In response to the claim that ayurveda is "pseudoscience"

This is my response to a post in a medical forum;

I think the best method to look at any science is to examine the short and long term outcomes. This was the testing measure of all attempts at addressing health issues before the current scientific approach.

The patient is interested in the outcome. He or she cares for little else. For a while all were happy with the present medical science as the acute problems were readily addressed. They could just pop a pill. Discrimination and discipline could be done away with. Responsibility shifted from the patient to the medical world that benefitted from disease.

However over the years the patients could observe (doctors meanwhile were deprived of their skills of observation) that the acute diseases were replaced by pains, aches, uneasiness, mental deviations, disruption of bodily cycles, followed by epidemics of chronic conditions which they were asked to bear with while taking medications that were not effective in preventing the downslide.

By this time the inbuilt clocks in the human body had gone haywire, the microbes accustomed to the wrong kind of foods and inputs, cells inconvenienced and performing at their lowest ebb, mitochondria destroyed leading to fatigue and loss of energy, metabolic disorder showed up as obesity and the affected population were unable to return to the lifestyle that kept them healthy. The LabRats were trapped in the cage.

When things changed the critics ranging from Huxley to Illich spelt out what exactly was wrong. The theme stirred thinkers who stated their opinion. The arguments were precise, logic impeccable. Dr Robert Mendelsohn and others from the profession spelt out the scientific reasons behind the trend. But the mainstream continued regardless. There was no effort at a public campaign to educate the public. Groups like the Cochrane Collaboration could not break the jargon and reach the people. The doctors did not get together to self evaluate. Errors were accepted and adopted.

Nobody has any doubt that Ayurveda has the answers to the problems of the day. And that is the problem. A system that talks of the healing powers of the body, lifestyle factors, constitution specific nutrition, element and organ specific exercise, need for a biological environment, adapting to the environment, bodily cycles and the need to adhere to them, the reasons behind acute disease, detoxification, and empowers the patient has to now reinvent itself and submit to manipulation.

I have been following this debate in many forums. The ayurveds have no objection to scientific rigor but they can discern the motives as well and are therefore defensive. The Panchamabhuta theory, they say, is easily observed. The play of elements is in plain display. They say if we can teach the allopaths how to read the pulse the ayurvedic way,  that would be enough for them to discern the play in their patients. It is as easy as that.

To the allegation that they lack continuous research they respond by saying ayurveda is more or less a complete science and requires research only when anomalies are noticed, unlike its counterpart that needs continuous research as the interventions are resisted by the body. The challenges are the changes wrought by the mass application of methods that are used to attack the body leading to extensive toxicity and depletion of vitality. With vitality lacking and the patient at the end of tolerance limit the body loses its protective and curative powers and only palliative treatment is possible.

Sincere ayurveds feel bad that they have to medicate. They say the efforts of the healers should be to educate the people to adopt natural methods and rectify imbalances. Medications neither educate the body nor the patient. This reminds me of the sage words of Gandhi who pointed out that disease comes to warn people that things are wrong and that rectification and discipline is necessary. Disease is the best teacher. The body is the only doctor if the patient is educated.

And then there are ayurveds fine tuning the science. We cannot complain that the world of ayurveda is static and not evolving. They are interested in teaching the people how to stay healthy.

The present system has inconvenienced ayurveda as those unable to get a seat in allopathic medical colleges are opting for ayurveda. The motive is a career. Such students do a great disservice to medicine as doctors of all systems would agree. Commercialization encouraged by the dominant medical paradigm has affected all systems. Ayurveds would prefer the Teacher Student system. Doctors should be allowed to set up their schools and the chosen students rigorously taught the science while practicing the lifestyle tenets and mastering them.

If we dip into history we observe mainstream doctors integrating naturopathy and herbalism into their practice as they observed the benefits. Coupled with their minimum medication approach this made them effective. Then the restrictions put them in place. The present approach to ayurveda is similar. The practitioners are being convinced that it is a "pseudoscience". They should not study it.

In my book I have narrated how the Principal of a medical college had cured me the naturopathic way when he was approached as the last resort. The prescription was two tender coconuts every hour in the waking state till a cure is observed. I was cured and my father had enquired how the tender coconuts helped. The answer was; 'they flushed the garbage that the earlier doctors had introduced into your child.'

The sane approach should be to ensure the freedom of the members to dip into holistic methods and take their pick. Many have always been doing so while treating themselves and their family members. I have been observing this in my relatives. They don't rush to medicate their own. They take care of nutrition, discourage junk food, and are not averse to herbs at all. After my grandmother was cured of her eyelid paralysis and ptosis by a homeopath, the aversion towards homeopathy reduced considerably. My aunt, a professor and gynecologist of repute in Bengal, was cured of her long standing problem by Dr Bholanath Chakraborty who was the personal homeopath of Indira Gandhi.

This is the way to proceed. This is normal. This is scientific. All methods have their benefits. Creating a rift, monopolizing a system, encouraging jingoism, rousing the ego of the practitioners to defend their system at any cost, has a downside. It goes against the interest of the patient. The doctor and his or her family also belong to that category. Holistic systems must be honored for they protect all.

Yes all systems require scrutiny. The best way to evaluate a system is to be free from conflict of interest, study the principles, the materia medica, and apply the remedies according to the principles, to observe the result. Here the doctor is the driver. Haranguing the holistic methods, pushing medicine to the industry laboratories, and mandating their approval has trapped us. Both the doctors and patients have been suffering ever since.

My formula is very simple;

  • Keep the healthy at their peak of health
  • Lead the unhealthy towards health
  • Cure the sick

If the holistic sciences are too much to bear, then we can adopt the science of microbiome, cellular health, nutrition, circadian rhythm, and autophagy. The benefits of a good lifestyle are well researched. These fall within our domain. The need for morality and ethics in medicine is acutely felt and expressed by many practitioners. Let the voice of the reformers be heard.

The personal cure is;

  • Detoxification
  • Nourishment
  • Restoration
  • Rectification, and
  • Education

The community cure is to establish the social determinants of health. Without these steps the medical system flounders at every step and the patients suffering reaches its peak. The answer to the growing disease graph is not more doctors and hospitals but to reduce to incidence of disease in society. It is not difficult if Dr Common Sense and Dr Essential Reform are un-caged and allowed to practice.

If education is proper there is no need of doctors and hospitals. In fact the doctor is the cause of disease. In a cryptic verse the Rig Veda warns, "Carpenters desire wood, doctors’ disease". The warning is thousands of years old borne out of observation.

The first duty is to reform the system that is most widespread and adopted. By setting that example the moral superiority over other systems can be claimed. However when that is sincerely done the quarrel will disappear. The usefulness of the very procedures being resented as pseudoscience will become obvious. Ensuring health, wellness and cures require a different mindset; one that is today being battled.

Regards,

Jagannath

My second mail;

I agree. There should be stringent quality control.

Early on the ayurveds used to prepare their own medication. There were two clinics in my city. After the doctor's consultation, one or two immediate remedies were provided in acute cases, but we had to wait for some days for the remedies that were prepared on the basis of our constitution. The medications would be accompanied by a prescription about food and lifestyle. 

In ayurveda quality control is about teaching the practitioner well and inculcating in him or her the highest standard of ethics. Every practitioner thus became the regulator. I was cured of my obstinate asthma by a gardener of a government herbal nursery who refused to take any fees because he feared he would lose his skill if he exploited it commercially. When I insisted he asked me to pay the clerk of the nursery and get a government receipt. I still remember that humble man. 

Homeopathy will simply not work if the manufacturer or the practitioner does not adhere to the principles. It is not broad spectrum but highly individualistic. 10 persons with the same named disease may require 10 different medications. In case of epidemics, the symptoms are analyzed to discern the pattern and prophylaxis recommended. 

Ayurveda received a very big jolt during the British times. First it was outlawed but its popularity could not be controlled. Then the philosophy behind it was obliterated and it was converted to a disease based approach. This medicine for that disease. It killed ayurveda, it deskilled the ayurveds, it turned ayurveda into a commercial entity, just like allopathy. Today we go to an ayurved and receive packaged drugs. No one tells us about food choices, lifestyle, physical exercise. Dr Kishore Patwardhan does not talk about this. He seems to be happy with reductionism. 

In India consulting an ayurved was the last resort. The rules set within the Patanjali Yoga Sutras - The Yamas and Niyamas - kept people healthy. There was no mass poisoning. People knew the basic tenets of naturopathy. Neti dhauti - the detoxification part was popular. People knew that internal (physical/ mental) and external cleanliness was the key to health. Remedies were available in the kitchen and backyard garden. Health was seldom discussed as it was the norm. It was taken for granted. 

When are we going to stress on these aspects? Quality control of medications is important, but more important is restoring the knowledge about health. Medical education needs a lot of attention. Who is seeking quality control in that? People need the right knowledge about health. What are we doing about it?  

Instead of pitting one system against another can we discuss what can be done to have a path that will genuinely lead to health? The system is important, drugs are important, but what is more important is changing perceptions, inculcating benevolence and ethics, putting the patient at the center, and setting the right goals. 

Regards,