Ayurveda has a long tradition of surgery. The sage Sushruta from 500 BC known in India who is also known as the “father of surgery” cites in his treatise “Sushruta Samhita” over a hundred kinds of surgical instruments. Scissors, scalpel, needles used in surgeries today were first designed in India.
On 19th November, the Central Council of Indian Medicine (CCIM) issued a notification allowing Ayurvedic physicians or Ayurveda surgery students who had completed their post-graduation to perform certain surgical procedures. The list includes 58 types of general, dental, ENT, and ophthalmological procedures.
The notification, however, has led to a storm in the medical community. In a statement, the Indian Medical Association (IMA) said it was corrupting modern medicine by mixing with other systems and poaching the disciplines of modern medicine through the back door. This was the foul play of the first order.
Prof. Kumar, who heads the department of Shalya Tantra at the Jaipur institute, said that “Three out of 14 departments in Ayurveda, namely Shalya, Shalakya, and Prasuti Tantra, involve surgeries. We have been doing it for years. I have been teaching them myself.”
The CCIM agrees. In a press note on 22nd November, it said the details of these surgical procedures were already laid down in the syllabi of Ayurvedic postgraduate courses decided by the CCIM. “The issue of the present clarification was in the overall public interest by CCIM. This is by bringing the said details into the regulation. Hence this does not signify any policy shift.” It did not mention why it felt the need to issue the notification at this point.
Are Hospitals And Ayurvedic Surgeons Equipped To Train Aspiring Surgeons?
From the medico-legal point of view, the surgeries aren’t and weren’t illegal. The notification has, however, made public questions of whether Ayurvedic surgeons and hospitals have the equipment to train aspiring surgeons. In an indication of how knotty this debate can be, some Ayurveds have reservations about their colleagues conducting surgeries, while some practitioners of modern medicine believe there is such a shortage of health infrastructure that all streams of medicine can lend a helping hand.
There isn’t much difference, it seems, between the approaches to surgery in modern medicine and Ayurveda. “The techniques are similar, although allopathy often uses advanced technology,” says Prof. Kumar. “Our surgeries are mostly minor and moderate, and often cost less than private allopathic hospitals. In the dental procedure, for example, we will do a tooth extraction, not a transplant.” Often, Ayurveda colleges employ modern medicine practitioners as anesthetists. For post-operative care, they prescribe antibiotics and painkillers used in modern medicine.
Does Ayurvedic Physicians Lack Training and Regulation?
What Ayurveda lacks, says Raghu Ram, president of the Association of Surgeons in India, is the ongoing research and rigorous regulatory oversight that modern medicine hospitals have.
“Surgery is an art and science,” says Dr. Ram. “It involves technical expertise; you need to attend many workshops to standardize training and impart it.” The infrastructure of training, research, and exchange of knowledge in modern medicine is much better in terms of evolution, he adds. “Many surgeons write about how many operations they have done, how many, and what kind of complications occur. These then go for publication in peer-reviewed journals across the world. Do Ayurvedic surgeons do the same to the same extent? The answer is no.”
Between 2016-18, the CCIM itself found at least 138 Ayurveda colleges unfit to run undergraduate or postgraduate courses.
In any case, India suffers significant gaps in healthcare infrastructure. According to research earlier this year by Brookings Institute, a US-based policy organization, the country has only 0.55 beds per 1000 people. According to a government statement in Parliament in 2019, there is only one modern medicine doctor for every 1445 Indians. The World Health Organisation’s norm is one doctor per 1000 people.
The Stark Difference In The Kind Of Facilities Available In India
“There’s a stark difference in the kind of facilities available in India based on where you live”, says Sambit Patnaik, a visiting surgeon at the Apollo-Spectra hospital, Mumbai. “In a city like Mumbai, you will have lots of choices. Seventy kilometers away, in Lonavala, you would find people running to a witch-doctor instead of a hospital. We need a helping hand from all specialties to run the show in India.”
For all its shortcomings, Ayurvedic surgery has changed from the time of Sushruta, says Dr. Patnaik. “Today, they have borrowed a lot of technology from modern medicine. They are also using cameras, cutting devices, laparoscopes, and almost everything available in modern medicine. I have also seen Ayurvedic surgeons do surgeries that are more complicated than the ones listed”.