N.A de S. Amaratunga Courtesy The Island

It is necessary to place Ayurveda in its correct perspective in the context of COVID. In this regard one cannot do justice to traditional medicine without reference to the development of early science and medicine. Ayurveda, ‘Sinhala Vedakama’ and other similar traditional medicine are scientific in the broad sense of the word. From early times up to the present there was only one science for there is only one nature to explore and one sensory system to do that. The science that developed in ancient civilizations in Mesopotamia, China, India and Arabia was similar in the areas of study and the methods employed. If one disregards the mystic and superstitious aspects, it is seen that the method was based on observation, experiment, and deduction which is what present day scientists basically do. Ancient man was bewildered and fearful of his environment particularly of disease and experimented with various remedies. This happened in all ancient civilizations which were geographically far apart and therefore it was an independent activity in each country driven by the mystery of nature and the inquiring mind of the human being.

Traditional medicine developed in China, India and Arabia and to some extent in Sri Lanka too. Ancient physicians developed remedies for different ailments depending mainly on experience. They wrote treatises on medicine and surgery and later this knowledge which was refined to a remarkable degree by the Arabian scientists traveled across to Europe which was lagging behind due to the ‘Dark Ages’, largely by the translation of the works into Spanish and Greek, a huge undertaking known as ‘The Great Greek Translation of the 12th Century’ which took place in Turin, Spain.

Thus traditional medicine including Ayurveda and ‘Sinhala Vedacama’ should be considered as precursors of today’s Western medicine rather than an entirely different entity. A good example that supports this idea is the fact that surgical techniques developed by the Indian Surgeon Sushrutha (600 BCE) are still being adopted by surgeons in the developed countries (nasal repair technique for example), and Sushrutha is considered the father of plastic surgery. His treatise on medicine ‘Sushrutha Samhitha’ is considered a comprehensive description of concepts and theories of causation of disease, classification of diseases, and their treatment and remains a major contribution to Ayurveda.

One may ask why early medicine in the East did not develop like in the West. The same fate that befell early science in these countries had befallen early medicine too. For instance science including medicine prospered in India during Buddhist era and declined with the decline of Buddhism. Sushrutha lived in Varanasi the centre of Indian Buddhism. Most of Indian science was absorbed by the developing science in Arab and eventually transmitted to Europe where it gained rapid advancement. Further, China until the 15th Century was far ahead of Europe but stagnated afterwards due to several reasons which have been extensively analyzed by Joseph Needham (1954).

The value of these ancient systems lies in the fact that the remedies are based on experience, or in other words empirical evidence. The Ayurvedic physician examines a patient and on the basis of clinical features that he has seen before arrives at a diagnosis and prescribes a treatment he knows works for that particular clinical picture. His theories of the cause, the disease process, how the remedy works may not stand up to modern scientific investigation. But we cannot, for that reason, throw the baby with the bath water because for some diseases their remedy works. These theories, remedies and medicines must be subjected to scientific inquiry and further developed forgetting hypocrisy and prejudices.

With regards to the claim that herbal and Ayurvedic preparations have a role in the treatment or prevention of COVID-19 there is no evidence either from clinical trials or laboratory studies that they have antiviral or immune boosting properties. Immunity is crucial in the fight against COVID as there is no antiviral drug or vaccine at present. Therefore the question is whether it is possible to improve the patient’s immune system. The concept of ‘boosting the immune system’, however, doesn’t seem to have scientific validity.

This is because the immune system is a system and not a single entity. It has several subsystems with two main divisions, the innate and the acquired and several mechanisms in each such as cellular and humoral. Vaccines induce the immune system to produce immunity against a specific foreign agent. While weakening of function in these subsystems due to disease and nutritional causes is possible, an improvement by an extraneous agent is not yet possible except by vaccination. To explain further, in a healthy person the cells responsible for immunity are produced in excess than required and there is no need to artificially increase their numbers. But in an immune-compromised person the system may be deficient, yet there is no agent-mediated mechanism to improve the immune system. Blood plasma from a person recovered from the infection may be used in patients who are fighting the infection hoping that antibodies may be present in the plasma to help the patient recover.

The nutritional factors and other health related measures like exercise may not, in effect, directly improve the compromised system but may help to overcome the disease condition that initially affected the immune system and thereby indirectly bring about an improvement of the immune system. Vitamin D for instance acts in symbiosis with T cells in the immune mechanism that kills viruses. A deficiency of vitamin D may weaken the immune system but an excess will not boost it.

It is the factors that affect general health that is important to maintain good immunity such as adequate nutrition, exercise, no smoking, alcohol in moderation, weight, stress control and very importantly adequate sleep. These factors have no ability in themselves to boost immunity but as good health is important for maintenance of immunity they have a role in the prevention and treatment of infections including COVID. Similarly diseases like diabetes which compromise immunity has to be controlled to ensure adequate immunity. Extra intake of micro-nutrients may not help but deficiency must be avoided. Herbs and plants may have these nutrients but so would a balanced diet.

The early practitioners of medicine knew about the antimicrobial properties of herbs and plants, for example turmeric, Kohomba, clove, cinnamon, thyme and cumin and these were used as disinfectants by our elders. Scientific proof of these effects is now available and in fact the potential of these as future antibiotic sources to fight antibiotic resistant bacteria is being explored, and there is hope that drugs may be extracted from these plants that may be effective even against the dangerous Methicillin resistant infections (International Journal of Molecular Sciences, June, 2017). But viruses are different and very few antiviral drugs are available and none against Corona. Therefore COVID could only be controlled by the measures presently adopted until a vaccine or an antiviral drug is available.