Research Articles
Myth and reality of “theory-driven individualised practice” in Ayurveda: Mapping physicians’ approaches using case-based scenarios
Background: The curricula of Ayurveda programmes emphasise various theoretical constructs such as Tridosha (three factors determining the state of health), Agnibala (digestive strength), Samprapti (patho-physiology), among others. It is often argued that practitioners follow an individualised approach based on these principles while treating patients. Yet, dependable data on their real-world influence is lacking. The aim of this study was to record the extent to which these constructs drive decision-making among Ayurveda practitioners and to examine whether these constructs determine individualisation of the interventions.
Methods: We employed an emailed survey to record physicians’ perceptions. Convenience sampling was chosen as the sampling method. Registered Ayurveda practitioners located across India with a minimum of five years of clinical experience were invited to participate. Five case-based scenarios depicting different clinical conditions were presented to the physicians. Questions that accompanied each case scenario asked the physicians to record clinical diagnoses, treatment plans, and the Ayurveda principles that determined their treatment.
Results: A total of 141 physicians responded, from whom we received 152 responses as seven physicians responded to more than one scenario. The results suggest a significant lack of consensus among physicians regarding clinical diagnoses, interventions, and their understanding of pathophysiology in the given clinical scenarios. Many conflicting opinions were also noted.
Conclusion: Theoretical constructs do not appear to determine either prescriptions or individualisation uniformly. Two ethical questions arise: “Is this situation due to an inherently weak theoretical framework of Ayurveda?” and “How can one justify spending hundreds of hours teaching these theories?”
Copyright and license ©Indian Journal of Medical Ethics 2024: Open Access and Distributed under the Creative Commons license ( CC BY-NC-ND 4.0), which permits only non-commercial and non-modified sharing in any medium, provided the original author(s) and source are credited.
Respected sir
Your study is marvelous for the future generation but no one going to change anything because policies makers are in today’s time is mostly old version.and new generation mostly involved in short cut money making. BAMS doctor means duplicate version of Indian health professional.
The conclusions of the paper are perhaps right, but the method of the study does not compellingly drive home the conclusions. Registered Ayurveda practitioners located across India with a minimum of five years of clinical experience were included in the study. Based on their approaches to diagnosis and treatment, the conclusions have been arrived at. Their approaches have been used to suggest that ayurveda’s theoretical framework is weak.
It can be argued that the participant practitioners in the study were not selected based on competence. An ayurvedic degree along with five years of experience does not guarantee competence. Earlier papers* have noted that “healthcare providers with medical degrees in urban Delhi can range from the very best to among the worst in terms of pure technical competence, depending on where they were trained.” Even among providers with medical qualifications “Correct diagnoses were rare, incorrect treatments were widely prescribed.”
Just as poorly skilled MBBS doctors cannot be used as proofs against the scientific soundness of modern medicine, it can be argued that poorly skilled BAMS doctors cannot used as proofs against the soundness of ayurvedic theories.
To tighten their case, the authors should have selected for their study only those ayurvedic practitioners who were renowned for their theoretical and practical knowledge of ayurveda. They could have, for instance, chosen the fellows of the National Academy of Ayurveda.
A few other aspects of the study too needed modifications.
I am not saying that the ayurvedic theories are very sound. As my papers have shown, they are not. The singular point I am making now is that the design of the current study is not robust enough to suggest that ayurveda’s theories are inherently weak.
* BMJ 2012;345:e8437
* Das, Jishnu et al. “In urban and rural India, a standardized patient study showed low levels of provider training and huge quality gaps.” Health affairs (Project Hope) vol. 31,12 (2012): 2774-84. doi:10.1377/hlthaff.2011.1356
The findings of this survey are partially truth. The genuine Ayurveda Vaidya considers Prakruti, Vikruti, Agni, Ama, Koshta, Desha, Kala, Bala, Oja and then treatment is planned. The sample size is very small, and I think not many of these participants are not classical and Experienced Vaidya.
A CRITICAL EXAMINATION: REFINING THE ASSESSMENT OF AYURVEDIC THEORY IN PRACTICE
Introduction
In the recent article titled ‘Myth and Reality of “Theory-Driven Individualised Practice” in Ayurveda Mapping Physicians’ Approaches Using Case-Based Scenarios’ (Chauhan et al., 2024), published in the Indian Journal of Medical Ethics, the authors investigate a novel approach to assess how well Ayurvedic theory translates into individualized patient care. This study is of interest because it addresses a critical gap in understanding the real-world application of Ayurvedic principles. The authors’ approach using case-based scenarios to assess the application of theory in real-world patient care is particularly insightful. Furthermore, the paper emphasizes the significance of internal critique within a scientific system, a concept crucial for the ongoing development of Ayurveda.
Specific Point and Observation:
While the paper by Chauhan et al. (2024)[1] provides valuable insights, it is worth considering how their methodology might not fully capture the epistemological underpinnings of Ayurveda. Future research could explore alternative approaches that integrate both theoretical and experiential aspects of Ayurvedic knowledge to provide a more comprehensive understanding of theory-practice relationships.
The article highlights limitations to interdisciplinary interaction within Ayurveda. However, it is important to acknowledge the growing recognition of integrative healthcare approaches that combine Ayurveda with other medical systems[2,3,4,5,6]. The inclusion of AYUSH systems (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) in India’s national health policy reflects this trend towards interdisciplinary collaboration[7]. Future research could explore successful models of integrating Ayurvedic principles with other healthcare systems to optimize patient care.
The reference used to discuss the Ayurvedic education system predates significant revisions implemented after 2011[8]. These revisions, while not yet validated by rigorous peer review, represent an effort to modernize the educational system. For a more current perspective, future iterations of this research could consider incorporating information from the Quality Council of India regarding the implementation of the new minimum standards for Ayurvedic education[9].
The article focuses only on individualization in Ayurvedic practice. While individual customization is a key aspect of Ayurveda, it’s important to acknowledge that the system also incorporates standardized treatment guidelines. Ayurveda’s treatment protocol for every disease is structured to start with a general approach, followed by dosha-specific and condition-based protocols outlined to address the unique manifestations of the disease in the patient. Additionally, Ayurveda allows for further modifications based on individual consultations showcasing Ayurveda’s unique individualized care. A physician’s success hinges on effectively combining these general principles with tailored approaches for each patient. Future research could explore how Ayurvedic practitioners navigate this balance between standardized protocols and individualized treatment plans because it is worth considering the potential for selection bias. The choice of specific case studies might unintentionally overrepresent examples where theory and practice diverge.
The authors have not considered the five-fold diagnostic tool (Nidana Panchaka) essential for disease examination in Ayurveda[10]. This omission is highly pivotal, and therefore, the information derived from these limited observations cannot be generalized. it appears that the authors may not fully appreciate the clinical holism inherent in Ayurveda. The perception of each case in Ayurveda is unique and should be validated based on therapeutic efficacy rather than merely by its name or terminology[11]. The validity of a diagnosis in Ayurveda should be evaluated also by examining the therapeutic outcomes of the proposed protocol and the understanding of the disease process (samprapti). However, a crucial aspect of Ayurvedic diagnosis and treatment is chikitsāsiddhi, or therapeutic efficacy[12]. Future research could explore how Ayurvedic practitioners evaluate the effectiveness of their treatment plans based on this concept. Additionally, incorporating upashaya-anupashaya the distinction between improvement and lack of improvement, could provide a more nuanced understanding of treatment outcomes in Ayurvedic practice[13].
While the questionnaire explores some details of patient examination, it’s important to distinguish this from the comprehensive āyurvedik parikshā, or Ayurvedic examination. This examination encompasses various methods beyond those typically used in biomedicine. For instance, dhātu parikshā, the examination of bodily tissues, is a crucial component of Ayurvedic diagnosis[14]. Future research could explore alternative methodologies that more completely capture the richness of Ayurvedic examination techniques used by practitioners in clinical settings.
The case studies employed by Chauhan et al. (2024) do not consider prior Ayurvedic treatment history. In Ayurvedic evaluation, upashaya-anupashaya, the distinction between improvement and lack of improvement, is crucial. Understanding a patient’s response to previous Ayurvedic interventions would provide valuable context for assessing the physician’s approach in each case study. Additionally, the article does not address the potential impact of biomedical treatments on samprapti, the pathogenesis of the disease according to Ayurveda. For instance, some biomedical painkillers may exacerbate pitta dosha, potentially complicating the disease picture.
In this study, the responses regarding insufficient information about the disease and patient were as follows: anaemia (6), IVDP (52), COVID-19 (14), pompholyx (30), and male infertility (6), totaling 108 responses. According to Ayurvedic epistemology, the available information is insufficient regarding disease as well as patient.
All five cases presented in the scenario contain highly insufficient data to accurately depict the Ayurvedic analysis of the given diseases. For example, in the analysis of Pandu (anemia), the status of Kapha and Rakta vitiation is not mentioned, even though Pandu is characterized by disturbances in Rakta (blood) and Kapha dosha[15]. In musculoskeletal disorders, which are primarily due to Vata vitiation in Mamsa (muscle) and Asthi (bone) dhatus[16], the status of these dhatus is not evaluated. COVID-19 is primarily a Rasa-vitiated disease affecting various koshtangas (internal organs), yet the spectrum of Rasa dhatu vitiation is not elucidated. Skin diseases are mainly caused by Kapha and Pitta vitiation involving Rasa, Rakta, Mamsa, and Kleda factors[17]; however, no comprehensive dhatu analysis is presented. In the case of male infertility, the authors only examine Shukra dhatu, whereas infertility in Ayurveda is a result of imbalances in multiple dhatus, and these additional evaluations are absent. This insufficiency significantly affects the data analysis and results. Moreover, these critical areas of opinion are not discussed in the article. The authors’ judgment based on this biased data in the crucial process of disease evaluation indicates either a lack of understanding or prejudice. Based on this biased judgment, a generalized evaluation of the fundamental practices of Ayurveda is unscientific.
Conclusion
Chauhan et al. (2024) offer valuable insights into the application of Ayurvedic theory in practice. Their use of case studies and focus on internal critique are strengths. However, the review highlights limitations in capturing the full picture of Ayurvedic practice. Future research can address these by integrating experiential knowledge with theory, exploring interdisciplinary models, and incorporating up-to-date information on Ayurvedic education. Additionally, investigating the balance between standardized protocols and individualization, utilizing methods that capture Ayurvedic diagnostic richness, and considering therapeutic outcomes would provide a more nuanced understanding. Finally, employing larger and more representative samples would strengthen the generalizability of findings. By addressing these limitations, future research can build on Chauhan et al.’s work to provide a more comprehensive picture of how Ayurvedic theory translates into real-world patient care.
REFERENCES
1. Chauhan M, Srivastava VK, Patwardhan K. Myth and reality of “theory-driven individualised practice” in Ayurveda: Mapping physicians’ approaches using case-based scenarios. Indian J Med Ethics. Published online first on June 17, 2024.DOI: 10.20529/IJME.2024.039.
2. Bendale YN, Kadam A, Birari-Gawande P, Patil A, Ingale D. Exploring the potential of the traditional Indian system of medicine, Ayurveda, for developing an evidence-based integrative model of cancer care in elderly patients with cancer.
3. Arnold JT. Integrating ayurvedic medicine into cancer research programs part 2: Ayurvedic herbs and research opportunities. Journal of Ayurveda and Integrative Medicine. 2023 Mar 1;14(2):100677.
4. Banerjee S, Debnath P, Debnath PK. Ayurnutrigenomics: Ayurveda-inspired personalized nutrition from inception to evidence. J Tradit Complement Med. 2015 Mar 24;5(4):228-33. doi: 10.1016/j.jtcme.2014.12.009. PMID: 26587393; PMCID: PMC4624353.
5. Purushotham A, Hankey A. Vegetarian Diets, Ayurveda, and the Case for an Integrative Nutrition Science. Medicina. 2021; 57(9):858. https://doi.org/10.3390/medicina57090858.
6. Thottapillil A, Kouser S, Kukkupuni SK, Vishnuprasad CN. An ‘Ayurveda-Biology’platform for integrative diabetes management. Journal of ethnopharmacology. 2021 Mar 25;268:113575.
7. Ministry of Health and Family Welfare. (2017). National Health Policy 2017. Government of India. Available at: https://main.mohfw.gov.in/sites/default/files/9147562941489753121.pdf
8. Patwardhan K, Gehlot S, Singh G, Rathore HC. The ayurveda education in India: how well are the graduates exposed to basic clinical skills? Evid Based Complement Alternat Med. 2011 Feb; 2011:197391. https://doi.org/10.1093/ecam/nep113
9. National Commission for Indian System of Medicine (2022).NCISM India rules and regulations. https://ncismindia.org/rulesandregulations.php
10. Prof.K.R.Srikantha Murthy, Vagbhata’s Astanga hridayam.Varanasi,Chowkhamba Krishnadas Academy, Reprint 2006,p.3.
11. Vaidya Bhagwan Das,Agnivesa’s Caraka Samhitha,Varanasi,Chowkhamba Sanskrit Series Office,Reprint 2008, p.345.
12. Vaidya Bhagwan Das,Agnivesa’s Caraka Samhitha,Varanasi,Chowkhamba Sanskrit Series Office,Reprint 2008, p.61.
13. Prof.K.R.Srikantha Murthy, Vagbhata’s Astanga hridayam.Varanasi,Chowkhamba Krishnadas Academy, Reprint 2006,p.5.
14. Prof.K.R.Srikantha Murthy, Vagbhata’s Astanga hridayam.Varanasi,Chowkhamba Krishnadas Academy, Reprint 2003,p.179.
15. Dr.B.Rama Rao,Astanga Samgraha of Vagbhata Vol.I,Varanasi,Chaukhambha Visvabharati,2006,p.294.
16. Prof.K.R.Srikantha Murthy,Ashtanga Samgraha of Vagbhata,Vol.II,Varansai, Chaukhambha Orientalia, Second edition 1999,p.243.
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The study reveals significant variability among Ayurveda practitioners in diagnoses and treatments, questioning the consistency of applying theoretical constructs. It suggests that Ayurveda’s theoretical framework may not effectively guide clinical practice. Methodological limitations, such as convenience sampling, may affect the study’s conclusions. The findings indicate a potential need to re-evaluate Ayurveda education to better integrate theory and practice. Further research with more rigorous participant selection is recommended to validate these insights.
A good attempt Sir… Acharya Charaka himself said, one can be a Kushala vaidya only when he finds the truth after proper examination, Parikshyakarinohi kushala bhavanti. Theoretical frameworks must be examined properly for a sound practical knowledge. The upcoming generations must get a proper understanding of this life science. Its high time for all of us to develop critical thinking than accept everything as such. Present education system makes a student biheart and pass the exam.. but what next is the big question ..
just want to quote few words from Cha.Sam.Su. 15/4-5,
Query by Agnivesha to Atreya about success of treatment;
“O Lord! A learned physician should prescribe a treatment in such a way that it should surely and invariably be successful. The success of all treatments depends upon proper administration and complications due to improper administration. However, sometimes, the success or failure of treatment doesn’t follow the rules of proper or improper administration, hence knowledge and ignorance becomes equal.”
Lord Atreya replied, “Oh Agnivesha!, it is possible for us to treat the patients successfully and also impart instructions for correct administration. But there is none who is able to grasp such instructions or having grasped it, is able to apply it or put it into practice. The variations in conditions of dosha, drugs, place, time, strength, body, diet, suitability, mind pattern, constitution, and age are subtle to understand. While considering these factors, when even a person with great intellect and pure knowledge gets confused, then what will be the condition of a person with less intellect?
We, the authors, thank everyone who took interest in our study and shared their comments on this article. We address all the major concerns in this response.
1. Competence of the respondents
G.L. Krishna and Vasant C have raised concerns about the proficiency of the physicians who participated in the study, particularly regarding their knowledge of classical Ayurvedic theories. GL Krishna points out that our inclusion criterion allowed anyone with a graduate degree in Ayurveda with five years of clinical experience to participate in the study. Though this is true, it is important to note that most respondents in our study held postgraduate or doctoral degrees. To be precise, only 16 out of 152 responses were from physicians with only a graduate degree, while 86 were from those with a master’s degree in Ayurveda and 46 responses were from those with a doctoral degree in Ayurveda. 4 responses were from those with master’s degrees in fields other than Ayurveda. Despite this, if there are still concerns about the theoretical competence of the participants, more serious questions about the quality of postgraduate and doctoral training in Ayurvedic institutions emerge. However, we plan to extend this study where we intend to include only such physicians who have established credentials.
2. Generalizability, Sample Size and Sampling Technique
Dinesh K.S. and Geethu Balakrishnan in their lengthy comment, voice their concerns about the generalizability of the findings, given the small sample size and the convenience sampling technique we used. Vasant C also highlights this limitation.
We would like to bring to their attention that this is a qualitative exploratory study, not a quantitative one. To our knowledge, this is the first study of its kind to have been conducted and published. Qualitative studies usually prioritize depth of understanding over generalizability. Considering the homogeneity of the respondents, a sample of 152 responses is not only good but also exceeds typical expectations for such studies. This substantial sample size enhances the depth, breadth, credibility, and reliability of the findings [1].
3. Inadequate Information
Dinesh and Geethu mention and elaborate on the inadequate information provided in the case scenarios (Nidana Panchaka, for example). We would like to stress that this was done intentionally. Physicians often rely on limited information about Ayurveda-based parameters to arrive at a diagnosis and to plan treatment. This is evident from the minimal additional details requested by the physicians. The numbers of such requests indicated by Dinesh and Geethu in their comment are simply wrong and are misleading. Further, our study results do not support the argument that Ayurveda physicians follow standardised treatment protocols.
4. Obsolete research cited
Another weakness pointed out by Dinesh and Geethu is the use of older research to support our argument that the quality of training in Ayurveda institutions is generally poor. In this context, we would like to state that the cited research was based on the doctoral research carried out by the corresponding author of the present study and was published in 2011. Since then, there have been no further efforts to examine this research question, making the study still relevant and the most recent available evidence on the matter. We do not agree with the suggestion that data from the Quality Council of India can be of use in this context. The cited research is based on the perceptions of students and teachers and not on the extent of implementation of minimum standards [2].
1. Moser, A., & Korstjens, I. (2018). Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. The European journal of general practice, 24(1), 9–18. https://doi.org/10.1080/13814788.2017.1375091
2. Patwardhan, K., Gehlot, S., Singh, G., & Rathore, H. C. (2011). The ayurveda education in India: how well are the graduates exposed to basic clinical skills?. Evidence-based complementary and alternative medicine : eCAM, 2011, 197391. https://doi.org/10.1093/ecam/nep113
The study’s findings are limited due to the use of convenience sampling, which affects the reliability and generalizability of its results. Relying on a sample of only 141 Ayurveda doctors may not represent the entire population accurately, impacting the study’s internal validity and risking biased conclusions. Therefore, any conclusions drawn should be interpreted cautiously within the study’s limitations.
Moreover, in the field of Ayurveda, where traditional knowledge is highly valued, misrepresenting its principles could undermine credibility among practitioners, scholars, and the public. When using study findings to inform policy or practice, these constraints should be acknowledged.
Regarding ethical questions raised:
1. Is this due to an inherently weak theoretical framework of Ayurveda?
Ayurveda’s theoretical framework is robust yet distinct from modern biomedical models. Like other traditional systems, Ayurveda encounters challenges in aligning with modern scientific standards and validating its practices. These challenges underscore areas requiring further development rather than indicating inherent weaknesses.
Current scientific methods may face limitations in comprehending Ayurvedic theoretical concepts due to several reasons.viz;
.**Different Paradigms**: Ayurveda focuses on holistic and personalized approaches, considering interconnectedness and unique constitutions. Modern science leans towards reductionist methods and measurable outcomes within controlled settings.
**Complexity**: Ayurvedic theories involve intricate interactions among bodily systems, energies, and environmental factors, which contrast with modern science’s segmented approach. The interconnected and dynamic nature of Ayurvedic concepts such as doshas, dhatus, and malas may require research methods that are holistic and consider entire systems.
While the dosha framework may not directly align with modern biomedical terminology or biochemical pathways, it provides a comprehensive and flexible system for understanding health and guiding therapeutic approaches.
**Measurement Issues & Adapting Research Methods**: Ayurvedic diagnostics often rely on qualitative assessments, such as evaluating dosha imbalances, which are challenging to quantify using standard scientific measurements. Research in Ayurveda must therefore develop methodologies that honor its principles while meeting scientific standards, accommodating personalized treatments and complex systems thinking.
**Cultural Context & Integrating Traditional Wisdom**: Ayurveda, deeply rooted in Indian culture and philosophy, faces challenges when validated within Western biomedical frameworks. Its knowledge integrates centuries of empirical observations, requiring approaches that blend experiential and empirical evidence.
Adapting research methodologies and promoting interdisciplinary collaboration while honoring Ayurveda’s holistic principles ensures integrity and greatly enhances our understanding of Ayurveda over time.
2. How can we justify spending time teaching these theories?
Teaching Ayurveda acknowledges its unique contributions to healthcare. Based on centuries of empirical observations, Ayurvedic theories have effectively treated various conditions. Despite not always aligning with modern scientific standards, these observations deserve study.
Regarding unsubstantiated theories in Ayurvedic texts, it’s acknowledged that some concepts lack modern scientific validation and may be rooted in philosophical or metaphysical principles rather than empirical evidence.
Integrating modern disciplines such as cell biology, anatomy, and physiology with Ayurvedic theoretical concepts depends on perspective and context. Instead of replacing certain Ayurvedic theories outright, a synergistic approach that incorporates relevant aspects of modern disciplines while honoring Ayurvedic principles and patient preferences can enhance the effectiveness and comprehensiveness of healthcare.
Approaching Ayurveda solely through the lens of modern scientific reductionism, with the aim to discard or reinterpret its traditional theories and principles, could lead to significant implications and outcomes.(That’s a paper on its own.)
The points elaborated by Dr. A.G. Vaijayanthi have already been addressed in this journal in the discussions following an earlier article authored by the corresponding author of this study [1]. Readers may refer to these discussions as listed below [2,3,4,5]. Regarding sample size, generalizability, and other methodological points, please refer to our previously posted response.
1. PATWARDHAN, K. . (2022). Confessions of an Ayurveda professor. Indian Journal of Medical Ethics, VIII (1 (NS)), 61. Retrieved from https://ijme.in/articles/confessions-of-an-ayurveda-professor/
2. KRISHNA, G. . (2023). Give truth a chance. Indian Journal of Medical Ethics, VIII (4 (NS)), 329. Retrieved from https://ijme.in/articles/give-truth-a-chance/
3. PATWARDHAN, K. . (2023). A case for testing and modifying theory in Ayurveda: Author’s response. Indian Journal of Medical Ethics, VIII (4 (NS)), 326. Retrieved from https://ijme.in/articles/a-case-for-testing-and-modifying-theory-in-ayurveda-authors-response/
4. LAKHOTIA, S. . (2023). “Confessions of an Ayurveda professor” — A wake up call. Indian Journal of Medical Ethics, VIII (2 (NS)), 143. Retrieved from https://ijme.in/articles/confessions-of-an-ayurveda-professor-a-wake-up-call/
5. PATWARDHAN, K. . (2023). Self-correction is essential to science: Author’s response. Indian Journal of Medical Ethics, VIII (1 (NS)), 68. Retrieved from https://ijme.in/articles/__trashed/
In the introduction part the authors have used the term Biomedicine and have also defined it suited to their needs. But, the responses they expected must be related to Biomedicine from their discussion on pg. 190. On pg 181, paragraph 2, evaluation of a disease has been described. The reference for the same is Ashtang Hridayam Sutrasthan adhyaya 12 and 67th shloka.proper evaluation technique would be mentioned in Nidana sthan.A concept of Samprapti Vighatana has been cited from a research article – ref.10. But the said term is not available in that text.Speculative descriptions – process of urine formation ( modern concepts of peritoneal dialysis can be correlated).In Methods the authors have used convenience sampling which is a really biased method of sampling.page 189, paragraph 2, they have mentioned IVDP as clinical equivalent of Gridhrasi, but IVDP only if it is compressing Sciatic Nerve can be similar to Gridhrasi, otherwise it can be any other type of IVDP. Also MRI report cited in the study- main impression is related to cervical spondylosis so, differential diagnosis is necessary.
I am again writing. The case report cited for your study regarding dimorphic anaemia is a very good research article and it is very well written. Also, I had some reservations regarding the questionnaire and I conveyed it to the publisher. They told me to look it up online. It is a very good questionnaire. But, as some responses are open ended they may be incomplete. Also, a suggestion. As an institute of repute, research must entail that there is progressive growth of our science. I understand the need for technology, but considering important concepts theoretical in nature maybe due to tunnel vision. As such cells would never had been discovered. Speculative theories lead to new research. Speculation in science is necessary. Ayurveda is presently bereft of individuals that can take responsibility to conduct research to understand the concepts mentioned in our science suited to the contemporary times. As teachers it is our responsibility that the students carry this burden and make advances so that theoretical concepts can be proved experimentally.