Ayurveda

3 February 2003

Published in The Age

With its roots in India’s ancient Vedic scriptures, the Ayurvedic healing system is one of the world’s oldest. Ayurveda (pronounced eye-yar-VAY-da) survived both the Muslim and British invasions of India, and began a renaissance after Indian independence in 1947.

Growing concerns about modern pharmaceuticals have greatly increased Ayurveda’s popularity in the past ten years. In Delhi, the government is creating dozens of “drugless” ayurvedic hospitals, clinics and dispensaries.

At the same time as this resurgence on its home turf, Ayurveda is now gaining a foothold in the West.

A keystone of Ayurveda is that mind and body are one. For example a seventh century ayurvedic text cites the need to purge the spirit of “desire, agitation, delusion and dissatisfaction” as a prerequisite to destroying disease. Such ideas, which would have seemed bizarre to us 20 years ago, are now gaining some support in the West through such new sciences as psycho-neuro-immunology.

Ayurveda’s 250,000 practitioners - nearly all of them in India - believe in the three dosas, or “principles of energy”. Vata is motion - everything that moves in the body, including thought. Pitta is in charge of transformation - for example digestion and processing data in the brain. And kapha is the stabilising energy: it lubricates, maintains and contains.

Too much or too little of one or the other is seen as a transgression against the rhythm of life - from which psychic and physical illness arise.

Nevertheless people are born with one dosa or the other predominating, and need to be treated accordingly. In sharp distinction to Western physicians, Ayurvedic doctors believe a treatment that will benefit creative, mercurial vata types, for instance, may not be of use to pitta people, with their large appetites and strong metabolisms. People’s dosas - which can run them off the rails if taken to excess - need to be tempered by their lifestyles.

Ayurvedic physicians diagnose by examining faeces, urine, tongue, sound (for example heartbeat, tone of voice), touch, face and pulse.

When irregularities are found, a practitioner will prescribe daily and seasonal routines - diet, activities, thoughts - the essence of which is moderation. Svasthavrtta - establishing oneself in good habits - is the aim.

Ayurveda also employs herbal “drugs”, purification (sweating, enemas), minerals, massage, yoga, music, meditation and worship. Some practitioners have incorporated outside arts such as acupressure, aromatherapy and homeopathy. Ayurveda began using surgery 3000 years ago.

Like Western, Islamic and Chinese medicine, Ayurveda is a model of health and illness. Like them, sometimes it is successful (that is, sometimes the model holds up) and sometimes it isn’t.

Indu Narayan is an Ayurvedic physician who practised in India for 15 years before moving to Sydney nine years ago. “When I arrived here, I contacted some of the complementary medical societies, and people hadn’t heard of Ayurveda,” she says. “But in the past two years it’s moving ahead very fast.”

Narayan treats digestive problems more than anything, and prescribes mostly herbs and dietary change. “And if the cause is an emotional one, also a bit of counselling. This is a holistic approach.”

Narayan lectures to Sydney University students - mostly Pharmacology and Medicine graduates studying for the Masters degree in Herbal Medicine, which now includes ayurvedic principles.

Away from the medical mainstream, the Australian Association of Ayurveda runs a training college in Adelaide.

For all this, Ayurveda is lagging other holistic modalities when it comes to scientific validation.

A search of the US Government database of clinical trials (http://clinicaltrials.gov) yielded not a single result for Ayurveda. Other medical databases also produced slender returns. Practitioners in India contacted by The Age, whilst staunchly maintaining that Ayurveda is “science”, were nevertheless unable to cite successful double-blind trials. A spokeswoman for the leading US Ayurvedic clinic, The Ayurvedic Institute in New Mexico, said:

“There are no comprehensive studies that we know of done on Ayurvedic therapies as the sole modality for healing.”

Ayurveda is unlikely to have survived 3,000 years if it didn’t work. But studies employing scientific method will help win over skeptical Western scientists, doctors and health bureaucrats, and thus gain it funding and recognition.

Better trials will also help sort Ayurveda’s wheat from its chaff. One of the few trials already conducted, in Sri Lanka in 1976, underlines this pointedly. It found that the ayurvedic compound Maharasnadhi quathar may significantly lower the inflammation caused by rheumatoid arthritis. But another oft-used ayurvedic compound, Weldehi choornaya, proved to be a dud.

Which only goes to show that traditional methods sometimes “work” because of the power of the placebo effect - that is, because patients believe in the therapy.

Overall though, Ayurveda does show scientific promise. The US National Institute on Aging has subjected 40 ayurvedic herb extracts to high-tech assays, and many were found to have “potent selectivity” to various receptors, including those involved in mental disorders. In other preliminary studies, ayurvedic herbs show promise for duodenal ulcers, rheumatoid arthritis and Parkinson’s Disease.

The trikatu group of ayurvedic “acrids” (long pepper, black pepper and ginger) appear to significantly increase absorption of pharmaceutical drugs.

In addition to getting serious about clinical trials, Ayurveda may also benefit from throwing out some of its more archaic practices, particularly regarding drug safety. A 1992 article in the Medical Journal of Australia reports that a 37-year-old man who had seen an ayurvedic doctor in India was admitted to the Flinders Medical Centre with lead poisoning. His herbal tablets, on analysis, proved to have “a very high lead content”. Other studies have found organochlorine pesticide residues in ayurvedic preparations.

Incidents like this should not be taken out of context - after all, Australian hospitals kill 18,000 patients a year with “preventable hospital mishaps”. Holistic approaches such as Ayurveda remain way ahead in terms of patient safety.

Finally, Ayurveda’s credibility has not been enhanced by the  statements of some of its modern interpreters, such as Dr Deepak Chopra. Chopra - who has taught “Maharishi Ayurveda” - claims that 15,000 American transcendental meditators can fly, without the aid of an aircraft.

He also believes: “If you could live in the moment you would see the flavor of eternity, and when you metabolize the experience of eternity your body doesn't age.”

This is Ayurveda for the US New Age market. Traditonal Ayurveda is far less concerned with Western sensibilities. In India, Ayurvedic physicians sometimes lie about a therapeutic food (for example describing fried earthworms as “noodles” so a patient will eat them); are forbidden to demand money from the poor before administering treatment; and tend not to treat the dying - believing they should be left to die in peace.

The World Health Organisation sums it up in a recent report:

“Systems like Ayurveda still need to gain an empirical support of modern medical science to make them credible and acceptable for all.”

This may seem like a tall order for a holistic modality, but Traditional Chinese Medicine has shown it is achievable - and TCM success stories are now appearing in a range of medical journals worldwide.

If ayurvedic practitioners do not follow suit, they may be left behind in the global swing away from mainstream medicine - as increasingly educated Western health consumers choose other, more proven, paths.