6th World Ayurveda Congress, New Delhi, 8th Nov. 2014
A
FOCAL THEME: ‘AYURVEDA AND HEALTH CHALLENGES’
6-9 November 2014, Pragati Maidan, Delhi, India
The 6th World Ayurveda Congress was organised by the Department of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) under the Union Health and Family Welfare Ministry (Government of India), in collaboration with the World Ayurveda Foundation (WAF) and the Delhi government.
8 November 2014
A Report on Dr. V.
Sujatha’s Talk
[Professor, Centre for the Study of
Social Systems, JNU, Delhi, India]
An
Integrated Perspective on AYUSH and Folk Health Practices
Medicine
is eminently a social science. Why, because the causation is not only
biological or physical, the recovery and the adaptation of a patient depends on
factors that go beyond clinical factors. Availability and efficacy of medicine
is not only a matter of chemical compositions. So health and illness are multi-factorial;
it is not enough that only health and medicine be handled by medical
specialists. Even though biomedicine has produced a large body of valuable
knowledge, however, they tend to focus only on structural and anatomical
features to the exclusion of patients’ experience of illness because biological
and clinical factors are the main reasons based on which biomedical doctors
take decisions. So social sciences over the years, sociologists, historians and
anthropologists have tried to talk to patients to find out how patient
experience is important to disease.
There has been much debate within biomedicine about the value of drugs
and sophisticated technology to ensuring health. This is not borne out in the
current time, when we have very sophisticated technology, the number of
pharmacies are growing but the number diseases are also growing. Health cannot
be handled only by drugs and surgery; we need social intervention and good
social support. A good attendant is required as is said in Ayurveda. The
patient’s narrative is important and the patient ought to have some knowledge
of his or her own body. Two historical studies show that the countries where
health status has improved have had robust government intervention in the form
of sanitation, clean water and food, and people have had good knowledge related
to health. This can be seen in the health indices of states like Manipur or
Kerala, which have a robust health culture even though their economic indices
may not be very high. As sociologists and historians, we would like to draw the
attention of planners and medical people that only therapeutic, medical or
clinical interventions are not enough of
a focus.
What
sets Ayurveda apart from biomedicine is that besides the very detailed
technical understanding of the human body that Ayurveda has, it also pays
attention to the social factors into account. Ayurvedic and Siddha texts in
regional languages give detailed account of the flora and fauna in every
region. The textual and folk traditions have a symbiotic relation. Women of
certain lower caste communities in central Tamil Nadu prepare a concoction with
40 herbs which serves practically as a protection/immunization against many
diseases of infancy. This kind of knowledge with ordinary people is very
valuable. In today’s time the system in the West is dominated by doctors - to
the extent it is the doctor’s word that takes precedence in workplaces or in
the courtroom or in schools over patient’s
narratives and assessments about his or her bodily condition. A lay
person in the biomedical system is ‘zero’. He or she is expected to hand the
body over for testing, for treatment and one has no power or say in the matter -
legal or epistemic. This is not true of traditional systems. Therefore, in the
West there are movements demanding control over the clinical process, the body is
ours and the knowledge is theirs. In Ayurvedic medicines, it is based on
knowledge of ordinary people and has structurally more of an element that gives
more space to the patient’s narrative. Have complicated methods of diagnosis
and treatment. But the description of disease is based on symptoms. It is easy
for any knowledgeable patient who can read the text to decide how the disease
is codified. But this strength of Ayurveda is speaking about. However, these strengths are being ignored in
the current context. Citing the example
of the WAC, the Dr. Sujatha pointed out how three main themes were being
emphasized by nearly every speaker and the Health Minister in the plenaries and
technical sessions. They want Ayurveda
to be scientifically validated and recognized; the focus is on drugs in all
plenaries, there are so many fresh herbs and external treatments and diets, but
there is a pharmaceuticalisation of Ayurveda - which is reducing it in
biomedical fashion to selected drugs.
Lastly,
the Health Minister has been speaking mostly in terms of reducing Ayurveda to
export-oriented drugs. Nobody who talks about Ayurvedic drugs talks about
making it available to local people; instead they aim to export it with utter
ignorance of the environmental sustainability of this enterprise. Thus, medicine has been reduced to a
commercial enterprise. When speaking of the history of Ayurveda, they tend to
focus on past glory of ancient times laying claims to nano-technology and
plastic surgery. There is little focus on history of the last 100 years.
Biomedicine became powerful and a state sponsored medicine much before the drug
discovery (after 1890), by 1820 throughout Europe, and by 1910 in America, and
this was made possible because of the physicians’ associations which exerted
extraordinary pressure on the government to derecognize other systems of
medicine. Medicine comes later and power comes before. This is what the history
of medicine shows.
Ayurveda
today is going very much the private way and seeking private company
collaborations. The folk healers outside the market are the ones who are
preserving the heritage. Was it not for them, then that would be sold out to
pharmaceutical companies. Therefore, there has to be a social perspective which
has been producing knowledge on the traditional Indian medicine. There needs to
be a dialogue with social science people and traditional practitioners. In the
ordinary discourse today, Ayurveda uses the same biomedical language and I
argue that Ayurveda must have a different perspective on the disease itself. It
has the potential.
One
of the problems that I am talking about is nutrition - income in India is
increasing, there is economic growth but under-nutrition with underweight and
stunted children is not reducing. Why is it so? Nutrition parameters are lower
than sub-Saharan Africa. Economists worry if poverty indicators are falling,
how come malnutrition parameters are not showing any improvement. They locate
the reason in a lack of awareness of what people should eat with a large number
of them spending on junk food. Nutrition scientists on the other side of the
debate disagree and attribute the poor health indices to deprivation and low
income due to which children do not get sufficient calories and nutrition. What
can Ayurveda do to intervene in this problem? When defining the problem, both
economists and nutrition scientists speak in terms of caloric intake. If you
have less than the required calories, malnutrition is lacking
carbohydrates/calories. Anemia is the lack of B12 and Iron. Economists see food
as a commodity, and unaware of the regional diversity in food. Nutritionists
only think in terms of caloric value even though they are aware of the regional
diversity. Ayurveda and folk traditions have a richer understanding of food,
and is different from the caloric understanding of food. The caloric value of a
food can be measured only in the lab. This ideal caloric value will be decided
based on the lab by the expert and the rest have to follow it. This is a
meaningless expert-centred debate on food which is a topic on which ordinary
human beings have a lot of community level knowledge.
In
fieldwork that she did in rural central Tamil Nadu, ordinary people still think
of food in terms of hot/cold, indigestion, healthy. Health depends on the
natural species around. If chemicals are added to the crop, then that is very
poor quality food and the animals that depend on hay and grass that has been
exposed to chemicals yield poor quality milk. Food free of chemicals is the
healthiest. They do not eat fruits and vegetables that we cultivate for
ourselves with pesticide, and that is what we eat. Ayurveda says life is made
of food and believes in the interrelationship between the micro and macrocosm.
“Andathil ullathe pindam and pundathil
ullathe andam.” Food is the route
through which the ecology enters the body. There are multiple physiologies -
fruits and vegetables are cooked by sunlight, then food is cooked by a human
agency or they are cooked in the human digestive system and become annarasa. You cannot eat salads at an
old age because one’s digestive system cannot manage the digestion. In Ayurveda,
nutrition is not a problem of what you take, but a problem of how much you
digest or how much you take. If my metabolism is not good, then the annaras will not get distributed to the
seven dhaatus. It gives one a formula
for understanding food based on taste, so ordinary people can understand it
unlike caloric value of food which is expert decided.
She presented
the case studies of nutritional problems that one encounters that of anemia and
underweight. They are treated as the same problem in Allopathy, whereas
underweight is the inadequacy of starch and carbohydrate; and whereas Anemia is
the lack of B12 and iron. In Ayurveda, this is not how anemia is understood. It
is called pandu - it can be caused by
salty, sour and pungent food then also you can get anemia. Caused by vitiation
of blood, hard physical labour, alcohol consumption, habitual day sleep and
emotional stress like fear, anxiety and grief. High anemia in Punjab and
Haryana as compared to relatively low income states like Manipur because of
different food patterns. Lot of leisure also leads to anaemenia. Not the same
problem according to Ayurveda.
Fieldwork in TN,
around 40 many people taking medication for diabetes and the health center
officials attributed it to rice consumption. However, the villagers disagreed
they believed it was the quality of rice and the way it is being grown, but
they said that it was not clear to them why. The ayurveds said that rice which
has been freshly harvested leads to diabetes.
So the PDS in TN is probably doing that because of which diabetes is
possibly being caused - a factor not
being examined by Allopaths. Ayurveda brings in the issue of lifestyle and kind
of food eaten when talking of anemia; whereas Allopathy looks for causes only
in the body. In the case of diabetes, Ayurveda points to environmental and
ecological causes of how the food grains are grown, whereas allopathy locates
the problem merely in lifestyle. These examples show that Ayurveda needn’t
limit itself to the task of providing drug solutions to allopathy, but can
contribute to redefining the problem itself. The WHO to treat the problem of
anemia has been distributing Vitamin A syrup and an overdose of the same has
led to the death of 15 infants in Assam and in TN 12 adolescent girls were
hospitalized due to being administered Vitamin D on an empty stomach.
What one needs
is a holistic environmental engagement, rather than technocratic solutions.
She thanked the
Chair and Prof. Ritu Priya for creating the opportunity for this engagement.
*
* * * * * *
FOCAL THEME: ‘AYURVEDA AND HEALTH
CHALLENGES’
6-9 November 2014, Pragati Maidan, Delhi, India
The 6th World Ayurveda Congress was organised by the Department of AYUSH (Ayurveda,
Yoga and Naturopathy, Unani, Siddha and Homoeopathy) under the Union Health and
Family Welfare Ministry (Government of India), in collaboration with the World
Ayurveda Foundation (WAF) and the Delhi government.
A Report on
Dr.
Ritu Priya’s Talk
A HEALTH SYSTEMS PERSPECTIVE FOR DEVELOPING
INTEGRATED HEALTH CARE
Why
are various other disciplines needed? There are three speakers who are not from
Ayurveda. The speakers from Ayurveda have not been able to join us. In the Charaka Samhita it is said that it is
the cowherd, the shepherd and the forest dweller who have the maximum knowledge
about plants and the medicinal qualities of herbs. But that knowledge needs to
be augmented with the complementary knowledge of the doctor who knows how to
make medicine and how to take care of the patient. That knowledge and systems
will grow only when there is more systematized research on the knowledge
possessed by the cowherd and the shepherd. It is about learning from them, even
though it is not non-formalized knowledge. The need is to develop an
interdisciplinary understanding. The knowledge that they have should be taken
to all across the world. “Foolish the
doctor who despises the knowledge acquired by the ancients.” Margaret Chan’s
(WHO) quote stating that there is a need to bring together traditional and
modern medical knowledge.
So
in the 21st century how do we think about this integration? We are
talking not merely about disciplinary knowledge but non-formally acquired
knowledge. How to bring that into this realm of knowledge and practice? If we
look at it from the public health perspective, then we find that modern public
health depends on demography, epidemiology and environmental sciences. Even
though they are separate realms of disciplinary expertise, we bring them into a
relationship in order to bring it into the greater public good through public
health. We use health technology
assessment to assess and choose health technology that is suitable and
applicable to a particular context - belonging to any system of medicine and
health technology development. Social sciences help to understand the origins
of these disciplines, which sections of society use what systems and why, and
what is more useful to them - anthropology, sociology, political science
psychology, economics and health management help decide how to run systems, how
to finance and manage them. This
together is the public health systems approach. How do we string them together
along with Ayurveda, Unani and Siddha in different parts of the country in a system? All will need to sit together
and learn from each other.
Inter-disciplinarity
- our thought has to be such that it sees different disciplines and their basic
principles together and understand phenomenon. Trans-diciplinarity - a third
perspective emerging from different disciplines. This is the direction that
knowledge generation is taking in the world today. Since 1920 we have been
speaking of inter-disciplinarity but nothing has been done till now. Ayurveda,
allopathy and social sciences mostly taught and function separately because
fundamental principles of each have not been studied or understood by each
other. If we do not bring this process in move, then knowledge will not grow.
Till now we have not done inter-disciplinary research. More than 3% of the budget has not been given
to the TS put together, whereas more than 90% has been given to modern
medicine. There is no equality, then how can there be a conversation? How to
integrate in such a context? This needs to be corrected. The non-formal
knowledge in all master plans since 2000 does not talk about LHTs; they stand
absolutely marginalized. For strengthening LHTs social science is going to be
very important.
In
PHS for integration what has been done till now - substituting allopaths by
ayurveds in rural areas since the former are not willing to go there. Co-location
of services to enable patient some choice, but what is the importance of this
knowledge. There is a need for an architectural correction of the modern health
system based on modern system and with such disparity between different systems
of medicine. So, balance needs to be corrected, but how will a conversation
take place between doctors of different systems? There is no provision for this
dialogue. There needs to be a change in imagination for this. Health Technology
Assessment - efficacy, no harmful effects, the good effects should be in
balance, delivery system needs to be thought of. Cost effectiveness and
people’s empowerment through the health service system. Everything is doctor
centred that weakens people’s capacities to deal with illness themselves. Why
didn’t you come earlier? Why did you come as soon as you had a problem? This
attitude is enervating people’s capacities to deal with illness. Also, the loss
of knowledge that the person acquired from their elders and grandparents is
affecting their ability to take care of their ailments. So one would need a
system that is able to think of all of these aspects which cannot be studied or
contributed by experts of Ayurveda of modern medicine alone. What should be the
basic principles of such a system?
1. The
healthcare or care that is closest to the home should be the first choice. The
primary level care when thinking of costing begins from the primary health care
centre. Most people however depend on home remedies or on healers in their
community like dais, bonesetters and
herbalists who are part of the primary level care in both cities and especially
more in villages. However, they are rarely, if ever, given space in the
system. So we cannot forget them. Hence
the need to include home remedies and traditional healers in our primary health
care system since they are the closest at hand when people are faced with a
health problem. If empowering people and providing care closest home is one of
our key principles, then we should be able to include them in our system.
2. This
is not to say that we do not need specialty and super specialty hospitals. But
they have to exist in a continuum with the primary level care that starts with
home remedies and traditional healer ending at super specialty care. Then we
will have a possibility of being able to secure a heath service system that
caters to the needs of people.
3. In
today’s time these systems of traditional health care and home remedies have
been weakened through the delegitimisation and hence we need to bring that
back. For that, the NRHM has some components and presents an opportunity to
intervene on this front. The local herbs can be grown in the public health
service centres like sub-centres and PHCs and the Ayurvedic doctors located
there can advise people on how and for what purpose the herbs might be used.
The planting of herbs in local PHCs with the government indicating its worth
will enable bringing back the legitimacy of these LHTs. They can also be grown
in schools and in public places, all of which will enable to buy legitimacy for
these LHTs.
4. Then
there are paramedics and ANMs who serve the public health service system. But
we also have our traditional healers, who we could consider our paramedics. If
their legitimacy and confidence were restored through validation, certification
and training to fill in the gaps, then you have an existing system of village
health services which could be used. This can be seen as useful if we want to
engage in health service provision from the bottom upwards. The assessment that
we cannot reach the villages at the moment comes from an understanding of
planning and provisioning that is bottom-up. They can even teach the ASHA and
the ANM to identify and use the herbs. A survey that we had conducted showed
that the ordinary people know more about local herbs and medicinal plants as
compared to the ASHA or the ANM. To my mind, the latter, due to their training
and exposure to the modern allopathic knowledge had also come to ignore or consider
inferior the local knowledge that they possessed.
5. Similarly if GPs and physicians are imparted
training about local healing practices, they may also be able to bring them
into effective use or provide advice to patients about these.
6. In
our survey we found that 70% of the doctors in government hospitals (whom we
interviewed) believed that they considered traditional knowledge useful. Among
them, 50% said that they also advised their patients to use certain remedies or
sometimes referred them to Ayurvedic practitioners.
7. Despite
this understanding, why are we not willing to give legitimacy to our own
knowledge? They are not willing to write prescriptions because we have finished
off their legitimacy. They wonder whether they are being disloyal to their
discipline. Why wonder about that when as practitioners our primary duty is
towards the patient? So this system needs to recognize that and have guidelines
to help doctors decide when they should refer to other systems of
medicine.
8. So
if we include the herbalist and the dai to
the ASHA, VHSCN and the ICDS at the village, they can act as complementary to
each other. Similarly, at the SC level the ANM and the MPW can be brought
closer home and if there is an Ayurvedic doctor at that level then he or she
can work with the entire system; similarly, at the PHC and CHC where the doctor
can be brought. If we estimate the expenses, then 20% expenditure can be
reduced. This will also serve the purpose of UHC empowering people.
9. There
is a need for bottom-up planning. Therefore, those on the ground should be able
to have an imagination that gives importance to this tradition.
Used
the example of diabetes which requires lifestyle, diet change and exercise in
its initial stages. Is fast becoming one of the most important diseases in all
sections of India. There are different herbs that are used to reduce sugar
levels. Diabetologists today say that they should induce lifestyle change, but
start medication pre-diabetes. The guidelines made by diabetologists at the
global level suggest medication. Now world over, Ayurvedic medicines are being
said to be effective but the methodology is limited, in such that the studies
show beneficial effect but the research does not say for sure how safe it
is. But it is important to do research
such that its safety can also be tested and established.
In
terms of a system we need a research institutional structure that allows Ayurvedic
and allopathic research in one place. The policy must be geared to
strengthening people’s knowledge and their power and not the doctor and the
industry. The services in health centres and hospitals must provide patients with
a choice between the systems, but also doctors from different systems should be
able to develop a dialogue with each other. Develop an integrated standard
guideline that incorporates Ayurvedic and allopathic treatment modalities.
These are interconnected arms of service delivery, institution building and
research.
*
* * * * * *
6th
World Ayurveda Congress, New Delhi, 8th Nov. 2014
A
FOCAL THEME: ‘AYURVEDA AND HEALTH
CHALLENGES’
6-9 November 2014, Pragati Maidan, Delhi, India
The 6th World Ayurveda Congress was organised by the Department of AYUSH
(Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) under the Union
Health and Family Welfare Ministry (Government of India), in collaboration with
the World Ayurveda Foundation (WAF) and the Delhi government.
8 November 2014
A Report on Dr. R.N.K. Bamezai’s Talk
[Dean, School of Computational and Integrative Sciences, JNU, New Delhi, India]
POTENTIAL
INTERACTIONS BETWEEN SYSTEMS BIOLOGY AND AYURVEDA
Speaking
on the topic of Potential Interactions
Between Systems Biology and Ayurveda, Prof. Bamezai said that in the
present scenario a necessity has been felt for systems biology approach in
Ayurveda, because Ayurveda has a concept for the entire body; we use
cell-to-body approach in modern biology, but the time has come to understand
molecular approach along with the system approach. The systems approach already
exists (Ayurveda) and both the molecular approach and system approach are
dependent on each other.
The genomes create a signature. In
our biology, which is the science of today, viz., genetics, it creates its own
fingerprint. According to my understanding, it is necessary to bridge the
biological fingerprints with the Ayurveda fingerprints. Ayurveda fingerprint
depends on the principle of Ayurveda; whereas the fingerprint of modern biology
depends on the principle of modern biology. Today we are not experimenting on
bridging both the principles. Experiment is necessary in this direction so we
all can benefit in future.
It may be that many things are new
and may be surprising for all of us. I will try to explain these things. I feel
that it is essential for a systems biology approach in Ayurveda, because
Ayurveda has a healing concept for the entire body. It already exists in
principle form in Ayurveda; whereas in modern medicine a reduction approach has
been taken into consideration, where after understanding of the molecular
level, we are trying to understand the body. This is known as molecular biology
approach.
The time has now come where science
understands the concept that reduction approach will understand the system
approach, and system approach already exists in Ayurveda. Hence, a symbiosis of
the two approaches is desirable.
We all know that how we are created
from a single cell zygote. A mother germ cell (2n) donates an egg (n),
and the father donates a sperm (n).
After fertilization, a 2n cell is
created. This 2n cell structure is
known as a zygote.
All of us present here are a mass
of cells. In each of these cells, there are two types of DNA - one is nucleus
DNA, and the other mitochondrial DNA. This mitochondrial DNA is inherited from
the mother’s side and moves into the boys and girls.
Mitochondrial DNA is the carrier of
the maternal properties or maternal inheritance, and the nucleus DNA has the
properties of both the father and mother.
In the nucleus 46 (22 + X or Y
– comes from the father, and 22 + X
comes from the mother) chromosomes are present in a single human cell. Y chromosome has the property of the
father and is inherited from father-to-son and son-to-grandson; whereas,
mitochondrial DNA is inherited from mother-to-son or daughter. Thus, DNA is a
book of life. It is the blueprint of each one of us – whether we believe in
Ayurveda or modern biology.
This blueprint has its own
language, it has its own geography, and it is a landscape – just like a natural
landscape. This is a book of history. History, because from mitochondrial DNA
we can know our maternal ancestry. Simultaneously, we can even know our
relationship with others. We can even identify our paternal ancestors. This
relationship can be established with any person not only in India, but also in
any corner of the world.
In each of us 99.99% DNA is
identical. Only 0.01% is different. Due to this 0.01%, diversity exists in the
world and we recognize each other by our unique face.
This genetical blueprint system
(mitochondrial blueprint and nucleus blueprint), has to be understood in
combination with the Ayurvedic system and molecular biological system. This is
a complex system and includes principles of mathematics, principles of physics
and the principles of various other subjects.
It is now time that the principle
of Ayurveda (which is systems-based or organism-based whole system) is
understood by a computational approach; and another important approach is the
physical principle which is also the principle of modern biology (i.e.,
DNA-based). It can be determined only in
the future how we can bridge the principle of Ayurveda with the principle of
the modern DNA-based biology. Thus, the principles which are well established
in Ayurveda, how can they be bridged with modern DNA biology? How can we make
this accessible in the Indian scenario?
We know that the fundamental
principle of Ayurveda is related with nature. When I was teaching the MBBS
students along with the Ayurveda students, then the Ayurveda students used to
ask me how the chromosomes were inherited from one generation to the future
generations; and from that point of time I understood that what we think about
genetics is already present in Ayurveda in a comprehensive way. Just like the
nature-based principle of Ayurveda, the chromosome is present in plants, in
microbes, and in animals. This means it is universal and is present everywhere;
it is the base of our diversity. Through the media and newspapers, we have come
to know since the last twenty years about the genetic material. The question
that arises today is, how do we coordinate between Ayurveda and modern biology;
it is the field of research and it needs to be enhanced.
Where are the genes situated? These
genes are situated in the chromosomes; 23 chromosomes come from the father and
23 from the mother. Genes are situated in the chromosomes in different density.
Somewhere the density is found to be very high and somewhere found to be
extremely low. These genes are the deciding factors for human beings as an
individual. It determines our structure and the whole process within us.
Take for instance, if we are to
understand the landscape of the genes, it would be similar to understanding the
natural landscape, i.e., constructed houses, jungles, trees – all these are the
features of the natural landscape; it is a parameter. Similarly, inside each
cell there is a DNA, which if spread out, it is found that they contain four
alphabets – A, T, C and G (it is the nitrogenous basis – A=Adenine, T=Thymine,
C=Cytosine, and G=Guanine). These four alphabets are present in chromosomes of
10 trillion cells (a human body is comprised of 10 trillion cells). It is only
these four alphabets that determine each and every aspect. In some cases
(individuals), the letter AA.. is repeated several times; whereas in other
cases GG.. is repeated several times; and in some cases GCTC is repeated many
times. In this way, these four alphabets are organized and design a landscape,
similar to a natural landscape. Each landscape has its own identity. The unique
repetition of these alphabets also has an identity. Different scientists
identify different repetition forms and give a different name. For example,
satellite DNA.
Just as rivers, lakes, forests,
trees, mountains, etc., are different names in the natural landscape, so
likewise inside the DNA there is a landscape. The person who can comprehend
this, can also understand how a new gene can be discovered and extracted.
Now let us return back to systems
biology and Ayurveda. Some people are susceptible to certain diseases, whereas
some people are resistant to these diseases. We study the DNA pattern (an
individual has both maternal and paternal DNA pattern) and thereby predict
whether the individual is susceptible or resistant to a particular disease.
This link needs to be established. One gene comes from the mother, and the
other gene comes from the father. These show different colours. Out of these,
one gene is susceptible to diseases, whereas the other gene is resistant to
diseases. These genes serve the purpose of a predictor. It is easy to identify
this predictor; however, when we associate this with a disease, it forms a
complex system because one disease involves many genes.
We can understand this complex
system in different diseases, for example diabetes. In Ayurveda, diabetes is
identified by checking the pulse of the patient and customized medicine is
given according to his or her prakriti
(vata, pitta and kapha). The
concept of this customized medicine has come up in modern medicine during the
last 10 years; whereas this concept is already present in Ayurveda. The level
of knowledge has increased tremendously; therefore it is necessary to combine
both. In the recent years very simple techniques have been developed. For
example, we can see the DNA by running it on a gel, and the sequence can also
be observed. Now we can take an example of leprosy. It has been observed that
many genes are involved in immune response. This is known as innate immunity
and acquired immunity. Immunity is the most important principle. I think we
need to assess and phase assay for immune response in Ayurveda. Immune response
is shown by B cell and T cell. We have to establish a co-relation based on DNA
or prakriti, or any other principle,
so that we can find a relationship – in immune response of an individual and
disease prevalence, and individual-to-individual differences. I sent a proposal
to the Planning Commission about 20 years ago on this subject.
In our modern system we work on
natural cell death. This is known as DNA response or hypothetic response, in
which death of cells occur. Whenever a natural death in cancer cells does not
occur, the DNA or genome gets damaged; so these cells show the uncontrolled
growth and multiplication and form a tumour. The gene of the immune response
tries to destroy the cancerous cells, but they are not successful. In the
tumour formation, there are three processes involved: (1) different damage response, (2) apoptosis,
and (3) immune response. The link between these three processes is called a
pathway. I will try to demonstrate the link between these three individual
pathways.
When we saw it in the form of
genes, there were some genes of importance. For example, the gene which
involves apoptosis, gene involved in transcription, and gene involved in immune
response. What is their individual role with each other, and out of these
genes, which are inherited from the mother or from the father? After making a
characterization of the genes, we can predict whether the gene is susceptible
or resistant to cancer.
Now we shall talk about epigenetic
control. In this, the genome expression is moderated. In epigenetic control,
our lifestyle and food habits are studied because this regulates the expression
of the gene. For example, turmeric, which is used in households and Ayurveda,
modern science experiments show that turmeric is useful for treating cystic
fibrosis because it changes the conformation of the protein structure and makes
the channel active.
We have a wide scope of studying
these lifestyles (just like use of turmeric) in medicinal science; not only in
this scenario, but also at the molecular level, protein folding and structural
biology. It was also observed that in the case of cancer how a gene gets
activated and how we can map this gene – just like the landscape in nature,
there is a landscape in the genome known as marker. If the gene of the disease
and the marker are in close proximity of each other, then they will both be
inherited together. However, if the gene of the disease and the marker are far
from each other, then they will be inherited independently. If I apply the
recombinant DNA technology and mapping of the gene, I can search for a new
marker. In this context we can take the example of some genes, viz., genes for
diabetes.
When we suffer from anything, there
is logic for that. We build up this logic in modern biology. For example,
during gestation period, the embryo develops by cell aggregation, formation of
organs and system. Which cell can be involved in disease, it is the hypotheses
depend approach, and is not independent. I believe that the hypotheses depend
approach is used in Ayurveda, but hypotheses independent approach is also
necessary in Ayurveda, and we can understand this as a complex biology system.
A gene has a complex system, cell
death is necessary and it is also necessary that a balance is maintained
between the cell death and the cell survivor. The complex system of a gene can
be understood by the metabolism process in which transcription, translation, folding
and activation take place. This is known as a system approach. Ayurveda is a
holistic science. Now we take a computational approach and make a link between
the Ayurveda and systems biology approach.
In the case of diabetes, it is
necessary to understand the mitochondrial and nucleus gene. Diabetes patients are of two categories –
Diabetes Type I, and Diabetes Type II. In Ayurveda, the patient is categorized
on the basis of his prakriti. In
modern biology we can understand this in the form of clinical heterogenecity,
and thereby can observe the individual to individual difference and make
individual treatment profiles.
If we adopt this system in systems
biology, we will need computational biology. Similarly, we can enhance this
approach in Ayurveda. By using bio-informatics, we can derive at a unified
principle from biology and Ayurveda.
The different types of genes that
are involved in the various levels of diabetes and how they will perform, are
illustrated in the colourful diagram below.
There is so much heterogenecity in
diabetes. By analyzing through the computer, there is a hub present in the
centre and various genes interact with the hub. When we take a drug, where does
it create an impact in the body? By understanding this at the individual level,
we can prescribe it in the desirable dosage. This approach has now been adopted
in molecular biology, whereas it already exists since thousands of years in
Ayurveda.
Our priority is to integrate the
systems for human beings. Integration is necessary to understand by
bio-informatics and computational approach in future.
Today, in JNU we are using a
complex system for understanding the social problems and economic problems. The
principle of the complex system is based on the principle of physics and the
principle of mathematics, which we would like to use for the future.
How decision-making is made in
general on the basis of certain issues. There are dominant voices in our
country and there have been dominant voices in the past, whether they are
experts or non-experts, whether they wish well for the country or the systems
and Ayurveda; they have been prevailing and they have been making decisions.
Now we know today probably those decisions are not so good, so we need to take
the right decisions. The time has come to take the right decisions now. We are
in that environment which is favourable. So there are vested interests who
manipulate the system and they take decisions, and there are people who have
their own needs, there are pressures, influences; there are emotional reasons,
political reasons, considerations and compulsions. I think we have to take
logical, rational, and professional opinions for decision-making.
In this integrated science, if we
have to take it forward, we need to take a rational, professional and logical
decision.
Thank you!
* * * * * * *
[NOTE: The talk was delivered in
Hindi; English translation done by V. Arora and Daya Lalvani]
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