An Ayurvedic pharmacy in Rishikesh, Uttarakhand. Photo: Ken Wieland/Wikimedia Commons, CC BY-SA 2.0.
In his address to mark Ayurveda Day, on November 13, WHO director-general Dr Tedros Adhanom Ghebreyesus announced the setting up of a ‘Global Centre for Traditional Medicine’ in India. But notwithstanding the Government of India’s elation about Ayurveda’s growing popularity, the fact remains that Ayurveda is widely perceived as a pseudoscience. And this perception is not altogether unfounded.
More than half a century has elapsed since the Central Council for Research in Ayurvedic Sciences was established – and it is still yet to verify or falsify core Ayurvedic theories. Many of these unverified theories continue to inform Ayurvedic practice to this day.
The causes of this sloth in Ayurvedic research are not hard to gauge. The dearth of a vibrant intellectual resource is a major factor impeding research. Ayurveda sadly does not attract good talent for its courses at the graduate and postgraduate levels. Consequently, research establishments that depend on Ayurveda degree-holders manage to get only mediocre workers. And because the government has no major schemes to incentivise talented researchers in related fields to migrate towards Ayurvedic research, the problem of mediocrity becomes amplified.
Also, given that this is a non-international field, reputed research institutes in other parts of the world rarely take any interest in it. The result of all this is only too obvious: Ayurvedic research seems to remain in a state of suspended animation.
This said, the Ayurveda ecosystem is another important impediment to its success. This ecosystem legitimises superstitions and incentivises scientific dullness. Outdated pathophysiological ideas constitute a major portion of training in the current Ayurveda degree course. Ancient medical conjectures like blood acquiring its redness in the stomach or semen originating in the bone-marrow are taught to students at the university level! Even the more recent postgraduate entrance tests unabashedly ask questions about these ‘facts’. Ayurvedic journals also carry articles that build on such tooth-fairy science.
When countered, the ecosystem typically responds by resorting to ludicrous intellectual gymnastics, attempting to extract current scientific information from millennia-old aphorisms. Outdated ideas thus fossilise and ruin the critical thinking faculties of Ayurvedic students.
Why does this happen? It happens because of a dangerous yet ill-recognised ideology that rules the roost in this field. The Ayurvedic establishment believes that core Ayurvedic theories are perfected products by virtue of their being divined by yogis and sages. This illusion of epistemic superiority has rendered Ayurvedic theories unfalsifiable, and unfalsifiable theories in turn cripple experimental design and hamper any straightforward attempts to verify claims grounded in Ayurveda.
When theories are unfalsifiable, practices based on them automatically turn unverifiable. This fear of falsification – disguised as epistemological distinction – has thus intellectually ghettoised Ayurvedic study and has left it oblivious to its true potential.
This problem has two practicable solutions – if only the authorities are capable of strong, radical reform.
First: encourage good scientific minds across disciplines to work on Ayurvedic projects. As a priority, the government must constitute an interdisciplinary committee comprising biologists, medical scientists and Ayurvedic physicians to verify, falsify or modify the Dosha theory. This theory is central to Ayurveda, so unless it is restated to be clearer and more scientifically tenable, experimental studies of Ayurvedic practices are doomed to remain suboptimal and Ayurvedic education itself will stay muddled by outdated ideas.
Second, the state must ensure that the Ayurveda ecosystem gives up its epistemic superstitions and develops the courage and openness to accept falsification, which is a normal process in science. We need a breeze – nay, a tornado – of fresh air to rescue Ayurveda from its current sloth and restore to it its heritage as an enterprising discipline of enquiry in its own right.
And this tornado cannot come merely by enhanced funding, jingoism and publicity. It needs an ideological catharsis, an intellectual reinvention.
But the authorities sadly appear oblivious to such priority reforms. Ill-advised changes and needless chest-thumping seem to usurp the place of evidence-based policymaking. The recently touted change to statutorily permit Ayurveda post-graduates in select disciplines to perform surgical procedures is a case in point. Surgery requires anaesthesia, which the Ayurvedic pharmacopeia does not possess. This being the case, one fails to understand the logic behind promoting “Ayurvedic surgeries” by importing anaesthesia and antibiotics from the modern pharmacopeia.
Ayurveda is appropriate to use as a system of primary care. Instead of training Ayurveda doctors to operate in specialty areas like surgery, the focus should be to support and equip them to function as full-fledged primary-care doctors. This will require us to approach and reform Ayurveda scientifically while also complementing it with modern medical knowledge, especially in the management of primary-care emergencies.
Overlooking these reforms and intruding into a space where modern medicine is clearly superior is ill-advised and can achieve nothing wholesome.
G.L. Krishna is an Ayurveda practitioner and independent researcher in Bengaluru.