‘Clinical medicine’ is the medical practice involving and based on direct observation of patients or healthy volunteers who were given the drug that is being tested, to evaluate the drug’s curative potential, side effects, dosage levels, contra-indications, etc,, before recommending it for use. This concept is opposed to the earlier norms of medical practice based on theoretical study or laboratory investigation or class room teaching. Allopathy is now both biomedicine and clinical medicine. Nevertheless, a number of other systems like Homoeopathy and Ayurveda have also introduced the clinical element into their drug evaluation procedures.

        A point of significance is that all major systems of medicine in Europe, China and India, are based on one or the other form of the humoural theory, similar to that of Hippocrates and Galen. But all these systems are a world apart from Allopathy today. The primary time point of separation of Allopathy from the other systems of medicine is unclear but is rather more a recent phenomenon, about a century and half old. Descriptions of several disease conditions like diabetes in the earliest works on Allopathy are also found in the Vedic hymns of the predecessors of Ayurveda (Canary, 1983). Similar are some of the ancient Chinese practices like using burnt sponges (as source of iodine).

       The development of Allopathy was mainly due to the contributions of Aretaeus of Cappadocia, Hippocrates of Greece and Ibn Sina (Avicenna) of Persia. These were followed by a host of European practitioners and observers, aided by the establishment of great Universities at Padua in Italy and Paris in France, and later at Cambridge and Oxford in England. Developments of the past 50 years or so in anatomy, biochemistry, physiology, pharmacology, physics, biology, electronics, engineering, etc., have made Allopathy radically different not only from the other systems of medicine but also from its own earlier versions. Vast changes have occurred in the philosophy, methods of diagnosis, drug development, treatment and prognosis. Concomitant with the progress in medicine are far reaching successful developments in surgery, which also has an important place in Ayurveda.

        Although almost every country has its own pharmacopoeia, there are no generally used standard international pharmacopoeiae and Materia Medicae for Allopathy (Canary, 1983). The information on the numerous specialities and aspects of Alllopathy is unmanageably voluminous. By and large, to the general practitioner as well as the specialist, other than those engaged in research, the drug manufacturers provide the functional clinical literature. Research oriented doctors obtain their information from journals, treatises, etc. Professional organsisations and conferences also provide a fillip. In the current times, understanding the patient, the disease and the multifarious effects of the medicine, before administering it, the cardinal principle of all systems of medicine, is easier pronounced than practised.

        Allopathy is firmly rooted in the products of synthetic chemistry, as its drug arsenal. Nevertheless, in the rich world, 25 per cent of all medical drugs are still plant based and in the poorer world this is closer to 75 per cent (Principe, 1991). Allopathy will continue to depend on plants for its drugs and this dependence is more likely to increase rather than decrease. Other reasons for the interminable relationship of Allopathy with plant based drugs are discussed in different contexts in this volume. For these reasons, Allopathy continues to be an area of interest to those who work on medicinal plants.

        Allopathy, with very impressive advancements in its numerous areas of specialisation, has performed wonders and achieved a phenomenal popularity throughout the world, much to the detriment of the indigenous/traditional systems of medicine. However, it has become increasingly inaccessible to the majority of the world population due to its dependence on expensive instrumentation and very high costs of drugs and services. It has also accumulated a long list of inadequecies and failures. These factors are responsible for leaving a lot of ground for the other systems of medicine to be of considerable importance.

        The terms ‘Alternative Medicine’ and ‘Complementary Medicine’ are often used interchangeably. However, some make a distinction; for example the international journal, ‘The Journal of Alternative and Complementary Medicine’, from the U.S.

        Alternative medical systems are those that offer independent therapies for the full range of all the diseases, as Allopathy does. Hence, Ayurveda, Chinese medicine, Homoeopathy, etc., come to be called systems of Alternative Medicine.

        Systems that are only supportive of other systems, such as Naturopathy, Aromatherapy, Hydrotherapy, etc., are regarded as Complementary Medicine.

        There arises a problem when a particular system of medicine falls in between. Acupuncture is considered by some as a totally potent system, while others regard it as only supportive. Herbal medicine, not in the sense of well established systems like Ayurveda or Chinese medicine, but in that of the unwritten traditional medical practices in South America and Africa, was cited as Alternative or Complementary, by different persons.

        Whatever the term used, Alternative or Complementary, does not matter, as the rallying point of distinction is Allopathy vs other systems of medicine.

        At the last count, at the 36th World Congress of Alternative and Complementary Medicines, in November 1997, at Colombo, it was observed that there are over 125 systems of Alternative Medicine. Listing all of them is not an easy task as some single plant remedies are also projected as systems of therapy, as for example, Camomile, Ginseng, Honey, Cucumber, Eucalyptus, Garlic, Peppermint, Rose-water, therapies. If this practice cintinues, the list of Alternative medicines would for ever be interminable.

        The range and depth of the Alternative therapies is both illuminating and interesting (Table 1). The plurality and the overlapping nature of these therapies makes it a very difficult task to classify them. Jamil (1997) made an atttempt to put the house in order, but was not very successful, for the following reasons: a) several of the mutually unrelated Alternative therapies have been grouped together as ‘other therapies’, b) Acupuncture was given an independent, but an ambiguous, status, and c) well established therapies like Yoga, Aerobics, Universal energy, Bioenergy, etc., do not find an appropriate place. There are many more claims than were accommodated in this classification (see McPartland and Soons, 1997). Nevertheless, Jamil’s classification can be used, till at least a better one is proposed. A modified version of Jamil’s classification is used in Table 1 below, to provide representative examples of Alternative therapies, with a brief note on each, wherever needed. There are far too many Alternative therapies, many of them with very restricted and local import, to attempt a complete list.

        There are institutions that impart training in the systems of Alternative Medicine in the countries of their origin. Several systems of Alternative Medicine enjoy varying degrees of populairty in the other parts of the world too. For example, several Medical Schools in the U.S. offer courses in Alternative Medicine (Daly, 1997), as also in Europe. Societies/Associations have been formed for different systems, many of which have their own journals and other means of communication.

        The literature on Alternative Medicine is very extensive, though there is little on some of the systems. Several journals, more particularly The Journal of Alternative and Complementary Medicine, serve the cause of this area of medicine. The extensive bibliography, listing the publiations on Alternative Medicine in English by West and Trevelyan (1985), is a good starting point for literature search. References relevant to some of the systems are cited at different places in this volume. Institutions, Websites and e-mail addresses related to Alternative Medicine are given in Appendices 39 and 40.

        In view of the direct interest, the major plant based systems of medicine, as marked by an asterisk (*) in Table 1, are detailed in the following pages. A detailed account of the non-herbal therapies is beyond the scope of this volume. Jamil (1997) has given details of most of the therapies listed in Table 1.

        Some of the Alternative therapies may go into disuse with time and many more may be proposed, but Alternative therapies, in general, will continue to occupy a very important place in our health care efforts.