Let ayurveda flourish freely
In the first week of July, Banaras Hindu University (BHU) hosted a national seminar on various aspects of the New Education Policy (NEP). The policy suggests wide-ranging reforms in the current education system, including the teaching of medicine. One of the several ideas proposed is the promotion of ‘pluralistic choices in healthcare’ and making health education ‘integrative’. It has been suggested that all students of allopathic medical education must have a basic understanding of Indian systems of medicine like ayurveda and vice versa. While NEP, with all such provisions, is being discussed, some disconcerting voices have emerged about the current ayurvedic curriculum. In a confessional article in the Indian Journal of Medical Ethics, a professor of ayurvedic physiology from BHU has pointed to serious flaws in ayurvedic teaching in India. The article by Kishor Patwardhan has raised eyebrows because he is a reputed ayurveda researcher and the author of popular textbooks on ayurvedic physiology.
The methodology of rationalising whatever is contained in ancient texts is being used by ideological and political supporters of ayurveda to claim its supremacy.
The discipline of ayurveda is based on the ancient text, Charak Samhita, and its interpretations by Sushrut and Vagbhat. From time to time, commentators and scholars have interpreted and rewritten these texts. In recent centuries, these texts have been reinterpreted in the light of new knowledge emerging in anatomy, physiology, pathology, biochemistry, microbiology etc. The objective of such interpretations was always to conclude that ayurvedic knowledge and contemporary medical concepts are similar or the same. The effort is to validate or rationalise ancient knowledge through the lens of modern discoveries. Patwardhan did the same as a teacher of ayurveda and writer of textbooks. He confesses that he ‘consciously selected the most rational versions of ancient aphorisms to make them appear relevant’ in modern times. Now, he says that his approach to justifying obsolete ideas is wrong, though he himself did so while teaching students and writing textbooks.
For example, ayurvedic scriptures — as taught to students of BAMS (Bachelor of Ayurvedic Medicine and Surgery) — say that semen (shukra) is formed in bone marrow (majja) and flows through blood in the entire body. To justify this statement, modern textbooks make a conjecture that shukra could be of two types — one that means semen and the other could be a substance present in the entire body such as a reproductive hormone. Another example Patwardhan cites is the role of kidneys in urine formation. While there is no hard evidence that ancient Indians knew the physiology of urine formation, reinterpretations were made to believe they did so. Such laboured reinterpretations of ancient texts continue as new concepts and theories emerge — reinforcing the popular notion that not only the ancient Indians knew everything but also were ahead of their times. What is worrying is that such irrational and unscientific interpretations are part of textbooks taught in hundreds of ayurvedic colleges around the country.
The controversy about excess amounts of heavy metals like mercury and cadmium in certain ayurvedic formulations brought many ayurvedic products under the scanner in the US and Europe. Instead of taking an evidence-based approach, the proponents of ayurveda resorted to rationalising texts using modern concepts. They said the bhasma concept in ayurveda was akin to modern-day nano-medicine. Ayurveda was thus ahead of modern science. Heavy metal presence in medicines continues to be a major issue, with several cases of severe liver injury being reported. A liver specialist from Kerala, Cyriac Abby Philips, regularly reports such cases in scientific journals and is trolled for highlighting toxicity caused due to ayurvedic formulations. In a tweet, he quoted a sloka from Astanga Hrdayam: ‘a dead black serpent and four scorpions (killed) are put in a pot of milk and kept undisturbed for three weeks. Afterwards, it is churned and butter obtained and fed to a cock. The excreta of that cock is collected, powdered well and used as a collyrium; by this even a blind man will be able to see.’ All this is part of the syllabus for ayurvedic courses.
The methodology of rationalising whatever is contained in ancient texts is being used by ideological and political supporters of ayurveda to claim its supremacy. Scientific departments are funding projects to find the ‘scientific basis’ of claims made in the texts, be it cow urine or the tridosha theory. The government does not want to allow a critical assessment of the ancient systems. It wants to project ancient knowledge as practical, modern and scientific. Government health agencies went out of their way to promote ayurvedic management of Covid-19 and supported unscientific claims made by some ayurvedic companies close to the ruling dispensation. A journalist in Manipur was jailed for questioning the use of cow urine to ward off Covid. Instead of taking note of heavy metal toxicity, the Central ministry of Ayush has accused Philips of denigrating the ancient medicine system. The ministry and ayurveda purists may do the same with Patwardhan.
A critical appraisal is necessary. Ayurvedic medicines need to be subjected to the same regulatory rigour of clinical trials for toxicity, safety and efficacy, as new allopathic drugs. Only qualified practitioners should be allowed to practise medicine, and manufacturers of the Indian system of medicines should be subjected to standard norms of manufacturing, quality, labelling and marketing set for modern medicine. The NEP offers an opportunity to the National Commission for the Indian System of Medicine to review the syllabus of ayurvedic courses. Let ayurveda flourish as a system of medicine free from ideological clutches.
