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Saturday, December 22, 2012

Time to Act - Mainstream Siddha Medicine

The initiative of the Govt. of Tamil Nadu particularly the Chief minister has started paying results in containing the 'Panic' caused by the outbreak of the dengue epidemic in Tamil Nadu. Initially there was a resistance from Public health personnel to admit the outbreak, subsequently efforts were taken to get the actual data on the outbreak from both Govt. Hospitals and Pvt. Health providers. The approach to the management of the outbreak was first to identify the actual number of dengue from all fever patients with ELISA in major hospitals and subsequently in major secondary level centres and disease surveillance by making it mandatory for Pvt. clinics and hospitals to inform public health dept. Awareness about controlling mosquito breeding was also made.  The treatment approach was to provide simple Anti-pyretics and wherever necessary platelet transfusion. Along side outbreaks of water borne diseases like Jaundice and Typhoid  also occurred making it difficult for the public health authorities. 

Practitioners of Traditional Siddha  Medicine started using the conventional 'Nilavembu kudineer' which showed promise of controlling fever and different siddha vaidyars suggested different herbs including Adathoda, Manjista, Pidangunaari to improve platelet counts. Social media was full with posts on Papaya leaves. Individual Siddha doctors and Groups conducted Camps to distribute Nilavembu kudineer. That is the point when CM intervened and issued not just a Govt. Order instructing all hospitals to co-administer Nilavembu kudineer and Juice of Papaya and Malai Vembu but released publicity material in both print and visual media. This became a Game changer. More and more people consumed these herbal medicines from Govt. Hospitals, Pvt. Clinics and even as 'Over the counter product'. Studies where initiated at the King Institute, Chennai which reconfirmed many earlier studies on the anti-viral properties of the herbs which Siddha physicians were insisting on. The epidemic is now slowing down but not completely stopped as i write this note ( 22nd Dec 2012).

Now is time for the key interventions needed to mainstream traditional medicine whole heartily and provide a decent budget for the native system of medicine, which time and again stand scrutiny not just in labs but in Clinical set ups.

1. Inspite of the assurance in Tamilnadu Health Policy note of the Present CM (2004) that every PHC will have a siddha doctor, it has not been done so far- Mainly as no new Siddha Wings were sanctioned between 2006-2011. Therefore about 40% of the rural population to do not  have access to Siddha Medicine even within the state. Another 30% have only a limited access as in about 450 PHC Siddha wing operate with contract physicians on a very low salary for 3 days a week. The Chief minister should take personal interest to convert in the first step the part time centres into Full fledged Siddha Wings. With building infrastructure already in place under NRHM  only additional post of Siddha Medical officers and paramedics need to be created and of course supply of quality medicines. The budget would be an additional Rs60 crore /annum (15 lakhs/Centre) Which is not impossible for a State like Tamil Nadu. Subsequently Rest of the PHCs could have Siddha wings in a phased manner.This will greatly reduce the health expense burden of the  people of Tamil Nadu and as Traditional medicine focus on Prevention and Promotive health - Productivity of the state will go up with a healthy population.

2. CM has been kind enough to sanction even a budget for starting an ISM university as early as Feb 2012 but unfortunately  even the spade work has not started. A competent Siddha expert with rich experience in establishing Institutes, Research council and worked closely in framing regulations with adequate expertise in Finance Planning and budgeting and ability to team up with the central govt and get the 'Acts & Rules' in place and mobilize central resources may be appointed immediately as Special officer. He need not have to be an academician as once the University is in place an Academician may be Posted as Vice- Chancellor.

3. All Siddha wings and hospitals which have external therapy facilities under the Centrally Sponsored Schemes need Para medical personnel and the first batch of therapists trained by the two Govt. Siddha Medical Colleges  are already available and they may be posted immediately.

4. It is the right time to fill all vacancies of higher faculties in Siddha Medical Colleges so that hospital, teaching and research activities happen in full swing with some additional infrastructure. 

Monday, November 5, 2012

Ban on industrial use of mercury to affect Traditional Medicine.

The 2nd International Conference on Tibetan Medicine concluded recently in the exile Tibetan headquarters of Dharamshala after three days (27th – 29th October 2012) of in depth discussions and presentations on various aspects of the ancient Tibetan medical system. The conference, jointly organised by the Central Council of Tibetan Medicine, Men-Tsee-Khang, Chakpori Medical Institute, Darjeeling and Department of Sowa Rigpa of the Central University of Tibetan Studies, Varanasi, was held at the Sarah College for Higher Tibetan Studies. More than 300 doctors, representing different medical systems from all over the world, including India, US, Israel, Russia, Mongolia, Spain, Latvia, Italy, China, and Japan among others took part in the conference. According to the organisers, the objective of the conference is to “preserve and promote the Tibetan medical system, to enhance the interaction among Tibetan medical doctors, and to get acquainted with the number of researches which have gone on to prove the authenticity and effectiveness of Tibetan medicine.”The first international conference on Tibetan medicine was held over a thousand years ago at Samye, central Tibet in the year 728 A.D. by Trisong Deutsen, the 37th King of Tibet.

Sowa Rigpa, the Tibetan science of healing is a unique medical system dating back more than 2500 years. With the Buddhist philosophy as its backbone, this system of medicine is influenced by the religion, culture, and environment of Tibet. The commonalities in the basic principles of Tibetian medicine and Siddha medicine was highlighted. Some of the major topics discussed during the conference included, History and Basic Principles of Tibetan Medicine, Research Methodology, Medicinal Herbs and Plants, Pregnancy and Child Care, Ethics of Physician, and State of Tibetan Medicine around the world. In the plenary Sessions were dedicated for deliberations on the salient features of different traditional medical systems including Siddha, Ayurveda, Mongolian and Traditional Chinese Medicine. Dr. D.Natasagdorj, Head of the Training Centre of  Mangolian Traditional medicine, Dr.Hsu, Sheng- Feng of Director of  Graduate Institute of Acupuncture Chinese, Taiwan, Dr. Balendu Prakasah, Ayurvedic physician from Dehuradoon, Dr.Dorji Wangchuk Director, National Institute of Traditional Medicine, Bhutan, Dr Sarah Sallon, Director, Natural Medicine Research Centre, Jerusalem, Israel and Dr.T.Thirunarayanan, Siddha Physician  of Centre for Traditional Medicine and Research, Chennai delivered lectures in the Plenary session.

H.H.Dalailama in his address to the delegates stressed the need for working together with Indian Medicine researchers to further enrich Tibetian medicine since, the Dept. of AYUSH has included Sowrigpa in the Indian Medical council Act in 2010. He also stressed  Compassion to fellow human beings as the main virtue of Tibetian medicine and adivised all medical personnel to follow it in letter and spirit.
Concerns were also expressed about the use of mercury in traditional medicines and the proposed ban on mercury for industrial use by UN, which will take out many of the traditional medicines. Research studies which clearly confirms the safety of detoxified mercurial salts used  in Traditional medicines and efforts should be taken by all stake holders to ensure the ban on element mercury should not affect the use of mercury ores used by Traditional medicines, including Siddha, Ayurveda, Sowrigpa, Manba Datsan and Chinese Medicine.

Wednesday, October 10, 2012

Change of address -CTMR

Centre for Traditional Medicine & Research
CTMR  Library, Palm Manuscripts Conservation Unit  & Publication Division  will move to the following address from  24th Wednesday- 2012 Vijayadasami Day.
4A/3  Mahalakshmi Nagar 12th Cross Street,
Chennai -600088

Contact person : Dr.S.Rajkumar. -  9444899640
Medicinal Plants unit and Training Division will continue to function from
4A, 4th Cross St.  Mahalakshmi Nagar,
Chennai -600088
Contact person : Dr.T.Thirunarayanan 9444018158
The Public Health charitable clinic will continue to function from
Chinnandi kuppam Main Road,
(Off  East Coast Road )

Contact person ; Dr.R. Sangeetha 9445643508

The Puzhuthiwakkam office will cease to function.

Tuesday, September 4, 2012

Drugs and Cosmetics Rules to be amended to define phytopharmaceutical drugs

News from Pharmabiz

With view to further regulate the phytopharmaceutical sector in the country, the Centre is planning to amend the Drugs and Cosmetics Rules to have a separate definition of phytopharmaceutical drugs and also for its inclusion in the definition of new drug.

The move, already approved by the DTAB, is to introduce phytopharmacueticals under the Drugs and Cosmetic Rules and provide guidelines for permission for their manufacturing and clinical trials in the country, taking into consideration the growing acceptance for these kinds of drugs.

The amendment to the Rules is planned with the purpose of having similar provisions for evaluating their safety and efficacy to authenticate the claims made for the phytopharmaceutical drugs. A separate Appendix I-B was being proposed to be incorporated under the Schedule Y for providing information specific to the phytopharmaceutical products in regard to their origin, pharmacognostic descriptions, quality specifications, process of extraction, stability data, safety and pharmacological information etc. along with the application to conduct clinical trial/import/manufacture of a phytopharmaceutical drug in the country, sources revealed.

Phytopharmaceutical products are drugs of plant origin having therapeutic effect. These are not single substances but comprise of standardized extracts or fractions of processed or unprocessed medicinal plants. These drugs are, however, required to be evaluated for their safety and efficacy like other new drugs belonging to the modern system of medicines.

“The system adopted for evaluation of modern drugs like toxicity, safety and efficacy studies should be made applicable to this class of drugs also. This will help in creating scientific and authenticated data about their therapeutic efficacy and safety,’’ sources said.

The matter was considered in the 60th meeting of DTAB held in October, 2011 and it was agreed in principle to incorporate provisions relating to phytopharmaceutical drugs under the Drugs and Cosmetics Rules. It came up further for discussion in the recent meeting of the DTAB also in July this year and got approval.

“The DTAB welcomed the proposal as this will help in evaluation of many of such drugs of Indian origin on the methods employed for modern medicines. The DTAB, however, recommended that repeat dose toxicity should be on two species of animals and one of them should be non-rodent as is under Schedule Y,’’ sources added.

Saturday, August 18, 2012

Season for Planting Medicinal Plants

After a long spell of summer heat, Chennai has cooled down a bit and this is an appropriate time for starting a Home herbal Garden. Increasing pollution and modern day stress, advance aging process, reflected by fine lines in the skin, pain in the knees and weakness. Traditional medicines are time tested and are in use for overcoming stress and ageing and for healthy living. Conventional medical practitioners are increasingly inclined towards herbal medicine. This herbal kit aims to revitalize our traditional medicinal knowledge; to promote herbal awareness at home and to re-introduce safe home herbal remedies particularly for children. This user-friendly kit has been designed by physicians of Centre for Traditional Medicine and Research based on community based clinical experience.
Indigofera tinctoriaAvuri or Neeli

 This stiff woody herb grows well with the least care. The leaves as well as the roots are medicinal. They are among the most reputed hepato protective (Liver protection). The leaves contain a blue (INDIGO) dye, and its related and associated compounds are effective in a wide variety of skin diseases including psoriasis and eczema. The leaf or root is converted into 250 mg paste and rolled into a pill. 2 to 3 pills are given everyday.  Fresh leaf soaked in equal weight of sesame oil till the leaves turn brittle and the oil takes a purple colour. This oil, when applied on affected part, is good for skin diseases, dandruff, psoriasis etc.
Hibiscus rosa sinensis -  Chemparathai ;
 A good ornamental garden plant. The leaves and flowers of shoe flower are of cosmetic value, particularly to those women who want to maintain soft silky hair. The dried or fresh leaves along with soap nut powder acts as a hair cleanser conditioner. The red pigments in the flower improve the strength of small blood vessels when consumed internally. A herbal tea made using four dried flowers of red variety, single petal flower could be used to protect against heart diseases.
Cissus quadrangularis – Pirandai
      The jointed winged stems are made into chutney with acid lime or tamarind. A good source of Vitamin C and calcium. According to Ayurveda and Siddha medicines, it is good for the bones and heals fractures faster. Researchers have confirmed this and shown that the healing time is reduced by 33% and the bone setting is stronger. It is good for growing children who are weak and thin because it is anabolic.  The tender stems are steeped in curd and dried, and to be eaten with food after frying it (Vathal- Pickle). This plant is recommended to prevent and treat post- menopausal osteoporosis patients.
Aloe vera – Sottru Katrazhai  
   An ornamental succulent, it does well in desert conditions too. The jelly-like substance present in the leaf is separated from the skin and rapidly washed in water to remove the yellow juice, which is irritant. Taken internally it is a cooling agent and heals stomach ulcers and nullifies inflammations.Externally it is a fine wound healer. The jelly when applied on the face, is an effective beauty care agent for a glowing face. The yellow juice from the leaf skin is an irritant and is rubbed on rheumatism-affected joints as a counter irritant. Internally the yellow juice will induce menstruation and trigger abortion.
Bacopa monnieri  - Neer Brahmi   
This mat forming runner with succulent leaves and purple flowers grows luxuriantly near water bodies and agricultural lands. It also can withstand salinity in water and is seen near industrial effluents drains. The leaves are bitter but help in calming down the mind. It holds promise as an anti-epileptic drug. It is also used as a remedy for polycystic ovary in women. It can be taken as a powder 1gm twice daily or “Brahmi Ghritham”.  It is commonly used as Memory enhancer for children.
Plectranthus ambonicus- Omavalli
 This succulent and brittle herb with highly aromatic leaves (smells like Ajwon) is grown in many households and used in health care. The leaf juice is a good digestive, appetizer and expectorant-removes phlegm and cures the upper respiratory tract infection. The leaves induce vomiting and removal of phlegm when chewed by people with severe respiratory infection. The “Bajji” made with the leaves during monsoon prevents respiratory infections. Leaf juice is taken from ½ teaspoon to 2 teaspoon with honey depending upon the age of children.
Andrographis paniculata    - Nilavembu        
   This small erect herb prefers to grow in partial shade and good humidity. The plant is called as the “King of bitters” owing to its bitterness. The decoction of the plant is very effective in controlling fever and is a powerful appetite stimulant. The plant is invariably a key ingredient in hepato protective formulations and medicines used to treat skin diseases. Native healers use this plant to treat bites and stings as an antidote. It has been found useful in the treatment of leucoderma also, internally and externally.
 Tinospora cordifolia – Seendilkodi
    A perennial climber that will grow anywhere. The leaves and stems are reputed immune-modulator. The plant contains principles that are effective anti-bacterials and is used to treat infections of the eye, respiratory, urinary and alimentary tract. According to Ayurveda and Siddha systems of medicines, this plant is a Rasayana & Kayakalpa plant.
  3 gm of dried stem, powder or a decoction of the aerial part of the plant including the leaves could be used. Thick stems are natural tooth brushes.
Lawsonia inermis – Maarudhani, Henna          
 The shrub of Marudhani is excellent hedge (Fence) plant. The leaves are traditionally used for tattooing and more particularly on special occasions. Henna is one of the largest export earner for India. It is also used as a hair conditioner and hair colorant. The application of ground leaf paste of Henna with eucalyptus oil or lime juice on the nails on a regular basis prevents fungal infection (Pittvedippu, Nagasutru ) of the palm, especially for women , who have to toil in water for washing, cleaning etc. Commercial Henna mostly contain harmful synthetic dyes, therefore growing Henna at home becomes absolutely essential.
Adhatoda vasica  - Aadathodai   
    The shrub is grown as a hedge plant as it is not browsed by cattle. The leaf is very good expectorant. The alkaloids present in the leaves are responsible for its pharmacological action. Innumerable cough remedies are made with the leaf both as syrups and capsule. The plant possesses anti-microbial activity and hence it is used to treat respiratory infections and some uro- genital infections but contraindicated in pregnancy. For adult one fresh leaf is enough for 30 ml decoction. Take one leaf, remove the central vein, cut into small pieces, then add 5 peppers, add 120 ml water, boil it till it reduced to 30ml.  It should be taken twice daily.
Ocimum tenuiflorum – Thulasi  
    The sacred plant of the Hindus is grown in every household. The holy water offered as Prasad in Vishnu temples contains this herb. Thulasi is extensively used in cough syrups and expectorants. It has anti-microbial properties and is used for enhancing the immunity of the human body. Ursolic acid present in Thulasi is a powerful anti-oxidant and studies have been carried out on its effect on stress induced by noise pollution. It is now mass cultivated and the bulk of the produce goes to herbal cosmetics industry and soap –scenting.
Centella asiatica  - Vallarai
This runner, known as Gotu-kola in most parts of the South East Asian countries, has long been associated with the property of enhancing memory. Since it also has a stimulant activity on central nervous system it is best avoided by epileptic patients. The asiaticoside and madacasic acid present in the plant makes it an excellent wound healer and prevents photo ageing of the skin. It is used in anti-wrinkle creams. The plant grows near water bodies and wet lands. Studies have established its value in the treatment of ulcers due to tuberculosis and leprosy. It can be taken as leafy vegetable or dried powder 2 gm twice daily.
Vitex negundo – Nochi
   This is a large aromatic shrub with quadrangular densely whitish tomentose branchlets up to 4.5m in height. It is very common in many parts of the country and often occurs gregariously. The leaves are aromatic and are considered tonic and vermifuge. 2 to 3 leaves with addition of long pepper -5nos, add 120 ml water, boil it and reduced it as 30 ml decoction is taker for fever and head ache. A decoction of the leaves and the vapors are employed in baths for the treatment of rheumatic complaints.
  Gymnema sylvestre   - Sirukurinjan
   The leaves of this perennial climber which grows almost through out the scrub and deciduous jungles are probably one of the very few Indian herbs investigated and accepted in almost every part of the world for its anti-diabetic property. Chewing of leaf blocks the taste buds and the taste of the sugar is masked temporarily. 1 to 2 gm dried leaf powder twice daily should be taken for diabetes along with other diabetic herbs.

Wednesday, August 1, 2012

CTMR Local Health Tradition -News from Pharmabiz

CTMR’s Revitalization Health Program to strengthen traditional healers enters third phase

Peethaambaran Kunnathoor, Chennai
Thursday, August 02, 2012, 08:00 Hrs  [IST]
In order to protect the indigenous traditional knowledge in medicine and local community knowledge in managing healthcare related issues, the Chennai-based Centre for Traditional Medicines and Research (CTMR) has initiated a programme Revitalization Health Program, which was conceived and funded by the department of Ayush to strengthen the traditional healers of rural areas in eight districts of Tamil Nadu.

The Centre identified eight districts --- Salem, Dharmapuri, Krishnagiri, Namakkal, Vellore, Thiruvannamalai, Kancheepuram and Thiruvallur --for implementing the project.

The program, started way back in 2010 with documentation and validation of indigenous and local health managements by the traditional healers, will culminate in December this year. The third phase of the program, scheduled for August 11, will focus on managing resources for better solutions for healthcare related issues affecting rural as well as urban people. Further to this, there will be two more programmes to strengthen the traditional knowledge of the healers.

As part of the project, the revitalization program in four districts of Salem, Dharmapuri, Krishnagiri and Namakkal will be held on August 11 in Salem. Seventy five healers who have completed the documentation and validation program will be allowed to attend the final training which is titled as ‘Documentation, Validation and Training in local health traditions”.

“The first phase was concentrated on documentation, second one on validation and the final one is to train the healers on how to manage the diseases with their indigenous knowledge. Only healers of Salem, Dharmapuri, Krishnagiri and Namakkal districts are allowed to attend the training. For healers of other four districts, separate programs will be held shortly”, said Dr T Thirunarayanan, secretary of CTMR.

After completing the work for documentation on the treatment method adopted by 150 traditional healers, the way they prepare the medicines, the raw materials used etc in the particular areas, the Centre went on with the second phase of the programme, Validation. The third stage is now for Revitalization and Capacity building, he added.

According to him, the training will also impart the knowledge on how to manage common ailments and lifestyle disorders with local biological resources in safe and cost effective manner. But in the third phase of training, admission has been restricted to 75 traditional healers from the four districts. Special coaching on danger signals in diseases, limitations of traditional healing, reference of patients to medical centres, particularly during outbreak of diseases etc will be discussed in the classes. The one day program will also contemplate over disseminating knowledge on collection and preservation of herbs and other traditional resources for the preparation of medicines.

The programme will begin with a function presided over by S Sathapillai, retired district judge. Officials from the department of Indian System of Medicine  & Homoeopathy and experts from Central Council for Research in Siddha and trainers from CTMR will  handle the programme.

Previously, the training and research institute in Chennai made remarkable impact in areas of mobilizing and organizing traditional healers in the interior villages of all major districts by implementing novel schemes for providing training and capacity building.  As part of their incessant training programs and for facilitating the implementation, CTMR has set up a charitable Siddha clinic at Chinnandikuppam,  a fisherman colony near Chennai, one charitable clinic in a remote village at Kanavaipudur in the border area of Salem – Dharmapuri districts and a mobile clinic for the urban slums in the state capital.

Besides the Ayush sponsored programs, CTMR is currently engaged in digitization of Siddha palm leaf manuscripts, promotion of medicinal tree plantations at Indian Medicine Institutes and creation of medicinal plant gardens in health centres and schools, publication and translation of classical Siddha texts and training manuals, the secretary of CTMR said.

Saturday, July 21, 2012

Trade Regulations in Medicinal Plant sector -Review

Executive Summary

Tamilnadu holds a key position in trade and export of botanicals used in medicine due its geographical position and well developed trade ports. In fact cultivation and conservation has always been a priority as much as the utilization of medicinal plants in the state.

Government Departments particularly Forest Department and Commercial Tax Departments have been proactive in bringing in regulation for facilitation of the medicinal plant sector. A review of the existing regulations both the central and state pertaining to the trade provide some more opportunity for further facilitation as this sector provides rural employment particularly in areas close to reserve forest.

The regulations and the bottlenecks were discussed jointly and individually with traders, exporters and growers and wherever required experts inputs and official/legal view points were sought and obtained from senior government officials.

The Key recommendations are

Forest Department

  • Tamilnadu Forest Department to come out with area specific list of Medicinal plant part permitted to be collected by VFC members
  • Issue of Origin certificate by Range officers in JFM area for non-forest wild collection and cultivation
  • Ban on collection of select plants  in a given area for a specific period to promote conservation and regeneration
  • Provisions of Identity cards for VFC members for collection, restricting them to a given area.
  • Suggestion to MoEF on revision of Negative list based on ground realities and to remove anomalies in export incentive schemes
 Commercial Tax Department 

·        Publication of Tax exempted list with Botanical names along with Tamil and Sanskrit name as given in Govt of India Formularies of ISM
·        Registration of VFC cooperatives and exempting them from Tax
·        Exempting all cultivated medicinal plant materials from Tax by issuing orders under Tamilnadu VAT ACT 2006

Land Reforms Department

  • Amendment in Tamilnadu Land Reforms (Fixation of Ceiling) Act 1961. to permit Crop diversification to medicinal plants in old Plantations.

Agricultural Marketing Department
  • The Provisions of contract farming with authority to proceed against defaulter – either buyer or seller needs to be made by amending  Tamilnadu Agricultural Marketing (Regulation) Act
Transport Department

  • Explore the possibility of providing free transport passes for members of VFCs for the purpose of bringing medicinal plant material to consolidation centres
  • To issue circulars to field officials to accept the weight mentioned in the certificate of origin or approved weigh bridge during transport in trucks