Ganga-Bhuji

In my previous blog – Demystifying Medical Prescriptions – I had discussed ‘Doc-write’ - the illegible prescriptions with mysterious abbreviations and symbols. I had also referred in passing to ‘Doc-speak.’ Doctors never tell a patient, ‘You’re to die soon,’ I had written. That’s not entirely correct.

Dr. Kabir Purohit is possibly the best General Physician in Sambalpur, but his ‘practice’ is rather modest since he is candid, blunt, and sometimes quite rude. Patients who want from a doctor diagnosis, drugs, and a dose of hope scrupulously avoid Dr. KP.

Sometime ago, a close friend of the doctor brought along his father who was very ill. The old man placed a bulky folder with history of treatment in leading hospitals of the country, and launched his litany of complaints – general debility, palpitation, breathlessness, loss of appetite and sleep, irregular bowel movements, and aches from tip to toe; but was cut short by the impatient doctor. He didn’t even bother to read the latest pathological reports from the folder. He had been seeing this patient quite regularly, and knew of all his health issues.

‘Should I take my father to Tata Memorial, Mumbai?’ asked the doctor’s friend.

‘No need. Prepare, instead, for Ganga-Bhuji.’

The doctor’s friend and his father stormed out of the consultation room swearing never again to see this doctor.

They didn’t have to. Ganga-Bhuji took place the next month.

***

Note:

Ganga-Bhuji is a customary death-ritual practiced in Odisha; a feast hosted in memory of the dear departed one after the son has performed asthi-visarjan (consigning the mortal remains) at Prayagraj.

Demystifying Medical Prescriptions

 A few Quotes

“Doctors’ handwriting proves that medicine is indeed a mystery — from diagnosis to deciphering the script.”

“A doctor’s signature looks like an ECG report — irregular, fast, and impossible to interpret.”

“If pharmacists can read doctors’ handwriting, they deserve a Nobel Prize for cryptography.”

Doctor Captain

If your body is a little vessel tossing in the vast, fathomless ocean of life with dangerous diseases as killer sharks prowling to devour you, doctors are the trained and seasoned captains who save you from drowning or being devoured, as far as possible. They help you to stay afloat, and on course for your life-journey; even though you mostly ignore the captain’s counsel to eat sensibly, exercise regularly, keep your weight in check (your boat is not designed to carry a load beyond its capacity!), and avoid alcohol and smoking.

Whenever you consult a doctor, he never says, ‘You’re soon to drown, begin saying your prayers, and prepare for your final destination.’ Instead, he mutters inaudible soothing words, writes an indecipherable prescription, beams a friendly smile at you which means, ‘Consultation is over; time for the next patient, you know.’

You present the prescription at a medicine shop. The 10^th Fail who is the body-double for the pharmacist required by law to dispense medicine has no difficulty in deciphering the codes. Business teaches smart survival skills including decoding the illegible hand of any doctor! He brings out from an open almirah the relevant alphabetically indexed plastic box and fishes out the medicine that you need.

OD, BD, TDS???

You return home with the sachet of tablets and capsules; but then you hesitate to pop the pill wondering which one to take when and what quantity for how many days? The doctor may have given rapid-fire oral instructions which never registered since you were mentally calculating the per minute consultation fees charged by your eminent doctor. You peer at the holy codes - OD, BD, TDS, SoS, and similar mysterious jargon in the prescriptions.

What does it mean? OD is Once Daily; that’s an easy one? How about BD? Twice Daily, you know; but why not call it TD? Okay, coz TDS means Thrice Daily; but what’s the ‘S’ for, you wonder. You may also wonder if many doctors are themselves aware of the origin of these mysterious notations.

Greek or Latin?

Is that Greek and Latin for you? Well; OD, BD, and TDS in medical prescriptions originate from Latin, not modern English. Modern medicine mostly refers to the western, allopathic system and its practitioners take the Hippocratic Oath. Hippocrates was a Greek medicine man. Why then do doctors follow the Latin notations and not Greek? Because, from Renaissance onwards, Latin had become the language of all learning including medicine.  

In due course, Latin terms like:

• Omni die (OD) – once a day
• Bis die (BD) – twice a day
• Ter die sumendum (TDS) – thrice a day
• Si opus sit (SOS) – if necessary

became standard medical shorthand worldwide — through colonial education and global standardization.

(Don’t  fear the ‘die’  in OD, BD, and TDS; it’s Latin for ‘day’ not ‘death.’ The Latin word for death is  “mŏrs” derived from the Proto-Indo-European root mr̥tós, which means “mortal” or “dead.” This root is related to various terms in other Indo-European languages, such as “mortality” in English, and “mort” in French. The words Sanskrit mṛtyu (मृत्यु) and Latin mors are etymologically related (cognates).)

But why do doctors persist with these Latin terms? Why in India where millions of patients have no knowledge even of English, not to speak of Latin?

Simple Symbols

To be fair to doctors, many use easy-to-understand, simple symbols – 0 for OD, 0-0 for BD, 0-0-0 for TDs. How many days? No issue; 0-0-0 x 7. Even illiterate patients would get it. Anyway, after so much investment in school education and adult literacy; someone in the family would understand what the doctor has prescribed!

AI gives up

Hoping that AI might be of help, I uploaded a recent prescription by a doctor with a memorable name: Darwin Thakur. Gemini AI read the prescription with much diligence and patience, and made several intelligent guesses about the medicines prescribed, but conceded defeat, and said, "Sorry, I can't read the handwritten prescription with accuracy, and I advise you against taking any medication based on my partial reading. I suggest you call up the doctor's office and seek the clarifications you need."

Tutorial for Doc

Next time your doctor writes a prescription for you, why don’t you politely ask for the origin and history of OD, BD, and TDS? If he falters, you could give a brief tutorial, and demand a reasonable discount in the Consultation Fees!

***

High Court's directives on legible prescriptions

In a landmark ruling, the Punjab and Haryana High Court has mandated clear and legible prescriptions; and a set of directions has been issued by Justice J. S. Puri on August 27, 2025.

In an anticipatory bail application  in a criminal case, the judge noticed that the Medico-Legal Report (MLR) submitted by a doctor was completely illegible, which led the court to take suo motu cognizance of the systemic issue.

The directives hold that the "Right to legible medical prescription and diagnosis" is an integral part of the Right to Health, which is a Fundamental Right under Article 21 of the Constitution of India.

***

Postscript

Why is the doc’s prescription illegible?

A doc is a detective. He launches a quick investigation, identifies the potential culprits, and orders immediate preventive or deterrent action on those villains. He has the unenviable task of completing this complex, challenging task in five minutes or less – the typical time spent by a specialist doc per patient. Obviously, he has no time to write an elaborate prescription like the following:

1.   Tab X – 1 Tab after lunch & 1 after dinner for 7 days

2.   Cap Y – 1 Cap 3 times a day for 4 days

3.   Tab Z – 2 Tabs daily for 30 days (A nutraceutical -  possibly curcumin, a fancy name for haldi – costing 120 rupees a Tab!)

4.   Tab ZZ – Analgesic – SoS

That’s why he scribbles fast. He knows well that the chemist across the street would easily decipher the codes which constitute the mysterious lingua franca of the medical care community.

What’s Rx?

A reader queried – what’s Rx? I had no idea, and looked up. That, too, is Latin; an abbreviation for ‘Recipe.’ The doc isn’t asking you to cook, but to eat the fistful of medicines he has listed in the menu.

I asked ChatGPT to provide a list of other common abbreviations used by docs. Here is the list:

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Common Abbreviations Used in Medical Prescriptions

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1. Frequency of Dosage

Abbreviation	Latin Term	Meaning / Explanation
OD	Omni die	Once daily
BD	Bis die	Twice daily (morning and evening)
TDS / TID	Ter die sumendum	Thrice daily (morning, afternoon, night)
QID	Quater in die	Four times a day (every 6 hours)
HS	Hora somni	At bedtime (night)
SOS	Si opus sit	As needed (only when required)
STAT	Statim	Immediately
Q4H / Q6H / Q8H	Quaque 4/6/8 hora	Every 4, 6, or 8 hours
QOD	Quaque altera die	Every other day

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2. Timing in Relation to Meals

Abbreviation	Latin Term	Meaning / Explanation
AC	Ante cibum	Before meals
PC	Post cibum	After meals
HS	Hora somni	At bedtime
PRN	Pro re nata	As needed
CC	Cum cibum	With food
BID AC / BID PC		Twice daily before / after meals

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3. Route or Method of Administration

Abbreviation	Latin Term / Modern	Meaning / Explanation
PO	Per os	By mouth (oral)
IM	Intra muscularis	Intramuscular injection
IV	Intra venous	Intravenous injection
SC / Subcut	Sub cutis	Subcutaneous (under the skin)
SL	Sub lingua	Under the tongue
INH	—	Inhalation
TOP / APPL.	—	Topical (apply on skin)
PR	Per rectum	Rectally
PV	Per vaginam	Vaginally
OTC	—	Over-the-counter (no prescription needed)

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4. Duration, Quantity, and Course

Abbreviation	Meaning / Explanation
X 5 days	Continue for 5 days
Tab / Cap / Syr	Tablet / Capsule / Syrup
Inj.	Injection
Gtt.	Drops (for eyes, ears, or nose)
Ung. / Oint. / Cream	Ointment
Supp.	Suppository
Neb.	Nebulization
NR	No refill (do not repeat without advice)
Refill x1	May be refilled once

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5. Miscellaneous and Cautionary Terms

Abbreviation	Meaning / Explanation
Rx	Recipe – “Take thou” (beginning of prescription)
Dx	Diagnosis
Tx	Treatment
Px	Prognosis
Hx	History
R / L / B/L	Right / Left / Bilateral
NPO	Nil per os – Nothing by mouth (fasting)
BM / BP / HR / PR	Bowel movement / Blood pressure / Heart rate / Pulse rate
NKDA	No known drug allergy

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Note

Most abbreviations derive from Latin — a legacy of early European medical education.
Modern safety guidelines (WHO, NMC, FDA) recommend writing full English terms such as “once daily” or “after meals” to reduce errors and make prescriptions clearer for patients.

 

(Image by Gemini AI)

Vignettes
from
Books by Mahesh Buch

When The Harvest Moon Is Blue

An unusual Autobiography

“… somewhat autobiographical without being an autobiography.”

“… it is Mahesh Buch in his most irreverent moments. For this I offer no apologies, but I do assure my readers that nothing I have stated is apocryphal or deliberately untrue. If there is some exaggeration, well, that is an old man’s prerogative. What interest does an unembellished story hold? But even this ornamentation, I promise you, is credible.”

Civil Servants with a swollen head

“Most civil servants have a somewhat exaggerated notion of their own importance in the scheme of things and the role that they play in shaping the nation.”

“Just as no one can choose the place, time and family of birth, the average civil servant does not decide his own posting.”

CM’s wife contracts jaundice

“By this accident of illness of the Chief Minister’s wife, I was launched on a career which, quite undeservedly, has won me the reputation of being an urban planner, administrator, and environmental expert. Supposing the lady had not contracted jaundice?”

A wonderful life

“It has been a wonderful life, in a marvellous country, amongst the most lovable people in the world, a life into which I would be prepared to be born again and again and for which I would even forego ultimate moksha.”

Humour in government

“Madhya Pradesh has always been relaxed in the matter of humour in government, but never as much as when Ron Noronha ruled the Civil Service as Chief Secretary.

My wife, Nirmala (we were not married then) was D.C. in Dewas, my friend, R.P. Kapur was D.C. in Indore and I was in Ujjain. Ron sent a circular letter to all Commissioners and D.C.s saying that he was very pleased with Raisen, Sehore and Hoshangabad Districts for the amount of wheat they had procured. Ujjain, Dewas and Indore had done reasonably well and other districts needed to pull up their socks.

Nirmala, R.P. Kapur and I wrote a joint letter to Noronha protesting that our efforts were much better than that of the top districts if we took into account the actual per acre procurement in the net sown area.

Ron replied, "My dear Nirmala, R.P., Mahesh, your letter reminds me of a story of Napoleon, who praised the chef's main course. On this the chef stormed into banquet hall, threw his toque on the floor and said, "Your Majesty, the soup was also magnificent but you did not praise it. Well, the three of you consider your soup and whatever else you want as praised."

(Chapter 4: The Eccentrics)

Foes (Chapter 16)

“This should be one of the shortest chapters ever written. Regarding foes i am like that centenarian who was being felicitated on his century. When asked whether he had any enemies he said, "Nary a one. Buried the lot of them."

Same here, too. But if I did have enemies I would agree with Heinrich Heine who said, "One should forgive one's enemies but not before they are hanged."”

An India Reimagined

“India is completely different [from the city state of Singapore]. There is a paradox of people who are personally very clean and fastidious about body hygiene, clothes and the spotless cleanliness of the inside of their house, particularly the kitchen, combined with an appalling sense of civic indifference and social irresponsibility. The house must be clean but it is all right to throw garbage on the streets.”

When in Doubt

'When I am in doubt I refer to the Constitution, a practice I would [re]commend to all civil servants.'

Quitting the IAS

“I served under the IAS for twenty-eight years and left eight years before my date of retirement. I left the service on an issue where I totally disagreed with the chief minister because I was convinced that he wanted me to do something which was contrary to the law ....”

Of Man and His Settlements

“I had a constant refrain in the past, committed to paper and conveyed orally to the then Cabinet Secretary, that senior officers must quit when they are asked to compromise on matters of principle or when their advice is no longer heard. When I came to a similar cross-road I could do no better than to follow the advice that I had given to others. I quit.

“He kept faith.”

I have had 28 lovely years in the IAS, perhaps the finest service in the world. These were years when I came to know our people and our country and had, in some small measure, the opportunity to serve them. I hope my epitaph will read, "He kept faith.""

Planned urban development

"In this country we have the choice either of being swamped by an unplanned process of urban growth, or of planning urban development by deliberate policy so that urbanization becomes an instrument of economic development and social change."

Planning the Indian City

“The cities in India have developed a culture in which the migrant, the urban poor, the casually employed and the economically down-trodden are subjected to human indignity and discomfort on a horrendous scale.”

The Forests of Madhya Pradesh

“The great river systems of India owe an enormous debt to the high-lands of Central India, but more than that, to the forests which clad these hills. Every tree cut in Madhya Pradesh is not so much a loss to the State but a direct blow to the water regime of the States which benefit from the flow of the rivers emanating from here.”

Books by Mahesh N. Buch

1.   Planning the Indian City, 1987

2.   Of Man and His Settlements, 1991

3.   The Forests of Madhya Pradesh, 1991

4.   When the Harvest Moon is Blue, 2008

5.   An India Reimagined, 2019

Note: No. 5 is a collection of 20 essays by M. N. Buch, Edited by N. Ravichandran, and published posthumously.

Heaven’s New Citizen

Link for an article written by this blogger in remembrance of M. N. Buch:

https://www.pkdash.in/2022/10/mahesh-neelkanth-buch.html

10^th Mahesh Buch Memorial Lecture

The 10^th Mahesh Buch Memorial Lecture was held on 5^th  October, 2025 at Bhopal. Prof. Kapil Gupta, IIT, Mumbai spoke on Strategies for Urban Flood Mitigation in Changing Climate. He discussed the challenges and solutions for urban flooding in Mumbai, and other cities in India and the world.

Shri S. N. Mishra, Chairman, State Administrative Unit Reorganisation, MP Chaired the meeting.

About Mahesh Buch

Dr. Mahesh Neelkanth Buch

Born – 5^th October, 1934

Education: -

·       Graduated in 1954 with Economics from St. Stephen’s College, New Delhi.

·       Post Graduate from Cambridge University in 1956

·       Parvin Fellow (during 1967-68) at the Woodrow Wilson School of the Princeton University.

·       Doctorate (Honoris Causa) from the Rajiv Gandhi Technical University in 2002.

Career :

·       Joined the IAS in 1957

·       Took voluntary retirement in 1984

Key Assignments:

·        Commissioner, Tribal Welfare, Housing, Forests and Town country planning, Govt of Madhya Pradesh

·        Vice Chairman - Delhi Development Authority

·        Director General of the National Institute of Urban Affairs

·        Principal Secretary, Forest, Government of Madhya Pradesh

·        Vice-Chairman - National Commission on Urbanization

·        Chairman - Lutyens Bungalow Zone Committee of the Government of India.

·        Chairman - Committee on the Heritage Zone of Mehrauli

·        Chairman - Empowered Committee for the New Vidhan Sabha building in Madhya Pradesh

·        Dean - Centre for Governance and Political Studies

·        Chairman - Atal Bihari Vajpayee Indian Institute of Information Technology and Management, Gwalior

·        Founding Chairman - National Centre for Human Settlements and Environment from 1984 until his death in 2015.

Awards:

• Padma Bhushan - 2011
• Man of Vision Award - the Hindustan Times - 2003
• Aga Khan Award for Architecture- 1998
• UNEP Award – 1995

Authored Books:

S. No.	Title of Book	Publisher	Year of Publication
1.	Planning the Indian City	Vikas Publishing House	1987, 1987 (2nd Impression), 2016 (3rd Impression)
2.	The Forests of Madhya Pradesh	Madhya Pradesh, Madhyam (English)	1991 (1st Edition)
3.	Of Man and His Settlements	Sanchar Publishing House	1991
4.	The Forests of Madhya Pradesh (Translated by Mr. Kalidatt Jha)	Madhya Pradesh, Madhyam (Hindi)	1992 (1st Edition)
5.	Urbanisation in India Basic Services & People’s Participation Authored by: K.C. Sivaramakrishnan, Biplab Dasgupta & M.N. Buch	Concept Publishing Co	1993
6.	When The Harvest Moon is Blue	Har Anand Publication	2008
7.	An India Reimagined – Governance and Administration in the World’s Largest Democracy Edited by N. Ravichandran	Penguin Random House	2019

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