Mixing Ayurveda with modern medicine: What matters is scientific proof

The Hindu

5 days ago

The proposal to integrate MBBS (Bachelor of Medicine and Bachelor of Surgery) and BAMS (Bachelor of Ayurvedic Medicine and Surgery) into a single course has sparked controversy and opposition, with some calling it 'mixopathy'. The Indian Medical Association (IMA) and other organisations have voiced concerns, stating it is unscientific and could compromise patient safety. The proposed course, planned for JIPMER, aims to create doctors capable of utilising both allopathic and Ayurvedic treatments and provide a holistic diagnosis and treatment plan for patients.
The Hindu webinar examined this proposal by the Central government to merge the Bachelor of Medicine and Bachelor of Surgery (MBBS) with the Bachelor of Ayurvedic Medicine and Surgery (BAMS) into a single integrated course. It has not just ignited a debate within the medical community, but will also have a direct impact on the way patients will be diagnosed and treated in as little as five years from now.
The panellists included Dr. R.P. Parasher from the All India Doctors Association of ISM; Dr. Lakshya Mittal from United Doctors Front; Dr. Rajeev Jayadevan, former IMA President in Cochin; and Dr. Manisha Mishra, Ayurveda Physician MD (Ayu). The discussion was moderated by Bindu Perappadan, Senior Assistant Editor at The Hindu.
The principle of falsifiability
Speaking against this integration, Dr. Jayadevan said that every country has its own traditional knowledge systems; while traditional systems like Ayurveda deserve respect, they cannot be mixed with modern medicine, as Ayurveda and modern medicine are founded on completely different principles.
Also Read: IMA opposes proposed integrated MBBS-BAMS course, calls it unscientific
He emphasised that modern medicine is evidence-based and founded on proof. So whatever is claimed must be supported by evidence, adhering to the principle of falsifiability. For instance, if it is said that water boils at 100 degrees Celsius, that statement should be demonstrable with proof as true or false. However, if it is said that a particular disease occurs due to one's actions in a past life, it is a belief-based and non-falsifiable statement. 'These systems can exist in parallel, but mixing them is not acceptable,' he said.
Dr. Manisha Mishra, speaking in support of integration, highlighted that Ayurveda is fundamentally focused on health preservation and disease prevention, viewing health as a balance of bioenergy, physical and mental attributes, lifestyle (vihar), and diet (ahaar). It considers the soul, emotions, and genotype and phenotype in assessing disease risk and advising lifestyle changes early on to avoid future illness.
She said that while Ayurveda once included surgical practices, its strength today lies more in therapeutic and holistic approaches. Unlike modern medicine's precision and symptom-focused interventions, Ayurveda aims to restore physiological balance.
Dr. Mishra argued that integrating both systems could lead to holistic patient care, especially in acute cases where diagnostics from modern medicine can be combined with Ayurvedic lifestyle interventions. Integration, she added, would also improve doctor-patient communication, reduce stigma around using alternative supplements, and offer cost-effective, accessible healthcare, particularly in rural and primary care settings.
Not at the cost of patient safety
Dr. Mittal questioned the scientific basis of integrating the two systems, suggesting that mixing treatments without full knowledge could lead to serious side effects. He said that reforms should be in the larger public interest, and not rushed at the cost of student welfare and patient safety.
Dr. Mittal called this policy idealistic but impractical. Drawing on feedback from medical students and young resident doctors, he argued that India's medical education system is already under strain, with infrastructure and quality degrading. Dr. Mittal emphasized that existing issues in medical colleges, including inadequate auditing and poor facilities must be addressed before introducing such major reforms. He warned that students are being treated like guinea pigs in these hybridisation experiments, and that this could eventually compromise both medical training and patient care.
No single system complete on its own
Dr. Parasher supported the integration of Ayurveda and modern medicine, arguing that no single system of medicine is complete on its own. He said that while modern medicine is heavily evidence-based, Ayurveda has its time-tested wisdom that can be valuable in today's healthcare context.
Also Read: Ayurvedic medicine manufacturers support move to launch integrated medicine course at JIPMER
Dr. Parasher noted that patients often do not receive complete or satisfactory treatment from a single system, and combining approaches could address the limitations of each. He also highlighted that many modern medicines, like TB drugs and antibiotics, are hepatotoxic, and Ayurvedic formulations can help manage or reduce these side effects, leading to better patient compliance. Lastly, he pointed out that despite scientific advancements, lifestyle diseases such as diabetes and hypertension are rising, and incorporating Ayurvedic principles and treatments could help manage these conditions more effectively.
Important to place regulatory norms for Ayurveda
Moderator Bindu Perappadan asked whether there is a lack of academic and research rigor in alternative medicine systems like Ayurveda compared to modern medicine. She highlighted that MBBS education involves stringent processes for documentation, publication, and clinical trials, and asked whether the absence of similar standards in Ayurveda could compromise the quality of education and ultimately impact patient care.
Also Read: What are the risks of the government's proposed 'mixopathy' move? | In Focus podcast
Dr. Manisha Mishra responded by acknowledging the gap in regulatory rigor and agreed that Ayurvedic patent medicines should be subjected to Randomised Controlled Trials (RCTs). She pointed out that while modern medicines are target-based and require DCGI approval, similar regulatory enforcement is lacking in Ayurveda, and it is the government's responsibility to address that.
However, she defended classical Ayurvedic formulations, noting they've been used safely over centuries and that reverse pharmacology research has been conducted on herbs like Ashwagandha, Brahmi, and Turmeric. She emphasized that CCRAS and PG students are doing research, but conceded that it should become more rigorous.
Improve scientific temperament
Dr. Rajeev Jayadevan stressed that belief or tradition alone cannot substitute for scientific evidence. He shared an anecdote from his medical training in New York, where his professor dismissed a drug recommendation because it lacked scientific backing, even though it had been taught to Jayadevan by another professor. Jayadevan explained, 'That's the point here, even in modern medicine, we must improve scientific temperament.'
He emphasized that modern medicine is built on evidence and transparency, including explicit documentation of side effects, which is often missing in alternative systems. He warned against the illusion of safety in traditional treatments and shared that some liver transplants today are necessitated by unregulated herbal medicine use.
As discussions continue around this proposal's implications for future medical education in India, it remains clear that any changes must prioritise patient welfare above all else while ensuring rigorous standards are maintained across all forms of medical practice.