Author's Introduction
Dr. Sandip G. Buddhadev is born at Junagadh in November 1978. He had completed his school at Rajkot. Then he completed B.A.M.S. from Gulabkunvarba Ayurved Mahavidyalaya, Jamnagar (Gujarat Ayurved University) in 2000. He had done M.D. (Ayu) at I.P.G.T. & R.A., Jamnagar in 2005 with the specialty in Dravyaguna Vigyan. He started his career from Parul Institute of Ayurved and then worked at J S Ayurved College Nadiad, Sheth J. P. Government Ayurved College, Bhavnagar. He attended many national and international seminars, workshops, CMEs an summits. He writes many articles in different magazines. He wrote books like "VANASPATI VANDANA" and MIRACULOUS MEDICINAL PLANT SERIES "THE WONDER DRUG TULSI" Presently he is working as reader and head of the department of Dravyaguna at Government Ayurved College, Junagadh-Gujarat.
The Complementary And Alternative Medicine System
Mrs. Sheetal S. Buddhadev is born at Jamnagar in June 1979. She had completed her school at Jamnagar. Then she completed B. Pharm. from B. K. Modi Government Pharmacy College - Rajkot in 2000. She had done M. Pharm in Ayurved with specilization in Quality Control & Standardization in 2002. She had completed her M. Pharm. with specialization in Pharmaceutics from Atmiya Pharmacy College. Rajkot (Gujarat Technology University) in 2012. She started her career from I.A.P.S., Jamnagar (Gujarat Ayurved University) and then worked at H. N. Shukla Institute of Pharmaceutical Science & Research Rajkot, Atmiya Institute of pharmacy for Diploma Studies, Rajkot. She attended many national and international seminars, workshops and summits. She writes many articles in different magazines. Presently she is working at Atmiya Institute of Pharmacy, RajkotGujarat.
ISBN - 978-93-5137-678-1
By: Dr. Sandip G. Buddhadev
Mrs. Sheetal S. Buddhadev
M.D. (Ayurved-Dravyaguna)
M.Pharm. (Pharmaceutics) M.Pharm. (Ayurved-Quality Control & Standardization)
The Complementary And Alternative Medicine System By: Dr. Sandip G. Buddhadev M.D. (Ayurved-Dravyaguna)
& Mrs. Sheetal S. Buddhadev M.Pharm. (Ayurved) M. Pharm. (Pharmaceutics)
The Complementary And Alternative Medicine System (An overview on different medicinal systems) ISBN
: 978-93-5137-678-1
Publisher
: Mrs. Sheetal S. Buddhadev
Author
: Dr. Sandip G. Buddhadev & Mrs. Sheetal S. Buddhadev
Year
: 2014-15
Available At
: 9429234659, 9429344675
Pages
: 100 (10+90)
Price
: INR 250
Subject
: Ayurved
Language
: English
Edition
: 1st edition
सर्वे सन्तु निरामया...
On this perception there are lots of medicinal systems are going on. In this book authors try to enlighten some basic concepts of different medicinal systems, which are called complementary and alternative medicine system. There is enormous difference between complementary and alternative medicine system. The prime aim of both systems is to make healthy people. Without understanding the basic concepts of these systems there may be a chance for misbelief. Here authors tried hard to explain these concepts. Of course, it will be helpful to medical people as well as to common public. I think that the authors can be confident that there will be many grateful readers who will have gained a broader perspective of the different disciplines as a result of their efforts. I would like to congratulate the authors from my heart for their commitment and also give my blessings to the authors for their great effort.
Prof. Dr. K. M. Chudasama Principal & H.O. D. Kayachikitsa, Sheth J. P. Govt. Ayurved College, Bhavnagar Gujarat.
FOREWORD Complementary medical treatments are now increasingly popular and the public demand for information and treatment is growing rapidly. It is therefore essential that healthcare professionals should have good knowledge of the main aspects of complementary therapies as they are meeting more and more patients who want advice and treatment with alternative therapies. In this book all main areas of AYUSH are explained in detail and the book is very informative for all level of students, faculties or medical fraternity. It contains information in well laid-out sections that would interest the healthcare professionals and at the same time, provide the general public valuable insights into the traditional system of medicines. This book provides wealthy information on the Complementary and Alternative Medicinal Systems. Chapters on other complementary therapies such as Aromatherapy, Yoga therapy, Naturopathy etc. are included which gives knowledge-based advice to the medical fraternity. I commend the authors for this labour of love and have no doubt that this book will be much sought after by both the healthcare professionals and the lay public.
Dr. Punit R. Rachh Head- R & D Mehta Group of companies
Introduction “The World Health Organization at its 1978 international conference held in the Soviet Union produced the Alma-Ata Health Declaration, which was designed to serve governments as a basis for planning health care that would reach people at all levels of society. The declaration reaffirmed that “health, which is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.” In its widest form the practice of medicine, that is to say the promotion and care of health, is concerned with this ideal.” In the past decade we have seen an increased awareness of complementary and alternative medicine (CAM) in both public and governmental sectors. What today is called alternative medicine covers a wide range of disciplines, most of which are guided by the “healing model” of holistic medicine, which emphasizes the complex interplay between multiple factors: biochemical, environmental, psychological, and spiritual, as opposed to the biomedical model which reduces disease to a disturbance in biochemical process and relies heavily on the “curative model” of care. Healthcare providers today are faced with challenging issues of health-promotion, disease prevention and management of chronic illnesses for which conventional medicine has offered only limited success. An increasingly knowledgeable patient population is now fueling the CAM movement by seeking alternatives to traditional treatments. The use of CAM modalities by Americans between 1990 and 1997 increased from 34% to 42% of the general population. In addition, the total number of visits to CAM providers increasedfrom 427 million to 629 million within this same time period. This number exceeds the total visits to all primary care physicians combined (386 million) in 1997.
Just a decade ago, alternative therapies were readily dismissed by physicians as fringe medicine, however today CAM is now beginning to earn attention and academic stature. The growing number of CAM clinics affiliated with hospitals, the expansion of CAM courses within academic medical education, and the increase in CAM benefits offered by insurers offer clear evidence of this trend. The costs of CAM approaches and their potential risks and benefits provide a public health rationale for subjecting them to critical appraisal. In pursuit of this vision, the US Congress authorized in 1998 the establishment of a new component of the National Institutes of Health—the National Center for Complementary and Alternative Medicine (“NCCAM”)—with a mandate to conduct CAM research, train CAM investigators, and disseminate authoritative information to practitioners and the public. That same year, the Journal of the American Medical Assoc. (JAMA) published a series of scientific studies in a special issue dedicated to alternative medicine. This was the first such effort by a mainstream US medical journal and was an attempt to meet doctors' needs for high-quality scientific information on treatments that more and more patients are trying. This book provides wealthy information on the Complementary and Alternative Medicinal Systems. Chapters on other complementary therapies such as Aromatherapy, Yoga therapy, Naturopathy etc. are included which gives knowledge-based advice to the medical fraternity.There is enormous difference between complementary and alternative medicine system. The prime aim of both systems is to make healthy people. Without understanding the basic concepts of these systems there may be a chance for misbelief. Here we tried hard to explain these concepts.
Dr. Sandip G. Buddhadev & Mrs. Sheetal S. Buddhadev
Catalogue Ch. No. 01
Theme
Page No.
Development of aware use of Plants in Different Complementary and Alternative Medicinal Systems
01
02
Development of Systems of Medicine
07
03
Allopathy
11
04
Alternative and Complementary Systems
14
05
Ayurved System of Medicine
21
06
Yoga System
32
07
Naturopathy
47
08
Chinese System of Medicine
49
09
The Siddha System of Medicine
53
10
Homoeopathy System of Medicine
58
11
Aromatherapy
72
12
Unani System of Medicine
74
13
Tibetan System of Medicine
81
14
References
85
The Complementary And Alternative Medicine System
1
1 Development of aware use of Plants in Different Complementary and Alternative Medicinal Systems As the human develops, he tried to use plants in as many ways as possible. As a result of this man used plant for food, shelter, health and in diseases. All through the human history, there has been a conspicuous concern for health care and the cure of the disease, though the concepts themselves took a very long time to develop into a body of knowledge. In the dawn of human Cultural Revolution, the art of curing was essentially magical. Few plants, that were usually psychoactive, known as magic or psychedelic plants, were used. Later, empirical medicine arose, using many plants for the treatment of various afflictions. This tendency culminated, in the Old World, in the famous work Materia Medica by Dioscorides, published in the first century CE, in which the characters and properties of numerous drugs are described, the majority of which are from the plant kingdom. Some of the oldest pre-literate archaeological records in both the old and new worlds concern the medicinal use of plants. A record of several plant species found in Iraq, dated to the pre-Christian Era, contained some of horticultural interest, but most others certainly were used in local medicine. The ancient possessed an extensive vegetal pharmacopoeia. The Egyptian Pharaohs sent scouts far and wide in search of medicinal plants. Alexander the Great, a student of Theophrastus (the Father of botany), sent back from his campaigns in Asia, medicinal plants for cultivation. Starting long before even Aristotle, till almost the early part of the 19th century, botanical studies were conducted mostly on medicinally useful plants, by the European physicians, and this fund The Complementary And Alternative Medicine System
1
The Complementary And Alternative Medicine System
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of information is the body and soul of plant taxonomy, that culminated in the Species Plantarum by Linnaeus (1753). India had an extensive Pharmacopoeia thousands of years ago. The rich heritage of herbal medical culture of China is still very much alive, with some of the written records dating from the beginning of the Christian era. The traditional plant therapeutic knowledge of Africa and South America, along with that of China and India, has given several new drugs to modern medicine. Every human community was conscious of the burden of disease and developed its own „medical system‟ which may be defined as "the pattern of social institutions and cultural traditions that evolves from a deliberate behavior to enhance health" (Dunn, 1976). Europe, particularly Greece, was largely responsible for the origin and development of a well-documented major trend in medicine. However, the traditional practices have mostly died out there, under the onslaught of modern medicine, now called Allopathy. The rest of the world has a different story. The term Allopathy was first used by Hahnemann, the founder of Homoeopathy, to differentiate between his system and the „other system of medicine‟ in use at that time in Europe. In contrast to Allopathy, most countries in the world have developed what is called the „Traditional medicine‟. The World Health Organization (WHO), created in 1948, is a specialized agency of the United Nations, with the primary responsibility for international health matters and public health. The WHO defined traditional medicine, in 1976, at a meeting at Brazzaville, as "...the sum total of all knowledge and practices, whether explicable or not, used in diagnosis, prevention and elimination of physical, mental or social imbalance and relying exclusively on practical experience and observations handed down from generation to generation, verbally or in writing." On the one hand, some systems of medicine, like the Chinese medicine, Ayurved, Siddha, Tibetan medicine, Unani and the humoural pathology of Latin America and the Philippines, etc., have been well recorded and developed extensive literature over a couple The Complementary And Alternative Medicine System
2
The Complementary And Alternative Medicine System
3
of millennia (Goldwater, 1983). On the other hand, there are other systems of medicine, of people who until recently have lacked literature but are effective in handling the health problems of the respective communities. These unwritten medical cultures constitute „ethno medicineâ€&#x;. This new discipline is defined as "those beliefs and practices relating to disease which are products of indigenous cultural development and are not explicitly derived from the conceptual frame work of modern medicine" (Hughes, 1968). By this definition, only the unwritten indigenous knowledge of the tribalâ€&#x;s and such other small communities, that are not too seriously affected by the onslaught of modern civilization, and which knowledge has been passed by the word of mouth, from generation to generation, qualifies to be called as ethno medicine. Since all systems have had such ethnic origins, some scientists argue that the definition of ethno medicine should be expanded to include even the contemporary allopathic medicine, as well. Such a definition is all inclusive and makes the definition itself useless. By the definition of Hughes (1968), no system of medicine that has written sources, such as Ayurved, Unani, Chinese medicine, etc., can be considered as ethno medicine. Although there appears to be a vast variety of data on almost every system of ethno medicine, seemingly impossible to find them in any order, there are several similarities among them. These similarities are due to a) the limited number of causes to which illnesses can be attributed to; because of which there are only so many ways a doctor can treat them, and b) historical contacts and interaction between people of different cultures (Foster, 1983). In spite of fundamental divergences in philosophy, the congruences in the Greek medicine and Unani, in Ayurved and Unani, in the Chinese medicine andAyurved, Ayurved and Tibetan medicine, etc., reflect such cultural exchange. A very considerable lot of ethno medicine is based on the following causes of illness: a) Angry deities who punish the wrongdoers, b) Ancestors and other ghosts feeling belittled, The Complementary And Alternative Medicine System
3
The Complementary And Alternative Medicine System
4
c) Sorcerers and witches hired by revenge seekers, d) Loss of soul, e) Possession by a spirit or intrusion of objects into the body, f) Evil eye, and g) Loss of basic body equilibrium. The cures for illnesses due to the upset of the body humours and the consequent loss of bodily equilibrium are called „natural‟ and the cures for illnesses due to the other causes as „magical‟ or „supernatural‟. Foster (1983) suggested the terms „personalistic‟ in place of magical or supernatural and „naturalistic‟ in place of natural cures. The concepts of „dosha‟ of Ayurved and „yin‟ and „yang‟ of the Chinese system fall under the naturalistic category while the traditional systems of Africa, Oceania, South America, preconquest North America, etc., fall under the personalistic category. Personalistic cures are still in practice almost in every country of the developing world, and these constitute the „folk medicine‟. One of the aims of WHO is „health for all by 2000‟ that will permit the citizens of the world to lead a socially and economically productive life. The WHO has recognized indigenous traditional systems of medicine as important to the greater part of the communities in most parts of the world and organized Regional Offices to monitor its activities as below: a) The African Region b) The Region of the Americas, c) The South-East Asia Region, d) The European Region, e) The Eastern Mediterranean Region, and f) The Western Pacific Region. Among the systems of non-ethno medicine being in use in different parts of the world today, Allopathy stands apart from the rest, in philosophy and methods. All the other systems are together called the „Alternative Medicine‟. Some of the practitioners of Alternative Medicine are irritated at this terminology and on the basis The Complementary And Alternative Medicine System
4
The Complementary And Alternative Medicine System
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of antiquity and the immensely large percentage of the world‟s population their systems serve, consider Allopathy as the Alternative Medicine. Like the term „developing world‟ which irritates many but has come to stay as a means of convenient reference, the terms Allopathy and Alternative Medicine should be seen merely as an easy means of communication. Allopathy, Homoeopathy, and many systems of Alternative Medicine, employ plant based drugs, to varying degrees. It is important to understand the philosophy, methods and the drug armamentarium of these systems in order to be able to evaluate the potential of plants as medicine. For this reason, the different plant based medical systems are introduced here. British Pharmacopoeia that of the Royal College of Physicians was published in 1618, the nineteenth century was the century of pharmacopoeias. Several countries published their own pharmacopoeias, incorporating drugs, the therapeutic effects of which were already „proven‟, at least according to the procedures and techniques of the period. Until 1930, around 90 per cent of the official medicines were of plant origin. Chemistry achieved very significant progress during the nineteenth century, and by the beginning of the twentieth century, the first artificial pharmaceuticals were obtained by synthesis, among these are phenacetin, urea, barbital, and acetylsalicylic acid (aspirin). The fruitful period of chemotherapy began in the 1930s, with the synthesis of the sulphonamides. The era of antibiotics began in the following decade, and when the Second World War ended, conditions became more favorable for the development of synthetic chemistry, to the point that in a few decades therapy was radically transformed. Since the 1960s, over 75 per cent of all standard medicines are of synthetic origin or the product of fermentation, lowering medicines of plant origin to a secondary role. In the biomedical system that pre dominates the developed world; there is an over-riding emphasis on research for synthetic therapeutic compounds, though a certain amount of interest in medicinal plants always persisted. As previously analyzed by many The Complementary And Alternative Medicine System
5
The Complementary And Alternative Medicine System
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authors , there are many powerful reasons for conducting broad ethno botanical, ethno pharmacological, and even clinical therapeutic research, on medicinal plants, as discussed separately.
Some important Announcement/Resolutions related to Complementary and Alternative Medicine: THE WORLD HEALTH ORGANISATION In 1977, the 30th world assembly of the World Health Organization (WHO), an organ of the United Nations, formed to deal with matters of health, adopted a far reaching resolution urging the governments of the member countries, to give „adequate importance to the utilization of their traditional systems of medicine, with appropriate regulations to suit their national health needs‟. Traditional medicine is defined as „the therapeutic practices that have been in existence, often for hundreds of years, before the development and spread of modern medicine and are still in use today‟ (WHO, 1991). Immediately following the 1977 resolution of the WHO, a worldwide promotional effort of traditional medicine was launched, creating a greater awareness and interest in traditional medicine, though in some countries the efforts came much later, for political and other reasons. For example, South Africa could not act till very recently, when her Parliament approved the formation of Statutory Council to regulate 350,000 traditional healers, who serve about 80 per cent of the population. THE ALMA-ATA DECLARATION At the meeting at Alma-Ata, in the former USSR, in 1962, the first step towards the recognition of indigenous and traditional medical practices was taken. This resulted in the establishment of MedicinaAlternativa Institute at Colombo, which is affiliated to the Open International University for Complementary Medicines, with branches and affiliate bodies in 120 countries.
The Complementary And Alternative Medicine System
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2 Development of Systems of Medicine Most of our debilities, illnesses and diseases have come to us from our bloods as a part of our evolutionary package. We also made our own contribution to this burden of ill-health. Ill-health threatens the sufferers, their relatives and friends and in effect the whole community. There are high financial, social and psychological costs imposed by disease and death. Consequently, it has been the concern of the society all along and the responsibility of Governments, to provide means of maintaining health and curing disease. Every human community was conscious of the burden of disease and developed its own „medical system‟ which may be defined as "the pattern of social institutions and cultural traditions that evolves from a deliberate behavior to enhance health". Europe, particularly Greece, was largely responsible for the origin and development of a well-documented major trend in medicine. However, the traditional practices have mostly died out there, under the offensive of modern medicine, now called Allopathy. The rest of the world has a different story. The term Allopathy was first used by Hahnemann, the founder of Homoeopathy, to differentiate between his system and the „other system of medicine‟ in use at that time in Europe. In contrast to Allopathy, most countries in the world have developed what is called the „Traditional medicine‟. The World Health Organization (WHO), created in 1948, is a specialized agency of the United Nations, with the primary responsibility for international health matters and public health. The WHO defined traditional medicine, in 1976, at a meeting at Brazzaville, as "...the sum total of all knowledge and practices, whether explicable or not, used in diagnosis, prevention and elimination of physical, mental or social imbalance and relying The Complementary And Alternative Medicine System
7
The Complementary And Alternative Medicine System
8
exclusively on practical experience and observations handed down from generation to generation, verbally or in writing." On the one hand, some systems of medicine, like the Chinese medicine, Ayurved, Siddha, Tibetan medicine, Unani and the humoural pathology of Latin America and the Philippines, etc., have been well recorded and developed extensive literature over a couple of millennia. On the other hand, there are other systems of medicine, of people who until recently have lacked literature but are effective in handling the health problems of the respective communities. These unwritten medical cultures constitute „ethno medicineâ€&#x;. This new discipline is defined as "those beliefs and practices relating to disease which are products of indigenous cultural development and are not explicitly derived from the conceptual frame work of modern medicine". By this definition, only the unwritten indigenous knowledge of the tribal and such other small communities, that are not too seriously affected by the offensive of modern development, and which knowledge has been passed by the word of mouth, from generation to generation, qualifies to be called as ethno medicine. Since all systems have had such ethnic origins, some scientists argue that the definition of ethno medicine should be expanded to include even the contemporary allopathic medicine, as well. Such a definition is all inclusive and makes the definition itself useless. By the definition of Hughes (1968), no system of medicine that has written sources, such as Ayurved, Unani, Chinese medicine, etc., can be considered as ethno medicine. Although there appears to be a vast variety of data on almost every system of ethno medicine, seemingly impossible to find them in any order, there are several similarities among them. These similarities are due to a) the limited number of causes to which illnesses can be attributed to; because of which there are only so many ways a doctor can treat them, and b) Historical contacts and interaction between people of different cultures. In spite of fundamental divergences in philosophy, the congruences in the Greek medicine and Unani, in Ayurved and Unani, The Complementary And Alternative Medicine System
8
The Complementary And Alternative Medicine System
9
in the Chinese medicine andAyurved, and Tibetan medicine, etc., reflect such cultural exchange. A very considerable lot of ethno medicine is based on the following causes of illness: a) Irritated deities who punish the wrongdoers, b) Ancestors and other ghosts feeling belittled, c) Sorcerers and witches hired by revenge seekers, d) Loss of soul, e) Possession by a spirit or intrusion of objects into the body, f) Evil eye, and g) Loss of basic body equilibrium. The cures for illnesses due to the upset of the body humours and the consequent loss of bodily equilibrium are called „natural‟ and the cures for illnesses due to the other causes as „magical‟ or „supernatural‟. Foster (1983) suggested the terms „personalistic‟ in place of magical or supernatural and „naturalistic‟ in place of natural cures. The concepts of „dosha‟ of Ayurved and „yin‟ and „yang‟ of the Chinese system fall under the naturalistic category while the traditional systems of Africa, Oceania, South America, preconquest North America, etc., fall under the personalistic category (Foster and Anderson, 1978). Personalistic cures are still in practice almost in every country of the developing world, and these constitute the „folk medicine‟. One of the aims of WHO is „health for all by 2000‟ that will permit the citizens of the world to lead a socially and economically productive life. The WHO has recognized indigenous traditional systems of medicine as important to the greater part of the communities in most parts of the world and organized Regional Offices to monitor its activities as below: a) The African Region The Complementary And Alternative Medicine System
9
The Complementary And Alternative Medicine System
10
b) The Region of the Americas, c) The South-East Asia Region, d) The European Region, e) The Eastern Mediterranean Region, and f) The Western Pacific Region. Among the systems of non-ethno medicine being in use in different parts of the world today, Allopathy stands apart from the rest, in philosophy and methods. All the other systems are together called the „Alternative Medicine‟. Some of the practitioners of Alternative Medicine are irritated at this terminology and on the basis of antiquity and the immensely large percentage of the world‟s population their systems serve, consider Allopathy as the Alternative Medicine. Like the term „developing world‟ which irritates many but has come to stay as a means of convenient reference, the terms Allopathy and Alternative Medicine should be seen merely as an easy means of communication. Allopathy, Homoeopathy, and many systems of Alternative Medicine, employ plant based drugs, to varying degrees. It is important to understand the philosophy, methods and the drug armamentarium of these systems in order to be able to evaluate the potential of plants as medicine. For this reason, the different plant based medical systems are introduced here.
The Complementary And Alternative Medicine System
10
The Complementary And Alternative Medicine System
11
3 Allopathy Allopathy (or allopathic system of medicine) is defined as that discipline advocating therapy with remedies that produce effects differing from those of the disease treated, and is based on the principle contrariacontraiiscurentur. In contrast, Homoeopathy is based on the principle that the remedies produce the same symptoms as the disease, similiasimilibuscurentur. Allopathy is also called „modern‟, „western‟, or „scientific‟ medicine. The term „biomedicine‟, defined as the „application of the principles of natural science, especially biology and physiology to clinical medicine‟, is also in use. „Clinical medicine‟ is the medical practice involving and based on direct observation of patients or healthy volunteers who were given the drug that is being tested, to evaluate the drug‟s curative potential, side effects, dosage levels, contra-indications, etc., before recommending it for use. This concept is opposed to the earlier norms of medical practice based on theoretical study or laboratory investigation or class room teaching. Allopathy is now both biomedicine and clinical medicine. Nevertheless, a number of other systems like Homoeopathy and Ayurved have also introduced the clinical element into their drug evaluation procedures. A point of significance is that all major systems of medicine in Europe, China and India, are based on one or the other form of the humoural theory, similar to that of Hippocrates and Galen. But all these systems are a world apart from Allopathy today. The primary time point of separation of Allopathy from the other systems of medicine is unclear but is rather more a recent phenomenon, about a century and half old. Descriptions of several disease conditions like diabetes in the earliest works on Allopathy are also found in the Vedic hymns of the predecessors of Ayurved. Similar are some of the ancient Chinese practices like using burnt sponges (as source of iodine). The Complementary And Alternative Medicine System
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The development of Allopathy was mainly due to the contributions of Aretaeus of Cappadocia, Hippocrates of Greece and IbnSina of Persia. These were followed by a host of European practitioners and observers, aided by the establishment of great Universities at Padua in Italy and Paris in France, and later at Cambridge and Oxford in England. Developments of the past 50 years or so in anatomy, biochemistry, physiology, pharmacology, physics, biology, electronics, engineering, etc., have made Allopathy radically different not only from the other systems of medicine but also from its own earlier versions. Vast changes have occurred in the philosophy, methods of diagnosis, drug development, treatment and prognosis. Concomitant with the progress in medicine are far reaching successful developments in surgery, which also has an important place in Ayurved. Although almost every country has its own pharmacopoeia, there are no generally used standard international pharmacopoeia and Materia Medicaefor Allopathy. The information on the numerous specialties and aspects of Allopathy is unmanageably voluminous. By and large, to the general practitioner as well as the specialist, other than those engaged in research, the drug manufacturers provide the functional clinical literature. Research oriented doctors obtain their information from journals, treatises, etc. Professional organizations and conferences also provide a fillip. In the current times, understanding the patient, the disease and the multifarious effects of the medicine, before administering it, the cardinal principle of all systems of medicine, is easier pronounced than practiced. Allopathy is firmly rooted in the products of synthetic chemistry, as its drug arsenal. Nevertheless, in the rich world, 25 per cent of all medical drugs are still plant based and in the poorer world this is closer to 75 per cent. Allopathy will continue to depend on plants for its drugs and this dependence is more likely to increase rather than decrease. Other reasons for the interminable relationship of Allopathy with plant based drugs are discussed in different contexts in this volume. For these reasons, Allopathy continues to be an area of interest to those who work on medicinal plants.
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Allopathy, with very impressive advancements in its numerous areas of specialization, has performed wonders and achieved a phenomenal popularity throughout the world, much to the detriment of the indigenous/traditional systems of medicine. However, it has become increasingly inaccessible to the majority of the world population due to its dependence on expensive instrumentation and very high costs of drugs and services. It has also accumulated a long list of inadequacies and failures. These factors are responsible for leaving a lot of ground for the other systems of medicine to be of considerable importance.
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4 Alternative And Complementary Medical Systems The words „Alternative Medicine‟ and „Complementary Medicine‟ are often used interchangeably. However, some make a distinction; for example the international journal, „The Journal of Alternative and Complementary Medicine‟, from the U.S. Alternative medical systems are those that offer independent therapies for the full range of all the diseases, as Allopathy does. Hence, Ayurved, Chinese medicine, Homoeopathy, etc., come to be called systems of Alternative Medicine. Systems that are only supportive of other systems, such as Naturopathy, Aromatherapy, Hydrotherapy, etc., are regarded as Complementary Medicine. There arises a problem when a particular system of medicine falls in between. Acupuncture is considered by some as a totally potent system, while others regard it as only supportive. Herbal medicine, not in the sense of well-established systems like Ayurved or Chinese medicine, but in that of the unwritten traditional medical practices in South America and Africa, was cited as Alternative or Complementary, by different persons. Whatever the term used, Alternative or Complementary, does not matter, as the rallying point of distinction is Allopathy vs. other systems of medicine. At the last count, at the 36th World Congress of Alternative and Complementary Medicines, in November 1997, at Colombo, it was observed that there are over 125 systems of Alternative Medicine. Listing all of them is not an easy task as some single plant remedies are also projected as systems of therapy, as for example, Camomile, Ginseng, Honey, Cucumber, Eucalyptus, Garlic, Peppermint, RoseThe Complementary And Alternative Medicine System
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The Complementary And Alternative Medicine System
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water, therapies. If this practice cintinues, the list of Alternative medicines would forever be interminable. The range and depth of the Alternative therapies is both illuminating and interesting. The plurality and the overlapping nature of these therapies make it a very difficult task to classify them made an attempt to put the house in order, but was not very successful, for the following reasons: a) several of the mutually unrelated Alternative therapies have been grouped together as „other therapiesâ€&#x;, b) Acupuncture was given an independent, but an ambiguous, status, and c) well established therapies like Yoga, Aerobics, Universal energy, Bioenergy, etc., do not find an appropriate place. There are institutions that impart training in the systems of Alternative Medicine in the countries of their origin. Several systems of Alternative Medicine enjoy varying degrees of popularity in the other parts of the world too. For example, several Medical Schools in the U.S. offer courses in Alternative Medicine, as also in Europe. Societies/Associations have been formed for different systems, many of which have their own journals and other means of communication. The literature on Alternative Medicine is very extensive, though there is little on some of the systems. Several journals, more particularly The Journal of Alternative and Complementary Medicine, serve the cause of this area of medicine. Some of the Alternative therapies may go into disuse with time and many more may be proposed, but Alternative therapies, in general, will continue to occupy a very important place in our health care efforts. ALTERNATIVE AND COMPLEMENTARY SYSTEMS OF MEDICINE 1. Manual therapies a) Osteopathy and Chiropractice: bone setting b) Applied Kinesiology: motion or movement of external or internal organs by external manipulation The Complementary And Alternative Medicine System
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c) Reflexology: zone therapy to treat the whole body through contact with feet d) Shiatzu: Chinese massage similar to acupressure e) Rolfing: correcting postural problems by structural integration f) Massage g) Rosen method: psychotherapy plus massage 2. Special implement based therapies a) Acupuncture: insertion of special needles at specific points in the body b) Electro-acupuncture: acupuncture with small direct current c) Laser acupuncture: acupuncture points stimulated by a weak laser beam d) Homoeopuncture: dipping acupuncture needles in homoeopathic medicine before acupuncture e) Moxibustion: application of moxa (Artemisia moxa) smoke and heat to acupuncture points f) Acupressure: fingertip or thumb pressure on acupuncture points g) Cupping: vacuum treatment on acupuncture points using a suction cup
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3. Postural therapies a) Yoga b) Alexander technique: correction of bad body postures c) Feldenkrais technique: Alexander technique plus yoga 4. Psychosomatic therapies a) Hypnotherapy b) Autogenic therapy: deep relaxation exercises c) Meditation d) Biofeedback: sensory control of involuntary body responses like blood pressure 5. Oral therapies a) Homoeopathy b) Herbal medicine: South American, African, etc., other than the well-established and recorded systems c) Ayurved d) Siddha e) Tibetan medicine f) Unani g) Chinese medicine h) Bachâ€&#x;s flower remedies i) Naturopathy j) Nutrition therapy k) Specific therapies: Aloe vera, vitamin E, garlic, folic acid, The Complementary And Alternative Medicine System
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green-lippedmussel, fasting, etc. 6. Energy therapies a) Radionics: healing by energy distance: also called „pranic healing‟
directed
from
a
b) Universal energy (Radiance technique, Reiki): exchange of universal energy between the patient and the therapist to reintroduce universal energy into the patient who lost it c) Polarity: balance of energy flow between different organs in the body 7. Diagnostic aids a) Iridology: study of iris b) Kirlian photography: photographic record of energy flow about and around the body 8. Sensory therapies a) Aromatherapy b) Sound therapy c) Colour therapy d) Dance therapy e) Primal scream therapy 9. Other therapies a) Anthroposophical medicine: inner feelings b) Bates‟ method of eye testing: exercises of the eye muscles c) Schuessler‟s Biochemic tissue salts: an adjunct of Homoeopathy, using salts extracted from plants
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d) Bowen technique: gentle and subtle massage e) Colonic irrigation: enema and purgation f) Conductive education: improvement of motor skills g) Crystal and gem therapy h) Enzyme potentiated desensitization: immunotherapy for allergies i) Eurhythmy: music and gentle dance j) Facial diagnosis k) Flotation therapy: lying in a tank of saline l) Healing: faith and spiritual healing m) Hydrotherapy n) Integration therapy: adult adjustment to oneâ€&#x;s own neo-natal reflexes o) Iscador therapy: use of mistletoe extract p) Jin shin jyutsu: Japanese method of touch and gentle massage q) Magneto therapy r) Manual lymphatic drainage: massage of lymph nodes and glands s) Neurolinguistic programming: programming neurological processes by communication t) Pilates method: exercises to strengthen the abdominal and related muscles u) Probiotics: use of friendly bacteria like Lactobacillus The Complementary And Alternative Medicine System
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v) T’ai chi ch’uan: a Chinese exercise w) Tea tree oil: oil of Melaleucaalternifolia, Myrtaceae, antibacterial, antifungal x) Zero balancing: osteopathy plus energy flow y) Zinc therapy
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5 Ayurved System of Medicine Ayurved, translated „the science of lifeâ€&#x;, is an Indian system of medicine, based on solid foundations that are fully sustained by long experimentation and philosophical propositions, dating back to about 1,000 BCE. In India Ayurved, Siddha and Unani systems are the formal and most organized amongst the traditional systems of medicine. The Tibetan system of medicine is considered as an offshoot of Ayurved. Ayurved encompasses all aspects of life and disease, such as anatomy, physiology, pathology, symptomatology and medical prescription to cure a disease. That this system of medicine, developed millennia ago, is still prevalent, in spite of great odds, is amazing. The Chinese system of medicine also is ancient and still prevalent, but it did not face such rough weather as Ayurved did. Knowledge of Ayurved medicine has unfortunately been confined to India and the west is largely ignorant of it. Even in India, this traditional medical practice has lost a lot of its importance in the urban situations. One of the main reasons for this is that much of the early and core medical literature onAyurved is in Sanskrit, the ancient language which ceased to be a day-to-day language in this century, except in extremely small groups of the vast Indian population. Even today a considerable bulk of Ayurvedic knowledge is in the form of ancient palm leaf manuscripts hidden in remote libraries and private collections, and as treasured personal knowledge of a few individuals. The net result is that Ayurved has been away from lime light and does not enjoy the importance and popularity it deserves. A sporadic chestbeating by a few Indians, on its antiquity, greatness and importance, has not done much to the cause of Ayurved. Ayurved is an eminently rational system of medicine and conceptually differing from the folk or home medicine, which is largely a matter of localized community experience and The Complementary And Alternative Medicine System
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individualized medical practice, and from bhoothavaidya which is heavily loaded with occult practices. The Ayurvedic system grew vigorously till about 1300 CE, and the beginning of that century, however, marked the end of a glorious era of growth and standardization. In the medieval times, by a curious combination of circumstances, the rasayana practices reappeared, and the drugs and remedies evolved in this system got incorporated into Ayurved. Ayurved had a glorious past even during the Buddhist times. It was taught in Universities of Nalanda and Taxsila. Subsequent cultural revolutions, spiritual renaissance and various political interventions have caused its decline. Jainism and preaching of total nonviolence have also affected practices ofCharakaSamhitha, as many animal products were used as medicine. Surgery was totally banned in the cause of nonviolence. Human cadaver dissections were forbidden. Muslim rulers invaded India resulting in a serious cultural change. Moghal concepts of medicine were encouraged and Ayurved faced a tough time. Further on, the European establishment and import of their medicine followed by the domination of Allopathy have caused an immense damage to the practice of Ayurved. Even after India achieved independence, the situation did not improve immediately. The Indian systems of medicine received governmental recognition only after the National Health Policy was adopted in 1983. The status of Ayurvedic education has improved slowly, though even now not to the extent desirable. A Central Council of Indian Medicine now supervises this area. The issue is now focused better after the setting up of the Department of Indian Systems of Medicine and Homoeopathy, in 1995, in the Ministry of Health and Family Welfare. The State Governments have similar departments. There are many colleges that teach Ayurved at the degree and postgraduate level. However, there is a great and urgent need to establish several centers of higher learning and research on Ayurved in the country, as there are only very few such institutions, such as the Gujarat Ayurved University, Jamnagar, the The Complementary And Alternative Medicine System
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Faculty of Ayurved of the Banaras Hindu University, and the National Institute of Ayurved, Jaipur. THE DIMENSIONS OF AYURVED Ayurved aims at all men being healthy fit in body and keen in mind. Curing of diseased condition and the maintenance of health have not been the only aims of Ayurved. It is concerned with harmonising secular conduct and spiritual pursuit through a realization of the true relationships between and among the complex of body, mind and soul and the eternal Universe. The ultimate end is not merely mundane happiness but spiritual elevation. To achieve its objectives, Ayurved developed into a comprehensive encyclopedia of knowledge in medical subjects like genetics, gynecology, obstetrics, etiology, diagnosis, therapeutics, surgery, physiology, biology, dietetics, ethics, personal hygiene, preventive treatment and social medicine. The allied subjects like animal biology, botany, herbal cultivation, Pharmacognocy, compounding and chemistry and also some subjects that are not usually considered as medical, like cosmology, climatology, psychology, parapsychology, philosophy and religion, have an important consideration in the Ayurvedic system. Mastery ofAyurved presupposes knowledge in all these subjects. The Ayurvedic texts (samhithas) are distinguished by careful and penetrating observations, exhaustive and classified information, and an able presentation of the available knowledge in medicine and allied subjects that contribute to medicine. There is a rigorous standard for the training of physicians and a meticulous code of personal ethics and social conduct for the medical profession. With deep insight, farsightedness and depth, Ayurvedic medical code stands a favorable comparison with the Hippocratic code. THE SAMHITHAS, BRUHATRAYEE The treatises called Samhithas prepared by Charaka, Sushrutha and Ashtangahridaya, are the major source texts of Ayurved. The Complementary And Alternative Medicine System
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CharakaSamhitha deals mainly with anatomy, physiology, etiology, and prognosis, and pathology, influence of environmental factors, medicines, appliances, procedure and sequence of medication. These topics were discussed in 120 chapters, under the following eight sections: a) Suthrasthana,
b) Nidana sthana,
c) Vimanasthana,
d) Shareerasthana,
e) Indriyasthana,
f) Chikitsasthana,
g) Kalpasthana and
h) Siddhi sthana.
SushrutaSamhitha follows more or less the same pattern, but gives surgery, the place of honour. In fact, the Dhanvanthari school of medicine, to which Sushruta belongs, believed surgery to be the most ancient and most efficacious of the eight branches of medical knowledge. Sushruta samhithas contains six sections. It deals with fundamental postulates, pathology, embryology, anatomy, therapeutic and surgical treatment, and toxicology in five sections (Sutra, Nidana, Shareera, Chikitsa, and Kalpasthanas). The final section is on subsequently gained and specialized knowledge of topics dealt with in earlier works known as Uttartantra. These are arranged in 185 chapters. SushrutaSamhitha is very concise in language and is a repository of extensive factual information. It describes the necessity and modus operandi of dissections on human cadavers for gaining accurate anatomical knowledge. The elaborations of a large variety of medical prescriptions and their compounding, therapeutic methods including psychiatric and surgical procedures employing specific instruments for each type of operation are scientific, sound and exhaustive. Sushruta described more than 300 different operations employing 42 different surgical processes and 121 different types of instruments. Symptoms described in the Samhithas deal with pathological conditions and diseases, including diabetes mellitus, pulmonary tuberculosis, malignant growths, leprosy, gangrene, erysipelas, jaundice, diphtheria, tetanus, calculi, paralysis, insanity, epilepsy, epidemic diseases, bites of poisonous snakes and animals and The Complementary And Alternative Medicine System
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hydrophobia. Rational and apparently efficacious surgery is described for many conditions including complicated fractures and dislocation, piles, fistulae and sinuses, tumours, carbuncles, malignant growths, cataract, complicated ophthalmic operations, strangulated hernia, urinary stones causing uremia, impacted gall stones, intestinal perforations and protrusions of the viscera, accidental injuries, amputations of the major limbs, tonsillitis, bone abscess and abscess of internal organs, serious head injuries with exudation of brain matter, and major obstetric operations including removal of the foetus. Interestingly even plastic surgery involving grafting of skin and muscular tissues from surrounding areas and/or other parts of the body was also discussed to help people whose noses and ears were removed for penal reasons, an apparently common practice of that period. ASTANG AYURVED There are eight specialized branches of Ayurved, called the chikitsas (the treatments), as follows: a) Kaaya chikitsa,
b) Baala chikitsa,
c) Graha chikitsa,
d) Shalakya or urdhwanga chikitsa,
e) Shalya chikitsa
f) Visha chikitsa
g) Jara chikitsa
h) Vaajikara Chikitsa
THE BASIC CONCEPTS OF AYURED a) The panchamahabhoothas, b) Thridosha, the humoral theory of ayurved, c) The saptadhathus THE AYURVEDIC PHARMACOPOEIA There are over 70 books that provide about 8,000 recipes of Ayurvedic medicines. The medicines are in the form of a) Arka (distillates), The Complementary And Alternative Medicine System
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b) Aasava andArista(fermented products), c) Avaleha (linctus), d) Bhasma(incinerated matter), e) Choorna (powder), f) Ghritha (in ghee), g) Tailas (in oil), h) Vati and gutika (tablets and pills) and i) Kwatha and kashaya (decoctions). In recent times, Ayurvedic medicines are also being dispensed as capsules or even injections, which naturally attracted a considerable criticism. THE AYURVEDIC MATERIA MEDICA Dravya is a substance, Rasa the taste and guna is its attribute or property. Virya is the drugâ€&#x;s potency, Vipaka Metabolic Property and karma its action.Dravyaguna is that aspect of Ayurved which describes the sources and properties of substances used as food and medicine, and is equivalent to Materia medica. The Materia medica of Ayurved is extensive and utilizes substances of animal, vegetable and mineral origin. The Ayurvedic texts make it abundantly clear that the drugs included had each been selected after careful clinical experiments and long experience. The specific properties like tastes, assimilability, potency and physiological actions are described in almost all cases. These experiments were naturally conducted mainly with materials available to the pioneers in their own environment, which explained the strong preference shown by classical Ayurved for indigenous plant remedies. A second reason for this preference was that the plants being composed of all the five elements (the panchamahabhoothas) had a natural flexibility to a wider range of application. The Complementary And Alternative Medicine System
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In Charaka samhitha, 341 drugs from plants, 177 drugs from animals and 64 from minerals and metals were discussed. The corresponding numbers, forSushrutasamhitha are 395, 57 and 64, respectively. The animal products are found less and less in the later works, due to the prevalence of Buddhistic and Jainistic philosophies. Plants provided the natural and traditional drugs for most oral and non-oral medication. A clear understanding of their properties had led to a rational classification into different groups according to their therapeutic action. PRINCIPLES OF TREATMENT IN AYURVED a) Food is medicine, b) The prevention of disease, c) Immunoenhancing in ayurved STRATEGIES OF AYURVEDIC TREATMENT Ayurved deals with the disease and health management through the following strategies: a) Chikitsadhatusatmyartha: to bring about balance in tissues; b) Swabhaavoparma: to augment the bodyâ€&#x;s efforts to ward of disease, through fasting, warm water, rest; c) Nidana parivarjana: avoidance of causative factors; d) Chikitsarukpratikriya: treatment that is antagonistic to disease; e) Saamanya and VisheshaSiddhantha: treatment by the principle of similarityand dissimilarity, of the body, food, medicine, etc. f) Satvavajaya, Aatmanigraha: by the control of body and mind; g) Chayaevajayeddosha: to treat at the initial stage of the disorder; h) Sampraptivighatana: to disrupt pathogenesis.
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DIAGNOSIS BY ROGA PAREEKSHA AND ROGI PAREEKSHA The Ayurvedic physician examines (pareeksha) the patient (rogi) and the disease (roga),to obtain information regarding dushya (body tissues), dosha(humours), desha (state of the body), bala (severity of the disease), kaala (time of the disease), anala (strength of digestion and metabolism), prakriti(constitution of the patient), vaaya (age of the patient), satva (psychological condition), saathmya (life style of the patient) and aahara (dietary habits). The examination of the patient constitutes the following aspects: nadi (pulse), mootra (urine), pureesha or mala (faeces), jihw a (tongue) and netra (eye) through shabda (auscultation, sound response), sparsha (tactile stimulation) and aakriti (the appearance and feel of different parts of the body). Types of Therapies in Ayurved SHAMANA Shamana is a palliative therapy that aims at balancing the disturbed doshas. Some examples of shamana therapy are pachana (carminatives), deepana (digestives), kshudha (appetisers), thrishna (thirst quenchers), etc., for which drugs are prescribed. Vyaayaama (exercise), ataapa (exposure to sunâ€&#x;s rays), marutha (exposure to wind), etc., constitute the supportive measures to therapy. SHODHANA Shodhana is an investigative therapy, better known as panchakarma, administered after a thorough examination of the patient. Panchakarma is a special treatment ofAyurved. The cells and tissues of the body, which function 24 hr a day, produce energy and do all else that is necessary to facilitate a proper functioning of the body. Naturally, waste products accumulate. Often the channels meant for the removal of the body wastes are not able to function
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properly. Panchakarma is the regimental practice that sets this problem right. Panchakarma aims at removing the vitiated dosha from the body. This constitutes the following five procedures: a) vamana (emesis), b) virechana (purgation), c) niroohabasthi (enemas using herbal decoctions, salts, etc.), d) anuvaahanabasthi (enemas using milk, oils, etc.), and e) nasya (nasal application of powdered herbs, snuff). The surgically oriented Sushrutha has introduced the practice of raktha moksha (bloodletting, srugically or by leeches). Panchakarma is preceded by swedana (sweating) and snehana (ceremonial baths), often referred to as poorva karma. Like all other Ayurvedic treatments, panchakarma is also supported by dietary regime of acceptable (pathya) and unacceptable (apathya) foods and drinks. Panchakarma has an important place inAyurved. A number of therapies, for example the rejuvenation therapy (Kaayakalpa), are given only after the Panchakarma procedure. Charaka believed that only a clean cloth can take up a dye. Bioengineering machinery is now available for conducting the panchakarma procedures. KAAYAKALPA, THE REJUVENATION THERAPY The rejuvenation or revitalization therapy, called kaayakalpa, is a prominent feature of Charaka Samhitha. It is suggested that the body fluids and tissues are capable of being replenished and renewed by proper medication, so that it is possible to achieve not only vitality, vigour and greater resistance to disease, but also longevity, prevention of senile decay, heightened memory and intelligence, and an improvement of bodily strength, personal beauty, and sense perceptions. In fact, Charaka asserts that even in old age it is possible to regain youth and remain youthful for long period. Claims are often made that it is possible by a special course of kaayakalpa to entirely transform, an aged and diseased body into a fresh and youthful one in the course of six months.
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METHODS OF TREATMENT IN AYURVED Ayurved uses the following means in treatment: a) Oral medication, single or compounded medicinal substances; b) Eye drops, salves for eye disease and in loss of visual power, etc.; c) Gargles for disease of mouth, throat, teeth, gums; d) Medicated cigars, smoking mixtures for diseases of head, nose, throat and bronchial tract; e) Nasal medicinal powders, ointments, fume and inhalation in fainting fits, epilepsy and insanity; f) Liquid unguents, creams-lotions and medicinal oil for skin; g) Suppositories, cotton swabs soaked in medicinal oil, for the ear passage, lower orifices, wounds; h) Enemas of nutritive and healing fluids (per rectal, per vaginal, per urethral); i) Sweating, sun bath, heated air, steam, and contact with hot surfaces; j) Douches to flush rectal/vaginal/urethral passages; k) Bandages, splints, tourniquets and ligatures for poisonous bites; l) Bloodletting by incision, using leeches or other methods; m) Eight types of surgical methods; and n) Psychiatric methods. MEDICAL ASTROLOGY Ayurved conceptualizes the human being as a miniature replica of the Universe and with a close relationship with it. Astrology, therefore, runs parallel to the Ayurvedic doctrines. The balance or The Complementary And Alternative Medicine System
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imbalance of the doshas is influenced by the 12 zodiacs, 27 stars and nine planets. The position of the celestial bodies at the time of oneâ€&#x;s birth is hence an important factor in determining the constitution of a person. The use of mantras incantation to bring in equilibrium in the disturbance caused by the astrological factors is recommended in Ayurved. Mantras are propitiatory hymns to Gods and celestial figures, now interpreted as packages of ordinate sound waves. They afford a psychological therapy combined with a form of sound therapy. Hence, a correct pronunciation and the proper style of chanting the mantras is a crucial aspect, mastered only by a few. THE PHYSICIAN-PATIENT RELATIONSHIP By tradition, the Vaidya, the Ayurvedic physician is well integrated with the society and knows the patient and family. He is the friend, guide and philosopher and is well respected by the community. This attitude is recommended in every system of medicine. Unfortunately, this ideal situation has undergone a vast change in recent times, with increased urbanization, but by and large is still present in the rural places. LITERATURE ON AYURVED Prime Source Texts (Laghutraiyee and Bruhatraiyee) The Ayurvedic Pharmacopoeia Of India Part I Vol. 1 to 5 The Ayurvedic Pharmacopoeia Of India Part IIVol. 1 Ayurvedic Formulary of India Part-I and II Harit Samhita kashyapa samhita Rig Veda
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6 Yoga System In Yoga, theory and practice, as well as left brain and right brain, go hand in hand so to speak. Study (svâdhyâya) is in fact an important aspect of many branches and schools of Yoga. This is another way in which Yoga‟s balanced approach shows itself. If you want to know where something is going, it is good to know where it came from. “To be ignorant of what happened before one was born,” said Cicero pointedly in his Orator, “is to remain ever a child.” History provides context and meaning, and Yoga is no exception to this rule. If you are fond of history, you‟ll enjoy what follows. Many of the facts and ideas presented here have not yet found their way into the textbooks or even into most Yoga books. We put you in touch with the leading edge of knowledge in this area. If you are not a history buff, well, perhaps we can tempt you to suspend your preferences for a few minutes and read on anyway. THE ORIGIN OF YOGA Despite more than a century of research, we still don‟t know much about the earliest beginnings of Yoga. We do know, though, that it originated in India 5,000 or more years ago. Until recently, many Western scholars thought that Yoga originated much later, maybe around 500 B.C., which is the time of Gautama the Buddha, the illustrious founder of Buddhism. But then, in the early 1920s, archeologists surprised the world with the discovery of the so-called Indus civilization—a culture that we now know extended over an area of roughly 300,000 square miles (the size of Texas and Ohio The Complementary And Alternative Medicine System
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combined). This was in fact the largest civilization in early antiquity. In the ruins of the big cities of Mohenjo Daro and Harappa, excavators found depictions engraved on soapstone seals that strongly resemble yogi-like figures. Many other finds show the amazing continuity between that civilization and later Hindu society and culture. There was nothing primitive about what is now called the IndusSarasvati civilization, which is named after two great rivers that once flowed in Northern India; today only the Indus River flows through Pakistan. That civilization‟s urbane population enjoyed multistory buildings, a sewage system unparalleled in the ancient world until the Roman empire, a huge public bath whose walls were water-proofed with bitumen, geometrically laid out brick roads, and standardized baked bricks for convenient construction. (We are so used to these technological achievements that we sometimes forget they had to be invented.) The Indus-Sarasvati people were a great maritime nation that exported a large variety of goods to Mesopotamia and other parts of the Middle East and Africa. Although only a few pieces of art have survived, some of them show exquisite craftsmanship. For a long time, scholars thought that this magnificent civilization was abruptly destroyed by invaders from the northwest who called themselves Aryans (ârya meaning “noble” in the Sanskrit language). Some proposed that these warlike nomads invented Yoga, others credited the Indus people with its creation. Yet others took Yoga to be the joint creation of both races. Nowadays researchers increasingly favor a completely different picture of ancient Indian history. They are coming to the conclusion that there never was an Aryan invasion and that the decline of the Indus-Sarasvati cities was due to dramatic changes in climate. These in turn appear to have been caused by a major tectonic catastrophe The Complementary And Alternative Medicine System
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changing the course of rivers. In particular, it led to the drying up of what was once Indiaâ€&#x;s largest river, the Sarasvati, along whose banks flourished numerous towns and villages (some 2500 sites have been identified thus far). Today the dry river bed runs through the vast Thar Desert. If it were not for satellite photography, we would not have learned about those many settlements buried under the sand. The drying up of the Sarasvati River, which was complete by around 1900 B.C., had far-reaching consequences. Just imagine the waters of the Mississippi running dry instead of flooding constantly. What havoc this would cause! The death of the Sarasvati River forced the population to migrate to more fertile parts of the country, especially east toward the Ganges (Ganga) River and south into Central India and Tamilnadu. Why is this important for the history of Yoga, you might ask? The Sarasvati River happens to be the most celebrated river in the Rig-Veda, which is the oldest known text in any Indo-European language. It is composed in an archaic (and difficult) form of Sanskrit and was transmitted by word of mouth for numerous generations. Sanskrit is the language in which most Yoga scriptures are written. It is related to languages like Greek, Latin, French, German, Spanish, and not least English. You can see this family relationship on the example of the word yoga itself, which corresponds to zugos, iugum, joug, Joch, yugo, and yoke in these languages. Sanskrit is like an older brother to the other Indo-European languages. Now, if the Sarasvati River dried up around or before 1900 B.C., the Rig-Veda must be earlier than that benchmark date. If that is so, then the composers of this collection of hymns must have been contemporaneous with the people of the Indus civilization, which flourished between circa 3000-1900 B.C. Indeed, astronomical references in the Rig-Veda suggest that at least some of its 1,028 The Complementary And Alternative Medicine System
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hymns were composed in the third or even fourth millennium B.C. Thus, the Sanskrit-speaking Aryans, who created the Rig-Veda, did not come from outside India to destroy the Indus-Sarasvati civilization. They had been there all along. What, then, was their relationship with the Indus-Sarasvati people? Here opinions still differ, but there is a growing understanding that the Aryans and the Indus-Sarasvati people were one and the same. There is nothing in the Rig-Veda to suggest otherwise. In fact, the Rig-Veda and the other archaic Sanskrit texts appear to be the “missing” literature of the Indus civilization. Conversely, the archeological artifacts of the Indus valley and adjoining areas give us the “missing” material base of the early Sanskrit literature—an elegant solution to a problem that has long vexed researchers. YOGA AND THE INDUS-SARASVATI CIVILIZATION This means that Yoga is the product of a mature civilization that was unparalleled in the ancient world. Think of it! As a Yoga practitioner you are part of an ancient and honorable stream of tradition, which makes you a descendant of that civilization at least at the level of the heart. Many of the inventions credited to Sumer rightfully belong to what is now known as the Indus-Sarasvati civilization, which evolved out of a cultural tradition that has reliably been dated back to the seventh millennium B.C. In turn it gave rise to the great religious and cultural tradition of Hinduism, but indirectly also to Buddhism and Jainism. India‟s civilization can claim to be the oldest enduring civilization in the world. Its present-day problems should not blind us to its glorious past and the lessons we can learn from it. Yoga practitioners in particular can benefit from India‟s protracted experimentation with life, especially its explorations of the mysteries The Complementary And Alternative Medicine System
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of the mind. The Indian civilization has produced great philosophical and spiritual geniuses who between them have covered every conceivable answer to the big questions, which are as relevant today as they were thousands of years ago. THE BIG QUESTIONS Traditional Yoga seeks to provide plausible answers to such profound questions as, “Who am I?”, “Whence do I come?”, “Whither do I go?” and “What must I do?” These are the sorts of questions that, sooner or later, we all end up asking ourselves. Or at least, we have our own implicit answers to them, though may not get round to consciously formulating them. Deep down, we all are philosophers, because we all need to make sense of our life. Some of us postpone thinking about these questions, but they don‟t ever go away. We quickly learn this when we lose a loved one or face a serious health crisis. So, we might as well ponder these questions while we are in good shape. And don‟t think you have to feel morose to do so. Yoga doesn‟t champion dark moods, but it is definitely in favor of awareness in all its forms, including self-awareness. If we know the stuff we are made of, we can function a lot better in the world. At the very least, our self-knowledge will give us the opportunity to make conscious and better choices. THE HISTORY OF YOGA The history of Yoga can conveniently be divided into the following four broad categories: a) Vedic Yoga. b) Preclassical Yoga The Complementary And Alternative Medicine System
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c) Classical Yoga d) Postclassical Yoga These categories are like static snapshots of something that is in actuality in continuous motion—the “march of history.” VEDIC YOGA Now we are entering somewhat more technical territory, and I will have to use and explain a number of Sanskrit terms. The yogic teachings found in the above-mentioned Rig-Veda and the other three ancient hymnodies are known as Vedic Yoga. The Sanskrit word Veda means “knowledge,” while the Sanskrit term rig (from ric) means “praise.” Thus the sacred Rig-Veda is the collection of hymns that are in praise of a higher power. This collection is in fact the fountainhead of Hinduism, which has around one billion adherents today. You could say that the Rig-Veda is to Hinduism what the Book of Genesis is to Christianity. The other three Vedic hymnodies are the Yajur-Veda (“Knowledge of Sacrifice”), Sama-Veda (“Knowledge of Chants”), and Atharva-Veda (“Knowledge of Atharvan”). The first collection contains the sacrificial formulas used by the Vedic priests. The second text contains the chants accompanying the sacrifices. The third hymnody is filled with magical incantations for all occasions but also includes a number of very powerful philosophical hymns. It is connected with Atharvan, a famous fire priest who is remembered as having been a master of magical rituals. These hymnodies can be compared to the various books of the Old Testament. It is clear from what has been said thus far that Vedic Yoga— which could also be called Archaic Yoga—was intimately connected with the ritual life of the ancient Indians. It revolved around the idea of sacrifice as a means of joining the material world with the invisible world of the spirit. In order to perform the exacting rituals The Complementary And Alternative Medicine System
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successfully, the sacrifices had to be able to focus their mind for a prolonged period of time. Such inner focusing for the sake of transcending the limitations of the ordinary mind is the root of Yoga. When successful, the Vedic yogi was graced with a “vision” or experience of the transcendental reality. A great master of Vedic Yoga was called a “seer”—in Sanskrit rishi. The Vedic seers were able to see the very fabric of existence, and their hymns speak of their marvelous intuitions, which can still inspire us today. PRECLASSICAL YOGA This category covers an extensive period of approximately 2,000 years until the second century A.D. Preclassical Yoga comes in various forms and guises. The earliest manifestations were still closely associated with the Vedic sacrificial culture, as developed in the Brâhmanas and Âranyakas. The Brâhmanas are Sanskrit texts explaining the Vedic hymns and the rituals behind them. The Âranyakas are ritual texts specific to those who chose to live in seclusion in a forest hermitage. Yoga came into its own with the Upanishads, which are gnostic texts expounding the hidden teaching about the ultimate unity of all things. There are over 200 of these scriptures, though only a handful of them were composed in the period prior to Gautama the Buddha (fifth century B.C.). These works can be likened to the New Testament, which rests on the Old Testament but at the same time goes beyond it. One of the most remarkable Yoga scriptures is the BhagavadGîtâ (“Lord‟s Song”), of which the great social reformer Mahatma Gandhi spoke as follows: When disappointment stares me in the face and all alone I see not one ray of light, I go back to the Bhagavad-Gita. I find a verse here and a verse there and I immediately begin to smile in the midst of overwhelming tragedies—and my life has been full of external The Complementary And Alternative Medicine System
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tragedies—and if they have left no visible, no indelible scar on me, I owe it all to the teachings of the Bhagavad-Gita. (Young India, 1925, pp. 1078-79) In its significance, this work of only 700 verses perhaps is to Hindus what Jesus‟ Sermon on the Mount is to Christians. Its message, however, is not to turn the other cheek but to actively oppose evil in the world. In its present form, the Bhagavad-Gîtâ (Gîtâ for short) was composed around 500 B.C. and since then has been a daily inspiration to millions of Hindus. Its central teaching is to the point: To be alive means to be active and, if we want to avoid difficulties for ourselves and others, our actions must be benign and also go beyond the grip of the ego. A simple matter, really, but how difficult to accomplish in daily life! Preclassical Yoga also comprises the many schools whose teachings can be found in India‟s two great national epics, the Râmâyana and the Mahâbhârata (in which the Bhagavad-Gîtâ is embedded and which is seven times the size of the Iliad and Odyssey combined). These various preclassical schools developed all kinds of techniques for achieving deep meditation through which yogis and yoginis can transcend the body and mind and discover their true nature. CLASSICAL YOGA This label applies to the eightfold Yoga—also known as RâjaYoga—taught by Patanjali in his Yoga-Sûtra. This Sanskrit text is composed of just under 200 aphoristic statements, which have been commented on over and over again through the centuries. Sooner or later all serious Yoga students discover this work and have to grapple with its terse statements. The word sûtra (which is related to Latin suture) means literally “thread.” Here it conveys a thread of memory, an aid to memorization for students eager to retain Patanjali‟s knowledge and wisdom. The Yoga-Sûtra was probably written sometime in the second The Complementary And Alternative Medicine System
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century A.D. The earliest available Sanskrit commentary on it is the Yoga-Bhâshya (“Speech on Yoga”) attributed to Vyâsa. It was authored in the fifth century A.D. and furnishes fundamental explanations of Patanjali‟s often cryptic statements. Beyond a few legends nothing is known about either Patanjali or Vyâsa. This is a problem with most ancient Yoga adepts and even with many more recent ones. Often all we have are their teachings, but this is of course more important than any historical information we could dig up about their personal lives. POSTCLASSICAL YOGA This is again a very comprehensive category, which refers to all those many types and schools of Yoga that have sprung up in the period after Patanjali‟s Yoga-Sûtra and that are independent of this seminal work. In contrast to classical Yoga, postclassical Yoga affirms the ultimate unity of everything. This is the core teaching of Vedânta, the philosophical system based on the teachings of the Upanishads. In a way, the dualism of classical Yoga can be seen as a brief but powerful interlude in a stream of nondualist teachings going back to ancient Vedic times. According to these teachings, you, we, and everyone or everything else is an aspect or expression of one and the same reality. In Sanskrit that singular reality is called brahman (meaning “that which has grown expansive”) or âtman (the transcendental Self as opposed to the limited ego-self). A few centuries after Patanjali, the evolution of Yoga took an interesting turn. Now some great adepts were beginning to probe the hidden potential of the body. Previous generations of yogis and yoginis had paid no particular attention to the body. They had been more interested in contemplation to the point where they could exit the body consciously. Their goal had been to leave the world behind and merge with the formless reality, the spirit.
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Under the influence of alchemy—the spiritual forerunner of chemistry—the new breed of Yoga masters created a system of practices designed to rejuvenate the body and prolong its life. They regarded the body as a temple of the immortal spirit, not merely as a container to be discarded at the first opportunity. They even explored through advanced yogic techniques the possibility of energizing the physical body to such a degree that its biochemistry is changed and even its basic matter is reorganized to render it immortal. This preoccupation of theirs led to the creation of Hatha-Yoga, an amateur version of which is today widely practiced throughout the world. It also led to the various branches and schools of Tantra-Yoga, of which Hatha-Yoga is just one approach. CURRENT YOGA The history of modern Yoga is widely thought to begin with the Parliament of Religions held in Chicago in 1893. It was at that congress that the young Swami Vivekananda—swami means “master”—made a big and lasting impression on the American public. At the behest of his teacher, the saintly Ramakrishna, he had found his way to the States where he didn‟t know a soul. Thanks to some well-wishers who recognized the inner greatness of this adept of Jnâna-Yoga (the Yoga of discernment), he was invited to the Parliament and ended up being its most popular diplomat. In the following years, he traveled widely attracting many students to Yoga and Vedânta. His various books on Yoga are still useful and enjoyable to read. Before Swami Vivekananda a few other Yoga masters had crossed the ocean to visit Europe, but their influence had remained local and ephemeral. Vivekananda‟s immense success opened a sluice gate for other adepts from India, and the stream of Eastern gurus has not ceased. After Swami Vivekananda, the most popular teacher in the early The Complementary And Alternative Medicine System
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years of the Western Yoga movement was Paramahansa Yogananda, who arrived in Boston in 1920. Five years later, he established the Self-Realizaton Fellowship, which still has its headquarters in Los Angeles. Although he left his body (as yogins call it) in 1952 at the age of fifty-nine, he continues to have a worldwide following. His Autobiography of a Yogi makes for fascinating reading, but be prepared to suspend any materialistic bias you may have! As with some other yogis and Christian or Muslim saints, after his death Yoganandaâ€&#x;s body showed no signs of decay for a full twenty days. Of more limited appeal was Swami Rama Tirtha, a former mathematics teacher who preferred spiritual life to academia and who came to the United States in 1902 and founded a retreat center on Mount Shasta in California. He stayed for only two years and drowned in the Ganges (Ganga) River in 1906 at the young age of thirty-three. Some of his inspirational talks were gathered into the five volumes of In Woods of God-Realization, which are still worth dipping into. In 1919, Yogendra Mastamani arrived in Long Island and for nearly three years demonstrated to astound Americans the power and elegance of Hatha Yoga. Before returning to India, he founded the American branch of Kaivalyadhama, an Indian organization created by the late Swami Kuvalayananda, which has contributed greatly to the scientific study of Yoga. A very popular figure for several decades after the 1920s was Ramacharaka, whose books can still be found in used bookstores. What few readers know, however, is that this Ramacharaka was apparently not an actual person. The name was the pseudonym of two people—William Walker Atkinson, who had left his law practice in Chicago to practice Yoga, and his teacher Baba Bharata. Paul Brunton, a former journalist and editor, burst on the scene of Yoga in 1934 with his book A Search in Secret India, which introduced the great sage Ramana Maharshi to Western seekers. Many more works flowed from his pen over the following eighteen The Complementary And Alternative Medicine System
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years, until the publication of The Spiritual Crisis of Man. Then, in the 1980s, his notebooks were published posthumously in sixteen volumes—a treasure-trove for serious Yoga students. Since the early 1930s until his death in 1986, Jiddu Krishnamurti delighted or perplexed thousands of philosophically minded Westerners with his eloquent talks. He had been groomed by the Theosophical Society as the coming world leader but had rejected this mission, which surely is too big and burdensome for any one person, however great. He demonstrated the wisdom of Jnana-Yoga (the Yoga of discernment), and drew large crowds of listeners and readers. Among his close circle of friends were the likes of Aldous Huxley, Christopher Isherwood, Charles Chaplin, and Greta Garbo. Bernard Shaw described Krishnamurti as the most beautiful human being he ever saw. Yoga, in the form of Hatha-Yoga, entered mainstream America when the Russian-born yoginî Indra Devi, who has been called the “First Lady of Yoga,” opened her Yoga studio in Hollywood in 1947. She taught stars like Gloria Swanson, Jennifer Jones, and Robert Ryan, and trained hundreds of teachers. Now in her nineties and living in Buenos Aires, she is still an influential voice for Yoga. In the 1950s, one of the most prominent Yoga teacher was Selvarajan Yesudian whose book Sport and Yoga has been translated into fourteen or so languages, with more than 500,000 copies sold. Today, as we mentioned before, many athletes have adopted yogic exercises into their training program because . . . it works. Among them are the Chicago Bulls. Just picture these champion basketball players stretching out on extra-long Yoga mats under the watchful eye of Yoga teacher Paula Kout! In the early 1950s, Shri Yogendra of the Yoga Institute of Santa Cruz in India visited the United States. He pioneered medical research on Yoga as early as 1918, and his son Jayadev Yogendra is continuing his valuable work, which demonstrates the efficacy of Yoga as a therapeutic tool. In 1961, Richard Hittleman brought Hatha-Yoga to American The Complementary And Alternative Medicine System
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television, and his book The Twenty-Eight-Day Yoga Plan sold millions of copies. In the mid-1960s, the Western Yoga movement received a big boost through Maharishi Mahesh Yogi, largely because of his brief association with the Beatles. He popularized yogic contemplation in the form of Transcendental Meditation (TM), which still has tens of thousands of practitioners around the world. TM practitioners also introduced meditation and Yoga into the corporate world. It, moreover, stimulated medical research on Yoga at various American universities. In 1965, the then sixty-nine-year-old Shrila Prabhupada arrived in New York with a suitcase full of books and $8.00 in his pockets. Six years later he founded the International Society for Krishna Consciousness (ISKCON), and by the time of his death in 1977, he had created a worldwide spiritual movement based on Bhakti Yoga (the Yoga of devotion). Also in the 1960s and 1970s, many swamis trained by the Himalayan master Swami Sivananda, a former physician who became a doctor of the soul, opened their schools in Europe and the two Americas. Most of them are still active today, and among them are Swami Vishnudevananda (author of the widely read Complete Illustrated Book of Yoga), Swami Satchitananda (well-known to Woodstock participants), Swami Sivananda Radha (a woman-swami who pioneered the link between Yoga spirituality and psychology), Swami Satyananda (about whom we will say more shortly), and Swami Chidananda (a saintly figure who directed the Sivananda Ashram in Rishikesh, India). The last-mentioned master‟s best known American student is the gentle Lilias Folan, made famous by her PBS television series Lilias, Yoga & You, broadcast between 1970 and 1979. In 1969, Yogi Bhajan caused an uproar among the traditional Sikh community (an offshoot of Hinduism) when he broke with tradition and began to teach Kundalini Yoga to his Western students. Today his Healthy, Happy, Holy Organization—better known as 3HO—has more than 200 centers around theworld. The Complementary And Alternative Medicine System
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A more controversial but wildly popular guru in the 1970 and 1980s was Bhagavan Rajneesh (now known as Osho), whose followers constantly made the headlines for their sexual orgies and other excesses. Rajneesh, a former philosophy professor, drew his teachings from authentic Yoga sources, mixed with his own personal experiences. His numerous books line the shelves of many secondhand bookstores. Rajneesh allowed his students to act out their repressed fantasies, notably of the sexual variety, in the hope that this would free them up for the deeper processes of Yoga. Many of them, however, got trapped in a mystically tinged hedonism, which proves the common-sense rule that too much of a good thing can be bad for you. Even though many of his disciples felt bitterly disappointed by him and the sad events surrounding his organization in the years immediately preceding his death in 1990, just as many still regard him as a genuine Yoga master. His life illustrates that Yoga adepts come in all shapes and sizes and that, to coin a phrase, one person‟s guru is another person‟s uru. (The Sanskrit word uru denotes “empty space.”) Another maxim that applies here is caveat emptor, “buyer bewares.” Other renowned modern Yoga adepts of Indian origin are Sri Aurobindo (the father of Integral Yoga), Ramana Maharshi (an unparalleled master of Jnana-Yoga), Papa Ramdas (who lived and breathed Mantra-Yoga, the Yoga of transformative sound), Swami Nityananda (a miracle-working master of Siddha-Yoga), and his disciple Swami Muktananda (a powerful yogi who put Siddha-Yoga, which is a Tantric Yoga, on the map for Western seekers). All these teachers are no longer among us. The great exponent in modern times of Hatha-Yoga was Sri Krishnamacharya, who died in 1989 at the ripe old age of 101. He practiced and taught the Viniyoga system of Hatha-Yoga until his last days. His son T. K. V. Desikachar continues his saintly father‟s teachings and taught Yoga, among others, to the famous Jiddu Krishnamurti. Another well-known student of Sri Krishnamacharya and a master in his own right is Desikachar‟s uncle B. K. S. Iyengar, who has taught tens of thousands of students, including the worldfamous violinist Jehudi Menuhin. The Complementary And Alternative Medicine System
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Mention must also be made of Pattabhi Jois and Indra Devi, both of whom studied with Krishnamacharya in their early years and have since then inspired thousands of Westerners. Of living Yoga masters from India, I can mention Sri Chinmoy and Swami Satyananda (a Tantra master who established the wellknown Bihar School of Yoga, has authored numerous books, and has disciples around the world). There are of course many other great Yoga adepts, both well-known and more hidden, who represent Yoga in one form or another, but I leave it up to you to discover them. Until modern times, the overwhelming majority of Yoga practitioners have been men, yogins. But there have also always been great female adepts, yoginîs. Happily, in recent years, a few woman saints—representing Bhakti-Yoga (Yoga of devotion)—have come to the West to bring their gospel of love to open-hearted seekers. Yoga embraces so many diverse approaches that anyone can find a home in it. An exceptional woman teacher from India who fits none of the yogic stereotypes is Meera Ma (“Mother Meera”). She doesn‟t teach in words but communicates in silence through her simple presence. Of all places, she has made her home in the middle of a quaint German village in the Black Forest, and every year is attracting thousands of people from all over the world. Since Yoga is not restricted to Hinduism, we may also mention here the Dalai Lama, champion of nonviolence and winner of the Nobel Peace Prize. He is unquestionably one of the truly great yogis of modern Tibet, who, above all, demonstrates that the principles of Yoga can fruitfully be brought not only into a busy daily life but also into the arena of politics. Today Tibetan Buddhism (which is a form of Tantra-Yoga) is extremely popular among Westerners, and there are many lamas (spiritual teacher) who are willing to share with sincere seekers the secrets of their hitherto well-guarded tradition.
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7 Naturopathy Naturopathy, or „nature cure‟, is in some countries, the practice of using simple methods like water treatment, dietetics, fasting, religious attitudes, etc. In some other countries, a naturopath utilizes latest diagnostic instruments and treatments which may include acupuncture, osteopathy, chiropractic, homoeopathy, herbalism, vitamin therapy, faith healing, etc., which virtually means all forms of non-allopathic medicine. It should be remembered that all systems of medicine have some component of Naturopathy, in the form of do‟s and don'ts, particularly with reference to diet and exercise. Lindlahr (1975) has contributed greatly to the concepts of Naturopathy, which many people consider to be prevalent only in the orient but it is widely practiced throughout the world, with Germany and India having exploited it to the full. Naturopaths consider that disease symptoms are warnings warranting an essential forcible house (body) cleanings beneficial to the body while the allopath considers that the same symptoms as harmful and hostile and those they should be cured by some means (Lindlahr, 1975). Baum and Gehman (1974) consider that the disease is nature‟s effort to get you well, and so naturopathic efforts are not intended to suppress the symptoms, but to be guided by the symptoms only to promote natural healing. The British Naturopathic and Osteopathic Association claims that Naturopathy exploits the self-regulating, self-adjusting and selfhealing ability of the human organism. Naturopaths believe that a sound body is not congenial for the development of disease. Naturopathy does not use any medicine. Some critics of Naturopathy say that what is natural is often difficult to determine and that nature cure believers miss the chance of getting cured of some eminently curable diseases. Dietetics is one of the important arms of Naturopathy and vegetarianism is its main stay. There are people, called „vegans‟, who The Complementary And Alternative Medicine System
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do not take even milk and its products (let alone eggs) as they are an animal produce. Apart from being the oldest medical system, Naturopathy is also the simplest and it represents the aim of all branches of medicine, which is the prevention of all unnecessary disease. Much of Naturopathy is preventive and the greatest benefit is that it does not cause iatrogenic (drug induced) illnesses.
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8 Chinese System of Medicine Like India, China has a very rich tradition in her indigenous medical practices. It appears to be a psychological compulsion of the west to be more enamored of closed political and social systems, as the Chinese medicine attracted far more attention in the west than the Indian systems. HISTORY OF CHINESE MEDICINE The earliest recorded history of traditional Chinese medicine was in 1800 BCE, the beginning of the Shang dynasty (Pei, 1985) and hence it was in development for far longer than this date. Oracle-bone writings are oldest form of Chinese writings carved on scapulae or tortoise shells, and used for divination, known from the Yin dynasty. As early as this, several diseases were named, described and classified, though in an elementary manner. Diseases of the head (JiShou), eye (Ji Mu), ear (JiEr), abdomen (Ji Fu), foot (JiZu), etc., were known, the prefix Ji indicating an ailment. The early Chinese writings, like the Chinese script, are pictorial and are subject to problems of interpretation. Records on dental caries and parasites appeared very early. Notions of hygiene and preventive measures appeared between 1400 and 1200 BCE (Pei, 1985). The Book of Rites written during the Zhou dynasty (1100 to 800 BCE) records specialization in nutrition, internal medicine, surgery and veterinary medicine as well as the practice of case recordings. The medical theory and clinical practice were defined, in the "Yellow Emperorâ€&#x;s Internal Classic", the oldest and most comprehensive work of 18 volumes on medicine dated 300 BCE, which established clinical symptoms, hygiene, prescription of herbal drugs, Acupuncture and Moxibustion.
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PHILOSOPHY OF CHINESE MEDICINE The basic philosophy of Chinese medical practice is comparable to the concept of doshas of Ayurved. The fundamental concept is based on yin andyang, which are essentially balanced in health. The symbolized representation of the balanced state of yin and yang is called T’ai chi t’u’, is in the form of a circle which looks similar to the logo of Doordarshan (the Indian public TV channels). Yin (quieter) and yang (fiery) are elemental forces, such as hot and cold, or wet and dry. They are opposing, interlocking and dynamic forces, which complement each other and remain in a state of permanent change, in the individual, the society and the environment, from moment to moment, hour to hour, day to day, and so on. The state of health essentially needs a balance of yin and yang which also should be in harmony with the five elements (wuxing), wood, fire, earth, metal and water. Each organ of the body represents one of these elements. The concept of the five elements resembles thepanchamahabhootha concept in Ayurved, with the difference that wood and metal do not find a place in the Ayurvedic concept, instead space and wind. Another factor is the concept of Zangfu (internal organs) and jingluo (channels and collaterals). Twelve meridians bear the names of twelve organs associated with the flow of qi, the vital force that circulates in the human body through the meridians. A continuous undisturbed flow of qi is needed for health. A broken flow causes excess of qi in one organ and a deficiency of it in another. Acupuncture aims to restore the flow of qi. Numerous herbs are also considered to effect a balance of yin and yang. The treatment is directed both for prevention and cure of a disease. PLANTS IN CHINESE MEDICINE Chinese medical practice involves several thousands of plant species, used singly or in combinations. One interesting point is that 230 species of Thallophytes, 39 of Bryophytes, 382 of Pteridophytes and 40 of Gymnosperms are used in Chinese herbal medicine, in The Complementary And Alternative Medicine System
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addition to over 4,000 species of Angiosperms. In contrast, in Ayurved and Indian herbal medicine in general, the flowering plants overwhelmingly predominate, while plants of other (lower) groups are hardly mentioned. There are a very large number of publications on Chinese medicinal plants but very useful information can be obtained from Stuart (1911), Leavitt (1974) and Keys (1976). A host of research articles and reviews appear regularly in several journals. A number of plant species are common to China and India. A collaborative interaction would greatly benefit both the countries. ACUPUNCTURE Acupuncture, Zhen diju in Chinese, is a clinical procedure, used to induce stimulation in various locations in the body to treat disease and more particularly to alleviate pain. Acupuncture requires knowledge of anatomy and pathophysiology. The human body is perceived to be pervaded by a system of energy channels (jingluo). There may be also extra channels (ahshi points). The system of channels and collaterals is composed of 12 regular and eight extra channels and 15 collaterals, together forming a criss-cross network spread all over the body. Acupuncture treatment involves insertion of thin and long filiform silver or stainless steel needles into various parts of the body, at the relevant Acupuncture point, which is the place where the Acupuncture needle (or Moxibustion) is applied. Over 2,000 Acupuncture points are recorded but only about 360 points are in active use, 200 of which more particularly so (Wei, 1985). Additional points are continuously being recognized. While the majority of Acupuncturists follow traditional methods of locating Acupuncture points, some have been seeking electronic gadgets (electro-acupuncture and laser-acupuncture) to locate and identify the points to apply the treatment. Infra-red „torches/gunsâ€&#x; have also been developed for use on the acupuncture points to relieve pain. The Complementary And Alternative Medicine System
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A variant of Acupuncture is Acupressure which involves the application of pressure by the finger or a blunt object. Cupping is application of vacuum over Acupuncture points. Homoeo-puncture is the practice of dipping the Acupuncture needles in a Homoeopathic drug before administering Acupuncture. MOXIBUSTION Moxibustion is a 2,000 year old Chinese therapeutic technique. It involves burning a piece of the Chinese drug plant moxa (Artemisia moxa, Asteraceae), either on the head of an Acupuncture needle to conduct heat into the body, or as in some cases directly on the surface of the body. This practice is closely associated with Acupuncture, because the sites chosen for Moxibustion are usually the Acupuncture points. The leaves of the moxa plant are ground into a cotton or woollike substance (moxa wool) which is made into sticks, moxa sticks, (20 cm x 1.4 cm), either in the pure form or mixed with other herbs such as ginger, garlic, onion, aconite, with or without salt. On burning, the heat and fumes are believed to stimulate the flow of energy in channels and collaterals, ameliorate the syndromes arising from cold or wind, and promote circulation of blood and vital energy (Wei, 1983). When moxa is burnt directly on the body, it may be the scarring or non-scarring procedure. Like Acupuncture, Moxibustion is used to treat a variety of disorders.
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9 The Siddha System of Medicine The name Siddha oushadha (Siddha medicine) relates to the earlier esoteric medicinal postulates concerning longevity, even immortality, and the later iatrochemical formulations as conceived and practiced by 18 Siddha, located in what is today, the Tamil Nadu. It is for this reason; the entire Siddhamedical literature is in Tamil. The Siddha system has about 800 texts of which 180 are in print. The Siddha system of medicine is rooted in the Dravidian culture, of the pre-Vedic period. The Vedic Aryans owed allegiance to the cult of Shiva, which was later absorbed by the Vedic culture. The Siddha tradition has incorporated minerals and metals, many of which are very toxic (mercury, sulphur, arsenic, etc.), and vegetable poisons. Independent of the Siddha system, India has developed its own tradition of alchemy and iatrochemistry, called Rasashashtra or Rasa vaidya that employed minerals, metals and some plants. The Siddha system of medicine is most predominant in Tamil Nadu. It is also popular in Andhra Pradesh, Karnataka and Kerala. Even outside India, theSiddha system is common in Sri Lanka, Malaysia and Singapore, where the Dravidian civilization had taken roots. In spite of the emphasis on iatrochemistry, there are many similarities between Siddha and Ayurved. Of the 18 Siddhars, Agastyar, Tirumalar, Bhogar, Ramadevar, Konganavar, Idaikkar, Yugimuni, Karunavar, Theriyar and Pambatti Siddhars deserve a special mention, although the Tamilian tradition considers that the rest of the Siddhars also have made significant contributions to the origin and evolution of the system. However, the question „who are the Siddhars?â€&#x; still generates controversies.
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The origin of alchemy in India has been traced to the seed ideas of the Chinese alchemy, which had established itself in China around the third and fourth centuries CE, giving a more important position to mercury and sulphur among other metals and minerals not only in respect of aurification but also in the preparation of metallic/mineral elixirs and other medical compositions. The Siddha alchemy came to the fore in India between 500 and 600 CE, and theSiddha medicine between 900 and 1000 CE. The Siddha system differs from pure alchemical medication in its insistence that the medicine be prepared through very elaborate processes incorporating a number of herbs in the formulations. In this respect the Siddha system is similar to the Rasashashtra ofAyurved, though the materiamedica of the Siddha system is not extensive. A Siddha medical practitioner uses the same formulation for different ailments but varies its adjuvant, called anupanam, such as milk, ghee, honey, herbal extracts, ginger juice, betel leaf juice, cold water, warm water, etc. It is believed that, if proper, the adjuvant itself would modify the therapeutic properties and potency of the drug leading to the desired effect. Siddha practitioners have adopted the Ayurvedic concept of Tridosha and give importance to the examination of the pulse. Siddha Theviar believed that the movement of the pulse in Vaatadosha is like the movement of a swan or peacock while in Pittadosha it would be similar to the movement of an ant or a hen. The pulse would be like the flight of a vulture in Kaphadosha. Siddha physicians are generally considered as very proficient in reading the subtilities of the pulse in various disease conditions. An examination of the urine is also considered important in the Siddha system. Ruby colored or white urine is indicative of an incurable state of the disease while yellow or honey colored urine indicates that the disease is in a curable stage. Astrology and incantation are also a part of the Siddha system. Minerals, metals, salts, toxic substances and even herbs are classified in the Siddha system as male and female, which is reminiscent of the practice in the Latin language which ascribes genders to nouns. These substances are also recognized as friendly or The Complementary And Alternative Medicine System
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inimical, probably based on their mutual compatibility or otherwise. The Siddha system identifies 120 uparasas, 64 toxic substances, nine metals and nine gems, each requiring an elaborate processing, most often by high physical heat before they are considered fit for use in a medical composition. In many ways, this processing has similarities with that found in Rasashashtra texts. Although there were attempts to categorise and interpret the ingredients of medicinal formulations in relation to thePanchabhoothas, they were not as detailed as in Ayurved in which the Panchabhootha concept is a fundamental principle. The formation of the embryo, physiological processes, six rasas, tridhathu, tridosha, curative practices and the like, find rational relative theories in Siddha as in Ayurved. In the Siddha system, Kaayakalpa has a very conspicuous place. Inherent in Kaayakalpa is the belief of the Siddha physicians that the human body consists of 72,000 veins and nerves, six vital centers, 10 vital airs, and 10 vital pulses. These appear to relate to tantrik and yogic concepts. One of the notable characteristics of Kaayakalpa is the intake of muppu, the three salts, besides the administration of meticulously processed minerals and other rejuvenating compositions, use of potent herbal extracts, breathing regulation, conservation of sperm and others. Muppu is believed to enhance the efficacy of any Siddha medicine, but its preparation, and even the composition are a closely guarded secret. In fact a very considerable part of the Siddha system appears to be shrouded in a cloak of secrecy; the texts being only in tamil and the formulations being referred mostly by numbers, promotes security. Two millennia old Siddha system received the patronage of tamil Kings and Chieftans as well as the general public all through. Siddha practitioners were active also during the British colonial times. Since the Indian independence, the Governments of India and the state of Tamil Nadu have encouraged the system very considerably. In fact, such close attention to an indigenous system is rare to find outside Tamil Nadu. There are over 11,000 registered Siddha medical practitioners and nearly 500 licensed pharmacies. Two medical colleges in Tamil The Complementary And Alternative Medicine System
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Nadu are exclusively devoted to teaching the Siddha system. There is a large number of hospitals and dispensaries, and three units of drug standardization. In addition, there are tribal health care centers dispensing Siddha medicine. There are clinical research centres, mobile clinics. And farms to cultivate rare herbs needed by the drug manufacturers and practitioners. A standardized formulary for 242 drug compositions that also involve about 100 species of plants was prepared even 20 years ago. The following are some species of plants used in the Siddha preparations: Caesalpiniabonducella,
Canavaliaensiformis,
Cephalandraindica,
Clerodendrumphlomides,
Crinum asiaticum,
Cucumiscolocynthis,
Cucurbita maxima,
Cycascircinalis,
Daemiaextensa,
Dolichosalbus,
Fumariaparviflora,
Gymnemasylvestre,
Lageneria vulgaris,
Mimusopskauki,
Momordicacharantia,
Mukiascabrella,
Passiflorafoetida,
Periplocaindica,
Rutagraveolens,
Solanumtrilobatum,
Sphaeranthusindicus,
Vignacatjang,
Vitexnegundo,etc. The Indian Medicine Practitioners Co-operative Society, set up about 1945 in Chennai, has been engaged in the preparation and marketing of over 200 Siddha formulations. It had also published Formulary of Siddha medicines (Anonymous, 1989). The Central Governmentâ€&#x;s Siddha Research Unit in Chennai has been conducting clinical trials of Siddha compositions. The Complementary And Alternative Medicine System
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All this certainly goes a very long way in support of the Siddha system. Nevertheless, the future of the system lies more in the verifiable capabilities of the drugs to cure the ailments against which they were formulated. For the present, the system is firmly established as an integral part of health care in Tamil Nadu.
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10 Homoeopathy System of Medicine Homoeopathy originated in 1796 with the historical publication, Versuch uber ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen(Essay on a new curative principle) by the German Doctor, Christian Samuel Freidrich Hahnemann, based on the Principle of Similarity. The Principle of Similarity was not new and can be traced back to Hippocrates, who said that „some diseases are best treated by similar and some by contraries‟. Nevertheless, Hahnemann was the first to systematize it and to introduce the dilutions of remedies (homoeopathic potencies). Hahnemann introduced Homoeopathy to the western world in 1810 through the book Organon der Heilkunst (Organan of the art of healing), of which there were six editions. The principles of the homoeopathic system generated long lasting controversies, which are still continuing today, as discussed later on. However, Hahnemann was credited with „disturbing and discrediting indefensible modes of practice‟ in medicine of his time. Homoeopathy is a system of medicine, with primary emphasis on therapeutics. The system has been used to treat both acute and chronic diseases. Successful treatment of chronic illnesses that were difficult to manage by the orthodox systems has been one of the contributions of Homoeopathy. It was once a low cost system but currently it is becoming more and more expensive. It was emphasized that Homoeopathy employs non-toxic drugs, but not really so, as several plant and animal toxins have entered its Materia Medica quite long ago. Homoeopathy takes a holistic approach and treats a patient on physical, emotional and mental levels at once, to bring back the body‟s equilibrium and to strengthen the defense mechanism such as the autoimmune system, the reticulo-endothelial system, the hormonal system, the sympathetic-parasympathetic system and the physiological mechanism that responds to stress. The Complementary And Alternative Medicine System
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There is extensive literature on various aspects of Homoeopathy in the form of Materia Medicae, Repertories, treatises on various ailments, etc., associated with such famous authors as Boericke, Kent, Kunzli, Herring, and others, in addition to Hahnemann. HOMOEOPATHIC MEDICAL PRACTICE IN THE WORLD Homoeopathy is being practiced in every country of the world, except in China, Taiwan, and Maldives. It has been banned in Israel. Homoeopathy has low popularity in the Muslim countries like Pakistan and Bangla Desh where the use of ethyl alcohol in the preparation of the medicine is a religious taboo. The degree of popularity of Homoeopathy varies from country to country in the western world but it is more prevalent in the developing countries, particularly because it is relatively inexpensive and the practitioners are far more informal and accessible. Like other systems of Alternative Medicine, Homoeopathy has too many amateur enthusiasts into prescribing. Fortunately, governments have of late been insisting on formal qualifications and registration. Homoeopathy is very much Indian now, not only by its strong presence for over a century but also from the fact that it is increasingly been Indianised by including Indian plants in its Materia Medica. MATERIA MEDICA OF HOMOEOPATHY The homoeopathic Materia Medica is largely plant based, as even the 12 tissue remedies, which are inorganic salts, are expected to be extracted from plants. Edward Bach, proposed in 1930, 38 remedies that are exclusively based on flowers, to treat 38 pathological states of the mind, as discussed separately. One interesting aspect is that Homoeopathy uses several nonangiospermous sources, as for example, viruses (small pox), bacteria (toxins of anthrax and botulinum), fungi (ergot, yeast, corn smut), puff balls, mushrooms (Amanita muscaria), The Complementary And Alternative Medicine System
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lichens (Usnea barbata), pteridophytes (Equisetum), and gymnosperms (Pinus canadensis). The non-angiospermous groups of plants have been largely ignored by many other systems of medicine. Homoeopathy uses material from diverse sources, in addition to plants, for itâ€&#x;s over 2,000 remedies, as indicated by the following examples: a) Elements (sulphur, iodine) b) Minerals (silica) c) Inorganic compounds (alum, ammonium bromide, ammonium carbonate) d) Inorganic acids (hydrofluoric, sulphuric, hydrocyanic, nitric) e) Metals/oxides (aluminum, arsenic, gold, iron, mercury, vanadium, titanium) f) Organic compounds (naphthalene, urea, glacial acetic acid, benzoic acid, butyric acid) g) Animal products (ambegris, lecithin, cod liver oil, bee venom, star fish,cockroach, snake venom, toad venom, plant lice, spiders), h) Hormones (adrenalin). MOTHER TINCTURES AND HOMOEOPATHIC POTENCIES Homoeopathic medicines are extracted from the source material in ethyl alcohol. The medicine is absorbed into sucrose or lactose (or sometimes starch) pills or small tablets, the size of which also determines the dosage. The weight/volume proportions of the raw material and the solvent are generally standardized for most of them. The Complementary And Alternative Medicine System
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This extraction gives the „mother tincture‟ which is serially diluted by 1:9 (solvent) proportion at each step, to obtain potencies that contain progressively smaller and smaller quantities of the active principle. This process is Potentization. The higher the potency, the smaller is the quantity of the active principle in the medicine, and stronger is the effect of medication. The mother tincture (1x) is infrequently administered. So are potencies higher than 200 x, while potencies of the order of 500x, 1000x or 2000x are used extremely rarely. THE LAWS OF HOMOEOPATHY Hahnemann extensively researched the toxicological literature of his day and experimented, on healthy volunteers comprised of a group of doctors and him, substances from minerals, animals and plants. He aimed his system to be a complete scientific method based on demonstrable Laws and Principles, the most important of them being: a) The law of similar b) The law of direction of cure c) The law of single remedy d) The law of minimum dose e) individualization f) The critique of homoeopathy Homoeopathy has been shown to be of tremendous value in reversing diseases such as diabetes, arthritis, bronchial asthma, epilepsy, skin eruptions, allergies, etc., especially if applied at the onset of the disease and before tissue damage takes place. It also gained reputation for lasting cures and in several conditions as an effective preventive medicine. Homoeopathy is „modernizing‟ and getting into using electronic and other diagnostic gadgetry and clinical tests. It is being integrated with other systems, as for example, Acupuncture where the The Complementary And Alternative Medicine System
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Acupuncture needle is dipped into a homoeopathic drug, a practice called „homoeopunctureâ€&#x; with encouraging results, even in plant pathology. Such efforts, however, drew criticism from the fundamentalists of Homoeopathy. All systems of medicine have critiques, both within and outside. Some even have questioned whether the whole of medicine is a science at all. Homoeopathy has had its own share of criticism, right from day one. At the 35th World Congress of Alternative Medicines, in November, 1997, at Colombo, two critical handouts on Homoeopathy were released. One was prepared by team of western homoeopaths (Anonymous, 1997) and the other was by Jayasuriya and Mehmke (1997). These two articles are identical on the issues raised. A summary of these is given below; a) Even today, homoeopathic practice is still based on the principles and practices enunciated by Hahnemann and his students, two centuries ago. Very little effort, by way of research or thinking, has been devoted to update the system and relate it to modern scientific practices. The findings of Hahnemann and his school have never been confirmed by others, particularly in this century. Replication is the essence scientific methodology. b) Hahnemann conducted his research on Germans. Since we now know that different ethnic groups in the world differ from each other in physical, physiological and psychological constitution, can the two century old results of Hahnemann be considered valid for all ethnic groups? c) Hahnemann created therapies for the Europeans of his day, in relation to their life style, environment and the diseases of that time. Since Europe and the world have changed so much in these two centuries, the same theory and practice of Homoeopathy may not be as relevant today. To consider just one of several factors, the food of today has pollutants, in the form of a) chlorine and heavy metals in water, b) synthetic colouring material, flavour enhancers like monosodium glutamate and chemical preservatives in food, c) The Complementary And Alternative Medicine System
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fruits, vegetables and grain contaminated by pesticides, d) hormone treated chicken, e) fish preserved in formalin, f) synthetic soft drinks and a myriad others, any or all of which may have antidoting or aggravating effects on the homoeopathic medicine, and may affect the constitution and resistance to disease, of vast human populations in different parts of the world, in different ways. Populations of the developing world, also have changed life styles and may find Homoeopathy much less effective today than earlier. These issues need to be examined critically, and suitable policy modifications be introduced. d) The totality of symptoms of disorders considered by Homoeopathy is a narrow and restricted way of looking at treatment, and the system totally ignores symptomatology borne out of modern diagnostics like laboratory tests, x-rays, scans, etc., that have been of great support in Allopathy. e) James Tyler Kent‟s Repertory is religiously used by a very large number of homoeopaths, all over the world. Computerisation of Kent‟s has been a disaster, as the work defied all logic and order. It is described as an outdated telephone directory needing updating, streamlining, and refinement, if not retirement. A lot of dead wood needs to be purged out of this universally referred „classic‟. What is the validity of prescriptions based on this much confused reference work today? f) There has been no quality control of homoeopathic medicines. A lax legal system allowed all and sundry into the field of manufacture, particularly in Asia. g) Complex Homoeopathy (mixed, simultaneous multiple remedies) negates Hahnemann‟s basic principle of single remedy and is considered as allopathy in the garb of Homoeopathy. h) The electronic gadgets, like the Homoeopathic diagnostic machine (EAV machine), being now used by homoeopaths in many countries, particularly Germany, have been shown to be a sham by research in Canada and Australia. Such fraudulent practices should be condemned. The Complementary And Alternative Medicine System
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A number of new procedures such as electrically or magnetically potentiated/energized water to prepare homoeopathic medicines, blood drawn from patient potentiated by medicine and re-injected, machines to filter out electromagnetic forces, application of principles of quantum physics, membrane biology, etc., have been introduced by some homoeopaths. Such methods, if beneficial to the patient are welcome, provided they have been thoroughly experimented and found to be efficient and safe. A suitable mechanism should be organized to evaluate such innovations. i) While antidoting of homoeopathic remedies is religiously prevented by advising the patient against using coffee, tobacco, menthol, etc., the possible antidoting effects of a number of other substances like lipstick, flouridated toothpaste, tooth amalgum, chewing gum, cola drinks, etc., have been ignored. j) On the one hand homoeopaths have departed from Hahnemann‟s rules, but on the other discouraged improvements in the system, as for example Homoeopuncture which has proven to be very effective, and it also avoids the complications of the oral route, like antidoting by the stomach contents. k) No studies have been carried out to elucidate the mechanism of action of homoeopathic medicines beyond Avogadro‟s limit of 12C, where there would be no molecules of the active principle in the medication. Another important point emerges from serial dilutions. In the source material, a plant or an animal, different chemical compounds are present in different quantities. Some are more abundant than others, while still others are present in minute quantities. When ethyl alcohol, or any other solvent for that matter, is used for extraction, the specific compounds and their quantities in the solution depend upon the solubility characteristics. Even if present in large quantities in the source material, a particular compound will not be in the solution if it is insoluble in the solvent used, while a soluble compound will all be there. Then when serial dilutions are made from this „mother tincture‟ , the compound that is in the smallest quantity in the solution will be the first to disappear and the compound that is in the largest quantity will be the last. Thus, the chemical composition of homoeopathic The Complementary And Alternative Medicine System
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potencies changes from dilution to dilution. In such a situation the therapeutic effects of different potencies cannot be the same. The issue of a higher potency being stronger than the lower one is relevant when all the potencies are chemically identical. The point is that different potencies are chemically not identical. Interestingly, scientists in other fields too were attracted to high dilutions. The „Benveniste affaire‟ was an excursion of the concept of ultra-dilutions into immunology which was soon shot down and subsequently again. l) Alcohol as the medium of preparing the mother tincture and the dilutions is acceptable to the Europeans and Americans, but has been unacceptable to a number of religious communities. The potential of water as a vehicle of homoeopathic medicine is to be considered. Homoeopathic medicines are extractions, in most cases from a single species of plants, in ethyl alcohol. Each single species contains a large number of different classes of chemical compounds, whose solubility characteristics are not the same. Some compounds are insoluble in water; some are insoluble in ethyl alcohol. Some compounds like lipids, terpenoids, phenolics and alkaloids are generally not soluble in either. They are soluble only in acid and other media. Pharmaceutical research has shown that these compounds, particularly phenolics and alkaloids are among the most therapeutically potential compounds. Homoeopathy uses a number of species of plants which are also used in Allopathy and plant based systems of Alternative Medicine and in which alkaloids are the active principles. Some examples of this kind are Piper nigrum, Coffea arabica, Nicotiana tabacum, Papaver somniferum, Atropa belladonna, Erythroxylon coca, Strychnos nux-vomica, Cinchona officinalis, etc. Ignoring the chemistry of these species, and the limitations of ethyl alcohol as a solvent, homoeopaths believe that these species afford the therapeutic benefits of the entire chemical complement. Boerick (1991) clearly mentions „Codeinum (An Alkaloid from Opium)‟, „Morphinum (An Alkaloid of Opium) and „Strychinum (An alkaloid of Nux Vomica)‟, which is an incorrect description for an alcohol extraction, as the concerned alkaloids are The Complementary And Alternative Medicine System
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only very slightly soluble in alcohol, if at all. By sticking only to ethanol extractions, Homoeopathy is losing out on the very valuable therapeutic benefits of several species. Since there is extensive pharmacological research on several plants that are also used in Homoeopathy, it will help the system immensely, if homoeopaths become familiar with Phytochemistry and pharmacology of the source material they use. They should open up their minds to the idea of extractions in different phytochemical solvents, in addition to water and alcohol, pooled up to prepare the „mother concentrateâ€&#x;, which can be potentiated in a suitable solvent, if thought necessary. Presently Homoeopathy gives an erroneous impression that the sum total of active principles in a biological source is present in its medicine. This is only partially true, as only those classes of compounds soluble in ethanol, and in quantities that depend upon their solubility, is present in the medicine. Hahnemann probably chose ethyl alcohol as the solvent for his medicines as it was regarded as the most efficient solvent at that time 200 yr. ago. Another probable reason is that alcohol also functions as a preservative; aqueous extractions decompose soon. The issue of solvents in Homoeopathy needs urgent attention. Jayasuriya and Mehmke (1997) have made the following suggestions to revitalize Homoeopathy: a) Research into the physicochemical properties of water in terms of its potential as a solvent for extraction and dilution of medicines; b) Design and development of experimental models of cells, tissues and organs,and animal models, for the study of biological effects of homoeopathic remedies; c) Pharmacological and biochemical studies of the active ingredients in homoeopathic medicine; and d) Controlled clinical trials. Ernst (1998) reviewed the history of 200 yearsâ€&#x; of criticism of Homoeopathy, and highlighted the following current issues:
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a) A number of narrative or systematic reviews and meta-analyses of controlled clinical trials concluded that there is evidence to suggest that the effects of homoeopathic treatments are more than a placebo response but methodological short comings invariably prevented a definitive conclusion. Till a plausible mechanism of action becomes available, it is difficult to negate this criticism. b) Homoeopathic medicine has been projected as entirely risk free. There has been evidence to the contrary. Even if the medicine is risk free, if the homoeopath is not, the patient is at risk. c) Other points: inconsistent with current science and medicine, there is no unified school thought, Hahnemann‟s original experiments were flawed, etc. Eskinazi (1998) raised more questions: a) Homoeopathy differentiates between „healthy‟ and „sick‟ individuals. Who is a healthy individual? b) Can homoeopathic dilutions push a healthy individual into sickness? Aspirin reduces temperature in an individual in fever but it does not induce hyper- or hypothermia in a person with normal temperature. Similarly, homoeopathic medicines may affect only people with unstable equilibrium. c) Since different dilutions of the same medicine have different effects, can two dilutions of a medicine be used to cure two different symptoms? This is the unicist vs pluralist debate. The basis for such issues is that, aspirin at usual dosage levels acts at the platelet level and increases bleeding time, but at homoeopathic dilutions it decreases bleeding time by acting at the level of the vascular parietal cells. Homoeopaths should take the criticism seriously and come out with convincing answers. The critics are actually helping homeopaths to know what is inconsistent with science and medicine in their system. Unfortunately, a vast majority of homoeopathic practitioners are not even aware of the criticism about their system. Much goes here on blind faith, although they may not be as dogmatic as The Complementary And Alternative Medicine System
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Hahnemann himself, who declared that „He who does not walk exactly on the same line with me is an apostate and a traitorâ€&#x;. Only homoeopaths can lift up Homoeopathy from the present controversial state. The clear need is for a multidisciplinary research oriented approach. A stronger scientific foundation will greatly enhance the respectability and acceptability of Homoeopathy, which is not just in the interests of the homoeopaths, but more importantly those of the patients at large. SPECIES OF PLANTS OCCURRING IN INDIA USED IN THE HOMOEOPATHIC MATERIA MEDICA The following species occurring in India and are a part of the homoeopathic materia medica, widely used in India: Abroma augusta
Abroma raxid
Abrus precatorius
Acalypha indica
Achyranthes aspera
Adhatoda vasica
Aegle marmelos
Aesculus hippocastanum
Agave americana
Allium cepa
Allium sativum
Aloe barbadensis
Alstonia scholaris
Amanita muscaria
Amygdalus persica
Anagallis arvensis
Andrographis paniculata
Apium graveolens
Areca catechu
Argemone mexicana
Artemisia vulgaris
Arundo donax
Atropa belladonna
Avena sativa
Azadirachta indica Bellis perennis
Beta vulgaris
Blumea odorata
Boerhaavia diffusa
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Brassica nigra Caesalpinia bonducella
Calendula officinalis
Calotropis gigantea
Calotropis procera
Caltha palustris
Camillea sinensis
Cannabis sativa
Capsella bursa-pastoris
Carica papaya
Capsicum frutesens
Cassia acutifolia
Centella asiatica
Cicer arietinum
Cinchona officinalis
Cinnamomum zeylanicum
Citrus spp.
Clerodendrum infortunatum
Coccinia indica
Cocculus hirsutus
Coffea arabica
Colchicum officinale
Coleus aromaticus
Colocynthis vulgaris
Conium maculatum
Crocus sativus
Croton tiglium
Cucurbita pepo
Cynodon dactylon
Daphne indica
Desmodium gangeticum
Digitalis lanata
Drosera burmannii
Equisetum arvensis
Eucalyptus globulus
Eugenia jambos Ferula assafoetida
Ficus benghalensis
Ficus religiosa Gaultheria indica
Gentiana chirata
Glycosmis pentaphylla
Gossypium spp.
Guaiacum officinale
Gymnema sylvestre
Haematoxylum campechianum Helianthus annuus The Complementary And Alternative Medicine System
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Holarrhena antidysenterica
Hura crepitans
Hydrocotyle javanica
Hygrophila auriculata
Ilex aquifolium
Illicium anise
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Indigofera tinctoria Jacaranda acutifolia
Jatropha carcas
Juglans regia
Justicia rubrum
Lemna minor
Lepidium sativum
Leucas aspera
Linum usitatissimum
Lupulus humulus
Lycoperdon esculentum
Lycopodium spp. Magnolia grandiflora
Mahonia leschenaultiana
Melandrium indicum
Mangifera indica
Medicago sativa
Melilotus indica
Mentha piperita
Momordica charantia
Myristica fragrans Nerium odorum
Nicotiana tabacum
Nyctanthes arbortristis Ocimum canum
Ocimum sanctum
Oldenlandia herbacea
Opuntia dillinii
Papaver somniferum
Passiflora incarnata
Physalis indica
Phytolacca americana
Pinus sylvestris
Piper cubeba
Piper nigrum
Plantago major
Primula veris
Punica granatum
Plumbago zeylanica The Complementary And Alternative Medicine System
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Ricinus communis
Ruta graveolens Saccharum officinarum
Sambucus nigra
Santalum album
Saraca asoca
Semicarpus anacardium
Smilax zeylanica
Solanum nigrum
Solanum xanthocarpum
Solidago virga-auria
Stellaria media
Strychnos nux-vomica
Syzygium jambolanum
Taraxacum officinale
Taxus baccata
Terminalia arjuna
Terminalia chebula
Thymus serpyllum
Tinospora cordifolia
Tribulus terrestris
Triticum aestivum
Usnea barbata
Ustilago maydis
Valeriana jatamansi
Vanilla planifolia
Vernonia anthelmintica
Viscum album
Xanthophyllum rhetsa Zea mays
Zingiber officinale
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11 Aromatherapy Aromatherapy is that area of complementary medicine which uses the naturally occurring volatile chemical compounds that impart odour to plants and animals, to alleviate certain kinds of symptoms of disease. The therapy is administered by applying the volatile compounds onto the skin as a massage or through inhalation. For thousands of years people have used Aromatherapy as an aid to physical and emotional wellbeing. Egyptians were possibly the first to recognise the therapeutic powers of plant aromatic compounds, particularly the essential oils. An established tradition of aromatherapy also existed in China and India, for long. Jamil (1997) dates Aromatherapy to 6,000 years back, in ancient Egypt and India. In addition to being in wide use in the orient, Aromatherapy has gained new popularity in Europe and to some extent in the US, during past four or five decades. Aromatherapy is classified as a Sensory therapy and considered as a harmless natural treatment to improve and maintain well-being, and suppress anxiety. The world over, there seem to be about 300 different aromatic oils, employed in Aromatherapy, many of them used as a massage. Lawless (1997) provides a detailed and wellillustrated account of aromatherapy. Sharma (1998) has given examples of aromatherapy in Ayurved. The aromatic compounds have several therapeutic properties, not linked to the aroma that has psychological effects on us. Gattefosse, the early French aroma therapist, would burn his hand and dip into a bowl of lavender essence, to demonstrate that the hand heals very quickly. A long time ago research was conducted at Milan University, to demonstrate the advantages of aromatherapy in treating anxiety and depression. Essential oils are believed to stimulate the olfactory nerves and exert influence on the brain center that controls emotions. The nerve endings in the skin also are stimulated when the oils are The Complementary And Alternative Medicine System
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applied to the skin. Aroma therapists believe that the dermal stimulus reaches the pituitary gland which exerts influence on other glands, including the adrenals, which in turn regulate stress or relaxation response. Research has been conducted on the effects of Aromatherapy. For example, jasmine flowers suppressed lactation mimicking the effects of bromocriptine and cancer patients were relieved of anxiety. A number of studies have indicated that aromatherapy is suitable in the treatment of pain, psychological disturbance, allergies, skin conditions, gastro-intestinal disorders, cardio-vascular problems, and urinary disturbances, and gynecological disturbances, behavioral anomalies of children, sports injuries, post-viral fatigue, and side effects of chemotherapy, cancer and pregnancy. But one has chosen the most appropriate prescription. Jamil (1997) has a few suggestions, as for example, geranium for menstrual tension or lavender for headaches. Aromatic plants or their products or chemical compounds, are given internally in different therapy regimes, but if they are essential oils, some caution and clinical observation seem to be desired. Massaging is the most common way of administration. Inhalation is another means. Chamomile, lavender, rose, jasmine, sandalwood, and geranium oils are the most common oils used in aromatherapy. Even if they do not actually affect any cure, many aromatic compounds induce a pleasant feeling.
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12 Unani System of Medicine The Unani Tibetian system of medicine is traced to the system of Greek medicine developed during the Arab civilization, is also called the Greco-Arab system. The name Unani (Ionian) is considered indicative of the Greek origin of the system, though the European historians call it Arab medicine, now prevalent in India, Pakisthan and Bangla Desh. It had gone also to places where the AsianMuslims took it along. The Hamdard Foundation in Karachi has done commendable service to the cause of the Unani system of medicine, more importantly through a series of publications on the subject. Detailed general information on various aspects of the Unani system of medicine can be obtained from Baquai (1977), Said (1983) and Sathnarayana Bhat and Kameswara Rao (1993). A very useful glossary of plants used in Unani medicine was compiled by Fathima (1994), which includes sources of therapeutic information. It was Hippocrates, the Greek philosopher-physician (460 to 377 BCE), who relieved medicine from the grip of superstition and magic and gave it the status of science. The theoretical frame work of Unani is based on the teachings of Hippocrates. Subsequent to him, a number of Greek scholars have enriched the system considerably. Of them was Galen (131—210 CE) standing out as the one who established the fundamentals of Unani on which the Arab physicians like Rhazes (850-925 CE) and Avicinna (980-1037 CE) constructed an imposing edifice. Thus there is some justification in calling Unani as a Greco-Arab (Islamic) system. By the time the Muslim religion came into being, Unani was in use. The Unani system owes its development to the Arab and Iranian physicians and to a very considerable extent to the Indian Hakeems. It has absorbed what was best in the contemporary medicine in Egypt, The Complementary And Alternative Medicine System
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Syria, Iraq, Persia, India, and China and other middle and far eastern countries. The Arabs have introduced the Unani system into India and soon it took to deep roots. When Mongols ravaged the Persian and Central Asian cities like Siraz, Tabrez and Geelan, scholars and physicians of Unani medicine fled to India. They received state patronage from the Delhi Sultans, the Khiljis, the Tughlaqs, and the Mughals. Some of the Unani scholars and physicians have even been employees of the State as court physicians. The Unani system had its heyday during the period between the 13th and the 17th centuries in India. Among those who made valuable contributions to this system, to name a few, were Abu Bakr, bin Ali Usman Kashmari, Sadruddin Damashqui, Bahwa bin Khwas Khan, Ali Geelani, Akbar Arzani and Mohammad Hashim Alvi Khan. The scholars and physicians of the Unani system who settled in India were not content with the known drugs but they subjected the Indian drugs to trials and as a result of their experimentation added numerous native drugs to their own system, thus enriching it. The system found immediate favour with the masses and soon spread all over the country and continued to hold an unchallenged sway for a long period even after the down fall of the Mughal Empire. During the British Rule, the Unani system sufferred a setback and its development were hampered due to the withdrawal of governmental patronage. But since the system enjoyed the faith of the masses, it continued to be practiced. It was mainly due to the efforts of the Sharifi family in Delhi, the Azizi family in Lucknow and the Nizam of Hyderabad, the Unani system survived in India during the British period. An outstanding physician and scholar of theUnani medicine, Hakim Ajmal Khan (1868-1927), championed the cause of the system in India. The Hindusthani Dawakhana and the Ayurvedic and Unani Tibbia College in Delhi are the two living examples of the Hakimâ€&#x;s immense contribution to the multi-pronged development of the two Indian systems of medicine. The development of the Unani as well as the other Indian systems of medicine gained momentum after India became The Complementary And Alternative Medicine System
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independent. In order to streamline education and regulating the practice of the Indian systems of medicine, the Government of India has established (by an Act of the Parliament, The Indian Medicine Central Council Act, 1970), the Central Council of Indian Medicine. In 1995, the Government of India has also set up a full-fledged Department of Indian Systems of Medicine and Homoeopathy, in the Ministry of Health and Family Welfare, to accelerate the pace of development of these systems. The Unani medicine, as said earlier, was based on the principles of Hippocrates, who first established that disease is a natural process, that its symptoms were the reactions of the body. He advocated that the chief function of a physician is to aid the natural forces of the body in combating the disease. Hippocrates was the first physician, and the only one on record from antiquity to introduce the practice of recording medical histories of patients. The chief contribution of Hippocrates to medical realm is the humoural theory, which passed on to Unani. The humoural theory in Unani presupposes the presence of four humours in the body: Dam (blood), Balgham (phlegm), Safra (yellow bile) and Sauda (black bile). The temperaments of persons are expressed by the terms sanguine, phlegmatic, choleric and melancholic, according to the preponderance of the humour (blood, phlegm, yellow and black bile) in them. The humours themselves were assigned temperaments—blood is hot and moist, phlegm is cold and moist, yellow bile is hot and dry and black bile is cold and dry. Every person is supposed to have the unique humoural constitution which represents his/her healthy state. The body is considered to be comprised of the following (Said, 1983): a) Arkan: different states of matter and materials entering into and forming a part of everything in Universe (elements); b) Mizaj: the bodily temperament (physico-chemical aspects); c) Akhlat: the structural components (bodily humours); The Complementary And Alternative Medicine System
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d) A’da: the fully developed mature organs (anatomy); e) Ruh: the vital or life-force (mental or nervous energy); f) Quwa’: the bodily power (physical energy); and g) Af’al: the corporeal function (physiological and biochemical processes). To maintain the correct humoural balance, there is a power of self-preservation or adjustment called Quwwate-Mudabbira (vis medicatrix naturae) in the body. If this power weakens, an imbalance of the humoural composition is bound to occur. This causes the disease. In the Unani system, good reliance is placed on this power. The medicines used in fact help the body to retain this power to an optimum level and thereby restore the humoural balance, thus restoring health. In addition, a correct diet and proper digestion are considered to be important in the maintenance of the humoural balance. In the Unani system, temperament (mizaj) has an important place, and forms the basis of pathology, diagnosis and treatment. The Galenic concept of temperament being sanguine, phlegmatic, choleric or meloncholic, finds expression in the Unani system that considers each individual as unique. The modern psycho-neuro-endocrinical concept is often taken in support of the idea that temperament is unique to an individual and that a shift in the temperament brings about a change in the person‟s state of health. Thus, disease is the consequence of humoural imbalance in the body and of the failure of one or more parts of the body to get rid of pathogenic waste from the body. As the humours, the drugs are also assigned temperaments. A drug considered hot, produces a temperament This is hot. Hence drugs are principally used to correct the abnormal or pathological temperament of the body or of any system or organ.
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The basic philosophy of the Unani system is that the body, composed of matter and spirit, is taken as a whole since a harmonious life is possible only when there is a proper balance between the physical and spiritual functions. It aims not only to correct the present disturbance but also to make the individual emerge after recovery with a greater power of resistance to future disturbances. Another distinctive feature of the Unani system is its emphasis on the diagnostic importance of Nabz, the pulse, the rhythmic expansion of the arteries which is felt by the fingers of the physician. Other methods of diagnosis include examination of Baul (urine) and Boraz (stool). The Unani system recognizes the influence of oneâ€&#x;s surroundings and the ecological conditions on the state of health of human beings. The system aims at restoring the equilibrium of various elements and faculties of the human body. It has laid down six essential pre-requisites for the prevention of disease and places great emphasis, on the one hand on the maintenance of proper ecological balance and on the other, on keeping water, food and air free from pollution. These essentials, known as ‘Asab-e-sistta Zarooriyaâ€&#x;, are the air, food and drinks, bodily movements, psychic movements, repose, sleep and wakefulness, and excretion and retention. In the Unani system, various types of treatment are employed such as ilaj bit tad bur (regimental therapy), ilaj bil Ghiza (diet therapy), ilaz bid Dawa(pharmaco-therapy) and jarhat (surgery). The regimental therapy includes, vivisection, cupping, diaphoresis, diuresis, Turkish bath, massage, cautery, purging, emesis, exercise, leeching, etc. Diet therapy aims at treating certain ailments by the administration of specific diets or by regulating the quality and quantity of food. The pharmaco-therapy deals with the use of naturally occurring drugs of predominantly mineral or animal origin. Surgery that has been in use in Unani practice for a long time employs surgical procedures for which certain instruments and techniques have been designed. In Unani medicine, single drugs or combinations in the raw form are preferred, over compound formulations. The Unani Materia The Complementary And Alternative Medicine System
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Medica is very vast, but most of the ingredients are locally available and easy to obtain. The naturally occurring drugs used in the system are symbolic of life and are generally free from side effects. And such drugs as are toxic are processed from crude material and purified in many ways before use. The medicines are polypharmaceuticals in the form of decoctions, infusions, tablets, powders, confections, syrups, and aquas. In the Unani system, although the general preference is for single drugs, compound formulations are also employed in the treatment of various complex and chronic diseases. Since this system lays stress upon the particular temperament of the individual, the medicines administered are such as go well with the temperament of the patient, thus accelerating the process of recovery and also eliminate the risk drug reactions. For these reasons, the treatment varies with the individual, even for the same disorder. The prescription is given in the name of God and begins with Howash Shafi (God is the healer). It contains instructions on the dosage and method of preparation of the medicine, diet, rest, etc. The tabib, the Unani medical practitioner, is not merely a doctor; he is the guide, on even moral and social values. There are tabibas, the lady doctors, to treat women. The Unani pharmacopoeia (Said, 1969) has a rich armamentarium of natural drugs, consisting of mostly herbs but also material of animal, mineral and marine origin. There are over 2,000 species of plants in the Unani Materia Medica (Daljithsimha, 1974), of which many species of plants occurring in India found a place (Fathima, 1994). Research was conducted on the efficacy of species such as; Adhatoda vasica,
Boerhaavia diffusa,
Cephalandra indica,
Nardostachys jatamansi,
Peganum haramala,
Podophyllum species,
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Psoralea corylifolia,
Rauvolfia serpentina,
Saraca asoca,
Swertia chirata,
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Tamarix dioica, etc., Which are also popular in Ayurved. Nevertheless, by and large, the Unani pharmacopoeia lacks in a detailed experimental, physicochemical and bio-mathematical data (Said, 1983), but the medication is considered nearly always safe. Presently there are several recognized institutions in the Indian subcontinent that train and give academic degrees, in the Unani system. The curriculum includes modern concepts of paraclinical and clinical aspects of medicine. As is the case with other systems of Alternative medicine, in Unanialso there are qualified practitioners, academically unqualified but very experienced and traditional practitioners and of course, quacks. The system expressly forbids quacks but now a day there is little control, even though the governments in most countries have constituted legal bodies to regulate the practice of the system.
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13 Tibetan System of Medicine The Tibetan system of medicine was a closely guarded secret for a very long time, and was passed on from father to son or from teacher to a single student. The system treats both the mind and the body with a holistic approach, the primary aim being the restoration of the bodyâ€&#x;s equilibrium needed for its normal functioning. The Tibetan system seems to have originated in folk cures of over 3,000 years ago, as for example, yak butter to stop bleeding and Tibetan barley beer to cleanse external wounds. Tibetan medicine is considered as more complex than even acupuncture and the system relates disease directly to astronomical changes, with the result the local medicine and astrology developed hand in hand. The Tibetan system is closely allied to the Indian system. With a large number of people of Tibetan origin now residing in various parts of the country, the system is gaining some popularity in India. The origin and development of the Tibetan medicine were reviewed by Changbhar (1993) and Jayasuriya (1997), a summary of which is given here. The origin of the Tibetan system was traced thousands of years before Christ. Chebur Trishe, the second son of Shenrab Meo, the founder of the Bonreligion (long before Buddhism), found a medical text at Shanshung, near mount Kailash. The Buddhists believed that Buddha (567 BCE) taught this medicine to one and all, in the Royal Palace at Odiyana, in India, when it was compiled in samskrit from the original Marying or Shanshung Yiggen language, different from the present Tibetan language. In 233 CE, the 28th King of Tibet, Lhathothori Nyantsen introduced the medical science along with Buddhism by inviting two Indian physicians, Vijay Gajay and Billa Gazema from Bodh Gaya, in Bihar. A son of Vijay Gajay, Dungyi Tharchok, learnt the system The Complementary And Alternative Medicine System
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from his father and became the first personal physician of the King. This established the medical practice based on Buddhist teachings. Emperor Songtsen Gonpo (617-650 CE), the most powerful ruler of Tibet, invited three famous medical scholars: Rishi Bharadwaj from India, Hsuan-Yuan Huang-ti from China and Galenos from Rome. They jointly compiled seven volumes of a medical treatise, Mijigpe Tson-ja, that combined the vast scholarship of all the three. The Great King, Trisong Dentsen (742-798 CE) extended royal patronage to the medical science and provided inspiration by convening an International Conference on Medicine participated by scholars from India, China, Persia, Rome, Schigchang and Nepal, besides those from Tibet. Yuthok Yonten Gonpo (729-854 CE), the foremost Tibetan physician of his time, visited India on three occasions and learnt the ancient Buddhist system of medicine known as So-wa-Rigpa. He sought the best out of the Indian-Buddhist, Chinese, Greco-Arabic and the Tibetan systems. He also founded the first Medical University at Kongpo, in Eastern Tibet. Yuthok is regarded as the Father of Tibetan medicine. Desi Sangyae Gyasto (1652-1705 CE), the regent of the 5th Dalai Lama, wrote detailed commentaries on the Tibetan medicine. He wrote a treatise on contagious diseases, edited a book on anatomical drawings, and founded the Chokporihill Tibetan Medical Institution in Lhasa, which soon gained international reputation. The Lhasa Institute of Astro-Medical Science was founded in 1916 on the wish of the 13th Dalai Lama. After the Chinese presence in Tibet, the Dalai Lama came to India in 1961, along with some physicians and medical texts. The Tibetan Astro-Medical Institute was founded in Dharmasala, Himachal Pradesh. This opened an avenue for fresh interaction and co-ordination between the Tibetan and other systems of medicine available in India. Now Tibetan medicine is making its presence felt in different parts of India and the world. The Complementary And Alternative Medicine System
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The Tibetan medical practice is based on the Tripod theory of humours. Rlung (wind), mkhrispa (bile) and badkan (phlegm) are the essential humours that regulate the normal functioning of the body. Changbhar (1993) comments that rlung actually refers to all functions of the central nervous system and other functions of the body and not wind. Similarly, mkhrispa does not mean bile but the metabolism and heat production, various secretions and excretions of the body. Badkan implies various functions of the digestive system, glandular secretions, hormones and other body fluids such as mucus, synovia, etc. Tibetan medicine holds that the human body is composed of seven materials: chyle, blood, flesh, fat, bone, marrow and the reproductive organs. These materials work together to produce vital energy, internal heat and mucous for the body to function. A balance of these is essential for good health, a concept parallel with Ayurveda, Siddha and Unani systems. The Tibetan medical literature indicates that the innumerable diseases are caused by a change in human mind and the environment. About a thousand curable diseases are designated in the system. Claims of curing chronic diseases, long term illnesses, cancer, etc., that were not cured by other systems of medicine, are made. The Tibetan medicine uses observation, palpation and interrogation as diagnostic tools. All parts of the body are subjected to observation. Urine examination is an important aspect in the diagnosis of several diseases. The origin of Urinotherapy, now widely practiced in India, is attributed to the Tibetans. Reading the pulse is believed to help both in diagnosis and prognosis. Herbs are an important ingredient of the Tibetan system. Great emphasis is laid on the part used and methods of identification, collection, preservation and extraction. Minerals are another important part of the medication. The medicine is administered in the form of decoction, powder, pills, syrups, oils, wine, buttery form, ashy form, etc. Medicine may constitute a single herb or a hundred of them. For example, a medicine called A=gar 35 (Agar sonya) has 35 different kinds of herbs. The physician is expected to be The Complementary And Alternative Medicine System
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knowledgeable in the herbs, their characters, potent effects, their synergy, etc. The Tibetan medicine is considered to be virtually free from any side effects and toxicity. The geographic location and climate of Tibet are vastly different from those of most parts of the Indian subcontinent. The herbs and minerals available in Tibet, form the main basis of Tibetan medicine, as all systems of medicine naturally include mostly the locally available material. But for the differences in the material used, the basic philosophy of the Tibetan medicine appears to be similar to that of Ayurveda. The Buddhist influence has taken from India to Tibet, both religion and medicine. Outside Tibet, now the system has to find substitutes to the Tibetan material that is not available outside.
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14 References
Anonymous. 1980. Advances in acupuncture and acupuncture anaesthesia. : Abstracts of papers presented at the National symposium of Acupuncture, Moxibustion and Acupuncture anaesthasia. The People‟s Medical publishing House, Beijing. Anonymous. 1989. Formulary of Siddha medicines. The Indian Medical Practitioners Co-operative Pharmacy and Stores, Ltd., Chennai. Anonymous. 1997. A critical update of Homoeopathy. A hand out at the 35th World Congress of Alternative Medicines, November, 1997, Colombo. Balandran, M.F., Klocke, J.A., Wurtele, E.S. and Bollinger, H. 1985. Natural plant chemicals: Sources of industrial and medicinal materials. Science, 228: 1154. Bannerman, R.H., Burton, J. and Wen-Chieh, C. 1983. (eds.) Traditional medicine and health care coverage. WHO, Geneva. Baquai, F.U. 1977. Traditional medicine in Pakistan. Hamdard Foundation, Karachi. Barz, W. and Ellis, E. 1981. Potential of plant cell cultures for pharmaceutical production. In Natural products as medicinal agents. (eds.) Beal, J.L. and Reinhard, E. Suppl. to Planta Medica, Hippokrates Verlag, Stuttgart. pp 471-508. Baum, H. and Gehman, J.M. 1974. Living today for tomorrow. Natural Health Foundation, Duncannon, U.S.A. Beauvais, D.E., Amara, J., et al. 1988. Human basiphil degranulation triggered by very dilute antiserum against IgE. Nature, 333:316-318. Bloomfield, R.J. 1983. Naturopathy. In Traditional medicine and health care coverage. (eds.) Bannerman, R.H., Burton, J. and Wen-Chieh, C. WHO, Geneva. pp. 117-123.
The Complementary And Alternative Medicine System
85
The Complementary And Alternative Medicine System
86
Boericke, W. 1991. Homoeopathic materia medica. 9th revised edition. First ed. 1927. (ed.) Boericke, O.E. B. Jain Publishers, New Delhi. Canary, J.J. 1983. Modern allopathic medicine and public health. In Traditional medicine and health care coverage. (eds.) Bannerman, R.H., Burton, J.and Wen-Chieh, C. WHO, Geneva. pp. 90-101. Cassady, J.M., Chang, C.-J. and McLaughlin, J.E. 1981. Recent advances in the isolation and structural elucidation of antineoplastic agents in higher plants. In Natural products as medicinal agents. (eds.) Beal, J.L. and Reinhard, E. Suppl. Planta Medica. Hippokrates Verlag, Stuttgart. pp 93-124. Changbhar, S.W. 1993. Brief introduction of Tibetan traditional medicine. In Traditional medicine. (ed.) Mukherjee, B. OxfordIBH, New Delhi. Compadre, C.M., Pezzuto, J.M., Kinghorn, A.D. and Kalmath, S.K. 1985. Hernandulcin: An intensely sweet compound discovered by review of ancient literature. Science, 227: 417419. Daljithsimha, K. 1974. Unani dravyagunadarshana. Ayurvedic and Tibbi Academy, Lucknow. Daly, D. 1997. Alternative Medicine courses taught at the United States Medical Schools: an ongoing list. The J. Alternative and Complementary Medicine, 3:405-410. Duke, J.A. 1985. Medicinal Plants. Science, 229: 1036. Dunn, F.L. 1976. Traditional Asian medicine and cosmopolitan medicine as adaptive systems. In Asian medical systems. (ed.) Leslie, C. Univ. of California Press, Berkeley. p. 135. Ernst, E. 1998. The heresy of homoeopathy. British Homoeopathic J., 87:28-32. Eskinazi, D. 1998. Some questions and thoughts on research in homoeopathy. British Homoeopathic J., 87:33-38. Evans, D., Nelson, J. and Taber, T. 1982. Topics in stereochemistry. In Interscience. (eds.) Alinger, N.L. and Elile, E.L. New York. Farnsworth, N.R. and Bingel, A. 1977. New natural products and plant drugs with pharmaceutical, biological or therapeutical The Complementary And Alternative Medicine System
86
The Complementary And Alternative Medicine System
87
activity. (eds.) Wagner, H. and Wolff, P. Springer-Verlag, New York. Fathima, T. 1994. Glossary of medicinal plants in Unani medicine. M.Sc., (Applied botany) dissertation. Bangalore University, India. Foster, G.M. and Anderson, B.G. 1978. Medical anthropology. Wiley, New York. Pp53-56. Goldwater, C. 1983. Traditional medicine in Latin America. In Traditional medicine and health care coverage. (eds.) (eds.) Bannerman, R.H., Burton, J. and Wen-Chieh, C. WHO, Geneva. pp. 37-49. Gottlieb, O.R. 1982. Micromolecular evolution, systematics and ecology. Springer-Verlag, Berlin. Hahnemann, S. 1796. Versuch uber ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen. J. Prakt Arzneykunde u Wundarzneykunst, 2:391-439. Hahnemann, S. 1796. Versuch uber ein neues Prinzip zur Auffindung der Heilkräfte der Arzneisubstanzen. J. Prakt Arzneykunde u Wundarzneykunst, 2:391-439. Hahnemann, S. 1810. Organon der Heilkunst. Arnold, Dresden. Hirst, S.J., Hays, N.A., Burridge, J., Pearce, F.L., and Foreman, J.C. 1993. Human basophil degranulation is not triggered by very dilute antiserum against human IgE. Nature, 366: 525-527. Hughes, C.C. 1968. Ethno medicine. In International encyclopedia of social sciences. Macmillan, New York. vol. 10, p 99. Inglis, B. 1972. Fringe medicine. Faber and Faber, London. Jamil, T. 1997. Complementary medicine. ButterworthHeinemann, Oxford. Jayasuriya, A. 1997. The future of complementary medicines. Medicina Alternativa International, Colombo. Jayasuriya, A. and Mehmke, A. 1997. Homoeopathy update. A hand-out at the 35th World Congress of Alternative Medicines, November, 1997, Colombo. Kameswara Rao, C. and Sangeetaa, W. 1993. Alternate sweeteners. Vatika, No. 4, Winter, 1993. The Complementary And Alternative Medicine System
87
The Complementary And Alternative Medicine System
88
Keys, J.D. 1976. Chinese herbs. C.E. Tuttle Co., inc., Tokyo. Kreig, M.B. 1964. Green Medicine. Skokie, I.L., Bantam Books. Kun, K.A. 1983. The Western Pacific Region. In Traditional medicine and health care coverage. (eds.) Bannerman, R.H., Burton, J. and Ch‟en Wen-Chieh. World Health Organisation, Geneva. pp 263-268. Kurup, P.N.V. 1983. Ayurveda. In Traditional medicine and health care coverage. (eds.) Bannerman, R.H., Burton, J. and Wen-Chieh, C. WHO, Geneva. pp 50-58. Lain-Entralgo, P. 1982. Historia universal de la medicine. vol 7. Salvat Edit, Madrid. Lawless, J. 1997. The complete illustrated guide to aromatherapy. Element Books Ltd., Dorset. Leavitt, D. 1974. Chinese herbal medicine. DHEW Publishers, New York. Lewith, G.T. 1982. Acupuncture. Thorsons Publishers Ltd., Wellingborough. pp 14; 32-33. Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F., Hedges, L.V. and Jonas, W. 1997. Are the clinical effects of homoeopathy placebo efffects? A meta-analysis of placebo controlled trials. Lancet, 350:834-843. Lindlahr, H. 1975. The philosophy of natural therapeutics. Maidstone Oesteopathic clinic, Maidstone, Kent. Longman, M.J.S. 1997. Homoeopathy trials, reasons for good ones but are they warranted? Lancet, 350:825. Lynch, G. and Baundry, M. 1984. The biochemistry of memory: A new specific hypothesis. Science, 224: 1057. Mabey, R. 1988. (ed.) The complete new herbal. Elm Tree Books, London. pp 150-151. Maddox, J., Randi, J. and Stewart, W.W. 1988. "High dilution" experiments a delusion. Nature, 333:287-290. McPartland, J.M. and Soons, K.R. 1997. Alternative medicine in Vermont—A census of practitioners: prevelence, patterns of use and national projection. The J. Alternative and Complementary Medicine, 3:337-342.
The Complementary And Alternative Medicine System
88
The Complementary And Alternative Medicine System
89
medical systems. (ed.) Leslie, C. Univ. of California Press, Berkeley. p. 135. Naranjo, P. 1970. Plantas psicotomimeticas y bioquimicas de la mente. Terapia, 25: 87. OTA (Office of Technology Assessment). 1983. Plants: The potentials for extracting protein, medicines and other useful chemicals. Washington, DC. Pardal, N. 1937. Medicina aborigen Americana. J. Anesi, Buenos Aires. Pearce, D. and Moran, D. 1994. The economic value of biodiversity. Earthscan Publications, London. pp 101-102. Pei, W. 1983. Traditional Chinese medicine. In Traditional medicine and health care coverage. (eds.) Bannerman, R.H., Burton, J. and Ch‟en Wen-Chieh. World Health Organisation, Geneva. pp 68-75. Principe, P. 1989. The economic significance of plants and their constituents as drugs. In Economic and medicinal plant research.. (eds.) Wagner, H., Hikino, H. and Farnsworth, N. ol. 3. Academic Press, London. pp 1-17. Principe, P. 1991. Monetizing the pharmacological benefits of plants. US Environmental Protection Agency, Washington, D.C. Reilly, D.T., Taylor, M.A. and Beattie, G. 1986. Is Homoeopathy a placebo response? The Lancet, 2: 881-886. Said, H.M. 1969. (ed.) Hamdard pharmacopoeia of eastern medicine. Institute of Health and Tibbi Research, Karachi. Sathyanarayana Bhat and Kameswara Rao, C. 1993. Unaani vaidya parichaya (in Kannada). Directorate of Indian Systems of Medicine and Homoeopathy, Government of Karnataka. pp 22. Schmeltz, I. 1971. Naturally occurring insecticides. (eds.) Jacobson, M. and Crosby, D.G. Dekker, New York. Sharma, P.V. 1998. Pushpayurveda. Chaukambika, Varanasi. Stuart, G.. 1911. Chinese materia medica of vegetable kingdom. International Book Distributors, Dehra Dun (reprint). Swain, T. 1972. (ed.) Plants in the development of modern medicine. Harvard Univ. Press, Cambridge, MA. The Complementary And Alternative Medicine System
89
The Complementary And Alternative Medicine System
90
Turner, R.N. and Low, R.H. 1978. The principles and practice of Moxibustion: a guide to the therapeutic application of heat to acupuncture points. Edisem, Quebec. Van der Brouk, J.P. 1997. Homoeopathy trials, going nowhere. Lancet, 350:824. Vithoulkas, G. 1983. Homoeopathy. In Traditional medicine and health care coverage. (eds.) Bannerman, R.H., Burton, J. and Wen-Chieh, C. WHO, Geneva. pp. 110-115. Von Reis Altschul, S. 1973. Drugs and foods from little-known plants. Harvard University Press, Cambridge, MA. Walach, H., Ives, G., Karragiannopoulas, C., Lindtke, R., von Wassenhoven, M. and Will, C. 1998. Electric measurement of ultra-high dilutions of blinded controlled experiment. British Homoeopathic J., 87:3-12. Wall, M.E. and Wani, M.C. 1981. Structure activity relationship of plant antitumour agents related to camptothecin and the quassinoids. In Natural products as medicinal agents. (eds.) Beal, J.L. and Reinhard, E. Suppl. Plants Medica. Hippokrates Verlag, Stuttgart. pp 125-149. Wei, Ru-Shu. 1983. Acupuncture and moxibustion. In Traditional medicine and health care coverage. (eds.) Bannerman, R.H., Burton, J. and Ch‟en Wen-Chieh. World Health Organisation, Geneva. pp 76-81. Wermuth, C.-G. 1981. Modulation of natural products in order to improve their pharmacokinetic properties. In Natural products as medicinal agents. (eds.) Beal, J.L. and Reinhard, E. Suppl. Planta Medica. Hippokrates Verlag, Stuttgart. pp 185215. West, R. and Travelyan, J.E. 1985. Alternative medicine. Mansell Publishing Ltd., London. WHO (World Health Organisation). 1978. The promotion and development of traditional medicine. Technical Report No. 622. Geneva. Wingate, P. 1972. (ed.) Penguin medical encyclopaedia. Penguin Books, Harmondsworth, UK.
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