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PETITIONER: DR. MUKHTIAR CHAND & ORS.

       Vs.

RESPONDENT: THE STATE OF PUNJAB & ORS.

DATE OF JUDGMENT:       08/10/1998

BENCH: K.T.THOMAS, SYED SHAH MOHAMMED QUADRI

ACT:

HEADNOTE:

JUDGMENT:  JUDJMENT QUADRI.J. These  cases  raise  questions of general importance and practical significance questions relating  not  only  to the  right  to  practise  medical profession but also to the right to life which includes  health  and  well-being  of  a person.  The controversy in these cases was iriggered off by the  issuance of declarations by the state Governments under clause (iii) of Rule 2(ee) of the Drugs and Cosmetics Rules, 1945 (for short ’the Drugs Rules’) which defines "Registered Medical Practitioner".  Under  such  declarations,  notified Vaids/Hakims  claim  right  to  prescribe  Allopathic  drugs covered by the Indian Drugs and  Cosmetics  Act,  1940  (for short ’the  Drugs Act’).  Furthermore, Vaids/Hakims who have obtained  degrees  in  integrated  courses  claim  right  to practise allopathic system of medicine. In  exercise of the power under clause (iii) of Rule 2(ee)  the  State  of   punjab   issued   Notification   No. 9874-Thbtt-67/34526  dated  29th October, 1967 declaring all the Vaids/Hakims who had  been  registered  under  the  East Punjab  Ayurvedic  and Unani Practitioners Act, 1949 and the Pepsu Ayurvedic and Unani Practitioners Act, 2008 BK and the Punjab  Ayurvedic  and  Unani  Practitioners  Act,  1963  as persons practising modern System of Medicine for purposes of the Drugs Act.    One  Dr.    Sarwan  Singh  Dardi who was a medical practitioner, registered with the Board of Ayurvedic and  Unani  System  of  Medicines,  Punjab,  and   who   was practising  modern  system  of  medicines was served with an order  of  the   District   Durgs   inspector,   Hoshiarpur, prohibiting   him   from   keeping  in  his  possession  any allopathic drug for administration to patients  and  further issuing  general  direction  to  the  chemists  not to issue allopathic drugs to any patient on the prescription  of  the said doctor.  That action of the Inspector was questioned by Dr.Dardi in the Punjab & Haryana Court in C.W.P.No.  2204 of 1986.    He   claimed  that  he  was  covered  by  the  said notification  and  was  entitled  to  prescribe   allopathic medicine  to  his  patients  and  store such drugs for their treatment (hereinafter referred to  as  Dardi’s  case).    A Division  Bench  of  the  Punjab  &  Haryana  High Court, by

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judgment dated  September  17,  1986,  held  that  the  said notification  was  ultra  vires  the provisions of sub-cluse (iii) of clause (ee) of rule 2 of the Drugs Rules  and  also contrary  to  the  provisions of Indian Medical Council Act, 1956 and accordingly dismissed his writ petition. Writ  petitions  in  the  High  Court  of Punjab and Haryana for a mandamus restraining the authorities concerned from interfering with their  right  to  prescribe  medicines falling  under  the  Drugs  Act  on  the  strength  of  such notifications were also dismissed by the High Court and  the aggrieved  persons  have  filed appeals before us by special leave. Writ Petitions are filed in this Court  by  various  persons claiming  that  they  are  registered  medical practitioners within the meaning of the said notification and are entitled to practise ’modern scientific system of medicine.   It  may be  noticed  here that the petitioners in W.P.No.1082/88 and 359.91  were  registered  by  Ayurvedic  and  Unani  Medical Council in   the   State   of  Bihar.    The  petitioner  in W.P.No.423/97 holds degree of B.A.M.S.  from  the  Maharishi Dayanand University,  Rohtak.   He asserts that on the basis of said degree he is entitled to practise ’modern scientific system of medicine’. On  the  same subject cases came up before Rajasthan High Court.    The  Jodhpur   Branch   of   Indian   Medical Association filed  Civil  Writ  Petition No.  1777/82 in the Hingh Court.  of Rajasthan seeking a declaration  that  rule 2(ee)(iii)   of   the   Drugs   Rules   and   the   Circular No.26(24)M.E.(Group-T)82  issued  by   the   Government   of Rajasthan  on  July  26, 1982, were void and ultra vires the provisions of the Drugs Act and the Indian  Medical  Council Act, 1956.   By judgment dated September 29, 1994 a Division Bench of the Rajasthan High Court held that  the  said  rule was  without  any legislative competence and consequentially the notification was illegal and void.  The  correctness  of the  said  judgment has been assailed by the Private Medical Practitioners Association of  India  (which  represents  the beneficiaries of a similar circular issued by the Government of Rajasthan) in  S.L.P.No.   8422 of 1995.  On the Strength of the aforesaid judgemnt of  the  Division  Bench,  another writ petition  filed  by  M/s.    Chandasi  Private  Medical Practitioners  Sansthan,  a  registered  society,  was  also dismissed.   That  judgment  is also challended by filling a special leave Petition. We heard all the said civil appeals,  special  leave petitions  and  writ  petitions  together  as  the  question involved in all the cases is common. Mr.D.D.Thakur,  learned senior counsel appearing for the appellants-petitioners in the appeals and special  leave petitions, has argued that the grounds on which the Punjab & Haryana High Court dismissed Dr.Dardi’s writ petition we not applicable   to   the   appellants-petitioners  and  without noticing the difference the Division Bench denied relief  to them so the judgments under appeal are unsustainable in law. The  rule  in  question, submits the learned senior counsel, was formed under the Drugs Act having regard to the  factual position  that  the  qualified  allopathic  doctors  are not available in the rural  areas  and  that  persons  like  the appellants-petitioners  have  been  catering  to the medical needs of the residents of such areas, as such the rule is in public interest.  The rule, it is argued, cannot be said  to be  illegal for want of legislative competence as Section 33 of the Drugs Act confers very wide  powers  on  the  Central Government to   frame  rules.    As  the  class  of  medical practitioners postulated by clause (iii)  of  the  rule  can

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properly  be  identified  by  the State Governments they are empowered to declare, by general  or  specific  order,  such class   and   the  notifications  issued  by  various  State Governments are well within the ambit of the rule.   In  any event urged the learned counsel, the High Court ought not to have dismissed the writ petition in limine and that it ought to  have gone into the merits of the case of the petitioners on the basis of the qualifications  possessed  by  them  and allowed them to prescribe allopathic medicines as registered medical practitioner. Mr.K.T.S.Tulsi, learned  senior  counsel,  supported the   notification   issued  by  the  State  Government  and submitted that had the State Government so desired it  would have  withdrawn  the  notification but the very fact that it had not done so, would  show  that  the  registered  medical practitioners  have  been  rendering  yeoman  service to the citizens, hence, the notification most be given full effect. Ms. Indra Jaising, learned senior  counsel,  adopted the  arguments  of Mr.thakur in general, but focussed on the plea that since  integrated  courses  in  Ayurvedic  medical education  comprises of various topics under modern medicine and when such persons have  put  in  considerable  years  of practice  covering such topics also, any infraction of their right to prescribe medicines which may fall under the  Drugs Act  would  very  adversely  affect the areas where they are mostly serving now.         Mr.P.C.Jain, learned senior  counsel  appearing  for the  petitioners  in  Writ  Petition  No.  423 of 1997 while supporting the contention of Mr.Thakur, highlighted that the right of practitioners of Indian Medicine to practise modern scientific  system  of  Medicine  (Allopathic  Medicine)  is protected  under Section 17(3)(b) of Indian Medicine Central Council Act, 1970. Mr.Kirit   N.Raval,  learned  Additional  Solicitor  General appearing for the Central Government, has submitted that the Central Governemnt is maintaining equal distance  from  both the  contenders,  namely,  the  doctors of modern scientific medicine  (allopathic)and  the  qualified  Vaids/Hakims   of Indian medicine; though the Central Government had taken the plea in the High Courts that practice in allopathic medicine should  not be allowed by non-allopathic doctors and in that he would support the  view  taken  by  the  High  Courts  of Rajasthan  and  Punjab  & Haryana regarding validity of rule 2(ee)(iii) and the notifications issued thereunder, he would however, add that as a matter of fact many  Ayurvedic  Vaids and  Unani  Hakims are prescribing allopathic drugs and that the Central Government will abide by the  decision  of  this Court.   Here  we  are constrained to observe that the stand taken by the Central  Government  shows  utter  bewilderment inasmuch   as   the  authority  which  framed  rule  is  not interested in supporting the legality and  the  validity  of the  rule  not  does  it want to do away with the Rule whole heartedly. Mr.K.S.Bhati,  learned  counsel  appearing  for  the State  of Rajasthan, in his arguments strongly supported the judgemnt of the Rajasthan High Court under appeal. Mr.H.M.Singh appearing for the State of Punjab  also supports  the  judgment of Punjab and Haryana High Court and went further and submitted that the rule itself was  invalid -- a strange plea by the State Government indeed. Mr. Devender Singh appearing for Respondent No. 1 in Special  Leave  Petition (c) No.8422 of 1995 also maintained the arguments of Mr. Bhati. Mr.  Ranjit  Kumar  who  appeared   for   allopathic doctors,  vehemently  contended that a non-allopathic doctor

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could not be permitted to prescribe allopathic medicines; he supported the grounds on which the Rajasthan High Court  had struck  down  the rule and also the interpretation placed by the Punjab & Haryana  High  Court  on  the  said  rule.  His alternative submission is that even if Vaids/Hakims are held to  be  within the ambit of clause (iii) after the enactment of Section 15(2)(b) of  the  Medical  Council  Acc  and  the Indian Medicine Central Council Act, 1970 that clause ceased to be operative.         On  the  submissions made by the learned counsel for the parties, the questions which fall for determination  are :- 1.Whether Rule 2(ee)(iii) of the Drugs Rule is bad for         want of legislative competence; and are the impugned         notifications issued by the State Governments, under         clause   (iii)  of  the  said  rule,  declaring  the         categories of persons  who  were  practising  modern         system of medicine invalid in law. 2.What  is  the  impact of Indian Medical Council Act,         1956 and Indian Medical Central Council Act, 1970 on         rule  2(ee)(iii)  of  the  Drugs   Rules   and   the         notifications issued thereunder? and 3.Whether   the   persons   who   have  qualified  the integrated  courses  in  Ayurveda  and  Unani  from  vairous universities  are  entitled  to  practise  in  and prescribe allopathic medicines. Before adverting to these  questions,  it  would  be useful  to  notice  various  systems of medicine in vogue in India and the statutes regulating them. The systems  of  medicines  generally  prevalent  in India are Ayurveda, Sidha, Unani Allopathic and Homeopathic. In  Ayurveda, Sidha and Unani systems the treatment is based on the harmony of the four  humors,  whereas  in  allopathic system  of medicine treatment of disease is given by the use of a drug which produces a reaction that itself  neutralizes the disease.  In  Homeopathy,  treatment  is provided by the likes. Of the medical  systems  that  in  vogue  in  India, Ayurveda  had its origin in 5000 B.C. and is being practised throughout   India   but   Sidha   is   practised   in   the Tamil-sepeaking  areas  of South India. These systems differ very little both in theory and practice.  The  Unani  system dates back to 460-370 B.C. but that had come to be practised in  India  in  the  10th  Century  A.D.  (Park’s Textbook of Preventive  and  Social  Medicine,  15th  Edn.  pp.1  &  2). Allopathic  medicine  is  comparatively  recent  and had its origin in the 19th century. Noticing that for practising  allopathic  system  of medicines  the  degrees  and  diplomas  were being issued by private institutions to untrained or insufficiently  trained persons  and  some of the were colorable imitations of those issued by recognized Universities and corporations which was resulting in unqualified persons posing  to  the  public  as possessing qualifications in medicine and surgery which they did not  possess.  The Indian Medical Degrees Act, 1916 (for short ’1916 Act’) was enacted to ban conferring  of  degrees or issuing  of  certificates,  licences  etc.    to practise western medical science, by  persons  or  authorities  other than  those  specified in the Schedule and notified by State Governments.  The western medical  science  was  defined  to mean  the western methods to allopathic medicine obstructors and surgery; the Homoeopathic, Ayurvedic and Unani system of medicine were excluded from its purview.  The  next  Central legislation  on  the  subject is Indian Medical Council Act, 1933 (for short  ’1933  Act’).    This  1933  enactment  was

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introduced to constitute a Medical Council in India in order to   establish   a   uniform   minimum  standard  of  higher qualifications in medicine for all the erstwhile  provinces. Section 2(d) of that Act defines the word "medicine" to mean "modern   scientific  medicine"  which  connotes  allopathic medicine) including surgery and  obstetrics,  but  excluding veterinary  medicine)  including surgery and obstetrics, but excluding veterinary  medicine  and   surgery.      Although Homeopathic,  Ayurvedic  or  Unani  system was not expressly excluded from the definition, yet a perusal of the  Schedule makes  it  abundantly  clear  that those system of medicines were not within the scope of that Act. It may be noted that since ’level, medical and other professions’ is them 26 of Fist  III  [Concurrent  List]  of Seventh   Schedule  to  our  Constitution,  both  the  State Legislatures and the Parliament have enacted on the  subject of medical  profession.   Now all these systems of medicines are governed by Central Acts.  The  Indian  Medical  Council Act  ,  1956  (which has repealed 1933 Act) regulates modern system of medicine; the Indian Medicine Central Council Act, 1970 regulates Indian medicine and The  Homeopathic  Central Council   act,   1973   regulates  practice  of  Homeopathic medicine. Here we  are  not  concerned  with  Homeopaths  in regard  to  practice  of allopathic medicine by a homeopath, this Court concluded thus, in Poonam Verma vs. Ashwin Patel, (1996) 4 SCC 332:         "A  person  who  does  not  have  knowledge   of   a         particular  system of medicine but practices in that         system is a quack and a mere  pretender  to  medical         knowledge  or  skill,  or  to  put it differently, a         charlatan." The erstwhile  provinces  were  and  thereafter  the present  States  are  also having their own legislation with regard to medical practitioners in different systems (Indian medicine  as  well  as  allopathic)  and   are   maintaining registers of  medical  practitioners in those systems.  They are too many to enlist them here least this judgment will be needlessly burdened.  However, we shall presently  refer  to the relevant Acts of the States to which the appeals relate. The Drugs Act enacted with a view  to  regulate  the import,  manufacture, distribution and sale of drugs to curb the evil of adulteration of drugs and production of spurious and sub-standard drugs which were posing serious  threat  to the health  of  the  community.    The amended definition of ’Drug’ in clause (b) of Section (3)  in  the  Drugs  Act  is inclusive   and   comprehensive  but  it  does  not  include ’Ayurvedic, Siddha or Unani’ drug.  Indeed at  the  time  of its  enactment in 1940, it was not intended to apply to such drugs.  It is only by Act 13 of 1964 that  those  drugs  are also  brought  within  the  purview  of  the  Drugs  Act  by including their definition in clause (a) of  Section  3  and Chapter IVA in the Act. Section 33 which falls in Chapter IV  of  the  Drugs Act,  empowers  the Central Government to the provi=sione of Chapter  IV  which  deals   with   manufacture,   said   and distribution of  drugs  and  cosmetics.   Sub-section (2) of Section 33 enumerates many subjects in clauses (a) to (g) in respect of which rules may be made.  Section 33-A says  that Chapter IV shall not except as provided in the Act, apply to Ayurvedic, Shidda  or Unani drugs.  On December 21, 1945, in exercise of the  powers  conferred  under  Section  33,  the Central Government  framed the Drugs Rules.  Rule 2 contains the definition of the terms  and  expressions  used  in  the Rules.   Rule  2(ee),  which  was  inserted by SO 1196 dated April 9, 1960 with effect from May  14,  1960,  defines  the

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expression "registered medical practitioner".         For   purposes   of  the  Pharmacy  Act,  1948,  the expression medical practitioner is defined  by  substituting Section 2(f) therein with effect form 1.5.1960. Section 2(f) of  Pharmacy  Act  and  Rule  2(ee)  of  the  Drug Rules are identical. Clause (i) to (iii) of Rule 2(ee) are  relevant  for our purpose and they read as under:            "2(ee)  Registered  medical  practitioner  means a            person -            i)holding  a  qualification   granted   by   an            authority specified or notified under Section 3 of            the  Indian Medical degrees Act, 1916 (7 of 1916),            or  specified  in  the  Schedules  to  the  Indian            Medical Council Act, 1956 (102 of 1956); or            ii)  registered  or eligible for registration in a            medical  register  of  a  State  meant   for   the            registration  of  persons  practising  the  modern            scientific  system  of  medicine  (excluding   the            Homeopathic system of medicine); or            iii) registered in a medical register (other  than            a  register  for  the  registration of Homeopathic            practitioners)  of  a  State,  who  although   not            falling  within  sub-clause (i) or sub-clause (ii)            is declared by a general or special order made  by            the  state  Government  in this behalf as a person            practising  the  modern   scientific   system   of            medicine for the purposes of this Act.            iv)   and (v) *** *** *** ***"            [They  are  omitted  as  they are not material for            this batch of cases.] A plain reading of  clauses,  extracted  above  shows that the ambit of clause (iii) must necessarily exclude those who would  fall  under  the  first  two clauses.  There is no controversy  that  categories  (i)   and   (ii)   relate   to practitioners of  allelopathic  medicines.   Hence, the third category falling under clause  (iii)  on  which  vaids/Hakims (non-Allopathic  doctors)  base  their  claim may be analysed here.  (a) It takes  in  persons  who  are  registered  in  a medical register of a State (it may be noticed here that such a   register   should   not  be  meant  for  registration  of Homeopathic practitioners but it need not be a register meant for registration  of  persons  practising  modern  system  of medicine);  (b)  such persons do not fall within category (i) or category (ii) of clause (ee), as noted above (c) they most be declared as persons practising modern system  of  medicine by  general  or special order made by the State Government in that behalf; and (d) such a declaration  would  operate  only for purposes of the Drugs Act and the Rules made thereunder. The learned counsel argued at length on the  question whether  clause (iii) is also intended for left out qualified allopathic doctors.  But if that interpretation  is  accepted the  said  clause will become redundant as admittedly clauses (i) and (ii) exhaust all categories of practitioners entitled to practice in allopathic medicine.  It was conceded  at  the end  of  the  day  and,  in out view rightly, that the clause takes  in  medical   practitioners   other   than   qualified practitioners entitled  to practise allopathic medicine.  And as practitioners of  Homeopathic  medicine  are  specifically excluded,  it becomes evident that this category comprises of practitioners who are enrolled in a  medical  register  of  a State and though not answering the description of clauses (i) and  (ii)  are  de facto practising modern system of medicine (allopathic) and  those  facts  are  declared  by  the  State Government concerned.     By  this  sub-clause,  a  de  facto

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practitioner of modern scientific  medicine  (allopathic)  is recognized  as  a  registered  medical  practitioner  and  is enabled to prescribe drugs covered by the Drugs Act. This being the content of clause (iii) of Rule 2(ee), we shall now turn to the question of  validity  of  the  said clause  and  the  circular/notifications issued thereunder by the State Governments.  Letter No.26(24)  M.E.    (group-1)82 dated  July  27, 1982 was issued by the Rajasthan Government, communicating the approval of recommendations subject to  the conditions  specified  therein  for  purposes  of issuing the notification  under  clause  (iii)  (herein  referred  to  as ’circular’) and  the  notification  No.   9874-IIBII-67/34526 dated October 29, 1967 was issued by the Punjab Government in exercise of powers conferred under the said clause. The learned counsel appearing for allopathic  doctors and  their  association  supported  the view of the Rajasthan High Court that the rule  is  bed  for  want  of  legislative competence.    We   are  afraid  we  cannot  accede  to  this contention.  Section 33 of the Drugs Act confers  wide  power on the  Central  Government to make rules.  Section 33, in so far as it is relevant, is reproduced hereunder : "33 Power of Central Government to make rules.            1.The    Central    Government    may   after            consultation with or on the recommendation of  the            Board    and   after   previous   publication   by            notification in the Official  by  notification  in            the  Official  Gazette, make rules for the purpose            of giving effect to the provisions of this Chapter            Provided that consultation with  the  Board            may be dispensed with if the Central Government is            of  opinion  that  circumstances have arisen which            render it necessary to  make  rules  without  such            consultation,  but  in such a case the Board shall            be consulted within six months of  the  making  of            the  rules  and  the Central Government shall take            into consideration any suggestions which the Board            may make in relation to the amendment of the  said            rules.            2.Without  prejudice to the generality of the            foregoing power, such rule may            (a) to (d) ****** ***            (e)prescribe the forms  of  licences  for  the            manufacture  for the sale or for distribution, for            the sale and for the distribution of drugs or  any            specified  drug  or class of drugs or of cosmetics            or any specified cosmetic or class  of  cosmetics,            the  form  of  application  for such licences, the            conditions subject to which such licences  may  be            issued,  the  qualifications of such authority and            the fees payable  therefor  and  provide  for  the            cencelation  or suspension of such licences in any            case where any provision of this  Chapter  or  the            rules made thereunder is contravened or any of the            thereunder is contravened or any of the conditions            subject  to  which they are issued is not complied            with            (f) to (p)   ***    ***    ***            (q)provide for the exemption, conditionally or            otherwise,  from  all  or any of the provisions of            this Chapter or the rules made thereunder, of  any            specified  drug  or  class of drugs or cosmetic or            class of cosmetics." Sub-section (1)  of  Section  33  of  the  Drugs  Act empowers the Central Government to make rules for purposes of giving effect to the provisions of Chapter IV which deal with

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manufacture,  sale  and  distribution of drugs and cosmetics. This is  a  general  power  of  great  amplitude.     Withhot prejudice  thothe  generality of the power in sub-section (1) specific topics are itemized in sub-section (2),  in  clauses (a)  to  (q),  in  respect  of which rules may be made by the Central Government.  Among them sub-clause (e) relates to the power to prescribe the forms of licences for the  manufacture for  sale,  or  for  distribution  for  the  sale and for the distribution of drugs, or any specified drugs or  classes  of drugs  or  of  cosmetics or of any specified cosmetics or any class  of  cosmetics,  the  form  of  application  for   such licences, the condition subject to which such licences may be issued,  the  authority  empowered  to  issue  the  same, the qualification for such authority,  etc.    Section  18  which falls  in Chapter IV, specifically deals with prohibition for manufacture and sale of certain drugs and cosmetics.  Rule 65 provides conditions of licence to sell, stock or  exhibit  or offer  for  sale  or  distribute  for  wholesale, retail etc. Various sub-urles of the said rule contain as a condition  of licence   that   the   supply  of  drugs  should  be  on  the prescription  of  a  ’registered  medical  practioner’   (See Conditions Nos.  2, 3(1), 5(1), 9 and 9(a)]. From  the above discussion what emerges is that drugs can be sold or supplied by pharmacist or druggist only on the prescription of a ’registered medical practitioner’  who  can also store  them  for  treatment  of  his  patients.  It has, therefore, became necessary for the rule-making authority  to define  the  expression ’registered medical practitioner’ for the purposes of the Act and the Rules.  Rule  2(ee)  does  no more than defining that expression, which is within the scope of Section 33(1) as well as 33(2)(e).  Therefore it cannot be said  that  the rule making authority was lacking legislative competence to make rule 2(ee).  The  High  Court  misdirected itself  by  looking  to  the  provisions of Sections 6 and 12 which do not contain the  rule-making  power.    It  is  only Section 33  which  contains  the rule-making power.  The High Court has also erred in searching for a power to frame  rules for the registration of medical practitioners; obviously such a power  is  not conferred under the Act.  The rule veritably does not deal with registration of the medical  practitioner. It   only   defines   the   expression   ’registered  medical practitioners’  by  specifying  the  categories  of   medical practitioners  which  fall within the definition for purposes of the Drugs Act and the Drugs Rules.  For the aforementioned reasons, we are unable to sustain the view taken by the  High Court  of Rajasthan that the impugned Rule 2(ee)(iii) suffers from the vice of lack of legislative competence and is  ultra vires the Drugs Act. Now coming to the notifications issued by the  Punjab Government on October 29, 1967 and the Circular issued by the Rajasthan  Government on July 26, 1982, referred to above, it has already been pointed out  that  for  purposes  of  clause (iii) of Rule 2(ee) what is required is not the qualification in  modern scientific system of medicine but a declaration by a  State  Government  that  a  person  is  practising  modern scientific  system  and  that  he  is registered in a medical register of the State (other than a register for registration of Homeopathic practitioner).  A notification can be  faulted with only  if  those  requirements  are  not  satisfied.  The Punjab and Haryana  High  Court  proceeded  with  an  assumed intention  of  the rule-making authority that it could not be within   its   conception   to   bring   Vaids/Hakims,    the practitioners of Ayurveda (Indian System of Medicine), within the  purview  of  the  said expression and that it could have only envisaged registration of medical practitioner of modern

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scientific system holding qualifications mentioned in clauses (i) and eligible for registration under clause  (ii)  and  on that  basis  held  the  said notification was ultra vires the rules.         From what has been discussed above, we are unable  to uphold the view of the Punjab and Haryana High Court. We  have  perused the above said notifications issued by the State Governments and  we  find  that  they  are  well within the confines of clause (iii) of rule 2(ee). Therefore, we  conclude  that  the  said  circular  and the notification issued by the said State Governments declaring the categories of Vaids/Hakims who were practising modern system of medicine and were registered in the State Medical Registers, are valid in law. Points 2 and 3 have some over lapping so it  will  be convenient to  discuss  them together.  The right to practise any profession  or  to  carry  on  any  occupation  trade  or business  in  no  doubt  a fundamental right guaranteed under Article 19(1)(g) of the Constitution  of  India.    But  that right  is  subject to any law relating to the professional or technical  qualifications   necessary   for   practsing   any profession or carrying on any occupation or trade or business enacted under  clause  6  of  Article  19.    The  regulatory measures on the exercise of this right both  with  regard  to standard  of  professional  qualifications  and  professional conduct have been applied keeping in view not only the  right of  the  medical practitioners but also the right to life and proper health care  of  persons  who  need  medial  care  and treatment.   There  can,  therefore,  be no compromise on the professional standards of medical practitioners.  With regard to  ensuring  professional  standards  required  to  practise allopathic medicine  the  1956  Act.   was passed which deals also with reconstitution of the Medical Register.  Thus,  for the  first  time  an Indian Medical Register for the whole of India came to be maintained from 1956.    In  the  1956  Act. Section  2(f)  defines  "medicine" to mean ’modern scientific medicine’ in  all  its  branches  and  includes  surgery  and obstetrics,  but  does  not  include  veterinary medicine and surgery and the expression recognised  medical  qualification is  defined  in  Section  2(h)  to  mean  any  of the medical qualifications included in the Schedules to the Act. There more expressions in the 1956  Act  have  to  be noticed here.    But  before  we do so, it must be noted here that the object and reasons of the 1956 Act took note of  the fact  that  there  are local Acts in the States providing for State  Medical  Council  and  maintenance  of  State  Medical Registers  for  registration  of  qualified  practitioners in western medical science or modern scientific  medicine,  that is allopathic medicine.  Now, reverting to the expressions in 1956 Act,  they  are  :    "State Medical Council" defined in Section 2(j) as a medical council constituted under  any  law for  the  time  being  in  force  in any State regulating the registration of practitioners  of  medicine;  "State  Medical Register"   defined  in  Section  2(k)  to  mean  a  register maintained under any law for the time being in force  in  any State   regulating   the  registration  of  practitioners  of medicine and ’Indian Medical Register’ to  mean  the  medical register maintained  by  the  Council.  The 1956 Act provides for the recognition  of  medical  qualifications  granted  by Universities  or  medical  institutions  in and outside India which are specified in the Schedules.  Section  15  which  is relevant,  was  in  the following terms when the said Act was passed in 1956 :            "15.  Subject to the other provisions contained in            this  Act,  the medical qualifications included in

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          the schedules shall  be  sufficient  qualification            for enrolment on any State Medical Register." It   laid  down  that  the  qualifications  included  in  the Schedules should be sufficient qualification for enrolment on any State Medical Register.  It may be pointed out here  that in  none  of  the  Schedules the qualifications of integrated courses figure consequently by virtue of this section persons holding degrees in integrated courses cannot be registered on any State Medical Register. By  Act  24  of  1964, Section 15 of the 1956 Act was modified by keeping the existing section as  sub-section  (1) and  by adding two more, sub-sections (2) and (3), which read thus :            "(2)Save as provide  in  Section  25,  no  person            other  than  a  medical practitioner enrolled on a            State Medical Register -            (a)shall hold office as physician or surgeon  or            any  other office (by whatever designation called)            in Government or in any institution maintained  by            a local or other authority.            (b)shall practices medicine in any State            (c)shall be entitled to sign or  authenticate  a            medical   or  fitness  certificate  or  any  other            certificate  required  by  any  other  certificate            required  by any law to be signed or authenticated            by a duly qualified medical practitioner.            (d)shall be entitled to  give  evidence  at  any            inquest  or in any Court of Law as an expert under            Section 45 of the Evidence Act,  1872  or  on  any            matter relating to medicine.            (3)Any  person  who acts in contravention of any            provision of sub-section  (2)  shall  be  punished            with  imprisonment  for a term which may extend to            one year, or with fine which  may  extend  to  one            thousand rupees, or with both." For  the present discussion, the germane provision is Section 15(2)(b)of the 1956 Act which prohibits  all  persons from   practising  modern  scientific  medicine  in  all  its branches in any State except a medical practitioner  enrolled on a  State  Medical  Register.    There  are  two  types  of registration as for the State Medical Register is  concerned. The  first  is under Section 25, provisional registration for the purposes of training in the approved institution and  the second is  registration  under  Section  15(1).    The  third category of registration is in the Indian  Medical  Register’ which  the  Council  is enjoined to maintain under Section 21 for which recognised medical qualification is a prerequisite. The privileges of persons who  are  enrolled  on  the  Indian Medical  Register  are  mentioned  in  Section 27 and include right to practise as medical  practitioner  in  any  part  of India.   ’State  Medical  Register’  in contra-distinction to ’Indian Medical Register’, is maintained by the State Medical Council which is  not  constituted  under  1956  Act  but  is constituted  under any law for the time being in force in any State; so also a State Medical  Register  is  maintained  not under  1956 Act but under any law for the time being in force in any State regulating the registration of practitioners  of medicine.   It  is  thus  possible that in any State, the law relating  to  registration   of   practitioners   of   modern scientific medicine may enable a person to be enrolled on the basis  of  the  qualifications  other  than  the  ’recognised medical qualification’ which  is  a  pre-requisite  only  for being  enrolled  on  Indian  Medical  Register  but  not  for registration in a State Medical register.    Even  under  the 1956  Act,  ’recognised  medical qualification’ is sufficient

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for that  purpose.    That  does  not   mean   that   it   is indispensably essential.  Persons holding ’recognised medical qualification’  cannot  be  denied  registration in any State Medical Register.  But the same cannot be insisted  upon  for registration on  a State Medical Register.  However, a person registered in a State Medical Register cannot be enrolled  on Indian  Medical  Register  unless  he  possesses  ’recognised medical qualification’.  This follows from a combined reading of Sections 15(1), 21(1) and  23.    So  by  virtue  of  such qualifications  as  prescribed  in  a  State Act and on being registered in a State Medical  Register,  a  person  will  be entitled   to  practise  allopathic  medicine  under  Section 15(2)(b) of the 1956 Act. In the above view of the matter,  we  are  unable  to agree  with  the  following  observations  of  this  Court in A.K.Sabhapathy vs. State of kerala, (1992) Supp1. (3) SCC 147 :            "These  provisions  contemplate  that a person can            practise in allopathic system  of  medicine  in  a            State  or  in  the  country only if he possesses a            recognised medical qualification.    Permitting  a            person who does not possess the recognised medical            qualification in the allopathic system of medicine            would be in direct conflict with the provisions of            the Central Act." We  have  perused the Bombay Medical Act, 1912, Bihar and Orissa Medical Act, 1916, Punjab Medical Registration Act 1916, Rajasthan Medical  Act  1952  and  Maharashtra  Medical Council  Act, 1965 which regulate maintenance of registers of medical  practitioners  and  the  entitlement   to   practice allopathic medicine.      Under   those  Acts  State  Medical Registers are maintained.  Section 7(3) of the Bombay Act  of 1912, enabled the Provincial Government, after consulting the State  medical  council,  to  permit  the registration of any person  who  was  actually  practising  medicine  in   Bombay Presidency  before 25th June, 1912, this seems to be the only case  of  registration   without   requisite   qualification. Further  persons  possessing  Ayurvidya Visharad of the Tilak Maharashtra Vidyapeeth of Poona, obtained  during  the  years 1921-1935  (which was included in the Schedule to that Act on 31st.  September, 2939 pursuant to Notification No.   3020/33 dated  12.9.1939) were entitled to be registered in the State Medical Register; this is the only Ayurvedic qualification on the basis of which persons were eligible to be registered  on the  State  Medical  Register  in  Maharashtra;  further with regard to rural areas, the prohibition to practice allopathic medicine under that Act did not apply provided a  person  had commenced  practice in any village in the rural area prior to 1912.  None of the petitioners has claimed benefit  of  these exceptions.   We  could  not  find  any other provision which enables a person, other than those  possessing  qualification prescribed  in the Schedules to the Acts, to be registered on the State Medical Register to practise  allopathic  medicine. So  it  can  be  observed  that  if any State law relating to registration of Medical  practitioners  permits  practise  of allopathic  medicine  on  the  basis  of degree in integrated medicines, the bar in Section 15(2)(b) of the 1956  Act  will not apply. Rule 2(ee), as noted above, has been inserted  in  the  Drugs Rules with  effect from May 14, 1960.  Section 15 of the 1956 Act, as  it  then  stood,  only  provided  that  the  medical qualifications   in   the   Schedule   shall   be  sufficient qualification for enrolment on any State medical register and so there was no inconsistency between  the  section  and  the Rule when  it  was brought into force.  But after Sub-section

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(2) of Section 15 was inserted in the 1956 Act,  with  effect from  15.09.1964,  which  inter alia, provides that on person other than  a  medical  practitioner  enrolled  on  a  ’State Medical  Register’  shall practise modern scientific medicine in  any  State,  the  right  of  non-allopathic  doctors   to prescribe drugs by virtue of the declaration issued under the said drugs  Rules, by implication, got obliterated.  However, this does not behar them from  prescribing  or  administering allopathic drugs hold across the counter for common ailments. Here it may be necessary to refer to the  development of law with regard to Indian medicine.  In pre-constitutional era  each  province  of  India  was  having its own enactment regulating the registration and practice in Indian  medicines like --  Uttar Pradesh Indian Medicine Act, 1939.  The Punjab Ayurvedic and Unani  Practitioners  Act,  1949  etc.    After coming   into   force   of   the   Constitution,  many  State legislations were enacted to regulate the practise of  Indian medicine, Ayurvedic and Unani like Punjab Ayurvedic and Unani Practitioners Act,  1963  etc.  However, on the model of 1956 Act, the  Parliament  enacted  The  Indian  Medicine  Central Council Act,  1970  (for  short ’1979 Act’).  The schemes and provisions of 1970 Act and 1956 Act are analogous.    ’Indian Medicine’  is  defined in Section 2(e) of the Act to mean the system of Indian medicine commonly known as Ashtang Ayurveda, Siddha or Unani Tibb whether  supplemented  or  not  by  such modern  advances  as  the  Central  Council  may  declare  by notification from  time  to  time.    In  Section  2(j)   the expression  "State Register of Indian Medicine" is defined to mean a register or registers maintained under any law for the time being in force in any State regulating the  registration of practitioners  of  Indian  medicine.  The Act contemplates having separate Committees for Ayurvedic,  Siddha  and  Unani medicines.   Section  17 enables, inter alia, the persons who possess medical qualifications mentioned in the Second, Third or Fourth Schedule to be enrolled on any  state  Register  of Indian Medicine.    A perusal of the Second, Third and Fourth Schedules shows that they contain both integrated medicine as well as other qualifications.   So  a  holder  of  degree  in integrated  medicine is entitled to be enrolled under Section 17 of 1970 Act.  Section 22 authorises the Central Council to prescribe  the  minimum  standards  of  education  in  Indian medicine    required    for   granting   recognized   medical qualifications   by   Universities,   Boards    or    medical institutions in  India.    The Central Council is enjoined to maintain Central Register of Indian medicine  containing  the particulars  mentioned  therein  and  Section  25  lays  down procedure for registration in the Central Register of  Indian medicine.   The  counterpart  of  Section  15  of 1956 Act is Section 17 of 1970 Act.  We shall quote it here :            "17.(1)  Subject to the other provisions contained            in this Act, any medical qualification included in            the Second, Third  or  Fourth  Schedule  shall  be            sufficient  qualification  for  enrolment  on  any            State Register of Indian Medicine.            (2)Save as provided in  section  28,  no  person            other  than  a practitioner of Indian Medicine who            possesses a recognised medical  qualification  and            is  enrolled  on  a  State Register or the Central            Register of Indian Medicine -            i)shall hold office as Vaid  Siddha,  Hakim  or            Physician   or   any  other  office  (by  whatever            designation called) in Govt. or in any institution            maintained by a local or other authority;            ii)shall practice Indian medicine in any State;            iii)shall be entitled to sign or  authenticate  a

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          medical   or  fitness  certificate  or  any  other            certificate required by any law to  be  signed  or            authenticated   by   a   duly   qualified  medical            practitioner;            iv)shall be entitled to  give  evidence  at  any            inquest  or in any court of law as an expert under            Section 45 of the Indian Evidence  Act,  1872,  on            any matter relating to Indian medicine.            3)Nothing  contained  in  sub-section (2) shall            affect -            i)the  right  of  a  practitioner   of   Indian            medicine  enrolled  on  a State Register of Indian            Medicine to practice Indian medicine in any  State            merely  on the ground that, on the commencement of            this Act, he does not possess a recognised medical            qualification;            ii)the  privileges  (including  the   right   to            practice  any  system of medicine) conferred by or            under  any  law  relating   to   registration   of            practitioners  of  Indian  medicine  for  the time            being in force in any State on a  practitioner  of            Indian  medicine  enrolled  on a State Register of            Indian Medicine;            iii)the  right  of  a  person  to practice Indian            medicine in a State in which, on the  commencement            of  this  Act, a State register of Indian Medicine            is not maintained if, on such commencement, he has            been practising Indian Medicine for not less  than            five years;            iv)the rights conferred by or under  the  Indian            Medical  Council act, 1956 (including the right to            practice medicine as  defined  in  clause  (f)  of            Section  2  of the said Act, on persons possessing            any qualifications included in  the  Schedules  to            the said Act.            4.Any  person  who acts in contravention of nay            provision of sub-section  (2)  shall  be  punished            with  imprisonment  for a term which may extend to            one year, or with fine which  may  extend  to  one            thousand rupees, or with both." A  perusal  of  the  provisions  extracted  above, shows that sub-section   (1)   prescribes   qualifications    considered sufficient  for  enrolment  on  any  State Register of Indian Medicine.  Sub-section (2) ordains that  all  persons  except those  who possess a recognised medical qualification and are enrolled on a State  Register  or  the  Central  Register  of Indian  medicine,  are  prohibited from doing any of the acts mentioned  in  Clause  (a)  to  (d)  of   that   sub-section. Sub-section  (3),  however,  carves  out  an exception to the prohibition contained in sub-section (2).  Clause (a) thereof saves the right to practise of any  medical  practitioner  of Indian   Medicine  who  was  not  having  recognised  medical qualification on the date of the commencement of 1970 Act but who was enrolled on a State Register to practise that  system of medicine; clause (b) protects the privileges which include the  right  to  practise  any  system  of  medicine which was conferred by or under any law  relating  to  registration  of practitioners  of Indian medicine for the time being in force in any State on a practitioner of  Indian  medicine  who  was enrolled  on  a State Register of Indian medicine; Clause (c) saves the right of a person to practise Indian  medicine  was maintained  at  the  commencement of that Act provided he has been practising in the Indian Medicine for not less than five years before the commencement  of  the  Act  and  Clause  (d) protects  the  rights  conferred  by  or  under  the 1956 Act

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including the right to practise  modern  medicine  possessing any qualification  included  in  that  Act.   In other words, under clause (d) the  right  to  practise  modern  scientific medicine in all its branches is confined to only such persons who  possess  any  qualification included in the Schedules to 1956 Act.  In view of this conclusion it  matters  little  if the   practitioners  registered  under  1970  Act  are  being involved in various programmes or given postings in hospitals of allopathic medicine and the like. It will be appropriate to notice that 1970  Act  also maintains  similar  distinction  between  State  register  of Indian medicine and  Central  register  of  Indian  medicine. Whereas  the  State register of Indian medicine is maintained under any law for the  time  being  in  force  in  any  State regulating   the  registration  of  practitioners  of  Indian medicine, the Central register of Indian medicine has  to  be maintained  by  the  Central Council under Section 23 of that Act.  For a person to be registered on the Central  register, Section  25  enjoins  that registrar should be satisfied that the persons concerned was eligible under that  Act  for  such registration.   Keeping  this  position  in  mind, if we read Section 17(3)(b), it becomes clear that the privileges  which include the right to practise any relating to registration of practitioners  of Indian medicine for the time being in force in any State on a practitioner of Indian medicine enrolled on a State register of Indian medicine, is not affected  by  the prohibition contained in sub-section (2) of Section 17. To ascertain if any State law confers ’the right to  practise any system’ we have perused Bombay Medical practitioners Act, 1938,  Rajasthan  Indian  Medicine  Act, 1953 and Maharashtra Medical Practitioners Act, 1961 which deal with  registration of practitioners  of  Indian  Medicine  in those States.  The requirement as to registration was  also  contemplated  under Pepsu Ayurvedic  &  Unani  Practitioners Act, 2008 R.K.  (No. XII  of  2008  B.K.)  and  East  Punjab  Ayurvedic  &   Unani practitioners Act.    1949  as well as under Punjab Ayurvedic and Unani Practitioners Act 1963, which repeated the said two Acts.  This 1963 prescribes qualifications  as  specified  in the  Schedule for the purpose of registration as a registered practitioner.  In the said Act of  1963  also,  there  is  an express  provision prohibiting a person other than registered practitioners, as defined therein, to practise  or  hold  out whether  directly  or  by  implication as practising or being prepared  to  practise  Ayurvedic  system  or  Unani  system. Section  16(3) of the Pepsu Ayurvedic and Unani Practitioners Act, 2008  B.K.    enjoins  that  no  Vaids/Hakims  shall  be registered  under  the Act if the Registrar is satisfied that such a person is  found  to  practise  any  other  system  of medicine  for  which  he  did  not  hold  any  certificate or diploma.  But we could not lay our hands on any provision  in the  said  State  Acts  under  which the right to precise any system of medicine is conferred on  practitioners  of  Indian medicine registered under those Acts. Nevertheless, Ms.  Indira Jaising asserted  that  the prohibition  contained  in  Section  15(2) and the punishment provided in Section 15(3) of the 1956 Act would apply only to persons practising  allopathic  system  of  medicine  without obtaining   the   registration   but   does   not   apply  to practitioners of Indian medicine.   This  submission  is  too broad to  merit acceptance.  It may be pointed out first that the Act regulates practice of allopathic medicine, so Section 15(2)(b) requires that only those who are registered on State Medical Register alone can practise allopathic  medicine  and secondly,  the  prohibition  is directed against every person who is not registered on any State Medical Register  and  all

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such   persons   are  precluded  from  practising  allopathic medicine.  The punishment under Section 15(3) is  in  respect of contravention of any provision of sub-section (2). However, the claim of those who have been notified  by  State Governments  under  clause  (iii)  of rule 2(ee) of the Drugs Rules and those who possess degrees in integrated courses  to practice  allopathic  medicine is sought to be supported from the definition of the Indian Medicine in Section 2(e) of 1970 Act, referred to above, meaning the system of Indian medicine commonly known as Ashtang  Ayurveda,  Siddha  or  Unani  Tibb whether  supplemented  or  not by such modern advances as the Central Council may declare  by  notification  from  time  to time.   Lot  of  emphasis  is laid on the words underlined to show that they indicate modern scientific medicine  as  under integrated  systems  various  branches  of  modern scientific medicine have been included in the syllabi.  A degree  holder in  integrated  courses  is imparted not only the theoretical knowledge of modern scientific  medicine  but  also  training thereunder, is the claim.  We shall examine the notifications issued  by  the  Central  Council  to ascertain the import of those words.  In its resolution dated  March  11,  1987,  the Central  Council  elucidated the concept of "modern advances" as follows :            "This  meeting  of  the  Central  Council   hereby            unanimously   resolved   that  in  Clause  (e)  of            Sub-section 2(1) of 1970 Act of the IMCC Act, ’the            modern advances’, the drug has advanced made under            the various branches of modern  scientific  system            of  medicine, clinical, non-clinical, biosciences,            also technological innovations made from  time  to            time  and  declare that the courses and curriculum            conducted  and  recognised   by   the   CCIM   are            supplemented by such modern advances." On  October 30, 1996 a clarificatory notification was issued, which reads as under :            "As per provision under Section 2(1) of the Indian            Medicine Central Council Act, 1970, hereby Central            Council   of   Indian   Medicine   notifies   that            ’institutionally qualified practitioners of Indian            system  of  medicine  (Ayurveda, Siddha and Unani)            are eligible to practise Indian system of medicine            and modern medicine including Surgery,  Gynecology            and   Obstetrics   based  on  their  training  and            teaching which are  included  in  the  syllabi  of            courses  of  ISM  prescribed by Central Council of            Indian Medicine after approval of  the  Government            of India.            The     meaning     of     the     work    ’modern            medicine’(Advances) means advances made in various            branches of Modern scientific medicine,  clinical,            non-clinical   bio-sciences   also   technological            innovations made from time to time and notify that            the   courses   and   curriculum   conducted   and            recognised   by  the  Central  Council  of  Indian            Medicine   are   supplemented   by   such   modern            advances." Based  on  those  clarifications,  the arguments proceed that persons who registered under  the  1970  Act  and  have  done integrated  courses,  are  entitled  to  practise  allopathic medicine. In our view, all that  the  definition  of  ’Indian Mecicine’  and  the  clarifications  issued  by  the  Central Council enable such practitioners of Indian  medicine  is  to make  use  of the modern advances in various sciences such as Radiology Report, (x-ray),  complete  blood  picture  report, lipids  report,  E.C.G.,  etc.  for purposes of practising in

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their own system. However, if any State  Act  recognized  the qualification of    integrated    course      as   sufficient qualification for registration in the State Medical  Register of  that  State, the prohibition of Section 15(2)(b) will not be attracted. A harmonious reading of Section 15 of  1956  Act  and Section  17 of 1970 Act leads to the conclusion that there is no scope for a person  enrolled  on  the  State  Register  of Indian  medicine  or  Central  Register of Indian Medicine to practise modern scientific medicine in any  of  its  branches unless  that  person  is  also  enrolled  on  a State Medical Register within the meaning of 1956 Act. The  right  to  practise modern scientific medicine or Indian system of medicine cannot be based on the provisions  of  the Drugs   Rules   and  declaration  made  thereunder  by  State Governments.  Indeed, Ms.  Indira Jaising has also  submitted that  the  right  to practise a system of medicine is derived from  the  Act  under  which  a   medical   practitioner   is registered.   But  she  has strenuously argued that the right which the holders of degree in integrated courses  of  Indian medicine  are  claiming  is  to  have  their  prescription of allopathic medicine, honored by a pharmacist or  the  chemist under the  Pharmacy  Act and the Drugs Act.  This argument is too technical to be acceded to because prescribing a drug  is a  concomitant of the right to practise a system of medicine. Therefore, in a broader sense the right to prescribe drugs of a system of medicine would be synonymous with  the  right  to practise that  system  of medicine.  In that sense, the right to prescribe allopathic drug cannot be wholly  divorced  from the claim to practice allopathic medicine. The  upshot  of  the  above  discussion  is that Rule 2(ee)(iii) as effected from May 14, 1960 is  valid  and  does not   suffer  from  the  vice  of  want  of  the  legislative competence  and  the  notifications  issued  by   the   State Governments  thereunder are not ultra vires the said rule and are legal. However, after sub-section (2) in  Section  15  of the  1956  Act occupied the field vide Central Act 24 of 1964 with effect from June 16, 1964, the benefit of the said  rule and  the  notifications  issued thereunder would be available only in those States where the privilege  of  such  right  to practise any system of medicine is conferred by the State Law under  which  practitioners of Indian Medicine are registered in the State, which is for  the  time  being  in  force.  The position  with  regard  to  Medical  practitioners  of Indian medicine holding degrees in integrated courses is on the same plain  inasmuch  as  if  any  State  Act   recognizes   their qualification  as  sufficient  for  registration in the State Medical  register,  the  prohibition  contained  in   Section 15(2)(b) of the 1956 Act will not apply. In the result, civil appeals, special leave petitions and  writ  petitions are accordingly disposed of. There shall be no order as to costs.