WHAT IS REQUIRED IN AYURVEDA FIRST AND FOREMOST

1. DR. REMYA KRISHNAN MD (AYU), PHD
Why Ayurveda doctors should Care about
practising Science Based Medicine

2. What is Science?
 Science is tested ,verified and
permanently proven and established
knowledge (set of rationale) based on
reasoning by cause- mechanism – effect.
 “Science" also refers to a body of
knowledge itself, of the type that can be
rationally explained and reliably applied in
every period .

3. Ayurveda is Science Based Medicine
 Ayurveda incorporates permanently proven and
established theorems and principles for practice .
 In Ayurveda, Medicine is led by Science and not
the reverse .
 So Ayurveda is Science Based Medicine

4. Science Based Ayurveda
 Ayurveda advocates conscientious use of Basic
science in making health care decisions .
 Ayurveda emphasises upon “Shasthrartha
karma” ( Science Based practice )and not “
Karmartha shasthra” (Practice based Science)
 The rationale which explain diagnosis,
pathophysiologic principles and treatment
principles in Ayurveda are fundamentally correct
and thus capable of accurate predictions .
 Thus Ayurveda is “Science Based Evidence
Based”

5. Science Based thinking is deterministic way of viewing
 Ayurveda advocates the scientific steps for
deterministic way of exploring a human subject
in his own unique circumstances and the
impact of external environment upon him .
 Ayurveda thus deserves to be instigated in
schools itself to inculcate the fundamental
knowledge of human being and his response to
external environment in children

6. Evidence Based Medicine
 Evidence Based Medicine is Medicine based on
evidence .
 Evidence is required for intended action of the
medicine in intended situation ( siddhi) and not mere
“efficacy” (karma) .
 Evidence in Ayurveda in primary level is not to enable
the medicine “do more good and less harm” in a
probabilistic way like in Modern Medicine.
 Instead, the primary evidence must enable the
medicine “do the intended” and thus protect from
every harm based on certainity.

7. Do the intended &protect from every harm
- This is the motto of Ayurveda
- Evidence in Ayurveda is not mere data to
support benefits of medicine .
- Evidence in Ayurveda is “the systematic science
based knowledge which guided to do the
intended on time and protect from every harm “.
- The systematic synthesised knowledge should be
acquired by every single brain of Vaidya by
shasthraarthakarmaanusheelana .
- Ayurveda require physicians to be scientists (who
ponder into shasthraarthas and apply) and not
scientific workers who handle data and call it
science .

8. Evidence is not
 Data supporting use of medicine .
 Data supporting the benefits of Medicine outweighing the risks .
 Data showing 80% chance of certainity
 Credibility of shared experiences offered by experts in the field
Evidence is proven and established :
 Knowledge refined to guide the use of medicine .
 Knowledge refined to guide the use in specific individual.
 Knowledge refined to guide the use in specific internal
circumstances .
 Experience based knowledge. But it is knowledge based
experience .
“ shasthrasahitatarko sadhanaanam”

9. Ayurveda applies MATHEMATICAL THINKING
 Mathematical thinking is deductive: the
inference of particular instances by
reference to a general law or principle.
“General to specific”.

10. Statistical Thinking vs. Mathematical Thinking
 Statistical thinking is inductive: the
inference of general laws from particular
instances.
“Specific to general”
Application of statistical thinking is
unscientific in Ayurveda

11. Why Should We Care About
Teaching “Shasthraarthas” and not
shasthra ?
The teaching of shaasthararthas would equip
Ayurvedic medical graduates to
 Understand algorithms of decision making in
diagnosis and treatment explained in shasthra
 Understand and apply shaasthraarthas (science
based evidences )
 Translate shasthraarthas into everyday clinical
situations which they encounter with
 Estimate and confirm the accuracy of their
calculations in decision making .
 Effective communiction of shasthraarthas with
colleagues and patients

12. NOT AYURVEDA
 Without the pertinent application of
shathraarthas, there is no shatshra .
 So today, though there is a community to
learn, practice and propagate Ayurveda,
as they are not even getting to know about
and practice shasthraarthas, what they
practice CANNOT be claimed as Ayurveda
 There is no solution other than learning
shaasthraarthas and their pertinent
application rather than read shaasthra !!!!

13. HEIGHT OF ABSURDITY
 Irrelevant and baseless incorporation and
discussions about modern research methodology
and biostatistics in Ayurveda should be diverted to
Basic science led Applied Medicine and INBUILT
research methodologies and standards.
 When basic science of Ayurveda readily provides
the solid primary evidence base for attaining pin
pointed diagnosis and on the target treatment
guidelines , it is true insult to science and pure
absurdity to blindly test“ blindly advocated”
treatments , collecting data and pushing treatment
forward.

14. Theorems vs theories
 Exploration, all kinds of decisions and
research in Ayurveda should be primarily
led by science , never misled by
statistics.
 It is to be noted that Ayurvedic science
incorporates settled theorems
(siddhanthas) and not empiricism based
unsettled theories as in Modern Medicine
as substratum for decision making

15. Science Based Evidence
 So we can make our patients to have full
confidence that the treatment which they
receive is based on solid science based
evidence and not the fragile data based
temporary evidence .

16. Tradition is not science
 The currently followed procedure of treatment in
Ayurveda is based on tradition and not science.
 Doctors teach and treat based on “ their knowledge”
passed over through generations in contrary to solid
“Science based knowledge” which explain the
standardised decision making guidelines and procedures
in diagnosis, differential diagnosis, prognosis and
treatment .
 Doctors infact do not know that what they practice
every day is not science. For this reason they
dangerously misinterpret the great science as
tradition ( practices blindly continued for generations )!!

17. Thinking outside the box
 After teaching the difference between
tradition based practice and the very
intended science based practice in
Ayurveda, it requires young and old
physicians to question the currently
ongoing convention ( copying what others
do) based or tradition (what forefathers
did) based treatments and to think outside
the box and based on science.

18. No reason to compare
 EBM studies in Ayurveda cannot be blinded
(neither the researcher nor the patient knows
what is given) because the science of
Ayurveda strictly advocates to practice
“jnana poorva karma “ .
 There is no reason for competition between
different treatments or medicines of Modern
Medicine and Ayurveda because the
objective of the former is benefits
outweighing risks while that of latter is the
intended effect of health.

19. No reason to compare
 Also, there is no reason for competition
between different treatments and
medicines in Ayurveda because the
science determines the standardied
treatment in every situation and not the
treatment determines the science.
 Each and every treatment is unique and
clearly intended for its own indications .

20. Crucial Necessity
 Science Based Evidence Based Medicine
is an inevitable component in curriculum of
Ayurveda, in BAMS, MD , PhD in all
Ayurvedic hospitals , teaching institutes
and research centres as it is an area that
Ayurveda medical students and doctors
must pay close and constant attention to
through out their life for the optimum
patient care and professional satisfaction

21. SBEBA Wisdom series
 The scientific infrastructure, tools and methodologies
to practice SBEBA are developed by Dr. Rajkumar MD
PhD and Dr . Remya Krishnan MD PhD and
published in the book authored and published by Dr.
Remya Krishnan, Evidence Based Ayurveda &
Rational Prescribing (2012).
 A training programme for doctors called BHARAT
MISSION BHISHAK in the form of CMEs and
Workshops are also being conducted ( A programme
of first kind in Ayurveda) to initiate the culture of
evidence based medical practice in Ayurveda and
attain the mission of “Scientific prescribing by all” by
2020 .

22. Government attention
required
 This project requires attention from central
and state Governments . Training is to be
initiated
a. In a university setting (all Ayurveda
institutes) .
b. Private practice associated with a
residency programme.
c. Research institutes of Ayurveda

23. LET US PROSPER BY SHASTHRAARTHAS
“Sarvam cha roga prashamaaya karmam
Heenatimatram vipareetakalam
Mithyopacharaaccha na tam vikaram
Shaantim nayet pathyamapi prayuktam”
( Cha. Si)
THANK YOU