Modernization of Ayurveda: A Needful or Purposeless Task

Introduction

In ancient India, valuable knowledge was passed down from the gurus to their shishyas in the form of oral narration (Shruti) during the early period. Later the transfer took place in the form of writings (Smruti) due to various limitations that existed thereafter. Vedas were considered as the elite sources of ancient literatures  inclusive of various disciplines and Ayurveda existed as the Upaveda (subsidiary areas of knowledge) of Atharva Veda. This ancient medical science has traversed through various time periods, namely Samhitha kala, Sangraha kala and Nighantu kala. With the advancement of contemporary sciences in the present era, there have been consequential discussions among the Ayurveda fraternity with regards to the necessity for modernization of Ayurveda. Few questions arise in the minds of todays’ Ayurvedic personnel, namely ‘Should the science of Ayurveda be re-validated and updated for its application in the present time?’, ‘Does Ayurveda need modernization in terms of instrumentation and incorporation of the latest technologies available for better implementation?’, ‘Do the concepts like Ama etc. need correlations with the contemporary sciences for their finer clinical utility?’, ‘Does modernization stay as an important necessity for globalizing Ayurveda?’. To address these questions, the first and foremost task is understanding what the term “Modernization” truly encompasses. Then comes bifurcating the components that need modernization, if at all, and those in which modernization is just a purposeless task. Hence it is crucial at this moment to assess and reassess the need for modernization of Ayurveda.

Objectives of the study

The present study was oriented towards elucidating “Modernization” in the field of Ayurveda and to identify the domains that require modernization, as well as those where modernization would seem purposeless.

Methods

The classical texts of Ayurveda and the research articles from standard e-data base were reviewed for the study. Initially, the guidelines for upgradation of Ayurveda provided in the classical texts were referred. Later, published research articles were reviewed for the gap analysis. Finally, domains that demand modernization and those that do not yield any outcome were delineated with appropriate illustrations from the classical texts.

Modernization is technically defined as ‘the process of adapting something to modern needs or habits.¹ Ayurveda is dated back to at least 5000 years since its advent. The main aim of its inception was to maintain the health of the healthy and also to cure the diseases of the disease.² The principles put forth in this direction are encrypted into Samhitas propounded by various seers of Ayurveda. Each of the Samhitas reflect the ideologies that were existent in their respective time periods. Madhava is considered the best among those expounding nidana/roga jnana (knowledge on disease pathologies); Vagbhatta among those expounding sutrasthana (the section on sutras/shlokas); Sushruta among those expounding shareera (knowledge of the body) and charaka among those expounding chikitsa (treatment principles).³ But one commonality that is to be understood is that all of these involved practical applicability and not a mere theoretical description.

Acharyas provided an internal framework within which Ayurveda can be reinvented and modernized. They are as follows:

1. Ashtanga Sangraha opines that the principles of Ayurveda must be reformulated every now and then according to the need of the time.⁴
2. The process of pratisamskarana (updating and rewriting) of the classical texts renders the work into a newly abridged form with newer applications. Even the text of Charaka Samhita has reached the modern-day world after many editions and revisions. So, an old treatise becomes new through the process of saṃskaraṇa.⁵
3. There is a provision provided for akshepa (attempting to disprove) and only when a proper samadhana (answer) is achieved, it can be accepted reflecting the process of reinvention.⁶ This sheds light on the critical analysis and deconstruction of the textual writings.
4. Anuktarthagrahana (exploration) is another direction provided by Ayurveda.⁷ This encourages to go beyond what is codified in the texts and discovering new knowledge and new applications.
5. Acceptance of new knowledge (shastravada) is allowed in Ayurveda. Charaka Samhita clarifies that new knowledge (shastravada) which is in tune with the principles of Ayurveda (vedarthad avipareeta), verified by investigators (pareeksha- kaih pareekshitah) and benefits humanity (lokhanugraha pravruttah) is acceptable.⁸
6. There is no substance without medicinal value in the world.⁹ Ayurveda is utilizing a mere 10% of plant wealth in the country for medicines.10 The pharmacopeia needs to be updated in terms of the unidentifiable controversial drugs must be removed and make it more functional. This highlights the need for expanding the pharmacopeia (dravya jnana vistruti).
7. Ayurveda provides directions for diagnosing newer disease conditions. Charaka Samhita opines that it is not possible to name each and every disease as the disease manifestations are innumerable in their presentations.¹¹ Thus, profiling new diseases (anukta vyadhi) in Ayurveda is essential to stay updated.
8. Ayurveda provides futuristic ideologies for developing formulations as per the contemporary needs. It is opined that a wise physician can formulate hundreds of formulations by applying his intellectual capacity and experience.¹²

These classical instructions certainly highlight the freedom laid down by Ayurveda to reinvent and remodulate the practices within a framework. The impending question here is, ‘Is this applicable in all scenarios, or are there any exceptions?’.

Discussion

Simplifying, “Modernization” is an approach of making necessary changes to the existing setting to make it more efficient and relevant to the present-day scenario. Modernization in the field of Ayurveda can include any of the domains like, re-structuring the Samhitas which are the store houses of ayurvedic knowledge to the present-day education protocols; re-defining various terms mentioned in Ayurveda with correlations from the present-day contemporary sciences; extraction of the active principles from the Ayurvedic herbs in laboratories; creating animal models to simulate various clinical conditions and assess the clinical efficacy of newly extracted molecules; adding newly recognized herbs and preparing monographs; exploring newer forms of medicine presentations like soft gel capsules, transdermal patches, etc.; developing new diagnostic tools; developing instrumentation for various panchakarma procedures incorporating a variety of technologies of the present day and the list goes on. Any modernization that is needed to be thought of as done above, invariably must fall into three main facets, including Literature, Drug and Clinical domains. Thus, mainly these three areas come into the purview while considering research in the field of Ayurveda with respect to modernization as well.

Ayurveda since its origin stands as a researched science incorporating various research methodologies that were prevalent in their respective time periods. Generally, all these principles fall into either ‘Static’ domain or ‘Dynamic’ domain. Static domain includes those constant aspects that remained the same 5000 years ago, which are remaining the same at present and which will surely remain the same in years to come. However, the Dynamic domain includes all those variables that have undergone modifications at numerous levels with the passage of time. The former category includes the structural formation and foundation of human body in terms of Shareera, Indriya, Satva and Atma components, Pancha Mahabhutas forming the integral skeleton of Loka as well as the Purusha, Ritu, Tri- doshas, Tri-malas, Sapta-dhatus and many such constants. The latter category includes the ever-changing lifestyle of people in terms of Ahara and Vihara. Which among the two domains if considered serves the purpose of modernization in the present scenario is the point of discussion. Thus, discussion regarding the relevance of modernization was carried out based on these lines in the three fields of Ayurveda research i.e. Literature, Drug and Clinicals.

Literature

Literature has two aspects that standout, i.e. Manuscriptology and Samhita Adhyayana krama. Manuscripts have always been like gold dust in their value and serious issue is that only 2% of the available Ayurvedic manuscripts have been published.¹³ One of the major reasons for this is the condition in which the Ayurvedic manuscripts become available. The manuscript would have got destroyed by either worm infestation or by human mishandle. There is a need for modernization of collection-preservation techniques that would facilitate at least the available manuscripts to be preserved better and made available for critical edition. Modernized techniques like digital copying, lamination, etc. are being utilized.

Further, there is always a particular krama to be followed to study any shastra. Ayurveda shastra also has a particular krama to be followed to study and understand the principles mentioned in the Samhitas. It can be listed as follows.

1. Vakyashah, Vakyarthashah and Arthavayavashah,¹⁴
2. Patha, Avabodha and Anushtana,¹⁵ 
3. Adhyayana, Adhyapana and Tadvidya sambhasha,¹⁶
4. antra, Tantrartha, Sthana, Sthanartha, Adhyaya, Adhyayartha, Prashna and Prashnartha.¹⁷

Various other methodologies like Tantrayukti, Tacchilya, Kalpana and Arthashrayas also aid in better understanding of Samhitas.¹⁸ The idea of modernization in this area of Samhita Adhyayana is futile as developing ready reckoners or shortcut methodologies will not serve the purpose. Only the use of authentic methods from the past can yield better outcomes.

Drug

Ayurveda considers every Dravya in the Loka as panchabhautika and possess medicinal properties. Among the Chikitsa Chatushtaya, dravya is one among Bhishak, Upastha and Rogi.¹⁹ Various aspects come into picture at this juncture when modernization is considered, such as:

i) Drug collection, preservation and processing techniques

ii)  Forms of drug administration

iii)  Routes of drug administration

Regarding drug collection and preservation techniques, various references of ancient methods are available in the classics. But in the present-day practices, using preservatives like sodium benzoate, etc. to enhance the shelf life of the dispensed medicines is not a useful modernization technique as there can be increased risk of inflammation and allergies in patients.²⁰ Hence, adopting principles given in the classics pertaining to swaveeryata avadhi of the respective kalpanas, like churna will cure the disease and in turn not cause other complications.

Drug processing techniques have been voluminously described in the classics, right from putapaka swarasa method from vasa plant till arka Kalpana, the present day distillation technique. In modern era, extraction of active principles from ayurvedic drugs has become a trend with a principle of one-to-one approach of disease and the respective active molecule. Modernized techniques of extraction methods like solvent extraction, distillation method, pressing and sublimation are in wide utilization, but Ayurveda has always believed in the concept of “Samyoga”, meaning having more than one drug used in combination for a specific karma, like in the case of fifty Dashemani Mahakashayas.21,22

Forms of drug administration has undergone a significant modification from the period of Charaka to the present day. Newer forms include extract filled soft gel capsules, Ghana vati, sugar syrups, aerosols, inhalers and creams with paraffin content in the form of patent medicines with erratic combination of drugs. As a part of modernization, this might improve the quality of the presentation of medicines, but will the efficiency remain the same in comparision with the classical dosage forms is still questionable.

Routes of drug administration in the classics have been restricted to Mukha, Nasa, Karna, Netra, Mutra reto marga/ yoni marga, Guda marga and Roma koopa (topical).23 Considering intravenous route of administration in view of modernization might be a purposeless task as administering Dravya in krutrima marga (artificial route) has not been considered in classics. Misunderstanding the reference of Suchikabharana rasa mentioned by Sharangdhara Samhita to intravenous drug administration might not be fruitful.²⁴

Hence in the aspect of drug, assessing the requirement of modernization before moving forward is a better approach, rather than considering everything as a subject of modernization with a view to present Ayurveda globally. This could be an incorrect way which may not prove fruitful to the field’s success and authenticity.

Clinicals

Acharyas have always stressed the importance of Pareeksha (Examination/Investigation) before applying chikitsa for a clinical condition.²⁵ Classics have enumerated various tools for examination of both the disease condition as well as the diseased, such as:

i) Ashtasthana Pareeksha (Nadi, etc),²⁶

ii)  Dashavidha Pareeksha^,27

iii)  Darshana, Sparshana and Prashna^.28

Applying these principles and considering the pratyaksha badhakara bhavas, the utility of various diagnostic tools has come up as a result of modernization.²⁹ Imaging techniques like MRI etc., hematological and biochemical investigations come very handy in confirming the diagnosis of a vyadhi in terms of contemporary science. Only when the utility of these modernized techniques is understood in terms of Ayurveda, like relevance of ama if there is a raised ESR, serum uric acid etc., then the utility of modern diagnostic techniques becomes complete. This should be the way forward as well.³⁰

Ayurveda has definite descriptions for every technical terminology which have been used by the Acharyas. For example, concept of ama, agni, vyadhikshamatva, etc. have their definite descriptions in samprapti of a vyadhi. In the verge of modernization, correlation of these terms into modern contemporary science and applying Ayurveda management protocol might not be purposeful. This domain of clinical facet can be considered as “Static” as described earlier and application of these as it is in the present era will be more beneficial.

Panchakarma is one of the major treatment modalities of Ayurveda which even the western countries agree to be an effective solution for many illnesses. Instrumentation plays a major role in the practice of Panchakarma. With the descriptions as explained in the classics, its application in the present-day practice stays unacceptable, sometimes because of its crudely designed instrumentations without standardization. In this aspect, there is a lot of scope in terms of standardization and modernization. Standard instrumentations for Basti putaka, Basti Netra, Shiro Basti, Pradhamana nasya netra, Agnikarma upakaranas, etc. are essential.

To summarize the above discussion, few of the aspects like instrumentations and diagnostic tools can be considered as “Dynamic” and there is a need for modernization and standardization in this area.

Conclusion

For a science to progress through generations, there is certainly a necessity for upgradation and improved presentation of the principles mentioned in the classics. The point to be noted at this juncture is to be vigilant about the sanctity of the principles while putting them to practice. Modernization is certainly need of the hour, but certain points must be taken into consideration, such as:

i) Its relevance in Literature-Drug-Clinical aspects

ii)  In what way, the necessity of modernization is the need of the hour

iii)  How the modernization would help in the progress of Ayurveda

iv)  Is the modernization not violating the authentic principles laid down in the Samhitas.

When the above questions are posed, clarity regarding the necessity of modernization can be achieved. Certainly, Ayurveda is a life science and completely holistic in its approach. The contemporary medicine mainly speaks of reductionist approaches and if modernization of Ayurveda is thought in this direction, be it in static components or in the dynamic components, it is then a purposeless task to achieve. To conclude, for a shastra to be alive for ages, practice of its core principles is most essential. But, when the practice needs modification/modernization without opposing the authenticity, there is no harm in accepting the same.

Sources of Support

None

Conflicts of Interest

None

Acknowledgement

I want to extend my sincere gratitude to my mentor and guide, Dr. Shreevathsa, for supporting and guiding me for this publication.