nose.
But the most important and tiresome part of the nursing duty is to keep the patient awake, and sometimes nurses are specially appointed to attend to this work. These nurses keep beside them a bowl containing cold water and one or two wooden sprinklers. When the patient is about to fall asleep, a nurse sprinkles water on his face, and this has the effect of preventing sleep. When this water-sprinkling fails, the nurse embraces the patient from behind and slightly presses him forward. Sometimes they call the patient by name and cause him to recover consciousness. The patient is thankful for the trouble taken by the nurses, being well aware that they do it in obedience to the doctor’s orders, and from their wish to ensure his recovery.
The idea that a patient must not be allowed to sleep in the day-time is strongly impressed on the minds of Tibetans, both professional and non-professional. The doctors enjoin both on him and on the nurses to observe this point strictly as the first essential for his recovery, and any person who comes to visit him first of all gives a similar warning. “Don’t allow him to fall asleep,” repeats the visitor to the nurses, and reminds them that they are principally responsible for carrying out faithfully this cardinal necessity in the treatment of the patient.
When a patient dies, the neighbors suspect that his nurses may not have been strict enough, and must have suffered him to fall asleep!
I tried to find out the reasons that have brought about this strange medical custom, and it was easy for me to make enquiries, having been obliged to play the part of a quack doctor through the earnest importunities of the simple-minded Tibetans. So far as I could ascertain from those enquiries, the idea seems to be that patients suffering from some diseases are liable to develop more fever when they sleep in the day-time, while patients suffering from a local disease, resembling dropsy, not unfrequently die while asleep or while in a state of coma. It seems to have been derived from some cases that occurred some time in the past, the unscientific doctors of Tibet having jumped to a general conclusion from certain specific occurrences. I need hardly add that this non-sleep prescription is efficacious (if ever it is efficacious at all) for the Tibetans only. When at times I suffered from disease while in Lhasa I slept as freely as I wished, and of course I found myself feeling all the better for it.
The fact is that, in Tibet, superstition plays a far more important part than medicine in the treatment of diseases.
People believe that a disease is the work of an evil spirit which enters the body of a person, and therefore they conclude that that spirit must first be exorcised before a patient may be entrusted to the care of a doctor. There being various kinds of evil spirits, some high Lama must be consulted in order to determine which particular one has possessed a given patient. A priest before whom the matter is brought consults books on demonology, then pronounces that the disease is the work of such and such an evil spirit, and that for exorcising him such and such a service must be performed.
The consulting priest may specify the name of a Lama when the service to be read is one of importance, but when it is an ordinary one it may be performed by any Lama. At the same time the consulting priest issues directions about medical treatment—that a doctor should be called in after the service has been performed for so many days, or that such and such a doctor should be invited simultaneously with the religious performance, or that medical aid may be dispensed with altogether.