Cultural Survival

The Persistence of Traditional Medicine in the Modern World

Young; ingram, grant; swartz.

Traditional medicine has been gradually forced underground in many societies due to pressure from missionaries and governments who perceived such practices as witchcraft. Contrary to those beliefs, however, traditional medicine has proven to be quite effective in treating both chronic diseases and psychological problems, especially those associated with stress, which frequently stem from social alienation, anxiety or loss of self-esteem. Examples of diseases influenced by stress are certain types of ulcers, skin problems and bronchial disorders.

Traditional medicine is not only effective in treating psychosomatic illnesses, however. Many practitioners of traditional medicine have a solid knowledge of herbs and of their effects in healing organically based illness as well. Rather than perpetuate what is probably a meaningless distinction between psychomatically based illnesses and organically based diseases, it is probably more useful to emphasize that most traditional healer utilize a holistic approach which deals with a wide variety of problems on three levels: physical, emotional and spiritual. Holistic treatment emphasizes disease prevention and positive changes in lifestyle to ensure a balance among these three aspects of life.

Traditional medicine is usually community based. Healers are selected by a community process that emphasizes personal qualities, and they frequently have to pass various tests. Because they are from the community, traditional healers usually know their patients personally, and are well acquainted with their backgrounds, lifestyles and cultural beliefs. Another benefit of traditional medicine is that it is decentralized: it is easily and quickly available to individuals for whom traveling to urban centers for treatment is inconvenient, time-consuming and costly.

Traditional Medicine in the Modern World

Cross-Cultural Trends

Some observers claim that successful moves to incorporate modern technology and medicine in traditional societies create needs for traditional practice. Urban living in particular creates conditions that hatch those stress-related diseases often most effectively treated by traditional practitioners, such as gastric and duodenal ulcers, migraines, dermatitis, limb pains and certain kinds of paralysis and hypertension. Thus, in some cases at least, traditional medicine tends to thrive in conjunction with Westernization, modernization and urbanization, as in the case of countries such as Ghana and Nigeria.

In light of the benefits of traditional medicine, many Asian, African and South American countries have allowed the development of a dual system of medical care in which individuals can choose whether they visit traditional or Western clinics. The same individual may choose one type of clinic for some diseases and another for other diseases. For example, in Costa Rica individuals tend to go to folk practitioners for culturally specific diseases (such as quebranto, aire, pegas or nervios) and chronic diseases. For preventive health care, such as immunization and nutritional instruction, however, government-sponsored clinics in rural communities attract as much as 90 percent of the population.

Traditional practitioners frequently adapt their practices in order to attract a larger clientele from a more diverse population. For example, practitioners in an urban setting in Ghana have added waiting rooms, telephones, visiting cards, white overall coats and sign boards to advertise available services. Traditional herbs and herbal combinations are packaged in the form of powders, capsules, salves and tonics to be self-administered. In addition, patients are referred to Western-style clinics for certain problems.

In some countries, such as China, the government itself has promoted a duel system in which paramedical personnel (originally called "barefoot doctors" in China) are trained in both traditional and modern orthodox diagnostic and treatment procedures. Although barefoot doctor program in China has been replaced by a "village doctor program." Practitioners known as "mid-level physicians" continue to dispense both traditional and modern, Western-style medicines.

A Nigerian example is provided by Dr. J.O. Mume, who had practiced traditional medicine for several years when he heard of a School of Natural Therapeutics being established in Lagos. After studying at this school, Dr. Mume said, "I returned home to Ekakpanre and started afresh, and with the knowledge gained from the school at Lagos, I started to plan, to meditate, to read, to develop and improve upon my traditional herbal products which I prepared in powdered and liquid forms." Needing money to continue his research on traditional herbal remedies, he formed a partnership with another individual, bought an old van and distributed his herbal products. Eventually in 1969 Dr. Mume established a clinic, where he continued to administer traditional treatment in a way that was attracted a wide spectrum of both rural and urban clients.

A Canadian Example

Russell Willier, a Cree healer from northern Alberta, Canada, although unaware of the innovations of traditional healers from countries such as Ghana, is in the process of adapting his practices to the modern world. In 1985, he permitted documentation of his treatment of psoriasis, a chronic skin disease. Eleven patients (one of whom dropped out) were recruited and the experiment was systematically documented using videotape and photographs. Treatment consisted of native religious rituals and the administration of herbal medicines at a health clinic in downtown Edmonton. Six of the 10 patients experienced improvement in varying degrees over the course of the experiment.

The response of the healer to the results of this experiment are interesting. Despite his modest success, he is disappointed that the result were not more spectacular. He is still determined to treat non-native patients, but on his own terms. He believes the experiment did not provide a true test of native medicine since it was conducted on alien territory and since there were insufficient controls on the regularity with which patients used the medicine. Thus he has decided to develop a healing center on his reserve which will treat both native and non-native patients. This will allow him to combine a modern facility with traditional treatment procedures.

The center will be designed to provide a familiar atmosphere for patients from different cultural backgrounds. For example, Willier envisions hiring a receptionist whose duties will include greeting new patients, taking appointments and directing patients to a private room to consult one of several healers who would assist in the operation of the center. Each healer will specialize in a specific aspect of treatment in which he or she is gifted and has a proven record, such as chronic diseases, contagious diseases, alcohol abuse or marital counseling. Treatment itself will proceed along traditional lines, with each healer operating a sweat lodge and administering herbal medicines.

Long-Term Survival of Native Medicine in Canada

The aspirations of native healers in Canada vary. Some healers prefer to practice under cover so they will not be harassed. Others, like Russell Willier, feel that because native medicine has something to offer, it should be made available to everyone. His goal is to prove that native medicine is effective. In so doing, he hopes to stimulate interest on the part of native young people and thereby help preserve a tradition that is dying out on some reserves.

Russell Willier is part of a widespread movement on the part of native peoples to assert their right to self-determination and to compete more effectively in the dominant Western culture. However, there are many problems in making native medicine more easily available to all people. For example, in addition to physical facilities envisioned by Willier, where patients from a different ethnic background than the healer could be accommodated in a way that would make them feel at ease and that would not impose upon the healer's private life, a fee structure must be established that will allow the healer to make a living and not require patients to have to guess about the amount of an appropriate gift. Legal structures have to exist to protect both patients and healers, and business structures must satisfy various levels of government that appropriate accounting procedures are being followed.

Role of the Anthropologist in Facilitating Change

Setting up these new structures requires expertise and money. Outside help brings in the danger of outside control. Setting up these structures involves changing native tradition as and moving further into the non-native cultural world. Thus a paradoxical situation arises: making native medicine more easily available can help preserve tradition in some ways but help destroy it in others.

Innovative ideas such as the healing center are controversial. Opposition from the native community comes because of fears that sacred knowledge might be sold or given away. Opposition from orthodox health care practitioners comes in the form of ears that quacks or poorly trained individuals will put non-native patients at risk. Some cynics fear the loss of a valuable monopoly in Westernized medicine, as the holistic health movement continues to grow around the world.

What can anthropologists do to ease the deepening conflict as native medicine takes an increasingly aggressive stance? One advantage that anthropologists have in their cross-cultural perspective. Anthropologists can gather concrete data on what native peoples themselves would like to see if decision-making power is returned to native communities in the area of health care. The anthropologist is certainly in a position to help bring about some consensus among native peoples and to serve as a cultural broker or intermediary between native communities and structures in the larger, dominant society.

Establishing positive long-term change will not be easy; native groups cannot simply emulate other traditional societies in their handling of the problem. When indigenous peoples constitute the dominant population, allowing native medicine to assume its rightful place in the modern world means valuing something from the majority's own tradition. In Canada, however, what is traditional for one group is not traditional for another. The cultural imperialism of European traditions has led to the devaluing of aboriginal traditions. This inherent combination of imperialism and racism has to be overcome before a genuinely pluralistic and multicultural approach to health care can evolve.

Regardless of which models are eventually chosen, native people should be involved in the selection process from the ground up. Bureaucrats can no longer expect to find single solutions that will work in all communities in Canada. The role of the anthropologist is not to be co-opted into providing bureaucrats with theoretical models, but rather to make available to native peoples an expanded repertoire of options, to assist native practitioners in experimenting with expanding roles and to bring natives and non-natives together to explore how to combine native and Western methods of health care in mutually beneficial ways. Given the positive interest in self-determination on the part of both native groups and the Canadian government, the chances that native medical traditions will survive and prosper in Canada appear to be excellent.

Article copyright Cultural Survival, Inc.

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Traditional Medicine vs. Modern Medicine

In the modern society, traditional medicine is considered the most appropriate way to treat sick people. In other words, modern medicine should incorporate technology-based medicine and traditional practices. This would let the doctors to dispense medicine in the best possible way to satisfy each cultural group. Modern doctors and physicians tend to neglect traditional practices in favor of modern technologies.

This creates a conflict between traditional medicine and modern medicine. In this regard, effective healing is affected because patients are reluctant to disclose information to doctors that do not consider culture when asking questions. As Anne Fediman observes, the misunderstanding between patients and doctors affects service delivery in a number of ways. This clearly shows that culture plays a significant role in enhancing the healing process. It makes sense to argue that little medicine and little need facilitate healing.

In her book, Fadiman (1998) notes that Lia could have lost her life due to cultural differences between her parents and doctors. Doctors interpreted Lia’s condition differently, because they believed that she suffered from ordinary epilepsy. On the other hand, Lia’s parents believed that their daughter suffered from a traditional disease.

They based their interpretation on the Hmong culture, which was considered powerful in the community. Doctors could not embrace the ideology of the Hmong community because they believed the culture was inferior to science. On their part, Lia’s parents questioned the methodology employed by doctors when diagnosing diseases.

This misunderstanding could have been resolved in case doctors understood the cultural values of Lia’s parents. For instance, doctors could have used records from Lia’s parents to identify the medical problem. The author shows that culture helps understand the way of living of a particular community. Doctors can come up with the best ways of delivering their services if they understand cultural practices. In the modern society, western medicine is believed to be accurate, yet it is full of mistakes.

Religiously, colonialism shaped the religious practices of Americans because people were forced to abandon traditional religious beliefs in favor of modern forms of religion. For instance, people were forced to adopt Christianity and drop traditional religions. In fact, religion was used to pacify the population.

Even in the modern society, religion is still used to pacify the population. Ethnically, colonialism generated ethnocentrism whereby people would identify themselves with certain ethnic groups. This led to discrimination because groups would judge others using their cultural standards.

Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures . New York: Noonday Press.

Gurung, R. (2010). Health psychology: A cultural approach . Belmont, CA: Wadsworth Cengage Learning.

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IvyPanda. (2023, November 21). Traditional Medicine vs. Modern Medicine. https://ivypanda.com/essays/traditional-vs-modern-medicine/

"Traditional Medicine vs. Modern Medicine." IvyPanda , 21 Nov. 2023, ivypanda.com/essays/traditional-vs-modern-medicine/.

IvyPanda . (2023) 'Traditional Medicine vs. Modern Medicine'. 21 November.

IvyPanda . 2023. "Traditional Medicine vs. Modern Medicine." November 21, 2023. https://ivypanda.com/essays/traditional-vs-modern-medicine/.

1. IvyPanda . "Traditional Medicine vs. Modern Medicine." November 21, 2023. https://ivypanda.com/essays/traditional-vs-modern-medicine/.

Bibliography

IvyPanda . "Traditional Medicine vs. Modern Medicine." November 21, 2023. https://ivypanda.com/essays/traditional-vs-modern-medicine/.

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What is medicine? Why it’s so important to answer this question

essay of traditional medicine

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essay of traditional medicine

What is medicine? We recognise it in all societies past and present. But the nature of medicine differs so greatly from place to place and time to time that it’s difficult to offer a single answer. So what is it that we see in common between a traditional healer’s throwing of bones and the cardiologist’s incisions?

One of the answers that often seems to be implicit in what we say and think about medicine is a curative thesis : medicine’s goal is to cure the sick. Curing the sick is the core medical competence, whose exercise is medicine’s core business.

But if the curative thesis is true, then most medicine throughout history – as well as much contemporary medicine – isn’t medicine at all. Much medicine was and is ineffective, or at best partially effective. The curative thesis leads to a dismissive attitude towards the past efforts upon which any current medicine is built, as well as failing to promote profitable collaboration between traditions.

A second idea is an inquiry thesis about medicine: although the goal of medicine is to cure, its core business is something quite different. It’s this thesis I explore in my latest article .

That “something” has to do with inquiring into the nature and causes of health and disease. The idea is that we don’t necessarily expect someone to be able to cure us. We will accept that they are a medical expert if they can show an understanding of our ailment, often by issuing an accurate prognosis. Perhaps they won’t have a complete understanding, but they should somehow be engaged with the larger project of inquiry into the nature and causes of health and disease.

The inquiry thesis offers a way to understand the history of medicine that makes it more than a tale of quackery and gullibility. It also provides a way to understand medical traditions that practised outside the West, or in the West in defiance of the mainstream. They may offer or at least engage with a project of obtaining; a kind of understanding that Western medicine cannot.

The inquiry model of medicine lays the ground for fruitful and respectful discussions between medical traditions that doesn’t descend into an untenable relativism about what works.

Towards understanding

The curative thesis faces a difficulty that I believe it cannot overcome.

We do not define an activity by its goal alone, unless it has at least some success in that respect. A blacksmith cannot be defined as one who makes horseshoes if he simply throws lumps of hot metal onto his anvil and hammers them randomly – occasionally producing something horseshoe-like, but more often producing a mess.

Yet, taking a historical perspective, something of this kind has been true of medicine for much of its history, before it developed a serious curative arsenal. Historian of medicine Roy Porter has remarked that

the prominence of medicine has lain only in small measure in its ability to make the sick well. This was always true, and remains so today.

What, then, could be the business of medicine – the thing in which we recognise expertise, even when we accept that there is no cure to be had?

This is where the inquiry model enters the picture. I propose that the business of medicine is understanding the nature and causes of health and disease, for the purpose of cure.

The core of the argument is simple: what could medical persons be good at doing, that relates to the goal of cure without achieving it? The most likely candidate is understanding. Understanding is something that we can gain without corresponding curative success.

Tackling objections

As with the curative thesis, there are several objections to the inquiry model. First, it is obvious that many doctors either don’t (fully) understand what they treat or, if they do, don’t (successfully) communicate this understanding to the patient. Who, then, understands? In what sense is the doctor’s competence understanding?

The answer is that understanding isn’t a binary. You can partially understand something. You can be one the road to understanding it better, by inquiring into it. Hence the inquiry model of medicine. The idea is not that medicine is a sack full of answers, but rather that it is an ongoing effort to find answers.

Another objection is that so-called understanding is often bogus, and that medicine is as unsuccessful in this regard as in cure. This fails to account for the historical record, which – at least for Western medicine –- is precisely a case of understanding without curative success.

And, just as false scientific theories have contributed to developing scientific understanding , so false medical theories have provided a foundation for what we now accept.

Medicine is an ancient and complex social phenomenon, variously seen as art, science and witchcraft. These visions share the goal of curing disease. But it is too crude to think medicine as only the business of curing, since in that case, few doctors would be in business.

The distinctive feature of medicine is that it tries to cure by obtaining some understanding of the nature and causes of health and disease: by inquiry, in short. This understanding of medicine permits a much healthier dialogue between proponents of different traditions, and enables a non-defensive perspective on areas where we remain sadly lacking in curative ability.

This is an edited, shortened version of an article that first appeared in the Canadian Medical Association Journal, ‘The inquiry model of medicine’ , accompanied by a podcast available on the article’s page and also here .

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Chinese Philosophy and Chinese Medicine

According to Zhang Xichun 張錫純 (1860–1933), one of the leading reformers of Chinese medicine in the early twentieth century:

Many recent medical journal reports take the view that [traditional Chinese] philosophy holds back the progress of medicine, but their authors do not understand the use of philosophy, nor do they understand that philosophy is actually the basis of medicine. (Zhang Xichun 1918–1934, 296).

At first glance, this assertion seems improbable to say the least. This essay addresses some of the connections between Chinese philosophy and Chinese medicine in both intellectual and social aspects.

The first section locates medicine among the Chinese sciences and introduces the intellectual shared common ground of Chinese philosophy and Chinese medicine, including shared theories of qi , yin-yang and “Five Agents” ( wuxing ) and their use in analogies between the human body and the state and cosmos, including the development of a systematic medical theory of the body. Section Two introduces the important medical contributions of “nurturing life” ( yang sheng ) traditions. Section Three takes up what has been represented as a long shared history of Daoism and medicine in the works of three great Daoist physicians. Section Four returns to the views of Zhang Xichun and his claims for an explicit link between Chinese Medicine and Chinese Philosophy.

1.1 Yin-yang , Qi and Wuxing

1.2 body, state and cosmos, 2. nurturing life ( yang sheng ), 3.1 ge hong, 3.2 tao hongjing, 3.3 sun simiao, 4. zhang xichun on chinese philosophy and chinese medicine, 5. conclusion, other internet resources, related entries, 1. introduction: shared intellectual contexts.

Before addressing connections between Chinese philosophy and Chinese medicine it is necessary to make two clarifications on the meaning of the term Chinese medicine. Chinese medicine could in principle refer to: (1) the full range of medical systems used in contemporary China, including Western biomedicine; (2) the traditional indigenous Chinese medicine that is conventionally referred to as Traditional Chinese Medicine (TCM); and (3) other indigenous medical systems, distinct from but TCM, practiced by non-Chinese or minorities who live in areas that historically were part of China or are now part of the Peoples Republic of China, for example, Korean and Tibetan medicine. For purposes of this essay I use the term Chinese medicine only to refer to TCM, but including issues of the integration of TCM and Western medicine. Second, Chinese medicine, in the sense of TCM just discussed, includes a wider range of practices than does Western medicine. In particular it includes: (1) “medicine” in its conventional sense of practices that cure or prevent disease, treat disease and injury and assist in childbirth, etc.; (2) a range of practice to prevent disease in the broadest sense by maintaining health, including practices associated with the martial arts such as Taijiquan (also known as T’ai chi); and (3) a range of practices that extend health by seeking longevity. In particular, a clear account of Chinese medicine cannot confine itself to the first of these only.

Within a Chinese historical context, medicine ( yi 醫) was one of several qualitative sciences. It included “nurturing life” ( yang sheng 養生), a broad category that comprised a wide range of self-cultivation techniques. In later periods, medicine also included materia medica ( bencao 本草) and internal ( nei dan 內丹) and external ( wai dan 外丹) alchemy. The early Chinese qualitative and quantitative sciences were specific, with no unified notion of science (Sivin 1982 and 1990).

Secondly, medical works, like other scientific works, were classified as technical specialties, distinct from generalist works, including the “Masters” texts associated with Chinese philosophy (Raphals 2008–2009, forthcoming). Medicine and its related disciplines appear in the last section of the Bibliographic Treatise (chapter 30) of the Standard History of the Han Dynasty ( Han shu ). This Treatise consists of six sections. The first two (“Six Classics” and “Masters”) contain philosophical works. The last two are technical: “Numbers and Techniques” (S hu shu 數術), and “Recipes and Methods” (F ang ji 方技). The latter includes works on medicine and longevity, including the categories of medical classics ( yi jing 醫經), classical recipes ( jing fang 經方), sexual arts ( fang zhong 房中, also referred to as “arts of the bedchamber”), and immortality practices ( shen xian 神仙). These chapters reflect the concerns and expertise of the technical and ritual specialists closely associated with the “Recipe Masters” ( fang shi 方士) associated with the Han court. But their concerns also appear in early philosophical texts to such an extent that any separation of their philosophical from their religious and technical content is arbitrary and artificial (Harper 1998 and 1999; Kalinowski 2004).

Nonetheless, Chinese philosophy and Chinese medicine shared important intellectual contexts in their early development. The origins of science in China seem to lie in an amalgam of ideas from both philosophers and technical specialists, including physicians. According to Sivin (1988 and 1990) the basic Chinese sciences were established some time between the first century BCE and the first century CE through what he describes as a combination of Ru (“Confucian”) ideas and ideas from technical specialists, especially experts in yin-yang, Five Agents ( wu xing ) 五行, henceforward wuxing and technical expertise traditions associated with “Numbers and Techniques” ( Shu shu ) and “Recipes and Methods” ( Fang ji, mentioned above).

Key to this amalgam were several concepts shared by both groups but deployed in very different ways. Early medical – and cosmological – thinking depicts a cosmos ultimately composed of qi 氣 (the energy that constitutes and organizes matter and causes growth and change) in processes of constant change, based on the interactions of yin and yang 陰陽 and the “Five Agents” or “Five Powers” ( wuxing . See Graham 1986, Raphals 1998 and 2013).

Philosophers deployed these ideas in (1) the yin-yang cosmology of the Book of Changes or Yi jing , (2) theories of correlative correspondence between heaven, earth and humanity as a shared representation of cosmic order, and (3) the idea of a “classic” or “canon” as the founding text of a textual lineage. The authors of the first medical classic, the Yellow Emperor’s Classic of Internal Medicine ( Huang Di neijing ), also deployed these concepts, in particular in models of the human body as a yin-yang and Five Agent microcosm of the cosmos.

Finally, physicians and philosophers created textual lineages and accounts of textual authority. The most important medical works of this kind are the Yellow Emperor’s Classic of Internal Medicine and the Materia Medica of Shen Nong ( Shen Nong bencao ), ascribed to the “Divine Husbandmen” Shen Nong, who, according to legend, tested hundred of herbs and plants to ascertain their curative properties. By contrast, the evidence of recently excavated texts indicates that the Huang Di neijing derived from prior textual traditions that were subsequently lost (Harper 1998) and that the extant version is a composite of several earlier texts (Keegan 1988, Unschuld 2003, Unschuld and Tessenow 2011, Yamada 1979).

Theories of qi and yin and yang also are importantly pursued in early philosophical works. Several Warring States texts contain references to the nature of qi , yin and yang , and their relation to health and longevity. The Zhuangzi clearly identifies qi as the basis of the physical constitution of the body: “Human birth is caused by the gathering together of qi ” (22, 733, misleadingly translated by Watson (2013, 180) as “purity”). The Zhuangzi also describes harmonizing or taking charge of the six qi .

The qi of heaven is not in harmony, the qi of earth is tangled and snarled. The six qi are maladjusted, the four seasons are disordered. Now I want to harmonize the essences of the six qi in order to nurture life (Zhuangzi 11, 386, emphasis added, cf. Watson 2013, 80).

Similarly, the Springs and Autumns of Master Lü ( Lüshi chunqiu ) describes sages as making their numinous essences ( jing shen 精神) tranquil, and preserving and increasing their longevity (3.2, pp. 3b-4a, trans. Knoblock and Riegel 2000, 3/2.1, 99).

In all these texts a sage or numinous person achieves that status through both meta-physical and physical means. This is the focus of Daoist “Nurturing Life” techniques (discussed in section 2).

We find a different account of these concepts in technical works. The apocryphal “founder” of scientific thought in China was Zou Yan 鄒衍 (305–240 BCE), who is credited with combining and systematizing yin-yang and wuxing theory. No works attributed to him survive. Sima Qian’s biography in Shi ji 76 describes him as a member of the Jixia 稷下 Academy, originally from the state of Qi in present day Shandong (Needham 1956: 231–34). By contrast, the Han shu describes him as a Recipe Master ( fang shi ). This is important because of the connection between fang shi and medicine.

Fang shi practiced medicine and divination and claimed to possess secret texts and formulae. They gained great influence during the earlier part of the Han dynasty, though their influence waned by the later Han. The fang shi used yin-yang and Five Agents cosmology. They seem to have originated from the Shandong peninsula, and were particularly associated with the mantic arts, including the use of the sexagenary cycle of stems and branches, the Yi jing , and divination by stars, dreams, physiognomy, the winds, and by the use of pitch pipes (Ngo 1976).

It is almost impossible to separate Chinese ideas of body, state, cosmos from concepts of “nature,” though, as Nathan Sivin points out, there is no indigenous Chinese term for “nature” before the nineteenth century. Over the course of the last three centuries BCE, Chinese understandings of the physical world developed to reflect, and mirror, political consolidation (Sivin 1995, 2007). These new ideas of cosmic order—correspondence between microcosm (the body) and macrocosm (the cosmos)—appeared in new representations of the body, the state, and the cosmos that were based on systematic applications and correlations of the ideas of yin-yang and wuxing . They are prominent in Warring States politico-philosophical writings such as the Springs and Autumns of Master Lü ( Lü Shi chunqiu ) of Lü Buwei (291?-235 BCE) and the Luxuriant Dew of the Springs and Autumns ( Chunqiu fanlü ), attributed to Dong Zhongshu (179–104 BCE).

Theories of qi , yin-yang and wuxing also inform medical works. New systematic medical theories based on these ideas were systematized in a cosmological framework in the Huang Di neijing , a complex and multi-layered text, probably compiled in the first century BCE (Keegan 1988, Unschuld 2003, Yamada 1979). It presents a systematic cosmology that analogizes the body, the state, and the cosmos in systems of “correlative cosmology” (Graham 1986b, Sivin 1995, Lloyd and Sivin 2002). It describes relations and analogies between the body (including the emotions), the state and the cosmos in terms of yin-yang and wuxing . For example, the Huang Di neijing describes correspondence between the articulations of the body and the cosmos, specifically between heaven and earth and the upper and lower parts of the body:

Heaven is round, earth is square; people’s heads are round, their feet are square and thereby correspond to them. Heaven has the sun and moon, people have two eyes; Earth has nine regions, people have nine orifices. Heaven has wind and rain, people have joy and anger; Heaven has thunder and lightning, people have the notes and sounds. Heaven has four seasons, people have four limbs. Heaven has five tones, people have the five depots; Heaven has six pitches, people have six palaces. Heaven has winter and summer, people have cold and hot [ailments]. Heaven has ten days, people have the hands’ ten fingers … Heaven has yin and yang; people have man and wife. The year has 365 days; the body has 360 joints ( Huang Di neijing ling shu 71.2, 446, cf. Wong Ming 1987, 336–338 (French). There is no good English translation of this text.).

Theories of yin-yang, qi and wuxing also inform Warring States and Han astrocalendrics, observational astronomy and the study of astronomical portents, and in the so-called “correlative cosmologies” of many Han dynasty texts.

Several Warring States texts express the need to preserve one’s person, self, or essential nature:

Therefore the sage puts his person last and it comes first, Treats it as extraneous and it is preserved. ( Daode jing , chap. 7)

One way to do this was to maintain health by nurturing life ( yang sheng ), an area of common ground for speculative thinkers and practitioners of traditional medical arts. The term yang sheng first appears in the Zhuangzi and then throughout a range of second (BCE) century medical literature.

The third chapter of the Zhuangzi is titled “The Lord of Nurturing Life” ( Yang sheng zhu 養生主). In it, the expert butcher Pao Ding instructs Duke Hui of Liang. Pao Ding describes the process of mastering his skill. His method is initially analytic; he begins by studying oxen as wholes, next as parts, and finally with faculties beyond ordinary vision. This discourse is presented as an instruction to the Lord Wenhui, who ends by saying that: “Pao Ding has taught me how to nurture life” ( yang sheng , Zhuangzi 3, 124, cf. Watson 2013, 20).

Another passage in the Outer Chapters refers to some of these exercises. It contrasts “real sages” who follow the way of heaven and earth with (among others) practitioners of “nurturing life” traditions who:

blow out, breathe in, old out, new in, dormant like the bear, neck-stretched like the bird, their only care for longevity; these are the practitioners of “guide-and-pull” [ dao yin 導引] and “nourishing the body” [ yang xing 養形] who desire the longevity of Pengzu ( Zhuangzi 15, 535, cf. Watson 2013, 119).

The passage continues. Real sages:

cultivate [their persons] without benevolence and righteousness, govern without merit or fame, are at ease without needing rivers and seas, attain longevity without “guiding and pulling,” forget everything but lack for nothing, placid without limit, things of value follow upon them (ch. 15, 537, cf. Graham 1986a, 265; Watson 2013, 119).

Since the whole point of the Zhuangzi passage is to oppose “guiding and pulling” and other longevity techniques to true sagehood, it does not dwell on their details. We can get a better idea of what he might have been talking about from other sources. Some of these ideas are elaborated in a chapter of the Guanzi titled “Inner Cultivation” ( Nei ye ), which describes the cultivation of qi, as well as vital essence ( jing ), and spirit ( shen ). It describes Dao as literally pervading the body or the person of a sage:

So long as the wellspring is not exhausted, The passages of the nine apertures will remain clear. Thus it is possible to explore the limits of Heaven and Earth, and cover the four seas. ( Guanzi 16.3a8–3b1; trans. Rickett 1998, 48).

The Zhuangzi and other texts refer to the figure of the spirit person or shen ren 神人 as someone who has effectively transformed the physical body and the qi that constitutes it. The Zhuangzi describes spirit person of Guye, who concentrates his spirit ( shen ), avoids the five grains, rides the clouds, and, through the concentration of his shen protects others against sicknesses and epidemics and makes the harvest ripen ( Zhuangzi 1, 28; cf. Graham, 1986a, 46). This passage suggests that a sage can have a nurturing effect on the world by acting at a distance, possibly as an unintended by-product of self-cultivation practices.

Other passages in the Zhuangzi extol the abilities of specialized craftsmen who possess highly technical skills. These stories liken mastery of the Way to mastery of a craft. They also emphasize the technical skills of commoners. Commoners, rather than rulers, are presented as sage-like figures. These technical experts include arrow makers, bell-stand carvers, boatmen, butchers, cicada catchers, potters, sword makers, and wheelwrights (Raphals 2005). It is curious that these passages never include physicians.

In the Han dynasty, “nurturing life” techniques became a major concern of the Recipe Masters (fang shi) of the Han court (Ngo 1976). Texts on nurturing life include methods for absorbing and circulating qi in the body—for example, breathing and meditation exercises, diet, drugs and sexual techniques.

Medical and mantic texts excavated from tombs make it clear that a wide range of longevity techniques had been developed before the Han dynasty (Harper 1998, 33). Most important is a corpus of medical manuscripts excavated from Mawangdui 馬王堆 (Changsha, Hubei), dated to 169 BCE. This tomb is best known for its two versions of the Daode jing , but it is meaningful to locate those texts among other texts of a scientific provenance found in the tomb (Harper 1998 and 2000, Ma Jixing 1992, Zhou Yimou 1994, Zhou Yimou and Xiao Zuotai 1987).

Six of the medical manuscripts are concerned with nurturing life in various ways. “Harmonizing Yin and Yang” ( He yin yang 合陰陽) and “Discussion of the Realized Way of All Under Heaven” ( Tianxia zhi dao tan 天下至道談) are concerned with sexual cultivation. They refer to the movements and postures of animals as whole-body metaphors for sexual techniques. An example is the description of ten postures in “Harmonizing Yin and Yang”:

The ten postures: the first is “tiger roving”; the second is “cicada clinging”; the third is “measuring worm”; the fourth is “river deer butting”; the fifth is “locust splayed”; the sixth is “gibbon grabbing”; the seventh is “toad”; the eighth is “rabbit bolting”; the ninth is “dragonfly”; the tenth is “fish gobbling.” (Harper 1998, 418)

These texts emphasize that sexual activity is a natural process, but one that must be regulated. As the “Realized Way of All Under Heaven” puts it, people know by nature how to breathe and how to eat, but everything else is a matter of learning and habit. “What assists life is eating; what injures life is lust. Therefore the sage when conjoining male and female invariably possesses a model” (Zhou and Xiao 1989, 431; Harper 1998, 432).

“Recipes for Nurturing Life” ( Yang sheng fang 養生方) consists of eighty-seven recipes, including food, drugs, and beverages, along with several sexual cultivation exercises. “Eliminating Grain and Eating Vapor” ( Que gu shi qi 卻榖食氣) specifies diet and breathing exercises to be performed in the morning and evening, and a seasonal regimen of breath cultivation through consuming six qi and avoiding another five (Harper 1998, 25–30). Another text, the “Ten Questions” ( Shi wen 十問) gives advice on techniques for nurturing life (Harper 1998, 22–30), for example:

Yao asked Shun: “In Under-heaven what is most valuable?” Shun replied: “Life is most valuable.” Yao said: “How can life be cultivated?” Shun said: “Investigate yin and yang.” (Zhou Yimou and Xiao Zuotao 1989, 379; Harper 1998, 399)

Finally, the “Drawings of Guiding and Pulling” ( Daoyin tu 導引圖) is a series of forty-four drawings of human figures performing exercises, some with captions. Some are described in another excavated text from tomb no. 247, Zhangjiashan 張家山 (Jiangling, Hubei). The “Pulling Book” ( Yin shu 引書) from Zhangjiashan describes exercises that refer to or are named after animals, including inchworms, snakes, mantises, wild ducks, owls, tigers, chickens, bears, frogs, deer, and dragons. Both exemplify a tradition of exercise for both therapy and health known as daoyin (pulling and guiding).

The “ yang sheng culture” of these texts emphasized control over physiological and mental processes, both understood as self-cultivation, through the transformation of qi. “Self-cultivation” in this context included moral excellence, health, and longevity (V. Lo 2001).

We can get a broader notion of what these techniques were like if we turn to the list of titles from the “Recipes and Methods” section of the Han shu Bibliographic Treatise, mentioned above. One of the few extant texts it lists is the Huang Di neijing , along with the titles of lost medical works on nurturing life, health, and longevity. The “Classical Recipes” ( jing fang ) section includes titles such as “Recipes for Married Women and Infants” ( Furen ying er fang 婦人嬰兒方) and “Food Prohibitions of Shen Nong and Huang Di” ( Shen Nong Huang Di shi jin 神農黃帝食禁). The sexual arts section includes “Recipes of Huang Di and the Three Sage-Kings for Nurturing Yang” ( Huang Di san wang yang yang fang 黃帝三王養陽方) and “Inner Chamber Recipes of the Three Schools for Having Children” ( San jia nei ju you zi fang 三家內房有子方). Other sections describe physical exercises and therapeutic techniques, such as the “Stepping and Pulling Book of Huang Di and Other Masters” ( Huang Di za zi bu yin 黃帝雜子步引 ( Han shu 30, 1778–79).

Another medical text from Mawangdui is a recipe ( fang 方) manual titled Recipes for Fifty-Two Ailments ( Wushier bing fang 五十二病方, translated and discussed in Harper 1998). Recipe texts also have been excavated from Zhangjiashan (Li Ling 1993 and 2000). In addition, the Mawangdui tombs also contained hexagram divination texts and charts and diagrams on cloud divination and physiognomy, including the oldest known representation of a comet (Li Ling 1993).

In summary, most of these texts can be described as part of a yang sheng culture, which offered and emphasized control over physiological processes of the body and mind that were understood as transformations of qi . What is the relation of these detailed technical texts to philosophy? These technical arts form a continuum with philosophy because their transformations were understood as self-cultivation in the coterminous senses of moral excellence, health, and longevity (rather than medical pathology), and physiological transformation through the manipulation of qi (V. Lo 2001).

Mark Csikszentmihalyi (2004) describes them as part of an “embodied virtue” tradition of self-cultivation practices. They structured much of early Daoist philosophy and medical theory, and also had profound effects on early Chinese ethics and metaphysics (V. Lo 2005). Such “material virtue” traditions held that the body-mind was constructed of qi and that embodied self-cultivation practices could transform qi . These views informed Warring States accounts of dietary practices, exercise regimens, breath meditation, sexual cultivation techniques, and other technical traditions associated with fang shi . Material virtue traditions also had important links with Daoist texts, southern schools, and the “moralization” of health in traditions that culminated in the Huang Di neijing . Accounts of these practices appear in passing in the texts of the received tradition. Many more come from texts excavated from tombs.

3. Daoist Medical Traditions and Physicians

Ge Hong 葛洪 (283–343 or 363 CE, a physician and Daoist from of the Eastern Jin (317–420 CE), was the first of several explicitly Daoist physicians to write about the practice of alchemy. He was the author of the Teachings of the Master Who Embraces Simplicity ( Baopuzi 抱樸子). The Baopuzi consists of seventy chapters ( pian 篇): twenty “Inner Chapters” ( Baopuzi neipian 抱樸子内篇) and fifty “Outer Chapters” ( Baopuzi waipi an 抱樸子外篇). The two were effectively different books that were not combined under one title until a thousand years after Ge Hong’s time (Sivin1969, 389. For a partial translation of the waipian see Sailey 1978). Ge Hong was also the author of the Collected Life Stories of Immortals ( Shen xian zhuan 神仙傳, trans. Campany 2002) and Biographies of Recluses ( Yin yi zhuan 隱逸傳).

According to his autobiography ( Baopuzi waipian , ch. 50; Sailey 1978, 242–272; Ware (1966, 6–21), in his youth he studied the Confucian classics, but at the same time, became interested in quasi-medical techniques for nourishing the body with the goal of achieving immortality. He became a student of the alchemical master Zheng Yin 鄭隱 (c.215-c.302 CE), and remained his disciple for some fifteen years. After brief success, he abandoned a military career to go to the capital at Luoyang to search for books on immortals. After difficulties during the political unrest in the south, Ge Hong entirely gave up political life and devoted himself to immortality practices. In 316 he returned to the north and was named a marquis by the Eastern Jin court and took up an administrative post. On learning that cinnabar had been discovered in the south (in present day North Vietnam), he secured a position as magistrate in the south in Guangxi, where he settled at Mt. Luofu 羅浮 and began the study of alchemy, remaining there until his death (Sailey 1978, 277–78; Ware 1981; Wells 2003).

Ge Hong was the first to systematically describe the history and theory of Daoist immortality techniques such as “preserving unity” ( shou yi 守一), circulating energy ( xing qi 行氣), “guiding and pulling” ( dao yin ), and sexual longevity techniques ( fang zhong 房中, Baopuzi neipian, ch. 2; Lai Chi-tim 1998, 203-204). But his accounts of these techniques clearly reflect an interest in self-cultivation according to broadly Confucian principles. For example, he considered moral self-cultivation a precondition for the search for immortality; self-cultivation included such Confucian virtues as benevolence ( ren ), trustworthiness ( xin ), loyalty ( zhong ) and filiality ( xiao ). Ge Hong criticized Daoist “pure conversation” ( qing tan ) and emphasized the importance of both moral virtue and Daoist study. His specifically Daoist writings emphasize the importance of both “mystery” ( xuan 玄) and emptiness ( xu 虛), and all-embracing unity, which the Daoist must actively preserve by meditation practices, techniques of “preserving the essence” ( bao jing 保精) and consuming medicinal herbs ( fu yao 服藥).

As an alchemist, Ge Hong experimented with drugs and minerals. The “Gold Elixir” ( Jin dan 金丹) and “Yellow and White” ( Huang bai 黄白) chapters of the B aopuzi neipian survey the history of alchemy and describe in detail a method for “alloying cinnabar,” quoting from ancient recipes and “cinnabar methods.” The “Immortal Herbs” ( Xian yao 仙藥) chapter gives information on medical herbs (Gao 1996, Qing 1994, Theobald 2013).

Although Robinet (1997) insists that Ge Hong was only interested in pharmacology as an adjunct to alchemy, the Baopuzi also includes important material on medicine and pharmacology. Other pharmacological treatises attributed to him are no longer extant: Prescriptions for Rescuing the Dying after the Pulse-takin g ( Zhou hou jiu zu Fang 肘後救卒方), Prescriptions from the Jade Box (玉函方 Yu han fang ), Herbal Recipes from the Gold Cabinet ( Jin gui yaofang 金匱藥方), and Prescriptions for Emergencies after Taking the Pulses ( Zhou hou bei ji fang 肘后備急方), which is said to be the first Chinese text to mention smallpox ( tian hua bing 天花病). Thirteen texts attributed to Ge Hong are preserved in the Daoist Canon ( Dao zang 道藏), but most are probably later works (Robinet 1997, 78–113, Theobald 2013).

In summary, Ge Hong’s writings combine interests in Confucian ethics, Daoist self-cultivation and alchemical techniques, and the details of medicine and pharmacology.

Tao Hongjing陶弘景 (456–536) was the effective founder of Shangqing 上清 (Highest Clarity) Daoism. He held several court positions under the Liu Song and Qi dynasties. In 492 he retired to Mount Mao (Maoshan 茅山), where he became interested in the so-called Shangqing revelations to Yang Xi a century before his time. He set himself to collect and edit the original manuscripts connected with these revelations. The result was the Declarations of the Perfected ( Zhen gao 真誥). When the Liang dynasty came to power in 502, he joined the court of Emperor Wu (r. 502–549), on whom he had considerable influence.

Tao was educated in Daoist traditions associated with the Daode jing, Zhuangzi, and the works of Ge Hong; and was initiated in the Linbao school at the age of thirty. He was also actively engaged in mostly unsuccessful attempts to produce alchemical elixirs (Strickman 1979, 152).

Tao’s father and grandfather were experts in medicinal drugs, and he shared their interests in materia medica and medicine. Shortly after compiling the Zhen gao he wrote a major work of pharmacology: the Collected Commentaries to the Canonical Pharmacopoeia ( Bencao jing jizhu 本草經集注), a commentary and re-edition of the Shen Nong bencao , a Han work of pharmacology attributed to Shen Nong, the legendary inventor of materia medica. Tao doubled the account of 365 drugs in the original and also rearranged the material (502–557), (Predagio 2013, 968–71; Robinet 1993; Strickman 1979).

Tao Hongjing is thus another clear case of overlapping interests between philosophy and medicine. His interests clearly included Daoist philosophy and practice, medicine, pharmacology and alchemy.

Sun Simiao 孫思邈 (581–682) was the author of two major works on medical practice and a work on Daoist longevity prescriptions. He has been worshiped as the “Medicine Buddha,” and as the “King of Medicine” ( yao wang ). Sun is said to have taken up medicine to strengthen his own health after childhood illnesses. He also treated relatives and neighbors, and practiced medicine near the Tang capital of Chang’an. He also traveled widely to learn new prescription recipes. After completing his first book, he lived in seclusion on Mt. Wubai (Wubai shan, later known, after him, as Yao wang Shan ), where he followed Daoist principles. He refused several official positions at the Sui and Tang courts, preferring to treat ordinary people in the countryside.

His biography (in both of the two Standard Histories of the Tang Dynasty , trans. Sivin 1968, 81–144) emphasizes his interests in philosophy, noting his particular study of the Yi jing , Daode jing , works concerned with yin-yang theory, and shu shu numerical calculations. His work reflected these interests in yin-yang and wuxing theory and macrocosm-microcosm correspondences between the body and cosmos. He is also the first Chinese physician to write extensively on medical ethics.

Sun Simiao is the author of two major medical works. Prescriptions Worth a Thousand Gold ( Qian jin fang 千金方, printed in 652 CE) was a comprehensive treatise on the practice of medicine in thirty chapters. It contained herbal remedies and reviewed the history of medicine since the Han Dynasty, starting with the Huang Di neijing .

The introduction to the Qianjin fang (ch. 1) describes the characteristics of a great physician and describes inappropriate conduct, especially the desire for wealth or reputation. According to Sun, a great physician should not pay attention to status, wealth or age; he should not care whether a person is attractive, a friend or enemy, or whether the person is (Han) Chinese or educated. He should meet everyone on equal grounds and should always act as if he were thinking of a close relative (ch.1. For translation see Unschuld 1979, 29–33).

The Qian jin fang also includes chapters on diet (ch. 26), nurturing life (yang xing, ch. 27), pulse diagnosis (ch. 28), acumoxa (chs. 29–30, the combination of acupuncture and moxibustion), massage, and exercise. His interests also included the treatment of women (ch. 2–4) and children (ch. 5). May chapters are concerned with herbal recipes. Sun Simiao emphasized that the effectiveness of herbal recipes depended on correct identification and preparation, including gathering herbs at the right time and drying them correctly. His formulas came from both famous physicians of the past and his own contemporaries, including minorities and foreigners. He also edited formulas to eliminate non-essential ingredients.

The second book is a supplement to the first. The supplement ( Qian jin yi fang 千金翼方, printed in 682) records some thirty years of Sun’s own experience with special attention to folk remedies. It adds some eight hundred recipes, with details on collection and preparation for two hundred. Some are new herbs, including herbs from India. It also refers to many mystical and magical practices, including exorcisms, talismans, incantations and descriptions of acumoxa points effective against demons.

Sun was also the author of several works on Daoist alchemy, which he is believed to have practiced (he died at the age of 101). These include the Essential Instructions from the Scripture of the Elixirs of Great Clarity ( Taiqing Danjing Yaojue, ca. 640), an anthology of some thirty selected methods (Sivin 1968, 262–264). His “Essay on Preserving and Nourishing Life” ( Sheyang lun 攝養論) gives monthly advice on food, sleeping habits and action of good and ill auspice (Predagio 2013,928).

In summary, Sun Simiao, like Ge Hong and Tao Honjing combines explicit interests in Daoist philosophy, medicine, materia medica and alchemy. These physicians were informed by the yin-yang theory and cosmology of the Yi jing and the philosophical concepts of the Zhuangzi and Daode jing. But, despite their strong philosophical interests, the major contributions of their writings lie in the areas of medicine, pharmacology and alchemy.

The views of the physician Zhang Xichun (1860–1933) provide an important testimony to the complex relations between Chinese medicine and Chinese philosophy. Zhang’s life coincided with the transition of China from the Qing dynasty to the modern era, a period in which major Chinese intellectuals were preoccupied by questions of the relative merits of indigenous philosophical and scientific traditions as compared to foreign knowledge, especially of science and medicine.

The medical context for these debates was the differences between Chinese and Western medicine, and the best role for traditional Chinese medicine in modern times. Zhang was a major contributor to these debates. Zhang Xichun was trained by his father in traditional medicine from youth, but he was also educated in the classics of Chinese philosophy. He became a leading proponent of the “school of converging and connecting” Chinese and Western medicine ( hui tong xue pai 匯衕學派. For the life of Zhang Xichun see Scheid 1995, 5–6).

Zhang’s book contains an essay explicitly titled “Concerning The Relation of Philosophy and Medicine.” It is so central to the topic of this essay that it is worth quoting at length. Zhang begins by remarking that recent (Chinese) medical journals accuse traditional Chinese philosophy of holding back the progress of medicine. He responds: “their authors do not understand the use of philosophy, nor do they understand that philosophy is actually the basis of medicine.” He quotes a passage from the Book of Songs (Shi jing) says: “he is intelligent and wise, and protects his own person” ( Shi jing , “Zheng min” 烝民, Mao 260). The passage refers to a certain Zhong Shanfu 仲山甫, a virtuous minister of King Xuan of Zhou (r. 827–782 BCE). The point is that “protecting one’s person means not only protecting oneself from attach by thieves or robbers but also protecting one’s person from being beset by disease and illness. But, Zhang continues, the point of the quotation is that people must possess an inherent aptitude for intelligence and wisdom. They must also make a systematic study of wisdom and virtue, and only then can we protect our persons.

He next identifies the combination of inherent aptitude and systematic study behind ”being intelligent and wise and protecting one’s own person“ with what the recluse-hermits of antiquity called ”the dao of nurturing life ( yang sheng zhi dao 養生之道). In his view, the nurturing life ( yang sheng ) practices of antiquity are what we now call philosophy.

He goes on to argue that those who had the benevolent disposition of a junzi and themselves understood nurturing life practices wanted to enable others to be able to nurture their own lives. However, for people who do not use understanding and wisdom to protect their persons, the way of nurturing life was not sufficient, and they themselves could not help falling ill: “therefore they promulgated the principles of philosophy and originated the disciplines of medicine and pharmacology (materia medica) in order to offer assistance to those who themselves were unable to engage in nurturing life practices.”

He then goes on to identify specific physicians with this derivation of medicine from philosophy, including Ge Hong, Tao Hongjing and Sun Simiao. All these great physicians, he argues, were really philosophers who wrote important philosophical works.

He then turns to the Huang Di neijing , which begins with a chapter titled “Discourse on the True [Qi Endowed by] Heaven in High Antiquity” (Shang Gu Tian Zhen Lun). It says: “In highest antiquity there were true men ( zhen ren ) who upheld [the patterns of] heaven and earth and grasped yin and yang, exhaled and inhaled essence qi ( jing qi ), stood alone and guarded their spirit ( shen ), and their muscles and flesh were like one, and thus they were able to achieve longevity in correspondence with heaven and earth” ( Huang Di neijing 1, trans. after Unschuld 2011, 42).

Zhang argues that, according to the neijing , these realized persons were able to use these techniques to transform their temperament and disposition and to achieved achieve an infinite life expectancy. He thus identifies a clear link from the realized persons of high antiquity to the great schools of Chinese philosophy through the methods and theories attributed to the Yellow Emperor.

His point is that, although the neijing is an exposition of medicine: “it necessarily begins with philosophy and takes philosophy as the study of how to safeguard one’s person. People must first be able themselves to protect their own persons; only then can they represent to others how to protect their persons. Taking philosophy as the way to protect one’s person, it is by means of the principles of philosophy that we are able to preserve our bodies by transforming our qi . Taking medicine is the way to protect other people’s bodies, it is by first completely understanding the transformation of qi in one’s own person that [the physician] is able to represent to others how to adjust the transformation of qi in their own bodies.” He concludes: “from this we understand that philosophy is the true source of medicine, or rather that medicine is the natural outcome of philosophy. This is why the Neijing states explicitly that the study of medicine must start from philosophy.” How, he concludes, could philosophy obstruct medicine? (Zhang Xichun 1918–1934, 296–98).

In conclusion, this brief account addresses important issues in the connections between Chinese philosophy and the development of Chinese medicine. Philosophical texts clearly influenced medicine in several ways. First, both are grounded in theories of qi, yin-yang and wuxing and microcosm-macrocosm analogies based on them. However, as in the case of science more generally, philosophical textualists emerged as a distinct social group from the fang shi , especially. Nonetheless, we can trace philosophical concerns in several areas of medical interest, especially the ongoing history of “nurturing life” ( yang sheng ) practices, first described in philosophical texts but elaborated in great and practical detail by physicians and alchemists such as Ge Hong, Tao Hongjing and Sun Simiao. This linkage is made explicit by one of the greatest of China’s twentieth-century physicians and medical reformers, Zhang Xichun, who unequivocally describes philosophy as the basis of medicine.

  • Baopuzi neipian jiao shi 抱樸子内篇校釋 (The Inner Chapters of the Master Who Embraces Simplicity) , Wang Ming 王明 (ed.), Beijing: Zhonghua shuju, 1996.
  • Campany, R., 2002, To Live as Long as Heaven and Earth: A Translation and Study of Ge Hong’s Traditions of Divine Transcendents , Berkeley and Los Angeles: University of California Press.
  • Csikszentmihalyi, M., 2004, Material Virtue Ethics and the Body in Early China , Leiden: Brill.
  • Csikszentmihalyi, M., and M. Nylan, 2003, “Constructing lineages and inventing traditions through exemplary figures in early China,” T’oung-pao , 89 (1-3): 59–99.
  • Despeux, C., 2018, Taoism and Self Knowledge: The Chart for the Cultivation of Perfection (Xiuzhen tu) , Boston and Leiden: Brill.
  • Furth, C., 1986, A Flourishing Yin: Gender in China’s Medical History, 960–1665 , Berkeley: University of California Press.
  • Gao Riguang 高日光, 1996, “Ge Hong 葛洪,” in Zhuzi baijia da cidian 諸子百家大辭典 (Dictionary of Philosophers), Feng Kezheng 馮克正 and Fu Qingsheng 傅慶升 (eds.), Shenyang: Liaoning renmin chubanshe, p. 87.
  • Graham, A. C., 1986, Yin-Yang and the Nature of Correlative Thinking , Singapore: Institute of East Asian Philosophies.
  • –––, 1986b, Chuang-tzu: The Inner Chapters , London: George Allen & Unwin.
  • Han shu 漢書 (Standard History of the Han Dynasty), Beijing: Zhonghua shuju, 1962.
  • Harper, D., 1998, Early Chinese Medical Literature , London and New York: Kegan Paul International.
  • –––, 1999, “Warring States Natural Philosophy and Occult Thought,” in The Cambridge History of Ancient China: From the Origins of Civilization to 221 B.C. , M. Loewe and E. L. Shaughnessy (eds.), Cambridge: Cambridge University Press, pp. 813–84.
  • Ho, Peng-Yoke, 2007, Explorations in Daoism: Medicine and Alchemy in Literature , J. P. C. Moffett and Cho Sungwu (eds.), with a foreword by T. H. Barrett, London: RoutledgeCurzon.
  • Huainanzi 淮南子 ( Huainan Annals ), Zhuzi jicheng edition.
  • Huang Di neijing zhang ju suo yin 黃帝內經章句索引 (Concordance to the Huang Di neijing), Ren Yingqiu 任應秋 et. al. (eds.), Beijing: Renmin weisheng chubanshe, 1986.
  • Kalinowski, M., 2004, “Technical Traditions in Ancient China and Shushu Culture in Chinese Religion,” in Religion and Chinese Society. Volume 1: Ancient and Medieval , J. Lagerwey (ed.), Hong Kong: Chinese University Press, pp. 223–248.
  • Keegan, D. J., 1988, “The Huang-ti Nei-ching: The Structure of the Compilation; The Significance of the Structure,” Doctoral dissertation, University of California, Berkeley.
  • Knoblock, J. and J. Riegel, 2000, The Annals of Lü Buwei: A Complete Translation and Study , Palo Alto: Stanford University Press.
  • Lai Chi-Tim, 1998, “Ko Hung’s Discourse of Hsien-Immortality: A Taoist Configuration of an Alternate Ideal Self-Identity,” Numen , 45 (2): 183–220.
  • Li, Ling 李零, 1993, Zhongguo fang shu kao 中國方術考 ( Study of the Magical Arts of China ), Beijing: Renmin Zhongguo chubanshe.
  • –––, 2000, Zhongguo fang shu xu kao 中國方術續考 ( Supplementary Studies of the Magical Arts of China ), Beijing: Renmin Zhongguo chubanshe.
  • Lo, V., 2001, “The Influence of Nurturing Life Culture,” in Innovation in Chinese Medicine , E. Hsu (ed.), Needham Research Institute Studies, Cambridge: Cambridge University Press, pp. 19–50.
  • –––, 2005, “Self-cultivation and the Popular Medical Traditions,” in Medieval Chinese Medicine: The Dunhuang Medical Manuscripts , V. Lo and C. Cullen (eds.), London: RoutledgeCurzon, pp. 207–290.
  • Lo, V. and C. Cullen (eds.), 2005, Medieval Chinese Medicine: The Dunhuang Medical Manuscripts , London: RoutledgeCurzon.
  • Lo, V. and P. Barrett (eds.), 2018, Imagining Chinese Medicine , Boston and Leiden: Brill.
  • Lloyd, G. E. R., 1996, Adversaries and Authorities: Investigations into Ancient Greek and Chinese Science , Cambridge: Cambridge University Press.
  • Lloyd, G. E. R., and N. Sivin, 2002, The Way and the Word: Science and Medicine in Early China and Greece , New Haven: Yale University Press.
  • Lü shi chunqiu jiao shi 呂氏春秋校釋 (Springs and Autumns of Master Lü), by Lü Buwei 呂不韋 (291?-235 BCE), Chen Qiyou 陳奇猷 (ed.), Shanghai: Guji chubanshe, 1984
  • Ma, Jixing 馬幾興 (ed.), 1992, Mawangdui gu yi shu kao shi 馬王堆古醫書考釋 ( Explanation of medical documents from Mawangdui ), Hunan: Hunan kexue jishu chubanshe.
  • Mawangdui Hanmu boshu 馬王堆漢墓帛書 (The Silk Manuscripts from the Han Tombs at Mawangdui), Mawangdui Hanmu boshu zhengli xiaozu (ed.), Volume 4, Beijing: Wenwu, 1985.
  • Metailié, G., 2015, Science and Civilisation in China Pt. 4. Traditional Botany: An Ethnographic Approach , Cambridge: Cambridge University Press.
  • Needham, J., 1979, The Grand Titration: Science and Society in East and West , Boston: G. Allen & Unwin.
  • Needham, J. and Wang Ling, 1956, Science and Civilization in China, Vol. 1: Introductory Orientations , Cambridge: Cambridge University Press.
  • Ngo, V. X., 1976, Divination Magie et Politique dans la Chine Ancienne , Paris: Presses Universitaires de France.
  • Predagio, F. (ed.), 2013, The Encyclopedia of Daoism , 2 volumes, London: Routledge.
  • Qing Xitai 卿希泰, 1994, Zhongguo daojiao 中國道教 (Chinese Daoism), Shanghai: Zhishi chubanshe, vol. 1, pp. 236–238.
  • Raphals, L., 1998, Sharing the Light: Representations of Women and Virtue in Early China , Albany: State University of New York Press.
  • –––, 2005, “Craft Analogies in Chinese and Greek Argumentation,” in Literature, Religion, and East-West Comparison: Essays in Honor of Anthony C. Yu , E. Ziolkowski (ed.), Wilmington: University of Delaware Press, pp. 181–201.
  • –––, 2008–2009, “Divination in the Han shu Bibliographic Treatise,” Early China , 32: 45–101.
  • –––, 2013, Divination and Prediction in Early China and Ancient Greece , Cambridge: Cambridge University Press.
  • –––, 2015, “Science and Chinese Philosophy,” The Stanford Encyclopedia of Philosophy (Summer 2015 Edition), Edward N. Zalta (ed.), URL = < https://plato.stanford.edu/archives/sum2015/entries/chinese-phil-science/ >.
  • Rickett, W. A., 1985, Guanzi: Political, Economic and Philosophical Essays from Early China , Volume 1, Princeton: Princeton University Press.
  • –––, 1998, Guanzi: Political, Economic and Philosophical Essays from Early China , Volume 2, Princeton: Princeton University Press.
  • Robinet, I., 1993, Taoist Meditation: The Mao-Shan Tradition of Great Purity , Albany: State University of New York Press.
  • –––, 1997, Daoism: Growth of a Religion , trans. P. Brooks, Palo Alto: Stanford University Press.
  • Sailey, J., 1978, The Master Who Embraces Simplicity: A Study of the Philosopher Ko Hung, A.D. 283–343 , San Francisco: Chinese Materials Center.
  • Scheid, V.,1995, “The Great Qi: Zhang Xichun’s Reflections On the Nature, Pathology and Treatment of the Daqi,” Journal of Chinese Medicine , 49 (5): 5–16.
  • Shi ji 史記 (Annals), by Sima Qian 司馬遷 (?145-?86) and others, Beijing: Zhonghua, 1959.
  • Sivin, N., 1968, Chinese Alchemy: Preliminary Studies , Cambridge: Harvard University Press.
  • –––, 1969, “On the Pao P’u Tzu Nei Pien and the Life of Ko Hong (283–343),” Isis , 60: 388–391.
  • –––, 1982, “Why the Scientific Revolution Did Not Take Place in China – Or Didn’t It?” Chinese Science , 5: 45–66.
  • –––, 1988, “Science and Medicine in Imperial China – The State of the Field,” Journal of Asian Studies , 47: 41–90.
  • –––, 1990, “Science and Medicine in Chinese History,” in Heritage of China. Contemporary Perspectives on Chinese Civilization, P. S. Ropp (ed.), Berkeley: University of California Press, pp. 164–196.
  • –––, 1995, “State Cosmos and Body in the Last Three Centuries B.C.E.,” Harvard Journal of Asiatic Studies , 1995(1): 5–37.
  • –––, 1995b, “Taoism and Science,” in Medicine, Philosophy and Religion in Ancient China: Researches and Reflections (Chapter VII, pp. 1–72), Aldershot: Ashgate (Variorum Collected Studies Series).
  • –––, 1998, “The History of Chinese Medicine: Now and Anon.,” Positions , 6(3): 731–762.
  • –––, 2007, “Drawing Insights from Chinese Medicine,” in New Interdisciplinary Perspectives in Chinese Philosophy , K. L. Lai (ed.), 34: 43–55. Journal Supplement Series to Journal of Chinese Philosophy , 2.
  • –––, 2015, Health Care in Eleventh-Century China , Cham: Springer International.
  • Strickman, M., 1979, “On the Alchemy of T’ao Hung-ching,” in Facets of Taoism: Essays in Chinese Religion , H. Welch and A. Seidel (eds.), New Haven: Yale University Press, pp. 123–192.
  • –––, 2002, Chinese Magical Medicine , B. Faure (ed.), Palo Alto: Stanford University Press.
  • Tessenow, H. and P. Unschuld, 2008, A Dictionary of the Huang Di Nei Jing Su Wen , Berkeley and Los Angeles: University of California Press.
  • Theobald, U., 2013, “Ge Hong 葛洪,” in Feng Kezheng and Fu Qingsheng (eds.), Zhuzi baijia da cidian, Shenyang: Liaoning renmin chubanshe, p. 87, available online .
  • Unschuld, P. U., 1979, Medical Ethics in Imperial China: A Study in Historical Anthropology , Berkeley and Los Angeles: University of California Press.
  • –––, 1986, Medicine in China: A History of Pharmaceutics , Berkeley and Los Angeles: University of California Press.
  • –––, 2003, Huang Di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text , Berkeley: University of California Press.
  • –––, 2016, Huang Di nei jing ling shu: The Ancient Classic on Needle Therapy. The Complete Chinese Text with an Annotated English Translation , Berkeley and Los Angeles: University of California Press.
  • Unschuld, P. U. and H. Tessenow, 2011, Huang Di Nei Jing Su Wen: An Annotated Translation of Huang Di’s Inner Classic – Basic Questions , 2 volumes, University of California Press.
  • Ware, J. R., 1981, Alchemy, Medicine & Religion in the China of A.D. 320: The Nei P’ien of Ko Hung , rpt; New York: Dover Publications, Inc.
  • Watson, B. (trans.), 2013, The Complete Work s of Zhuangzi , New York: Columbia University Press.
  • Wells, M.,2003, “Self as Historical Artifact: Ge Hong and Early Chinese Autobiography,” Early Medieval China 9: 71–103.
  • Wong, Ming (trans.), 1987, Ling-shu. Base de l’acupuncture traditionnelle chinoise , Paris: Masson.
  • Yamada, Keiji 山田慶兒, 1979, “The Formation of the Huang-ti Nei-ching .” Acta Asiatica , 36: 67–89.
  • Yates, R. D. S., 2005, “Medicine for Women in Early China: A Preliminary Survey,” Nan Nü , 7(2): 127–181.
  • Zhang Xichun 張錫純, 1918–1934, Lun zhexue yu yixue zhi guanxi 論哲學與醫學之關係 (Concerning The Relation of Philosophy and Medicine) in Yi xue zhong zhong can xi lu 醫學衷中參西錄 (Records of Heart-felt Experiences in Medicine with Reference to the West), rpt. Taiyuan: Shanxi kexue jizhu chubanshe, 1990, pp. 296–298.
  • Zhou Yimou 周一謀, and Xiao Zuotao 蕭佐桃, 1987, Mawangdui yi shu kao zhu 馬王堆醫書考注 ( Investigations and Notes on the Medical Books from Mawangdui ), Tianjin: Tianjin kexue.
  • Zhou Yimou 周一謀 (ed.), 1994, Mawangdui yi xue wenhua 馬王堆醫學文化 ( The Medical Culture of Mawangdui ), Shanghai: Wenhui chubanshe.
  • Zhuangzi ji shi 莊子集釋 ( Collected Explanations of the Zhuangzi), ed. Guo Qingfan 郭慶籓, Beijing: Zhonghua shuju, 1961.
How to cite this entry . Preview the PDF version of this entry at the Friends of the SEP Society . Look up topics and thinkers related to this entry at the Internet Philosophy Ontology Project (InPhO). Enhanced bibliography for this entry at PhilPapers , with links to its database.
  • Daoism and Daoist Studies , James Miller, Duke University.
  • Golden Elixirs (Chinese alchemy), Fabrizio Predagio, University of Erlangen-Nuremberg.
  • Guides to Research: Chinese Science and Medicine , Nathan Sivin, History and Sociology of Science, University of Pennsylvania.
  • Needham Research Institute , a centre for the study of the history of East Asian science, technology and medicine.

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Comparison of Traditional and Modern Medicine

The history of modern medicine development includes many different stages, including traditional medicine. Traditional medicine primarily focuses on using herbs and plants to improve the population’s health status and solve minor health issues. Nowadays, traditional medicine is commonly acknowledged as outdated, as modern medicine with more sophisticated intervention methods has proven itself to be more effective and allows more straightforward treatment of many illnesses and diseases. However, there still are some conditions that modern medicine cannot treat, meaning that both traditional and modern medicine have limits. This essay will compare the primary difference between traditional and modern medicine.

Firstly, in order to determine the core difference between traditional and modern medicine, one needs to define the core principles of both subjects. As mentioned earlier, traditional medicine predominantly focuses on health practices that focus on the use of plant, mineral, or animal-based medicines. Traditional medicine presents a complex of historically developed medical knowledge about the benefits of natural components for health maintenance and prevention of diseases. Therefore, considering the goals of traditional medicine and its studies of herbalism and ethnomedicine, the health practices used in traditional medicine are more focused on health maintenance and prevention methods.

On the other hand, modern medicine was built on the foundation of practical knowledge acquired from tests and detailed examinations. Modern medicine prioritizes the process of defining diagnosis statements and therefore focuses on providing effective treatment of specific diseases. Compared with traditional medicine that utilizes a more complex approach to human health, modern medicine combines knowledge of various intervention health practices to ensure fast recovery for the patient. However, in prioritizing the treatment of biological conditions and abnormalities of human organism’ functions, modern medicine tends to overlook non-physical conditions such as mental health problems.

Next, comparing the differences in how traditional and modern medicine approach health allows defining further valuable distinctions. As medications in modern medicine are tailored for specific health needs to achieve a certain result or effect, the development of medications in traditional medicine requires significant material resources and time. However, even though modern medications are developed for specific goals, the compounds cannot be changed or altered for each individual patient. Furthermore, in order to achieve significant results in a short period, modern medicines often include a substantial dosage of active ingredients. Incorrect dosage, individual reactions, and interactions between different drugs can cause a wide range of side effects. Therefore, the lack of a personal approach to the patient in modern medicine can result in mixed results, where treating one condition can harm the patient’s overall health.

On the contrary, medications in traditional medicine are often made differently for patients with different health needs and consider patients’ individual characteristics. While many mistakenly perceive traditional herbal medication as safer than modern medications, they similarly can cause allergic reactions and different negative effects. However, as medications in traditional medicine imply prolonged use, the dosage of active ingredients tends to be less effective. Instead of using the mix of active ingredients from different plans as in modern medications, traditional herbal medications use the whole plant. Lastly, compared to herbal medications, excessive use of modern medications with various components can eventually cause drug resistance and reduce the efficiency of drug use for the patient.

Lastly, it is important to acknowledge that traditional and modern medicine use different methods for treatments and training forms for the professionals. In modern medicine, the treatment process is predominantly presented by focusing on the initial cause of the disease, and intervention methods can include complex operations such as surgical interventions. Therefore, professionals in modern medicine need a long time to study the functioning of the human body and the connections within the human body system. The training process includes learning the theoretical knowledge basis and practice. Furthermore, as modern medicine develops rapidly with new technologies, professionals need to be aware of discoveries and improvements in the healthcare area.

On the other hand, traditional medicine utilizes less intrusive treatment methods, such as massages and acupuncture. Therefore, the training for health professionals in traditional medicine is mostly presented by the transfer of theoretical knowledge. In some cases, the knowledge is passed to members of the families to preserve the skills and experience. Moreover, there are no significant innovations in traditional medicine found in modern times, and therefore the practitioners do not have to access new knowledge sources.

In conclusion, this essay defined the critical differences between traditional and modern medicine. Modern medicine is developed to solve specific health issues in a short time, while traditional medicine utilizes a holistic approach to health and therefore is mistakenly perceived as less effective. In some cases, traditional medicine can be more helpful than modern medicine. Traditional medicine utilizes less intrusive methods, and herbal medications have fewer side effects than modern medications as they do not have many active ingredients. Thus, while traditional medicine can be more helpful for the population for health maintenance and health issues prevention, modern medicine helps with the effective management of health issues.

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Traditional Chinese Medicine Meets Evidence-Based Medicine in the Acutely Infarcted Heart

  • 1 Cardiovascular Division, Washington University School of Medicine in St Louis, St Louis, Missouri
  • Original Investigation Traditional Chinese Medicine Compound and Clinical Outcomes of Patients With Acute Myocardial Infarction Yuejin Yang, MD, PhD; Xiangdong Li, MD, PhD; Guihao Chen, MD, PhD; Ying Xian, MD, PhD; Haitao Zhang, MD, PhD; Yuan Wu, MD; Yanmin Yang, MD; Jianhua Wu, MD; Chuntong Wang, MD; Shenghu He, MD; Zhong Wang, MD; Yixin Wang, MD; Zhifang Wang, MD; Hui Liu, MD; Xiping Wang, MD; Minzhou Zhang, MD; Jun Zhang, MD, PhD; Jia Li, MD; Tao An, MD; Hao Guan, MD; Lin Li, MD; Meixia Shang, MD; Chen Yao, MD; Yaling Han, MD, PhD; Boli Zhang, MD; Runlin Gao, MD; Eric D. Peterson, MD, MPH; CTS-AMI Investigators; Yuejin Yang; Jianhua Wu; Chuntong Wang; Shenghu He; Zhong Wang; Yixin Wang; Yongquan Jing; Linqiang Liu; Xuxia Zhang; Hanjun Pei; Yuzeng Xue; Guanzhong Zheng; Changyu Wang; Zhongming Zhao; Yanjie Zheng; Baoliang Duan; Gaoxing Zhang; Hui Liu; Zhifang Wang; Zeyuan Fan; Wenzhai Cao; Huanyi Zhang; Xiaoyong Qi; Xiping Wang; Guoqing Wu; Feng Gao; Zidong Bie; Long Yue; Heng Hong; Jun Qian; Bingguang Dai; Weiguang Dou; Liming Yue; Zhongqun Zhan; Man Liu; Xiaohong Gao; Yitian Lian; Yi Zheng; Jiangwu Zhang; Ronghai Man; Peng Dong; Lianling Wu; Junguo Deng; Yong Guo; Minzhou Zhang; Jia Li; Zheying Wang; Peisheng Dai; Guleng Siri; Qiming Xu; Xinyang Li; Keqing Li; Shengli Han; Huaixin Wang; Xia Li; Ping Yang; Haowen Zhang; Yuesen Liu; Bo Xin; Menglang Zhang; Zhiduo Cao; Meng Zhang; Gang Ma; Lei Wang; Jun Song; Weiguo Li; Hongchun Li; Zhenglu Shang; Ouhua Feng; Hongjun Zhang; Hongtao Gao; Rongqi Bao; Fengshun Wang; Linqing Shang; Lei Qin; Jianping Wang; Genshan Ma; Jiayu Cui; Shixi Wang; Fangzhou Cheng; Shujiang Zhang; Xianshi Liu; Chunxi Cha; Min Sun; Wenbao Han; Hang Lu; Haiying Wang; Hongguang Zhu; Wei Wang; Zhili Wang; Yufeng Guo; Haisheng Zhang; Zhong Shao; Xirong Cui; Changlin Lu; Zhan Lv; Jiyin Zhang; Guangkai Cui; Hongwei Zhang; Ying Han; Wenli Liu; Bingfeng Zhou; Hua Ge; Liqun Zhang; Taihong Chen; Bingying Niu; Baoxi Mu; Jiao Zhang; Huaimin Guan; Yuhu Chun; Hua Zhang; Fangjiang Li; Shufang Yin; Xu Wang; Xiao Zou; Junshuai Song; Lang Hong; Mingqi Zheng; Bo Jiang; Shuying Liu; Rui Zhu; Wenbo Liu; Jie Zhang; Bin Wu; Zonggui Wu; Quan Fang; Zuyi Yuan; Chuanyu Gao; Hong Jiang; Xinli Li; Peili Bu; Wei Gao; Hongxu Liu; Ying Xian; Runlin Gao; Boli Zhang; Yaling Han; Junbo Ge; Eric Peterson; Shaoliang Chen; Jielin Pu; Qingshan Zheng; Congxin Huang; Weifeng Shen; Yuan Wu; Chen Yao; Xiaoyan Yan; Meixia Shang; Xiaohan Fan; Huaibing Cheng; Wenlan Chang; Hui Wang; Zhi Li; Wenxuan Zhai; Zhenghui Zhu; Hui Li; Jianpeng Wang; Jin Tao; Bo Xu; Meiying Sun; Fan Wu; Tongqiang Zou; Yue Chang; Peng Yin; Junyan  Shen; Yaxing  Zhang; Yunfei  Huang; Guihao Chen; Xiangdong Li; Yi Xu; Jingang Yang; Haitao Zhang; Chen Jin; Min Wang JAMA

Over the past 40 years, outcomes for patients experiencing acute ST-segment elevation myocardial infarction (STEMI) have improved dramatically, fueled by therapeutic interventions proven effective and safe by rigorous clinical trials. 1 Those often landmark clinical trials arose from the transformational concept that treatment should be guided by the results of simple, adequately powered, placebo-controlled, randomized clinical trials that test the effects of single pharmaceutical-grade agents or devices for the outcomes of interest. And the advances they afforded to clinical practice arguably represent some of the most important achievements of modern evidence-based medicine. Despite those advances, patients with STEMI still have a high risk of morbidity and mortality, and no major advances in STEMI therapeutics have emerged in more than a decade.

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Bach RG. Traditional Chinese Medicine Meets Evidence-Based Medicine in the Acutely Infarcted Heart. JAMA. 2023;330(16):1529–1530. doi:10.1001/jama.2023.20838

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How modern design is giving traditional Asian medicine a new lease of life

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essay of traditional medicine

By Floydd Wood | Strategy director

1HQ Brand Agency

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March 6, 2024 | 8 min read

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1HQ’s Floydd Wood charts a boom in creative branding of neo-traditional Asian medicine, enabled by smart packaging, modernized designs, and cutting-edge spaces.

Someone dropping a quantity of oil onto their hand

Traditional Chinese medicine has taken a modern infusion, says 1HQ's Floydd Wood / Christin Hume via Unsplash

Driven by Asia’s extraordinary economic momentum, traditional medicines and healthcare services are being repackaged for a growing, younger, and style-conscious audience. The results are remarkable and inspiring.

Dating back some 23 centuries , it’s hardly surprising that traditional Asian medicine systems were beginning to go out of fashion. In affluent and consumerist modern Asia, the dated image of traditional medicines lacks accessibility for a new generation of consumers.

According to The British Medical Journal, in 2010, 30% of Chinese people were using traditional Chinese medicine (TCM), but less than 10 years later, this figure had dropped to just 13% , with many taking a new interest in ‘modern’ alternatives.

While TCM is one of the most well-regarded traditional Asian medicinal systems across the globe, this same relevancy problem exists for other popular systems including Kampo from Japan, Jamu from Indonesia and Ayurveda from India. Popular? Well, less so as time moves on.

Changing expectations of millennials and gen Z

The changing age demographic in Asia has compounded the issue for this business sector. Many Asian populations are getting younger; over 60% of the world’s youth live in the Asia-Pacific region. That’s more than 750 million young adults aged from 15 to 24 .

Many of these young adults have increasing levels of disposable income, with Asia’s economic success over the past 30 years raising living standards for people at every income level, according to McKinsey . The question, as McKinsey puts it, “is no longer how quickly Asia will rise; it is how Asia will lead.”

With their money, their aspirations and their social media, many young Asians are keen to explore new ways of doing things and are developing tastes for elevated experiences.

Packaging and the process of rejuvenation

For traditional Asian medicine to survive in this shiny modern world, something needed to change. Packaging design has played an important role in making these remedies relevant again.

Inspired by ancient Chinese cosmic concepts of yin and yang, the stunning new brand identity for the Mari Acupuncture Clinic , by Nero Atelier, is a perfect illustration of the new wave of design within the sector. The yin, dark and passive, is represented by the earth; the yang, active and light is represented by the heavens. Symbolizing wisdom, 16 acupuncture needles make up the sun at the heart of the design, while the sun itself, embodies the center of healing energy.

Now check out the fresh (literally) design cues of the Indonesian wellness brand Jamu With You. Both the taste of the product and the appearance of the stylish packaging have been transformed to appeal to a new fashion-conscious and youthful target, with an emphasis on the natural health-promoting ingredients.

Then look at Namaskar Ayurved, an Indian-origin, Ayurveda-based range of beauty and wellness supplements made from natural ingredients. The packaging is sleek and contemporary ; the free-flowing typography is refined; the sun-kissed color palette evokes warming Indian spices. The jars use frosted colored glass with a screen print to make the packaging even more distinctive.

Many traditional Asian remedies are now being marketed in similarly sophisticated ways to give them the kind of social kudos that would normally be reserved for leading FMCG brands. The zinging colors and intricately-shaped containers are attracting both plaudits and customers.

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Modernizing retail and treatment spaces

Retail and treatment spaces are another key component of the shopping experience that’s undergoing transformation. We’re beginning to see stylish environments that would look quite at home on the glossy pages of an interior design magazine.

The Sumiyoshido Kampo Lounge, specializing in acupuncture and moxibustion, feels more like a leisure space than a medical clinic . The use of soothing mint green and white creates a fresh and tranquil ambiance, with the designer boldly striving to achieve the look of an expansive shop window. Unfamiliar for older consumers, perhaps, trend-setting surroundings like this are creating a buzz with an image-conscious younger audience. Traditional Asian medicine has never looked less traditional.

While these changes are predominantly impacting the local market within Asia, the sophisticated designs are finding their way into alternative therapy outlets further afield in trend-setting cities such as Sydney, San Francisco and London.

All these best practice examples illustrate the way that, driven by Asia’s economic development, healthcare products and services are being reframed as approachable, everyday, even enjoyable products. This reflects a global shift of health and wellness products into a new space we like to call FMCH (‘fast moving consumer health’).

Content by The Drum Network member:

essay of traditional medicine

1HQ is a global brand agency. For over 30 years, 90% of our business has come from people happy to spread the word about their experience working with us, and the powerful impact we’ve had on their brand. We help define and communicate a brand’s Meaningful Difference by identifying and amplifying the attributes and assets that maximise its relevance, credibility, and distinctiveness. In doing so, we ask and answer the hard questions that determine how brands should be positioned, how they should innovate, and how they are best represented through strategy, design and communication.

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India’s struggle to integrate traditional medicine into modern healthcare

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  • Geetanjali Krishna , freelance journalist
  • geetanjalikr{at}gmail.com

India finds itself at the forefront of a push to incorporate traditional healers into an overstretched medical system. Missteps and a constant battle against a billion dollar wellness industry have led to legal skirmishes and rising tensions, Geetanjali Krishna reports

In August 2023 India hosted the World Health Organization’s first ever Traditional Medicine Global Summit. Thirteen countries, including Brazil, Cuba, India, and Mexico, disclosed that they had a plan for integrating traditional, complementary, and integrative medicine (TCIM) systems 1 into their national health service delivery.

Back in 2005, 45 of WHO’s 194 member states had national policies on TCIM 2 ; in 2023 this was around 100. 3 TCIM treatments are part of WHO’s essential medicine list and essential health service packages. They are covered by national health insurance schemes in several countries, including many US states and Canadian provinces, where naturopathic doctors 4 can make diagnoses, order tests, use medical technology, write prescription drugs, and perform minor surgeries.

A major reason for this trend is patchy health coverage due to a shortage of health workers. In India 71% of the population live in rural areas, but only 36% of its health workforce is located there. In such areas healthcare leans heavily on traditional medicine, an approach backed up by government policy. However, challenges arise because traditional medical treatments are based on beliefs that often run often counter to modern medical models—and because traditional medicine is a lucrative industry in itself. In India the billion dollar TCIM market is reportedly pricing patients out of treatments, 5 and tensions between medical doctors and alternative therapists are boiling over into legal action.

Health or business?

In 2005, in a bid to tackle a severe staff shortage in rural areas, India’s National Rural Health Mission made the case 6 for involving the Ayush ministry—an acronym of the TCIM systems of ayurveda, yoga and naturopathy, unani, siddha, and homeopathy. The ministry was created in 2014, and TCIM facilities 7 were combined with modern medical structures such as primary health centres, community health centres, and district hospitals. By 2023 it had set up 12 Ayush research and training centres in India, with a combined budget of 12.91 million Indian rupees (about US$1.1m (£0.87m; €1m) at the time).

By 2020 India’s Ayush industry was valued at $18.1bn 8 and was expected to grow fivefold by 2025, fuelled by sales of premium wellness and spa therapies, special diets, nutritional supplements, and cosmetics. The global homoeopathy market is also expected to double 9 from $6.31bn in 2022 to $13.21bn in 2027, again relying on the sale of creams, ointments, and combination remedies used in healing practices.

In India the multiplicity of products has led to several grey areas in regulation. The Drugs and Cosmetics Act 1940 and the Drugs and Cosmetics Rules 1945 apply to the quality control and issuing of drug licences for Ayush drugs, just as they do to modern pharmaceuticals, requiring stringent evidence including clinical trials.

But during the covid pandemic Patanjali Ayurved, a company that manufactures and sells ayurvedic products, food, and cosmetics, launched Coronil as a herbal “cure” for covid, citing a laboratory trial conducted on zebrafish. The product had been approved by the Ayush ministry as an “immunity booster.” After a complaint was made to the police 10 Patanjali stopped advertising Coronil as a covid remedy, but it continues to sell it as a supplement. 11

An unsafe “mixopathy”

In 2020 the government proposed to train Ayush doctors to perform surgeries, with the goal of increasing the number of qualified health staff. This was criticised by non-profit groups and public health experts. 12 The Indian Medical Association (IMA) labelled it an unsafe “mixopathy,” amassing more than 100 000 signatures from members 13 in a public petition and an open letter 14 to the prime minister. It also organised two fortnight-long hunger strikes, 15 in 2020 and 2021. Thousands of doctors and medical students throughout India—all IMA members—participated in the protests.

The IMA has suggested that, instead of using Ayush doctors, the government should create a national medical service within the national bureaucracy to ease the problem of medical access in India. It has even developed a list of 1500 junior doctors who have offered to join the service. 16 Additionally, it has filed repeated notices and cases against Ayush entrepreneurs such as Baba Ramdev, 17 18 cofounder of Patanjali Ayurved. Leaving the “choice of treatment system” to patients has led to serious consequences, 19 from liver failure to death, says the IMA. But the protests haven’t led to any change in the government’s push for Ayush: a new law to regulate and systematise its education and practice was passed in 2021. 20

Meanwhile, more criticism has come from the Liver Research Club India, a collaboration of hepatologists and gastroenterologists from 13 tertiary care hospitals in nine locations in India. They have conducted research based on small sample clinical observations of adverse events linked to ayurvedic, homoeopathic, and naturopathic drugs.

In 2019 Cyriac Abby Philips, a liver transplant surgeon in Kerala, met a patient 21 with cirrhosis related to non-alcoholic fatty liver disease. A biopsy suggested severe alcoholic hepatitis, but the patient denied having consumed alcohol. Philips found that the homoeopathic drugs the patient had taken for more than a month contained 18% ethanol. He also found that most homoeopathic tinctures needed significant quantities of methanol or ethanol to dissolve and carry homoeopathic components. The patient died of liver failure shortly after.

Philips’s earlier research 22 had found that patients who regularly consumed ayurvedic formulations for various reasons—such as “gas trouble,” loss of appetite, diabetes, or fatty liver—developed severe liver injury in almost 20% of cases. He tells The BMJ , “As a clinical hepatologist and a liver transplant physician, I see at least three new cases of traditional medicine/herbal and dietary supplement related liver injury in a week.”

He adds that the number was more like six to nine cases a week during the pandemic because of increased demand for traditional medicines such as the herb giloy, 23 the ashwagandha 24 shrub, and arsenicum album (a homoeopathic remedy), 25 which the Ayush ministry continues to recommend 26 as covid prophylactics. 27 The increased demand has spurred many entrepreneurs to gather and sell these herbs to ayurvedic medicine manufacturers. 28

Philips and colleagues at the Liver Research Club have identified and published details of potentially harmful ingredients such as alcohol, 29 as well as heavy metal contaminants, 22 in medicines that are perceived as being “natural and safe.” This has led to complaints from the Ayush industry: Philips’s X (Twitter) account was suspended 30 for two weeks in September 2023 after the Himalaya Wellness Company, a multinational personal care and pharmaceutical company based in Bangalore, filed a defamation suit against him. 31 Philips had claimed on social media that in his clinical experience Himalaya’s Liv 52, which claims to supports digestion and help improve liver activity, wasn’t based on ayurvedic principles and was marketed as a treatment for more medical conditions than it had been tested for (a paper on this is in peer review for publication, says Philips).

Global pushback

India isn’t alone in finding itself in a difficult position regarding TCIM. Drug induced liver injury linked to TCIM is being reported worldwide. 32

In 2015 Australia’s National Health and Medical Research Council considered 57 systematic reviews that assessed the effectiveness of homoeopathy, in terms of placebos and other treatments, for 68 health conditions. It concluded, “Based on all the evidence considered, there were no health conditions for which there was reliable evidence that homoeopathy was effective. No good-quality, well-designed studies with enough participants for a meaningful result reported either that homoeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment.” 33 The council’s recommendations were reviewed after charges of possible conflict of interest but were upheld 34 in 2023 owing to “the absence of independent, expert scientific expertise” on the scientific methodology of the study.

In 2019 the French government decided to end social security reimbursements for homoeopathy prescriptions by 2021, citing a lack of evidence that they work. 35

Last year a US study found that 61% of herbal supplement products had at least one instance of non-compliance on the physical label. 36 The researchers concluded that the sale of ayurvedic medicines that didn’t conform to the US Food and Drug Administration’s labelling standards and didn’t list all ingredients, benefits, and possible side effects were “a major public health concern, as many consumers are not likely to understand the regulatory differences between dietary supplements and drugs.”

WHO is in the process of establishing the Global Traditional Medicine Centre, based in Gujarat, to try to build a solid evidence base for policies and standards on TCIM. Geetha Krishnan G Pillai, unit head of evidence and learning at the centre, says that the adverse events linked to traditional remedies are often due to self-medication. “There is a misconception that Ayush remedies are harmless, and so people don’t exercise the same caution while taking them that they would with allopathic drugs,” he tells The BMJ .

Pillai, an ayurvedic physician and clinical pharmacologist himself, is studying the efficacy of traditional medicines such as Phyllanthus amarus (for hepatitis B) and Trichopus zeylanicus (for reducing fatigue and improving stamina). He says, “Traditional systems like ayurveda are definitely effective, but their medicines must be taken only under prescription from a registered practitioner, in the prescribed dosage and for the prescribed duration.”

For ayurveda to be taken seriously as an effective system of medicine, it’s necessary to “delink ayurveda as a medical practice from the market driven pharmaceutical industry flourishing in the country today,” Pillai adds. If this doesn’t happen, he warns, mistakes like the launch of Coronil will reduce the credibility of systems using traditional and complementary medicines.

Competing interests: None.

Provenance and peer review: Commissioned, not externally peer reviewed.

  • ↵ World Health Organization. Traditional, complementary and integrative medicine. https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine#tab=tab_1
  • ↵ World Health Organization. WHO global report on traditional and complementary medicine 2019. 2019. https://iris.who.int/bitstream/handle/10665/312342/9789241515436-eng.pdf?sequence=1
  • ↵ World Health Organization. Global partners commit to advance evidence-based traditional, complementary and integrative medicine. 19 Aug 2023. https://www.who.int/news/item/19-08-2023-global-partners-commit-to-advance-evidence-based-traditional--complementary-and-integrative-medicine
  • ↵ Nelson DH, Perchaluk JM, Logan AC, Katzman MA. The bell tolls for homeopathy: time for change in the training and practice of North American naturopathic physicians. J Evid Based Integr Med 2019;24:2515690X18823696. doi: 10.1177/2515690X18823696 . https://pubmed.ncbi.nlm.nih.gov/30789055/
  • ↵ Interest in Ayurvedic beauty surges, but 1 in 5 Indian consumers find it old-fashioned. PR Newswire 2023 Aug 3. https://www.prnewswire.com/in/news-releases/interest-in-ayurvedic-beauty-surges-but-1-in-5-indian-consumers-find-it-old-fashioned-301891519.html
  • ↵ Press Information Bureau (Delhi). Harmonising Ayush and modern medicine. 9 Feb 2021. https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1696425
  • ↵ Press Information Bureau (Delhi). Prime Minister highlights the importance of Ayurveda and Yoga in his inaugural address at “World Food India”. 3 Nov 2023. https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1974572
  • ↵ Business Research Company. 2023 forecast: global homeopathy market analysis. Feb 2024. https://www.reportlinker.com/p06486479/Homeopathy-Global-Market-Report.html?utm_source=GNW
  • ↵ What legal action can Ramdev face for selling an unproven covid-19 “cure”? Wire 2020 Jun 29. https://thewire.in/law/ramdev-patanjali-coronil-covid-19-cure
  • ↵ Amazon. Patanjali Coronil tablet—80 tablets. https://amzn.eu/d/g0jSyoo
  • Chandra S ,
  • Patwardhan K
  • ↵ No to mixopathy. Change.org. 17 Feb 2021. https://bit.ly/3SlSkbI
  • ↵ Indian Medical Association. Letter to Narendra Modi. https://ima-india.org/ima/images/letter-addressed-to-Hon-PM-N-Modi.pdf
  • ↵ Indian Medical Association. No to mixopathy (relay hunger strike against mixopathy). https://ima-india.org/ima/important-news-mixopathy.php
  • ↵ Indian Medical Association. Country report (p 8). 2021. https://www.cmaao.org/wp-content/uploads/2021/08/India_Country-Report_2021.pdf
  • ↵ Kumar S. Stop misleading advertisements, will impose Rs 1 crore cost on every product claiming false cure: Supreme Court to Patanjali Ayurved. Live Law 2023 Nov 21. https://www.livelaw.in/top-stories/supreme-court-patanjali-baba-ramdev-misleading-advertisements-indian-medical-association-242694
  • ↵ Will give befitting reply”: Patanjali on legal notice sent by top medical body. NDTV 2021 May 27. https://www.ndtv.com/india-news/patanjali-on-legal-notice-sent-by-indian-medical-association-will-give-befitting-reply-2450682
  • Philips CA ,
  • Augustine P ,
  • Paramaguru R ,
  • ↵ PRS India. Bill summary: the National Commission for Indian System of Medicine (Amendment) Bill, 2021. 10 Aug 2021. https://prsindia.org/billtrack/prs-products/prs-bill-summary-3775
  • Antony KL ,
  • Augustine P
  • Kulkarni AV ,
  • Hanchanale P ,
  • Prakash V ,
  • Liver Research Club India
  • Theruvath AH ,
  • Raveendran R ,
  • ↵ Government of India, Ministry of Ayush. National clinical management protocol based on Ayurveda and Yoga for management of covid-19. 6 Oct 2020. https://yoga.ayush.gov.in/public/assets/ayush-Protocol-covid-19.pdf
  • ↵ Press Information Bureau (Delhi). Ayush Ministry kickstarts campaign to distribute prophylactic medicines. 2 Sep 2021. https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1751452
  • ↵ Nair A. Maharashtra: Rush for medicinal plant giloy during pandemic sparks tribal youth’s business idea. Times of India 2021 Jun 17. https://timesofindia.indiatimes.com/city/pune/rush-for-medicinal-plant-giloy-during-pandemic-sparks-tribal-youths-biz-idea/articleshow/83588671.cms
  • Abduljaleel JK ,
  • ↵ Wankhade S. Bengaluru Court directs X Corp to temporarily suspend TheLiverDoc id on defamation suit by Himalaya Wellness. Bar Bench 2023 Sep 28. https://www.barandbench.com/news/bengaluru-court-directs-x-corp-temporarily-suspend-theliverdoc-id-defamation-himalaya-wellness
  • ↵ X account of “The Liver Doc” suspended after court issues ex-parte injunction in suit filed by Himalaya. Wire 2023 Sep 28. https://thewire.in/law/x-account-of-the-liver-doc-suspended-after-court-issues-ex-parte-injunction-in-suit-filed-by-himalaya
  • ↵ Australian Government, National Health and Medical Research Council. NHMRC statement: statement on homeopathy. Mar 2015. https://www.nhmrc.gov.au/sites/default/files/images/nhmrc-statement-on-homeopathy.pdf
  • ↵ Commonwealth Ombudsman. Finalisation of investigation relating to the National Health and Medical Research Council’s review of the evidence for the effectiveness of homeopathy. 4 Aug 2023. https://www.ombudsman.gov.au/__data/assets/pdf_file/0008/300014/NHMRC-2023-Statement.pdf
  • ↵ Haute Autorité de Santé. Médicaments homéopathiques: une efficacité insuffisante pour être proposés au remboursement [Homeopathic medicines: insufficient effectiveness to be offered for reimbursement]. 28 Jun 2019. https://www.has-sante.fr/jcms/p_3066934/fr/medicaments-homeopathiques-une-efficacite-insuffisante-pour-etre-proposes-au-remboursement (In French)
  • Jordan CR ,
  • Harris CM ,
  • Miranda MI ,
  • Hellberg RS

essay of traditional medicine

  • Open access
  • Published: 07 March 2024

A multi-center cross-sectional study of Chinese Herbal Medicine-Drug adverse reactions using active surveillance in Singapore’s Traditional Chinese Medicine clinics

  • Chester Yan Jie Ng 1 ,
  • Yan Zhao 1 ,
  • Ning Wang 2 ,
  • Kwan Leung Chia 3 ,
  • Chun Huat Teo 4 ,
  • William Peh 5 ,
  • Pansy Yeo 6 &
  • Linda L. D. Zhong 1  

Chinese Medicine volume  19 , Article number:  44 ( 2024 ) Cite this article

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This study aimed to investigate the rates and causality of patient-reported adverse events (AEs) associated with concomitant Chinese Herbal Medicine (CHM) and Western Medicine prescription drug (WMPD) consumption through active surveillance in Singapore’s Traditional Chinese Medicine (TCM) clinics.

A cross-sectional study was conducted at five TCM clinics across Singapore from 8th May till 8th July 2023. Patients were screened to determine rates of CHM and WMPD consumption, and then interviewed if an AE was reported. An expert committee assessed the AE reports to determine causality. Along with descriptive statistics, odds ratios were calculated to determine AE occurrence likelihoods for patients who consumed both CHM and WMPD compared to CHM consumption alone.

1028 patients were screened and 62.65% of them reported concurrent CHM-WMPD consumption. Patients who consumed CHM and WMPD were 3.65 times more likely to experience an AE as compared to CHM consumption alone. 18 AE reports were adjudicated, with most AEs deemed unlikely due to CHM consumption.

Conclusions

A large proportion of patients consumed CHM and WMPD concurrently, thus increasing their risk of experiencing AEs compared to those consuming CHM only. Active surveillance is applicable for detecting AEs, collecting data for causality assessment, and analysis.

Introduction

With increasing popularity and usage of Traditional Chinese Medicine (TCM) worldwide, the consumption of Chinese Herbal Medicine (CHM) has also increased [ 1 , 2 ]. Many developed countries have shown interest in complementary and alternative medicine (CAM), thus generating an increase in demand for complementary medical therapies [ 3 ]. In Singapore, although Western Medicine (WM) is the main mode of healthcare, TCM also enjoys considerable popularity as a complementary therapy. The Singapore National Health Survey 2010 revealed that 39.6% of the population respondents had visited a TCM physician, 26.0% sought treatment for general well-being, 25.8% for acute minor injuries such as sprains, 20.6% for chronic aches and pain like headaches, back pain and rheumatism, and 17.5% for acute minor illnesses [ 4 ]. TCM is also the most widely used form of CAM in Singapore, accounting for 88% of total CAM use [ 5 ]. One probable explanation for this high rate of use is TCM's long history, and a general belief that TCM is a safe treatment alternative for preventative care and chronic disease management [ 6 ]. Furthermore, the Ministry of Health (MOH) estimated that about 45% of the population had consulted a TCM practitioner in the past in 1994, and 7 years later, it was revealed that the rate had increased to 67%. Hence, TCM use is progressively growing amongst the Singapore population [ 7 ].

Increased risks of herb-drug interactions

Increasing CHM consumption necessitates a greater awareness of potential risks that may arise from the concurrent use of CHM and WM prescription drugs (WMPD). Any negative or undesired sign, symptom, or disease correlated with the use of a pharmaceutical product, regardless of whether it is related to the product itself, is defined as an adverse event (AE) emerging from consumption. An AE that is suspected to be due to the consumption of a pharmaceutical product is defined as an adverse reaction (AR) [ 8 ]. With increasing prevalence of concurrent consumption of CHM with WMPD, patients are at a higher risk of unintended herb-drug interactions, especially with drugs with narrow therapeutic indices such as warfarin [ 9 ]. An increase in the frequency of herb-drug interactions could lead to increased occurrences of AEs and ARs, thus impacting patient safety [ 10 , 11 ]. Therefore, it is crucial to have a system in place to monitor the occurrences of such AE reports, and for the necessary authorities to act and assess the underlying reasons behind these AEs to minimize repeat events.

Current methods to detect AEs and ARs

Currently, regulatory agencies rely primarily on passive surveillance systems to detect the presence of AEs and ARs, a common example being surveillance systems to monitor potential adverse effects of vaccines [ 12 , 13 ]. This model has also been used for other healthcare-related purposes, such as monitoring the safety of point-of-care products, new healthcare products and dengue prevention [ 14 , 15 , 16 ]. However, the success of these systems is largely dependent on spontaneous reporting by both patients and healthcare professionals, the individual's discretion in recognizing when an AE should be recorded, and their ability to submit a thorough report for assessment [ 17 , 18 ]. Other variables influencing the detection of AEs include healthcare professionals not actively inquiring about the patient's AE and medication consumption history, patients’ unwillingness to disclose AEs, and an overall lack of awareness about the risks associated with medicinal product consumption [ 8 , 19 , 20 , 21 ]. Hence, there is a growing need for an alternative system to complement passive surveillance to actively identify AEs and enhance patient safety [ 22 ].

Active surveillance as an alternative model

In terms of epidemiological surveillance, active and passive surveillance are two main methods of surveillance. In passive surveillance systems, medical professionals in the community and at health facilities report cases to the public health agency, which conducts data management and analysis once the data are received [ 23 ]. On the other hand, active surveillance necessitates that public health personnel participate actively in the system and take action to obtain case reports. This may involve calling or visiting health facilities to encourage follow-up or having staff review medical records to identify cases meeting prescribed case definitions. Recent studies have shown that active surveillance systems are effective in collecting AE and AR data [ 22 ]. For instance, pharmacy Study Of Natural health product Adverse Reactions (SONAR) was a multicenter population-based observational study in which the researchers partnered with Health Canada, community pharmacists, and pharmacies to implement an active surveillance screening system to detect patient-reported AEs associated with natural health product consumption [ 24 ]. The pilot study conducted in Ontario in 2012 discovered that the deployment of active surveillance detected a 3000-fold greater rate of ARs than the passive monitoring approach used by Health Canada during the same time period [ 22 ]. Following the pilot study, the subsequent multi-center cross-sectional study conducted in Alberta, and British Columbia (Western Canada) also confirmed that active surveillance had significantly increased AE reporting rates [ 24 ]. During the study, community pharmacists screened consecutive patients, or agents of patients who were dropping or picking up prescription medications. Thereafter, patient interviews were conducted for patients who reported and AE to collect meaningful information for full causality assessment of an AE. Laboratory analysis was conducted to support this assessment. Both studies were well received, and feedback from the participating clinics and patients was also positive. Considering the success of this active surveillance model in Canada, we chose to adopt and adapt this model of active surveillance for data collection at local TCM clinics. For this study, we decided to engage TCM physicians and clinic staff to conduct screening of patients. Thereafter, patient interviews were conducted for patients who reported and AE to collect meaningful information before causality assessment of an AE was conducted.

Significance and objectives

In Singapore, related studies have relied on data-mining techniques to evaluate AEs reported from consumption of CAM products and supplements [ 25 , 26 ]. These studies were able to reveal trends associated with AE occurrences, and one common consensus was the importance of AE reporting even if causality could not be proven, as the presence of significant clusters of AE reports could compel relevant authorities to take immediate corrective action and investigate the causes of these AEs. However, the effectiveness and feasibility of different methods of AE surveillance has not yet been investigated. This study would also be the first and largest multi-center observational study on CHM-WMPD adverse reaction conducted in Singapore. Through active surveillance, we aimed to determine the proportions of patients using both CHM and WMPD concurrently, and their respective AE rates. Causality assessment would also be conducted on the reported AEs to better understand the underlying reasons behind AEs reported by patients who consume CHM and WMPD.

Firstly, this study protocol was approved by the Institutional Review Board of Nanyang Technological University (Reference Number: IRB-2023-312). The study was then conducted using a two-phase cross-sectional model, and was reported in accordance with the STROBE statement [ 27 , 28 ]. Phase 1 involved the implementation of an active surveillance model in local TCM clinics and data collection via patient interviews. Thereafter, Phase 2 involved causality assessment of the AEs by a team of medical and pharmacology experts. The study flow is shown in Fig.  1 below.

figure 1

Flowchart depicting the study flow

Five local TCM clinics were approached to take part in the study for 9 weeks, lasting from 8th May 2023 to 8th July 2023. The clinics involved were: (1) NTU Chinese Medicine Clinic (NTU TCM), (2) Singapore Thong Chai Medical Institution (STCMI), (3) Singapore Chung Hwa Medical Institution (SCHMI), (4) Chong Hoe Healthcare Beauty World Centre Branch (CHHC BWC), and (5) Chong Hoe Healthcare Clarke Quay Central Branch (CHHC CQC). We chose to include commercial (CHHC BWC and CHHC CQC), nonprofit (STCMI and SCHMI), and educational institutions (NTU TCM) to provide a more unbiased sampling of the nation’s TCM patient population. Subsequently, training was provided to the designated staff in charge of data collection, and relevant study materials such as consent forms and patient information packages were provided. Clinic staff were also provided with follow-up and assistance via remote support such as telephone calls and online meetings if necessary.

All adult patients (≥ 21 years of age) who have consumed CHM at the participating clinics were included in the study. Prior to the study, the clinic managers and clinic staff involved in this study were passed copies of the consent form to inform them of the details of the questions to be asked, and they were asked to sign a participation consent form as well. For this study, the primary investigator oversaw and conducted patient recruitment. Research assistants were stationed at the patient waiting area and interviewed consecutive patients to ask if they would be willing to take part in this study. In addition, the physicians involved in this study also assisted with patient recruitment by asking the patients during their consult period. All participation in this study was voluntary and no remuneration was given to the participants. Thereafter, if they agreed to participate in the study, they would be tasked to sign a patient consent form. The patient information package passed to the patients was an information sheet detailing our study details and the aim of our study. It was displayed both in the clinic and passed out to the patients who participated in our study. Patients who could not communicate in either English or Chinese were not included in this study.

During the study, patient confidentiality was ensured as no patient identifiers were collected. All results collected were only by name, and no other private details (such as phone number, email, NRIC, and other ID information) were collected. In addition, the results collected were stored on a password-protected Excel document that was only accessible to the PI.

For our study, clinic patients were asked to recall their medication usage history and any AE occurrences within the past 2 months. The participating clinic staff and/or physicians asked patients three questions as listed in the Preliminary Questionnaire. The questions are shown in Fig.  2 below. If the patients answered “Yes” to Question 1 and/or Question 2, the patients would be asked to participate in a second interview using the SONAR Interview Questions. The participating clinic staff and/or physicians did not assess the causality of any reported AEs at this stage as causality assessment would only be conducted by an expert committee in Phase 2 of the study.

figure 2

Flow of preliminary questions for patient screening

For patients who have reported an AE from concurrent CHM and WMPD consumption and completed the SONAR Interview Questionnaire, the cases were summarized and adjudicated by a three-member committee of medical experts. The committee consisted of an expert in epidemiology, an expert in TCM herb pharmacology and an expert in Western Medicine.

Our first expert is an experienced researcher in the field, who is a senior lecturer and practicing TCM consultant at NTU TCM Clinic with over 30 years of clinical practice and is actively involved in various basic science research projects and clinical trials involving TCM herbs. She is also a member of the TCM taskforce in Singapore, and Co-Chair of TCM Research Grant Committee of Singapore’s Ministry of Health. Our second expert is trained in TCM herb pharmacology, and an experienced researcher in the field actively engaged in basic science and translational research on the prevention and treatment of human gastrointestinal cancers using CHM. Our last expert is a private general practitioner and emergency doctor with special interests in integrative Chinese and Western Medicine. He has around 10 years of experience, including working in the field of toxicovigilance in Hong Kong’s Department of Health and has published high quality research articles in internationally peer-reviewed journals. In addition, our team also had two advisors, Dr Sunita Vohra and Dr Heather Boon who conducted pharmacy SONAR in Canada, to assist and guide us in the causality assessment process. Dr Sunita Vohra is a clinician scientist with training in pediatrics, clinical pharmacology, and clinical epidemiology and her primary research interest is enhancing clinical research methods, including: (i) innovative clinical trial design; (ii) active surveillance in safety research; and (iii) improved outcomes reporting. Dr Heather Boon is the current Vice-Provost, Faculty & Academic Life of the University of Toronto and her research focuses on the safety and efficacy of traditional, complementary, and integrative health practices and products, and related regulatory and policy issues, which has been supported by over $10 million of competitive research grants.

During the causality assessment process, patient identifier information was blinded to the members of the expert committee. The adjudication process involved the presentation of the cases by the primary researcher, followed by a sharing of views and opinions from each of the three experts, after which the expert committee produced a joint assessment using both the WHO Causality Algorithm and the Naranjo Causality Scale [ 29 , 30 ]. In each instance, consensus was reached through discussion.

Statistical analysis

The data collected from Phase 1 was used to calculate population demographics by clinic. The data were first compiled into a Microsoft Excel file, before being exported for further analyses and data visualization. To evaluate any differences between the male and female groups, a two-sample t -test comparison was performed using IBM SPSS Statistics [ 31 ]. Thereafter, a population pyramid and box and whisker plot by gender were visualized with R Studio using the packages “tidyverse” and “ggplot2” [ 32 , 33 ]. In addition to descriptive statistics, data measures calculated included standard deviation (SD), standard error mean (SEM), and 95% confidence interval (CI). The odds ratio (OR) was also calculated using IBM SPSS Statistics to determine AE occurrence likelihoods for patients who consumed both CHM and WMPD compared to CHM consumption alone. A P-value less than 0.05 was considered statistically significant.

Baseline characteristics

A total of five outpatient clinics participated in the study over 9 weeks, lasting from 8th May 2023 to 8th July 2023. 1028 patients were screened in total. Most of the patients screened were from STCMI, accounting for 55.45% of the study population. A detailed distribution of patients by clinic is shown in Table  1 below. Additionally, it was found that most of the patients screened were of Chinese ethnicity (96.89%). In terms of education, the majority had received tertiary education (53.50%). Internal medicine (51.46%) was the main purpose of visit amongst the patients. A detailed breakdown of patient characteristics is shown in Table  2 below.

In terms of gender distribution, the percentage of male and female patients were 43.09% and 56.91% respectively. The two-sample t -test also produced the values of t (1026) = 0.643 and P = 0.52, thus showing that the mean age of the male patients screened (Patients: 443, Mean: 57.00, SD:18.31; SEM: 0.87) was not significantly different from the mean age of female patients screened (Patients: 585, Mean: 56.28, SD: 17.25; SEM: 0.71). The majority of the male patient population were of the 70–74 age group, accounting for 6.23% of the overall patient population, while the majority of the female patient population were of the 65–69 age group, accounting for 7.10% of the total patient population. A population pyramid and box and whisker plot depicting the patient gender demographic distribution is depicted in Fig.  3 below.

figure 3

A Population pyramid showing demographic distribution of the participants; B Box and whisker plots of patients screened

Phase 1: Active surveillance

From the results, it was observed that concurrent CHM and WMPD consumption was common, occurring in 62.65% (95% CI 59.69 to 65.60) of the total patients screened. Table 3 shows the proportions of participants screened who were consuming CHM, or CHM and WMPD in each clinic.

Subsequently, the OR was calculated, and it was shown that patients who consumed both CHM and WMPD were 3.65 times (95% CI 1.07 to 12.48; P = 0.0389) more likely to experience an AE when compared to CHM intake alone. STCMI patients had an OR of 3.48 (95% CI 0.43 to 28.03; P = 0.242), while NTU TCM patients had an OR of 5.03 (95% CI 0.55 to 45.63; P = 0.151). For three clinics (SCHMI, CHHC BWC, CHHC CQC), an OR could not be calculated as there were no AE reports in either the CHM consumption and/or the CHM and WMPD consumption group. Table 4 shows the proportions of patients reporting AEs and the respective OR when CHM and WMPD consumption was compared with CHM consumption only.

Of the patients screened, 18 patients (1.75%) reported an AE after consuming CHM and WMPD while 3 patients (0.29%) reported an AE after consuming only CHM. Amongst the AE reports, the 18 patients who reported an AE from CHM and WMPD consumption were then questioned in depth using the SONAR Interview Questions to obtain further information for Phase 2 of the study. The 3 patients who reported an AE from consuming only CHM were not interviewed as our study wished to focus on potential CHM-WMPD interactions only.

Phase 2: Causality assessment

A total of 18 detailed AE reports underwent causality assessment by the three-member expert committee. Following recommendations from past studies, the WHO Causality Scale and the Naranjo Causality Scale were used together for a more comprehensive evaluation [ 34 , 35 ]. Firstly, adjudication with the WHO Causality Scale revealed that 1 case was likely caused by CHM, 5 cases were possibly caused by CHM, and 12 cases were unlikely to be caused by CHM. Thereafter, adjudication with the Naranjo Causality Scale revealed that 6 cases were doubtful adverse drug reactions while 12 causes were possible adverse drug reactions. A detailed flow chart depicting the results of Phase 1 and Phase 2 is shown in Fig.  4 below.

figure 4

Flow chart depicting Phase 1 and Phase 2 results

Among the AE reports adjudicated, 9 patients reported stomach discomfort, 2 patients reported fatigue and lethargy, 2 patients reported headaches, 2 patients reported nausea, 2 patients reported diarrhea, and 1 patient reported rashes and itching. A detailed summary of the cases adjudicated is provided in Table  5 below.

Main findings

The implementation of active surveillance in outpatient TCM clinics allowed for the detection of AEs reported by patients consuming CHM and/without WMPD. A total of 1028 individuals were screened for our study, and it was discovered that concurrent CHM and WMPD intake was prevalent, occurring in 62.65% (95% CI 59.69 to 65.60) of the total patients examined. Clinic patients who consumed both CHM and WMPD were 3.65 times (95% CI 1.07 to 12.48; P = 0.0389) more likely to experience an AE than those who used CHM alone.

In addition, our study’s interview and adjudication process allowed for complete causality assessment of the reported AEs. The participation of an expert committee comprising of professionals in epidemiology, TCM herb pharmacology, and Western Medicine allowed for a thorough evaluation and exchange of meaningful insights from multiple perspectives, thus enhancing the comprehensiveness of the adjudication process. Amongst the cases adjudicated, most patients reported that their reported AEs did not interfere with their ability to conduct regular daily activities. Based on the evaluations from the two causality scales, we found that AE occurrence is likely to be multi-factorial and not solely attributed to the consumption of both CHM and WMPD. Although we could not identify the exact causes just by the two causality scales, we could further conduct more animal studies or toxicity studies to investigate the underlying mechanisms of action.

Lastly, our study found that the incidence of patient-reported AEs in TCM clinic settings was low, with only 21 patients (2.04%) reporting either an AE arising from solely CHM or from CHM and WMPD consumption. In contrast, the level of severity and AE occurrences in other healthcare practices were found to be greater. For instance, a recent scoping review of 25 studies investigating in-hospital AEs revealed that approximately 10% of hospital patients reported at least one AE, with 7.3% of these AEs being fatal [ 36 ]. A similar study on the prevalence of AEs in home healthcare populations in America also discovered that 13% of home healthcare patients reported an AE, with more than 75% of reported AEs being post-discharge related and requiring prolonged patient support [ 37 ]. Therefore, the low AE rate and mild nature of reported AEs in our study is a positive indication, and local TCM institutions should strive to further improve patient safety. Lastly, as compared to the pharmacy SONAR study in Canada, which also used a similar outpatient study model, their study indicated that 7.3% of study participants reported an AE from concurrent use of natural health products and prescription medications.

One strength of our study was the large sample size of 1028 patients across five TCM outpatient clinics. To date, this is the first and largest TCM related multi-center observational study on CHM-WMPD adverse reaction conducted in Singapore. The inclusion of commercial, nonprofit, and educational institutions provided a good overview and sampling of the nation’s TCM patient population, allowing us to gain a better understanding of patient demographics and medicine consumption patterns.

Furthermore, post-study feedback from the participating clinics revealed that the preliminary screening questions were quick and straightforward, and were well accepted by patients, participating clinic personnel, and physicians. The use of brief and succinct screening questions allowed for swift and efficient screening while also causing little dissatisfaction to the patients. The physician was also made aware of the patient's existing medication consumption history through this screening method, allowing them to better formulate prescriptions to complement the WMPD consumed by the patients, if any. Hence, the implementation of active surveillance into TCM AE collection is one key strength of our study and hopefully, this would help further enhance the comprehensiveness of TCM clinical diagnosis and treatment.

Limitations

Potential sources of bias.

The first potential source of bias identified was the possibility of sampling bias, as not all patients were screened due to the hectic clinic schedule. Due to the physicians and clinic staff’s busy schedules, the screening of patients depended largely on their workload. Furthermore, as this project had no form of monetary funding and incentive, all external assistance was voluntary, therefore physicians and clinic personnel may not have prioritized the screening and data collection as it was an imposition on their hectic schedules as well. As a result, the primary researcher was responsible for most of the screening and data collecting, rather than the physicians and clinic personnel. Considering this limitation, the following strategies were applied to counter these challenges. Firstly, recently graduated physicians with prior research experience were more actively engaged to assist in the patient screening process. This was advantageous as they were more likely to actively participate in the study process. Secondly, numerous site visits were made to ensure that the research protocol was adhered to. The primary researcher visited each study site once a week to conduct patient screening and to ensure seamless study implementation throughout the whole study period.

Another source of bias identified could have been recall or response bias. It was possible that the patient was not able to provide accurate information to the interviewer, thus leading to possible inaccuracies in data collection. To mitigate this constraint, the primary researcher verified the information supplied by respondents with the attending physician in as many cases as possible. In addition, the information supplied by the patients for the AE reports was cross-checked against patient records in the clinic database to confirm that the information provided was accurate. The patient’s medication records were also verified against their “Health Hub” application, which stores the patient’s prescription medication and health check records. This was especially useful in acquiring the patients' specific CHM and WMPD prescriptions, as they may not be able to recollect all details properly during the interview procedure.

Variations in results

One key variation identified through our study was the uneven ethnic composition of our patient population as compared to the actual ethnic composition in Singapore. In our study, Chinese patients formed the vast majority, accounting for 96.89% of the total patient population. This might be explained by TCM's profound roots in Chinese culture, which may be more appealing to the Chinese population due to its long-standing history [ 41 ]. Although this trend may be within expectations, it could affect the generalizability of study findings to different patient ethnic groups. Future epidemiological research might take this factor into account during the planning of the study design and strive to maintain a well-balanced ethnic diversity to improve the generalizability of study findings.

Another key variation identified was the difference in AE rates across the different TCM outpatient clinics. The lack of AE reports in either the CHM consumption or the CHM and WMPD consumption group in some clinics did not allow for the calculation of their respective AEs. One probable explanation is that the overall number of patients at these clinics was insufficient to capture an accurate AE rate. As privatized clinics, CHHC BWC and CHHC CQC screened fewer people than SCTMI and SCHMI, which were nonprofit institutions that offered significantly subsidized TCM consultations, thus attracting a higher patient flow. Therefore, more research is required to evaluate the validity of these reported variances.

Lastly, variation was observed when causality assessment was undertaken using two different assessment scales. Using the WHO Causality Scale, 1 case was determined to be likely caused by CHM, 5 cases possibly caused by CHM, and 12 cases unlikely caused by CHM. On the other hand, 6 cases were determined to be doubtful adverse drug reactions while 12 cases were determined to be possible adverse drug reactions using the Naranjo Causality Scale. A literature search also revealed that this trend was detected in similar investigations. For instance, in a study conducted between 2016 and 2018 at the Department of Pharmacology at the All India Institute of Medical Sciences Bhopal, two independent groups analyzed 842 AE case reports using either the WHO or the Naranjo Causality Scale [ 30 ]. However, the Cohen's kappa coefficient (κ) statistical test, demonstrated that there was no agreement between the WHO and Naranjo Causality Scales. Studies conducted by other research groups also yielded similar results, with the kappa coefficient statistical test demonstrating low agreement between the WHO and Naranjo Causality Scales [ 34 , 42 , 43 ]. Given these findings, adapting an active surveillance model to detect the AEs from herb-drug interactions is essential to improve the quality and reliability of further causality assessments.

Possible explanations and further studies

Amongst the clinics involved in the study, the common practice was to advise patients to space out the consumption of CHM and WMPD by 2 h to minimize possible incidences of herb-drug interactions [ 44 ]. This is a common clinical practice enforced in Singapore TCM clinics, and is often provided in the physician’s instructions to patients to consume CHM 2 h apart from WMPD [ 45 , 46 ]. However, one possible limitation lies in the different half-lives of different drugs. For example, diabetic drugs such as metformin and linagliptin have lengthy half-lives in plasma (2.7 h for metformin and 12 h for linagliptin) as compared to blood thinning agents like aspirin which has a shorter half-life of 20 min [ 47 , 48 , 49 ]. With variances in drug half-lives, it is thus difficult to predict the rates of drug clearance from our body systems. Furthermore, hepatic and renal diseases may interfere with the body's metabolism and elimination of the drugs, resulting in the drugs being present in the patient's body systems for an extended period of time [ 50 , 51 ]. Hence, the recommended time gap of 2 h might not be sufficient to account for the plasma clearance of the WMPD. Therefore, based on the patient's prior diseases and medication use, it is essential that physicians reconsider the acceptable time gap between CHM and WMPD consumption and counsel patients appropriately to ensure patient safety.

Another critical point to emphasize is herbal bioactivation. While the molecular processes behind herbal compound-related AEs are not well elucidated, recent research has discovered that bioactivation of herbal compounds could potentially generate reactive intermediates [ 52 , 53 ]. Like drugs, constituents of herbal compounds can also undergo Phase I and Phase II reactions to form nontoxic metabolites, which are eventually excreted from the body. However, reactive and potentially toxic metabolites could also be formed in the process, which could be an underlying cause of AE occurrences [ 54 ]. Some examples of known herbal compounds undergoing bioactivation associated with clinical toxicity include aristolochic acid and furans [ 55 , 56 ]. In addition, the use of CHM may cause synergistic or antagonistic interactions with concomitant drugs and/or modify drug disposition, resulting in therapeutic failure or toxicity [ 57 ]. Moving forward, research could thus focus on the following areas. Firstly, reliable toxicity biomarkers should be utilized to identify and predict the occurrence of AEs. Furthermore, basic research should try to better understand the mechanisms of action behind herbal bioactivation. Together with existing knowledge on the pharmacokinetics and pharmacodynamics of WMPD, this would allow for a better understanding of both the fates of drugs and herbs upon consumption, as well as ensuring that CHM and WMPD exert their effects in a complementary manner rather than contributing to AE occurrences.

In addition, a common observation in clinical practice was physicians prescribing multiple herbal formulas together in treatment. This is due to TCM’s belief that multiple ingredients in herbal formulas targeting multiple targets could produce synergistic or cumulative effects, thus enhancing therapeutic potential [ 58 ]. Novel techniques such as network pharmacology have also attempted to elucidate the synergistic effect of TCM compounds [ 59 , 60 ]. One such herb highlighted by one of the pharmacological experts during causality assessment was Glycyrrhiza glabra. Glycyrrhiza glabra is known as a “courier medicinal” herb which serves to regulate the other herbs in the same formula [ 61 ]. As a result, Glycyrrhiza glabra is prevalent in TCM formulations, and studies have indicated that it is a primary component in almost 60% of all TCM prescriptions [ 62 ]. Although Glycyrrhiza glabra possesses anti-inflammatory, immunostimulatory, and antiviral bioactivities, it has been demonstrated that excessive and prolonged usage of Glycyrrhiza glabra may result in pseudoaldosteronism [ 63 ]. Glycyrrhetinic acid, a key component of Glycyrrhiza glabra , has been shown to (1) block the 11-hydroxysteroid dehydrogenase 2 enzyme, which is responsible for the breakdown of active cortisol into inactive cortisol, (2) and bind to the mineralocorticoid receptor as an agonist [ 64 , 65 ]. As a result of high glycyrrhetinic acid levels, cortisol is unable to be deactivated and instead binds and activates the mineralocorticoid receptor, resulting in pseudoaldosteronism. Common presenting symptoms include headaches, weariness, and high blood pressure [ 66 ]. Hence, TCM practitioners must be aware of the recommended safe dosages of herbs, particularly when there are repeating herbs in their prescribed formulas.

Future directions

Improving clinical practice.

Active surveillance was found to be applicable in detecting AEs in this trial. One clinical application may be as follows. Doctors should try to include these screening questions in their diagnostic approach to better understand their patients' current medication consumption history and to know which herbs to avoid in prescriptions. By increasing the rates of AE identification and reporting, possible risk factors may be identified early, potentially preventing the transition from an AE to an AR. The preliminary screening questions were also brief and simple, lasting only around 30 s for each patient. Therefore, this should lower the number of AEs in the clinical environment, thus increasing overall patient safety.

At this present moment, an Adverse Event Online Database exists in Singapore and can be found on the Health Sciences Authority website [ 67 ]. In Singapore, there is a sizable, patented medicine industry for both acute and chronic disorders [ 68 ]. Hence, the Health Sciences Authority has formed a Product Vigilance Advisory Committee comprised of professionals in medicine, pharmacy, pharmacology, and forensic sciences responsible for analyzing important drug safety concerns and advising on the relevant regulatory steps to improve drug safety [ 69 ]. However, TCM practitioners do not have access to this database, and it is only accessible to the WM practitioners. This might be understandable, given that the primary focus of these surveillance methods is focused on WM products such as vaccines and new drugs undergoing clinical trials [ 70 , 71 , 72 ]. Nonetheless, it would be advantageous for authorities to offer both TCM and WM practitioners joint access to this database to monitor AEs from both TCM and WM patients. This would also allow TCM practitioners to assist with AE reporting and monitoring, thus contributing to improved patient safety.

Additionally, data acquired in this study could potentially be included into a database that TCM and WM doctors could access. With a database of combinations used with and without AEs, TCM and WM professionals might be better equipped to know which combinations to avoid when administering medicine. According to a recent summary by Zhang et al. in 2022, some examples of freely accessible databases include The Chinese-Western Medicine Integrative Information Network and Probot Chinese Medicine-Drug Interaction Database; while examples of commercially available databases include the UW Drug Interaction Database and Natural Medicines Comprehensive Database [ 73 ]. Hence, a similar model could be applied in Singapore to include updated herb-drug interactions, which could be implemented and shared across major healthcare providers nationwide such as clinics and hospitals. Together with the input from TCM and WM healthcare professionals, the creation of such a database should aim to be constantly revised and supplemented to present healthcare professionals with comprehensive and correct information to aid with medicine prescription. In the future, this could potentially be beneficial to improving overall patient safety.

Future research directions

As shown in this study, we have found that the rates of concomitant usage of CHM and WM were high in the Singapore environment. As a result, there may be more instances of possible herb-drug interactions. Therefore, future research might concentrate on better understanding the molecular mechanisms of actions of possible herb-drug interactions. The data collected through preliminary screenings could be used in collaborations with pharmacology professionals and researchers to identify potential compounds that led to reported AEs, and these compounds could be sent for chemical and pharmacological analysis to elucidate possible mechanisms of herb-drug interactions.

Additionally, future research should also concentrate on certain patient groups with a greater rate of reported AEs, such as those with oncological or renal disorders. Concurrent use of CHM and WM was highly prevalent (100% for renal patients, 82.10% for oncology patients), thus putting these patient groups at a greater risk of possible herb-drug interactions [ 74 , 75 ]. In addition, the drugs prescribed for these disorders, such as anti-diabetic or anti-cancer drugs tend to have longer half-lives to maintain a prolonged effect. This also contributes to an increased risk of potential herb-drug interactions. Thus, future studies could focus on these high-risk patient groups to better understand the CHM and WMPD consumption patterns, and respective AE rates of these patients. Subsequent studies could then attempt to investigate the respective pharmacokinetic and pharmacodynamic properties of these drugs together with that of prescribed CHM to avoid their concurrent presence in plasma before complete clearance of the other. Hopefully, these initiatives will contribute to improved patient safety in the long run. In addition, our results show that AE occurrence likelihood for patients who consumed both CHM and WMPD is higher compared to CHM consumption alone. However, it remains unclear what the likelihood is of CHM and WMPD consumption as compared to WMPD consumption alone. Hence, future studies should also consider the rate of AE among patients using WMPD alone. It would also be beneficial to employ qualitative methods such as patient interviews or focus groups to gain a deeper understanding of patients' perspectives and experiences. This would allow research groups to then better understand the experience of AE related to the use of CHM.

Lastly, our study found that concurrent administrations of CHM and WMPD increased risks of AEs occurrence as compared to CHM treatment alone. Hence, there could be a possibility that concurrent administrations of CHM and WMPD could reduce toxicity of WMPD. In TCM, preparation procedures such as the processing of the raw materials, decoction, and drug compatibility to the identification of the patient’s constitution and adjustment of remedies, aim to enhance the therapeutic efficacy and reduce toxicity at the same time [ 76 ]. The preparation of TCM using various different adjuvants, such as vinegar, wine, or honey, contributes significantly to the change in chemical profile and pharmacological effects and toxicity of TCM drugs [ 77 ]. When used together, it has also beenshown that CHM could potentially lower the toxicity of some WMPD. For instance, Forsythia and Ginger were used to reduce nausea and vomiting caused by the treatment of digoxin [ 78 ]. Poria and Eucommia were also added in decoction formulas to prevent the occurrence of hypokalemia and hyponatremia resulting from diuretic consumption [ 79 ]. Additionally, an integrative approach of concurrent Chinese and Western medicine consumption has also been shown to reduce chemo-toxicity in cancer therapy while maintaining or even enhancing therapeutic effects [ 80 ]. However, as our study did not involve basic research, we could not validate possible herb-drug interactions from our case studies on a biomolecular level at this point. Hence, future studies could consider the inclusion of laboratory analysis together with causality assessment to allow for better validation of herb-drug interactions.

A summary diagram detailing the proposed implications on clinical practice and future research directions is shown in Fig.  5 below.

figure 5

Summary diagram of implications on clinical practice and future research directions

In closing, our study has shown that implementation of active surveillance for the detection of CHM-WMPD related AEs in local TCM clinics is feasible. We also found that concurrent CHM-WMPD consumption was prevalent and patients who consumed CHM and WMPD were 3.65 times more likely to experience an AE as compared to CHM consumption alone. The AEs reported were all milder in nature and most AEs were deemed unlikely due to CHM consumption.

In addition, feedback received from the participating clinics has also been positive, thus supporting implementation into the diagnosis protocols of TCM physicians. Nonetheless, future studies might concentrate on the following areas. In terms of clinical practice, we propose extending the time between CHM and WMPD consumption, creating a common AE database, and incorporating active screening into TCM diagnostic processes. In terms of research focus, we recommend a greater emphasis on the toxicity and pharmacology of CHM and WMPD interactions, as well as a greater emphasis on herb-drug interactions in high-risk patient groups.

Availability of data and materials

All data sources described in this research are available from the corresponding authors.

Abbreviations

Adverse event

Adverse reaction

Complementary and alternative medicine

Chong Hoe Healthcare Beauty World Centre Branch

Chong Hoe Healthcare Clarke Quay Central Branch

Chinese Herbal medicine

Confidence interval

NTU Chinese Medicine Clinic

Singapore Chung Hwa Medical Institution

Standard deviation

Standard error mean

Study Of Natural health product adverse reactions

Singapore Thong Chai Medical Institution

  • Traditional Chinese Medicine

Western Medicine

Western Medicine Prescription Drugs

Boullata JI, Nace AM. Safety issues with herbal medicine. Pharmacotherapy. 2000;20(3):257–69.

Article   CAS   PubMed   Google Scholar  

Chen FP, Chen TJ, Kung YY, Chen YC, Chou LF, Chen FJ, et al. Use frequency of traditional Chinese medicine in Taiwan. BMC Health Serv Res. 2007;7(1):1–11.

Article   CAS   Google Scholar  

BM Association. Complementary medicine: new approaches to good practice. Oxford: Oxford University Press; 1993.

Google Scholar  

Singapore MoH. National Health Survey 2010. Singapore MoH: Singapore; 2010.

Lim MK, Sadarangani P, Chan H, Heng J. Complementary and alternative medicine use in multiracial Singapore. Complement Ther Med. 2005;13(1):16–24.

Liu S-H, Chuang W-C, Lam W, Jiang Z, Cheng Y-C. Safety surveillance of traditional Chinese medicine: current and future. Drug Saf. 2015;38:117–28.

Article   PubMed   PubMed Central   Google Scholar  

Lee T-L. Complementary and alternative medicine, and traditional Chinese medicine: time for critical engagement. Ann Acad Med Singap. 2006;35(11):749.

Article   PubMed   Google Scholar  

van Grootheest K, Olsson S, Couper M, de Jong-van den Berg L. Pharmacists’ role in reporting adverse drug reactions in an international perspective. Pharmacoepidemiol Drug Saf. 2004;13(7):457–64.

Asher GN, Corbett AH, Hawke RL. Common herbal dietary supplement–drug interactions. Am Fam Physician. 2017;96(2):101–7.

PubMed   Google Scholar  

Che C-T, Wang ZJ, Chow MSS, Lam CWK. Herb-herb combination for therapeutic enhancement and advancement: theory, practice and future perspectives. Molecules. 2013;18(5):5125–41.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Brazier NC, Levine MA. Drug-herb interaction among commonly used conventional medicines: a compendium for health care professionals. Am J Ther. 2003;10(3):163–9.

Shimabukuro TT, Nguyen M, Martin D, DeStefano F. Safety monitoring in the vaccine adverse event reporting system (VAERS). Vaccine. 2015;33(36):4398–405.

Clothier HJ, Hosking L, Crawford NW, Russell M, Easton ML, Quinn J-A, et al. Bacillus Calmette-Guerin (BCG) vaccine adverse events in Victoria, Australia: analysis of reports to an enhanced passive surveillance system. Drug Saf. 2015;38:79–86.

Choi S, Choi SJ, Kim JK, Lee Y-W, Lee YK. Real-World evidence of point-of-care glucometers: enhanced passive surveillance and adverse event reporting status in Korea and the United States. Ann Lab Med. 2023;43(5):515–9.

Hattersley AM, Kiernan M, Goldberg D, Dierickx C, Sliney DH, Haedersdal M, et al. Assessment of adverse events for a home-use intense pulsed light hair removal device using postmarketing surveillance. Lasers Surg Med. 2023;55(4):414–22.

Ngim CF, Husain SMT, Hassan SS, Dhanoa A, Ahmad SAA, Mariapun J, et al. Rapid testing requires clinical evaluation for accurate diagnosis of dengue disease: a passive surveillance study in Southern Malaysia. PLoS Negl Trop Dis. 2021;15(5): e0009445.

Larizgoitia I, Bouesseau MC, Kelley E. WHO efforts to promote reporting of adverse events and global learning. J Public Health Res. 2013;2(3):e29.

Rafter N, Hickey A, Condell S, Conroy R, O’connor P, Vaughan D, et al. Adverse events in healthcare: learning from mistakes. QJM. 2015;108(4):273–7.

Charrois TL, Hill RL, Vu D, Foster BC, Boon HS, Cramer K, et al. Community identification of natural health product–drug interactions. Ann Pharmacother. 2007;41(7–8):1124–9.

Barnes J. Pharmacovigilance of herbal medicines: a UK perspective. Drug Saf. 2003;26:829–51.

Raynor DK, Dickinson R, Knapp P, Long AF, Nicolson DJ. Buyer beware? Does the information provided with herbal products available over the counter enable safe use? BMC Med. 2011;9:1–9.

Article   Google Scholar  

Vohra S, Cvijovic K, Boon H, Foster BC, Jaeger W, LeGatt D, et al. Study of natural health product adverse reactions (SONAR): active surveillance of adverse events following concurrent natural health product and prescription drug use in community pharmacies. PLoS ONE. 2012. https://doi.org/10.1371/journal.pone.0045196 .

Murray J, Cohen AL. Infectious disease surveillance. Int Encycl Public Health. 2017. https://doi.org/10.1016/b978-0-12-803678-5.00517-8 .

Necyk C, Tsuyuki RT, Boon H, Foster BC, LeGatt D, Cembrowski G, et al. Pharmacy study of natural health product adverse reactions (SONAR): a cross-sectional study using active surveillance in community pharmacies to detect adverse events associated with natural health products and assess causality. BMJ Open. 2014;4(3): e003431.

Patel DN, Low WL, Tan LL, Tan MMB, Zhang Q, Low MY, et al. Adverse events associated with the use of complementary medicine and health supplements: an analysis of reports in the Singapore Pharmacovigilance database from 1998 to 2009. Clin Toxicol. 2012;50(6):481–9.

Xu Y, Patel DN, Ng S-LP, Tan S-H, Toh D, Poh J, et al. Retrospective study of reported adverse events due to complementary health products in Singapore from to 2016. Front Med. 2010;2018(5):167.

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9.

Da Costa BR, Cevallos M, Altman DG, Rutjes AW, Egger M. Uses and misuses of the STROBE statement: bibliographic study. BMJ Open. 2011;1(1): e000048.

Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–45. https://doi.org/10.1038/clpt.1981.154 .

Shukla AK, Jhaj R, Misra S, Ahmed SN, Nanda M, Chaudhary D. Agreement between WHO-UMC causality scale and the Naranjo algorithm for causality assessment of adverse drug reactions. J Family Med Prim Care. 2021;10(9):3303–8.

George D, Mallery P. IBM SPSS statistics 26 step by step: a simple guide and reference. Milton: Routledge; 2019.

Book   Google Scholar  

Wickham H, Averick M, Bryan J, Chang W, McGowan LDA, François R, et al. Welcome to the Tidyverse. J Open Source Softw. 2019;4(43):1686.

Article   ADS   Google Scholar  

Gómez-Rubio V. ggplot2-elegant graphics for data analysis. J Stat Softw. 2017;77:1–3.

Acharya TA, Trivedi MD, Joshi KJ, Chhaiya SB, Mehta DS. A study of agreement between WHO-UMC causality assessment system and the Naranjo algorithm for causality assessment of adverse drug reactions observed in medical ICU of a tertiary care teaching hospital. Biomed Pharmacol J. 2020;13(1):79–83.

Ravi G, Chikara G, Bandyopadhyay A, Handu S. Antimicrobial-associated adverse drug reaction profiling and assessing the agreement between the WHO-UMC scale and the Naranjo algorithm for causality assessment at a tertiary care teaching hospital in India. Natl J Physiol Pharm Pharmacol. 2020;10(11):945.

Schwendimann R, Blatter C, Dhaini S, Simon M, Ausserhofer D. The occurrence, types, consequences and preventability of in-hospital adverse events–a scoping review. BMC Health Serv Res. 2018;18(1):1–13.

Madigan EA. A description of adverse events in home healthcare. Home Healthcare Now. 2007;25(3):191–7.

Beggs C, Knibbs LD, Johnson GR, Morawska L. Environmental contamination and hospital-acquired infection: factors that are easily overlooked. Indoor Air. 2015;25(5):462–74.

Allegranzi B, Pittet D. Healthcare-associated infection in developing countries: simple solutions to meet complex challenges. Infect Control Hosp Epidemiol. 2007;28(12):1323–7.

Guo Y, Chen J. A case report: traditional Chinese medicine for curing psychosomatic tinnitus symptoms. Psychosom Med Res. 2021;3(3):157–64.

Chung VC, Ma PH, Lau CH, Wong SY, Yeoh EK, Griffiths SM. Views on traditional Chinese medicine amongst Chinese population: a systematic review of qualitative and quantitative studies. Health Expect. 2014;17(5):622–36.

Belhekar MN, Taur SR, Munshi RP. A study of agreement between the Naranjo algorithm and WHO-UMC criteria for causality assessment of adverse drug reactions. Indian J Pharmacol. 2014;46(1):117–20.

Rana DA, Bhadiyadara SN, Shah HJ, Malhotra SD, Patel VJ. Consistency between causality assessments obtained with various scales and their agreement for adverse drug events reported in pediatric population. J Young Pharm. 2015;7(2):89.

Lim JW, Chee SX, Wong WJ, He QL, Lau TC. Traditional Chinese medicine: herb-drug interactions with aspirin. Singapore Med J. 2018;59(5):230.

Khim KB. Turning to TCM to boost your health? Here’s what you should know. CNA Lifestyle: Singapore; 2020.

TCM MK. Frequently Asked Questions. https://www.makuang.com.sg/en/FAQ#:~:text=Can%20I%20receive%20TCM%20treatment,herbal%20medication%20and%20western%20medication . Accessed.

Needs CJ, Brooks PM. Clinical pharmacokinetics of the salicylates. Clin Pharmacokinet. 1985;10:164–77.

Kajbaf F, Bennis Y, Hurtel-Lemaire AS, Andrejak M, Lalau JD. Unexpectedly long half-life of metformin elimination in cases of metformin accumulation. Diabet Med. 2016;33(1):105–10.

Page RCL. 42 - Insulin, other hypoglycemic drugs, and glucagon. In: Aronson JK, editor. Side effects of drugs annual. Amsterdam: Elsevier; 2012. p. 685–702.

Merrell MD, Cherrington NJ. Drug metabolism alterations in nonalcoholic fatty liver disease. Drug Metab Rev. 2011;43(3):317–34.

Sun H, Frassetto L, Benet LZ. Effects of renal failure on drug transport and metabolism. Pharmacol Ther. 2006;109(1–2):1–11.

Chen X-W, Serag ES, Sneed KB, Zhou S-F. Herbal bioactivation, molecular targets and the toxicity relevance. Chem Biol Interact. 2011;192(3):161–76.

Wen B, Gorycki P. Bioactivation of herbal constituents: mechanisms and toxicological relevance. Drug Metab Rev. 2019;51(4):453–97.

He SM, Li GC, Liu JP, Chan E, Duan W, Zhou SF. Disposition pathways and pharmacokinetics of herbal medicines in humans. Curr Med Chem. 2010;17(33):4072–113.

Sidorenko VS, Attaluri S, Zaitseva I, Iden CR, Dickman KG, Johnson F, et al. Bioactivation of the human carcinogen aristolochic acid. Carcinogenesis. 2014;35(8):1814–22.

Kedderis GL, Held SD. Prediction of furan pharmacokinetics from hepatocyte studies: comparison of bioactivation and hepatic dosimetry in rats, mice, and humans. Toxicol Appl Pharmacol. 1996;140(1):124–30.

Shi P, Lin X, Yao H. A comprehensive review of recent studies on pharmacokinetics of traditional Chinese medicines (2014–2017) and perspectives. Drug Metab Rev. 2018;50(2):161–92.

Jia W, Gao W, Yan Y, Wang J, Xu Z, Zheng W, et al. The rediscovery of ancient Chinese herbal formulas. Phytother Res. 2004;18(8):681–6.

Duan H, Zhai K, Khan GJ, Zhou J, Cao T, Wu Y, et al. Revealing the synergistic mechanism of multiple components in compound fengshiding capsule for rheumatoid arthritis therapeutics by network pharmacology. Curr Mol Med. 2019;19(4):303–14.

Yuan H, Ma Q, Cui H, Liu G, Zhao X, Li W, et al. How can synergism of traditional medicines benefit from network pharmacology? Molecules. 2017;22(7):1135.

Hu J, Liu B. The basic theory, diagnostic, and therapeutic system of traditional Chinese medicine and the challenges they bring to statistics. Stat Med. 2012;31(7):602–5.

Article   MathSciNet   PubMed   Google Scholar  

Mander L, Liu HW. Comprehensive natural products II: chemistry and biology. Amsterdam: Elsevier; 2010.

Hasan MK, Ara I, Mondal MSA, Kabir Y. Phytochemistry, pharmacological activity, and potential health benefits of Glycyrrhiza glabra . Heliyon. 2021;7(6):e07240.

Sabbadin C, Bordin L, Donà G, Manso J, Avruscio G, Armanini D. Licorice: from pseudohyperaldosteronism to therapeutic uses. Front Endocrinol. 2019;10:484.

Yoshino T, Shimada S, Homma M, Makino T, Mimura M, Watanabe K. Clinical risk factors of licorice-induced pseudoaldosteronism based on glycyrrhizin-metabolite concentrations: a narrative review. Front Nutr. 2021;8: 719197.

Takahashi K, Yoshino T, Maki Y, Ki I, Namiki T, Ogawa-Ochiai K, et al. Identification of glycyrrhizin metabolites in humans and of a potential biomarker of liquorice-induced pseudoaldosteronism a multi-centre cross-sectional study. Arch Toxicol. 2019;93:3111–9.

HSA Singapore. Report adverse events. Singapore: Singapore HAS; 2022.

Biswas P. Pharmacovigilance in Asia. J Pharmacol Pharmacother. 2013;4(1_suppl):7–19.

HAS Singapore. Advisory committees. Singapore HAS: Singapore; 2023.

Sakaeda T, Tamon A, Kadoyama K, Okuno Y. Data mining of the public version of the FDA adverse event reporting system. Int J Med Sci. 2013;10(7):796.

Singleton JA, Lloyd JC, Mootrey GT, Salive ME, Chen RT, Ellenberg S, et al. An overview of the vaccine adverse event reporting system (VAERS) as a surveillance system. Vaccine. 1999;17(22):2908–17.

Davidson MH, Clark JA, Glass LM, Kanumalla A. Statin safety: an appraisal from the adverse event reporting system. Am J Cardiol. 2006;97(8):S32–43.

Zhang Y, Ip CM, Lai YS, Zuo Z. Overview of current herb–drug interaction databases. Drug Metab Dispos. 2022;50(1):86–94.

Ramos-Esquivel A, Víquez-Jaikel Á, Fernández C. Potential drug-drug and herb-drug interactions in patients with cancer: a prospective study of medication surveillance. J Oncol Pract. 2017;13(7):e613–22. https://doi.org/10.1200/jop.2017.020859 .

Awortwe C, Makiwane M, Reuter H, Muller C, Louw J, Rosenkranz B. Critical evaluation of causality assessment of herb–drug interactions in patients. Br J Clin Pharmacol. 2018;84(4):679–93.

Liu R, Li X, Huang N, Fan M, Sun R. Chapter Eleven—Toxicity of traditional Chinese medicine herbal and mineral products. In: Du G, editor. Advances in pharmacology. Academic Press; 2020. p. 301–46.

Wu X, Wang S, Lu J, Jing Y, Li M, Cao J, et al. Seeing the unseen of Chinese herbal medicine processing (Paozhi): advances in new perspectives. Chin Med. 2018;13(1):1–13.

Xu Q, Lu C, Ou M, Wang N, Mi S. Preventive and thearapeutic effects of ginger extraction on rabbits with acute heart failure. Tradit Chin Drug Res Clin Pharmacol. 1993. https://doi.org/10.19378/j.issn.1003-9783.2004.04.007 .

Sen L, Xie R, Sun W. Comparison of the diuretic effect of Tuckahoe, Polyporusumbellatus and astragalus. Tradit Chin Med. 2010;33(2):264–7.

Zhou L, Shan Z, You JI. Clinical observation on treatment of colonic cancer with combined treatment of chemotherapy and Chinese herbal medicine. Chin J Integr Med. 2009;15:107–11.

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Acknowledgements

The authors would like to thank Dr Sunita Vohra and Dr Heather Boon for generously sharing SONAR-related materials used by our study team for this study. We also wish to thank the team at NTU TCM Clinic, Chong Hoe Healthcare, Singapore Thong Chai Medical Institution, and Singapore Chung Hwa Medical Institution for their logistical support in this study.

This study is financially supported by the Qi Huang Young Scholar Programme (No. SCM-2020-001, Linda LD Zhong).

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CYJN: Conceptualization, Writing—Original Draft, Writing—Review & Editing, Data curation, Formal analysis, Investigation. YZ: Formal analysis, Writing—Review & Editing. NW: Formal analysis, Writing—Review & Editing. KLC: Formal analysis, Writing—Review & Editing. CHT: Resources. WP: Resources.

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Ng, C.Y.J., Zhao, Y., Wang, N. et al. A multi-center cross-sectional study of Chinese Herbal Medicine-Drug adverse reactions using active surveillance in Singapore’s Traditional Chinese Medicine clinics. Chin Med 19 , 44 (2024). https://doi.org/10.1186/s13020-024-00915-z

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Indian Systems of Medicine: A Brief Profile

Medicinal plants based traditional systems of medicines are playing important role in providing health care to large section of population, especially in developing countries. Interest in them and utilization of herbal products produced based on them is increasing in developed countries also. To obtain optimum benefit and to understand the way these systems function, it is necessary to have minimum basic level information on their different aspects. Indian Systems of Medicine are among the well known global traditional systems of medicine. In this review, an attempt has been made to provide general information pertaining to different aspects of these systems. This is being done to enable the readers to appreciate the importance of the conceptual basis of these system in evolving the material medica. The aspects covered include information about historical background, conceptual basis, different disciplines studied in the systems, Research and Development aspects, Drug manufacturing aspects and impact of globalization on Ayurveda. In addition, basic information on Siddha and Unani systems has also been provided.

Introduction

It is a well-known fact that Traditional Systems of medicines always played important role in meeting the global health care needs. They are continuing to do so at present and shall play major role in future also. The system of medicines which are considered to be Indian in origin or the systems of medicine, which have come to India from outside and got assimilated in to Indian culture are known as Indian Systems of Medicine ( Prasad, 2002 ). India has the unique distinction of having six recognized systems of medicine in this category. They are-Ayurveda, Siddha, Unani and Yoga, Naturopathy and Homoeopathy. Though Homoeopathy came to India in 18 th Century, it completely assimilated in to the Indian culture and got enriched like any other traditional system hence it is considered as part of Indian Systems of Medicine ( Prasad, 2002 ). Apart from these systems- there are large number of healers in the folklore stream who have not been organized under any category. In the present review, attempt would be made to provide brief profile of three systems to familiarize the readers about them so as to facilitate acquisition of further information.

Most of the traditional systems of India including Ayurveda have their roots in folk medicine. However what distinguishes Ayurveda from other systems is that it has a well-defined conceptual framework that is consistent throughout the ages. In conceptual base, it was perhaps highly evolved and far ahead of its time. It was among the first medical systems to advocate an integrated approach towards matters of health and disease. Another important distinguishing feature of Ayurveda is that unlike other medical systems, which developed their conceptual framework based on the results obtained with the use of drugs and therapy, it first provided philosophical framework that determined the therapeutic practice with good effects. Its philosophical base is partly derived from ‘Samkhya’ and ‘Nyaya vaisheshika’ streams of Indian philosophy. This enabled it to evolve into rational system of medicine quite early in its evolution and to get detached from religious influence. It laid great emphasis on the value of evidence of senses and human reasoning ( Ramachandra Rao, 1987 ).

Historical background

Ayurveda literally means the Science of life. It is presumed that the fundamental and applied principles of Ayurveda got organized and enunciated around 1500 BC. Atharvaveda , the last of the four great bodies of knowledge- known as Vedas, which forms the backbone of Indian civilization, contains 114 hymns related to formulations for the treatment of different diseases. From the knowledge gathered and nurtured over centuries two major schools and eight specializations got evolved. One was the school of physicians called as ‘Dhanvantri Sampradaya’ (Sampradaya means tradition) and the second school of surgeons referred in literature as ‘Atreya Sampradaya’ . These schools had their respective representative compilations- Charaka Samhita for the school of Medicine and Sushruta Samhita for the school of Surgery. The former contains several chapters dealing with different aspects of medicine and related subjects. Around six hundred drugs of plant, animal and mineral origin have been mentioned in this treatise.

Sushruta Samhita primarily deals with different aspects of fundamental principles and theory of surgery. More than 100 kinds of surgical instruments including scalpels, scissors, forceps, specula etc. are described along with their use in this document. Dissection and operative procedures are explained making use of vegetables and dead animals. It contains description of about 650 drugs and discusses different aspects related to other surgery related topics such as anatomy, embryology, toxicology and therapeutics ( http://www.indianmedicine.nac.in ). Vagabhata's ‘Astanga-Hridaya’ is considered as another major treatise of Ayurveda. The above three documents are popularly known as ‘Brihat trayees’ (the big or major three). In addition to these three scholarly and authoritative treatises a vast body of literature exist in the form of compilations covering a period of more than 1500 years ( http://www.indianmedicine.nac.in ).

Till the medieval period it was perhaps the only system available in the Indian sub-continent at that time to cater to the healthcare requirement of the people. It enjoyed the unquestioned patronage and support of the people and their rulers. This can be considered as the golden period of Ayurveda because most of the work related to basic concepts, enunciation of different principles, evolvement of different formulations occurred during this period. The patronage for the Ayurvedic system of medicine considerably decreased during the medieval period, which was marked by unsettled political conditions in the country and series of invasion by foreigners. The neglect became worse during British rule during which importance was given to Allopathy through official patronage. In the early part of 20 th century interest in Ayurveda rekindled as part of national freedom movement. People's representatives even in British India and princely states started asking for suitable measures to develop Ayurveda on scientific lines ( http://www.indianmedicine.nac.in ).

After India gained Independence from the British rule in 1947, the movement for revival of Traditional Systems of Medicine gained momentum. The systems got official recognition and became part of the National Health care network to provide health care to the country's citizen. Government of India initiated a series of measures to improve the position of Ayurveda as one of the major health care systems vital for catering to the primary health care needs of the country. A number of hospitals and colleges for Ayurveda were established. The other major initiatives were establishment of a research Institute to take care of the R & D needs (Central Institute of Research in Indigenous System of Medicine (CIRISM)- in 1955); a Post Graduate Training Centre of Ayurveda in 1956- to impart Post graduate education; establishment of a University- named Gujarat Ayurved University at Jamnagar in the Gujarat State in 1967; creation of Central Council of Indian Medicine (CCIM) in 1972 for regulating Education and Registration in Ayurveda, Siddha and Unani systems of medicine. A research council named Central Council for Research in Indian Medicine, Homoeopathy and Yoga (CCRIMH) was established in 1971. Subsequently, this council was bifurcated to create three separate councils -Central Council for Research in Ayurveda & Siddha (CCRAS), Central Council for Research in Unani Medicine (CCRUM), Central Council for Research in Homoeopathy (CCRH) and Central Council for Research in Naturopathy and Yoga (CCRNY). National Institute of Ayurveda (NIA) was established at Jaipur in Rajasthan state. Recently another University has been established known as Rajasthan Ayurved University- Jodhpur (Rajasthan state). A draft national policy for the development of Indian System of Medicine has been prepared which is available on the web site of Department of Ayurveda - ( http://www.indianmedicine.nac.in ).

The concept of health in Ayurveda

In India, Ayurveda is considered not just as an ethnomedicine but also as a complete medical system that takes in to consideration physical, psychological, philosophical, ethical and spiritual well being of mankind. It lays great importance on living in harmony with the Universe and harmony of nature and science. This universal and holistic approach makes it a unique and distinct medical system. This system emphasizes the importance of maintenance of proper life style for keeping positive health. This concept was in practice since two millennium and the practitioners of modern medicine have now taken into consideration importance of this aspect. Not surprisingly the WHO's concept of health propounded in the modern era is in close approximation with the concept of health defined in Ayurveda ( Kurup, 2004 ).

The philosophical background

The basic foundation is the fundamental doctrine according to which whatever present in the Universe (macrocosm) should be present in the body (the microcosm). It has been conceptualized that the universe is composed of five basic elements named Prithvi (Earth), Jala (Water), Teja (Fire), Vayu (Air) and Akash (Space/Ether). The human body is derived from them in which these basic elements join together to form what are known as ‘Tridoshas’ (humors) named as Vata, Pitta and Kapha . These humors govern and control the basic psycho-biological functions in the body. In addition to these three humors, there exist seven basic tissues ( saptha dhatus )- Rasa, Rakta, Mamsa, Meda, Asthi, Majja and Shukra- and three waste products of the body (mala) such as faeces, urine and sweat. Healthy condition of the body represents the state of optimum equilibrium among the three doshas. Whenever this equilibrium is disturbed due to any reason- disease condition results. The growth and development of the body components depend on nutrition provided in the form of food. The food is conceptualized to be composed of the basic five elements mentioned above. Hence it is considered to be the basic source material to replenish or nourish the different components of the body after the action of bio-fire ( Agni ). The tissues of the body are considered as the structural entities and the humours are considered as physiological entities, derived from different combinations and permutations of the five basic elements ( http://www.indianmedicine.nac.in ).

The concept of pathogenesis

People are categorized in to different categories based on their psychosomatic constitution. Constitution specific daily ( Dinacharya ) and seasonal routines ( Ritucharya ) are prescribed to maintain positive health. Body may become afflicted with disease if these routines are not adhered to. This will lead to the loss of equilibrium among the three humors. The loss of equilibrium of the three humors can also occur as a consequence of dietary indiscrimination, undesirable habits, seasonal abnormalities, improper exercise or erratic application of sense organs and incompatible actions of the body and mind.

Disease condition may ensue due to other reasons also. For example any external factor like microorganism, changes in the climatic conditions may cause the accumulation of dosha leading to disturbance in the doshic equilibrium and vitiation of doshas. It is conceptualized that normally doshas are circulated through macro and micro-channels known as srotas . The srotas are the important medium through which the body tissues get their nutrition and also the metabolic end products are transported out of the tissue. If any blockade occurs ( srotorodha ) due to accumulation of doshas, the bi-directional flow of nutrients and end products ( malas ) gets affected. The doshas accumulated in the region react with the dushyas (reactants- in this case tissues) resulting in a condition known as dosha dushya sammurchana - this affects body metabolism. Ama, which is a semi-processed intermediary product of metabolism, gets accumulated. At this stage the prodromal symptoms of the disease gets manifested. Thus disturbances in the bio-channels are considered to be the main reason for the expression of diseased state of an organ or system.

The diagnosis is always done by considering the patient as a whole object to be examined. The physician takes a careful note of the patient's internal physiological characteristics and mental disposition. He also studies other factors like- the affected bodily tissues, humors, the site at which the disease is located, patient's resistance and vitality, his daily routine, dietary habits, the gravity of clinical conditions, condition of digestion and details of personal, social, economic and environmental situation of the patient. The general examination is known as ten-fold examination- through which a physician examines the following parameters in the patient- 1. Psychosomatic constitution, 2. Disease susceptibility, 3. Quality of tissues, 4. Body build, 5. Anthropometry, 6. Adaptability, 7. Mental health, 8. Digestive power, 9. Exercise endurance and 10. Age. In addition to this, examination of pulse, urine, stool, tongue, voice and speech, skin, eyes and overall appearance is also carried out ( Kurup, 2002 ).

Treatment aspects

The treatment lies in restoring the balance of disturbed humors (doshas) through regulating diet, correcting life-routine and behavior, administration of drugs and resorting to preventive non-drug therapies known as ‘Panchkarma’ (Five process) and ‘Rasayana’ (rejuvenation) therapy. Before initiating treatment many factors like the status of tissue and end products, environment, vitality, time, digestion and metabolic power, body constitution, age, psyche, body compatibility, type of food consumed are taken in to consideration.

Types of Treatment

The treatments are of different types- a- Shodhana therapy (purification treatment), b- Shamana therapy (palliative treatment), Pathya Vyavastha (prescription of appropriate diet and activity), Nidan Parivarjan (avoidance of causes and situations leading to disease or disease aggravation), Satvajaya (psychotherapy) and Rasayan (adaptogens- including immunomodulators, anti-stress and rejuvenation drugs) therapy. Dipan (digestion) and Pachan (assimilation) enhancing drugs are considered good for pacifying the vitiated doshas (humors). This therapy is supposed to dissolve the vitiated and accumulated doshas by improving the agni (digestive power) and restoring the deranged metabolic process. In severe conditions the above therapy has to be supplemented with purificatory processes like Panchakarma. In this therapy initially the accumulated vitiated dosha is liquefied by resorting to external and internal oleation of the patient; followed by sudation ( swedhana ) and elimination of vitiated dosha through emesis ( Vamana ) or purgation ( Virechana ), Basti ( enema - evacuating type) and Nasya (nasal insufflation).

Shodhana therapy provides purificatory effect through which therapeutic benefits can be derived. This type of treatment is considered useful in neurological and musculo-skeletal disorders, certain vascular or neuro-vascular states, respiratory diseases, and metabolic and degenerative disorders. Shamana therapy involves restoring normalcy in the vitiated doshas (humors). This is achieved without causing imbalance in other doshas. In this use of appetizers, digestives, exercise and exposure to sun and fresh air are employed. In the Pathya Vyavastha type of treatment certain indications and contraindications are suggested with respect to diet, activity, habits and emotional status. In Nidan Parivarjan type of treatment the emphasis is on avoiding known causes of the disease by the patient. In Satvavajaya type of treatment the emphasis is on restraining the mind from the desires for unwholesome objects and Rasayana therapy deals with the promotion of strength and vitality ( http://www.indianmedicine.nac.in ).

Dietics in Ayurveda

Ayurveda lays great emphasis on the diet regulation. According to Ayurvedic concepts food has great influence over physical, temperamental and mental development of an individual. The food is the basic material for the production of the body and life supporting vital matter known as Rasa . The rasa is converted to body components and supports all types of life activities.

Different disciplines of Ayurveda

Ayurveda is known as Astanga Ayurveda - means that which is made up of eight parts. The eight major divisions of Ayurveda are as follow as:

1. Kayachikitsa (Internal Medicine) 2. Kaumar Bhritya (Pediatrics) 3. Bhootavidya (Psychiatry) 4. Shalakya (Otorhinolaryngology and Ophthalmology) 5. Shalya (Surgery) 6. Agada Tantra (toxicology) 7. Rasayana (Geriatrics) and 8. Vajikarana (Aprhodisiacs and Eugenics)

Present status of Ayurveda and other Indigenous Systems of Medicine in India Regulation of the practice of ISM & H

Eighteen major states have independent Directorate to look after ISM related issues. In six states the ISM is administrated under the Health Directorate of the State, in around six smaller states and Union Territories Officer in-charges look after the issues concerned with ISM. At present there are more than 6.11 lakh practioners of ISM & H. The number of Hospitals and dispensaries in this sector is more than 26,000 where free treatment facility is available. In addition large number of practioners in the un-organized folklore sector provide remedies to considerable portion of the population ( http://www.indianmedicine.nac.in )

At present there are more than 200 colleges, which offer a four and half year course leading to Bachelor Degree in Ayurvedic Medicine and Surgery, followed by one year internship. Similarly 2 colleges offer graduate degree in Siddha System of Medicine and 34 colleges offer degree in Unani System of Medicine and 130 colleges offer courses leading to degree in Homoeopathy. The turnover of candidates from these colleges exceeds 9,000 per year. More than 30 Institutes offer postgraduate courses for Ayurveda and specialization is available in 16 disciplines. In addition there is National Academy of Ayurveda, which imparts PG education under the scheme of ‘Guru Shishya parampara’ . This scheme has been created with a view to provide education on traditional lines like what used to be in ancient times. In ancient times students used to visit the abode of the teacher to serve him while learning the art of healing from him. At present around 750 Post graduate scholars are turned out every year (the duration of course is 3 years). The degree offered is M.D. (Ayu) and M.S. (Ayu). Recently Pharmacy colleges have been opened which offer D.Pharm (Ayu), B.Pharm (Ayu) and M.Pharm (Ayu) (for further details visit- http://www.ayurveduniversity.com ). Training programmes mainly, in-house are conducted, through out the country to train para-ayruvedic staff. These trained technicians help in carrying out therapeutic process like panchakarma and ksarasutra (an effective surgical procedure for removing hemorrhoids). Similarly pharmacists are trained to shoulder responsibilities of running an ayurvedic pharmacy.

Research and Development

The research activities are being carried out by Central Council for Research in Ayurveda & Siddha (CCRAS) and similar councils for Unani, Homoeopathy and Naturopathy & Yoga. The CCRAS is the premier agency involved in research and development ( http://www.ccras.com ). It has 89 field units, which have been re-organized in to 30 institutes and units. The types of activities undertaken are clinical research- involving planned clinical trial of single and compound ayurvedic preparations and drug research which includes medico-botanical surveys, cultivation of medicinal plants, pharmacognostical studies, phytochemical studies, drug standardization, pharmacological and toxicological studies. A vast body of data is available in various published literature and data bases (Sharma et al 2000, 2001, 2002; Billore et al 2004; Satyavati et al, 1976 , 1987 , Satyavati, 2005 ; Mishra, 2004 ; De et al 1993 ; Chatterjee and Pakrashi (1995–1997) ; Gupta and Tandon (2004) ; Wealth of India series (1959–69; 1985 and 2000); Dahanukar et al 2000 ; Rastogi and Dhawan (1982) ; Ayurvedic Pharmacopoeia Part- I in three volumes ( Anonymous-1989 , 1999 and 2000); Sivarajan and Balachandran (1999); Raghunathan and Mitra (1982) and five volumes (1–5) by Rastogi and Mehrotra (1990 , 1991 , 1993 , 1995 and 1998 ). Literary research, which involves publication of rare and classical manuscripts of ISM & H., is also carried out ( http://www.ccras.com ).

Besides research councils research activities are carried out in Post Graduate centers and Institutes of national importance like- Central Drug Research Institute (CDRI), Central Institute of Medicinal and Aromatic Plants (CIMAP), National Botanical Research Institutes (NBRI) etc and R & D centers attached to Ayurvedic drug manufacturing firms ( Kurup- 2004 ). However the main tendency is to consider medicinal plants used in Ayurveda as source material for bio-prospecting of drugs. There are very few studies, which take in to consideration the ayurvedic concept behind a given formulation. Ayurveda has a very well developed drug formulation discipline known as ‘Bhaishajya Kalpana’ , which provides great deal of information about methods of drug preparation, use of adjuvants, collection and processing drugs in a particular manner. Research efforts on this aspect and on basic principles of Ayurveda are yet to be undertaken in concerted manner.

Drug manufacturing in Ayurvedic sector

Ayurvedic drugs are marketed in various forms. They are available in both classical forms (tablets, powder, decoction, medicated oil, medicated ghee, fermented products) and modern drug presentation forms like capsules, lotions, syrups, ointments, liniments, creams, granules etc. There are more than 8500 manufacturers of Ayurvedic drugs in the country and the gross turnover of drugs used in all the ISM & H systems is approximately around 1 billion US dollars. Drug manufacturing in this sector is regulated by Drugs and Cosmetic act (1940) and rules (1945) ( Jain, 2001 ). Subsequently many chapters have been added to these acts over the years. Three types of agencies are involved in the administration of the Acts and Rules enacted by the parliament. There is Drug Technical Advisory Board and Drug Consultative Committee to advise the Govt., The Drug Controller General of India who with the help of the supporting staff is in charge of licensing and enforcing different laws related to drug manufacturing and dispensing. At the state level Food and Drug Administration Commissioners shoulder this responsibility. Recently Good Manufacturing Process for ISM has been defined which have to be followed by all the agencies involved in the manufacturing of drugs in this sector ( http://www.indianmedicine.nac.in ).

Globalization of Ayurveda

Globalization of Ayurvedic practice has gained momentum in the past two decades. Ayurvedic drugs are used as food supplements in USA, European Union and Japan. Many physicians practice Ayurveda in many parts of the world. Facilities are available in countries like USA, Argentina, Australia, Brazil, New Zealand, South Africa, Czech Republic, Greece, Italy, Hungary, Netherlands, Russia, UK, Israel, Japan, Nepal, Sri Lanka ( Kurup, 2004 ) for imparting short and long-term training in Ayurveda.

The concepts of proper life styles, dietary habits, daily and seasonal routines followed in Ayurveda can be adopted with suitable modification to different countries in different parts of the globe after giving due consideration to the cultural milieu existing in those countries and also to the constitutional profile of their population. Attempts can also be made to utilize the medicinal plant resources of these countries for meeting the health care needs of their people after categorization of the plants according to Ayurvedic concepts. Drugs used in ISM can be used as adjuvant to the main drugs used in Allopathy. Non-drug therapeutic approaches such as ‘Panchakarma’, ‘Ksarasutra’ etc can certainly be integrated into other health systems broadening the choices available to physicians and patients.

A recent review ( Dahanukar et al., 2000 ) points out that more than 13,000 plants have been investigated during the past 5 years. Number of medicinal plants have been shown to possess important pharmacological activities in pre-clinical testing however the generated leads have not been adequately followed up with double blind, placebo controlled clinical trails. Curcuma longa Linn, Boswellia serrata Roxb. ex Coleb., Picrorhiza kurroa Royle ex Benth, Terminalia chebula Retz., Emblica officinalis Gaertn., Bacopa monnieri (Linn.) Pennel, Boerhavia diffusa Linn, Phyllanthus niruri Linn, Celastrus paniculatus, Ocimum sanctum Linn, Gymnema sylvestre R.Br., Momordica charantia Linn, Commiphora wighti (Arn.) Bhandari, Withania somnifera (Linn.) Dunal, Pterocarpus marsupium Roxb., Tinospora cordifolia (Willd). Miers. Ex Hook.f. & Thomson, Trichopus zeylanicum, Terminalia arjuna (Roxb.) Wight & Arn etc have great potential to develop in to drugs of global importance. Table-1 provides list of some of the important medicinal plants with good potential to develop at global level. This list is not exhaustive and is based mainly on the author's own preference. Many of the drugs in the list are not available in sufficient quantity in India but may be available in other countries especially Nigeria where Commiphora species are abundant- they can be the source of supply to Indian ISM based industry. One of the main lacunae is the lack of co-ordinated multi-disciplinary studies to prove their clinical efficacy beyond doubt. This aspect should be the main focus of future research endeavors.

Some well-known Indian medicinal plants and their uses

Siddha system of medicine

Siddha system of medicine is practiced in some parts of South India especially in the state of Tamilnadu. It has close affinity to Ayurveda yet it maintains a distinctive identity of its own. This system has come to be closely identified with Tamil civilization. The term ‘ Siddha ’ has come from ‘ Siddhi ’- which means achievement. Siddhars were the men who achieved supreme knowledge in the filed of medicine, yoga or tapa (meditation) ( Narayanaswamy, 1975 ).

It is a well-known fact that before the advent of the Aryans in India a well-developed civilization flourished in South India especially on the banks of rivers Cauvery, Vaigai, Tamiraparani etc. The system of medicine in vogue in this civilization seems to be the precursor of the present day Siddha system of medicine. During the passage of time it interacted with the other streams of medicines complementing and enriching them and in turn getting enriched. The materia medica of Siddha system of medicine depends to large extent on drugs of metal and mineral origin in contrast to Ayurveda of earlier period, which was mainly dependent upon drugs of vegetable origin.

According to the tradition eighteen Siddhars were supposed to have contributed to the development of Siddha medicine, yoga and philosophy. However, literature generated by them is not available in entirety. In accordance with the well-known self-effacing nature of ancient Indian Acharyas (preceptors) authorship of many literary work of great merit remains to be determined. There was also a tradition of ascribing the authorship of one's work to his teacher, patron even to a great scholar of the time. This has made it extremely difficult to clearly identify the real author of many classics.

Philosophical foundation

According to the Siddha concepts matter and energy are the two dominant entities, which have great influence in shaping the nature of the Universe. They are called Siva and Sakthi in Siddha system. Matter cannot exist without energy and vice-versa. Thus both are inseparable. The universe is made up of five proto-elements. The concept of five proto-elements and three doshas in this system of medicine is quite similar to Ayurvedic concept pertaining to them. However there are certain differences in the interpretation ( Narayanaswamy, 1975 ). The concepts behind diagnostic measures also show great similarities differing in certain aspects only. Diagnosis in Siddha system is carried out by the well -known ‘ashtasthana pareeksha’ (examination of eight sites) that encompasses examination of nadi (pulse), kan (eyes), swara (voice), sparisam (touch), varna (colour), na (tongue), mala (faeces) and neer (urine). These examination procedures are provided in greater detail in classical Siddha literature in comparison to classical literature of Ayurveda ( Narayanaswamy, 1975 ).

Principles of treatment

Similar to Ayurveda, Siddha system also follows ashtanga concept with regards to treatment procedures. However the main emphasis is on the three branches - Bala vahatam (pediatrics), Nanjunool (toxicology) and Nayana vidhi (ophthalmology). The other branches have not developed to the extent seen in Ayurveda. The surgical procedures, which have been explained in great detail in Ayurvedic classics, do not find mention in Siddha classics. The therapeutics in both the systems can be broadly categorized into samana and sodhana therapies. The latter consists of well-known procedures categorized under panchakarma therapy. This therapy is not that well developed in Siddha system, only the vamana therapy has received attention of the Siddha physicians ( Narayanaswamy, 1975 ).

Materia medica

The concept pertaining to drug composition, the concept of rasapanchaka (concept explaining drug properties) is almost similar in both the systems of medicine. One of the major characteristic features of Siddha materia medica is utilization of mineral and metal-based preparations to greater extent in comparison to the drugs of vegetable origin.

The mineral and metal-based drugs in Siddha System are categorized under the following categories: 1. Uppu (Lavanam) - drugs that are dissolved in water and get decrepitated when put into the fire giving rise to vapor. 2. Pashanam : drugs that are water insoluble but give off vapors when put in to fire 3. Uparasam : Similar to pashanam chemically but have different actions. 4. Ratnas and uparatnas , which include drugs based on precious and semi-precious stones 5. Loham - metals and metal alloys that do not dissolve in water but melt when put in to fire and solidify on cooling. 6. Rasam : drugs that are soft, sublime when put in to fire changing into small crystals or amorphous powders. 7. Gandhakam: sulphur is insoluble in water and burns off when put into fire. From the above basic drugs compound preparations are derived. From the animal kingdom thirty-five products have been included in the materia medica. It is much similar to preparations used in Ayurveda. Numbers of plant-based preparations are also used in Siddha system of medicine they are quite similar in profile to those mentioned in Ayurveda.

Unani system of medicine Historical background

Unani medicine has its origin in Greece. It is believed to have been established by the great physician and philosopher- Hippocrates (460–377 BC). Galen (130–201 AD) contributed for its further development. Aristotle (384–322 BC) laid down foundation of Anatomy & physiology. Dioscorides - the renowned physician of the 1 st Century AD has made significant contribution to the development of pharmacology, especially of drugs of plant origin. The next phase of development took place in Egypt and Persia (the present day Iran). The Egyptians had well evolved pharmacy; they were adept in the preparation of different dosage forms like oils, powder, ointment and alcohol etc. ( http://www.indianmedicine.nac.in ).

The Arabian scholars and physicians under the patronage of Islamic rulers of many Arabian countries have played great role in the development of this system. Many disciplines like chemistry, pharmaceutical procedures like distillation, sublimation, calcinations and fermentation were developed and refined by them. There are many well-known names- only some names have been mentioned in this article. Jabir bin Hayyan (717–813 AD) a Royal physician of his time has worked on the chemical aspects; Ibne Raban Tabari (810–895 AD) is the author of the book- Firdous ul Hikmat and introduced concept of official formulary. Abu Bakar Zarakariya Razi (865–925 AD) has authored a book known as “ Alhawi fit tibb ”. He has worked in the field of immunology. Of course the name of Bu Ali Sina (Avicenna 980–1037 AD) is always referred in all matters related to Unani. He was a renowned global level scholar and philosopher. He had great role in the development of Unani medicine in the present form. His book Alqanoon or (The canon of medicine) was an internationally acclaimed book on medicine, which was taught in European countries till the 17 th century. Many physician of Arab descent in Spain have also contributed to the development of the system. Some of the important names are- Abul Qasim Zohravi (Abulcasus 946 – 1036 AD) he is the author of the famous book on surgery “ Al Tasreef ”-( http://www.indianmedicine.nac.in ).

The Arabs were instrumental in introducing Unani medicine in India around 1350 AD. The first known Hakim (Physician) was Zia Mohd Masood Rasheed Zangi. Some of the renowned physicians who were instrumental in development of the system are- Akbar Mohd Akbar Arzani (around 1721 AD)- the author of the books- Qarabadin Qadri and Tibbe Akbar ; Hakim M. Shareef Khan (1725–1807)- a renowned physician well-known for his book Ilaj ul Amraz . Hakim Ajmal Khan (1864–1927) a great name among the 20 th Century Unani physicians in India. He was a multifaceted personality besides being a physician he was a scientist, politician and a freedom fighter. He was instrumental in the establishment of Unani and Ayurvedic College at Karol Bagh, Delhi. He was a keen researcher and has supervised many studies on Rauwolfia serpentina - the source plant for many well-known alkaloids like reserpine, Ajamaloon etc. Another great contributor is Hakim kabeeruddin (1894–1976), he has translated 88 Unani books of Arabic and Persian languages into Urdu. The first institution of Unani medicine was established in 1872 as Oriental College at Lahore in the undivided India. Thereafter many institutions came into existence.

After Independence Unani received boost in the form of Government support through various agencies involved in the development of ISM. At present there are more than 30 colleges offering degree course in Unani medicine and the approximate number of physician turn out is around 20,000. There are around 177 hospitals. A National Institute of Unani Medicine has been established at Bangalore in Karnataka state in 1983 in collaboration with the Govt. of Karnataka- for catering to both academic and R & D requirements. Central Council for Research in Unani Medicine (CCRUM), is the premier agency involved in R & D activities ( http://www.indianmedicine.nac.in ).

Basic principles

According to the basic principles of Unani the body is made up of four basic elements i.e. Earth, Air, Water, Fire which have different Temperaments i.e. Cold, Hot, Wet, Dry. They give raise, through mixing and interaction, to new entities. The body is made up of simple and complex organs. They obtain their nourishment from four humors namely- blood, phlegm, black bile and yellow bile. These humors also have their specific temperament. In the healthy state of the body there is equilibrium among the humors and the body functions in normal manner as per its own temperament and environment. Disease occurs whenever the balance of humors is disturbed.

In this system also prime importance is given for the preservation of health. It is conceptualized that six essentials are required for maintenance of healthy state. They are i. Air, ii. Food and drink, iii. Bodily movements and response, iv. Psychic movement and repose, V. Sleep and wakefulness and vi. Evacuation and retention. Specific requirement for each of these six essentials have been discussed- ( Syed Khaleefathullah, 2002 ).

The human body is considered to be made up of seven components, which have direct bearing on the health status of a person. They are 1. Elements (Arkan) 2. Temperament (Mijaz) . 3. Humors (Aklat) 4. Organs (Aaza) 5. Faculties (Quwa) 6. Spirits (Arwah) . These components are taken in to consideration by the physician for diagnosis and also for deciding the line of treatment ( Syed Khaleefathullah, 2002 ).

Examination of the pulse occupies a very important place in the disease diagnosis in Unani. In addition examination of the urine and stool is also undertaken. The pulse is examined to record different features like- size, strength, speed, consistency, fullness, rate, temperature, constancy, regularity and rhythm. Different attributes of urine are examined like odor, quantity, mature urine and urine at different age groups. Stool is examined for color, consistency, froth and time required for passage etc.

Disease conditions are treated by employing four types of therapies- a- Regimental therapy, b-Dietotherapy, c-Pharmacotherapy and d- Surgery. Regimental therapy mainly consists of drug less therapy like exercise, massage, turkish bath, douches etc. Dietotherapy is based on recommendation of patient specific dietary regimen. Pharmacotherapy involves administration of drugs to correct the cause of the disease. The drugs employed are mainly derived from plants some are obtained from animals and some are of mineral origin. Both single and compound preparations are used for the treatment.

Published literature in the field of ISM & H

A large number of studies have been carried out on number of medicinal plants used in ISM of medicine. Central Drug Research Institute undertook a series of studies ( Anonymous - 1991 ) under drug screening programme. Number of compilation have been published providing information about pharmacological activity profile of medicinal plants, publications are also available on the chemical profile of number of medicinal plants, Ayurvedic pharmacopoeia has been published - three volumes have come out so far, CCRAS has published a series of books under its Data base preparation project. There is an international publication on scientific validation of Ayurvedic therapies. Besides these books large number of review articles have been published in national and international Journals providing names of drugs used in particular type of disease conditions or screened for particular type of pharmacological activities.

If the situation prevailing in this sector is analyzed taking into consideration different aspects- it becomes clear that there is a perceptible trend towards increased usage of drugs used in Indian Traditional Systems especially those which are based on herbal products not only in India but in different parts of the world. However, one of the basic problems that still remained to be solved is related to proving efficacy of the products used in these systems on the basis of controlled clinical trial and complementary pharmacological studies. It is difficult to ensure consistency in the results and components in the products. This is traced mainly to lack of standardization of the inputs used and the process adopted for preparation of the formulations. Government of India has taken these aspects in to consideration and has initiated many projects for standardization of single and compound formulations along with standardization of operating procedures for important formulations. Though standardization is very difficult it is not an un-attainable goal. Once this is done it would help in promoting wider use of these drugs especially in chronic degenerative disorders. Further non-drug therapies and preventive and life management techniques are also receiving increased attention. Thus this sector seems to be poised for remarkable growth in the coming years ( Kurup, 2004 ).

The above presentation can be considered only as brief introduction to the above systems. Lot of literature and information is available in the published literature citation of which would make this write up voluminous hence not attempted. However the websites referred above provide sufficient information for a beginner. Full complement of information can be obtained by contacting appropriate bodies. No attempt has been made to provide information about Yoga and Naturopathy systems because they are mainly non-drug therapies. Similarly Homoeopathy system has not been discussed since it is well known out side Indian sub-continent.

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