Just What The Doctor Ordered

Context: Evidence-based medicine the way to go, be it allopathic, ayurvedic or other systems.

Case study 1:

• Till the middle of the 20th century, hypertension had no specific treatment except a low-salt diet.
• Kaviraj Gananath Sen and Kartick Chandra Bose from Kolkata had reported in 1931 that an alkaloid extracted from sarpagandha could treat hypertension.
• After this, Dr Salimuzzaman Siddiqui in Delhi’s Tibbia College isolated five crystalline alkaloids from the herb and tested them on frogs and cats.
• Building upon this, Dr Rutom Jal Vakil, a Bombay cardiologist, conducted a small study on hypertension patients and published his findings in the British Medical Journal in 1949.
• The paper took the medical world by storm and changed the face of hypertension management globally.

Case study 2:

• In the 1990s the Central Drug Research Institute (CDRI) of the Council of Scientific and Industrial Research (CSIR), developed a memory enhancer using baccopa monnieri extracted from
• The technology was transferred to a Chennai firm that marketed it as Memory Plus.
• A few years down the line, the CDRI found that Memory Plus had very low availability of the active compound and its effect was no better than grass growing in backyards.

Background:

• The pandemic has exposed and deepened existing fault lines between modern and traditional systems of medicine.
• The tussle is well exemplified in the public spat between the Indian Medical Association (IMA) and Ramdev, founder of Patanjali Ayurveda.
• The focus on the so-called supremacy of different systems of knowledge is superficial and misleading.
• It should instead be on evidence or lack of it and about yardsticks to measure the acceptable evidence.

Redefining health systems on the basis of evidence

• Based on evidence: Everything mentioned in ancient texts cannot be marketed as drugs in modern times till evidence is generated about their efficacy and safety based on well-accepted criteria.
  • For e.g. Coronil, launched by Patanjali a was first marketed as a cure for Covid- 19 and later was downgraded to an ‘immunity booster.’ Thus, evidence is either lacking or is dodgy.
  • Ayurvedic medicines are sold on the premise of ‘scientific proof’ through presenting scientific papers in predatory and small forums in order to somehow produce evidence to substantiate the tall claims Ramdev makes.
• Based on constant revision: Science evolves based on evidence. It is not dogmatic like ancient texts.
  • This explains constant revision in the guidance on the administration of plasma therapy, HCQ and Ivermectin during the pandemic.
  • At the same time, there are loopholes in the allopathic system where unscrupulous people can fudge data and fool medical journals, and use of irrational combinations and antibiotics is rampant.

Conclusion:

• In a country like India with layered health systems and cultural beliefs, it would be unwise to completely reject traditional systems in favour of modern medicine.
• We need to develop a necessary regulatory mechanism, teaching standards, licensing system and marketing norms that apply to all systems uniformly.