On 2014 Aug 11, Dr. Priyanka. M Jadhav commented:

Ayurveda: science beyond scepticism and snake oil

Priyanka M. Jadhav, Research Scientist

Maharashtra University of Health Sciences

Comment on: Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial

Sir, This is the age when the concept of remote surgery does not surprise us, but we are not prepared to accept a concept that has existed and survived for centuries—the science of Ayurveda. I read with great interest the study published by Chopra et al. and am excited that the New Millennium Indian Technology Leadership Initiative (NIMTLI) project set up with an interdisciplinary approach is evaluating traditional and Ayurvedic drugs in clinical trials for treatment of osteoarthritis[1]. It is interesting to see how modern medicine approach is being used to study the effect of an Ayurvedic medicine assessed by a series of experiments [2–4]. The acceptance of Ayurveda or any other traditional system of medicine in western medicine is low; however, what causes frustration are the allegations and misinformation being promoted.

Recently, a a letter was published in which the author termed Ayurveda as quackery.[5] Patients and the next generation who aspire to find a cure and career in this age-old science find such information as very misleading and confusing. On the other hand, many other journals are documenting the reports on the study of these drugs.

The National Center for Complementary and Alternative Medicine clearly states the lack of randomized controlled clinical trial for complementary and alternative medicines and a need to build evidence-based datab to assess the plausibility of claims[6].

As an Ayurvedic practitioner, I welcome such suggestions and efforts, which are more than mere dismissal of age-old science. Although the current research and published papers concentrate on the extracts of plants, the point of holistic treatment is lost. As many scientists use extracts, the pressure of using purified extracts in studies is very high. Any researcher who proposes to work on a whole medicinal plant not only faces technical difficulties but also pressure from the scientific community, which again steers them to use purified extracts. Negative results of many experiments are not even published.

NMITLI arthritis project is one such attempt to translate the language of traditional medicine in a way that the western world can understand. In doing so, the scientists involved are those who are experts in their field and have done their best to generate data from in vitro and human studies. Moreover, one can also argue that Ayurveda treats a patient not only by medicine but also by other methods such as application of oil, hot fermentation, purgation, etc., which varies for each patient depending on their prakruti or constitution.[7] If one aims to study these medicines, a novel and innovative approach or a fresh perspective is needed when designing a suitable trial. [8]

More such studies as the one done by Chopra et al. should be done. Such studies will focus on chronic and infectious diseases, which are of grave concern not only for the developing or resource-poor countries but also for the developed world too. These medicines may form a good alternative, if not a substitute, for modern medicine that has mild to severe adverse effects particularly for chronic diseases. In a way, this study may be a base to prove to the funding agencies and other organizations that natural products can be just as effective as modern ones.

Some very important issues to be addressed are whether we are prepared to accept a concept riddled with prejudice or embrace one used by billions for their good for centuries.

References

1 Chopra A, Saluja M, Tillu G et al. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology 2013. doi: 10.1093/rheumatology/kes414. First published online: January 30, 2013.

2 Chopra A, Saluja M, Tillu G et al. Evaluating higher doses of Shunthi - Guduchi formulations for safety in treatment of osteoarthritis knees: a Government of India NMITLI arthritis project. J Ayurveda Integr Med 2012;3:38-44.

3 Chopra A, Saluja M, Tillu G et al. A randomized controlled exploratory evaluation of standardized ayurvedic formulations in symptomatic osteoarthritis knees: a government of India NMITLI project. eCAM 2011;2011:724291.

4 Sumantran VN, Kulkarni A, Chandwaskar R et al. Chondroprotective potential of fruit extracts of Phyllanthus emblica in osteoarthritis. Evidence-based complementary and alternative medicine : eCAM 2008;5:329-35.

5 O'Cathail S, Stebbing J. Ayurveda: alternative or complementary? Lancet Oncol 2012;13:865.

6 Briggs JP. NIH. Turning discovery into health? Available from: http://nccam.nih.gov/about/offices/od/2011-06.htm (17 April 2013, date last accessed).

7 Dieppe P, Marsden D. Managing arthritis: the need to think about whole systems. Rheumatology 2013.doi: 10.1093/rheumatology/ket127 First published online: March 7, 2013.

8 Patwardhan B. Ayurveda GCP guidelines: need for freedom from RCT ascendancy in favor of whole system approach. J Ayurveda Integr Med 2011;2:1-4.

Conflict of Interest: None declared

Published July 9, 2013 http://rheumatology.oxfordjournals.org/content/52/8/1408.long/reply#rheumatology_el_105

On 2014 Aug 11, Dr. Priyanka. M Jadhav commented:

Ayurveda: science beyond scepticism and snake oil

Priyanka M. Jadhav, Research Scientist

Maharashtra University of Health Sciences

Comment on: Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial

Sir, This is the age when the concept of remote surgery does not surprise us, but we are not prepared to accept a concept that has existed and survived for centuries—the science of Ayurveda. I read with great interest the study published by Chopra et al. and am excited that the New Millennium Indian Technology Leadership Initiative (NIMTLI) project set up with an interdisciplinary approach is evaluating traditional and Ayurvedic drugs in clinical trials for treatment of osteoarthritis[1]. It is interesting to see how modern medicine approach is being used to study the effect of an Ayurvedic medicine assessed by a series of experiments [2–4]. The acceptance of Ayurveda or any other traditional system of medicine in western medicine is low; however, what causes frustration are the allegations and misinformation being promoted.

Recently, a a letter was published in which the author termed Ayurveda as quackery.[5] Patients and the next generation who aspire to find a cure and career in this age-old science find such information as very misleading and confusing. On the other hand, many other journals are documenting the reports on the study of these drugs.

The National Center for Complementary and Alternative Medicine clearly states the lack of randomized controlled clinical trial for complementary and alternative medicines and a need to build evidence-based datab to assess the plausibility of claims[6].

As an Ayurvedic practitioner, I welcome such suggestions and efforts, which are more than mere dismissal of age-old science. Although the current research and published papers concentrate on the extracts of plants, the point of holistic treatment is lost. As many scientists use extracts, the pressure of using purified extracts in studies is very high. Any researcher who proposes to work on a whole medicinal plant not only faces technical difficulties but also pressure from the scientific community, which again steers them to use purified extracts. Negative results of many experiments are not even published.

NMITLI arthritis project is one such attempt to translate the language of traditional medicine in a way that the western world can understand. In doing so, the scientists involved are those who are experts in their field and have done their best to generate data from in vitro and human studies. Moreover, one can also argue that Ayurveda treats a patient not only by medicine but also by other methods such as application of oil, hot fermentation, purgation, etc., which varies for each patient depending on their prakruti or constitution.[7] If one aims to study these medicines, a novel and innovative approach or a fresh perspective is needed when designing a suitable trial. [8]

More such studies as the one done by Chopra et al. should be done. Such studies will focus on chronic and infectious diseases, which are of grave concern not only for the developing or resource-poor countries but also for the developed world too. These medicines may form a good alternative, if not a substitute, for modern medicine that has mild to severe adverse effects particularly for chronic diseases. In a way, this study may be a base to prove to the funding agencies and other organizations that natural products can be just as effective as modern ones.

Some very important issues to be addressed are whether we are prepared to accept a concept riddled with prejudice or embrace one used by billions for their good for centuries.

References

1 Chopra A, Saluja M, Tillu G et al. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology 2013. doi: 10.1093/rheumatology/kes414. First published online: January 30, 2013.

2 Chopra A, Saluja M, Tillu G et al. Evaluating higher doses of Shunthi - Guduchi formulations for safety in treatment of osteoarthritis knees: a Government of India NMITLI arthritis project. J Ayurveda Integr Med 2012;3:38-44.

3 Chopra A, Saluja M, Tillu G et al. A randomized controlled exploratory evaluation of standardized ayurvedic formulations in symptomatic osteoarthritis knees: a government of India NMITLI project. eCAM 2011;2011:724291.

4 Sumantran VN, Kulkarni A, Chandwaskar R et al. Chondroprotective potential of fruit extracts of Phyllanthus emblica in osteoarthritis. Evidence-based complementary and alternative medicine : eCAM 2008;5:329-35.

5 O'Cathail S, Stebbing J. Ayurveda: alternative or complementary? Lancet Oncol 2012;13:865.

6 Briggs JP. NIH. Turning discovery into health? Available from: http://nccam.nih.gov/about/offices/od/2011-06.htm (17 April 2013, date last accessed).

7 Dieppe P, Marsden D. Managing arthritis: the need to think about whole systems. Rheumatology 2013.doi: 10.1093/rheumatology/ket127 First published online: March 7, 2013.

8 Patwardhan B. Ayurveda GCP guidelines: need for freedom from RCT ascendancy in favor of whole system approach. J Ayurveda Integr Med 2011;2:1-4.

Conflict of Interest: None declared

Published July 9, 2013 http://rheumatology.oxfordjournals.org/content/52/8/1408.long/reply#rheumatology_el_105