CTMR – Annual Report- 2012-13

CTMR – Annual Report- 2012-13

Centre for Traditional Medicine & Research (CTMR), is a ‘Voluntary organization’ operational since 2000. The key objectives of CTMR are Mainstreaming Traditional medicine in the area of public health, Creation of awareness, Capacity building by way of training, Developing cost effective treatment protocols based traditional medicine  and promotion of research in traditional medicine including cultivation and conservation of Medicinal plants. The NGO works closely with different Government departments, other institutions and organizations for the above cause.

1.  Public Health Initiatives:

1.1    Primary Health Care :

Almost 80% of the population in the semi-urban areas and 60% of the rural population depend on private health care providers- both qualified as well as unqualified in spite of improvement in Public health delivery infrastructure. Marginalized communities like fishermen, dalits and tribal, who are daily wage earners still find it difficult to utilize the Govt. services due to reasons like loss of wage on the days of hospital visits, distance to the nearest health facility and the timing of the outpatient clinics. There is very limited awareness about disease prevention and treatment through AYUSH systems. CTMR felt it necessary to provide the AYUSH services at the doorstep of such marginalized communities, create awareness about healthy lifestyle, food as envisaged in Traditional Medical systems and reduce health expense burden of these communities. CTMR runs two Primary Health Care Centres (Chinnandikuppam in Kanchipuram district and Kanavaaipudur in Salem District) and a Mobile clinic (Velankaadu in Kanchipuram district). About 10,000 people are benefitted by these intervention, where medical services and medicines are provided free of cost to the beneficiaries. A uniform treatment protocol is developed and followed. The drug list for the centers is based on the ‘Essential drug list’ of Dept. of AYUSH which essentially contains safe plant medicines and they are procured from GMP approved units.  40% of the residents of these adopted villages now solely dependent on AYUSH services, while 40% utilize these services for primary health needs and avail services of other medical facilities for Lab investigations and medical emergencies. 20% have reservations in using traditional medicines. Medical Records are maintained for all registered users. Tamil Nadu Industrial Investment Corporation and AMR Charitable trusts provide partial support for these activities.

1.2    Public Awareness on Healthy Living:

Health Education is of primary importance particularly in prevention and management of Non Communicable Diseases – Lifestyle Disorders. CTMR use a three pronged strategy for health education. Since young student population is attracted to unhealthy processed food due to strong enticing advertisement both in print and visual media, CTMR conducts regular interactive programme in both govt. and private schools and colleges and also conducts health exhibitions including medicinal plants, minor millets, health food and healthy lifestyle. These sessions also cover the ill effects of lack of physical activities, smoking and consumption of alcohol. CTMR volunteers along with Ekam foundation organized awareness programme for health workers and anganwadi workers on ‘Managing common ailments with locally available medicinal plants’ in almost 10 districts of Tamil Nadu during the ‘Joy of Giving Week’. CTMR also conducts interactive sessions for public on diseases like diabetes, hypertension, obesity and cancer along with various residents associations and Community Based Organizations. The Third approach is by a serial of Talk shows on health in Doordarshan – Pothigai sponsored by Ministry of Health and Family welfare. (About 50 shows during the current year) and write-ups in both English and Tamil dailies and magazine including one published from Srilanka.

2.      Documenting Traditional Knowledge.

2.1    Local Health Traditions

Traditional Health Practitioners still put to use the knowledge acquired from their 

forefathers and treat patients with locally available plant resources. This knowledge also helps conservation of the medicinal plant resources. As the continuation of the project of ‘Documentation and Validation of Local Health traditions’ supported by Dept. of AYUSH, further interactions were held with the healers individually and as groups and the peer validation of the practices were carried out in six districts of Tamil Nadu namely, Vellore, Thiruvanamalai, Salem, Dharmapuri, Krishnagiri and Namakkal Preliminary interactions have also been initiated with healers of Villupuram, Kanchipuram and Thiruvallur districts. The use of plants and practices mentioned by the healers were further validated with classical Siddha texts and recent research publications. This compilation is ready for finalization.

2.2    Digitalization of Siddha Palm Manuscripts

During the previous year 160 bundles consisting of 257 works of Siddha Palm Manuscripts collected from individual healers were digitalized with Grant-in- Aid from Dept. of AYUSH and the digital copy along with the catalogue was submitted to Dept. of AYUSH and Siddha Central Research Institute.  The work of collection of Palm manuscripts and digitalization was further continued and currently 367 works are digitalized. This will be a continuous process and requires financial support.

3.  Capacity building

3.1    Training

One day training was conducted for the traditional healers of Salem and Dharmapuri district at Kolathur in Mettur Taluk (August 2012). Management and treatment of common ailments, differential diagnosis in Jaundice, Mother and child health care were covered. 80 healers from this district took part. This was followed by field visit for identification of Medicinal plants.

The Objective of conserving the palm manuscripts is to enable passing on the traditional knowledge to the next generation. Very few people have the expertise to decipher the writings in Palm manuscripts particularly the ones in poetic form. CTMR has conducted training to Siddha physicians, students of plant sciences and Tamil literature to read and interpret the palm manuscripts. Training in groups was conducted at Madras Christian College (Feb 2013) and for individuals at CTMR.

3.2    Workshops

One day interactive session was held for the tribal medicinal plant collectors and growers from Dindigul and Thiruvanamalai districts affiliated to Centre for Indian Knowledge Systems along with Tamil Nadu Siddha Ayurveda Unani Drug manufacturers Association in Apl 2012. The Sustainable collection practices, Good Post harvest handling practices were explained to them.

One day workshop on medicinal plants was conducted in association with Healers association of Kolli hills for the traditional healers at Kolli hills in Namakkal district in May 2012. Healers from Namakkal, Thirupur, Sivaganga and Ramanathapuram districts took part

One day workshop was conducted in May 2012 on the ‘Beauty of Siddha Formulations’ in which a large number of practicing Siddha doctors, Post graduate Scholars and Traditional healers participated. The synergy of the ingredients in the formulation to enhance efficacy, safety profile and the ability to enhance the bio-availability was dealt in great details.

One day workshop on identification, propagation and utilization of medicinal plants was conducted for the students of Community College of Agriculture at Sukkankolai farm of the CIKS. 50 students took part in the workshop.

4.  International Training and interactions.

4.1    International Conference;

Dr.T.Thirunarayanan was invited to present a keynote address on Siddha Medicine in the Second international conference of Tibetan Medicine held in Dharmshala in the august presence of H.H.Dalai Lama. There was also a Joint meeting on ‘Impact in Traditional pharmaceutics on UN ban on the use of Mercury’

4.2    Training on Siddha for foreigners

A three days training was conducted in association with Siddha Applied Science Institute at Penang, Malaysia on the ‘Management of lifestyle disorders and common ailments with plant drugs based on the principles of Siddha Medicine in Sept 2012.Forty  participants from Russia, USA, Canada, France, U.K and Switzerland took active part and the trainees continue the learning online.

4.3    A two days interactive session on the ‘Commonalities between Siddha and Tibetan Medicine’ was organized by CTMR along with Mee-See- Khan at Chennai in March 2013. Eighteen Tibetan doctors and 14 Siddha Physicians took part in the interaction. This helped the participants appreciate the common features of the two traditional medical systems and paved way for joint research in the future.

5.  Medicinal Plants

5.1    Institutional Gardens  and Home herbal garden

During the current Year, School herbal garden has been established in five city schools.  Herbal garden has also been initiated in Institute of Child Health Egmore and 100 households were trained in establishment of home herbal garden.

Continuous technical support is rendered to Green kovai- a unit of AIM For Sewa. Technical inputs provided for farmers group affiliated to CIKS and Murugappa Chetty Research Centre.

A survey of the Medicinal Plant Flora of National Institute of Siddha was carried out by Vd.S.Usman Ali along with volunteers of Siddha Maruthuva Mandram, Kalpakkam in Nov 2012 and report presented to the Director.

6.  Research

6.1 A study was carried out on the ‘Role of traditional food with minor millets on Obesity, Hypertension and Non Insulin Dependent Diabetes Mellitus’ by Dr.T.Thirunarayanan

6.2 A study on the propagation and survival of select medicinal plants by stem cuttings is initiated for three important medicinal plants.

6.3 Three Research Scholars were guided on the ethno botanical studies and Urban garden studies with reference to medicinal plants by Vd.S.Usman Ali.

6.4 Authentic samples of medicinal plant materials were provided to numerous research scholars for carrying out pharmacognostical, phytochemical and toxicological studies. Results are published in their research reports.

6.5 Two students were provided support for studies on Siddha Palm Manuscripts as part of their Ph.D programme by Vidwan N.Srinivasan.

7.  Publications

Two books, ‘Introduction to Siddha Medicine’ in English and ‘Training manual for traditional healers’ were published during the current year. A small booklet on ‘Home Herbal Garden’ was published in association with ‘reStore garden’ a NGO. Manuscripts for two other books are in the pre-press stage. Three research papers of CTMR staff were published in peer reviewed international journals

8.  Advocacy

CTMR has been continuously interacting with Government Departments on the various regulations which have an impact on improving the quality standards of medical services through Traditional Medicine. The organization has enabled the revision of ‘Poisonous drug list, Essential Drug List and the Siddha Dossier of the Dept. of AYUSH. CTMR office bearers  have also participated in stake holders meeting organized by different Govt. Depart on Safe guarding Intellectual Property of Traditional knowledge and promotion of Traditional health food and minor millets. CTMR has also been instrumental in pushing for opening of Urban Siddha Health Centers by Local Govt. Chennai corporation in fact in its current year budget has announced opening of 25 AYUSH centers in Chennai. CTMR has also been advising ISM drug manufacturers on continuous quality improvement.

9.    Resource Management

All units (Office and two Health Centres) are operating from ‘Rent free accommodation’ provided by donors. The fund for procurement of medicine, medical records and dispensing material are provided by AMR trust and TIIC. Local Health Tradition documentation is partially supported by Dept. of AYUSH.  Excepting three junior staff all others render service voluntarily. Most activities are carried out with support from Partner NGOs and deficit of Rs 5, 00,000 is met by office bearers.

Acknowledgement

CTMR is thankful to the following Govt. Department and other organizations for their continuous support

·         Dept. of AYUSH, Govt. of India. New Delhi

·         Tamil Nadu Industrial Investment Corporation, Chennai particularly its Chairman. Mr Md.Nasimuddin ,I.A.S. Mr. A.Mohan , Deputy Gen. Manager & Mrs.S.Sashikala.

·         Mr.P.Arulmudi Chairman, AMR Charitable Trust, Chennai

·         Dr.R.Vijayakumar I.A.S Addl. Chief Secretary –Planning Govt. of Tamil Nadu, Smt.Sheela Rani Chunkath. I.A.S Addl Chief Secretary, Govt. of Tamil Nadu Mr.V.Prabakaran-I.F.S, Chief Conservator of Forest. Tamil Nadu for constant support and guidance for various projects.

·         Dr.K.Manikavasagam- Director, National Institute of Siddha

·         Siddha Applied Science Institute. Malaysia and its founder SriPranaji.

·         Principal, Head of the Dept. of Plant Biology and Biotechnology Madras Christian College, Chennai and Prof.D.Narasimhan 

·         Mr.R.T.Vijayaraghavan Charted Accountant

·         Siddha Physicians– Dr.R.Sudha, Dr.V.Tamilalagan, Dr.T.R.Siddique Ali,

Dr. G.Padmavathy and Dr. R.B.Ramamoorthy.

CTMR Personnel

Name	Area
Vd.S.Usman Ali	President. Research  &  Local Health Tradition
Vidwan. N.Srinivasan	Manuscriptology
Dr.T.Thirunarayanan	Public Health &  Training
Dr.R.Padmapriya	Health awareness & Publication
Dr.S.Rajkumar *	Digitalization of Palm Manuscript
Dr. S.Sangeetha	Public Health Initiative
Dr.Thirumagal	Primary Health Care
Mrs.V.Sundaravalli	Medicinal Plants –Garden initiative
Mr.Adikesavan	Photodocumentation & Palm Manuscript Conservation

Dr.S.Rajkumar *  resigned during the course of the year.

Be part of our mission.

Contact us:

Secretary,

Centre for Traditional Medicine & Research,

 4A,4^th Cross Street, Mahalakshmi Nagar.

 Adambakkam,

Chennai- 600088.

Ph: 044-22533399

E-Mail: ttn64@sify.com/siddhactmr@gmail.com

Palliative care in cancer management -Siddha

This is an article presented for World Siddha Day- 2013

Dr.T.Thirunarayanan

Centre for Traditional Medicine & Research

4A, 4^th Cross Street,

Mahalakshmi Nagar, Adambakkam, Chennai- 600088

E-mail: ttn64@sify.com

Disease burden due to epidemics caused by vector borne diseases like dengue, swine flu, malaria are unabated on one hand, with no respite in communicable diseases like tuberculosis, hepatitis, HIV, the incidence of non- communicable diseases like stress, obesity, hypertension, diabetes, Ischemic heart disease and cancer pose a major challenge to the Public health managers of a developing country like India. There is a possibility of reducing the burden of the vector borne diseases by effective mosquito control, improving sanitation, making potable drinking water available to the mass. Early lifestyle modification, better diet control, exercise can reduce the burden of diabetes, obesity and hypertension. The large majority of the cancers except the tobacco caused cancers as of today is not preventable and once afflicted severely affects the quality of life or life threatening. 

The incidence of cancer is given in the Table- 1

Type in Men	Percentage	Type in Women	Percentage
Oral, including lip and Pharynx	22.9%	Cervical	17.1%
Stomach	12.6%	Stomach	14.1%
Lung	11.4%	Breast	10.2%

Source;  Dikshit R et al, Cancer mortality in India: a nationally representative survey. Lancet. 2012 May 12;379 (9828):1807-16.

Leukemia is common among children, Prostrate cancer a very common problem among men in US (25%) is not that prevalent in India. Cancer of the Urinary Bladder constitutes 5% of the cancer cases.

Cancer Drugs according to classical Siddha texts

Classical literature of the codified system of medicines of India namely Siddha and Ayurveda have detailed descriptions of cancer of the different organs of the body, their clinical manifestations, treatment procedures and drug formulations. ‘Puttru’, ‘Kazhalai’ are the terms used in Siddha, and ‘Arbuda’ ‘Gulma’ in Ayurveda for neoplasm. Many texts on Inorganic Pharmaceutics ‘Rasaoushadi’ list various drugs that could be used in neo-growth. A detailed literature search on the drugs indicated in the classical Siddha texts and are currently being manufactured by Siddha drug industry are the following.

‘Agathiyar Kuzhambu’ (Source-Agasthiyar Amutha Kalai Gnanam) A drug containing purified inorganics like mercury, red orpiment, yellow orpiment, dehydrated borax, rock salt, and herbal drugs like  aconite, croton seeds asefoetida, black mustard, ajowan, black cumin and castor oil is indicated as topical application in mammary cancer   

‘Kaantha chendooram’ (Source- Agasthiyar paripooranam 400) A drug containing purified  lode stone, sulphur, lead wort powder processed with eclipta juice, lime juice, milk, egg albumin, madder latex is indicated in Abdominal tumor

‘Poorna chandroodayam’ (Source- Theriyar Karisal 300) A drug containing Gold filling, Mercury, Sulphur processed with red cotton flower juice and banana rhizome juice is indicated in cancerous ulcers.

Mahaavallaathi (Source - Bogar Vaithyam 700 and Vallathi 600) A drug containing all herbal ingredients milk, ghee and honey- china root, emblic and belleric myrobalan, dry ginger, lesser galangal, Indian spikenard, cinnamon bark, picrorrhiza, telichery seeds, shiva’s neem, black musale, nutmeg, c;loves, cinnamon leaves, black pepper, cardamom, ajowan, long pepper, psoralea, coriander seeds, embelia, nigella, leadwort root, celestrus, withania, saffron, korochan, purified marking nut, brown sugar, is indicated in cancer.

Kowsiker kuzhambu  (Source  Kowsika muni nool)

Chebulic myrobalans, black mustard, rock salt, asafoetida, dehydrated borax, purified mercury, purified red orpiment, long pepper, purified yellow orpiment, cumin, picrorrhiza, purified aconite, purified croton seed kernel, carbonized coconut shell, palm jiggery, daemia leaf juice, coconut milk is indicated in cancer with daemia juice

Rasakanthi mezhugu (Source-Pulippani vaidhyam 500)

Purified mercury, purified sulphur, calomel, yellow orpiment, lode stone, blue vitriol, calamine, litharge, dry ginger, ajowan, turmeric, embelia, sweet flag, clove, china root, purified marking nuts, chebulic myrobalan, nigella seeds, wild cumin, beetle killer, yew leaf, raisins, long pepper, lesser galangal, costus, celastrus, fennel, cardamom, nutmeg, black pepper, cumin, psoralea, oak grass, long pepper root, rattan cane root, purified nux vomica, purified nux potatorum, astercantha seeds, sesame seed, horse gram, copra, acalypha fruticosa root, azima root, withania, corallocarpus root, lead wort root, eggs, palm jaggery is indicated for cancers and cancerous ulcers.

Some drugs like Chandamarutha chedooram, Idivallathy Mezhugu, Serankottai Nei, which are used by healers do not have a direct reference for treatment of cancer in the  texts

Treatment seeking pattern

Centre for Traditional Medicine & Research receives cancer patients at different stages. Difficulty in swallowing, abnormal bleeding, loss of appetite, weight loss, low grade fever, fatigue, altered bowel habits and pain are some of the features with which patients present themselves. Most of the patients come to us with diagnosis from cancer hospitals.

Detailed interactions with the patients reveal increasing number of patients seek remedy from practitioners of Traditional medicines for the following reasons.

• 1.      Most cases are diagnosed very late after metastasis has occurred and the general health of the patient does not permit complete surgical removal as the disease has spread to multiple locations. In spite of removal in rest of the cases where the lesion is localized the possibility of microscopic metastasis cannot be ruled out.
• 2.      The serious side effect of chemotherapy like severe vomiting, diarrhea makes the patient does not continue the treatment for its suggested full course.
• 3.      The possibility of chemotherapy and radiotherapy destroying the normal cells apart from the cancer cells due their cytotoxic effects.
• 4.      Target chemotherapy and monoclonal antibodies therapies are not widely available.
• 5.      The absence of specific cancer treatment hospitals even in many district head quarters is yet another hurdle.
• 6.      Without health insurance, the cost of treatment is prohibitive for most people and they are ill affordable to a vast majority.

Above all there is a trust that the traditional medicine, particularly Siddha can cure cancer is very strong among people.

The following are the different categories of patients who seek treatment at CTMR.

• ·   Patients in advanced stage where all other options of chemotherapy, surgery and radiotherapy are not possible,
• ·         Patients not willing to undergo the orthodox method but wants to be treated with Siddha medicine
• ·         Patients who want supportive therapy- supplementation alongside conventional treatment and
• ·       the last set of patients who have undergone treatment including surgery but want to prevent reoccurrence or with late secondaries.

Pallative Care

The basis of treatment at CTMR is palliative care. Since vast majority come at advanced stages the realistic option is palliative care aimed at improving the quality of life of the patient and their immediate family by providing pain relief, psychological support and administration of specific plant based drugs for which enough evidence are available in classical texts and also evaluated by scientific methods both in-vitro and in-vivo.

The first step in the care is proper counseling to the patient and the attendants on the nature of the condition, the likely prognosis and need for following the suggestions on dietary recommendations, lifestyle modification, abstaining from causative substances like tobacco, alcohol and adation of Kayakalpa methods including breathing exercise, meditation etc.

The dietary recommendation is generally rich in fruits and vegetable salads- baked vegetables rather than deep fried once. Significant reduction in intake of meat products, avoidance of oily, fat rich deep fried spicy pungent diet is also suggested. Depending upon the patient’s ability to sallow porridge, fruit juices, soups are suggested.

Then the administration of drugs. The preferred drug of choice in most types of cancer is Mahavallathy Among the different drugs listed in Siddha this drug is free from inorganic and contains powerful anti-oxidants like Amla, long pepper etc, appetite enhancers like black pepper, clove, cinnamon bark etc. cytotoxics like leadwort and marking nut.

As supportive therapy all patients are provided with a blend of turmeric and Indian gooseberry which are known to quench the free radicals. Withania somnifera, apart from being a drug which sensitize cytotoxic drugs is an anabolic and adaptogen helps the patient in overcoming stress and ensure sleep. Dry ginger or Inji legiyam greatly helps in preventing nausea and vomiting in co-adminstered in patients undergoing chemotherapy. The blend of Indian gooseberry and turmeric is also a hypoglycemic drug and reduces supply of glucose to cancer cells and slows down cell multiplication.

In pancreatic carcinoma and secondaries in liver, Phyllanthus amarus extract is also administered. In conditions of spread to lungs manifested with coughing, Thalisathy churanam is included. In anemia associated with blood loss ‘ Karsalai Karpam’ is also prescribed.

Conclusion

Our observations assure us all these patients including the ones with esophageal, pancreatic cancer, ovarian cancer patient have lived over two years without much of clinical symptom and compromising on the quality of life. It is worth considering the Pallative care approach of Siddha in improving the quality of life of cancer patients.

Faulty disbursement of funds pose threat to cultivation of widely used medicinal plants in TN

Cultivation of widely used medicinal plants has slowed down in Tamil Nadu  as the government subsidies earmarked for the medicinal plant cultivation were not properly disbursed among all the herb growers in the rural areas, it is learnt. Due to lack of financial assistance and technical support, the farmers are unable to cultivate many of the medicinal and aromatic plants which are the source for essential raw materials for commonly used Ayurveda and Siddha medicines. This situation forces the market to increase the prices of the available crude drugs day by day. According to sources close to the plant cultivators, the fund coming to the state horticultural department from the national medicine plant board (NMPB) is disbursed among a few number of farmers, and majority of the cultivators who grow the most needed herbs for Ayurveda and Siddha medicines are being deprived of the benefits. The fund is diverted only for one or two varieties of crops which are not widely used for medicines, they alleged. A technical expert and Siddha doctor in Chennai, who regularly trains the growers and provides them valuable information about plant cultivation, said the government subsidies are benefiting only the exporters of herbal extracts and medicinal plants. All the funds supposed to be disbursed among herb cultivators is going to one or two societies or associations of plant cultivators. He said a total of 180 raw drugs are required for manufacturing the commonly used Ayurveda and Siddha medicines. But the farmers of these widely used plants are unable to avail the benefit of the government scheme. This diversion of funds to selected plant growers forces the farmers of other crops to hike the prices of their produce. He said while disbursing the money, the authorities should consider the most important and widely used plants that are required for the manufacture of Ayurveda and Siddha medicines. The money should not be distributed among a few number of farmers, but should be given to all those engage in the plant cultivation and have linkage to Ayurveda and Siddha industry. He alleged that currently the fund is diverted to some extract exporting units only. In Tirupur alone about 9000 acres of land belonging to over 2000 farmers is used for medicinal plant cultivation. The seeds of ‘Glorisa Superba' produced from the area are exported to countries like Italy where the alkaloid extracted from it is used for the preparation of herbal drugs to fight diseases like cancer, said a plant grower from Tirupur. The cultivation of medicinal plants in Tamil Nadu is the key to meeting the raw material needs of the ayush industry in the state and it offers opportunities for exports of extracts and raw herbs, he said. When contacted Dr T Thirunarayanan, secretary of the Centre for Traditional Medicines and Research (CTMR), said, the needs of the ISM industry need to be assessed and funds should be provided to farmers to cultivate the plants in different agro climatic regions. He said some widely used medicinal plants like Andrographis paniculata, Mucuna pruriens, Saraca asoca (Roxb.) Withania somnifera, Piper longum, Oldenlandia umbellata, Desmodium gangeticam,Centella asiatica. Piper nigrum. Pseudarthira viscid, Trichosanthes cucumerina L Gmelia arborea, Vettiveria zizonoides and Steriospermum colais are now rarely available in the market.

Tibetan Medicine- Siddha Practitioners Interaction

Objective :

 Sow rig pa – The Tibetan Medical System has been officially recogonised by the Govt. of India by including it in the IMCC Act 1970 with due approval of the Indian Parliament in 2010. Since this sy.stem has a lot of commonalities with the Indian Systems of Traditional Medicine      -Ayurveda and Siddha it was decided to understand the commanalities in the area of Basic principles, Drugs & Pharmaceutics, Diagnostic methods and Treatment methods among these systems and also sensitize physicians of the unique speciality procedures of each system.

Organizers

The director of Mee- Tsee-Khang ( Tibetan Medical Astrological Institute) of His Holiness Dalai Lama deputed 16 Tibetan Medical practitioners from TMAI- Dharamsala and its branch clinics (53) functioning across the country to Centre for Traditional Medicine & Research for this interactive meet.

The Local Siddha Partner- CTMR invited 12 Siddha experts (From National Institute of Siddha, Siddha Medical College, Anna Hospital of Indian Medicine,  CCIM E.C member, Siddha Primary health care physician, Varma Physician, Researchers, Private Practitioners and NGO) to interact with the visiting Tibetan practitioners.

Venue and Date

The proceedings took place in the CPR Foundation, Enviornmental Research Centre, Chennai on 8^th and 9^th March, 2013. The delegates also visited Sri Ragavendra Siddha Varma Hospital  the evening of 8^th and National Institute of Siddha on 9^th morning.

First day proceedings

           The proceedings started with traditional invocation in tamil followed by invocation in Tibetian language”Medicine Buddha” . Dr. Nandhitha Krishnan of CPR Foundation welcomed the gathering and explained how the tibetan medicine was able to help cancer patients in chennai and Bangalore This was followed by the inaugural address by Dr. Prof. K. Manickavasakam Director,National Institute of Siddha who appreciated the initiative of dialogoue between two traditional systems of medicines which could further strengthen the systems. The Chief Conservator of Forest and  Director of Sericulture Govt. of Tamilnadu Mr. V. Prabakaran in his keynote address stressed the need of conservation and propagation of medicinal plants, both tropical and high alltitute plants and explained how his department is working towards increasing local production of silk to stop import of chinese silk which could also be done in medicinal plant sector.

The first presentation was by Dr. Thirunarayanan, Secretary, CTMR on the  Basic principles and History of Siddha Medicine where he briefly introduced the system to the Tibetian doctors and also spoke on the scope of collaboration between the two systems. The Basis and History of Tibetian system of medicine was presented by Dr. Sonam Dolkar Oshoe of Documentation & Publication Department Men-Tsee-Khang. The Commonanities where explained by both speakers on the Five Physico cosmic elements. Three humours ( Vata- rlung, Pita- tripa and Kapha- Bad-kan) and the historical exchange between Indian and Tibetan traditional  physicians as early as 7^th Centuary A.D was appreciated by the delegates. The influence of Buddhist thoughts on siddha medicine was clearly spelt out.

 Dr. R.Sudha of Govt. Siddha Medical college Chennai elaborated on understanding disease and diagnostic methods of Siddha while Dr. Migmar Lhamo, Resident Doctor Bylakupee Branch Clinic spoke for Tibetian medicine which was also followed by a question session. The understaning on the Pulse diagnosis and Urine analysis though common for both systems, which does not require any high end laboratory, certain finer details like examining the radial pulse of both hands related to different internal organs of tibetan medicine reminded one of the Chinese pulse diagnosis.

The post lunch session commenced with Vaidya S.Usman Ali’s presentation on Inorganic Pharmaceutics of Siddha. The emphasis on inorganic pharmaceutics in siddha due to non-availability of herbs all round the year, long shelf life of the inorganic drugs, its nano particle size, formulation expertise, requirment of minute dose for short term use and efficacy in addressing nutritional needs (Trace elements) and management of even life threatening conditions.He also explained the intricacies of the detoxifying process of inorganics and mentioned their use only in appropriate condition.The thirty two dosage forms of internal medicine was also touched upon.

 Tibetian medicine pharmaceutics was presented in tibetian by Jamyang Tashi, Head of Pharmaceutical Department of Men-Tsee-Khang and was translated by Dr. Sonam Dolkar Oshoe for the audience. He explained the ten dosage morms – Decoction, concentrate, powder, pills, medicinal paste, medicinal butter,medicinal ash, medicinal wines, gem medicines and herbal compounds. In all 176 drugs are prepared under GMP conditions in his department at TMAI, Dharamsala and distributed to all 53 branch clinics in the country and abroad. He also mentioned that medicines are not being prepared for the purpose of commerce and there is no deviation from the textual reference both in terms of ingredients or process. But however Modern equipments for particle size reduction, cleaning, blending, pill making are used as well as utilities for clean manufacture. Quality parameters for raw material and processing are follwed as per the text Rgyud-bzhi ( Four tantras)

The Topic on Plant medicine resource was also presented by Vaidya S.Usman Ali for Siddha and by Dr. Tsetan Mingyur, Materia Medica Department, Men-Tsee-Khang, Dharamsala for Tibetian medicine. The drug raw materials are classified as gem, stone, soil, tree, musciliginous, shrubs, herbs and animal products. Most plants are common like Chebulic myrobalan, belleric myrobalan, Indian gooseberry, Pushkaramool, kutki etc, There are some exclusive high alltitute plants that are unique to Tibetan medicine. The issue of  non availabity of certain species like musk were also discussed. The issue of ban on mercurial drugs from 2013 Jan and its implication on both systems and ayurveda as well was discussed.

 The entire interactive programme was co-ordinated by Dr. T. Thirunarayanan.

The participants then went on a field visit to Sri Ragavendra Siddha Varma Hospital were a private siddha hospital specializing in varma and other external therapies are being carried out in North Chennai, the tibetan practitioners said it motivated them to take up the accessory therapies of their system with more seriousness in their branch clincs  and the day closed with dinner hosted by CTMR.

Second day proceedings

The morning session started with a visit to NIS and Dr.A.Rajendrakumar presented a overview of the functioning of NIS, its clinical services, academic branches, research, capacity building activities. The visiting practitioners were surprised with huge turn out of patients in the NIS hospital (around 2300 p[er day). They expressed the apprehension that individual patients have to wait for their turn both to see physicians as well as to collect their medicines. The proposal for expansion of hospital services was explained to them by the Director, NIS. They were also taken around the campus to study its flora, particularly medicinal plants used in siddha system.

The post lunch session started with presentation on Role Of Diet by Dr. R. Padmapriya of Centre for Traditional Medicine & Research and by Dr. Sonam Dolkar Oshoe for Siddha and Tibetian medicine respectively. The similarities between the two system of medicines reflected beautifully in these presentations. In fact the incompatabile foods mentioned in both systems were too similar.Dr Bhooma of Ambattur briefed with clarity on Cleansing Therapy while Dr. T. Thirunarayanan introduced External Therapies of Siddha Medicine and Dr. Siddique Ali demonstrated it for frozen shoulder which hogged the attention of all participants. Specialtiy treatment for Tibetian medicine was presented.

Dr. B.Muthukumar Executive committee member of Central Council For Indian Medicine rendered his reflection of the interactive meet. He mentioned gSowa-rigpa and Siddha medicine should also be compared in the areas of reproductive and child care and this was a good platform to debate and many similarities were discussed and there is a good scope for collaborative efforts. Dr. Dorjee Rapten Neshar CMO of the Bangalore unit of Mee- Tsee- Khang made the concluding remarks and expressed his desire for continued interaction between the two systems.

Dr.T.Thirunarayanan, Secretary, CTMR said as both systems have many commanalities that collaborations in areas of drug research, treatment is possible and expressed his desire that Siddha system should emulate the TM in expanding it services to all over the country and subsequently to humankind all over the world. He appreciated that with 300 registered practitioners 53 branch clinics of Mee- Tsee- Khang is functioning all over, then it is time for Siddha too to spread.

Language barrier (Texts of Siddha and training being only in Tamil) is the impediment and it should be overcome. The Dept of AYUSH should come out with Special schemes for Siddha to open centres atleast in all major cities of India with Sizable Tamil population.

Dr.V.Tamilalagan and Dr.R.Sangeetha documented the whole proceedings. Vd.R.B.Ramamurthy, traditional siddha physician also provided his insight.