Research Roadmap

Ayurvedic Perspectives
Vaidya P. Rammanohar
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VATA PITTA KAPHA SATVA RAJAS TAMAS CETANĀ
ĀDHIBHAUTIKA ĀDHIDAIVIKA ĀDHYĀTMIKA
ĀYURVEDA ĀROGYA AYURVEDA SVĀSTHYA YOGA
Physical Science, Psychology, Sociology, Spirituality,
Biology, Medicine Anthropology Parapsychology
LIFE HEALTH WELLNESS
HARD SCIENCE SOFT SCIENCE TRANS SCIENCE
YUKTIVYAPĀŚRAYA DAIVAVYAPĀŚRAYA SATVĀVAJAYA
 Correct understanding of texts

Jñānaṃ
DOMAIN KNOWLEDGE
Study of authentic texts Investigation
पूवर्माप्तोपदे शाज्ज्ञानम्।।

Āptopadeśa Parīkṣā
REVIEW OF LITERATURE RESEARCH QUESTION/HYPOTHESIS
आप्तस्तावद् यथाथर्वक्ता ।। ततः प्रत्यक्षानुमानाभ्यां परीक्षोपपद्यते।।

Codification of knowledge Direct Perception

Tantraracanā Pratyakṣa
PUBLICATION OBSERVATION/DATA COLLECTION
िस्थत्यथर्मायुवेर्दस्य तेऽथ तन्त्रािण चिक्ररे।।
प्रत्यक्षं तु खलु तद्यत् स्वयिमिन्द्रयैमर्नसा चोपलभ्यते।।
Practical Applications Inference based on perception

Yukti Anumāna
EVIDENCE BASED PRACTICE DATA ANALYSIS/INTERPRETATION
िसिद्धयुर्क्तौ प्रितिष्ठता ।। Validated Knowledge अनुमानं खलु तकोर् युक्त्यपेक्षः।।

Vijñānaṃ
HIERARCHY OF EVIDENCE
िवना तकेर्ण या िसिद्धः यदृच्छािसिद्धरेव सा ।।
 Correct understanding of texts

Jñānaṃ
DOMAIN KNOWLEDGE
Study of authentic texts Investigation
पूवर्माप्तोपदे शाज्ज्ञानम्।।

Āptopadeśa Parīkṣā
REVIEW OF LITERATURE RESEARCH QUESTION/HYPOTHESIS
आप्तस्तावद् यथाथर्वक्ता ।। KNOWLEDGE ततः प्रत्यक्षानुमानाभ्यां परीक्षोपपद्यते।।

Codification of knowledge BUILDING IN AYURVEDA Direct Perception

Tantraracanā Pratyakṣa
PUBLICATION OBSERVATION/DATA COLLECTION
िस्थत्यथर्मायुवेर्दस्य तेऽथ तन्त्रािण चिक्ररे।।
प्रत्यक्षं तु खलु तद्यत् स्वयिमिन्द्रयैमर्नसा चोपलभ्यते।।
Practical Applications Inference based on perception

Yukti Anumāna
EVIDENCE BASED PRACTICE DATA ANALYSIS/INTERPRETATION
िसिद्धयुर्क्तौ प्रितिष्ठता ।। Validated Knowledge अनुमानं खलु तकोर् युक्त्यपेक्षः।।

Vijñānaṃ
HIERARCHY OF EVIDENCE
िवना तकेर्ण या िसिद्धः यदृच्छािसिद्धरेव सा ।।
 Āptopadeśa Literature Review

पूवर्माप्तोपदे शाज्ज्ञानम्।।
Jñānaṃ Up to date Knowledge

Parīkṣā Research Question/Hypothesis

ततः प्रत्यक्षानुमानाभ्यां परीक्षोपपद्यते।।

Pratyakṣa Observation/Data Collection

Anumāna Data Analysis/Interpretation

परीक्ष्यकािरणो िह कुशालाः भविन्त ।।

Vijñānaṃ Validated Knowledge

िसिद्धयुर्क्तौ प्रितिष्ठता ।। Yukti Translation to Practice

िस्थत्यथर्मायुवेर्दस्य तेऽथ तन्त्रािण चिक्ररे।। Tantraracanā Publication

RESEARCH ROAD MAP

OBSERVATION

BASIC RESEARCH IN AYURVEDA EXISTENT NON EXISTENT

SUBSTANCE ABSOLUTE

ENUMERATION PROPERTY PRIOR

VERBAL TESTIMONY ACTION POSTERIOR
DEFINITION
SIMILARITY MUTUAL
INFERENCE
INVESTIGATION DISSIMILARITY
PERCEPTION
INHERENCE

DEFINITION:
AVYAPTI, ATIVYAPTI, ASAMBHAVA VIMUKTA
ASADHARANA DHARMA
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BHAVA AND ABHAVA

▸ BHAVA PADARTHA means that which has existence and

can be experienced.

▸ ABHAVA PADARTHA means that which does not have

exisence.

▸ BHAVA PADARTHA has three characteristics

▸ ASTITVA - Existence, JNEYATVA - Knowability,

ABHIDHEYATVA - Nameability
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CRITICAL STUDY OF TEXTS

▸ Padaccheda - Splitting words

▸ Padārtha - Deriving the meanings

▸ Vākyayojanā - Forming sentences

▸ Vākyārtha - Deriving sentence by sentence meaning

▸ Ākṣepa - Refuting, questioning the statements

▸ Samādhāna - Finding answers for the refutations,

questions
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THE METHOD OF SASTRA

▸ UDDESA - Listing the objects of knowledge

▸ LAKSANA - Describing and defining the characteristics of

the objects of knowledge

▸ PARIKSA - Confirming and verifying the existence of the

objects of knowledge by experience
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CHARACTERISATION OF SUBSTANCES, PROPERTIES AND ACTIONS

▸ Characterisation is done by LAKSANA

▸ LAKSANA means to reveal the ASADHARANA DHARMA or

unique characteristics

▸ It should be devoid of the defects of AVYAPTI (it is only partly

applicable to the object being described), ATIVYAPTI (it is
applicable to even objects other than being studied),
ASAMBHAVA (it is not applicable to the object being described)

▸ Cow has white skin, Milk is liquid, Humans have horns

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CHANCE VS REAL EFFECT

▸ The Caraka Samhita distinguishes between chance effect and real effect of
an intervention.

▸ Chance effect is known as यदृच्छािसिद्धः and real effect is known as

प्राितिनयिमकिमकी िसिद्धः

▸ A physician is expected to substantiate the outcomes of each clinical

encounter with proper rationale and evidence.

▸ Claims of efficacy not backed up with evidence are to be dismissed as

chance effects - िवना तकेर्ण या िसिद्धः यदृच्छािसिद्धरेव सा

▸ The physician has to distinguish between self limiting diseases, placebo

effect and spontaneous remission as well as incurable and curable diseases.
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COINCIDENCE VS CAUSATION

▸ Coincidence is not causation

▸ Coincidence, correlation and causation - साहचयर्, व्यािप्त,

परामशर्

▸ Sensitivity and Specificity of variables - अव्यिभचािरत्व,

अिवनाभावसंभन्ध

▸ Concept of positive and negative controls - पक्ष, सपक्ष, िवपक्ष

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RELATIONSHIP BETWEEN VARIABLES AND MARKERS

▸ Avinabhavasambandha - The variables/markers are always

seen together.

▸ Avyabhicāritva - The dependent variable is seen only with

a specific independent variable.

▸ Ayutasiddhatva - When the independent variable is

absent, the dependent variable must become absent.

▸ Causation can be confirmed only by testing these

elements.
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SAFETY AND EFFICACY

▸ Safe and efficacious interventions - शुद्ध and िसद्ध प्रयोगा:

▸ There is no safe substance - न च िकंिचददोषिनगुर्णम्

▸ Unknown substance not to be used, known substance not to be

abused, slow growth of pharmacopoeia

▸ Combination, processing and application to enhance safety

▸ Risk assessment and exposure, risk benefit ratio

▸ Iatrogenic diseases िमथ्योपचारजन्यव्यािध, Adverse events व्यापत्

▸ Public warning against irrational use of drugs by physicians

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TWO STEPS IN PHARMACY

Study of Individual Drugs N Ā M A R Ū PA G U Ṇ A

N O M E N C L AT U R E I D E N T I F I C AT I O N PROPERTIES

Study of Combining Drugs YUKTI

A P P L I C AT I O N S
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CRITERIA FOR ACCEPTANCE OF DRUG SOURCES IN AYURVEDA

N O M E N C L AT U R E I D E N T I F I C AT I O N PROPERTIES A P P L I C AT I O N S

Codification of Botanical Physico-Chemical Classification

Names features Properties
Disease Target
Cross linking and Differential Bio-transformation
enumeration of names properties of Pharmacology Formulation
parts
Target
Classification of Pharmaceutical
Varieties
Nomenclature Risk Benefit Analysis Processing
Related species
Interactions with
Descriptive Analysis Dosage Form
other herbs,
of Names Substitutes antagonism, synergy Mode of
Interactions with Administration
Adulterants foods Individualisation
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COMPLEX FORMULATIONS TO ISOLATED MOLECULES

Formulation with ▸ In Ayurveda, complex system of combinatorics
and pharmaceutical processes are used to
many ingredients develop formulations from plant, animal and
mineral sources.
Simplified to few
▸ Chemically, these are very complex mixtures of
ingredients molecules.

Broken down to ▸ Each herb is a complex soup of chemicals and

formulations may contain as few as two or
phytochemicals three herbs to nearly hundreds of herbs.

▸ Modern research on Ayurvedic drugs have

Fractionation almost always focussed on simplification,
reducing the complexity rather than
attempting to understand it.
Isolation
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Super Formulation
(More than 30 Ingredients)

Complex Formulation
(11 to 30 Ingredients)

Simple Formulation
(2 to 10 Ingredients)

Single Ingredients

Phytochemicals

Fractions

Single Molecules
TEXT

Biomedicine Ayurveda
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EVIDENCE BUILDING IN THE TRADITION OF AYURVEDA

Individual Herbs Clinical Practice
Nomenclature, identity, properties, applications

Methods of Combination Outcomes Analysis

Friend, Enemy, Neutral

Methods of Processing
Ruling out chance
Bioavailability and targeting

Developing Formulations
Rationale
Individualisation
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CRITICAL STUDY OF CLASSICAL TEXTS

▸ The Ākṣepa Samādhāna approach.

▸ All statements in texts are subject to critical analysis and

questioning.

▸ Questioning the fundamental tenets could be assignment

for students.
RESEARCH ROAD MAP

TESTABLE HYPOTHESES

▸ Based on Ākṣepa-Samādhāna approach, testable

hypotheses can be formulated based on the fundamental
principles of Ayurveda.

▸ Appropriate methods can be incorporated from modern

research to develop experimental models.
RESEARCH ROAD MAP

DRUG FORMULATIONS

▸ Addressing complexity of Ayurvedic formulations.

▸ Critical analysis of Ayurvedic formulations, based on King

and Courtiers approach, Pradhana-Apradhana approach.

▸ Developing testable hypotheses regarding interaction of

multiple ingredients in a formulation

▸ Incorporating suitable methods from modern disciplines

to develop experimental models.
RESEARCH ROAD MAP

DIAGNOSIS OF AYURVEDA DISEASE CATEGORIES

▸ Clinically validated diagnostic criteria for diseases from

Ayurvedic viewpoint.

▸ Clinical consensus statements.

▸ Hypothetical criteria for diagnosis.

▸ Clinical validation.
RESEARCH ROAD MAP

DEFINING TREATMENT ALGORITHMS

▸ Treatment algorithms to be defined based on the

diagnostic criteria from Ayurvedic viewpoint.

▸ Identify areas where integrative care may be required.

▸ Designing complex clinical trials to test treatment

algorithms.
RESEARCH ROAD MAP

CLINICAL CASE REPORTS BASED ON CARAKA’S APPROACH

▸ Comprehensive documentation based on Ayurvedic and

Allopathic parameters.

▸ Clear demonstration of outcomes both positive and

negative

▸ Ruling out chance (yadriccha siddhi).

▸ Establishing the probability of the role of clinical

intervention (pratiniyamiki siddhi)