|Year : 2018 | Volume
| Issue : 2 | Page : 56-59
Modernization of medical traditions: Indian and Chinese approaches to health and well-being
University of Strathclyde, UK and Shanghai University, China
|Date of Web Publication||9-Oct-2018|
Dr. Ved Baruah
David F Musto Centre for Drug Policy Studies, College of Liberal Arts, Shanghai University, Shanghai - 200444
Source of Support: None, Conflict of Interest: None
The provisioning of health and well-being for every human being on the planet calls for a rethink of conventional medical practices. In both the developed as well as developing world contexts, there is a growing need to rejuvenate alternative medical systems, but they have to be modernized to have cross-cultural appeal and acceptance. This paper explores the clash between Western medicine and Indian traditional medicine in 19th century colonial India which offers a historical precedent that could hold key lessons to the spread of traditional medicine across the world. The paper argues that the British government used biomedicine as a political tool to dominate Indians and resistance from Indian practitioners of traditional systems of medicines (TSMs) was systematically put down through policy measures. However, it was the clash between the medical modalities that transformed Indian TSMs forever as systems such as Ayurveda (the science of life) and Yoga took on the challenge and modernized and continue to have global appeal. The paper compares Indian and Chinese medical systems and argues that similarities in theory and practice in two different historical contexts, 19th century India and modern-day China, enable us to understand the relevance of modernization practices in our contemporary world.
Keywords: Ayurveda, biomedicine, colonial India, ethnomedicine, health and health-care, medical traditions, modernization, social history of medicine
|How to cite this article:|
Baruah V. Modernization of medical traditions: Indian and Chinese approaches to health and well-being. Chin Med Cult 2018;1:56-9
| Introduction|| |
As ancient sources of medical knowledge, both Chinese and Indian traditional medicine date back to at least 2000 BCE. The theoretical roots as well as practices connected with these two systems of medicine share a number of commonalities. At their core, the idea of balance that outlines the basis of the two modalities hold the key to a number of other connections. In the last decade or so, there has been a resurgence of interest in alternative medical practices that stem from a sense of cynicism about the efficacy of allopathic or Western medicine. This is especially true with the failure of effective treatment protocols to tackle the rise of chronic diseases like diabetes as well as lifestyle-based disorders such as obesity. The rise in global demand for holistic medicine means that traditional systems of medicine (TSM) are bound to become central to health and well-being strategies of governments across the world. A positive development in this regard is the inclusion of “Goal 3: Ensure healthy lives and promote well-being for all at all ages” as part of the the United Nations Sustainable Development Goals (popularly called Agenda 2030). The provisioning of health and well-being for every human being on the planet calls for a rethink of conventional medical practices and strategies that have failed in both the developed as well as developing world contexts.
| From Traditional Systems of Medicine to Modern Western Medicine: The Case of 19th Century India|| |
Exploring the history behind the upsurge in the adoption of Western medicine in the 19th century in India makes three things clear. First, there was a championing of modern medicine by the colonial British government as a political tool of domination. Second, the resistance from Indian practitioners of TSMs was systematically put down through policy measures and the adoption of Western medicine in public health schemes. Third, the clash between the medical modalities transformed Indian TSMs forever as systems like Ayurveda (the science of life) and Yoga took on the challenge and modernized.
The push toward allopathic medicine, armed with its arsenal of vaccines, tablets, and compounds, resulted in the marginalization of Indian TSMs that were based on therapeutic principles. This prompted the modernization of Indian TSMs as Ayurveda became formalized and practitioners adopted modern technology and protocols. The paper hints that the trend in India mirrors that of a global shift from ethnomedicine toward biomedicine resulting in the establishment of modern Western medical knowledge and practices across the world. It needs to be stressed here that in the long sweep of human history, this is a relatively recent phenomenon and therefore the dogma against alternative systems of medicine needs to be reexamined critically. Using this as the point of inquiry, this paper will engage with the larger economic, social, and political implications of the shift toward adoption of health and well-being practices on a global scale.
| Traditional Indian Medicine and Traditional Chinese Medicine: Similarities and Divergence|| |
A number of medical practitioners as well as historians have commented on the similarities in the approach to health and well-being that bind Indian and Chinese Traditional medicine. I will first briefly explain Ayurveda – its philosophy and principles, methods of diagnosis, and treatment practices. I will then draw out some common features between TIM and TCM in order to make a few larger observations about TSMs.
Ayurveda is one of the oldest traditional medical systems in the world. It originated in South Asia and textual records date back to the time of the Buddha, that is, 5th century BCE. Although religious scriptures indicate that the practice goes back even further back in time, textual evidence from that era has not yet been discovered. Ayurveda is a structured method of theorizing the human body, the illnesses that afflict it and provides regimens of therapy through remedies (herbal, mineral/chemical, and animal based) along with advocating a healthy lifestyle built on the principle of balance. Over the last two millennia, thousands of authors in South Asia produced a very extensive literature on Ayurveda. As Dominik Wujastyk argues, this knowledge system was transmitted from one generation to another in manuscript form until printing of Sanskrit texts became common in the 19th century. This medical tradition is primarily accessible to us through the hundreds of thousands of Sanskrit medical manuscripts that have been preserved but also through oral transmittal of knowledge from one generation to another.
Nearly half of the most commonly used herbs in both Indian and Chinese traditional medicine are almost identical and the ways in which the actions of these substances are described are very similar. In both systems, herbs are described according to the symptoms they treat, their warming or cooling nature, and their influence on the body humors. What differs is the basic set of categories of disharmony: the diagnostic and therapeutic groupings. In traditional Chinese medicine, the correspondence systems of Yin and Yang and the five elements have a strong influence, as do the depictions of certain bodily humors (qi, blood, moisture, and essence), and the internal organ systems (zangfu). In Ayurvedic medicine, although the total system is quite complex, there is a dominance of the three dosha (tridosha) system: kapha, pitta, and vata (also called vayu). These three function within a body that is described primarily in terms of stages of transformation (following the path of ingested food as it is converted into essential substances that comprise the body) rather than by physical structures and functional organs.
Despite these similarities, it is surprising that there is virtually no research to document systematically the knowledge systems in order to benefit mutually from each other's ancient traditions. Similarly, it is noteworthy that there is very little exchange between India and China on their medical heritage, despite these systems being popular in both the countries as well as globally. There needs to be more done in this regard so as to build connections between India and China as well as contribute to the emerging challenges to global health and well-being.
| Modernization of Ayurveda: Social, Political, and Economic Contexts|| |
The modernization of the Ayurveda texts was also accompanied by the introduction of new methods of diagnosis and drug dispensing as well as reimagining of the system through visual means. A unique example of this development in Ayurveda in the precolonial context in India is the “Ayurveda Anatomical Man,” a c. 1700 CE pen and ink drawing using the gouache technique [Figure 1]. Although the image seems similar to Western anatomical studies, it is entirely drawn from the Ayurvedic understanding of the human body.
|Figure 1: Ayurveda Anatomical Man, c.1700 CE. The text captions are extracts from the Bhāvaprakāśaḥ, written between 1550 and 1590 by Bhāvamiśra. Courtesy: Wellcome Collection|
Click here to view
The channels and “organs” drawn on the torso are specified as in Ayurvedic literature, with “organs” named as receptacles for one or other of the organic fluids. It is noteworthy that in Ayurveda, the “organs” are not understood as engaged in the kind of processing which modern Western biomedicine assumes but rather as the seats of the humors (wind, bile, and phlegm). Despite extensive cataloging and study of Ayurveda manuscripts, the existence of no other premodern image has been discovered. Wujastyk asserts that although “the medical texts discuss and describe many topics that would lend themselves to illustration, such as intricate surgery, human anatomy, and medical botany, no images related to these or any other subjects are to be found in the manuscripts of these works.” The modernization of the Ayurveda texts was also accompanied by the introduction of new methods of diagnosis and drug dispensing which will be discussed later.
The forces that modernized Ayurveda before the 19th century were vastly different from earlier. By the mid-19th century, Ayurveda faced intense competition from modern Western biomedicine. Changes in social, economic, and most importantly political climate, in India, meant that traditional knowledge was based on ritual, faith, and superstition rather than scientific know-how or evidence. The discovery of penicillin and other “wonder” drugs, the invention of medical instruments to measure and diagnose the human body as well the extraction of active compounds from plant and mineral sources meant that modern medicine was regarded as a system that was replicable and effective in all conditions. The move toward suppression of symptoms across population groups rather than personalized therapy that was the hallmark of TSMs was also regarded as proof of the efficacy of modern medicine. In the face of challenge from modern Western medicine, Ayurveda incorporated modern technology and embraced medical instruments like the thermometer and the sphygmomanometer. This period also witnessed the rise of Ayurveda brands where medicines and compounds were produced in factories in the form of tablets and syrups, packaged in glass bottles and vials, and marketed around the through contemporary means like newspaper and radio advertisements.
| Current Outlook of Traditional Systems of Medicine: Heritage Preservation and Knowledge Transmission to Future Generations|| |
The way in which Indian medicine modernized in the late 19th and early 20th century transformed the system forever. From an arrangement where knowledge was transferred from one generation of vaids (Ayurveda practitioners) to another, mostly in a family line, the modernization of Ayurveda was accompanied by institutionalization as well as codification as a system of knowledge with distinct protocols and practices.
In the 21st century, Ayurveda faces a new challenge from globalization and the accompanying threat to indigenous knowledge (IK). In the wake of intellectual property and trademark regimes, traditional knowledge has become a contested ground, primarily due to the growing economic potential from herbal cures. In the context of the developing world and the health-care needs of these populations, it is pertinent that governments and nongovernmental actors do their utmost to protect and promote TSMs in a concerted manner.
There are two main issues in this regard. First is the question of sustainability and ecological protections that need to be ensured so that TSMs can survive and flourish for generations to come. Second, the argument that “ethnomedical tourism” or the selling of place-based heritage to global audiences is the best way to revive these practices in the 21st century needs to be critically evaluated. In both the above issues, as Sita Reddy argues “the underlying subtext was that the global market would save this tradition from loss, not nationalist revivals of practice or institutionalized reform of Ayurvedic education, which had been judged a professionalizing failure.” A solution to this could be that the knowledge of the value and potential of indigenous plants with medicinal properties can be used to incentivise local populations to take care and tend to local ecosystems as these herbs, barks, and roots would be seen as resources that need careful management.
There have been a number of initiatives in this regard and one such project was the creation of a database by the Indian government which involved the documentation of Indian IK regarding medicinal plants and their uses. This is a significant development as nearly half of the world's 300 million indigenous people (ethnic minorities) live in Asia, mostly in China and India. These communities still live in forests or in their original homelands and have profound knowledge about the uses of bioresources, and this IK is especially rich in medicinal plants for curing various diseases. As Mukherjee et al. have argues, the medical knowledge has economic potential that “has raised the interest of the corporate world for profitable acquisition and given a jolt to India to arouse consciousness about her own knowledge wealth.” It is essential to document this knowledge as it survives in an oral tradition can is open to “becoming either victim of biopiracy or becoming extinct.”
Indian government agencies have been set up a database that covers more than 230,000 formulations from ancient texts on Indian systems of medicine (Ayurveda, Unani, Siddha, and Yoga), in Hindi, Sanskrit, Arabic, Persian, and Urdu. The database has been made available to the public in a number of languages including Japanese, French, German, and Spanish and is aimed to dissuade foreign companies from patenting traditional medicines. A number of other initiatives have also been launched to ensure that the IK is preserved and protected as well as adequate research is undertaken to develop a scientific approach to encourage compatibility with biomedicine and modern medical practices.
| Conclusion|| |
In the encounter between ethnomedicine and biomedicine, it is still too early to guess which system comes out on top or even conjecture if these systems would be used in a symbiotic manner to attend to the health and well-being of everyone. However, what is evident is that IK needs to be protected from the threat of obliteration and the global community needs to act as one to preserve the knowledge of ancients.
Yoga is currently the most widespread Indian approach to promoting the health of the body. It has started received financial backing from the Indian government and a number of research centers have been envisioned. In 2015, the United Nations declared 21 June as World Yoga Day giving a new fillip to the spread of yoga beyond countries, especially in the West, where it has already become popular in the last couple of decades. A very good example is China where the popularity of yoga, especially among the youth, is on the rise. Millions across the world affirm that yoga makes them feel better in body and mind and it is noteworthy that Ayurvedic concepts such as diet and balance are increasingly being adopted as integral to a yoga lifestyle.
It is important to note that globally the shift from singularity to plurality is taking place. This has been driven primarily by the fact that it is becoming increasingly evident that no single modality of health science has the capacity to contribute solutions to all the health needs of the population. In the era of medical pluralism, countries like China and India have a strong advantage because of their strong foundations in evidence-based biomedical sciences as well as an immensely rich and complex indigenous medical heritage. There is definitely a scope for greater cooperation between the two nations as evidenced by the similarities between TCM and TIM both in terms of the Material Medica as well as the philosophical and sociocultural understanding of health and well-being.
Financial support and sponsorship
Wellcome Trust, UK and CSHHH Glasgow.
Conflicts of interest
There are no conflicts of interest.
| References|| |
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