Shifting Paradigm: from Conventional to Alternative Medicines an Introduction on Traditional Indian Medicines

Shifting Paradigm: From Conventional to Alternative Medicines An Introduction on Traditional Indian Medicines Grover JK, M.D. and Vats V, Ph.D. Department of Pharmacology All India Institute of Medical Sciences ankind has the right to avail the best that is available medical schools or generally available at allopathic or M in any system of medicine. The proposition of cause western hospitals.”2 In the 1970s or 1980s these disciplines and effect relationship by Lister in the 19th century laid were mainly thought as an alternative to the existing the foundation of modern medicine and brought about a allopathic system and therefore became known collectively revolution in the diagnosis and treatment of diseases. With as “alternative medicine.” However in developing countries the advent of antibiotics, diagnostics, asepsis and surgery, especially in the eastern part of the globe, this is a misnomer emerged a period where the cure of disease and the and there is little consensus as to whether these modalities improvement in quality and longevity surpassed the are alternative or mainstream in some parts of the region. imagination of all and diseases once thought to be deadly The alternative medical practices all over the world is were tamed easily.1 In this fast growing pace of modern disparate3,4 and encompasses traditional health care systems. medicine, traditional practices of medicine took a back seat. Shifting Paradigm “From Conventional to Alternative Although much has been achieved by the wonder Medicine” treatments of modern medicine, cure is still not possible With the increasing super specialization, technology and for many diseases and treatment is largely aimed at cost escalation in modern medicine, the element of suppressing the symptoms. In addition, use of modern drugs empowerment, participation in the healing process, time is associated with adverse reactions. Moreover, providing and personal attention has dwindled.7 Perhaps this has been modern medical healthcare across the world (especially in one of the most important factors that has contributed in developing countries such as India) is still a far-reaching patients switching from conventional to alternative medicine goal due to economic constraints. Interestingly, the most which on the other hand relies greatly on providing patients commonly used drugs of modern medicine such as aspirin, with understanding, meaning and self-care methods for anti-malarials, anti-cancers, digitalis, etc, have originated managing their conditions. The other important reason for from plant sources. In the light of these factors, both the the increased popularity of alternative medicine is the health-related policy makers as well as the patients have adverse effects of certain conventional treatments. In been advocating the revival of such traditional practices addition, sky-rocketing costs of conventional medicine has and its scientific validation. In India, the emphasis has also driven the search for alternatives. been on the revival of older systems of medicines such as Ayurveda, Siddha and Unani. The single and greatest most Differences between biomedicine and traditional medicine strength of alternative system of medicine is emphasis on self-healing as the lead approach for improving wellness The two most important principles of all traditional or and for treatment of disease. alternative form of medicines including Ayurveda are the existence of a vital force and holism, which states that nothing Definition of Alternative Medicine can be considered in isolation.8-11 This vital force in China is designated as “Qi,” in Japan as “Ki” and in India as “Prana.” A clear-cut definition of alternative medicine has not yet been established. Eisenberg et al. defined alternative While alternative medicine relies on vital force, medicine as “medical interventions not taught widely at spirituality and holism, modern medicine is based on a 28 APBN • Vol. 5 • No. 1 • 2001 APBN5n1•Special28-37 28 1/23/01, 12:43 PM ASIA-PACIFIC BI TECHNEWS more obscure meanings of Ayurvedic texts and practices are beginning to be understood and evaluated using modern techniques. “The principle of holistic approach of There are other ancient approaches from Ayurveda such alternative medicine leads to considering as oil massage, oleation, purgation, steam baths, special enemas and other procedures for purification; dietary the person as an indivisible whole rather prescriptions, specific postures and physical exercise (yoga), guidelines for behavior, breathing exercises, than dissected anatomic parts. As such, meditations and so on. diagnosis as well as treatment is Ayurveda primarily on concepts of organ This form of medicine has been practiced for over 8000 years12 and is derived from the Sanskrit word “ayus” functions and not with their anatomic meaning life or life span, and “veda” meaning knowledge or science, hence it means the “science of life or life span.” locations. Ayurveda not only describes the symptoms, cases and treatments of over a thousand diseases, it also describes hundreds of detailed surgical practices and preventive methods on the levels of mind, body, behavior and the ” 13-17 different theory. The principle of holistic approach of environment. Ayurveda recognizes three humoral alternative medicine leads to considering the person as an concepts — wind (Vata), bile (Pitta) and phlegm (Kapha), indivisible whole rather than dissected anatomic parts. As and attaches considerable importance to the examination of such, diagnosis as well as treatment is primarily on the pulse for determining the disposition of the three humors. concepts of organ functions and not with their anatomic Ayurveda is broadly classified into two groups. The first locations. In addition, it is believed that health maintenance group is Brihat trayee (greater triad) comprising of Charaka depends on a proper interaction with the environment. Samhita, Sushrita Samhita and Ashtanga Sangraha (also Similarly, means of communications with the invisible called as Hridaya). The second group is the Laghu trayee environment (e.g. meditation or prayer) forms an important (lesser triad) comprising of Madhava Nidana, Sharngadhara 8-11 part of the therapeutic approach. Samhita and Bhavaprakasha.15 Ayurveda defines disease Modern medicine is based on the theory that “physical as “any disturbance in the equilibrium of tissue elements 13,15,16 matter is the fundamental reality and beings, processes and known as Dhatus” which are eight in number. This phenomenon are all manifestations or results of matter.”11 principle is akin to what is called today as homeostatic Another important difference is that biomedicine considers balance. Dhatus are transformed and transported in the biological entities more or less as equal to the sum of their physiology via shrotas, which are the channels for the anatomic parts and tries to elucidate molecular, physiological flow of energy. Disturbances in the equilibrium of Dhatus and pathological mechanisms that form the basis of arise from wrong utilization, non-utilization or excessive biological processes. On the other hand, alternative medicine utilization of time, mental faculties or sense organs resulting includes an emphasis on wholeness, the relationships in three types of diseases; endogenous, exogenous and between the mind, body, and spirit and a person’s interaction psychic. The eight Dhatus defined in Ayurveda are Rasa with the environment. Thus the focus is on determining the (plasma or chyle), Rakta (blood), Mamsa (muscle tissue), internal and external causes of a problem rather than treating Medas (fat), Asthi (bone), Majia (bone marrow), Shukra the patient’s signs and symptoms. Due to the above inherent (sperm or ovum) and Sattva (spirit and mental). The Dhatus differences, techniques and treatments used in traditional arise from Ojas, which consisits of two types — ordinary systems of medicine are starkly different from modern type that exists in large quantity; and superior type found medicine. The specific goal of therapy therefore is to enhance in much smaller quantity. Ojas is present all over the body the body’s innate capacity for wellness and self healing by and is described as being white, unctuous and greasy. Its creating or restoring balance between a person’s physiologic diminution results in fear, weakness, grief, anger, fatigue, and psychological characteristics and bodily functions. starvation and tirelessness. Optimal levels of Ojas are Furthermore, with the aid of modern service some of the responsible for strength, power of resistance, containment APBN • Vol. 5 • No. 1 • 2001 29 APBN5n1•Special28-37 29 1/23/01, 12:43 PM and improved digestion. Hridaya is the seat of Ojas but administration of processed mercurial and other mineral does not refer to the anatomical heart. Walton and Hugh derived drugs. Certain plants such as Aloe indica and Edipta et al.18 have described the equivalents of Ojas and Dhatus alba have also been reported to be used in Kaya-Kalpa. with terminologies in modern medicine where Ojas has Muppu, another constituent of Siddha medicine, is a been correlated to be or equivalent of cholesterol in the combination of three salts.25 Its constituents and mode of modern medicine. The eight Dhatus have also been equated preparation is a closely guarded secret, and it supposedly with eight steroid classes comprising of bile acids, enhances the efficiency of any Siddha medicine and also cardioactive steroids, anabolic steroids, androgen engenders Yogic concentration.

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