It was recently reported that the Indian Medical Association called on the health minister, himself a doctor (Dr. Harsh Vardhan), to provide evidence that Ayurveda and yoga are effective in treating the coronavirus.¹ This has been the source of ongoing, and sometimes contentious, discourse. The story of Asha (not her real name) illustrates this point.

A year ago, Asha pleaded with her Ayurveda practitioner, “Please listen to me. Everyone is just passing me from one specialist to the next.” When she was 35 years old, after several years of investigations, Asha was finally diagnosed by the endocrinologist as being hypothyroid. Her relief that with this diagnosis she would begin to then heal was short lived.

When her menstrual cycle was still not regulated, Asha was referred to a gynaecologist who prescribed the contraceptive pill. When her eyesight was affected as a side-effect of the pill, she was referred to an ophthalmologist to get prescription glasses. When she found that her skin was dry and she suffered from allergies, a dermatologist prescribed steroidal cream. With the unexplained weight gain came a visit to the cardiologist who diagnosed her as being pre-diabetic and prescribed yet another medication.

“One day, I sat alone in my flat and cried,” Asha said. “I had spent close to RM2,000.00 on tests alone because each specialist wanted his own tests done. I tried to tell them that maybe the medicines were all contraindicating with each other, but they wouldn’t listen. When I told my endocrinologist that I was too tired to commit suicide, she wanted to refer me to the psychiatrist.”

Refusing to do so, Asha turned to the Ayurveda practitioner for help; she had nothing left to lose. Deeply frustrated, Asha said, “All the specialists said that there was no evidence that Ayurveda would work. Sometimes, I wonder if they even know what evidence means.”

What does evidence mean?

The word evidence has its origins in the legal field and is an entire undergraduate module for those who read law. At its most basic, it is the available body of facts or information indicating whether or not a belief is true or valid. The application of such evidence requires a lawyer to state a particular rule, provide facts that support this rule, state the exception to the rule, provide facts that showcase this and, finally, apply these to any particular case in hand.

When those in the healthcare industry demand evidence, as the Indian Medical Association has, what they are often referring to is ‘evidenced-based medicine’ (EBM) which is reported to mean ‘the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients.’ The EBM movement is now used as means to dismiss any treatment of a disease that isn’t subject to systematic reviews and meta-analyses, research methods based on multiple studies and critical analyses.

Treating the disease, not the patient

Therein lies the basic problem and fundamental difference between the two systems of treatment of a patient: where allopathic medicine focuses on ‘treatment of a disease’, complementary medicine focuses on the patient. The endocrinologist treated Asha’s hypothyroid, the dermatologist treated her skin condition, the cardiologist treated her pre-diabetes and the psychiatrist would have examined her state of mind. The Ayurveda practitioner, on the other hand, treated Asha.

Making this distinction does not in any way dismiss the contributions that each of these specialists makes towards the treatment of patients seek their help. The majority of doctors are no doubt providing treatment to the best of their ability.

What this statement aims to showcase is that the responsibility of what is happening to a patient isn’t confined to only one part of the patient’s body. And that there is no better person who understands what is happening to his body than the patient himself.

Complementary not alternative

This emphasises the point that each patient must shoulder part of the responsibility of the treatment he agrees to undertake. Asha’s road to recovery was fast because of her discipline and the methodical approach she took: she followed all the instructions given, took the medications (both allopathic and complementary), listened to her body, communicated her concerns to healthcare professionals who listened to her and, in some cases, stood her ground.

“Even though all my test results showed that I was back to normal, the cardiologist insisted that I start taking statins as a precautionary measure. He was so angry when I told him it was unnecessary and scolded me for believing in Ayurveda.”

Therein lies the next problem. There is an assumption that practitioners of Ayurveda and yoga are practising alternative medicine and either circumventing or usurping the role of modern medicine. This cannot be further from the truth. Ayurveda and yoga are not alternatives to allopathic medicine. They complement the established medical systems.

Ultimately, the last word belongs to Asha who said, “I had to learn to listen to and understand my body. I also accepted that with complementary medicine, there is never going to be the kind of evidence they want. Every single patient is different. I didn’t know if Ayurveda and yoga, together with allopathic medicines, would work for me until I tried them. And what worked for me may not work for someone else. But I am the evidence that it works for me.”

References:

1. Home remedies boom as India pandemic cases soar. Starlifestyle, Monday 2 November 2020 (Woman); p.p. 6
2. Masic I, Miokovic M and Muhamedagic B; Evidence Based Medicine – New Approaches and Challenges; Acta Inform Med. 2008; 16(4): 219–225 or online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789163/

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Vaidya C. D. Siby is the Chief Ayurveda Practitioner at Ayur Centre, Petaling Jaya and Council Member of the Traditional and Complementary Medicine Council, Ministry of Health in Malaysia. Together with Aneeta Sundararaj, he is the co-author of the best-selling book, Knowledge of Life: Tales of An Ayurveda Practitioner in Malaysia published by MPH Publishers (ISBN 9789674154004).