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Need for Integration of Ayurveda with Modern Biology and Medicine*

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Abstract

The mankind's concern for health since the beginning of civilization led each community to develop its own health/medical care system. Ayurveda, the oldest and a well-documented Indian health-care system, is being practiced for several thousand years. It is expected that the system would have had an evidence-based origin. However, in the current perspective and practices, it is largely experience-based system with myths, fallacies and inappropriate commercial practices having made inroads in its integrative health-care practices and philosophies. Historically, the so-called 'modern medicine' practices and formulations had their origins in traditional health-care systems, especially the Indian and Chinese. However, the traditional and the modern medicine systems today are competitive and mutually exclusive. The Ayurvedic Biology initiative aims to re-understand Ayurveda in light of the remarkable developments in all disciplines of natural sciences, including biology and understanding of human body and its systems, so that not only the claimed effectiveness of the various formulations and practices is rationally assessed but also the physiological, cellular and molecular bases of their actions get revealed. Recent experimental studies on Ayurveda indeed illustrate the advantages of Ayurvedic Biology approach. More such studies would generate the much needed evidence-based practices, and also provide simple quality-control systems for Ayurvedic formulations. This can be expected to finally lead to emergence of integrative health-care practices, incorporating the best of traditional and modern health-care systems and procedures. 2
Medal Lecture
Need for Integration of Ayurveda with Modern Biology and Medicine#
SUBHASH C LAKHOTIA*
Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi 221 005, India
(Lecture delivered on 26 December 2018)
Mankind’s concern for health since the beginning of civilization led each community to develop its own health/medical care
system. Ayurveda, the oldest and a well-documented Indian health-care system, is being practiced for several thousand
years. It is expected that the system would have had an evidence-based origin. However, in the current perspective and
practices, it is largely experience-based system with myths, fallacies and inappropriate commercial practices having made
inroads in its otherwise integrative health-care practices and philosophies. Historically, the so-called ‘modern medicine’
practices and formulations had their origins in tradiational health-care systems, especially the Indian and Chinese. However,
the traditional and the modern medicine systems today are competitive and mutually exclusive. The Ayurvedic Biology
initiative aims to re-understand Ayurveda in light of the remarkable developments in all disciplines of natural sciences,
including biology and understanding of human body and its systems, so that not only the claimed effectiveness of the
various formulations and practices is rationally assessed but also the physiological, cellular and molecular bases of their
actions get revealed. Recent experimental studies on Ayurveda indeed illustrate the advantages of Ayurvedic Biology
approach. More such studies would generate the much needed evidence-based practices, and also provide simple quality-
control systems for Ayurvedic formulations. This can be expected to finally lead to emergence of integrative health-care
practices, incorporating the best of traditional and modern health-care systems and procedures.
Keywords: Ayurvedic Biology; Amalaki Rasayana; Rasa-Sindoor; Neurodegeneration
*Author for Correspondence: E-mail: lakhotia@bhu.ac.in
#Based on the Aryabhatta Medal lecture delivered on 26 December 2018 at the Anniversary General Meeting of the Indian National
Science Academy held at the Physical research Laboratory, Ahmedabad
Proc Indian Natn Sci Acad 85 No. 3 September 2019 pp.
Printed in India.DOI: 10.16943/pinsa/2019/49588
Introduction
It is indeed a great honour to be delivering the INSA
Aryabhatta Medal 2018 lecture during the
Anniversary General Meeting of INSA held at the
Physical Research Laboratory, Ahmedabad. Keeping
in view the multi-disciplinary audience, I find it
appropriate to talk about Ayurvedic Biology, which is
one of my current research interests and which I
believe would be of a wider interest and relevance.
Studies in Ayurvedic Biology, initiated and
catalyzed by Professors M S Valiathan and R
Chidambaram in early years of the current millennium,
aim to re-understand Ayurvedic formulations and
practices in the context of contemporary knowledge
in biology and other sciences (Lakhotia, 2016;
Valiathan, 2006a, b, 2016). Ayurveda as a formal
health-care system seems to have started in India
several thousand years ago with the compilations by
Carak and Susruta being its foundation pillars
(Sharma, 1994, 1999; Valiathan, 2006a, 2016). This
knowledge base, available mostly through hand-
written manuscripts, has been transmitted and
expanded during the interim period by many scholars.
In view of the antiquity and absence of documentation,
we do not know the bases on which the detailed
procedures and specifications were formulated by the
scholars in ancient times. These may perhaps be never
known.
Since its formulation several thousand years ago,
Ayurveda, like the many other traditional health-care
systems across the globe (Lakhotia, 2015b), has been
followed and practiced without a break. Most of the
medicines used in ‘modern medicine’ were initially
derived from the knowledge base of traditional health-
care systems including Ayurveda (Valiathan, 2016).
Published Online: 8 April 2019
2Subhash C Lakhotia
However, while the modern medicine has been and
continues to be driven by vigorous research and
development, the field of Ayurveda has hardly anything
to claim as new developments beyond the traditional
literature. The practice of Ayurveda, during its long
history, has ‘faithfully’ followed the ancient texts
without any serious attempts to understand or to
validate the principles and philosophies enunciated in
the classical treatise of Ayurveda as available now.
This has unfortunately led to a situation where this
“classical” knowledge system is often not considered
“classy”.
Poor State of Understanding of Principles of
Ayurveda
An urgent need for establishing Ayurveda on sound-
footing has been felt for a long time. This was
emphasized more than 100 years ago in 1916 by
Kaviraj Gananath Sen in his address on the occasion
of the foundation stone-laying ceremony of the
Banaras Hindu University at Varanasi (Shah, 2017).
Kaviraj Sen stated “Whatever may have been the
past glory of Ayurveda, it would be self-deception on
our part to think that we still sit on a high pedestal.
The fact is unfortunately just the other way. The
number of Ayurvedic physicians in India is legion but
soundly educated exponents of the ancient system
are not yet numerous. Besides this, there is yet a good
deal of conservatism which is contrary to the liberal
spirit of Ayurveda and which must be overcome.”
He continued “In other words, we must establish
them on the sound-footing of actual observations and
experiments according the methods of the West, we
must make good the losses we have already
sustained.”
Mahatma Gandhi, despite being the most ardent
follower of ‘Swadeshi’ and naturopathy, was also
critical of the prevailing state of Ayurveda. While
inaugurating the Ashtanga Ayurveda Vidyalaya,
Calcutta, on May 6, 1925 he spoke “I have hitherto
confined my remarks to medicine and surgery in
general, but when I come to the Ayurvedic and the
Unani system, I am filled with greater doubts. ….
There was a time when I used to swear by the
Ayurvedic medicine and used to commend it to all my
friends, who went in for Western medicine, to go to
these Ayurvedic physicians. But I feel sorry to have
to own to you that I was undeceived and I found that
our Ayurvedic and Unani physician lack sanity. They
lack the humility. Instead of that I found in them an
arrogance that they knew everything, that there was
no disease which they could not cure” (Publications
Division, Govt. of India, 1999, The Collected Works
of Mahatma Gandhi, vol. 31, p. 282, http://
www.gandhiashramsevagram.org/gandhi-literature/
mahatma-gandhi-collected-works-volume-31.pdf).
Nearly two decades later (May 26, 1946), Gandhi
was asked, “Why do you go to the doctors for
examination and diagnosis and not to the vaidyas?”
The answer, reflecting his mis-trust of Ayurvedic
practitioners because they did not undertake any
research, was “The vaidyas do not possess the
knowledge of the human body as the doctors do. The
basis of diagnosis in Ayurveda is the theory of tridosh.
They have not got to the bottom even of that. The
doctors are ever carrying on research and making
new discoveries. One either goes forward or
backward. Nothing remains static in the world. Those
who become static, become lifeless.” (Publications
Division, Govt. of India, 1999, The Collected Works
of Mahatma Gandhi, vol. 91, p. 43 http://
www.gandhiashramsevagram.org/gandhi-literature/
mahatma-gandhi-collected-works-volume-91.pdf).
Continuing his concern for the absence of research
by Ayurvedic practitioners and their excuse that the
government was not providing appropriate institutional
support, he wrote in Harijan on August 4, 1946: “I
am unable to subscribe to the condemnation of the
State for not providing institutions for research. I have
always blamed the Vaids’ apathy in the matter of real
research. The top ones are busy making money. The
others are too ignorant to do so or are easily satisfied
with what they find in the orthodox Ayurvedic books.
I am sorry for this view. I come to it, in spite of my
great regard for the Ayurvedic system and the Unani
which are suited to the soil.” (Publications Division,
Govt. of India, 1999, The Collected Works of Mahatma
Gandhi, vol. 91, p. 415, http://www.gandhiashra
msevagram.org/gandhi-literature/mahatma-gandhi-
collected-works-volume-91.pdf).
Such strong views expressed in the past by very
knowledgeable persons unfortunately appear to be
substantially reflective of the reality even today.
Intellectuals in India are largely partitioned in 2 groups
– i) believers in western philosophies and approaches,
and ii) the “pro-Indian faithful” who remain
Need for Integration of Ayurveda with Modern Biology and Medicine 3
unquestioning followers of the ancient wisdom!
Consequently, like many other things, Ayurveda has
also suffered since it is negated by those trained in
“modern Science and Medicine” but faithfully followed
by Ayurvedic practitioners and common man without
any serious attempt to validate and understand its age-
old principles and practices in light of contemporary
knowledge. Both attitudes need change.
Need for Serious, Unbiased and Integrated
Research in Ayurveda: the Ayurvedic Biology
Initiative
In view of the above and as has been noted earlier
(Lakhotia, 2013a, 2015a, b; Lakhotia, 2016; Valiathan,
2006a, b, 2016), it is clear that Ayurveda, and for that
matter all traditional health-care systems, need detailed
and extensive unbiased studies with highest rigor so
that the rich traditional wisdom can be enriched further
by transforming it from experience-based to evidence-
based system as well. We need to rediscover and
understand the principles of Ayurveda in the context
of contemporary knowledge using an unbiased
approach. Ayurvedic Biology promotes such an
approach (Lakhotia, 2016; Valiathan, 2006a, b, 2016).
We need in-depth and unbiased studies of the ancient
texts in synergy with scientific experimental studies.
This requires participation of learned and open minded
practitioners of Ayurveda, linguists with a good
understanding of Sanskrit and other languages in which
classical texts exist, experimental scientists and
medical doctors with expertise in fields like plant
taxonomy, plant physiology, human physiology, cell and
molecular biology, chemistry, material sciences, modern
medicine etc. These systematic and in-depth studies
need to be directed to understand i) the mechanisms
of biological actions of the large variety of the standard
Ayurvedic formulations (Rasayanas, Bhasmas,
Asavas, etc.), ii) understanding of the chemical,
physical and material science perspectives underlying
the elaborate procedures employed in preparation of
various formulations, iii) biochemical bases of actions
of the various “Anupana”, iv) bases of various
Dosaprakritis” in terms of modern physiology,
immunology, metabolomics, microbiomics, genomics
and epigenomics, v) physiological and immunological
effects of the diverse “Pancakarma” procedures,
vi) role of epigenetics in these procedures and in the
response of the subject to a given therapy and life-
style, etc. Equally important is to define precise identity
of various herbs and their parts and the seasonal and
geographic effects on their efficacies as described in
traditional Ayurvedic literature and to standardize the
preparatory procedures.
New insights from Ayurvedic Biological Studies
Several Ayurvedic Biology studies, that have been
undertaken or are in progress, have already established
the advantages of unbiased experimental approaches
to fulfil the above objectives. In addition, such studies
may also unravel novel therapeutic strategies. Our
studies on Amalaki Rasayana (a herbal Rasayana
primarily based on the Indian Gooseberry or Amla
fruit) and Rasa-Sindoor (a Bhasma preparation
based on mercury and sulphur) in Drosophila model
suggested that the broad effects of these formulations
on flies were in general similar to those described in
classical Ayurvedic practices (Dwivedi et al., 2012).
Interestingly, both these formulations were found to
enhance levels of different hnRNPs (heterogeneous
nuclear RNA-binding proteins), which are involved
in transcriptional and post-transcriptional regulation
of gene expression, and of CBP300, a histone acetyl
transferase required for modifying chromatin for
elevated gene expression (Dwivedi et al., 2012).
Interestingly, it was also found that both these
formulations suppressed induced but not
developmental apoptosis (Dwivedi et al., 2015) and
Amalaki Rasayana, but not Rasa-Sindoor, enhanced
tolerance of flies to oxidative stress, which may
contribute to the increased life span by Amalaki
Rasayana therapy (Dwivedi and Lakhotia, 2016). In
other studies, Amalaki Rasayana was found to
improve the DNA-repair activity in aged rats (Swain
et al., 2012) and to improve the telomerase activity in
human blood cells (Guruprasad et al., 2017). Amalaki
Rasayana was also found to improve myocardial
energetics, muscle contractile function and exercise
tolerance capacity in rats (Kumar et al., 2017).
Together, these effects are expected to promote
‘healthy aging’ and longer life-span, the major usages
prescribed for Amalaki Rasayana in classic
Ayurvedic texts (Sharma, 1994).
In agreement with earlier reports that enhanced
levels of hnRNPs and/or CBP suppress
neurodegeneration seen in diseases like Huntington’s
and several Spino-Cerebellar Ataxias (Caccamo et
al., 2010; Sofola et al., 2007) and our earlier finding
4Subhash C Lakhotia
(Dwivedi et al., 2012) that Amalaki Rasayana and
Rasa-Sindoor feeding enhanced the levels hnRNPs
and CBP in Drosophila tissues, we found that these
formulations substantially suppressed the Huntington’s
and Alzheimers disease associated neurodegeneration
in fly models, with the mercury-based Rasa-Sindoor
being much more effective (Dwivedi et al., 2013).
Encouraged by these results in fly models, similar
studies were extended to mouse models of
Alzheimers and very significantly, both these
formulations suppressed Alzheimers symptoms in the
mouse models (Saba et al., 2017; Tiwari et al., 2017).
Furthermore, unpublished studies in the laboratory of
Prof. S. Ganesh at IIT, Kanpur, show that seizures
and other neurological symptoms displayed by mouse
models of Lafora disease are remarkably suppressed
by either of these two Ayurvedic formulations (S.
Ganesh, personal communication). Ongoing studies
in my laboratory show that transcripts of a large
number of genes become significantly elevated or
reduced in the affected tissues in fly models of
Huntington-like neurodegeneration; interestingly, most
of these transcripts are restored to near-normal levels
when Amalaki Rasayana or Rasa-Sindoor is
administered to the affected larvae (Yashvant Patel
and S. C. Lakhotia, unpublished). Thus our systematic
and unbiased experimental studies have unravelled
novel and potentially effective therapeutic applications
of these Ayurvedic formulations in different
neurodegenerative disorders (Lakhotia, 2013b, 2017).
Since neurodegenerative disorders are becoming
increasingly common and as yet without safe and
satisfactory therapies, these findings in fly and
mammalian models raise great hopes that these
Ayurvedic formulations may indeed turn out to be very
effective (Lakhotia, 2013b, 2017). These leads now
need to be taken up by practitioners of Ayurveda for
evaluation of therapeutic potential of Amalaki
Rasayana or Rasa-Sindoor in human patients.
A common apprehension about Ayurvedic
formulations, especially for those based on metals is
their potential toxicity. We did not find any toxic effects
of Amalaki Rasayana or of the mercury and sulphur
based Rasa-Sindoor in any of our studies in fly or
the mouse model. A study on the zebra fish also did
not find any adverse effect or toxicity of Rasa-
Sindoor on its behavior (Biswas et al., 2018).
Advanced physico-chemical studies have also shown
the Rasa-Sindoor particles to be in nanoscale size
after the classically recommended processing, and
which cannot be metabolized in the body to any toxic
form of mercury (Mukhi et al., 2017; Ramanan et
al., 2015). Thus the claimed fear of toxicity of heavy
metals in traditional Ayurvedic formulations seems to
be unfounded but may occur due to poor quality-
control measures and/or when the elaborate
preparatory steps are not properly followed.
A recent study on effects of administration of
Guduchi and Madhuyashti to Drosophila revealed
complex responses of traits like reproductive output,
life-span and stress responses, which indicates the
need for a holistic analyses of Ayurvedic Rasayanas
on a broad spectrum of life-history traits (Singh et
al., 2018; Singh and Tapadia, 2019).
The Tridosa concept of Ayurveda, based on
certain defined bodily dispositions of a person, is used
to provide personalized therapeutic regimes since each
person is believed to have a specific Prakriti
depending upon the relative proportions of the three
Dosas, viz., Vata, Pitta and Kapha (Patwardhan et
al., 2015; Rastogi and Chiappelli, 2017; Sharma,
1994). Several recent studies have attempted to find
biochemical, physiological, genomic and/or epigenetic
correlates that may underlie the specific Dosa-
Prakriti of an individual. A study using biochemical,
hematological and genome wide expression
parameters of individuals displaying the three most
contrasting constitutional types showed striking
differences in their liver function tests, lipid profiles,
and haemoglobin levels; likewise a correlation was
also found between the Prakriti types and expression
of core biological processes like transport, regulation
of cyclin dependent protein kinase activity, immune
response and regulation of blood coagulation (Prasher
et al., 2008; Sethi et al., 2011). Another study that
examined differential methylation of promoter and
untranslated regions of genes also claimed correlation
of methylation patterns of certain genes with the
Prakriti types (Rotti et al., 2015). Another study
(Govindaraj et al., 2015) suggested that the Prakriti
classification of Ayurveda may indeed have a genetic
basis. These encouraging findings, however, need to
be followed at a much larger scale involving Ayurvedic
practitioners and those well conversant with
physiological, biochemical, genomic and epigenetic
studies so that the validity of the Prakriti types can
be rationally ascertained and appropriate diagnostic
Need for Integration of Ayurveda with Modern Biology and Medicine 5
assays established to identify the Prakriti type of an
individual with experimental rigour.
Integration of ‘Traditional’ and ‘Modern’ Health-
Care Systems
Every “Old” thing may not be “Gold”, and even gold
needs periodic cleaning! Science and technology and
the health-care systems in India were obviously well
developed in ancient times. However, those principles
and practices cannot and should not be accepted as
such just because of their antiquity. Neither should
they be thrown out because of their antiquity. In order
to take advantage of the wisdom underlying the
science and technology in ancient literature, we must
dispassionately examine them in light of the current
understanding of principles and processes of Natural
Sciences so that we know not only what, but also
why and how?
I should point out that, encouraged by the
traditional health-care systems, innumerable studies
have been carried out during the past several decades
to identify their ‘active compounds’ and exploit them
for developing novel target-specific drugs. Although
there has been notable success in some cases, such
‘reductionist’ approach has, in general, severe
limitations as borne out by the ‘side-effects’ manifest
with most of the so-called ‘target-specific’ drugs. In
this context, it appears desirable to follow the ‘holistic’
and ‘systems’ view inherent in Ayurveda and
systematically examine the numerous Rasayanas,
Bhasmas and Asavas described in classical literature
for their modes of actions and effectiveness in specific
health-conditions.
Following the upsurge in popularity of Ayurveda
in recent times, quality control has become a major
concern not only for the various Rasayanas and other
Ayurvedic formulations but also for the other
Ayurvedic processes and practices like Pancakarma
and various massages. Since most of the Ayurvedic
formulations are complex mixes of various herbal and/
or mineral components, their quality control through
physico-chemical parameters may not be feasible,
except in a few simpler formulations (Shengule et
al., 2019). Appropriate biological quality control
parameters using model organisms need to be defined.
At the same time, the tendency of industry and
practitioners to designate any so-called ‘herbal’
preparation as ‘Ayurvedic’ needs to be curbed. The
prevailing mutual mistrust between practitioners of
traditional and modern health-care systems has to be
resolved. The Ayurvedic and other traditional health-
care system practitioners need to come out of their
shells, and be exposed to and trained in contemporary
principles of biology, especially genetics and genomics,
cell and molecular biology, developmental biology,
physiology etc. At the same time, practitioners of
contemporary science and medicine need to
appreciate the systems organization of living body and
the holistic philosophy inherent in Ayurveda. Such
combined efforts only would help in separating myths
and facts that are inherently present in any age-old
tradition and knowledge base. An integration of the
contemporary diagnostic procedures with the holistic
principles of Ayurvedic and other traditional health-
care systems would go a long way in ensuring ‘health
for all’ objectives of any society (Katoch, 2018;
Lakhotia, 2015a; Patwardhan, 2014; Patwardhan et
al., 2015; Ramaswamy, 2018; Rastogi, 2015; Shankar,
2018). There is a strong need to correlate different
languages and philosophies to find and
understand the commonalities.
Acknowledgements
I thank Prof. M S Valiathan and Prof. R
Chidambaram for involving me in the Ayurvedic
Biology initiative and to my colleagues and students
for help in establishing the fly model for our studies. I
thank Professor Kishor Patwardhan (Ayurveda
Faculty, Banaras Hindu University) for drawing my
attention to Mahatma Gandhi’s views about Ayurveda.
Currently, research in this area in my laboratory is
supported through SERB grant no. CO/SB-10/2013.
I also thank the Indian National Science Academy
(New Delhi) for support as INSA Senior Scientist
and for the award of Aryabhatta Medal (2018).
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