NEWSFOCUS
Not snake oil? The Indian government aims to
TRADITIONAL MEDICINE
Piercing the Veil of Ayurveda
Enthusiasts hope that clinical trials of Ayurvedic medicines will buff the ancient art’s
tarnished reputation
BANGALORE, INDIA—At a gleaming new
facility here in India’s biomedical research
hub, chemists and Ayurvedic practitioners
are teaming up to breathe new life—and
instill scientific rigor—into an ancient art
of healing. At the $10 million Institute of
Ayurveda and Integrative Medicine (IAIM),
several dozen researchers scour ancient
manuscripts for therapeutic recipes, cultivate
rare medicinal plants, and attempt to isolate
active compounds. Meanwhile, healers use
modern diagnostics to refine treatments at
IAIM’s 100-bed hospital.
The new institute is part of a concerted
effort to buff Ayurveda’s reputation. Last
May, the European Union, concerned about
mercury and other heavy metals in prepa-
rations, banned the sale of nonauthorized
Ayurvedic products. Since then, no prepa-
rations have passed muster. Even in India,
where Ayurvedic medicine has been prac-
ticed for 3500 years, “today most people
turn to Ayurveda literally as a last resort,”
says Vaidya Balendu Prakash, director of the
VCPC Research Foundation, an Ayurvedic
treatment center in Dehradun.
Hoping to turn the tide, India’s Council
for Scientific and Industrial Research (CSIR)
in New Delhi has embarked on a $25 million
initiative to modernize a discipline practiced
by 500,000 registered healers in India alone.
The initiative will subject concoctions—
from benign herbs to bona fide poisons—to
CREDIT: PALLAVA BAGLA
modern analysis.
Proponents face an uphill struggle.
“Ayurveda has been demonized by modern
science,” says Rajiv Kumar, a chemist at
Tata Chemicals Innovation Centre in Pune.
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Kumar lays the blame on healers, who he
says are “closed and secretive about what and
how they practice.” Healers say that secrecy
is necessary to protect intellectual property.
They aim to balance three “energies” that
roughly correlate to vata, or wind; pitta, or
bile; and kapha, or phlegm. According to
ancient texts, all doshas, or ailments, arise
when the energies are off kilter.
Putting Ayurvedic medicine on a firmer
scientific footing won’t be easy, as Prakash
attests. A second-generation healer, he is
promoting a silver- and mercury-based
treatment called “Navjeevan” that he has
refined for acute promyelocytic leukemia.
At the U.S. National Institutes of Health in
Bethesda, Maryland, in June 2010, Prakash
presented positive results from his Dehradun
lab and from others on Ayurvedic anticancer
treatments. But he acknowledges that some
data were ambiguous; few in the audience
were swayed.
To tamp down toxicity concerns, Prakash
invited Kumar to vet Navjeevan in 2005.
Kumar was astonished. “It’s scary to see how
callously mercury is handled by the pharma-
cists” in the preparation of some medicines,
he says. But to his surprise, Kumar found
that Navjeevan’s months-long preparation
had converted liquid mercury to a complex
or polysulfide form of mercury, blunting its
toxicity, he says.
The faith that healers place in poisons has
tended to undermine Ayurveda’s reputation.
The field took a hit in August 2008, when
Robert Saper of Boston Medical Center and
colleagues reported that one-fifth of 193
Ayurvedic medicines they tested after pur-
16 DECEMBER 2011
Published by AAAS
show that Ayurveda has modern-day relevance.
chase over the Internet contained detectable
levels of lead, mercury, or arsenic. Writing in
The Journal of the American Medical Asso-
ciation, the researchers called for “strictly
enforced, government-mandated daily dose
limits for toxic metals in all dietary supple-
ments.” “This led to a severe backlash and
growing distrust in Ayurveda,” says IAIM
founder Darshan Shankar.
Some experts are dubious that Ayurveda
can navigate the path to respectability offered
by standard clinical trials. “The use of con-
trols and placebos, so central to clinical tri-
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als, sits ill with Ayurveda,” says Marthanda
Varma Sankaran Valiathan, a cardiac surgeon
and former vice chancellor of Manipal Uni-
versity. Ayurveda, he explains, “regards every
individual as unique and the package of thera-
peutic measures, including virtuous conduct,
lifestyle, diet, and drugs, as inseparable.”
Others argue that Ayurveda’s relevance
will fade if concoctions don’t pass standard
tests. One formulation used to treat rheuma-
toid arthritis did well in a double-blind, ran-
domized match-up against a Western drug.
In the first trial of this kind involving a total
of 43 patients, people were assigned the
unnamed Ayurvedic preparation, the Western
drug methotrexate, both, or a placebo. “All
three treatments were equivalent in efficacy,
but adverse events were fewer in patients
treated with the Ayurvedic medicine,” a team
led by Daniel Furst of the University of Cal-
ifornia, Los Angeles, reported in the June
issue of the Journal of Clinical Rheumatol-
ogy. “This marriage of a traditional medicine
system with modern inquiry augurs well and
is probably the best way forward,” says micro-
biologist Padma Venkat, IAIM director.
Ayurveda may soon make its debut in
Western apothecaries. A herbal preparation
mentioned in Ayurvedic texts and extracted
from the weedy Mexican poppy (Argemone
mexicana) led to the discovery of a possi-
ble treatment for psoriasis, a skin disorder
that afflicts 2% of people around the world.
Desoris, developed by Lupin Laboratories in
Mumbai, is now in clinical trials. And last
year, following leads from Ayurveda, CSIR
researchers discovered what they claim is a
memory-enhancing compound derived from
brahmi (Bacopa monnieri), a marsh plant in
northern India.
To Venkat, the findings herald the emer-
gence of a new discipline: Ayur-biology. But
restoring the ancient art’s reputation, she
acknowledges, will not happen overnight.
–PALLAVA BAGLA
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