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The Modern Ayurveda: Milestones Beyond the Classical Age

The Modern Ayurveda: Milestones Beyond the Classical Age by C.P. Khare and Chandra K. Katiyar (eds.). Boca Raton, Florida: CRC Press; 2012. Hardcover; 403 pages. ISBN: 978-1-4398-9632-7. $149.95.

The Modern Ayurveda: Milestones Beyond the Classical Age is a first-edition publication produced as a compilation of multiple authors on classical and modern herbalism of Ayurveda. Many of the contributing authors are associated with the Society of New Age Herbals in New Delhi and have held positions in research, government, and academia in relation to Ayurvedic medicine in India. This book is a comprehensive collection of information on common Ayurvedic herbs. In addition to listing the major medicinal herbs of Ayurveda, the intention of this work is to provide background on the history of Ayurvedic medicine and the current standing of the modern practice of Ayurveda.

Bringing the practice of Ayurvedic herbal medicine into the modern medical practice can be a complex task. In general, there is a lack of knowledge and understanding of herbs used in terms of the modern scientific framework. The historical and anecdotal uses of Ayurvedic herbs have withstood the test of time; however, modern medicine compels us practitioners to a greater mechanistic understanding about how these plant medicines work. One main challenge to understanding Ayurvedic herbs in a modern way stems from the dichotomy of using traditional herbs in their original form as compared to an emphasis on “active compounds” and standardization. We are at the crossroads of information, meaning the practitioner can decide to use herbs based on traditional formulations and organoleptic (sensory-based) descriptions or by focusing on active constituents, research, and standardization. Historically, classification of herbs in Ayurveda has been centered on the energetics imparted by the plant based on the 5 elements and qualities of the particular plant. The sense organs were crucial for classification and understanding the medicinal value of plants. In addition to the historical and energetic classification, the same herbs can now be understood and utilized based on evidence gathered from complex laboratory analysis and double-blind, placebo-controlled studies. This book helps highlight issues that come with bringing an ancient practice into modern times and presents a foundational listing of the major herbs of Ayurveda.

The herbal nomenclature in this text is based on the last classical Ayurvedic treatise (Bhavaprakash). Bhavaprakash is a complete reference book for Indian medicines including herbs, minerals, and animal products compiled in the 16-17th centuries. The authors note that there has been little effort to classify herbs based on traditional energetics since the publication of this text. There are 130 pages devoted to categorizing the nomenclature of Ayurvedic herbal medicines. Herbs from Ayurveda are often interchangeably called by their names in Latin, Sanskrit, and other Indian dialects — making it a confusing task for many herbalists. This space dedicated to nomenclature helps clarify potential confusion and allows the reader to easily cross-reference names.

In addition to the aforementioned table, there is much more information presented in tabular form. The tables in Chapter 5 provide information to enable the practitioner to connect herbs and practical medicinal application. This section includes specific conditions each herb is used for and provides both the Sanskrit terminology and an English translation where required. In general, the list of uses for each herb is brief and seems limited to the most common conditions. This brevity may be due to the space constraints of presenting the information in tabular form. More space could have been devoted to relevant indications and uses of the herbs if the authors chose to omit columns that repeat nomenclature from multiple systems. In addition, it would be interesting and useful, perhaps in a future edition, to denote some of the classical or common formulations.

Chapter 6 jumps to the modern aspects of herbal medicine. The biochemistry of active constituents and introductory pharmacognosy are presented here. This section provides an introduction to plant constituents for the novice, or it could help a learned practitioner review the basics of this field.

After this review material, the tabular form is utilized again to link the Ayurvedic herb with its chemical composition and plant parts used. It would have been useful for the authors to list the specific plant part(s) in which the varied constituents were present, instead of listing constituents and plant parts used as separate columns. Currently, practitioners who want to know which plant part to use for which constituent would have to consult an additional resource. Chapter 10 classifies the herbs by modern pharmacological actions — categories like expectorant, diuretic, and sedative. This highlights the key herbs in the action categories, but is by no means exhaustive. For example, the only herbs mentioned as carminatives are dill (Anethum graveolens, Apiaceae), asafoetida (Ferula assa-foetida, Apiaceae), and fennel (Foeniculum vulgare, Apiaceae). Other notable herbs with historical and research-based evidence to support their use are not listed, including ginger (Zingiber officinale, Zingiberaceae), cumin (Cuminum cyminum, Apiaceae), and cardamom (Elettaria cardamomum, Zingiberaceae), to name a few. Only Mucuna pruriens (Fabaceae) is listed in the “Anti-Parkinson’s” section, and so the reader is not educated on the plethora of other effective Ayurvedic herbs that can benefit the nervous system.

Going back, in Chapter 9 the authors’attempt to highlight modern scientific research to support the safety and efficacy of Ayurvedic herbs. The information is again presented in tabular form, and is a confusing mixture of toxicity data, medicinal actions, research data published on specific conditions, as well as drug-herb interactions, and herbs’ safety for use during pregnancy and in children. There are limitations in the scientific literature; it is likely not possible to present all of this information for each herb. However, it would be clearer for the reader to devote distinct columns to safety concerns (interactions, toxicities, pregnancy, etc.) separate from research evidence supporting use for specific conditions.

Finally, this text provides a basic resource for information on regulatory agencies, traditional use, and modern research around Ayurvedic herbs. This text will best serve practitioners who desire a concise, tabular form of the major herbs from the Ayurvedic system of medicine and already have some knowledge of herbal medicine and Ayurveda. The goal of bridging traditional and modern aspects of Ayurveda is successful in that this compendium carefully lists everything from an Ayurvedic understanding of disease to the major chemical constituents and research data available. The major limitations of this text include the redundancy found throughout the tables and the lack of detailed information that most practitioners would find beneficial in using some of the less familiar herbs.

–Virender Sodhi, MD (Ayurved), ND Ayurvedic and Naturopathic Medical Clinic CEO, Ayush Herbs Inc. Bellevue, Washington