Claim: Ayurvedic curriculum should not teach ayurvedic fundamentals!

A paper in the Indian Journal of Medical Ethics (IJME) by Dr Kishor Patwardhan, an ayurved, claims that the ayurvedic practitioners are not going as per the basic concepts taught in the ayurvedic curriculum, The IJME therefore concludes that the basic concepts should no longer be taught. The study details are provided at the end. This is my response in a medical forum where the study was put up for discussion.

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My response;

I could not really understand the logic. Maybe I should place it this way; 

"I question 1000 allopathic practitioners whether they comply with medical ethics, true informed consent, keep in mind patient rights, while treating their patients. All of them say they do not really think about these issues." 

So do I conclude that teaching medical ethics, informed consent, and patient rights is impractical and it is a waste of time to teach these? 

Would the IJME then recommend that ethics should not be a part of the medical curriculum? 

This entire exercise of denouncing everything that ayurveda stands for can be the subject of medical journals sponsored by the pharmaceutical industry. IJME I feel is a bit out of place here. 

But that is my opinion.

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Sir thank you for your reply. The general reader as well as practitioners are getting the impression that ayurveda is being pushed towards oblivion. 

My note written recently is here;

https://www.currenthealthscenario.com/2024/06/the-allopathization-of-ayurveda-last.html

I have also shared a few points with Dr Patwardhan on X. His like on one gives me hope. 

The word "unscientific" rattles. Unscientific as to what parameters?

Ayurveda is based upon certain qualities that were once treasured by all physicians;

• Altruism 
• Intuition 
• The powers of observation 
• Experience
• Learning from outcomes
• Ability of course correction

As I keep on saying, we observed these even in allopaths till the MBBS doctors prevailed. They were reluctant to believe everything that pharma ordered. 

I have pointed out in my note; the corruption of ayurveda began early under British rule. Currently we have a version that is no different from allopathy in approach. The "sincere efforts" of IJME will hasten the demise of ayurveda. 

The abstract philosophy and the concepts that IJME claims are unscientific are the core strength of ayurveda. These are currently neglected. At the base of health is vitality - the intelligent energy. This can only be observed. The conservation of vitality and directing it towards wellness and cures is the core of ayurveda; hence the high empasis on moral, ethical, social and spiritual teachings. Even to understand ayurveda the physician has to imbibe the highest of spiritual living so as to prepare the mind and intellect to grasp and understand the teachings. The teaching of ayurveda therefore traditionally began with such education and practice. Only the adept were allowed to proceed. 

There is a play of various forces within the body. Ayurveda classifies them according to the purpose and direction. The catabolism and metabolism processes are described as fires; the most important being the jatharagni or the digestive forces. 

Then there is the play of elements - space, air, fire, water, and earth. The qualities of these elements and their interaction is to be observed and understood in full. The physiology of ayurveda is different with the processes and performance of organs made of the elements that will not tally with modern purely physiogical anatomical findings. The interaction of the body with the environment is another aspect that has to be minutely observed and understood. 

These are not emphasized in the modern ayurvedic curriculum and the practitioners feel helpless. They are also peeved that the patients are no longer amenable to lifestyle changes; the body clock being almost irreversibly damaged and mitochondrial damage, microbial damage, nerve damage, coupled with cellular damage adds to the insult by creating lethargy and mood disturbances that hinder much needed changes in routine. Therefore they get attracted to the disease - drug approach. Ayurveda is NOT about drug delivery. Drugs are absolutely last resort when options like diet, fasting, cleansing etc cannot complete the process. Herbs are used to assist the organs cope rather than stopping any process initiated by the body. 

You cannot map ayurveda using allopathic standards. Harnessing disgruntled ayurveds to seek detrimental changes in ayurveda is NOT going to help. We have already destroyed health. It does not help to corrupt all means and knowledge to get back in shape.  

Ayurveda is about empowering people. We have already seen what empowering doctors and the medical industry leads to. Ideally there should not be full time doctors as the optimal working of the mind body complex and its correct interaction with the environment is the path to health. Health volunteers who guide people, as I used to observe in tribal communities I worked with, is the best option for people to remain protected from overzealous doctors and their undue interference. 

I can only stand and watch as an underlying agenda is taken forward. I am happy that homeopathy is somewhat protected (though the same corruptive forces are at work) because it is intrinsically principle and result oriented. Playing with the principles renders homeopathy useless. 

Let me end with a cautionary note that I found in a book by a monk disciple of Swami Sivananda. It touches upon medical ethics as was imprinted on practicing ayurveds; 

“The physicians approach towards health should be absolutely sincere and knowledgeable. Worsening of health is a sure indication that things are wrong. The physician that justifies the harm and does not rectify himself loses the status of a health giver. Continuing on the path has serious spiritual repercussions. Such physicians lose their spiritual gifts and are condemned to remain in a bodiless state in the lowest realms of existence (rasatala) till the cycle of creation lasts.” 

Not scientific perhaps; But profound. Man is in search of spiritual growth having attained a human body and mind. Corrupting these vital aspects and converting human beings into worse than animals ought not to be the goal of any medical science; Therefore the above caution. 

Regards.

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https://ijme.in/articles/myth-and-reality-of-theory-driven-individualised-practice-in-ayurveda-mapping-physicians-approaches-using-case-based-scenarios/?galley=html

 

RESEARCH ARTICLE

Myth and reality of “theory-driven individualised practice” in Ayurveda: Mapping physicians’ approaches using case-based scenarios

Mayank Chauhan, Vijay Kumar Srivastava, Kishor Patwardhan

Published online first on June 17, 2024. DOI:10.20529/IJME.2024.039

Abstract

Background: The curricula of Ayurveda programmes emphasise various theoretical constructs such as Tridoaha (three factors determining the state of health), Agnibala (digestive strength), Samprapti (patho-physiology), among others. It is often argued that practitioners follow an individualised approach based on these principles while treating patients. Yet, dependable data on their real-world influence is lacking. The aim of this study was to record the extent to which these constructs drive decision-making among Ayurveda practitioners and to examine whether these constructs determine individualisation of the interventions.

Methods: We employed an emailed survey to record physicians’ perceptions. Convenience sampling was chosen as the sampling method. Registered Ayurveda practitioners located across India with a minimum of five years of clinical experience were invited to participate. Five case-based scenarios depicting different clinical conditions were presented to the physicians. Questions that accompanied each case scenario asked the physicians to record clinical diagnoses, treatment plans, and the Ayurveda principles that determined their treatment.

Results: A total of 141 physicians responded, from whom we received 152 responses as seven physicians responded to more than one scenario. The results suggest a significant lack of consensus among physicians regarding clinical diagnoses, interventions, and their understanding of pathophysiology in the given clinical scenarios. Many conflicting opinions were also noted.

Conclusion: Theoretical constructs do not appear to determine either prescriptions or individualisation uniformly. Two ethical questions arise: “Is this situation due to an inherently weak theoretical framework of Ayurveda?” and “How can one justify spending hundreds of hours teaching these theories?”