Interactive session on Contemporary Ayurveda

(This article is based on interactive session with Padma Shree Prof.R.H.Singh on July 11, 2021.)

An online interactive session was organized by Charak Samhita Research, Training and Skill Development Centre (CSRTSDC), I.T.R.A, Jamnagar. Padma Shree Prof.R.H.Singh, lifetime Distinguished Professor from Banaras Hindu University, Varanasi guided in the session on current important issues of Ayurveda and healthcare field. Dr.Gopal Basisht, senior rheumatologist and project director, Charak Samhita New Edition Project, Orlando, USA presided over the session. Prof.S.K.Sharma Khandel, Director, ArogyaLaxmi, Jaipur and Prof.G.S.Tomar, President, Vishva Ayurveda Mission, Prayagraj actively participated in the session. The session was moderated by Dr.Yogesh Deole, Project Co-ordinator, Charak Samhita New Edition Project. Prof.R.H.Singh guided on following issues.

Q 1. Which are the unexplored areas of Ayurveda? Please share your expert views on current research in Ayurveda.

Answer: There are many things which are unexplored in Ayurveda. However, as per my experience the following are more important things to be explored. Number 1 is classical Ayurvedic pharmacology. Rasa, Guna, Veerya, Vipaka, Prabhava were the methods of drug testing in ancient times. They are not used nowadays. The reason is they have not been formatted or updated in current views. Most of the research done today, is done by modern pharmacological methods. The result goes in the favour of modern medicine, not Ayurveda. Ayurveda is not becoming strong by research. This is one thing that affects to me.

Similarly, the clinical Ayurvedic methodology, which is so nicely described in Ayurveda in the form of roga pariksha, rogi pariksha, prakriti, vikriti etc. These can be developed in a practical way, so that the Ayurvedic diagnostics can be used effectively. This is not happening. Probably the reason is that it has not been clearly updated and brought in the form of contemporary tools. And therefore, most of the practitioners of Ayurveda, do modern diagnosis and Ayurveda treatment. This was a situation in 1958, when Udupa committee commented on that. Things have not changed since then. They have become worse, I would say. This needs more work and to be re-examined.

Third thing that is important is the Tridosha theory of Ayurveda itself. Lot of research has been done on dosha prakriti, lots of clinical methods have been developed. But what is actually Vata, Pitta and Kapha, we do not know. Clearly, they are to be known. I consider the tridosha as a kind of formula or a conceptual construct to explain triangular physiology. Why there is a need to have a triangular physiology? It is because the whole globe, according to Ayurveda is (regulated by) triangular forces. The three important powers of nature are The Sun, water and the air. Similarly, the three natural powers are present in our body in the form of three dosha. The Sun in the globe is the Pitta of our body; the air in the globe is Vata of our body, and the water of the globe is Kapha of our body. It is something like that. Probably this was the purpose to copy the nature into the biology. Therefore, tridosha theory was evolved. This is according to my thinking. Otherwise, Vata, Pitta and Kapha are nothing but just a formula. This is what looks to me.

The next part of your question is about current research. What is the situation of current research? I classify current research into three categories.

I. Literary research

II. Clinical research

III. Drug research

The literary research is very successful. All the Sanskrit classical texts are translated in Hindi, or Indian languages or in English. Very powerful commentaries are written on Brihat-trayees, like Chakrapani on Charak Samhita, Dalhana on Sushruta Samhita. These commentators have made commendable contributions in expanding that knowledge and trying to make it more contemporary. So, I should say that out of all researches, that we think we are doing, literary research is succeeded. This is my view. I wish to add, in the same sequence of literary research, the work of Dr.Gopal Basisht is very important. The Charak Samhita New Edition is in the same line of ancient tradition of literary research. So, I congratulate his team for doing very important work.

Q 2. Nowadays we have a discussion on unified healthcare system in India. How can we connect or bridge fundamental concepts of Ayurveda with contemporary basic sciences? Please explain with an example.

Ans: This needs a rigours integrative approach. Integrative means the modern medicine and Ayurvedic medicine have come closer, sincerely closer. Not only closer, sincerely closer. Then only it can happen. I will give an example of a small experiment done at B.H.U. years ago on dosha prakriti. We selected 100 normal healthy volunteers. Their prakriti was decided by a panel of experts. Their blood samples were taken to assess acetylcholine, catecholamines and histamine, the three important neurohumors. It was observed that those who had vata prakriti, higher levels of acetylcholine were observed. Those, who had pitta prakriti, higher levels of catecholamines were observed. And, those who had kapha prakriti, they had higher histamine levels. This was a small experiment. It can be an example of how we can link ancient Ayurveda with modern knowledge.

3. Technological advances in medical field have helped us in precise diagnosis. Please share your views on the importance of pathological, biochemical, radiological investigations in contemporary Ayurvedic practice? As they add on the healthcare cost in Ayurveda practice, can we avoid them?

Ans: If you prescribe the investigations, it will definitely add to the healthcare cost. When I practiced, I never prescribed any investigation. Off course, I observed all the reports, patient brought to me. Because, the patient was treated by many other doctors and they had a lot of reports with them. With our integrative training approach, we can use them, interpret them. This is what I view. It is better to avoid them, as it overloads the patient. The treatment of Ayurveda has to be cost effective, then only the patient will come to you. Otherwise, why they shall come to you? So, as far as possible avoid the investigations to reduce healthcare cost in Ayurveda practice.

4. Please share your expert views on management of emergency medical conditions through Ayurveda. Can Ayurveda prevent or minimize use of emergency drugs or antibiotics?

Ans: I will advise not to take emergency cases in Ayurveda. Because Ayurveda is not emergency medicine. It Is for chronic disease management. The best is to avoid or prevent emergency conditions. One help we can give is rasayana therapy. Even in emergency cases, if we give rasayana, it promotes immunity and recovery as well. This is all the help we can provide. In my practice, I always prescribed amalaki rasayana with a cup of turmeric milk every day in addition to our prescription. This definitely helps. This is all that can be done. The emergency management, we shall not handle.

5. Sir, as you have served more than 50 years as a teacher, we will be happy to listen about what are the tools or teaching methodology techniques to teach Ayurveda to non-ayurvedic medical students? How can we make Ayurveda simpler for a newcomer? What are the hurdles and solutions?

Ans: When I was teaching in B.H.U., there was a course for allopathic students (M.B.B.S.) to do M.D. in Ayurveda. If we teach them with a lot of integration, or examples of correlation , it doesn’t develop interest in learning Ayurveda. They are more interested in learning what actually Ayurveda is? I will suggest to teach them Ayurveda as it is, rather than comparing other things which is not successful. So let us teach them Ayurveda as it is, so that they can understand triangular nature of physiology through vata, pitta and kapha. They shall understand what is panchamahabhuta? They understand why tridosha theory was brought in, when panchamahabhuta theory was already there. What is the need of talking of tridosha? Many people now say that tridosha are not understood. It is easier to explain the panchamahabhuta relations. All these singular things shall be taught to them. So that they can judge themselves, that is what is new in Ayurveda. It is their judgement about what to take from Ayurveda. We have to improve their judgement, not to teach them. Because they are already doctors, they understand.

Dr.Basisht: I practiced modern medicine for fifty years. And I found that our mindset is about disease management. It is just focusing on disease management “if you remove the disease, the person becomes healthy”. This may not be the newer definition, that is there, but this is the mindset of us all who go into modern medicine. On the other hand, Ayurveda looks at the whole environment and the things that can affect the person. And this is a major problem. Because of the mindset, it is very difficult to change mindset of modern medicine persons. Diseases are continuously increasing. We continue to find newer treatments for better outcome. We have not placed any significance to what are the factors which keep people healthy. While I was looking at various systems, I found, this (Ayurveda) is the only system in the world, which has described the components of health, that can be taken care of by a practicing physician. If you look at the WHO definition of health, it says that physical, mental and social wellbeing and not just absence of diseases is health. With knowledge of this definition, if I sit in the office to advise the patient, then it can’t be followed. But, if we understand the definition of health in Ayurveda, describing equilibrium of dosha, agni, dhatu and mala, Prasanna atma, indriya mana. We focus on five factors which have been described and specifically start taking care of people, which helps overall and should be much more effective. And it is. This is what I saw. When I was practicing, I used to give modern medicines, but I advised patients about doing meditation, yogic exercise and diet. And what I started to find was that those patients who followed this advice felt better and their requirement for drugs started to come down gradually and many of them were able to get off the medications. This is how I very strongly feel that the current modern medical system is very deficient and diseases will continue to increase, unless Ayurvedic principles are included there.

6. How can we improve the acceptance of Ayurveda in society? Please share your views on the current status of Ayurveda in the healthcare field. Ans.: I think in a very practical way, we need a quality cost effective medicine. This is lacking today. The patient don’t get sufficient amount of cost effective quality Ayuvedic drugs. There is a need of repeated refresher training of a practitioner to develop a kind of scientific temper in their work. This is seriously lacking. Similarly, the work culture has to be improved. It will be more accepted in the society. I should say that the overall situation of Ayurveda is not satisfactory, nothing more than that.

7. What can be done to improve the situation? What can we do? What are the expectations? Ans: Education is in very bad state which has to improve. The hospitals have to be improved. Mushroom growth of Ayurveda colleges shall be stopped. There shall be quality Ayurveda colleges to produce quality Ayurveda graduates. We can not depend only on the Government. The Government is doing what it can do. It has nothing to do. It is we who are supposed to do. Then and then only the things will change gradually.

8. What is your message to the younger generation? How they can improve their selves and be passionate towards Ayurveda? What do you suggest them to be ideal disciples?

Ans: I suggest them at first that once they adopt Ayurveda as a student, they should really become student of Ayurveda and follow it. They have double mind. Because, they have not come to Ayurvedic college as their first choice. Their first choice was something else. This is the main problem. They should work up on this complex. They should study Ayurveda sincerely and wholeheartedly. This is what I would like to say. 9. One nation one medicine policy is suggested by the government. In that policy, Ayurveda has been included as a preventive medicine only. However, Ayurveda has principles of management of disease too. What are your views on this? Ans: One nation one medicine policy is a wrong notion. It can never happen. India has six official healthcare systems. How can we have only healthcare system? We shall negate the policy.

Prof.Khandel: Our basic problems are visible. We are not producing Vaidya or physicians. We are producing teachers. The reason behind this as you said is poverty of our hospitals. The hospitals attached to colleges are not very sophisticated. That’s why we are unable to deliver good clinical training.

The second thing is that our concepts are very powerful and strong. However, the language used by teachers to clarify them is not very good. The students are confused till the end of course. They ultimately develop disease centric approach. They do not follow patient centric approach. Unfortunately, we miss the strength of Ayurveda and follow the same line as modern medicine does. The cosmic connection is not well understood to the students. Therefore, the health and hygiene, which is a strong subject of Ayurveda has been reduced to a smaller topic in education system. The drug research favours modern medicine.

However, there is new trend in new Ayurveda scholars, that they are willing to practice concept-based Ayurveda. There are various gurukula in India, which propagate concept-based practices.

The one nation one health policy can be a threat to Ayurveda and it might lose its importance by becoming a small chapter in healthcare system. There is need to strengthen Ayurveda institutes and cater the global demand of quality delivery of Ayurveda.

Link to access the online session: https://www.facebook.com/csrtsdc

Contact: csrtsdc@gmail.com