Interview with Prof. Muralidhara Sharma

Conducted via email by Dr. Kishor Patwardhan

We are pleased to present an interview with Professor Muralidhara Sharma. Following the publication of his recent book Clinical Experiences of an Ayurveda Practitioner, Professor Kishor Patwardhan, representing the Ayurveda Network, engaged him in an email-based discussion. In response, Professor Sharma has provided detailed and forthright answers. The following are selected excerpts from that exchange.

Dr. Kishor: Thanks for agreeing to this interview Sir. After reading your book repeatedly, I have a few questions to ask.

You strongly emphasise the need for clinicians to stay updated with contemporary medical knowledge. In practice, you seem to use this knowledge to identify clinical conditions and then match these with the nearest Ayurvedic diagnosis, often from Charaka or Sushruta Samhita. However, you do not seem to explicitly discuss Ayurvedic pathophysiology in your clinical reasoning.

If I understand this correctly, my question is: While you implicitly acknowledge that ancient Ayurveda did not have access to disciplines like endocrinology or microbiology, you stop short of saying explicitly that Ayurvedic theories of physiology and pathology are inadequate for handling complex diseases. Why?

Dr. Muralidhara Sharma: Thank you for the insightful question. I consider the patient’s welfare the foremost priority in clinical decision-making. My commitment to Ayurveda comes next. My clinical approach is designed to balance both.

To elaborate: the diagnostic approaches in contemporary medicine and Ayurveda are fundamentally different, each with its own strengths and limitations. A patient chooses a treatment modality based on factors such as cost, accessibility, or personal beliefs, often without rigorous analytical reasoning. As a clinician, I must provide unbiased guidance while preserving the integrity of the Ayurvedic framework.

Hence, I believe it is essential to have up-to-date knowledge of modern medicine, including its strengths and limitations. Charaka or Sushruta did not face this dilemma, as there were no competing systems at the time.

My standard operating procedure involves first evaluating each patient using modern clinical guidelines and available prognostic data. I only offer Ayurvedic treatment if I am confident that it will provide an equal or superior outcome in terms of relief, cost, convenience, and safety. Otherwise, I refer the patient to the contemporary system.

Sometimes I co-prescribe Ayurvedic medicines or adjust ongoing modern treatments, but only when I have a thorough understanding of both systems. This would be impossible without adequate knowledge of modern medicine.

Now to your point about not correlating pathophysiology: When I prescribe an Ayurvedic treatment, it is based on Ayurvedic assessment, including dosha, dooshya, rasa, veerya, vipaka, and so on. Correlating modern pathophysiological entities directly with Ayurvedic ones is problematic because the ontological premises are different.

For example, Madhuyashti (Glycyrrhiza glabra) is widely used in Ayurveda for its madhura rasa, pitta-kapha shamaka, and rasayana properties. But modern pharmacology isolates a steroidal compound from it and assigns an entirely different interpretation. This kind of reductionism risks undermining Ayurvedic logic. There are hundreds of similar examples.

To clarify a key point: it is not true that I have avoided saying these things explicitly. In my lectures and writings, I have often emphasized that “to be a successful Ayurvedic practitioner, you should be more modern than a modern doctor.”

Dr. Kishor: Thank you for that detailed response. A related question came up from a fellow practitioner in Kerala who attended one of your lectures. They remarked that your clinical reasoning often draws from classical Ayurvedic texts, such as Charaka and Sushruta, but your prescriptions predominantly involve Rasaushadhis, which are not mentioned in those texts. How do you respond to this apparent inconsistency?

Dr. Sharma: That observation, though commonly raised, stems from a misunderstanding. Rasaushadhis were developed within the same philosophical and clinical framework as earlier Ayurveda. Their principles of preparation, application, and safety are grounded in Ayurvedic epistemology. To claim a gap between Ayurvedic tenets and Rasaushadhis is not justified.

My preference for Rasaushadhis arises from their convenience, efficacy, safety, and cost-effectiveness. That does not mean I reject herbal formulations or kashaya kalpanas. I use them when they are appropriate. Evolution in formulation is natural across historical epochs.

Dr. Kishor: You affirm that Rasaushadhis are safe. Yet, your book includes a few cases where adverse effects occurred following their administration. Whether due to manufacturing faults or otherwise, shouldn’t such risks be more explicitly highlighted for the benefit of practitioners?

Dr. Sharma: Safety protocols for both herbal and Rasa drugs are clearly described in Ayurvedic texts. These include detailed guidelines for raw materials, preparation methods, and clinical usage. When these are meticulously followed, the drugs are safe.

However, the current landscape is worrying. Many pharmaceutical companies deviate from classical preparation techniques, leading to substandard products. I have raised these issues on several occasions. The only thing I have not done is name companies publicly, because that would involve ethical complications.

Dr. Kishor: You make an important claim: “To correlate a contemporary diagnosis to an Ayurvedic diagnosis is not justified as the basic tenets are absolutely different.” But doesn’t such an absolute dichotomy risk undermining the observational acumen of ancient scholars?

Let me explain with three examples. First, Pitta as the mala of Rakta—we now know bilirubin is a product of hemoglobin breakdown. Pittaja jwara closely resembles viral hepatitis. Second, Adrishya krimi—clearly an intuitive anticipation of microorganisms. Third, Sushruta’s prescription of raw goat liver for extreme blood loss—long before the discovery of vitamin B12, which liver contains abundantly.

If we treat Ayurveda and modern medicine as absolutely separate, aren’t we discrediting such pioneering insights?

Dr. Sharma: The foundational theories in Ayurveda are based on carefully verified observations, as Charaka says:

“Siddhānto nāma sa yaḥ parīkṣakair bahuvidhaṃ parīkṣya hetubhiś ca sādhayitvā sthāpyate nirṇayaḥ” (Vi.8).

Contemporary science and Ayurveda both share this commitment to evidence, but differ in orientation. Modern biology focuses on the material plane—cells as biochemical machines. Ayurveda interprets life through both physical and metaphysical lenses, involving atma, manas, and mahabhootas.

I do not deny the need for both views. As the Upanishads say: “Hiraṇmayena pātreṇa satyasyāpihitaṃ mukham.” The ultimate truth is veiled. Viewing it through both metaphysical and empirical perspectives brings us closer.

For further reading, I recommend:

1. Genome to Om by Bhushan Patwardhan and Indu Ramachandani
2. Molecules of Emotion by Candace Pert
3. From Being to Becoming by Ilya Prigogine

So, when I speak of absolute dichotomy, I refer not to the rejection of empirical insights but to the foundational difference in epistemology. Ayurveda cannot be understood if it is force-fitted into the modern paradigm. For example, Tridosha is not a reductive physiological concept. It is a dynamic functional model rooted in systemic interaction, perception, and consciousness.

When I say Pitta is a “bioactive metabolic energy,” it includes all of these functions and processes. This is why Kamadugha Rasa is effective in multiple Pitta-related conditions such as gastritis, herpes zoster, anxiety, and others.

Dr. Kishor: That leads precisely to my next question. You cite the use of Kamadugha Rasa across a broad spectrum of conditions—gastritis, herpes zoster, anxiety, and more. But that generality includes enzymes, hormones, neurotransmitters, and inflammatory mediators. Without pathophysiological differentiation, doesn’t this undermine specificity?

For example, hyperthyroidism and septicaemia might both present with Pitta-like features, but require different interventions. Impetigo may resemble herpes zoster, yet Kamadugha Rasa may fail in such cases. Can Tridosha theory predict such distinctions in the absence of modern pathophysiology?

Isn’t the core area where integration is needed precisely pathophysiology, where similar symptoms can arise from vastly different causes?

Dr. Sharma: Your concern is valid. When I say Pitta includes biochemical processes, it encompasses bile secretion too. But I object to reducing Pitta solely to bile. Similarly, Katuki is not just a hepatoprotective herb. Classical sources list its use in conditions like krimi, shwasa, jwara, atisara, gulma, and even moodhagarbha.

To restrict its use based on pharmacological studies of picroside-I would be to disregard millennia of observed therapeutic breadth. The Ayurvedic understanding of rasa, veerya, and the cumulative experience of generations are no less valid than molecular findings.

You are right to say that pathophysiology is the key point for epistemological integration. This is precisely why I emphasize dual assessment: modern pathophysiology for diagnosis and prognosis, and Ayurvedic principles for therapeutic decisions.

I do not claim Ayurveda is complete. Nor is modern medicine. Neither system is currently adequate. But to integrate the strengths of both, without dissolving the identity of either, is the path forward.

Dr. Kishor: Thank you so much, Sir, for this candid and reflective interview. I am confident that our readers—students, practitioners, and researchers—will find these insights deeply enriching.