In search of India’s Chen-Kuo-Fu and the Charak Shapath

Bhanu Duggal is Officer on Special Duty (Health), NITI Aayog, and head of cardiology, AIIMS Rishikesh The views expressed are personal

Predictably, the Indian Medical Association (IMA) has denounced the National Medical Council’s decision to replace the Hippocratic oath with the Charakh Shapath. This clearly shows the deep cleavage between the cosmopolitan practitioners of modern medicine and those of traditional medicine. The animosity between the two systems of medicine in India has an interesting history and is nearly 200 years old.

In 1822, the Britishers established the Native Medical Institution (NMI) in Calcutta to provide medical training to Indians. Anatomical, medical, and surgical texts were translated into vernacular languages and indigenous systems of medicine were taught alongside western medicine.

In 1822, the Britishers established the Native Medical Institution (NMI) in Calcutta to provide medical training to Indians. Anatomical, medical, and surgical texts were translated into vernacular languages and indigenous systems of medicine were taught alongside western medicine. John Tyler, an Orientalist, was the first medical superintendent of the NMI. A Sanskrit college was established to conduct classes on Ayurvedic medicine and Unani was taught at the Calcutta madrasa. Clinical training was imparted at various hospitals and dispensaries. Twenty young Indians were enrolled in the first batch and the successful graduates took up positions of native medical doctors in the government. Simultaneously, an Indian medical school was started in South Bombay with John McLennan, a surgeon, as the medical superintendent.

In the 1830s, the Anglicists succeeded in repealing several cultural-educational policies started by the vernaculars and orientalists. This foreshadowed the change in the British temperament towards India, from that of wonder and genuine interest at the time of Warren Hastings to that of disdain and condemnation of all things ‘Indian’ during William Bentinck’s time. Thus, in 1835, Thomas Macaulay’s resolution was passed for the promotion of European science and literature in English alone. It recommended that the government withhold further grants to institutions imparting oriental learning and confer ‘instruction in the native languages’.

This termination of official patronage to indigenous systems of medicine was the final nail in the coffin for the students of the two leading oriental institutions in Calcutta. The NMI was dissolved. The instruction given at the madrasa and the Sanskrit College was also terminated in 1835. There was denial of registration to practitioners of indigenous systems of medicine after the promulgation of the Madras Medical Registration Act of 1914. According to Roger Jeffery, indigenous practitioners who served about 80% of the people were treated as untouchables of the profession by the allopathic practitioners. Soon after, the IMA was established in 1920.

Seven decades post-Independence, we in the health care field have still been unable to shrug off the colonial yoke. MS Valliathan, the famous cardiac surgeon and innovator of the first Indian valve, had observed, ‘Ayurveda is not only the mother of medicine but of all life sciences in India.’

In 1990, Dean Ornish, in his landmark Lifestyle Heart Trial in Lancet, said that comprehensive lifestyle (with a low-fat vegetarian diet, no smoking, stress management, and moderate exercise) changes may be able to bring about a regression of even severe coronary atherosclerosis after only one year, without the usage of lipid-lowering drugs. Similar sentiments were also echoed by former head of cardiology at AIIMS, Dr HS Wasir, in his book Preventive Cardiology, published in 1994. Interestingly, Dr Wasir’s stance reflected that of Charak in Charak Sutra 17–34 (composed 30 centuries ago): ‘Over-eating, heavy and fatty meals, worries sedentary habits and over-indulgence in sleep are the causes of cardiac diseases due to Kapha.’

Indian systems of medicine have always focused on health promotion and prevention instead of curation, as is the case with the West. Imagine then, what we could accomplish by the combination of both? Regularising and merging the ancient and modern sciences would help to weed out the quacks and ensure that people get the best of both worlds.

Meanwhile in China, Ch’en Kuo-Fu in 1920s managed to produce a better medical system, scientific yet distinctly Chinese, by convincing the people of the need to synthesizs modern medicine with traditional Chinese systems. This was backed strongly by the government, which successfully reconciled the conflicting claims of modernity and cultural tradition by imposing a prescribed medical policy.

India must devise a national medical curriculum to cater to the country’s needs. With patients becoming increasingly aware of the side effects of medications and actively seeking alternative treatments for chronic diseases, a dialogue needs to be initiated between the two systems for the best treatment. It is time to take a leaf out of China’s book and move towards integrative medicine.

NITI Aayog is currently exploring an integrative health system to achieve inclusive, affordable, and evidence-based healthcare. The work done during the pandemic by the interdisciplinary Ayush R&D taskforce was exemplary.

Charak’s paradigm-shifting spirit of yukti-vyapashraya (evidence-based reasoning) can be our guiding light here. Clinical observations in Ayurvedic texts would acquire greater clarity and utility, if polished by modern science and research.  This process of refinement might even stretch the frontiers of biology and medicine, and hence a merging of the best practices of medicines must be strived towards for the benefit of mankind.

 

(Bhanu Duggal is Officer on Special Duty (Health), NITI Aayog, and head of cardiology, AIIMS Rishikesh The views expressed are personal )