In 2018, health minister JP Nadda introduced the National Medical Commission Bill in the Lok Sabha. Among other things, the bill proposed licensing Siddha, Ayurvedic, and homoeopathic practitioners as allopathic health care providers upon completion of a ‘bridge course’.
After vociferous protest by the Indian Medical Association (IMA), which said the bill would legitimize “quackery”, a parliamentary panel recommended against such a change, leading to the ‘bridge course’ clause being removed.
While the bill remains on course to being passed with several controversial revisions—such as the addition of clause 32, under which health providers like compounders, lab technicians, and blood sample collectors could get a license to practice medicine—the first draft of the bill raised the question: What are the dangers of legitimizing Ayurveda?
The origins of Ayurveda may stretch as far back as 6000 BCE, starting out as an oral tradition in the Indus Valley Civilization, and later inscribed in the four sacred Vedas: Rig Veda, Yajur Veda, Sam Veda, and Atharva Veda.
Built on the bedrock of knowledge gained using observation and experience, the Ayurvedic system of medicine prescribes advice on diet, exercise, sleep, hygiene, and the use of herbal preparations with spices, herbs, plants, and oils.
It is becoming increasingly popular both inside and outside India as a complementary mode of treatment alongside “conventional medical approaches”, and in some cases as a replacement.
A system that is one of the precursors to modern pharmacology and is built on observations and experiences over thousands of years cannot haphazardly be dismissed as fantasy, myth, or old wives’ tales.
However, does it pass the rigours of modern scientific methodology, which designs methods to minimize variables and provide data and empirical evidence?
Ayurveda’s three basic principles–vata, pitta, and kapha–are called doshas, or energies, which are derived from the five elements of Indian philosophy: vayu meaning air; aakaksha or dyaus meaning aether; agni meaning fire; apas, varuna, or jal meaning water; and prithvi or bhudevi meaning earth.
The vata dosha refers to the body processes governed by air and space, and regulates the input-output processes and motion, such as blood flow, breathing, thinking, and waste elimination.
The pitta dosha is associated with fire and water, and regulates our “throughput”, or our metabolism.
And the kapha dosha is related to earth and water, and regulates our storage and structure.
It is believed that each individual has a unique combination of these three energy forms that compose their bodily functions, structures, mannerisms, and psychologies. Ayurvedic treatments are designed to balance and synergize these energies.
Thus, by modern scientific principles, Ayurveda cannot be considered a science as it relies too heavily on largely untested hypotheses and metaphysics. The unique energies of people might indeed exist, but modern science relies on quantifiable data and empirical evidence, while Ayurveda focuses on more esoteric and unquantifiable elements.
Accordingly, if Ayurveda is a pseudoscience, what then are the inherent risks and dangers of legitimizing it?
The Drugs & Cosmetics Act, 1940 and the Drugs and Cosmetics Rules, 1945 provide regulations and quality control mechanisms for Ayurvedic medicines. There are 27 State Drugs Testing Laboratories and 41 government-approved private sector laboratories that test Ayurvedic medicines.
However, former President of the Indian National Science Academy and National Research Professor of the Government of India Dr. M. S. Valiathan says “the absence of post-market surveillance” and a lack of “test laboratory facilities” undermine quality control mechanisms.
Furthermore, the World Health Organization (WHO) guidelines on clinical trials requiring “randomized, double-blind, controlled trials” do not apply to traditional medicine like Ayurveda. Rather than abiding by the ‘theoretical framework’ of modern medicine, Ayurveda can be evaluated within “its own theoretical framework”.
Thus, not only are there infrastructural deficiencies to ensure quality control, there is also a lack of regulation to ensure scientifically-supported clinical trials.
Therefore, while legitimizing Ayurvedic practitioners might alleviate some of the pressures generated by the 600,000 doctor shortage in India, such solutions merely paper over cracks and ignore the global impacts of giving scientific and medical credence to Ayurveda.
Proposals such as the National Medical Commission Bill tabled by JP Nadda draw parallels with the infiltration of Traditional Chinese Medicine (TCM) into conventional medical circles. The medical efficacy of practices like acupuncture—the insertion of needles into the skin to harmonize one’s life force, or qi—has been debunked through thousands of medical studies, yet has gained global legitimacy.
Similarly, it is vital to ward off the pseudoscientific elements of Ayurveda, which endanger people’s health and undermine the legitimacy of evidence-based medicine (EBM) by mere association.
For instance, rasa shastra—“the practice of adding metals, minerals or gems to herbal preparations”—has been found to include toxic metals such as lead, mercury and arsenic.
A 1990 study on Ayurvedic medicines in India found arsenic in 41%, and lead and mercury in 64% of the products tested. Traces of microbial organisms and pesticides have also been found. The lack of regulation and dangers of Ayurvedic products remain unaddressed, and threaten global health.
A 2004 Journal Of The American Medical Association (JAMA) study revealed toxic levels of heavy metals in 20% of Ayurvedic products that were made in South Asia and sold in Boston. A 2008 JAMA study found that roughly 20% of Ayurvedic preparations and 40% of rasa shastra medicines purchased online from US and Indian suppliers contained lead, mercury, or arsenic. A 2015 International Journal of Occupational and Environmental Health study of users of Ayurvedic products in the USA found “elevated blood lead levels” in 40% of the participants.
Proponents of Ayurveda claim that such results can be explained by the fact that modern mass production techniques do not properly practice samskara or shodhanas–the process of detoxifying heavy metals and toxic herbs. However, numerous studies of Ayurvedic products across three decades point to the fact that such processes are ineffective in removing heavy metals from Ayurvedic preparations, regardless of the scale of production.
Ultimately, there are elements of Ayurveda that are useful as cost-effective complementary treatments for non-life threatening conditions, and there is no reason to discard the practice as a whole. However, moves to license ayurvedic practitioners as allopathic medical practitioners, and the growing global influence of Ayurveda, present a unique set of dangers and challenges. Without stricter regulations or rigorous clinical testing measuring the efficacy of Ayurvedic products, legitimizing a pseudoscience threatens global health, and delegitimizes evidence-based medicine by association.
What Are The Dangers Of Legitimizing Ayurveda?
Licensing ayurvedic practitioners as allopathic medical practitioners sets a highly dangerous precedent for the future of medicine in the country.
November 21, 2019
IMAGE SOURCE: NIKOLAYDONETSK / DREAMSTIME.COMA system that is one of the precursors to modern pharmacology and is built on observations and experiences over thousands of years cannot haphazardly be dismissed as fantasy, myth, or old wives’ tales.