“By the twentieth century, Western medicine though established itself in South India, it was still considered antithetical in the eyes of native population.” (2)
As the British and Indian governments sought to define the appropriate balance between modern and traditional medicine, efforts to regulate medical practice in India became increasingly prevalent. During this time, an abundance of extensive documents and reports were created, assessed, and often disagreed upon. The Usman Report (1923) and The Bhore Report (1946) were two of the most critical compilations to spread their influence prior to Indian Independence. These reports opposed one another deeply. The Chopra Report (1947), on the other hand, was compiled just after independence in an effort to convey a more balanced tone.
The Usman Report, 1923
In 1921, Sir Mahomed Usman was invited to prepare a report for the Madras Government Committee on the indigenous systems of medicine in practice in India. The Usman report would be the first major health report to be published in India. The objective of this report was as follows:
“. . . to afford the exponents of the Ayurvedic and Unani systems an opportunity to state their case fully in writing for scientific criticism and to justify State encouragement of these systems.” (Usman 1923: i.154)
This report took into consideration the tension between the practitioners of the indigenous and Western systems of medicine, noting that practitioners who had mastered both systems could supply the “scientific criticism” called for in the aforementioned objectives.
The 50-page report contains 4 main parts, but the appendices and evidence expand it into 500 pages contained within two separate volumes. Within this large compilation, there are many features that are of note.
First, appendix I, A Memorandum on The Science and the Art of Indian Medicine, by G. Srinivasa Murti, is a book-length study written on Ayurveda, Siddha and Unani medicine. The objective of this memorandum was to study these traditional systems “from the two standpoints from which every system of medicine has to be judged,” 1) as a science, 2) as an art. Murti’s conclusions are stated at the outset of the book:
“(1) As a Science — The Indian systems are undoubtedly scientific ; their general principles and theories (both in subjects of preliminary scientific study like physics, physiology and the like, as also in the subjects of medical science proper, like pathology, medicine and so on) are quite rational and scientific.
(2) As an Art — As practiced at present, Indian systems are not self-sufficient. If we divide Medical Science broadly into two sections, medicine and surgery, the Indian systems are, in the main, self-sufficient and efficient in medicine, while in surgery they are not.
In both Science and Art, there are points which Indian and European systems can well learn from each other with immense profit to both ; that they may so fraternise and learn is a consummation devoutly to be wished, not only in the best interests of science but also of what is even more important than science itself, viz., suffering humanity.”
Secondly, of note is part II of the report is a compilation of the testimonies of many Hakims and Vaidyas in which they describe, in their native tongue, the Ayurvedic and Unani medical traditions, their importance, and their basic tenets.
The Madras Government Committee prepared a detailed questionnaire which was translated into various languages and distributed widely. 183 written replies were received from all over the country, forty representatives were orally examined, and a three-member subcommittee traveled throughout the country visiting important centers and meeting with prominent leaders and promoters of indigenous medicine. Despite being commissioned and published in Madras, the Usman report, therefore, represented an all-inclusive survey of India.
The Bhore Report, 1946
The next government committee of major importance, the Health Survey and Development Committee, was convened over twenty years later under the chairmanship of Sir Joseph Bhore (Bhore 1946). The committee produced The Bhore Report, which served to guide the Indian government’s post-Independence health system. Compared to Usman, Bhore’s appointment to the head of the committee was more politically motivated than academically motivated, and represented a shift away from the idea that any form of indigenous medicine could make an important contribution to the nation’s health.
Bhore’s committee was writing at a time before any central national medical authority existed, and was thus charged with surveying the current conditions of health and health organizations in British India and providing recommendations for their future development. The terms were broad enough to allow the committee to examine all aspects of the nation’s health and medical establishment. The committee itself was comprised of 24 members, most of whom had trained in medicine in Britain and were predominantly involved in the world of British state medicine. The report they produced was longer and more detailed than the Usman Report, spanning four volumes in total.
Though the report focuses mostly on allopathic medicine, it does also address indigenous medicine as well, and its view is unreservedly negative. The possibility of growth or expansion of indigenous medical practices is not entertained in any way. The committee viewed Indian medicine and culture as a whole as static and unchanging, which put it at odds with “scientific medicine”. They did not recognize any past efforts made to incorporate new knowledge and/or practice in indigenous medical practice, and believed that a system of medicine that did not do so could not provide adequate care. They also did not acknowledge any knowledge or practices in various specialties such as obstetrics, gynaecology, or advanced surgery.
They did recognize that indigenous medicine has accumulated knowledge of the medicinal use of plants, minerals, and animal substances, “which is of some value”. They also recognized the contributions that indigenous medicine had made to the development of medicine in other countries, but this is framed in the context of the people’s attachment to and pride in indigenous medicine, running up as an obstacle against the establishment of allopathic medicine in India. The overall tone of the committee’s report is that of disdain and impatience, wanting to leave indigenous medicine behind in the pursuit of establishing health policy in india.
Some of the key recommendations that came from the report included limiting the use of the title “doctor” to those trained in western medicine, and limiting the use of any drug in the British pharmacopeia to those trained in western medicine. While several members of the committee wished to create ways of licensing vaidyas and hakims through the government, the majority of the committee and Bhore himself were against this idea.
There were a few areas where the report made some room for indigenous medical practices. One was in the recommendation of the establishment of a professorial chair in medical history at the All-India Medical Institute, one of whose functions would be to study the indigenous medical systems to discover “the extent to which they can contribute to the sum total of medical knowledge”. The committee also left it up to the provincial government to decide what part, if any, should be played by indigenous medicine in Public Health and Medical relief, acknowledging the people’s existing ties to traditional practices and their lower cost compared to allopathic medicine.
The Chopra Report, 1948
With the extreme influence of The Bhore Report underway, others soon stepped up in opposition to demonstrate the value of an approach which would be more inclusive of indigenous medicine. In 1948, immediately following India’s Independence from the British Raj, The Chopra Report was enacted/presented. Sir Ran Nath Chopra, who the report was named for, was a prominent health reform figure in the 1940s. His interest in indigenous medicine may have been the disqualifying factor that led to his exclusion from the Bhore Committee. Instead, the Chopra Committee was formed to create their own report under the view that, “if the aim of all (systems) was the maintenance of health and prevention and cure of diseases they should all be properly investigated and integrated in the form of a single system which should be capable of the suitable alteration of adaptation in accordance with the time and other conditions.” The report itself suggests a merging of traditional and allopathic medicines based on the view that science itself will eventually reveal the truth of indigenous medicine to the allopathic doctor. Within this perspective, is it thought that modern medicine will be able to absorb principles of traditional medicine into its practice.
While The Usman Report favored Ayurvedic tradition and The Bhore Report favored Western modern medicine, The Chopra Report ultimately proposed complete equality of traditional and modern physicians in training and in practice. Despite the timing of their efforts, The Chopra Report was rejected by the Indian government. Later a number of committees would come together (in the 1950s) to discuss the potential of implementing select recommendations from the report. To this day, these committees still struggle to understand whether Ayurveda should be integrated within more modern practices of medicine, or kept “pure” through teachings and practice based solely in accordance with tradition.
- The Evolution of Indian Government Policy on Ayurveda in the Twentieth Century. Modern and Global Ayurveda.
- Shodhganga.inflibnet.ac.in. (2018). Report of the Committee on the Indigenous Systems of Medicine. [online] Available at: http://shodhganga.inflibnet.ac.in/bitstream/10603/5235/14/14_chapter%205.pdf [Accessed 11 May 2018].
- Murti, G. (2018). Full text of "The Science And The Art Of Indian Medicine". [online] Archive.org. Available at: https://archive.org/stream/in.ernet.dli.2015.206755/2015.206755.The-Science_djvu.txt [Accessed 11 May 2018].