Integrative approaches for health: Biomedical research, ayurveda, and yoga

Abstract

One of the current questions and challenges in the context of Traditional, Complementary, and Alternative Medicine (TCAM) concerns the implementation and possibility of integrating these within various countries’ health systems. Indeed, it isn’t a surprise that the National Center for Complementary and Alternative Medicine has changed its name, becoming the National Center for Complementary and Integrative Health, indicating a choice which focuses attention on the question of TCAM (but we believe of medicine in general) on two aspects in particular: The concept of integration and that of health. A problem, therefore, not only of means but, more importantly, that of the outcome. The book “Integrative Approaches for health”[1] by Dr. Patwardhan et al. deals with the matter of focusing on and giving priority to these two knots/ties/bonds, setting out with a clear and honest analysis of the problems and arriving at the development of justified solutions, defining these as the principles; the differentiation of integrative health and integrative medicine posed by them is the proof. While reading the book, we are, in fact, presented with many paradoxes which we often ignore, such as in the case of India, where the incidences of undernourishment increase at the same rate as those of obesity, or in the West where better conditions of hygiene have almost wiped out certain pathologies but where you can die from environmental pollution; statistics which open the debate about on which terms we should be judging “progress,” but which bring us away from the purpose of this article, although the necessity of an intervention of the political kind is promoted by the authors themselves. After having defined the concepts of health and illnesses, explained the dimensions of health (we are rightly reminded that health is a collective asset), described what “well-being” means, and having clarified over-misused concepts such as “quality of life” and “holism,” the authors touch on one of the most debated points in methodology, regarding the applicability of the evidence-based medicine (EBM) to TCAM. Although our analysis might seem superficial, we consider it as opportune to remember the two points highlighted by the authors, both of which are epistemological in nature but address two different topics. The first regards the tools with which we know the world, “Scientific evidence is just one of the many forms of evidence such as anecdotal evidence, intuition, personal experience, and testimonial cases” (p. 96) whereas the second, more direct update of an old episteme “Whether or not Ayurveda can be considered EBM is not the right question. The real question is whether the Ayurvedic fraternity has an open mind and the vibrancy required for the system to grow and evolve” (p. 96). It appears evident, therefore, how the complexity of systems’ biology needs to be faced by means of a re-think of the philosophical prerequisites, capable of dismantling from its base the outdated, unsustainable, and inefficient way of dealing with chronic illnesses;“Today, predominant diseases such as diabetes, asthma, obesity, cardiovascular diseases, cancer, and many others, are the result of changes in human lifestyle and behavior. Obviously, their prevention, control, and treatment cannot be expected to be achieved by pharmaceutical drugs, unless the root causes are addressed by suitable modifications in lifestyle and behavior” (p. 167). What emerges is that in order to treat illness, it is necessary to re-think, using new terms, not only health, but most of all, the means with which this is safeguarded, imposing an essential change of paradigm from prevention to salutogenesis; one talks of the sick and not of sickness and Ayurveda, being an anthropologically based system, allows the implementation of person-centered medicine (which does not coincide with personalized medicine), in all of its particular aspects such as consideration of health determiners, the strong influence of lifestyle, and diet on longevity, the importance of a spiritual connection of the single with him/herself and with everything. “Integrative approach for health,” is, therefore, a book which can be read and used along the same lines as a valid manual, not only by those who work in the field and wish to clarify concepts which are frequently misinterpreted in the Western world but also by those not expert but who wish to understand clearly and effectively the true meaning of Ayurveda and Yoga and potential that both of these offer if implemented in an interactive manner in national health systems; a difficult, but already necessary challenge. We can only conclude, therefore, by paraphrasing a quotation used by Doctors and Patwardhan et al., “The totality of a book is certainly more than a review of it” and it is for this reason that we recommend one to read it.