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