Research in Ayurveda
Ayurveda emphasizes experience and verification as the ultimate criteria to validate a knowledge system. The term veda denotes sattā (existence), jñāna (knowledge), vicāra (inquiry) and lābha (attainment).
The method of knowledge building as explained in Ayurvedic texts can be summarised as follows.
Observation: All Indian knowledge systems emphatically declare that experience is the true basis of knowledge. Therefore, knowledge is experiential - anubhava. However, the ancient sages realized that experience in itself does not constitute knowledge. Experiences have to be validated through the process of verification. Verified experiences are valid and constitute the true source of knowledge. Thus, experience is of two types – valid - yathārtha anubhava or invalid - ayathārtha anubhava. Technically, the understanding gained out of rigorous observations is called as pramā and that gained out of improper observations is called as apramā. The source of knowledge in Ayurveda, therefore, is rigorous and systematic observation. This is indicated by sattā, meaning existence, one of the meanings of the root from which the word veda is derived.
Codification: Experiences gained by observations have to be codified in a proper way so that others can verify it. Ayurvedic texts have laid down guidelines for effective codification of technical information. The perfect technical codification is called as a tantra and the criteria to construct a tantra are well defined through the concept of tantraguṇas. A good presentation is quintessential and unambiguous. This is indicated by vetti, meaning to know clearly, one of the meanings of the root from which the word veda is derived.
Analysis: Before attempting to verify, one has to properly understand a technical presentation. In other words, a technical presentation has to be analyzed and understood properly first. Otherwise, the process of verification will be defeating its purpose. This is indicated by vicAra, meaning to analyze, one of the meanings of the root from which the word veda is derived.
Verification: Verification adds value to the knowledge and in due course of time, generates a body of knowledge that has been rigorously tested again and again. Ayurveda distinguishes between jñāna and vijñāna, the former denoting understanding and the latter experience. Ayurvedic texts say that one needs both understanding and experience and neither understanding nor experience by itself can lead to complete knowledge. Therefore, the student is advised to first gain understanding by study of authoritative texts and then confirm the understanding personally through the process of investigation called parīkṣā. This is indicated by the word lābha, meaning to obtain, one of the meanings of the root from which the word veda is derived.
Research in the modern sense of the word is a recent development in the field of Ayurveda, it seems.
Modern research in Ayurveda began in the pre-colonial period. The first encounters of Europeans with indigenous health care systems in India resulted in the documentation of traditional medical practices like rhinoplasty (nose reconstruction surgery) and small pox inoculation. In the 16th century, the Portuguese physician Garcia Da Orta compiled information on drugs from Ayurvedic pharmacopoeias.
The Dutch Governor of Malabar , Hendrick Van Rheede, commissioned the work on the Hortus Malabaricus. This work captured on copper plates the wealth of information on medicinal plants of Kerala in the form of stunning diagrams and notes. The indigenous physician, Itty Achuthan made substantial contributions to generate the content for this work. Much of the research on Ayurveda that has taken place consequently has been from a medical historical, linguistic and philological point of view. Many western scholars like Hoernle, Filliozat, Roşu, Zimmerman, Leslie, Meulenbeld, Wujastyk and others, studied Ayurveda extensively and brought to light many aspects of Ayurveda to the modern world. GJ Meulenbeld has written the most comprehensive history on Ayurveda in five volumes. This work is titled as History of Indian Medical Literature. Such research approached Ayurveda from a historical and philological point of view. There is lack of good anthropological studies in Ayurveda that captures the richness and depth of India’s living medical traditions.
India’s first prime minister Jawaharlal Nehru emphasized the need to initiate research in Ayurveda with inputs from modern science. Mahatma Gandhi had also pointed out the need to study Ayurveda from a scientific perspective. However, it took a long time for independent India to set up the facilities and formal mechanisms for systematic research in Ayurveda. There is still a lot of work that needs to be done to step up research in the field of Ayurveda so that it meets global standards.
Institutional research environments for Ayurveda are today broadly of three kinds. We have the Post Graduate and Doctoral programs in university based Ayurvedic education. Here Ayurvedic students learn the first lessons of research. The compilation of research thesis deposited in the schools of Ayurveda have revealed a large number of titles ranging from literary to experimental and clinical research conducted by students of Ayurveda pursuing their post graduate and doctoral degrees. The apex body for research is the Central Council for Research in Ayurvedic Sciences (CCRAS) (www.ccras.nic.in) run by the Government of India with various units spread out in the length and breadth of the country. The Council has many publications to its credit including research journals, conducts research in specialized areas, and also funds research done at other organizations through grants offered under an extra mural scheme. The third category of research institutions are in the private sector undertakings which are mostly attached to the pharmaceutical industry and engages in research related to quality control and standardization of commercially manufactured Ayurvedic medicines. Many such research units are recognized by the Government of India as SIROs (Scientific and Industrial Research Organizations). Examples are the Dabur Research Foundation and the AVP Research Foundation. There are research centres working within the University environments like Amrita Centre for Advanced Research in Ayurveda. The Trans Disciplinary University in Bengaluru also
For a long time, research on Ayurveda was more or less centered on ethnobotany and ethnopharmacology. Ayurvedic pharmacopoeias were seen as a rich source of information that could provide leads for the development of new drugs with the help of modern drug discovery protocols. Ethnobotanical surveys listed medicinal plants used by indigenous medical traditions and attempts were made to isolate the active molecules to discover so- called new chemical entities.
The story of the discovery of reserpine from the plant Rauwolfia serpentine was hailed as the blue print for similar breakthroughs in the future. Much of Ayurvedic research in research institutes across the country follow such methods. The Golden Triangle Initiative under the New Millennium Indian Technology Leadership Initiative (NMITLI) is an attempt to bring traditional medicine, western biomedicine and modern positivist science together to spark off new pathways in drug development based on clues from traditional medical systems like Ayurveda. The Golden Triangle Project is being implemented through apex bodies like the Central Council for Research in Ayurvedic Sciences (CCRAS). A spin off from the modern ethnopharmacological research in Ayurveda is the Traditional Knowledge Digital Library (TKDL), which is an attempt to protect traditional medical knowledge of India from commercial misapporpriation by providing access to codified knowledge in ancient manuscripts to patent offices around the world.
The reverse pharmacology approach propounded by the Indian pharmacologist Ashok Vaidya emphasizes that research in Ayurveda should begin at the clinic and proceed to the lab unlike what is the case in of western biomedicine where drugs are first developed in the lab and then applied in clinical practice. Ashok Vaidya also highlighted the need for pharmaco-epidemiological studies in Ayurveda because a large number of people in past and present take Ayurvedic medications. In Ayurveda, more than often, it is a case of understanding how medicines already in use work rather than developing new drugs that have never been used by human and therefore need testing.
It is interesting to see that modern research initiatives are also shifting from drug development to validation of the core concepts of Ayurveda. The Ayurvedic concept of physical constitution known as prakriti has been subjected to scientific studies with a view to establish a genomic basis or identify biochemical markers that can help to characterize a particular body constitution. Some of these research initiatives led by scientists like Bhushan Patwardhan, Bhavna Prasher, Supriya Bhalerao and others have led to publication of research papers in high impact journals.
Prof. M.S. Valiathan’s, a retired modern surgeon who holds the prestigious position of National Research Professor, has initiated ‘A Science Initiative in Ayurveda’ (ASIA) as a novel approach to the scientific validation of Ayurveda, which shifts attention from drugs to concepts. ASIA attempts to validate key concepts that constitute the corner stone of Ayurvedic thinking like dehaprakriti (physical constitution), rasashastra (the manufacturing and application of metallic compounds in therapy), dravyaguna sastra (Ayurvedic pharmacology), pancakarma (five-fold therapy), shodana (bio-cleansing of the body) and rasayana (anti-ageing therapies). The ASIA project has also led to a few publications in high impact journals. The Department of Science and Technology (DST) under the Government of India now invites research proposals for projects to be implemented under a scheme known as Ayurvedic Biology, which draws its inspiration from the idea that ancient Ayurvedic insights can open new avenues of knowledge in modern biology.
In recent time, the Ayurvedic community has made great strides by publishing a few research journals that have found their way into international research databases like PubMed and Scopus.
The first research journal from Ayurveda to be indexed in PubMed database was the International Journal of Ayurveda Research published by Ministry of AYUSH, though it was discontinued. The other PubMed indexed journals are Ancient Science of Life, Ayu and Journal of Ayurveda and Integrative Medicine, which also happens to be the only Scopus indexed research journal in the field of Ayurveda. Recently, All India Institute of Ayurveda launched the Journal of Ayurveda Case Reports, which is published by Wolters Kluwer. There are also research journals published by National Institute of Ayurveda and Central Council for Research in Ayurvedic Sciences, but these are not yet indexed in PubMed or Scopus. Annals of Ayurvedic Medicine is another research journal in the field of Ayurveda which is included in the UGC Care list.
Two research databases providing a one stop access to published research papers on Ayurveda have been set up, one of which is hosted by the Department of AYUSH, Government of India, known as the AYUSH RESEARCH PORTAL (http://ayushportal.ap.nic.in/). The other database known as DHARA – Digital Helpline for Ayurveda Research Articles (http://www.dharaonline.org/) was developed by AVP Research Foundation, with funding from CCRAS. The former is a repository of research papers and other official documents related to Ayurveda and other systems in the AYUSH stream, whereas the latter is exclusively dealing with research papers published in indexed journals.
In recent times, there is much talk about evaluating complex systems of therapy through Whole Systems Research (WSR) approaches, which offer the possibility of looking at the complex multimodal nature of Ayurvedic interventions in its totality. There are two landmark studies in this area. Both studies won the prestigioius Excellence in Integrative Medicine Research Award from European Society of Integrative Medicine. The first study was conducted with a research grant from the National Institute of Health, USA, fostering a collaboration between the University of Washington(Seattle), the University of California( Los Angeles) and The Ayurvedic Trust, Coimbatore, India. The study, led by the leading Rheumatologist, Dr. Daniel Furst challenges the conclusions of previously published systematic reviews on the efficacy of Ayurvedic treatment in Rheumatoid Arthritis. Through a rigorously conducted pilot study Furst and his colleagues show that complex individualized Ayurvedic treatments for rheumatoid arthritis may be equivalent to the biomedical arthritis drug methotrexate in efficacy. The second study assessed the effect of whole system Ayurvedic intervention in osteoarthritis and was a collaboration between Central Council for Research in Ayurvedic Sciences, India and Charite Medical University, Germany. The outcomes of this study demonstrated that the whole system Ayurvedic interventions resulted in better clinical outcomes compared with standard of care.
In spite of these advancements, research in Ayurveda faces many challenges. Limited allocation of funds, limited access to laboratory and clinical facilities to conduct research, adoption of inappropriate research methodologies and scarcity of high quality publications are factors that have come in the way of research in Ayurveda making a significant impact globally.