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The best interest of the patient is the only interest to be considered, and in order that the sick may have the benefit of advancing knowledge, union of forces is necessary

The best interest of the patient is the only interest to be considered, and in order that the sick may have the benefit of advancing knowledge, union of forces is necessary

Epidemiologist Prof. Archibald Cochrane’s (1909-1988) teachings and writings2 led to the renaissance of advanced health care in Europe in early 1990. Now known as evidence based medicine gradually persuaded medical journals and practitioners of Europe and North America to look for evidence in their own publications and patient care protocols. IT tools and World Wide Web brought evidence based movement in health care to the desk top of health care workers and patients. Globalization resulted in the exodus of villagers to urban area. Their migration brought traditional medicine to cities.

Coupled with personal experiences wealthy and powerful policy makers began understanding the limitations of modern medicine. Increase in the popularity of traditional herbal medicines led to the National Institute of Health, USA to respond (1991) by opening office of complementary & Alternative Medicine (CAM). Prof. Terence Ryan led the British interest in CAM by hosting awareness and policy making organization of traditional medicines, GIFTS of Health in his department of dermatology at Oxford (1993). Finally, Government of India woke up to the reality to establish (1995) department of AYUSH. Thus began a focused attention in India to the development of Education & Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy systems.

Although lesser known, especially due to the poor penetration of information technology during the same period, several biomedical doctors, scientists, patients and farmers growing medicinal plants were informally collaborating in India to explore CAM and Integrative Medicine. Their major work involved translating classical Sanskrit text books of AYUSH to English. This was led by Bangalore based Foundation for Revitalization of Local Health Traditions (1991-now a state university- Institute of Trans-Disciplinary Health Sciences & Technology), albeit with their own theoretical interpretations without clinical illustrations3. Several such translations and personalized experiences of Mumbai based clinicians appeared in series of house journals on traditional medicines by Lupin India Ltd (1992-94). These booklets were distributed free to medical practitioners wherever the pharmaceuticals operated in India. I was attracted by the logic of Ayurveda in essays of Late Prof. Shardini Dhahanukar, then professor of clinical pharmacology at Seth G S Medical College and KEM hospital Mumbai. Her writings and scholarly papers of Dr. M.S. Valiathan4, Srichithra Institute, Thiruvananthapuram persuaded me to explore Ayurvedic dermatology, if it could bring succor to my chronic difficult, to treat patients. In those days of poor connectivity ‘Pen friendship’ with Dr. Dhahanukar constantly encouraged my thoughts on Integrative Medicine.

In 1994 I began discussing the research opportunities in Integrative Medicine with learned medical college teachers, my peers and family physicians who later became the founder members of IAD. These discussions were critically reviewed with value addition, ethics and global perspective by Mr. S. R. Vijayashankar, then Manager Communication, Novell India Ltd., now Intel volunteer in IAD. Bangalore based Advocate Mr. S.R. Raviprakash and company secretary Mr. Lakshmi Narayana Jois voluntarily synthesized these discussions contained in tens and hundreds of postal letters, notes and telephone calls into a legal document of Memorandum of Understanding and Association of IAD. This required over 2 years of reading, discussion, conference presentations and meeting people from different disciplines of science and medicine. Following this another long struggle began to obtain Indian Government’s license to begin operations. Two ways of file movement, a daunting task even in present time, from Chennai to Cochin to Kasaragod was voluntarily facilitated by the then Kerala Government Secretary Mr. K. Shashidhara, IAS and then Commissioner of Income Tax at Chennai Dr. K. Sathyanarayana, IRS. Both were not connected to the department of company affairs, Government of India where registration was sought. These voluntary efforts of selfless and highly skilled intellectuals led to the formation of not-for–profit charitable section 25 company, Institute of Applied Dermatology in July 26, 1999.

When registration process was voluntarily shouldered by two senior bureaucrats, I presented the idea of integrating different systems of medicine, its low cost, safety and benefits to patients to many interdisciplinary experts. One among them was Late Dr. Katara Subrahmanya Bhat during his visit to native village in Kasaragod. He was working in UK agriculture department and co-authored papers with Prof. Ryan on medicinal plants. On his return to UK Dr. Bhat discussed my views with Prof. Terence Ryan, then head of the department of dermatology, Oxford Brooks University, Oxford. In return Prof. Terence Ryan extended invitation to me, dermatologist Dr. Shyam Verma from Baroda, Late Dr. Tom Oomen, clinical pharmacologist from Manipal to participate in a symposium on traditional medicine held in his department. The symposium was organized by GIFTS of Health team on 14th May 1998. I could not attend the symposium. However, Dr. Bhat presented my paper on clinical evaluation of traditional medicinal formulations5. Later Prof. Terrence Ryan sent an email reply to my postal letter dated 7th October 1998. His email dated 16th October 1998 was sent to Mr. S.R. Vijayashankar, Novell India Ltd at Bangalore as Kasaragod didn’t have internet facility at that time. This made the beginning of his mentorship even before IAD was registered. Until we got internet access through now defunct Satyam (later sify) domain our communications were routed through Novell’s email domain. 15 years drove past; we, at IAD, continue the spirit of volunteerism and global vision that led to its formation. We generate new knowledge on Integrative Medicine and Evidence Based Ayurveda through voluntary contributions of intellectual property of collaborators, associates, volunteers and mentor. None of them receives any kind of remuneration or is interested in copy right of their intellectual contributions. Most often their travels also are not reimbursed. They share their knowledge on IAD platform for ‘the best interest of patients’. These forces are united voluntarily to expand Integrative Medicine from Applied Dermatology.

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  1. Quotes from Dr. William Mayo (1910)
  2. Cochrane AL. Effectiveness and Efficiency. Random Reflections on Health Services. London: Nuffield Provincial Hospitals Trust, 1972. (Reprinted in 1989 in association with the BMJ, reprinted in 1999 for Nuffield Trust by the Royal Society of Medicine Press, L o n d o n (ISBN 1 – 8 5 3 1 5 – 3 9 4 – X) also read //www.cochrane.org/
  3. Narahari, S. R., Ryan, T. J., Bose, K. S., Prasanna, K. S. and Aggithaya, G. M., Integrating modern dermatology and Ayurveda in the treatment of vitiligo and lymphedema in India. International Journal of Dermatology, 2011;50: 310–334
  4. Valiathan MS. Whither India’s medical legacy? Current Science 1990; 59: 125–127.
  5. Narahari S R and Prasanna KS. A methodology for clinical evaluation of existing practice, using traditional herbal medicinal formulations. Current Science, 1999; 76:467 – 68. (First peer review comment received from editor Prof. P. Balaram on 10th July 1998)

Author: Dr. S.R. Narahari, MD.DVD. (Modern Dermatology)

Chairman & Director

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