|Year : 2014 | Volume
| Issue : 3 | Page : 219-220
Watermark of original Ayurveda: Is it fading away in current clinical practice and research?
Executive Editor - AYU, IPGT and RA, Gujarat Ayurved University, Jamnagar, Gujarat, India
|Date of Web Publication||20-Mar-2015|
Executive Editor - AYU, IPGT and RA, Gujarat Ayurved University, Jamnagar, Gujarat
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nishteswar K. Watermark of original Ayurveda: Is it fading away in current clinical practice and research?. AYU 2014;35:219-20
Enlightened ancient teachers of Ayurveda initiated to document their observations with a motto, that is, the quest for longevity by adopting three principles viz., etiology (Hetujnana), symptomatology (Lingajnana), and knowledge of therapeutics (Oushadhajnana). Chakrapani learned the commentator of Charaka samhita interprets that disease and health are also regarded as symptoms/signs, and it is true as Ayurveda described signs of good health as well as diseased conditions.  Health as well as disease depend on proper functioning of Agni and balance of Dosha (physical and psychological).
In Ayurvedic treatise, the concept of Agni is given utmost importance with regard to diagnostic and therapeutic procedures. In the common language, the term Agni means fire. In physicochemical, bio-physical and bio-chemical sequences, this term does not actually mean fire. It comprehends various factors, which participate in and direct the course of digestion and metabolism in physiologically functioning organisms. Jatharagni (a factor located in intestine) represents the substance concerned with chemical processes involved in digestion of foods and drugs that takes place in the gastro-intestinal tract, while more complex biochemical reactions of absorbed substances (both aerobic and anaerobic) which are due to enzymes and hormones represented by word "Dhatvagni" (factor that residing in various tissues and initiate metabolic processes). Hypo-function of Agni is considered as the prime etiological factor along with vitiation of Tridoshas (bio-humors namely Vata, Pitta and Kapha) for most of the diseases. Modern medical scientists may not accept this concept in case of infectious diseases as they made scalpel sharp observations and identified microbes (bacteria or virus or parasite) which engender such conditions. In the context of noncommunicable diseases and metabolic disorders, the role of Agni cannot be undermined.
Tridoshas which form the pivot round which every aspect of Ayurveda rotates have been equated to humeral concept of ancient, such as Galen, Hippocrates, and rest, is considered as an obsolete doctrine according to perspective of modern medicine. Some opine that Tridosha theory is borrowed from humoral theory of west. P.C. Ray observes that "Such views are advanced by critics who represent a school, which cannot and will not see anything in India which can claim originality or authority." Prof. C. Dwarakanath attempted to explain Tridoshas from modern physiological properties viz. Vata represents the functions attributed to the nervous system; Pitta activities resemble with the activities of enzymes and hormones, and Kapha refers to the activities of skeletal and anabolic systems. In mid-seventies, some attempts were made to interpret the functions of Tridoshas from neuro-humoral perspectives by equating the functions of acetylcholine, catecholamine and histamine with Vata, Pitta and Kapha, respectively. In Ayurveda pathogenesis of each and every disease is explained by vitiation of Tridoshas whereas the hyper or hyposecretion of these neuro-humors acts as specific etiological factors only for certain diseases and hence the interpretation fails to represent Tridoshas in their entirety.
The concept of Prakritii (consitution) is also given due importance while prescribing the treatment. Prakriti (substance or the nature of the individual) corresponds to the temperament or personality. It is defined as "the integrated organization of all the psychological, intellectual, emotional and physical characteristics of an individual, and it is determining factor for the attitude of the individual. It largely determines the individual's life activities in health and disease. Modern scientist identified that the gene in the reproductive cell of the parents determine the traits of the individual and it is equally true that the environment, diet, habits, upgrading, etc., which contribute a great deal, either to actualize these potentialities/traits or keep them dormant.
Among the modern theories of constitution, "Type A" individuals are described as ambitious, rigidly organized, highly status-conscious, sensitive, impatient take on more than they can handle, want other people to get to the point, anxious, proactive, and concerned with time management. People with Type A personalities are often high-achieving "workaholics" who with multi-tasks, push themselves with deadlines and hate both delays and ambivalence. It is therefore understood that, Type A personalities usually opt for various addictions for relieving stress. People with Type B personality by definition generally live at a lower stress level and keep on working steadily, enjoying achievement but not becoming stressed when they do not achieve.
Type A subjects are more sensitive to stress and produce a more catecholamine than type B subjects. This, in turn, seems to induce an intracellular Mg loss. In the long run, type A individuals would develop a state of Mg deficiency, which may promote a greater sensitivity to stress and ultimately, lead to the development of cardiovascular problems. These two personalities may represent Vata-Pitta Prakruti (Type A) and Kapha Prakruti (Type B).
During 1978, Alma Ata conference World Health Organization (WHO) recognized certain indigenous systems of medicine under the name traditional system of medicine for achieving the goal "Health for all by 2000 AD." The goal was left unfulfilled, but in this process Ayurveda has successfully drawn the attention of international scientific community.  WHO has started collaborative centers and one of them is established at I.P.G.T. and R.A., Jamnagar.  One can confidently say that, Ayurved is globalized though some intelligent Ayurvedic physicians are trading this medical system in western countries. Ayurvedic herbal extracts, Prakriti assessment, and Panchakarma therapy are chosen as prominent areas to popularize Ayurveda globally. Under the name of scientific herbalism the herbs described in Ayurvedic materia medica are being explored and marketed as herbal medicine  and Panchakarma therapy, centers are reduced to the level of spa centers. It is also observed that most of the foreigner students participating in training program of Ayurveda are non-medical personnel who can satisfy their enthusiasm for adopting Ayurvedic health care practices in their personal life. So far, several research projects have been completed, and hundreds of Ph.D. theses were submitted, but path breaking researches are yet to be recorded. The percentage of reproducibility of research findings can be considered as very minimal. Knowledge deposited in original treatises like Charaka samhita and Sushruta samhita is being kept intact, and so far no additions or modifications were made to it.
Several international conferences, World conferences, and National workshops are being conducted which is a definite sign of scientific research activity, but the quintessence of the researches has failed to reach the general practitioner.
The core doctrine of original Ayurveda such as Panchamahabhuta, Agni, Tridosha, Srotasa, Malas, Prakriti, Principles of drug action (Rasapanchaka) are referred in the discussions of research works by theoretical thread bare analysis since the evaluation is carried out in most of the researches by modern protocols, e.g. AYUSH-64 is only Ayurvedic formulation, which was administered in >4000 cases of Malaria (multi centric clinical trials) and recorded positive observations. In these trials, the mode of action of formulations was explained against varieties of malarial parasites but factors such as Agni, Tridosha, Prakriti were not meticulously evaluated since diagnosis was based on malaria positive cases.
The current clinical practitioners of Ayurveda are opting for Vyadhipratyanika Shamana Chikitsa (disease antagonizing palliative therapy) instead of preferring for Doshapratyanika Chikitsa (therapy to address vitiated Doshas). Charaka opines that a physician, well acquainted with classification of Rasa (taste) of drugs and Doshas (bio-humors), involved in disease seldom commits blunders in ascertaining the etiology, symptomatology and treatment of disease. No attempts have been made so far either to refute the opinion of Charaka or accept it by religiously following it. 
Ayurveda laid down certain guidelines for evaluation of diseases, diseased, drugs along with the flow chart of treatment guidelines in the form of Chikitsasutra. In the current research, no data are available with regard to clinical evaluation of Chikitsasutra of a particular disease on a larger sample. For example, Shodhana is to be prescribed before the commencement of Rasayana therapy. A well-planned clinical study (Double blind) with relevant biochemical indices in addition to hair melanin and nail calcium estimations did not include Shodhana procedure a prerequisite measure Rasayana therapy.
The question is "Who has to bell the cat?" and the answer is the Ayurvedic fraternity has to feel the responsibility to conduct research from true Ayurvedic perspectives without employing intellectual acrobatics. The prime responsibility lies with every Ayurvedic researcher to protect the watermark of the original Ayurveda by recording terse observations in their research with regards to original doctrines of Ayurveda.
Sushruta and Vagbhata furnished a list of conditions, which are difficult to cure under "Ashtamahavadhyis." No attempt has been made so far to modify this list by excluding certain conditions with some inclusions basing on the research studies. Basing on epidemiological data WHO modifies the list of "Top ten killer diseases" and it is a known fact that Ayurvedic research studies are lacking in the documentation of prevalence of diseases described in Ayurvedic texts such as Amplapitta, Raktapitta, Vatarakta, Amavata, Prameha, etc. Such surveys help for identifying the thrust areas of research to modify "Essential Ayurvedic drug list" periodically. A special handbook of information may be compiled consisting of "100 diseases, 100 single drugs recipes and 100 classical formulations" which may help the young Ayurvedic graduates to practice Ayurveda confidently. Treatment modalities from Ayurvedic perspectives for newer diseases such as Chickungunya, Dengue, Swine flu, Congo fevers, hitherto which are not described in Ayurveda are to be drafted to meet the challenges of 21 st century.
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