Science-Based Evidence-Based Ayurveda (SBEBA) is a conscientious, explicit, and judicious employment of Ayurvedic Science Based Evidence in clinical decision-making in every subject based on unique circumstances. The term ‘Science Based Evidence Based Ayurveda” was coined in 2012 by the physician faculties and scientists of Ayurveda Drs Rajkumar KC and Remya Krishnan, Kerala, India. SBEBA encompasses standardized tools and methods for conducting research, clinical practice, and the teaching of medicine, and there are also currently seven scientific publications of SBEBA explaining the innate logic, principles, and methods for rational implementation of SBEBA in clinical decisions and practice by the physicians of Ayurveda. The practice of Science Based evidence-based Ayurveda means integrating the physician's intelligence and clinical reasoning with the innate rational principles and standards (Shaasthraarthas) from Shaastra/the Science of Ayurveda. SBEBA is being embraced by many aspirant physicians all over India by themselves self-recognizing the impact of their transformation from the previous Belief/ Blind experience-oriented trial and error practice to the rational science-based Based Medicine practice. SBEBA not only cut down the length of the prescription but also considerably improved the accuracy and quality of the same without the burden of complicated therapies and procedures which are done so commonly today without considering Ayurvedic Science Based Evidence led standards of clinical decision-making. The cause-effect relationship between disease and treatment is thoroughly explorable by SBEBA tools and methods to establish conclusive evidence for professional diagnosis and treatment in Ayurveda for the first time in the history of Ayurveda.
Evidence-Based Medicine of Ayurveda is to be primarily logically approved by the Science of Ayurveda to approve for employment in a subject. Unlike the pain killers in pain and antying drugs in Western Medicine which block mask and suppress different chemicals, pathways, and neurons, Ayurvedic medicines are intended to work on appropriate disease targets in the single or multitangled pathology manifested as one or more diseases if they are chosen and applied wisely led by the innate logical algorithms of Ayurvedic scientific decision making. The working of treatment is meant to do reversal of cause mechanisms and not merely suppress or deactivate something for some time. So while deciding to treat a patient, the physician needs to have highly precise knowledge of the scientific clinical decision-making process led by the rational standards of science but this has never been educated and trained in Ayurveda colleges ever and for this reason, hundreds of Ayurveda physicians today will diagnose the same patient and his status in five hundred different ways blindly assuming something as something without any sort of clarity and objectivity. At the same time, SBEBA-trained physicians have a systematically organized method of arriving at rational diagnosis and treatment led by the inbuilt standards of science of Ayurveda.
The Evidence Triad Approach (ETA) which is the hallmark of SBEBA is fairly complex to perform and hence requires advanced knowledge and training in skills to perform the technique. Currently, the fundamental principles of Ayurveda are not rationally educated and trained for BAMS students and for this reason they lack the clarity and comprehension of the underlying scientific principles of Ayurveda, even though they are mugging up the same for examinations. When there is SBEBA-oriented education, research and training in Ayurveda medical colleges, the quality standards of clinical performance of physicians today would have been of the next level and Ayurveda would have become the Mainstream Medicine of India. Till now there has never been any quality evaluation or clinical audit for Ayurvedic prescribing and physicians continue to prescribe as per their beliefs, self, and shared experiences with innumerable medicines and treatments. This has often resulted in emerging some casual benefits along with high risks to patients but ultimately Ayurveda is not a medical science intended to emerge benefits and risks, rather it is intended effects and health in the intended period. Also, the existing mode of prescribing hardly questions what is fundamentally wrong with the patient and why and how. Thus a unifying movement of SBEBA makes it possible to shift the clinical practice of Ayurveda in such a way that the inbuilt rational standards of Ayurvedic Science have become the central axis for the process of clinical decision-making for emerging scientifically optimised patient-cantered care without devaluing the external evidence of healing in every individual patient. The evidence of healing solely matters in Evidence Based Medicine of Ayurveda and when a medicine/treatment is scientifically chosen and applied, the evidence of healing in the intended period by a predictable cause effect relationship only establishes the effectiveness of treatment in the medical science of Ayurveda. A couple of interchangeable benefits and risks by random blind administration of a treatment in a random population is entirely unscientific research enterprise in Ayurveda and the ancient scientists of this system have repeatedly warned in several instances to abandon such evidences of spontaneous benefits of outcome of irrational therapeutic decision and application in patients. It is technically termed as Yadrichha siddhi which is advocated to be discarded and not counted as a scientific achievement in Ayurveda.
It is a very indisputable matter that a solid foundation led by the rational components of “solid background science” is inevitable to practice a medical system as “Science-Based Medicine”. In Science Based Medicine, Medicine should begin from Science and advance through the innate logic of concerned science for attaining its most optimized application in the unique circumstances of every individual patient and this cannot be achieved by the different formulae of Biostatistics. Ayurveda is a deterministic science and not a probabilistic one and therefore it is silly and stupid to do Randomised Control Trials and blinded assays with compound/ treatment after treatment in Ayurveda. Ayurveda does not require new medicines; what is seriously lacking is physician intelligence in Science Based Medicine for emerging the most scientifically optimized clinical decisions that is why polytherapy, mixopathy and allopathy practices are done by Ayurveda physicians today.
Following the original thinking of SBEBA, the junior doctor would be precisely
as well equipped to make the right diagnosis and be as successful as the senior
one expertise in SBEBA because SBEBA Tools and methods enable all of them to uniformly and pertinently conduct uniform clinical decision-making processes in Ayurvedic diagnosis and treatment. Currently irrespective of senior or junior, unless a physician attains specific and specialized knowledge and proficiency in SBEBA, everyone equally sails in the ocean of uncertainity in clinical decision making and thus prescribes endless medications and procedures for endless periods. Clinical expertise and experience are required in the knowledge and skills in the practice of Science-Based Medicine (Shaasthraarthas) of Ayurveda and not in Biostatistics and Research Methodology the latter which is applicable only for the hunt of data for approval of drug for marketing which is in no way the objective of research of Ayurveda. Ultimately the research is meant to discover and optimise the diagnostic and treatment protocol and save the patient by facilitating fast recovery and health.
The patient is not to be treated based on empirical evidence of observational data sheets of benefits and risks that emerged from conducting a trial and error with an unknown compound in Ayurveda. Ayurvedic science advocates the practice of Jnana Poorva Karma (Knowledge Based Practice); deep seated knowledge in Science-Based Medicine for which systematic tools and methodologies are required to be known and practiced. The fundamental principles of Ayurvedic diagnosis and treatment are to be well comprehended “rightly” by the entire physician/faculty community and misled knowledge in the scientific substratum of Ayurveda would emerge fatal consequences through irrational prescribing habits of unlearnt physicians. Hence SBEBA is very much crucial today for the intended scientific updating of Ayurvedic clinical practice, research and professional education.
Dr. Remya Krishnan MD, PhD
The Pioneer of SBEBA
Ayurveda Faculty, Physician & Scientist
Q: Who is a scientist?
Ans: A scientist is the one who is absorbed in science to explore the truth
Q: What is Science?
Ans: Science refers to a body of knowledge which incorporates the Laws of Nature
Q. Is Ayurveda a Science? Why?
Ans: Yes, it is. Because it is a well-systematically organized body of knowledge of life and human beings in their entirety.
Q. Why do modern scientists not consider Ayurveda as Science?
Ans: Modern scientists probably do not know Ayurveda and Science as well.
Q: For years, Ayurveda has been addressed as Tradition; what is the reality and why?
Ans: The reality is that it is not. The reason is that science cannot be a tradition as Science follows innate logics while tradition follows beliefs and experiences
Q: They call it Traditional Science?
Ans: When Tradition is not Science and vice versa, is it fair to mix them?
Q: No. Unfair
Q: What is SBEBA?
A: Science Based Evidence Based Ayurveda
Q: You told me that Ayurveda is itself a Science. Then why do you need to address Science -Based Evidence Based Ayurveda?
A: Why is your name Mr. X Varma when everyone surrounding you knows that you belong to the Varma community?
Q. For everyone to recognise me as Varma
A. The same applies here. For everyone to recognize Ayurveda as Science and not something else, the name SBEBA is given.
Q. Everyone is telling that the introduction of SBEBA is a marketing strategy
A. Is adding your caste name to name for marketing yourself or to reveal your identity?
Q. No
Q. How does SBEBA differ from conventional Ayurveda?
A. Conventional Ayurveda does not practice Ayurveda as it is while SBEBA does. That is the difference
Q. Do you have evidence to show this?
A. Do you have evidence to show that you are not Mr. G?
Q. Yes. I have my identity card to prove
A. Mr. G if manipulated the details of his identity card as yours, then how will you prove it?
Q. I can present Mr. G right beside me and show the proof
A. Similarly, SBEBA can present conventional Ayurveda by its side and show directly that both are different. Quality of Actions and their impact in the patients are the proof of identity of medical practice. Genuine and fake practices can be thus differentiated.
Q. But all are genuine qualified Ayurveda doctors right; who learn the science of Ayurveda?
A. If you are good at problem-solving in Mathematics but your friend is bad in the same while both of you are graduating in the same discipline, does your discipline of graduation merely ensure that you both do right and fair problem-solving?
Q. No; for that, we need to know accurate problem-solving techniques and do it correctly. Knowing and doing in the right manner is important to judge right
A. SBEBA teaches that right manner of doing while conventional Ayurveda does not and hence the former is only Ayurveda as it is
Q. I believe that everyone has to learn correctly
A. Ofcourse yes, it is every student’s right to secure the right knowledge. That happens only by quality professional education and training to students and physicians and for that SBEBA is developed and training programs are conducted in the same.
Q. But senior physicians say that after coming out of college, learning starts and you need to learn practice by sitting with elderly physicians
A. Can you learn Mathematics problem solving by sitting along with veterans of Mathematics and copying what they do?
Q. No. For that, I need to learn myself by knowing how to do
Q. Again, they say that theory and practice are different. Is it so?
A. Theory is what is intended to be practiced and an accurate mode of practice verifies the truth in theories. You learn physics theories in the classroom and then go to the lab to verify the truth in the same. Right? What you do in the lab has no connection with what you learned in class?
Q. They are connected
Q. One last question- What is this scientific temper? How does SBEBA see that?
A. Scientific temper refers to adopting the innately logical methods of a particular science in problem-solving by the concerned science. When you have a scientific temper, you analyze an observation/phenomenon logically and interpret it based on the innate logic of science. So the phenomenon is explored in a scientific manner (logically accepted manner of science and devoid of personal bias) thus making it completely transparent and reproducible. SBEBA cultures scientific temper in Ayurveda professional community
Q. Thank you. I will come later with more queries
A. My pleasure and duty and welcome
Dr. Remya Krishnan MD PhD(Ayurveda)
Evidence Based Practice defines the quality of standard of care provided by the physicians of every recognised medical system of the world. The quality of clinical practice guidelines which the patients receive must be ensured by evidence of what is but a matter of utmost importance. When we are attempting to solve a problem in Mathematics or Physics, it is absolutely mandatory that we must attain the fundamental knowledge in respective sciences as prerequisite before attempting to solve them. Without knowing the fundamental logics of the particular discipline of Science with clarity and objectivity and instead by knowing the fundamentals of probabilistic Biostatistics, it is never possible to practically solve a problem and reach a valid conclusion in a deterministic science.
Ayurveda belongs to the category of such kind of deterministic sciences where inbuilt theorems, logics, laws and principles of Health, Disease and Life are explained to understand man in relation to the peculiarities of his external environment and thereby intervene upon his unique internal environment which constantly modifies in accordance to the exterior. So, in order to choose a valid treatment decision, it is vital to know the finest aspects of scientific substratum of core science of diagnosis, differential diagnosis and management of Ayurveda. How ever the information of Randomised Control Trials of empirical compound administration in a random population by counting the temporary benefit risks observed there then cannot be counted as valid evidence for the physicians in deterministic medical sciences.
Randomized controlled trials that demonstrate the comparative effectiveness of one treatment over another simply tell us that without any inbuilt rationality to anticipate how a specific treatment may be better than the other in a population merely led by the temporary data of benefit risk led observations in population. This kind of casual observation led results are but strongly recommended to be abandoned in Ayurvedic science by the ancient scientists of the same addressing it as “ Yadrichaasiddhi” (random results) because they are unscientific and not a valid trust worthy substratum for clinical decision making. To make results scientific, the application is to be sensible and logical first and to ensure the sensible application, the knowledge and practice of core science and its innate logics of application are extremely vital. Hence the very practice of inbuilt Evidence Based Medicine led by the rational evidences of algorithms of Science Based Medicine is extremely crucial in the case of deterministic medical sciences like Ayurveda. No medicine can be made universally suited to the same disease in a population. There always personalised variations in patients with same disease in their cause and nature of mode of onset, progress, aggravation and alleviation, co morbidities etc and hence “ This medicine in that disease” consideration is very illogical and substandard. A patient’s improvement and recovery is led by several factors other than mere medication/ treatment alone but rather his diet and lifestyle, the multiple pathologies if present and their existing mode of management. Hence the very concept of New Drug development itself is very unethical as every new drug is later getting discarded for its potent harm and side effects and this is why new drugs are always required to be developed. It means that human beings are always meant to stay as Guinea pigs or rat specimens to test and fail various drugs and treatments and more badly it is purely a luck that decides who will get more benefits and whom risks and whether they get interchanged also. As the entire so-called Evidence Based Medicine of Western Medicine is led by probability and uncertainity, many physicians may be nudged to provide wrong treatments (Biostatistically wrong also) for their patients. More over Statistical significance of a treatment does never mean that it is clinically significant in a realistic situation which in simple terms convey that proven drug does never mean proven recovery and health. But unfortunately a large majority of world population still believe that Western Medicine as emerging scientifically proven drugs and treatments they are best protected by them .
Ultimately, the successful application of evidence-based medicine is an art that requires first and foremost, an awareness of logics and principles of inbuilt Science Based Medicine, and also an ability to pre determine how well the particular logical decision impacts every individual patient , why and how. A physician who follows Science Based -evidence-based guidelines of Ayurveda 100% of the time is likely to have better aggregate outcomes than one who never follows Science Based Evidence based guidelines, since the guideline will steer a physician intelligence to comprehend what is intended to be done in the particular clinical status of the patient instead of blindly doing trial and error with different medications and treatments for benefit risks. But, the optimal application of evidence (principles) is as important as awareness of that evidence, and physicians must be scientists of this science of Ayurveda, using their best judgment to determine which evidence applies best and which treatments will most likely benefit individual patients.
This is why Science Based Evidence Based Ayurveda only deserves to be addressed as Evidence Based Practice in Ayurvedic System of Medicine.
Dr.Remya Krishnan MD PhD, The pioneer of Science Based Evidence Based Ayurveda
Evidence Based Practice defines the quality of standard of care provided by the physicians of every recognised medical system of the world. The quality of clinical practice guidelines which the patients receive must be ensured by evidence of what is but a matter of utmost importance. When we are attempting to solve a problem in Mathematics of Physics, it is absolutely mandatory that we must attain the fundamental knowledge in respective sciences as prerequisite before attempting to solve them. Without knowing the fundamental logics of a particular discipline of Science with clarity and objectivity and instead by knowing the fundamentals of probabilistic Biostatistics, it is never possible to practically solve a problem and reach a valid conclusion in a deterministic science.
Ayurveda belongs to the category of deterministic sciences where inbuilt theorems, logics, laws and principles of Health, Disease and Life are explained to understand man in relation to the peculiarities of his external environment and thereby intervene upon his unique internal environment which constantly modifies in accordance to the exterior. So, in order to choose a valid treatment decision, it is vital to know the finest aspects of scientific substratum of core science of diagnosis, differential diagnosis and management of Ayurveda. How ever the information of Randomised Control Trials of empirical compound administration in a random population by counting the temporary benefit risks observed there then cannot be counted as valid evidence for the physicians in deterministic medical sciences.
Randomized controlled trials that demonstrate the comparative effectiveness of one treatment over another simply tell us that without any inbuilt rationality to anticipate how a specific treatment may be better than the other in a population merely led by the temporary data of benefit risk led observations in population. This kind of casual observation led results are but strongly recommended to be abandoned in Ayurvedic science by the ancient scientists of the same addressing it as “ Yadrichaasiddhi” (random results) because they are unscientific and not a valid trust worthy substratum for clinical decision making. To make results scientific, the application is to be sensible and logical first and to ensure the sensible application, the knowledge and practice of core science and its innate logics of application are extremely vital. Hence the very practice of inbuilt Evidence Based Medicine led by the rational evidences of algorithms of Science Based Medicine is extremely crucial in the case of deterministic medical sciences like Ayurveda. No medicine can be made universally suited to the same disease in a population. There always personalised variations in patients with same disease in their cause and nature of mode of onset, progress, aggravation and alleviation, co morbidities etc and hence “ This medicine in that disease” consideration is very illogical and substandard. A patient’s improvement and recovery is led by several factors other than mere medication/ treatment alone but rather his diet and lifestyle, the multiple pathologies if present and their existing mode of management. Hence the very concept of New Drug development itself is very unethical as every new drug is later getting discarded for its potent harm and side effects and this is why new drugs are always required to be developed. It means that human beings are always meant to stay as Guinea pigs or rat specimens to test and fail various drugs and treatments and more badly it is purely a luck that decides who will get more benefits and whom risks and whether they get interchanged also. As the entire so-called Evidence Based Medicine of Western Medicine is led by probability and uncertainity, many physicians may be nudged to provide wrong treatments (Biostatistically wrong also) for their patients. More over Statistical significance of a treatment does never mean that it is clinically significant in a realistic situation which in simple terms convey that proven drug does never mean proven recovery and health. But unfortunately a large majority of world population still believe that Western Medicine as emerging scientifically proven drugs and treatments they are best protected by them .
Ultimately, the successful application of evidence-based medicine is an art that requires first and foremost, an awareness of logics and principles of inbuilt Science Based Medicine, and also an ability to pre determine how well the particular logical decision impacts every individual patient , why and how. A physician who follows Science Based -evidence-based guidelines of Ayurveda 100% of the time is likely to have better aggregate outcomes than one who never follows Science Based Evidence based guidelines, since the guideline will steer a physician intelligence to comprehend what is intended to be done in the particular clinical status of the patient instead of blindly doing trial and error with different medications and treatments for benefit risks. But, the optimal application of evidence (principles) is as important as awareness of that evidence, and physicians must be scientists of this science of Ayurveda, using their best judgment to determine which evidence applies best and which treatments will most likely benefit individual patients.
This is why Science Based Evidence Based Ayurveda only deserves to be addressed as Evidence Based Practice in Ayurvedic System of Medicine.
Dr.Remya Krishnan MD PhD, The pioneer of Science Based Evidence Based Ayurveda
Whenever I engage in a conversation with my conventional Ayurveda colleagues, I frequently find many of their faces getting disappointed or frowning at me. My fellow physicians are unhappy to hear my words on the need for crucial updating of the system and the quality of performance of Ayurveda physicians as they take it personalized criticism against them and that I am an arrogant personality. What I understand from this after such a long period of receiving this attitude from many in my professional community is that the Ayurvedic community is raised in medical colleges in such a way that they should surrender their intelligence and common sense to anything and everything which they listen to under the label Ayurveda from faculties and real humbleness is doing that without any queries of clarification. As Ayurvedic biology is quite unfamiliar to fresh students of Ayurveda, it is natural for them to get too many queries. But their inquisitive mind is suppressed from the very first year by telling that Ayurveda is a highly controversial philosophy where variable opinions of different so-called “experts” (expertise does not have quality parameters defined in conventional Ayurveda) are very much acceptable for the same context and that we should not question anything. So, there is no wonder that any faculty who encourages them to keep asking and arguing for clarity and confirmation would be considered as the one who is trafficking in Anti Ayurveda. According to these large majority of faculties who wish to stay in their comfort zones permanently, anything which contradicts their thoughts, beliefs and blind experiences is Anti Ayurveda. Obviously, anything which stay static in brains sealed and double insulated would deteriorate eventually and Ayurveda professional community forgets to think and apply the innate common sense in the science of Ayurveda as they do not get specific education and motivation to do that. Thus they become eternal diffident slaves to themselves and society and in spite of prescribing to hundred patients a day also, they become incapable to reverse their own infective fever confidently.
The people who are conferred “expert” titles in Ayurveda mostly secure it by big political influence or business and not based on an unbiased evaluation of their knowledge of expertise and quality performance. Unfortunately, once few people are entitled as experts in the above said manner, they will be only continuously given opportunities in policy changes with regard to professional education, research and clinical practice and hence any dedicated medical professional who genuinely proposes some out of the box ideas and methodologies to consider in policy will be naturally suppressed or blocked by the already selected “expert panel” as this new proposal is rationally challenging the existing policies with effective practical solutions to revise them. This is why I believe SBEBA proposals which offer promising Health future to this science ,humanity and national economy continue to stay without serious appraisal and response.
Science Based Evidence Based Ayurveda (SBEBA) practises the Science Based Medicine in place of conventional Ayurveda practice which is based on different beliefs, ideas, experience and individual opinions of “legends”. Ayurveda strictly advocates to practice Science-Based Medicine (Jnana Poorva Karma), but as the conventional Ayurveda does not do the same, conventional Ayurveda cannot be counted as Rational Ayurveda.Ayurvedic science being highly complex and vast , strictly advocate its practitioners to constantly culture their intelligence in the innate theorems, logics and principles of Ayurveda which is technically speaking “ Shaasthraarthakarmaanusheelana”. But currently it is not adopted and instead the practice of “This medicine in that disease” is encouraged in different policies of education, research and clinical practice. In Ayurveda, it is the innate intelligence of physician that requires constant enhancement and refinement and artificial intelligence can absolutely do nothing to promote natural intelligence of humanbeing. Ayurveda being a deterministic science led by deductive logics, inductive reasoning based on the results of statistical data of empirical drug administration is of no value in the same. Attaining high-level intelligence in the knowledge and application of Science Based Medicine by development of certain innate methodologies is what is done by the SBEBA pioneers for the past decade and more and large number of physicians who have undergone training through workshops of SBEBA are aware of the difference in the precision and quality of their mode of clinical practice before and now.
The fundamental principles of the deterministic science of Ayurveda like Mathematics can specifically predict whether the particular treatment works to produce the “intended effects” (not mere Benefit- Risks) in the particular patient in a particular condition by answering specifically the questions “HOW and WHY” and thus SBEBA deserves to be addressed as Science Based Medicine. Science refers to the knowledge of precision and certainity and not data of probability and confusion and Ayurveda is such a science that explains in detail the methods and logic to abandon confusion and uncertainity in choice and application of its logic. Therefore, applying Randomised Control Trial studies in such deterministic sciences is arguably unethical because the very fundamental requirement of any clinical trial is to establish that the particular treatment is grounded in good science which explains its cause and consequences.
If SBEBA is suspicious to anyone, SBEBA has to be professionally challenged through scientific debates and discourses instead of baseless blaming, backbiting, and personalized defamation of the pioneers of the same. The wide revolutionary ideas and evidence of SBEBA overturn much of the what is presently known and adopted as Ayurveda and hence it is natural to feel uncomfortable with this. But uncritical rejection is equally pathetic and dangerous as uncritical acceptance and doing it will arrest the intended professional renaissance of the Ayurveda community and the timely updation of this medical system
Dr. Remya Krishnan MD PhD
AYURVEDA - WHERE IS THE EVIDENCE?
By this small write up, I honestly would like to analyse the ethicality of so addressed scientificity of evidence of medical system as such, before coming to Ayurvedic system of Medicine. As a physician, faculty and scientist of Ayurveda, I have been working on professional solutions to the challenges faced by Ayurveda medical professionals today among which the predominant one is “Evidence” of Evidence Based Medicine. Evidence is undoubtedly the corner stone of the scientificity of a medical system. Evidence literally means proof employed to back-up or refute arguments allowing us to work out what is effective and what is not. Now let us take an example of lock and key system used to open a door. To open a door-lock, we need to use only one key which is aptly suited to do the same and if that right key is with us, there is no need and absolutely no use of doing trial and error with key after key. The process of trial and error with many unsuited keys may lead to damage of the lock and sometimes the door itself and hence it is important that first of all, we need to comprehend the highly specific and specialised details of the door and lock in-order to find out the right key for the same. The right key once chosen, is not opening the door with any probability but it opens the door every-time with precision and certainity. Any medical system is ultimately intended to heal man and not as trial and error system with different keys. The process of healing can never be associated with risks because healing is innately natural and unique for the reversal of cause-mechanisms of disease(s) in the subject thereby facilitating health. Hence the very proof of working of a medical system is the proof of showing in a live setting that the person is healing hour by hour, day by day and thereby attaining health. This is the real evidence to substantiate that the system of Medicine is scientific. A scientific medical system describes the innate process of healing leading to fastest recovery by reversal of pathogenesis.
Unlike a machine, which is primarily complex and secondarily simple (artificial), man is primarily simple but secondarily highly complex. In-order to prove that something works to resolve a problem in man (naturally complex), the comparative benefit-risk ratio and statistical significance of an unknown compound trial in population cannot be considered as a proof for an effective solution to the problem as the effective solution is only that which leads to the intended outcome of reversal of cause-mechanisms of disease leading to emergence of health in every individual subject. A man in real life situation can be morbid in a highly variable and complex way. There can be multiple pathologies working at the same time or sometimes one alone or sometimes one pathology leading to the other or even wrong ways of dealing with old pathologies leading to newly emerging pathologies. So, there is absolutely no point to begin the research to solve a clinical problem in a variable population with the same unknown compound and check for its working by the process of masking, blocking, suppressing or altering different intrinsic pathways, enzymes or ion channels or chemicals inside the body. Multiple unique factors play at the same time interacting in dynamic and unpredictable ways in an active pathology in the body and hence it is extremely crucial that an integral estimation of man and disease(s) as well, are to be done to ultimately reverse the problem. Definitely, masking, blocking and suppression are not ethically approved working in the process of healing the man. If the purpose of medical research is reversal of disease, then definitely, “a fit for purpose scientific paradigm” is required to be adopted in medical research to be addressed as scientific medical system.
Ayurveda is Science of man and hence it explains the process of problem solving in man within man and not outside. Hence the science addresses how to comprehend the nature of different clinical problems along with the crucial hints to probe into the underlying dysfunction of subtle-most functional classification of structures in man and HOW and WHY of the dysfunction unique to the particular subject. Ayurveda is thus not a Medicine Based Science, rather it is Science Based Medicine. The evidence in Ayurveda are hence inbuilt science led answers to know what happened in the patient, how and why and what exactly is to be done to reverse the same (how to choose the right key). There are no benefit-risk oriented evidences in Ayurveda because Ayurveda is meant to produce intended effect of healing the disease and not blocking, masking or suppression of the same. Evidence in Ayurveda is meant for right decision making of physician resulting in intended effects in every individual patient and not the blind trial and error hunt of drug after drug for marketing approval.
In short, Evidence in Ayurveda entirely lies in the Natural Applied Science and the Science Based Medicine of Ayurveda itself and not in the data sheets emerged by the practice of probability-based trial and error hunt of Statistical Medicine. Statistical Medicine can never be the Scientific Medicine in healing man. Now let me conclude by this open question to every one - “Western Medicine - Where is the evidence of healing?”
Dr. Remya Krishnan MD PhD
Honestly, Research in healthcare is meant to advance knowledge for good of the society, to improve the health of people worldwide, and to discover the optimized ways to treat and prevent disease But is this what the reality is with regard to medical research happening today? The research funders have adopted a long drawn-out bureaucratic process for their grant giving. The Ayurvedic Research Fund system operates within the accepted framework of thinking of western research methodologies which are incompatible with the fundamental nature, attitude, approach, and goals of Ayurvedic research. Any outside-the-box ideas and proposals oriented toward Ayurvedic research and clinical methodologies are seen as uncritically rejected and opposed. Eminence Based Medicine and Experience Based Medicine is seen as widely accepted today and conventional Ayurveda practice is entirely based on decisions of opaque peers and "experts" assessments though experts are never assessed. It is high time to stop and reflect on how we can restructure and reframe the research, clinical practice, and education of Ayurveda strictly based on the inbuilt rational standards of the independent Science of Ayurveda itself and this is what Science Based Evidence Based Ayurveda is aimed to achieve. Meaningful impact in research is more important than profitful impact of research in healthcare. Western Medicine has always aspired to be scientific but the Science of Western Medicine is probabilistic data-oriented conclusions on the benefit- risks of unknown compounds and not the rational knowledge to explain the deep and complex pathophysiological mechanisms happening in the patient in accordance to the nature, state, and stage of his morbidity.
The mission of Science Based Evidence Based Ayurveda ( SBEBA) is to educate medical students in accordance with the highest professional standards to intellectually prepare them to practice the "Patient-centered Medicine" of the highest standard to identify and answer the fundamental questions in identifying the cause mechanism and treatment of diseases in accordance to the state and stage of patients. The goal of SBEBA is to emerge the leaders of Ayurvedic Medicine who will take the foundation of Ayurvedic Science to rationalize, evolve and emerge the finest quality in patient care, research, and education. SBEBA-oriented education enables them to apply the scientific principles of Ayurveda to the diagnosis, management, and prevention of diseases of the present and future. It also enables them to understand the subtlest changes happening in the body of the patient in accordance with the variations in stage and stage of their disease and thereby critical evaluation of the patient is possible in relation to his all activities. This process of critical appraisal will emerge the finest quality algorithms for treatment decisions. Thus SBEBA will enable Ayurvedic medical professionals to obtain a sufficient level of optimized medical knowledge vital to understand the basic facts, concepts, and principles of Ayurveda which are crucial for competent medical practice in Ayurveda. Data of the impact of conventional Ayurveda practice in relation to SBEBA-oriented practice are available in large volumes to explicit the reality about the relevance of the practice of Science-Based Medicine in Ayurveda.
SBEBA promotes Professionalism
SBEBA-oriented education in BAMS and MD and higher education will abolish the existing diffidence and slavery of Ayurveda medical professionals and help them to build up compassion, honesty, and integrity in their profession. This will also result in adherence to the highest ethical standards of professional judgment and conduct advised by the ancient scientists of Ayurveda in place of currently adopted mere business standards and conduct in the Ayurvedic healthcare system. It also helps to emerge a constant critical self-appraisal attitude towards self-knowledge and practice of the system and thereby emerges a healthy professional spirit and integrity among Ayurveda medical professionals. The rational standards of SBEBA could be applied to emerge prescription audit and clinical audit and thereby implement a standardized decision-making process a reality in Ayurveda. It enhances the spirit to constantly work hard in the principles of Science-Based Medicine of Ayurveda and thereby culture and refine their intelligence to upgrade their knowledge and professional skills and stay as responsible medical professionals in the society
Dr. Remya Krishnan MD PhD( Ay)
The Co Pioneer of SBEBA
Science-Based Evidence Based Ayurveda ( SBEBA ) is a new paradigm for performing scientifically standardised clinical practice by the Ayurveda practitioners for the first time in the history of Ayurveda.SBEBA de- emphasizes unsystematic beliefs, self and shared experiences with medicines and treatments ,intuitions and empirical observations in patients and data sheets as sufficient grounds for clinical decision-making in Ayurveda and stresses the knowledge and practice of inbuilt logics and algorithms of Ayurvedic science in their place. The practice of SBEBA requires new and improvised knowledge and skills for learning and comprehending Ayurvedic scientific literature and its optimized mode of translation into the unique patient environment.
An important goal of SBEBA education is the practice of systematic and Precision oriented Ayurvedic Science-Based Medicine (SBM) in place of the current unsystematic and unscientific practice of Tradition oriented beliefs and experiences.SBEBA is thus an important mandatory tool for social justice by Ayurveda. It has immense potential to save man-days and thus improve the national and global economy.SBEBA has also a prominent role in national healthcare policy-making by implementing its inbuilt tools and methodologies based on the science of Ayurveda to inform the clinical decisions of physicians in a science-led standardized manner.
The clinical decisions are to be entirely based on evidence. But the evidence is to be based on precision logic in the Science of Ayurveda as Ayurveda is fundamentally a deterministic Science and Science led Medicine and not Probabilistic unknown compound-led data-oriented practice. Hence the best proof to demonstrate the scientificity and potential of Ayurveda is possible only by the inevitably sensible application of the science of Ayurveda. The most valid evidence to demarcate Scientific Medicine and charlatanism is the basement knowledge of Ayurvedic science itself which are transparent and reproducible in every period.
Teaching in Ayurveda
It is important that professional education of Ayurveda is to be redesigned and optimized by the knowledge of principles and practice of Science-Based Medicine in place of existing unsystematic Eminence Based Medicine or Experience Based Medicine. For that, the faculties of all disciplines should be first and foremost passionate in their system of practice and again for that they require continuous orientation programs to understand and apply science-based principles and algorithms. Learning science and acquiring professional degrees is what is happening today but to become an effective faculty or clinician beneficial to society as a medical professional/ faculty, one has to acquire the accurate comprehension of Shaasthraarthas ( the true intention of scientific verses) explained in Samhitas of Ayurveda and their sensible application. This is never taught and demonstrated ever in Ayurveda colleges and hence the existing curriculum is emerging medical graduates as diffident slaves who cannot even take care of the healthcare needs of themselves and their families. Here are the crucial necessities for Ayurveda faculties to become worthy for their students and society:
a. Faculties should possess sufficient clarity and objectivity in the concepts of this science that they teach and are supposed to train. If they cannot quickly explain and simplify the core principles and basics of the science of Ayurveda to their students, the students will never be able to grasp the intentions of what the faculties are delivering in class. Everything merely appears as stories and not Science and this is what is happening today.
b.Questioning to check the understanding of students in a particular topic is to be done by the faculties .instead of asking to reproduce verses alone ( learning scientific verses and byhearting them are also crucial but comprehending their real intentions and sensible application is vital). Hence applied questions are to be asked to students to encourage to develop a scientific temper in them which will uplift their true professional spirit.
c.Graphical representations - Codes, mind maps, and flow charts after teaching science help to summarise what they have grasped sensibly without losing the interrelationship between the different components. This will enable them to keep their comprehension of the topic alive in their brains.
d.Practice " Right" things-The scientific knowledge in Ayurveda is entirely practical and not crude and abstract theories and hence Ayurveda is a complete science. Hence students of BAMS itself should be constantly practicing what they are taught and demonstrated in a realistic patient environment, constantly verifying and analyzing the results of the same from time to time with simultaneous analysis of concepts and their logical application. This process is intended to scientifically sharpen and culture their intelligence and systems thinking technically termed " Shaastraarthakarmaanusheelana" which is inevitable to become a scientific practitioner( Bhishak) of Ayurveda.
e. Feedback to students on their particular tasks instead of praise- Today faculties are seen praising students mostly with vested interests and motives. If a faculty is genuinely interested in the intellectual progress of students, they care to recognize the individual strength and flaws with identical minds and advocate highly specific and specialized personalized strategies for their intended knowledge and progress. Thus they help students to develop integrity, professional spirits, and confidence in their system of Medicine.
f. Tasks to improve productivity- Quiz, workshops, debates, and different publishing initiatives will be constantly encouraged for students to incorporate problem-solving skills which serve as motivation for students in their process of learning and evolving
CONCLUSION
SBEBA is oriented based on the above kind of approach to emerging scientific practitioners in Ayurveda in place of current medicine prescribers and sellers. Ayurveda is Science-Based Medicine and not Medicine Based Science and healing ( responsibility) and not mere prescribing ( duty) is strictly advocated for Ayurveda physicians by the ancient Ayurveda scientists. Continuous learning, research, teaching, and practice and simultaneously required for an Ayurveda physician for his constant intellectual upliftment to do sensible practice and justice.
We can observe a lot by just watching but cannot learn anything. A factual conclusion about any of our observations is possible only if we know the “Why & How” behind these observations. Science is that which incorporates knowledge for us to do reasoning in all our observations. Once we do inductive reasoning (observation-oriented reasoning) led by this Science (knowledge of laws of nature of man and universe), then there are fruitful conclusions or else it is similar to the observations made by a dog when it visits a market. It does not have any idea regarding the purpose of the visit and hence will roam here and there without any definite objective. Medical research is meant to save lives and the health of the patients by comprehending human body and the active cause mechanisms behind the morbidity and not merely do trial and error with unknown drugs and compounds. Testing new drugs by discarding the old ones because of detrimental side effects in many subjects led by observational research like what is happened in the case of the drug Remdesivir used in COVID-19 patients is a perfect example of unethical medical research led by empirical observation.
Testing a drug in modern times is that it is tested by randomized Control trials done in a random population observing for benefits and risks and such trials are counted as the golden standard of medical research today. Laboratory serendipity based on temporary observations of some identified benefits and identified and unidentified risks are getting approval as drugs in the Western Medicine market for use in human beings to block, mask, suppress or alter disease mechanisms addressed as “Treatments”. After the patients with an infective fever worsen hour by hour and day by day because nothing is known to be done to reverse the intrinsic cause of the progress of infection in tissues and claiming to study the disease by mere observation and empirical drug administration allowing the subject to die is not research but rather crime. COVID-19 is like any other viral fever and it is not the virus but rather the fever (immune response to the virus) that is addressed as disease. An infective fever can manifest and progress in accordance to multiple interlinked cause mechanisms active in the subject responsible for the progress of infection and the true culprit here is not really the non-living particle of the virus. Unless and until nothing is done in favor of the immune mechanisms of the subject to facilitate recovery, any time and every time, the infection can escalate to emergency. Instead of conducting a crucial study of multiple components impacting the progression of infection in the host, sharing external observations of different clinical manifestations in the patients through presentations and case reports putting blame on so believed to be a non-living thing as real culprit is not at all a desirable endeavour of a medical science. I do not consider it as progression in medical research, rather it is regression. Mere observations without attempting to understand the underlying subtle most and interlinked cause mechanisms will never improve the care of patients, no matter how much expensive technological interventions are used in observation. Research in Medicine should be an honest attempt to explore and conclude without disturbing the natural environment as much thus enabling to reach valid conclusions instead of uncertain observations.
When the patients of COVID -19 suffered from dry cough, difficult breathing, fever and fatigue, what is most important is to logically intervene upon the intrinsic cause mechanisms of infection which originally led them to the pathetic state and reverse them instantaneously by adopting precise strategies in favour of the immune mechanisms to naturally eliminate infection instead of researching on whether mechanical ventilation is better than rendering pure oxygen. It is so silly and primitive idea and worsely unethical to leave the patient to oxygen and uncertainity by doing nothing against the active pathogenesis which led them to the state. Another silly observational study is observing blood clots in patients with moderate to severe COVID Infection. If they had clots that they never had before the reason for the clotting is an undesirable immune response which could be either infection or immunization against infection or both. An honest research in the basic Science of immune system, infection ,and immunization will help to explore the reality and this was what is required in place of recommending risky blood thinning drugs to all moderate to severely infected patients.
Finally the observation led research in COVID-19 patients never led to any successful outcome in saving patients by reversal of disease or preventing illness in them and still possibility of endless mutations possible in every human being endless times open up new challenges for researchers. The more uncertainity-led treatments emerge, the more uncertainity led emergencies would also set in naturally as a consequence. Thus with the latest COVID-19 example itself, it is easy to prove that we can observe a lot by watching but can do nothing to reverse an ailment by merely watching
Dr. Remya Krishnan MD PhD( Ay)
To have the right application of medical science, pure science must guide the choice and application of treatment Hence to have the sensible application of medical science, a science of “healing” must exist. Why do we neglect to seek the comprehension of a completely natural phenomenon of the emergence of the particular nature of the disease in man ( a natural creation) and blindly seek some unnatural means to block, mask or suppress ailments? Is it not a reductionist mode of approach to attempt to solve a natural problem by absolutely deviating from the causal mechanisms and nature of the problem and thinking of some external means to block, mask or alter the same?
India being addressed as a wise and civilized nation from the olden days must sensibly think of adopting those pure sciences which deal with healing diseases in man in place of the sciences selling unknown compounds under the label of Medicine. Everybody can earn millions of rupees by selling anything if they know business and marketing strategies but how few can heal people and stabilize their health fast and without messing with the knowledge and skills in the Science of healing! In fact the latter community deserves to be addressed as physicians as what they apply are sensible logic of Science of healing and not unstable data of unknown compounds
Science is not about empirical observation; it is very much about logical reasoning to understand and solve a problem in its own natural setting. We do not need statistics to understand why and how fever develops in man and for the same reason, we do not need statistics that emerge compounds to block fever. The intended therapeutic action in fever is to resolve fever along with its cause mechanisms and heal the subject as quick as possible and not block or mask the same.This is simple common sense to know. Disrupting a natural environment by some artificial means and calling it science is real nonsense. Science is the knowledge of the laws of nature. As diseases are natural phenomena in human beings, their solutions are also meant to be natural and that facilitates natural healing by the body itself by rendering Science led support in the diet and regimen of the sick subject and that is what medical science is intended to do. Statistics f unknown compounds show data of benefits and risks. Data can only help to show temporary benefit risks of unknown compounds and never help to “know “ WHY and HOW” the disease and WHY and HOW healing is possible. But if WHY and HOW are explored, the results of the sensible application of the healing process will originally show the Science of Healing instead of casual observations. Medicine without statistics would rationally explain the knowledge of healing. This knowledge of healing disease is crucial for anything to be addressed as treatment. Thus we do not need statistics to understand and reverse a disease but for that we crucially need the Science of man and the Science of healing in man.
When statistics is employed to analyse compounds for benefit risks also, there is no certainity that the compound will heal the subject. Then what is the benefit of knowing the compound and its mode of blocking disease along with risks ?? Statistics help pharma companies to sell their products effectively but there is no guarantee to heal man effectively. Thus a medical science is to emerge based on the Science of healing to deserve to be called a medical science and scientific publications of medical science must discuss this very science of healing instead of benefits risks of blocking, masking, and suppressing ailments
Dr. Remya Krishnan Ph.D. (Ay)
Assocaite professor & Head
Dept of Clinical Pharmacology,
RGAMC,Mahe
Even though we are forced to believe that COVID 19 is going to end ,in the past two years we have seen multiple lives lost and multiple sufferers comprising of atleast one in every home by some or other way. For the sufferers, it is not mere data but instead true suffering itself. And people have watched their dearest ones getting steadily sicker and often breathing their last. All these two years, we the Indians were pressurised to follow the guidelines of a single medical system for getting rid of infection. People were both threatened and frightened of new virus and its endless possible mutations by this system and inspite of the fact that there is so much that they do not understand about this viral fever, they were seeking all attention and appreciation from Government for all their experimental trial and error games irrespective of the fact that people are in eternal suffering and many dying continuously. They even successfully created an impact to such a detrimental level that oxygen cylinder deficit is the real reason for increased mortality in viral fever by enabling people to wash away their common sense from themselves for ever.
Western Medicine was given the entire rights and privileges to handle patients while other recognised medical systems were sidelined in India . There were medical systems like Ayurveda who counted viral fever as healthy immune response against virus (irrespective of the name and variety of virus)and immune system winning virus is counted as recovery by health which is possible by the scientific strategies of Science Based Evidence Based Ayurveda . We, the SBEBA practitioners do not mind whether it is old or new virus because we are learning to intervene upon the immune response and enabling to make it in favour of subject for his fast recovery from our medical science. But we were denied our own rights to handle the patients and enable them to get back to healthy lives but still we have enabled many who reached us without letting ourselves and them as well getting bothered about name of the infection. Who cares it is COVID 17 , 18 or 19 , only what matters is whether we enabled the patient to get back to his health in less than 2-3 days and this is what as physicians we are meant to do by our science. Nobody beat plates for us when we enabled patients who were in severe stages unresponsive to all the cocktail experimental drugs reverse to health and life fast, but we got deeply satisfied within for what we do in this panic stricken world when we find our healthy patients smile at us ready to face fearless life ahead. It was hard to watch many doctors getting sick and dying by still doing the best of what they know and do in themselves and covid 19 era enabled us to deeply recognise the value , quality and purity of our own medical system which guard us continuously when we attend patients absolutely without any worries for getting self infected even when we work in the midst of different kinds of patients without any PPE kits or face shields. When doctors feared deadly variants and their potent fatal impact, our own medical science ensured us that all is well as long as we meticulously take care of our innate immune intelligence.
When we seal our homes and sit inside , there is no guarantee that thieves will not enter our homes. Also when we seal our homes and sit permanently at home fearing thieves without doing anything , we may fall into panic or depression or anxiety and other physical problems too. To ensure protection from thieves, we need to improve security of our homes, efficient alert devices working and lock the thieves if at all entered by efficient man power and intelligence. Ultimately it is the thieves that are to be locked and not the homes and people living there .As long as a viral fever is considered , body has innate immune soldiers to fight and win all kinds of viral fevers and any infective fevers and our duty is to improve their efficiency constantly to cut down virulence of any pathogen and shut it down . For our immune system, name and strain of virus is immaterial and we have inbuilt mechanisms to destroy them and eliminate any kind of viral fever by our immune system and this simple straight common sense fact is thoroughly educated in the 5000 years old science of Ayurveda. It is not mere immune boosting that is recommended , rather it is highly specific and specialised immune efficiency improvement. In viral fever, destroying virus leads to recovery and health and not any post viral stage. Post covid stage itself is the clear cut evidence of mismanagement of the viral infection.
The present agony of people in the form of several old and new diseases inspite of all the so called interventions clearly reveal that still Modern Medicine has long way ahead to become prepared to handle a viral fever patient and people must finally know that this mere weakness of Modern Medicine should not be counted as virulence of virus or poor compliance of people to the guidelines of Modern Medicine. Unless this system gets ready to look inward , unlearn and relearn Infective fevers and biological immune response to different pathogens in living humans, this catastrophe will continue for ever.
Dr. Remya Krishnan MD PhD( Ay)
The Pioneer & Practitioner, SBEBA
Scientific thinking is the process of translating an observable phenomenon in man or universe into a demonstrable, reproducible and measurable phenomenon based on individual unique cause circumstances. Objectivity and rationality are compulsory part of scientific thinking and scientific thinking of all kinds are intended to obtain conclusions regarding the laws of nature that govern man and universe regardless of interests and opinions of people. Scientific thinking also inculcate demonstrability and verifiability of cause mechanisms of all conclusions by logical arguments by an orderly explainable procedure which is rational and analyzable based on inbuilt knowledge of the phenomenon. Accuracy in understanding and communicability are crucial components of scientific thinking .
Value of understanding
In science , understanding matters more than discovery of something. Understanding reality may require to think freely from every kind of prejudice that is ingrained in conventional modality and the only purpose of understanding is exploring truth as it is . Understanding is interesting and more over exciting part of research because it is absolutely free from vested interests and career ambitions and therefore completely unbiased the purpose of which is to acquire command in the method of knowing the reality in its natural scenario.In Medical research, when I ask my students to do thesis on medicines , Iam not allowing them to explore the science of diagnosis and treatment of the situation because treatment is not equal to medicine ,treatment refers solely to the process of reversal of disease.When old medicines are discarded or new medicines are developed , it does never guarantee that treatment is fair or better as the latter happens only by deepening of the highly specific and specialized mode of understanding of cause mechanisms of disease and its mode of reversal. The old mistakes in comprehending and reversing the cause mechanisms of clinical situations can be recognized and rectified if and only when the clinical situations are lively studied and explored instead of going behind medications. This is what exactly scientific thinking in Medicine is intended to be . It is intended to save man and render protection to him by the scientifically accurate decision making thoughts and deeds of the physician and for this reason in Ayurveda, every physician is recommended to be a clinical scientists who pertinently employs the algorithms in science in variable clinical situations by constant research and refining of intelligence .
The theorems, laws and principles of a settled science like Ayurveda are not something which can be changed and hence they are meant to be comprehended rightly and seriously and judiciously learnt to apply in variable clinical situations.This is what exactly scientific method is and not sailing in the ocean of uncertainity endlessly.Scientific method is the constant process of refining natural intelligence and common sense of the scientists based on the existing knowledge of theorems , laws and principles of that particular system of science thereby enhancing the clarity and objectivity in their application and not randomly picking some idea, hypothesizing and testing it blindly and display the observations . Science has absolutely nothing to do assembling data and analysing , rather it has everything to do with the way we understand and apply the established logics in realistic situations for recognizing and solving problems.The past knowledge is the chief ingredient of our basement knowledge and understanding of any new problem.Only knowledge take us ahead in research and not any blind guess work or imagination. The latter are worth for making stories and not meant to explore and establish truth.Scientific method is not constantly flushing off and replacing old by junk by new junk rather it is an educated journey of taming common sense in science.It is the method of science led exploration of adopting most reliable methods to know and apply science and not statistics. It is not based on probability rather it is based on reliability. The rational demonstrable and verifiable logics pertaining to the phenomenon is the subject of scientific thinking and not blind observational data of may be- may not be. Science is not about data collection and analysis rather it is all about understanding laws of nature of man and universe and its accurate application for problem solving.
Misinterpreting statistical methods as scientific method in natural sciences is height of absurdity
Dr. Remya Krishnan MD PhD
The co pioneer of SBEBA
Rejection of absolutely irrational , superstitious beliefs which are prima facie is inevitable for social health and wellbeing . Social progress originally happens with honest and dedicated efforts of society to develop higher standards of scrutiny for any rigid rules imposed by the power of rule. In an era of lies and evil marketing , it is important that every citizen must learn to culture basic common sense to distinguish truth from fake to safeguard themselves from falling prey to dangerous agendas.
It is important to keep in mind that science is not the exclusive of domain of certain so called scientists who have pursued the path of science in their career. Health Science for example refers to the basic knowledge of laws of nature, man and the interaction between both. If we closely observe the changes in our body itself in accordance to our variable activities like eating , starving, exercising, different emotions , before and after bowel movement, state of being hungry or not hungry etc, we get different clues regarding what makes you basically well or not and it is practically possible for each one of us to cultivate the habit of developing common sense to know when to eat, when to drink water, when to sleep, when to wake up, when to exercise, when to stop exercise etc if we follow these clues of our own body wisely by ourselves. No definition of health is taught to school students but at the same time, they learn about germs and antibiotics. They are never taught how immune system fight germs ,but rather they are imposed regarding how antibiotics fight germs. So for these children , they get a false notion that antibiotics are needed to kill germs in the body just as we spray cockroach repellants in the room to kill cockroaches. So here what happens is that certain beliefs and vested interests of a single particular system of Medicine regarding mode and manifestation of infections is forcibly imposed on these innocent kids thus shutting down their curiosity regarding how they fall sick by infection. Infection is not invasion of germs in the body .If it is so, then we would have been sick almost every time in life as germs are always present in our body. Infection is a healthy immune response to destroy any harmful germs or toxins and hence nature of this crucial immune response determines whether you will fall sick by infection and if sick also, in how much time you will need to recover, why and how. Today none of the people have clear cut idea regarding all these crucial matters and hence they endlessly suffer throughout their life. The crucial knowledge regarding what exactly that which is inside our body which make us prone to any infection and how we can resist it or win it are all explained in the science of Ayurveda . Germs are immaterial and hence not explained in this advanced and cultured science , infection is rather explained. This knowledge explained in this science did not emerge from superstitions or beliefs or ideas but are developed by brilliant ancient scientists of life science who had immense power of logical reasoning of cause effect relationship who conducted live experiments in populations for many years in multiple ways and the conclusive rationale behind different natural phenomena are proven and established thereby emerging theorems and laws of science. These fundamental theorems of Ayurveda are not tempting a true scientist of Ayurveda to close their inquisition but rather eternally open it for further inquiry by providing a much stable a solid scientific foundation of broad wholistic perspective of human body and its functioning. Religious dogma is built upon philosophy of ego and ignorance while shasthra or science tries to determine the unknown by a well educated method of enquiry which is constant and omnipresent.
Scientific temper:
Scientific temper is originally the process of Science ( knowledge) based reasoning , questioning and being open to questions after acquiring the fundamental knowledge of laws of nature .Scientific temper is not accepting something without appropriate logical reasoning done based on laws of nature of the particular instance with material facts for verification and confirmation. Material explanations are transparent and repeatable and not anything hidden or obscure. Shasthra sahita tarka ( science based reasoning) is mentioned as the best tool of clinical decision making by Acharya Charaka, the ancient clinician scientist of Ayurveda. He also recommended that any therapeutic accomplishment without rational justification based on principles of basic and applied science is just spontaneous cure with no credit to physician and should be abandoned. This very well points out to the fact that Ayurveda is developed by true scholars with highest form of unbiased scientific temper and selfless spirit for universal health and wellbeing. Every theorem, logic and principles of Ayurvedic science open multidimensional diagnostic and therapeutic inquiries in accordance to conventional healthcare scenario and requirements and this serve as best scientific foundation for natural updation of this medical system in every period , today and tomorrow as well. Such brilliant bottom layers and inputs are the structure of scientific substratum of Ayurveda.
Scientific inquiry
The hallmark of scientific inquiry is that the only reason to believe anything in real world is if evidence can be furnished for it. But at the same time there is no much clarity regarding the nature of emergence of evidence, the nature of clarity and quality of evidence emerged after testing through experiment and observation. The mode of emergence, clarity and quality are but very crucial components which originally determine the validity of an outbuilt evidence. For example we want to study coconut and we have taken different specimens of chestnuts and palm fruits to study coconut . We do not know anything about coconuts and not seen them but after hearing about the details we hypothesise that either chest nuts or palm fruits may be coconut and we initiate collecting data of them . Even when we perform impartial, unbiased and objective analysis of data of chestnut and palmfruit for hundred years also and classify and analyse them, it not possible to attain even a minimal knowledge about the real object of inquiry coconut even after a century and this happens because the researchers have absolutely no basic knowledge regarding the specific details of coconut and by blindly experimenting the unknown with something, it is not possible to explore the reality. Ultimately research is meant to explore the reality and not for blindly disproving hypothesis after hypothesis . That is only staying in fool’s paradise and not research. Research should be always backed by accurate knowledge of fundamental details of subject of research which is to be kept as standard for guidance and operation. The knowledge of laws of nature of man and universe did not emerge by falsification, they have emerged by testing and verifying logics of respective sciences by multiple scientists by multiple ways are fundamental truths established by cause effect relationship. Hence Physics, Chemistry, Mathematics etc are real sciences which deserve for applied research to explore further by their innate logics, theorems and principles which can be traversed from general to specific most details ( not specific to general) with explanatory adequacy of inbuilt logics and repeatable by other learnt persons also which is another important hallmark of scientific method.
So what I mean to say is that blind experimentation and observational data of the same does no way guarantee that research gets fruitful and meaningful in future. There can be variable observations by the same experiment performed in variable environment and man is a perfect example for variable internal and external environment. So cause mechanisms of results give meaning to research rather than mere observational data oriented results of the research. The cause mechanisms (WHY and HOW) are to be replicated to understand the real logic of working of phenomena subjected to research rather than mere data of observations. Every drug of Western medicine produces some benefits and risks for sure as they are targeted to certain receptors for blocking , masking, suppressing, altering etc of different enzymes, hormones and channels and that does never mean they are the ultimate solutions for different disease conditions . Working for temporary data of benefits and risks are not same as working for reversal of cause mechanisms of disease . For an unknown compound drug to be known as scientific medicine, there should be innate logics of working of the medicine to reverse the cause mechanisms of the disease and thereby intended to reverse the disease. Astronauts are space scientists who apply science of astronautics to practical use of their work and in the same way medical doctors are to apply the Science of humanbeing and Science of identification and reversal of disease to heal people to be called as scientific Medicine. When statistics is applied in place of Science of man, it becomes only “statistical medicine” and never scientific and this is what is happening today.
Science is not doing experiement , rather it is knowing to do experiment by knowledge foundation of theorems , laws of principles of working of man and nature. The knowledge of Science is not falsifiable simply because the laws of nature are not falsifiable.They are objective and universal truths , it is true and works true everywhere regardless of whether one approves or not. For example, by applying Newton’s laws of motion, humans travelled to Moon and satellites are sent to orbits around the earth. So the scientific experimental missions follow science and not the empitical data sheets of statistics.
Knowledge begins from Science and ends in Science
Albert Einstein once told ;” If I had an hour to solve a problem, I would spend 55 minutes thinking about the problem and five minutes thinking about the solutions” and this is what a genuine scientist does . Solutions emerge from problems and not from outside. This medicine in that disease approach of research focuses on new drug development from unknown compounds by biostatistics instead of going deep into the disease and its nature of origin, onset and manifestation in the host. This is reductionist, unscientific and unethical in solving health hazards of man which is a dynamic natural creation on earth. When we ponder into the problem by understanding the nature of problem, we discover that there are multiple facets to the problem and we need to study these multiple facets in man itself instead isolated setting inorder to emerge solutions which may or may not even require any drugs . Disease is not deficiency of drugs in the body. How to think what to do to solve the problem in specific in specific condition is explanable only by a natural science and never by a reductionist tool of statistics.
Conclusion
Scientific method is following science and not data sheets of statistics. When scientific discoveries of Medicine are put to use, it benefits the entire humanity by saving lives and health of people instead of producing uncertainity led falsifiable benefit risks of unknown compounds. For Modern Medicine where the treatment is always unknown compounds to suppress, mask or alter diseases , Biostatistics is mandatory to prove that drugs work by producing benefits and risks but that is not the case of Science Based Medicine like Ayurveda which is based on solid science of man and explain logics solely for healing man and not do any adjustments. Developing scientific temper is the process of cultivating true knowledge about what is science and scientific method right from childhood and promote true rationalism in place of pseudorationalism and their critical thought process. It will be a true tribute to ancient scholarly scientists of the world who cared to emerge truth by their research instead of emerging results with vested interests
Dr. Remya Krishnan MD PhD ( Ay)
In 2012, Dr.Remya Krishnan defined Evidence-based medicine (SBEBA, henceforth) in Ayurvedic Science as the “conscientious, explicit, and judicious use of most pertinent Science Based Evidence to the unique cause circumstances of every individual subject in making decisions about their diagnostic and therapeutic care (Evidence Based Ayurveda & Rational Prescribing, First Edition, 2012). But today what Ayurvedic fraternity is doing is conducting research based on randomized control trials, systematic reviews and other types of population data oriented research of empirically chosen medicines which is nothing but the practice of the very unscientific cook book medicine when originally Ayurveda recommends solely the practice of Science Based Medicine .It should be noted here that at the same time, physicians are not clinically adopting these evidences of benefits and risks of known and unknown compounds but rather follow their blind intuitions ,self and shared experiences and Eminence Based Medicine . Then why RCTs are done is expected to prove medicine after medicine aimlessly and baselessly for benefits and risks and at the same time, patients are treated by physicians entirely not based on this but based on other trial and error means.
KNOWLEDGE MATTERS BEFORE STUDY
The fundamental proposition of Evidence Based Medicine in Ayurveda is primarily to attain clarity and confirmation regarding what to know and how to do in every individual subject infront of physician, why and how and all these are answered best by the theorems, algorithms and logics explained within the science of Ayurveda itself and not anywhere else. Recording observations based on personal clinical experiences is outbuilt evidence but what is crucial in determining the quality and purity of these outbuilt evidence is the accuracy in choice and application of Science Based Evidence in the subject , a fact which is unknown to Ayurvedic fraternity today. A pudding gets truly relishing and tempting only if the ingredients and method of preparation is accurate and not merely when data of pudding consumers are compiled and shown .Growing data of pudding consumers no way guarantee that every person gets the rightly cooked pudding by looking at the data of number of consumers. For that the method of making pudding with right proportion of ingredients in the right way is to be learnt and this is explained in the background knowledge of pudding making and not in foreground knowledge of data of number of consumers. So learning accurately what to do in a clinical situation matters a lot in rightly intervening upon the same.Hence Science Based Evidence Based Medicine is crucial to establish the scientific evidence based practice of Ayurveda . It is not the medicine that matter in the practice of Science Based Medicine but rather the clarity and objectivity for deciding the medicine in particular situation and whether it served the objective or not. For that in Ayurveda, the practice is to be entirely guided by background science itself and that is what is Evidence Based practice is intended to be in the system.
If Evidence Based Medicine is a concept intended with good intentions to reach the right decisions from the medical science to intervene upon man, then definitely it should not be some outbuilt indefinite unknown compound oriented temporary data of benefit- risks applied in trial and error terms by embracing the fool’s paradise of falsifiability. Ayurvedic science recommends a physician to constantly culture his intelligence in Science Based Evidences so as to resolve the endless confusions which are common in the process of clinical decision making. Also Ayurveda does not recommend multi- disciplinary approach in handling a patient, rather it advocates that every physician has to individually equip himself in the knowledge and judicious practice of Science Based Medicine to intervene upon a patient on the whole in the scenario of complexity of real clinical cases and reverse their entire morbidity instead of fragmented intervention focused on any structure and its function alone. When it is the background science which directs clinical actions on individual patients, then on what basis it is considered today in Ayurveda that external evidence are to inform scientificity of medicine ? Does it make any sense really to say so?
PROVE APPLICATION OF SCIENCE AND NOT MEDICINE
There is a very crucial thing missed by current Ayurveda fraternity. Unlike Modern Medicine in Ayurveda, there is absolutely no need to prove treatment after treatment or classical medicine after medicine to establish their safety primarily because there are existing documented evidences regarding the manufacturing, quality control procedures in manufacturing and science led algorithms and guidelines regarding where to use a particular treatment or compound, why and how, when , what all to consider while employing the same, what all to follow in the patient, and how to interpret the results . Instead of adopting this higly scientific innate methodology of science how does blind RCT of a new or old compound help to attain clarity and objectivity in Ayurvedic research. If a compound is established to be safe and beneficial in such a way in a random population, what is the certainity that it will guarantee the “intended results” ( Ayurvedic science recommends to produce only intended result and not benefit risks) in an individual patient in real clinical situations??? How do the population level of current EBM studies of baselessly chosen compounds or treatments applies to individual level in realistic clinical situations ???Let me know please !
Where is Ayurveda fraternity heading to? Guidelines of clinical decision making are to serve as accurate piece of advices appropriate to the particular clinical situation in the particular subject and not to blindly emerge compounds of cook book medicine. How does the current mimicry of Ayurveda to that of Western Medicine in the matter of hunt for Evidence Based Medicine end up in valid and effective conclusive decisions beneficial to save and protect every patient who seeks Ayurveda? Gawande’s popular science book summarizes it well: “A statistical formula may be highly successful in predicting whether or not a person will go to a movie in the next week. But someone who knows that this person is laid up with a broken leg will beat the formula. No formula can take into account the infinite range of such exceptional events. Despite of having a vast and deep science in hand , going behind these reductionist biostatistics to prove scientificity of Ayurvedic practice is entirely idiotic and detrimental to the very existance and identity of this medical system Ayurveda. There is no wonder that physicians still need to adopt aimless and baseless self and shared experiences or mixopathy or expert opinions ( experts are not standardised) as they are never equipped in the knowledge and practice of Science Based Medicine but at the same time need to survive in their profession by some fair or unfair means.
In Ayurveda, Medicine is a practice of Science in the background and not the data in the foreground because fundamentally Ayurveda is Science Based Medicine and not Medicine based science.Science is the proven and established knowledge of man in Ayurveda which explains what- why- where- when- how- why not etc of fundamental aspects of health, disease, diagnosis, differential diagnosis, prognosis and management and there is nothing truly "scientific" possible by entirely deviating from this very basic Science of man. Science originally refers to the knowledge of proven and established rationale of precision and certainity and not merely the number sets of probability and uncertainity.Hence for the purpose of scientific research, diagnostic and treatment principles are to be derived from this back ground science to be applied pertinently in every clinical situation and this kind of translational research is first and foremost done by Science Based Evidence Based Ayurveda pioneers , Dr. Rajkumar KC and Dr. Remya Krishnan, the outputs of same which are published in their four scientific publications so far and trained for hundreds of practitioners whose variation in evidences of former and latter clinical practice( after receiving training) speak the accuracy of the outcome of this most intended form of Science led Evidence based practice . We can trust and act in a rational way in our patients when Science Based Evidence Based Ayurveda ( SBEBA) is learnt and practised in place of current uncertainity led empirical ways of biostatistics or follow blind intuitions or experience or believed to be experts . Also it is important to know that getting evidence for treatment and diagnostics will involve getting “accurate knowledge about the circumstances of individual patient” which causally relevant factor might affect the interaction with the treatment and this is exactly what Science Based Evidence Based Ayurveda offers in place of current cook book medicine oriented practice of Ayurveda. Human judgers are fallible and so are doctors. Hence it is crucial that some rational standards which are proven and established based on logics are vital to be adopted in the practice of Evidence Based Medicine and such rational standards are available in the rational science of man Ayurveda.Transparency and predictability, the two components of scientificity are possible by Science Based Evidence Based Ayurveda (SBEBA). One has to rightly comprehend and learn to apply them is the only big challenge and SBEBA has already developed tools and techniques to train the physicians to overcome this big challenge. Statistics have very limited roles in proving the application of Ayurvedic science , all that it can do is only show and not “ know”. Knowing is possible only from background knowledge and anything that is shown without knowing background application is scientifically invalid in Ayurveda.
CONCLUSION
In short, the evidence in Evidence Based Medicine of Ayurveda must consider Ayurvedic scientific infrastructure itself to create a clear structured set of inbuilt science led decisions for individual patients in place of current epidemiological study oriented Biostatistical approach . Evidence Based Medicine is ultimately meant for patient cure and care and not for new drug development in the case of Ayurveda. Here we need" new intelligence development" for physicians in the knowledge and practice of Science Based Medicine and not any new medicines or treatments . This work is already started authentically and systematically by the pioneers of Science Based Evidence Based Ayurveda which forms the very foundation for an era of renaissance of professional Ayurveda.
Dr. Remya Krishnan PhD( Ayurveda)
Associate Professor& Head
Rajiv Gandhi Ayurveda Medical College
Govt of Puducherry Institution
Mahe
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Carl Popper who died in 1994 is today hailed as one of the most important philosopher of science and his book “ The Logic of scientific discovery” is counted as the most importantbook of the century. He is known for his principle of falsifiability which is based on the idea that science progress based on conjectures ( incomplete observations) and refutations ( the action of proving a statement/ theory wrong or false). According to him , a theory becomes scientific by exposing itself to the possibility of proving false. Anything which cannot be proven false is counted as pseudoscience based on dogma and superstition.
SCIENCE IN MEDICINE
The term “Science” is derived from Latin name “Scientia”(knowledge) which refers to knowledge of precision and certainity applying universal laws of nature where basic rules pertaining to man and universe everywhere are same. For example, the principles of motion and gravitation are same as principles of falling objects which are also employed to explain the moon, planets , nuclear particles, sail boats , bullets and light rays . When ever and where ever, modification of concepts happened in further research, it is to be noted that only “modification” had happened and not out right rejection by proving false. So the real scientific arguments must conform to the principles of logical precision and reasoning and possess the quality of continuity or stability.Ayurveda which is the Science of man fundamentally comprises of theorems and laws to explain the regularity of nature of structure and functioning of man in relation to the external environment as long as man exist as man. The theorems , logics and laws explained in real science provide answers to WHY, HOW, WHAT, WHEN, WHERE , WHY NOT etc and thus enables to train the common sense of learner of science in developing fundamental knowledge and creative insight in his theme of study. When variable observations which are unexpected are observed in further experiment based on a logic, under what conditions, such observations resulted will need to be scrutinized and comprehended. All the scientific arguments must ultimately confirm to the principles of innate logical reasoning of that particular science. Current falsifiable theories derived by doing baseless experiments of unknown compounds are not based on a single fact compatible to law of nature. For example, if the research behind paracetamol is meant to be a scientific research, first and foremost, the objectivity of the Paracetamol should be addressing the “ real cause mechanisms” of rise of body temperature instead of merely blocking the chemical messengers responsible for increasing body temperature. Rise of body temperature is a natural healthy signal of immune system of the body to show that something is wrong somewhere and it is time to correct that something and Paracetamol is not meant to do this. Paracetamol is just an example and all the drugs in western medical system are working by “masking, blocking, suppressing, altering etc “ of enzymes, hormones, neuronal pathways and channels. When antacid which is given to neutralize acid in stomach does not relieve acidity after withdrawing the drug, then on what basis it is counted as a scientific remedy for acidity? “Scientific” is intended to be “ Science Based” which means it should address the cause mechanisms of the phenomenon and explain innate logics to rectify them instead of mere suppression of symptoms .If such kind of compounds are not borne from a science (knowledge based on logical reasoning addressing cause mechanisms), then how do they get ethical clearance and approval for even experimenting in man??? Ultimately fever in man is not by the deficiency of Paracetamol in the body and acidity is caused not by the deficiency of antacids. In such a situation, it is utterly useless, waste of time and dangerous in counting benefit risks of any complete unknown compounds with some what known compound for use in man because as someone rightly told , half of what is true today is going to be incorrect in next two years and worst of all, nobody knows which half that is going to be. Popper forgets the real fact that even falsifiability is a falsifiable one!
SCIENCE IS NOT STORY
What shows up in laboratory or animals or isolated tissues are not the same thing intended to happen in realistic situation in body of human being. Hence it is extremely important to understand the basic nature of response of human body to adverse conditions , no matter whether it be climatic conditions or dietary or regimen factors or pathogens or toxins. The body’s innate mechanisms to defend these adverse factors are to be studied deeply and those logics which are derived by conducting basic and applied research in man are to be applied as primary tools to intervene upon various clinical problems in man. This is what is exactly recommended to be done in Ayurveda, The Science of man which explains logics, laws, theorems and principles to understand the fundamental nature of clinical problem in its unique natural setting and intervene upon the same to reverse it in the same natural setting as fast as possible to attain homeostasis. The proponents of Ayurveda were great scientists as they stood unbiased for proving , repeatedly verifying and establishing the fundamental biology of man in man and documented all the logics they have explored in a systematic manner for further basic and clinical research. Everything explained in Sanskrit 5000 years ago does never mean it is not science and modernity and falsifiability do not merely make anything science . Science is too complicated for falsifiability . Tempting to seek a simple single aspect and explaining the outcome based on the same is analytical reductionism . Man unlike machine is highly complicated inside even if appear simple from outside. Hence repair and restoration are more scientific and advanced process in man and not removal and replacement as counted by the world today.
SCIENCE IS NOT OBSERVATIONS
A scientific theorem unlike a theory is developed after verifying , proving and establishing all the cause mechanisms behind and stays eternally true unlike an imperfect theory which is valid only for the moment. Theorem cannot be falsified do not mean theorems are unscientific . Ayurveda and Mathematics are certain sciences which comprise of theorems. They are called deterministic sciences , they provide the fundamental infrastructure to understand and solve a problem. Data are based on external observations after experiment and not based on internal logics applied in performing experiments. Hence data are only temporary incomplete imperfect observations which can easily be falsified by different observations in future. But in matter of science , it is not mere observation that matters but rather “how -what- why- when- where ” of these observations and merely classifying and analysing the observations for making interpretations do not explore the foresaid questions. Hence the observation get falsified easily and that is because the method of research adopted was not knowledge based but rather data based. Modern scientists call such research as query of truth and science but I would call it nonsense why because it is like a boy incessantly trying to insert a real elephant into a match box . No matter how much failure happens, somebody told him that failure is path to real success and he keeps trying endlessly and even after growth with moustache and beard !!! The current scientific method reminds me of this elephant boy story.
When a theoretical prediction disagrees with experimental data, it could be by several reasons . Either the logic in the theory is wrong or the premises could be wrong or the interpretation could be wrong or the observations are too much generalised as derived from a highly variable population. Statistics cannot explain man and it inevitably requires Science of man and this very simple straight fact is but unknown to modern scientists . Just what Einstein rightly said:” so many people today -and even the professional scientists – seem to me like somebody who has seen thousands of trees but has never seen a forest .”Infact science is the knowledge of precision based on laws of nature in its natural circumstance which provides confidence and creative insight to the scientist to proceed in the process of seeking truth known as research instead of killing both eternally and proceed aimlessly.
CONCLUSION
By the process of falsification, the journey is only through the false and hence the truth hardly comes to limelight. Also in medical science today unfortunately anything which is repeatedly proven falsifiable are not getting discarded also but instead promoted many times by creating spin in data. Infact a single risk exposed is enough to discard a drug in terms of falsifiability and in such a case on what basis modern medical science decided to proceed by counting benefits outweighing risks?? When according to them , the important characteristic of a scientist is the ability to accept when he is proven wrong and change course and that is what humility is meant to be , why such a course of action is not observed from their side??? Why the proven false things are not still discarded and why no humility shown???? The answers to these questions are to be readily provided by them because they themselves tell repeatedly that falsifiability cause progress in science .
Last but not the least I would say with emphasis that if a myth story is passed on from generation to generation without any cost , it can solidify into a fact and not story anymore and this had happened in the case of story of falsifiability. No where in the history of science it is written as science is based on falsifiability , even the very definition of science is distorted by myth story for long. Remember we have’nt learnt falsifiable stuffs in Science and Mathematics class rooms in Schools and none of our teachers showed “humility” to us when we ever wrote wrong answers
Dr. Remya Krishnan MD PhD(Ay)
Associate Professor
Rajiv Gandhi Ayurveda Medical College
Govt of Puducherry Institution
Mahe (This email address is being protected from spambots. You need JavaScript enabled to view it.)
a.Ayurveda well deserves to be an independent mainstream Medicine of India. Instead it is evolved under AYUSH stream of Complementary and Alternative system which destroy the very identity and independent quality and potential of this system
b.Ayurveda is taught with many hypothetical contents with-out any scientific basement and deep infrastructure of core science is hardly known to faculties owing to deeply flawed education and training.
c.Nobody in policy making is exactly aware of how to judiciously employ the curriculum of Modern Medicine in Ayurveda so ast emerge rational standards for optimised knowledge and practice of Science Based Medicine of Ayurveda. Little knowledge is also very dangerous.
d.Available textbooks followed by both BAMS and MD students are very substandard and based on faulty perception, comprehension and beliefs of the author in the scientific concepts and not based on rational standards of science of Ayurveda. No standard learning or reading stuff is available for students.
e.When compound oriented data oriented RCT oriented research is encouraged in Ayurveda which is innately Science Based Medicine and not Medicine based Science, such research based applications will not go in compliance this scientific algoithms of clinical decision making explained in Ayurvedic science . This fact is unknown to curriculum makers and probabilistic statistics is forcibly induced in the curriculum to substantiate the application of deterministic Ayurvedic science which has its own solid settled theorems, laws and algorithms to prove its action and application. This absurd way of teaching by neglecting innate scientific clinical and research methodologies of Ayurveda have led to utter failure in establishing scientific evidence based practice of Ayurveda .
f. The quality of both theory and practical examination of students to evaluate their clinical competence and practical knowledge is zero in the current scenario and this results in nil chance of producing competent Ayurveda clinicians.
g.Extreme poor and faulty content of curriculum in all disciplines which include faulty interpretation of many scientific aspects and absence of Hands on Training for students of contents in curriculum are serious lacunae in the present mode of education . For this reason, the students are not even prepared to handle primary healthcare .
h. Though Ayurveda has independent immense scope in the practice of Emergency care , as the knowledge and practice of Science Based Medicine of Ayurveda is unknown to faculties, emergency care is given with quack practice of Western Medicine by Ayurveda practitioners or referring them to the latter. This utter shameful act which represent as best evidence for deeply flawed education of Ayurveda.
i.Even when there is unform curriculum implemented under regulations of Central Council of Indian Medicine, different states of India follow different acts of Ayurveda practice. There is no clinical audit or quality control of clinical decision making in Ayurveda after 75 years of independence also. Many practice mixopathy or Modern Medicine which is complete quackery and nothing is done to resolve the underlying anomalies all these years.
j. Unprofessional Ayurveda education is encouraged by several means abroad as certificate courses and other quack practices under the label of Ayurveda which is never regulated by Government of India ever. Besides graduates and postgraduates of Western Medicine are invited by certain reputed Ayurveda universities to do MD of Ayurveda which is highly ridiculous and utter defaming of this system.
Dr.Remya Krishnan MD PhD
Co-pioneer, SBEBA
When human body is viewed as a collection of components, any abnormality with regard to a specific component will be observed and studied in an entirely isolated setting and this is exactly what the western medicine is doing . Just like the mechanic of a damaged car focus on the damaged part, a physician is entirely focusing upon the isolatable abnormality only. For example in infection which is originally not a bite of pathogen but rather an immune response of the body towars the pathogen where pathogen is merely counted , in the case of cancer, tumour is only counted and in the case of bleeding from GIT, only the bleeding vessel or ulcer is counted . every person who has variable immune, metabolic, digestive and drainage mechanisms , variable load of toxins in system, variable co -morbidities will be treated in a unform mode of setting without considering any of the foresaid factors. The contemporary analytical tools of Western Medicine are not advanced to deal with complex questions like “ how do a person’s metabolic status influenced by specific components in his food and life style become solid reasons for his atherosclerosis and coronary vessel block despite of him taking statin and Losartan. They ignore that part nicely and go ahead with further set of medications and interventions
Homeostasis is tissues is a vital underlying cause of health of human being.It is incorporated in clinical practice of western medicine in 1865 by Claude Bernard but at the same time is very much explained in a very elaborative manner in the science of Ayurveda. Illness is defined as failed homeostatic mechanisms of all structures and their independent and co-ordinated functions in the body the nature and cause mechanisms of which are easily comprehensible by certain parameters explained in the science of Ayurveda. Hence treatment is aimed at rectification of well identifiable cause mechanisms of even the subtle most level of pathogenesis happening inside the gross structures and their functioning in every medical conditions prevalent in society today” .
“ One risk factor” in one disease approach is a very unfair deal with any disease as disease has to be explored right from its onset in the body along with its all intrinsic and extrinsic factors responsible for the same which is impossible if there is no solid knowledge basement which explain fundamental and subtle-most cause mechanism effect relationship of different pathologies. The inability to trace exact initiating factors of pathologies along with individual and multiple components of the patient’s lifestyle which impact the state and stage of his disease is the real cause of all time every time failure of western medicine in reversing the disease instead of blocking, masking or suppressing it. In a patient with multiple diseases, if every disease present in a subject at the same time is treated individually, it completely neglects the complex interplay between several components which are commonly working in multiple pathologies.Instead of knowing this when every disease is separately attempted to mask, bloc, suppress etc by benefit risk oriented compounds , any kind of predictable and unpredictable harm could happen to the subject in the form of emergence of new pathologies or worsening or complications of the older ones.The scientists from molecular biology, computational science, engineering, physics, chemistry and biostatistics together cannot resolve the health issues of man and it inevitably requires in-depth study, re-search and judicious application of “The one and only Science of man”, Ayurveda itself without any compromise.
Dr. Remya Krishnan MD PhD( Ay)
SBEBA Co-pioneer& Faculty
THE BEST RESEARCH EVIDENCE IN MEDICINE
Research evidence is currently counted as methodologically sound and statistically relevant research about the effectiveness and safety of treatment. When an unknown compound is subjected to clinical research , what is first and foremost important is to appraise the very objective of that compound in the subject who is being researched and whether the objective logically contribute to the purpose of reversing the “cause- mechanism” of the particular clinical condition in particular subject. This part of enquiry has high ethical impact in research. If a compound is logically targeted not to reverse any disease ,then why and how the compound gets approved for clinical trial is question of great concern which is but absolutely neglected today. If the answer of this is that if any particular disease as such is irreversible and hence considering the prevention of progress , something is required and so the trial is ethically right , it is not really an ethical answer to the problem. How was it decided that the disease is irreversible? Chiefly it was decided based on the reason that the true aetiopathogenesis of the disease is unknown to Western Medicine and for this reason it is judged as irreversible. But here the main point is this. If the true aetiopathogenesis of a disease is unknown , then is it not the primary step to explore the true aetiopathogenesis of any disease itself before seeking drugs for the same? How is it possible to discover a real therapeutic solution for a problem which is not fairly comprehended? In Western Medicine , most of the diseases are unexplored for their initiating cause mechanisms but at the same time , drugs are prescribed in the label of control or modify disease. Infact this is purely unethical as a disease process cannot be justified to be controlled even when the lab parameters are controlled by different suppressants as nothing is done originally to reverse the initiating cause mechanisms which favour silent progress of the disease . For example, blocking / masking immune response might control the symptoms to certain extent with predictable and unpredictable risks but it never controls the disease process as such. Clinical Re-search is originally meant for exploring the cause mechanisms of the disease and reversing the same because clinical research is meant for ultimately saving and protecting the patient and not for developing drugs. So clinically relevant research is when research outcome logically work against the intrinsic cause and course of the disease and thereby contribute to stabilise health of the subject. Hence it should be logically sound (approved by logics from Science of man to consider application in man) and intended to produce health and not a mix of benefit risks. Medicine is intended to nothing else but reverse disease and produce health. How is it decided that medicine is something which will cause a mix of interchangeable benefits and risks and the latter is because the drugs are working ?? Any stuff which is put into mouth or introduced to blood will certainly work by some or other means and “working” merely does not mean that it is a medicine . Something better working than the other by more benefits and less risks are approved everytime for treatment by so called re-search but what is originally intended to reverse the disease and emerge health is hardly contemplated ever! How can it become ethical research?
Science of man must guide research in man
When research is targeted to manufacture antying drugs and not for understanding and reversing disease in the subject in his unique setting , then obviously drug approval and not disease reversal will be the prime objective of research and this is what is happening today. As intrinsic multitangled cause mechanisms unique to the subject cannot be even imagined to be explored by western medicine for a patient with multiple diseases at the same time , they target at suppressing different diseases by different drugs by different specialists , the interaction of which in the subject also is least explored . There are people who get a chain of diseases after initiating drugs for one disease and later multiple drugs become part of their lifestyle which cause different problems for which again new list of drugs are prescribed. As there is no approval by any sound logics from science of man to recommend the use of these drug suppressant in a subject , it is completely unscientific research in the scientific perspective of Ayurveda. Ayurveda is Science Based Medicine and any kind of therapeutic decision in Ayurveda has to be first and foremost approved by the pertinent logic of science of Ayurveda as compatible to the clinical situation. There is absolutely no necessity for trial and error with medicines and treatments in Ayurveda because every medicine or treatment recommended in this science has its own highly specific and specialized background research done based on logics of Science Based Medicine with clearly specified indications and contraindications. Nothing other than the process of reversal of cause mechanisms deserve to be addressed as treatment in Ayurveda. Treating for one disease if emerging another risk, it is counted as impure / unscientific treatment in Ayurveda. The evidence of scientific treatment is naturally manifested in every subject in the form of recovery of disease and emergence of health in diseases of reversible category and enable the patient to lead a problem free healthy life on minimum medicine or life style discipline in the case of those which require lifelong therapeutic support . Ayurveda consider man as a single unit and every kind of morbidity present at the same time can be interconnected and comprehended by applying the innate logics of this science and thereby reverse by most minimum medicine without the need of any interdepartmental transfer. So the Science Based logically sound evidence is the best evidence for a human subject to be applied to make fair clinical decision in a subject for a physician as Science of Ayurveda unlike western medicine recommend means for the patient to reverse disease and not for the pharma to approve drugs.
Patient satisfaction emerges from health
What are these shared values mentioned in Evidence Based Medicine? Patient satisfaction ultimately comes from fast recovery from disease at reduced cost and this is undoubtedly their expectation on reaching a physician. Their preference is neither pain killer nor surgery , rather it is reversal of cause of pain without much interventions and reverse back to health. In such a case , if the medical system has nothing to offer to reverse other than pain killer or replacement, it has to be specifically confined to the system alone and not as generalised approved fact .There are other independent systems of Medicine with their own innate set of logics to work upon in the patient and evaluate the prognosis of the same which are unknown to western medicine practitioners.
CONCLUSION
Best research evidence must consider these questions with prime importance
1.Does the drug evidence contribute to natural reversal of cause mechanisms of disease ,equilibrium and health?
2.Is the drug proven to work based on a rational method to solve the clinical morbidity of the subject in entirety?
3. Does the drug evidence substantiate producing “Intended effect” in place of benefit risks in the patient infront of physician?
4.Does the drug evidence ensure safety and protection of the patient infront of the physician?
5.Does the drug evidence specifically ensure safety of immune system, digestion,metabolism, circulation and drainage mechanisms in the subject?
6. Does the drug evidence enable the subject to get out of drugs after reversal of the problem and stabilising health?
7. Does the drug ensure no undesirable interaction with other different drugs consumed by the same subject at the same time ?
If the answer to any or all these are no, then it is not scientific clinical research beneficial to patient and it is unethical research in the scientific perspective of Ayurveda. Currently Ayurveda community are seen mesmerised at the kind of research adopted by western medicine and copy it as it is to develop new medicines in Ayurveda. This is a worst form of insult to this brilliant system of man.
Dr. Remya Krishnan MD PhD
Associate Professor & Head
Dept of Applied Pharmacology
RGAMC
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Today science is counted as something with fallibility holding that everything will keep on proving false. I defend a more confident view; science refers to knowledge of precision and certainity and much of what a science is telling about man and universe is settled. Science incorporates repeatable fundamental logics for practical reliability and predictability. Infact such kind of sciences originally contribute to internal prosperity of man and his healthy survival on earth. And well established and repeatable observational results are paradigmatic examples of settled science . One best example is of Ayurvedic science winning pathogens by employing 5000 years old logics much faster than western Medicine. Being a clinician and scientist myself, Iam viewing this impact in my daily clinical practice.
Settled Science
Settled sciences comprise of theorems and no theories. Theories are imperfect derivations based on present available generalised observational data to explain natural phenomena while theorems or siddhanthas are proven and established facts transparent and verifiable by observational data in every period , yesterday, today and tomorrow . Hence theorems which fundamentally explain the cause- mechanism- effect relationship are able to predict the future observations and thus naturally stable and credible. Theories on the other hand possess no guarantee of stability and might require complete modification or outright dismissal. When theories are rusted, what is considered as true today might turn upside down the next day when new data of observations come to light. Theorems can explain the cause mechanisms of variable data emerging at variable period with precision and hence theorems are put forward only by settled sciences like Ayurveda and Mathematics. Settled science is not that which keeps changing rather it is that which rationally explain changes and their reasons with solid base.
Medicine must inevitably follow the logics of Science of man because Medicine is vitally meant for healing man and not for emerging drugs. Man is a settled creation on earth which means all the fundamental aspects of structure and function of man remain constant as long as man exists in the form of man. The subtle-most composition of structure and both individual and co-ordinated functioning of several tissues, organs and structures of human body are highly standardized based on certain rational logics and laws of nature at times of health and disease as long as man exist fundamentally as man in universe. Irrespective of variable external environment and internal environment, there are standardised laws to explain the mode of interaction between internal and external environment of man in settled science of man called Ayurveda. Ayurveda explains all those subtlemost invisible network of channels to modern technological aids to understand how our cells function and communicate in relation to external environment , howviable pathologies emerge in man and how to reverse them naturally by understanding logics behind with or without medications These knowledge inputs of settled science of Ayurveda are a true treasure of the times as they fill up the huge gaps in conventional understanding of behaviour of host immune system in infective disorders, metabolic diseases , circulatory and hormonal diseases etc and pertinently guide a Science Based Evidence Based Ayurveda practitioner to handle the patient by enabling him to get connected to the specific internal environment of the subject handled. These fundamental brilliant discoveries in Ayurveda remind us of the importance of understanding morbidity of any patient in totality in place of doing baseless analytic reductionism .I myself understand that counting benefit risks by applying a partially known compound in man intended to block, mask, suppress, alter etc of different enzymes, immune system,channels or hormones is utter stupidity only because I was able to learn Ayurvedic science which is technically enabling me to handle the multiple intertangled pathogenesis in a subject with confidence and predictability by employing 5000 years old laws and logics of the science .
The problems of policy makers ignoring settled science
COVID 19 is currently a social pandemic which force politicians , researchers and the public to make health decisions based on unsettled sciences which adopt falsifiability as a hallmark of their medical decisions .Allowing complete freedom to unsettled medical science of Western Medicine to possess unanimous control of people in the country is unfortunate as in Western Medicine , there is long standing impulse to prescribe a range of treatments for the sake of doing something even in cases where medical evidence is fairly clear that it is ineffective and harmful. In a democratic country like India, innate medical systems which possess core independent scientific infrastructure of settled nature are currently denied to execute their independent policies in the patients who wish for the same in pandemic and this is detrimental to humanity. FDA is an agency of Western Medicine whose intention is to produce benefits outweighing risks for the moment while Ayurvedic medical system focus on innate logical principles to DO THE INTENDED and enable to reverse disease and produce health which is fundamentally mismatching to the objective of Western Medicine. When experimental unproven drugs are used in the patients , there is clear violation of motto of “DO NO HARM” .Every medical system deserves freedom to do independent research based on their own technical scientific infrastructure of theorems, axioms, laws and logics to tackle the pandemic and one cannot be made superior to others in framing policies and action plans for pandemic. Besides, settled medical science of Ayurveda has to be given priority first because it is based on a settled science with proven and established fundamental science to guide Medicine and second because it has such a lot to offer in preventing people reach ICUs by the potential to instantaneously reverse their morbidity back to health. Ayurveda is Science Based Medicine and not medicine based science where reductionist search for a pharmaceutical cure is being continuously done based on trial and error approach.
CONCLUSION
Settled medical science of man Ayurveda undoubtedly deserves priority in handling pandemic of man and hence confident qualified people of the system are to be called upon by the Government to make urgent policies and action plans instead of doing watch and wait for aimless period by constantly adhering to policies of unsettled sciences.It has been more than a year and a half that people are suffering and WHO is speaking that we need to live with the pandemic. Every time mutation can happen to any virus and more deadly forms of virus can emerge any time and every time and hence it is high time to turn towards a settled science of man Ayurveda which does not count pathogens but explains thoroughly how to intervene upon an infected host and enable him to win infection as quick as possible and stay healthy. Do we really deserve to to err more on the side of doing something in the face of uncertain Medicine or increase the potential of intended effects of fast recovery and health of our citizens? Originally what types of evidence do we need collectively to prove that a treatment is effective or in-effective ? Do we really need temporarily valid evidences of benefit risk ratio of trial and error drugs after drugs published in so called peer reviewed journals or a live evidence of growing community of healthy self realised people in the country not only devoid of any kind of infections, but also enlightened of their own crucial role in reversing their infections ? The imperative to get independent rights to Ayurvedic system for therapeutic decisions and policies is especially high in this current scenario where future waves of COVID infection and many other viral infections are anticipated. Bringing true confident experts of the system of Ayurveda who can prove the potential of the system are to be brought to the table with administration for discussion and implementation at the earliest possible. COVID 19 could serve as the best moment for unlearning and relearning the role settled sciences in acute infections based on certainity led Science Based evidences . The earlier it is done, the better it is to save humanity
Dr. Remya Krishnan MD PhD(Ay)
Associate Professor & Head
Dept of Dravyagunavijnana
RGAMC, Mahe
WHY MODERN MEDICINE CANNOT BE SCIENCE?
Data worship
Data is just a collection of numbers , words, measurements , observations etc that can be translated into a form that computers can process. It is by collection of data that a business or management has quality information that they need to make informed decisions from further analysis and research .
Currently it is believed that health data can be used to better understand diseases and conditions in-order to make amendment to improve healthcare . But logically thinking, this belief is untrue first because healthcare is not a business, rather it is a mission . To understand the process of onset and manifestation of disease in a subject it is important that the subjects has to be studied deeply based on his unique internal and external environment and not data of population of hundred subjects with the disease who are deeply influenced by several disease modifiable factors continuously in process in the body which originally determine the state, stage and prognosis of the disease in himself. So in-order to understand a disease , the disease is to be studied wholistically in his individual unique setting especially if the final objective of the very study is nothing but to reverse the disease and thus enable the subject to be healthy. This logic applies to all kinds of diseases because even though the nature of onset, signs and symptoms of a particular disease is nearly common in all subjects, the impact of the same and hence their mode of reversal might significantly vary from individual to individual. Data is all that which display the observations and not anything with regard to the cause mechanisms of the observations. If we identify 50 spoiled jelebies in a pack of 150 jelebies , all that we can understand is that 50 got spoiled among 150 and nothing pertaining to HOW and WHY spoiled . So if a solution has to emerge to resolve a problem, knowing both WHY and HOW of the problem is extremely important and re- search is originally meant to be the process to explore and explain this “WHY and HOW” of the phenomenon which happened with finest details . The observations as such would definitely provide some clues of probability to reasons but the phenomenon has to be thoroughly known based on the subtle most aspects of several components of the phenomenon and their intertangled functioning to establish the logical reasons with precision and certainity. For that, data is not sufficient but rather a complete science of man is needed to guide pertinently in every stage of appraisal of the problem.
In the case of a disease when we consider population data, it is highly reductionist method of going from specific to general. The more generalised our analysis go, the more reductionist the result will be as several crucial deterministic logical components of analysis are missed from top to bottom in such a reductionist kind of knowledge exploration in man. The data of every individual needs separate analysis to understand the nature of impact of disease in the subject and such a kind of study would eventually emerge a series several new knowledge inputs to save the same subject and others. This kind of re- search is but only worth when there is sufficient solid knowledge base available to know the rational standards of exploring the cause mechanisms of a particular pathogenesis and its impact. Ayurveda is such a vast and subtle most science of man which explains tools and algorithms to explore any new or old disease happening to man in any period as long as man exist fundamentally as man . There are logical methods to explore by both basic and applied re-search in Ayurveda to understand any disease process happening in man and thus the system of Ayurveda has endless possibilities to help mankind in all the present day diseases including the latest emerged infective fevers and inflammatory conditions. So the crucial point is that knowledge about WHY and HOW will only help to resolve any disease in a subject and most effective and smartest medicine / treatment is best informed by an inbuilt solid background science and not an outbuilt vapour foreground data .
What do patients exactly need from a medical system?
It is not really so important for each patient to know live data every day regarding how many of them are sick in total , how many are in fatal status and how many died. Infact that kind of show information induce nothing apart from stress in the patient community which will further adversely affect their immune ,metabolic and circulatory status. What public in times of pandemic need are highly specific and highly specialized information and knowledge insight regarding how they can help themselves to get out of illness at the moment they realise that they are not well, quickly reverse the disease process and attain health. For this current statistical literacy must be switched over to essential health science literacy which enable ordinary people to understand how they get infected , how their immune system fight and resolve infections and how about their own crucial role in rendering scientific support to their immune system to reverse / prevent illness as fast as possible so that they will not escalate to complications which necessitate shift to hospital and critical care.
Only Ayurvedic science has explained these facts so meticulously based on logical demonstrable theorems and principles of precision which can be easily educated to common man for his fast and healthy recovery and all time healthy survival from pandemic. Data of benefits and risks of unknown compounds help Western Medicine to emerge new trial and error drugs which are a mandatory part of Western Medicine but this is not the case of Ayurveda. Ayurveda is Science Based Medicine and not medicine-based science. Ayurveda is a deterministic science and has a solid basement of proven and established theorems and logical algorithms to first of all understand a named or unnamed disease by its very nature of manifestation and explore its etiopathogenesis. It is the primary duty and responsibility of practitioner of Ayurveda to judiciously employ these tools and algorithms in the patient, estimate his morbidity and arrive at rational therapeutic decisions to reverse the entire morbidity ( single or multiple pathologies existing together affecting each other) and take him out of both the drugs and the disease(s). The very objective of Ayurveda is not just doing the reductionist benefit- risk ratio counting by unknown medicines but rather reverse the intrinsic cause mechanisms of illness and thus protect the patient by all means by innate logics of known and established science of Ayurveda . So public health strategies begins with private health strategies for every subject at home and thereby extending to the whole world by creating awareness regarding how to instantaneously cut down virulence of any kind of pathogen “inside his body” by adopting scientific routine for a specific short period till health is stabilized. If this is widely done all over the nation and the world, then the need of hospital admissions dramatically cut down, there will be tremendous improvement even in the status of co- morbidities like metabolic and immune disorders along with resolution of infection and inflammation , death rate by viral fever will be nearly nil and national/ global economy will improve fast and active
Data only provides probabilistic statistically meaningful prevention and treatment strategies while the solid science of man Ayurveda provides realistic scientifically meaningful strategies to originally save and protect man in any stage of pandemic. Smart and personalized self-centered healthcare emerges by implementing the strategies of Science Based Medicine of Ayurveda are required by means of which every citizen of the nation and the world becomes strong, productive and self sufficient inside out.
Logical fallacies about Scientific Medicine in the present scenario
Today the term “scientific” in Medicine is interpreted as that which is led by data and not science. Originally “scientific” is that pertaining to science and not data and science emerges from the term “scientia” which refers to knowledge and not data. Science of man (Ayurveda) consider man as a vast single system in which the basic rules of working of man are same in man anywhere, everywhere . There are standardised logical parameters to estimate the nature and aetiopathogenesis of any kind of malfunction in the working of body tissues and systems from subtlemost level and mode of rectification of the same explained in Ayurvedic science. In the case of data driven treatment , old data gets discarded and new data based on new generation drugs keep emerging from time to time. But in Ayurvedic research, as the very fundamental logics to comprehend a patient and nature of disease and mode management in accordance to the pathogenesis always remain standardized , there is only modification in the very application of logics in accordance to the patient and his unique disease circumstances.Research in settled sciences like Ayurveda is not outright rejection of existing ideas of settled proofs of treatment principles but rather deepening their applied knowledge in accordance to the conventional healthcare needs. Continuity and stability are the hallmarks of settled sciences like Ayurveda. Background knowledge and creative insight are employed by a real physician scientist of settled sciences to recognize the core essence of any disease which appears new and different. All the scientific arguments must conform to the principles of logical reasoning in inbuilt rational standards of science of Ayurveda and not based on blind probabilistic theories of Biostatistics. Ayurvedic science incorporate axioms which are absolute truths pertaining to man. Transparency and repeatability are required to be verified for axioms and logics of science and not the data of observations in clinical research . Ayurveda is thus hundred percent real science which has incorporated a very vast systematic knowledge pertaining to man organized by established logics and prinicipes with the characteristics of precision and certainity. True science explains causation and not correlation and applies deductive reasoning , i.e from general to specific unlike the inductive reasoning of probability led statistics.
Conclusion
Though Modern Medicine apply various scientific disciplines like Physics, chemistry , Biology, Biotechnology etc in drug development , patient evaluation etc , Modern Medicine ( treatment) is chosen and applied based on Biostatistics and not Science of man by counting benefit risk ratio of benefit risks of unknown or partially known compounds and there is constant falsifiability of theories emerging from temporary valid observational data of benefit risks. They rely on population oriented statistical evidence to shape guidelines for every individual patient who approach them and call it Evidence Based Medicine , though originally what they follow is reverse which is medicine based evidence. Medicine/ treatment is fundamentally intended to follow the Science of man and modify the unique internal and external environment of the subject in favour of his recovery , but Modern Medicine primarily follows Science of drugs to block, mask, suppress and alter enzymes, hormones , neuronal pathways and diseases and claim to make patients comfortable , delay symptoms , delay complications all with the risk of all time and anytime complications. Modern Medicine is thus better addressed as art of adjustments instead of science of healing of man.
Science Based Evidence Based Ayurveda (SBEBA) is a scientific innovative diagnostic and treatment methodology developed after more than ten years of intense basic and clinical research by the proponents Dr. Rajkumar KC, MD PhD(Ayurveda) and Dr. Remya Krishnan MD ,PhD ( Ayurveda)
DR. REMYA KRISHNAN
Associate Professor and Head of the Department
Department of Clinical Pharmacology
Rajiv Gandhi Ayurveda Medcical College,
( Govt. Of Puducherry Institution), Mahe
DR. RAJ KUMAR
Associate professor and Head of the department
Department of Diagnostics
Rajiv Gandhi Ayurveda Medcical College,
( Govt. Of Puducherry Institution), Mahe
