The topic of my presentation this
morning is Ayurveda: An Alternative or Complementary Medicine? I
am not sure, however, that this is the right question to ask. I think
we must first ask several other questions before we can answer this
one.
Question One: Does modern medicine
need alternatives and complements? The answer, I believe, is yes.
Modern medicine responds admirably to crises which require quick,
intensive, invasive intervention, and deals far less effectively with
slowly progressing degenerative diseases The Journal of the
American Medical Association recently reported that nearly half the people
in the United States suffer from at least
one chronic illness, and that together these
illnesses account for three-fourths of all
medical expenses in our country.[1] In this
climate of change in the West which is now
calling into question many of the assumptions
which we once accepted unthinkingly an awareness
is growing that our paradigm is shifting.
A system's paradigm is its pattern, the archetype
which structures each of its products.
Crisis medicine promotes a
crisis-based lifestyle. An imbalance that begins in one location can
surface elsewhere, since all facets of the organism communicate with
each other; physical imbalances can thus be generated from
disturbances of the mind or the life-force, mental disorders can be
due to physical derangements, and so on. Imbalanced individuals tend
to perturb their surroundings, and a polluted habitat will pollute
its inhabitants. Ayurvedists who survey today's world find the human
creature destroying its environment and itself everywhere they look,
and are not surprised to discover the gargantuan imbalances thus
created emerging as rampant disease.
The inability of crisis-based medicine
to deal with these crises has led to the present situation in the
West in which many alternative paradigms compete for the acceptance
of scientists and public alike. Last week I spoke at a conference on
organ transplantation organized by Howard University. While I was
there I attended a lecture by Dr. James Gordon, Professor at the
Georgetown University School of Medicine and first Chair of the
Advisory council of the OAM at the NIH. During the course of his talk
Dr. Gordon mentioned that 2 out of every 3 people who consult with
M.D.s in this country are also doing something extra: herbs,
supplements, chiropractic, whatever. 2 out of 3 is a decisive
majority. Is it possible that our health care system is changing
faster than our ability and willingness to perceive and describe it?
Do all the people who are being served by the system still accept the
fundamental premises that make up the system? It would appear that
the ajority wants change.
Question Two: Is Ayurveda a worthy
alternative? This answer is also, in my opinion, yes. This
"superstition" has already contributed much to modern
medicine, including the drug reserpine, which is extracted from a
plant (Rauwolfia serpentina) that is still used today in India
to safely control hypertension. More recently it has provided the
cholesterol-controlling gugulipid (from Commiphora mukul),
which apparently binds cholesterol in GI tract and has been reported
to be as good as Lopid at lowering blood cholesterol levels.
Ayurveda has also given us plastic
surgery. During the nineteenth century the Germans translated from
the 2000-year-old treatise of the Ayurvedic author Sushruta the
details of an operation for repair of damaged noses and ears. This
operation, which appears in modern textbooks of surgery as the
pedicle graft, led to the development of plastic surgery as an
independent speciality. Today Sushruta is regarded by plastic
surgeons around the world as the father of their craft.
Ideally, all Ayurvedic treatment is
carefully tailored to the individual. Though it concentrates first on
making simple changes of diet and behavior, for simple alterations
are sometimes sufficient to produce big results, Ayurveda does not
hesitate to use surgery, shock therapy, and other intensive
treatments when mild interventions fail to produce results.
Ayurveda's materia medica and
therapeutic techniques have much more yet to contribute. I maintain,
however, that Ayurveda's most valuable contributions will be made to
the new theory that medicine is trying to grow. These contributions
will be derived from Ayurveda's way of seeing the world, its
darshana, a vision which will facilitate medicine's ability to
teach people not just how to avoid disease but how to proactively
develop and maintain a healthy "state." Modern medicine
defines health as the absence of disease, Ayurveda focuses on health
as a positive condition that is independent of disease, an active
state of being that can be promoted by appropriate behavior. When you
can upgrade your health you may find diseases disappearing without
ever having been directly addressed. The same Ayurvedic principles
that are used to correct yourself when you are out of balance can be
used to preserve your balance once it is corrected.
Question Three: Can modern
mechanical medicine adequately perceive, describe, understand and
implement Ayurveda? I rather doubt this. Many similarities
already do exist between the standpoints from which Ayurveda and
modern medicine survey the world. Both believe in technological
progress; on its part Ayurveda has absorbed therapeutic innovations
from many sources within and without India over its history.
Empiricism too is fundamental to both; the Ayurvedic author Sushruta
declares, "A learned physician must never try to examine on
grounds of pure logic the efficacy of a medicine, which is known by
direct observation as having by nature a specific medical action."
Both agree that an allopathic approach to disease is
ordinarily efficient, and both thus usually treat conditions
with their opposites: fever is countered with temperature-lowering
measures, obesity with reduction in caloric intake, and so on.
In spite of this Ayurveda does not
yet have a sterling reputation among physicians of Western medicine;
in fact, one recently called it in print "a superstition of
ancient times." But then this is because the majority of modern
physicians do not know what to look for when they look at Ayurveda.
Western materialist science presupposes that the way to eschew
ambiguity in science is to distance ourselves from the things that we
measure. This posture achieves precision by denying a place in
Western experimental philosophy to any phenomena that are not
externally measurable, and discourages Western medicine from
accepting, or even grasping, that which cannot be explained
phenomenologically.
The Ayurvedic system maintains that
all phenomena however ambiguous are worthy of investigation if they
influence embodied life. It encourages the free application of both
rationality and intuition to scrutinize all states of being, internal
and external. Over thousands of years the sages who moulded Ayurveda
studied how embodied life is affected by what we do and how we do it
in all of life's arenas, including diet, exercise, vocation,
avocation, and personal relationships. Though most of their
experiments were performed internally these were no less rigorous and
systematic than those that scientists perform in external
laboratories. Nor were they less logical; Ayurveda is a different
"language" from modern medicine, and its logic is a fuzzier
sort of logic (in the non-pejorative, cybernetic sense of "fuzzy
logic").
Their inner explorations led these
savants to conclude that consciousness is omnipresent in the
universe, and in fact pre-existed the cosmos. This premise is
fundamental to Ayurveda: that consciousness is omnipresent in the
universe, and pre-existed the cosmos. Everything in the universe that
is not pure unconditional consciousness is a form of matter, and the
material universe and all that is within it evolved from and
continues to evolve because of that consciousness. Consciousness
expresses itself in and through everything that exists, its
expression varying with the density of the matter that contains it.
Everything with which an organism comes in contact interacts with its
matter and its consciousness, however minimally; consequently, all
living organisms are innately interdependent.
This is the gulf that truly parts
Ayurveda from materialist science, which teaches that consciousness
evolved from matter. No conclusions drawn by reasoning from one of
these two competing and mutually exclusive postulates can be expected
to prove or disprove the "validity" of the other postulate.
The "consciousness" model, however, continues to gain
ground as scientific evidence of consciousness's ability to influence
matter, at least in the form of observers affecting their
observations, continues to accumulate.
Ayurveda's approach is more
alchemical. The alchemical paradigm holds that that reality is
paradoxical. This means that a thing is closely related to its
opposite, as we see today in love-hate relationships and the like.
The approach of Chinese medicine is similar. India and China have
always appreciated life's innate ambiguities. Carl Jung wrote, "The
Chinese have never failed to recognize the paradoxes and the polarity
inherent in what is alive. The opposites always balanced one
another-a sign of high culture. One-sidedness, though it lends
momentum, is a mark of barbarism."[2]
While Ayurveda and traditional Chinese medicine try to mirror this
ambiguity in their processes, materialist science abhors ambiguity.
Ambiguity has not always been anathema
to science. John Maynard Keynes discovered in 1936 that Isaac Newton
had been obsessed with alchemy and had mentioned it in early editions
of his books. He eventually decided that he would have to repress
this side of himself if he wanted to get ahead in the world of that
time, and so purged all references to alchemy from later editions of
his works.
Newton's early form of "political
correctness" reflects the sad truth that even modern medical
science, research and practice alike, is structured in large measure
through political means. Modern medicine itself succeeded in gaining
a paramount position in our country with substantial help from
political sources; consider for example the generally successful
attempts at the end of the nineteenth century to outlaw homeopathy at
a time when in many parts of the country homeopathy was more popular
than allopathy. This is merely the most recent incarnation of a
generalized ancient trend to support orthodoxy at the expense of
innovation. Galileo's fate and the witch-burnings were two other
European examples, but no culture (including India's) is spared this
sort of thing entirely.
How we structure a thing determines to
great extent its reality. "As Gregory Bateson has rightly
remarked, Newton did not discover gravity; he invented it."
How we structure our reality determines what might be "alternative
or complementary" to it, and the key to structuring what we
believe to be real usually boils down to the amount of repetition and
intensity that is brought to it. If you call something a duck long
enough and loudly enough many people will eventually become convinced
that it is a duck, whether or not it actually quacks. The more that
the medical establishment calls chiropractic or homeopathy or
Ayurveda "alternative or complementary" the more that is
what they will become: secondary to, adjunct to, assistant to modern
medicine.
All medical systems are models,
approximations of reality. The modern fixed and unchangeable view of
medical reality has meant that until very recently few scientists
were prepared to accept that the mind and the body can and do
influence one another in measurable ways. Many of the problems that
we have today stem from the fact that our reality system officially
denies that the mind participates in the creation, preservation and
destruction of our physical reality. Denying the mind its influence
does not prevent that influence; it only prevents us from perceiving
it. Modern medicine assumes that the reality we can perceive with our
senses is the only reality there is, and that we can observe portions
of this reality as non-participating observers. But this act of
mechanically constructing a separate, rationally ordered reality for
ourselves is itself an active participatation in that reality from
which we are trying to separate ourselves.
This totalitarian rationality, which
by denying participation with our reality implicitly denies
everything that is irrational about us, has created and is creating
enormous difficulties for us humans and for our world. The most
important of our irrational influences exist in the vast terrain of
the unconscious mind, but modern science, by promoting the idea that
rational knowledge is the whole of knowing, has cut itself off from
the 90% of the iceberg of consciousness that is outside the control
of the conscious mind. Now the mass of this iceberg is reacting
against that neglect, counterattacking with epidemics of
psychological and psychosomatic disease.
To be worthy of possessing
alternatives or complements a system should accurately reflect and
describe the reality that is embodied life to a substantial degree in
a systematic and logical way. Modern medical science, which is
currently in the throes of a revolution that will dramatically affect
both its vision of the nature of medicine and the way that medicine
is practised, may not qualify as such a system.
Question Four: How can we understand
Ayurveda? The Ayurvedic model takes the approach advocated by
Michael Polyani, who in his classic book Personal Knowledge
showed that (even though most scientists like to claim otherwise)
science is a craft. Whether it involves the growing of crystals or
the reading of X-rays, a scientist becomes proficient at his science
not by strictly following the dictates of some unambiguous rule book
but by immersing himself in the slow trial-and-error process of
discerning patterns and learning to follow those patterns. We have to
do the same thing with our health; we must learn to improve it like
we learn any other craft.
This process happens to be very
natural to us humans. It is in fact innate to us, for this is how the
brain learns as well. The brain is too parsimonious to assign one
memory to one neuron. Instead, it organizes its neurons into neural
networks. Any sensory stimulus that enters one of these networks
activates each of the neurons to a different degree. The more highly
activated neurons signal strongly and the weakly activated ones less
strongly, the members of the network continuing to share information
until a pattern develops. Many types of patterns arise and are held
in the same net.
One of Ayurveda's basic theses is that
similar patterns appear at all levels of a living organism's
existence, both in its internal interplay and in the interplay
between it and its environment. Each pattern affects us whether we
are aware of it or not. Taste is one example of the many patterns in
our daily lives than cannot be easily quantified. You can express
your blood pressure in mm of Hg, but how do you measure taste? Most
of us find it natural to believe that that well-cooked food tastes
better than poorly-cooked food, even though there is no way to
externally verify this internal perception. Ayurveda suggests that
the self-evident good or bad taste of food has more than a trivial
effect on the organism that consumes it. Ayurveda asserts that the
internal reality of something as outwardly ephemeral as a taste
pattern is in fact very real to the tasting organism. Evidence that
supports this conjecture has also begun to accumulate in Western
science (e.g.in studies on the ways in which the taste of fat or
sugar in the mouth can influence physiology even before they are
metabolized).
Taste is only one of the many patterns
that characterize our bodies and minds. Another is prana, the
force of life, which the Chinese call chi and the Japanese ki.
We can describe prana as the energy that inspires life to persist
within a particular living being. Students of yoga, Tai Chi and the
martial arts who learn to identify and circulate this force within
themselves discover that prana is as easily measured with
their own internal instruments as it is difficult to measure with
external gadgets. The pattern that these practitioners call prana
is as real to them as the patterns that neural networks of taste
produce when they sample a mango. Whatever their external reality,
patterns are very real to the organism in which they occur.
Athletes around the world are now
studying the life force as they learn that cultivating a healthy
pranic pattern facilitates the type of body-mind cohesion that allows
one to shine out on the playing field. Athletic training is basically
a matter of breaking down old physical and mental patterns and
building up new ones. Each living body hosts a wide variety of
strongly-held metabolic patterns which influence its ability to build
up new patterns. Ayurveda classifies each these many metabolic
patterns into one of three classes. Each of these classes forms a
metapattern, a pattern which actively reproduces itself whenever it
is given the opportunity to do so. These three metapatterns are the
Three Doshas, the body's so-called "humors." They
are called doshas ("mistakes," in Sanskrit) because
when they are deranged they induce the organism to go off balance, in
predictable ways. Students of Ayurveda work with the reality of life
from the dosha perspective because of its practical utility in
everyday practice. The dosha approach allows associations to be
detected between seemingly unconnected causative pathways and
manifested symptoms.
Ayurveda defines health as balance and
ill health as imbalance, in all aspects of existence but particularly
in the context of the Three Doshas. When they are balanced the Three
Doshas ensure that the organism functions well. Disease-causing
imbalance patterns may result whenever an organism fails to adapt
properly to a change in its internal or external environment. The
need to adapt is universal, but the ways in which people adapt differ
from person to person. Though many of these adaptation patterns are
learned behavior others are innate properties of the organism itself.
Everyone has physical, psychological, pranic, and emotional strengths
and weaknesses; taken together these form a set of "reaction
prints" which are as characteristic of their owners as are
fingerprints or footprints. The aggregate of these innate properties
forms the individual's "nature" or "personal
constitution" (in Sanskrit, prakriti), a temperament
which profoundly influences predisposition to health, general and
specific sensitivity to illness, and responsiveness to various forms
of therapy.
The Ayurvedic approach to healing
concentrates first on making simple changes of diet and behavior, for
simple alterations are sometimes sufficient to produce big results.
Ayurveda escalates into surgery and other intensively invasive
therapies only when mild interventions fail to produce results.
Modern researchers continue to rediscover truths that Ayurvedic
researchers learned many centuries ago.
For example, since 1935 modern science
has known that when mice and rats are fed a very low calorie diet (30
- 50% of their normal intake) in the laboratory they live about 30%
longer than do well-fed rodents, so long as they receive sufficient
nutrition. Though the mechanism of this effect remains in doubt (it
may be due to decreased production of free radicals) the effect
itself is clear.
Americans not only eat too much food,
too much of that food is fat. Dr. Dean Ornish has shown how a
judicious program of exercise and dietary change can not only control
but in some cases reverse the course of obstructive coronary artery
disease.
Recall that the two most common
diagnoses requiring transplantation in African-Americans are
hypertension and diabetes. High blood pressure afflicts one-third of
all Americans in their 50's, half of those in their 60's, and more
than two-thirds of those over 70. But hypertension is not inevitable;
it is a disease of civilization. Preindustrial people rarely get
increases in blood pressure as they age, whether they live in China,
Africa, Alaska, or the Amazon, mainly because they do not eat
processed foods.
Dr. Paul Whelton of Tulane
University's School of Public Health has spent the past decade
tracking 15,000 indigenous Yi people in southwest China. As long as
they eat a traditional diet-rice, a little meat, and lots of fresh
fruits and vegetables-almost none of them suffer from hypertension.
But when they migrate to nearby towns their blood pressure starts to
rise with age.[3]
Our ancestors subsisted mainly on
fresh plant foods for about seven million years, and anyone who lives
on such a diet ingests about ten times more potassium than sodium.
"Civilized" people consume far more sodium; for instance,
while a four-ounce tomato contains 9 mg. sodium four ounces of
bottled tomato sauce has nearly 700 mg. Modern humans are the only
mammals that consume more sodium than potassium, and we are the only
ones that suffer from hypertension. Dietary changes can reduce blood
pressure as markedly as drug treatment, and in as little as two
months. In a study known as DASH (Dietary Approaches to Stop
Hypertension) researchers at several institutions put volunteers on
one of three diets. Normotensives who ate a low-fat menu including
ten daily servings of fresh fruits and vegetables plus two servings
of calcium-rich dairy products reduced their systolic and diastolic
readings by 5.5 mm and 3.0 mm respectively. Hypertensives had
reductions of twice that magnitude. Potassium supplements can bring a
similar but less dramatic effect, but consuming fresh, unrefined
plants provides you the bonus of phytochemicals which combat cancers
and boost immunity.[4]
Dietary change is potentiated by
exercise, which in judicious amounts can help everyone, even the
frail. Dr. Maria Fiatarone of Tufts University recently got ten
chronically-ill nursing home residents to lift weights three times a
week for two months. At the end of this period their average walking
speed had nearly tripled, and their balance improved by half. Two
went so far as to throw away their canes.[5]
A positive attitude is also a big plus
in regaining and preserving health. Most people who live to be a
hundred maintain through their lives a social network of support,
keep their minds active, manage stress well, and never give up. It
has been said that "patients suffer illnesses and physicians
diagnose and treat diseases." The two may have little in common.
For example, in a seven-year study of 3,500 older people who were
asked to evaluate their own health, those who rated their health as
poor were three times as likely to die as were those who believed
their health to be good. However, those who were clinically in poor
health but who rated themselves as being healthy were less likely to
die than those who believed themselves to be unwell.[6]
We are what we eat, what we do, and
what we think. Observers can affect their observations; Larry Dossey,
M.D. comments: "It appears that double-blind studies can
sometimes be steered in directions that correspond to the thoughts
and attitudes of the experimenters. This might shed light on why
skeptical experimenters appear unable to replicate the findings of
believers, and why "true believers" seem more able to
produce positive results. The validity of decades of experimental
findings in medical research would need to be reevaluated if it is
proved that the mind can "shove the data around."[7]
Ayurveda seeks to find positive ways
for each of us to "shove our data around."
By examining metapatterns in an
organism it can help that organism's owner decide what kind of food,
exercise, meditation, and other healthful habits will be
health-promotive to the greatest degree. When it is too late for
prevention early detection becomes the key. In all cases, removal of
the causative factors is the first step: the patient's diet,
lifestyle, and way of thinking all must change. Thereafter, one must
carefully consider all the factors affecting the case, including the
patient's constitution and age, the season of the year, and most
importantly the strength of the patient versus the strength of the
disease. When therapeutic intervention is called for we generally
focus on plant materials, at least initially. In choosing herbs for a
patient we focus primarily on the pattern that the disease has
generated rather than the specific symptom alone.
Question Five: "How necessary,
desirable or useful is it that Ayurveda be described in and bound by
terms provided by another model?" Our answer to this
question might be, "Scientifically, not much. Politically, quite
a bit." Two essential steps on the path to good health are to
establish a healthy relationship between yourself and your
environment and to enhance and maintain that relationship with your
every choice and action. Promoting Ayurveda's health in North America
in the current environment requires that it develop some sort of
relationship with its environment, of which a major portion is modern
medicine. The danger is that this will not be a mutually healthy
relationship but will instead be one in which Ayurveda will be
"commodified" and "mainstreamed" into the current
disease-care system.
Conclusion: Ayurveda could be
an alternative to modern medicine now except for the facts that the
medical establishment in this country is not yet ready for it.
Ayurveda is not yet ready either, for there is a dramatic scarcity of
qualified Ayurvedic physicians. Now, therefore, it will have to act
as a complementary medicine before it can become alternative.
It would be better it would be to
first reestablish other modes of thinking and doing science, and
create a new model of reality that is a culture of the alternative
and complementary. This new model could do much worse than to model
itself on the ancient model which continues to serve us so well:
Ayurveda.
Footnotes:
1 JAMA Vol. 276, Issue No. 18, Nov 13, 1996,
pp. 1473-79
2 David Rosen, M.D., The Tao of Jung: The Way of Integrity,
(New York: Viking Arkana, 1996), p. 92
3 Newsweek June 30, 1997, p.62
4 Newsweek June 30, 1997, p.64
5 Newsweek June 30, 1997, p.61
6 Mossey and Shapiro, "Self-Rated Health:
A Predictor of Mortality Among the Elderly,"
American Journal of Public
Health, 72 (1982):800-807 7
7 Dossey, p. 195
Copyright © 1997
Robert Edwin Svoboda
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