A Development AnD environment fortnightly 60 ` Price ou y and hy P ra ssue 2020 3, No. 141, i G Vol. 20, Geo

FOCUSING ON the eFFICaCy OF hOmeOpathy medICINeS aNd the Need tO INteGrate alterNatIve SyStem

HomoeopatHy: a primer on its applicability triaging for mainstreaming HomeopatHy Quality of life: an ayurvedic approacH t raditional Healing: reviving an ancient art tH e siddHa system of medicine AlternAtive Medicines

CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE Ministry of AYUSH, Government of India

The Central Council for Research in Unani Medicine (CCRUM) is an autonomous organization under the Ministry of AYUSH, Government of India.Since its establishment in March 1978, the Council has been busy in researching various fundamental and applied aspects of Unani Medicine. Over the years, the CCRUM has emerged as the world- leader in the field of research in Unani Medicine.

THE NETWORK AREAS OF ACTIVITY The CCRUM has 23 research centers functioning The Research Programme of the Council has in different parts of the country, besides its four major components: headquarters in New Delhi. . Clinical Research . Drug Standardization . Literary Research . Survey and Cultivation of Medicinal Plants

MAJOR ACHIEVEMENTS Some of the significant achievements of the Council are as follows: Clinical Research . Developed 27 Unani drugs, which are purely natural, standardized and without any side-effects, for successful treatment of vitiligo, sinusitis, infective hepatitis, eczema, filariasis, malaria, rheumatoid arthritis, bronchial asthma and some other common ailments. . Obtained 17 patents on for developing certain novel therapeutic compositions and SCAR primers. Drug Standardization . Developed pharmacopoeial standards for 298 single and 150 compound drugs. Besides, Standard Operating Procedures (SOPs) for manufacture of 50 compound drugs have also been finalized. Developing . Published six volumes of National Formulary of Unani Medicine, six Research volumes of Unani Pharmacopoeia of India (UPI), Part 1 (on single In Unani drugs), and three volumes of the UPI, Part 2 (on compound drugs). Medicine Survey and Cultivation of Medicinal Plants . Collected over 104,568 specimens of medicinal plants belonging to 1,800 species from the wild. . Undertaken successful cultivation of 33 important medicinal species. . Gathered and documented over 16,261 folk medicinal claims. Literary Research . Translated 56 volumes of 21 classical books/manuscripts from Arabic/Persian into Urdu and other languages. . Prepared a database of 2,400 manuscripts of Unani Medicine. . Reprinted over 70 rare classical books. . Compiled Standard Unani Medical Terminology for 4,028 terms of Unani Medicine. . Developed ‘Standard Unani Treatment Guidelines for Common Diseases’. Publications . Produced over 2,000 research papers and brought out about 400 publications, besides regular publication of a quarterly bulletin CCRUM Newsletter, quarterly Urdu Journal Jahan-e-Tib and quarterly English Journal Hippocratic Journal of Unani Medicine. For further information please contact: Director General CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE Ministry of AYUSH, Government of India 61-65 Institutional Area, Janakupri, New Delhi – 110 058 (India) | Tel: 91-11-28521981 E-mail: [email protected] Website: http://ccrum.res.in G’nY SINCE 2001 A Development and geographyandyou.com Geo graphy and You Environment fortnightly Vol. 20  Issue 3 No. 141  2020

Altern ative MedicineS 6 Homoeopathy: A Primer on its Applicability Khushali Gambhir In an era where the World Health Organisation (WHO) is worried about antibiotic sensitivity and chronic non-communicable diseases, homoeopathy is a therapeutic science that can step in to fill the gap. Research leads us to understand that homoeopathy is based on nano-technology that works on immunity enhancement.

10 Quality of Life: An Ayurvedic Approach Chhaju Ram Yadav and Sanjeev Sharma The origin of Ayurveda has been traced to around 6000 BCE. The first recorded medical texts evolved from the Vedas. More than 1.5 million practitioners are using this traditional medicinal system for health care in India. It is estimated that 7800 manufacturing units are involved in the production of natural health products and traditional plant-based formulations in the nation, which requires more than 2000 tonnes of medicinal plant material annually.

16 Traditional Healing: Reviving an Ancient Art Imlikumba and P Ringu Traditional or indigenous and folk medicine is a system developed over generations within various civilizations, societies, communities, tribes and clans. The World Health Organisation estimated that 80 per cent of the population in developing countries rely on traditional medicine, mostly plant drugs for their primary health care needs. In India, 70 per cent of the population uses traditional medicine.

26 The Siddha System of Medicine: A Geographical Perspective K Kanakavalli and E Wilson The word AYUSH denotes traditional and non-conventional systems of health care and healing which includes ayurveda, yoga, naturopathy, unani, siddha, sowa rigpa and homoeopathy. AYUSH systems of medicine are codified and recognised by the Ministry of AYUSH, Government of India. Medical pluralism in India is a reflection of its cultural diversity and AYUSH systems have evolved over thousands of years, absorbing and adapting yet maintaining its individual identity. Focu s: Homeopathy 32 Criticisms of Homeopathy: Addressed Through Scientific Research Chaturbhuja Nayak Despite being practised for over 200 years homeopathy is still facing credibility challenges. Emerging research in this field has however, proven the plausibility of this science. During last two decades developed nations like Britain, France, USA and Australia, have questioned the effectiveness of homeopathy, although results have proven the scientificity of the alternative system. In the years to come studies conducted by homeopathic research organisations around globe is likely to further validate its scientific basis. 36 Hahnemann: The Therapeutic Pioneer of Psychosomatic Medicine of Today Mayur Jain I n wellness clinics world over, there is an increased inflow of patients with symptoms diagnosed by modern medicine as psychosomatic diseases. These latest advancements in medical science were well documented in the homoeopathic system of medicine since 1796. Samuel Hahnemann was the first to design therapeutic cures for such diseases. Rubrics from the repertory of materia medica emphasise homeopathy’s focus on these conditions.

42 Triaging for Mainstreaming Homeopathy harleen Kaur H omoeopathy, as a system of medicine, is a science of ‘similars’ and ‘overalls’. The role of homoeopathy in alleviating chronic ailments like skin, respiratory, gynaecological, joint, paediatric and psychiatric problems is promising.

50 Homoeopathy: The Second Most Popular System of Medicine in the World Girish Gupta H omoeopathy was invented in 1796 by Samuel Hahnemann as a holistic system of medicine where ‘the person in the disease’ is treated and not ‘the disease in the person’. It has been accepted as the best alternative system of medicine which is safest for the new born and the elderly, affordable to the poorest. Homoeopathic medicines are effective in infections, allergies, auto-immune, surgical, hormonal and psychological diseases as well as veterinary and plant diseases.

IN CONVERSATION WITH Vaidya R Kotecha Secretary, Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa and Homoeopathy (AYUSH) 23 An integrated system of medicine to address India’s health care concerns : PR SY :

Photo Cou RtE IN CONVERSATION WITH Anil Khurana Director General, Central Council for Research in Homoeopathy A 2017 PwC report states that 77 per cent of Indian households are using ayurvedic products. 47 Broadening the role of homeopathy in India’s health care

In BrIef 3 Letters; 4 Editor’s Note; 56 Books & Website

Expert Panel Rasik Ravindra Sachidanand Sinha B Meenakumari Prithvish Nag Geologist and Professor, CSRD, Former Chairperson, Former Vice Chancellor, Secretary General, Jawaharlal Nehru National Biodiversity MG Kashi Vidyapeeth, 36 IGC, New Delhi. University, New Delhi. Authority, Chennai. Varanasi. Ajit Tyagi K J Ramesh Saraswati Raju B Sengupta Air Vice Marshal (Retd) Former Director Former Professor, CSRD, Former Member Secretary, Former DG, IMD, General, IMD, Jawaharlal Nehru Central Pollution Control New Delhi. New Delhi. University, New Delhi. Board, New Delhi. Vol. 20, Issue 1-2, No. 139-140, 2020, ‘Disaster Resilience Perspectives’ published an article titled, ‘Flood Resilience Capacity of Coastal Ecosystem: Violation of Coastal Regulation Zone Notification’ was a well articulated, informative piece which comprehensively covered the Geo graphy and You problems facing the coastal ecosystems of the country. Being an inhabitant of a coastal region myself, I not only identify with the risks but also witness E ditor Sulagna Chattopadhyay the exploitation of the coastal resources under the garb of ‘development’. Several points in the article in ‘Disaster Resilient Infrastructure in India’ Senior Advisors were new for me.—Upasana Das via Consumer Feedback. Ajit Tyagi Rasik Ravindra For more details log on to our website www.geographyandyou.com Saraswati Raju Every point iterated in the Legal Advisor Krishnendu Datta G’nY articles is clearly understood. Yet, I was Cover PHOTO hoping that if the editorial homeopathic medicines and books on ayurveda team could put some more by Anulekha facts in flowcharts and graphs, it could better the Correspondence/ Editorial Office interpretation by the readers. 504, bhikaji cama bhawan, The last issue on ‘Disaster Bhikaji Cama Place, Resilience Perspectives’ was new delhi - 110066 very interesting. Every article Phone: +91-11-46014233; +91-11-26186350 was spot on but the article For new subscriptions, title, ‘The 2018 Kerala Flood: renewals, enquiries Best Practices and Lessons please contact Circulation Manager Learnt’ by Shailendra Rai E-mail: info@geographyandyou. impressed me the most. I com always find myself reading Please visit our site at www.geographyandyou.com Geography and You more for further information. than any other publication. —Radhika Kumari via ©geography and you Consumer Feedback. All rights reserved —Shared with G’nY by Prof PS Ranawat throughout the world. Reproduction in any manner, I am delighted to be a Disaster Perspective gave M any pressing topics have part or whole, is prohibited. member of the Geography a new understanding been covered by G’nY Printed, published and and You community. I of effectively dealing recently. The articles owned by Dr Narmadeshwar recently read the G’nY with disasters with the are well researched Prasad. issue titled, ‘Disaster cooperation of our neighbors and present a unique Resilience Perspectives’. and understanding of the perspective which Printed at India Graphic Systems Pvt. Use of diagrams and geographical challenges makes the reader think Ltd. F-23, Okhla Industrial many examples in the faced by India and its and arrive at their own Area, Phase-1, article, Disaster Resilient neighboring countries. I opinions. The independent New Delhi - 110020. Infrastructures (Page 14-21), would happy to see some thinking approach of G’nY Published from use of relevant maps, flood articles being published on is refreshing. I would Learning in Geography, resilience capacity of the how tribal people deal with love to see an issue on Humanities, Technology and Science (LIGHTS) coastal ecosystem: violation the natural disasters and the geopolitical issues 504, bhikaji cama bhawan, of coastal regulation what the urban world can in the Indian Ocean Bhikaji Cama Place, notification made the content learn from them. realm.—Sabyasachi new delhi - 110066. very engaging. The article —Karuna Tiwari via Chowdhury via

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Geo graphy and You . 2020 3 Editor’s note Sulagna Chattopadhyay Founder-Editor, Geography and You, New Delhi. editor@ geographyandyou.com

Medical pluralism and the element of choice When my second child was to be born, my doctors put me on a handful of vibrantly coloured capsules and tablets, considering that I had a tough time with my first. I dutifully appeared at every checkup and nodded energetically when asked whether I was following the prescription. Wonderful, the doctor chirped, you seem to be doing great, she said. Once, I was nearly caught. She asked me for the size of the new tablet she had prescribed, to which I muttered, small..ish…? Homeopathy medications, administered by one of the finest doctors of the nation, Padma Shri Dr Kalyan Banerjee, steered me through an effortless pregnancy. For more than two decades now, I have reposed my faith in a science that purportedly still needs to prove itself in the medico-academic circles. Placebo many say, simply water says others, yet millions flock the gates of reputed practitioners. As India is perhaps one of the very few countries that still holds on to medical plurality, it is perhaps time that the medical fraternity look towards the benefits of holistic treatment. This issue of G’nY, brings insights into the science of homeopathy, in addition to several other traditional systems of medicine. Proven lines of treatments originating from ancient schools, such as the bone setting technique of traditional medicine systems needs to be integrated into the mainstream health care system of India. The onus for this successful incorporation is on the entire medical fraternity of the country.

4 2019 . GeoGraphy and you vol 19, issue 25 & 26 no. 136 & 137 Guest Editor’s note Kushal Banerjee MD - Hom., MSc. (Oxon.) MBRCP - Hom.(Eng.), MF (Mal.), FAN [email protected]

Alternative medicine inching towards mainstream acceptance India is the world leader in complementary and alternative medicine (CAM) and home to the largest number of homeopaths practitioners and patients. The nation is also the birthplace of the oldest system of medicine—ayurveda. India, more recently, has become the only country in the world, to have established, in essence, a ministry of alternative medicine: the ministry of AYUSH—ayurveda, yoga, unani, siddha and homeopathy. CAM is immensely popular globally, with homeopathy ranking second. Homeopaths and practitioners of other forms of CAM are beginning to rise to the challenge posed by enthusiasts of evidence-based medicine. Substantial research demonstrating the effects of CAM exist. However, there is need for much more. Homeopaths and homeopathic organisations are beginning to understand the significance of evolving their methodology as homeopathy is one of the systems most amenable to contemporary research methodology. It may be pertinent to note however, that homeopathic research is largely debilitated by a publication bias. Mainstream medical journals have, for the most part, stopped publishing manuscripts that contain homeopathic findings. Stifling dissemination of research in the world of medicine is not a desirable mechanism for discourse and assimilation. Homeopathy is set to sail well into the next decade as patients continue to repose their faith in the two-hundred-year old system of medicine, choosing a safe and reliable alternative. Indeed, it is this choice which needs to be honoured and protected by the health services the world over. India made huge strides in providing a robust training and regulation mechanism for various of forms of CAM within the first few decades of independence. The pace that was set should not be allowed to falter. As the country redefines the landscape of public health services through programmes like Ayushman Bharat at the central and mohalla clinics and many such other programmes at the state levels, the provision of CAM services needs to be considered within these progressive projects. Ensuring the availability of CAM practitioners alongside doctors of conventional medicine will result in quick referrals, reduce the burden on the suboptimal number of conventional doctors and shorten the time that a patient spends visiting different state-run health care centres. The articles in this issue will make readers aware of the wide range of illnesses that homeopathy is able to effectively tackle and learn about cutting-edge experiments being conducted to understand the mode of action of homeopathic medicines. The articles on ayurveda and siddha trace the origins of these systems of medicine and provide a view of recent developments and advances. Another article delves into forms of traditional medicine including the relatively less known non- codified system of folk medicine.

GeoGraphy and you . 2019 5 + Altern ative MedicineS

Most of the homeopathic medicines are extracted from plants and formulated according to the homeopathic principles. A small amount of raw material yields considerable quantities of medication.

6 2020 . Geo graphy and You vol 20, issue 3 No. 141 By Khushali Gambhir HomoeopatHy A Primer on its APPlicAbility In an era where the World Health Organisation (WHO) is worried about antibiotic sensitivity and chronic non-communicable diseases, homoeopathy is a therapeutic science that can step in to fill the gap. Research leads us to understand that homoeopathy is based on nano-technology and works on immunity enhancement.

n the contemporary world, where there and eventually dropped to 30,000 per cubic is a marked rise in the number of lifestyle millimetre of blood (the normal range diseases and recurrent flare ups of a is 150000- 2,70 000). Her haematocrit multitude of infections, homeopathy can (percentage of red blood cells in the blood) was be seen to offer curative and preventive rising, indicating she could go into shock. At solutions. Let us consider the four cases below: this stage she was treated with homoeopathic ICase 1: An eleven- year-old girl child was medicine—Eupatorium perfoliatum 200 COm/ presented with a fever of 103o F, ‘bursting’ alternated with Phosphorus 30. Within 72 xels.

.Pe headache and weakness. She tested positive hours, her platelets crossed 1,50,000, the WW

W for dengue and her platelets were dropping haematocrit value and fever touched normal. esy: The author is a practitioner at Dr Khushali Homoeopathic Clinic, Chennai. [email protected]. The article should be cited as Gambhir K., 2020. Homeopathy: A Primer on its Applicability, Geography and You, 20(3): 6-9 PHOtO COuRt GeoGraphy and you . 2020 7 The usual time taken for platelet and haematocrit were used. Her HbA1c dropped from 11.4 per cent recovery is seven days, but the damage done in (normal range < 6.5 per cent) to 6.2 per cent in eight these seven days can be high. months. The patient was advised to change her diet Case 2: A 32-year-old lady, suffering from with an increase in vegetable intake and millets. recurrent urinary tract infections was being Regular one hour walks were also suggested. This treated with antibiotics. On further investigation, advisory enabled a holistic recovery. it was found that she had developed distal urethral In this case, the treatment addressed the stricture (narrowing of the opening of the causative factor and strengthened the liver. urethra), further contributing to the recurrence The patient developed hyper glycemia after of the infection. She was advised dilatation of the contracting malaria and dengue and it is likely urethra once in three months initially and then that these infections left behind a residual based on her improvement, once in six months effect altering the capacity of the liver to or a year. She underwent the first dilatation maintain glucose homoeostasis. Homoeopathic and then started homoeopathic treatment to formulations re-established the equilibrium and prevent further dilatations and infections. She re-built the capacity of the liver. was treated with Syphillinum 200– followed by Thiocinaminum 30 and occasional doses of holistic approach Lycopodium 200 for ten months. She did not Be it a cold, eczema or cancer, homoeopathy will require any further dilatation and her urinary consider the nature of the individual and the infections also stopped recurring. ailment to attempt a cure. The homoeopathic Case 3: A three and a half year toddler, with a history-taking process will consider the disease history of recurrent upper respiratory infections condition along with the general features of the was wheezing requiring nebulisation frequently. person like their conditions of aggravation, their She was also being given a daily dose of steroid- physical, mental and environmental makeup, their based inhalers and was diagnosed with adenoidal sleep and specific cravings and aversions. These hypertrophy (increase in the size of the adenoids) characteristics that identify an individual along and lactose sensitivity. She also suffered from a with the affected pathology, form the basis of a rectal prolapse. With regular administering of a homoeopathic prescription. This differentiation range of homoeopathic medicines, she was free is done in order to understand the constitution of of the wheeze and her rectal prolapse has been an individual and helps in stimulating the innate corrected. These and many more of such cases immunity of the person to mobilise the factors outlined in academic journals demonstrate the required for recovery. value of homoeopathic treatment. With the WHO worried about antibiotic sensitivity and chronic how homoeopathy Works diseases receiving only palliative care, the world Homoeopathy works by stimulating an immune must be willing to look at therapeutic sciences response. Once, the homoeopathic medicine is which may have profound treatment options administered, it encourages a cascade of physical aimed at cure. and chemical reactions based on the status of Case 4: A 33- year old lady, diagnosed with the immune system and its sensitivity to the diabetes mellitus was suffering repeated bouts medication at that stage of the illness. It stimulates of dizziness, fatigue, sinusitis accompanied the innate immune response and the adaptive with recurrent right- sided retro-auricular gene responses of a person which, through a series lymphadenopathy (diseased condition of lymph of events, facilitates recovery. Khuda Buksh, a nodes behind the ear) and hyper glycemia senior scientist, demonstrated this response to (increased blood sugar levels) for over a year after injuries through his experiments with Arnica on contracting dengue and malaria. the E.coli bacteria (Rahman et al. 2018). She was treated with Lycopodium 0/3, then Homoeopathic medicines facilitate the natural Lycopodium 0/6 and Cardus marianus 30 healing process of an individual. It works as a predominantly. When her HbA1c percentage catalyst in the body and the body’s relation to (percentage of glycosylated haemoglobin which the environment. This is an important aspect is indicative of a three-month average of blood since homeopathy is one of the few sciences that sugar readings) fluctuated, intercurrent remedies takes into consideration the emotional aspect

8 2020 . GeoGraphy and you vol 20, issue 3 no. 141 of the individual. This plays a vital role in the prepared from minerals—Natrum muriaticum healing process, both internally for the individual (common salt) and Silicea (sand). A few medicines and the relationship of the individual to their are prepared from micro-organisms like– environment. This is a crucial aspect of health as Influenzinum (the flu virus), Variolinum (derived the evolution of all diseases and ailments originate from the small-pox virus). Medicines may also from the interaction of the environment to an be made from healthy tissues like Thyroidinum individual, be it the action of a virus on the human and Adrenaline. There are also some homeopathic or the presence of emotional upheaval in the medicines which are developed from energy and evolution of a disease. radiation sources too. scientific Backing sustainability There are vast amounts of experimental literature Homoeopathy is the most economical and and research data on homeopathy. These include environmental-friendly form of medication. The controlled studies and clinical outcome trials. crux of homoeopathic medicines is dilution and Research on homoeopathy has been conducted potentisation. It is this process that makes a simple by doctors, molecular biologists, physicists and onion a powerful medicine. An essential aspect nanotechnologists globally. Homoeopathic of this is the fact that a single gram of original research utilises the expertise of all the basic and medicinal substance is used to create a substantial allied sciences (Kay and Khuda-Bukhsh 2016). quantity of medication . To make the first potency of Pulsatilla (a standard homeopathic medicine educational Backing from the plant kingdom), one drop of the original In India, knowledge on homoeopathy is imparted Pulsatilla ‘mother tincture’ (herbal solution) is through degree programmes such as Bachelor of added to 99 drops of dispensing alcohol (used Homoeopathic Medicine and Surgery (BHMS) as a preservative). This is then shaken through which constitutes five and a half years of study and a scientific process called succussion, giving the an internship. This course has the same modules first potency ofPulsatilla 1c. This process results as that of conventional medicine in addition to in a 1:100 dilution of the original tincture. Further homoeopathic subjects of pharmacy, philosophy potencies are made from one drop of one C and and ‘materiamedica’. The Doctor of Medicine, MD 99 drops of dispensing alcohol and repeating the (Hom) programme constituting an additional process. Thus, a considerable amount of medicine three years of study is also being offered. is made from a small amount of the original substance preventing the need for dipping into regulation of homoeopathy the natural resource time and again. There is Homoeopathy is regulated by the Central Council negligible and zero toxic waste in the making of of Homeopathy (CCH), under the Ministry of these medications. ayurveda, yoga and naturopathy, unani, siddha, sowa rigpa and homoeopathy (AYUSH) as references well as several state registration councils—for Kay P.H. and A.R. Khuda-Bukhsh. 2016. The instance, the Tamil Nadu Homoeopathic Medical Contribution of Homeogenomic and Council. All medicines come under the Indian, Homeogenetic Studies in the Support of the the American, the German and the British Practice of Homoeopathy, Indian Journal of Homoeopathic Pharmacopoeia. Strict validation Research in Homeopathy, 10(2): 101-107. Available of registration is carried out periodically by at: https://bit.ly/39rYui6 relevant governmental bodies. Rahman A., K. Bukhsh and J. Biomed. 2018. Ultra- Highly Diluted Homeopathic Remedy Arnica sources of homoeopathic medicines Montana 30C can Reduce UV-induced DNA Homoeopathic medicines are predominantly Damage in Escherichia Coli through its Regulatory from the plant kingdom, but few are also prepared Influence on Nucleotide Excision Repair Genes: A from sources in the animal kingdom. These may Commentary on our Published Research Finding, be formulated from substances that the animal use Biomedical Journal of Scientific & Technical to protect itself like Apis (the honey bee’s sting) and Research, 5(4): 1-4. Available at: https://bit. Sepia (the ink of cuttlefish). Formulations are also ly/2UJMMvg

GeoGraphy and you . 2020 9 + Altern ative MedicineS

By Chhaju Ram Yadav & Sanjeev Sharma QUALITY OF

LIFEAN AYURVEDIc APPROACH The origin of Ayurveda has been traced to around 6000 BCE. The first recorded medical texts evolved from the Vedas. More than 1.5 million practitioners are using this traditional medicinal system for health care in India. It is estimated that 7800 manufacturing units are involved in the production of natural health products and traditional plant-based formulations in the nation, which requires more than 2000 tonnes of medicinal plant material annually.

The authors are Associate Professor and Director respectively at National Institute of Ayurveda, Jaipur,Rajasthan. [email protected]. The article should be cited as Yadav C.R., S. Sharma, 2020. Quality of Life:An Ayurvedic Approach, Geography and You, 20(3): 10-15

10 2020 . Geo graphy and You vol 20, issue 3-4 No. 141-142 Herbs play a big role in the formulation of ayurvedic medicines. Use of locally available plants is emphasised significantly in the ayurvedic system of medicine. INA Or : C sY TE r OU C PhOTO

GeoGraphy and you . 2020 11 he science which imparts knowledge ayurveda too underwent specialisation and was of life is known as ayurveda. Ayu classified into various streams (Fig.1). is the complex structure formed by the conjunction of shareera, indriya, preventive aspect sattva and atma (body, senses, mind The maintenance of the state of equilibrium in a and self). The first recorded form of ayurveda is healthy individual or Nidana Parivarjana is the Tfound in the vedic texts dedicated to medicine first line of treatment, mentioned in ayurvedic (Dikshith 2008). For instance, the Rigveda, dated classics. Ayurveda begins with the premise of 1000 BCE refers to the first divine physician prevention, promotion and preservation of Rudra and also to the physician Aswini Kumara health as opposed to cure only. Therefore, lifestyle who is said to have miraculously cured sage rules mentioned in ayurvedic texts, which if Chyavana of senility (New World Encyclopedia applied rigorously, gives definitive positive 2016; Narayanaswamy 1981). Although these health outcomes. Preventive measures include- references are from the Rigveda, systematic and Dincharya, Ritucharya and Sadavritta Palana comprehensive treatment of medicine is outlined —daily regimen, regimen according to season in the Atharvaveda—ayurveda being an upveda and rules which are beneficial for healthy life. or an auxiliary part. As there was primarily verbal, Dincharya includes maintaining a regular sleep- inter-generational record keeping in the ancient wake cycle, practising personal hygiene, exercising times, in addition to the loss that royal libraries the eyes, the lungs and the body (anjana, aasya, faced during incessant wars, the earliest recorded abhyang), massaging medicated powders source of ayurvedic practices can be traced back and oils (udavartan) and taking a bath. Use of only to 6000 BCE (Narayanaswamy 1981). ayurvedic formulations (rasayana, vajikarana and panchkarma) helps boost general health and origin of ayurveda prevents diseases through better immunity and According to Hindu philosophy Lord Brahma stamina, avoiding infection and alleviating stress. is considered the creator of the universe and is Sadavritta Palana or the rules that benefit said to have introduced the science of ayurveda, healthy life interestingly include both the body composing it in a work named Brahma Samhita, and the mind. Being a better human inevitably which bore one lakh verses or hymns. He adds to the overall well-being. For instance, presented it to his first born Dakshprajapati who speaking the truth (lying leads to stress), serving then taught it to Ashwini Kumara (Ashwini elderly people, being free of anger, practising Samhita). Ashwini Kumara indoctrinated Indra Ahimsa and compassion, speaking politely and (the supreme God of the Rigveda scripture) and maintaining an even temper contributes to being a from him the knowledge spread through sage good human as well as a healthy one (Gaur 2014). Bhardwaja and many others to the populace (New World Encyclopedia 2018). Another version of Curative aspect the lineage of the teachings can be traced through Ayurveda advocates two categories of curative the Brahmavaivarta Purana which states that health. The first, shamana chikitsa, is adopted Bhaskara learned the science of ayurveda directly when the magnitude of ailment is mild to from Dakshaprajapati and taught it to his 16 moderate and where the chances of recurrence disciples who then spread it among the masses are present. The second, shodhana chikitsa, is (Chary 2012). With the multiplicity of disciples comparable to machinery that demands regular

12 2020 . GeoGraphy and you vol 20, issue 3-4 no. 141-142 Fig. 1: Descent of Ayurveda on Earth from Heaven Brahma

Dakshprajapati

Aswini Kumara

Indra

Kayachikitsa Shalyachikitsa Kaumarbhritya Sampradaya Sampradaya Sampradaya

As per As per As per As per Charaka Ashtangahridyam Sushruta Samhita Kashyapa Samhita Samhita and Bhavaprakash Indra Indra Indra Indra

Bharadwaja Atreyaa Divodasa Dhanvantri Kashyapa Atreya Agnivesha Sushtruta Vashishtha Agnivesha Bhela Aupadenava Atri Bhela Jatukarna Aurabhra Bhrigu Jatukarna Parashara Paushkalavata Sons Parashara Harita Vaitarana Disciples Harita Ksharapani Karveerya Ksharapani Gopurarakshita Bhoja

Source: DCL Chary, 2012, A Text Book of History of Ayurveda Charaka Samhita

servicing and oiling. When the ailment or the shift global market. A 2017 PricewaterhouseCoopers in the alignment in a healthy individual (dosha) (PwC) report states that 77 per cent of Indian are of a higher magnitude shodhana is resorted households are using ayurvedic products. The to. This ensures a complete cure from the root of global market for ayurveda is also growing the cause, cleansing the body and eliminating the exponentially with its size expected to almost vitiated dosha, not only treating the disease but treble from 3.4 billion USD in 2015 to 9.7 also improving health, longevity and rejuvenation. billion USD by 2022 (ET Bureau 2018). There are more than 1.5 million practitioners using ayurveda Today the traditional medicinal system for health In the current context, it can be seen that ayurveda care in India and it is estimated that more than holds a significant place in the Indian as well as the 7800 Indian manufacturing units are involved

GeoGraphy and you . 2020 13 Studies on Ixora coccinea, also known as jungle geranium indicate that the plant contains the phytochemicals that has curative properties. The flowers, leaves, roots and the stem are used to treat various ailments in ayurveda.

in the production of traditional plant-based formulations. This requires more than 2000 tonnes of medicinal plant raw material annually Ayurveda begins (Pandey et al. 2008). with the premise of Government policies There has been a steady policy support to prevention, promotion promote traditional medicine in India. The government also supports different plans related and preservation of to research and development of medicinal health as opposed to plant research. The budget allocation for the Ministry of Ayurveda, Yoga and Naturopathy, cure only. Preventive Unani, Siddha, Sowa Rigpa and Homoeopathy (AYUSH) has been increasing gradually over measures include- the years. During the 12th five year plan period (2012–2017), the total allocation for AYUSH Dincharya, Ritucharya was INR 10,044 crore, which was a 235 per cent increase over 11th Plan expenditure and Sadavritta Palana— (Sharkar 2013). With a view to integrate the AYUSH system within India’s health daily regimen, regimen care, several policies have been formulated according to season (Planning Commission 2015). From utilisation of AYUSH doctors in National Reproductive and lifestyle rules. and Child Health (RCH) and population stabilisation programme, to the inclusion of

14 2020 . GeoGraphy and you vol 20, issue 3-4 no. 141-142 several traditional ayurvedic formulations for references mother and child—ayush ghutti, bal rasayana, Chary D.C.L. 2012. Descent of Ayurveda, A Text soubhagya shunthi, ark ajwain, ark pudina, Book of History of Ayurveda Charaka punarnavadi mandoor and ksheerbalatel in Samhita, Delhi: Chaukhamba Sanskrit the RCH programme have been seen in recent Pratishthan. times. Apart from the above, a pilot project to Dikshith T.S.S. 2008. Safe use of Chemicals: A monitor the effects of ayurvedic treatment in the Practical Guide, Florida: CRC Press. ante and post-natal care has also been launched. ET Bureau. 2018. 77 Per cent Indian Households Moreover, it has been attempted to integrate the use Ayurvedic Products: PwC Report. Indian system of medicine into the National The Economic Times, November 23. Rural Health Care Mission (NRHM) and Available at: https://bit.ly/31O10wK. ayurvedic doctors and paramedics are Gaur B. L. 2014. Commentary on Charaka being appointed in the primary health care Samhita; Chapter 1/4 verse 30-35 ; Reprint. delivery system. New Delhi: Rashtriya Ayurveda In addition, the inclusion of AYUSH Vidyapeeth. formulation—punarnavadi mandoor for the Health Division, Planning Commission. 2012. management of anemia during pregnancy in Report of the Steering Committee for 12th Five the kit of the Accredited Social Health Activist Year Plan : Government of India, New Delhi: (ASHA) Act along with generic drugs for India. Available at: https://bit.ly/2ShN4YF common ailments at sub-centre/primary health Narayanaswamy N. 1981. Origin and Development centre/community health centre is heartening of Ayurveda -A Brief History, Ancient Science indeed.The inclusion of AYUSH medicine and of Life, 1(1): 1-7. their sustained availability in schemes such as New World Encyclopedia, 2016. Vedic Janani Suraksha Yojana (JSY-AYUSH), ICDS- Period. Available at: https://www. AYUSH, RCH, early breastfeeding, growth newworldencyclopedia.org/entry/Vedic_ monitoring of children, ante and post-natal Period. Accessed on February 10, 2020. care have led to the renewed faith in their New World Encyclopedia, 2018. Indra. Available at: effectiveness. https://www.newworldencyclopedia.org/entry/ indra. Accessed on February 11, 2020. Way Forward Pandey M., S. Rastogi, A. Rawat. 2007. Indian Although ayurveda is the oldest medical Herbal Drug for General Healthcare: An science, its applicability in the present Overview, The Internet Journal of Alternative scenario seems just as practical. It can help Medicine, 6(1): 1-12. Available at: https://bit. prevent a multitude of ailments as also offer ly/2UKy86V. personalised and effective medicine. Ayurveda Sharkar R. 2013. Ayush Dept Under-utilises today is gaining prominence worldwide with Funds Allocated during Last Three Years. an enlightened and educated user group, Pharmabiz.com, September 28. Available at: demanding traditional therapies. With many http://www.pharmabiz.com/NewsDetails. foreign universities running training courses aspx?aid=77870&sid=1. in ayurveda, it would not be long before this Wise J. 2013. Herbal Products are Often traditional medicine system will begin to Contaminated, Study Finds. BMJ, Available at: unequivocally partner modern medicine. https://doi.org/10.1136/bmj.f6138.

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Tribal practitioners from indigenous communities have developed their unique health care systems and were actively involved in the certification of traditional community health care providers in Tripura in March 2019.

16 2020 . Geo graphy and You vol 20, issue 3 No. 141 By Imlikumba & P Ringu TRADITIONAL HEALING Reviving an anCienT aRT Traditional,indigenous and folk medicine is a system developed over generations within various civilizations, societies, communities, tribes and clans. The World Health Organisation estimated that 80 per cent of the population in developing countries rely on traditional medicine, mostly plant medicines for their primary health care needs. In India, 70 per cent of the population is seen to use traditional medicine. r HO T sy: Au The authors are medical officer and director respectively at North Eastern Institute of Folk Medicine, Arunachal

COurTe Pradesh. [email protected]. The article should be cited as Imlikumba, P. Ringu, 2020. Traditional Healing: OTO

PH Reviving an Ancient Art, Geography and You, 20(3): 16-21

GeoGraphy and you . 2020 17 raditional medicine was the only healing option in India before modern medicine acquired prominence. The World Health Organization (WHO) defines traditional medicine as the sum total of the knowledge,T skills and practices based on the theories, beliefs and experiences indigenous to different cultures. The usage of traditional medicine in the maintenance of health incorporates plant animal or mineral-based medicine, spiritual therapies, manual techniques and exercise applied singularly or in combination to maintain the well being and in prevention, diagnosis, improvement or treatment of physical and mental illness (WHO 1978).

origin of Traditional Medicine The use of herbs and roots in curing and healing was known among many ethnic groups (Sharma 1999). The ancient civilization of India, China, Greece, Arab and many other countries of the world developed their systems of medicine independent of each other, but all of them were predominantly plant-based (Planning Commission 2000). The tribes who live in isolation, practice their own system of medicine known as ethnomedicine or tribal medicine. Experts opine , "it may surprise people to learn that throughout India, in most of her There are folk communities, there exist living traditions of health care. These are based on the use of estimated locally available fauna, flora and minerals. They to be around encompass important areas of health care like mother and child care, treatment of common 25,000 effective ailments, home remedies, first aid and nutrition. They also deal with specialised areas like snake plant-based poisons, dental care, broken bones, veterinary care and treatment of chronic ailments (Fig. 1). formulations used These traditions are decentralised in nature. At one extreme is the housewife with the knowledge in folk medicine of home remedies while on the other there are the folk practitioners who deal with special areas and known to rural like the village midwives and traditional tribal communities all practitioners" (Shankar 2001). over India. extent of population using Traditional Medicine It is estimated that over one-third of the world's

18 2020 . GeoGraphy and you vol 20, issue 3 no. 141 Fig. 1: Bone setting technique used by traditional tribal practitioners

 There are three medicinal plants Tinospora cordifolia, Pouzolzia sp., Solanum spirale which are primarily used in bone-setting treatment.  Alongside are two cases— one of the hand and the other of the foot of individuals who have suffered a fracture (bhagna).  The healer ascertains the location of the fracture and then formulates a paste comprising the three herbs mentioned above.  The paste is then applied to the location of the fracture and held in place with a crepe bandage and a gauze respectively.

Table 1: Medicinal plants used in bone-setting treatment

Scientific name Family Local name (Adi) Parts used Preparation

Tinospora cordifolia Menispermaceae Tartapuk Stem Paste

Pouzolzia sp. Urticaceae Ossik Roots Paste

Solanum spirale Solanaceae Banko Leaves Paste

Geo graphy and You . 2020 19 Fig. 2: Global usage of plant-based medicine

90 80 80 7575 70 60 50 48 50 40 42 40 Percentage 30 20 10 0 Belgium USA Australia Canada France India Africa

Source: Hoareau and DaSilva, 1999

Fig. 3: Patients treated in NEIFM, Pasighat, 2012 to 2019

10000

10000

8000

6000

4000 Patients Treated in NEIFM

2000

0 2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 2018-19 2019-20 (Upto Nov. 2019) Male Female Source: North Eastern Institute of Folk Medicine, Arunachal Pradesh

population lacks regular access to affordable population has been reportedly using traditional essential drugs. For these people, modern medicine (UNESCO 1996) (Fig. 2). medicine is never likely to be a realistic treatment option. In contrast, traditional medicine is Traditional Medicine Classification widely available and affordable, even in remote in india areas and generally accessible to most people The Task Force Report by the Indian government (UNCTAD 2000). It has been observed that states that the classification of traditional the use of traditional medicine and medicinal medicine in India can be placed under two broad plants in most developing countries, is a systems. The first is a codified system, also known normative basis for maintenance of good health as the classical stream, which includes, ayurveda, (UNESCO 1996). In China, about 40 per cent of unani, sidha, yoga and naturopathy. The other the total medicinal consumption is attributed is the non–codified system of folk/ethno/tribal to traditional tribal medicines. In Japan, herbal medicine/folk medicine consists of healing medicinal preparations are more in demand than practices and ideas of health preservation known mainstream pharmaceutical products (Hoareau to a few in an ethnic or cultural group, transmitted and DaSilva1999). In India, 70 per cent of the informally as knowledge and practised or applied

20 2020 . GeoGraphy and you vol 20, issue 3 no. 141 by anyone having a prior experience. It usually India (QCI) and Foundation for Revitalisation consists of practices received through oral of Local Health Traditions (FRLHT) designed traditions , its practitioners addressed by various and launched a special scheme for certification names—kobirajs, vaidyas and others in different of healers. The scheme defines the process of parts of the nation. These healers practising in certification of TCHP under the Voluntary diverse fields such as traditional birth attendant, Certification Scheme for Traditional Community traditional bone setters, poisonous bites and Healthcare Practitioner (VCSTCHP) with common ailments and can be called Traditional an objective to promote uniformity in its Community Healthcare Providers (TCHP). implementation throughout the country. It may be With a sustained demand of folk medicine mentioned that the Tripura certification was one and due to an increasing threat of it losing the of the first in India, conducted from March 7-9, traditional knowledge the Indian government set 2019. A similar exercise was carried out for Assam up a national institute of folk medicine at North and Nagaland in a phased manner between Eastern Institute of Folk Medicine (NEIFM) in July and September, 2019. The total strength of 2008, placing it within the rich tribal heritage belt certified traditional healers in different domains of Arunachal Pradesh. in the north-eastern States now stands at 37. The north-east region of India—Arunachal Although there is a long way to go, traditional Pradesh, Assam, Manipur, Nagaland, Meghalaya, healers have slowly begun to find their way into Mizoram, Sikkim and Tripura is endowed with the mainstream discourse. a rich biodiversity of flora and fauna. This has helped it build a vast repository of traditional Acknowledgement: Selfless Traditional Healers; folk medicine practices, remedies and therapies. Quality Council of India and PrCB; and North East The NEIFM, Pasighat, Arunachal Pradesh is Christian University (NECU). Special thanks to Prof. an autonomous institute under the Ministry Darlando Khathing, Vice- Chancellor, NECU . of AYUSH and is equipped with essential infrastructure, including a 50 bedded hospital references for research. The institute has begun to create Hoareau L. and DaSilva E.J. 1999. Medicinal Plants: an interface between traditional/folk medicine Are Emerging Health Aid, Electronic Journal of practitioners and research institutions, after Biotechnology, 2(2). Available at: www.ejb.org/ scientists and medical officers were appointed content/Vo1.2/issue2/full/2 in October 2018, to enable an understanding of Planning Commission. 2000. Report of the Task Force folk medicine. Once the feasibility is ensured, on Conservation and Sustainable Use of Medicinal the validated folk medicine practices are to be Plants: Planning Commission, Government integrated into the mainstream health care system of India, New Delhi: India. Available at: http:// and made available to the public. planningcommission.nic.in/ task/ tsk-medi.pdf The NEIFM functions as an apex research Shankar, D. 2001. Agenda for Revitalization of Indian centre for folk medicine knowledge and attempts Medical Heritage. Voluntary Health Association to create an interface between traditional healers of India, New Delhi?) and scientific research, enhancing capacities and Sharma P.D. 1999. A Study on Bio-diversity of Hatma upgrading skills to enable a robustness of the Village, Mandar, Ranchi, The Anthropologist, 1(1): profession. The institute has been running an 73-79. OPD facility not only for patients from Arunachal, UNESCO .1996. Culture and Health, Orientation but also from other states. In the recent years the Texts – World Decade for Cultural Development inflow of patients has shown a marked increase 1988 – 1997: United Nations, Paris: France. (Fig. 3). WHO(World Health Organization).1978. The Promotion and Development of Traditional Way Forward Medicine - Technical Report Series: World Health As folk medicine is a non-codified system it is a Organization,Geneva: WHO. Available at: https:// challenge to parameter its competency. Hence apps.who.int/iris/handle/10665/40995 there is an urgent need to seek uniformity in UNCTAD. 2000. Traditional Medicine and its its implementation. The Quality Council of Knowledge - United Nations, Geneva.

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22 2020 . GeoGraphy and you vol 20, issue 3 no. 141 An integrated system of medicine to address India’s health care concerns Vaidya R Kotecha, Secretary, Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa and Homoeopathy (AYUSH) discusses the scope of mainstreaming the traditional system of preventive and curative care and the proactive interventions by the Indian government.

I think the project on reliability testing and validation of Ayurveda diagnostic tools focusing on development of Standardised Ayurvedic Case Taking Protocol (SACTP) will establish certain norms in the industry.

GeoGraphy and you . 2020 23 G’nY. Do you believe that integrated joint and connective tissue disorders the country? medicine systems have the potential like rheumatoid arthritis, degenerative Various studies to understand the to deal with health care problems diseases like early stages of amnesia, role of AYUSH systems in public in India? Parkinson‘s diseases, osteoarthritis, health is underway. For instance, the Traditional systems of medicine, inclusion of traditional medicines especially ayurveda, yoga and in primary health care through the naturopathy, unani, siddha, sowa rigpa National Rural Health Mission (NRHM) and homoeopathy (AYUSH) have a provides an opportunity to map its huge potential in addressing the health effectiveness. The National Programme care needs of the society. Traditional for Prevention and Control of Cancer, medicines, in well codified systems can Diabetes, Cardio-vascular diseases be integrated with modern medicines and Stroke (NPCDCS) wherein the to provide holistic health. The systems introduction of AYUSH was initiated all have their unique strengths and The analysis of the in 2015-2016 across eight districts are being presently supported by pan India, through the Ministry of governmental setups in primary 2016 World Health AYUSH’s research councils, shows health centre (PHCs), hospitals, promising results. Various lifestyle colleges and many other institutions. Organisation’s study disorders—cardiovascular diseases, Additionally, research is also being on global ageing and diabetes and obesity and osteoarthritis actively undertaken in dedicated are addressed. Furthermore, the research councils and post- graduate adult health (WHO- effectiveness of AYUSH systems in colleges, further strengthening the role SAGE), marked 11.7 Reproductive and Child Health (RCH) of traditional medicines in providing programmes have been health care services and generating per cent respondents well documented. tangible evidence of their efficacy as frequent users of Way back in 1987, the Central and safety. Council for Research in Ayurvedic India enjoys the distinction of having traditional medicine for Sciences (CCRAS) conducted a survey the largest network of traditional health care. in 12 states on various aspects of health care units, fully functional with health related demography, publishing a network of registered practitioners, a report wherein it was evident that research institutions and licensed about 70 per cent of India’s population pharmacies. As per the summary uses the traditional system of medicine we have provided in ayush.gov.in, at as the first line of treatment. In fact a present there are about 3986 AYUSH conditions of gastrointestinal tract, pilot study in 2015 was conducted in hospitals, 27199 dispensaries, about skin diseases and mental health are two districts of Himachal Pradesh, as 8 lakhs practitioners, 711 colleges and areas of clinical competence of varied a part of CCRAS and Indian Council of 8954 manufacturing units across the traditional systems. Medical Research (ICMR) collaborative country. It is now fairly well-established project which revealed that in the that traditional medicine is playing an G’nY. Is there any national level selected study area, 54 per cent of the important role in the cure of chronic study to prove the success of head of the household recommended diseases. Respiratory disorders such as complementary roles played by traditional medicines and about 65 asthma and bronchitis, cardiovascular alternative medicinal systems in per cent of women sought ayurvedic disorders, osteoporosis in women, tackling the health issues in treatment for antenatal, post natal

24 2020 . GeoGraphy and you vol 20, issue 3 no. 141 and gynaecological problems in central sector scheme for Promotion Diseases, WHO, was launched in 2017. addition to child health care. Following of Information, Education, and This will help popularise AYUSH as a the successful integration of the Communication (IEC) in AYUSH, codified system of medicine globally. programme in Himachal, a study of the besides various research oriented Also, the AYUSH Hospital Management effectiveness of ayurveda in the RCH schemes and events—Arogya mela, Information System (A-HMIS) was programme has been initiated in the International Yoga Day, and Ayurveda launched in 2018. The Ayur Prakriti Gadchiroli district of Maharashtra. Also, web portal—Standardised Prakriti studying the role of AYUSH and local Assessment Scale was also developed health traditions under the NRHM in 18 and launched, the copyright for which states across India, outcomes revealed was recently obtained. that 80-90 per cent households were A project on reliability testing and aware about the utility of local health validation of Ayurveda diagnostic traditions and co-located services tools focusing on development of (along with allopathic health care) were Standardized Ayurvedic Case Taking well utilised in several states. In this Dedicated research Protocol (SACTP) has been undertaken. regard the successful demonstration of councils are working Moreover, dedicated research councils integrating ayurveda with the modern are working under the Ministry of system of medicine in a tertiary care under the Ministry AYUSH for each system of medicine, hospital—Safdarjung, New Delhi, for of AYUSH for each to back it with tangible evidence. the management of osteoarthritis of the The AYUSH research councils knee, may be mentioned. system of medicine, run research oriented health care The analysis of the 2016 World to back it with services—Tribal Health Care Research Health Organisation’s study on global Programme, Ayurvedic Mobile Health ageing and adult health (WHO-SAGE), tangible evidence. Care Research Programme under marked 11.7 per cent respondents as Schedule Castes Sub Plan, Swasthya frequent users of traditional medicine Rakshan Programme in Assam, Sikkim for health care. The study also and Arunachal Pradesh, to collect suggested that those individuals with a morbidity patterns and to determine the lower socio-economic status and those efficacy of the traditional treatments. living in rural areas were more likely to Dedicated to research publications, report the use of traditional medicines. the AYUSH research portal has been Day. The 12,500 health and wellness functional since 2011, where more than G’nY. What are the plans/schemes of centres of AYUSH are being established 25,000 research abstracts contributed the Indian government to popularise in a phased manner at the grass-root by research councils, national institutes alternative medicine systems levels with a special focus on preventive and universities have been uploaded. amongst the masses? health care. Around 56,127 article downloads from Various programmes have been A national AYUSH morbidity and 157 countries around the world have undertaken by Ministry of AYUSH for standardised terminology E-portal been recorded so far. popularising the traditional system (NAMSTE), for uniform centralised Thus there is considerable ongoing of medicines in India—the Public collection of AYUSH statistics and to effort to recognise, nurture and develop Health Initiatives scheme, scheme include these systems of medicine the traditional alternative medicines in for Revitalisation of Local Health in the traditional medicine chapter the interest of the health Traditions, Midwifery Practices, of the International Classification of of mankind.

GeoGraphy and you . 2020 25 + Altern ative MedicineS

By K Kanakavalli & E Wilson The SIDDHA SYSTEM OF MEDICINE A GEOGRAPHICAL PERSPECTIVE The word AYUSH denotes traditional and non-conventional systems of health care and healing which includes ayurveda, yoga, naturopathy, unani, siddha, sowa rigpa and homoeopathy. AYUSH systems of medicine are codified and recognised by the Ministry of AYUSH, Government of India. Medical pluralism in India is a reflection of its cultural diversity and AYUSH systems have evolved over thousands of years, absorbing and adapting yet maintaining its individual identity.

The authors are Director General and Research Officer respectively at Central Council for Research in Siddha, Chennai. [email protected]. The article should be cited as Kanakavalli K., E.Wilson, 2020. The Siddha System of Medicine: A Geographical Perspective, Geography and You, 20(3): 26-31 The Siddha system of medicine uses herbs such as Solanum trilobatum L. (purple flower), Mukia maderaspatana (L.) M. Roem (yellow flower), Hedyotis puberuia (G.Don.) Arn.(white flower) to cure various ailments. iddha is derived from the word ‘siddhi’ region of the forest (mullai), the fertile river bed that denotes ‘an object to be attained’. (marudham), the coastal region (neidhal) and the The founders of siddha medicine known desert (paalai) (Durairasan 1999). The nature of as Siddhars aimed at perfection of health the people will depend on the place and the time and were exceedingly scholarly faculties. period in which they live. They strongly believed in the ‘immortal’ corporal Kurinchi/ hilly tracts: This is a place of iyyam/ bodyS being in tune with the divine eternal ‘soul’. kapham with a profusion of herbs that cure Siddhars believed that through the temporary diseases. The people here suffer from fever which corporal body an individual can accomplish the affects the blood. They also suffer from tumours definitive goal to become united with the Lord and of the abdomen and hepatomegaly thus the system of medicine that emerged is the (Uthamarayan 1983). outcome of this search (Gurusironmani 1972). Neidhal/maritime tracts: It is a salty place of Siddhar Thirumular in ~3000 BC provided azhal–vayu (pitha-vatham) domination. Those an apt definition of siddha medicine, “One that who reside here suffer from elephantiasis and cures physical ailment is medicine/ One that hernia which happens due to the stagnation of cures psychological ailment is medicine/ One that iyyam (kapham) in the vital parts of the body prevents ailment is medicine/One that bestows (Durairasamy 1999). Immortality is medicine” (Thirunarayanan 1993). Mullai/sylvan tracts: A forest area having herds There seems to be a similarity of this definition of bullocks, cows and goats is where azhal is with the World Health Organisation (WHO) actuated. Along with azhal, vazhi combines to 1948 statement, “ a state of complete physical, produce various diseases and it is difficult to mental and social well-being and not merely the differentiate their types (Uthamarayan 1983). absence of disease or infirmity”, which highlights Marudham/agricultural tracts: A fertile river cure, prevention and long-lasting life as health bed can cure the diseases caused by all the three (Manickam 2013). humours—vazhi/vatham, azhal/pitham and iyyam/kapham. The agricultural yields contain origin of siddha all the six tastes which are capable of curing The history of siddha medicine is as old as the diseases. Hence, it is inferred that good food has history of the Tamil culture and civilization, a preventive effect and this fact was known to which is a part of the Dravidian culture and can the ancient people of Tamil Nadu (Durairasamy be dated back to the Indus Valley Civilization. 1999). The era of siddha medicine can be traced back to Paalai /arid tracts: These areas are a place for the pre-vedic times during the time of the three fatal diseases caused by vazhi/vatham, azhal/ syndicates of Tamil academicians (sangams) pitham and iyyam/kapham (Uthamarayan 1983). between 3,000 and 5,000 BC. There was also an additional syndicate consisting of 18 Siddhars popularity of siddha solely for medical deliberations pertaining to Siddha system is popular in southern India, the siddha system of medicine (Uthamarayan Sri Lanka, Malaysia, Singapore, Mauritius and 1992). According to Sage Yugi, in his text Vaidhya in some South-East Asian countries. It is also Chinthamani, written during the same period, popular among the Tamil-speaking diaspora. the origin of siddha medicine is traceable to Lord The Malaysian government regulates siddha Siva. The Lord provided the original lessons practice by registering the practitioners under of siddha medicine to Nandhi Thevar who Traditional and Complementary Medicine (T/ consequently, through a lineage of disciples, CM) division. In Sri Lanka, the siddha department taught Saint Agasthiar—the Siddhar proponent is affiliated to Jaffna University and another (Subbarayappa 1997 ). institute in Trincomalee Campus is affiliated to the Eastern University which imparts siddha Five Geographical divisions education as an undergraduate course. A module According to siddha, principles of social and for Varmam treatment has been developed by preventive medicine terrain is divided into five Central Council for Research in Siddha, India geographical divisions known as thinai (areas). (CCRS) which is provided to Malaysia in order to They are the mountain range kurinchi( ), pastoral establish and propagate the speciality therapies

28 2020 . GeoGraphy and you vol 20, issue 3 no. 141 1

2 3

1. A Siddha practitioner examining a patient at 16th International India Hospitality Expo at Goa on 1 August 2019; 2. Governor of Telagana visiting the Siddha Expo at Chennai; 3. A Siddha practitioner demonstrating Varmam Therapy to foreign nationals at Birstein, Germany on 5 September 2009.

to the considerable population of Indian Tamils (i) developing research through the establishment residing there (Ministry of AYUSH 2019). of CCRS and its peripheral institutes/units Under the Department’s International in many parts of the country, (ii) developing Cooperation scheme, the Ministry of AYUSH has siddha education by establishing and supporting set up an AYUSH information cell in the premises siddha educational institutions like National of the Indian Cultural Centre in Malaysia with Institute of Siddha (NIS), (iii) rendering medical the support of Indian High Commission in service to the public through NRHM (National Kuala Lumpur. Through the Indian Technical & Rural Health Mission) by posting many siddha Economic Cooperation (ITEC) programme, a physicians in the rural parts of Tamil Nadu, Siddha (Varmam) Unit is functioning since 2017 Puducherry and Kerala, (iv) creating a widespread in Sungai Buloh Hospital near Kuala Lumpur and awareness by propagating siddha through a research officer (siddha) from CCRS has been Arogya Health Melas, (v) organising Swasthya r posted here (Ministry of AYUSH 2019). Raksha programme to promote health and UTHO

: A health education in villages, (vi) upholding the SY rTe efforts Made to popularise siddha National AYUSH Mission (NAM) with a vision to OU C The Ministry of AYUSH has taken major provide cost effective and equitable health care by HOTO P initiatives to uphold the spirit of siddha system by, improving access to the services and to revitalise

GeoGraphy and you . 2020 29 and strengthen the AYUSH systems making them prominent medical streams in addressing the health care of the society. NAM is also mandated to improve educational institutions capable of imparting quality AYUSH learning and adopt quality standards of AYUSH drugs, making the sustained supply of raw-materials available (CCRS 2019). Ministry of AYUSH, with the active cooperation of Accelerating Growth of New India Innovation (AGNIi) is attempting to commercialise research and development technologies and products developed by CCRS. Reading materials have been published for IEC in Tamil, English, Hindi, Malayalam, Telugu and Kannada to popularise the siddha system across the country. The Swasthya Raksha programme is being executed through seven CCRS institutes in three states and two union territories with thirteen villages covered.

siddha research Bodies CCRS is the apex body for research for siddha and has eight peripheral institutes – three in Tamil Nadu and one each in Puducherry, Kerala, New Delhi, Karnataka and Andhra Pradesh. These institutes carry out drug, fundamental, medicinal plant and clinical research. The outcome of research at CCRS is evident as six patents have been published in the patent journal. CCRS has a unique siddha medicinal plants garden at Mettur Dam, Salem. Apart from research, health care services are also being provided by the centre (CCRS 2019). The top ten diseases treated at CCRS and its peripheral units are listed in Table 1. CCRS has granted 33 intramural research The Siddha system (IMR) projects and out of this eight projects have been completed and 25 are ongoing. THERAN is popular in software was developed and upscaled to AYUSH- Hospital Management Information System Southern India, Sri (AHMIS) and two applications were developed namely siddha initiative for documentation Lanka, Malaysia, of drug Adverse Reaction (SiddAR) and Documentation of Objectionable advertisement Singapore, and Reporting under Magic Remedies Act Mauritius and in Notification (DOOR MAN) (CCRS 2019). The National Institute of Siddha (NIS) is as an some South-East apex institute of siddha in all aspects of siddha system of medicine and offers a post-graduate and Asian countries. doctoral programme under the Central Council of Indian Medicine (CCIM) and is affiliated to MGR Medical University, Chennai. A National

30 2020 . GeoGraphy and you vol 20, issue 3 no. 141 Table 1: Top 10 diseases reported in the Institutes of plants by promoting ex-situ and in-situ Central Council for Research in Siddha conservation as per the guidelines of the National Diseases Medicinal Plants Board ( DIM & H 2018). Efforts Azhal Keel Vayu (Osteoarthritis) are underway to establish a Siddha Clinical Neerizhivu (Diabetes Mellitus) Research Unit in Goa and in the north and north- Kalanjagapadai (Psoriasis) east India. Peenisam (Sinusitis) Thandaga Vatham (Lumbar spondylosis) Way Forward Irumal (Bronchitis) Siddha medicine is a unique blend of therapies Gunmam (Acid peptic disease) that provides holistic care, offering advice for a Karappan (Eczema) more natural and healthy lifestyle. It has been the Sinaipai Neerkatti (Poly cystic ovarian syndrome) constant effort of CCRS to generate and record Iraippu Noi (Bronchial asthma) evidence to support the various time-tested

Source: CCRS 2019 practices, medicines and therapies of siddha, to seek a wider role for the medicine system and to take its benefits to the people in different corners of the nation and beyond. Table 2: Siddha healthcare service network in Tamil Nadu references Name of healthcare service network Numbers Durairasan G. 1999. Siddha Principles of Social Primary health centres 406 and Preventive Medicine, Tamil Nadu: Siddha National rural health mission (NRHM) wings at 275 Medical Literature Research Centre. Government primary health centres (PHCs) Directorate of Indian Medicine and Homoeopathy Taluk hospitals 191 Non-taluk hospitals 58 (DIM &H). 2018. Report from DIM&H, Tamil Rural dispensaries 45 Nadu: India. District headquarters hospitals 31 Gurusironmani P. 1972. A Short Note on History of ESI dispensaries 28 Siddha Medicine. Bulletin of the Indian Institute Modern medical college hospitals 15 of History of Medicine, 2(2): 78-80. Dispensaries 13 Manickam P. 2013. Shastarth- 3000 BC Concept National AYUSH Mission siddha wings 11 of Health and its Relevance Today, Ingenieous, Part-time dispensaries in collectorate offices 8 National Institute of Epidemiology. Available at: Tribal dispensaries 7 https://bit.ly/2P1qnWD Major hospitals 2 Ministry of AYUSH. 2019. Annual Accounts: CCRS Varmam and Thokkanam specialty hospital 1 2018-19: Central Council for Research in Mobile medical unit 1 Siddha, Tamil Nadu: India. Available at: http:// Central sub-jail dispensary 1 siddhacouncil.com/annual-report/ Source: DIM&H, 2018 Ministry of AYUSH. 2019. Siddha Dossier: The Science of Holistic Health: Central Council for Research in Siddha, Tamil Nadu: India. Accreditation Board for Hospitals and Healthcare NIS (National Institute of Siddha). 2019. Annual (NABH) approved the 250 bedded Ayothidoss Report of NIS 2018-19, Tamil Nadu: India. Pandithar Hospital and Research Centre which Subbarayappa B.V. 1997. Siddha Medicine: An assists scholars in their academic pursuits Overview. The Lancet, 350(9094): 1841–44. (NIS 2019). Thirunarayanan T. 1993.An Introduction to Siddha Through the Directorate of Indian Medicine Medicine, Tamil Nadu: Thirukumaran Publishers. and Homoeopathy (DIM&H) established by Uthamarayan K.S. 1992. Thotra Kirama Aaraichi Tamil Nadu in 1970, siddha health care services & Siddha Maruthuva Varalaru, (5): 124- are being extended to the masses through a 130. Directorate of Indian Medicine and significantly large statewide network (Table 2). Homeopathy. In addition, State Medicinal Plants Board Uthamarayan K.S. 1983. Siddhar Maruthuvanga (SMPB) functioning under DIM&H is responsible Churukkam, Directorate of Indian Medicine and for conservation and cultivation of medicinal Homeopathy, Tamil Nadu: India.

GeoGraphy and you . 2020 31 + Focus: HomeopatHy

By Chaturbhuja Nayak CRITICISMS OF HOMEOPATHY ADDRESSED THROUGH SCIENTIFIC RESEARCH

Despite being practised for over 200 years homeopathy is still facing credibility challenges. Emerging research in this field has however, proven the plausibility of this science. During last two decades developed nations like Britain, France, USA and Australia, have questioned the effectiveness of homeopathy, although results have proven the scientificity of the alternative system. In the years to come studies conducted by homoepathic research organisations around globe is likely to further validate its scientific basis.

32 2020 . GeoGraphy and you vol 20, issue 3 no. 141 In the modern era, homeopathic medicinal system is supported by available contemporary research and scientific experiments.

The author is a professor, Head, Homoeopathy University, Jaipur, Rajasthan and former Director General, Central SAD A Council for Research in Homoeopathy, Govt. of India. [email protected]. The article should be cited as Nayak C., 2020. Criticisms of Homeopathy: Addressed Through Scientific Research, Geography and You, 20(3): 32-35 Photo: Pr Photo:

GeoGraphy and you . 2020 33 omeopathy is fundamentally based Recently, the gene regulatory hypothesis (Khuda- on the assumption that a biological Bukhsh 2014), nanoparticle (Upadhyay and Nayak activity is borne by a chemical 2011) and hormesis theory (Bell and Schwartz system. The system is based on a 2013) have emerged in the field. Although the molecular solute within a solvent exact mode of action underlying specific effects that is diluted and mechanically ‘succussed’ of highly diluted homeopathic preparations Ha defined number of times. It then reaches a are yet to be determined, basic research in zero point where molecules disappear (beyond homeopathy has reached incredible heights, the 12CH dilution) and the solvent is the only especially in the last few decades. Several lines of chemical species left. Thus, no solvent possesses evidence suggest that homeopathic high dilutions the extreme variability of molecular masses acting possess pharmacological action and so cannot be on any biological system – an idea that is exactly considered merely a placebo (Bellavite et al. 2014). contradictory to Avogadro’s constant (Chirumbolo This is quite interesting and supports the scientific 2013). Naturally, since its inception, the mode basis of homeopathy, contrary to the findings of A of action underlying specific effects of highly Shang and team, published in the medical journal diluted homeopathic preparations has remained The Lancet (Shang et al. 2005). ‘implausible’ and could not yet be established, The literature related to observational trials, which strongly hampers the acceptance of though largely significant, is not considered to be homeopathy by the scientific community. A the ‘gold standard’ of efficacy or effectiveness of variety of models have been proposed—local homeopathy (or of any intervention). The ‘gold and non-local; physicochemical and pharmaco- standard’—the randomised controlled trials dynamic. These models seemed promising, (RCTs) in homeopathy has remained controversial. but inconclusive (Klein et al. 2018). The famous In the latest meta-analysis by R T Mathie and Benveniste experiment in 1988 published in the team, 22 RCTs of individualised homeopathy journal ‘Nature’ reported that basophils (a type of yielded an odds ratio of 1.53 only, thus indicating white blood cells) can be activated to produce an a small, but specific treatment effect beyond immune response by solutions of antibodies that placebo. Subsequent to the meta-analysis, a few have been diluted so far that they contain none more RCTs of individualised homeopathy have of these biomolecules at all (Davenas et al. 1988). been conducted on conditions like irritable bowel His concept seemed to support the underlying syndrome (Peckham et al. 2014), climacteric principles of drug dynamisation in homeopathy. depression (Macias-Cortes et al. 2018), asthma However, the attempts of reproducing similar (Qutubuddin et al. 2019), insomnia (Michael et results failed in other experiments, perhaps al. 2019), and premenstrual syndrome (Yakir et aided by the strong lobby of contemporary al. 2019) with promising outcomes. Pragmatic pharmaceutical companies, who want to RCTs of adjunctive homeopathy also appears to be denounce homeopathy in the scientific world. promising. However, any decisive interpretation Surprisingly, water samples which underwent the is yet to be arrived at. A research study conducted procedure of homeopathic medicine preparation by P S Chikramane and his team from IIT, were found to be different from plain water Bombay in 2010 has shown the presence of nano- by well-established techniques including flux particles in higher potencies of homoeopathic calorimetry, conductometry, pHmetry and medicines. Thus, there is an increasing body of galvanic cell electrodes. Thereafter, the controversy clinical evidence in support of the efficacy and took an interesting turn: the ‘clathrate’ model effectiveness of homeopathic treatment beyond the was put forward and was substantiated by placebo effect. However, the overall effect remains Fourier-transform infrared (FT-IR) spectroscopy, inconclusive. ultra-violet (UV) spectroscopy, fluorescence A multitude of studies in homoeopathy have microscopy and atomic force microscopy (Elia been conducted related to basic and fundamental et al. 2014). Subsequently the silica model (Anick research (Tournier et al. 2019), drug proving and Ives 2007), electromagnetic model (Ruzic et (Sundaram et al. 2010), clinical verification and al. 2008), epitaxy (Rao et al. 2007) and quantum clinical research (Mathie et al. 2019). The studies entanglement (Fishe 2016) models were put referred to here and the results of many other forward and all these proved to be quite promising. research work can perhaps counter the arguments of

34 2020 . GeoGraphy and you vol 20, issue 3 no. 141 conventional scientists and allopathic practitioners, Davidson. 2019. Systemic Review and Meta-Analysis moving homoeopathy beyond the realm of of Randomised, Other-than-Placebo Controlled, ‘implausibility’ and ‘placebo effect’. However, more Trials of Non-Individualised Homeopathic independent replication should be undertaken to Treatment, Homeopathy, 108(2):88-101. Michael J., S. Singh, S. Sadhukhan, A. Nath and establish models that are stable across laboratories N. Kundu. 2019. Efficacy of Individualized and teams (Bellavite et al. 2014). Homeopathic Treatment of Insomnia: Double- Acknowledgment: The author is thankful to Subhranil Blind, Randomized, Placebo-Controlled Clinical Saha, Scientist, Homoeopathic Drug Research Institute, Trial, Complementary Therapies in Medicine, 43: Lucknow (Uttar Pradesh), India, for providing useful 53-59. data for the article. Peckham E.J., C Relton, J Raw, C Walters, and Thomas K. 2014. Interim Results of a Randomised references Controlled Trial of Homeopathic Treatment for Anick D.J. and J.A. Ives. 2007. The Silica Hypothesis for Irritable Bowel Syndrome, Homeopathy, 103(03): Homeopathy: Physical Chemistry, Homeopathy, 172-177. 96(03): 189-195. Qutubuddin M., S.M. Singh, C. Nayak, M. Koley and S. Bell I.R. and G.E. Schwartz. 2013. Adaptive Network Saha. 2019. Efficacy of Individualized Homeopathy Nanomedicine: An Integrated Model for in Bronchial Asthma in Adults: Double-Blind, Homeopathic Medicine, Frontiers in Bioscience Randomized, Placebo-Controlled, Clinical Trial in (Scholar Edition), 5(2): 685-708. the Context of Usual Care, Advances in Integrative Bellavite P., M. Marzotto, D. Olioso, E. Moratti and A. Medicine, 6(2): 58-65. Conforti. 2014. High-Dilution Effects Revisited, 1. Rao M.L., R. Roy, I.R. Bell and R. Hoover. 2007. The Physicochemical Aspects, Homeopathy, 103(01): 4-21. Defining Role of Structure (Including Epitaxy) Chirumbolo S. 2013. Bias and Adverse Effects in the Plausibility of Homeopathy,Homeopathy, of Homeopathy: Is Scientific Criticism in 96(03): 175-182. Homeopathy a "Mission Impossible"?, International Ruzic R., I. Jerman, M. Skarja, R.T. Leskovar and L. Journal of Clinical Practice, 67(9): 923-926. Mogilnicki. 2008. Electromagnetic Transference of Davenas E., F. Beauvais, J. Amara, M. Oberbaum and B. Molecular Information Garden Cress Germination, Robinzon. 1988. Human Basophil Degranulation International Journal of High Dilution Research, Triggered by Very Dilute Antiserum Against IgE, 7(24): 122-1317: 122-131. Nature, 333(6176): 816-818. Shang A., K. Huwiler-Müntener, L. Nartey, P. Jüni Elia V., G. Ausani, F. Gentile, R. Germano and E. Napol. and S. Dörig. 2005. Are the Clinical Effects of Homoeopathy Placebo Effects? Comparative Study 2014. Experimental Evidence of Stable Water of Placebo-Controlled Trials of Homoeopathy and Nanostructures in Extremely Dilute Solutions,At Allopathy, The Lancet, 366(9487): 726-732. Standard Pressure and Temperature, Homeopathy, Sundaram E.N., K.P. Singh, K.P. Reddy, U.P. Reddy 103(01): 44-50. and K.R.J. Nair et al. 2010. A Preliminary Study to Fishe P. 2016. Is Quantum Entanglement in Evaluate Analgesic and Behavioural Activities of the Homeopathy a Reality?, Homeopathy, 105(03): Homoeopathic Drug, Anagallis Arvensis in Rats, 209-210. Indian Journal of Medical Research Homoeopathic, Klein S.D., S. Würtenberger, U. Wolf, S.Baumgartner 4(2):41-48. and A. Tournier. et al. 2018. Physicochemical Tournier A., S.D. Klein, S. Wurtenberger, U. Wolf and S. Investigations of Homeopathic Preparations: A Baumgartner. 2019. Physicochemical Investigations Systematic Review and Bibliometric Analysis—Part of Homeopathic Preparations: A Systematic 1, The Journal of Alternative and Complementary Review and Bibliometric Analysis - Part 2, Journal Medicine, 24(5): 409-421. of Alternative and Complementary Medicine, Khuda-Bukhsh A.R. 2014. Current Trends in High 25(9):890-901. Dilution Research With Particular Reference to Gene Upadhyay R.P. and C. Nayak. 2011. Homeopathy Regulatory Hypothesis, The Nucleus, 57(1): 3-17. Emerging as Nanomedicine, International Journal Macias-Cortes E.D.C., L. Llanes-González, L. Aguilar- of High Dilution Research, 10(37): 299-310. Faisal and J. Asbun-Bojalil. 2018. Response to Yakir M., C.T. Klein-Laansma, S. Kreitle, A. Individualized Homeopathic Treatment for Brzezinski and M. Oberbaum. 2019. A Placebo- Depression in Climacteric Women with History Controlled Double-Blind Randomized Trial with of Domestic Violence, Marital Dissatisfaction Individualized Homeopathic Treatment Using or Sexual Abuse: Results from the HOMDEP- a Symptom Cluster Approach in Women with MENOP Study, Homeopathy, 107(3): 202-208. Premenstrual Syndrome, Homeopathy, 108(04): Mathie R.T., Y.Y.Y. Fok, P. Viksveen, A.K.L. To and J.R.T. 256-269.

GeoGraphy and you . 2020 35 + Focus: HomeopatHy

Modern immunotherapy is taking a personalised approach currently as opposed to homeopathy, which has always been tailoring its treatments with the help of patient specific causation rubrics. HaHnemann

36 2020 . GeoGraphy and you vol 20, issue 3 no. 141 By Mayur Jain HaHnemann The Therapeutic Pioneer of Psychosomatic Medicine of Today In wellness clinics of the modern world, there is an increased inflow of patients with symptoms diagnosed by modern medicine as psychosomatic diseases. These latest advancements in medical science were well documented in the homoeopathic system of medicine since 1796. Samuel Hahnemann was in fact the first to design therapeutic cures for such diseases.

The author is Holistic Healer and Consulting Physician - Homoeopathy, New Delhi. [email protected]. The article should be cited as Jain M., 2020. Hahnemann: The Therapeutic Pioneer of Psychosomatic Medicine of Today, Geography and You, 20(3): 36-41

GeoGraphy and you . 2020 37 ny person with any bodily symptoms have psychological, emotional or mental distortion or dysfunction at its origin (psychosomatic). This is coming up as a big breakthrough in current medical Aadvancement, but history suggests that some of this work has been done in the past by Hippocrates, Galen and others—the influence of the psychic over the physical body. Modern medicine is now recognising the trinity of life—mind-body-soul and its relation to humans in health and in disease. Way back in 1796, Samuel Hahnemann, the father of homoeopathy recognised the importance of integrating mental and subjective symptoms in addition to pathological diagnosis or symptoms in selecting the ‘simillimum’ for cure. Hahnemann in 1813, mentioned ‘biological-whole treatment theory’ in his famous essay, Spirit of the homoeopathic doctrine of medicine. He reiterated the theory in the 6th edition of ‘Organon of Medicine’ too. This today is popularly known as psychosomatic medicine-the study of the sick human as a biological whole among multiple psychosomatic inter-reactions. He explains, “Nearly all morbid states which are referred to as ‘psychic’ are, in reality, nothing but somatic ailments in which the discord between According to the intellectual and moral faculties, each in its specific way and in a manner more or less rapid, statistics from have become predominant through their relation to the purely physical symptoms. Thus, they finish Meridian Stress by taking on the character of a ‘defective’ disease which gives the appearance of a local ailment Management having its seat in the delicate and invisible organs Consultancy, of thought.” Hahnemann built upon the theory advocated by almost 1,80,000 Hippocrates and Galen that every human sickness has roots at the emotional or mental dysfunction people from the level and was the first to design the solution and possible therapeutic cure for the diseases that are UK die each year arising inside the mind and later reflecting on the physical body. from some form In the current narrative the world has begun to recognise the emotional origin of physical of stress-related symptoms or diseases, instances of which are illness. presented here. “I listen with love to my body’s messages,” from Louise L Hay’s book published in 1984 ‘You Can Heal Your Life’ sends out a

38 2020 . GeoGraphy and you vol 20, issue 3 no. 141 powerful message. The book remained a New York and rebellion—may possibly begin a process of Times best- seller for several weeks and reportedly transcendence of the disease. sold more than 50 million copies (Genzlinger Kaya also explains that every disease has some 2017). This book explains the unseen but well- positive impact on the soul—the deepest memory observed, discussing the multi-dimensional bank of different experiences and sensations of the connection and the interdependent relationship human system, which we are still in the process of between physical and mental diseases, examples of exploring-scientifically. The diagnosis of cancer which are as follows: symbolically means that the potential of healing  Hair complaints are due to a lack of inner or or transcendence of these negative memories is emotional strength/tension. in process at the level of the soul. The cancer is  Ear diseases are the result of unwillingness to giving an opportunity to the suffering person to hear what’s going on around you/ anger about become aware of these deep negative emotions or what is heard/ lack of receptivity. psychological disturbances.  Digestive or stomach complaints are rooted in an inability to assimilate new experiences/fear of stress and illness new ideas. Mohd. Razali Salleh in an article (Salleh 2008)  Back-muscles pain or stiffness or any other says, “The relationship between stress and illness symptoms have some kind of emotional origin is complex. Chronic stress has a significant like lack of support. If in the upper area it may be effect on the immune system that ultimately lack of emotional support/ holding back love; in manifests as an illness. It raises catecholamine the middle area it maybe due to a sense of guilt; and suppressor T cells levels, which suppress in the lower back area it becomes more about the immune system. This suppression, in turn, lack of financial security and support/fear of raises the risk of viral infection. Stress also leads money. to the release of histamine, which can trigger  Obesity, weight gain or being overweight is severe bronchoconstriction in asthmatics. related to a need for protection or insecurity. It Stress increases the risk of developing diabetes could also be because of seeking love/fear of loss/ mellitus, especially in overweight individuals, stuffing feelings. since psychological stress alters insulin needs.  Constipation is also an emotion related The correlation between stressful life events disorder—inability to let go/ tendency to and psychiatric illness is stronger than the over-save. correlation between medical or physical illness. Her key message is, "If we are willing to do the The relationship of stress with psychiatric illness mental work, almost anything can be healed." is strongest in neuroses, which is followed by Another book that is referred in contemporary depression and schizophrenia. Recent studies wellness practice, published in 2014, is found a link between stress, tumor development ‘Dictionary Dreams-Signs-Symbols, The Source and the suppression of natural killer (NK) Code’ by Francis L Kaya. On cancer he writes, cells, which are actively involved in preventing “Symbolically, this illness reveals an accumulation metastasis and destroying small metastases.” of memories and it is related to dysfunctional In measuring emotional intelligence the behavior regarding the way we nourish ourselves Simmons duo writes, “Emotional stress is a major on all levels; an accumulation of frustration, contributing factor to the six leading causes of resignation, things left unsaid, repressed anger, death in the United States: cancer, coronary heart rage,frustration, failures, guilt, and lack of love, disease, accidental injuries, respiratory disorders, affection retained rebellion and revolt.” cirrhosis of the liver and suicide” (Simmons and He further adds a very different viewpoint Simmons 1997). According to statistics from from the ‘suffering soul’ level. The very diagnosis Meridian Stress Management Consultancy in the of cancer, symbolically, means healing has UK, almost 180,000 people in the UK die each begun and is in process. Making the affected year from some form of stress-related illness. person aware that he harbours a lot of old, S Cohen and his team in the seminal work former memories of repressed emotions, anger ‘Measuring Stress’ published in 1997 summed up

GeoGraphy and you . 2020 39 stress and its associated causes as follows: “Stress the psychosomatic rubrics of the Hahnemann's is defined as a process in which environmental system. For instance, a close friend consulting demands strain an organism’s adaptive capacity for stammering was unable to speak intelligibly resulting in both psychological demands as well as for a month. Despite neurological examination biological changes that could place the organism pointing out no apparent cause, she was advised at risk for illness” (Cohen et al. 1997). He also medicines that gave her no relief. She expressed writes that “even our thoughts can cause us stress that she had had a difficult day at the workplace and make the human body more susceptible to and was annoyed, frustrated and angry. Referring illness.” The author postulates three scenarios, to rubric [Kent] mouth; speech, stammering, a) Environmental stress—this emphasises the vexation a single remedy mentioned was role of experiences that are objectively related to prescribed (Caust2+). Within a week she started substantial adaptive demands; b) Psychological showing signs of improvement. or emotional stress—people’s subjective Another common condition is the flaring up evaluations of their ability to cope with demands of asthma after getting angry. Patients opine that presented to them by certain situations and they force themselves to remain away from anger experiences; c) Biological stress—the function to help manage asthma, although in some cases of certain physiological systems in the body that they find it almost impossible. The rubric that are regulated by both emotions and physically proves useful in this situation is [Kent] respiration; demanding situations. asthmatic, anger, which not only relieves the There is a growing concern about the increasing asthma attack but also the incidence of anger cost and prevalence of stress-related disorders; induced asthma over time (Ars2+ and Cham3+). especially in relation to the workplace. Countries Stress and asthma are often seen together. renowned for their long working hours know this Anxiety, crying, yelling, stress, anger, or laughing well enough—Japan and China each having a hard can bring on an asthma attack. According word for death by overwork karoshi and guolaosi to Asthma UK, 43 per cent of people with asthma respectively. Both Japan and Korea recognise report that stress can trigger their symptoms suicide as an official and ‘compensatable’ work- (Asthma UK 2019). related condition. In the year 1810, Hahnemann started to Based on the above references, we understand promote the essential relationship between the that for complete cure or restoration of the health physical and the psychic condition of the patient. of an individual it is crucial to reach the roots In his book, Organon of Medicine, he writes, “… resting deep in the emotions or mental sphere of there does not exist a single so-called somatic that individual. Often a person is not aware of it illness where we may not discover constant as he or she has developed some compensatory modifications in the psychic condition of the mechanism around it or a façade to please the ego patient …”. He continues, “It will never be possible and to remain in denial mode. But, if good case to effect a cure in conformation with nature—that taking is done then a well-trained physician can is to say homeopathically—if, in every individual join the dots of the current disease condition of the case disease, even acute, we do not at the same patient to its initial starting point. time observe the changes which have taken place in the psychic or the mental state of the patient.” examples from MateriaMedica “Furthermore, we shall no longer be able to cure Following are a few rubrics from ‘Repertory if we fail to choose from among the medicines a of Homoeopathic Materia Medica’ by J T Kent pathogenetic force capable of provoking not only (Kent 1992), first published in 1897. These rubrics symptoms similar to those of the disease, but even highlight how great homeopathic physicians more, one that is similar to the mental state and observed and recorded physical reactions of the character of the patient.” body stimulated by emotions, excitement, anger, grief, mortification, vexation, fear, fright and other Way Forward mental symptoms. Hahnemann recognised the role of stress, The author has in several cases found value in emotions and mental symptoms in giving rise to

40 2020 . GeoGraphy and you vol 20, issue 3 no. 141 The book, Repertory of Homoeopathic Materia Medica and a Word Index, is authored by James Tyler Kent and printed in 1897. Frequently referred rubrics for psychosomatic diseases are found in this repertory.

different physical disease conditions and he was Genzlinger N. 2017. Lousie Hay, Widely read successful in developing a complete therapeutic self-help author, dies at 90.The New York protocol or treatment system to restore the sick to Times, September 2017. Available at: https:// health. Today modern science is also recognising www.nytimes.com/2017/09/01/obituaries/ the same in the name of psychosomatic diseases, louise-hay-dead-widely-read-self-help- but the curative approach is not that well defined. author.html. For today’s fast-paced stressful life with low Kaya F.L. 2014. Dictionary, Dreams-Signs-Symbols: The emotional quotient, homeopathy provides a Source Code (The Ultimate Spiritual Guide to Dream therapeutic science for both acute and chronic Interpretation), Quebec, Canada: Universe/City diseases. This will not only heal the person Mikael (UCM) Publishing. physically but also deep at the emotional or mental Kent J.T.1992. Repertory of the Homoeopathic level for multi- dimensional cure. MateriaMedica, New Delhi: B. Jain Publishers. Salleh M.R. 2008. Life Event, Stress and Illness, The references Malaysian Journal of Medical Sciences, 15(4): 9-18. Asthma UK. 2019. Emotions. Available at: https:// Available at: https://www.ncbi.nlm.nih.gov/pmc/ www.asthma.org.uk/advice/triggers/emotions/. articles/PMC3341916/ Accessed on February 21, 2020. Simmons S. and J.C. Simmons. 1997. Measuring Cohen S., R.C. Kessler and L.U. Gordon, 1997. Emotional Intelligence: The Groundbreaking Guide Measuring Stress: A Guide for Health and Social to Applying the Principles of Emotional Intelligence, Scientists, Oxford, UK: Oxford University Press. New York: The Summit Publishing Group.

GeoGraphy and you . 2020 41 + Focus: HomeopatHy

By Harleen Kaur TRIAGING foR

HoHomoeopathy,ME as a system of medicine, is a oPATHY science of ‘similars’ and ‘overalls’. The role of homoeopathy in alleviating chronic ailments like skin, respiratory, gynaecological, joint, paediatric and psychiatric problems is promising.

The author is a Research Officer (Homoeopathy) at Central Council for Research in Homoeopathy, Ministry of AYUSH. [email protected]. The article should be cited as Kaur H., 2020. Triaging for Mainstream Homeopathy, Geography and You, 20(3): 42-46

42 2020 . GeoGraphy and you vol 20, issue 3 no. 141 MAINSTREAMING HoMEoPATHY

There is a bigger scope of triaging for the inclusion of homeopathy in many national health programmes in an integrative manner. One such programme,

d the National Programme for Prevention and Control ASA R of Cancer, Diabetes, Cardiovascular Diseases and : P Stroke (NPCDCS) is now adopting this approach. PHoTo

GeoGraphy and you . 2020 43 icture these—a couple is expecting work or attend a social event has become all too their first child and the excitement, common. These could be the initial worrying signs, anxiety, and uncertainty of what to which, if ignored, can show up on the physical expect is eating up into the charm of level, with problems like migraine, hyperacidity, the cherishable period that pregnancy musculoskeletal pains, or even unexplained is otherwise; A toddler is crying incessantly due headaches or chest pains. Another understanding toP his earache that is not letting him sleep, or even of holistic health is to identify and appreciate that eat; A teenager just got her first pimple and does when we are dealing with a physical illness, we are not know whether peeling it off would make it affected mentally too. For instance, in diseases like, better, or worse—and the prospect of letting it osteoarthritis or kidney stones we may find disease be for a couple of days sounds scary; A young coming in the way of our day to day routine, which woman is worried about her marriage—what if eventually affects our mental and social make up. the cysts in her ovary fiddle with her chances of Holistic treatment for a 360-degree management conception, just as they are doing with her monthly of illnesses is best offered by various traditional cycles for two years now; An elderly gentleman and complementary medicine (TCM). The is very disturbed with his enlarged prostate and recent Global Report of the World Health the already weak urine stream seems to be getting Organization(WHO) on TCM reviews global even weaker, faster than he imagined; An elderly progress over the past two decades and is based woman is suffering from bed sores. The pain and on contributions from 179 WHO member states discomfort they cause is worse than her other long (WHO 2019). As per this report, homoeopathy is standing disease. practiced by 100 out of 179 member states and is Well, most of us either have been in or know popular in many South-East Asian and someone who has been in one of the above European countries. situations. Although we hope that dark clouds Homoeopathy, as a system of medicine, is of illness will stop looming over our heads one a science of ‘similars’ and ‘overalls’. In the six day, in reality, though, the future looks grim. The scenarios shared above, it is possible that two of pollution levels we are exposed to on a daily basis, the six people discussed get the same medicine for sedentary lifestyles, unhealthy eating habits, different ailments, as their underlying ‘personality’ poor sleeping patterns, and not to mention work or ‘constitution’ match with the drug. Also, these pressures—are silently writing a ruthless story six individuals might report a particular ailment for human health. Much as we would not want to to their homoeopathic doctor, but are cured of accept it, we are the culprits for allowing each of peripheral sufferings that was not primemost on these components to creep into our lives to reduce their minds. As the medicine acts holistically, it is our health scores, except, of course, pollution not uncommon for a homoeopath to have patients which we cannot directly control. coming back surprised that even though they Having said that, what can we possibly do to wanted treatment for their ‘sinusitis’, their constant avoid these? Remedying the situation is grit-based pain in the back and corn in the foot are gone too. and seeking fitness goals is not tough. Thanks to Or, for that matter, it is a common experience to social media, we can set our daily goals of fitness see a patient with breathing trouble reporting an from any of its myriad platforms which are full of improved quality of life, better appetite and success stories about fighting illnesses, staying fit sound sleep. and aiming to live longer. Even before many evidence-based studies While some diseases are expressed by our body, validated the traditional knowledge, homoeopathy there are others that are expressed solely by our was used as the preferred choice of treatment for minds. These may not even be considered a disease many chronic ailments like those of the skin, by family or friends, because they manifest at a respiratory system, gynaecological system, joints different level than what our eye is trained to see. and for paediatric and psychiatric problems. In Awareness drives for health encompasses physical, India, its usage was already widespread, with SIVARAM V social and mental wellbeing—which, in other many allopath-turned-homeopath practitioners. : TESY words, can also be called holistic health. However, Consequently, the Indian government recognised R instances where we find ourselves fit to get out of it as one of the national systems of medicine Cou bed every morning, but not inclined to report to through the Homeopathy Central Council Act of PHoTo

44 2020 . GeoGraphy and you vol 20, issue 3 no. 141 1973. For progress and development purposes of In what can be seen a motivating occurrence this system, that blended well into the ethos and was the visit of a UK Conservative Party traditions of the country, homoeopathy was taken member, David Treddinick to India in October under the ambit of Indian Systems of Medicine and 2019. Treddinick toured many parts of India Homoeopathy (later termed AYUSH-ayurveda, to understand how India was running the yoga and naturopathy, unani, siddha and model of integrated healthcare. He noted that homoeopathy). Ever since, the Indian Government a large number of people flooded the treatment and state governments have been the propeller and centres offering AYUSH therapies. Visiting provider of homoeopathic cure based on people’s the homoeopathy and ayurveda units, he demands and its classic virtues of affordability and found it impressive that the National Institute gentle healing. of Homoeopathy in Kolkata saw about 2000 A literature review of recent surveys and patients in its outpatient department every single articles to assess the morbidity trends and the day. Treddinick visited the research centres of treatment modalities being sought by patients in homoeopathy and remarked that it showed the India revealed homeopathy is well represented quest for evidence is as high in homeopathy in public health, being a close second among the professionals as is the desire of the people of India AYUSH services. Homeopathy wellness centers to seek homeopathic treatment. Upon returning to run by the Indian government comprise 31 per the UK, Treddinick gave a high-spirited lecture in cent of the total for AYUSH and seven out of the British Parliament about how the UK remains 10 diseases recognised as part of the national several years behind India in holistic health care health burden in India are in the category of most delivery, advocating the idea of integrated health or commonly reported diseases at the homeopathy medical pluralism. wellness centres. It also revealed that homeopathy Triaging for homoeopathy in the health care practitioners constitute 37 per cent of all AYUSH mainstream is already being done, or so it seems, practitioners, and homeopathy units comprise when it comes to primary health care offered by 1/19th of the number of allopathy units. Yet the the central and state governments. But there is a annual patient footfall in the homeopathic units is much bigger scope for inclusion of homoeopathy 1/5th of the allopathy units. The paper concluded at many levels. Many national health programmes that homeopathy services, wherever available, are now adopting an integrated approach. One are being used fully and thus sharing the patient such programme, National Programme for load in the government-run wellness centres and Prevention and Control of Cancer, Diabetes, that there is the potential for more homeopathic Cardiovascular Diseases and Stroke (NPCDCS) practitioners to contribute importantly to health launched by the Indian government in 2010 later care delivery in India (Kaur et al. 2019). adopted AYUSH systems for offering holistic Furthermore, the role of homoeopathy as an care. This led to wider screening of patients adjuvant to modern medicine is also an integration with more practitioners available to conduct that seems to be working well as a model that fits screening, timely referrals of more serious cases easily in many public health delivery centres. In and early intervention with homoeopathy or many private and government hospitals, such other therapies wherever required. Similarly, in co-therapy is being offered. Doctors do not hesitate a national campaign on mother and child care and are, in fact, supportive in cross-referring or launched in 2007, homoeopathy was taken to the co-referring the patients where they feel such a district level through ‘train the trainer’ module, combination can be more beneficial than a single where health workers like Accredited Social Health treatment method. The examples of such references Activists (ASHAs) were trained to provide timely in healthcare setups are innumerable. Search homoeopathic treatment to mothers and children. engines bring up many examples of such successful Whenever efforts of integrating homoeopathy integration, if one looks for ‘homeopathy as at the national level, have been made, they have adjuvant’ or other similar terms. In fact, such yielded promising results (Taneja et. al, 2019). Yet, an integration leads to benefits like lesser such ventures are few and far between. hospitalisation, reduced hospital admission days, better quality of life, better patient compliance and Way Forward improved tolerance to drugs. The promotion and development of AYUSH

Geography and You . 2020 45 systems are now directly under the purview of the Ministry of AYUSH (earlier a department under the Ministry of Health and Family Welfare). This has resulted in wider acceptance from the health authorities of the integration of AYUSH systems in national programmes. Patients with diseases with limited scope of treatment with modern medicine should be referred for homeopathic treatment by government run health centers. Some examples are non-communicable diseases like diabetes mellitus, hypothyroidism, dyslipidemia, hypertension and osteoarthritis. Many of these diseases tend to co-exist and contribute to ‘multimorbidity’ in the patients. Secondly, epidemic diseases of viral origin, like influenza-like illnesses, seasonal flu, or bacterial or other infections that have no vaccine readily available, like diarrhea, dengue (Nayak et. al. 2019), chikungunya, malaria and acute encephalitis syndrome (Oberai et. al. 2018) can be considered for co-therapy to maximise the treatment possibilities. Thirdly, it is prudent to discourage incorrect use of antibiotics and other Schedule H drugs that people self-prescribe for day to day illnesses. This eventually leads to rise in drug-resistant cases, which primarily means that disease-causing microorganisms (usually bacteria) turn resistant to the drugs they were once sensitive to, due to repeated, undue exposure of antibiotics. Drug resistance is a major concern being voiced by the WHO of late. However, the best way to stop people from self- prescribing antibiotics is to provide them an alternative, which can be homoeopathy. The Indian references Kaur H., D.S. Chalia and R.K. Manchanda. 2019. government Homeopathy in Public Health in India, Homeopathy, 108(02): 076-087. recognised Nayak D., V. Chadha and S. Jain. 2019. Effect of Adjuvant Homeopathy with Usual Care in Management of homeopathy Thrombocytopenia Due to Dengue: A comparative Cohort Study, Homeopathy, 108: 150-157. as one of the Oberai P., R. Varanasi and M. Padmanabhan. 2018. national systems Effectiveness of Homeopathic Medicines as Add- on to Institutional Management Protocol for Acute of medicine with Encephalitis Syndrome in Children: An Open-Label Randomized Placebo-Controlled Trial, Homeopathy, the passing of 107: 161-171. Taneja D., A. Khurana and A. Vichitra. 2019. An Assessment the Homeopathy of A Public Health Initiative of Homeopathy for Primary Teething, Homeopathy, 108: 2-11. Central Council World Health Organization. 2019. WHO Global Report on Traditional and Complementary Medicine, Creative Act of 1973. Commons, Mountain View: USA. Available at: https:// bit.ly/3abtnbY

46 2020 . GeoGraphy and you vol 20, issue 3 no. 141 + In conversatIon

Broadening the role of homeopathy in India’s health care

Anil Khurana, Director General, Central Council for Research in Homeopathy (CCRH) shares his perspective on the need for homeopathy to be significantly integrated with the holistic health care needs of India.

Of the total number of AYUSH practitioners, 37 per cent belong to the system of homoeopathy, which is about 0.3 million homeopathic doctors.

GeoGraphy and you . 2020 47 G’nY. In the developed part of the internationally accepted research scientists. Special committees have world, homeopathy is not part of the designs. Central Council for Research been set up for various kinds of mainstream health plan. In India, in Homoeopathy (CCRH) is leading by research such as Clinical Research, however it is. Do you think that the example in conducting contemporary Fundamental Research, Drug efficacy of homeopathic treatments research in homoeopathy as per the Standardisation and Drug Proving. is undermined in the health care scientific guidelines issued by Good Besides, CCRH also has an Ethical trajectories of the developed nations? Committee and Scientific Advisory It is not only homoeopathy treatment, Board for overseeing all research all complementary and alternative projects. The policies, directions and treatment options are not accepted as overall guidance for the activities of a part of mainstream health care in the Council are regulated by a several developed nations globally. In governing body. India, homoeopathy as well as other Also, several clinical and traditional systems of medicine are fundamental research has been accepted and made available by the published in international peer- Indian government at many health reviewed journals from India, centres through co-location within an ranging from autoimmune thyroiditis, allopathic set-up, like dispensaries India has been cited multi drug resistant pulmonary and hospitals. India has been cited tuberculosis, diabetic distal symmetric as an ideal example by health care as an ideal example by polyneuropathy, acute otitis media, delivery professionals and policy health care delivery chronic sinusitis, diabetic foot ulcer, makers of developed nations for its gastroenteritis, acute diarrheal health model—‘cafeteria approach’ professionals and policy diseases in children, HIV infection, kidney stones, to behavioural disorders, for offering treatment choices to its makers of developed people. Recently, health care users in alcohol addiction, rhino-sinusitis and many developed countries have urged nations for its health acute trachea-bronchitis. their governments to offer alternative health care modalities. A campaign model—‘cafeteria G’nY. What is the infrastructure for ‘your health, your choice’ was launched approach’ for offering homoeopathy in India like? What in 2019 by the people of Australia are the institutes involved with to demand an enabling environment treatment choices to homeopathic research in India? regarding treatment plans in their its people. Till date, 673 ayurveda, yoga and health delivery system. naturopathy, unani, siddha, sowa rigpa and homoeopathy (AYUSH) wellness G’nY. Does India have any centres are being run in India by the robust research methodology central government, while another for documenting the efficacy of 25,000 AYUSH dispensaries are being homeopathic treatment? Please run by various state governments. provide a peer reviewed research Out of these 7856 dispensaries are status of Indian papers in global Clinical Research Practices of the of homoeopathy alone. Further, there publications. World Health Organisation (WHO). are 544 AYUSH medical colleges, of Yes, most Indian researches It has expert committees that vet the which 195 are for homeopathy. The in homoeopathy follow robust, protocols developed by the Council’s annual student intake in these colleges

48 2020 . GeoGraphy and you vol 20, issue 3 no. 141 is around 14,000. In fact 37 per cent of is based on individualised treatment, homeopathic treatment? the total number of AYUSH practitioners which, in turn, is based on how the As long as a homoeopathic treatment is are of homoeopathy, which amounts to physician perceives you and your aimed at treating the individual having about 0.3 million homeopathic doctors. ailments, some degree of variation the disease, and not merely the disease, CCRH alone has 26 research in prescriptions and methods are it is all good. ‘Individualisation’ is institutes/ units across the nation. expected. However, largely, the the basic principle of homoeopathy. These units conduct research on treatment protocol can be the same. Classical method, as per the tenets diseases that are more commonly To bring in more uniformity in practice of this gentle science is typically prevalent in their respective regions. methods of homoeopathic physicians, the way homoeopathy should be Further, CCRH ties up with many the Council has developed Standard practiced. However, ‘modern stream science or research institutes for Treatment Guidelines, a two-volume of homoeopathic treatment’ can be multidisciplinary research—Indian publication that has laid out a interpreted in various ways. Using Institute of Technology (IIT) Mumbai, computer software for recording a IIT Delhi, Bose Institute-Kolkata, All patient’s symptoms and analysing his India Institute of Medical Sciences or her case may be modern, but could (AIIMS) Delhi, Indian Council of still be done for a classical prescription. Medical Research-Delhi, Delhi State On the other hand, there could be a Cancer Institute, Janakpuri, Super doctor giving two or three medicines Speciality Hospital-Delhi, BRD Medical CCRH has together for a multi-morbid patient. College and King George’s Medical multidisciplinary University-Lucknow, JIMS Institute G’nY. What do you think the future and Centre for Cellular and Molecular research tie ups with looks like for homeopathic treatment Biology (CCMB)-Hyderabad are some eminent institutes in India? of our prominent collaborators for joint With separate Ministry of AYUSH, the research projects. such as IIT Mumbai and future is definitely brighter. India is Besides, there are private Delhi, AIIMS Delhi and a frontrunner in homoeopathy, be it organisations and independent infrastructure, research, number of researchers too, many of whom CCMB Hyderabad. practitioners, pharmaceutical firms, seek grants from the government or even number of patients who use for conducting their studies under homoeopathy. In fact, many eminent the Ministry of AYUSH’s Extramural practitioners and researchers from Research Scheme. other countries turn to India for joint research and clinical programmes. G’nY. Do all homoeopathy India is also doing hand holding for its practitioners follow a similar standard approach of a practitioner border countries who want to adopt our treatment protocol and are there to various diseases that are reported homoeopathy academic curriculum, any referral systems in place for to a homoeopathy clinic and the most treatment integration model, or learn homeopathic treatment? recommended or used medicines in through our conferences. But there All homoeopathic practitioners follow those diseases are based on various is a huge responsibility. There is a common principles for homoeopathic study outcomes and experts’ opinions. need to add rigour in every aspect of treatment. However, their protocol can homoeopathy—quality of education, be slightly different from one another. G’nY. What are your views regarding infrastructure, research and even To some extent, since homoeopathy classical vs modern streams of drug production.

GeoGraphy and you . 2020 49 + Focus: HomeopatHy

By Girish Gupta HomoeopatHy The Second MoST PoPular SySTeMTeM of Medicine in The World Samuel hahnemann founded homoeopathy in 1796 as a holistic system of medicine where ‘the person in the disease’ is treated and not ‘the disease in the person’. it is perhaps the best alternative system of medicine, which is safest for the new born, the elderly and affordable even to the poorest. homoeopathic medicines are effective in infections, allergies, auto-immune, surgical, hormonal and psychological diseases, in addition to veterinary and plant diseases.

50 2020 . GeoGraphy and you vol 20, issue 3 no. 141 Meticulous record keeping in the homeopathic facility of Kalyan Banerjee in South Delhi marks the key scientific structure of homeopathic treatment.

The author is a Chief Consultant at Gaurang Clinic and Centre for Homoeopathic Research, Lucknow. [email protected]. The article should be cited as Gupta G. 2020. Homeopathy: The Second Most Popular

Photo: PrasadPhoto: System of Medicine in the World, Geography and You, 20(3): 50-55

GeoGraphy and you . 2020 51 omoeopathy was invented by disorders (Chauhan et al. 2014) can be cured by a German physician, Samuel homoeopathy. These are only palliated in the Hahnemann, in 1796, rising allopathic system through immuno-suppressive from his discontentment with the treatment. Long term use of these immuno- contemporary mode of treatment. suppressive drugs leads to a lot of side effects The Cinchona bark was to him what that falling which further complicates the original disease. Hof an apple was to Newton. The bark of the plant Homoeopathy can successfully treat a number was used to alleviate malaria symptoms at the of diseases requiring surgical interventions like time. He used it on himself to find that Cinchona cystic hygroma, fibroadenoma of the breast elicits symptoms similar to the disease itself. (uterine fibroid, ovarian cysts, benign prostatic That set him thinking, leading him to conduct hyperplasia, thyroid adenoma, tonsillitis, several experiments with different substances, adenoidal hypertrophy, ganglion, chalazion. which in each instance produced symptoms in the Apart from this, stones of the kidney (Bhalerao et healthy individuals, similar to those in the unwell. al. 2019) and gall bladder can also be dissolved in Subsequently, he coined the phrase ‘Similia a good number of cases if the stones are not very Similibus Curantur’ which means ‘Let likes be large or multiple in number. Not only this, but the treated by likes’ (Hahnemann 2007). He also tendency of stone formation can also be prevented demonstrated the therapeutic potential of ultra- with constitutional treatment. Nowadays high diluted or potentised drugs on healthy as well allergic disorders like allergic rhinitis,bronchitis, as ailing individuals. Homoeopathy is a holistic urticaria, conjunctivitis and even asthma are on system of medicine in which a person is treated in the increase. These disorders are being treated totality, not only a diseased organ or a pathological by antihistaminic drugs and steroids, which condition. From the point of view of modern only provide temporary relief. Homoeopathy, medicine, it is a psychosomatic system where a however, can cure all these conditions in an ‘person in disease’ is taken into consideration and effective manner (Fig 1-Fig 5). Long term use of not the ‘disease in person’. steroids is known to cause side effects which can Homoeopathy has spread in almost all the be avoided by using safe homoeopathic medicines. countries of the world and has been accepted by Various hormone disorders like hypothyroidism the public as an alternative system of medicine. Its (Manchanda et al. 2010), polycystic ovarian affordability and lack of adverse effects marks its syndrome (Lamba et al. 2018), hyperprolactinemia increasing acceptance despite poor support by the can also be successfully treated with homeopathic governments. Homoeopathy, since its inception, medicines whereas a patient has to take lifelong has always been a target of criticism by modern therapy in allopathy for such conditions (Table 1). scientists and physicians the world over. This is mainly due to a lack of scientific evidence of Case of uterine Fibroid medicinal materials or molecules in the potentised A 35 year old lady with two children, both through formulations. However, ‘absence of evidence is not caesarean section, suffered from clotted, profuse the evidence of absence’. Scientific investigations and long lasting menstruation for 17-18 days have elicited the presence of nanoparticles in since mid 2019, visited for consultation near the homoeopathic drugs beyond Avogadro's number end of the year. Her ultrasonography revealed which may explain the mechanism of action of cervicitis and small myoma on anterior uterine these formulations (Rajendran 2015). wall measuring 2.28 x 1.54 cm. Her rubrics match As observed during clinical trials and was considered and Pulsatilla as similimum was subsequently presented in research papers, prescribed. The post treatment ultrasonography the author finds that the best system to treat in early 2020 was normal without any evidence ‘idiopathic diseases’ is through homoeopathy of fibroid. where the exact cause of the disease is not known. Various auto-immune diseases like Case of ovarian Cyst psoriasis, lichen planus, vitiligo, systemic A young unmarried eighteen year old suffered lupus erythematosus, rheumatoid arthritis from pain in the right iliac fossa since 2015 ulcerative colitis (Pal et al. 2017), thyroid with agonising, clotted menstruation reported

52 2020 . GeoGraphy and you vol 20, issue 3 no. 141 Fig. 1: Success rate in surgical diseases Fig. 4: Success rate in arthritis 100 100 80 80 60 60 40 40 20 Success rate (Per cent) 20 0 Success rate (Per cent) 0 Gout hyperplasia Ovarian cyst Rheumatic Cholelithiasis Breast lesions Uterine fibroid Rheumatoid Nephrolithiasis Benign prostatic Source: Compiled from various studies conducted by G. Gupta and team Source: Compiled from various studies conducted by G. Gupta and between 2003-2016. For instance, Role of Homoeopathy in Kidney stones: team between 2010-2014. For instance, Role of Homeopathic drugs in A Pilot Study, National Journal of Homeopathy. case of Rheumatoid arthirits, Asian Journal of Homeopathy.

Fig. 5: Success rate in various Fig. 2: Success rate in skin diseases difficult to cure diseases 100 100 80 80 60 60

40 40 20

Success rate (Per cent) 20 Success rate (Per cent) 0 0 Warts failure of liver Vitiligo/ Psoriasis syndrome Molluscum Leucoderma contagiosum Lichen planus Chronic renal Fatty infiltration Hypothyroidism Polycystic ovarian

Source: Compiled from various studies conducted by G. Gupta Source: Compiled from various studies conducted by G. Gupta and team and team between 2014-2016. For instance, Photographic between 2010-2017. For instance, Role of homoeopathic medicines on evidence based study on the Role of Homoeopathic medicines inhibition of Serum TSH in cases of Subclinical Hypothyroidism, Advancements in Vitiligo, Asian Journal of Homeopathy. in Homoeopathic Research (formerly Asian Journal of Homoeopathy).

Table 1: Multiple conditions/diseases which could be treated by Homoeopathy

disease disease Fig. 3: Success rate in fungal infections Attention deficit hyperactivity Herpes zoster disorder (ADHD) 100 Obsessive compulsive Chicken pox 80 disorder (OCD) 60 Anxiety neurosis Measles Schizophrenia Mumps 40 Depression Influenza 20

Success rate (Per cent) Autism Hepatitis B & C 0 Chikungunya Dengue Swine flu Conjunctivitis Nail Hair Oral Skin

Source: Compiled from various studies conducted by G. Gupta Source: George Guess, 2016. American Journal of Homoeopathic and team between 1997-2015. For instance, A short clinical study Medicine (AJHM) on Alopecia Areata, Asian Journal of Homeopathy.

GeoGraphy and you . 2020 53 for treatment in the latter half of 2019. She was under allopathic medications but had found no relief. Her ultrasonography revealed right ovarian cyst measuring 33 x 30 x 30 mm (vol. 15.6 cc). During consultation she mentioned stress in the family and the remedy considered for her ailment was Natrum muriaticum. Post treatment ultrasonography of the pelvis in early 2020 was normal with no evidence of any cyst in the ovary. Homoeopathy is also effective in the treatment of diseases of the liver, like fatty infiltration, cirrhosis caused by alcohol or prolonged use of drugs, viral hepatitis B (Gupta and Pandey 2016) and hepatitis C (Gupta and Pandey 2017) infections. These drugs can not only turn the patients seronegative but can also reverse the pathological process (Table 1). Likewise, homoeopathic drugs can tackle cases of chronic renal failure caused by hypertension, diabetes and prolonged use of painkillers. The urea and creatinine levels in blood come down drastically by using suitable medicines which can prevent patients from undergoing dialysis or a renal transplant. There is a need to work together with nephrologists who have an open mind and are willing to make use of homoeopathic drugs in ‘super-specialty’ cases. A joint effort will inculcate confidence in the specialists and the public as well, which will ultimately benefit the patients at large. Viral infections like measles, mumps, chickenpox, dengue, influenza, chikungunya, herpes zoster and swine flu are posing a significant Long term use threat to a large population around the world. The modern system of medicine has little to of steroids offer in such conditions. Homoeopathy, on the contrary, has effective drugs to mitigate almost all is known to these infections. Unfortunately, homoeopathic cause side physicians are unable to prove their dexterity in the absence of an opportunity. effects which Homoeopathic medicines have also been found effective in the treatment of plants and animals. can be avoided Various research studies have proved their efficacy in viral and fungal infections like that of tobacco by using safe mosaic virus (Singh et al. 1980), aspergillosis (Gupta and Srivastava 2002), mango rot and homoeopathic tomato and potato mosaic viruses. Crop yields can be increased if these drugs are used at the right medicines. time. These formulations can also treat veterinary diseases like foot and mouth disease, distemper,

54 2020 . GeoGraphy and you vol 20, issue 3 no. 141 mastitis and other viral diseases of cattle and pets references safely and successfully at a meagre cost. Bhalerao R., P. Oberai, P. Mehra, Y. Rai and G. Various psychological and developmental Choubey et. al. 2019. Lycopodium clavatum for ailments like depression, anxiety neurosis, the Management of Urolithiasis: A Randomised obsessive-compulsive disorder, schizophrenia, Double BlindPlacebo Controlled Trial,Indian attention deficit hyperactivity disorder (ADHD), Journal of Research in Homoeopathy, 13(3): 139-149. autism and insomnia can also be treated with non- Chauhan V.K., R.K. Manchanda, A. Narang, R.K. addictive homoeopathic medicines. These drugs Marwaha and S. Arora et. al. 2014. Efficacy are safe and cost-effective in the treatment of of Homeopathic Intervention in Subclinical fever, upper respiratory tract infection, diarrhoea, Hypothyroidism With or Without Autoimmune dysentery and constipation especially in children Thyroiditis in Children: An exploratory Randomized and elderly patients where the side effects of Control Study,Homeopathy, 103(4): 224-231. medicines must be kept to a minimum or nil. Gupta G. and A.K. Srivastava. 2002. In-vitro Activity No system of medicine can stand equal to of ThujaOccidentalis Linn. against Human homoeopathy in treating skin diseases like Pathogenic Aspergilli,The Homoeopathic Heritage, leucoderma, psoriasis, warts, molluscum 27(1): 5-12. contagiosum (Gupta and Pandey 2014), acne Gupta G. and D.K. Pandey. 2014. A clinical study rosacea, eczema, fungal infections rapidly, gently on Molluscum contagiosum, Asian Journal of and permanently. Other systems only have Homoeopathy, 82(27): 13-18. palliative and suppressive treatment with high Gupta G. and D.K. Pandey. 2016. Efficacy of rates of recurrence after stopping the medication. Homoeopathic Medicines in Cases of Hepatitis Despite the acceptance of homoeopathy by B,Advancements in Homoeopathic Research, 1(1): the public, evidence-based science is wanting. 16-27. Pharmaceutical companies and modern Gupta G. and D.K. Pandey. 2017. Role of Homoeopathic physicians have been pressing governments Medicines in the Patients of Chronic Hepatitis-C. world over to not include homoeopathy in Advancements in Homoeopathic Research (formerly its national health care systems. Methodical Asian Journal of Homoeopathy), 2(2): 24-32. research can prove the scientificity and efficacy Hahnemann S., Translated by William Boericke. 2007. of homoeopathy provided that this work is Organon of medicine, New Delhi : B. Jain Pvt. Ltd. done without any prejudice. A large number Lamba C.D., P. Oberai, R.K. Manchanda, P. Rath of politicians, bureaucrats, scientists and even and P.H. Bindu et. al. 2018. Evaluation of physicians of other systems of medicine are using Homoeopathic Treatment in Polycystic Ovary homoeopathy for their families. They should Syndrome: A Single-blind, Randomised, Placebo- come forward to safeguard this system. controlled Pilot Study. Indian Journal of Research in Homoeopathy. 12(1): 35-45. Way Forward Manchanda R.K., A. Narang, S. Arora and L. The Indian government has established the Nagpal. 2010. Homoeopathic Perspective of Ministry of AYUSH, a National Institute of Thyroid Disorders, E-Journal of Hpathy.com, Homoeopathy (NIH) and many other institutes 1-19. Available at: https://bit.ly/2P5NM9y for alternative therapies of national importance. Pal P.P., M.S. Ghosh and A. Chakma. 2017. But more has to be done to bring these Homoeopathic Treatment of Ulcerative Colitis: alternative systems into mainstream health A case Report, Indian Journal of Research in care. Once integrated, homoeopathy can engage Homoeopathy, 11(1):74-78. Available at: https:// in a wider spectrum of ailments, assisting the bit.ly/32fL72s. developed and developing world, to follow Rajendran E.S. 2015. Nanodynamics, Kerala: Mohna the lead of the Indian government. The World publications. Health Organization (WHO) should ponder Singh B.P., G. Gupta and K.M. Srivastava. 1980. over this without being skewed towards a single Homoeopathic Drugs as Inhibitors of Tobacco system of medicine, so that its mission of ‘Health Mosaic Virus,The Hahnemannian Gleanings, for All’ can be achieved. XL-VII: 265-267.

GeoGraphy and you . 2020 55 Website + BookS Cardiac examination in homeopathy: a practical approach to examination, in ayush research portal the Tradition of the homeopathic Masters www.ayushportal.nic.in/ By: Janice Block This portal comes under Cover: Paperback Ministry of ayurveda, yoga isBn: 9789659001323 and naturopathy, unani, published: 2018 siddha and homeopathy publisher: Block Publications (AYUSH), Government of pages: 278 India. AYUSH Research price: USD 16.7 Portal helps to spread information about various AYUSH systems and also his book examines in detail heart disease like coronary artery updates on a regular basis Tthe topic of homeopathic disease, arrhythmias which are various research activities in cardiology and also looks prevalent in our society and the domain of AYUSH. into the different technical also provides a useful summary instructions found within the of the associated symptoms of classical texts of homeopathy. the diagnosis for each of the homeopathy research It covers topics like the physical mentioned heart conditions. institute examination of heart and blood Thus, this book shall be an ideal www.hri-research.org/ vessels, the circulatory system, foundation in cardiology while HRI is an international the cardiac anatomy and the also helping to build the skill sets charity organisation materia medica. The book also of practitioners already in the developed to promote quality analyses the common types of field of homeopathy. research in the field of homeopathy. HRI is trying to find homeopathic solutions to the various challenges homeopathy: The healing with faced by the contemporary Complete Guide to information: The society such as—overuse of natural remedies new homeopathy antibiotics and methods to By: albert-Claude By: Maria sagi control increasing health Quemoun, sophie Cover: Paperback budget. pensa isBn: Cover: Paperback 978-1782798583 isBn: 978-1454926375 published: 2018 liga Medicorum published: 2019 publisher: O Books homoeopathica publisher: Sterling Ethos pages: 422 internationalis (lMhi) pages: 352 price: USD 27.43 www.lmhi.org price: USD 3.79 – 9.39 LMHI is a non profit What’s The organisation that brings The Companion remedy For That? together homeopathic doctors to homoeopathy: The definitive hom. and various associations The practitioner’s Guide to Mastering in the field of homeopathy. Guide everyday self-Care Founded in 1925, the goal By: Colin Griffiths Without drugs of LMHI is to promote Cover: Paperback By: Kathleen K. Fry homeopathy worldwide and isBn: Cover: Paperback create links between medical 978-1906787714 isBn: 978-0984753420 practitioners of homeopathy published: 2019 published: 2017 and civil society interested publisher: Watkins Publishing publisher: Collett Avenue Press in homeopathy. pages: 864 pages: 222 price: USD 33.70 price: USD 17.99

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