Ayurveda, India’s traditional medicine, has been in practice for close to three millennia. Even today, this ancient system serves the health-care needs of millions of Indians. The adaptation of a traditional knowledge-system for current use comes with its challenges, which, if dealt with lackadaisically, can endanger the welfare of its users. A few challenges that the Ayurveda establishment has for long failed to skilfully address are discussed here.
Speculations versus facts
Ayurveda’s ancient treatises, for obvious reasons, cannot be expected to retain relevance in their entirety. They contain useful portions alongside obsolete ones. Therefore, a dispassionate sifting through their contents is a prerequisite for their prudent practical use. Valuable observations relating to health promotion and illness management need to be carefully sifted from outdated theories, implausible conjectures, and socio-religious superstitions.
An example would make this point clear. While documenting its observations on the benefits of physical exercise, an Ayurveda classic notes: “A sense of ease, improved fitness, easy digestion, ideal body-weight, and handsomeness of bodily features are the benefits that would accrue from regular exercise.” These observations are as valid today as they were 1,500 years ago when they were first documented. But, such continued validity cannot be claimed for the physiological and pathological conjectures the same text contains.
On urine formation, for instance, the text posits that tiny ducts from the intestines carry urine to fill the bladder. This simplistic scheme of urine formation has no role for the kidneys at all. Needless to say, this very outdated idea can have no place in current medical education except as an anecdote from history. Placing such conjectural ideas side by side with modern physiology and implicitly equalising the truth value of both is a serious malaise that has been plaguing the current approach to Ayurveda. Teachers of Ayurveda physiology have the unenviable job of constantly grappling with the difficulty of reconciling ancient speculations with established scientific facts.
Two main factors — one theoretical and the other epistemological — have led to this sad situation. The tridosha theory of Ayurveda is a rough-and-ready model that the ancients devised to systematise their medical experience. Clinical features of illnesses and therapeutic measures to manage them were all classified on the basis of this heuristic model. In the absence of a cogent understanding of the biological processes underlying health and illness, speculations on these topics were also woven around the same model. The theory thus has aspects that are heuristically tenable alongside those that are merely conjectural. Recasting the theory in a way that retains the relevant aspects while jettisoning the obsolete parts is a priority area in Ayurvedic research. The research centres under the Ministry of AYUSH (Ayurveda, Yoga and naturopathy, Unani, Siddha, and Homeopathy) have remained oblivious to this important work and their omissions have resulted in retaining the theory, lock, stock, and barrel. Consequently, outdated pathophysiological conjectures have become fossilised in the current approach to the subject.
The other factor that has been instrumental in choking the renewal of Ayurveda is the widespread belief among its academics that ancient texts, by virtue of their being divined by sages in deep yogic states, retain timeless relevance. This notion of epistemic superiority has its roots in the hugely influential memorandum on the Science and Art of Indian Medicine authored by G. Srinivasa Murti. The memorandum formed part of two reports: of the Usman Committee (1923) and later, of the Chopra Committee (1948). The flawed idea, antithetical to the yukti-vyapashraya (reason-based) character of classical ayurveda, has kept the field from demystifying its theories and achieving the reforms long overdue. In short, the belief in epistemic superiority has dethroned ancient medical writings from being revisable scientific treatises into being dogmatic scriptures.
A century ago, P.S. Varier of the Arya Vaidya Sala Kottakkal noted that the “Sareerasthana (section on body structure and function in the Ayurvedic classics) must firstly be revised and made clearer and the remaining parts must be suited to it (sic). Secondly, after this, the other important works should also be corrected. Necessary additions must be made either by translations or by collaboration with experts in portions still deficient.” Ironically, Varier’s submission also forms part of the Usman Committee report alluded to earlier. His suggestions though appear to have fallen on deaf ears. More recently, scholars such as Debiprasad Chattopadhyaya and Priyavrat Sharma have also drawn attention to the myth of epistemic superiority that has rendered Ayurveda texts non-revisable. But the Ayurveda establishment and its research centres have stayed intellectually inept to address the issue. What can enhanced funding do in a field that lacks a vibrant intellectual resource?
A renewed plea to reform
A recent article in the Indian Journal of Medical Ethics has renewed the plea to reform and update Ayurveda. Titled “Confessions of an Ayurveda Professor”, the article is authored by Kishor Patwardhan, a faculty member of Banaras Hindu University, Varanasi. Prof. Patwardhan has candidly admitted that the anatomy and physiology contained in the Ayurvedic classics is mostly outdated and that the official approach to this subject is misguided. He has also disclosed the ecosystem-influences that made him adopt a wrong approach to the subject and the ill-effects this approach has had. While implicitly retracting his book Human Physiology in Ayurveda, he has called for a thorough change in the curriculum.
This article also points out the flawed approach of making ancient concepts sound relevant by super-imposing current scientific findings upon them. In addition to resulting in a travesty of truth, such misinterpretations in a practical field such as Ayurveda carry the risk of leading to dangerously wrong clinical choices. While petitioning for a scientific scrutiny of Ayurveda’s foundational theories, the professor hopes that Ayurveda students get to unreservedly study current anatomy and physiology.
The basic truth
The Ministry of AYUSH must wake up and take cognisance of the points made here. Academics drawing handsome salaries from government-run AYUSH institutes need to see how sinful it is to hand over an unprocessed proto-science to gullible youngsters and then mislead them into believing that it is a super-sophisticated advanced science. As a medical system, Ayurveda is valuable immensely for its observations, only marginally for its theories, and not at all for its speculations. The sooner the establishment comes to terms with this basic truth, the better.
G.L. Krishna is an Ayurveda physician and Homi Bhabha Fellow. He is also a visiting scholar at the Indian Institute of Science, Bengaluru. E-mail: firstname.lastname@example.org