What is Systems Thinking? How is conventional biomedicine is different from Ayurveda? What is the difference between Wholistic and Reductionitic approaches?

1. Systems Thinking and
Ayurveda
(How is Ayurveda different from Biomedical
Sciences?)
Kishor Patwardhan
Professor, Department of Kriya Sharir, Faculty of Ayurveda,
Institute of Medical Sciences, Banaras Hindu University, Varanasi

2. Reductionism: Classical Thinking in science
• A complex system can be studied by understanding its
most fundamental constituent parts.
• The complex problems are resolved by dividing them into
smaller, simpler (and more ‘manageable’) units.

3. “The ultimate aim of the modern movement in
biology is in fact to explain all biology in terms
of physics and chemistry.”
- Francis Crick in his book “Of Molecules and Men” (1966)

4. Ontology: Worldview
Reductionism (Analytical)
• Physics: Basic particles (atoms/sub-atomic
particles) and forces
• Chemistry: Chemical bonds
• Biology: DNA sequences and molecular structures

5. Reductionist: ‘Low-level view is all you need’
• The low level view is all you need.
• If you know the precise structure and functions of all the
cells and their components, you should be able to
understand how that individual organism functions.
Louridas GE, Lourida KG. Conceptual Foundations of Systems Biology Explaining Complex Cardiac
Diseases. Parthasarathy S, ed. Healthcare. 2017;5(1):10. doi:10.3390/healthcare5010010.

6. Elephant and the Blind People
Each one fails
to understand
the whole!
Bhushan Patwardhan, Gururaj Mutalik, Girish Tillu
Integrative Approaches for Health: Biomedical Research, Ayurveda and Yoga

7. The Problem with reductionism
• Can life be understood through this approach?
• Can life be treated similar to a machine?
• Often the model of computers is used to explain life processes.
How far can this approach take us?
• Computers do not have the ability to ‘self-damage themselves’ and
to ‘self-repair’, but living systems have!

8. Synthesis (W)holistic worldview
• Each component is interdependent
• There are processes that interconnect the components and
make a system complex
• By understanding one component in isolation, one cannot
understand the system
• Understanding how a process/ a cell/ a tissue/ an organ/ an
organism ‘works as a whole’.

9. Wholistic approach:
You cannot always have a low-level view
• If we look at the super-system as a whole, we don't need to be
aware of all its parts.
• We can again just look at its total input and total output without
worrying which part of the input goes to which subsystem.
F. Heylighen, Basic Concepts of the Systems Approach, http://pespmc1.vub.ac.be/SYSAPPR.html

10. Closed System
• In a physicist’s model (of, say, of a pendulum) it is possible to
calculate future states with accuracy because mass, gravity,
speed, force etc are known
• In Biology, it is not possible (we do not know the details of the
roles of different components)
F. Heylighen, Basic Concepts of the Systems Approach, http://pespmc1.vub.ac.be/SYSAPPR.html

11. Open System
• Living organisms are open systems: they need to continuously
exchange matter and energy with their environment to survive.
• Open systems interact with other systems outside of themselves.
• Breathing, water intake, nutrition intake
• Excretion of by-products and wastes such as CO2, Urea, etc
F. Heylighen, Basic Concepts of the Systems Approach, http://pespmc1.vub.ac.be/SYSAPPR.html

12. Charaka Samhita, Vimana Sthana, 7/4

13. Systems Approach
नहि ज्ञानावयवेन कृ त्स्ने ज्ञेये
ववज्ञानमुत्सपद्यते ।
Charaka Samhita, Vimana Sthana, 7/4
One cannot have the knowledge of the ‘whole’ simply
by knowing its 'parts'.

14. Organisms interact with environment
• This interaction has three components:
• Input- Output (Vayu)
• Transformation/ metabolism / throughput (Pitta)
• Assimilation / storage / growth (Kapha)
Alex Hankey
A Test of the Systems Analysis Underlying the Scientific Theory of Ayurveda's Tridosha
The Journal of Alternative and Complementary Medicine, Vol. 11, No. 3

15. Super-System and Sub-systems
• Bigger systems consist of sub-systems interacting with their own
environments.
• Organism consists of systems, organs, tissues, cells etc
• The environment of a cell: ECF/ other cells / tissues
• This ‘interaction between the components’ is the one that adds
‘something more’ to what we get when we simply add individual
components
• That is why the Whole is more than the sum of its parts
F. Heylighen, Basic Concepts of the Systems Approach, http://pespmc1.vub.ac.be/SYSAPPR.html

16. Homeostasis Vs Homeodynamics
• Homeostasis (normalcy/ constancy/ risk-reduction)
• Homeodynamics (adaptability/ plasticity/ robustness)
Ahn AC, Tewari M, Poon C-S, Phillips RS. The Limits of Reductionism in Medicine: Could Systems
Biology Offer an Alternative? PLoS Medicine. 2006;3(6):e208. doi:10.1371/journal.pmed.0030208.

17. • Reductionists view ‘consciousness’ and ‘mental state’ as
chemical reactions that occur in the brain.
• They focus on the disease rather than the state of the
person contributing to the disease.
• The state of mind can affect the state of stomach which in
turn can affect the state of mind!
• These interactions are not simple, linear ‘cause-and-effect’
relations, but complex networks of interdependencies
Ahn AC, Tewari M, Poon C-S, Phillips RS. The Limits of Reductionism in Medicine: Could Systems
Biology Offer an Alternative? PLoS Medicine. 2006;3(6):e208. doi:10.1371/journal.pmed.0030208.

18. • In chronic diseases such as diabetes, coronary artery disease
the equation is non-linear with multiple factors.
• The multiple factors lead to complex interactions and thus
the conditions keep evolving.
• Therefore the systems approach is appropriate to investigate
the chronic conditions.
Ahn AC, Tewari M, Poon C-S, Phillips RS. The Limits of Reductionism in Medicine: Could Systems
Biology Offer an Alternative? PLoS Medicine. 2006;3(6):e208. doi:10.1371/journal.pmed.0030208.

19. Wholistic approach of Ayurveda
• Similar stimulus can lead to different responses in different
individuals
• Same risk factor may or may not give rise to a disease in all
individuals
• All individuals suffering from same illness may not have same
level of severity
• Same medicine may not work in all patients with same illness
• Role of diet and life-style (adhyashana/ vishamashana / akala
bhojana/ mithyahara-vihara/ etc) are the common etiological
factors enumerated in almost all diseases

20. Person-Centric Approach
दूष्यं देशं बलं कालमनलं प्रकृ त ं वयः |
सत्त्वं सात्म्यं थाऽऽहारमवस्थाश्च पृथग्ववधाः ||
सूक्ष्मसूक्ष्माः समीक्ष्यैषां दोषौषधतनरूपणे |
यो व त े चचककत्मसायां न स स्खलत जा ुचच ्||
(A.H.Su. 12/67-68)

21. Why is this understanding important?
• Avoid copying research methods that are incompatible to Ayurveda
• Clinical trials
• Drug Discovery
• To understand the role of multiple factors in causation of diseases
and also in prevention
• Ahara Vidhi/ Pathya-Apathya
• Ritu Charya/ Dina-Charya
• Kriyakala
• Prakriti / Agnibala / etc

22. The Systems Biology Graphical Notation, Nature Biotechnology 27, 735 - 741 (2009)

23. Reductionism
•Ontological
•Methodological
Explanatory pluralism in the medical sciences: Theory and practice
Leen De Vreese, Erik Weber & Jeroen Van Bouwel
Theoretical Medicine and Bioethics 31 (5):371-390 (2010)

24. Thanks!