HOW THE AYURVEDIC TRADITION BECAME A SYSTEM OF EMPIRICAL MEDICINE

Any history of ayurvedic development requires discussing two different perspectives; a linear religio-historical approach and a circular organic expansion. The first perceives Ayurveda as a timeless system of medicine   where its knowledge is perfect and divinely inspired; the second view is that ayurvedic medical knowledge has developed out of ritualistic healing into an empirical medicine system that is grounded in clinical experience.

The introductory verses of ayurvedic texts reflect the perspective that Ayurveda is an eternal revelation. They all start with a mythological account of the gods passing ayurvedic knowledge down to humans. This divine  stamp is a well-known Indian method of authenticating a text and making it orthodox (Wujastyk 2003). It is a way of bringing formerly untraditional and perhaps unaccepted ideas into mainstream culture. Much of the secondary and modern ayurvedic literature also implies a consistent tradition that is divinely inspired and  eternal (see, for example, Frawley’s and Svoboda’s insightful books on Ayurveda). But, as you untangle the web of influences that have affected Ayurveda the evidence clearly reveals an expanding tradition that has accumulated knowledge over time and through experience. This latter organic perspective, first introduced by Jan Meulenbeld (‘Reflections on the basic concepts of Indian pharmacology’, see Meulenbeld 1987), holds that Ayurveda is a science of unfolding truth and as a path of discovery it has not and will not remain static. These developments are not necessarily mutually exclusive, but it is useful to understand the roots of different ayurvedic traits.

The concept of a timeless tradition has great appeal, for the insights of Ayurveda are incredible and they do appear to be divinely inspired. How else have we learnt about the properties of so many herbs and minerals? How was it discovered, for example, that brahmi (Bacopa monniera) is so effective at improving the intellect and guggulu (Commiphora mukul) so useful at reducing tumours? How did the pioneers of Ayurveda learn to diagnose illness with only the five senses at their disposal? Having said this, the idea of human knowledge growing through experience, logic and insight has great value. Human development is firmly grounded in endeavour. For Indian minds this duality causes no conflict as Ayurveda can be two things at the same time: both divinely inspired and open to human adaptation. This is a powerful medium for expression of the truth as it is both reductionist and holistic.

Taking the first paradigm, while there is nothing inherently wrong with the claim of eternal divine origins there are some potential problems with this perspective. It could potentially stifle new ideas within Ayurveda as, in order to gain validity, there is a tendency for clinical experience to be referenced back to a divine eternal source. Humble that this approach is, new ideas are not easily propagated. There is an element of this attitude displayed by the core theoretical ground of Ayurveda, having remained very similar over the last 2000 years. The relative lack of modern innovative ayurvedic literature generating improved methods of treatment, in comparison to Chinese and Western herbal medicine, is perhaps partially a result of this. It may be that the inherent theories of Ayurveda are already com-plete, but effective clinical insights are always of benefit as new diseases and cultural habits arise. The insistence on divine origins has stagnated this process of valuing both clinical experience and theory.

It is not therefore surprising that as Ayurveda has been under continual threat from certain Moghul, British and, currently, allopathic forces in the last 400 years, it has in some quarters been necessary to fall back on its ancient roots in order to validate and justify its presence. This has protected but also weakened Ayurveda. Its strength is really in its present clinical excellence and the ayurvedic community should be harnessing powerful social forces and speaking with confidence about its ability to help our society. However, this is made difficult when Ayurveda is presently only recognised as an adjunctive medical system, where ayurvedic doctors can only hold the position of a third medical officer at primary health centres in India, and complementary medicine the world over holds a similarly lowly position in the medical hierarchy. As a literature base of over 2000 years, hundreds of thousands of expert physicians, millions of healed patients andnumerous positive clinical trials attest, ayurvedic treatment works and practitioners and professional registers should promote this, researchers should publish clinical data and governments should support it enthusiastically. Although Ayurveda has its roots in the past, its practitioners must embrace the present. Ayurveda and ayurvedic physicians deserve greater recognition than they receive today.

Another, and potentially more serious, problem of relying on a doctrine that holds its origins as divinely and infallibly inspired, is that it can and has resulted in right-wing fundamental political groups utilising it to their own ends. This is clearly the case in India today with the current rise in popularity of right-wing fundamental Hindu groups, and shows how the struggle for political supremacy can infect religion (and vice versa). This insistence of the divine origins of Ayurveda may unwittingly reinforce this political doctrine if it continues to ignore modern Indological historical knowledge. By this, I refer to certain quarters of the academic community promoting this ideology as though Vedic knowledge has remained eternally and statically predominant in all aspects of Indian culture for all time. The point is that while religion, medicine and politics are interrelated, the  potential repercussions of an ideology must be considered; in this case, pandering to extreme political causes that oppose the central tenet of Ayurveda—caring for all humanity.

The second paradigm, the scientific dependence on empirical evidence, can also be taken too far to the extreme, with similar detriment. This has occurred within the modern medical paradigm of ‘evidence-based medicine’ requiring ethically dubious double-blind clinical trials and animal experiments with a heavy dependence on single active ingredi-ents, synthesised medicines, separate chemical pathways and a reductionist methodology that has lost the holistic view.

Holding onto the primacy of either of these two paradigms means that the complete picture is missed. As we shall see, Ayurveda can offer a balance to these extremes as it contains both paradigms within it.

I think this inner debate between tradition and progression is mirrored in our everyday lives and specifically experienced when using natural medicine. The question is how to respect tradition while integrating personal experience. Internally it is a case of communication between heart and head where intuition and intellect are both valid. As we shall see, intuition and intellect are both essential for medicine to be, as Ayurveda is, truly holistic.