Ayurveda, Siddha: Can Indian Knowledge Systems Be Evidence-Based?

Can Indian Systems of Medicine, such as Ayurveda, Siddha, and tribal medicine, be proven? These questions arose in the Ramdev Baba Coronil debate, where a herbal product was said to be a cure for COVID-19 without sufficient scientific evidence.

Decades ago, in Vietnam, during the war, many soldiers who fought with the American army were dying of malaria that resisted chloroquine more than American bullets. At the request of Ho Chi Min, Mao Zedong of China created Project 523, sending researchers to examine traditional Chinese literature to find herbs for symptoms such as malaria.

The most remarkable result was the discovery of artemisinin, a life-saving anti-malarial drug. Tu Youyou and his team, inspired by a 1,700-year-old book, discovered artemisinin using modern scientific methods. This achievement saved millions of lives and earned him the Nobel Prize in 2015.

Despite initial doubts, clinical trials and pathophysiological studies have confirmed the efficacy of artemisinin in malaria control. This strong evidence convinced the global health community and led the World Health Organization to support artemisinin. Today, academics around the world are conducting research on traditional Chinese medicine using the latest scientific tools.

In the past, Indian systems were based on evidence

In ancient Indian philosophies and scientific texts, key epistemological terms such as testify, Accept, see me, yukti, matter, siddhanta, variegatedand Anvesana share space with some kind of legend. According to Narasimha (7th-8th century), the commentator of Rasavaiseshika-sutraattributed to Bhadanta Nagarjuna in the 5th-6th century, only two types of evidence are cited in Ayurveda: Pratyaksha (literally) and Accept (considered/copied), which has no ‘faith’ element in the sense of blind faith. (Na hy Ayurveda prayaksarthanumeyarthabham agamabham aniacchraddeyarthavam asti, drishtaphalatvad iti-RVSBh 3.45).

Caraka distinguishes between Yuktivyapashraya beshaja (reason-based) and Daivavyapashraya beshaja (faith-based) therapies, which emphasize a research approach,’testify‘, as essential for achieving scientific truth. He said that a claim is generally accepted only after several investigators have thoroughly examined it and it is supported by solid and reasonable evidence.

So why has Ayurveda fallen by the wayside?

From the sixth to the tenth century CE, Ayurveda was a thriving and active field. New drugs were discovered and added to its extensive corpus. For example, Vagbhata (6th century CE) emphasized the importance of updating medical literature, ‘same yugaand wrote new commentaries on Charaka Samhita and Sushruta Samhita. Dalhana (11th century CE) did not refrain from modifying and adding two new iron compounds for the treatment of anemia in his commentary on the Sushruta Samhita.

“Ayurveda does not get its authority because it was told by Brahma; its value comes only from the proven truths it contains”, according to Vagbhata. However, many Ayurveda practitioners believed that it was achieved by the ancient rishis through their yogic powers rather than a scientific treatment method of experimentation and experience. can be criticized.

MS Valiathan, a well-known cardiologist and a well-known author, says: “Listening to the written word and the power of the text, reinforced by the social effect of high caste and mystical philosophies, slowly- gradually replaced the spirit of scientific renaissance and research that characterized the work of the Ayurvedic pioneers.the legacy of Charaka, Sushruta, and Vagbata.

In recent history, conservatism and mysticism were strengthened and encouraged by the trope created by Captain G Srinivasa Murti, a practicing medical doctor, in a committee formed by the Madras presidency in 1921 under the chairmanship of Muhammad Usman in the matter of discernment. and promoting indigenous medical systems. Although modern Western science uses external aids such as microscopes, telescopes, spectroscopes, etc. to understand things beyond the senses, he asserted that Hindu philosophers “were they want to produce the same results, not by giving their minds to the outside. aids, but by developing their inner senses”.

“The general reluctance of modern Ayurvedic doctors to question the wisdom expressed in the ancient Samhitas contradicts the teachings of the sages of ancient India who preferred to do so. Pratyaksha (direct evidence), Accept (trivial evidence), and yukti (logic) more shabda pramana (text reports)” says Subhash C Lakhotia, professor of cytogenetics at Banaras Hindu University and a pioneer in using the drosophila model to study Ayurvedic biology.

West and East

Not everyone prays to God to reject scientific analysis; others hide behind cultural affiliation. They argue that ‘allopathy’ is based on Western science and that Ayurveda is an academically different but still practical body of knowledge, which can only be validated by applying Ayurvedic thinking and methods.

According to Ayurvedic physiology and anatomy, thank you (semen) is formed in the majja (bone marrow), and urine is formed without the involvement of the kidneys. The text goes on to say that the union of sperm and menstrual blood results in the creation of a newly conceived baby. All these contradict each other’Pratyaksha‘, and can these be accepted as alternative ‘ways of seeing’?

Kishor Patwardhan, a body of action A professor of Ayurveda at Banaras Hindu University, he explains that the epistemology of Ayurveda is consistent with the Nyaya Vaisheshika schools of thought, which are similar to modern science but use simple tools. “In ancient times, Pratyaksha it meant using the senses to acquire knowledge; today, we use tools like microscopes for the same purpose”, he says.

Clinical trials

Randomized Control Trials (RCTs) are the gold standard for clinical trials that evaluate the effectiveness of medications. Allopathy offers the same treatment for two people with the same diagnostic tests.

However, Ayurvedic treatment is based on the principle (prakriti, agni, I’m sorryand so on). Because of its complexity, including multiple medications, mid-course adjustments, treatment regimens, dietary restrictions, and lifestyle changes, RCTs seem impractical for clinical trials. of Ayurvedic. Others argue that only case studies from the experience of Ayurvedic medical practitioners can be effective.

However, the situation does not end with hope. Recently, treatment based on methotrexate was compared with Ayurvedic intervention in patients with radiological symptoms of rheumatoid arthritis, proving that there are double-blind, placebo-controlled trials even and for individual treatment. If there’s a will, there’s a way.

The elephant in the room

It is often argued that modern science provides a second step in the treatment of ancient medical practices. But this is not so. Inspired by former President of the Indian National Science Academy, MS Valiathan’s eloquent speech on Ayurveda and modern medicine, Naveen Khanna and his team at the International Institute of Genetic Engineering and Biotechnology (ICGEB) discovered an antiviral drug against all four types of dengue. , after reviewing Ayurvedic literature. After years of research, they found that the botanical extract of Cissampelos pareira Linn (Cipa) was effective against dengue both in vitro and in animals. Human clinical trials are ongoing.

Similarly, researchers at CSIR-Indian Institute of Integrative Medicine in Jammu isolated Sinococuline, a bioactive constituent of Cocculus hirsutus, which has potent anti-dengue activity, and discovered IIIM-290 , a botanical medicine with anti-cancer properties.

China invests large amounts of government funds in modernizing old medicines using current evidence standards, accepting effective treatments while rejecting ineffective ones. In India, we don’t have money and unequivocal commitment to proof.

A mysterious aura, a critical barrier

Sushruta asserts that medical measures can be trusted not only because they work in his own experience (Pratyaksha / phaladarshana) but only because they have been reasonably evaluated by the professional community. He requires what is now known as rigorous peer review before applications are accepted. It is clear that case studies cannot replace well-designed clinical trials to assess efficacy and assess the pathophysiology of disorders.

Naturally, ancient medical texts from centuries past have inaccurate anatomy and physiology, with outdated concepts of pathophysiology and aetiology. However, scholars often claim that they were revealed by God and do nothing to update or change this knowledge. Discovering the biological basis of this trove of knowledge can benefit both the Indian system of Medicine and biology.

(The author acknowledges Krishna GL, especially in his paper ‘Ayurveda waits for a new dawn’, for commenting on the philosophical and theoretical aspects of Ayurveda)