The spat between Allopathy and Ayurveda medical practitioners has never been so pronounced like the present times.
In the latest controversy, Sushruta is the man of the hour. The father of surgery’s treatise written about 3,000 years ago has become a debating point in which modern medical practitioners want their Ayurveda counterparts to stick to the treatise and not do surgeries assisted by modern medical tools like anaesthesia and antibiotics and other post-operative care.
A recent Union Government notification in this regard had removed a technical glitch, thereby ‘enabling’ surgical procedures in Ayurveda.
Terming it ‘mixopathy,’ the protesting modern medical practitioners say they do not want any medical system to encroach upon the other.
However, Ayurveda physicians believe technological advances cannot be the prerogative of modern medicine alone.
Only 2% of the total number of Ayurveda doctors are permitted to do surgeries, says Sadath Dinakar, general secretary of the Ayurveda Medical Association of India. A postgraduate degree in Salyathantra (general surgery) and Salakyathantra (ear, nose, throat and neck) makes them eligible.
Having said that, not many Ayurveda physicians see a comeback of old days as the surgical skills have perhaps been lost to a point of no return.
Remya Krishnan, an Ayurveda physician from Kannur, who is highly critical about the unscientific manner Ayurveda is being practised today, says that surgery is perhaps the limitation of Ayurveda.
“Mainly because there is little technological investment in it. New techniques can be developed with proper support to Ayurveda surgery,” says Dr Krishnan, who promotes what she calls Science-based Evidence-based Ayurveda (SBEBA).
Anaesthesia as a cause
Legendary Ayurveda physician and Sanskrit scholar the late K Raghavan Thirumulpad’s overview on surgery, written as an introduction to his book Ashthangasangraham (Prakashika Vyakhya), on Salyathanthram, states that even though Ayurveda had grown with scientific knowledge assimilated from various quarters over the period, loss of surgical skill in Ayurveda could be because of advances in anaesthesia were introduced in India as part of western medicine.
It was taught as a part of the discipline in western medicine, which was also the officially recognised system of healthcare in colonial India, the book says.
Instead of confronting the western system, Ayurveda was left to die on its own. But the fact remains that Ayurveda did not die, says Thirumulpad. The system moved forward shelving many surgical procedures in its march towards modern India and physicians practised Ayurveda without active surgical procedures. Hence, over a period, surgical knowledge came down.
On the other hand, the technical advances with anaesthesia helped modern medicine scale up.
If the political and cultural climate in the country at that time had not prevented the growth of Ayurveda, it could have revived surgical procedures and would have developed to a new peak, says Thirumulpad.
The surgical tools described by Sushruta about 3000 years ago are seen to be similar to the ones used in modern surgery. There are, of course, some technological variations.
Modern medicine doctors too attest to the fact that their own practice has nothing but the oath to connect them to Hippocrates, the father of modern medicine who laid the foundation of western medical science in 5th century BC during the Greek Civilisation.
Today, modern medicine has even shed the name Allopathy and prefers to be known as the former. Technology has made medical practice different from what it was just about three years ago.
So, are there more concerns than what probably meets the eye?
Perhaps the most vehement protest by modern medical practitioners was in Kerala, where the doctor to population ratio overwhelms the ratio prescribed by the World Health Organisation. Against the prescribed 1:1000 ratio, Kerala has 1:400. Actually, less than that if one takes into account 80,000 doctors to a population of 3 crore.
Now, add to that about 22,000 Ayurveda physicians. So, access to health care in Kerala is indeed at a very enviable position.
N Sulphi, central committee member, Indian Medical Association (IMA), says the trend in Kerala is definitely not a good indication. It is estimated that 10 years down the line, the ratio is likely to come down to 1:150. It will lead to large-scale unemployment for doctors, malpractice, and other issues, Dr Sulphi said.
It is in such a situation that a healthy competition gives way to fear of encroachment and suspicion. Could there be such fears? “Not at all,” says R V Ashokan, general secretary, IMA. “Our protest is against the unlawful practice of using modern medicines by Ayurveda practitioners,” Dr Ashokan said. He says, “the latest issue has quality at stake.”
If Ayurveda practitioners are to use modern medicines independently, it is ‘mixopathy’ and IMA is against such practice. Ayurveda should be using their own medicines and procedures and not borrow from modern medicine textbooks, he adds.
Practising Ayurveda surgery is different, especially in Kerala. Despite being called the bowl of Ayurveda, so to say, the State does not provide surgical services to the patients even though there are physicians trained in the procedures. This denial comes from the State’s policy that does not allow them to practice it.
Training and efficacy
S Gopakumar, Associate Professor, Government Ayurveda College, Thiruvananthapuram, who is trained in surgery under eminent modern medical professors in Kerala, has not been able to offer this service to patients. Dr Gopakumar, who had won the award for the best teacher three times in his career and had the opportunity to speak in the British Parliament on Ayurveda, says he has no comments to offer in this regard. “I am abiding by the government rule,” he says.
Dr Sreeja Sukesan, Head of Salakyathnatra at Government Ayurveda Medical College, Tripunithura, has been more adventurous in her pursuit of surgical skills. For two years, with loss to her own service and pay, she pursued her specialisation at Banaras Hindu University. “There is no discrimination out there. The surgical speciality course calls for candidates who have completed either MBBS or BAMS,” she says.
There are Ayurveda medicines used in post-operative care. A professor trained in surgery in a self-financing Ayurveda medical college says that more studies are required for Ayurvedic drugs used in pre- and post-surgical care even when there have been good results.
Dr Ashokan points out that the government is trying to undercut modern medical practices by allowing surgeries by Ayurveda practitioners so that it can be incorporated under the prestigious Ayushman Bharat programme. The rates quoted in the schemes had been rather uncompetitive, he said. It was not able to attract modern medicine hospitals in taking the government packages. The cost had also been revised in certain procedures at the behest of the IMA, he added.