Bashir Kak is not well. He has had acute pain on the right of his chest and back for the past five days now. He has already received injections from ‘Riyaz Saeb’ – the local pharmacist who doubles up as the local ‘doctor saeb’.
There has been no relief in the pain and Bashir Kak has developed redness and fluid-filled skin lesions on the right side of his chest and back.
On the way back from his Asr Namaz, Bashir Kak talked to his close friend about it. Upon hearing of the signs and symptoms, the friend immediately said, “This is Mal-der, Bashir Kak. Don’t go to any doctor for this. Their medicines won’t help. You should immediately go for ‘Maetrawun’. If you want I will accompany you to Khazar Kak, the famous Maetrawan wol of the town.”
Now, Bashir Kak is in confusion. Should he go to a doctor or to a maetrawan wol!
He is really suffering from the pain and he wants quick relief. No pain killers are helping and he has not been able to sleep for the past five days.
Ultimately he decides against the advice of his close friend and visits the dermatologist.
Here is the conversation between Bashir Kak and the dermatologist.
“Asalam u alaikum, doctor soob”
“Walaikum Assalam. What is the problem?”
“Doctor soob, I have severe pain on the right side of my chest and back for the past five days. I have not slept even for a minute all these days. Please have a look at my chest and back. My friend said that this is ‘Mal-der’.”
The doctor, after examining Bashir Kak properly, says to him, “Yes, it is ‘Mal-der’, or Herpes zoster as we call it in our language. So, you had pain for five days, but when did the rash start?”
“Doctor, it started yesterday. But I had severe pain prior to that as well and the same is still continuing.”
“Ok, it is good that you have come to us within a short time after the onset of rashes. We can treat it better at this stage. If you had come later, maybe after 2-3 days, then some of the drugs would not have helped.”
“But, doctor, some people told me not to go to a doctor for this. They advised me to go to a ‘maetrawan wol’. Should I go to him or not?”
The doctor smiles and says, “Let me answer this question in detail. I know that you can understand it very well.
“See, Herpes zoster (mal-der in our local language) or ‘Shingles’ in English language is basically caused by a virus known as ‘Varicella zoster’. This virus usually infects humans and causes what is known as ‘Chicken pox’ or ‘waawpet’ in our Kashmiri language. The virus, after gaining entry into our body, remains inside the body lifelong in a dormant state. And it favours a typical site for this — it remains or rests in our nerve roots.
“Once our immunity, against infections in the body, goes down because of any reason, the virus gets a chance to become active again. It then replicates and travels along the nerve sheath from its original resting place and infects the skin that is supplied by the same nerve trunk. That is why we have the skin lesions along a segment on one side of the body in this disease.”
“Oh, ok. So that is why my right side only is afflicted and the infection is restricted to a particular area only on the chest. But why is it so painful? And why is the pain not going away with analgesics?” Bashir Kak asks.
“I will tell you the reason. See, once the virus gets activated, it travels along the nerve trunk. While travelling along the nerve it causes an inflammation of the nerve which is known as ‘Neuritis’ in medical language. This neuritis is the cause of severe pain in Herpes zoster.
“And as the nerve is inflamed, it does not respond well to traditional analgesics but only to specific drugs that have an effect on the nerves specifically.”
“But what about ‘maetrawun’ — does he have a role to play?”
“We Kashmiris are really health conscious people but there are a few myths and wrong practices that we are still continuing even in today’s age. About ‘maetrawun’— let me tell you that medical science does not dismiss the role of this particular treatment in human disease. We, in allopathy, call this mode of treatment as ‘Hypnotherapy’. And hypnotherapy is a treatment option that has been used in a number of human diseases in clinical studies.
“You may be surprised to know that hypnotherapy has been used in diseases like atopic eczema, warts, and many other human diseases including Herpes zoster.
“However, the most important thing is to use medical treatment first and keep hypnotherapy as a reserve if the condition does not respond to medical therapies alone. The role of hypnotherapy comes late in the disease if the person has intractable neuralgic pain that does not respond to drugs alone. Hypnotherapy does not have a role in the acute stage of the disease.
“I will tell you about a relative of ours whom we saw in our home recently. This person, a male of about 37 years, had lost his eyesight just because he had not treated his Mal-der on time and went for hypnotherapy alone as treatment.”
“Oh, Allah! Is it true? Can this disease lead to such complications as well?”
Yes, it is true and that is why I want to put this message across. At some sites like the forehead/ eyes, ears, and perianal or genital areas, the treatment of Herpes zoster has to be immediate. Otherwise, the person is going to land into serious complications. If Herpes zoster involves the forehead or area around the eyes, it can lead to a permanent blindness in the affected eye. That is an unfortunate event and that should not happen in today’s age when we have access to many effective drugs against this virus.”
—The writer is a student of BSc Nursing at Pacific Institute of Medical Science

UMAIR SHAFIQ