The Teaching of Indian Traditional Medicine
Contibuted by S. Rajasekharan, T.G. Vinod Kumar, A.E. Shanavaskhan, S. Binu and P. Pushpangadan, Tropical Botanic Garden and Research Institute, Pacha Palode, Thiruvananthapuram 695562 Kerala, India
The Teaching of Indian Traditional Medicine
Indian Traditional Medicine functions through two social streams:
- The Classical Health Traditions (CHT) like Ayurveda and Siddha are highly organised, classified, and codified and have a sophisticated conceptual and theoretical foundation and philosophical explanations.
- The other stream, Oral Health Traditions (OHT), is very rich and diverse, but is not organised or codified. It is a distilled knowledge from people’s experience and is prevalent in rural and tribal areas of India. This oral folk tradition is mainly based on plants and it holds a respectable position today, especially in developing countries where modern health care is limited. Safe, effective and inexpensive indigenous remedies are gaining popularity among the urban and rural populations especially in India and China.
Classic Health Tradition (Ayurveda, Siddha and Amchi)
- Classic health traditions have developed from Vedic/classical texts and treatises like Rigveda, Yajurveda, Samaveda and Atharvaveda, Charaka Samhita (text on ancient Indian medicine), Susruta Samhita (text on ancient Indian surgery), Ashtanga Samgraha, Ashtanga Hridaya (text on ancient Indian medicine and surgery), Kashyapa Samhita (text on gynaecology and child health), and other numerous related text books in both Sanskrit and regional languages.
Oral Health Tradition (Folk and Tribal)
Oral health traditions have developed from:
- Traditionally trained folk healers/village physicians.
- Folk healers/village physicians who are not traditionally trained but experienced in certain health practices (e.g. Dai, bone setters, specialists in treating poisons, jaundice, mental disorders.
- Old individual or different ethnic communities including women treating the patients based on the knowledge acquired from their predecessors.
- Individuals belonging to different professions (educated group) who acquired certain knowledge from their predecessors
- Ancient copper plate/palm leaf writings.
- Old and recent publications in regional language.
- Traditional groups of tribes.
- Organised groups of tribal communities/tribal physicians/old individuals.
- Tribal physicians among the migrated groups of tribe settled in the plains.
Ayurveda is not merely a system of medicine, in a broader sense it is the science of life of the universe; hence it is universally applicable. The word originates from Sanskrit; ‘Ayu’ meaning life and ‘Veda’ meaning knowledge/science pertaining to human beings thereby forming the word Ayurveda, or in the case of knowledge pertaining to plants or animals the words Vrikshayurveda and Mrugayurveda are used respectively.
Ayurveda teaches us the science of life from a micro to a macro level. Therefore Ayurveda, conceptualised with concrete fundamental theories, begins with the theory of evolution of the universe (Brahmanda) with the entire life forms (Pindanda) prevailing in it (including human beings, plants, animals and microbes etc.), supported with non living components like soil, water, minerals and metals. According to Ayurveda, all the living and non-living things are made up of the five elementary principles (Panchamahabhutas) which are derived from the three effective principles/energies of nature (Prakruti):
- Satwa - responsible for conscious manifestation
- Rajas - responsible for the existence of energy in matter
- Tamas - responsible for resistance and stability.
The actions, interactions and transformations of the five elementary principles, ‘Apancheekrita panchabhuta and Pancheekrita panchabhuta’ which have evolved from the pre-particle state to the molecular state (Panchatanmatras) leads to their different states of equilibrium.
The objective of the science of life is to maintain the equilibrium state of the body’s elements. In short, when an imbalance takes place in the Panchabhautika character of the body and mind due to various etiological factors, the balancing state of doshas will be affected and this will be reflected on Saptadhatus and Malas. This in turn aggravates or depletes the balancing equilibrium of dosha, dhatu and mala of the body and mind and produces different kinds of disorders. The ultimate objective of treatment is to bring a person back to a balanced state. This process is termed in Ayurveda as Dhatusamyakriya. This balancing technique helps the doshas to achieve an equilibrium, therefore the selection of a drug should be based on the bhuta character of the drug. For example, if the disorder is due to Prithvi bhuta depletion, the drug prescribed must be Prithvi bhuta predominant.
Divisions of Ayurveda
There are two divisions of Ayurveda: Swasthavritta and Athuravritta.
- Swasthavritta mainly deals with Swasthasya Swasrhya Rakshanam i.e. how to maintain the health of a healthy person in a positive way through prevention, promotion and correction (Table 2).
- Athuravritta deals with disease management and treatment through prevention, promotion, correction and curation. Athuravritta can involve medicine and/or surgery.
Within Ayurveda there are eight specialities:
- Kayachikitsa - internal medicine
- Kaumarabhritya - paediatrics and gynaecology
- Shalyatantra - surgery
- Shalakyatantra - ophthalmology and otorihnolaryngyology
- Grihachikitsa - psychiatry
- Agatatantra - toxicology
- Rasayanatantra - geriatrics / rejuvenation therapy
- Vajeekaranatantra - sexology / virilification
How to maintain the mental and physical health of a healthy person through Swasthavritta
Sadvritha (Mental) - Ethical Conduct
- Natural urges (urine, faeces, semen, sneezing, yawning, hunger, thirst, sleep, tears and taking deep breaths after exertion) are important and should not be suppressed or induced.
- Nithya Rasayanas, the ethical principles which rejuvenate the mental faculty should be followed.
Sadvritha (Physical) - Health Conduct
- Daily routine (Dinacharya)
- Seasonal regimens (Ritucharya)
- Exercise, yoga and meditation are important.
- Wholesome food, seasonal food and ethnic food are important and should be taken.
- Healthy sexual behaviour and sound sleep.
- Panchakarma (techniques adopted for servicing/conditioning the physical faculty/mental faculty) should be applied.
- Rasayana* should be applied in Vajeekarana.
*The aim of applying Rasayana at the right time and age is to bleach out the toxins accumulated in the cellular level so as to condition and/or service the whole body and mind. Further it accelerates the process of RASA + AYANA which is a enriching/nourishing mechanism which helps to control ageing and enhances strength and vitality.
Plants in Ayurveda
The study of plant species can be traced from the age of Vedas. Plants are considered as divine in origin and were worshipped as Mother (Goddess). In the aushadi sooktha of Rigveda it is said ‘Oh! Divine plants! Always be kind to us! Pour happiness over us, you are having great power like the horse, you are the greatest destroyer of fatal diseases, you are the guardian of mankind, save and protect us from all kinds of illness’.
There are a number of plants which have been mentioned in the three main treatises of Ayurveda:
- Charaka Samhita: 1100 plant names
- Susruta Samhita: 1270 plant names
- Astanga Hridaya: 1150 plant names
The total number of plants mentioned in the above three samhitas has been estimated to be 1900, out of which 670 are common to all three texts and about 240, 370 and 240 respectively have been exclusively mentioned in the three texts.
Different ethnic groups of ancient lineage and the occurrence of rich biodiversity make India one of the richest countries in the world in the field of ethnobotanical knowledge. Over 53 million tribal people belonging to over 550 tribal communities coming under 227 linguistic groups inhabit the Indian subcontinent. They inhabit varied geographic climatic zones throughout the country.
Ethno-medico-botanical investigation has led to the documentation of a large number of wild plants used by tribal people for meeting their multifarious requirements. The application of most of the plants recorded are either lesser known or hitherto unknown to the outside world.
Wild Plants for Food, Medicine, Fibre, Fodder and Other Purposes
Over 9500 wild species used by tribal groups for meeting their varied requirements have been recorded so far. Out of 7500 wild plant species used by these groups for medicinal purposes, about 950 have not been previously recorded and are worthy of scientific scrutiny. Of the 3900 or more wild plant species used for edible purposes (as subsidiary food/vegetables) by tribal groups, about 800 have provided new information and at least 250 of them are worthy of attention because of their potential to be developed as alternative food sources food to meet future world needs.
Similarly, out of over 525 wild plant species used by tribal groups for making fibre and cordage, 50 have potential for commercial exploitation. Out of 400 plant species used as fodder, 100 are worth recommending for wider use and out of the 300 wild plant species used as pesticides, at least 175 show promise as safe biopesticides. Due to the revived interest worldwide, almost all the plants used as gum, resin, dye, incense and perfumes are worth investigating.
Ethnomedicine denotes plants, animal products and minerals used by tribal communities of a particular region or country for medicinal purposes other than those mentioned in classical streams of the respective cultures.
Ethnomedicinal information/data is playing an important role for developing new scientifically validated and standardised drugs (both herbal and modern). In India, uses of more than 7500 plant species by different ethnic communities have been recorded so far.
An intensive ethnomedical survey conducted by the author and his team from 1987-1992 in the southern most state of India (Kerala), has provided rich and varied ethnomedical data recorded from the different tribal communities including Kani, Malapandaram, and Cholanaykan. During this study, the author documented medicinal uses of over 300 single plant species and 100 formulations. Much of the information is new and hitherto unknown to the outside world and has not been mentioned in other classical systems of medicine for the scientific validation of these data.
Arogyappacha and Benefit Sharing with the Kani Tribal People
Based on the ethnomedical data collected from the Kani tribal people, the author and his team selected Arogyappacha (Trichopus zeylanicus subsp. travancoricus) for detailed ethnopharmacological investigations. In 1987, Mr. Mallan Kani and Mr. Kuttimathan Kani of Chonampara provided the clue that ‘…the tender fruits of the plant are having anti-fatigue property’.
The Kanis inhabit the forests of the Thiruvananthapuram district of Kerala in southwestern India. According to the census of India from 1991, their population is 16 181, which is approximately 1.8 percent of the total population of the district. The Kanis are traditionally a nomadic community. The traditional occupation of the Kanis, which they continue to follow to some extent, includes handicrafts such as basket making, mat making and cane works. They are also engaged in the seasonal collection of minor forest produce such as honey, bee wax and medicinal plants.
Based on the Kanis information on Arogyappacha scientists of TBGRI developed a scientifically validated and standardised herbal drug called Jeevani. It is a formulation consisting of four ingredients. The drug was designed by the Ethnomedicine and Ethnopharmacology Division of TBGRI in which Arogyappacha is one of the constituents. Therapeutic efficacy of this formulation has been proved by conducting research studies at various levels. Jeevani has been found to have good anti-fatigue and immuno-enhancing properties and it has also shown good hepato-protective and anti-stress properties.
In 1995, the technology for the production of Jeevani has been transferred to an Ayurvedic drug manufacturing company (Coimbatore Arya Vaidya Pharmacy Ltd.) for a period of 7 years after obtaining a licence fee of Rs 10Lakhs (one million rupees; approximately $ 25 000US) and 2% royalty on the ex-factory sales price from the company.
Subsequently TBGRI decided to share 50% of the licence fee as well as the royalty with the Kani people to encourage an equitable sharing of the benefits arising from the utilisation of such knowledge, innovations and practices as stated in the mandate of Article 8(j) of the Convention on Biological Diversity (CBD). This is considered to be one of the first models for benefit sharing in the world, which is popularly known as the TBGRI Model for Benefit Sharing. The Government of India has presented this case study to the Secretariat of CBD.
The 50% share promised to the Kani people was handed over to them in March 1999 and remitted in the account of the trust, constituted by the Kani people known as Kerala Kani Samudaya Kshema Trust.
Primary Health Care Through the Botanic Gardens - Herbs for all and Health for all
The security of a nation is directly related to the food and health security of its people. A biodiversity rich nation like India can achieve a reasonably high level of food and health security, if the people are encouraged to make the best use of the local biodiversity resources with appropriate science and technology intervention.
Herbs for All and Health for All is a model, experimented by the scientists of TBGRI, with a view to empower the people to take care of their primary health care needs by making best use of the locally available medicinal plant resources. It is essentially a participatory, action-oriented programme. It has been designed to equip the rural villages of Kerala State, India, to conserve and utilise plant biodiversity in a sustainable manner.
In this programme training was given especially to the women folk on public health and hygiene, (based on both traditional and modern medical systems), biodiversity conservation, cultivation and sustainable utilisation of plants including medicinal plants and lesser known fruits and vegetables. The programme emphasised the nutritive, preventive, promotive, corrective and curative properties of plants with a view to combat common ailments through the administration of home remedies.
There were several key steps in the approach used for the Herbs for All and Health for All project. These steps included:
- Undertaking an awareness campaign in the village on conservation, cultivation and the sustainable utilisation of local biodiversity.
- Selecting a core group of 10 members from each village.
- Developing and conducting a Trainers Training Programme
- Each trainer then in turn trained 20 families in their own village, therefore 20x10 = 200 families per village were trained.
- Evaluation of the project.
Training is imparted to the core group members in:
- general awareness on public health and hygiene
- conservation of biodiversity
- cultivation and propagation of medicinal plants
- cultivation and propagation of lesser known wild edible fruits and vegetables
- the sustainable utilisation of medicinal and edible plants
- practical training in the preparation of home remedies for primary health care.
In conclusion, it is the collective responsibility of individuals, families and governments to ensure the health security of members of the community. The staff at TBGRI have recognised the importance of continuing, and supporting, the teaching of traditional Indian medicine to ensure the health and well being of their local communities and the maintenance of biodiversity. The Herbs for All and Health for All project provides a excellent model for botanic gardens so that they can play an important role in educating people about the sustainable utilisation of the local biodiversity for health care and income generation.
Lele, R.D. (1986) Ayurveda and Modern Medicine. Bharatiya Vidya Bhavan, Bombay India.
Savnur, H.V. (1950) A Handbook of Ayurvedic Materia Medica. Vol.l Dr. Jarthar and Sons, Maruthi Street, Belgaum Karnataka India.
Savnur, H.V. (1993) A handbook of Ayurvedic Materia Medica. Vol.VI (4) Dr. Jarthar and Sons, Maruthi Street, Belgaum Karnataka India pp258-261.
Savnur, H.V. (1995) Ethnobiology in India – A Status Report. All India Coordinated Research Project on Ethnobiology. Ministry of Environment and Forests, Government of India, New Delhi.
P. Pushpangadan (1995) Ethnobiology in India - A Status Report. All India Coordinated Research Project on Ethnobiology published by Ministry of Environment and Forests, Govt. of India, New Delhi.
Rajasekharan, S. and Pushpangadan, P. (1995) Conceptual Foundation of Ayurvedic Pharmacology in Pushpangadan, P., Nyman, U. and George, V. (ed) Glimpses of Indian Ethnopharmacology. Tropical Botanic Garden and Research Institute, Kerala India.
Rajasekharan, S. and Pushpangadan, P. (1993) Indigenous Taxonomy of Plants According to Samhitas and Nighantus ‘Aryavaidyan’. Journal of the Aryavaidyasala Kottakkal Vol. 10 (3) pp182-188.
S. Rajasekharan, S. and Pushpangadan, P., and Biju, S.D. (1996) Folk Medicines of Kerala - A Study on Native Traditional Folk Healing Art and its Practitioners in Jain, S.K. (ed) Deep Publications, New Delhi India pp167-172.