|Year : 2016 | Volume
| Issue : 1 | Page : 48-50
Integrative approached for health: Biomedical research Ayurveda and Yoga
Ashok D.B. Vaidya
Chief Editor, Journal of Obesity and Metabolic Research, 102, Vasudha Clinic, Madhuvan C.H.S., Santacruz (W), Mumbai, Maharashtra, India
|Date of Submission||10-Oct-2015|
|Date of Decision||11-Dec-2015|
|Date of Acceptance||10-Jan-2016|
|Date of Web Publication||16-Jun-2016|
Ashok D.B. Vaidya
Medical Research Centre, Kasturba Heath Society, Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Vaidya AD. Integrative approached for health: Biomedical research Ayurveda and Yoga. J Obes Metab Res 2016;3:48-50
Editors : Bhushan Patwardhan, Gururaj Mutalik, Girish Tillu
Publisher: Elsevier-Academic Press, Amsterdam
Pages : 343
Year : 2015
ISBN : 978-0-12-801282-6
Price : Rs. 5173/-
There are times in history of medicine, when unforeseen challenges emerge not only to fundamental principles of healing but also to the dominant practices which become untenable. The beginning of the new millennium is one such period of great churning - the paradox of humongous advances in biomedical technology and globally decreasing quality of health. The book on Integrative Approached for Health is the first and stumbling step, by courageous authors of three generations, to address the challenges.
The very design adorning the cover of the book, by Ajey Shalaka and Yogini from Neelmudra Creative Carnival, expressed the strange colocations of pestle-mortar, shat-chakra, DNA and caduceus of Apollo. Such a trans-cultural and trans-system symbols / metaphors are formidable myths to be represented for their harmonious integration. The artists, under the guidance of the authors have strived excellently to achieve the impossible and succeeded to a large extent. But the Ayurveda symbol at Muladhar chakra and the caduceus far above the Sahasra chakra may raise eyebrows at both the ends of the spectrum of the healing art. But this is a minor criticism of the first faltering step for a motif of integration. This is likely to inspire a future artist to do justice to depict integral health in a classic circular painting, where there is a movement but no lower/higher or beginning /end.
The publisher - Elsevier - has to be complimented for their initiative to take up such a millennium theme for a book. Their invitation to the right authors in the field bespeaks of their sensitive antennae of what is happening half-way round the globe. Elsevier has been criticized in the past for their costly books / journals and a neglect of the needs of the developing world. But, they have learnt from the positive criticism and launched with Bookaid (www.bookaid.org) - a partnership "to grow libraries in developing countries." That move emboldens the reviewer to suggest that the present pioneering book can be made available as a free E-book to the eager academia of the developing world.
The book has been divided into fifteen chapters. From the first chapter in Integrative Approaches for the Future, one can sense the angst of the authors. That angst nudges to persuasively communicate to the readers their concern and cry for a revolution in biomedicine. In that process the detours on the history of medicine, systems biology, nutrition, drug discovery etc. are attempted valiantly but relatively lightly. The transitions from one chapter to another sometimes do not appear that smooth for the central theme of the integrative approach. One often gets the feeling that the chapters can stand alone as independent essays or reviews more suited to the format of biomedical journals. But even then each would whet the appetite of any avid reader. She may be initiated onto exploring the integrative approaches with vigour.
Right at the onset, the authors have carefully avoided taking strong extreme positions in favour of either modern or traditional systems of medicine. They have mentioned about the strengths and weakness of each system. However, a careful S.W.O.T. analysis of systems in selected domains of health could have been more helpful to delineate the areas of complementarily, integration and direct adoption of certain practices. The latter is easier than the integration of the unique principles underlying the diverse systems. The epistemology of a system can be so different that it would be a formidable challenge to integrate the principles. The authors state, "Basic philosophy, doctrines, ethos and approaches appear to be the same." This appears to be an over-simplification. It is offered due to an overt motivation to integrate the systems of healthcare. It would be desirable to state the nature of epistemological differences clearly and then investigate the potential or lack of it for integration.
The Figure in the book depicts very lucidly the current vicious circle in healthcare. Could a figure of the virtuous circle of healthcare be juxtaposed to stress the plea of integrative care? The case of Sofobuvir for hepatitis C has been cited. The cost will be $80,000/- per patient for treatment. Could the authors have described the discoveries of hepatoprotective Ayurvedic plants like Phyllanthus amarus? It is customary not to use the brand names of drugs in the academic literature. In case a specific brand is to be mentioned, the trade mark ™ or Rx need to appear as superscripts. The stress on the socioeconomic costs of high-tech medicine is well stated.
Figure 1.3 on the integration of Ayurveda, Yoga and modern medicine proposes an epistemological transformation and subsequent integration leading to future medicine. But the daunting complexity of diverse epistemologies is a major challenge. This has been understated. The fact that ontology precedes epistemology has not been stressed. The trans-culture and unique ontology of systems of medicines need to be understood in terms of the cultural webs. This would require a stupendous effort. But the authors have made a beginning.
The chapter on Evolution of Medicine covers a vast subject with snapshots of history. The oldest references on health, diseases and remedies in Rigveda need to have been cited rather than starting with the western mode of historiography. The beginning of Ayurveda has been ascribed to Charaka rather than Atreya or Dhanvantri or Ashwinikumars. The Himalayan conference of Rishis and Bharadwaj going to Indra to learn advanced Ayurveda could have been cited. Though authors criticize William Osler for not mentioning Ayurveda it should not be forgotten that he started the first Charaka Club in the U.S. The left brain - right brain "dichotomy" Figure 2.1 ascribed to the East/South and West/North, though interesting, appears a bit overstretched. Intuitions and reasons have worked in unison for many of the great minds globally. The coverage of the Chinese and Japanese medicine could have been more in-depth as integration is also a challenge there.
The concepts of health and disease have been fairly and extensively covered. But the transition of thoughts is sometimes not smooth and connected across the paragraphs and topics. The use of several terms - well being, holistic health, quality of life etc. could have been synergized with the Ayurvedic definition of health. Dinacarya and Ritucharya could have been dealt with at length for the integrative approach. On pp. 66 there is a statement, "Well-being is about wellness." What does that mean? There is a recurrent and often right but a repetitive stress on the medicalization of healthcare. But how the integrative focus on health can solve the medicalization problem has not been elaborated upon. Dean Ornish has cited. But how he learnt the elements of reversal of heart disease from Swami Sacchidananda is not described?
The chapter on evidence-based medicine and Ayurveda is a highlight of the book. There are 87 references for the chapter. However, a book on Evidence-based Ayurveda, published by AYUSH and CSIR is not cited. The reviewer's lectures on Ayurvedic Statistics have been listened to by the authors but not cited. On pp. 93 there is a statement that there is no record of tumour reduction in the placebo arm of any trial. This is not correct. There are published case reports which have shown such a reduction. It is intriguing to propose E 2 BM as experimental and experiential Figure 4.3. When the experiential data are surveyed, documented, wetted, tabulated and analyzed for verity, which is also a population experiment. Some may find it a bit presumptive to offer the New EBM. The stress on individual patient's responses, though pragmatic, need not be over emphasized.
The chapters on system biology and holistic concepts, lifestyles and behavior and food and diet are indicative of the authors' needs to find novel grounds to base the proposed integration across the system. Figure 5.4 does injustice to the multimodal therapy in modern medicine. The details of modern diagnosis are a bit de-emphasized. The Figure 5.5 showing the visual similarity of the neuron structure with a computerized model of the universe demands too much of credulity from a reader to correlate the microcosm and the macrocosm! Prakruti Genomics as a domain was first presented at the International Conference of Ayurveds at New York.
The Figure 5.7 is trying to correlate systems biology with holistic concepts with an example of Piper longum. It would appear a bit far-feted to those who are uninitiated in Ayurveda. The same criticism may apply to the generalizations on agni, bhutas and dhatus in Figure 5.8. The chapter on lifestyle and behaviors is extensive with 88 references. This chapter could have focused only on those unique aspects of Yoga and Ayurveda which are currently lacking in modern medicine eg. Pragnyparadha-Panchkarma, particularly vamana vis-ΰ-vis vagus nerve is covered in several conjectures. For example a list of a lot of neurotransmitters has been stated without any clear relevance to the topic of vamana. The section on spirituality is not dealt with in depth. Karmaja Vyndhi would be a topic for a change of this paradigm in modern medicine.
The subsequent chapters on Health supplements, drug discovery and Ayurveda, longevity and personal approaches for health cover many diverse concept, ideas and anecdotes discussed at several meetings, conferences and workshops held. The sources and persons who presented these ideas first could have been cited more often. Otherwise it would appear that many of these ideas are only from the authors.
The primer of Ayurveda and Yoga appears to be an afterthought, as an appendix. The primer would neither whet the appetite nor nudge the reader to seek the authors cited for further readings - where one author only predominates (cited three out of four). It is sad that a profound domain like Yoga has been superficially covered. The authors could have cited the extensive literature and research on Yoga. Swami Vivekananda has been cited but his four books on yoga are not cited. But all these are minor critical remarks on a sizable labour of love.
All those who are partly or significantly dissatisfied with the current quality of healthcare would derive an excellent orientation for the integrative approached in this book. All the medical colleges, Life Science Centre, colleges and Yoga Institutes should get a copy of the book for their libraries. I also strongly feel that serious scholars, teachers, health authorities and scientists to in the field of biomedical Ayurvedic and Yoga domains too would find interesting ideas and direction for their integrative work in services, education and research healthcare. The health and nutra industries in India and abroad would find several golden nuggets for research and innovations in this pioneering work.