reorientation courses should then be of- fered to the different categories of tradi- tional practitioners. For example in the training programme for birth attendants, emphasis should be on basic education regarding pregnancy and child birth, hygiene, gynaecological complications and the basic principles of infant and child care. After providing appropriate training, all this medical expertise can be absorbed into the main stream of general health services for the rural population, so that the largest number of people can benefit from an effective and person- alized service.
These traditional practitioners com- mand the implicit faith and confidence of their rural clientele, as they form an integral part of the village life. They can treat most of the common ailments which constitute almost 80 per cent of diseases. Treatment in these systems is much cheaper, and is especially effective in dealing with chronic ailments, allergic conditions and psychosomatic diseases. They make use of locally available herbs and other ingredients in their day-to-day practice, and often write out prescrip- tions with detailed instructions for pre- paring the decoction to be taken by the patient. The services of traditional heal- ers and practitioners could therefore be utilized with advantage at primary health centres in remote rural areas.
If the health care delivery system is to reach the maximum number of people in the shortest possible time, and is to become a real instrument in alleviating human suffering, an open-minded ap- proach devoid of rigid dogmas is called for. No single system can thrive or be useful to all irrespective of its origin, location or merit. Anything that is good in all these systems should be made available, while false claims or ineffective practices and faulty approaches that may be currently in vogue should be eliminat- ed through intensive and systematic research.
In our anxiety to make an effective, comprehensive community health service available as soon as possible to the max- imum number of people, the available material, financial and manpower resources that are rooted in traditional medical practices should not be over- looked. In order to reach the masses in the developing countries, there must be proper planning as well as a building up of health care facilities with all the lim- ited resources available. Against this background the traditional systems of medicine and their rich heritage can play a vital role as an additional or alternative approach in a country's Health Delivery
Programme. •
Ayurvedic tra · •
BY 1(. N. UDUPA
I
care to coucIndihas nitithine e oa is ontrin beepeople Althfor provas es wn ne of tha givesyshere n dtem iding e few Asougue recoAof mediyh urveda heathere ian lth g-- are references to Ayurvedic princi- ples in Vedic literature written about 2000 B C. the present available li- terature on Ayurveda starts with Sushruta Samhita and Charaka Sam- hita. compiled some time during the fifth Century B.C From these ancient documents it appears that education in this science was initially imparted to highly selected groups of stu- dents.In more recent times it has taken more than a century for a standard- ized and acceptable training pro- gramme to be introduced in most of the Ayurvedic colleges in India. The admission standard. and the duration of the course and internship training. are quite similar to the training in modern medical colleges Thus after 1 2 years of education in science and humanities. five years of training in various Ayurvedic subjects are en- visaged Peculiar to this training is a thorough grounding in basic princi- ples- the philosophical aspects of life. the body-mind relationship. the
"humours" of the body and their function. including the best methods for leading a healthy life according to the body's constitution and the tem- perament
The technical methodology of cli- nical examination is similar to mo- dern medicine. the primary methods being the clinical history and a five- fold physical examination using the five senses. However. greater em- phasis is given to the constitutional aspects of patients. their nutritional status and their psychosomatic in- tegrity The pulse examination forms an important part of the clinical methodology. The patient is exami- ned and treated as a whole. unlike the modern medical approach where a large number of specialists may be involved simultaneously in such an examination.
The undergraduate curriculum compnses radiology, pathology, parasitology, microbiology and prac- tical laboratory instruction. The Ayurvedic principles of surgery. gy- naecology, child health and other allied subjects are also taught The training in surgery includes the prin- ciples of management of different types of fracture. and various opera- tive and palliative procedures for such conditions as urinary stones.
piles. fistulae. goitre. lymphadenitis and hernia
Students wanting to undertake further studies are admitted to post- graduate courses leading to the award of a Doctorate of Ayurvedic Medicine. These consist of three years of postgraduate training In the first year. the postgraduates receive advanced training in applied basic medical sciences. both Ayurvedic and modern. In the second and third years they are allowed to specialize in one of the five major disciplines- internal medicine. Ayurvedic surgery.
obstetrics and gynaecology, materia medica or the basic principles of Ayurveda
Doctor of Philosophy degrees in various specialities can also be ob- tained at some universities. This has led to considerable output of re- search material which could prove very useful in modernizing Ayurvedic investigation and treatment
Thus training in Ayurveda. both at the undergraduate and postgraduate level. has undergone a rapid change in recent years Modernization conti- nues and in due course the differ- ence between the pattern of modern medical training and Ayurvedic train- ing will be minimal. to the point where trained Ayurvedic and modern doctors should prove complementary to each other. Their services could then be utilized for health care at various levels. and a better coopera- tive attitude between the two types of practitioners should contribute to- wards improving the health care of India's vast population both in urban
and rural areas. •
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