India is a vast country having wide diversity in eco-climatic conditions besides having peoples of

different race, religion, cultural beliefs and great social, economic disparity. The ethnic diversity in the
country is represented by as many as 400 ethnic groups including the tribes and others. There has been
wide difference in health infrastructure, facilities influencing the healthcare delivery across different
regions and ethnic groups. In addition to cultural beliefs, knowledge, sustainability in AYUSH specific
healthcare delivery certainly has great impact on the health seeking attitude and utilization of AYUSH
Systems and other LHTs. Very little information is available on the utilization of AYUSH Systems and
other local health traditions in India. A number of studies have been conductive with different protocols
and objectives to document the health seeking behavior and utilization.

The common conditions approaching for AYUSH systems include 1. Non-life-threatening conditions that
may be chronic like Rheumatoid arthritis and Allied conditions; Osteoarthritis, Joint diseases, conditions
with an allergic component in their etiology (e.g. bronchial asthma, skin allergies, eczema, psoriasis etc.);
Liver disorders; Obesity, Diabetes mellitus; Sequelae of Cerebrovascular disorders like Hemiplegia and
Paraplegia; Digestive disorders 2. The second largest groups of users are those struggling with chronic,
potentially life-threatening diseases, such as cancer and HIV-AIDS. The other important reason to prefer
AYUSH systems by both the groups include to improve immune functioning, to improve overall
functioning, to increase quality of life, to cope with side effects from conventional therapies, and to
relieve symptoms related to their illness.

AYUSH Systems is preferred as standalone therapy in Musculo skeletal diseases, Joint diseases, Arthritis,
Skin diseases, Mental disorders, Liver disorders, Neurological disorders, Degenerative diseases,
Reproductive Healthcare. For life-threatening diseases like HIV, Cancer etc. AYUSH Systems is preferred
as add on/complementary to bio-medicine either to cope with side effects from conventional therapies,
and to relieve symptoms related to their illness. While the Local Health Traditions, as a primary health
care, are preferred by all for common diseases like cold, cough, diarrhea, vomiting, skin diseases,
digestive diseases, women and child health problems, fever etc. Preferred for acute and chronic
condition in remote/tribal areas probably may be due to non-availability medical facilities and cultural
beliefs. In remote /tribal areas the preference is to consult Bhopa/faith healers/herbalist for all the
diseases ranging from common cold, fever, diarrhea to reproductive health problems, antenatal care
etc. Some are treated with available herbs and sometimes faith healing will be the choice.

Up gradation of the skill and knowledge of Ayurvedic service providers aided by reorientation
programmes and practical training workshops to ensure patient safety.  Doctors of Ayurveda and
Biomedicine have to improve mutual communication on regular basis and be active partners of
interdisciplinary research.  Safety, effectiveness and quality of Ayurvedic products and practices should
be ensuring based on research and evidence.  All efforts should be made to improve public awareness
regarding the safe usage of Ayurvedic medicines and therapies. Anything amounting to magic remedies,
unrealistic claims which tarnish the authenticity and reputation of Ayurveda must be discouraged. 
Improved Access to high-quality, cost-effective, safe Ayurveda medicines and procedures has to be in
place.

NRHM by more than one pathy being located under one roof for a kind of functional integration would
require mutual understanding and creating an environment of mutual respect amongst medical
professionals trained in different systems. It will involve an appreciation of the strengths and limitations
of different medical systems and based on this appreciation, a carefully worked out code of ethics for
cross referrals. Such a plan of functional integration can immediately provide better options and
informed choices to millions of health care seekers and one need not wait for more complex research
led epistemological integration to be completed. Legal as well as scientific issues become relevant here,
besides cost-effectiveness, accessibility and acceptability.

Challenges for AYUSH & LHT in Indian Context National policy and regulatory frameworks • Lack of
recognition of significant role of AYUSH Systems and AYUSH providers in spite of their legal recognition
in the country and also a separate department under the Ministry of Health &Family Welfare. •
Inadequate allocation of resources for development of AYUSH services and capacity building. •
Inadequate framework of AYUSH education in contemporary context. • AYUSH not integrated into
national health care systems, but functioning as a parallel system. • Lack of proper regulatory and legal
mechanisms for integrated practice. • Lack of a clear definition for defining ‘quacks’, leading to
harassment of traditional healers. • Unequal distribution of benefits of indigenous knowledge and
products. Safety, Efficacy and Quality • Inadequate evidence-base for AYUSH therapies and products. •
Lack of international and national standards for ensuring safety, efficacy and quality control of AYUSH
therapies and products. • Lack of appropriate registration of AYUSH providers. • Inadequate support for
research to generate advances in the systems. • Lack of research methodologies based on an
appropriate amalgamation of the AYUSH system’s theoretical foundations and modern science. • Lack of
standards for quality assessment of AYUSH facilities.

Challenges for AYUSH & LHT in Indian Context Access • Destruction of sources of raw material for AYUSH
remedies and LHT (deforestation and other forms of ecological degradation); including by unsustainable
use of medicinal plant resources due to unregulated commercial exploitation. • Lack of data measuring
access levels and affordability • Lack of official recognition of role of AYUSH providers • Lack of
cooperation between AYUSH providers and allopathic practitioners. Rational Use • Lack of confidence
among practitioners of AYUSH systems. • Weaknesses in education and training for AYUSH providers •
Lack of information on AYUSH among allopathic practitioners • Lack of communication between AYUSH
and allopathic practitioners, and between allopathic practitioners and consumers • Lack of information
for public on rational use of AYUSH and Local health traditions. • Unscrupulous practice by some
practitioners of traditional and folk medicine, just as a section of allopathic practitioners exploit the
vulnerability of the ill.

Fistula in ano, chronic rheumatic diseases, residual psychosis and anxiety disorders, chronic colitis and
IBS, diseases of the liver and jaundice, degenerative brain disease and neuropathy and terminally sick
patients of all kinds declared incurable and/or financially unable to afford modern treatment.

Traditional Therapies which can be integrated to advantage:

Research studies have also shown the beneficial effects of Ksharasootra and Panchakarma, two
Ayurvedic therapies. Ksharasootra comprises the use of Ayurvedic medicated thread in the management
of fistula-in-ano, and multicentric trials have been conducted at the collaborating centres of the Indian
Council of Medical Research on 265 patients where the approach was compared with conventional
surgery. The finding showed that the long-term outcome of Ksharasootra is better than surgery,
although the initial healing time is longer. It is an effective, ambulatory and safe alternative treatment
for patients with fistula-in-ano, the main advantage being that general anaesthesia is avoided and the
chance of recurrence of the problem is nil.

What Causes The Boom To Ayurveda Over Allopathy? In the recent times there is a new realization,
awakening and awareness in the whole world, even in the western medical world that a) A holistic
approach to medicine is essential b) The human personality as a whole has to be studied and
understood c) The cause of ill-health could be other than just infection or physical origin d) The mind /
psyche and emotional state is accepted now as the major cause of ill health (e) Life style – discipline and
moral character are accepted to have major role in health e) Diet – green and natural is now being
accepted as a major force in health f) Treatment has to be holistic – acting at various levels – physical,
mental, emotional and even spiritual levels of the individual g) Life style changes can lead to dramatic
improvements in health h) Stress management-avoidance of stress and recovery from stress by
techniques such as yoga, meditation, relaxation – all accepted as fundamental requirements to healthy
life i) Avoidance of chemical drugs – using alternative natural therapies using natural items such as
water, green diet, fruit diet, herbal medicines (if at all) for curing common health problems. This list
could be much stronger than the original symptom.

8. Can Ayurveda Treat Chronic Diseases? Ayurveda can provide better solution for chronic diseases like
asthma, arthritis, diseases than many current allopathic treatments available today. In SWINEFLU, the
present challenging disease. Ayurveda offers simple and effective remedies to boost immunity and build
resistance. Tea made from Tulsi, Amla and Amrut (giloy) act as an immunity enhancers. Alternatively &
additionally, Ginger, Turmeric (haldi) powder mixed with either lime juice or honey can also be taken
twice a day.

. Current Status of Ayurveda At present the Ayurveda medicine is well set to re-orient itself to modern
scientific parameters. Simultaneously, it is well poised for much greater, effective utilization to benefit
the whole humanity to reach its goals of Health. Ayurveda medicine which started as a magico-religious
practice, matured into a fully developed medical science with eight branches which have parallels in the
modern western system of medicine and it has developed into following sixteen specialities. WHO has
framed a code of drug manufacturing practice in Ayurveda – Indian government has also undertaken
many measures to observe GMP in Ayurvedic drug production. Many testing laboratories are working in
collaboration with Ayurvedic pharmaceutical to make the Ayurvedic drugs more authenticated if these
practices are taken honestly we may look for a complete changes in appearance of Ayurvedic drugs in
near future.

Hence both Ayurveda and Allopathy has their own merits and demerits. We cannot supplement
Ayurveda with Allopathy or vice versa. Ayurveda has to be studied and applied, integrated into
allopathic practice-in both preventive and therapeutic levels for the better treatment quality-a good
integration and absorption, of Ayurveda with Allopathy is the answer. Let us look forward for an
integrated health care system which integrates Ayurveda and Allopathy. However this calls for greater
effort from both sides-the Allopaths should study and understand Ayurveda in its depth of spirit in detail
similarly the Ayurvedics – very few of them being of high standard and quality should understand how
to integrate Allopathy with Ayurveda in the larger interest of the society. An integrated research is the
call of the hour.

Atreya taught medicine to six disciples: viz., Agnivesa, Bhela, Jatukarna, Parasara, Ksirapani and Hariia,
each of whom wrote a treatise of medicine.
Similarly, Dhanvantari taught surgery to six disciples: Aupadhenava, Aurabhra, Pouskalavata,
Gopuraraksita, Bhoja, and Susruta, each of whom wrote a tantra on surgery.

Susruta, the junior, added an Uttaratantra consisting of the divisions: Salakya, Bhutavidya and
Kaumarabhrtya.

NIMI Videhadhipati, Rajasri Nimi, was known as a spokesman of Salakya tantra. Caraka samhita and
quoting of Vagbhata state that acaryas, such as Nimi and Videhadhipati were experts in Salakya tantra.
Acarya Dalhana, narrator of Susruta Sarnhita states that videhadhipa kirtita ityadi nimiprinitah satsaptair
netraroga instead of the passage of salakya sastrabhihita videhadhipa kirtita from the Susruta Sarnhita,
uttara tantra. Nimi was the twelfth son of Emperor Iksvaku, founder of Mithila dynasty. Nimi, Videha
and Janaka were the same, so states Ramayana. Excerpts from Caraka such as ^Nimisca rajarsi
vaideho^and ^Janako vaideho'\u6\ca\e that names such as Videha and Janaka could be connected to
the Videha king Nimi.

KANKAYANA TANTRA. It is shown in Caraka Sarrihita that, Kahkayana, the physician of Bahlika desam,
was among those who participated in discussions about the eradication of diseases, held at Himalayas. It
is stated in Kasyapa Sarphita that Kankayana has classified diseases as Sadhyam, Yapyam and Asadhyam.
Unfortunately, none of the Kahkayana tantras or quotes is presently not available. Yet, many narrations
are found to have adapted the Kahkayana tantra for remedial measures. Pythika virecana in Bower
manuscript, Kahkayanamodakam in Vyakhya kusumavali and Cakradattam^^ Kahkayana tablets
described in Haritasarnhita, Cakradattam, Sarhgadhara Sarnhita, Kankayanavatakam In Gadanigraham
are good examples of the same.

There is adequate evidence in the Agnivesasamhita, a contemporary medical work, to

show that specialisation had reached a stage when general practitioners and medical
specialists preferred to refer all cases that may need surgical treatment to specialists in
surgery. This ancient medical classic is not only encycolopaedic in its sweep, but is
also held in great esteem as a highly authoritative treatise on Kayacikitsa. It may be
incidentally stated that Kayacikitsa, like its modern counterpart, internal Medicine, is
a department of medicine which deals with diseases that involve metabolic
disturbances to a lesser or greater extent and cannot be treated surgically. The
reference it has made in several contexts to Dhanvantariyas and Dhanvantari support
the view (a) that Kasiraja Divodasa Dhanvantari was not only a contemporary of
Bhagavan Punarvasu Atreya but was also recognised by the latter as a great authority
on surgery; (b) that the school of surgeons was already well established; (c) that this
school comprised surgical specialists, specialists in the surgery of the mouth, throat,
nose, ear, eye and head, as well as experts in cauterisation (agni or dahakarma), the
application of ksara (alkalies/caustics) and other special procedures employed in the
practice of surgery; and (d) that, as in modern times, the internists confined
themselves to the practice of medicine only and, by a convention and tacit
understanding, they either sought the help of surgical specialists in cases which
needed surgical intervention or referred such cases to surgeons.
Obstertrical surgery too seems to have been highly developed. This is evidenced not
only by references that occur in the Agnivesasamhita but also by the description of the
procedures for (i) the induction of abortion in cases where the pregnancy may either
endanger the health or the life of the mother, (ii) curetting in cases of incomplete
abortion, (iii) the induction of labour in cases of delayed delivery or uterine inertia,
(iv) versions of different kinds, in cases of mal-positions and mal-presentations, (v)
the removal of the foetus in cases of difficult labour or defects in the maternal
passage, by an abdominal section, reminiscent generally of the modern Caesarian
section, (vi) evacuation of a dead foetus by craniotomy, and (vii) the delivery of
retained placenta by manual manipulation, specially massage which is reminiscent of
the Credas method.

The reference to the views of Dhanvantari (Kasiraja Divodasa) on the formation and
development of the human embryo in thr Agnivesasamhita bears out the vivid
description furnished by Acarya Susruta in his samhita. Commenting on this
description, Prof. Keswani observes:

"The various development stages of the human embryo from the time of its
fertilisation until full term have been so well described that one is amazed at the
acuity of their observations. The only interference one can therefore draw is that they
must have had some sort of aid of optical instruments to be able to describe even the
microscopic appearance of the early zygote (fertilized ovum) and must have studied
embryology in experimental animals; or, that it was their routine practice to examine
and even to dissect the abortus and the still born. (Quoted by Dwarkanath)"

"Therefore, a surgeon desiring knowledge free of all doubt must investigate well the
dead body and study the human anatomy. In short, direct observation and
theoretical knowledge together contribute to the enhancement of the surgeon's
store of knowledge as a whole.