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STATUS OF INDIAN MEDICINE AND FOLK HEALING With a focus on integration of AYUSH medical systems in health care delivery Part II

Shailaja Chandra

Former Secretary, Government of India Ministry of Health & Family Welfare Department of AYUSH and Former Chief Secretary, Government of Delhi

Under the aegis of Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) Ministry of Health & Family Welfare Government of India FEBRUARY 2013


Front cover: Collage of medical manuscripts in Sanskrit, Tamil and Arabic Back cover: Holy basil (Ocimum sanctum)

Intellectual property rights of this report rest with Department of AYUSH, Ministry of Health & Family Welfare, Government of India and Shailaja Chandra, former Secretary, Government of India and former Chief Secretary, Delhi

Printed at: India Offset Press A-1, Mayapuri Industrial Area, Phase-I New Delhi – 110 064 (India)

ii  Status of Indian Medicine and Folk Healing


Contents Acknowledgements

vii

Officers, Experts and Stakeholders Consulted

xi

Abbreviations and Acronyms

xxi

Executive Summary

xxvii

Summary of Major Findings and Recommendations

xxxv

Chapter 1: Status of Integration

3 – 63

Health Seeking Behaviour and Medical Pluralism

3

Congruence of Traditional and Modern Medicine

14

Status of Adjuvant Use of Ayurveda and Unani Medicine

22

Contemporary Ayurveda and Ethical Marketing of Ayurvedic Drugs

40

Annexures:

Annexure-I: Roadmap for Mainstreaming of AYUSH under NRHM - Joint letter of Secretary, Department of Health and Secretary, Department of AYUSH to all States

53

Annexure-II: Joint Letter of Secretary, Health and Secretary, AYUSH to States

56

Annexure-III: Minutes of the Meeting on Approach to Part II of the Status Report held on 9th December 2011at 2.30 pm in the CCRUM Conference Hall, Janakpuri, New Delhi

58

Annexure-IV: Questionnaire to Investigate the extent of Adjuvant AYUSH Therapy with Patient Responses

61

Annexure-V: List of Experts/Faculty/Practitioners who commented on Survey outcomes on the Adjuvant use of AYUSH

62

Annexure-VI: List of leading Pharmaceutical Companies engaged in manufacturing Ayurvedic Medicines

63

Chapter 2: AYUSH in Selected States - Findings from Field Visits

67 – 140

Odisha

67

Uttar Pradesh

75

Andhra Pradesh

91

Himachal Pradesh

102

Jammu & Kashmir

111

States Consulted (Bihar, Uttarakhand, West Bengal)

118

Contents  iii


Annexures:

Annexure-I: List of Officers who attended the meeting chaired by the Commissioner-cum-Secretary, Health and Family Welfare, Government of Odisha at the request of the PI

121

Annexure-II: List of Faculty members the PI met at AK Tibbiya College, AMU, Aligarh

122

Annexure-III: Treatment of choice in Ayurveda and Unani for Common Disease Conditions

123

Annexure-IV: Letter of the PI to Principal Secretary, Andhra Pradesh

128

Annexure-V: List of Faculty and Staff PI met at the Rajiv Gandhi Government PG Ayurvedic College and Hospital, Paprola

130

Annexure-VI: Letter sent to the Health Secretaries of West Bengal, Uttarakhand, Bihar and Madhya Pradesh

131

Annexure-VII: Questionnaire sent to the Health Secretaries of States

132

Annexure-VIII: Anubandh for AYUSH doctors in Uttarakhand

135

Chapter 3: Postgraduate Education in Ayurveda – Filling the Gaps

143 – 149

Chapter 4: Building Credibility for Panchakarma

153 – 160

Chapter 5: A Study of Selected State Pharmacies

163 – 175

Annexures:

Annexure-I: Grant in Aid released to States/UTs under the Centrally Sponsored Scheme for Quality Control of ASU&H drugs from 2000-01 to 2011-12 (in Rs. lakhs)

173

Annexure-II: Questionnaire for Preparing Status Report on Government Ayurvedic Pharmacies

174

Chapter 6: Regulatory Framework for ASU Drugs

179 – 201

Annexures:

Annexure-I: Letter of Secretary, UP to all the CMOs regarding harassment faced by the ISM practitioners in the State

194

Annexure-II: Court order on the issue of Inter-disciplinary Cross-practice in UP

195

Annexure-III: Ministry of Health & Family Welfare’s notification regarding practice of Gynaecology & Obstetrics and Diagnostic Ultrasonography by ISM Graduates

197

Annexure-IV: Himachal Government’s circular allowing ISM practitioners to use modern medicine

198

Annexure-V: Directorate of ISM, J&K Circular regarding “Prescription of Allopathic Medicine by AYUSH Doctors”

199

Annexure-VI: Proposal of J&K Department of ISM to notify the use of essential allopathic medicine by AYUSH doctors

200

iv  Status of Indian Medicine and Folk Healing


Chapter 7: Guru-Shishya Parampara – A Critique of the Rashtriya Ayurveda Vidyapeeth

205 – 222

Annexures:

Annexure-IA: Recommendations of the Review Committee of Department of ISM, Government of India which had reviewed the performance of RAV

213

Annexure-IB: Recommendations of the International Management Institute, New Delhi on the future growth options for Rashtriya Ayurveda Vidyapeetha (RAV), New Delhi

215

Annexure-II: Details of Gurus and Shishyas associated with RAV since the time of inception

217

Annexure-III: Covering letter of the PI with Questionnaire issued to MRAV/CRAV alumni/Shishyas

218

Annexure-IV: List of Gurus and Shishyas who responded/ did not respond

220

Chapter 8: National Institute of Indian Medical Heritage (NIIMH) – A Historical Overview and Major Contributions

225 – 231

Annexure:

Annexure-I: Research Activities Reported in NIIMH Bulletin/Journal, 1963-2009 Chapter 9: Folk Healing Practices of the North East

230 235 – 265

Annexures:

Annexure-I: Letter of the PI to the Director of North East Institute of Folk Healing

263

Annexure-II: Questionnaire on the Practice of Traditional Medicine and Folk Healing in the North Eastern States

265

Chapter 10: Ayurvedic Veterinary Products – Status and Future Prospects

269 – 273

Chapter 11: Initiatives with a Difference

277 – 279

Chapter 12: Transformation Needed

283 – 286

Contents  v


Acknowledgements When Part I of this report was written I had acknowledged the contribution of scores of people who had helped me in big ways and small. What follows are a few repetitions but many more additions. Under the Presidentship of the Honourable Minister for Health and Family Welfare, Shri Ghulam Nabi Azad as the President of CCRUM I continued to receive whole-hearted support from the Department of AYUSH and the Research Councils particularly from Unani Medicine and Ayurvedic Sciences. Headed by the Union Secretary (AYUSH), Shri Anil Kumar the Department’s officers gave me access to data and information without which it would not have been possible to have delved down to the root of so many subjects. The Secretary was always accessible whenever I requested to meet him and shared his thoughts with candour. I am grateful to stalwarts like Prof. Valiathan, Prof. Ranjit Roy Chaudhury, Prof. RH Singh who gave me the benefit of their valuable advice which has been acknowledged in the report. I must also mention the part played by Dr. SP Aggarwal, the former Director General Health Services, Ministry of Health & Family Welfare who grounded his remarks in down-to-earth wisdom on what was possible and practical. Shri Bala Prasad (then the only Joint Secretary in the Department), put me in touch with the right persons which facilitated my work greatly. In particular Dr. DC Katoch was one person who provided information by return e-mail within minutes. Of greatest value were the official letters of introduction sent to the State Governments which enabled me to observe and record the ground realities. The Director-General of CCRUM Professor Shakir Jamil continued to extend the support of the whole institution and enabled me to hold two joint meetings of the two Research Councils for Unani and Ayurvedic medicine where numerous experts, faculty members and practitioners of both systems gave me the benefit of their advice. Dr. KM Siddiqui, Deputy Director in CCRUM did the behind the scenes work for the meetings and also drew up and time-tuned the travel itineraries for my visits to different States. Without this, it would have been difficult to have synchronised meetings with so many people at so many places. He also provided me the services of a statistician Shri Zameer Ahmad who assisted me in assembling the statistical portions of the report. Dr. Ramesh Babu Devalla, the Director General of CCRAS continued to extend invaluable support, chiefly by finding the right person at each juncture who could give the technical support that I needed. Because of this I was able to get useful base papers prepared by Dr. N Srikanth, Dr. Sarada Ota and Dr. Pradeep Dua - all from CCRAS who helped me to assemble the facts for three chapters. The role of several officers from the National Institutes under the Department of AYUSH must also be placed on record. Among these I recall Dr. V V Prasad, Director, Rashtriya Ayurved Vidyapeeth because of his brevity with words but capacity to deliver on promises.

Acknowledgements  vii


Dr. Ajay Kumar Sharma, the Director of the National Institute of Ayurveda was good enough to assign four faculty members to help me to get a study on selected State pharmacies done, when I was about to abandon the idea. Shri Otem Dai, the Director of the North-Eastern Institute of Folk Medicine went out of his way to help me to prepare the chapter on folk medicine in the North-East with enthusiasm. He assigned a resourceful Senior Research Officer Shri Hemen Hazarika to coordinate the work. The work was organized despite many parts of the North-East being affected by torrential rain and floods and the Internet system remaining out of commission for several weeks at a stretch. Before the work relating to the interface of AYUSH and NRHM was undertaken, I had requested Dr. Ritu Priya, Professor, Center of Social Medicine & Community Health, Jawaharlal Nehru University (JNU), former Advisor, Public Health Planning (NHSRC) to help unravel her own report on 18 States. Dr. Priya gave me the benefit of briefing me through her experience and introduced me to Dr. Shweta also an Ayurvedic doctor who walked me through the report with enthusiasm. A very special mention needs to be made of the Principal Secretaries in charge of AYUSH Shri K Ratna Kishore in Andhra Pradesh, Shri J P Sharma in U.P., Shri Ashok Shekhar in Rajasthan, Shri Ali Raja Rizvi in Himachal Pradesh, Smt Anu Garg in Odisha and Shri M K Dwivedi in Jammu and Kashmir, all of whom went out of their way to make my visits to their States as meaningful as possible. In Andhra Pradesh Dr. Srivasuki held charge as the Commissioner AYUSH and accompanied me during most of my visits to the facilities in Hyderabad. The State Directors of Ayurveda/Unani/ ISM who gave me immense support in different ways include Dr. KR Kohli from Maharashtra, Dr. Raksha Goswami, Director Ayurveda and Dr. Shoeb Qasmi, Director (Unani)-both from Uttar Pradesh, Dr. PS Draik from Himachal Pradesh and Dr. Kabir Dar from Jammu & Kashmir. All of them wanted to see the project succeed in the interest of the systems and used their personal contacts and initiative to pack in as much as possible, including gracious hospitality . Several other State officials from the departments of Ayurveda and Unani medicine looked after me and their resourcefulness must be acknowledged. Among these I will always remember Dr. Narendra Hota, the State Research Officer for AYUSH in Odisha, Dr. Ramanna, Regional Deputy Director, AYUSH in Andhra Pradesh along with Dr. Satya Prasad, the Principal of BRKR Ayurvedic College, Hyderabad for arranging the visits with enthusiasm and imagination. I also recall with warmth the tremendous support given by Dr. A.A. Hashmi, Deputy Director Unani in Uttar Pradesh. Dr. Nuzhat Manzoor and Dr. Shabeer Ahmed Gaffari from J&K accompanied me to innumerable health facilities with meticulous planning. Although the programme included several scheduled meetings and the distances to be covered to different districts were long, they took care of every detail so that I could spend limited time fruitfully. Likewise, Dr. Om Raj Sharma, Research Officer of CCRAS at Mandi accompanied me during my entire visit to Himachal Pradesh and his personal contacts and friendly approach provided me with rare insights. Thanks must be given to numerous people who helped me at the back end without whose help this report could never have been completed. To start with, I am grateful to Dr. Sathyanarayana Dornala who coordinated the amalgamation of the chapters using his dexterity with computer

viii  Status of Indian Medicine and Folk Healing


applications and knowledge of people, places and happenings to make useful suggestions. That most of the work could be done on e-mail across the country and also across continents and oceans (when I was overseas) reflects his quick understanding. I was assisted throughout by a young BAMS graduate Dr. Anubha Yadav who despite her youth and relative inexperience made up through her quick comprehension, willingness to learn despite being buffeted with constant instructions. That she could measure up to the most exacting standards which I laid down and also maintain enormous documentation systematically, speaks volumes for her potential. She is a gem of a girl. Behind the scenes, Shri Dilawar Singh, Administrative Officer at CCRUM, his assistant Shri Arya, Accountant maintained all my accounts and rid me of so many tedious but essential responsibilities. Shri Humayun, the ever-helpful PA to the DG asssisted me in innumerable ways, always smiling and never putting off anything he could accomplish even to the next minute! A rare virtue. I also acknowledge the support of Shri Ajay Nirwal who looks after the office of the Chairman of the Delhi Public Library - a position I hold in an honorary capacity. In the end, I depended on Shri Mehr-e-Alam Khan, Consultant (Portal) at CCRUM, who enabled me to turn sheaves of unruly paper into an organized report despite his several pressing commitments. If editorial mistakes remain, I am at fault. I hope the report will be found useful and will be disseminated to the State Governments along with copies of Part-I of the Report. The findings and recommendations given in the Report are my own and do not reflect the views of the Department of AYUSH. This has been an exciting learning experience for me and one that I will always treasure. My grateful thanks to all those who made it possible. Shailaja Chandra Principal Investigator and Former Secretary, Government of India & Former Chief Secretary, Delhi

Acknowledgements  ix


Officers, Experts and Stakeholders Consulted Department of AYUSH, Ministry of Health & Family Welfare, Government of India 1. 2. 3. 4.

Shri Anil Kumar Secretary Shri Bala Prasad Joint Secretary Dr. Dinesh Katoch Joint Advisor (Ayurveda) Dr. Manoj Nesari Joint Advisor (Ayurveda)

ASU Research Councils Central Council for Research in Unani Medicine: Headquarters, New Delhi: 1. Prof. Syed Shakir Jamil Director General 2. Dr. Khalid M Siddiqui Deputy Director 3. Mr. Mehr-e-Alam Khan Consultant & formerly Research Officer (Publication) 4. Dr. Abdul Raheem Assistant Director (Unani) RRIUM, Bhadrak (Odisha): 1. Dr. L Samiullah

Deputy Director (Unani)

2.

Dr. Subhan Allah Khan

Assistant Director (Bio-chemistry)

CRIUM, Lucknow: 1. Dr. Maqbool Ahmed Assistant Director (Unani) RRIUM, Aligarh: 1. Dr. Latafat Ali Khan Deputy Director (Unani)

CRIUM, Hyderabad: 1.

Dr. Ataullah Sharief

Director Incharge

2.

Dr. MA Waheed

Deputy Director

3.

Dr. Mushtaq Ahmad

Ex-Director

4.

Dr. MA Wajid

Assistant Director

5.

Dr. S Mazhur-ul-Haq

Assistant Director (Pathology)

6.

Dr. Alokananda Chakraborty Assistant Director (Physiology)

RRIUM, Srinagar (J&K): 1. Dr. Arsheed Iqbal Research Officer (Unani) Central Council for Research in Ayurvedic Sciences: Headquarters, New Delhi: 1.

Dr. Ramesh Babu Devalla

Director General

2.

Dr. N Srikanth

Assistant Director (Ayurveda)

3.

Dr. Sarada Ota

Research Officer (Ayurveda)

4.

Dr. Pradeep Dua

Research Officer (Ayurveda)

CRI(Ayurveda), Lucknow: 1.

Dr. Ramji Singh

Assistant Director (Ayurveda)

ARRI, Mandi: 1.

Dr. SK Sharma

Assistant Director (Ayurveda)

Officers, Experts and Stakeholders Consulted  xi


2.

Dr. Om Raj Sharma

Research Officer (Ayurveda)

ARRI, Jammu: 1.

Dr. Krishna Kumari

Assistant Director (Ayurveda)

National Research Institute of Ayurvedic Drug Development (NRIADD), Odisha: 1. 2.

Dr. Banamali Das Research Officer (Ayurveda), Scientist-II Dr. MV Acharya Assistant Director

National Institute of Indian Medical Heritage (NIIMH), Hyderabad: 1. 2. 3. 4. 5. 6.

Dr. Ala Narayana Director Dr. K Bharathi Research Officer (Ayurveda) Dr. GP Prasad Research Officer (Ayurveda) Dr. V Sridevi Research Officer (Ayurveda) Dr. B Venkateshwarlu Research Officer (Ayurveda) Dr. T Saket Ram Research Officer (Ayurveda)

AYUSH National Institutes 1. 2. 3.

Prof. V V Prasad Director Rashtriya Ayurveda Vidyapeeth, New Delhi Prof. Ajay Kumar Sharma Director National Institute of Ayurveda (NIA) Jaipur Dr. K Shankar Rao* Associate Professor & HOD Department of Rasa Shashtra & Bhaisajya Kalpana National Institute of Ayurveda (NIA) Jaipur

xii  Status of Indian Medicine and Folk Healing

4.

Dr. V Nageswar Rao* Associate Professor Department of Rasa Shashtra & Bhaisajya Kalpana National Institute of Ayurveda (NIA) Jaipur 5. Dr. Parimi Suresh* Assistant Professor Department of Rasa Shashtra & Bhaisajya Kalpana National Institute of Ayurveda (NIA) Jaipur 6. Dr. Sanjay Kumar* Lecturer Department of Rasa Shashtra & Bhaisajya Kalpana National Institute of Ayurveda (NIA) Jaipur 7. Dr. Otem Dai* Director North East Institute of Folk Medicine (NEIFM), Pasighat 10. Shri Hemen Hazarika* Senior Research Fellow North East Institute of Folk Medicine (NEIFM), Pasighat 11. Shri K Jeyaprakash* Senior Research Fellow North East Institute of Folk Medicine (NEIFM), Pasighat State Health Ministers, Chief Secretaries, Principal Secretaries, Commissioners, Directors and Others Odisha: 1. Smt Anu Garg Commissioner-cum-Secretary Department of Health and Family Welfare 2. Dr. BK Mishra Special Secretary Department of Health and Family Welfare 3. Shri Pramod Meherda Managing Director NRHM, Odisha


4. 5.

Dr. Upendra Kumar Sahu Director of Health Services Shri Padmalochan Behera Director Indian Medicine & Homeopathy Joint Secretary Department of Health and Family Welfare 6. Dr. PK Das Director of Medical Education & Training Uttar Pradesh: 1. Shri JP Sharma Principal Secretary Medical Education & AYUSH 2. Sh. SK Saxena Special Secretary Medical Education 3. Shri Sanjay Agarwal* Principal Secretary (NRHM) 4. Dr. Saudan Singh Director General Medical Education 5. Dr. Mohammad Sikander Hyat Siddiqui* Director (Unani) 6. Dr. RR Choudhary Director (Ayurveda) 7. Dr. Raksha Goswami Ex-Director (Ayurveda) 8. Dr. M Shoeb Qasmi Ex-Director of Unani Services 9. Dr. AA Hashmi Deputy Director (Unani Services) Andhra Pradesh: 1. Shri KR Kishore Principal Secretary Health & Family Welfare 2. Dr. KP Srivasuki IFS Commissioner ( AYUSH) 3. Dr. KV Ramanna Regional Deputy Director of Ayurveda 4. Dr. K Vishnu Prasad Director (Medical Education)

Himachal Pradesh: 1.

Shri Ali Raja Rizvi

Principal Secretary (Health & Ayurveda)

2. 3. 4.

Shri PS Draik Director (Ayurveda) Shri Rameshwar Sharma Additional Director (Ayurveda) Dr. RakeshPandit Ex-OSD, Directorate Ayurveda

Jammu & Kashmir: 1.

Shri Sham Lal Sharma

Health Minister

2.

Shri Madhav Lal

Chief Secretary

3.

Shri MK Dwivedi

Secretary of Government of Jammu & Kashmir

Health & Medical Education Department

4.

Shri Syed Iftikhar

Special Secretary

Health & Medical Education Department

5.

Dr. Yashpal Sharma

Mission Director

NRHM

6.

Dr. Saleem-ur-Rehman

Director Health Services

Kashmir

7.

Dr. Abdul Kabir Dar

Director, Indian Systems of Medicine & Homoeopathy

8.

Mr. KA Quasba

Joint Director

Agriculture

9.

Mr. Pran Dullo

Joint Director

Floriculture

10. Dr. KS Manhas

Dy. Director

ISM, Jammu

Officers, Experts and Stakeholders Consulted  xiii


11. Dr. Abdul Lateef

Assistant Director

ISM Unani

12. Dr. Rakesh Kumar Raina

Assistant Director (Ayurveda)

ISM

Bihar 1. Shri Vyasji* Principal Secretary Department of Health and Family Welfare 2. Shri Amarjeet Sinha* Ex-Principal Secretary Department of Health and Family Welfare Uttarakhand: 1. Dr. Ranbeer Singh* Principal Secretary 2. Dr. Pooja Bhardwaj* Director General (AYUSH) West Bengal: 1. Shri Sanjay Mitra* Principal Secretary Madhya Pradesh: 1. Shri Tanvir Krishnan* Principal Secretary 2. Shri Sudesh Kumar* Ex-Principal Secretary Maharashtra: 1. Dr. KR Kohli* Director (Ayurveda) Rajasthan: 1. Shri Ashok Shekhar* Principal Secretary (AYUSH) 2. Dr. Ujwal Rathore* Director (Ayurveda) Karnataka: 1. Shri GN Sreekantiah* Director (AYUSH)

xiv  Status of Indian Medicine and Folk Healing

Arunachal Pradesh: 1. Shri K Tayeng* Secretary Department of Health & Family Welfare Assam: 1. Shri JC Goswami* Commissioner & Secretary Department of Health & Family Welfare 2. Shri AB Mohammad Younis* Commissioner Department of Health & Family Welfare Manipur: 1. Shri K Moses Chalai* Commissioner Health & Family Welfare Meghalaya: 1. Shri DP Wahlang* Commissioner-cum-Secretary(Health) Department of Health & Family Welfare 2. Dr. A Das* Director of Health Services Nagaland: 1. Shri Menukhol John* Commissioner & Secretary (Family Welfare) Department of Health & Family Welfare 2. Shri T Limsong* Secretary (Family Welfare) Department of Health & Family Welfare Government of Nagaland North Eastern Council, Shillong: 1. Shri PS Thangkhiew* Planning Advisor North Eastern Council Government of Shillong Sikkim: 1. Shri K Bhandari* Secretary Department of Health & Family Welfare


Tripura: 2. Shri SK Roy* Principal Secretary Department of Health & Family Welfare Academics and Experts consulted 1. 2. 3. 4. 5. 6. 7.

Prof. MS Valiathan National Research Professor Manipal University, Manipal Prof. Ranjit Roy Chaudhury National Professor of Pharmacology (National Academy of Medical Science) And Advisor Health Government of National Capital Territory of Delhi Prof. Ram Harsh Singh Life time Distinguished Professor Faculty of Ayurveda Banaras Hindu University Dr. LS Chauhan Director National Centre for Disease Control Ministry of Health and Family Welfare Government of India Prof. Bhushan Patwardhan Professor Interdisciplinary School of Health Sciences University of Pune, Pune Mr. Darshan Shankar Chairman Foundation for Re-vitalization of Local Health Tradition (FRLHT) Bengaluru Dr. Ritu Priya Professor Center of Social Medicine & Community Health Jawaharlal Nehru University (JNU) Former Advisor Public Health Planning National Health Systems Resource Center (NHSRC), Delhi

8.

Dr. Rama Jaysundar Additional Professor Department of NMR All India Institute of Medical Sciences, New Delhi 9. Dr. SR Narahari MBBS, DVD; MD (Dermatology) Director, Institute of Applied Dermatology Kasaragod, Kerala 10. Dr. Madhulika Banerjee Associate Professor Department of Political Sciences Delhi University 11. Dr. Kishor Patwardhan Assistant Professor Department of KriyaSharir Faculty of Ayurveda Institute of Medical Sciences Banaras Hindu University 12. Dr. Shweta AS Ex-Consultant (AYUSH) Public Health Planning National Health Systems Resource Center (NHSRC), Delhi ASU Pharmaceutical Sector 1.

Dr. DBA Narayana

Chairman

Indian Pharmacopoeia Commissions Crude Dry & Herbal Product Committee

2.

Dr. Philipe Haydon

CEO

The Himalaya Drug Company

3.

Ms. Julie Buragohain

Head-Corporate Legal

The Himalaya Drug Company

4.

Dr. JLN Sastry

Head Healthcare Research

Dabur Research and Development Centre, Ghaziabad

Officers, Experts and Stakeholders Consulted  xv


5.

Brigadier VAM Hussain

Ex-Managing Director

IMPCL

6.

Dr. Amit Agarwal

M/s Natural Remedies Ltd. Group of Industries

Bengaluru

Heads of Educational Institutions Faculty Members, Research Officers and Medical Officers Odisha 1. Dr. BB Behera Deputy Director Homoeopathy Department of Indian Medicine & Homeopathy 2. Dr. Gaurav Giri Drugs Inspector (Ayurveda) Department of Indian Medicine & Homoeopathy 3. Shri RN Sethy Establishment Officer Department of Indian Medicine & Homoeopathy 4. Shri Adait Kumar Pradhan State Programme Manager National Rural Health Mission 5. Dr. Rama Krushna Mishra Inspector Ayurveda Cuttak Circle, Odisha 6. Dr. Surendra Kumar Mishra I/C Inspector of Ayurvedic Eastern Circle Bhubaneshwar 7. Prof. (Dr.) Kamadev Das Principal Gopalbandhu Ayurveda Mahavidyalaya Puri, Odisha 8. Dr. LK Nanda Former Principal Dr. ACHMC&HC Bhubaneshwar

xvi  Status of Indian Medicine and Folk Healing

9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21.

Dr. NP Naik Deputy Superintendent Government Ayurvedic Hospital Bhubaneswar Dr. Narendra Hota State Research Officer Directorate of AYUSH State Government Dr. RN Acharya Scientific Officer Drug Testing Laboratory (ISM) Bhubaneshwar Dr. Kamal Khan In-charge Government Unani Dispensary District Bhadrak, Odisha Dr. Satyabrata Mohapatra Ayurvedic Medical Officer Odisha Dr. Subrat Mohanty Ayurvedic Medical Officer Odisha Dr. Md. Okar Shamce Unani Medical Officer Government Unani Dispensary Cuttak Dr. Safiqur Rehman Medical Officer (Unani) Dobal, District Bhadrak, Odisha Dr. Ashok Kumar Sitha In-charge PHC, Satasankh, Odisha Dr. RN Mishra In-charge Medical Officer CHC, Dharamshala, Jajpur, Odisha Dr. JJ Mishra Gynaecologist CHC, Badachana, Odisha Dr. Manoranjan Mohapatra Consultant AYUSH Odisha Dr. Soumya Devi AYUSH Doctor


22. 23.

PHC, Satasankh Odisha Dr. Anita Behera AYUSH Doctor CHC, Dharamshala, Jajpur, Odisha Dr. Rehanuddin Khan AYUSH Doctor (Unani) City Hospital, Cuttak

Uttar Pradesh 1. Prof. Saood Ali Khan Principal and Chief Medical Superintendent AK Tibbiya College 2. Prof. Shagufta Aleem Dean Faculty of Unani Medicine AK Tibbiya College, AMU, Aligarh 3. Prof. Mukhtar Husain Hakim Department of Moalijat AK Tibbiya College, AMU, Aligarh 4. Prof. Abdul Mannan Department of Moalijat AK Tibbiya College, AMU, Aligarh 5. Prof. MMH Siddiqui Department of Elaj Bit Tadbir (Regimental Therapy) AK Tibbiya College, AMU, Aligarh 6. Dr. Misbahuddin Siddiqui Associate Professor Department of Moalijat AK Tibbiya College, AMU, Aligarh 7. Dr. Younus Siddiqui Associate Professor Department of Moalijat AK Tibbiya College, AMU, Aligarh 8. Dr. Sanjeev Rastogi Associate Professor Department of Panchakarma State Ayurvedic College& Hospital University of Lucknow, Uttar Pradesh 9. Dr. Tafseer Ali Assistant Professor and Deputy Medical Superintendent AK Tibbiya College & Hospital, AMU Aligarh

10. 11. 12. 13.

Prof. M Wasi Akhtar Department of Moalijat AK Tibbiya College, AMU, Aligarh Dr. YC Sharma Lecturer (Medicine) State Ayurvedic College Lucknow, Uttar Pradesh Dr. Arvind Srivastava Lecturer State Ayurvedic College, Uttar Pradesh Dr. Mohd Belal Guest Faculty Department of Amaraze Jild AK Tibbiya College, AMU, Aligarh

Andhra Pradesh 1.

Dr. N Satya Prasad

Principal

Dr. BRKR Government Ayurvedic College

Hyderabad

2.

Dr. Syed Arifuddin

Principal

Government Nizamia Tibbi College

Hyderabad

3.

Dr. Mir Yousuf Ali

Professor & HOD

Department of Ilmul Advia

Government Nizamia Tibbi College

Hyderabad

Himachal Pradesh 1.

Dr. SK Sharma

Sr. Medical Superintendent

Regional Ayurvedic Hospital

State Government of Shimla

2.

Prof. Sanjeev Sharma

Medical Superintendent

Rajiv Gandhi Government PG Ayurvedic College (RGGPGAC&H)

Himachal Pradesh

3.

Prof. YK Sharma

Head

Department of Kayachikitsa

Officers, Experts and Stakeholders Consulted  xvii


4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

Rajiv Gandhi Government PG Ayurvedic College (RGGPGAC&H) Himachal Pradesh Prof. Eena Sharma Head Striroga avam Prasuti Tantra Rajiv Gandhi Government PG Ayurvedic College (RGGPGAC&H) Himachal Pradesh Dr. Ramesh Arya Head & Professor Department of Shalya RGGPGAC&H Himachal Pradesh Dr. Sanjeev Awasthi Reader & Head Department of Shalakya RGGPGAC&H, Himachal Pradesh Dr. Baldev Awasthi District Ayurvedic Officer Kullu Dr. Vidyasagar Gupta District Ayurvedic Officer Mandi Dr. Bhagat Ram Sharma District Ayurvedic Officer Kangra Dr. Hemraj Sharma District Ayurvedic Officer Solan Dr. Uttam Chand Chandel District Ayurvedic Officer Bilaspur Dr. Subhash Rana In-charge ISM Herbal Garden Jogindernagar, Himachal Pradesh Dr. Sushil Nag Ayurvedic Medical Officer, Casualty RGGPGAC&H Himachal Pradesh Dr. Thakur Singh Bhatt Ayurvedic Medical Officer, Casualty RGGPGAC&H Himachal Pradesh

xviii  Status of Indian Medicine and Folk Healing

15. 16.

Dr. Virender Kaul Ayurvedic Medical Officer, Casualty RGGPGAC&H Himachal Pradesh Dr. Vikram Rana Ayurvedic Medical Officer, Casualty RGGPGAC&H Himachal Pradesh

Jammu & Kashmir 1. Dr. Mohammad Iqbal Principal KTC, Srinagar 2. Dr. Khurshid Ahmad Bhakshi Principal IAMS, Srinagar 3. Dr. Mohammad Iqbal Medical Superintendent Jawahar Lal Nehru Memorial Hospital Rainawari, Srinagar 4. Dr. Mohammad Maqbool Medical Superintendent District Hospital, Pulwama 5. Smt Geeta Garg Professor Jammu Institute of Ayurveda Research Jammu & Kashmir 6. Dr. Mohammad Ayuoob Ganie District Medical Officer District Hospital, Pulwama 7. Dr. Syed Ashaq Hussain District Medical Officer Srinagar 8. Dr. Syed Ashiq Hussain ADMO, Srinagar 9. Dr. Saif-ul-Abrar In-charge, AYUSH Unit Jawahar Lal Nehru Memorial Hospital Rainawari, Srinagar 10. Dr. Mushtaq Ahmad Parry In-charge, AYUSH Unit Government Medical College & Hospital Srinagar 11. Dr. Bilal Ahmad Wani Unani Doctor In-charge PHC, Gulmarg


12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23.

Dr. Asif Khan Block Medical Officer and In-charge CHC, Tanmarg Dr. Shabeer Ahmed Gaffari Medical Officer Directorate of ISM, J&K Dr. Nuzhat Manzoor Technical Officer J&K State Medicinal Plant Board Dr. AS Shawl Sr. Scientist (Ex-HOD) Indian Institute of Integrative Medicine (IIIM), Jammu Dr. Nazir Ahmed Ahanger Unani Doctor Government Unani Hospital Shaltang, Srinagar Dr. Irfan Bandey Unani Doctor Government Unani Hospital Shaltang, Srinagar Dr. Musaddaq Ahmed Unani Doctor Government Unani Hospital Shaltang, Srinagar Dr. Roohi Tabbasum Ayurvedic Doctor Government Unani Hospital Shaltang, Srinagar Dr. Shaheen Mir Ayurvedic Doctor Government Unani Hospital Shaltang, Srinagar Dr. Bilal Ahmed Ayurvedic Doctor Government Unani Hospital Shaltang, Srinagar Dr. Taseer Unani Doctor Jawahar Lal Nehru Memorial Hospital Rainawari, Srinagar Dr. Shahnawaz Unani Doctor Jawahar Lal Nehru Memorial Hospital Rainawari, Srinagar

24. 25. 26.

Dr. Mushtaq Ahmad Aga Unani Doctor Government Medical College & Hospital Srinagar Dr. Irfana Latief Unani Doctor Government Medical College & Hospital Srinagar Dr. Arshad Hussain Thoker Unani Doctor District Hospital, Pulwama

Delhi 1. Prof. Raisur Rahman Department of Moalejat Ayurvedic & Unani Tibbia College & Hospital Karol Bagh, New Delhi 2. Dr. HC Gupta Associate Professor Department of Kayachikitsa Ayurvedic & Unani Tibbia College & Hospital Karol Bagh, New Delhi 3. Dr. Praveen Choudhary Associate Professor Department of Shalya Ayurvedic & Unani Tibbia College & Hospital Karol Bagh, New Delhi 4. Dr. Prabhakar Rao Chief Medical Officer Employees State Insurance Corporation (ESIC Dispensary) Nand Nagri, New Delhi 5. Dr. Sathyanarayana Dornala Panchakarma Specialist Swami Vivekanand Ayurvedic Panchakarma Hospital Dilshad Garden East Delhi Municipal Corporation 6. Dr. Mamta Ralhan Senior Medical Officer Municipal Corporation of Delhi Rajouri Garden New Delhi

Officers, Experts and Stakeholders Consulted  xix


Private Practitioners 1. 2.

Dr. G Geetha Krishnan Senior Consultant Ayurveda Co-ordinator Integrative Medicine Department of Integrative Medicine Medanta the Medicity, Gurgaon Dr. Gopal Dutt Sharma Principal Vaidya Yagya Dutt Sharma Ayurved Mahavidyalaya Khurja, Uttar Pradesh 3. Hakim MS Usmani Formerly Senior Faculty Ayurvedic &Unani Tibbia College & Hospital Karol Bagh, New Delhi 4. Hakim AJ Khan Formerly Senior Faculty Ayurvedic & Unani Tibbia College & Hospital Karol Bagh, New Delhi 5. Hakim Anwar Ahmad Formerly Senior Faculty Ayurvedic & Unani Tibbia College & Hospital Karol Bagh, New Delhi 6. Dr. Tom Paul Angamali, Ernakulum 7. Dr. Rakesh Kapoor Traditional Healer Himachal Pradesh 8. Dr. Ashwini Sharma Ayurvedic Practitioner Himachal Pradesh 9. Dr. Manik Soni Ayurvedic Practitioner Himachal Pradesh 10. Dr. Mohammad Haroon Unani Practitioner Uttarakhand

11. 12. 13. 14. 15. 16. 17.

Dr. M Sadique Unani Practitioner District Bhadrak Odisha Dr. Niyametullah Siddique Unani Practitioner District Bhadrak Odisha Dr. Mazharuddin Private Practitioner Nimasahi, Cuttak Vaidya Kripa Ram Traditional Healer Arki Village, Himachal Pradesh Vaidya Ram Kumar Bindal Ayurvedic Practitioner Solan Hakim Zafar Khan Unani Practitioner Sambal District, Uttar Pradesh Shri Sabir Ali Ansari Bone Setter (Unani) Uttar Pradesh

Others 1. 2.

Ms. Reecha Das 5th year B.A.L.L.B The West Bengal National University of Jurisdical Science Kolkata Dr. Claudia Lang* Postdoctural Researcher of Cultural Anthropology Institute of Social and Cultural Anthropology Ludwig-Maximilians-University Munich Germany

Technical Staff: 1. Shri Zameer Ahmad Investigator, CRIUM Lucknow

Note: * Those with whom the PI corresponded through mail or phone.

xx  Status of Indian Medicine and Folk Healing


Abbreviations and Acronyms ADHD

Attention Disorder

ADMA

Deficit

Hyperactive

BAMS

Bachelor of Ayurvedic Medicine & Surgery

Ayurvedic Drug Manufacturers' Association

BD

Bis Die (two times in a day)

BHU

Benaras Hindu University

ADMO

Assistant District Medical Officer

BMO

Block Medical Officer

AIDS

Acquired Immuno Syndrome

BPH

Benign Prostatic Hypertrophy

BPL

Below Poverty Line

AIIA

All India Institute of Ayurveda

BUMS

AIIMS

All India Institute of Medical Sciences

Bachelor of Unani Medicine & Surgery

CABG

Coronary Artery Bypass Graft

AIIPMR

All India Institute of Physical Medicine and Rehabilitation

CAM

Complementary and Alternative Medicine

AIW

Artificial Insemination Workers

CCIM

AMO

Ayush Medical Officer

Central Council Medicine

AMU

Aligarh Muslim University

CCMB

ANM

Auxiliary Nurse Midwife

Centre for Cellular Molecular Biology

AP

Andhra Pradesh

CCRAS

APD

Acid Peptic Disease

Central Council for Research in Ayurvedic Sciences

APL

Above Poverty line

CCRUM

APM

Ayurvedic Proprietary Medicine

Central Council for Research in Unani Medicine

ARRI

Ayurveda Institute

CD

Compact Disc

CEO

Chief Executive Officer

CGHS

Central Scheme

Deficiency

Regional

Research

of

Government

Indian and

Health

ART

Anti Retroviral Therapy

ASC

Altered State of Consciousness

ASHA

Accredited Social Health Activist

CH

Community Health

ASIIA

A Science Initiative in Ayurveda

CHC

Community Health Centre

ASU*

Ayurveda, Siddha, Unani

CMC

Christian Medical College

ASUDCC

Ayurveda, Siddha & Unani Drugs Consultative Committee

CME

Continuing Medical Education

CMO

Chief Medical Officer

ASUDTAB Ayurveda, Siddha & Unani Drugs Technical Advisory Board

CRAV

Certificate of Rashtriya Ayurveda Vidyapeeth

ATT

Anti-tuberculosis Treatment

CRIUM

AVP

Ayurvedic Veterinary Products/ Ayurvedic Veterinary Practice

Central Research Institute of Unani Medicine

CRM

Common Review Mission

AVS

Arya Vaidya Sala

CSIR

AYUSH*

Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy

Council of Scientific & Industrial Research

CSRP

Centre for Scientific Research in Panchakarma

Abbreviations and Acronyms  xxi


FMRI

Functional Magnetic Resonance Imaging

Clinical Trials Registry of India

FPG

Fasting Plasma Glucose

CV

Curriculum Vitae

FRLHT

D&C Act

Drugs & Cosmetics Act

Foundation for Revitalization of Local Health Traditions

DAO

District Ayurveda Officer

FSSAI

DCA

Drugs & Cosmetics Act

Food Safety & Authority of India

DCAR

Drugs & Cosmetics Act Rules

GAU

Gujarat Ayurved University

DCGI

Drugs Controller General of India

GB

Governing Body

GCP

Good Clinical Practices

DDA

Delhi Development Authority

GDP

Gross Domestic Product

DG

Director General

GHPL

Good Health Plan Ltd.

DGHS

Director-General Services

GIT

Gastro-Intestinal Tract

GMP

Good Manufacturing Practices

CSS

Centrally Sponsored Scheme

CT

Computerized Tomography

CTRI

of

Health

Standards

DH

District Hospital

GOI

Government of India

DHS

Directorate of Health Services

GP

General Practitioner

DIL

Dabur India Limited

HCCA

DIMH

Department of Indian Medicine & Homoeopathy

Homoeopathic Central Council Act

HDC

Himalaya Drug Company

DM

Diabetes Mellitus

HIV

Human Immunodeficiency Virus

DMET

Director of Medical Education & Training

HOD

Head of Department

HP

Himachal Pradesh

DMRA

Drugs and Magic Remedies Act

HPTLC

DNB

Diplomate of National Board

High Performance Thin Layer Chromatography

DOTS

Directly Observed Treatment – Shortcourse chemotherapy

HS

Hora Somni (at bed time)

IAD

Institute of Applied Dermatology

DPR

Detailed Project Report

I-AIM

DS

Double Strength

Institute of Ayurveda Integrative Medicine

DTL

Drug Testing Laboratory

IAS

Indian Administrative Service

DUB

Dysfunctional Uterine Bleeding

IBS

Irritable Bowel Syndrome

EAG

Empowered Action Group

ICCMR

ECG

Electro Cardiography

EEG

Electroencephalography

International Congress on Complementary Medicine Research

EFC

Expenditure Finance Committee

ICMR

ELISA

Enzyme Linked Immunosorbent Assay

Indian Council Research

ICU

Intensive Care Unit

ENT

Ear, Nose, Throat

IDEA

ESIC

Employees State Corporation

Initiative on Diabetes Education and Awareness

IEC

FMCG

Fast Moving Consumer Goods

Information, Education Communication

xxii  Status of Indian Medicine and Folk Healing

Insurance

of

and

Medical

and


J-AIM

Journal of Ayurveda Integrative medicine

Indian Forest Service

JAMA

Indira Gandhi National Open University

Journal of American Medical Association

J&K

Jammu & Kashmir

IHD

Ischaemic Heart Disease

JNU

Jawaharlal Nehru University

IIHM

Indian Institute of History of Medicine

KHADC

Khasi Hills Autonomous District Council

IIHMR

Indian Institute of Management Research

KIMS

Kalinga Institute Sciences

IIIM

Indian Institute of Integrative Medicine

LCMS

Liquid Chromatography Mass Spectrometry

IIPS

International Institute Population Sciences

LHT

Local Health Traditions

MBBS

Bachelor of Medicine Bachelor of Surgery

IEEE

Institute of Electrical Electronic Engineers

IFS IGNOU

and

Health

of

of

and

Medical

and

IISc

Indian Institute of Science

IIT

Indian Institute of Technology

MCI

Medical Council of India

IJAR

International Journal of Ayurveda Research

MD

Doctor of Medicine

MDT

Multi Drug Therapy

IJCP

International Journal of Clinical Practice

MIS

Management System

IM

Integrative Medicine

MLA

Member of Legislative Assembly

IMA

Indian Medical Association

MLC

Member of Legislative Council

IMCC

Indian Council

MMP

Modern Medicine Practice

MO

Medical Officer

IMI

International Institute

MoHFW

Ministry of Health & Family Welfare

IMNCI

Integrated Management of Neonatal and Childhood Illness

MR

Medical Representative

IMPCL

Indian Medicines Pharmaceutical Corporation Ltd.

MRAV

Member of Rashtriya Ayurveda Vidyapeeth

IMS

Institute of Medical Sciences

MSR

Minimum Requirements

INCAA

Indian National Confederation and Academy of Anthoropologists

NAAC

National Assessment Accreditation Council

IPCA

Indian Pharmaceutical Combine Association

NABH

National Accreditation Board for Hospitals & Health Care Providers

IPD

In Patient Department

NBE

National Board of Examinations

IPHS

Indian Public Health Standards

NBRC

National Brain Research Centre

ISM&H*

Indian Systems of Medicine & Homoeopathy

NCAER

National Council of Applied Economic Research

IT

Information Technology

Medicine

Central

Management

Information

Standard and

Abbreviations and Acronyms  xxiii


National Centre for Complementary and Alternative Medicine

OD

Omne die (once a day)

OHA

Oral Hypoglycemic Agents

OPD

Out Patient Department

NCD

Non-Communicable Diseases

OSD

Officer on Special Duty

NCE

New Chemical Entities

OTC

Over the Counter

NCHRH

National Council for Human Resources in Health

PA

Personal Assistant

NCT

National Capital Territory

PNDT Act

Pre Natal Diagnostic Techniques Act

NE

North East

PCIM

NEIFM

North East Institute of Folk Medicine

Pharmacopoeia Commission for Indian Medicine

PCOD

Poly Cystic Ovarian Disease

NFHS

National Family Health Survey

PCT

Participating Countries Treaty

NGO

Non-Government Organization

PEPC

NHSRC

National Health Research Centre

Performance Expectations Patient Counselling

PEPSU

NIA

National Institute of Ayurveda

Patiala and East Punjab States Union

NIDDM

Non Insulin Dependent Diabetes Mellitus

PG

Post Graduation

PGI

Post Graduate Institute

NIH

National Institutes of Health

PHC

Primary Health Centre

NIHFW

National Institute of Health and Family Welfare

PhD

Doctor of Philosophy

NIIMH

National Institute Medical Heritage

PHFI

Public Health Foundation of India

PHSC

Public Health Sub Centre

NLEM

National List Medicines

PI

Principal Investigator

PIL

Public Interest Litigation

NMBG

Nehru Memorial Garden

PIP

Project Implementation Plan

PLIM

NMITLI

New Millennium Indian Technology Leadership Initiative

Pharmacopoeial Laboratory for Indian Medicine

PME

Pre-mature Ejaculation

NMPB

National Medicinal Plants Board

PPG

Post Prandial Glucose

NMR

Nuclear Magnetic Resonance

PPM

Patent & Proprietary Medicine

NRHM

National Rural Health Mission

PRI

Panchayati Raj Institutions

NRI

Non Resident Indian

PSA

Principal Scientific Adviser

NRIADD

National Research Institute of Ayurvedic Drug Development

PSC

Public Service Commission

PSU

Public Sector Undertaking

NSAIDS

Non Steroidal Anti Inflammatory Drugs

QCI

Quality Control of India

RAV

Rashtriya Ayurveda Vidyapeeth

NSG

National Security Guards

RCH

Reproductive & Child Health

NSSO

National Sample Organization

R&D

Research and Development

NCCAM

NUD

Systems

of

of

Non Ulcer Dyspepsia

xxiv  Status of Indian Medicine and Folk Healing

Indian Essential

Botanical

Survey

&

RGGPGAC Rajiv Gandhi Government Post Graduate Ayurveda College


TDS

Ter die sumendus (three times a day)

TID

Ter in die (three times a day)

TM

Traditional Medicine

Regional Research Institute of Unani Medicine

UAE

United Arab Emirates

UGC

University Grants Commission

SAB

Skill Attendant at Birth

UNAIDS

SC

Sub Centre

United Nations Programme on AIDS

SMPB

State Medicinal Plants Board

UP

Uttar Pradesh

SOP

Standard Operating Procedures/ Practices

US

United States

USA

United States of America

SPECT

Single Photon Emission Computerized Tomography

USG

Ultra Sonography

UT

Union Territory

SPM

State Programme Manager

UTI

Urinary Tract Infection

SRF

Senior Research Fellow

VAP

Veterinary Ayurvedic Products

STD

Sexually Transmitted Diseases

VATS

Video-Assisted Thoracic Surgery

VD

Veterinary Doctor

VHC

Village Health Committee

VLI

Veterinary Livestock Inspectors

VLW

Village Level Workers

WHO

World Health Organization

RMP

Rural Medical Practitioners

RO

Research Officer

ROTP

Re-Orientation Programme

RRIUM

Training

TAMPCOL Tamil Nadu Medicinal Plant Farms and Herbal Medicines Corporation Ltd. TB

Tuberculosis

TBS

Traditional Bone Setter

TCM

Traditional Complementary Medicine/Traditional Chinese Medicine

* Explanatory Note on the alternate use of ASU, AU, AYUSH and ISM&H in Parts I and II of the Report. •

In Part I the term ASU was used because that report dealt with specific aspects of the Ayurvedic, Siddha and Unani systems of medicine in relation to research, education, practice and drug manufacture. The acronym ASU referred to the three systems and was also used to distinguish them from Homoeopathy, Naturopathy and Yoga.

In Part II there is practically no mention of the Siddha system. This is because the PI has based most of the findings upon observations and interviews held in States where the Siddha system is not being practised. Hence when referring to the medical systems, the term AU has been used.

The acronym AYUSH has been used mainly in the context of integration of health delivery envisaged by NRHM. The term AYUSH has therefore been used in a generic sense as used in Government parlance and refers to its role in service delivery.

The term ISM has been used occasionally in keeping with this nomenclature which continues to be used in States like Jammu & Kashmir.

Abbreviations and Acronyms  xxv


3. Title to Acronyms