1.
Evidence Based Ayurveda in reality
DR.REMYA KRISHNAN MD(AY) PHD
ASSOCIATE PROFESSOR & HOD
DEPARTMENT OF DRAVYAGUNA, RGAMC , MAHE.

2.
FACTS, SOLUTIONS AND DIRECTIONS
FOR:
Would be Doctors
Doctors who are just
starting out their career.
Doctors who are in the
thick of Medical practise.
Doctors who are at the
sharp end of difficult decision
in the clinic.

3.
AIM OF THE BOOK
• To enable the physician to enjoy his patients .
• To enable the physician to practise “Science
based Medicine” instead of “Medicine based
Science”.
• To inspire a Medical student/House surgeon/
Doctor of any age “to constantly inspire
himself” to do the best in the Science for the
patient .

4.
WHAT THE BOOK SPEAKS
• Ayurvedic evidence?! How can we best find it,
interpret it, and contribute to it?
• The crucial role of Basic science of Ayurveda
in its evidence structure.
• How can we sort of ways for which we can
think of and apply evidence in our practise
and research?
• “How” to choose an Evidence Based medicine
(More important than what to choose )

5.
OBJECTIVE OF THE BOOK
• Exercise judgement on the best estimates of
diagnosis, prognosis , cure and prevention.
• Accurately project the scientificity of this
Medical system .
• World wide recognition of what is called
EVIDENCE BASED AYURVEDA.

6.
WHAT IS THIS “EVIDENCE” ???
• Evidence simply means proof .
• Evidence is required for the “SCIENCE
FORWARDED MEDICINE” and not for the
“Medicine forwarded Science”
• Evidence (Proven Science) behind ,the medicine
originally determines the strength of proof of a
medicine .
• Medicine forwarded science starts from an
“unknown compound for an unknown disease“
and hence is not necessarily proven.

7.
PROVEN MEDICINE
Proven Medicine DOES NOT MEAN Proven
Medical Science.
Proven Medical Science can only narrate
ETERNALLY PROVEN MEDICINES .
Proven Medicine with no proven science
behind makes it “UNCERTAIN medicine”.
Proven Medicine with no proven science
behind is INVALID PROOF.

8.
MEDICAL EVIDENCE TODAY
The current medical research is focussed
on “medicine” and not on “Science”
The core of current research evidence is
Randomised Control Study and Probability
based Statistics .
 Probability Based Evidence - Physician’s
detachment from the dynamic principles
of Basic science which best explains the
nature of patient and disease.

9.
Medical(Mechanical)evidence
Understanding - The physician is made deprived
of “Science based reasoning .
Wisdom – The physician is not allowed to apply
wisdom .

10.
What is lacking ??
DISSATISFIED DOCTOR
• Medicine not led by Proven Science can turn harmful in any moment.
• The medicine is applied based on “Statistics” and not “ Science”.
• Today’s medicine can turn out to be tomorrow’s venom
• MODERNITY DOES NOT NECESSARILY MEAN VALIDITY OF MEDICINE

11.
Is today’s EBM “evident”??
Today’s EBM is not the real EBM .
In true EBM, Evidence (Proven
Science) must lead the Applied
Medicine .
In current EBM , ‘Medicine
based proof ’ is leading the
Applied Medicine .
Today’s EBM is originally
just MBE ( Medicine
Based Evidence)

12.
A comparison of evidence
Modern Medicine (MBE) Ayurveda (EBM)
Evidence resources are Evidence resources are
published DRUG reports and published and peer reviewed
journal articles (Pubmed/ LIFE SCIENCE theorems &
Medline) principles to guide Applied
Medicine
Applied Research Evidence Basic research Evidence
Medicine Based Evidence Based Medicine
Evidences(MBE) (EBM)
Temporarily valid Permananantly valid

13.
Ayurveda –Evidence Based??
Ayurveda- EBM or MBE ?
“tt: kmR iw8k pXcat )anpUvR. smacret|
“tt: kmR iw8k pXcat )anpUvR. smacret|
)animit AaPtopdexm“
)animit AaPtopdexm“
“ “ svR4a svRmaloCy y4a sMwvm4Rivt|
svR4a svRmaloCy y4a sMwvm4Rivt|
A4a@yvSyet tTve cckayeR cctdnNtrm||“
A4a@yvSyet tTve kayeR tdnNtrm||“
EVIDENCE (TATWA) APPLIED MEDICINE(KARYA)
)ansmudaye pUvRmaPtopdex)anm||

14.
Evidence Based Ayurveda
Evidence Based Ayurveda is Ayurvedic
Medical decision making and action based on
systematic scientific critical appraisal of Basic
Science( Ayurvedic) Evidences in patient
health care .

15.
Present scenario
• Poorly recognised by the majority of
physicians of Ayurveda in India .
• No specific knowledge regarding EBA to
medical students and physicians .
• Absence of EBA Physicians provides little
stimulus for the development of specific
protocols of EBA .

16.
Bruhathrayees
• Imperative resource for medical decision making .
• Evidences formed after scientific evaluation and best peer
reviewed for over centuries.
• Evidences based on “ Basic science of human life ”.
• Evidences deemed safest and effective by unbiased scientists .
• Evidences which aptly guide Applied Medicine .

17.
VALIDITY
The most scientific theories do not change in
their fundamental understanding.
 No amendment possible means “truly
scientific” .
Could be best simplified and applied on
target.

18.
Five fold evidences in Ayurveda
Scientific Principles
• Roga tatwas- Disease oriented principles
• Rogi tatwas- Patient oriented principles
• Bheshaja tatwas- Treatment Principles
• Kaala tatwas – State and stage (disease and
patient) oriented principles
• Phala tatwas- Effect determinant principles

19.
Current Ayurvedic research
• Disconnected from basic science.
• Deviated from Five- fold evidences.
• Absence of scientific reasoning (Tarka).
• Probability based statistics.
• Unscientific Double blind studies and Placebo
control

20.
What to re-search?
Appraisal of Evidence
 Application of Evidence.
Optimization of Evidence in new health care
requirements .
 Science based Quality control of Ayurvedic
drugs & formulations.

21.
Current problem in Ayurveda
Ignorance of Evidence Based Medicine
Blind hunt of Medicine Based Evidence
The Drug action is unpredictable
without Evidence Based Medicine .

22.
Medicine Based Evidence
Conflicting opinions
Misinterpretation of
research outcome by
Modern scientific
parameters.
Research outcome mostly
benefit Modern Medicine.
Research outcome
immaterial to Ayurveda

23.
WHAT DO WE LACK??
WE HAVE STABLE EVIDENCE OF BASIC RESEARCH
 WE LACK : APPRAISAL OF EVIDENCE
APLICATION OF EVIDENCE
 INFACT IT IS’’ WE ‘’WHO ARE LACKING , NOT
OUR SCIENCE

24.
EVIDENCE APPRAISAL
 Evidence appraisal refers to the process of
systematised examination and analysis of Five
fold evidence to evolve scientific standards from
them relevant to the medical context to
streamline the therapeutics for attaining
effectiveness of therapies
A Novel scientific technique for appraisal of
evidences are mentioned for the first time in
Ayurveda in this book known as EVIDENCE TRIAD
APPROACH (ETA)

25.
WHY EVIDENCE APPRAISAL?!
• Trains you for “on the target prescribing”.
• Transforms you into a true “Bhishak”.
• Enables you to choose the simplest & best
Evidence Based intervention for your patient.
• Minimises the number of drugs in your
prescription just to one or two.

26.
When EBA is practised
No separate logic of treatment
for each specialist.
Each specialist would be the best
Doctor integrator of various
systemic pathologies.
Diagnosis of one integral disease
behind multiple symptoms is
possible.
Implementation of the best
appropriate evidence .

27.
Why do we mimic Modern Medicine?
Obsessed by Western
charm
 Ignorance .
Misunderstanding.
Diffidence .
Excessive commercial
interest.

28.
Only Solution
• TRAINING& WORKSHOPS ON PRACTISE OF
EVIDENCE BASED AYURVEDA.
• ALL IDEAS ARE USELESS UNLESS WE APPLY
THEM .
• THIS BOOK INCORORATES SOME BEST
PRACTICAL SOLUTIONS .
• THIS BOOK INCORPORATES SIMPLE AND
DIRECT STEPS FOR GUIDANCE IN PRACTISE OF
EBA.

29.
Finding Evidence-Based Answers to Clinical Questions
I need Example Evidence resources to
consider
How to evolve the Five fold Evidence
An overview of a pathogenesis of
particular disease, Dengue fever in
condition or Ayurvedic terms?
background I have a Dengue
information suspicious patient ,
hence need an
immediate overview
of the condition
Drug action Which Treatment Five fold evidence
Principle is
appropriate for my
patient with HTN?

30.
Finding Evidence-Based Answers to Clinical Questions
Best recommendations What is the best Treatment Five fold
for disease Principle for my patient with evidence
management DUB ? How to decipher the
patient particular samprapti in
Ayurveda?
To solve confusions : Why does Amrutharishta fail to Five fold
check fever in my patient? evidence
What should I understand when
my patient’s joint pain shoot up
after Sneha sweda??
What specific Pathya should I Five fold
Information to share suggest to my patient ? evidence
with patients What Apathya should I ask him
to avoid ?

31.
ART OF PRESCRIBING
Abandon This medicine –
That disease Approach.
Adopt Treatment Principle (Evidence) based
Clinical Practise & Research .

32.
Medicine Based Prescribing
Unscientific
Unpredictable
Dangerous
Destructive

33.
Why not Evidence Based Ayurveda?????
Commercial gain
EBA “HEALTH FOR ALL”
World wide acceptance
Today, world is not accepting Ayurveda, only
because it is practiced ‘Medicine Based’ and not
‘Evidence Based’

34.
EVIDENCE BASED AYURVEDA
Why not practise
EBA??

35.
Modern Medicine –PROBABILITY BASED
Modern Medicine is
only MEDICINE
BASED EVIDENCE .

36.
SALIENT FEATURES OF
BOOK“EBA&RP”
• ENABLES YOU TO KNOW AND PRACTISE EVIDENCE
BASED AYURVEDA .
• INCORPORATES NEW TECHNIQUES ON HOW TO
MAKE THE BEST USE OF OUR EVIDENCES .
• EMPHASIS ON HOW TO DEAL WITH THE COMMON
CONFUSIONS IN MEDICAL DECISION MAKING.
• GREATER COVERAGE OF APPLIED ASPECTS IN
MEDICINE
• MAKE US COMPETENT AND CONFIDENT IN OUR
CAREER

37.
Conclusion
 Let us stop living in science as if we are asleep !!
 Let us ponder into our Basic Science and streamline
evidence by their organized application!
 Let us recognize and practise Evidence Based
Medicine !
 Let us adopt the best scientific ways to serve the
mankind!

38.
ATTENTION PLEASE!
ONLY WE CAN PRACTISE
EVIDENCE BASED MEDICINE
IN REALITY
LET US SHOW THE WORLD
THE WORLD
THE STRENGTH OF
EVIDENCE BASED AYURVEDA

39.
xuw. wUyat....Have a GREAT Year
Ahead!