RANDOM MUSINGS

PART 1

First published in Brhat Dhiti online magazine on November 7, 2025

https://www.brhat.in/dhiti/the-mixing-of-ayurveda-and-allopathy-holistic-or-dangerous-part-one

Acknowledgements: The author extends heartfelt gratitude to Sri Chittaranjan Naikji, a distinguished engineer-turned-philosopher, whose books on Indian philosophy provide a crucial foundation for this article. The author also acknowledges Sri Chittaranjan Naikji for his meticulous review and insightful contributions to the article.

The Proposal: “Mixopathy” or Holistic? 

There is a recent proposal for an integrated mixed curriculum for Āyurveda and Allopathy (MBBS-BAMS program) in line with the National Education Policy (NEP) of 2020. The Central Government, via the Union Minister of State for Health and AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homoeopathy), announced the proposed integrated course in May 2025. The aim is to blend a vibrant traditional form of medicine with modern medicine, which currently dominates the healthcare landscape. This proposed holistic health approach has drawn vociferous criticism from the Indian Medical Association (IMA), the body representing allopathic doctors, who object to what they term ‘mixopathy’ and its consequent adverse effects.

Modern medicine encompasses foundational subjects such as anatomy, physiology, and biochemistry, which are broadly categorized as “preclinical subjects”. The clinical subjects include medicine, surgery, gynecology, and others. The Āyurvedic BAMS course lasts for a similar duration and covers roughly equivalent subjects. The overarching intention behind integrating the two systems is to provide comprehensive care for individuals and society, positing that the shortcomings of one system could be addressed by the other.

There are significant challenges in designing a combined curriculum and securing international recognition for such degrees. Drug interactions present a complex issue; in poly-drug therapy involving both systems, there is scant research, necessitating a fresh start. Allopathic doctors have largely opposed these initiatives, labeling them as unscientific and potentially compromising patient safety. There is a fierce debate from all sides. However, is such a combination feasible or even desirable? The answer, in a single word, is no. The primary reason for such an arrangement is the incommensurability of paradigms, and the most unfortunate consequence is the injustice it inflicts upon both systems.

Āyurveda: A Note 

Extreme claims, such as head transplantations, present an unbalanced view and, unfortunately, parody the strengths of Āyurveda. Āyurveda, at its core, is a tradition that spans at least 2,500 years and comprises two main schools represented by their foundational texts: the Caraka Saṃhitā and the Suśruta Saṃhitā. Records dating back to the 6th century BCE indicate that procedures such as limb amputations, fracture settings, haemorrhoid excisions, tonsillectomies, caesarean sections, craniotomies, abdominal operations, and stone removals were commonplace in India.

Caraka Saṃhitā, likely dating back to 500 BCE, consists of 120 chapters, divided into eight sections covering surgery, pediatrics, conditions of the head and eyes, mental diseases, reproductive systems, pharmacology, therapeutics, and toxicology. It details various plant products (including roots, bark, pith, exudation, stalks, juice, sprouts, fruit, flowers, ash, oils, thorns, and more), 165 types of animal products, and 64 minerals used for therapeutic purposes. This significant work was translated into Persian, Arabic, and Latin.

The Suśruta Saṃhitā comprises 192 chapters, with the initial nine devoted solely to surgical instruments. The colonial powers rediscovered Suśruta‘s plastic surgery techniques, particularly the method of rotating forehead skin flaps for reconstructions of amputated noses. This revelation came as a surprise when a potter in Pune successfully performed the procedure according to these ancient texts. Suśruta classified surgery into eight types: extracting solid bodies, excision, incision, probing, scarification, puncturing, evacuating fluids, and suturing.

Āyurveda posits that nature is the source of diseases, yet it also holds the remedy. Central to Āyurveda is the tridoṣa theory, which suggests that an imbalance in the body’s elemental composition—classified as vāta (air and space), pitta (fire), and kapha (water and gross matter)—leads to disease. Interventions aim to restore this balance. Despite differing guiding principles, Āyurveda as a medical system engages deeply with physiology, anatomy, and observational studies of diseases.

Āyurveda has maintained the notion of health as a condition of total physical, mental, and social well-being for millennia. Key principles, including the sāttvika diet, yoga, prāṇāyāma, and meditation, are integral to preventive medicine. Moreover, meditation and deep breathing are vital for mental and emotional well-being, offering solutions to various psychosomatic illnesses.

Ancient practitioners understood the use of intoxicating substances for anesthesia. While the atomic and germ theories underpin modern medicine, the ancient Vaiśeṣika philosophy alluded to atoms and molecules. Contemporary Āyurveda, however, adopts a systems approach, suggesting that a pure chemical may not be effective unless combined with other known and unknown substances. Concerning surgery and the management of more tangible matter, the prescribed procedures were grounded in well-organized anatomical, physiological, and surgical principles that have endured over time.

Dharampal, the British Records, and Colonial Consciousness 

Believing that everything from the past is “primitive” and viewing the present merely as a stepping stone towards a “progressive” future reflects a colonial mindset that hinders Indians from recognizing their traditional past and its accomplishments. Regrettably, few Indians are familiar with Dharampal and his influential works, such as The Beautiful Tree and Indian Science and Technology in the Eighteenth Century. The inclusion of this remarkable scholarship in our school curriculum would strongly change the misconception that Indians were a primitive people prior to colonial rule.

Beginning in 1964–65 and continuing for over a decade, Dharampal meticulously gathered archival British records from the remotest libraries in both India and England. The materials he unearthed significantly challenge the prevailing perceptions of Indian society. According to Dharampal, neglect, disdain, and economic disintegration had uprooted and erased indigenous sciences and technologies, not only from society but from the Indian collective memory as well. He asserted that Indian society was remarkably adept in the arts and sciences of its era, with an undeniable command over its immediate natural environment that warranted recognition.

Reuben Burrow (1790) remarks, 

“Hindoo religion probably spread over the whole earth; there are signs of it in every northern country and in almost every system of worship.” (A proof that the Hindoos had the Binomial Theorem, Asiatic Researches, 1799)

Burrow further posits in this essay that Stonehenge, arithmetic, astronomy, astrology, holidays, games, the names of stars and constellations, ancient monuments, laws, languages, and the Druids of Britain all have clear connections to the ‘Hindoo world’! 

In relation to pre-colonial Indian medical practices, Dharampal cites Dr. Helenus Scott in reference to Indians performing cataract surgery and the removal of renal calculi (stones) from time immemorial. Dr. Scott states that, “They practice with great success the operation of depressing the crystalline lens when it becomes opaque, and from time immemorial, they have cut for the stone at the same place that they now do in Europe.”

Dharampal also notes that inoculation using materials from diseased individuals to combat smallpox was nearly universal in many regions of Northern and Southern India until it was prohibited in several locations under the Bengal Presidency around 1802–1803. Ro. Coult (1731) writes, 

“The operation of inoculation, referred to by the natives as tikah, has been known for at least 150 years. Their method of performing this operation involves taking a small amount of pus and dipping it into the point of a fairly large, sharp needle. They make several punctures in the hollow under the deltoid muscle. If the punctures do suppurate and no fever or eruption occurs, then they are no longer susceptible to the infection.”

Holwell, for the College of Physicians in London in 1767, gave the most detailed account of inoculation practices in India, covering the timing, methodology, dietary restrictions, and other pre- and post-inoculation care. He believed that after the inoculation, one in a million people had a chance of contracting smallpox. He was impressed, and he wanted a more profound analysis of the procedure for application to the Western world. Importantly, Holwell’s account relates to the prevalence of some theories of bacterial infection. He stated that Indians believed “imperceptible animalcule” caused smallpox and other epidemical diseases. When taken in through food, they pass into the blood, where, at a certain time, their malignant juices excite fermentation and end in an eruption on the skin.

The Superintendent General of Vaccine Inoculation in 1804 thought that fatalities among the inoculated were around 1 in 200 and 1 in 60–70 for Indians and Europeans, respectively, unlike the one in a million believed by Holwell. British rule changed the status of vaccination as a universal practice. Public revenues financed inoculators in India, and when the British precipitated a collapse in the fiscal system, it likely led the inoculators to seek employment in other fields. 

Europeans began to view practices that were universally effective as hazardous. The frequent smallpox epidemics in the nineteenth and early twentieth centuries largely trace back to the state’s indifference to universal inoculation. Despite the prohibitions, the indigenous inoculation continued discreetly until approximately 1870. Edward Jenner (1749–1823), much later, took credit for developing the first vaccine for smallpox from cowpox pustules in 1796. Thus, inoculation was one indigenous medical practice that pre-dated the Western medical practice and is now a universal standard of healthcare. The well-established and highly effective Indian inoculation practice remains a blip in the history of Indian medicine and the consciousness of most Indians. 

The Philosophical Underpinnings of Indian Traditional Sciences

Vedas and Upavedas

Fundamentally, Āyurveda belongs to the category known as “traditional sciences”, while contemporary medicine falls under the category of “modern sciences”. René Guénon (1886-1951) adeptly elucidates the distinctions between these two categories in his seminal work, The Crisis of the Modern World (1927). At a fundamental level, the “traditional sciences” derive from ultimate metaphysical doctrines, whereas the “modern sciences” begin with an atomic understanding of matter and its applications. The former adopts a top-down approach, starting from Unity, dividing into a world of multiplicity, and ultimately converging back towards that Unity. In contrast, the latter confines itself to the realm of matter, characterized by increasing multiplicity and division, while lacking the guiding principle of higher unity.

The four puruṣārthas (objectives of human life) represent a foundational metaphysical doctrine within Bhāratīya philosophy. These are dharma (duty), artha (material wealth), kāma (desires), and mokṣa (liberation). The extensive body of knowledge known as the Upavedas (upa meaning ‘secondary’ to the Vedas) primarily addresses artha and kāma (the outer world), while the Vedas focus on dharma and mokṣa (practices for the inner realm of self-realization). Naturally, there are areas of overlap between these.

Consequently, each Upaveda, which pertains to the material world, is grounded in one or two of the principal Vedas. The Vedas consist of four texts: Ṛg, Yajur, Atharva, and Sāma. The overarching philosophy of the Upavedas is to use the material world to achieve the ultimate transcendental realm. Thus, āyurveda, being an Upaveda, has a significant teleological role in maintaining the health of individuals, facilitating their journey towards the final state of mokṣa.

For the sake of completeness, the four principal Upavedas are:

• Āyurveda, the medical and surgical science, is associated with the Ṛgveda and Atharvaveda. 
• Arthaveda encompasses subjects related to economics, political science, law, ethics, constitutional studies, defense management, sociology, trade, commerce, and both civil and military engineering; it is linked to the Yajurveda. 
• Sthāpatyaveda, which pertains to engineering and architecture (derived from the Atharvaveda). 
• Gāndharvaveda, which represents the wisdom of arts and crafts (associated with the Sāmaveda). 

Traditional and Modern Sciences: The Work of René Guénon 

Traditional and modern sciences may address the same issue at the gross level, such as the human body in medical sciences; however, their foundational principles differ markedly. The following section summarizes and paraphrases René Guénon’s thoughts regarding the distinction between these two major concepts. This understanding lies at the heart of the problem of the incommensurability of paradigms.

There are two radical and mutually incompatible conceptions of science: traditional and modern. Traditional sciences continue to exist in the East today, whereas they were present in the West only during antiquity and the Middle Ages. “Traditional sciences” represent changes in the form of an intact metaphysical doctrine. In traditional civilisations, all knowledge derives from or applies to the “core” of intellectual intuition or pure metaphysical doctrine. Relative knowledge in areas such as social institutions and sciences is a dependency, prolongation, or reflection of absolute knowledge. 

The relative, while not non-existent, occupies its rightful but secondary and subordinate place. Sciences and social institutions exist within a realm of form and multiplicity. In modern sciences, a build-up of intricate knowledge is incomprehensible in its entirety. The plethora of detailed knowledge fails to recognise the higher principle of unity.

The traditional conception ties all sciences as particular applications to the principles. For Aristotle, physics is secondary to metaphysics, with higher principles existing above nature and reflected in its laws. In contrast, the modern conception asserts the independence of various sciences and dismisses anything that transcends them as ‘unknowable’. Western science primarily seeks practical applications. Modern science, deeply entrenched in change and lacking a definitive starting point, reduces itself to probabilities, approximations, or hypothetical constructs. Any coincidental alignment with traditional sciences has no meaning. Ancient teachings require no such validation, and attempting to reconcile two disparate paradigms is futile.

Modern scientific conclusions, many times temporary, exist within the realm of hypothesis, while traditional sciences represent the undeniable outcomes of intuitive metaphysical truths. Modern experimentalism has the misconception that facts can substantiate a theory. However, various theories invariably fit the same facts, and at times, preconceived theories assist in their elucidation — the theory-ladenness of observation. Traditional sciences enabled experimental investigations strictly within the confines of higher knowledge.

Traditional science reflects not only higher knowledge within a domain but also facilitates the attainment of that knowledge itself. Traditional sciences are thus often referred to as “sacred” sciences with these two complementary roles. In contrast, modern or “profane” sciences are incapable of fulfilling either function. 

The traditional perspective views knowledge as either unfolding (or descending) from foundational principles to practical applications or as an acquisition (or ascending) from lower levels of understanding to higher ones. Sacred science is finally grounded in universal principles, intellectual intuition, and the most direct and profound knowledge. Consequently, any science can transform into a sacred science if higher knowledge remains in view. From the traditional standpoint, every science ultimately attains this unity.

The ‘profane realm’ is not opposed to a ‘sacred realm’; rather, it represents a ‘profane perspective’ or ignorance of anything beyond the lowest level of reality. By severing all ties with transcendent truth and supreme wisdom, modernity amasses vain and illusory knowledge that emerges from imaginary speculation, which would ultimately pose an obstruction to ascending to higher knowledge. This approach exemplifies the ‘rationalist’ error of entirely denying intellectual intuition.

Commenting on the above passage, philosopher Chittaranjan Naik draws attention to a slight variation in the Bhāratīya perspective. He says that: 

“In Indian traditions, knowledge (vidya) is classified into two types: para vidya (the higher, transcendental) and apara vidya (the lower, related to the material world). Indian tradition does not assert that all apara vidyas, although derived from the Vedas, necessarily lead to the attainment of higher knowledge. Therefore, apara vidyas can be further divided into two categories. Some are part of the six darshanas and serve as auxiliaries to para vidya, acting as complementary aids in the pursuit of higher knowledge. Other apara vidyas—such as Ayurveda, Dhanurvidya, Gandharvashastra, and those associated with metallurgy, engineering, architecture, shipbuilding, etc.—may not directly contribute to higher knowledge but do not obstruct its acquisition. In contrast, the so-called profane sciences, including allopathy, physics, quantum physics, chemistry, and even AI, could hinder the pursuit of higher knowledge.Indian traditions maintain that the lower vidyas, even if not helping directly, do not obstruct an individual (Jiva) when the time comes to ascend to higher knowledge. Consequently, all apara vidyas are regarded as “sacred sciences” because they are grounded in the Sacred Word, the Vedas, whose truths are self-established (svatah-siddha), rather than due to the apara vidyas having complementary roles.Conversely, the profane sciences are often based on principles that contradict the truths found in the Sacred Word or deviate from its intended meaning, thereby significantly hindering an individual’s pursuit of higher knowledge. For instance, a blending of Ayurveda and Allopathy would result in a discipline that loses the sanctity of being a “sacred science” and devolves into a “profane science”. This illustrates the fundamental issue with all profane sciences: the belief in the truth of their postulates can become an obstruction to the quest for higher knowledge.”

Science Versus Metaphysics 

Many have written extensively on this subject, but Venkat Nagarajan, in his incisive article, The False Supremacy of Science, summarizes why science and metaphysics cannot be directly compared because they approach reality from fundamentally different perspectives. In modern scientific philosophy, the validation of scientific theories was initially based solely on empirical evidence. However, revolutionary changes in scientific thought replaced this reliance with the criterion of falsifiability, which recognized that any current theory could potentially be disproven by a competing one in the future. A typical example is the replacement of Dalton’s atomic model by Niels Bohr’s atomic model.

A scientific theory or hypothesis invariably links to a series of supporting premises, which limits this argument. Consequently, any falsifying evidence or observations may invalidate at least one of these supporting assumptions without necessarily disproving the theory itself. Subsequently, an attempt was made to argue that scientific theories could be shown to be conditionally true in a probabilistic sense based on empirical evidence. However, this argument also proved inadequate, as there are multiple ways to derive conditional probabilities, and there is no definitive basis to assert that one method of derivation is correct.

As Nagarajan points out, all efforts to establish the supremacy of science over metaphysics have ultimately failed. Therefore, one cannot make such claims without making a value judgment regarding the superiority of some form of intersubjective empirical verifiability. Such assertions of supremacy are not grounded in logic but rather in faith or belief.

Vedānta defines “Being” as Consciousness or the knowing Self, a concept that science does not recognize. The standard scientific-materialistic view posits that atoms, molecules, compounds, matter, life, mind, and consciousness evolve in that specific order. In evolutionary terms, life is often viewed as purposeless and accidental. In contrast, metaphysical systems attribute meaning and a definite purpose to life. These more holistic systems emphasize first-hand experience and unexplained phenomena in elucidating reality. Thus, science and metaphysical interpretations of reality are mutually exclusive theories that co-exist, with the choice of belief being an individual prerogative. Assumptions and value judgements underpin all scientific theories, while metaphysics rests upon the unshakeable foundation of Unity.

Bhāratīya philosophy distinguishes between parā vidyā and aparā vidyā, referring to the knowledge of the higher Self and the knowledge of the external material world, respectively. A fundamental tenet of Indian knowledge systems is that these two forms of knowledge are not antagonistic; rather, they are manifestations of a single unity, known as Brahman (or the Self or Consciousness). In this perspective, there is a profound spiritualization of every aspect of aparā vidyā (all secular activities that engage with the material world). The perceived antagonism between the ‘word of God’ and the ‘word of science’ does not exist within Indian knowledge systems. Most secular activities ultimately seek the unity that connects parā and aparā. In contrast, science, as popularised in Western culture, seeks unity solely within the realm of aparā, or the material world.

The Incommensurability of Paradigms 

V. Srinidhi (Engagements Between Ayurveda and Biomedicine: Practice, Policy, and Philosophy, 2018) outlines three fundamental principles of modern medicine, or biomedicine: 

1) The body is analogous to a machine and is a sum of its individual parts;  

2) Biophysical factors are the sole determinants of health and disease; and  

3) Knowledge is derived exclusively from observations, the validity of which is contingent upon adherence to the first two principles.

In Indian knowledge systems, which operate in a top-down manner, the prerequisites for studying Āyurveda include a comprehensive understanding of Saṃskṛta and a profound familiarity with Indian philosophical schools, primarily nyāya (the Indian equivalent of logic). This requirement is akin to necessitating knowledge of chemistry, physics, or English before pursuing modern medicine.

The foundational paradigm of Āyurveda begins with the primary nature of singular Consciousness and the secondary nature of mind and matter. Bhāratīya darśanas, despite minor variations, position consciousness (self, brahman) as the sole fundamental reality, from which ego, mind, and matter emerge in succession. In contrast, modern medicine prioritizes matter, progressing from atoms to molecules, then inorganic matter, organic matter, life, the brain, the mind, and ultimately consciousness. Thus, consciousness is regarded as secondary to increasingly complex forms of matter, which starkly contrasts with the paradigms of Bhāratīya darśanas that underpin Āyurveda. This conceptual attitude embodies a fundamental divergence between modern medicine and Āyurveda.

In Āyurveda, the mind is viewed as an essential and integral component of health and disease. In the Caraka Saṃhitā, although the mind is treated as a distinct entity from the body for analytical purposes, it is physiologically and therapeutically intertwined with human health and disease. Therefore, studying Āyurveda as an independent discipline, detached from the broader Saṃskṛta corpus encompassing mind and spirituality, undermines a more holistic understanding of Indian medicine. Srinidhi ultimately indicates that the levels at which the causal models of Āyurveda and biomedicine operate require careful interpretation; Āyurveda addresses the level of causes, whereas biomedicine focuses on effects.

Āyurvedic texts delineate three sources of knowledge: pratyakṣa (direct perception), anumāna (inference), and āptopadeśa (the teachings of an āpta or authority). Concerning the latter, the highest authority is the Veda, which, in most Indian schools, is regarded as apauruṣeya (non-human origin). As a result, the foundational principles (ontology) and methodologies for acquiring knowledge (epistemology) differ markedly between Āyurveda and modern medicine.

While the first two sources of knowledge are generally uncontroversial, the third source (āptopadeśa) and the fundamental ontology (consciousness as primary; mind-matter as secondary) are not derived from empirical observation but are viewed as revealed knowledge. In other words, only a qualified authority or an āpta can impart the theory of tridoṣa, its characteristics, the causal links, and the existence of metaphysical entities such as the soul and the mind. Nonetheless, direct observation and logic must be employed when diagnosing and developing a treatment protocol for a patient.

To explain why direct observation and logic are required in Indian philosophy as well as in Indian science would require a detailed analysis of what is called a priori knowledge and a posteriori knowledge in Western philosophy. In short, the two are not different kinds of reasoning (the one attributed to intuition and the other attributed to what is obtained from experience) as it is believed in Western philosophy. In Bhāratīya philosophy, these are two aspects of the same logic as applied to two modes of existence in order to make knowledge veridical. 

Āyurvedic treatment relies more on principles and the directly observable imbalances in doṣas than on providing specific prescriptions. It is up to the individual practitioner to exercise their judgment by analyzing various factors and selecting the appropriate remedy. Āyurveda addresses both health and disease, focusing on whole entities—such as a food item, an herb, or an individual—rather than on isolated parts. It posits that a comprehensive understanding of medical conditions and healthy behaviors can be derived from the first principles.

The system encompasses metaphysical elements, including divine cures, as well as non-biological aspects like the mind and the soul. Nonetheless, it permits an analytical framework where physical and biological factors can be examined independently. While emphasizing the value of the texts, it offers opportunities to interpret their meanings, particularly in practical contexts and in relation to other texts within the Saṃskṛta corpus. These factors likely contribute to the critique of Āyurveda as a non-falsifiable belief system rather than as a knowledge system open to ‘scientific’ inquiry.

PART 2

Ontology, Epistemology, and Consciousness in Western and Indian Philosophies 

Indian and Western philosophies differ significantly on numerous issues. As philosopher Chittaranjan Naik explains in his books, Consciousness (with a capital C)—also referred to as the Self, Puruṣa, or Cognizer—underpins the entire ontology and epistemology of Indian traditions and sciences and is considered primary. In contrast, it is viewed as secondary to matter in Western traditions. The concepts of the Self and mind-matter are categorically distinct; the former represents the sentient “cognizer”, while the latter embodies the insentient “cognized”. Mind and matter serve as the two modes through which objects of cognition manifest, revealing what can be understood as legitimate objective reality. In Western philosophy, consciousness emerges as a secondary outcome of matter, which begins with fundamental building blocks such as atoms, quarks, or strings.

In terms of ontology, the prevailing Western paradigm for perception involves light striking an object, reflecting onto the retina, and the resultant image being transmitted to the brain via neural impulses, followed by reconstruction of the image within the brain. This sequence applies uniformly across all senses. This “stimulus-response theory of perception” posits that perception is merely a response occurring within our brains, mediated by an intermediate causal chain. 

However, this framework raises challenges in elucidating how an internal image in the brain projects to the external world. Consequently, the perceived world is viewed merely as an internal representation of an external reality, rendering it an indirect form of reality. That which exists outside remains unknowable. This standard model of representation thus fails to adequately address the subject of ontology (reality), as the true nature of the world (noumenon) always eludes our comprehension. What we perceive consists solely of phenomena.

Conversely, Indian philosophy advocates for an active theory of perception in which the perceiver occupies a central role. The perceiver actively engages with the object in the world. This “contact theory of perception” posits that direct contact with an object provides the perceiver with genuine information about the world as it exists. As a result, the external world, whether seen or heard, is regarded as an actual reality rather than a mere construct. This perspective demonstrates the value of pratyakṣa, or direct perception, as a valid pramāṇa, or means of knowledge. This viewpoint stands in stark contrast to Western philosophy, which asserts that the external world can never be fully known; thus, perception is not considered a reliable source of knowledge in Western traditions.

When discussing epistemology—the method of acquiring knowledge—the conventional definition in Western philosophy is justified true belief (JTB). Edmund Gettier highlighted various problems with this framework of knowledge. In Indian traditions, knowledge is regarded as the supreme ideal. One of the attributes of Brahman, or the Self, which underpins the universe, is knowledge; thus, the pursuit of knowledge is viewed as the most divine endeavor within human pursuits.

Any knowledge must have a certain means of acquisition. Pramāṇa (proof or a valid ‘means of true knowledge’) plays a crucial role in Indian philosophical traditions. There are six pramāṇas, with the first three being the most significant: perception, inference, and testimony of reliable authorities, along with comparison and analogy, postulation, and non-perceptive negative proof. It is surprising that the West, which prides itself on numerous scientific and technological advancements, lacks a comprehensive theory of knowledge. The criteria for what constitutes scientific validity have undergone repeated revisions, too, as seen previously. In contrast, Indian science and traditions uphold verifiability as the criterion for acquiring knowledge.

Brahman, or the self, characterized by the primary attributes of knowledge (sat), truth (cit), and bliss (ānanda), serves as the foundation for both epistemology and ontology within Indian traditions. The ontology, or perception of reality, is an inside-out process that begins with the Self, which directly engages with the objects of perception. Knowledge of any object in the parā or aparā realm provides access to Brahman. Consequently, any activity in any domain can serve as a pathway, at least not an obstruction, to mokṣa in Indian knowledge traditions.

Yoga 

Yoga is a philosophical system comprising graded steps aimed at attaining knowledge of the immortal Self, which liberates individuals from the constraints of nature. Both orthodox (Nyāya, Vaiśeṣika, Yoga, Saṅkhya, Mīmāṃsā, Vedānta) and non-orthodox (Buddhist, Jain) Indian schools—excluding atheism—place significant emphasis on yoga and meditation within their frameworks. The initial five components of yoga serve as preparatory stages for higher states: yama, niyama, āsana, prāṇāyāma, and pratyāhāra. The first two—yama and niyama—focus on controlling desires and emotions, while the next two—āsana and prāṇāyāma—address disturbances originating from the physical body. Pratyāhāra involves detaching the sense organs from the mind, effectively severing the connection to the external world and its impressions.

Following this preparatory phase, the last three aṅgas (or limbs) are dhāraṇa, dhyāna, and samādhi. Dhāraṇa entails concentrating the mind within a limited mental space; dhyāna represents an uninterrupted flow or contemplation directed towards an object of meditation; and the final state, samādhi, is characterized by a consciousness solely of the object of meditation, devoid of any awareness of the mind. In this state, the mind merges into the ultimate experience of samādhi.

Do these states yield knowledge of the mundane world? The Yogic perspective affirms this, as elucidated by Ramakrishna Puligundla in his seminal work, Fundamentals of Indian Philosophy. Samādhi encompasses progressive stages known as savitarka and nirvitarka, according to Patañjali. In the savitarka state, knowledge manifests at three levels: śabda (knowledge based on words), jñāna (knowledge derived from perception and reasoning), and artha (intuitive knowledge of the object in its essence). In the final nirvitarka state, the yogī achieves unity with the Supreme Consciousness. The savitarka state, particularly its jñāna component, allows for the formation of conceptual knowledge. As articulated by Patañjali, the highest state does not facilitate knowledge of individual objects; however, the yogī can, should they choose, access corresponding states of consciousness and attain worldly knowledge. 

Dean Ornish, in his book Dr. Dean Ornish’s Program for Reversing Heart Disease, presents compelling evidence-based arguments for his program, which integrates Indian yogic exercises, breathing techniques, meditation, and dietary practices to reverse heart disease. Most conventional interventions, such as aspirin, medications, stents, and surgery, at best, halt disease progression; they rarely accomplish reversal, as Ornish demonstrates in his work. He strongly advocates for these yogic methods in addressing heart issues. Nonetheless, to gain Western funding approvals, he had to rebrand the techniques with more secular-sounding terms, such as “alternate nostril breathing,” “forced breathing,” and “visualization” techniques.

The ongoing debate about whether yoga is an Indian tradition or a universal practice akin to the law of gravity has drawn attention from prominent figures on both sides. The confusion largely stems from the widespread applicability of āsanas and prāṇāyāma in promoting physical health. Viewed through this narrow lens of physicality, yoga can indeed be considered universal and beneficial for all individuals. However, when understood as a holistic philosophy, yoga is unequivocally Indian, with its ultimate aim being mokṣa, or liberation.

Western interpretations often selectively highlight certain aspects of the practice while overlooking the broader metaphysical context. Consequently, terms like “cardiac coherence breathing” are used to secularize these breathing and physical exercises. Such usage represents a form of appropriation without proper acknowledgement. Therefore, when discussing its origins, it is clear that yoga is fundamentally Indian, and drawing parallels to concepts like gravity is misleading. There is no ambiguity within the realm of modern Western science regarding Newton’s role in the discovery of gravity.

The concept of immortality, too, presents different perspectives within Western scientific materialism and Indian philosophy. In the former, which adheres to a single-life metaphysics, immortality is perceived as one continuous, deathless existence. Contemporary science and medicine strive towards this goal. While the duration of life is certainly increasing, its quality has yet to improve correspondingly. It is conceivable that, in a distant future, humans—provided they do not annihilate themselves—may attain a state of permanent youth with death being a choice rather than an inevitability. It would naturally follow that humans would need to seek extraterrestrial planets or moons to alleviate the strain on the resources of a single Earth.  

Āyurveda, in contrast, aligning with Indian darśanas, has multiple-lives metaphysics along with ideas like karma prevailing across many lives. The concept of immortality refers to a state of complete and everlasting happiness in which the striving jīva does not experience any further rebirth. Such ideals are in better harmony with nature and ecology, as well.  Modern medicine is perhaps a long way from achieving its goals. It is just possible that Āyurveda perfected its system thousands of years ago to serve human life. 

Surgery and Anesthesia: Challenging Questions 

From ancient times, India was renowned for performing a range of routine and complex surgeries, including plastic surgical procedures such as the use of rotational flaps from the forehead for reconstructing amputated noses. Ancient practitioners demonstrated considerable expertise in employing various wines and intoxicants for anesthetic purposes. However, at a certain point, modern medicine began to overshadow the natural evolution of surgery rooted in Āyurvedic principles, effectively stating, “Thank you, but we will take it from here.”

In contemporary times, envisioning how Āyurveda could re-establish its presence in the field of surgery appears challenging. Modern medicine has pursued a path of specialization to such an extent that it is often joked that there are now separate specialists for the right and left hands. The training, apprenticeship, accreditation, and advancements in areas such as antimicrobials, diagnostics, imaging, and anesthesia have reached extraordinary levels of complexity. From abscess drainages to organ transplantations, modern surgery in an operation theater provides a snapshot of the significant progress of human medicine over the centuries. The operation theater is the place where medicine and instrumentation engineering have the greatest interface.  

Such complexity raises questions about whether Āyurveda could gain access to these resources or if practitioners would be denied even basic tools like oxygen for treatment purposes. Moreover, it is noteworthy that, on numerous occasions, non-qualified personnel in the operating theater can perform remarkably well—sometimes even surpassing qualified surgeons—in both open and minimally invasive techniques.

An adage states, “Good surgeons know how to operate; better surgeons know when to operate; and the best surgeons know when not to operate.” The “how”, or technical aspect of surgery, ultimately hinges on practical skills honed through repeated practice, akin to any sport or skilled trade. Some of the best technical surgeons are, in fact, non-qualified people working under the supervision of qualified surgeons. In fact, there is a burgeoning international movement advocating for the official accreditation of technically proficient laparoscopic assistants.

Should this trend continue, it may not be far-fetched to envisage Āyurvedic doctors re-entering the surgical field at a more significant level. The “how” of surgery (broadly, trauma-related, extractive, excisional, reconstructive, or replacive) may be within the reach of Āyurvedic doctors because it is essentially a technical job. However, it would take a lot of work to see how paradigmatic differences could play in the “when” and “when not” of surgery. However, it requires extreme caution and thoughtful consideration to make such ideas a viable reality. Certainly, an outright condemnation is not required if Āyurveda practitioners want to gain surgical skills on a bigger scale. The Āyurveda department at the Banaras Hindu University in Varanasi does offer postgraduate courses in surgery. However, very few patients would approach an Āyurvedic surgeon today for their operative needs. 

Integration, Symbiosis, Assimilation, or Absorption: How do the Twain Meet? 

How can we integrate the two forms of medicine for both preventive and therapeutic aspects concerning individuals and the community? P. L. T. Girija, T. M Mukundan, and M. D Srinivas, in their work, Ayurveda for Revitalising Healthcare in India, propose several strategies. They argue that a careful study is essential for leveraging the strengths of both systems without fostering antagonism between them.

As a first step, they suggest that government expenditure on health should be increased from the current low level of 1% of GDP to at least 3% over the next eight years. Also, funding support for Āyurveda, which currently stands at 1.5%, should rise to at least 30% of the health budget. This is warranted, as the Āyurvedic system comprises over one-third of registered medical practitioners and one-fifth of undergraduate medical students and serves more than two-thirds of the population. The level of state support must be proportional to its significance and user base.

Rather than encouraging antagonism, the curricula of both Bachelor of Ayurvedic Medicine and Surgery (BAMS) and Bachelor of Medicine, Bachelor of Surgery (MBBS) should be designed to foster a more profound understanding of each system, promoting healthy interactions between them. Enhanced understanding would enable physicians to refer patients to a system more adept at addressing specific diseases, without worrying about the fundamental paradigms of the two systems. 

Āyurveda has a well-defined role in managing respiratory infections, viral fevers (such as chikungunya and dengue), and diarrhoeal diseases, which significantly contribute to morbidity and mortality in children. Furthermore, Āyurvedic treatments for autoimmune diseases and wound healing present additional opportunities for collaboration. Surgeons extensively use the Āyurvedic thread for treating anal fistulae.

The authors suggest integrating traditional bone-setters and midwives (dais) into the public health system. Allopathic doctors would highly debate the former, however. Āyurvedic nutritional strategies, refined over millennia, play a crucial role in addressing the needs of malnourished and anemic children and in managing lifestyle disorders. Consequently, they write that government hospitals and primary health care centers should ideally incorporate all branches of Āyurveda alongside their counterparts in modern western medicine (MWM). In 2003, Tamil Nadu successfully included Āyurveda and Siddha medicines in its Reproductive and Child Health Program, training 10,000 nurses to manage a medicine kit comprising 50 treatments for pregnancy and post-delivery care, as well as various diseases.

They also highlight that many individuals who are genuinely interested in and better prepared for the study of Āyurveda, such as students of Saṃskṛta, are denied admission to Āyurvedic courses. Given that Āyurvedic science is based on principles distinct from those of modern medicine, the existing admission criteria are flawed and require revision. The authors are concerned that the current syllabus for the bachelor’s degree in Āyurveda places greater emphasis on modern medicine than on Āyurveda itself. Consequently, many graduates possess incomplete knowledge of Āyurveda, undermining the integrity of Āyurvedic education and legitimizing ‘mixed practice’.

A significant shortcoming of the current curriculum is its conflation of both systems within the same paper, resulting in the potential for individuals to pass all examinations without adequately learning the Āyurvedic components. The BAMS course suffers from glaring deficiencies in Āyurvedic content, which poses a serious threat to the practice of Āyurveda in its own native land. Furthermore, the study of Saṃskṛta has been nearly rendered obsolete; yet, Saṃskṛta serves as the technical language of Āyurveda, with Nyāya-Vaiśeṣika providing its foundational logic. Rather than engaging in selective reading, there is a pressing need for undergraduate students to study the three principal canonical texts—namely, Caraka Saṃhitā, Suśruta Saṃhitā, and Aṣṭāṅgahṛdayam—in their entirety.

The National Health Policy of 2017 scarcely acknowledges Āyurveda. While it advocates for the optimal use of existing infrastructure, it appears oblivious to the significant manpower and resources within the Āyurvedic system that cater to the health needs of the majority of the population, despite receiving less than 1.5% of the government’s health budget. 

The authors encapsulate their position by asserting that Āyurveda constitutes a distinct medical science, possessing a valid yet fundamentally different understanding of health and disease. It does not employ the modern medical paradigm to comprehend ailments, nor does it rely on contemporary Western medicines for treatment. Consequently, the guidelines for accrediting AYUSH hospitals for insurance coverage should be developed in alignment with the principles of Āyurvedic science, aiming to genuinely promote Indian Systems of Medicine.

Concluding Remarks

A medical college dean’s suspension for permitting his students to recite the “Caraka Śapathā” reflects a profound colonial mindset. The oath is as relevant to India in its comprehensive reiteration of ethical principles as the Hippocratic Oath of contemporary medicine. Both oaths are non-binding and inadequate for today’s complex medical field, which has seen major scientific, economic, political, and social changes. Nevertheless, what accounts for the greater acceptance of the Hippocratic Oath compared to the perception of the Charak Oath as superstitious and unscientific?

A claim that Indians were aware of vaccination prior to Jenner is likely to provoke either disbelief or a condescending smile, suggesting an embellishment of the Indian historical narrative. A mentality shaped by colonial influences creates a formidable barrier. While Jenner may have independently discovered a method for vaccinating against smallpox, it is implausible to believe he was ignorant of the Indian inoculation practices in use, especially since the English were already documenting Indian advancements in their writings. Individuals like Holwell acknowledged the Indian contributions to vaccination, as highlighted by Dharampal (see Part 1). Regrettably, this Western validation seems to be the only way to persuade certain Indian sceptics.

As philosopher Chittaranjan Naik notes: 

In Indian vidyās, there is no such thing as a third-person account of knowledge. Knowledge is an attribute of the ātman, and it is always a first-person account. What is called a third-person account of knowledge is actually erroneous knowledge because it uses speculative approaches that tend to posit inexperiencable (unknowable) entities as ‘facts’ of objective knowledge from the third-person perspective. The world as described by means of a first-person account is exactly what Husserl calls the ‘life-world’. And the tridoṣa of Āyurveda is to be understood only through the first-person, which is what nyāya enables us to do. But nyāya requires knowledge of the padārthas—something to which we have become blind in the modern world. The two paradigms do not meet. And it is not necessary that they should meet because the vaidika paradigm provides the sciences (vidyās) necessary for leading even a secular life. The vaidika vidyās related to archery, architecture, metallurgy, engineering, agriculture, trade, Āyurveda, etc., are based on nyāya as the logical method of reasoning and Vaiśeṣika as the ontological framework into which the vidyās fit. The problem of paradigms does not have to do with integrating the spiritual and secular dimensions of life. It has to do with the devolution of human beings, the gradual degradation of their organic existence on earth, due to which they become progressively blind to the texture of human life and to the poetry of human existence. This mutation in human beings was not a blindness just to the poetry of human existence—it was also a blindness to the nature of the padārthas, the fundamental building blocks of logic. The onset of this blindness is when we had a ‘renaissance’ and started building the sciences afresh based on empiricism after rejecting the ‘authority of the tradition’. It is this new ‘science’ that is the root cause of the problem of paradigms because it is built on a different foundation.  There was never a need for this so-called ‘betterment of the human condition’. The vidyās we had were sufficient to lead a full life based on the four purṣārthas, even the secular aspects of it, such as the pursuit of kāma and artha. There was poetry and sacredness in every aspect of human life then. We are trying to make up for their loss through the so-called ‘amelioration of the material condition of man’ and such amelioration requires the new science for bringing about material progress and development, a science that is incommensurate with the timeless vaidika sciences belonging to a different paradigm based on the padārthas. It is perhaps not practical to go back to the idyllic kind of vaidika society we once had. However, the least we can do is not to mix up those sciences that have their roots in the sacred ṛta and the profane sciences based on nothing more than imaginative speculation and which are liable to promote the erosion of vaidika culture. Ultimately, ‘padārtha’, which means word-object, is based on the meaning of the vaidika word, which in its pure, unadulterated, unalterable form is known as ṛta. The new sciences, on the other hand, twist word-meanings and go on speaking about things like space being bent, etc. 

Western culture, as it has evolved in modern times, attempts to answer the question ‘why’ solely from material causes, and this has resulted in the rise of both science and atheism in such cultures.  The colonizers, entrenched in a Western worldview, adopted a “scientific” perspective that engendered a profound disdain for Indian traditions, including their medicinal practices, despite their significant advancements. Unfortunately, thinkers in the post-independence era have perpetuated this negative perception of traditional India. The narrative portrays the past as primitive, the future as golden, and the present as merely a transitional phase, reflecting a linear historical interpretation inherited from the West.

Āyurveda ought not to be evaluated through the lens of modern medicine, nor does it require validation from Western sources. We possess a medical system in which we can justifiably take pride. A constructive interaction between these two medicinal approaches holds considerable potential for enhancing the health and happiness of individuals and communities alike. Despite the potential conflict between fundamental paradigms, a proper understanding of both systems can lead to a beneficial interaction. In the realm of preventive medicine, a sātvika diet, breathing exercises, āsanas, and meditation provide results unattainable by modern medicine. Challenges persist within both systems. Engaging in healthy debate is always preferable to launching antagonistic critiques against one another.

The current BAMS curriculum requires significant improvements; however, the proposal to merge BAMS and MBBS into a single program is untenable and would result in considerable injustice to both fields. There is an urgent need to bring together genuinely concerned experts in Indian philosophy, Āyurveda, and modern medicine to forge a better path forward. National pride about Indian heritage without understanding the philosophical foundations of Indian civilization is certainly not the solution. 

References And Further Readings

1. Indian Science And Technology In The Eighteenth Century: Some Contemporary European Accounts by Dharampal (1971)
2. The Beautiful Tree by Dharampal (1983)
3. The Crisis of the Modern World by René Guénon (1927)
4. Understanding Hinduism: V. Foundational Texts of Hinduism by Shatavadhani Ganesh (2020)
5. Understanding Hinduism: VI. Bodies of Knowledge in Hinduism by Shatavadhani Ganesh (2020)
6. False Supremacy of Science by Venkat Nagarajan (2019) in Pragyata Online Magazine
7. Engagements between Ayurveda and biomedicine: practice, policy and philosophy: Doctoral Thesis at IIM-Bengaluru by V. Srinidhi (2018)
8. Natural Realism and Contact Theory of Perception: Indian Philosophy’s Challenge to Contemporary Paradigms of Knowledge by Chittaranjan Naik (2019)
9. On the Existence of the Self by Chittaranjan Naik (2021)
10. Fundamentals of Indian Philosophy by Ramakrishna Puligandla (1997)
11. Presuppositions of India’s Philosophies by Karl H. Potter (1963)
12. Dr. Dean Ornish’s Program for Reversing Heart Disease by Dean Ornish (1995)
13. Ayurveda for Revitalising Healthcare in India by P L T Girija, T. M. Mukundan, D. Srinivas (2025)
14. https://science.thewire.in/health/tamil-nadu-medical-college-dean-removed-for-administering-charak-shapath-to-new-students/
15. Reconceptualizing India Studies by S. N. Balagangadhara (2012)