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Vol IX, Issue 1
Date of Publication: January 12, 2024
DOI: https://doi.org/10.20529/IJME.2023.067
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Commentaries
Scientific evaluation of Ayurvedic drugs — the use of N-of-1 clinical trials
Abstract:
Despite its ancient roots and prominence in India as an accepted alternative to modern medicine, Ayurveda’s growth has been hampered by an inability to carry out clinical studies of its effectiveness and safety using modern scientific methods ― while preserving the core of Ayurveda, which is personalised medicine. In this comment, we propose that the N-of-1 trial be used as a practical method to evaluate Ayurvedic treatments, which is simultaneously consistent with the canons of modern medicine and of Ayurveda. We emphasise the importance of doing this as a practical alternative that will benefit patients. We need not wait to resolve the epistemic inconsistency between Ayurveda and modern medicine to take steps in this direction.
Copyright and license ©Indian Journal of Medical Ethics 2023: 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.
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Comments:
Ayurvedic theories such as the doctrine of doshas need to be demystified, by subjecting them to an evidence-based appraisal, precisely because this demystification is necessary to glean researchable propositions on ayurvedic treatments. Propositions gleaned otherwise would always be subject to valid criticisms from ayurveda physicians. As R H Singh writes in one of his editorials, “Any research which does not take into account the denominators of ayurvedic biology such as Tridosha, Saptadhatu, Ojabala, Agnibala, Ama and srotas, that kind of research cannot be considered as ayurvedic research. It is merely a blind research endeavour.” (Paraphrased from his editorial ‘Ayurveda based scientific methodology for research in Ayurveda’; Annals of Ayurvedic Medicine Vol-6 Issue-3-4 Jul-Dec, 2017)
So, the present article’s view that solving theoretical problems “need not precede or preclude the evaluation of Ayurvedic treatments using modern methods given the potential utility of Ayurveda interventions,” misses the nuance involved in the subject.
Until the theories are cogently demystified and theoretical imperatives are clearly understood, it would be difficult to arrive at unanimous treatment protocols that are worthy of being tested.
During the COVID pandemic, for instance, the AYUSH ministry released a treatment protocol that I found grossly wanting*. I suggested another protocol through a journal editorial**. Such a lack of unanimity in arriving at researchable protocols is, in part, due to an inadequate grasp of ayurveda’s theories and their imperatives.
* https://confluence.ias.ac.in/why-the-national-ayurveda-protocol-on-covid-management-appears-wanting/
** https://articles.theindianpractitioner.com/index.php/tip/article/download/1006/946/