Traditional Medicine (TM) along with Complementary Medicine (CM) and Alternative Medicine (AM) are terminologies that are often used interchangeably for a broad range of healthcare practices, theory, service delivery and systems in both Eastern and Western parts of the world (including for Ayurvedic Medicine, naturopathy, traditional Chinese medicine and homeopathy etc) that have developed separately from the conventional system of medicine. These systems put together are referred to as Traditional and Complementary Medicine (T&CM).  India has a rich culture of T&CM, Alternative Systems of Medicine (ASM), which include both, Indian/indigenous systems i.e, Ayurveda and Siddha as well as those not originated in India, i.e, Homeopathy.

Evolution of Medicine since Ancient Times:

• The history of medicine indicates that almost every major civilization and culture had developed their own system for curing diseases through the approaches varied.
• Medicine in ancient form was practices in all societies and civilizations – Egyptian, Chinese, Indian, Mesopotamian, Greek, Roman and Arab and is referred to and recognized by the names of the civilization.
• The dawn of scientific or modern medicine started in the mid of the 15th It evolved on the foundation created by the ancient systems of medicine over a period of 4500 years (2500 BC-1500 AD).
• In the mid of the twentieth century, the stream of medicine based upon the concept of treatment of diseases by use of a drug which produces a reaction that itself neutralizes the disease condition or disease-causing agents’ started getting popular and is now known as Allopathy or Allopathic Medicine.
• Allopathy: is the most commonly used system of medicine in India and most other parts of the world. Most often, it is Allopathic medicine compared to which other systems are termed as traditional, complementary or alternative systems of medicine.
• Indian Medicine: Medicine in India originated around 3000 BC, when the practice of Ayurveda is considered to have started. In addition, the Siddha system of medicine is also Indian in origin. The period of 800 BC to 600 AD is regarded as the golden period for Indian medicine, a period which coincides with widely accepted authorities in Ayurvedic medicine, such as Atreya, Charaka and Sushruta. Of them, Atreya (about 800 BC) is considered as the first great Indian physician and teacher. Charaka (200 AD) wrote Charaka Samhita and was the most popular physician of the time. Sushruta is referred to as the father of Indian surgery. He wrote Sushrura Samhita, a treatise on surgery (between 800 BC and 400 AD). Around 800 AD, the Charaka and Sushruta Samhitas were translated into Persian and Arabic and Indian medicine had spread to Indo-China, Indonesia, Tibet, central Asia and Japan.
• Egyptian Medicine: Egyptian civilization had well-advanced medicine, which is reported to have reached its peak in the days of Imhotep (2800 BC).
• Chinese Medicine: There are well-documented records of Chinese medicine since 2700 BC. Some of the medicinal practices of those times are still followed in various forms.
• Mesopotamian Medicine: The Codes of Hammurabi, in name Of King of Baby Lone, were formulated around 2000 BC in the Mesopotamian civilization to govern the conduct of physicians to guide health practices.
• Greek Medicine: Greek Medicine was most evolved between 460 BC-136 BC and Aesculapius (around 1200 BC) and Hippocrates (460-370 BC) were amongst the leaders in Greek Medicine, Hippocrates is often termed as “Father of Medicine” and the oath drafted by him guides medical ethics even now.
• Roman Medicine: Roman Medicine emerged from Greek Medicine. Roman Medicine was more about overall health with focus on disease prevention and control (and not restricted to curing illnesses, as was the predominant feature of some other medicines prevalent at that time or earlier)- Galen (130-205 AD) was a famous Roman medical teacher, whose teaching lasted till mid of sixteenth century when some recent knowledge on anatomy and physiology emerged.
• Arab Medicine (Unani Medicine): From 500 AD to 1500 AD, Greeko-Roman medical literature was translated into Arabic. The local adaptation gave birth to the Unani system of medicines in schools of medicines and hospitals in Baghdad, Damascus and Cairo. The period of 800-1300 AD is often referred to as the golden period in Arabic medicine. Abu Beer (also known as Rhazes) and Ibn Sina (also known as Avicenna) are known as two leaders of Arab medicine.

India and Alternative Systems of Medicine:

• In the last three decades, there have been focused initiatives to mainstream traditional and alternative systems of medicine in healthcare services in India.
• The first full-fledged department for Indian Systems of Medicine and Homeopathy (ISM&H) was created under the Ministry of Health and Family Welfare, Government of lndia, in March 1995 to promote and regulate the practice of alternative systems of medicine in the country.
• This department was, in November 2003, renamed as Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH).
• A fully independent Ministry of AYUSH was formed in November 2014.
• In 2002, the Government of India also formulated the National Policy on Indian Systems of Medicine and Homeopathy.
• The current National Health Policy of India has proposed functional linkage of AYUSH at all levels of health systems, including service delivery as well as work force.
• The policy proposal focuses on inclusion of Yoga at work- place, in schools and in the community as an important form of promoting health and wellness.

Discussion and Way Forward:

• The Current and predicted increasing burden of chronic and Non- Communicable Diseases (NCDs) is often considered the most urgent reason for developing and strengthening collaboration between conventional and T&CM health sectors.
• The study of state level burden of diseases in India has highlighted the emerging burden of NCDs, which mandates higher provision of preventive and promotive health services, along with curative and diagnostic services.
• Many T&CM (especially Ayurveda, Yoga and Naturopathy) largely focus on principles of wellness and health promotion.
• There is a vast infrastructure and plenty of providers in these systems and it is a great opportunity to tackle NCDs as well as other emerging health challenges in the country.
• The global evidence has pointed towards the need for task shifting (assigning some of the tasks done by allopathic doctors to other cadres of healthcare providers) in health systems.
• A lot of such approaches are the standard of care in many resource poor settings and countries.
• The discourse is aligned with dialogues for moving from ‘doctor-centric’ to a ‘team-based’ approach to health service delivery, where each type of provider (doctors, nurse, alternative system of medicine, pharmacist, counsellor) play different and complementary roles.
• India is making some progress in this area through MLHP under HWCs, yet more is needed and is possible through engagement of already available human resources under alternative systems of medicine in delivery of personal, population and public health services.
• The ongoing initiatives at all levels need support through government leadership and financing. The research on different aspects of T&CM and the use of proven methods and approaches need to be promoted in addition to ensuring the availability of these Services for the people.

TID-BITS:

Traditional and Complementary Medicine-Definitions:

• Traditional Medicine (TM): The sum-total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.
• Complementary Medicine (CM) or Alternative Medicine (AM): A broad set of healthcare practices that are not part of that country’s own tradition or conventional medicine and are not fully integrated into the dominant healthcare system. In some countries, the term Traditional Medicine (TM) is used interchangeably with CM and AM and also together as ‘Complementary and Alternative Medicine’ (C&AM) and are used interchangeably. These systems typically use a variety of methods that fall under the CAM umbrella (herbal remedies, manipulative practices).
• Traditional and Complementary Medicine (T&CM): T&CM merges the terms TM and CM, encompassing products, practices and practitioners.