In the thought-provoking editorial entitled “Extending Ayurveda further…. thinking beyond the possibilities” published in AYU, Vol.32, April-June 2011 issue, the Executive Editor has raised several key questions:
As many as 1200 Ayurvedic post-graduates pass their examination each year and enter into the streamline of academics and practice. Why is it that the least of them choose their profession as research in Ayurveda?
Why does Ayurveda not get as much importance as modern medicine in its own birthplace – India? Why is this ancient wisdom lagging behind, despite having tremendous potential to treat diseases successfully? Has this science remained at a superficial level?
Very few organizations have well-established research infrastructure for exclusive research in Ayurveda. Why? What kind of modern technology is required in order to conduct proper research in Ayurveda?
Are Ayurvedic scholars clear about their views for an Ayurvedic future?
In order to address these questions, we must first ask ourselves the following questions: “What is the core competency of Ayurveda?” and “What is the fundamental thinking behind this ancient system of medicine?”
According to Ayurveda, the definition of health is a state in which the tridosha, metabolic fires, body tissues, and components, and all the physiological processes are in perfect unison, and the sense organs, mind, and soul are in a state of total satisfaction and content. In Ayurveda, the primary goal is to make the body strong so that it can fight disease. Essentially, Ayurvedic practice is based upon two questions: (1) Why does disease not occur? (2) How can the health of an individual be protected, enhanced, and the body be rejuvenated? On the other hand, modern medicine is based upon the opposite questions: (1) Why and how does disease occur? (2) How can it be removed? Based on these questions, it is clear that Ayurveda is based on defense thinking, whereas modern medicine is based on offense thinking. This phenomenon of offense and defense can be seen in all aspects of life associated with competition and survival. In a war, there must be strong defense to protect the soldiers and territory and strong offense to fight the enemy. In a human relationship, like a man and a woman, there must be an understanding of the two different thought processes for a harmonious married life. An awareness of the presence of this dualism in all aspects of our lives will help people to live better.
So, why should the fight against disease be any different? We cannot fight with only one strategy. We need both an offense and defense strategy to win the war against disease. The key is to use the appropriate strategy at the appropriate time.
Let us look at a historical example. During India's independence movement, Gandhiji wanted to obtain Swaraj, which he achieved by using a defense strategy of civil disobedience. On the other hand, Netaji and his associates wanted to expel the British with the use of a strong offense strategy of force. However, because Gandhiji used the most appropriate tool at the appropriate time, the objective was achieved and has since been repeated in various countries.
With two different types of thinking, there should also be different tools and procedures that correspond to each philosophy. However, currently in medicine, this is not the case. Modern medicine is progressing with leaps and bounds due to its appropriate tools and procedures, whereas the Ayurvedic community, using modern medicine's tools and procedures, continues to lag behind. The Ayurvedic community must develop its own tools and procedures to achieve any progress.
Unless we understand this fundamental difference between offense and defense thinking and left-brain and right-brain thinking, and understand Ayurveda's shortcomings, the system will continue to lag behind.
Ayurvedic Involvement in the “Human Epigenome Project”
The human genome project was an extensive project that lasted for 13 years. It continues to stimulate researchers to find answers to questions raised about the understanding of biological systems.
Over the last 20 years, scientists have found that epigenes can cause functionally relevant modifications to the genome that do not involve a change in the nucleotide sequence. These changes can remain throughout the life of the cell and may last for several generations. Moreover, environmental factors influence epigenes and can help suppress or stimulate genes. Ayurveda has extensive knowledge in terms of lifestyle, diet, detoxification, and rejuvenation treatments that can suppress the bad genes and stimulate the good genes.
Essentially, the human genome functions as the hardware for the computer and the epigenome is the software. Indians have avidly participated in the information technology revolution, and now is the time for Ayurveda to participate in epigenome research, which can potentially turn into the largest healthcare research project in the world. Participating in research that is so relevant in today's society will help Ayurveda to become more of a “mainstream” system of medicine. Should leaders in the Ayurvedic community get together and deliberate on these observations and develop a strategy to participate in epigenome research?
Now let us revisit the questions discussed earlier.
As many as 1200 Ayurvedic post-graduates pass their examination each year and enter into the streamline of academics and practice. Why is it that the least of them choose their profession as research in Ayurveda?
Each year, 1200–2000 post-graduate students complete their education and the majority of them join the teaching faculty at various Ayurvedic colleges. As post-graduate students, they write a thesis as a passport to their degree. Generally, this thesis or research project is focused on finding the effect of a particular herbal medicine or another subject that is not relevant enough to be used in clinical practice or research. As these young Ayurvedic physicians begin the transition from student to professionals, they lose their connection to their research due to the lack of emotional attachment and relevance to clinical practice, and they abandon any possibility of a career in research. If students could participate as junior researchers alongside an expert faculty member to rewrite Charak Samhita and other Ayurvedic texts – considering that Ayurvedic texts have two components: “Tattwa,” the scientific fact, which does not change, and “Vidhi,” the relevance to the present conditions – these new editions will update the practice of Ayurveda to current standards and provide insights for future research. Moreover, rewriting these ancient texts will also motivate young graduates to pursue careers in research after taking part in such an important project with clinical relevance.
Why is this ancient wisdom lagging behind?
It becomes obvious when you see that most people in the world are left-brain thinkers. They favor modern medicine over Ayurveda because they prefer fast relief from disease, which is better served by modern medicine's “offense strategy.” In order to cater to the needs of these people, the Ayurvedic community is pulling Ayurveda further and further in the direction of modern medicine, leaving Ayurveda's “defense strategy” of health management behind. However, currently the awareness, and thus fear of toxicity to drugs and high cost of healthcare is causing an increasingly large number of people to seek alternatives. Rather than competing and veering toward the “offense” strategy of modern medicine, the Ayurvedic community should work to enhance the core competency of the “defense” strategy of Ayurveda.
Very few organizations have well-established research infrastructure for exclusive research in Ayurveda. Why? What kind of modern technology is required in order to conduct proper research in Ayurveda?
Once the Ayurvedic “Vidhis” are clearly defined, various forms of technology will be needed. Taking into account the epistemology of Ayurveda, with the help of basic scientists, a new method of research that employs technology specific to Ayurveda can be developed. It is important not to underestimate the genius of humans – especially Indians – to develop the technology needed to prove these concepts.
Are Ayurvedic scholars clear about their views on the future of Ayurveda and the need for scientific data?
According to certain renowned Ayurvedic experts, the answer is no; they are confused and unclear about their views. Thus, Ayurvedic scholars must come together and communicate their ideas on the future of Ayurveda to establish a single, cohesive, and articulate vision based upon the questions raised. Once this vision is communicated, the field of Ayurveda will progress with leaps and bounds.
The market economy is a strong driving force. This has worked for Ayurveda in a limited sector of herbal, beauty, and skincare products. To successfully bring Ayurveda to the forefront of healthcare, there must be a driving economic force and commercial interest. This driving force is the core incompetency of modern medicine – prevention. The Symbiohealth project is designed to achieve this objective where the core competency of Ayurveda –prevention is clubbed in such a way to make a healthcare system that is more effective than either system alone, less expensive and toxic than modern medicine, and creates a healthier society. The suggestions given above will facilitate the marketing of Ayurveda.
How to go about it?
The project envisaged above must be brainstormed by a group of activists in relevant fields that may comprise a few senior Ayurvedists/professionals, Sanskrit scholars, linguistic experts, biomedical scientists, and basic scientists.
The following steps should then be taken:
Identification of a working group
Brainstorming sessions
Compilation of the project
Locating a funding agency for support
Work distribution
Creating prototype centers with the above concept
Monitoring the progress and quality of work
Former union secretary in her excellent report on the “status of Indian Medicine and folk healing, with a focus on the benefits that the systems have given the public,” published in AYU, Vol. 32, July – Sept 2011, noted:
“When questionnaires were issued to over 200 Ayurveda, Yoga and Naturopathy, Unani, Siddha, Homeopathy (AYUSH) colleges throughout the country, the responses showed that nearly 80% of the respondents were emphatic that when the public demands that Ayurveda practitioners prescribe allopathic medicines, the practitioner has necessarily to accede to public demand. Several state governments like Maharashtra, Punjab, Tamilnadu, Assam and Himachal Pradesh, among others, have explicitly permitted the Ayurveda, Siddha, and Unani (ASU) practitioner to prescribe allopathic drugs and conduct interventions undertaken in hospital settings. The report describes these ground realities, but goes on to highlight how this is detracting from the standing and intrinsic value of traditional medicine”.
What message are the people of India giving us? Is this a “detraction from the standing and intrinsic value of traditional medicine” or our lack of understanding of the core competency of Ayurveda? People are screaming, “Please kill with a sword and not with a shield.” The Chinese have understood the core competency of acupuncture and promoted it well. Should we do the same?
Whether this will happen depends upon destiny; but on the other hand, “Karma” creates destiny. Will leaders of the Ayurvedic community accept this challenge?