Lecture Note: Are the Theoretical Foundations of Ayurveda Beyond the Scope of Research?

0
99

Are the Theoretical Foundations of Ayurveda Beyond the Scope of Research?

Kishor Patwardhan

Research in Ayurveda often revolves around the consideration of statements such as, “Research is needed but it has to be according to Ayurveda theories.” However, this approach raises questions about whether keeping “Theories” out of the ambit of research limits the exploration of Ayurveda as a scientific discipline, despite commonly referring to it as the “Science of life.” One may ponder whether it’s possible to subject Ayurvedic theories and principles to rigorous research, as this is typically how scientific knowledge advances and evolves over time.

The case in point is Tridosha, a concept developed to systematize knowledge on health and disease within Ayurveda. Tridosha is a common theory that interconnects various aspects such as physiology, anatomy, pathology, diagnosis, drugs, interventions, and constitution/personality. However, some criticisms arise regarding the primitive understanding of anatomy and physiology in Ayurveda, for instance, in terms of the role of kidneys in urine formation or the conversion of one Dhatu into another (e.g., Majja into Shukra). These critiques prompt the question of whether there is a need for theory modification within Ayurveda to align it more closely with contemporary scientific understanding and advancements.

Air-Water-Food: The essentials for survival

The analogy of a plant kept in the dark in a closed, airtight jar, which dies soon, highlights the fundamental need for light and air in sustaining life. Similarly, too cold a climate is generally inhospitable to life, emphasizing the importance of a suitable environment for survival. The observation that being “warm on touch” is a sign of life further emphasizes the need for a favorable temperature range for living organisms. The example of an animal suffocating and dying underscores the critical role of air in respiration and life processes. It is widely accepted that humans and other living beings cannot survive without essential elements such as air, water, and food.

In terms of survival essentials, three primary elements emerge:

  1. Air/Wind: Essential for breathing and the respiratory process.
  2. Sun: Vital for sustaining life indirectly through photosynthesis in plants, which forms the basis of the food chain.
  3. Water: Crucial for hydration, sustaining life processes, and food preparation.

These essentials form the basis of life’s sustainability, highlighting the interconnectedness of living beings with their environment and resources. The proposition equating Vata with wind, Pitta with the Sun and fire, and Kapha with water draws parallels between Ayurvedic principles and the essential elements required for life.

Vata, representing wind, is associated with controlling activities such as movements, similar to how wind influences various processes in nature. Pitta, likened to the Sun and fire, is linked to generating heat, imparting color, and facilitating digestion, reflecting the transformative and energetic aspects of these elements. Kapha, symbolizing water, is attributed to providing nourishment and acting as a coolant, akin to the nurturing and stabilizing properties associated with water. These associations provide a conceptual framework within Ayurveda, aligning physiological functions and characteristics with elemental qualities to understand health and wellness.

Inductive Reasoning and Tridosha Theory:

Inductive reasoning plays a crucial role in various fields, including medical sciences, where it aids in drawing generalized conclusions from specific observations or evidence. Here’s how inductive reasoning applies in the context of the Tridosha theory in Ayurveda:

Observational Basis: The development of the Tridosha theory was rooted in centuries of observation and experience by ancient Ayurvedic scholars. They keenly observed patterns in human health, responses to different environments, and individual constitutions, leading to the formulation of general principles about health and disease.

Empirical Evidence: Ayurvedic texts contain detailed discussions on how specific foods or activities can influence doshas and manifest symptoms in individuals. This empirical evidence, gathered through meticulous observation and documentation, provides support for the generalizations made in the Tridosha theory.

Individualized Approach: Central to the Tridosha theory is the recognition that each person has a unique constitution with varying dosha proportions. This personalized approach stems from inductive reasoning, where observations of individual differences lead to the formulation of general principles guiding personalized treatment plans.

Practical Application: Ayurvedic practitioners apply the Tridosha theory by assessing patients’ constitution, classifying symptoms based on doshas, and by recommending treatments aimed at Dosha-based symptoms. This practical application underscores the importance of inductive reasoning in guiding therapeutic interventions.

Overall, the Tridosha theory in Ayurveda emerged from a synthesis of empirical observations, cultural insights, and practical applications, highlighting the role of inductive reasoning in shaping medical concepts and treatments.

Falsification principle of Karl Popper and Deductive Reasoning:

Karl Popper’s falsification principle is a pivotal concept in the philosophy of science, diverging from the conventional notion of scientific theories being confirmed through induction. Instead, Popper proposed that scientific theories should be subjected to attempts at falsification to assess their validity. This principle is widely applied in hypothesis testing within scientific research.

For instance, consider the statement “X drug is effective in Y disease.” According to Popper’s falsification principle, this statement is testable because it can be reformulated as “X drug is not effective in Y disease.” If the drug indeed proves effective in treating Y disease, the second statement (X drug is not effective) stands falsified. Conversely, if the drug fails to demonstrate effectiveness, the original statement (X drug is effective) stands falsified. This approach emphasizes the importance of rigorous testing and potential falsifiability in evaluating scientific hypotheses and theories.

Deductive reasoning is a systematic method of logical thinking that involves deriving conclusions from a set of premises or assumptions. It operates by starting with general principles or statements and then applying them to reach specific, logically derived conclusions. The fundamental goal of deductive reasoning is to achieve certainty; if the premises are true and the reasoning process is valid, then the conclusion must also be true. This method is extensively utilized in mathematics, formal logic, and structured arguments, where the validity of the conclusion hinges entirely on the accuracy of the premises.

The structure of deductive reasoning often follows an if-then format, where the “if” part represents the premise or assumption, and the “then” part signifies the conclusion drawn from the premise. Examples of deductive reasoning include mathematical proofs, syllogisms, and logical arguments that rely on established rules or principles. Deductive reasoning is highly valuable for generating conclusions that are guaranteed to be true if the initial premises are correct and the logical process is valid.

Popper’s Falsification Principle and deductive reasoning are intertwined concepts that challenge traditional views on scientific methodology:

Deductive Reasoning: In deductive reasoning, if the premises (theory or hypothesis) are true and the reasoning is valid, then the conclusion (prediction) must also be true. It relies on logical inference from general principles to specific conclusions.

Popper’s Falsification Principle: Karl Popper proposed that scientific theories should be formulated in a way that allows for falsification. This means they should make testable predictions that, if proven false by empirical evidence, would refute the theory. Popper emphasized the importance of deductive reasoning and empirical testing over the inductive method of confirming theories through repeated observations.

Scientific Knowledge Advancement: According to Popper, scientific knowledge progresses not by confirming theories but by attempting to falsify them. This involves making bold and specific predictions that can be tested empirically.

Example: Consider the hypothesis that all swans are white, proposed by a European scientist. Traditional inductive reasoning might confirm this hypothesis by observing numerous white swans. However, Popper’s approach suggests making a deductive prediction: if all swans are white, then no black swans should exist.

Popper’s falsification principle encourages actively seeking out counterexamples, such as black swans, to test the hypothesis. The discovery of even one black swan (as found in Australia) would falsify the hypothesis, necessitating revision or abandonment of the theory.

Essentially, Popper’s Falsification Principle aligns with deductive reasoning by advocating for the formulation of scientific theories that make testable predictions, allowing for empirical falsification and advancement of knowledge.

Deductive Reasoning in Medical Sciences:

Deductive reasoning plays a crucial role in various aspects of medical sciences:

Clinical Decision Making: Healthcare professionals often utilize deductive reasoning when making clinical decisions. They start with general medical knowledge regarding symptoms, diseases, and treatments (premises) and then apply this knowledge to a specific patient case (conclusion). For instance, if a patient presents with symptoms like fever, cough, and chest pain (premises), a doctor may deduce that the patient likely has pneumonia (conclusion) based on established medical knowledge.

Medical Education: Deductive reasoning is integral to medical education. Students learn foundational principles of anatomy, physiology, pathology, pharmacology, and other medical disciplines (premises). They then use deductive reasoning to apply this knowledge to clinical scenarios (conclusions) in order to make accurate diagnoses and formulate appropriate treatment plans.

Evidence-Based Medicine (EBM): In evidence-based medicine, deductive reasoning is employed by researchers and clinicians to apply established guidelines, protocols, and evidence-based practices (premises) to individual patient cases (conclusions). This approach ensures that medical decisions are grounded in sound evidence, logical reasoning, and established best practices, ultimately improving patient outcomes and healthcare quality.

Deductive reasoning serves as a fundamental cognitive tool in medical sciences, facilitating clinical decision making, medical education, and the practice of evidence-based medicine by enabling healthcare professionals to apply general medical knowledge to specific patient situations in a logical and systematic manner.

Science as an iterative process:

Karl Popper’s perspective on science as an iterative process of conjecture and refutation highlights the significance of critical testing and falsifiability in scientific inquiry. According to Popper, scientific theories should be subject to rigorous testing through attempts at falsification rather than seeking mere confirmation through induction. This approach introduces a critical perspective on deductive reasoning in science.

Scientific theories that withstand repeated attempts at falsification gain stronger empirical support and are considered more robust. However, Popper emphasizes that even theories with strong empirical support are never conclusively proven true. Instead, they are considered valid until they are potentially falsified by new evidence or observations.

Popper’s falsification principle encourages scientists to approach deductive reasoning with a focus on testing and critical examination. Rather than seeking to confirm theories, scientists should actively seek out ways to challenge and potentially falsify them. This approach fosters a dynamic and evolving understanding of scientific knowledge, where theories are constantly refined and updated based on empirical evidence and critical evaluation. This approach encourages scientific theories to be specific, bold, and open to potential refutation, leading to a dynamic and self-correcting scientific process.

Is Tridosha theory testable?

Let us evaluate if the Tridosha theory can sustain the challenge of falsification. First of all, is it testable reasonably well? I doubt it, because there are three mutually opposite entities that balance each other out whenever there is some disturbance in one of them. This structure makes it easy to explain any phenomenon using any of the three entities; if one entity cannot explain something, the other can do so easily because it is inverse to the first. This makes the theory irrefutable and hence non-testable.

I explain this in the following paragraphs: A Kapha-aggravating diet and lifestyle (indulgence in a high-fat/carbohydrate diet, a lack of physical activity, excessive sleep, etc.) leading to overweight and obesity is confirmation of the theory. But we know that confirmation or verification is not enough to call a theory sound enough. We can find verification for nearly any theory if we look for it. We need to search for an instance where this phenomenon goes wrong.

For example, Hyperthyroidism and Diabetes mellitus are two conditions where there is progressive weight loss despite increased appetite. A person suffering from these conditions eats more (a Kapha-aggravating cause) but still loses weight (a Vata-aggravating effect). Hence, here, the theory crumbles. However, one may argue that eating is not the cause of these diseases and that we have identified a wrong cause for the sake of demolishing the theory. Here, the real cause is endocrine abnormalities. However, even in the case of obesity, aren’t there endocrine abnormalities involved? There are. Overeating normally should trigger a behavior that discourages more eating. Hence, a simple explanation like “increase or decrease in Kapha” is grossly insufficient to explain such complex phenomena.

Supporters of the theory usually bring in some other Dosha to explain these mechanisms. For example, they may say that increased Pitta leads to an increased rate of metabolism, and that is how the case of hyperthyroidism should be understood. But is this not an instance of a “conventionalist stratagem,” wherein we rescue the theory by proposing ad hoc conjecture? By simply observing one eating more, one would expect that there should be weight gain, which doesn’t happen here. To explain this, when we bring in Pitta, we make the theory non-falsifiable and hence irrefutable.

In the case of diabetes mellitus, one might say that it is a Vata disease and hence there is a loss of weight. But as per our theory, indulgence in a Kapha-aggravating diet should lead to the suppression of Vata, not to its aggravation. Supporters may say that initially there would be obesity which later leads to insulin resistance and eventually to diabetes and loss of weight. Hence, it requires a deeper understanding of Tridosha such as Samprapti. They may say that aggravated Kapha leading to insulin resistance makes Vata get aggravated, and it is a case of Avarana. But they forget that they are using current biological understanding to explain away the Tridosha model. That again makes our theory inadequate. They don’t realize that they are rescuing the theory using a conventionalist stratagem.

Let us similarly test Vata. By indulging in a Vata-aggravating diet and lifestyle (exercise/ loss of sleep/ fasting/ low-fat – low carbohydrate intake), there should be a decrease in body weight (Vata features). Indeed, it is seen in the real world. This is confirmation of the theory. It doesn’t make the theory strong. Now, is there an instance where this doesn’t happen? Yes, it may be seen in abnormal endocrine conditions such as Cushing syndrome where obesity may result irrespective of lifestyle. Increased corticosteroid levels due to any reason may lead to this disease. Without understanding this endocrine physiology, we cannot explain this disease using Tridosha logic. Supporters may say that Cushing Syndrome is a Kapha disease or Pitta disease. However, this disease can manifest irrespective of indulgence in a Kapha/Pitta-alleviating diet and lifestyle. Basically, it is not the diet that leads to this condition. But without understanding the pathophysiology in terms of current science, we cannot explain this. One would diagnose it as Obesity and would treat it as a Kapha disease normally, in the absence of this knowledge.

Delving into the pathophysiology of endocrinal disease, if we propose that Hyperthyroidism is a Pitta disease and Cushing Syndrome is a Kapha disease, Pittahara and Kaphahara drugs should be useful in treating these conditions, respectively. But so far, I haven’t come across any proven effective treatment of these conditions using Ayurveda interventions. This is how we make the Tridosha theory irrefutable but at the same time, weak.

How do clinicians use Tridosha theory?

It is essential for us to understand how Ayurveda clinicians use Tridosha theory in their clinical practice.

  1. Symptom Classification: Clinicians apply the Tridosha theory to classify symptoms based on Tridosha. For example, symptoms of inflammation may be categorized under Pitta and symptoms of pain under Vata.
  2. Planning Interventions: Ayurvedic clinicians use the Tridosha theory to plan interventions. For instance, therapies like Vamana, Virechana and Basti are recommended in the diseases with the prominent symptoms of Kapha, Pitta and Vayu.
  3. Do not use it for understanding pathophysiology: While clinicians use the Tridosha theory for classification and interventions, they typically do not rely on it for understanding pathophysiology in detail. This is because the theory’s explanatory power may be limited when it comes to intricate pathophysiological mechanisms.
  4. Clinicians recognize the limitations of Samprapti: Clinicians know the limitations of Samprapti (pathogenesis) as recognized by scholars in texts like Bhava Prakasha, Bhaishajya Ratnavali, and Chakradatta. These texts give almost no importance to disease progression and underlying mechanisms.
  5. View Tridosha Theory as Heuristic: Clinicians recognize that the Tridosha theory can be useful as a heuristic or guiding framework than as an absolute explanation for all aspects of health and disease.

Why is recognising the limitations of Tridosha theory important?

Acknowledging these limitations and adopting a more critical perspective on traditional theories is important for several reasons:

  1. Reducing the Burden of Memorization: Shifting focus from impractical aspects of traditional theories reduces the memorization burden on students.
  2. Introducing More Useful Subjects in Curricula: Allocating more time to subjects like molecular biology, genetics, biochemistry, and pathology enhances the depth of understanding and relevance in modern healthcare practices.
  3. Influencing Examination Patterns and PG Entrance Tests: Emphasizing modern scientific subjects in curricula can influence examination patterns and entrance tests, ensuring that students are assessed on relevant and practical knowledge.
  4. Reducing Stress Among Students: By streamlining curricula and focusing on more applicable knowledge, the stress levels among students can be reduced.

Clinicians in Ayurveda recognize the value of traditional theories like Tridosha but also know the need for a balanced approach that integrates modern scientific knowledge and practical clinical skills.

Conclusion:

In conclusion, the Tridosha theory within Ayurveda presents a complex challenge when subjected to the scrutiny of falsification. While it offers heuristic value and historical significance, its testability and explanatory power face significant limitations. The theory’s structure, where doshas balance each other and can be explained inversely, renders it non-falsifiable in many instances. The theory’s ability to explain phenomena like obesity can be countered by real-world conditions such as hyperthyroidism and diabetes mellitus, where expected outcomes do not align with doshic imbalances. Attempts to rescue the theory through ad hoc explanations or introducing additional doshas raise questions about its robustness and falsifiability. Moreover, the lack of proven effective treatments for some of these medical conditions using Tridosha logic underscores its limitations in practical application. Therefore, while the Tridosha theory remains a cornerstone in Ayurveda, acknowledging its limitations and integrating modern scientific knowledge is crucial for advancing research and clinical practice in Ayurvedic medicine.


  1. Patwardhan, K. (2023). Confessions of an Ayurveda professor. Indian Journal of Medical Ethics, VIII(1), 61–64. https://doi.org/10.20529/IJME.2022.049
  2. Chattopadhyaya DP. Methodology and epistemology. In: Science and Society in Ancient India. 1977.
  3. Krishna GL. Ayurveda’s bane. The Hindu. April 15, 2018.
  4. Popper K. Science as Falsification. Originally published in: Conjectures and Refutations. 1963.
  5. Krishna GL. The Ayurvedic Dosha Theory: A Deconstruction. Confluence. July 11, 2019
  6. Sokal AD. Pseudoscience and Postmodernism: Antagonists or fellow travelers? In: How pseudoarchaeology misrepresents the past and misleads the public. Editor: Garrett Fagan. 2004.
  7. Engler S. “Science” vs. “Religion” in Classical Ayurveda. Numen, Vol. 50, No. 4 (2003), pp. 416-463.
  8. Krishna GL. The Need to Recast the Dosha Theory as a Heuristic. The Indian Practitioner, Vol.75 No.1 January 2022.
  9. Krishna GL. Ayurveda awaits a new dawn. Indian J Med Ethics. 2022 Jan-Mar;7(1)NS:16-21.
  10. Krishna GL. Ayurveda Needs an Intellectual Reinvention. The Sciences. November 24, 2020.
  11. Krishna GL. The History of a Superstition. BMJ Blogs. May 21, 2019
  12. Chauhan Mayank. Physicians’ perceptions on the application of principles of Ayurveda Physiology (Kriya Sharir) in clinical practice (2023). MD(Ay) thesis submitted in the department of Kriya Sharir, Faculty of Ayurveda, IMS, BHU, Varanasi

 

LEAVE A REPLY

Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.