Medical Work in Tropical Mexico
By Carlos Fattebert
I AM working on a sugar plantation at Rascon, San Luis Potosi, Mexico. The plantation has an elevation of fifteen hundred feet above sea-level. Vegetation here keeps green all the year round. The hot months are from March to June, when the rains begin, lasting until October, although there are rains occasionally all through the year. Frost is rare, though it nipped the cane last year in January, stopping its growth, and completely destroyed it four years before. The hacienda, or ranch, employs from three hundred fifty to seven hundred men, according to the season. There is a resident population of eight hundred. Large numbers come for from two to four weeks, and then go away. This makes it difficult to estimate the number of persons actually on the place during the year, probably twenty-five hundred. I was here all last year, and in the twelve months gave 12,500 treatments. This number represents only the principal ailment in each case, secondary ones not being reported, although several often needed attention. Most of these cases were seen at the office, although 1,680 visits were made, including fifty trips at a distance averaging five miles. None of these figures include private work on other haciendas, of which there was considerable, as there are but two other physicians within thirty miles. Deaths during the year were thirty-three reported by me, and some more of which I knew nothing, as the law does not require notification. The principal diseases treated were as follows: Malaria, 2,438; enlarged spleen, 97; dyspepsia, 324; diarrhea, 186; constipation, 309; dysentery, 132; worms, 97; bronchitis, 746; catarrh, 222; tonsillitis, 40; pneumonia, 35; otitis (mostly media), 177; toothache, 160; stomatitis, 75; skin diseases, 197; wounds and ulcers, 2,075; venereal disease, 171; pelvic, 81; neuralgia, 286; rheumatism, 77; vaccinations, 77. Other diseases varied in number from one to sixty. Had four cases of tuberculosis, and five of appendicitis, one of which required operation. Be it understood that operations under general anesthesia are done only in cases of absolute necessity, owing to lack of assistants and conveniences, as I have to return patients to their huts after operation. Did not have a single case of smallpox, measles, mumps, scarlet fever, nor other epidemic diseases, during the year. Anemia is common, but seems due mainly to malaria and malnutrition, and yields readily to good food and tonic treatment. Some claim it is due to hookworm; but I have not found any, though the careless habits of the people would lead one to look for it. Obstetrical work is entirely in the hands of women who are ignorant and untrained. The physician is called only in case of trouble. The law does not protect physicians and registered midwives, so in many places these women reign supreme, and do much harm, as there is no disease they will not undertake to treat. They usually collect good fees for their work, too. Each man employed here pays one day's wages a month for medical attention. This amounts to from thirty-one cents to $2.50 (gold), and includes treatment for their families. When the medical department was first organized, it was necessary to treat some of the sick almost by force, as they had no idea what a physician was for. It is easier now, and I have been able to teach many how to care for themselves, and the value of the bath, fresh air, and certain foods. This is slow work, however, and the instruction has to be repeated many times. But those who do learn will teach others, who often value more the opinion of one of their kind than that of one above them. Over twenty families here are reading one or another of our papers. These include all of the better class, and the majority of those who can read at all. Many will converse about the Bible, but few dare to read it. This is the best we can do for them at present, as the management is not friendly to evangelical work. CARLOS FATTEBERT, M. D.