1. SBEBA – SOLUTION TO ALL
PROBLEMS IN AYURVEDA
Dr. Remya Krishnan MD PhD (Ay)
2. Questions to consider…
How do we know whether what we are
doing for the patient is right or wrong?
Where do our “standards of practice”
come from?
Why do we not gain global acceptance
despite of research and publishing ?
3. Example: a patient with vicharchika
Treatment for Agantu dosha ?
Rakta sodhana ?
Virechana ( treatment for kushta)?
There are endless
confusions for an
Ayurvedic
physician
4. How to decide medicine?
Based on empirical evidence
of shared experience ?
Based on empirical evidence
of medicine based study
reports ?
Based on empirical evidence
from tradition ?
Trial and error method?
5. How will I know what is correct ?
What faculty teaches ? It could be logical, he has PhD
He does the same for his large number of patients
What the eminent speakers in seminar highlighted
could be correct . They are great speakers .
Too many medicines in one context, why I can’t
randomly choose one ?
Why not go for dosha vipareetha approach ?
Jwara is Pitta predominant , but patient showing kapha
features??
HOW MANY OF YOU FEEL LIKE THIS IN YOUR
PRACTICE EVERY DAY ???
6. Science based reasoning guides
clinical judgment
We have very much standardised and established
Basic & applied science to pertinently guide our
clinical judgement .
We have to pass through three steps in clinical
decision making :
a. Roga pareeksha ( examination of disease )
b. Rogi pareeksha ( examination of patient )
c. Tatwa pareeksha ( examination of Diagnostic &
Treatment principles )
We need to accurately appraise Roga- rogi –
Bheshaja tatwas before determining the treatment
for sure to avoid any kind of uncertainity
7. A case of Acute fever
How to examine & reach conclusion
Status of fever – Nidana panchaka
Status of patient – Dasavidha pareekshya (
charaka)
Bheshaja pareeksha – Langhana / Pachana
/ langhana + Pachana
Agantudosha guna vipareetha drug, diet and regimen
selected in accordance to pertinent treatment principle
.
8. Science Based -Evidence-based Medicine ( SBEBM)
Conscientious, explicit and judicious use of
pertinent Science based evidence and optimise it to
individual clinical situation
Say NO to intuition, unsystematic clinical
experience, teachers’ choice , eminent speaker’s
choice or peer reviewed journal reports
Only SBEBM will standardise the clinical practice
and research of Ayurveda.
9. Scientificity
Teachers are correct if and only if they
systematically followed science step by step.
Seminar speakers are correct if and only if
they systematically explain the three staeps
in the clinical context by Science based
reasoning .
Peer review journals are correct if and only
if the peers have adopted the Science based
techniques for review and not statistics .
Otherwise the journals cannot be counted
as peer reviewed
11. Total chaos for Ayurvedic physicians
Unless timely managed, it leads to
emergency .
Unless scientifically managed, it leads to
emergency .
Should I take risk? How will I approach
such a case ? The patient has fever also
Should I go for treating fever or manage
Asthma first ?
How many of you get in chaos like this ??
12. We must follow science based guidelines
In diagnosis
In stagewise management
We have to adopt hetu vipareetha chikitsa .
Science based administration .
Accurate monitoring of status based on
science based guidelines
13. Physicians lack insight about scientific
ways
Physicians use medicine with medicine or medicine
after medicine . Physicians using many contradictory
approaches in the same situation and don’t
understand why their treatments fail
Indefinite diagnosis leads to indefinite
treatments and uncertain effects .
Medicines or system is blamed , not the
way they practice
14. Why do Doctors cling to experience?
All Ayurvedic practitioners follow self
experiences and tradition
Some follow blindly what others follow
Some follow specific formulations/
procedures blindly .
No standardised ways to follow science is
implemented in today’s Ayurvedic
practice .
15. Summary points
“Experience of wrong” induces and
transmits confusions and
uncertainity from generation to
generation
Ayurveda which is practised today is
far deviated from “Ayurveda as it is”
Understanding and applying
Science Based Medicine reduces
controversy and advances the field.
16. PRACTICAL SOLUTIONS
With this view, we have developed a school
of thought called “Science Based Evidence
Bsaed Ayurveda” ( SBEBA).
SBEBA incorporates standardised
technique for appraisal of science of
Ayurveda in clinical practice as well as
research .
Acquiring knowledge and skills in SBEBA
thus removes contradictions , confusions
and uncertainity in medical practice and
research.
17. Official proposal for SBEBA
With this is mind, we have made a detailed
plan and proposal for the necessity of
implementing it in curriculum of BAMS
and MD .
We have submitted the proposal to Ministry
of Health as well as to AYUSH in Ocober
2014.
We have not yet received any response so
far .
18. Golden era for Ayurveda
Once the project is taken up , it will be a
turning point in the field of Ayurveda.
It will tremendously contribute to Indian
economy by decrease in treatment costs for
all diseases , stay in the hospitals and
expensive treatments and interventions gets
reduced , number of ICU admissions will
decline and number of man days will
considerably improve .
It will eventually lead to global acceptance
of Ayurveda as a medical system .
19. Urgent attention from Government is required
To take up the project
To discuss the action plans
To implement the action plans
To monitor the action plans
To evaluate the effects time to time