Chapter 35: Indian Systems of Medicine and Homoeopathy

Introduction

For centuries man has evolved several ways of coping with illness and different societies have looked for different substances and methods that would ease pain and elevate spirits. All the ancient civilisations have thus developed their own medical systems which reflect not only specific philosophies but also appear to be influenced by the social beliefs and practices of the time. With the introduction of the Western systems of medicine well-known as the “allopathic system” and considered “modern”, this ancient system came to be known as the “traditional” or “indigenous” system.

A group of experts at WHO sponsored meeting defined traditional medicine as “…the sum total of all knowledge and practices, whether explicable or not, used in diagnosis, prevention and elimination of physical, mental or social imbalance and relying exclusively on practical experience or observation handed down from generation to generation, verbally or in writing (American Journal of Pharmacy 1976, 148, 46-52). With the Western system of medicine, now perceived as the “mainstream system”, taking deep roots all over the world, the term alternative medicine was coined to label the diverse assortment of medical practices which are outside of it. However, some experts find the term inappropriate because these therapies could never entirely replace the “mainstream system”, and therefore, recommend the term “complementary medicine”.

Promotion of Education and Research

Be that as it may, India has a rich heritage of medicine and therapies. The term Indian Systems of Medicine covers both the systems which originated in India as well as outside but got adopted in India in course of time. These systems are Ayurveda, Siddha, Unani, Homoeopathy, Yoga, and Naturopathy. They have become a part of the culture and traditions of India. The National Health Policy (1983) envisaged the necessity for the Indian systems to find a role and place in the overall health care delivery system. In December 1995, the Government of India created a new Department of Indian Systems of Medicine and Homoeopathy in the Ministry of Health and Welfare to promote these systems.

The Department has set up four Research Councils, viz., (1) The Central Council for Research in Ayurveda and Siddha, with nearly 90 research centres spread across the country, (2) The Central Council for Research in Unani Medicine, (3) The Central Council for Research in Homoeopathy, and (4) The Central Council for Research in Yoga and Naturopathy to promote research in the concerned systems of medicine. Seven National Institutions have also been set up to offer educational and research facilities in these fields, viz., (1) Rashtriya Ayurved Sansthan, (National Institute of Ayurveda) (Jaipur), (2) National Institute of Postgraduate Teaching and Research in Ayurveda (Jamnagar), (3) Rashtriya Ayurveda Vidyapeeth, (National Academy of Ayurveda) (New Delhi), (4) National Institution of Unani Medicine (Bangalore), (5) National Institute of Homoeopathy (Calcutta), (6) National Institute of Naturopathy (Pune), and (7) Morarji Desai National Institute of Yoga (New Delhi).

A National Institute of Siddha is also likely to be set up in Chennai. As a part of continuing medical education, the government has introduced a scheme to upgrade the knowledge of teachers, researchers, practitioners in Indian Systems of Medicine and Homoeopathy. In order to formulate standards for drugs, Pharmacopoeia Committees for each of these systems were also set up. They are supported by the Pharmacopoeia Laboratory for Indian Medicine, and Homoeopathy Pharmacopoeia Laboratory both located in Ghaziabad. There are 13 government assisted pharmacies and over 5,000 licensed pharmacists. The total annual turnover of the Ayurvedic drug manufacturing industry is estimated to be around Rs.1, 000 crore.

Two statutory Councils, viz., the Central Council of Indian Medicine, and the Central Council of Homoeopathy were also established for laying down and maintaining uniform standards of education as well as to regulate the professional practices in the fields of Indian Systems of Medicine and Homoeopathy, respectively. (See Chapter 7 – Regulatory Authorities). The Central Council of Indian Medicine, through a public notice has warned that the courses in electropathy, electro homoeopathy, biochemical, alternative medicine, etc., offered by several institutions and so-called universities are not recognized by it.

Specifically, it named three Institutions which offer such courses: (1) New Delhi Medical Institute of Electropathy (9 New Mahavir Marg, Dew Delhi-110010), (2) Health and Medicine (80 Chowringhee Road, Calcutta-700020), and (3) Medical College of Alternative Medicines (3 Canal Street, Calcutta-700014). The Medical Council of India has also warned that the awards of these institutions are not valid qualifications under Indian Medical Council Act, 1956.

A brief account of the nature of the various systems is given in Annexure 1.

Educational Opportunities

Education in the Indian Systems of Medicine and Homoeopathy is offered by colleges affiliated to universities. In States, where there are health science universities, all these colleges are affiliated to them. As stated earlier, the courses and colleges need the recognition of the Central Council of Indian Medicine, and the Central Council of Homoeopathy.

Ayurveda

Education in Ayurveda is offered at first degree, postgraduate degree and doctoral degree levels leading to Bachelor of Ayurvedic Medicine and Surgery (BAMS), MD (Ayurveda) and Ph.D (Ayurveda), respectively. As on April 1, 1998 there were 154 Ayurved Colleges affiliated to 48 universities which include one exclusive Ayurved university, viz., the Gujarat Ayurved University (Jamnagar). Many colleges have been established by the State governments. The largest concentration of colleges is in Karnataka (40) and Maharashtra (37). The total admission capacity is 6,117. Postgraduate courses are of Ayurveda hospitals in the country is 2,203 (with 31,042 beds). Besides, there are 14,048 dispensaries. The number of practitioners is of the order of 3,52,328.

Like the MBBS degree, the duration of BAMS degree course is five and a half years including one year of compulsory internship. The entry requirement is a pass in 10+2 class examination with science subjects. In most of the States, the admission is made on the basis of a common entrance test conducted along with the medicine and dentistry courses. The postgraduate course is of three year duration. In Calcutta University, the course of two year duration is also open to MBBS degree holders. A total number of 33 universities have introduced MD study one of the specialised areas (See Annexure 2).

Specialised Institutions in Ayurveda: A brief account of the educational programmes of the three National Institutes established by the Ministry of Health and Family Welfare follows. The National Institute of Postgraduate Teaching and Research in Ayurveda located within Gujarat Ayurved University, set up by the Department of Indian System of Medicine and Homoeopathy, imparts education leading to MD (Ay) in 13 specialities of Ayurveda. It has seven teaching departments and six laboratories. The Institute also conducts Ph.D programmes. Gujarat Ayurved University, besides BAMS course, also offers five courses at its Institute of Ayurvedic Pharmaceutical Sciences and the Institute of Plant Sciences in the area of Pharmaceutical science: (1) Master of Pharmacy (Ayurveda) of two-year duration open to B.Phram degree holders, (2) Bachelor of Pharmacy (Ayurveda) of four-year duration open to candidates who have passed the 10+2 examination with science subjects; (3) Diploma in Pharmacy (Ayurveda) of two-year duration open to candidates who have passed the 10+2 examination, (4) One year PG Diploma in Medicinal Plants. And (5) M.Sc in Medicinal plants are open to graduates in Botany, Pharmacy, Agriculture or Ayurveda.

Rashtriya Ayurved Sansthan (National Institute of Ayurveda) in Jaipur, established in 1976 by the Ministry of Health and Family Welfare, besides BAMS (Ayurvedacharya) course also offers MD (Ayurveda Vachaspati) course in nine specialities. The Sansthan is affiliated to the Rajasthan University and provides guidance to Ph.D (Ayurveda) to candidates registered with the University.

The Rashtriya Ayurveda Vidyapeeth (Dhanwantri Bhavan, Road No.66, Punjabi Bagh, New Delhi), an Autonomous institution was established in 1988 with the objective of promoting the knowledge of Ayurveda through acharya-guru-shishya-parampara, and chikitsak-guru-shishya-parampara systems. It has two training programmes, viz., (a) two-year programme leading to the Degree of Membership of Rashtriya Ayruveda Vidyapeeth (MRAV), and (b) one-year training programme for studying under eminent physicians leading to the Certificate of RAV. The MRAV course is open to teachers of Ayurveda colleges holding a graduate or postgraduate degree with five years of teaching experience. There is a scheme of payment of honorarium to Gurus and stipend (Rs.3, 500 p.m.) to Shishyas during the period of study. The Certificate course is open to candidates with an Ayurveda degree and having experience in clinical practice.

Three other specialised institutions offering postgraduate programmes are: (1) Institute of Indian Medicine (Pune-411029)-Ph.D (Ay); (2) Institute of Postgraduate Education and Research in Ayurveda (Calcutta-700009)-MD (Ay); and (3) University of Madras-Two-year diploma courses including one on ophthalmology.

Siddha

There are only three Siddha medical colleges in the country, all located in Tamil Nadu viz., Government Siddha Medical College at Palayamkottai, Thirunelveli (Kattabomman District), Palani (624601) and Chennai (600106). All the three are affiliated to the Tamil Nadu Dr. MGR Medical University. The first degree in the subject is Bachelor of Siddha Medicine and Surgery (BSMS) of five-and-a-half year duration including one year of compulsory internship. The total number of seats is 155. The eligibility requirement is a pass in 10+2 examination with Physics, Chemistry and Biological Sciences.

The candidates should have studied in Tamil medium or have passed Tamil as a subject in Class 10. The admission is based on the performance in a combined entrance test conducted by the Directorate of Indian Medicine and Homoeopathy of the Government of Tamil Nadu for admission to first degree courses in Siddha, Homoeopathy, Ayurveda and Naturopathy. The Colleges at Chennai and Thirunelveli have MD Course in Siddha of three-year duration. Students from neighbouring countries (Sri Lanka, Malaysia, Singapore, etc.,) are also admitted to the course. There are 22 hospitals, all in Tamil Nadu, with 1,636 beds. Siddha medicine is practiced by 12,528 registered practitioners.

Unani

As on April 1, 1998 there are 31 Unani Colleges in India, affiliated to 13 universities with an intake capacity of 1,239 offering first degree course leading to the award to Bachelor of Unani Medicine and Surgery (BUMS), also called Kamil-e-Tibb-O-Jarajat. The MD (Unani) is offered by three colleges having 55 seats. BUMS course is of five and a half year duration including one year of compulsory internship. The entry requirement is a pass in 10+2 examination. Those who have passed the Pre-Tibb examination of one year duration are also eligible. Knowledge of Arabic and Urdu is desirable. Pune University admits students who have passed the Class 10 examination, and for them the duration is 71/2 years.

Courses offered by the Aligarh Muslim University and Jamia Hamdard (New Delhi), a deemed university, have high reputation. Only three universities, viz., Aligarh Muslim University (Ajmal Khan Tibbia College, Aligarh-202002), Jamia Hamdard, and NTR University of Health Sciences (Government Nizamia Tibbi College, Hyderabad-500002) offer MD in Unani Medicine of three-year duration. The Pre-Tibb course is available in Aligarh Muslim University and Jamia Hamdard (New Delhi). The entry requirement is a pass in Fazil (Deoband), Alim (Arabic or Aimyat Nadwa) or Farighul Tehsil from a Dare-e-Nizami Madrasah. There are 183 Unani Hospitals with 3,551 beds. The number of registered practitioners is 41,630.

Homoeopathy

Homoeopathy education is offered at first degree and postgraduate degree levels. The diploma level course (DHMS) has been discontinued since 1998. The first degree course leading to Bachelor of Homoeopathic Medicine and Surgery (BHMS) is available in 118 colleges affiliated to various universities having 4, 3318 seats. The entry requirement is a pass in 10+2 examination in science (including biological science). Like any other course in medicine, the duration is five and a half years including one year of compulsory internship. The largest concentration of Homoeopathy colleges (37) is in Maharashtra with 1,937 seats.

National Institute of Homoeopathy (Calcutta-700091) was established by the Government of India as a model institute to provide a high standard of teaching, training and research in all aspects of Homoeopathic system. Its BHMS course is affiliated to the Calcutta University. Of the 50 seats, 18 are reserved for candidates from States and Union Territories where no homoeopathic college exists, and two for foreign nationals.

The remaining 30 seats are filled up through an All-India Entrance Examination. It has now introduced postgraduate course in Homoeopathy –MD (Homy) of three year duration. The eligibility requirement for MD (Homy) is BHMS degree. Six other universities (Calicut University, Maharashtra University of Health Sciences, Mumbai University, NTR University of Health Sciences, Rajiv Gandhi University of Health Sciences and Utkal University) offer MD (Homy) of three years duration. The subjects of study include Materia Medica, Organon of Medicine, Case Taking and Repertorisation, Homoeopathic Philosophy.

Yoga and Naturopathy

Imparting formal university education in Yoga and Naturopathy is a recent development. The first degree course is offered by three universities viz., (1) Rajiv Gandhi University of Medical Sciences (SDM College (DK), 574240, INYS College of Naturopathy and Yogic Sciences, Mysore-570073). (2) Tamil Nadu Dr. MGR Medical University (at Tamil Nadu College of Naturopathy and Yoga Research, Salem-636006, and JSS College of Naturopathy and Yoga Research, Ooty-643001), and (3) NTR University of Health Sciences at Gandhi Nature Cure College, Hyderabad-500016. It is of five and half year duration. The nomenclature of the degree is Bachelor of Naturopathy and Yogic Science (BNYS).

The entry requirement is a pass in 10+2 with biology as one of the combinations. Master’s degree programmes are available in three universities, viz., (1) Manipal Academy of Higher Education-M.Sc (Yoga); (2) Mangalore University-M.Sc (Yogic Science) open to graduates in all disciplines; (3) Gurukula Kangri Vishwavidyala (Hardwar-249404)-MA (Yoga); and (4) Jain Vishva Bharati-MA/M.Sc (Science of Living, Preksha Meditation and Yoga Therapy) open to B.Sc degree holders. More than 20 universities have introduces certificate and diploma (including postgraduate diploma) courses in the subject.

Promotion of Yoga and Naturopathy

The Government of India has set up Morarji Desai National Institute of Yoga (New Delhi) as an autonomous body to propagate Yogic science and also promote facilities for training, teaching and research in the subject. It has a hospital for providing treatment. In 1998, it has introduced a diploma programme of one year duration. The Government has also established National Institute of Naturopathy is Pune which, apart from providing treatment, undertakes promotional activities for popularising Naturopathy by holding camps and seminars. The Central Council for Research in Yoga and Naturopathy provides grant-in-aid to voluntary Yoga and Nature Cure Organisations for conducting scientific research and one-year diploma courses in Yoga and Naturopathy (See Annexure 3). The Central Council also provide funds to medical and yogic institutions, such as, Defence Institute of Physiology and Allied Science (Delhi), National Institute of Mental Health and Neuro Sciences (Bangalore), Banaras Hindu University, All India Institute of Medical Sciences (New Delhi), to conduct clinical research in physiological and therapeutic aspects of yoga and naturopathy.

Career Opportunities

The Indian systems of Medicine and Homoeopathy are still perceived by many as rural-centric and poor men’s panacea for all diseases. The main reason is that compared to the Western system of medicine, the health infrastructure and services of the traditional systems are poorly supported. Only about 4% of the national health budget was allocated to the traditional sector. While State government budgets range from less than 1% (in West Bengal) to 13% (in Kerala), on an average, most States provide less than 2%.

Though the allopathy system continues to dominate the national health care scene, there is an increasing awareness among a large section of people about the beneficial aspects of the traditional systems. Many newspapers and newsmagazines carry articles on Indian Systems of Medicine and Homoeopathy. Several TV channels also air programmes on it. All these are creating awareness particularly among the upper strata of the society about the efficacy of this alternative or complementary system of health care. It is only recently that the Government of India has started paying more attention to this sector with the creation of a separate Department in the Ministry of Health and Family Welfare.

While Unani and Siddha systems are more or less restricted to certain regions, the other three viz., Ayurveda, Homoeopathy and Yoga and Naturopathy are practiced all over the country. In Particular, Ayurveda is flourishing in the private sector. As has been observed by the Independent Commission on Health in India in its Reports (Voluntary Health Association of India, 1997). “Not only are private clinics and hospitals self-financed and well-attended, some of them also compare well with the best hospitals and clinics in this field of modern medicine.

It is not, therefore, surprising that Ayurvedic practice has been gaining popularity and leading Ayurvedic physicians are setting up clinics or small hospitals and earning as well as, or even more than, their allopathic counterparts (p.68). The success story of Arya Vaidya Sala (Kottakkal, Kerala) is a case in point. Yoga and Naturopathy are also fast gaining popularity particularly among those who are victims of stress and strain of the present day hectic life style. The bane of the traditional system is the presence of a large number of quacks who dupe the unsuspecting patients. This has been eroding the confidence of people in the system. With large-scale inputs of scientific research and creation of better educational facilities, the things have started changing for the better. Apart from jobs in government and private sectors, the Indian systems provide opportunities for a reasonably good career as private practitioners.