The rapid rate of development in science and technology in recent years, particularly, in mass communications has posed a great challenge to the Indian society. Welfare of the society can no longer be dependent on the totally inadequate and ill-defined "philanthropy" of charitable institutions and condescending moneyed men. Political changes must be accompanied with radical social changes, if social unrest is to be avoided. This requires a comprehensive social plan, of which medical and public health services form an important component. Medical social planning calls for a total change in the concepts in the teaching, research, and practice in the medical sciences. In the teaching of social medicine, more emphasis must be laid on the adequate utilisation of the already available knowledge for the good of the entire society. The main trend in medical research must be to get such basic knowledge about social medicine. Medical personnel inculcated with such a knowledge about social medicine will, in turn, determine the pattern of medical practice. Further, the administration in medical and public health services must get tuned to this social bias so as to extend the maximum aid to the newly oriented medical and para-medical personnel working in the various health services.

Before the advent of western system of medicine in the eighteenth century, the practice of the empirical indigenous system of medicine of very high standard was in vogue in India. However, with growing industrialization in Europe allopathic system made spectacular progress of which Indian sub continent could not remain unaffected during British rule. As a result, indigenous systems of medicine declined and became more or less cult of the quacks. Only a small fraction of the educated Indians have a chance to acquire knowledge of western medicine and only a few could afford to avail these services while millions of Indians living all over the country had very little use of very advanced medical institutions based in big cities. Even after 14 years of political independence India continues to be the home of preventable epidemics as well as has high incidence of innumerable communicable diseases. Extreme poverty is perhaps the most important factor responsible for the poor state of health of the people in India. A plan for having better nutrition, better water supply, housing and better education will certainly result in great improvement in the national health. In the initial stage of social development all efforts should be directed to provide basic elementary medical and public health services to the entire population. The doctor going to work in an interior village in India must have a wide and varied knowledge of the preventive and curative aspects of medicine, all specialization rolled into one. The state must provide free medical care to all, particularly to the poor. In the concept of socialized medicine there is no place of top sided approach of having highly trained doctors who have nothing to offer to the public other than some useless mixtures. What is urgently needed is a social transformation of the practice of public health and medicine in India.

Common psychological trends in TB patients are described. Psychological complex of 17 TB patients treated in their homes are investigated, and it is concluded that there are no specific patterns of behaviour in persons suffering from TB. The physician`s role in treating TB cases is discussed.

With the introduction of effective TB drugs, the importance of the outpatient-clinic in relation to that of the hospital, concerning treatment, has suddenly increased. Some of the social problems attaching to the out-patient care of TB are: 1) maintaining patients under supervision for long periods of time, 2) the problem of irregular drug-taking (the major reason for failure to take medicines were found to be laziness and indifference on the part of the patient), 3) some patients encountered obstacles (financial, emotional, social or other) which prevented them from following instructions. Special problems are encountered in special groups of patients: the aged, the emotionally unstable, the sociopathic, the alcoholic, the young. All of the above- mentioned social problems are discussed in detail.

The editorial describes briefly, the history of hospitalization for pulmonary TB, noting that this history, in the two succeeding centuries, had been chequered, as it was influenced by successive scientific advances. Currently, even the near revolution of modern chemotherapy has not made hospitalization obsolete. In the developing world, this may not happen for a long time, because admission criteria other than medical could have equal weight. Those who will not accept that hospitalization for TB may have become irrelevant were ignoring economic reality and sensible practicality. It is urged, therefore, that hospitalization for TB be confined to managing emergencies, as a part of general emergency services. In developing countries, all the beds thus released could be handed over to the GHS as contribution to newly emerging primary and secondary health services.

Illness is mostly a subjective awareness of an individual, the relief of which may be sought within or outside medical or health facilities. Perception of illness vary from people to people depending upon cultural, ethnic and socio-economic differences. Perception of symptoms by persons suffering from TB is very high yet only half of them approach modern medical facility for alleviation of their suffering. A survey was carried out in rural area of Hoskote taluk, Bangalore district to determine perceived morbidity and accessible medical relief in 1433 households belonging to 18 villages; of them, 1393 (97%) were successfully interviewed. Selected households belonged to three types of villages i.e., those being within 3 kms of a i) PHC, ii) taluk headquarters hospital and iii) non governmental health centre.

Of the 9286 individuals belonging to 1393 households satisfactorily interviewed regarding health, 1201 (12.9%) were found to be ill at some point of time during the reference period of one month. No differences were observed in the perception of morbidity or in the health seeking behaviour in the three groups of villages. Persons with symptoms/disease accounted for 88.8% of the total sickness, 3.4% for injuries and 9.3% for disabilities, while action taking was 61.6%, 90% and 13.5% respectively. Age sex distribution showed no difference in illness occurrence. Sputum was collected from 147 chest symptomatics and seven were found to be sputum positive. Government health facilities were utilized by 37.6% of the sick persons, private doctors by 36.4%, nature medicine by 10.6% and home remedies by only 9.9%. In conclusion, the services at the government health facilities were acceptable and were utilized if accessible. Prompt and adequate relief for injuries and acute indispositions ensures confidence of the people and better utilization.