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Research Methodology and Statistics Evident in Ayurveda Treatises

Dr. Asmita Wele
M.D. (Ayurveda) Rasashastra

The gold standard to judge the popularity and usefulness of any scientific branch is associated with the ongoing research activities in that branch. This is because active research indicates addition of new dimensions of applications, which in turn is a marker of liveliness, vibrancy and futuristic approach of the branch. Research in health sector is of the utmost importance pertaining to the immediate application of the outcome to relieve human beings from pain and agony. Amongst all the branches of science, medicine is the branch, which always receives high priority due to its potential to address and solve current health problems and issues.

In the course of development, about the understanding of human body and diseases over the last thousands of years, much water has flown under the bridge but the concept of gold standard remain unchanged. This is evident in a quote in Charaka Samhitaa that says the science that is practiced by the famous, successful, eminent people, praised by the intellectual class and is economically rewarding to the practitioner is the best one. The quote is just an example pointing towards the high status of Ayurvedain ancient times, which is generally achieved only when research is an integral part of the science. Available literary sources of Ayurvedanot only highlight the research attitude but also elaborate the methodology to the minutest details.

It is important to remember that research crux is palpable in the text all the time, indirectly. The difference is today methodology of research and statistics has become a consequential separate scientific branch associated with each respective segment of knowledge. Ample literature about how to conduct research with all aspect, is available in both text and digital form. This type of generation of literature pertaining only to research methods and statistics is not evident in Ayurvedic texts. Rather whatever is found scattered in Charaka Samhitaa the oldest document is not found with the same or more rigor in later Samhitaa_s like Sus`hruta Samhitaa and Asht`aanga Hridaya. Therefore Charaka Samhitaa is the main reference source for this article.

Introduction to concept:
The quest for knowledge generates out of inquisitiveness, which ultimately leads to better understanding and explanation of various phenomena. In all ancient sciences, the methods adapted to increase understanding or knowledge base, are mainly experiential, observational and inferential. In the process of development of knowledge the perspective regarding a scientific concept or criteria of classification may change based on the logical interpretations and experimental evidences. Ayurvedais no exception to the rule where the knowledge has developed according to the above-mentioned system prevalent in those areas. Thus in order to get an unbiased view of concepts of research in Ayurveda, it is a must to understand its background circumstances and situations.

Ayurveda was an oral tradition, which proliferated to the written tradition later on and currently it is being digitized to keep pace with time. Technologically the propagation of knowledge has always been at par. Questions arise about the correct understanding and interpretation of the contents of the revered science with changing circumstances. The education methodology earlier was teacher centered rather than learner centered. Methods of exchange of knowledge or testing, presentation and spread of new knowledge were relevant to those days. At times subjectivity used to take center stage on the practical level but the ultimate objective has always been to search and arrive at truth.

If we compare the process of development of research methods and associated activities of oriental sciences then we find a few difference. Till the seventeenth century the perspective towards development of knowledge was holisticthe world over. There was no need for separation or systemization of knowledge in a different way than the existing. But then the industrial revolution changed the traditional thought process in the west; with redefining concepts and introduction of methods of systematization; which was accepted in all fields, barring or rearranging of old principles, did not break the continuity of the understanding; instead of changed principles opened up new ways and dimensions that gave human race new tools and techniques. Change in the perspective of understanding of the science of materials and basic concepts in accordance with that gave rise to certain applications more supportive to technological development leading to a favorable atmosphere for experimental research process. Acceptance and application of the new concepts like the quantum theory, relativity principle or atomic structure in pure sciences provided a foundation for the development of experimental research techniques. True experiments were thus possible in all settings.

Here the difference in current and ancient science becomes starkly cognizable. Modern science started becoming more reductionisttrying to put one to one co-relation as against the traditions holistic approach of addressing complexity in one go. On the other hand the majority of the scientists from the traditional sciences did not take serious cognizance of the challenge posed by new or changed fundamentals and in turn did not make use of the new knowledge to interpret or contemporarizethe heritage they carried. They went in to a shell or in defensive state that has led to hazy and misguiding picture of Ayurvedafor a while. Thus being much practiced Ayurvedais always painted only as an inferential old science. Now the picture is changing. Therefore to find the facts and to assess where Ayurvedadoes stand today, in terms of research process some of the methods, which are reflected in Ayurvedaare elaborated below.

If someone has a question in mind like what are the principles of research in Ayurvedathen there is nothing such as principles of research of any science including Ayurveda. To find out the relationship between cause and effect is the only one principle of research common to science as a whole. Principles are of the science stream where one applies the mind to find truth or to solve a problem. Research is a science of methods employed to gain knowledge about a particular relationship based on principles related to that phenomenon. If someone aims at finding out how effective a new chemical is which when added to petrol, reduces consumption of petrol and increases mileage then this research is designed using principles of physics and chemistry. This is true about any research problem.

For convenience of understanding, approach of the present article is comparison and matching of current or modern knowledge about research with the same from three main treatises Charaka Samhitaa, Sus`hruta Samhitaa and Asht`aanga Hridaya.

Definitions and elaboration:
All the basic level research is defined as a process to find the truth. At the operational level the steps involved to find the truth are:

Conceptualization of an idea
Hypothesis development based on principles and theories supporting the hypothesis
Collection of data considering appropriate variables
Verification of hypothesis through experimentation and analysis of collected data
Acceptance or modification or rejection of hypothesis
Strengthening of the underlying principle

The exercise is completed with the help of tools. Depending on different kinds of applications theories differ and so also the tools. The whole process is interwoven in the treatises of Ayurvedaexcept for the conduction of experiments in todays sense. As mentioned earlier more explicit and aggregate elaboration about the theories is available in Charaka Samhitaa than in all the remaining treatises; with reference to contexts at various places. One has to compile without losing the reference and essence of the underlying thought.

The terms that reflect the above-stated phenomena are listed below with possible co-relation to current terms [italics indicate implied meaning]

  1. Unknown: Anukta: undocumented, in experienced, implicit. Completely new fact regarding disease manifestation, drug, instrument, technique etc.
  2. Research: Anusandhaana: synonyms: Anves`han`a, Gaveshan`a, Paryeshan`a
  3. Tools: Hetu or Upalabdhikaran`a or Karan`a. It includes four types of Pramaan`a. It is the theme explaining universal process of conduction and appraisal of any kind of research.
    Pratyaksha
    Anumaana
    Aitihya
    Yukti
  4. Materials and Methodology or factors of protocol development: Yukti is a process of management of thoughts, ideas, concepts and course of action.
    • Drug: Karan`a: Bheshaja: Medicine of all types, equipment, instrument etc. in case of raw drugs and formulations parameters of quality are expected to be specified.
      Points b and c together comprise selection and exclusion criteria.
    • Patient: Aaturades`ha or Kaaryades`ha: classification of patients depending on ten parameters. It is important to decide the dose of the medicine under study.
    • Disease specifications: Kaaryayoni.
    • Points d and e specify the study methodology based on rational considerations
    • Setting of study: Des`ha Adhisht`haana: geographical area or study location which gives an idea about the natural climatic conditions, as well as genetic or racial make up, of socio-economic status of the subjects in study. Identification of co-existence of humans and drug in a given setting is important from the viewpoint of symbiotic relationship. It is now accepted that these factors contribute to the efficacy, which is applicable to generalized assessment of mass health.
    • Time period of study:
    • a.    Kaala Rituayan Roopa Specific atmospheric conditions in different seasons have a role in efficacy and certain procedures related to Panchakarma as stipulated to be conducted in a specific season only. Moreover the prescription method of a medicine is expected to be stated here as it is closely associated with time of day and food intake in accordance with the type of disease
    • b.    Study duration
    • Conduction of study: Pravritti all the factors that take part in the study should be available and work in coordination. This may be interpreted as research management that includes data, funds, time and human resource.
    • Criteria of assessment: Kaarya–Anumaana The general characteristics indicative of quality of life should be considered but emphasis should be given to the change in the cardinal signs and symptoms of the disease.
  5. Results: Kaarya: Avasthaantara This is co-related with objectives for which research activity is conducted. This may be interpreted as expected effect / end result. Positive change in disease leading to promotion of health.
  6. Analysis: Kaaryaphala and Anubandha Confirmation of broader aim or baseline principle that is persistent for reasonable duration of time [efficacy]. The result may be good or bad. It is important to consider dimension of time to know recurrence or non-recurrence. Prediction of maintenance of healthy status after stopping of treatments.
  7. Discussion: Sambhashaa Vaada
  8. Conclusion: Siddhaanta or Nirn`aya
  9. Method of presentation:
    1. Oral: Sambhaashaavidhi Vaadamaarga: these are guidelines of oral presentation
    2. Written: Pratidnyaa Siddhaanta, Panchaavayava Vaakya: these are the criteria of good writing
    3. Method of critical analysis of research document: S`hastrapareekshaa, Tantrayukti, Tantra Dosha, Taachchhilya, Vyaakhyaa, Kalpanaa : these are guidelines and rules to be followed in assessment of scientific literature.
  10. Raw drug: Aushadha
  11. Concept of formulation development: Kalpanaa
  12. Formulation: Kalpa. A single finished drug or compound
  13. Drug activity parameters: Dravyakarma: Rasa, Gun`a, Veerya, Vipaaka, Prabhaava
  14. Efficacy: Karma
  15. Pharmacodynamics: Upaaya
  16. Interaction: Kriyaasamkara
  17. Authentic Scientific text: Tantra or S`haastra
  18. Compendia: Samhitaa
  19. Handbook : Samgrahagrantha
  20. Encyclopedia : Kos`ha
  21. Commentary: Vyaakhyaa or T`eekaa
  22. Statement or hypothesis under consideration: Pratidnyaa
  23. Rational: Hetu. It is reasoning behind the hypothesis established with the help of tools
  24. Example: Udaaharan`a: Drisht`aanta
  25. Establishment of hypothesis based on interpretation: Upanaya
  26. Propounding of statement at the end of discussion: Nigamana
  27. Editing: Pratisamskaara backed up by literary research for addition of new knowledge
  28. Observation : Dars`hana
  29. Inquiry: Pras`hn`a
  30. Direct examination : Spars`ha
  31. Principle: Tatva
  32. Examination methods: Pareekshaa
  33. Quantitative examination: Dravyatah Pareekshaa
  34. Qualitative examination: Gun`atah Pareekshaa
  35. Combination of examination methods: Ubhayatah Pareekshaa

Classifications:

A careful analysis of Ayurvedatreatises reveals that there is a comprehensive approach regarding research along with research processes discernible in different categories according to expected focus or direction of thought, within a frame of reference. The broad categories, objectives and methodology to conduct research with a particular focus are as follows:

Clinical research
Drug research
Literary research
Epidemiological
Fundamental

The classification is for the understanding of the predominant characteristics of each type. In practice all types intermingle with each other at various points depending upon crux of the topic.

Fundamentatal research 
Epidemiological research 
Clinical research 
    
 Drug research  Literary research 
 

Types of research

Clinical research

Clinical research is defined, as a prospective study to evaluate any intervention, be it preventive, diagnostic or therapeutic against a control inhuman subjects. Another definition quotes, Clinical trial is carefully and ethically designed experiment with the aim of answering some precisely framed question Sir Austin Bradford Hill. The definition suggests that clinical research is different from practice of medicine. Practice is aimed at the well being of a patient in spite of changes in drugs, diet and therapy as needed. Research aims at finding out the exact role of intervention in a particular situation or condition and therefore is focused.

Objectives

  1. To understand the therapeutic efficacy, preventive, promotive, therapeutic actions and
    Also adverse reactions, of the drugs in the disease which are not documented or experienced due to the enormity of manifestations of abnormal conditions.
  2. To study the reasons of relapse of disease; effect of known drugs or treatment methods in a different dose or duration to control or avoid relapse.
  3. To assess the role of dietary and behavioral restriction or positive environment in cure. In other words to study all the factors responsible in treatment of and to achieve the complete cure of a disease.

The subtypes of clinical research with respect to current definition can be seen according to the focus of topic:

Oral drug Treatment using single or compound formulation [S`hamana Chikitsaa internal medication]

Behavioral Treatments for psychological disorders. This is classified under Yuktivyapaas`hraya Chikitsaa which are termed as non-drug methods threatening, sedation, massage, stress release, counseling to help the patient understand his problem and facilitate a solution.

Therapy Panchakarma S`hodhana Vamana, Virechana, Basti, Nasya, Raktamokshan`a. Yogic postures to treat some orthopaedicproblems and exercises in particular conditions

Surgical treatments Application of different surgical techniques in all the branches.

Methodology – Though there are subtypes of clinical research; due to practical modifications in accordance with the focal issue; basic understanding of methodology or rules for all the types do not change. The important factors in methodology are drug, equipment or instrument, patients, disease condition under study and setting of the study. Specification of all these are listed as below:

Karan`a The word denotes any material, which can be a medicine, tools like enema bag, surgical instrument, medicinal leech etc, with reference to context. The quality assurance of the drug is done based on soil type, cultivation and harvesting techniques etc. or that of instrument carries utmost importance and is written in detail. The prescription method of the medicine under study is specified according to the rules of drug administration with respect to time of day and food intake.

Kaaryayoni Here it is expected that the framework of the disease condition under study should be stated clearly. The classification of disease is important. Whether it is curable or incurable that needs continuous treatment; whether new or chronic, systemic or local. The cardinal signs and symptoms under consideration should be defined precisely. Method of examination of the particular condition should be described.

Aaturades`ha A rational understanding of any human being is achieved depending on some basic parameters. Thee are Prakriti, Vikriti, Saara, Samhanan, Pramaan`a, Saatmya, Satva, Aahaars`hakti, Vyaayaamas`hakti, Vaya which help put any person in a typical set, for better judgment of the effect and to reduce the bias generated from extraneous or sometimes attribute variables. The method gives accurate results because each factor considered here has a significant role in both healthy and disease conditions. Careful selection of patients considering all factors together leads researcher more close to the true results. The outline is comparable to selection and exclusion criteria of patients according to the set classification. It is also important to decide the dose of the medicine under study for the selected patient.

Bhoomides`ha: Geographical area or study location which gives an idea about the natural climatic conditions, as well as of genetic or racial make up and socio-economical status of the subject in study. Identification of co-existence of humans and drug in a given setting is important from the viewpoint of symbiotic relationship. Specific atmospheric conditions in different seasons have a role in efficacy and certain therapy procedures are conducted in a specific season only.

Kaarya : Kaaryaphala and Anubandha: These are measure with respect to the topic under study. For example, burning sensation is one complication of diabetes [Prameha–Vaataja–Madhumeha]. Yas`hada Bhasma has some control over Madhumeha Sampraapti. The main tool here is Pratyaksha. The work is carried out by the researcher employing the above-mentioned parameters.

Clinical research examples: The clinical research process is evident at various places in the Samhitaa_s. One or two are quoted here.

  1. In the treatment of Kusht`ha external application of medicines should be administered only after S`hodhana [removal of Dosha by Panchakarma technique]. Otherwise it leads to increase in the symptoms instead of cure. The two quotes undoubtedly indicate outcome of practical experience in many cases and are not just a guideline.
  2. Introduction of minerals and metals as medicines in Ayurveda, took place at a later stage. These medicines were tried to relieve specific diseases. The record of efficacy and adverse drug reaction of a mercurial preparation titled Makaradhvaja is proof of clinical experience.

Clinical research comment: A clinical research project is designed on the basis of Yukti a systematic, intelligent arrangement of thought based on Aaptopades`ha known facts about the topic; conducted Pratyaksha in specified precise setting; with Anumaana expected outcome or inference. When the work is complete it can be added to Aitihya a written document. There are no references to the designs like randomized controlled trials or longitudinal methods but the theme method can be co-related to case control studies which are now being supported by WHO considering individuality. Also keeping the meaning at the core intact, new thinking can be developed.

Drug research
Drug is the most important factor in treatment because it is the real material tool, which cures. The approach of research in medicine is drug centered all the time. Other tools of treatment like counseling get comparatively less prominence than the drug. Therefore scope of drug research is very wide. Ultimately, clinical research is a proliferation of drug research which has been studied separately for convenience or understanding.

Objectives:

  1. To find out the medicinal properties or pharmacology of any new or unknown drug.
  2. To use the known drugs for new application or efficacy in new manifestations of diseases.
  3. To study a drug used in folk or local tradition with scientific perspective of Ayurvedain order to add it to the Ayurvedic repertory I.e. to conduct pharmacognosticalstudies.
  4. To develop new dosage forms from new drugs and to modify existing forms using new techniques. To conduct drug development based on principles of formulation to manage new health problems.
  5. To study the pharmacodynamicsand pharmacokineticsof unknown drugs and new formulations in different doses and variety of settings. To verify therapeutics with respect to primary actions, secondary actions.
  6. To note toxicity and adverse reactions, if any, of a drug in a particular dose.

Methodology
Drug research has a wider scope as it deals with all the aspects of a drug. The method varies depending on a particular aspect under study. Therefore subtypes in drug research are pharmacognosy, pharmaceutics, pharmacology including therapeutics and toxicology. It is must to note that research in any of the above direction is conducted with medicines prepared under strict observance of quality assurance parameters. Each type is elaborated below with reference to the context.

Pharmacognosy:
Identification of raw material is of utmost importance and at times of crisis, help should be taken from local people who are regular users of plants, specification regarding nature or morphology of the plant which in turn depends on soil type and regional agro-climatic conditions i.e. habitat; and collection or harvesting season; are monitored for quality. The nature of a drug is tested based on the direct examination by Panchendriya Pareekshaa because the drugs are Paanchbhautika. According to test results the drugs are classified into Paarthiva, Aapya, Taijasa, Vaayaviya, and Naabhasa categories depending on the predominance of one of the five constituting Bhoota for the convenience of understanding. This hypothesis comes close to an accurate knowledge of the constitution type of drug on which judgment is built, about its processing, formulation and activity.

Criteria of best quality drug:
The single drug, which can be converted into many dosage forms, having high potential, multi-dimensional efficacy and easy availability is the best drug.

Comment: Correct identification is an important pre-step, on which actual pharmaco-therapeuticsis dependant. This fact is stressed upon in all the treatises though the drugs were forest produced and use of local talent at controversial time is a wise mans best attitude.

Pharmaceutics:
Pharmaceutics is the next step towards effect. This is the most interesting part, which deals with enormous possibilities of drug development. It is amazing to note that the treatises never restricted to a fixed number of formulations rather always keep open ways to new possibilities. The main objective of phamaceuticsis to bring palatability to the drugs along with its better availability for targeted efficacy in the body in a small dose.

Pharmaceutical quality assurance emphasizes on the method of harvesting and preservation where principles like comparative selection considering parameters like habitat, season, maturity, Vipaaka, Veerya, and Rasa are adopted. Moreover storage techniques and use of container is specified according to characteristics of individual drug items like fresh, dry, poisonous, expensive etc. the core section of pharmaceutics i.e. processing is elaborated with the help of principles of drug development with reference to the following factors

  1. Number of drug in a formulation: Samkhyaa. On the basis of creative imagination towards desire efficacy then number of ingredients in a formulation id decided
  2. Proportion of ingredients of a formulation:
    1. Parimaan`a: each ingredient in the formulation is added in a particular amount according to its properties in relation to the desire efficacy.
    2. Quantity: Raas`hi Total amount of the formulation is calculated by summation of all. The general rules regarding proportion of dried drugs as against fresh drugs are led down.
  3. Concept of Synthesis: Samyoga means to combine more than two drugs to form a new compound. The combination is designed depending on the Paancbhautika nature of each ingredient, which eventually is expressed in terms of Rasa, Gun`a, Veerya, Vipaaka and Prabhaava in the context of activity. The emphasis is put on concept of Viruddha Veerya because drugs are Veeryapradhaana. At the same time the concept of synthesis is exemplified using Rasa–Dosha Sannipaata which can be extrapolated to the rest of the factors. The exact understanding of one to one relationship between cause and effect is difficult due to complexity of drugs on one hand and that of disease on the other yet it is desirable to rationalize each factor of both the units to decide the true relationship between the two sequential addition of drugs in a formulation and end result of the formulation is predicted based on synergistic and antagonistic viewpoint. The drugs possessing similar characteristics or properties, when blended to form a compound, synergistically. The drugs possessing dissimilar or opposite properties when combined, reduce or neutralize unwanted characteristics of the target ingredient and make the combination effective yet non toxic. It is elaborated that the final effect is a cumulative effect of the compound and not of any individual ingredient in the compound. To reach the stepwise conclusive understanding of development of any formulation; first one has to realize the cumulative effect of Rasa then to infer the cumulative effect of Dravya and finally of disease. This relates to the theory of Rasa–Dosha Sambandha
  4. Division of the whole: Vibhaaga In the context of pharmaceutics it is related to divide a formulation in uniform does to administer to individual patient according to the need. It is not the separation of all ingredients in the formulation. E.g. each tab of Tribhuvanakirti is Samyoga of 10 drugs and it is one tablet of 125 mg strength.
  5. Methods of processing: Samskaara: Karan`a

The Samyoga is brought about by Samskaara. Samskaara is the key to fetch a desired change in the set of physical, chemical and biological properties of the drugs. The raw drugs are processed by various methods appropriate for each drug. These include washing using water, boiling, heating, churning, trituraton, marinating and more. Varieties of apparatus are used for the processing and the process is carried out in a particular area [pharmacy], climatic condition, for particular time period to get a good quality medicine.

  1. Criteria of assessment of finished products: These are explained along with the description of individual product. They are based on organoleptictests and for some dosage forms specific other practical tests are advocated.
  2. Stability of the product: This is not explained in detail but while elaborating unwanted effects of a drug, the word Puraan`a is used to indicate outdated medicine.
  3. Repetitions for perfection: Abhyaasa. In formulation development, repetitions of the process lead to refinement of the finished product.

Quality of best formulation: A formulation has to be simple to administer, fast acting in minimal dose and without any untoward effects. It is possible to design infinite formulations using one drug or combining many potential drugs on the basis of correct understanding of complexity stated above, involved in the process. Therefore to predict or limit the exact number of formulations is difficult.

Comment: This is a guideline which, may further be extended and brought into practicality by employing new technologies of manufacturing and combinatorial chemistry techniques in virtual laboratory for drug designing.

Pharmacology:
This section deals with the action of medicine single drug or compound formulation. How a medicine acts; what change it brings in the status of Dosha_s; how it moves in the body or what transformation it undergoes once in the body system is studied in pharmacology.

Pharmacodynamics: The thrust of analysis is upon attributes [Gun`a] and the specific function [Prabhaava]. Pharmacodynamicresearch is generally focused on the five factors, which are elaborated as Rasa, Gun`a, Veerya, Vipaaka, Prabhaava. If the medicine is developed from a single drug then the efficacy can be explained with the help of three features Dravyaprabhaava. Gun`a Prabhaava or both. The dynamics of any particular formulation for primary and secondary expected action is examined with respect to some aspects namely:

  1. the specific dosage form which is developed using creative imagination
  2. its potency [Veerya] is judged by the site of action and time period for which drugs is available at that site
  3. target organ or etiopathologyor stage and condition of disease [Adhikaran`a]
  4. in a specific season [Kaala]
  5. mode of action [Upaaya]
  6. the action [Karma there are 50 main categories which in turn relate to Doshaavasthaa] and
  7. the ultimate effect or feeling of well-being [Phala]

This is verified by actual results on the patients. If a multi-ingredient formulation is designed, applying creative thinking based on knowledge of factors like synthesis elaborated in pharmaceutics, then the final cumulative effect of the compound of the body is rationalized by applying the guidelines described to identify the Rasa–Dosha Sambandha and drug disease relationship. The efficacy may be due to cumulative Rasa, Veerya, Vipaaka, Gun`a etc of the compound formulation or single drug. To find out the rational in each set of drug disease is the pharmacological research pertaining to dynamics. This concept opens possibilities for development of innumerable formulations.

Pharmacokinetics: The study deals with the movement of a drug in the body. Here the principles which are explained in relation to food may be applied to drugs because, drugs when administered orally follow the same route that of food. Thereare three types of distribution viz. selective distribution [Khale Kapota], sequential distribution

[ Kedaara Kulyaa] and direct yet immediate distribution [Ksheer–Dadhi Nyaaya]. A clear statement regarding time of action of drugs mentions that activity of aphrodisiacsis seen immediately and that of all the other medicines within 24 hours. Another reference elaborates some symptoms, which are indicative of complete metabolism of medicine in the body. If the expected efficacy is not achieved within seven days duration then it is advised to discontinue the drug and after some gap, to avoid interaction, new treatment should be commenced. There is no specific record however, of an individual medicines action in a specific span with a few exceptions like Aarogyavardhini and Gandhaka Kalpa in latertexts.

Pharmaco-therapeutics:
This branch is generally merged with pharmacology. In the context of modern medicines, the study of a new chemical entity is incomplete without knowing its action in a particular dose, frequency and administration method in a particular disease condition. But during last decade or two, studies are planned and conducted on known medicines or formulation to see other affects in various dose schedules. The famous example is of aspirin as an anti-platelet drug.

A similar concept is the best proof in Ayurveda. There are fifty types of primary action. They are sub classified into therapeutic, preventive and promotivecategories. In each action group there are ten individual plants capable of achieving the effect singly and in combination thus leading to 500 end products. The therapeutic studies for any drug are designed considering factors like a particular dose of the medicine, a prescription technique consisting of Anupaana, time of day, before or after meals, to treat a particular disease, in a person of particular constitution; to assess whether it eliminates the vitiated Dosha or pacifies it.

To exemplify, the drug Pippali [Piper longum] possesses two primary actions; digestive [ Deepaniya] and appetizer

[ Triptighna]. Another drug Haridraa [Curcuma longa] is included into anti-dermatosis[[Kusht`haghna] as well as in poison anti-dote [Vishaghna] action groups. In other words one drug does possess more than one main therapeutic action in different dosage forms, doses, different prescription schedules according to administration time and with respect to season and other factors. Based on thee principles pharmaco-therapeutic studies of various combinations can be designed. The best example of pharmaco-therapeutics is the development of potent medicines known as Bhasma, from mineral-metal sources by treating them with medicinal herbs. Rasas`haastra [Rasa is mercury] became a special branch of Ayurvedain the later era during first century AD. Therapeutic efficacy of these metallic preparations and herbo-mineral preparations added new dimensions to treatment.

The therapeutics also focuses on relationship between food and drug. Efficacy of the medicine is increased if some type of food items are consumed during the course of treatment and it decreases with some other types of food. To exemplify; during the treatment of Vran`a the patient must avoid salty, sour and hot and heavy foods which negatively influence the rate of cure. Instead he should consume moderately heavy, soothing, and tasty but non-spicy food. Also he should not indulge in exertive acts or take a nap in the afternoon, which adversely influences cure. The concept of Pathya and Apathya not only is restricted to food but also is stretched to exercise and behavior patterns, which have a definite role in cure.

A completed study of known drugs to treat unknown disease conditions must be undertaken considering the variables Dosha, Aushadha, Des`ha, Kaala, Baala, S`hareera, Aahaara, Saatmya, Satva, Prakriti and Vaya. This is the best guideline, which propounds the role of each and every variable in the process of cure.

Comment: Thus the therapeutics in Ayurvedacan be co-related to the concept of clinical pharmacology in its entirety. Various approaches can also be co-related with dose response studies, effect of presence of food in stomach during drug administration etc.

Toxicity and Incompatibility / Intolerance:
Along with therapeutics the concept of adverse reaction and toxicity is also explained. Adverse reactions are defined as the harmful effects occurring with does intended for therapeutic effect. Toxicity is the direct action of the drug at high dose, damaging cells. Intolerance is a low threshold to the normal pharmacological action of drug. Normally a medicine or therapy is administered to patients by taking all precautions but as the efficacy depends on many factors; misjudgment of one or two may lead to adverse reactions. These may be seen due to a substandard drug too. There are other possibilities that patients are not always knowledgeable [Dnyaapaka] and may furnish misinformation unintentionally or the treating Vaidya is in-experienced.

Examples of adverse drug reactions are evident in the texts. The detailed contra-indications mentioned for Vamana, Virechana and Basti have originated from the understanding of adverse reactions of the procedures. In Ayurvedamedicated wines are administered in treatment of various conditions. Medicated wines have a positive effect on all the sense organs and intellect. At the same time it develops toxicity it prescribed to those for whom it is contra-indicated or consumed in excess dose. The toxicity of Copper [Taamra] is mentioned in the very first chapter of Charaka Samhitaa as an example. In the texts of Rasas`haastra, toxicity of each and every material used as a drug source in raw or partially processed form is documented. Antidotes of each one are mentioned too. A guideline regarding therapeutics states that many medicines are intolerable to children, elderly, thin and fragile ladies in their normal therapeutic dose, which give rise to certain adverse effects. In such cases the doses are altered to suit the needs of the patient.

Comment: Though these are not comparable to the toxicity studies conducted today but are more valuable as these are generalized conclusions of toxic effects on patients. They point towards retrospective inferences.

Drug Research Examples: The formulation Pippali Ksheera that is Piper longumprocessed in milk is advised and not Pippali Kashaaya. Similarly use of Centellaasiaticajuice, Glycerrhizaglabrapowder or Convolvulus pluricaulispaste with milk to achieve the Medhya effect [nootropic] points out that a particular dosage form along with a particular Anupaana is administered to achieve a specific pharmacological action is nothing but a conclusion after research. Another example comes from a later text like Bhaavprakaas`ha. Chopachinee [Smilex china] a plant of Chinese origin is identified for its Rasa Veerya, Vipaaka, Gun`a and Karma. Its action is best seen in powder form than decoction, in inflammatory conditions of joints and second or third stage or venereal diseases.

Drug Research Comment: At this point it is a must to note that the understanding of Ayurvedawith respect to drug quality assurance, toxicity, antidotes, and efficacy is similar to the current understanding. The development of dosage forms like Parpat`ee or Pot`t`ali are concrete examples of drug development process through research where herbs and minerals metals are processed together. It is obvious from the above data that the factors, which must be considered accountable for the quality of a drug, do not end with the drug but they encompass the particular patient and the particular etiogenesis. To elaborate further; the Q factor depends on all thee variables and not on one or two. Rather, if any one of the whole set is not fulfilled then there can be a change in the expected or predicted efficacy.

To emphasize the point further; it becomes crystal clear that any Ayurvedic drug cannot be labeled standard based only on its chemical reactivity pattern but has to be standardized on the specific biological or biochemical responses. This can only happen in live tissues and therefore biological models may help not only to understand the mechanism of action but also as a counterbalance to develop a marker to know whether the drug is standard or not. The guidelines to develop the profile of any unknown drug right from its identification to its therapeutic use are elaborated in the texts. Some details may be added due to technological advancement but the theme remains unchanged.

The original thought of using existing drugs to treat new disease or new syndromes is clearly evident in Charaka Samhitaa. This may be the first attempt towards clinical pharmacology because the parameters are clearly laid down to initiate such use of medicine in unknown situations.

Literary Research

Introduction:
Literature is the means to transfer knowledge from generation to generation. New knowledge that is acquired is stored in literature. Literature is generated by intellectuals in the society for various purposes like entertainment, spread of information, dissemination of technical details and many more. As mankind is enriched with many races and communities region wise; literature also develops in all possible ways. Generally, till the last century literature used to originate in the mother tongue of the persons, writing it. Over the time, form, structure and style of writing has been designed based upon the thought process of the experts in the field and then a definite set of rules and conventions evolved according to the type of the information to be communicated. Development of new knowledge, in other words understanding the phenomenon of life in all respect, is a continuous process, which is expressed using language. New words are coined. Every language gets enriched with time due to the cross-cultural interactions taking place between the people. Not only goods are exchanged when two different communities come together but there is a cultural exchange as well.

Meanings change through decades and centuries with reference to contexts. New concepts, ideas are propounded. Some of them always remain at the forefront while some others are recorded but ignored or forgotten. However literature maintains a continuous thread of knowledge diversities. At times it becomes essential to trace the literature to explore an unexplored possibility. It initiates knowledge based on imagination. Literary study encompasses all these factors, which strengthen the knowledge base. It is a must to note that there is difference between the standard meaning of literary research and that of Ayurvedic literary, research. In the original sense the term literature is associated with presentation of human emotion and the term literary theory is linked to artistic writing. In the context of Ayurvedaliterature, these terms may not be useful because Ayurvedic literature is scientific material generated through many centuries to disseminate the information regarding the science of health. It has followed the rules of writing, which existed at the time of development of the Ayurvedicliterature. As Ayurvedahas been practiced for more than 2500 years, there exists a considerable amount of contemporary literature generated in each century to address relevant health problems. Thus it becomes essential to focus on literary research in terms of content rather than its artistic aspects. This process is defined in the treatises as follows:

Objectives:

  • To verify the principles of methods of development in the light of changed situation of usage of Ayurvedicterminology and frame of reference.
  • To understand the changes that took place in structure and form of scientific literature
  • To know and organize original meanings and changes in the shades of various technical sentences [Arthayojanaa]
  • To understand the process of development of any concept and its application chronologically
  • To identify grasp and learn different thought processes and get new clues leading to application
  • To contribute new knowledge through development of good contemporary literature based on present day applications.

Materials and methodology:
There are two processes involved in literary research; how to analyze literature critically and how to write.
Materials: the main materials are literature of various types:

  1. S`haastra or Tantra
  2. Samhitaa
  3. Samgrahagrantha Nighant`ugrantha
  4. Kos`ha
  5. Vyaakhyaa
  6. Textbooks and
  7. Recently published works in the form of papers, records, reports, articles etc.

Except for the last one, all other types of literature were available in manuscript form in those days till the innovation of printing. Method of literary research of manuscripts to prepare correct document for printing is known as manuscriptology. Since the 18th century the material were available in printed form. The guideline in Sus`hruta Samhitaa underlines that to acquire complete knowledge about anything it is a must to read and analyze a variety of treatises and all types of literary works. It further advocates that reading together relevant scientific works along with continued study of ones own science and discussions leads to enlightenment of intellect.

Methodology

  • Critical analysis methods

To analyze literature critically it has to be examined from three viewpoints:

  1. Chronologically, geography, authorship and overall societal set up reflected in the literature
  2. Structure of a selected material: form, style and language etc.
  3. Content: meaning conveyed through literature

In the Ayurvedictreatises there are references regarding all the three aspects.

Chronology aspect: The explanations regarding chronology, geographical areas etc. are covered in each text in the initial chapter only. Various practices regarding food habits, dressing of different races of people with their genotypic and phenotypic characters are also explained at different places with reference to context. Descriptions of people taking part in conferences are noted in apt words to enable the reader to a view of his background. These are some examples to explain the above points.

Structure Aspect: Literature shows a particular type of structure when the main three treatises

Charaka Samhitaa, Sus`hruta Samhitaa and Asht`aanga Hridaya are scrutinized. They are Sthaana part, Adhyaaya chapter, and Sootra verse. Also each chapter is structured to fit in a pattern of introduction, elaboration and summary of a topic. All the topics are covered in a logical sequence. Predominant form is poetic with some prose at places for better explanation.

In the later compendia 10th century onwards, including Laghutrayee, the chapter pattern remains same but that of parts i.e. Khan`d`a and of other arrangement is different. This itself is an evidence of literary research. Post 18th century the literature is written in prose form and not in poetic. Language of interpretation has also changed from Samskrita to regional ones and in recent years it has changed to English; though the principle of structural analysis is the same.

How to analyze a document critically, starts from selection. The text or literature has to come from the domain of well-known, successful, eminent and intelligent scientific fraternity; then only it is considered authentic.

  1. Target reader: Serve to any type of learner: advanced, average, poor
  2. Style of writing: The standard style of abstract, elaboration, and summary
  3. Title: Self explanatory, accurate
  4. Method of writing: Use of terminology, grammatically correct yet meaningful use of words and sentences; coverage of the topic of discussion in logical sequence without confusion of thoughts and easily understandable with appropriate examples. No repetition of the same thing words, sentences etc.

These guidelines help to understand the structure in detail.

Content Aspect:
This aspect is well explained in Charaka Samhitaa. The parameter is elaborated under the umbrella term Tantrayukti which means the methodology or technique or systematic approach of studying a Tantra to interpret its correct and unambiguous meaning for its practical application. There are total 36 major and 4 minor Tantrayukti_s. The number of Tantrayukti_s differs according to Samhitaa. It depends on the authors viewpoint of expression and his judgment about confusing statements. He propounds use of those specific Tantrayukiti_s for the benefit of the readers. The difference is practically negligible and all the important treatises follow the same types of Tantrayukti_s.

Adhikaran`a Tantrayukti denotes subject [Ingrammaticalsense], which can be of the entire science or of its part or of a chapter or of subpart of a chapter or of a single sentence. Similarly if one gets confused to establish the co-relation with one set of Dosha as Vaayu, Pitta, Kapha and another set of Karma Basti, Vireka, Vamana, then Vidhaana Tantrayukti helps to solve the problem. Vidhaana means orderly and systematic placement. It becomes easy to understand that Basti, Vireka and Vaman procedures are employed for Vaayu, Pitta, Kapha respectively. Each Tantrayujkti plays a specific role here. The literature must comply on the parameter of Tantrayukti to receive critical acclaim.

Another aspect of examining the Tantra is Vaakyas`hah, Vaakyaarthas`hah and Arthaavayavas`hah which indicates concept of Panchaavayava Vyaakya. It means that the literature is examined as a whole on comprehensive level to grasp its total content; further it is examined in detail to get the theme and principle, elaborate and concise descriptions wherever necessary, in the standard pattern of statement or hypothesis, rational of the hypothesis, supportive and appropriate general examples, establishing the hypothesis with logical explanation. One more feature is to assess whether an attempt is made to simplify the complex content to extract correct meanings for better understanding of an average reader or not. Here the method of getting the correct meaning through Lakshan`a interpretative or implied meaning is applicable. The literary meaning may give a false interpretation while implied meaning of the same words will give true interpretation because it is associated with practical experience.

Apart from these two main domains under content analysis there are other parameters termed as Pramaan`a [4types] Tools Vyaakhyaa [15] operational definitions, Kalpanaa [9] concepts, Nyaaya [17] general rules and Taachchhilyaadi [17] specific conventions; which are examined in the process of analysis of literature. Some of thee are related to grammar as well. The text is evaluated for presence of any of the fifteen Tantradosha. This highlights the complexity involved in methodology of literary research during development of Ayurvedicliterature.

  • Method of presentation of work:
    The method of presentation of the work, which can be of any type literary, experimental or clinical is discussed in literary research. It can be done in two ways, either in written form or an oral presentation. The guidelines regarding written documentation follow the same structure used for evaluation I.e. hypothesis, establishment of study hypothesis and null hypothesis, tools used, discussion including elaboration of the topic under study with appropriate yet easily understandable examples, specific conclusion, principle on which the hypothesis is based. The guidelines regarding oral presentation are also very precise. Oral presentation happens in a conference. For all practical purposed based on the objectives, conference can be either scientific or purely academic oriented or showy. Participants at both places may have three types of attitude: friendly, indifferent and obstinate. Based on these parameters validity and authenticity of the research done is acknowledge in the scientific fraternity. The presentation tactics to make own impression, to neutralize other speakers are also elaborated in the chapter. The presentation has to be within the parameters mentioned for writing a report. Apart from these, the researcher has to be well acquainted with some techniques, which are explained as Vaadamaarga. He has to satisfy all the queries raised regarding the subject or topic he presents; with properly supported justifications. In the end of this discussion the importance of literary research is emphasized by saying that clarity of thought and acquisition of knowledge by presentation of research work and open discussion is must for administration of treatments to patients because ultimately that leads a researcher to success.

Literary research examples: The best example of literary research is of Charaka Samhitaa itself. Its original title was Agnives`ha Tantra after the name of its author. This text was edited by Charaka who incorporated new findings, elaborated some concepts, changed some part from the original text to suit the need of his time and the text was renamed as Charaka Samhitaa. Further the same process was carried out by Drid`habala to add new knowledge and to complete the missing. One-third part of the original Charaka Samhitaa. We refer to this text today. Apart from this, thirty-five scholars have written commentaries on the text to relate the meaning with experience of their time. Another example is of Asht`aanga Samgraha and Asht`aanga Hridaya by Vaagbhat`aachaarya. The text is prepared to place medicine and surgery together for the benefit of learners which is written with reference to Charaka Samhitaa the bible of medicine and Sus`hruta Samhitaa the bible of surgery. More recent texts regarding methods of clinical diagnosis Maadhavanidaanam written by Maadhavakara and the handbook of medicine Chakradatta by Chakrapaan`i are examples of contemporary literary research because unlike the original, these are topic oriented texts that represent the thought line prevalent in that century.

Literary research Comment: The most important feature or gain from literary research is realization of the thought process of construction of theory or principle, which is, at times more valuable than the content itself. The guidelines reflect stringent criteria which a literary work or presentation has to comply with. Only then the scientific fraternity of the first type accepts it. This is a remarkable feature existing even today.

The techniques described or factors considered for literary research seem complex in modern days because of the main constraint of limited availability of writing material, which is responsible for preparation of a few copies of manuscripts of any book. It must have been quite a worthwhile. Brainstorming exercise to express the content in a well-structured mainly poetic form without hampering the exact shade of meanings. Today writing, printing and publishing has become easily accessible and affordable to the common man. The extra efforts of using poetic form are reduced but the basic principle of correct usage of terminology, sentence construction, grammatical correctness and expression in minimum possible words to convey a scientific invention and discovery remains the same. This places Ayurvedaon a higher pedestal as the best example of medical literature.

Epidemiological research
Epidemic is disease outbreak occurring suddenly in numbers clearly in excess of normal expectancy. Epidemiology in its true sense is the science concerned with the study of factors determining and influencing the frequency and distribution of disease, injury and other health related events and their causes in a defined human population for the purpose of establishing programmesto prevent and control their development and speed. Epidemiological research is no different than the meaning explained above. Currently the scope of epidemiological research is widened to the concept health statistics of population due to inclusion of studies regarding effects of various types of foods, habits like coffee, tea, smoking, alcohol etc., exercise and occupation of large population groups. These types of population studies are described as descriptive research in sociology from where various models like case control or time series have come.

The concept similar to the original meaning of epidemiology is explained under the title Janapadodhvamsa in Charaka Samhitaa, infectious factor in Sus`hruta Samhitaa while other aspects are taken care of in different parts like S`haareerasthaana, Sootrasthaana etc.

Objectives:

  • To find out the causative factors which influence a basically diverse population from a particular geographical area at one and the same time.
  • To study the possible measures of treatment and further prevention of health of people at such time. To study the effect of certain types of common conditions on people of a particular constitution.
  • To find out prognosis of diseases under specific conditions
  • To verify the association between certain foods and habits and disease.

Materials and Methodology

Materials:

  1. Here the study materials are suffering patients fallen prey to the calamity or outbreak and the survivors. Those who are not affected but have witnessed also become subject for the study.
  2. For the purpose of health statistics, healthy individuals are those, not acutely suffering from any conditions but are following a particular type of life style.

Methodology: In the opening statement of the third chapter in Vimaanasthaana, Rishi Aatreya suggests that the methodology employed to conduct this type of study is direct observation [Pratyaksha] and inference [Anumaana]. Experts who are able to sense the undesired changes that take place in the normal atmospheric conditions can predict its effects on human health based on their experience. Similarly behavioral changes are noticed by psychologists and social scientists that, they can predict the social behavior of the future generations. Once the catastrophe strikes then, only relief work can take place and it should be provided to the needy and seeking is another piece of advice by Rishi Aatreya.

The studies, which are conducted to fulfill the above-mentioned objectives, are designed using all four tools viz. known recorded facts [documented data], practical experience, rational thought and logical interpretation. Moreover the main tools are observation and inquiry. In case of direct observations the researcher must have a keen attitude to grasp the situation under study and he must use all the five sense organs coupled with intellect efficiency to understand the situation. Similarly the questions must be logical, relevant, simple and to the point to get the right kind of information.

Epidemiological Research Examples:
The best food article from a group of similar articles or the best drug which has desire effect amongst all drugs with similar effect cannot be decided unless a large population has shared the same experience or shown the same type of result. Also the most harmful fish is Chilachima or eating fish and milk together leads to skin disease are the outcome, which can be generated only after many observations, are put together. Effect of pollution on environmental factors like air, water, soil and the measures to be adopted in such conditions to maintain the health of people, is an example of epidemiological study.

Epidemiological Research Comment:
It seems that the present methods of epidemiological research, observation and inquiry were used with both approaches prospective and retrospective. When the suggestions like what dietary and behavioral pattern an expecting couple should practice if a typical progeny is expected are written then it is indicative of prospective one. Similarly all Pitta dominant Prakriti people suffer from blood disorders if they indulge themselves on hot taste foods, alcohol, consumption, work under burning sun for a considerably long period is a prospective kind of study.

In case of guidelines of predicting death of a suffering person, or effects of Viruddha Aahaara in developing certain skin conditions; the approach is retrospective. This statement one can make because the science that propounds ethics in use of plants would not try harmful things on humans. The section of Charaka Samhitaa where these observations are recorded categorically is titled as Indriyasthaana.

Fundamental research
Dictionary meaning of the word is as follows:
Fundamental: serving as a base or foundation, essential
Principle truth as basis of reasoning

Theory systematic exposition of principles of science. A theory is a set of interrelated constructs, definitions and propositions that present a systematic view of phenomena by specifying relations among variables, with the purpose of explaining and predicting the phenomena.

However, conventionally principle and theory are used as synonyms of each other with reference to context. In a nutshell, the true basis of reasoning which serves as essential or as a foundation to understand a phenomenon is known as fundamental principle. Fundamental principles are few, which give rise to many systematic expositions called theory. Theory involves a consideration of the principles governing practice, and different theories will point to different kinds of practice. The natural principles behind every phenomena happening in the universe are termed as fundamental principles of natural science. The phenomenon may be normal or abnormal; principle remains unchanged in the particular case. Theories are developed considering the specific variables taking part in the particular practice. Therefore they are applicable to that setting.

The research that is focused on fundamental principles or theories with an aim to find out the true reasoning behind any phenomenon is known as fundamental research. The fundamental principles are categorized into two parts universal and pertaining to a specific area. During ancient days Hindu scientific ideas and methodology had deeply influenced natural philosophy in Asia. The construction of scientific concepts and methodology to investigate the physical phenomena as well as building up a body of positive scientific knowledge was stored under the title Dars`hana. There are nine Dars`hana_s, which are grossly co-related with the modern scientific understanding. A few examples are given below which are quoted from Pr. BrajendranathSeals book Positive Sciences of Ancient Hindus.

  1. Saamkhya Paatanjala system: Concept of original constituents and energy. Mechanical, physical and chemical theories. Measures of time and space, directions, molecular motions biology and biochemistry etc
  2. Vedaanta evolution of forms of matter, Panchikaran`a
  3. Buddha atomic theory
  4. Nyaaya Vais`heshika chemistry, geometry, method of science cause effect relationship etc

Based on these basic sciences applied branches originated; like Astronomy, plant biology, etc. while assessing the potential of Oriental sciences; experts have also suggested that the Veda_s are basic sciences while Upaveda_s are applied ones. S`hilpas`haastra is the applied part of Rigveda, Dhanurveda is of Yajurveda, Gandharvveda is of Saamveda and Ayurvedais applied branch of Atharvaveda. Therefore Atharvaveda talks of basic biological principles, which are elaborated and modified according to the area of application. Those related to plants are developed in Vrikshaayurveda, related to elephants are Hastyaaurveda and those to horses are As`hvaayurveda.

Ayurveda, which deals with the health of human beings is an applied science, which originated from basic concepts related to ancient biology. The basic principles are accepted and modified in Ayurvedawithin its frame of reference to understand the functions taking place in the human body. The modification of fundamental principles within the framework of Ayurvedais explained in Charaka Samhitaa

The word Siddhaanta means theory or fundamental principle. Siddhaanta is defined as the ultimate true decision taken by many scientists [unanimously] after employing various tools or methods of scientific examination. Siddhaanta is classified into four groups.

  • Sarvatantra Siddhaanta: fundamental principles encompassing or common to all streams of science. For example:
  1. Saptapadaartha Basic even concepts viz Dravya, Gun`a, Karma, Saamaanya, Vis`hesha, Samavaaya and Abhaava which provide the rationale to all types of phenomena. The search for the root of any function taking place n the universe has been explained or stretched up to the level of Saptapadaartha to gain true knowledge.
  2. Navadravya Proliferation of the first concept Dravya into nine factors Prithvi, Aapa, Teja, Vaayu, Aakaas`ha, Kaala, Dik, Manas and Aatmaa; which are more directory responsible for everything that is happening in the universe. In this way each of the remaining six concepts is elaborated
  3. Paanchbhautika Siddhaanta: theory of genesis of basic materials by Anyonya–Anupraves`ha of Panchamahaabhoota
  4. Lokapurusha Saamya: Elaboration of functional approach based on Saamaanya–Vis`hesha theory
  5. Parin`aamavaada Paakajotpatti: Law of conversion or transformation of energy.

There are many such principles. These are common to every branch of science

  • Pratitantra Siddhaanta: These are the theories, which are propounded and applied to explain the reasoning about the subject matter dealt within the particular Tantra or science stream. It encompasses the entire subject. Some of these are listed below:
  1. Saamkhya Purush Group of factors must be considered to analyze a human being. There are other theories which consider less or more factors but those are not applied here
  2. Tridosha Vaata, Pitta, Kapha Factors govern the live human body by all means.
  3. Trigun`a Satva, Raja, Tama Factors govern mind
  4. Agni The factor which represents Teja within the framework of human body
  5. Gun`a karma of Phanchbhautika substances These are studied with respect to normal and abnormal body conditions
  6. Samyoga Vibhaaga The concept is studied within the frame of drugs and diseases. These examples suggest that the main theories are modified to understand and analyze the phenomenon related to human structure and function in healthy and disease conditions.
  • Adhikaran`a Siddhaanta These theories are specific to the topic under consideration. The topic comes under the purview of a subject, therefore Pratitantra Siddhaanta are applicable to the topic but on a broader level. At the core of the topic is the specific theory e.g.
  1. Garbhotpattikara Bhaava : These are application specific but not without Tridosha and Trigun`a theories
  2. Dhaatu
  3. Mala
  4. Prakriti variations
  5. Trayopastambha: Aahaara Nidraa Brahmacharya
  6. Vyaadhihetusamgraha Kaalaarthakarmayoga Heena, Mithyaa, Ati Maatraa
  7. Sampraapti Doshadooshya Samoorchchhanaa to know how the disease has progressed
  8. Dravya, Rasa, Veerya, Vipaaka, Prabhaava, Gun`a, Karma to know how a drug acts
  9. Samyoga
  10. Samskaara
  11. Chikitsaa Siddhaant Shaareera Daiva and Yukti; Manas Satvaavajaya
  12. Sadya vikaara Sootra Viparitagun`a, Des`ha, Maatraa, Kaala
  • Abhyupagama Siddhaanta: This category clearly reflects that research and development were considered at the fundamental level in Ayurveda. The theories and principles underlying those theories; which are newly proposed and which are not yet established; are put in this category. Thus methodology to verify new theories or even new principles is the method of fundamental research. As the frame of reference here is Ayurvedait covers research in fundamental principles adopted in Ayurveda.

Objectives:
To find out the exact theory behind unknown disease syndromes from generated or gathered evidence
To provide a rational and to design method of treatment of new and unknown health conditions based on fundamental principles
To find out the exact cause effect relationship between efficacies due to particular treatment – preventive promotiveor curative and the new unknown condition under study.

Methodology : The tools that help to unfold the true knowledge regarding any effect are termed as Hetu. These parameters are of four types and known as Pramaan`a_s. Definition of Pramaan`a is Pramaa Karan`am Pramaan`am, where Pramaa means true positive knowledge. The tools or parameters, which enable one to reach unto the truth, are Pramaan`a_s. Charaka Samhitaa elaborates the types of Pramaan`a_s at three places with reference to context. Sequentially they are listed as:

  1. Aapta or S`habda or AitihyaAuthentic scientific evidence documented in literature like Veda Upanishada and moreover from the devoted scientists.
  2. PratyakshaDirect, validated, logically analyzed experiences of each individual. Any experience perceived by an individual using his sense organs can be analyzed as gross level experience and subtle level experience which explains the details. Also it can be classified as present experience and past experience.
  3. Anumaan`aThis tool operates based on the above two tools Aapta and Pratyaksha. Method of prediction or judgment is of two types; futuristic and inferential. Futuristic prediction is based on logical analysis of knowledge acquired through documents and past experience while inferential judgment is based on drawing conclusions from the immediate experience.
  4. YuktiDesigning and putting Aapta and Pratyaksha together in a logical way to propose answers to unknown phenomenon. This is also known as creative thinking or management of thoughts as well as events:

One more parameter is explained which is termed as Upamaana.It is accepted from Nyaaya–Dars`hana to exemplify certain disease conditions. It points out similarity between two objects which may not necessarily have some common factor but only visual similarity e.g. Dan`d`a means stick. Cardinal sign of the disease Dan`d`aapataanaka is stiffness of the body similar to stick or Dhanusha means arch, hence the disease where body bends like an arch of the archer is named Dhanustambha.

By employing all the tools a researcher can analyze and find out the true relationship between cause and effect. The relationship can be of two types Nitya i.e. permanent and Anitya i.e. short term. The cause can be of three types directly responsible for the effect, associated but not solely responsible for the effect and responsible for only a particular section or at a given moment of effect [Samavaayi, Asamavaayi, Nimitta]

All the three factors lead to real or true knowledge, which is of two types comprehensive or with minute details depending on the approach of the researcher. The whole exercise of research is done in the quest of true knowledge. It is done with the help of theories mainly within the limit of Pratitantra and Adhikaran`a. Change in theory coming within the ambit of Sarvatantra leads to the change in theories of the other two that depend on it. Change in the principles of basic sciences reflects change in applied sciences.

Fundamental research examples

  1. The twelfth chapter in Charaka Samhitaa titled Vaatakalaakaleeya explains the functional types of Vaata Dosha but does not elaborate in types of remaining two Dosha_s. About a millennium later Asht`aaanga Hridaya elaborates Pitta Dosha and Kapha Dosha in similar fashion. The hypothesis is Pitta and Kapha can also be classified on the basis of functionality.
  2. The 63 permutations and combinations arising from six Rasa_s explained in Charaka Samhitaa are cross matched with 63 permutations and combinations originating from three Dosha_s in Asht`aanga Samgraha
  3. The debate about number of Rasa documented in Aatreya–Bhadrakapyeeya is chapter of Charaka Samhitaa, underlines that fundamental principle regarding the number of Rasa is six. It was challenged and various hypotheses like Rasa are two, three or eight were tested on above-mentioned parameters with a conclusive justification by Rishi Aatreya that Rasa_s are six.
  4. Similarly D`alhan`a at one place proposes that Rakta should be considered the fourth Dosha, which is debated by other Dosha_s are three is confirmed.

Fundamental Research Comment:
A careful scrutiny of all the types of research explained in the above article or known today or has been practiced since ages are merely a part of the fundamental research. Literary study is predominantly within the limit of the tool Aapta / S`habda or Aithihya; experimental or experiential methods come within the tool Pratyaksha; epidemiological studies are conducted using the parameter of Anumaana and Yukti encompasses all types of studies. When a study is conducted at a single level of literary etc, then generally it is guided by established principles unless it challenges the accepted theory. Each research problem focusing each of the area aims at finding out true relationship between cause and effect. All the tools must be put together to verify fundamental principle.

Principles of Fundamental research explain the method of science. How to analyze and understand any unknown fact is elaborated in this method. Most important fact is that the principles have not changed over the last thousand of years and the change in application is also not very drastic. What has changed is development of technologies, which aid Pratyaksa and enable oneself to acquire knowledge directly, which was not possible before. Apart from the main body of method of science concept of bias is covered where criteria of Aapta, Guru S`hishya, are decided. They suggest an impartial attitude and point out that only quality should be considered. Concept of ethics is touched upon while elaborating on the rules of collection of raw drugs or gathering information from shepherds or behavioral conduct of Vaidya, with respect to patient.

The marvel of the scientists of Ayurvedaperiod is, that they have kept open all possibilities of gaining new knowledge and have not posed themselves as rigid followers.

Statistics in Ayurveda
Statistics is the science of collecting and analyzing significant numerical data. Numerical means to deal with numbers. But the numbers are understood in two ways mathematics as well as statistics. Mathematics gives complete stepwise sets and solution exact and unchanging, leaving no room for accepting errors while statistics keeps the possibility of change open and gives solutions in a probabilistic manner. In mathematics if the results differ from the expected; then it proves that the method is wrong; but in statistics it is not so. Statistics is based on the principle of error [or Obsolon], which deals with the allowable errors involved in experiment. These are natural errors, which are irremovable. Statistics is an applied science and is used in medical science, psychology, engineering, social sciences, economics, and education.

However mathematicians and statisticians bifurcate from one common stream of numerical data. At some point it may be said that the method is inadequate and at other the thought has not missed out on anything rather has a more subtle understanding of the analyzing processes. In all the three treatises, particularly in Charaka Samhitaa, numerical values are used for a particular data. Right from the beginning of the principles there are numerical values use to denote five Mahaabhoota_s, three Dosha_s, three Upakrama_s, three Rogamaarga_s, eight Mahaagada, eight Nindita etc. in the chapter Snehaadhyaaya there is a direct evidence of presence of Saankhya people who are trained in the philosophy of Saankhya [numbers]. Wherever there is description regarding the thought process about the unknown disease, drug or treatment modality statements indicative of probability are made. The quotes saying Bhettaa Hi Bhedyam Anyathaa Binnatti, or Tasya Vikalpaat Aparisamkhyeyaani Bhavanti Vikalpabhedaat Aparisamkhyeyatva are indicative of the statistical thought process.

Anything is measurable is the principle of mathematics. It also relates to statistics, the concept of measurement is well evident in the Ayurvedictreatises. The section Vimaanasthaana is developed around the focal theme of measurable variables and methods of measurement. A Vaidya must be well versed with method of measurement of all the variables like Dosha, drug, strength, diet etc. to be able to treat the diseases successfully. The measure is of three types quantitative [Dravyatah], qualitative [Gun`atah], and a combination of both [Ubhayatah]. For example, quantity of urine passed by a person in 24 hours is measured using the unit liters while its color, clarity, smell are compared to standards and noted; is an example of application of both types of measurement.

Abhaava may be reflected as principle of Obsolon. Saankhya and Nyaaya Dars`hana_s introductory part authored by Annambhat`t`a is the root of logic and statistics. Many theories are proposed and established in this work. Deductive and inductive analysis methods are explained in detail well before the period of Aristotle. The concept of false positive and false negative results is defined in the same first chapter of Saankhyadars`hana, titled Tarkasamgraha. Forerunners of descriptive or inferential statistical methods are evident in Tarkasamgraha.

But it cannot be compared to the statistics of todays era, which has proliferated into a huge science with many techniques of calculation, which leads to true knowledge. No formulae or such other parameters are evident in the treatises. These may be available in those days in texts of mathematics like Leelaavati by Bhaskaraachaarya. Therefore it can be said that the concept or theory of statistical phenomena too originated in ancient texts to a certain extent.

Summary
Intelligent minds trained in the current system of categorization of knowledge, try to analyze or judge the ancient texts for proofs of the extent and depth of knowledge find that the classification or contextual references seem different and therefore at times difficult to understand. But once the answers to the three scientific questions what, why and how are carefully gathered with a different arrangement of available literary data, the intellectual thought process of research in Ayurvedic texts lives up.

There cannot be one to one matching of the methods in Ayurvedawith those, which are practiced today. As mentioned in the introduction, there are no separate manuals on how to do research in Ayurvedaas the manuals or books are available today. This is a literary review to analyze whether research thought was prevailing or not among the intelligent class of people practicing Ayurvedaby using modern day understanding as a yardstick. Therefore this work is an inferential work put together by compiling and analyzing the available data from the main treatises. If someone wants to counter question about the actual records of researches conducted or any such supporting documents then I am afraid, it is not possible to provide any. It is the limitation of this literature. This literature is developed on the guidelines format and not of actual records. Moreover considering the time span through which this science moves it does not seem possible to maintain such records in manuscripts forms, as compared to todays advanced technology of writing and printing etc.

There is no need for a learned man to say that after churning loads of data, one principle is established; for when a whole process is scrutinized it gives the crystal clear idea about the fact that how much churning or efforts have been put to generate so many treatises.

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Dr. Asmita Wele
Department of Rasashastra and Bhaishajya Kalpana,
BVDU College of Ayurved, Pune

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