Dear Editor

I’m writing this in response to the article, “My Health, My Right: Our Health, Our Responsibility!” by Kalra et al published in the April 2024 issue of the journal.

I appreciate and agree with the authors’ perspective on the diverse nature of health within our society and how smooth functioning of all is essential to attain the highest standards of health.

Even Ayurveda, the ancient system of Indian medicine holds favorable views. The textbooks of Ayurveda offer many guidelines on good medical practices, one of which is the concept of Chatushpada. Some refer to it as the four limbs of the medical system or health care, while others call it the earliest mention of hospital management. These four components, when actively engage with each other, are responsible for the complete cure of disease.

The first component is the physician (vaidya) who by virtue of his knowledge and administrative power holds the most important position among these four. Acharya Charaka mentions the four qualities of an ideal physician as – intelligent enough to reach an accurate diagnosis, having detailed theoretical knowledge of the text (shastra), extensive practical experience (drushtakarma), alert (daksha), and purity of the mind and body (shuchi).

Next in order of merit comes the medicine (aushadhi). An ideal medicine should be available in abundant quantity, should be effective and potent, could be used in many forms and be compatible with other drugs (i.e., should not cause drug-drug interactions).

The third in order, are the nurses or attendants, because a patient needs someone to take care of him/her. The support staff at the hospital, friends and family at home must be kindred spirits, follow hygiene protocols, be wise and understanding of the situation and intelligent enough to follow the instructions of the physician.

The treatment line up is majorly curated to target the patient and his disease and hence the patient forms the fourth and the final limb. He/she must possess a good memory in order to take the advised treatment in time; he must be obedient to follow the instructions, be tolerant to his disease and its treatment and have the arrangements in place in order to get the prescribed medications.

These four pillars vis-a-vis physician, medicine, attendants, and the patient, all in their best qualities are responsible for complete cure of disease.

The treating doctor however holds the most important position. Acharya Charaka uses a simile that just as a potter requires mud, stick, wheel and thread to form a pot, a doctor also requires the help of medicines, attendants, hospital staff, and the patient.

And just as in spite of the presence of above said and in the absence of potter himself, a pot cannot be formed, similarly in the absence of a learned doctor, the treatment is incomplete.