Translated from Juv. Tec. Digital, (https://medium.com/juventud-tecnica/el-ayurveda-y-la-medicina-no-cientifica-45f9dd743f75

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Ayurveda and non-scientific medicine

Arnaldo González Arias, May 2019

Versión en español

 

A few weeks ago, medical staff of the Natural and Traditional Medicine (NTM) group of the Ministry of Public Health described in a very favorable way the "Ayurvedic medicine" in a television space of wide audience; this modality was qualified as "great". This is why it seems opportune analyzing in detail what is Ayurvedic medicine.


Descripción: D:\Arnaldo 2019\WEBgeocities\rationalis\ayurveda\portada.jpg  Descripción: D:\Arnaldo 2019\WEBgeocities\rationalis\ayurveda\Dhanwantari.jpgDescripción: D:\Arnaldo 2019\WEBgeocities\rationalis\ayurveda\doshas.jpg  Descripción: D:\Arnaldo 2019\WEBgeocities\rationalis\ayurveda\Susruta.jpg


 Scientific and non-scientific medicine

There are two main types of medical care in the world: scientific (or evidence-based) and non-scientific. Scientific medicine is what we all hope to find when attending the medical consultation. It is based on procedures and medications that have been proven by rigorous clinical trials and meta-analysis, often carried out over a long period, involving hundreds or thousands of people including doctors, patients, biochemists, pharmacists and other specialists. This way of acting includes laboratory analysis of all kinds, medical images and other techniques, to get to know which procedures are effective, the doses that should be administered and their contraindications, side effects and interaction with other medications

Non-scientific medicine is usually associated with other names to disguise the absence of all of the above: alternative, natural, traditional, bioenergetic, or some other, although it should be clarified that there are scientific expressions of natural and traditional medicine, such as the contrasted employment of medicinal plants in the management of many ailments.

But this non-scientific medicine (or without evidence) is based essentially on the well-known fallacy of the Argument ad antiquitatem, which can be summarized as: "this is correct because it has always been done in this way".1 Such an argument ignores the advance of science, considering that what might have seemed appropriate hundreds of years ago does not have to remain so in the light of current knowledge. On the other hand, products that are poisonous abound in nature. Being natural is not synonymous with harmlessness. Many examples of toxic plants can be found under that title on the WEB (see, for example, wikipedia.org). Also on the WEB there are reports that for a long time it was thought that star anise was very beneficial, and was given to small children and even newborns, but recent studies have determined that in large quantities it can be fatal, and that is why withdrew from the market in 2001. Another example of non-scientific medicine, although not related to natural products, is as follows. Beginning with the 1956 edition of Benjamin Spock's book Baby and Child Care, which was a great sales success, it was thought that putting babies on their backs could cause their drowning by vomiting, although that criterion was not supported by clinical investigations. Putting babies to sleep on their tummies became a widespread practice in hospitals in many countries and was adopted by millions of parents at  home. However, there was a drastic reduction in the sudden death of babies (Sudden Infant Death Syndrome) when the advice to put babies to sleep on their backs was spread, following a series of scientific studies that began in 1965 and ended with a systematic review in 2005 (figure 1).2 Descripción: D:\Arnaldo 2019\WEBgeocities\rationalis\ayurveda\Baby care.jpg


Figure 1. How criteria changed about the way babies should sleep when applying scientific medicine (ref.2). Legend: First edition 1946. Dr. Spock recommendation: sleep on the back.  1956 edition: Dr. Spock change recommendation to sleep on the tummy.  First study suggest damage. Second study suggest damage. Three more studies suggest damage. To sleep on the back in USA (1995).  Systematic revision published (2005)


Other variants of the so-called natural or traditional medicine are even worse, because they do not even count on tradition. Sometimes they are very recent and have a religious origin, such as floral therapy,3 or they are based on absurd recommendations that contradict basic principles of different basic sciences, and that throw again and again negative clinical trials, as occurs with homeopathy, -although not for that reasons his stubborn followers stop from recommending it to their patients.4,5

In reference [2], in relation to the so-called alternative medicines, and as a summary, the following key points are remarked (p.20):

• Neither theory nor professional opinion is a reliable guide to safe and effective treatments.

• Just because a treatment is "established" does not mean that it is more beneficial than harmful.

• Even when patients do not suffer from receiving treatments that have not been adequately tested, their use can be a waste of individual and community resources.

No one can deny that, in our country, any citizen has access to primary and specialized care regardless of his/her geographical location or any other personal characteristic. The medical culture of our population has been scientific for many years because, even the most convinced believers, although they raise offerings to gods or saints to ask for their own healing, or that of a friend or relative, they do not stop looking for, or recommend, the doctor's assistance or follow his/her instructions. There is a lot of confidence among the population that our health system will apply scientific medicine, although unfortunately it does not always happen that way. There are still those who indiscriminately apply 'another' medicine, without giving due information to patients -i.e., without communicating the degree to which such procedures or medications have a scientific basis-. Luckily, apparently they are becoming less.

Given these experiences it is not very disconcerting to praise and promote remedies of foreign healers without giving detailed explanations, which could derive from a desire to pass through medical science what is obviously not, to the detriment of the confidence that the population deposits in our public health. It is not the first time it happens; previously unproven remedies, 'good for everything', have been promoted, which have turned out to be illusory.6,7 The usual in these cases is that praiseworthy qualifiers are used, but without revealing the real basis of these 'novel' procedures, and without providing data or well-conducted clinical trials can be consulted to support their effectiveness.

A few weeks ago, medical staff of the Natural and Traditional Medicine (NTM) group of the Ministry of Public Health described in a very favorable way the "Ayurvedic medicine" in a television space of wide audience; this modality was qualified as "great". This is why it seems opportune analyzing in detail what is Ayurvedic medicine.

Ayurvedic medicine in India

Universal healthcare refers to the medical care of all residents of a country, geographic or political region, regardless of their economic capacity, race, beliefs, age or any other particularity. It is a right widely recognized by most countries in the European continent, but this is not the case in other countries. In 2015, in the Americas, in addition to Cuba, there was only universal assistance in Canada, Argentina, Costa Rica, Venezuela and Ecuador.8,9 In the rest of the world, European countries such as Australia and New Zealand have universal assistance, but it is practically non-existent in Africa and Asia, with the exception of Botswana, Japan and Thailand.10 India is not among the exceptions.

In 2015, a total of 24 countries were reported trying to develop reforms in their health systems to provide effective and universal healthcare.11

An official text on Ayurveda, Ayurveda, the Science of Life, published by the AYUSH12 department of the Indian Ministry of Health, (figure 2)13 is not only pseudoscientific; it is also antiscientific, because despite showing the word science in the title, it considers this practice valid on the exclusive basis of religious criteria.

The material emphasizes that Ayurveda is based on Vedic documents that began five thousand years ago and in its holistic nature,14 which recognizes the integrality of mind, body and soul.15 These concepts have to do with religious beliefs, and nothing to do with science (figure 3). In fact, they are contrary to scientific knowledge. In addition, the text of the Ministry of Health of India does not appear a single scientific result, not even the words clinical trial. There they are recognized as fundamental, without some kind of subsequent critical evaluation, two basic books of mystical character: the Súsruta-samjita, from the fifth century (or III) BC, and the later Cháraka-samjita, from the second century AD.


Descripción: D:\Arnaldo 2019\WEBgeocities\rationalis\ayurveda\portada.jpgFigure 2. Official text of the Ministry of Health and Family Welfare of India. 'Ayurveda, the Science of Life'.


Susruta, founder of Ayurvedic medicine, who claimed to be a descendant of the god Dhanu Antari, recommended taking donkey urine to neutralize poisons and that of camel for leprosy and hemorrhoids, among other ailments. Also, that scratches with rat semen should be avoided, as they can cause anemia, joint pain, epileptic seizures or cancerous tumors. In relation to leprosy, he maintained that a man can be cursed by this disease because of killing a priest (Brahmin), and that he would attack him again in his next birth (sic). A leper would eliminate his illness observing a proper diet, an irreproachable behavior, and practicing all kinds of expiatory penances, (like giving money to the Brahmin priests) (sic).16

In his p. 13, the text of the Ministry of Health and Family Welfare of India also explains how the Indian government supports this false science. It does through the commercialization of Ayurvedic medicines in other countries, the translation of literature to the effect, the dissemination of information in Indian embassies and cultural missions throughout the world, and the granting of scholarships to foreigners in order to receive Ayurveda courses in India.

Even though the number of scientific publications increases dramatically year after year, an academic Google search showed a single scientific article about Ayurveda in the last 15 years. This, referred only to the possibility of using the Ayurvedic remedies to find valid medicines in the light of scientific medicine.17 On the contrary, criticism of all kinds abounds in the international press.18-21

Studies conducted in the USA and India concluded that up to 20 percent of the Ayurvedic preparations tested contained toxic levels of lead, mercury or arsenic. These analyzes also warned of the nonexistent quality controls or the use of herbs that contain other harmful substances. The concentrations were dangerous enough to cause damage to the tissues of the brain, kidney and the nervous and reproductive systems, mainly in pregnant women. Frequent cases of hepatoxicity have been described by the use of various products of the ayurvedic herbalist.22


Descripción: D:\Arnaldo 2019\WEBgeocities\rationalis\ayurveda\doshas.jpgFigure 3. Composition of the human body according to religious philosophy Ayurveda: ethereal element (AKASHA); gaseous element (VAYU); thermal element (AGNI); terrestrial element (PRITHVI). These elements make up three dosha (VATA, PITTA and KAPHA). If the DOSHAs are balanced there is health (HEALTH); its disequilibrium gives rise to diseases (DI-SEASE) (from the text in figure 2).


A necessary conclusion

If we refer to our country, among other indicators that speak in favor of our medical care, we have that in Cuba there are 82 doctors for every ten thousand inhabitants.23 In India there were only 4.8 in 2017.24,25 According to the World Health Organization, every year 900,000 Indians die from drinking water in poor condition and inhaling contaminated air. Is this the model of medical attention that NTM personnel in Cuba want to imitate?  Or just choose Ayurvedic treatments that show to be really effective and not harmful?  But ...how to determine those treatments, if clinical trials are non-existent? Will the scientific literature be consulted, will they design and carry out well-founded clinical trials, or will they begin to prescribe Ayurvedic procedures to patients "to see what happens", as has occurred with the aforementioned homeopathy and floral therapy?

It would be of great interest to have serious information on this and other "alternative" therapies, which still exist in our health system despite criticism and lack of scientific basis.

 

References


[1] Argument ad antiquitatem, en www.wikipedia.org

[2] Imogen Evans, Hazel Thornton, Iain Chalmers and Paul Glasziou, How Treatments are Tested: Better Research for Better Health Care © Pan American Health Organization, 2nd. Ed., 2010. ISBN 978 -92-75-3326

[3] Francisco Rojas Ochoa. El desmedido e incontrolado auge de la llamada medicina natural y tradicional, Cap. 19 en ‘Actor y testigo. Medio siglo de un trabajador de la salud” Editorial Lazo Adentro, 2016.

[5] Homeopatía: revisión clínica, metanálisis y otros ensayos. Adaptado de ‘Homeopatía’ en Wikipedia, 2019.

[6] A. González Arias. Breve historia de las terapias alternativas en Cuba, en www.geocities.ws/rationalis/MNT/Breve-historia/index.htm; otros artículos de diferentes autores en www.geocities.ws/rationalis/MNT/index.htm

[8] «These 5 Countries Provide The Best Health Care In The World». The Huffington Post(en inglés). Consulted november 2017.

[12] AYUSH: ayurveda, yoga, naturopathy, unani, siddha and homeopathy. Unani medicine is founded on medieval european medicine, which is based in the theory of the four humors: blood, yellow bile, black bile and flegma. Siddha is a more strict variant of yoga, which practice rituals, meditation and austerity to reach 'spiritual enlightenment'.

[13] Ayurveda, The Science of Life. Dept. of AYUSH, Ministry of Health and Family Welfare, Goverment of India, New Delhi, www.indianmedicine.nic.in

[15] Soul refers to an inmaterial entity that, according to believes and staments of differents traditions and religious and philosophical perspectives, is common to living beings. Description and properties change in accord to each one of these traditions and perspectives.

[16] Súsruta-samjita, cap. 2,6,22,26,45. See Susruta-samhita en www.wikipedia.org

[17] Bhushan Patwardhant, Ashok D. B.Vaidya and Mukund Chorghade. Ayurveda and natural products drug discovery, CURRENT SCIENCE, VOL. 86, NO. 6, 25 MARCH 2004.

[21] Superstición y pseudomedicinas en las bases de datos científicas (I): Homeopatía y “medicina” Ayurveda (2013) https://lacienciaysusdemonios.com/2013/06/20/supersticion-y-pseudomedicinas-en-las-bases-de-datos-cientificas-i-homeopatia-y-medicina-ayurveda/

[22] Ayurveda, in www.wikipedia.org

[23] Anuario Estadístico de Salud; MINSAP, 2017.