|Year : 2017 | Volume
| Issue : 1 | Page : 1-2
Need to strategize standardization of Indian systems of medicine
K Subrahmanya Kumar
Centre for Ayurveda Biology, The Institute of Trans-Disciplinary Health Sciences and Technology, Bengaluru, Karnataka, India
|Date of Web Publication||13-Jul-2018|
K Subrahmanya Kumar
Centre for Ayurveda Biology, The Institute of Trans-Disciplinary Health Sciences and Technology, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kumar K S. Need to strategize standardization of Indian systems of medicine. Ancient Sci Life 2017;37:1-2
Indian Systems of Medicine (ISM) developed over centuries with an epistemology totally different from that of Biomedicine. They have developed perspectives and theories on manifestation of life, health, disease treatment and medicaments with their unique world-views, most often nurtured from ancient philosophical insights. Adequate thought was given to the quality standards of the raw materials and medicinal preparations by most of ISMs. Surprisingly, deeper studies on the quality standards put forward in terms of selection of raw materials, primary processing and formulation techniques gives an impression that, they are developed after careful observations and several modifications over the centuries. However, most of such knowledge is sparsely documented in the classical literature of ISM.
Recent developments in global health-care are clearly emphasizing wellness, preventive healthcare, psychological wellness, personalized medicine and natural product therapeutics. Complementary and Alternative Systems of Medicine (CAM) including ISM, focus on wellness and preventive healthcare. It is also anticipated that in the coming days, a single health-care system may not cater the needs of society. Therefore there is increasing interest on the possible role of alternative medical systems in the obtaining scenario.
Originally, ISM was practiced by the physicians in small setups with their own manufacturing facilities to cater the needs of their patients. The quality control systems of Indian medicine are also developed in accordance with the style of independent practice and small-scale medicine preparation. Several challenges, including the quality assurance of ISM products were faced by the pioneers of mass production of these medicines in India, during the beginning of 20th Century. However, with the efforts of formularies, regulating authorities, researchers and the manufacturers of ISM medicines we have been able to produce standardized ISM products across India. Efforts to bring about safe and quality medicinal products in accordance with global standards are continuing.
However, the quality standards/techniques are borrowed from or developed based on modern biomedicine thought-systems. There are debates about the suitability of such standards to CAM including ISM. Also, the efforts to standardize compound formulations of ISM are sparse. Designing standards involving the knowledge from its own philosophies and 'science' is the need of Indian Traditional Medicine.
Unlike biomedical pharmaceutical products, which are single target oriented, the ISM products are designed to bring in homeostasis of physiological processes (svāsthya) within an individual. Recent studies using advanced computational biology have proved that multi compounds in a complex herbal formulation work at multi-targets, but achieve the desired pharmacological effects through 'network pharmacology.' This strength of complex plant drugs and formulations of CAMs itself is one of the challenges in standardization. Due to the complexity of multiple compounds in the formulations, at several instances, ISM products show considerable variations in terms of sensorial and quality control parameters. The situation often raises concerns about the authenticity of the product by the consumers and about the necessary concentration of compounds essential to achieve pharmacological activities as well.
Contemporary researchers working on traditional medicine are putting in efforts to bring uniformity in generic products. One of the articles in this issue elaborates on the standardization of one of the popular ISM product 'Ciruvilvādi kaṣāyam' with the guidance of marker assays using advanced phytochemical and chromatography techniques. It also puts forward the proposal of application of such standardization in the process of industrial quality control to identify and rectify various issues related to the quality of raw material and manufacturing process. Researches of this kind will go a long way to help development of SOPs and quality control parameters and thus is appreciable.
The actual challenge with reference to standardization of ISM formulations is much larger. Primarily we need to produce acceptable, fool proof yet practical standardization parameters for the compound formulations in terms of chemistry and biology, which itself is a complex process because of multi ingredients and compounds in the formulations. The second challenge is developing standards involving the parameters suggested by the theories, worldviews and practices of ISM on crude drugs, processing and formulation techniques.
There are suggestions right from the health (normal growth) of plant material, stages of maturation and seasons appropriate for the collection of plant parts for medicinal usage. Deśavicāra(considerations on geographical area of plant growth/cultivation) of Ayurveda is another potential subject which needs to be considered. Parameters described in the pharmacognosy and pharmacology of ISM (e.g. dravyagunṇa in Ayurveda)needs appropriate interpretation and real considerations. Principles and practice of ISM allows use of substitute plant drugs in case of critical shortage of the original ones. Several such practices are well accepted within the purview of ISM theories even though they may not be acceptable by science at cursory glance. In fact, insightful analysis may prove that such 'fine' parameters are vital for ISM. Neglecting them may prove fatal to the interests of traditional systems of medicine in the due course of time.
For decades, philosophers and scientists in ISM research started to voice the critical need for intercultural and 'more appropriate' standards for ISM. There is a necessity of dialogue between the ISM knowledge holders and biomedical scientists in order to develop standards. Researchers have established with adequate scientific evidences that several such quality standards on maturation, processing techniques etc., are worth adopting for ISM products. However, such activities are happening with the interests and efforts of a limited number of institutions and individual researchers. Therefore such efforts are unable to bring visible changes in the actual scenario. On the other hand, the demand from the traditional practitioners to consider quality standards of ISM is not strong. Strategies to involve the inputs on quality standards from ISM may pose several challenges in terms of identifying appropriate chemistry and biology tools, practicality of adopting them in industrial production etc. The best researchers concerned about strengthening traditional medicine in this field need to put together their efforts. Coordinated, systematic and nation-wide research activities are the immediate need.
While adopting the needs of globalization of traditional systems of medicine in terms of quality control parameters for the products, it is necessary to consider the parameters developed within the systems, so that the original philosophies of traditional medicines are not diluted. Additionally, inter-cultural research of high order may give new insights to conventional thoughts in biomedicine as well.
| References|| |
Togo T, Urata S, Sawazaki K, Sakuraba H, Ishida T, Yokoyama K, et al.
Demand for CAM practice at hospitals in japan: A population survey in mie prefecture. Evid Based Complement Alternat Med 2011;2011:591868.
Mandal SC, Mandal M. Quality, safety, and efficacy of herbal products through regulatory harmonization. Drug Inf J 2011;45:45-53.
Chandran U, Mehendale N, Tillu G, Patwardhan B. Network pharmacology of ayurveda formulation triphala with special reference to anti-cancer property. Comb Chem High Throughput Screen 2015;18:846-54.
Shankar D, Unnikrishnan PM, Venkatasubramanian P. Need to develop inter-cultural standards for quality, safety and efficacy of traditional Indian systems of medicine. Curr Sci 2007;92:1499-505.