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Traditional Healthcare Systems; A blessing or curse

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Anam was an eleven-year-old girl who had her menstrual periods for only three months, and then they stopped. At first, her parents thought that it was not severe and that she was of minor age, and her periods would naturally start again. After a few months, though, they decided to get medical advice. They went to a Yunani Hakeem, who focused on the fact that the girl’s hair was thinning and graying (which it was). He gave a dozen bottles of murabba and herbal pastes. The girl ate them and developed acne all over her body since the herbs were warm enough. The problem of the periods remained unsolved.

Later, Anam’s parents took her to a homeopath, who listened to the symptoms and assured them that he would ‘fix’ everything, but that it would take time. The poor girl sucked the homeopathic tablets after every meal, and several years passed. Upon each visit, she was given more pills and the reassurance that she would get well, the treatment only needed time.

When Anam reached the age of 20, her symptoms weren’t getting well, and finally, her parents decided to take her to a gynecologist. They had been avoiding allopathy because of the fear of side-effects. The gynecologist was well-known in her field and asked for a proper ultrasound, hormonal blood tests as well as an MRI scan. After looking at the criteria, it was found the Anam had a tumor in the anterior pituitary gland and an imbalance of hormones. There was nothing wrong with her reproductive organs.

Anam referred to an experienced endocrinologist, and after taking prescribed medicine for 14 months, her tumor had shrunk, her hormones were balanced, and finally, her periods started as well. But she still has to consume the medicines to keep the tumor in check as well as the hormones.

Medicine is the science or practice of the diagnosis, prevention, and treatment of disease. Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant and mineral-based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being.

What are the main traditional systems in Pakistan?

There are several kinds of traditional medicine practiced throughout different areas of Pakistan. These are also known as folk medicine, since they are based on knowledge about herbs and spices, plants and remedies etc and have been passed on and practiced from generation to generation before the advent of modern medicine.

Homeopathy

Usually, anyone who has a slight physical problem runs to the nearest homeopathic practitioner because the medicine is deemed effective with no side effects. In principle, Homeopathic medicine is pseudoscientific. It is compatible with factual science as well as beliefs and traditions to some extent. The founder of this kind of medicine was Samuel Hahnemann, a German physician, who was not satisfied with the medical practices of his time as it caused harm to the patient as well.

The basic principle involves diluting the medicinal substance with water, ethanol or sugar. The belief that a substance that causes symptoms of a disease in healthy people would cure similar symptoms in a sick person is te main doctrine of this type of medicine and is called similia similibus curenter meaning ‘like cures like’.

Herbal medicine

This is also known as phytotherapy, as it revolves around the basic concept of utilizing the medicinal potential of plants. According to botany, a herb is any plant with leaves, seeds, and flowers which does not have a woody stem and dies down to the ground after flowering. Herbs are usually useful for flavoring food, making perfumes and scents as well as medicines. An example of a herbaceous plant is Mint, which is used in soothing an upset stomach.

Archaeological evidence supports the fact that herbal medicine dates back to about 5000 years, with the Sumerians in the Paleolithic age being the first ones to compile data about herbaceous plant species. There are several writings on herbal plants from ancient Egypt as well, followed by Greek work on them and then from the Shang dynasty of China in 1600 BC.

According to the World Health Organization, modern herbal medicines are the basis for present pharmaceuticals, precisely 25 percent of modern drugs in the USA. At least 7000 medical components in the modern pharmacopoeia are plant-based. Common ones include artemisinin, opium, digitalis, and quinine. The most common form of using these herbal medicines is  liquid extraction via chromatography and then making herbal teas e.g chamomile, mint, sage, lavender, thyme, rosemary etc. they can be added to foods in their original leafy form as well to add taste as well as to get their benefit.

On 14th December 2019, the first ever TCM entered Pakistan and it was against bronchitis.
On 14th December 2019, the first ever TCM entered Pakistan and it was against bronchitis.

Chinese traditional medicine

This is a type of medicine prevalent for thousands of years to prevent, diagnose and treat disease. It is based on the belief that qi( the body’s vital energy) flows along meridians(channels) in the body and keeps a balance between mental, spiritual and physical health. TCM works for restoring the body’s balance and harmony between the natural opposing forces of yin and yang, which can block qi and cause disease. It is also known as oriental medicine.

It originated back in the days of the Shang Dynasty and includes several practices which may sound a bit odd. E.g. acupuncture, cupping, gua sha/scrapping off of skin, tui na/massage, die-da/bone-setting, qigong./exercise and dietary therapy.

On 14th December 2019, the first ever TCM entered Pakistan and it was against bronchitis. The Yinhuang Qingfei Capsule passed a one-year trial at the ICCBS, Karachi University and was declared safe to use against the usual medicine Amoxicillin-Clauvulanate, which is losing its potency due to resistance by the bacteria.

Chiropractic

This is a medicine concerned with treating mechanical and muscoskeletal disoreders and pains. The main concept revolves around manual therapy, with extra stress on the manipulation of the spine, other joints, and soft tissues. It also includes excercises and lifestyle counseling, but chiropractors are not physicians or medical doctors.

D.D. Palmer found it in the 1890s and claimed it to be effective as it was ‘a science of healing without drugs’, although today it is subject to controversy.

Presently there are several registered chiropractors all over cities in Pakistan and they claim ‘full body pain adjustment’ for a reasonable amount of fee.

Naturopathy

What’s the first thing your parents do when you complain of an ache or ailment or an injury? That’s right, search for a home remedy!

This medicine is based on ideas like natural, non-invasive and self-healing concepts.  It is based on vitalism and folk medicine rather than evidence based research. It is passed on from generation to generation as ‘wisdom.’ I believe this is the most common type of traditional medicine in Pakistan, as every other person has some ‘totkay’ to share when someone complains of an illness.

There are professional naturopaths as well, who usually focus on lifestyle, emotional care, physical examination and treat with introducing changes in lifestyle. They usually oppose drugs and their usage.

Usual practices include herbalism, homeopathy, natural cures, applied kinesiology, psychotherapy, public health measures and hygiene, reflexology etc.

Yunani Medicine

This is a system that was practiced in the subcontinent during the Mughal reign. It means Perso-arabic traditional medicine, initially introduced by Greek physicians Hippocrates and Galen.

According to Unani practitioners, the failure of the body to maintain its own its own health and equilibrium leads to derangement of the fluids.

It is also practiced by Muslims in Central Asia and has originated from the four basic classical humours of the body; phlegm, blood, yellow bile and black bile. According to Unani practitioners, the failure of the body to maintain its own its own health and equilibrium leads to derangement of the fluids. Each person has a unique mixture of these fluids and they determine the person’s temperament.

After diagnosis, treatments like cupping, aromatherapy and bathing, massaging etc are used for treatment.

Spiritual Medicine

This is a filed of medicine which believes in the well-being of the spirit band mind. The body is linked to the spirit and in order for one to be healthy, the other should be well too. This medicine is based on beliefs and religion.

Since religion is defined as the way of living, this type of medicine explores the power of meditation and calming the mind in order to attain peace. It guides us towards achieving peace through a better lifestyle. 

Spiritual healing is also called energy healing and supported by other cultures and countries as well. Surprisingly, scientific research also praises the calming effect that this has in some psychological as well as physical illnesses.

In Pakistan, this is practiced via reading verses of the Quran and prayers in a redundant and specific manner (dam darood), reading the names of Allah and other prayers on a rosary, taweez etc.

Complementary therapies

These can either be used alone, in combination, or paired with any of the above. They include:

  • Physical activity and exercise
  • Nutrition
  • Massage
  • Acupuncture
  • Mind and body practices e.g. meditation and yoga

Which system of Traditional Medicine is most prevalent in Pakistan?

According to Sheikh et al., 2009, modern medicine is prevalent over all other forms of TCM, and amongst TCM, Homeopathy is most commonly opted for, with Yunani medicine being second common.
According to Sheikh et al., 2009, modern medicine is prevalent over all other forms of TCM, and amongst TCM, Homeopathy is most commonly opted for, with Yunani medicine being second common.

Modern Medicine/Allopathy

This is science-based modern medicine based on medication and surgery against symptoms of the disease. Doctors and pharmacists use drugs, radiation, and surgery to treat symptoms and diseases. Treatment includes antibiotics, vaccines, chemotherapeutics. The word ‘allos’ comes from the Greek language and means ‘opposite’ and ‘pathos’ meaning ‘to suffer.’

TCM v.s. MM

Although modern medicine is fast evolving, scientific-based, precise, and more efficient, it is often expensive and has side-effects as well. The technology involved has not yet reached remote areas like villages etc 

Traditional medicine is a thousand years old and practiced more frequently, so many people in Pakistan have strong faith in it. Also, since most ingredients are derived from nature and not chemically synthesized via industrial processes, it is cheaper and thus affordable as well. TCM, like homeopathy, typically has no side-effects. Other TCMs, which include the usage of herbs or minerals or physical processes, may cause unwanted effects and pull of muscles. Often the root cause of the illness is not diagnosed and thus neglected, and the medicines and treatments prescribed may lead to complications of issues and symptoms.

Why do so many different systems exist?

In this colorful and heterogenous wedge of humanity, thought processes, norms, cultures, and beliefs are also as diverse. Every person believes in a different cure and supports and uses that cure. Some people accept more than one health system and some are critical to the rest while only supporting one.

People support the system, which is linked to their areas of residence, their forefathers, their norms, and traditions. Very few venture to understand or practice other approaches. That is why, in Pakistan, the rigid establishment of traditional health systems is stable and steadfast. It doesn’t matter if the cure is practical or influential; if there is a Hakeem in your muhalla and everyone gets their medicine from him, then that is where you are also going.

Is there a possibility for all these systems to combine into one single system?

Wouldn’t it be lovely if all this hullabaloo of choosing a health practitioner and being juggled between different systems was solved and there was only one standard health system practiced throughout the world? It would make life so simple.

As brilliant an idea as it sounds, it is quite impossible due to the opposite beliefs of traditional and modern medicine. Their basic principles have a stark difference. The purpose of each health system is the same; to relieve discomfort and cure disease. Despite that, it is impossible to combine them into one field.

But yes, it is possible to use some systems simultaneously like modern medicine can be paired with any of the complementary therapies e.g., nutrition or yoga, to attain mental peace along with being physically cured. Many Pakistanis, being Muslims, believe in the power of spiritual healing, redundantly reading the name of Allah or a verse of the Quran along with any medicine they use.

Also Read: The comparative reliability of diagnostic tools and laboratory testing in PAKISTAN

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