WHAT IS THE ROLE OF INDIGENOUS MEDICAL SCIENCES IN OUR HEALTH CARE SYSTEM?


(Response of indigenous medical practitioners to the Madras inquiry sixty years ago)

In India as well as in most other non-Western Societies today, there exist two distinctly different systems of medicine—namely the Traditional system, and the Modern Western System of Medicine introduced during the period of colonial rule. A uniform feature of all these societies is that the Western System serves less than 15% of the population, though it often takes up a lion's share of the budget. In India, even today (as it was around the turn of the century and earlier) only a small minority of our population is served by Western Medicine. In the last ten years, there has been a lot of talk about 'paying attention' to traditional systems of health care. In 1976, the World Health Assembly took note of the role that Traditional Medicine can play in the extension of health services, particularly to the remotes rural areas". In 1977 the World "Health Assembly passed a resolution (WHO 30.49) urging interested governments to give "adequate importance to the utilization of their traditional systems of medicine with appropriate regulations"1 Today's talk of the "revival" of traditional medicine, and the level and [manner in which it is portrayed has tended to obscure certain key aspects of the role of traditional systems of medicines and the history of their interaction with Western Medicine. Ever since the beginning of J the encounter between Allopathy and Indigenous Systems, Allopathic professionals have consistently tended to view any support for indigenous Medicine as the encouragement given to the most regressive tendencies in Indian Society. And the ambit in which the Government policy has moved ever since the establishment of British rule is typically illustrated say by what occurred in Punjab in the 1860s.

In 1867 in Punjab, the Government sanctioned a programme, proposed by Lt.r Col. T.W. Msrcer, Oistrict Commissioner of Sialkot, to establish a district wide scheme for medical relief using1 the district hakims. Hakims were given a brief course of training by Mercer and sent into villages. The scheme was wound up later because of protests from the practitioners of Western Medicine. However" what is important to note is that Mercer himself was not concerned with the restoration or revitalization of the Yunani System. He in fact planned "The gradual substitution of English Medicines for useless native drugs, the attendance of the sick of all classes to effect prompt medical relief, and ultimately th3 subversion of the system of medicine as practiced by the natives".* Thus, his aim was no different from the allopath opposed to his scheme, 'namely the spread of allopathic medical system in Punjab controlled entirely by Western professionals. But to insist that this must be done, without concern to local customs and beliefs, was in Mercer's opinion, "to insure resistance on the part of the population and to slow the spread of Western Medicine for years to come".3

Today, over a hundred years later, very similar arguments are taking place mainly to decide between courses of action which will lead to the same result—namely the further entrenchment of Western Medical System. However, they are often portrayed as a struggle between supporters and opponents of Traditional Medical Systems. In order to have an understanding of this issue, it is instructive to look back at the history of interaction between the two systems.

Indigenous Medicine in the Twentieth Century

Ever since the advent of colonial rule in India, Indigenous systems of Medicine lost state support—which was usually the dispersal of revenue assignments through local bodies, to support both the practitioners and their clinics as well as the schools of Medical education. By mid-nineteenth century, the allopathic system had become the sole recipient of state patronage. The beginning of the 20th century saw a great revival of nationalist spirit and several efforts were made in this climate to strengthen the Indigenous Systems of Medicine. Various institutions were started for providing education and medical care along these lines.* The All India Ayurvedic Mahasmmelan Jywas formed in 1907. The same spirit was reflected by the Indian National Congress, which passed the following resolution at its Nagpur session in 1920.—"This conference is of the opinion that, having regard to the widely prevalent and generally accepted utility of the Ayurvedic and Unani Systems of Medicine in India, earnest and defend/fe efforts should be made by the people of this country to further popularize schools, colleges and hospitals for instruction and treatment in accordance with indigenous Systems".4

By 1919 when the so called "local self governments" were formed in several provinces, a number of Bills were introduced in legislatures demanding support for indigenous systems of medicine. These events created a situation, where the Government could no longer just ignore the indigenous systems outright without taking note of them. Hence in several States Committees were appointed to look into the matter. The Calcutta University Commission, for instance, went into this question and came-up with the pronouncement that" though the ancient system [of medicine] reached the height of a systematizing, theorizing, school of thought, it "lacked the freedom of individual action essential to the pursuit of real Science, and its evolution was prematurely arrested by an unscientific veneration for petrified dogmas". It also slated that "There is an obvious and promising desire at the present moment among the numerous adherents of these1 (indigenous) systems for closer touch with modern scientific methods. In time no doubt they will be able to make available for the practitioners' of Western Medicine the traditional knowledge which is of real value and will reject, as Western medicine continually rejects, those theories which are mere survivals and cannot stand the test of experiments. The distinction between y-Western and Indian 'Systems' of medicine will then disappear". Thus the report provided a justification for the status quo by f questioning the scientific validity of the indigenous systems. It also provided a framework for the interaction jof Allopathy with Indigenous systems'—a process is suggested by which allopaths would selectively assimilate all that they find 'useful' in indigenous systems by their own criteria. Around the same time several other committees were. appointed in the states, which did gather detailed information about the indigenous systems.

The Madras Committee - 1921

The report of the committee appointed by the Madras Govt, in 1921 is particularly interesting since it contains the testimony of several indigenous practitioners themselves, on-a variety of issues such as cost, efficiency, scientific nature etc. of the Indigenous Medical systems. The Govt, of Madras appointed this committee "to report on' the question of recognition and encouragement of indigenous systems' of medicine in vogue in the Presidency". The object of the enquiry was to "afford the exponents of Unani and Ayurveda systems, an opportunity to state their case fully in writing for scientific criticism and to justify state encouragement of these systems". The ten member committee was constituted with Mohammed Usman as Chairman and Captain G. Srinivasamurthi as Secretary. The Committee contained two Ayurvedic Physicians—K. G. Natesa Sastrigal and C. T. Arumugam Pillai—and three Allopathic, doctors (who were acquainted with and sympathetic to indigenous medical systems) and four M.L.Cs. The Committee prepared a questionable and obtained responses from various' indigenous medical practitioners.

The tenor of the questionnaire can be gauged from some of the questions listed below:

Q. 2(a) What are the theory or theories of causation of disease according to your system. Please favour the committee with your views on how far your theory or theories stand thejtest of modern scientific criticism.

Q. 5. Do you agree with the view of the Calcutta University Commission that "There | is a great and promising desire at the moment, among the numerous adherents of these (indigenous) systems for closer touch with modern scientific methods.................... [cited earlier]

If you agree that a unified system of medicine as indicated in the above passage is the ideal to be aimed at, what steps would you suggest for the fulfillment of such an ideal?

Other questions solicited their views on the cost effectiveness of treatment, reasons for decline of indigenous systems, the question of registration of indigenous medical practitioners etc. The Madras Committee survey was mainly in the Madras Presidency but some replies were also solicited from outside. The committee submitted its report in 1923.

The Madras Committee

The question of the 'Scientificity’ of the indigenous systems seems to have been given the foremost consideration and the report at the very beginning says "The first question we addressed ourselves to was to decide whether the indigenous systems of medicine were scientific or not. The Secretary (Captain G. Srinivasa-murthi) furnished us with a memorandum reviewing the question in all its bearing and we agree in the main with his two general conclusions, viz, that (1) From the standpoint of science, the Indian systems are strictly logical and scientific; and (2) from the standpoint of art, they are not self sufficient at the present especially in the surgical line though in the medical line they are generally speaking quite self sufficient, efficient and economical." The report establishes with facts and figures that in the Madras Presidency, less than ten percent of the population is served by allopathic practitioners and institutions.".................. for a population of 4,23,18,985 inhabiting our Presidency, the total number of medical practitioners following the European system is not more than 3,000 as a maximum and the numbers following the Indian system is not less than 21,000 as a minimum; in other words there are at least seven practitioners of the Indian system of medicine to everyone practitioner of the European system". A total of 578 medical institutions provide "Western Medical Relief". They cater to a population of 17-18 lakh people (less than five percent of the population).This was provided at a cost of Rs. 56,68,845/ to the State.

The committee goes on to make several recommendations and spells out details in a few cases. Some typical recommendations and observations made are :

1. It is only through the promotion of Indian systems of medicine that under the present circumstances, the state can hope to achieve the ideal of bringing medical relief within easy reach of the people, especially in the rural areas.

2. Medical registration is necessary in the best interests of both the public and the practitioners.

3. Establishment of colleges and hospitals of Indian medicine. A budget of Rs. 5 lakhs is suggested for the same.

Disagreements on specific points.were voiced in separate notes appended to the report by two members. Mr. A. T. Palner, an M.LC, in his note states that is "............ not sure whether these ancient systems can now stand comparisonwith the modern systems for the simple reason that scientific knowledge has greatly advanced since. For my own part I am not in favor of the government establishing hospitals and schools of indigenous systems at their expense till more is known about the sufficiency of these systems".

Representing (the Ayurvedic Physicians viewpoint K. G. Natesa Sastrigal, Principal, Venkataramana Ayurvedic College, in" his note states— "I. desire that in the beginning the indigenous medical colleges and hospitals be maintained separately and away from the allopathic medical colleges' and hospitals. I do not share the view that dearth of funds is a bar to achieve this end. It has been pointed out in the main report that J something like 57 lakhs of rupees is being expended in the maintenance of allopathic system. [Could not a fifth of this sum to begin with, be spent on thejancient systems of medicine which is indigenous to the land and benefits nine tenths of the population? It does not seem reasonable that the indigenous system of medicine should be asked to prove their bona fide scientific basis before such a big sum may be expended for their maintenance. The allopathic system was never asked to prove its scientific basis. If that has been proved long ago Ayurveda has also proved its scientific basis long long ago in the days of its Maharishis and Kings. Moreover it is not just, to compel the follower of Sankara's monism or Advaita to prove his tenets, to the satisfaction of Sri Ramanuja's qualified monism or Visistadwaita ; or a catholic Christian, to the satisfaction of a protestant. And even the impossible feat is achieved as is evident from the secretary's memorandum based on the statements of expert witnesses. I therefore think that the recommendation for 5 lakhs of rupees is insufficient for the object in view. A big cut must be made anywhere in the budget and at least 10 lakhs should be earmarked for the puposes of indigenous systems of medicine".

The Reaction of the Indigenous Practioners to the formation of such Committee:

The response of the indigenous medical practitioners to such committees was varied. The j All India Ayurvedic Conference passed a resolution, urging its members to "give replies to questionnaires issued by the committees appointed by different provincial Governments and to give evidence and work on the committees if, called upon".6(In contrast, the Andhra Ayurvedic conference held at Tenali passed a resolution that "the Ayurvedic physicians of Andhra desa should not cooperate with the Committee, (i.'e. the Madras Presidency Committee of 1921) as they believed that the committee will not be conducive to the interests of the Ayurvedic system ; they* also thought that it was a bait to pass off some more time also they had no confidence in the Government."7 Similarly when the Bengal Government appointed two committees in 1921, one on the restoration and development of Ayurvedic Medicine and the other of Unani Medicine, ' the practitioners of indigenous medicine in their note expressed the following view about the committee:

"We must point out that the followers of the Allopathic system who have been appointed to the committee, have no intimate knowledge of our system, and however well intentioned they may be towards that system, they cannot be possessed of the qualifications which are essential for working out a scheme for its restoration. Even in the improbable event of their (earning enough of our systems in a short time to enable them to cooperate with us in an intelligent manner in preparing a united report, we feel that any report that might be agreed on by them and us, would be looked on with natural suspicions and mistrust by the main body of the practitioners of our system.......We beg also to point out that although some of us admit that our system might derive benefit by adopting some of the methods which are in use among the allopathic practitioners, a majority of our practitioners ‘regard our system as complete and self-sufficient so that they would resent the suggestion that it can be restored and improved by the help of allopathic medical men. Had the Government been pleased to appoint a committee consisting of representative practitioners of our ancient system, we should have been glad to show how best the system could be encouraged and fostered so that it might take its proper place as the natural and official system of our province. After years of official neglect and discouragement, our system is still accepted by the large numbers of our population, and the fact that it is still popular in spite of alf difficulties, is enough to show that it would be capable of supplying the needs of our people if it were accorded the same degree of recognition and support as the official system".

The Madras Committee sought to reassure the practitioners by citing the autonomy' achieved under the 'reform scheme'. When a group of witnesses testifying on behalf of South India Ayurveda Sangam deplored the unsympathetic attitude of the Government, the President Mohammed Usman, intervened to State—" These are days of self determination. Prejudices are things of the past. Medicine is a transferred subject and it is in the hands of your minister. It is you who elect members of the legislative council and the minister is an elected member of the council. This is one of the blessings of the reform scheme. So be helpful".

Nevertheless, even among those who did testify before the Madras Committee, there were several who did so only "under protest" and for reasons of their own, rather than out of any real faith in, or expectations from, the Government. Thus, Vaidya Pandit Hari Prapanna Sharma and 16 others from Bombay, state in conclusion to their answers that "As we do not and cannot expect any hearty support or patronage from the Government towards Ayurveda and as we have very little hopes of their ever sincerely trying to raise the position of the Ayurvedic practitioners in public estimation, it might at first sight be thought that this reply would serve no useful purpose ; but as the committee have, by their very second question,* tried to deal a deadly blow at the very foundation of Ayurveda, our silence would have been misinterpreted as our inability to prove the perfectly scientific nature of some of the Ayurvedic theories which have been unjustly ridiculed in the past on account of the ignorance of the followers of Allopathy. We shall be quite satisfied if the committee is pleased to publish this answer in to without applying the pruning knife for the information of the general public

Testimony of Indigenous Medical Practitioners:

Our' main interest however is in the testimony of the practitioners themselves, which gives us a glimpse into how they viewed their own medical system, its relation to allopathy, etc. We present here extracts from the testimonies of these practitioners, focusing on a few issues like efficacy and cost of the indigenous systems, their scientific basis etc and also the views of these practioners on the relationship between Allopathy and Indian systems of medicine and the proposals often made for "closer contact and interaction between them :

1. Cost of Treatment: A comparison one of the major conclusions of the report is that the indigenous systems are more effective and economical than the allopathic system. As the report states,

"Then again is not a prima facie case already made out in favor of the Indian systems, by the noteworthy records of the few dispensaries of these systems that are now being maintained by non-Governmental agencies in the different parts of the country? A number of such institutions exist even in our own Presidency town (i.e. Madras) and though greatly hampered by lack of state recognition and sufficient funds, they are nevertheless holding their own against the comparatively well financed dispensaries in the neighborhood, maintained by the state or the corporation and are popular among all sections of our people, besides being decidedly cheap, as may be seen from the records of a few of these institutions.

Below we give a summary of the statistics of only one of them, viz; The Lee Chengalvaraya Naicker's Free Ayurvedic Dispensary, Madras. Total number of patients treated (July 1921 to June 1922)

Hindus 94,983 122,238
Eurasians 4,470
Christians 19,200
Mohammadans 3,585
Average daily attendance   335
Cost of Medicines   Rs. 1375 - 13 - 9
Cost of Maintenance   Rs. 3765 - 14 - 9
Average cost per head per day   0 - 0 - 8

It is instructive to compare the figures given above with the comparative figures for Bauliah Naidu Dispensary—the most popular among the dispensaries in Madras City worked on the Western System and situated in the same neighborhood as the Chengalvaraya Naicker's Ayurvedic dispensary referred to above.

Total number treated   37,626  
Total Expenditure      
  Salaries Rs. 3,385 7,058
  Medicines Rs. 3,453
  Miscellaneous Rs. 220
Average cost per head per day (roughly)  0-3-0
Average for corporation dispensaries of the city taken as a whole 0-6-2.

The cost of treatment as listed for some other dispensaries in Appendix VII of the report is as follows :

Dispensary Cost of treatment
1.   Sri Venkateswara Dispensary Tirupathi (1921-22) 11 pies/patient
2.   Madras Ayurvedic College Dispensary 6 pies/patient
3.   South Indian Ayurveda Vaidya Sangam, Madras 6 1/2 pies per patient per day .
4.   Sri Murugan Free Ayurvedic Dispensary
Choolai, Madras
6 pies per head, per day


The report further states

"We have like-wise the testimony of the results obtained in those state—recognised and state— aided institutions which are maintained by some of our Indian states—notably Travancore and Cochin, the former of which also maintains a Government Ayurvedic Medical College with a hospital and dispensary attached to it. Is this not valuable prima facie evidence especially when' we remember that no less than 170, 641 cases (including 5,190 cases of poisoning, the treatment for which seems to be more or less a specialty in Malabar) were treated during the year 1920-21 in the grant-in-aid Ayurvedic institutions

  Trivandrum
Ayurvedic
Hospital
Govt. General
Hospital Madras
Govt. Royapuram,
Hospital Madras
Total No. of in
patients treated
115 8,358 4,861
Total No. of. out
patients treated
29,151 60,648 53,783
Death rate
(in-patient)
0.9% 6.99% 10.35%
  *   Rs—Ch—ca Rs. Rs.
Total cost of
Maitenance
12,588—5—5 6,82,924 2,31,324
Salaries      
Medical
Officers
1667-23-2 1,01,77 30,100
Nurses   74,581 24,177
Inferior
servants
71,752 24,387
Medicine      
European 9,000-0-0 75,622 22,798
Bazaar 6,712 1.091
Diet 428-0-0 1,19,960 59)028
Miscellaneous 1717-9-0 1,36,685 92,541
*One Sircar Rs = Anna 15 and 9 pies only
One Chakram = Pies 6 nearly, one cash = Half pie nearly


of the State while 115 in" patients and 29,151 out patients were treated during the same period at the state Ayurvedic Hospital and dispensary at Trivandrum Among the in patients 82.4%, were cured and 12.4% relieved while death rate was as low as 0.97%. Below* we give corresponding figure for the Govt. General Hospital and Govt. Royapuram Hospital Madras, the reason for selecting these institutions for comparison being that they are to Western Medicine, what the Trivandrum Hospital is to Ayurveda, that is to say they are centers of medical relief which act also as centre’s of medical education. In instituting this comparison, we do not of course mean to suggest in the very least that, strict comparison can be made between statistics of institutions that differ so much in size, staff, organization and so on, but unfortunately at present we have no other comparisons to institute.

The statistics given above, do certainly afford clear evidence that the Indian systems are not only efficient as far as they go, but undoubtedly more economical than the Western systems".

2. Popularity of Ayurveda : Ayurveda was not only decidedly cheaper than Allopathy but also it was tremendously popular and effective. To quote Mahamahopadhyaya Kaviraj Gananath Sen of Calcutta. "As to the general efficacy of Ayurvedic treatment, I think there can be little doubt...... Where there are well equipped Ayurvedic charitable dispensaries side by side with similar allopathic dispensaries in a town, the attendance in the former goes on increasing steadily to an extent which would seem to be incredible."

This is substantiated by several statements of physicians who have testified. We shall quote just two examples. Vaidya Appa Sastri Sathe of Bombay States:

"When there was a cholera epidemic at Parel (Bombay.) in'1918, the Deccan volunteer corps' of which I was then the President, had opened two charitable dispensaries, one Ayurvedic and j the other Allopathic. The Allopathic dispensary was in charge of Dr. Madan, L. M. and S an'd the Ayurvedic one was managed by Vaidya Patwardhan. There it was found that the proportion of patients at the Ayurvedic dispensary was six times as that at the Allopathic dispensary. Not only was the number of patients who visited the Ayurvedic dispensaries great, but the percentage of recoveries in the Ayurvedic dispensaries was much in excess of that in the Allopathic dispensaries.

Again, under the auspices of the debt Redemption Society Bombay, a dispensary was started in the Servants of India Society building where Vaidya Bhushan Ganesh Shastri Joshi used to dispense Ayurvedic medicines in the morning and Dr. Desai and others used to dispense Allopathic medicines in the evening. There also the number of patients treated in the Ayurvedic method, was far higher than that treated in the Allopathic method and the percentage of recoveries by the former, was also in excess of that by the latter".

Similarly an extract from the administration report of Poona city municipality (1918-19) given in Appendix VII States that: "(During the) terrible influenza epidemic of the year under report............the unwillingness of the stricken people to submit to hospital treatment, was insuperable. Nothing could induce them to go to a hospital............but when Ayurvedic hospitals were opened, they were exceedingly eager to avail themselves of that treatment. The Poona Vaidya Mandal came forward at a critical time, and without any remuneration, voluntarily undertook at much personal cost and trouble, to look after and treat the patients at the municipal hospital,- for which the Mandal and its secretary deserve the special thanks of the municipality............ They inspired in the minds of the suffering people, a confidence nothing else could have created".

3. Why Allopathy is costlie: Several of the pandits go on to analyze reasons why Allopathy is bound to be costlier, such as its high dependence on foreign inputs, the costly nature of its diagnostic tools and aids, and so on. To quote Appa Sastri Sathe (cited earlier),

"The cost of Ayurvedic treatment is trifling when compared to -that of Allopathic treatment. The reasons as to why Allopathic treatment is so costly are that (1) The doctors undergo through a costly training and therefore charge high fees. (2) All their medicines are foreign imports and are monopolized; so they have to buy them at high prices. The experience during the last war is common to everyone. The doctors had to pay, and even now do pay, high prices for medicines of daily use such as quinine, sartonine etc. They are not taught to prepare these medicines themselves and have therefore to buy them at exorbitant rates. The case of Ayurvedic physicians is quite different. Their education not being so costly, they can charge less. They prepare their own medicines from indigenous plants and herb and other ordinary articles got from bazaars and therefore they can dispense them at a very low charge. The figures of charges for Ayurvedic treatment at the Servants of India Society's dispensary are astonishing. There, on an average for every patient, the medicine charges per day, amounted to one pisa or even less".

One of the main reasons cited for the greater costs of allopathic treatment is the cost of its drugs. There is clear recognition that many of these are only "processed" (and hence inferior) forms of Indian drugs, and the increased costs only benefit middle men or go towards making cosmetic changes in presentation and packaging that adds nothing to the medicinal value of the drug. To quote S. R. V. Das from Vellore,

"There is no doubt that medicines prepared according to Ayurvedic principles are very much cheaper than medicines made by the English method. We see that "Chukku (dried ginger) that is grown in our country and bought up Jor two annas, goes across the ocean, changes its natural form, gets packed in a fancy container and covered by colored labels, and comes across the ocean again with a new name unknown to us and gets sold at a price of Rs. 4 to 5 per bottle. No matter how often it crosses the seas, and however many bottles it is packed in, colored labels it bears or any new name it assumes, our Chukku remains the same old Chukku. By such numerous trips across the ocean, will its qualities grows......?
Because of such trips and its stay there, it may get old and its Guna and Veerya may decrease and nothing else. What is the expense for these travels across the sea ? What is the profit of the company that processes it ? What is the profit of the shopkeepers who sell it to us here ? What is the 'discount' of doctors who get it for patients? Who is to bear all these expenses? It is not the poor patients? A similar description can be given for every medicinal product. Our Ayurvedic medicines are not like] this. We need not go across the oceans for them. A lot of the medicines of our Ayurvedic Pharmacoepia are made from herbs. There may be a deficiency in our knowledge of it, but not a deficiency in our Science.........Herbs are available right in our backyards. Only because we reject them carelessly, we are subject to great difficulty and losses. We can easily prepare Sundershana fever tablets required to cures 50 patients. It cures all types of stomach disorders. Sundarshana Lavena is easily obtained, it cures belching, mandham and diarrhea. Sudarshana Bhojanagutari costs only in annas. Karpooradhi tablet that arrests all diarrheas costs only in cannas. There are crores of such medicines in Ayurveda".

The commercialised production, and some of the attendant evils, ranging from exorbitant prices during periods of high demand and promotion of drugs with exaggerated and false' claims are also criticised. To quote Sjt. Mela Ram Vaidya.

"Most of the allopathic medicines are produced in foreign, especially European countries where the cost of labour is higher than in India............ According –to the taste of richer people in Europe, f the medicine makers try to acquire a high standard, of excellence in outward form, in packing and other contingencies, which do not affect the real value of the medicine, but evidently raises its cost. Medicines prepared in India are sold (in any quantity required by the patient, while most of the foreign medicines cannot be had for less than a certain definite quantity, in which it is packed by the maker and whether it does or does not suit the' patient afterwards, he has paid for a full phial, bottle or box as the case may be, and if another medicine is then prescribed, the same procedure repeats itself."

Or as Shri Das (cited earlier) observes "moreover everybody knows that foreign medicines can .increase or decrease their prices according to demand. It is my experience that the last time we had an epidemic of influenza, the medicine Anti-Philogistine and Liq. Peptonoids, Manola, Essence of Chicken, were sold at 15-20 times more than their normal prices, depending on the demand. The intelligent recognize that these are nothing but conspiracies to ensure that we decay and those others should prosper and grow at our expense. While we have an abundance of natural products, it is a great insult to us to be dependent on foreigners for artificial products. Our own medicines are free of such ups and downs. When a label says that on taking a bottle of (allopathic) medicine, it will produce a whole list of benefits, and we buy it; and unpack it eagerly, only to find that for a cure, we have to take 6-9 bottles, it is as helpful as a promise that 'if you think of Reddi pattu Swami and eat this bhasma, your disease will be cured in an hour or a day or a week or may be in a fortnight or a year or a Yuga".

Yet another reason noted for the high cost of allopathy, is the expensive clinical and diagnostic aids it demands. As Kaviraj Haran Chandra Chakrawarthy (from Gharmara, Bengal), observes-

"Allopathic treatment which has been adopted as is followed by physicians nowadays it is almost an impossibility for a poor country like ours to undergo. Firstly for the proper diagnosis of disease, it is necessary to examine blood, urine and sputum at least, with the help of Western Chemical Science and microscope. These Scientific diagnosis is impossible in villages. And as it seems it cannot
perfectly be demonstrated in almost all the towns and cities, save and except Calcutta. Poor village doctors on account of their parsimonious habits do not manage to keep all these costly instruments and apparatus. In order to be treated by them it is necessary to get reports of urine, blood, etc. from at least three medical men, by spending four to five rupees at different places costing altogether Rs. 15. After being furnished with their 'reports the first physician will take his fee and then prescribe. Thus we see that Scientific diagnosis costs at the very outset at least Rs. 20/- by way of fee and this seems the minimum charge".

4. Is Ayurveda more effective? Numerous instances are cited where Ayurveda has provided effective remedies for conditions pronounced incurable by Allopathy. To quote Kaviraj Gananath Sen once again,

"In private practice the average Ayurvedic physician often does better than his Western trained brother. Besides, Western trained medical men very often request the services of their Ayurvedic Colleagues, in chronic intractable cases, not only among their patients, but also among their own family members. This is everyday experience with me and several of my colleagues in Ayurvedic practice. Hundreds of patients declared incurable and cured under Ayurvedic treatment would bear testimony to the unique success of Ayurvedic * treatment......From records of so called incurable cases kept in my clinic I am able strongly to assert that the efficacy of Ayurvedic treatment in cable hands is so remarkable, that all sections of the people—the prince and the peasant, the Indian and the European—resort to it freely. I find in my own practice that I daily have to attend difficult cases in the houses of at least two or three allopathic doctors of Calcutta. This is not the experience of me alone, but also ayurvedic practitioners trained purely on orthodox lines, many of whom still thrive as the favored family physicians of the rich and the noblemen of Bengal".

Several pundits have cited specific examples from their observation and experience on similar lines Appa Saetri Sathe (cited earlier) states:

"I hold the view that ayurvedic system of medicine is more effective than allopathy in Jeernajwar (long standing hectic fever), Sangrahanee (sprue .and dysentary) and many other chronic diseases. The evidence in support of the above statement can well be adduced by doctors. Dr. R. H. Bhadkamkar M. D. and Dr. M. G. Desh-mukh M. D. of Bombay when they find Allopathic medicines unserviceable in Jeernajwar (hecticj fever) etc. after continued administration for many days, are known to resort to Ayurvedic medicines such as Gudcheesathva, Pravaal etc. With success Dr. Garde of Poona used to cure chronic Sangrahanee (sprue and dysentary, by administering Parpatee. The late. Dr. Annasaheb Patwardhan of Poona — he died only a few years ago—used to cure many chronic diseases with Ayurvedic Khavthaha and in the articles' that were written on him after his death in the Kesari and other news papers, special mention was made about this fact and many persons will still be found who will bear testimony to it".

Similarly to quote Shri Das again -

"Several English physicians who are truthful and impartial and true to their conscience will bear witness to the act that several diseases abandoned' as incurable by English medical systems have been cured by our Ayurvedic Medicines. At one time there was a competition between the medicine Mst. Santal Flava etc. Bachu...... and our medicine Gokhsarathi Choornam prepared according to Ayurvedic principles. When the great mysterious influenza visited our country in 1916, at that time I had supplied the Sudarshana Fever Tablets meant for all fevers free of cost to all, and innumerable people had banefited from it. I state with proofs and witnesses that at one time, 18 members of the family of Rai Bahadur Srinivasa Rao, who is a steno-graphed ,in police Training School, Vellore, who were afflicted with this disease could not be cured after taking medicine in hospitals for 7-8 days and they were cured in a single day by the above (Sudarshana) tablets. We Ayurvedic practitioners have made possible treatments not achievable by the English doctors".

5. On the question of suitability to our people and local conditions:

Ayurveda, developed in our country is adapted to suit our people and blends our cultural, religious and social practices. Allopathy on the other hand is alien context and its practices were being imported and imposed with born in an wholesale on our people. As Shri Das (cited earlier)states : "Our forefathers who were Ttikala Gyanis have discovered Ayurvedic medicines that are suited to our people, time, context and their religious observances, regimen and constitution— medicines that are cheap and are related to some herbs that are here available.........Many English medicines are connected with sprituous liquors, the use of which is contrary of the observances of the Hindus. This may aid in a cold climate, but is counter indicated in our climate which is hot, and contrary to our culture, observances and religion".

A glaring problem with Allopathy, a practice totally unsuited to our people, that find repeated mention is in the matter of diet. It is pointed out that at one level, even as a science. Allopathy does not have well developed notions on dietetics and the adaptation of diet to suit individuals and their specific needs; while in practice doctors do not invoke even the most obvious changes dictated by a change of place, context etc. As Appa Sastri Sathe (cited earlier) declares:

"Doctors do not know and do not care how to make their treatment suitable to the poor people of India. Wherever they go, without regard to the patients' status, they advice the use of only milk for food, and such costly things as ice, icebags, cologne water, thermometer etc. These things are be-yond the means of the average lower and middle class people of India—so sometimes fearing the expense they prefer to go without treatment. Surgical operations and stay in private hospitals is a luxury which only the rich can avail themselves of. The Ayurvedic system is suitable even to the very poor. The food they prescribe is as cheap as their medicines. They do not require ice, icebags and thermometer but make use of ordinary things of every household with equal success".

Similarly Haran Chakravarthi (cited earlier) also states :

"As regards diet, juice of masuri dal, milk, meat juice and other cheap easily available foods are prescribed by Ayurveda. Whereas the expenses we are to meet in Allopathy are four times the cost on account of Pearl Barley, Plasmon Arrowroot, malted milk, milk food, essence of chicken and other foreign diets.As regards our country the Ayurvedic system of treatment is undoubtedly more efficacious than other systems of medical treatment, in as much as its principles of treatment is based on the place, time, diet and the customs of our country. In the first place as regards diet the injunctions of Ayurveda are best suited to our countrymen. The Western system of medicine has hardly discussed the dietetics and customs of our country while Ayurveda has laid down what is particularly beneficial or detrimental to our health, after due consideration of merits and defects of every one of our food stuffs in all their different conditions and forms, and of every one of our actions. It has further enjoined that in selecting every diet, the physician should closely observe the conditions of the place, time, vitality, natural constitution, habits and age of the patient. In the West, consideration of diets is based on the chemical analysis of those ingredients, but in a majority of cases such a process hardly yields any useful result. If we analyse sugar, we find only carbon and water, but I don't think that a Sarbat of charcoai, can therefore produce the same result as a Sarbat of sugar.1 Boiled rice would indeed be a lighter diet to those, who are used to half boiled beef. But for those people who live upon fine old rice and yet suffer from indigestion, raw meat juice can never be used as a diet. Without due consideration are Western physicians prescribing for
us, diets examined in their own land and this is causing much harm".

6. Surgery in Indigenous system:

The report also includes some details about 14 Institutions of Indian medicine—13 Ayurvedic dispensaries (7 in Madras city and 6 outside) as well as Takmul-ut-Tib Institution in Luckndw. It is revealing, to see the extent to which surgical relief was provided by some of these dispensaries, even when surgery was supposed to be in a state of 'decay'.

The Ashtanga Ayurveda Vidyalaya Dispensary in Calcutta has listed the number of patients in its surgical dept through the years 1918-20 as follows.

Year Period Number of patients in surgical dept. Operations performed
New Total
1918   First 6 months 112 455 11
  Second 6 months 523 1,114 70
1919 First 6 months 674 2,000 100
  Second 6 months 948 2,777 57
1920 First 6 months 1,016 2,893 106
  Second 6 months 1,035 3,140 103


For the half-year ending 31st Dec. 1920, a table is provided that gives the breakdown of surgical treatment in terms of class and nature of operations (See table next page).

The Takmul - ut - Tib Institution in Lucknow lists under treatment of patients, several thousands of patients under "surgical diseases" for every year since its inception in 1902. It records 3,952 surgical cases for the year 1919 and a total of 54,723 people treated under this category in the period 1902-1919. The Venkatramana Ayurvedic Dispensary in Mylapore, Madras, lists 49, and operations performed in 1921-22.

Class of Operation Nature of Operation Number of Operations
Primary Secondary Total
Operation on tumours Liporq removed and stiched 1 - 1
Operation on abscesses Acute abscess incision      
Removal of foreign
bodies
Removal of foreign
bodies
(excluding external ear)
54 - 54
Operation for arrest
of hoemorrhage Operation
in the mouth
Application of styptics
(a)   chemicals Infected
Wisdom tooth incision
5 - 5
Operations on
Lymphatics
Removal of Lymphatic
glands
3 - 3
Operation on the
skin
Boils opened 10 - 10
and subcutaneous
tissue
Whitlow incised 8 - 8
  Carbuncle incised   -  
  Dectylitis incised 4 - 4
  Cellulitis incised   -  
  Sinus incised 11 - 11
Operations on
generative organs
Phimoiss
circumcised
1 - 1
  Hydrocele tapped 1 - 1
    103   103


Surgical treatment seems to have been popular and some institutions like the P. T Lee Chengalvaraya Naicker Ayurvedic Institute seem to be limiting the scope and number of their surgical cases due to severe constraints on resources. The superintendent of the above institute observes :

"The number of patients treated in this dispensary during the year 1921-22, viz. 122,238, includes, scraping of malignant and chronic ulcers of various types, extraction of foreign bodies from ear, nose etc. and such other minor things that can be done easily. We are obliged to handle these cases, not because we have the necessary equipment and leisure to do so, but because of the importunity of the patients themselves who seem to believe that our ointment and applications cure then more speedily. Although we in some cases insist on the patients to go to Allopathic hospitals for operations, they invariably go here againfor further treatment. With this experience I can confidently say that if more facilities are made available we will not be less successful in surgical cases also".

One reason -for such popularity could have been that Ayurvedic surgery like Ayurvedic medicine in general was perhaps cheaper than Allopathic treatment. As Kaviraj Haran Chandra Chakravarthy observes :

"In surgery j Eastern method of treatment is far less costly than the Allopathic one. In allopathy many things such as 20% carbolic soap, lotion, wool gauze and such other things j cost at least not less than Rs. 1/- in a day, whereas in Ayurveda it would be done by easily available Nohimba Kashaya (Margosa water)......Sometimes specially prepared ghrith (medicated ghee) worth only one or two rupees. It is almost impossible for the poor to have allopathic operation, save and except in hospitals. But I have myself cured many, poor men even of abdomen or liver abscess at a very normal cost".

Comparing some aspects of Ayurvedic surgery with its Allopathic counterpart he states : 'Even in the matter of surgical treatment where the Westerns occupy the highest place at the present time; even in this department of treat ment, I know it from my personal experience of actual operations, that there can be no doubt the present scientific antiseptic processes are admirable, but the Western systems are in want of good medicines to induce healing up of wounds. If any wound for some reason refuses to heal up, the only remedy with the Westerns is a fresh operation, viz, scraping of the wound. But the Ayurvedic system possesses such powerful medicines for inducing granulation, that not to speak of simple abscesses or wounds, that even sinuses can be cured without the help of any surgical operation. (I have myself cured many patients of this type). Then again the Western system does not seem to know the process by which the cicatrix mark can be avoided jbut this process of Sarbarikaran (i.e. recovering the orginal complexion of the skin after the wound is healed) is a principal thing under the treatment of abscesses or wounds under the Ayurveda. I have been studying and applying the Saiya Tantra (surgical system of the Ayurveda) for the last fifty years and this has made it plain to me that even in the matter of Satya Tantra (surgery) as well as in many other respects,' the Ayurvedic system is superior to that of the West".

In addition to all other handicaps. Ayurvedic practitioners also seem to have been under some legal constraints at least in some places. Shri. S. R. Das (cited earlier), states :

"Even though we are eligible for practicing surgery, because we have been unjustly prohibited from handling surgical cases and practicing surgery and thus English doctors are enjoying this as a monopoly, we may lag behind English doctors in surgery, but Ayurvedic physicians are not behind English doctors in Kaya Chikithsa (Clinical/general medicine)".

Unfortunately it is not possible to know more about-surgery, since the data provided on many other dispensaries do not show a breakdown in terms of types of diseases treated or even when they do they do not mention surgical treatment as a separate class. Nevertheless it is clear that despite absence of any government aid and in the face of many constraints a significant amount of surgery was still in vogue.

7. Is the "Scientiftcity" of Indigenous systems Matter for Debate? At the very outset questions are raised about the very need for such an enquiry—one "of whose stated aims was to ascertain whether the indigenous systems are scientific. To quote S.R.V. Das "Those who claim today that Ayurveda is not a shastra, and it is a medicine of Adam and Eve age, and it is of no help in today's society, and it is laughable to ask for its support today, and money spent in its support is useless and other such things that hurt the minds of our fellow countrymen—should ponder over this. Just as we take naturally to our religion, so also should we adopt our own shastras naturally; if instead we start speculating on whether or not we should adopt it we would be told that it is not for the benefit of the world and it is best enclosed in a casket and flushed into the Ganga for disposal".

In addition, objections are voiced about the competence of allopaths to make -a pronouncement on Ayurveda. As Vaidya Pandit Hari Prapanna Sharma and 16 others State—"In reply to your questionnaire we beg to state that we are willing to appear as witnesses before your committee provided it includes gentlemen who are fully conversant with the oriental systems of medicine in their original form and the majority does not consist of those who know merely Allopathy because we believe that Allopathy and its allied Sciences, do not and cannot monopolize all knowledge in this world as is very often presumed directly or indirectly in this country". In a similar vein Kaviraj Jaimini Bhushan Roy States-"..................From what has been stated above it would be clear that our system is perfectly Scientific and can stand the test of any scientific criticism—provided our critics take the trouble to acquaint themselves with what they are criticizing—doubtless an elementary qualification demanded of every critic in other branches of technical study, but somehow or other totally neglected by some professors, who think it is apparently the correct thing to judge Ayurveda from ignorance born prejudice or bigotry".

Several pundits are unwilling to accept the presupposition of the second question —(i.e. how far your theory or theories stand the test of modern scientific criticism) that Modern Western Science provides unique criteria, that constitute some kind of an 'acid test' to determine if a body of knowledge such as Ayurveda is logical and scientific. In the words of Kaviraj Gananath Sen—"The question (i. e. question number two) is rather wide almost to vagueness and the expression 'modern Scientific methods' is an unhappy insinuation that indigenous systems of medicine are based' on unscientific methods".

Pandits provide instances to illustrate the biased outlook of Allopaths. To quote S. R. Das :- ="A great amount of abuse is heaped on Ayurveda—it is said that Ayurvedic medications are quite harmful and that Ayurvedic physicians do great-.harm by excessive dosage of such drugs due to ignorance and when they treat a headache, they tend to add on a stomach ache to it. We do not know how this is fair. In (English medicine/it is decided that there is a tumour in the stomach and it should be 'operated' upon, and when with the intention of good to the patient, the stomach is cut open, the patient attains Vaikuntha (i.e. dies). So do we now declare that on top of stomach -tumor the patient had a ripped stomach inflicted on [him and died of ruptured intestines? Death occurs in both treatments. How then on this basis can we call one of them Scientific and the other unscientific? If a patient dies with an Allopathic physician, they say "The treatment was very successful, but unfortunately the patient died." But if death of a patient occurs with an Ayurvedic physician, they spread the news that it is "metallic poisoning" or "vegetable poisoning". They do not seem to know that, no matter how much they abuse us out of selfishness, just as there will be a Westward direction, so long as' there is an Eastward direction, so also Ayurvedic Medicine will exist so long as there is Allopathic medicine".

8. Clearing Some Misconceptions Regarding the Science of Ayurveda : At the
outset some attempts are made to clear up wrong notions about Ayurveda that have gained currency due to various reasons—such as wrong translations, or premature seeking of correspondence with Western notions after a mere superficial acquaintance with the subject: etc., Kaviraj Gannath Sen States

"The theory of Vayu, Pitta and Kapha was also a great discovery, which unfortunately has been misunderstood by Western Scholars judging by the wrong mercenary translations, rendering these terms as Wind, Bile and Phlegm............... It must be remembeVed that the theory of Vayu, Pitta and Kapha is not the same as the old exploded humoral theory bf Greek and Roman Physicians, who though they borrowed the I idea from Ayurveda, failed to grasp the true meaning of the theory..............'.To be more explicit I may add that these principles known as Vayu, Pitta and Kapha occur in two5 forms. (1) An invisible or essential from that mainly guide the physiological processes pertaining to them severally and (2) A crude or visible form, the products (as secretions, or excretions) of those processes induced by these essential form. The] relation between the two forms is very close, so that derangement of the essential form of one principle gives rise at once to morbid excretions or secretions of that principle. The failure to recognize the difference-between these two (forms of the principle has given rise to the erroneous rendering of Pitta, as 'Bile' and Kapha as 'Phlegm'. The rendering of 'Vayu' as 'Wind' is preposterous and has brought unmerited obloquy on the theory".

Captain G. Srinivasamurthy is his memorandum on "The Science and the Art of Indian Medicine" which forms an Appendix to the main report, makes the following observation about the limitations of the attempts to understand Ayurveda in terms of modern Western Physiology and Medicine.

"I might perhaps illustrate this difficulty by an analogy. The citizens of Madras may be classified in various ways, linguistically, territorially, professionally and so on; if we try to express the particular division of any one of these "-classifications in terms of the divisions of any other, we find at once that there is a great difficulty in doing so. Take for instance the lawyers division of the professional classification; lawyers may be found among all linguistic sections—among people larking Telegu, Tamil, Malayalam, Urdu and English and so on likewise they may be found distributed in all the territorial divisions of Madras, in other words, while lawyers occupy a horizontal position if we may say so, in the professional chart of Madras, they occupy a vertical position in the linguistic and territorial charts being present all the way through from top to bottom. If further we imagine that to one, the limits of the City of Madras are same as the Municipal limits while to another, they denote 'the University limits', within the meaning of the new University Bill {which includes a wider zone viz. an area of ten miles radius from Fort St. George), then we can easily see how very difficult it is to equate the several divisions of each classification exactly in terms of one another. Now, to my mind, attempts at trying to fit the Ayurvedic Tri-Dhatu classification into the classification of Western Physiology seems to stand on more or-less a similar footing".

Pandit Hari Prapanna Sharma and 16 others from Bombay in their testimony take up the issue of 'Sabda Pramana' with reference to question number 2 (which raises the issue of whether the indigenous system can stand the test of modern Scientific criticism) — "The wording of the second questions is enough to show that the committee is not willing to accept the third instrument of right knowledge, viz. Shabda Pramana as authoritative, but would accept only two, viz. perception and inference. Both these latter are impossible for a child who has to depend upon his elders even in accepting the names of things he has never heard before of. -If you take the instance of grown up rational young man, has he not to consider as true, the words of an ordinary teacher. Much more so is the case with those great masters of the past, who were neither misguiding the world nor were themselves misguided. Charaka in his Vimana Sthana, Chapter V, says "A shrewd doctor should learn about disease by (1) the teachings of the authorities (2) one's own visual evidence (3) Inference".

The reason why this appears to be made an issue of is that, often this (i.e. acceptance of reliable word or tradition as a source of knowledge) has been leveled as a charge against the indigenous sciences. For example the Calcutta University commission attributed the "unscientific veneration of petrified dogmas" as the reason for the "premature arrest" of example, argues that Ayurveda Indian Scientific development. Shri S. R. V. Das for has its own methodology of research and development and points out how Allopaths too have their own traditions and authorities in research and methodology:

"The reason for the decline of our Ayurvedic medicine is the absence of support from the government and the competition from foreign medicine. No matter what, if only we would have had the support of the government, our national medicine would not have come to this.........AM the blame heaped on it is-With an attitude of one who wants to prosper at another's death and no more. Is it possible to pronounce" without research and investigation, that a lean person should get iron, a pale (leucodermic?) person'should eat Karisilankanni, Nilavembu will cure fevers, Chukku (dried ginger) is a deepankari (appetiser and digestive), mudakkarutham reduces vata and Madhubala is Vamankari (i.e. induces vomitting) ? Without research how could we have known the gunas, properties and characteristics of these objects?. We are told j that if one grinds and squeezes Chukku (dried ginger) and if we add this and that to it and finally, announce that it has something called Chukkarain, that this procedure is scientific. If not, it is not considered scientific. English doctors adopt methods following the £path many great English physicians as Drs. Wood, Gross.........Read, Hooper etc.! So also we follow in the footsteps of many great physicians such- as Dhanvantri, Susruta, Charaka. Agappeya Siddhar, Yerra Siddhar etc. Does it get dishonoured by this?”

9. Drugs and the theory of drug-action in Ayurveda: Several Pandits have set forth detailed descriptions of the principles and methodology of aiteology, diagnosis, treatment and various other aspects of Ayurveda. We will here concentrate on only one aspect of this namely the understanding of the basis of drug action in Ayurveda. By 1920s many attempts were being made to "evaluate" Ayurvedic drugs by allopathic criteria and to selectively assimilate those judged to be 'useful' by screening the drugs for "active ingredients". Many indigenous practitioners have commented about the absurdity of using Western Science to understand the mode of action of Ayurvedic drugs and. in the process, they have also outlined some Ayurvedic principles used to understand drug action.

It is pointed out that the so called, active principle is merely one of the several facets of a drug, and that by itself it will not suffice to comprehend its action in totality. To quote Vaidya Appa Sastri Sathe, "chemistry and physics are not able to analyze properties of many substances. They find no difference in Shankabhasma, Moukthikabhasma or Shoukthikabhasma while Ayurvedic physicians have been successfully using them as different medicines on different diseases". To describe a drug fully, one needs to know its other facets, aside from chemical composition. To quote Vaidya Bhupati Krishna Rao of Madras,

"Drugs act according to Rasa, Veerya, Vipaka and Dravya. Dravya refers to the physical and chemical properties including the active ingredient in the drug. It is a resultant of the five elements panchabhootas). But the elements do not exist in the same proportion in various substances. Agni may predominate in one, at in another and so on and so forth. By virtue of its rasam and active principle, Kadukkai (myrobalan) is calculated to produce constipation, but by virtue of its prabhavam it will purge. The Vipaka of a drug may be different according as it is given as an extract by hypodermic injection or through the mouth. Some drugs if they are to act satisfactorily will have to be given only through the mouth, and some in other ways. If we extract merely what you call the active principle of a drug that may be of no use for our purpose; its Veeryam may not be there. Moreover the action of the active principle and whole drug may be different".

"Standardization" or "research" based only on active ingredients are shown to be inadequate. Examples are cited of drugs that agree in chemical composition but differ in action due to differences in veeryam etc. Thus C. V. Subramania Sastri states;

"If we know the chemical composition alone of a drug, it is not enough for us to use it. We must also know its Rasa-Veerya-Vipaka-Prabhava. Even if the government should standardize a drug in terms of its chemical composition or active principle, it would not be sufficient for our purpose; for we should know its veeryam also. The active principle of 'Chitramoolam' and 'Nepalam' may be one and the same but the one will cause purging whereas the other cannot. 'Sunnam' and 'Muthya Bhasmam' may be same in chemical composition, but their Veeryams are quite different. The Western system takes the essence of drugs by soaking them in alcohol or some such substance. We cannot take that as really representing the essence of a drug. We do not know what Veeryam it might have lost in the process of soaking. The combination of several 'bhutams' produces the dravya of a drug—we do not know which bhutam goes away in the process of extracting the .essence. Therefore I am of the opinion that the method of standardisation adopted in the West is not suited to our system. If we come across a new drug, we can find out its properties by tests laid down in shastras. Then we will know its Veeryam". In an interesting exchange with the committee, Mr, K. Sesha Iyer of Bangalore in his oral testimony, warns against the casual use of Ayurvedic drugs by Allopaths who are not well versed in Ayurveda Sastra:

"For an allopathic doctor to safely use indigenous drugs—especially certain powerful ones—it will be necessary he should know the action of drugs in terms of Ayurveda. It is rather dangerous for a Western trained doctor to make use of a Dravya without any knowledge of f its Rasa, Veerya and Vipaka. In the case of ordinary remedies' perhaps it may be safe; but if a medicine is at all powerful it might do harm, without knowledge of the doshas the Allopathic doctor may be at sea, when he takes to the use of our remedies, without knowing its pathology etc. according to our Shastras; he will have to be termed a quack if he uses a drug without' knowing its effect......he (ie. allopath) may be landed in difficulties if he uses our remedies without a knowledge of our Shastras regarding diet, anupanam and many other things like these. We administer only such medicines of are conducive to the temperament and vitality of our patient......"

Asked (by Dr. Lakshmipathi) if whether a qualified allopathic doctor may not safely use Ayurvedic medicies ifjfull instructions are given with the medicine, the witness stated for that matter any intelligent layman can use like that. Why should there be a doctor?...... "Asked further, whether or not it was more easy for a qualified allopathic doctor to use them, rather than for a layman, witness stated— "Yes, if Veerya and Vipaka is understood, but then he will himself be something of an Ayurvedic doctor".

Thus there is a clear statement that Ayurveda is not a mere list of drug recipes and cures, but a science with its own method. Allopaths often fail to recognize this and are in fact handicapped by their preconceptions and prejudices when they look at Ayuryeda. As Shri. Ravishankar Ganesh Anjaria (Mongrol State, Kathiavar) states " as a layman can be a good Allopath after five years medical study and ten years experience, so an Allopath can understand this system (i.e. Ayurveda) by study though it is more difficult for him than a layman, as the Allopath has to unlearn or disregard certain formed views and principles which he has made his own."

Occasional comments are also made about Allopathic drugs from the view point of Ayurvedic methodology. To quote Haran Chandra Chakravarthy (cited earlier)— "what is regarded as the best medicine or the best application of it by Westerns may not appear to be so to the Orientals. They (i.e. Indigenous systems) detest medicines which prove injurious to men in some respects. Potassium Bromide and Aspirin which are useful in particular maladies, but also harmful in some respects, cannot be regarded by Ayurveda as proper drugs at all". Many physicians also similarly reject Quinine—widely used by Allopathy in favour of Ayurvedic drugs,

Some popular allopath understanding that Ayurveda c theories are commented upon in the light of the offers. To quote Kaviraj Gananath Sen (cited earlier)—........now that so much is talked and written about Bacterial or Germ theory of causation of disease, I think I should indicate to you what, according to Ayurveda is the role of germs (Jeevanus) in the causation of disease.........according to our Rishis, germs by themselves are powerless to cause disease, unless the field (Kshetra) is suitable for the growth of the seeds or, as our ancients would put it, unless the constitution was undermined by the non-observance of Brahmacharya (celibacy or regulated sexual function) and other rules of health as described in the Dinacharya, Ritucharya etc. of Ayurveda. It is the non-observance of such health-ensuring practices that make -us easy prey to germs, which were powerless in the .case of those holy persons who kept their bodies pure and strong by the observance of self control and regular healthful habits. To my mind, this is the reason why in Ayurveda, germs do not occupy the all important role that they do in the Western medicine of today. That our ancients did recognize their existence and potential for mischief is amply clear from the writings of our rishis. For instance, in dealing with the Nidan or causation of Kushtas (some forms of leprosy" and other parasitic skin diseases) Sushrutha says, "All kinds of Kushthas show the derangement of Vayu, Pitta and Kapha and also of Krimis or microbes." (Sushrutha, Nidan Ch. V).

10. Why were the indigenous systems on the decline: There is a recognition of the severe constraints under which Ayurveda is operating—not the least of which is an atmosphere 'where Western ideas are beginning to predominate people's thinking. To quote Shri. Sankara Menon—" The humanitarian side of Indian intellectual life, has of late received a materialistic baptism under the influence of Western culture and civilization, producing at the same the inevitable result of natural contempt for our literature, science and art and a blind admiration for everything Western".

Most of the Ayurvedic Physicians appear to be keenly aware of this—as is reflected in their statements. As Shri Das says—''Because our Ayurveda is in our native language and because now there is no respect for native languages, those who are fully proficient in that language and sastras, are full of Sastric qualities and being devoid of ostentation which is one of today's needs, are being dubbed, as pedestrian. Thus Ayurvedic experts who are great scholars are very much in the background-......and are not seen in prominence". Kaviraj Jaimini Bhushan Roy, who refers to the glorious achievements of Ayurveda, goes on to state - "I quote here Encyclopaedia Britannica and not our original texts, because our mentality has now become so deteriorated, as to make even my own countrymen believe me only if I quote Encyopacledia Britannica but not if I quote Sushrutha".

Removal of constraints on Ayurveda and an understanding of Ayurveda as it ' is, is seen as the first task. The question of "interaction" with Allopathy, is seen as as something that may take place if necessary, only on terms of equality. Not that this view was unanimous there were some physicians Who expressed the view that various forms of "interaction" with Allopathy was called for. But it is significant that a strong and vocal body of physicians expressed the former view.

11.Constraints on the Practice the Indigenous systems: The most blatant constraint was of course the financial' constraint with the Government spending its entire health budget on Allopathy. But there are several other restrictions those handicap Ayurveda practitioners such as their non-recognition arising out of not being "registered". As Ayurveda Bhushan Pandit C. V. Subramania Sastri states, "We have certain disabilities at present due to want of registration. We cannot grant certificates of Jill health to persons who are summoned to court while they are ill". Or as Ayurveda Bhushan Pandit M. V. Sastri of Madras states: "Many people come: under our treatment, but our medical certificates are not accepted by the Government. Once a patient came under my treatment, but for the sake of the medical certificate he had. to go to- an English Doctor". Pandit K. S. Subramania Pillai of Coimbatore describes how Allopaths benefit by this—"At first I give a certificate to my patient and based on that certificate, 'a Western practitioner gives another on receipt of some fees". Hence several practitioners suggest that registrations should be introduced, but that the Board of control should Consist of Indigenous Medical Practitioners. As Ayurvedacharya Madhava Menon of Madras Ayurvedic College states—"I am for having a" separate board, for the registration of Ayurvedic medical practitioners—a board consisting exclusively of indigenous medical practitioners, without the control of the English medical council, because I am of the opinion that the Surgeon General is against our system and also because I feei that it may not be conducive to the progress of the indigenous system"..

Furthermore some legal restrictions are noted, such as the restriction on the practice of surgery (cited earlier under 'Ayurvedic Surgery') and the treatment of certain diseases. For example P. S. Varrier, Secretary of Ayurvedic Samajam and a practitioner from Kottakal, Malabar states—"Plague is not treated by Ayurvedic physicians owing to government restrictions". About the restrictions on the use of certain raw materials, Shri. S. R. V. Das (cited earlier) states—"Just like poking our eyes with our own fingers, we are told that as soon as our drugs are included in their Pharamacoepia, we are not permitted to use it according to the medical act. As per the English pharmacoepia under Deepankari, referred to as carmanative mixtures are included, Navaksharamadhu............ettikottai (Nux Vomica nut).........etc. In our deepankari tablets, rasam.........ettikottai (Nux Vomica nut) etc. are added. The ettikottai (Nux Vomica seeds) that are common to both, cannot be bought or used by anybody without a licence.

Even in Ayurvedic Institutions set up with State aid in native States, its control is vested with the Surgeon General, who is an Allopath often hostile to Ayurveda. We quote here from the testimony of A. Subbaraya Pandit, Principal, Govt. Ayurvedic College, Mysore, which describes the conditions in a 'Native State ruled by a 'Native king' who is acclaimed as a patron of Indian learning. We do not want those who are prejudiced against our system to have any halve in its control. There are 30-40 Ayurvedic hospitals in Mysore State. Even now there are Ayurvedic practitioners 'in many villages but they do not get any encouragement and they do not prosper. The Surgeon General or the Senior Surgeon is the head of the Ayurvedic Hospital also, though he does not know anything of Ayurveda. All proposals connected with Ayurvedic system pass through him. If he understands poor system of medicine it will be much better, but up to now, no good has come to us."

12. How should Ayurvedic Education be? The first task then is the removal of constraints on Ayurveda. It is considered equally important to comprehend the wealth of knowledge in the published and unpublished works of Ayurveda especially since there was already much talk about "bringing it into contact with Western Science", supposedly to remove its defects. K. Sankara Menon of Trivandrum states-"With regard to the incorporation of Scientific discoveries into Ayurveda, I am of the opinion that it is the first duty of every lover of yurveda to study it in the proper fashion .and understand the level it attained to in the ancient days. Any incorporation of new ideas into the system now in vogue, without knowing the exact condition of Ayurveda at present would prove 'to be either harmful or unprofitable. What I mean is that much so called modern incorporation may have had a place in the ancient science and hasty addition and accretion might be contradictory to the principle of Ayurveda. What I mean is that the Science of Ayurveda as it is now known should be thoroughly analyzed and sifted, so that an exact knowledge of it may be gained, before any additions are made to it!. One has to be exceedingly careful to modify a system which has stood the test f of thousands of years."

Thus, many reject the view of the Calcutta University Commission, and prefer that the Ayurvedic 'education should be separate. As Ayurvedacharya Madhava Menon state.— "I prefer that Ayurveda should have a college of its own, rather,than it should be taught in Western medical colleges, for the latter course will not promote Ayurveda any more than the teaching of Sanskrit or vernacular in the arts colleges has promoted Sanskrit or venacular scholarship. Moreover, the professors of Western medicine are paid so highly that a poorly paid vaidyan on the staff of a Western Medical College will not command respect."

13. Ayurveda and'Modern Scientific Criticism' Reacting to the statement of the Calcutta University Commission that indigenous practitioners have come to realize the value of 'modern scientific method'/ Pandit Narayana Aiyangar of Madura declares— "I entirely dissent [from the view of the Calcutta University Commission. I do not believe that there is anybody truly trained in the Ayurvedic system of medicine that desires to come in any touch whatever with 'Modern Scientific Methods.' The combination which is proposed by the Calcutta University Commission will only be a product calculated to profit neither, at any rate not certainly the Ayurvedic system. The reference to "survivals which cannot stand the test of experiments" is thoughtless verbiage. I challenge anybody to point out such a theory and I shall demonstrate that observations such as these afe only begotten of ignorance. Time which antiquates antiquity, and has an art to make dust of all things, finds and shall find the Ayurveda inexpugnable. And all "progress of modern science" has shown but more unmistakably that Ayurveda is' a science not for an age—but for all time."

There is not only a great amount of criticism about the so called "modern scientific method" but also sometimes even a total rejection of it. As Ayurvedacharya Kaviraj Gnanendra Nath Sen states-........."I am afraid Ayurvedic theory has nothing to do with so called modern scientific criticism, which in my opinion is not scientific at all, as considered from the point of view of Eastern Scientific ideas, at least so far as Western Medical Science is concerned. Western medical science in my opinion is only in its infant state and is engaged at most only in making observations and experiments and has not yet reached the scientific stage. The methods of scientific observation are also different with the Eastern and the Westerns."

Again as S. R. V. Das says "Now a days a famous medicine that may be discovered by a great English physician disappears without a 'trace the very next year. Unlike this Ayurvedic medicines even today yield the same results, and cures that were described thousands of years ago are used till now by all our people. Suddha Bhairavam, Sornananda Bhairavam.Bootha Bhairavam and innumerable others have yielded the same results then and now, and will doubtless do so in future." As captain C. Srinivasamurthy observes— "There has been less exhibition in Ayurveda than in Western medicine of too hasty a promulgation of new and novel theories, followed by their subsequent repudiation and of alternate enunciation and denunciation of hypotheses which is sometimes mistaken for progress."

To attach the label of 'Science' to such gimmicks is considered absurd by Pandit Hari Prapanna Sharma and 16 others who in their testimony set down their own ideas on what science should be and how Allopathy falls short of this ideal:

"Now we are very much grieved at your words How far your theory or theories stand the test of modern Scientific criticism? We beg to state that moderners cannot even comprehend our theories of causation and modes of - treatment. They are changing their ground almost every year by changing their old theories and experimenting each according to his own whims upon poor creatures without any proportionate gain to anybody. Is it this that deserves the name of Science? Our idea of Science is that it should be a storehouse of incontrovertible universal knowledge which holds good for all time—past, present, and future. Please examine your own pharmacopeia of a hundred years ago and how vastly it differs from the present one, and is still undergoing further mutilations. Is this Science or a mere compendium of ascertained and unascertained facts?"

14. On the Unification or Integration of Ayurveda with Allopathy: That the Ayurvedic physicians by and large are not too enthused about such proposals is amply clear. This is quite understandable since, Ayurveda's struggle for survival and advancement is seen by them as part of a larger national effort, wherein an entire people are attempting to maintain their national and cultural identity, in the face of efforts to import and impose on them alien social, cultural and scientific practices that do not serve their best interests. We illustrate this with the fallowing extract from the testimony of Shri. B. R. V. Das, which clearly brings out this larger perspective: "It is amusing to say that if the government established Ayurvedic Colleges all over the country run along modern lines, this would be unified with modern medicine...... It is not clear how this will happen when it seems a matter of doubt that we are a people and we have our own languages and sciences. When we speak of our medical science,; they ask us with great wonder, if there is indeed such a thing. Instead of posing such a question, if we first agree that there is such a thing as the Hindu people and they also like others have a religion, a language, a science and a great ancient civilization, and if we have a well intentioned thought to adapt it to suit the world not only can the two be linked but a English Medicine so it is clear that it will be a cut above the English Medicine.

There is no doubt that India is a huge nation of 33 crores people, even if not a subcontinent as stated; would there not be a religion, language, knowledge, civilization and science belonging to such a people? Were the people of this country steeped in stupidity right from antiquity? Should they follow only a foreign religion if they are to worship? Should they speak only in foreign languages if they want to speak? Should they study, only foreign sciences if they wish to study? Should they only follow foreign traits in dress and. manners? We do not know on what basis, 'educated' refers to only those who have read English, 'civilized' refers to only those who dress according to foreign traditions, eating 'good food' refers to eating meat foods and 'drinking' refers to alcoholic drinks. While every country has its own religion, language, knowledge, science and civilization, why is it that everything is borrowed for our countrymen? While our country has had four Vedas, four Upa Vedas, Six Shastras and Sixty four Vidyas (arts and sciences) and there is real evidence for their existence, where are they now hidden? In which sea are they drowned?

When we need architects to put up buildings, they have to come from abroad. If Medical Science has to be taught, they have to come from abroad. We' import' Scientists from abroad to deal with horses, cows, geology, mathematics, music, dance, astronomy etc. To say that we have our own Science and Scientists has turned out to be fictitious. (For our own countrymen, everything stands out as a doubt. Why is there a doubt on Vedas, Shastras, Puranas and Vidyas (arts and sciences) ? Maybe they have not been pronounced upon by foreign experts—God alone knows !

More than any other doubtj there is total doubting of our own medical sciences. Because, there is a blind faith that by partaking English medicines even if there is no cure, there is no harm done. But only those who have taken Quinine, Pot. Iodide or Calomel know its after effects. Some of our own people are mouthing baseless abuse that Ayurvedic physicians are ruining the body by careless preparation and administration of medicine without knowledge of or care for physique, sex, nature of disease etc. Even if some physicians or our science is in that state, who is responsible? Why should not our countrymen support it and advance its cause? Do not other countrymen do so! Foreign domination has still not left us, it seems. Alas India what indeed were your status before and what a state you are in now? Please think well over this.

Though the sea has several rare things in it that it gives to one who dives deep into it, if instead of diving into it, one were to reject the whole sea after just superficially licking its waters and finding it salty, so also, instead of diving into this great sea of Ayurveda and delighting in knowing the several rare treasures in it, English physicians and others reject it superficially, by claiming that it is harmful and it advocates the use of blood, urine and faces and that it is a science unsuited to the times.

So long as they have such an opinion, it is very difficult for English medicine and Ayurveda to unify in course of time. Only if the English physicians are possessed of the noble idea—that 'Ayurveda 'is also the Science of a great country, it has received the support of the people of this country since ancient times and used to treat their diseases, we should not neglect it due to our power and influence, we should adopt a fraternal attitude and give it help'—and they give it the position and status that is accorded to English medicine and if they look at it without selfishness or professional jealousy, and treat it as they would their own system, then the two systems can work towards the same goal, like two bulls that draw a cart together. Or else it would be like a bufallow1 yoked with a bull, with the bull seeking the shade and the buffalo the sun, with a struggle between the two".

Kaviraj Jaimini Bhushan sums up his views on this question :

"The Statement that the distinctions between the two systems (Indian and European) will disappear,, is a pious wish that is not likely to come to pass in the near future at all events. Well may we say that the distinctions between Hinduism and Christianity will disappear when each recognizes and adopts whatever is good in the other......1 believe that the statement may be taken to express a wish that is capable of early realization, always provided that we have a real cooperation of both parties and not indulge in that brand of pseudo-cooperation so much affected nowadays, where one party is always the boss and laying down the law and the other party always to yield and obey, under the peril of being branded otherwise as an infamous non-cooperator".

Conclusion:

The contents of the report demolish some popular current myths about Indigenous Sciences and their relation to Western Science. Today many of the practices of traditional Science and Technology have -undergone considerable distortion and ...decay and in most areas the traditional practices are being rapidly replaced by Western S and T. It has become common among a section of historians and scientists to offer a post factum explanation for this situation to the effect that this decay is a "natural" process by which a science that was not serving the needs of the people and not suited to the changing times, was replaced by modern science, which patronage and well over a century became the sole recipient of State not only serving the need of over after the introduction of Western Medicine which help, the indigenous Systems of medicine were, 90% of our people, but doing so much more effectively and economically than Western Medicine. This is a remarkable comment on their intrinsic strength, vitality and effectiveness. The 'decline' that was setting in was not because they had ceased to be useful or effective, but the result of constraints being imposed on them by a political process, that favored Western Medicine.

In the testimony of the practitioners there is a clear statement that Ayurveda is a Science with its own distinct world view,-which was in consonance with our culture and civilization and ideally suited to meet the specific needs and conditions of our peoples. Ayurveda, to them, is not a mere compilation of recipes, but an entire philosophy of approach towards health care.

But today, the myth of -the Universality of Western medicine and- Western Science in genera! is far more wide spread than it was in the 1920s. In the past 50 years, Ayurvedic education has been taking new forms, with varying degrees of 'integration' with Allopathy. A lot of research and investigation performed in the name of indigenous medicine employs the framework of western medicine; thus increasingly drugs are 'standardized' by chemical composition, and efficiency of drugs or treatments are 'tested' by employing criteria prescribed by Western Medicine as a yardstick. Today's talk about 'development' of Indigenous Systems by the World Health Organization, has also been with' a similar perspective. The Chief of the Unit of Traditional Medicine at WHO he adquarters at Geneva, Olagiwola Akerole has in a recent essay spelt out some aspects of the role of W.H.O.; "The large number of health practices in specific countries need to be identified, gathered, sifted and Evaluated modern technology can be used to provide .evidence of efficacy and safety or to prove the placebo J effect of some practices and remedies". Do-all these constitute the development of indigenous medicine?

There is an urgent need! Today for us to have a clear understanding of what should be the system of health care to be adopted, and if it is the indigenous system of medicine, how best it can be developed to suit the needs of our people. A certain clarity on these issues that the indigenous practitioners had over 60 years' age, seem to be shaken today or is at least not heard prominently in the forefront. We hope that this article in its historical perspective would be a help in the discussion of some of these issues.

References :

1. Which way for traditional medicine, by Olayiwola Akerele, in World Health, June 1983.

2. The place of indigenous medical practitioners in modernization of Health Services, by C. E. Taylor-in Asian medical systems—a comparative study, by C. Leslie (University of California Press, Berkeley CA, 1976).

3. Rival Traditions: Western Medicine and Yunani-Tibb in the Punjab, 1849—1889, by John C. Hume Jr., Bulletin of the History of Medicine (1977) Vol. 55 pp. 214-231.

4. "Western medicine in India: Social impact" by 0. P. Jaggi, Vol. XV of the series on 'History of Science, Technology and Medicine in India', Atma Ram and Sons, Delhi (1980) p. 18.

5. Report of the Committee on the Indigenous system of Medicine (Govt, of Madras, 1923). Part I—Report of the Committee and appendices. Part II—Testimony of the Indigenous medical practitioners.

6. Testimony of M. V. Sastri in part II of ref. 5, pp. 440-41

7. Testimony of Mr. K. Sesha Sastri, President, Andhra Ayurvedic conference in part II of ref. 5, p. 446.

8. pp. 19 — 12 in ref. 4.88

9. Testimony of C. Maduraimuthu Mudaliar and four others, pp 449-55 in vol. II of ref. 5.

10. Testimony of Pandit Hari Parapanna Sharma and 16 others, p. 78, vol. II of ref. 5.



Author:Madras Group



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