Counter Think

Professor BM Hegde,
hegdebm@gmail.com

To have something different you must do something different. But in order to do

something different you must be able to think something different. And before you can
think something different you must be willing to believe something different.

Anon.

E very thought is a thing, so say many quantum physicists. Therefore, if you want to get anything

you must be able to think first. Today in the world of science no body is permitted to think! Even if
you write a new sentence in any of your papers, the editor and the so called peer-reviewer want a
reference to that statement. Logically, that eliminates fresh thinking. If only I could think, if only I
could think! lamented Albert Einstein many times. Curiously, physics died a natural death with his
student, Werner Heisenberg, thinking laterally following some of his mediation sessions on the
Mountains in 1925. Heisenbergs uncertainty principle put an end to conventional physics. That was
finally sealed by another colleague of Einstein and Heisenberg, Hans Peter Durr, Director of the Max
Planck Institute in Munich, who showed that matter is not made up of matter. He calls that a-
duality, which he himself admits is not as good a concept as Advaitha of ancient Sanathana Dharma in
India! Without matter where is physics?

Years ago in 1968, I wrote a paper with the title-Should we be drugging every elevated blood
pressure?-which landed me in real trouble in my department. I survived with the skin of my teeth! I
have been thinking and researching that ever since. I met a middle aged but young looking man in his
early 60s, a retired Dean of an Agricultural University, yesterday after my talk at the International
Cocoanut Meet at the CPCRI, Kasargod in Kerala, who wanted my opinion on his cholesterol levels of
600-800 mg per decilitre for decades. He tried drugs for a couple of days and felt miserable and
stopped. He was a specimen of perfect health. Health, incidentally, is defined as enthusiasm to work
and enthusiasm to be compassionate lately. The concept of organ based disease is long back dead in
true science of man. There is NO science of man, wrote Dr. Alexis Carrel, Nobel Laureate, in his
celebrated book, Man the Unknown.

A silent killer is a new mantra invented by the powerful pharma lobbys paid scientists to rope in
millions to buy drugs for the rest of their lives. Gullible doctors buy that argument whole heartedly
which incidentally helps the doctors also if one has read that illuminating editorial in the prestigious
JAMA, the official journal of the American Medical Association, entitled Looking the Gift Horse in the
Mouth!

Disease inventors is a fascinating book by Professor Jerg Blech that gives a graphic description of this
menace called hypertension first started in the Well Man Clinics that German companies started
there outside Cinema Halls and Shopping Malls, to label apparently healthy people with a disease!
That has been extended to raised cholesterol and raised sugar in healthy people as diseases! The
Patron Saint of hypertension research in the UK, Professor Sir George Pickering, wrote the real truth
after decades of teaching and researching hypertension thus: More people in this world make a living
OFF hypertension than dying OF it. Same could be said about cholesterol and sugar in healthy people.
Studies have shown that drug therapy of asymptomatic high blood pressures and sugars have not
benefitted the recipients but, have shown to be harmful! A meta-analysis of seventeen large
conventional studies of hypertension and two much touted cholesterol lowering treatment studies,
conducted by Uffe Ravnskov showed that there is hardly any difference in the absolute risk reduction
(ARR) in the treated groups, although the relative risk reduction, (RRR) a statistical trick sold to
doctors, did demonstrate some benefit. Similar is the experience of drugs lowering sugar levels in
asymptomatic Impaired Glucose Tolerance (IGT) patients by a Scandinavian group of researchers!

To cite a few examples of this syndrome here seems relevant. Mahatma Gandhis blood pressure was
always way high which made his physician, Dr. Sushila Nayyar, lose her sleep. Her patient never took
drugs and did not die of the consequences of his label. One of the leading neurosurgeons in Bangalore
(who has permitted me to disclose this secret) tells me each time we lecture together that his BP has
always has been 90/50 or so. Both have had very long lives and the latter is alive at 80 plus! I pray
for his century. French nursing home studies have now shown that to be alive at 90 plus one need to
have cholesterols in the range of 800 mg plus! One of my dear friends that died last year at 89 had his
systolic pressures recorded in 200 ranges ever since he was a student in the 1920s in London. He
could not tolerate the treatment and remained hale and healthy all his life without drugs, being a very
active management guru of India. A young friend of mine at 89 does not take any pills even now and
says he has survived many cardiologists in his long life. He does yoga even now!

Science should learn from nature; neither from the laboratory alone nor try to teach nature a lesson
or two. Nature tells us that health is mans birth right and any deviation from the normal (which is the
rule rather than exception, called healthy chaos in science) is being managed by the human immune
system. The range of change in blood pressure, sugar, cholesterol or any other of the millions of
chemical molecules that humans have ( a single human cell cytoplasm has 10,000 protein molecules:
there are one hundred thousand billion cells in all) all been managed properly by the immune
mechanism. We have recent increase in diseases now, thanks to our messing up with our life styles
and environment. A good scientist will dismiss all these as anecdotal, a fashionable word to dismiss
unwanted truths. When their rules fail they label it as exceptions only prove the rule-strange logic
indeed!
Diseases are only exceptions and accidents. Even diseases, in their incipient stages, are managed by
the immune mechanism built in to the human physiology. It is only in the unlikely event that the latter
can not afford to correct the deviation does the body show signs of distress-the symptoms of any
disease. It is only under those rare occasions that doctors are needed to help patients to cure rarely,
comfort mostly but to console always. Every one needs a humane family doctor to assist him/her in
times of need. No one should be his/her own doctor and self medicate even for silly symptom like a
headache.

To claim that one will be able to catch diseases in their early phase to radically cure them etc, the
daily advertisements that we see extolling the virtues of regular health check ups and screening for
this or that deadly diseases, is plain rubbish and not based on any science. Routine screening of
apparently healthy people is the most dangerous activity avers a leading article in the famous British
Medical Journal followed by a devastating editorial by the then editor, Richard Smith, entitled the
Screening Industry, which it surely is. Modern Medicine has become a corporate monstrosity,
writes Ruth Richardson, a British medical historian. That was precisely the reason why Thomas Wakely
started a new journal in 1823, The Lancet, which he claimed could open the large abscess containing
foul smelling pus that medicine at that time had become, using his surgical lancet. The Journal has
survived to this day with the abscess now becoming a corporate monstrosity according to Ruth
Richardson in spite of Wakelys lancet! Thomas Wakely (1795-1862) was a physician, a demagogue
and a young radical Member of the House of Commons. Little did he realise, young as he was, that it
is folly to be wise in the world of the blind.

You can bend it and twist it... You can misuse and abuse it... But even God cannot change
the Truth.

Michael Levy

Editorial Coronary Angiogram is not the Diagnostic Gold

Standard: Plea for Parsimony
Men are vain authorities who can resolve nothing

Michel de Montaigne Almost every American has some degree of blocks in the coronary arteries, avers
a re c e n t editorial in a leading medical journal

1. Most blocks have been there from our childhood and are innocuous. They stimulate the growth of
multiple collateral vessels that naturally, bypass the blocks. This, to a great extent, applies to other
races as well; only the degree varies. Recent studies have shown these blocks in all the major vessels
in young healthy American soldiers killed on the battle front as also young kids killed in the cross fire
in Los Angeles riots a few years ago

2. What, then, is the role of an angiogram in the diagnosis of coronary artery disease? Hardly any!
The only role for coronary angiogram is after the diagnosis of coronary artery disease is confirmed by
various other methods, most important being the patients clinical presentation, in the unlikely event
of an intervention being considered as the best management s t r a t e g y, the coronary angiogram
becomes mandatory to decide the plumbing techniques

3. Does the presence of calcium indicate the nature of the plaque? Recently, there have been attempts
to establish another expensive and, to a certain degre e, dangerous diagnostic test to detect alcium in
the coronary blocks to indicate the risky type of blocks that are supposed to progress to plaque
rupture with intravascular clots, producing myocard i a l infarcts. EBCT, the computed tomography
(fast CT) e l e c t ron beam double helical system, detects calcium in the vessel walls as a sign of
atherosclerosis .

4. There are two kinds of atherosclerotic plaques, the one with and another without calcium. The
former is seen in elderly patients with stable angina and the calcium deficient plaques are seen in
younger patients but, the presence of calcium does not mean that the plaque is active. EBCT again is
not the Holy Grail of coronary artery disease diagnosis. As much as 19% of patients with acute
myocardial infarction, in a recent study, did not have calcium in their infarct related vessels!

5. The advertisers of this machine miss this vital point deliberately. In addition, each EBCT scan gives
the patient as much as six chest radiogram worth of radiation. If this is combined, as many times
done, with a lung scan, it adds another six chest radiogram worth radiation and if done with
abdominal scan another twelve radiographs worth of radiation. As such this is a dangerous procedure
in patient follow-up. How to detect a dangerous plaque? The best method, of course, would be
intravascular angioscopy coupled with intravascular echo. It has its limitations, though and, the facility
is not available routinely. It needs a great degree of skill to interpret the results. Among the various
methods the one that stands out is the presence of nflammation in the plaque. Inside the coronary
vessels it is very difficult to detect the four major signs of inflammation, viz, color, dolor, rubor and
tumor. However, part of the chest pain could come from the inflamed plaque itself, as the heart
muscle, per se, has no pain fibers, anyway. That would again be a crude denominator. Raised local
temperature is a definite sign. The plaques that are going to create problems in the near future are
always a couple of degrees centigrade warmer than the quiet plaques that remain dormant all through
ones life. Measuring coronary intimal temperatures is not easy. The next best would be to look for
indirect evidence. Inflammatory cells of all kinds leave their foot prints in the circulation. Most
inflammatory cells produce the kind of cytokine response that stimulates the liver to generate C
reactive proteins. A serial study of rising titers of the C reactive protein, in the absence of other
inflammations, is a very good sign of imminent danger from the playque

6. In addition, the macrophages, the scavenger cells that mop up the debris around the area of
inflammation also leave their markers. Another new test recently approved by the American FDA is
called the PLAC, which measures the macrophage markers

7. This test measures the level of l i p o p r o t e i n associated phospholipase A2, the end product of
macrophage degradation - the tell-tale feature of a recent inflammation. Once again, if there is no
other evidence of inflammation in the body and, in the presence of unstable angina, PLAC test is worth
its cost. I must hasten to add here that no test should ethically be performed in clinical medicine, that
too an expensive test, which does not give a new direction to get at the diagnosis nor helps plan a
new management strategy. From that point of view PLAC is a good test. This, coupled with high
density lipoprotein levels, and homocysteine levels might help the diagnosis of coronary artery disease
in a patient with unstable angina. Intravascular echocardiogram has helped us to get much more
information about atherosclerotic plaques than all that we have believed so far. It was believed till
recently that early plaques that are small usually rupture. A prospective study did show that one in a
hundred such plaques only produced trouble; most of them remain quiescent for life.

8. So the size of the plaque is of no consequence. The large plaques which are calcified rarely create
any problem. In addition, these early plaques help remodel the coronary arteries and rarely block the
flow of blood. They may induce collateral growth as well. The Holy Grail of coronary disease? Medical
world has yet to find the Holy Grail of coronary artery disease diagnosis, leave alone drinking from
it. However, recent studies have re i n f o rced some of the well know facts that coronary artery blocks
are not synonymous with coronary artery disease. The two are poles apart. This brings us to the heart
of the matter. Atherosclerosis is only a band-aid that nature puts on any vessel injury. Unfortunately,
Aniskov and Rokithansky found the gruel (cholesterol) inside those plaques and we have been
equating serum cholesterol and all its cousins as the be all and end all of vascular disease till very
recently. Similar is the story of coronary angiograms. Although they do not tell us anything about the
nature and the future of the coronary plaque we still make the gullible people believe that detecting a
plaque is the gold standard for diagnosing coronary artery disease and have been predicting the
unpredictable to increase patient anxiety to get them into our net for interventions that are the
biggest till movers in medicine today

9. . Nothing could be farther from the truth, though. Let us accept this fact and act fast before society
realizes our tricks to hold us in contempt. The size or extent of the plaque has no relevance to disease
but is needed to help the plumber if we chose to intervene with either angioplasty or CABG. Both
these procedures are also anti-Nature. Both of them increase the original disease, the intimal damage,
not to mention the other dangers. The original disease in the vessel is the intimal damage and if we
could find a solution to avoid that, we could win the war against this killer. The key could be in the
human mind

10. It is the disturbed mind that is at the root of vessel wall damage. The urgent need now is to
confine the angiography set ups to scientific research departments only and not let them mushroom
on a commercial scale. The latter is a curse on mankind. There have been sane pleas for this kind of
action even from the advanced west

11. Hope we will be able to practice humane medicine and be ready to walk our talk, to get back the
lost glory of the medical profession. We do not see things as they are, We see them as we are.

NOBILITY OF THE NOBEL PRIZE.

He has a right to criticize who has a heart to help.

Abraham Lincoln.

How noble is the Nobel Prize? I was pleased to read in one of our English dailies an open letter written
by ten noted physicists to the Nobel committee protesting the exclusion of Prof. EVG (George)
Sudarshan from this years Nobel in physics while giving it to Prof. Glauber. I feel they are fully
justified in doing so as Sudarshan richly deserved this honour much before Glauber. The Nobel
tradition has been like that all through if one looked critically at the history of Nobel Prizes ever since
Alfred Nobel, who made his millions by selling dynamite, had a heart transformation following a
devastating fire in his own factory. He then realized, for the first time, that it is in giving that one
gets. He gave it all to establish this great tradition of honouring great brains in several fields. The list
got expanded after some years with more money coming in. Respice to prospice - let us look back to
look forwards. Mahatma Gandhi, the apostle of peace, never got the Nobel Peace Prize, while some
confirmed criminals got the same for their heart transformation in their evening of life (vridda naari
pathivritaa).

Wagner Juregg got the Nobel for medicine in 1927. He claimed, in a scientific paper that he invented
the fever therapy for successfully treating the most dreaded disease of those days, GPI (General
Paresis of the Insane), miserable complication of the then King of diseases, syphilis. What is AIDS
today was syphilis then. These are all dynamic diseases having their cycles periodically. Just as any
one worth his salt that researches AIDS today gets a large booty of the $ 8 billion of the NIH
research grant money, people were venerated when they talked about syphilis those days. The story
repeats in history with an unchanged pattern of falsehood and mystery. We talk and do so many
things about this enigma called AIDS while the father of the PCR test, a Nobel Laureate in Chemistry,
Kary Mullis, is wondering as to what is the connection between the AIDS syndrome and the (in)
famous HIV virus. He should know better as all viruses are identified using his test. His friend,
Professor Peter Duesberg, a virologist of great fame at the Berkeley University, in his great book
Inventing the AIDS Virus goes to great lengths to expose the fraud in the field. That is for another
time.

Be that as it may, let us go back to our friend Wagner Juregg. His name came up before the Nobel
committee in 1926. Gladius, a physician member of the Nobel committee that year knew that Juregg
did not invent anything new. It was Hippocrates, the father of modern medicine, in 100 BC that
introduced fever therapy to medicine. Juregg tried to inject malaria parasite into the GPI victims in
mental hospitals to see if the very high fever that malaria parasites produce could kill the treponema
pallidum, the fearsome germ of syphilis, which people normally acquired through sexual intercourse.
Six of the one hundred patients thus injected improved clinically and more than fifty of them died (not
reported in the paper) of malaria as Europeans do not have racial immunity against falciparum
malaria. Of course, both Juregg and Gladius did not know the existence of the now well know caste
system among malaria parasites. Juregg thought all malarial parasites belonged to one caste. Gladius
could thus avert a tragedy in 1926. Gladius told the committee that Juregg must be tried in a criminal
court instead for killing that many patients out of the one hundred that he used for his experiments!
There were no ethical committees those days! But read on to know that Wagner Juregg got the Nobel
Prize the following year after Gladius died providentially of a massive heart attack in 1926.

There are exceptions and many good deserving people did get the Nobels. One of them was my
teacher, Bernard Lown, who deserved the Nobel for his invention-the Lowns defibrillator-the machine
that saves many lives in the emergency room after cardiac arrest. But he did get the Nobel Peace
Prize instead much later. He founded the Physicians Against Nuclear War (PANW) in 1974 and fought
against the might of the US war lords to prevent further nuclear stockpiling and was instrumental in
getting the Russian communists to talk to the American capitalists. He was mainly responsible for
preventing America dumping its plutonium waste in a small island off the west coast of Africa. But the
numbers that were cheated in this process are too many to enumerate. However, a few deserve to be
mentioned for their great contributions in different fields of human endeavour for which they richly
deserved the Nobel.

John OM Bockris is a distinguished Emeritus professor of chemistry at the A&M University in Texas. He
is the father of cold fission - nuclear fusion occurring in a laboratory test tube! He was ridiculed,
persecuted but he survived all that. He was cheated of the Nobel despite several nominations over the
decades! Professor Rustom Roy, Evan Pugh Professor of material sciences (and many other
professorships) at the Penn State University is the worlds top material scientist. His laboratory is
considered the leader. He invented the sol-gel technique that is used even today to extract nano-
particles. He should be rightly called the father of nanotechnology. He was nominated a dozen times
for the Nobel without the committee selecting him. His technique is the one that scientists use even
today, though.

Most recent is the case of Professor Eddie Escultura, from the Philippines, a great mathematical brain
who contributed something novel in the field of quantum physics. He was considered for the Nobel this
year by the committee only to be rejected in favour of Professor Glauber. But the developments
following this would reveal the sickness that has afflicted the Nobel committee. Professor Gerholms,
an eminent physicist on the Nobel committee resigned from the committee to protest the dropping of
Eddie. He goes one step further. In a personal letter to Prof. Escultura, Prof Gerholms wrote as to
what went on inside the committee room and named two prominent members of the committee
lobbying for their candidates. Gerholms in his resignation letter wrote to the committee that lobbying
is highly objectionable inside the Nobel committee. Bold man indeed!

Another distinguished Indian mathematician, Professor Lakshmikantham of the Florida Institute of

Technology, whose original work in the field of non-linear analysis has taken him to the top in the
world of mathematics also falls into this category of losers. He was rejected several times. One could
go on and on. I have come to one conclusion that where there are men manning any organization,
including governments, morality and authenticity would be the casualties. Poor Alfred Nobel did not
know that it would have been better to have the Nobel committee of laws rather than of men. Even
government of laws would make the world more tranquil in place of the crafty criminal politicians
manning governments! Men, whether in palace or pad; castle or cottage, are governed by the same
emotions and passions. Winston Churchill was dead right when he said that it is better to deserve
than to get. All the losers mentioned above and the countless others who have wasted their
sweetness in the desert air (including the one Indian who keeps telling me that he should have got
the Nobel in his field) could take heart from the knowledge that it is better that they deserved the
Nobel much more than many around them that managed to bag the prize. Injustice is called justice
these days and justice seems to be convenience of the powerful today.

Only the wise possess ideas, the greater part of mankind are (is) possessed by them.

Samuel Taylor Coleridge

1. YOUR HEALTH IN YOUR HANDS-OSTEOPOROSIS

Knowledge of what is possible is the beginning of happiness.
George Santayana.

The health of any individual is, to a large extent, in the hands of the individual himself/herself. Of
course, this statement does not take into consideration the genetic inheritance. Even the latter could
be influenced by the individual by changing ones environment and the mind. Gene penetrance, the
capacity of any gene to produce a disease, depends mainly on the environmental support. This
statement might surprise the well informed public who has come to believe that man lives mainly
because of the efforts of the medical fraternity and the pharma industry with the help of technology
manufacturers.
One is constantly reminded that there is a pill for every ill, which is only a myth like the many that we
are sold daily by the media barons. If the reader wants some help in this area Myrna Blyth, a top
magazine editor for twenty years, tells you how the media takes you for a ride. She also gives tips in
her book about how not to get spun by what one reads or sees on the small screen. In addition, one is
also made to believe that one could prevent most, if not all, illnesses by regular check up and
correcting the deviations from the so called normal levels of various body parameters. These myths
have been perpetrated by the disease inventors, the Big pharma lobby, with the help of the black
sheep in the medical profession, called the thought leaders in American jargon.

In this article let us analyze one disease, which is an ongoing ageing process- osteoporosis. The
usual fear generating statements like the following abound in the lay media. Osteoporosis is often
called the silent disease because bone loss occurs without symptoms. Twenty percent of all women
over the age of 50 have osteoporosis and another 40 per cent have osteopaenia, thinning of the bones
that break easily. These statements would make all women at risk and is very frightening, indeed.
This is the statement of the National Osteoporosis Foundation. Any informed woman aged fifty and
above would immediately rush to a hospital for a bone density scan, more so, if she has also been
scanning the internet with a plethora of health sites frightening people; most of them being funded
by vested interests.

In health bones undergo constant remodeling to repair minor injuries, maintain strength, and give the
body a reservoir of calcium. There are two kinds of cells doing this routinely-osteoclasts removing
calcium from the bone, and osteoblasts that lay down new bone. This balance changes after the age of
40 or so when the loss is more than the gain and gradually the bone mineral density decreases in
every human being as age advances. The original WHO expert group, intentionally or unintentionally,
made a fatal mistake in taking young bone as healthy and the adult and elderly bone as a disease-
osteoporosis. In fact, osteoporosis is a normal ageing process and not a disease.

The WHO study group recommended that every post-menopausal woman should have a bone scan.
Aided and abetted by the drug companies, doctors now prescribe costly drugs to treat this normal
physiologic change. A recent audit showed that 81 women in society with osteoporosis will have to
take an expensive drug (Fosamax) for 4.2 years, at a cost of more than $ 300,000, to prevent one hip
fracture. A recent study published in the New England Journal of Medicine (2001; 344: 333-340)
showed that even advanced osteoporosis in the age group of 70-79 did get very little help by any of
the drugs that are prescribed. More so these drugs have been shown NOT to change the hip fracture
rates in elderly women!

The real risk factors for hip fractures are increased frailty due to age, muscle weakness due to lack of
exercise, side effects of many of the drugs that one takes, declining vision, and cigarette smoking.
Bone Mineral Density screening detects only a small percentage of those at risk-less than 20% at an
enormous cost to the patient. Another study showed in the Journal of the American Medical
Association (1998; 280: 2077-2082) that many of the drugs used in the treatment of osteoporosis
actually increased the risk of hip fractures! Divine interventionalists should never delude themselves in
thinking that they could upset Natures methods.

Eighty per cent of the bodys bone is made up of the outer hard cover called cortical bone. In some
areas the bones also have an inner structure of trabacular bone, which anchors the outer cortex like
the three dimensional geodesic dome, giving additional strength to the areas most vulnerable to
fractures, such as the hip, wrists and the spine. Since trabacular bone is larger in mass it suffers the
most in ageing process. The new bone, said to be formed by drugs given by doctors, would only make
the cortical bone denser, thus making the vulnerable areas more prone to fractures. Recently the FDA
even wrote a letter to Eli Lily Company to stop their advertisement for these drugs in the media!
What, then, is the remedy?

Regular exercise and good nutrition are the key to keep the bones healthy for a long time. The main
culprit in the diet is salt. Since sodium exchanges for calcium in the kidneys the more salt one eats
more calcium one loses from the body. Low salt intake, even when one is young, would go a long way
in keeping normal bone density longer. High calcium content in diet is another vital part of good
health. Many of us think that milk is a good source of calcium. Yes, it is for the calf and not for man.
Milk is bad food for man. Highly absorbable calcium is found in abundance in dark leafy vegetables
and beans. In the west there are the calcium rich vegetable milks made from Soya, rice, almonds and
oats. Oral calcium is no good. Higher the calcium intake as a drug, larger is the calcium quantity that
gets lost through the kidneys, leaving the system with a negative calcium balance at the end of the
day. Exercise is the key to healthy bones. The earlier one starts the better, but if one has been
sedentary for years, exercise at any age quickly tries to help strengthen the bones. Your health,
therefore, is in your hands only.

Do what you can, with what you have, where you are.

Theodore Roosevelt.

CHAOS-A NEW SCIENCE OF NON-LINEARITY.

Men are never so likely to settle a question rightly as when they discuss it freely.

Macaulay.

Nature has a reason for everything, but mans reasoning may not be able to understand that. The
present day positive sciences can never answer the question why, although they could, at best,
answer the questions, how or how much. Ratio rei is, therefore, not reason why! A physician could
explain how does the heart pump blood but, will never be able to say as to why does the heart pump?
Man is a very, very tiny part of Nature and lives in harmony with nature. Man, therefore, like nature,
is dynamic, changing from second to second and never remaining static, at any given time, except
after death. How nature could tie such complexity to such simplicity that one sees in man is far from
obvious.1 One can only think of it as a miracle, the simple laws of theory and experiment, as is
practised in the present day static sciences, can never apply to this dynamic human body. New
concept of consciousness, which physics is trying to grapple with, gives us an inkling into the way man
merges with nature.

This requires serious differential equations and not simple difference equations! In simple sciences the
physical causes dominate. Human body follows natural selection that operates not at the level of the
genes or embryo, but at the level of the final product-the final cause. Goethes Theory of colours and
his On the Transformation of Plants go to explain this dichotomy very well. The dynamic man is
continually run by food and oxygen to do what he/she does. Ecology simply means that everything
here is related to everything else.

Consequently, health is that state of dynamic equilibrium where man is in tune with all that is around
him. In the broad sense, health has to be a judicious combination of physical, psychological,
emotional, spiritual, ecological, political, and creative wellbeing. Illness is an exception and, is an
accident. Health is the birth right of every one. Preserving that healthy state and living in harmony
with nature should be our aim in life. That is the essence of the ancient system of medical care,
Ayurveda (Ayush=life and vid=knowledge), which has been in existence since time out of mind in
India. It is said to be a part of the Vedas, the Indian scriptures of the Sanaathana Dharma - ageless
wisdom for all mankind. It is not a religion in the strict sense of the word. God concept in that system
is represented by love, truth and high ethics. Nature is thought to be our mother and propitiating
nature in its bounty is considered propitiating the supreme power, prajaapathy, that bestows Nature
with all its bounties. That kind of God concept is really good for healthy living since there is no room to
exclude anybody from that belief. As such man becomes tranquil, hating no one- an important pre-
requisite for good health in Ayurveda.2 (Aapthopasevi Bhaveth Aarogyam)

Swasthashya swastha rakshitham-Try to keep the healthy well, is the bija manthra, the essence of
Ayurveda. To preserve health, as defined above, one needs the total involvement of all that is
mentioned above in nature that man is a part of. Health, therefore, is a dynamic concept in Ayurveda.
Ayurveda has elaborate methods of keeping the harmony between man and his surroundings, to
prevent him from breaking down with illnesses. However, occasionally, and certainly when ones
sojourn here ends, man could fall ill. In such an unlikely event Ayurveda has many methods of disease
management to cure rarely, comfort mostly, but to console always.3

Modern medicine started as mumbo-jumbo, sorcery and witchcraft, nearly five thousand years ago, on
the banks of the river Nile. During its passage westward modern medicine got transformed into what
we call today a science. It was in the twelfth century that the European Universities accepted
medicine as a science. Since then medicine has been riding piggyback on the natural sciences of
physics, chemistry and biology. Physics forked off in the early part of the last century to unravel the
mysteries of the quantum world and came up with the idea that this world is a wonder and a
wonderful wonder, where the only certainty is uncertainty and everything is in the eye of the beholder
(maya). Medicine, on the contrary, still follows the biological sciences of deterministic predictability in
a dynamic system. This has been the bane of modern medicine in that it has now come to a cul-de-sac
from where it does not know how to get out.4

The reductionist science that biology follows is mired in statistics and it earns its livelihood from
statistics. Unfortunately, linear mathematics and its statistics do not apply to a dynamic system like
the human body. Consequently, doctors and scientists have been predicting the unpredictable all
these years. Wholistic science of chaos is the only remedy. This is the science followed in the holistic
concept of Ayurveda, nay in Vedic mathematics of which Ayurveda is only a part. The history of
science is replete with examples of how real progress had been halted by such tragedies for centuries.
It is very difficult to swim against the current. For five long centuries scientists repeated what
Ptolemy said about the sun moving round the earth up until Copernicus came on the scene. For nearly
fifteen centuries medical scientists believed that blood originally circulates from the liver to mix with
air from the lung through the small holes in the median wall of the chambers of the heart. William
Harvey, in the seventeenth century, discovered that the heart pumps blood out that circulates round
and round. He literally had to run for his life under cover of darkness and hide for one long year
because he opposed Galen who had said that blood circulates from the liver. History repeats itself: let
us not suffer that long before we realise that linear mathematical rules do not apply to a non-linear
systems like the human body.

Tridoshas are genetico-constitutional types of human beings. Vaata, pitta, and kapha do not mean
any symptom of disease. Ayurveda with this kind of classification has made it easy for future
controlled studies in medicine which could be more scientific compared to the present controlled
studies in medicine where only a few phenotypic features are matched like sex, body mass index and
age et cetera. The latter does not have any meaning in a dynamic system. Time evolution in dynamic
systems depends on the total initial state of organism-the mind, body and the genes. When a good
Ayurvedic physician tries to classify people into these sub-types and their innumerable permutations
and combinations, he would arrive at a reasonable group of people who could then be divided into two
matched groups to conduct controlled studies on drugs and interventions. Modern medicine has come
to grief through those controlled studies. Drug treatment of hypertension, hyperglyaemia,
hypercholesteraemia and many other drug interventions based on controlled studies in the long run
have done more harm than good.5, 6, 7, 8, 9, 10,11 Let us not try and extrapolate modern medical
methods as such to Ayurveda, which does not follow linear mathematics.

Modern medicine has one more curse for mankind. That is the saga of screening the apparently
healthy in society for any sign of future disease to be corrected early. Ayurveda leaves the well alone
and tries to help them to remain well as long as possible with the help of immune boosters and a
system called Panchakarma- a natural method to help the body get rid of accumulated toxins and
postpone ageing. Screening is one of the dangerous procedures. No one gets any benefit in the long
run, as linear relations do not hold good as time evolves in any dynamic system. That apart the very
idea of the normal is faulty. Normal is the mean +- 2SD from the mean value of the Gaussian
distribution. Simply put, this amounts to 5% of healthy people falling into the abnormal range in any
study. If a study like total body scanning were done on the population it would throw up thousands of
values in the abnormal range creating truckloads of anxiety for those thousands.

It would also make them consume potentially dangerous drugs for no fault of theirs. One in four drugs
given to patients would have serious side effects resulting in a large chunk of the hopsitalised patients
suffering from iatrogenic diseases at the end. It is very expensive, in addition. Two examples would
suffice. It would take 850 healthy people, with borderline elevated blood pressure, to take
unnecessary medicines to prevent one man from getting stroke in the next five years! Worse still is
the picture of 1000 women needing screening for 35 long years to prevent one death from cervical
cancer. One nurse doing 200 tests in one year would take 38 years of continuous work to prevent one
cancer death. In that time interval she will have seen 152 women with false positive results, over 79
women would be sent for invasive investigations, and 53 women would have abnormal biopsy report
of cancer where none exists. Is there anything more serious than this statistical blunder?12, 13

The greatest drawback of using reductionist scientific methods in holistic science could be gauged from
this experience. Pharmacology uses extracts of plants from Ayurvedic texts to conduct various studies
to sell them as drugs. Herbal ayurvedic drugs do not work that way. To cite a common example,
tomato is very rich in ascorbic acid. If one thinks that giving ascorbic acid as such is as good as eating
fresh tomato, one is making a big mistake. While vitamin C in tomato is the same as in a tablet, the
other chemicals present in tomato (whole) have the power to suppress the long term side effects of
vitamin C, given as a drug. Daily intake of vitamin C in large doses has been shown to be associated
with cancer, but that does not happen with eating tomato. The same principle holds good to other
redcutionist methods vis-a-vis Ayurvedic pharmacy. The drug has to be administered as is described
in the ancient texts.14

Similarly straight-jacketing vaata, pitta, and kapha into bio-statistical models could look attractive to
the reductionist scientists in modern medicine, but may not work that way in the holistic concept of
Ayurveda, described above. We may have to find complicated differential equations for that purpose,
simple difference equations will not do. We will have to think of newer scientific methods of
measurement in a holistic science of chaos in the human body where rhythmia could be illness and
arrhythmia could be health.

No man, no author, not even the greatest, ever provide the last word on anything. Men (women) are
vein authorities who can resolve nothing.

-Michel de Montaigne.

(MIS) TRUST.
The world is a dangerous place to live-not because of the people who are evil but because of the
people who dont do anything about it.

Albert Einstein.

Confucius told his disciple, Tsze-Kung, that there are three vital things for any King or Government:
food, weapons, and trust. If all three are not available at a given time, the King could first spare
weapons and then food. Trust should be the sheet anchor of any system. He said: without trust we
can not stand. I think he was right. Recently, when the foot soldiers of Saddam Hussein lost trust in
him they deserted. Food shortage need not necessarily topple any government. Second World War is
an example. India had severe food shortage but we accepted the strict rationing and still supported
the King! The sad events of 9/11 showed that the enemy could strike and destroy without the
sophisticated weapons at their command compared to the American army. When the king loses trust
of his people, he would soon lose his grip on the empire! Dame Onora ONeill, in her Reith Lecture
series 2002 for the BBC, gave a graphic account of how complete absence of trust would prevent us
from even getting up in the morning.1

Modern medicine is at the crossroads today. Hospitals are empty, patients angry, doctors frustrated,
HMOs in the US are declaring chapter eleven by the day and there seems to be confusion all round.
NHS patients in the UK have to wait for months to get routine surgeries done. These days doctors do
not get enough time for even talking to their patients. Technology has made medicine prohibitively
expensive. Modern medicine is beyond the reach of more than eighty per cent of the world population.
We doctors have a holier-than-thou attitude towards many effective methods of disease palliation in
other complementary systems of medicine.2 Their practitioners carry on unconcerned and the annual
herbal drug market alone is more than $ 70 billion!

If Confucius were to be alive today he would have given guidelines to doctors also on the same lines
like the ones he gave to Kings. He would have listed the following three as vital for medical practice:

* Medical humanism

* Medical science of the right variety-holistic and not reductionist.

* Patients trust in their doctors.

Here again he would have said that the last is the most important, although the other two are as vital
to the core of medicine-medical consultation, as the third. When a man/woman who is ill or imagines
he/she is ill, comes to seek the advice of another man/woman in whom he/she has confidence, the
meeting of two minds is called medical consultation. This is the heart of patient satisfaction and this
helps in no small measure in the eventual patient recovery. Even the best surgeon, many of them do
not get time to see their patients in the waking state hopping from one theatre to another without any
break, could only cut and suture but the healing or non-healing depends on the patients immune
system. The latter is mainly under the control of the human mind.3 Patient satisfaction, therefore, is
as important for recovery, as are the drugs, technology, the surgeon, and the array of scopes and
scanners. This is one of the reasons why many practitioners of complementary medicine score over
us. They practice empathy in addition to their skills and have more time to spare for each patient
thereby stimulating the patients immune system.

Bad News:
Modern medical methods and their practitioners have been shown in bad light by many skeletons
stumbling out of their cupboards lately. Doctors went on strike in Israel for three months in the year
2000. They attended to emergencies, though.

Death rate and disabilities were reduced dramatically during those months only to reach their original
levels soon after the doctors came back to work.4 Routine screening has been one of the biggest
money spinners for the profession and the instrument manufacturers, but has been a curse on the
healthy population.5 The divine interventionalists have been having hey day making money and
earning fame and respectability but all their efforts have been misdirected, since time evolution in a
dynamic system is not linear. Most of the drugs used to correct the presumed abnormalities like raised
blood pressure, sugar, cholesterol and many others in the apparently healthy people have not had the
desired results in the long run.6 To give a simple example: eight hundred and fifty healthy people
would have to take blood pressure lowering drugs for a period of five long years to save probably one
person with mild-moderate hypertension from stroke in the next five years!7 One could also imagine
the unimaginable side effects of those drugs in those hapless people who agree to take drugs hoping
to get direct benefit for themselves. One in four drugs prescribed for any ailment in the normal course
would result in serious side effects, many times necessitating hospitalisation.8 Epidemiology, applied
to non-communicable diseases, makes the false positives go up exponentially. Disease statistics when
applied to healthy population distort the outcomes making life miserable for those who opt to come to
modern medical treatment.9 Statistics apply only to large cohorts of men or women but they have no
relevance to the individual patient sitting in the doctors office. A clever statistician could even make
his tool work for him. Mushrooming of risk factor studies came out of large research grants for such
studies in the post-Second World War period. Hospitals have been closed because of the misuse and
overuse of inappropriate technology.10 Drug manufacturers were caught inventing diseases to sell
their wares.11 Money has been an attraction even to fake research. People have not hesitated to
invent newer viral causes for diseases basically to sell drugs or get fame.12

Need for a paradigm shift in medical philosophy:

Human activities are guided in society by the common philosophic outlook. The western materialistic
mindset has eroded the altruistic medical ethics of Hippocrates and his followers in Greece. Doctors
are trained not to make money but to look after the health of the public. This laudable motto has long
been forgotten and medicine was taken to the market place, where all the market forces started
working on it. Today in the west, medicine is a commodity: the doctor the seller and the patient a
buyer. Immanuel Kant, one of the great brains in the west, had classified the western mindset into
two different classes: happy but not good and good might not be happy. Today doctors are happy by
and large but I doubt if they are good on Kants terms. Kant thought that people should be good even
when their own happiness is at stake.13 Owen, quoted by Daniel Goleman, in his interesting book
Destructive Emotions, tries to put the western mindset into three water tight compartments thus:

* Rational egoists
* Selfish and compassionate

* Compassionate and selfish

The first live totally for themselves and are rational to the core. The second are very selfish, but when
there is plenty to waste they might think of others. The last are compassionate in the sense that when
there is plenty they would like to share it with others, but under special conditions of scarcity of any
commodity, they only think of their needs and forget others. A very comprehensive picture of the
western mind set, indeed. The east is different. Buddhism teaches what they call tseva (service) as
the motto of life. This is service above self philosophy. Goutam Buddha did record that a doctor is like
a mother to every patient. The mother, especially the one with only one child, showering all her
compassion and love on the child. Doctor, he felt, should do the same. The Indian timeless Vedic
wisdom does propagate the dictum that a human being is born here primarily for the good of others in
society-societal dharma, the obligation to society-the rent one pays for the parking lot here on earth.

Medical fraternity would do well to change from the totally materialistic mindset to that of a new
philosophy in between the eastern and the western ones. It may be difficult to follow the east in its
totality in the present world of cutthroat competition. One could choose to be compassionate and
selfish and try to intervene only when the patient needs help. Patient doing well do not interfere was
the Oslerian dictum, which is true even today. Interfering in the asymptomatic stage of any incubating
disease might interfere with bodys efforts to correct the damage.

What role does patient trust play in healing?

Recent advances in psycho-neuro-immunology have opened up a new vista of knowledge that gives us
an insight into the human mind. Gone are the days when the answer to the million dollars question:
where is the mind? was never mind. Quantum physics has thrown new light, which the eastern
wisdom had shown thousands of years ago, that the mind resides in every cell at the sub-atomic level
and is connected to the universal consciousness of which each individual is an indivisible part. With
this background, scientific studies of even intercessory prayer were shown to help in the treatment of
acute myocardial infarction, as an important adjunct.14 Placebo effect is nothing but this immune
stimulation. Patient trust in the doctor, therefore, is the centre of attraction for healing. Nocebo
doctors, doctors that do not have time for their patients to get an insight into patient problems,
naturally do not command patient trust. Patient care is caring for the patient. Patients emotions do
play a vital role in the aetiology of diseases. Destructive emotions like hatred, anger, jealousy, and
depression play an important role. Young medical students, studied prospectively with PET scanners,
did show a strong relationship between early coronary calcium deposits and hostility scores! To
understand all that and to undo the damage, the doctor has not only to intervene with angioplasty
and/or CABG, but also by helping the patient to replace his destructive emotions with positive
thinking.15 Then, and then only, would doctors earn patients trust, which assists the final healing,
reversing the damage inside the vessel wall. In the normal intervention the patient improvement is
only temporary, recurrence waits round the corner. The physician should have a healers heart and a
careers hands.

Civilization is just a slow process of learning to be kind.

..Charles L. Lucas

A PIECE OF MIND
Know thou this-that men Are as the time is
Shakespeare.

I shall give you a piece of my mind to help you get some peace
of mind. All writings on esoteric matters like meditation, God
and philosophy are shrouded in mystery and couched in
unintelligible sesquipedalia verba. Nowadays they come
packaged for sale, not to speak of their high cost in tune with
the present trend in the market. They remind me of the popular
junk food.I hope these methods are not as dangerous to health
as are the junk food packets!

The need for peace of mind started with the onset of the
monetary economy,culminating in the new epidemic of suicides
and divorces in the west. The plastic card economy would only
enhance this need. Once a student reminded me that my efforts to make man tranquil would have to,
per force, fail, since this universe is a combination of the opposites- good with the bad, yin with yang,
positive with the negative, happiness with sorrow, elation and depression, etc. Even at the micro level,
he said, the atom remains intact because of the protons, neutrons, and other quantum particles with
opposite charges.

While I agreed with him, my submission was that the balance between the good and the bad- the bad
arising out of oppression, suppression, and denial- has reached a flash point. If that were to happen to
the atom the latter would have exploded by now. Before the macro world explodes we have to hasten
to act. Otherwise, the saying of the poet when the last tree is cut, when the last river is poisoned,
and the last fish eaten, mankind would realize, for the first time, that money can not be the substitute
for food and water, would come true. Mankind then would have to follow the path shown by the
mighty dinosaurs.

I have tried every one of the methods of meditation to get tranquility. While each one of them results
in lower breathing and heart rates, I am not sure if there would be long term tranquility. I could draw
a parallel from modern medicine. While blood pressure, sugar, and cholesterol lowering drugs get us
better laboratory reports, almost all of them fail to translate into better health in the long run.The
reason is not far to seek. Lowering the physical parameters alone will not translate into holistic health
and longevity.
Be that as it may, let us look at common day to day human activities that bring permanent pleasure
and lasting tranquility. Our scriptures have shown the path and the great science of Ayurveda has
reiterated the same time and again for centuries. Aaapthopasevi bhavet aarogyam-treating
everyone around you like your near and dear ones would give you positive health for certain, is the
basis of Ayurvedic art of healthy living. I have been trying this experiment on myself for decades now
with very good results. If I had a day when I did not get an opportunity to show some kindness to
someone, do a good turn to others, give a smile to the needy, or wipe a tear from anothers eye, I get
tired easily. On the other hand even when I was dead tired, if I got an opportunity to be of some use
to another, my tiredness would vanish. Similarly, if I had inadvertently harmed someone, my body
signals that all is not well by way of backache, pain in the neck, heartburn, sleeplessness, tension
headaches, migraine etc.

Over the years I have learnt to analyze my body responses to my thoughts. Even when I think ill of
others my breathing and heart rates hasten. When I help another I feel very tranquil and have peace
within. Anger, hatred, jealousy, hostility, frustration, and other similar negative thoughts bring on
discomfort immediately. This needs one to fine tune oneself to receive body signals. My post-
meditation feeling is not comparable with the immense happiness that I get from sharing and caring
that make me tranquil round the clock. I have come to realize that spirituality and meditation are
nothing but sharing and caring. The joy of sharing is enormous when one cares for those that hate
you. This is not easy, though. It requires lots of practice and understanding. If one could fill the
unforgiving minute with sixty seconds of distance run, one could be really, really happy.

That said, I must hasten to add that the above simple message can not be packaged into a ready
made recipe for all. No two individuals are alike, not even the uni-ovular twins. Each one will have to
tailor this to his/her convenience. Perseverance pays dividends in the long run. Total health requires a
holistic approach. I am not infallible. I, however, feel that I have described meditation in a more
tangible fashion for the common man to understand. There are no easy short cuts in life. One has to
work hard to get good results, but the results are better if one does not get too possessive about the
outcome.

Joy, temperance, and repose

Slam the door on the doctors nose.
H.W.Longfellow.

AFFLUENT WEST AS A GLOBAL THREAT TO HEALTH?

The common ingredients of health and long life are:
Great temrance, open air,
Easy labour, little care.
Sir P.Sydney

The heading might raise a few eyebrows but, the truth, however unpleasant, has to be told in this
instance since the health of the future generations of this planet in the next century is in real danger.
The danger might even come earlier if something is not done on a global scale. The major player is
the United States of America. They might or might not be aware of this. Twenty-five per cent of the
global emission of carbon dioxide, the most dangerous global warming gas, is produced by the US
alone. Human activities are the main cause of global warming according to the report of the United
Nations Environmental Protection Agency (EPA).

The main reasons for these changes are the burning of fossil fuels for energy at the present time and
changing the earths surface constituents, mainly due to deforestation. The latter results in depletion
of the necessary ingredients in the top soil that help to absorb or scatter the radiant energy which
contributes to global warming. In addition, when air temperatures go up there could be vigorous
cycles of both evaporation of water and precipitation producing more and more aberrations in
weather.

While there has been some progress in this direction on a global scale things have not moved at the
necessary pace. The 1992 United Nations Framework Convention on Climatic Change (UNFCCC) has
been ratified by more than 186 countries so far. Despite all this if the United States does not give the
leadership in this direction there is no hope for mankind on this planet. I am an optimist and I hope
something will come out but we have to wake up the sleeping giant before it is too late to see the
writing on the wall. Unless we try and look for alternative energy sources that do not increase the
green house gases and alternative strategies to preserve and increase the forest land there is no
solution.

Health threats from all these are enormous, to say the least. If left alone the world will be the biggest
mortuary in the next century. Large populations would be decimated by this threat of climatic change
as well as by the therapeutic population control due to dangerous drugs and unwanted technology in
medicine. The main threat to human health will be all over but more so in the poorer nations starved
for resources. Water for drinking will be scarce and food for the hungry will dry up sooner than
expected when the ambient temperatures go up. Vector borne parasitic, viral, and bacterial diseases
will go up exponentially as also the vascular killer diseases with the temperatures going up.

That apart, the threat to the very existence of many areas on the globe is very real. New York City
might be under water. New Delhi will be snow covered. Many of the coastal belts in many countries
and the island nations would be submerged. In an imaginative movie, Day After Tomorrow, the picture
depicted looks very gloomy. Even if that does not become a reality the picture could be pathetic. Even
a slow rise of earths temperature would result in abnormal evaporation and precipitation that might
leave in its trail devastations due to droughts, floods and stormy heavy down poor at unusual times
and places resulting in loss of lives and property.

The disease picture might again change. Europe became free of plague after the mid-eighteenth
century because of the cooling of that Continent by a degree centigrade. Rattus rattus, the black rat,
that carries pasturella pestis, the germ that causes plague, disappeared in that lowered temperature.
If the temperature goes up now the same species might reappear and plague might be a new
pandemic there. The present rattus novegenous in Europe, the white rat, is not capable of harbouring
the plague bacillus.

As in any calamity it is the poorest of the poor that get hit the hardest. The cyclones in Bangla Desh in
1970 and in 1991 killed nearly 300,000 and 139,000 people respectively whereas the Hurricane
Andrew in the US in 1992, which was equally ferocious, killed a meager 55 people. The poor have less
coping capacity and their governments have money for other luxuries but there is no money for these
calamities. The estimated number of hungry people in the twenty-first century, if the climatic change
is not controlled forthwith, is estimated to be around 80-90 million, mostly in the poorer countries.

The subdued debate about climatic dangers by a few extremist environmentalists has shifted now
from doubt to inevitability. David King, the chief scientist of the UK government, had recently stated
that climatic change is the most severe problem we are facing today-more serious than the threat of
terrorism. But no body seems to talk about it, least of all our holy media. The media seems to be
obsessed with terrorism all the time and have no time to tell the people that a greater threat is
looming large. In a very lucid book edited by McMichael et. al, published by the World Health
Organization, the real threat is exposed thread bare. The book is entitled Climatic Change and Human
Health. One could get the details from the following email address: publications@who.int from the
WHOs office.

The big names in business are also slowly waking up from their deep slumber. Recently James
Wolfesohn, the World Bank President, alerted an important audience of world business leaders and
other civil society groups about the real danger of the threat of climatic change. I hope that it would
stir their conscience if they have one in the first place. Their greed has been the cause of all these
problems for mankind. He lamented that the most important environmental debate was on the back
burner of international deliberations on development. Any development that does not address this
serious issue will only be destroying this world in the long run.

It is not that the medical profession has not been informed about it, but we in the profession have not
raised any voice in this important area. Doctors are not trained just to make money. They are
basically trained to keep the health of the public. The father of modern medicine, Hippocrates, did
warn us adequately: physicians should have due regard to the seasons of the year, the diseases
which they produce, and to the state of the wind peculiar to each country and the qualities of its
waters. In the great Indian system of Ayurveda, the mother of all medical wisdoms, weather and
climatic changes with seasonal variations are stressed as a vital part of the study of any disease as
also in disease management. Lost in the jungle of the pseudo-science of modern medicine and its
technology, we have lost sight of this important aspect. This is never taught in the medical school and,
consequently, doctors do not take any interest in the environment.

No drug or technology company will be interested in funding any postgraduate activity in this area.
Since medical education is mostly under the influence of drug company money even in the US doctors
are oblivious to this.

In a hard hitting editorial in the leading medical journal The Lancet captioned Medical Education is run
with drug company money in the USA the journal warns of the grave threat to doctors integrity.
Similar sentiments are expressed in another editorial in the leading American medical journal New
England Journal of Medicine entitled Is Academic Medicine for Sale? the writer laments at the present
business atmosphere in medical establishment. Medical humanism demands that doctors become
more human and humane. Earlier we act to stop the monetary economys madness to make profit at
any cost-mostly at the cost of the poor man, the better for mankind.

Western drug companies also see that the drug prizes go up all over the globe in the name of
globalization and the poorer nations pay for their poverty with their poor peoples lives as a
consequence. Life saving drugs have already become prohibitively expensive and are beyond the
reach of even the middle class these days. May I appeal to the business community to have a serious
debate on all these issues and formulate a people friendly economy-call it what you will? It is also an
urgent matter that alternative sources of energy are researched fast to prevent green house gasses
destroying our biosphere and the global ecosystem.

God made the country and man made the town;

What wonder then, that health and virtue, gifts
That can alone make sweet the bitter draught
That life holds out to all, should most abound,
And least be threatend in the fields and groves? Cowper.

AGEING GRACEFULLY
Age, I abhor thee,
Youth, I adore thee.
Shakespeare.

One does not have to abhor aged people at all. I do not agree with Shakespeare. One could grow up
gracefully and could achieve many things even at the ripe old age. There are examples of people who
have been creative even in their eighties and nineties. How to grow old gracefully is a million-dollar
question. Any society, which does not have the wise counsel of its elderly people, is a poor society.
Age mellows people a lot. If one is a thinker, age teaches many useful lessons. Life is not long enough
for each of us to make all the mistakes ourselves and then learn from them. We could learn from
others mistakes and, in this direction, the thinking elders are a great boon.

The craze for money and power seems to be the cause of degradation of societal morals and ethics.
The bad effects of this are seen in all walks of life. Competition, which is alien to human physiology, is
the key word these days. Competition breeds mediocrity in every sphere, resulting in falling standards
of morality, ethics, and common courtesies. This is not new. Look at what Shakespeare wrote about
the state of affairs then:

For in the fatness of these pursy times

Virtue itself of vice must pardon beg.
Hamlet.

If one goes deep into this malady, one quickly realizes that the root cause of our entire competitive
ethos starts with our present system of education at the primary level. The innocent child, born with
only two basic instincts of self preservation and procreation, is injected with the poisons of pride, ego,
jealousy, hatred and anger right from the first examination in school where we encourage all these by
grading students into different ranks.

Ageing starts from the day one is made in the mothers womb, soon after the fathers spermatazoan
enters the mothers ovum. The resultant zygote is only a small speck of protein weighing just
0.0000000000001 gm. This little speck of protein is the beginning of man. The zygote starts life at
that very second with a consciousness, which gets to know all about all other living things on this
planet postori and priori. The consciousness runs the person from that time till he eventually dies. The
difference between life and death could only be made out by observation by others. This is the
Schrodingers cat hypothesis. All zygotes thus formed have one certainty in this world, that is death.
All other aspects of life are uncertain.

Thus defined, ageing starts from the day you are made, and goes on ceaselessly until death. In other
words, ageing is a constant change from conception to death. The most important stimulus for ageing
is the human consciousness; which, in simple terms, boils down to the vagaries of the human mind.
Where, then, is the human mind? Never mind! The mind certainly is not in the brain or the heart or
any other anatomic structure at the cellular level. Mind is a sub-cellular, sub-atomic quantum concept.
It transcends all the physical laws of deterministic predictability. Even the Einsteins theory of motion
that states that nothing could move faster than light does not apply to the human mind. Mind could
travel faster than light and could even communicate unconventionally by teleportation.
Mind has the greatest influence on all bodily functions that physical sciences understand now. The
mind, in short, runs the body. For every change in the body there are reasons in the mind and every
alteration in the mind and human feelings would have to have corresponding reverberations in the
body. Mind could influence every single cell in the human system, of which there are 10 14 cells in all.

The human consciousness (mind) is at the root of all our illnesses as well as our happiness. The inner
mind is always happy to be of some use to others and is not very happy to hurt someone else. The
Universal consciousness demands the survival of all creatures in this Universe. The rules of the game
are such that very bad people with malice would have to be, per force, curtailed in their demonic
behaviour in society. This may be one of the reasons why one gets illness in the first place. Modern
science does not tell us why does one get a disease, but tries to explain as to how one gets an illness.
It was the great brain in Medicine, Dr. Charles Sherrington, who at the age of 42 became the youngest
professor of Physiology at the University of Liverpool in England. Medical students would remember
Sherrington very well as he has contributed a lot to medical science. It was he who said in 1899 AD,
while accepting his new assignment:

Positive sciences could never answer the question why. They could, at best, answer the questions
how or how much but not the question why! A physiologist could say how does the heart contract, but
would never be able to why does the heart contract; he would be able to define death but would not
be able to define life! Ratio rei is therefore not reason why.

He has come very close to quantum physics, which says that life could only be observed by the eye of
the beholder. (Schrodingers cat) Later in the year 1937, aged 90 years, Sherrington gave a Lumlein
Lecture at the Royal College of Physicians of London, entitled Wisdom of the Human Body.

All those thinkers have also found it impossible to understand the human mind completely. It is now
known that the human consciousness runs every cell in the human body from the time of conception.
Cancers to common colds are the result of unhappiness and its bad effects on our consciousness and,
consequently, on all our body cells. Even the abnormal heart rhythms that we have been treating as
an aberration of the hearts function without much success have been now traced to the human mind!

What pleases the human consciousness is the Universal consciousness of Universal Love. What hurts it
is anything against this dictum. Ageing that happens from day one of our existence would, per force,
depend on this principle. Love and compassion slows the ageing process while hatred and anger along
with ego, pride, jealousy, and fear would enhance the ageing process. The secret of keeping your cells
healthy and young (as much as possible), is Universal love. This message has to go down to the next
generation before they get converted like us to hate one another. We, in the present generation, could
not get the benefit of this message, except in a limited sense, since we have had all the bad feelings
all along for our brethren in society. We could still benfit if we change now! But the next generation
could change all that for their good if we let them grow up with the innocence that they are born with.
One positive way of achieving that would be avoid examinations and ranking in schools till the child
attains the age of fifteen, when most of the foundations for future life vis--vis the human mind are
well set.

I wonder if I would be bale to convince our powers-that-be in charge of primary education, the most
important part of a nation's growth, about this message. Healthy citizens of the future need healthy
education to keep their body cells young and healthy. Copying the West in keeping our old elderly
comparatively comfortable is secondary. If we could teach our young the secret of love and
compassion, they would look after their elders as in the past. They used to venerate their teachers,
parents and God. Times have changed with the western ways getting more fashionable with our
younger generation, who think that the Indian wisdom of yore is only a myth and the reality is to live
a rat race of living with hatred and greed. Medical science and quantum physics have proved them
wrong and have shown how modern and scientific are the Indian thoughts of the Vedas, even in this
field of trying to keep oneself young and healthy. The West is now anxious to go back the large family
system of the East, especially India. Since they can not change overnight they are forming so-called
church groups. These are a group of unit families that live like a large family in every way possible,
helping each other. The latter gives that sense of belonging that keeps the mind happy and the body
cells healthy and young. The long-term solution for the problems of our elderly is to inculcate this new
philosophy in our young minds.

Morphological ageing has very little to do with cellular ageing. One could still see many white haired
elderly looking people still happy and healthy while the young looking people could have the most
devastating illnesses. Cellular ageing depends on the mind to a great extent and the mind is not a
cellular concept but a sub-cellular-sub-atomic concept. Happy mind resides in a healthy body and vice
versa. The modern epidemics of the West, divorce and suicide, both originate in the mind. Wars are
born in the minds of men and not in the battlefields. Did we not notice in recent times wars each time
Monica Lewinsky came out with more revealing sexual exploits of those in charge of the deadly
arsenal?

The solution to all the ills of the world is to ensure a healthy mind in our next generation by the
methods advocated above. It may not be very appealing to most of the readers, as this concept has
not reached medical textbooks yet.Truth, said Aristotle, could influence only half a score of men in
a given century or time, while falsehood and mystery would drag millions by the nose.

Listen to the sane voice of the Indian wisdom:

Prasanna Aathma Indriya Manaha Swastha Ithyabhideeyathe.

[Happiness of the soul, senses, and the mind would ensure good health definitely]

How to achieve that?

Janaha Naanaa vachasamNaanaa Dharmanaam,

? Napaschuraanthi.

[People in this world speak different tongues and belong to different religions; but please give me a
thousand milch cows so that they could all be fed]

These two thoughts from the Vedic literature give credence to my hypothesis above that we have to
keep our mind happy to keep ourselves healthy as long as we live; death being the only certainty in
life, we can not afford to hate anyone due to any reason. Even the different religions that were going
to come up later were predicted in those lines; but they have also got to be loved and respected as
ones own religion! I have not been able to find anything more laudable than this. Long live mankind
on this planet! Love everyone to live happily till you die. Ageing would then be not a problem for the
East as also the West. Death can never be postponed, nor avoided; as it is against the Laws of Nature.
The following Ameri-Indian song tells it all.

I eat when I am hungry,

I drink when I am thirsty,
If heavens dont fall down,
I shall certainly live till I die.

The only thing that we could try to do is to live well till death. Modern medicine and all the scientific
knowledge, put together, could just about do that; if only we could change our attitude to life as
enunciated above.

ALL THAT GLITTERS IS NOT GOLD

He is the best physician who knows
the worthlessness of most medicines.
Benjamin Franklin, 1733.

India is shining. I could not agree more. Our foreign reserves have touched the all time new high,
share markets are very, very bullish, exports are doing extremely well, we have surplus food, we are
now taken seriously in all world fora, statistical figures for inflation are unbelievably low, bank rates
have fallen and the industry is buoyant, the movers and shakers that could change the sensex figures
are very vocal and have become the messiahs of progress in this country. What comes out of their
mouth is taken as the wisdom for mankind and they are being heard with devotion by all and sundry
like the rishis of yore. The economic gurus pontificate on anything and everything.

So far so good. Say notI have found the truth, but rather, I have found a truth, wrote Kahlil
Gibran in The Prophet.Economic development, most of the time with an inverse-care-law, where the
rich become richer and the poor poorer, is not the whole truth. It is a reductionist view of progress,
just like our present day science where every new discovery is true only till it is proved to be untrue.
Reductionism does not give us a holistic view of anything at any time. Healthy growth of a nation
depends on the holistic growth of man who makes society what it is. Economic development is but an
integral vital part of mans progress but not the be all and end all of it.

Post industrialized America and the pre-industrial British Empire are two good examples to learn about
mankinds progress in this world in recent times. Yesterday is but to-days memory and to-morrow is
to-days dream. History repeats itself: if one does not learn from history one will have to relive
history, wrote Cicero, the great Roman thinker, centuries ago.Let us learn from the rich countries and
be wiser. The rich have become so rich that eighty per cent of the worlds wealth is held by fifteen per
cent of the rich, while the paltry fifteen per cent of the resources will have to be shared by the
remaining eighty five per cent of the worlds poor! The gulf between the rich and the poor is widening
by the day. Both groups suffer because of the fear of the other. Crime and, even, terrorism spring
from misery, poverty, suffering, oppression and suppression with denial.

The voiceless poor, even in the west, pay for their poverty with their lives. The great British Empire,
where at one time the sun never set; is now waiting with bated breath for the sun to show up
occasionally. Britain has now become an appendage of the rich America. Both those countries built
their economic empires believing that mans growth depends solely on reductionist economic
development. Whereas the British Empire was built with the sweat, blood and toil of the poor colonies,
Americans built their empire on technology which they thought would take them to the moon.
Technology did take Americans to the moon, or they say so, but failed to take Americans to their
neighbours house with a smile on their face. America is paying a rich price for that lop-sided
development by way of the two dominant epidemics there of suicide and divorce. In an elegant book
Closing of the American mind, Allan Bloom, a well respected professor of social philosophy at Chicago,
brings out, in great detail, the hazards of this kind of monetary economy.

The most sought after commodity today in America is eastern spiritualism. Any clever man from India
could get into an ochre robe and sell packaged Indian spirituality to become rich overnight there. Pure
materialism has driven Americans to the brink of total frustration and depression. Contentment does
not exist in economic prosperity. Real contentment is in giving and not getting. Truly rich man is one
who reduces his wants and not the one who increases his needs. The latter would eventually destroy
all God given resources of this planet to satisfy his greed and his proclivity for comfort. Every religion
seems to preach this philosophy but no religious zealot seems to practise it.

Holistic development:

Rounded development of any society and nation depends basically on a healthy society. Health does
not depend on absence of bodily diseases alone, although it is better to be physically fit to be healthy.
Total health is that state of the mind where man is enthusiastic to be creative in society and has got a
balanced mind with physical, mental, spiritual, environmental, and social well being to enjoy the heat
of summer days, the warmth of spring and also the cold of winter of life to live well and let others live
in peace as well. It is only when man develops social consciousness and understands his societal
obligations will a nation truly develop into a great nation. One is great only when one gives of
himself/herself. India was one such nation in the hoary past and our efforts here and now should be
geared to rebuild that great India of our past glory.However, that could never be done by shouting
slogans or blaming any section of society. It could only be done by hard work and co-operation. None
of the isms of the past have really succeeded as all of them were reductionist-be it autocracy,
aristocracy, plutocracy, bureaucracy, democracy of the western model, communism, radicalism, or
socialism sold in post-independent India! The only ism that will succeed for ever is humanism.

Humanism is a term used to describe an ethic based on human nobility. It recognizes and exalts the
greatness of human genius and the power of its creations. Reach towards the highest form of
existence. wrote Goethe at the beginning of the second part of Faust by dint of uninterrupted effort,
he added. Such a society lays the foundations of individual and collective morality, it establishes laws
and creates an economy; it produces a political system which is egalitarian, and it nourishes art and
literature.Humanism is against exclusive submission to God; against a wholly materialistic world
view, against anything that neglects humanity, and against anything that denigrates human nature.

All the isms of the past failed because they neglected humanism. When sociologist Edgar Morin left
the Communist party and was asked why he did so? His answer was very revealing. Marxism, my
friend, has studied economics and social class. Thats marvelous, my friend. But it forgot to study
humanity. The same is true of todays science and economic development. Thomas Malthus, the
inspiration for both Karl Marx and Charles Darwin, did mention, while exhorting them on the
importance of class struggle and the survival of the fittest, that both these derive their strength from
co-operation. Co-operation is altruism in a different language and it is based on humanism. Both Marx
and Darwin seem to have forgotten the first advice.

A similarity in reductionist science is there for all of us to know. It was when the great brains, Nobels
all, Oppenheimer, Otto Frisch, and Rudolph Pearls were getting ready to split an atom that their great
guru, Max Bohm, exclaimed: I am very proud of my pupils cleverness; how I wish they had used a
bit of their wisdom, instead! This atom that they are trying to split would teach mankind a lesson one
day. How prophetic were the words? The split atom has taught mankind a lesson, although it has
made man very proud and powerful. Millions perished in Hiroshima and Nagasaki within fifteen
minutes to win the Second World War. But today we do not know what to with the plutonium waste
that is threatenin g mankind! We know that if one splits the hydrons further, one gets the lepto-
quarks, which form the universal consciousness that binds everything on this earth as one large family
of all that exists. Vasudaievakutumbakam. This is where the quantum world meets Indian wisdom.

The prophecy of the Rg.Veda says the same thing. Humanism based on truth and highest ethics alone
could run this world. It also warned:

etad vaco jaritar mapi mrisththa

a yat te ghoshan uttara yugani.

[Forget not, singer! This word of thine, which after ages, will resound]

India will have to take a leaf out of this advice to make mankind really get developed by holistic
methods and not just ape the west and depend on economic development alone as the real
development and get deluded. Walt Whitman did warn the world that one could easily be deluded
while riding high on the waves of success.

New Planning:

Half a century since independence and, after ten five-year plans, we need a new direction for our
planning for the future, a holistic direction. While the powerful and the rich are asking for a single
window to get their claims and difficulties cleared, the voiceless millions, that form eighty per cent of
India, need at least a widow for their sorrows to be redressed. While the wise learn from their own
mistakes, the wiser learn from others mistakes.

Let us take a couple of examples from the west to plan wisely for the future. The two areas that India
needs drastic changes are in the areas of education and health care. While we could boast of hi-tech
hospitals that could attract western patients to make money, we lose sight of the fact that even today
our health needs like clean water to drink, contamination-free food for the masses, basic sanitary
needs like toilets to let our children grow normally with full blood avoiding hookworms ravages, and
smoke-free houses to lessen the heart attack and cancer rates in the unlabelled poor in the villages
that die, have been neglected. Holistic development must take all these into consideration. Let us not
ape the west in areas of health care. The western hi-tech medical care has already come to grief
there. Oregon experiment is one such experience. The state of Oregon found out that to keep a
terminally ill child with blood cancer alive for a few more months with the help of bone marrow
transplant would cost the tax payers as much money as is needed to keep one thousand pregnant
women properly looked after during pregnancy and their infants for a year thereafter. They could not
balance their budget doing both those activities at the same time. Hence the new law, very
controversial to begin with but followed by seven other states now, came into being. No child gets
terminal bone marrow transplant at the tax payers cost there. If that were so in America there is no
point in our Govt. hospitals competing with one another in giving this kind of palliative treatment to
the millions in India.

West realized, in addition, that the top heavy, interventional, medical care systems result in a higher
percentage of iatrogenic diseases. Third cause of death in the US is the medical establishment and the
fourth cause are the drug side effects of pharmaceuticals. A study revealed reduced death and
disability rates in Israel when doctors recently went on strike only to climb to the original levels after
doctors came back to work! West also realized that where there were more doctors per unit
population, longevity and health of the public was not better; on the contrary, longevity and health
were better in countries with poorer doctor patient ratio-another lesson for our developers!
Investments in health infrastructure, like water and food, gave better dividends and we may have to
innovate methods in our country. What we are doing and planning in India at the present is only
quick-fix medical care and very little of it is health care. This trend must be reversed for better
development in the future.

Conclusion:

While I congratulate the powers-that-be today for shifting the gear to take the country forwards in the
economic field in the short span of five years compared to the reverse gear of the last half a century
after independence, I must hasten to inform them that by aping the west in the area of economic
development they should not forget the holistic human development. Technology alone will make us
rich but unhappy at the end. Humanistic rounded development would make the country the leader in
the world. While we have the greatest resource, two and a half billion hands, we should harness that
for our overall development using the roots of spiritual development from Indian heritage and the
branches of hi-tech modern economic development striking a logical balance between the two. This
should be possible as our leaders have the wisdom of age to guide them and the computer savvy
handsome young people to give a boost to the old wisdom to make it appear modern.

Let us, in India, move from science to scientific humanism, hi-tech medicine to medical humanism,
from war to peace, hatred to debate, suspicion to understanding, and from religious fanaticism to
spirituality which simply means sharing and caring, common to all religions-religious humanism. Let us
show the way to the world as to what true progress and development is all about. This world would
never be peaceful unless and until the lowest man gets three square meals a day, a roof on his head
and an opportunity to honestly earn his daily bread with the sweat of his brow.

Two sorts of writers possess the genius;

those who think, and those who cause
others to think.

Joseph Roux.

ANTIBIOTIC CRISIS
Nearly seventy years ago, when Alexander Fleming and Prof.Florey discovered a mouldy growth on
their culture plates to be a powerful antibiotic, penicillin, a new era began in medicine. The predictions
then were, as usual, that the end of mans fight against germs on this planet is drawing closer. Like all
other predictions in linear science this one has also been proven wrong. Doctors have been predicting
the unpredictable all these years. That in itself is not bad! But we are now facing a new and
formidable threat in that many of the germs that were initially sensitive to antibiotics have now
become resistant and threaten to annihilate man from this planet. One example would suffice. One
common germ, the streptococcus, was the most sensitive germ to be killed by penicillin. While 95% of
these germs could be easily killed by penicillin to begin with, today 95% of the same is resistant to
penicillin.
The history of this universe is very closely connected to human births and deaths, but illnesses do
change history much more dramatically compared to the former two. The black death due to plague in
Europe in the sixteenth century, the white death- so called because it killed most people with extreme
anaemia and mostly young adolescents in particular- of tuberculosis, have been the greatest tragedies
of mankind. Tuberculosis still eludes a cure despite our euphoria after the advent of antibiotics against
the germ mycobacterium tuberculosis.

In fact, it has become much more rampant and dangerous now that AIDS abets and assists
tuberculosis to ravage human life. Tuberculosis has assumed a different form these days because of
the changing circumstances. Historical milestones of tuberculosis include the hunchbacks of Egyptian
mummies, the phthisis (wasting) of the Greeks, and the English consumption for the lay public. Most
diseases respected wealth and status to a certain extent, but plague and TB did play truant with even
the rich and the famous from time to time.

The gravity of the situation is such that the Royal College of Physicians of London organized a meet to
discuss the Clinical Implications of Anti-microbial Resistance on the 28th February 2001. It has been
estimated that around 15,000 people die in that small country every year from infections against
which no antibiotic is effective. Such of those germs that are resistant to most antibiotics are called
the super bugs and, as of now, we have no defense against them. One of the biggest hospitals in that
country, Portsmouth Hospitals NHS Trust, has been forced to shut down most of its operating theatres
last summer because of super bugs there.At the Queen Alexandra Hospital the orthopaedic surgeons
could not perform any operation around that time. Another leading authority in the field, Professor
Hugh Pennington of Aberdeen University, feels that the next big problem would be that of drug
resistant tuberculosis. They had an outbreak of TB in Scotland recently, traced to a travelling family.
He also feels that the Russian prisons have many inmates who have drug resistant TB without proper
treatment. Since TB does not respect geographic borders this time bomb might explode anytime
anywhere!

The usual thinking in the West was that this kind of uncontrolled infectious disease scenario could
exist only in the poor countries like India and sub-Saharan Africa. They are now in for a great shock.
In a well researched book, Betrayal of Trust: The Collapse of Global Public Health, Laurie Garrett from
the USA, shows how the threat is not confined to the poor countries but, is greater in the West,
basically because doctors there over-prescribe antibiotics so that bacterial infectionsare becoming
increasingly resistant to the most widely used antibiotics. She writes that "doctors who over-prescribe
antibiotics undermine the health care system by encouraging germs to become resistant." She is dead
right there.

The blame must also come on the consumers, the patients, as many of the latter, who think that they
are well informed, demand antibiotics for the common trivial infections, most of which are viral to
begin with. This adds to the problem. Doctors who follow ethics and refuse to give antibiotics are not
usually popular. The fear of losing the patients makes many doctors to oblige patients with over-
prescribing. Educating the public about the serious dangers of taking antibiotics for minor infections
against medical advice should go a long way in reducing this menace.

Studies have shown in the USA that it is the rich kids that suffer more from ear infections and other
common childhood infections. Since antibiotics are very expensive the poor parents do not bother to
give their children antibiotics for minor illnesses. This helps the child to fight the infection with the
help of its own immune system and, in the bargain; the child develops immunity against major
infections. This has another very dangerous ramification to it. Antibiotics given to minor viral illnesses
of childhood make the immune system change its response to infection in such a way that the
cytokine response to infections, based on their genes, changes from TH1 to TH2. The latter is the
most important trigger for asthma in later life. The slum dwellers kids, when they have enough to eat,
have very robust health and have very low incidence of asthma and many other common illnesses.
Whenever they do not thrive, it is only because they do not get enough nutrition intheir diet.

The other dangers of antibiotics are in commercial fields like farming and the diary industry. Broiler
sheds use a lot of antibiotics to not only treat the infections in chicks but also in the fond hope of
preventing infections in them.The amount of antibiotics used in cattle and broiler sheds far outweighs
all that is used in hospitals and operation theatres! Today it only takes six weeks to get a bird on the
dining table from the egg stage, about half the time normally required. The farmers, therefore, make
double money and the birds come cheaper.But it means that we get a huge dose of antibiotics each
time we bite a chicken lollypop! This does not take into account the added hazards of excessive
hormones fed to fatten the birds. In short, we are only eating a slow poison.

Mastitis in cows is another danger. The incidence is around 10% of the cows in a diary on a given day!
The huge amount of antibiotics, like ciprofloxacin, injected into the udder (one udder dose costs Indian
rupees 8,000) makes the milk not potable for a week. But the farmers might use the milk earlier to
reduce loss of money. So the milk that we drink from large pools in larger diaries might also contain
unacceptable doses of antibiotics.

The House of Lords in Britain was worried about the large scale abuse of antibiotics in farming and
spoke of a "vicious circle repeatedly witnessed in which the value of each new antibiotic has been
progressively eroded by resistance." Very dangerous indeed. In a shocking incidence recently at the
Prince Edward Hospital in Wales a patient had an infection in his leg wherein the germs were resistant
to all the antibiotics available. Doctors had to go back to Nature to get maggots to help cure that
infection! Now they are routinely culturing maggots to treat resistant infections there. In Nature this is
a very common way of controlling bacterial infections, evident even during the Second World War.

Minor wounds could be smeared with fresh, clean honey. Honey gives a coating to the wound to
prevent germs getting in and the germs already there are prevented from multiplying, as honey stops
the nutrition needed for growth and multiplication in the germ world. Therefore the existing germs die
out and the new ones can not get in.

The time bomb of tuberculosis is threatening to burst anytime now. The West is in the middle of the
worst TB epidemic in the last twenty years. Tuberculosis never went away. It was only lying low
because we depended on the powers of the anti-TB antibiotics too much and did away with the
methods to enhance the capacity of the immune system as we used to do before the advent of
antibiotics. Sanatoria, good food, complete rest, and a healthy environment were given up as useless.
Surgery, which in the olden days, helped to get rid of the infected part of the lung, thereby reducing
the risk of death and bleeding, took a back seat. Now we are threatened by the MDR, multiple drugs
resistant germs of this deadly disease, waiting to produce another epidemic of the white death.
Thomas Dormandy in his treatise The White Death (The Hambledon Press) gives us the horror stories
of the hoary past with even people like Napoleon Bonaparte having suffered its ravages.

TB is no respecter of status or position and even money power for that matter. Many were the victims
such as leaders, poets (Keats was the leading one), writers, soldiers, beggars, children, adults,
mothers and also the medical and the nursing professionals. Many careers had to be either terminated
or changed in mid-waters when TB struck. Things could be gloomier with the added burden of AIDS
reducing the potency of the immune system of man. Vaccination against TB came and went without
much fanfare. May be we need to look more carefully into this aspect of TB prevention. One could go
on and on but the moral of the story is that to try and go against nature by producing antibiotics to kill
germs in not going to succeed as the germs mutate to teach us a lesson. We must look for biological
methods of making germs fight one another and our aim should be to enhance mans immune system,
as advised in Ayurveda.

ARE WE BARKING UP THE WRONG TREE

Time has come the Walrus said, to talk of many things-cabbages and kingsWe could now add to
this list diseases and drugs, health and man, in addition. Man has been here for thousands of years in
hundreds of generations; naturally diseases have been around for as long. Modern medicine must
have originated nearly five thousand years ago on the banks of the River Nile in Egypt, mostly as
magic, sorcery and witchcraft! It evolved through many generations and geographic areas to its
present state. The latter is called modern scientific medicine.Ever since medicine was accepted as a
scientific discipline in the European Universities in the early part of this millennium along with physics,
chemistry and natural sciences, medicine has been following reductionism like all the others.

Man, being dependent on nature for his very existence, is a part of this cosmos. Consequently, he
would have to depend on all other species on this planet, in addition to working as a whole with all his
organs in tandem. Reductionist science that looks at bits and pieces to study the whole would
naturally give wrong signals in human affairs, or for that matter, in any other dynamic system.1
Quantum physics did show this truth very elegantly. Both Schrodingers cat hypothesis and Werner
Heisenbergers uncertainty principle have brought to fore the role of the human consciousness.2
Medicine has to follow quantum physics in search of the truth.3 It is time to take stock of the
prevailing situation and go forward to look at human beings as a whole, both in the realm of diseases
and their management, lest medicine should continue to bark up the wrong tree.4

Diagnosis and management strategies depend on many imponderables. When a patient sees a doctor
expecting to get the right diagnosis and treatment in addition to an accurate prognosis, the doctor is
in a dilemma if he were to tell the whole truth. Since many diseases have their own time frame, most
patients get better despite the fact that physicians have been predicting the unpredictable all these
days! With the human genome having been unfolded, doctors could get a better grip on the initial
state of the patient for better prognostication. Time evolution in a dynamic system, like the human
body, depends on the total initial state of the organism. Reductionist science has given the medical
profession a fairly good knowledge of the phenotype, what with all the physical findings and
biochemical parameters along with the scanners and imagery. This knowledge, added to the genetic
pattern that would be available for clinical use in the near future, would sharpen the predicting
capacity, although the mystery of the human mind still would hamper total knowledge of the initial
state for correct predictions.5

The present scenario is quite depressing. Modern medicine has gone to the market place riding
piggyback on technology resulting in health care costs escalating beyond the wildest imagination,
making even the rich nations incapable of footing the bill. There also is the inverse care law in
operation. While diseases are more common in the poorer segments resulting in the poor paying for
their poverty with their lives, medical care is mostly concentrated around the rich and powerful who
do not need it so much. The distribution of doctors also follows the same rule.6There is a thriving
business around drugs and technology leading to ethics being sacrificed in the market place. Research
data are being faked in some cases and the surgical procedures in many areas far outnumber the real
scientific indications. Cardiac interventions stand out clearly as being overused.7
Despite the inability to predict the future correctly using the present day phenotypic features alone,
the well in society are not left alone. This brings to mind the lamentations of Late Sir Robert
Hutchinson: God, give us deliverance from not letting the well alone! Studies have shown the futility
of routine screening procedures, many of which are not capable of predicting the future. Medi-
business in that field, however, is very fruitful.

Cross sectional studies of cohorts in quantitative research many times lead to wrong conclusions
because of the inherent defects in the reductionist science. Small cohorts many times give favourable
results, while larger number of patients included in the study could reverse the outcome.8 Drug trials
are another area where short term follow up data in small groups of patients could be belied in long
term prospective studies of larger numbers.9 Qualitative research involving many of the non-
quantifiable data has been shown to be useful in certain areas.10 Routine labelling has resulted in
over diagnosis and a distorted view of epidemics of degenerative diseases. While epidemiology has
been useful in unraveling the mysteries of communicable diseases, the same does not hold good in
the field of chronic degenerative diseases, where at times epidemiologists could cause epidemics.11
Using mortality statistics and false labelling of dangerous diseases spurious increases in the incidence
of certain diseases like vascular diseases are being projected. This frightens the public and enhances
anxiety levels in society.12

Philosophically the major role of medicine is to allay anxiety, patient anxiety of disability and death
and doctor anxiety of having done enough or not. On the contrary modern medical predictions,
especially in the realm of chronic diseases, makes man more anxious.13 Lots of educated people die
everyday worrying about the possibility of falling a prey to one of the killer diseases and do not enjoy
living at all. Happiness is living dangerously. If one wants everything to be absolutely safe life would
become miserable. Present day regular check ups leave very little time for any one to enjoy life to the
full. In one sense there are no well persons in society at all. Well man would be the one who has not
been properly investigated!14

Long-term follow up of large cohorts of people has upturned most of our predictions about the risk
factors and their management. More and more studies throw up various negative attitudes like hatred,
depression, anger and jealousy as powerful risk factors for major killer diseases like cancer, stroke,
and heart attacks.15 All is not well with the risk factor hypotheses. Modern technology has replaced
the time-honoured skill of listening to the patient. Doctors have no time to waste listening to the
woes of their patients. They have to get on with their scanners and x-ray images, forgetting that the
shadow is not the man. If you listen to your patient long enough, he will tell you what is wrong with
him was the strong conviction of a great physician of yester years, Lord Platt. Some students of Lord
Platt investigated this statement recently using modern technology. They showed that the statement
holds good even today.16 Listening adds the missing third dimension to the organisms initial state of
health, the human mind. "Diseases present through the personality of the patient. wrote Sir James
Spence.

In the midst of all this confusion there seems to be a ray of hope in the distance horizon. The new
science of non-linear mathematics and chaos has opened up new avenues in human health and illness.
Using this science and assessing the patient more intimately probing his mind one could get a better
grip on the situation. In addition, prediction becomes more accurate as time evolution follows non-
linear mathematics. All the organs in the human body are interconnected and mode-locked to one
another. The system with the most dominant rhythm controls other organs. Breathing is the most
dominant rhythm in the body. Ancient Indian system of medicine, Ayurveda, stressed this very much
using the Vedic non-linear mathematics. Recent studies using modern technology has shown how
proper breathing techniques could even change tissue oxygenation in-patients with intractable heart
failure. Heart rate variability is another parameter that follows non-linearity and gives much better
assessment of cardiac function at a given time. Newer patterns of HRV, using computerized wavelet
analysis of the surface ECG recorded continuously over a period of fifteen minutes, gives much better
and detailed analysis of the myocardial state at that point in time. Since it is non-linear this has a
better predictability.17

A healthy child has marked heart rate variability with breathing, sinus arrhythmia. The variability
gradually decreases as age advances or as the heart muscle gets damaged. Keeping a childs heart
even in old age is one way of keeping oneself fit. Breathing exercises originally perfected in the Yoga
system of Ayurveda helps keep healthy HRV for a long time even in elderly people.18

Another area that needs change is the present preoccupation with quick fixes for every minor
deviation from the so-called normal range. There could not be any parameter that is constant in a
dynamic system like the human body.All biochemical parameters have to, per force, keep fluctuating.
Loss of this constant fluctuation gives better indication of the state of health rather than a given
measure falling within a narrow range at a particular point in time. This applies to blood pressures,
blood cholesterol and many others. Experience has clearly shown that long term prospective studies
did not show significant benefit by our efforts to lower any of these parameters to the expected
normal ranges, although short term benefits in symptomatic patients deserves our attention. Better
prediction of future trouble could be assessed by studying the above parameters over a longer period
of time keeping a watch on the rate of variability of the levels similar to the HRV discussed above.

Many of the quick fix drugs have also shown disappointing results. Comparing the antioxidant vitamin
combinations of AC and E given to postmenopausal women in Canada compared to a similar cohort of
matched controls given extra fruits and vegetables over a period of five years showed the futility of
those quick fixes in preventing cancer and heart diseases. On the contrary the incidence was
significantly less in the fruit and vegetable-eating group.19

Be that as it may, the cohort studies of matched controls are flawed from its beginning. Control
studies, claimed to be the best way to study drug effects and many other areas in medicine, do not
reflect the real future events. As discussed earlier time evolution being dependent on the complete
organism-genotype, phenotype and consciousness, controlled studies only match the phenotype. Many
of those studies, if not all of them, have given wrong signals.20

An Indian Dream
When a man vows to advance his community,

God Himself will wrap His robes and lead the way.

Tirukural.

Think! Why do millions around us still live in squalor and abject poverty struggling to bring up their
young ones, not even knowing where their next meal comes from? Think again. Not only of the poor
but also millions of us in the middle class who are still struggling. Think of nearly 70% Indian children
who only have half the needed blood haemoglobin, thanks to the ubiquitous hook worms that creep in
for want of toilets in the villages and in city slums! India has the largest number of malnourished
children in the world, 57 million in all as against 41 million in Africa. Right inside the hi-tech city of
Bangalore one in eleven children dies for want of low tech solutions like clean drinking water and
sanitation. Just outside the financial capital of India, Mumbai, there is an Adivasi village, Jamsar,
where every day children are dying of malnutrition! Think of this wide gulf between the two Indias-the
hi-tech shining India and the low-tech poor India that falls outside the radar range of the rich and the
famous.

Let us dream of an India where every Indian, rich or poor, is blessed with identical opportunities. It is
an India where even the poorest of the poor has three square meals a day, a roof over his head
instead of the star-lit sky and a healthy enthusiasm to work on a level playing ground. For these
dreams to come true we need balanced, humane, and holistic development centred on our far flung
villages. Let every village have an arterial road that connects it with the rest of India. Let there be
clean drinking water and smoke free cooking facilities. Good food is another dire necessity for the
villagers. We need co-operative micro-financing to save them from money lending sharks.

If technology alone could make mankind happy, some of the advanced Western countries must have
been the happiest. The fact is, they are not. Every social ill from corruption, crime, economic one-
upmanship, political trickery, to exploitation of the vulnerable is a kind of mental illness in need of
permanent solution. The game starts with proper education. Education must primarily build character
along with the three R s. Education should stress on the Indian culture of not doing anything that one
doesnt want the world to know. Education must teach the child that it is better to fail than to cheat.
Let every citizen know that failure is not fatal and success is not final. Young minds should never be
exposed to unhealthy competition with others. Such unhealthy competition breeds negative thoughts
that are at the root of all social evils, including killer diseases that man is heir to. Competing with
others is mediocrity but competing with oneself is excellence. Education must aim only at excellence.

We talk of our huge population as a curse. Let us look at it as our largest man power pool to be
nurtured. When the day comes where the poor man feels assured that his new born child would
survive, family planning begins at the grass roots level. What with our present peri-natal and infant
mortality being precariously high, how can we expect our poor people to adopt family planning? Let us
be realistic. They are also human and they also want their progeny to carry the torch forwards. Let us
invest wisely in basic health needs to change this dismal picture. It is not wishful thinking as some
parts of India even today have slightly better life expectancy than European countries!

We have no choice but to invest much more of our GDP in education to provide compulsory primary
education for every citizen. Vocational and higher education could be optional. We need to strengthen
our higher educational base to cater to more than 700-800 million youngsters in the next fifty years
by reviving our ancient University culture that existed in Nalanda at a time when the rest of the world
was still in the dark. Higher education should aim at acquiring wisdom and not just knowledge and
information.
Westminster type of democracy seems to have failed here. Gandhiji did not attend the first
Independence Day function in the Red Fort as his vision of Swaraj (self rule) had not been on the
agenda. We should concentrate on holistic village development based on self reliant micro-financing.
Political humanism with mature wisdom is the need of the hour. Let us prepare our future generations
to realize their societal obligations to others before they become our leaders. Biologically every living
cell wants to come close to another cell, if allowed. Why then are we killing one another in the name
of religion, language, region, caste, creed or our misguided belief systems?

What is our vision for India of tomorrow? What sort of India do we want to build for our future
generations? Where are we headed? If we have gone wrong what is the remedy? These nagging
thoughts haunt me everyday. I have an Indian vision. Let us come together to build a strong India.
When the world becomes tranquil the billions of rupees spent on defence and security could be better
utilized to provide clean drinking water for the masses, three meals a day for everyone and the
healthy basic sanitary amenities! This would build a physically and psychologically strong India to
compete with the world to rise above the rest in the comity of nations.

The three enemies of mankind, poverty, ignorance and illness, could be easily won over. We could
build an India where justice is not injustice and justice is not the convenience of the powerful either.
Let us come together in this Herculean task of rebuilding India morally, physically and economically.
India has all the potentials needed for mankind to develop fully. Healthy India is happy India. But
remember, the task is stupendous and we have miles to go, miles to go before we sleep!

* Corrected transcript of a speech delivered in Chennai recently by Prof. B. M. Hegde, a thinker,

writer, and a former Vice Chancellor of MAHE University, Manipal. He can be contacted at
hegdebm@gmail.com

DO WE NEED MORE DRUGS FOR HYPERTENSION?

The question of therapy in medicine comes after the diagnosis. The most difficult diagnosis in medicine
is the diagnosis of hypertension. Since this label encompasses many maladies, both known (secondary
hypertension), and the unknown, the office recording of blood pressure alone will not suffice to
warrant treatment with drugs right away. The old dictum that the war is too serious a matter to be
left to the generals alone could be applied here very aptly thus: Hypertension is too complicated a
matter to be decided on the spot by doctors alone, without due concern for the human beings total
environment. If one makes the correct diagnosis therapy becomes very simple. We have enough and
more drugs already. Search for newer drugs at this point in time is not worthwhile. We need more
research into the aetio-pathogenesis of this enigma and that might give us better clues to the
management. In fact, even the very well controlled hypertensives on drug treatment did have
significantly increased mortality, in the long run compared to their normotensive counterparts. There
is more to it than meets the eye in this business of drug treatment of elevated blood pressure!1
Many a time, the numbers he records might alarm the practitioner himself and, he could draw wrong
conclusions, in the first place. If only the doctor could sit back, take a couple of deep breaths, and
then listen carefully to the patients woes, trying to soothe his frayed nerves; the next recording of the
pressure could even have come down so much that the patient could not possibly be labeled
hypertensive at that time! This scenario is not rare as many would want to believe.

Even after repeated checking of blood pressures over a period of three months, to make a diagnosis of
mild-moderate hypertension, in the famous Australasian study, half the patients became normotensive
on placebo alone,2 over a period of next three more months. All that could have changed their
diagnosis, would be the tender loving care of the research team. A recent meta-alaysis of the six
major journals reporting anti-hypertensive treatment studies, revealed that all of them had flaws in
the method of checking blood pressure.

The gravity of the diagnostic dilemma must be clearer to the reader by now. To add to the doctors
problems is the fact that hypertension, per se, is not a disease. It is, at best, a risk factor for future
degenerative diseases, like stroke, heart attack, renal failure, and retinal diseases. Here we are on a
very wet wicket. Predicting the future in a dynamic system, like the human body is an impossibility,
unless we have the total knowledge of the initial state of the organism. The latter is impossible at the
present time. Man consists of his phenotype (of which we know something, viz. blood pressure level
etc.), his genotype (of which we know nothing at the moment), and his mind or consciousness (which
has been found to play the most decisive role in disease). This was brought home to us in a clear way
in the MRC study of mild hypertension treatment. To save one person from a possible future stroke,
one has to treat eight hundred and fifty people unnecessarily all their lives.3 If one could imagine the
drug side effects in those 850 people, one would quickly understand the doctors dilemma.

However, when the drug companies promote the drugs is a simplified fashion, the gullible doctor falls
a prey to the falsehoods and mysteries. He/she starts prescribing drugs at the first contact. Elsewhere
in this issue the details of drugless management of hypertension have been detailed. For the more
discerning scientific minded doctor the dilemma is no less. There are more than six major guidelines
in the world about the rules of the game of drug therapy of hypertension. If all of them are compiled
together in a super computer, they will have covered only 31% of all hypertensives. Remaining 69%
of hypertensives are not covered in this exercise. Put differently, majority (69%) of hypertension
patients would not fit into the scientific standards of management!4 Here we have an evidence-
burdened scenario, instead of the much touted evidence-based logic.

In addition, the vested interests are trying to even refute the guidelines of their own countries, on the
plea that seven trusted specialists there do not follow the guidelines in their practice!5

Outwith all these concerns, is the problem of pharmaco-economics in our country. We have been
repeatedly stressing the importance of poverty as the basis of human ills. Hypertension is no
exception here, even in the advanced countries. A study in the UK showed that the highest incidence
of vascular diseases was seen in the lowest socio-economic groups! The present pre-occupation with
newer drugs as first line anti-hypertensive drugs would ruin any economy, if the exchequer is to foot
the bill. It is estimated that in the USA, about 50-60 million white-coat hypertensives are being
treated with ACE inhibitors and Calcium channel blockers, at a phenomenal cost of 8.4 billion dollars.
(Roughly three times the annual budget of India). To cap it we have the scenario where these newer
drugs are yet to prove their merit in long term clinical trials.6

The stress in drug treatment has been the step-care mode of drug therapy where one starts with one
drug in small doses, building the dose gradually; adding the next drug to get cumulative power to
lower the pressure. We would like to call this as the step-up therapy. We have been stressing, since
the early seventies, about the need to step- down therapy, wherein the doctor starts cutting down the
drugs and the dosage, once he achieves the desired blood pressure levels.6 About 50% of the patients
remain normo-tensives on that regime and a small percentage would need no more drugs. This could
be assessed by trial and error, without detriment to the patients well being. As and when the pressure
starts moving up, drugs could be reintroduced. Even intermittent treatment with drugs has been
shown to be good enough for mild hypertensives.7 Whereas we introduced it in the seventies, it is
now accepted in the West, as well.

Drugs for Treatment:

To do or not to do is the real dilemma in anti-hypertensive drug therapy.8 As has been already
pointed out, all the guidelines, of which there are six organized ones, have differing advices. That
makes life that much more difficult for the practising doctor. I have been in this business for well over
three decades. My best advice would be to follow the following rules for the time being, till further
knowledge comes in. We have the latest Joint National Committee recommendations, JNC VI of the
USA, which matches most of the following suggestions:9,10

* Diuretics and beta-blockers should be the first choice when drugs are indicated, unless there are
positive indications for other drugs, or the first line drugs are contra-indicated.

* Routine treatment with drugs is recommended by the American JNC for people with sustained blood
pressures above 140/90 mm.Hg, but the British recommendations put the cut off at the pressure of
160/100. Your best bet is to take a via media. Watch people in that grey zone between 140/90 and
160/100 without drugs, but with life style modifications; which are now known to be very effective.

* Indian patients respond to very small doses in the beginning. Our experience is that our patients
respond to as small a dose as 10-20 mg of propranolol and/or 25 mg of hydrochlorthiazide. Potassium
supplements may be needed, if hydrochlorthiazide is used alone. Some of our patients may not
respond to a larger doses if used initially, without trying the small dose first!

* Although the JNC VI committee has slightly modified their stand from their own JNC V
recommendations, we feel this was done at the behest of vested interests! The above
recommendations meet with the approval of JNC V, JNC VI, and also the British recommendations.

* If Calcium Channel-Blockers and/ or ACE inhibitors are to be used as the first line, there must be
very compelling reasons; keeping in mind the fact that we are only treating a risk factor, and not a
disease and, therefore, our selection of drugs for life long use, in an apparently healthy individual,
must be above all suspicion. This can not be said about the latter drugs in the setting of
uncomplicated hypertension.

* When in doubt, it is better to take an opinion of the specialist in the field. This should also be done
in the following special circumstances.

a) Very young or very old hypertensives detected for the first time.

b) Patients who do not respond to the ideal line of treatment, despite the fact that the patient
compliance is good (resistant hypertension)

c) Hypertension with end organ damage.

d) Patients with evidence of coronary artery disease, in addition.

e) Secondary hypertensives.

The compelling reasons for using drugs other than thiazides and beta-blockers, as the first line drugs,
are listed below:

* Presence of associated Diabetic Nephropathy.

* Congestive Heart failure.

* Post-myocardial Infarction.

* Systolic hypertension in the elderly.

* Presence of diseases likes Asthma, Benign Prostatic Hypertrophy, and dyslipidaemias.

As has been pointed out earlier, it is safe to keep ones options to a few well trusted drugs, as
otherwise one could get into trouble with prolonged usage of the newer drugs. Labetolol is a good
example. This was being advocated for use in pregnancy hypertension at one time, and was freely
being used, based on theoretical considerations. Now there are reports to show how this drug could
produce foetal changes in the new born babies of mothers, who have been on labetolol during
pregnancy.11

The main goal of anti-hypertensive therapy is to reduce cardiovascular morbidity and mortality. This
has been demonstrated for diuretics and beta-blockers very well. Other drugs should be recommended
for initial therapy only if they demonstrate their capacity to do just that, without serious side effects.
In that direction a new class of drugs is showing good promise, to be proved by the passage of time.
AT1 blockers (Angiotensin II antagonist) could be ideal candidates. Candesartan seems to be the most
efficient molecule, as far as potency goes. Other drugs are also being tried. Two important aspects of
these drugs are their prolonged action, due to prolonged receptor blockage property with a peak
trough ratio of more than 0.9, and the dose response curve, which shows a continuous increase in
efficacy between 2mg and16 mg daily.12

What does the future hold for us in this field? We have been in for quite a lot of disappointment in this
field. The HOT study ( hypertension optimal treatment study) failed to demonstrate a significant
difference between the three randomized target blood pressure groups for the majority of
cardiovascular events, although it did prove the theoretical hypothesis, that more vigorous treatment
could certainly bring down the measured blood pressure to greater extent, in 90% of patients!13
Linear relationship between blood pressure and benefit does not seem to work in a dynamic system
like the human body! This brings me back to my old and firm belief that the step-care treatment,
although good for bringing down the box blood pressure, need not necessarily be good for the patient
in the long run.

Gussipi Mancia, a great proponent of the step-care treatment, is slowly being converted to our view,
which was being criticized by many, of step-down treatment, of using less and less drugs, as the
pressures start coming down, to see if one could withdraw the drugs, at least intermittently, to lessen
their side effects. Greater importance will be given in the future for the non-pharmacological
approaches, as well as to baseline blood pressure values, at which drug treatment should be started
writes Mancia, in his recent article in the Journal of Hypertension, entitled Anti-Hypertensive
treatment: Past, Present, and Future.14 We are pleased that our stand is being slowly vindicated!
Ours was a plea to treat with empathy the human being with raised blood pressure, and not to target
the blood pressure level, without any consideration for the human being that is labeled.14

DO WE NEED MORE DRUGS FOR HYPERTENSION?

ARE YOU EATING RIGHT

Riches enlarge, rather than satisfy appetites.
Thomas Fuller.

On the face of it this looks like a silly question. This is the most profound question today as most of
us, the unfortunate literate lot, are being bombarded on all sides, both by the print and electronic
media, about the benefits of eating this or that food supplement. A simple formula would be to
consider anything very heavily advertised as potentially harmful. If that is not so why, on earth,
should such a thing like a food item be advertised in the first place? To make matters worse we are in
the rat race against time these days. Both husband and wife working full time adds to the problem,
while it is an economic necessity. Under those circumstances it looks very attractive to go in for ready-
made quick fixes of canned and preserved foods. To make the whole exercise safe we think we could
swallow a few multivitamin and anti-oxidant pills along with meals!
In most sophisticated households today we get to see vitamin pills on the dining table! Every one,
from the baby in arms to the old granny, takes vitamins in some form or the other. There is a
multibillion-dollar business in vitamin trade. Most large multinationals are chipping in their lot in this
lucrative business. In fact, the manufacture of life saving drugs has been pushed to the background!
No company is interested in ploughing money into antibiotics now, as the initial seed money required
might not be recovered easily in that area, what with more than five hundred antibiotics already in the
market.

Let us examine the whole business for the good of humanity at large. While it is true that many of the
vitamins in Nature are very essential for growth and health, it is far removed from truth that the
artificial vitamins made by man are as good! They have been shown to be bad instead! However, the
business in vitamins is so good that the NPVr (risk adjusted net present value) for vitamins is said to
be 200 times that of antibiotics!

The reason is that plant based foods, like fruits and vegetables, have many hitherto unidentified
"phyto-chemicals" in them, in addition to the known vitamins which, together, work to give us the
benefit, that too in the fresh state in Nature Man made vitamin pills contain many other ingredients
like: fillers, binders, yeast, sugars and artificial sweeteners, preservatives, and gum etc, many of
which could be health hazards when taken on a long term basis. There is also the concept of hormesis,
a new idea in pharmacology that a small dose of a drug has a bio-positive effect while the larger dose
could have a bio-negative effect.

Clever marketing tactics by large companies promise amazing results from these supplements.
Starting from dry skin, dry hair, fatigue, stress to long life are all promised, based on anecdotal
testimony from individuals rather than hard scientific evidence. Some of the scientific studies did show
the reverse. Two large studies involving more than 29,000 smoking men in two groups showed the
controlled half that received vitamin supplements did have between 18-28% more cancers compared
to the group that did not receive these vitamin supplements.

This could be easily explained, but suffice it to say that extra supply of these artificial chemicals might
interact with other body needs during the absorption phase in the intestine. To cite one example, an
extra dose of food iron might suppress the absorption of zinc from the gut resulting in its deficiency.
When given in excess most of these vitamins, if they are water soluble, get lost in the urine and help
the germs in the toilet. Your hard-earned money is not wasted after all. It goes to help the poor germs
there!

There are some very important ingredients that we need to get in our diet to keep diseases like cancer
and heart attacks away. Beta-carotene, vitamin C, vitamin E, and the mineral selenium are the
leading ones in that category. Please try to get them in the daily diet and not through pills. Carrots,
sweet potatoes, red pepper, pumpkin, tomatoes, spinach, greens, mangoes, peaches, and apricots are
the main sources of the above anti-oxidants. Oranges, grapefruit, cauliflower, cabbage, frozen peas,
nuts of different kinds, chickpeas, sweetcorn, soya, and wholegrain products are an added bonus in
diet.

Who ShouldTake Vitamins?

Most people do not require vitamin pills, but there are a few exceptions and they are:
1.Women ready to conceive or already pregnant need extra 400 mcg. Of folic acid daily.

2.People over 60 years who do not get a balanced diet or who have any one of the gastrointestinal
diseases coming in the way of proper absorption.

3.Pregnant women, women with very heavy menstrual flow, some infants and adolescents might need
extra iron supplements as also very old people.

4.Vegans might need vitamin B12 supplements.

5.People on heavy dieting, chronically ill patients and those who are recovering from such illnesses
need extra supplements.

Under all the above circumstances do not self medicate yourself, but consult your family doctor and
take his advice.

We must all learn to eat to live and not live to eat, although it is not what you eat that kills you, but
what eats you (negative thoughts) that kills you. That said I must hasten to add that fussing over
what one eats is more stressful than eating the wrong food. Enjoy what you eat but try to include the
necessary things mentioned above in the diet. An occasional binge at some things, which do not come
under the above category, is not a sin. The golden rule is to enjoy what you do. Sensible eating could
reduce your medical bills significantly and make you live happily as long as you live. Trying to live
here forever would never succeed. Happy eating folks!

There is nothing new under the sun.Ecclesastes 1:9.

ARYAN INVASION OF INDIA-MYTH Vs REALITY

Man has been fighting man all through the history of mankind. It is almost reaching a point where
man is ready to eat man. There seems to be some vested interest in all these happenings in our so-
called civilized world. We have gone too far from the time we were hanging from the tree branches, to
the present when we are hanging about cyber cafes!Alas, on the other front, we seem to have
regressed quite a bit in our quest for self-realization from the time of our forefathers of the Vedic
Enlightenment period, when we had a great insight into human consciousness. Man spends most of his
time, nay all his time, in his own company; but many of us have never tried to understand ourselves.
We are not at peace with ourselves.We try to delude ourselves with material pleasures, at the cost of
real pleasure of the ever-lasting inner peace.

Indian wisdom of the yore was peerless in its depth and dimensions, to say the least. Obviously,
others wanted to belittle this in every way possible. One of the methods was to destroy the Indian
wisdom, if possible. This could have been done through cultural and religious invasions of India.
Although we have had many such onslaughts on us in the last thousands of years, our ancient culture
has remained like a solid rock of Gibraltar. The main reason, I feel, has been the strong bedrock of the
ancient Indian wisdom. The latter was called Hindu religion by the British, to try and divide us from
our Islamic brothers and sisters, lest India should live happily like a large family, despite its many
tribes, regions, castes, religions, languages, and what have you!

There is no organized religion called Hindu religion. Ancient Vedic wisdom is no religion in the true
sense of the word, as I have understood it. The original Vedas, the Shrutis were only songs sung in
praise of Nature. They sang to praise the sun, the moon, the clouds, and the water, the hills and so
on. Next stage came where they thought of propitiating the various parts of Nature by certain rituals,
called the Bhramanaas. Following that came the time when the rishis thought of human renunciation
and the Aranyakaas came into being. The last stage, the Vedanta, mainly the Upanishads have been
the pinnacle of Enlightenment, in that they condensed all the human wisdom into sixty or so
documents; the necklace of those pearls is the Bhagavad Gita, the greatest of them all. These are
eternal and have no clear beginning or end. They form the Indian Dharma, the Indians societal
obligations. To say that religion was not a part of this Indian Vedic Wisdom was the evidence that
even agnostics and atheists like the Chaarvakaas were venerated as learned men in India, although
they propagated mainly materialism in all its pristine glory!

One of the attempts at destroying this legacy has been a concerted effort to show that Indians are not
one race, and that they have had a great invasion by nomadic light-skinned Indo-European tribes
from Central Asia around 1500-100 BC. They are said to have overthrown an earlier and dark-skinned
Dravidian civilization, from which they took most of what later came to be called the Hindu religion.
The concept of the war between the powers of the light and darkness in the Vedas was misinterpreted
as that between the dark coloured Dravidians and the fair-skinned Aryans; thus turning the great
Vedas into primitive poems of the uncivilized plunderers.

Even serious western scholars have now rejected this false idea, the leader amongst them being David
Frawley, of the American Institute of Vedic studies in Santa Fe, New Mexico. In his recent book Gods,
Sages, and Kings: Vedic Secrets of Ancient Civilization he argued very effectively against all falsehood
and mystery in this field. Unfortunately it is falsehood and mystery that influence more people in this
world!It was Aristotle who wrote: truth might influence half a score of men at a time or in a century,
while falsehood and mystery will drag millions by the nose!

The Indus valley culture was called pre-Aryan, based on the false calculations by many western
scholars, led by Max Muller.Like many other western scholars, Max Muller took western chronology
into consideration while pronouncing his judgment. They put the beginning of the world at about 400
BC, and the flood around 2500 BC. If one assumes these dates to be correct, it becomes difficult to
get the Aryans to India before 1500 BC.Max Muller, therefore, decided that the Aryans came to India
around 1500 BC.That, perforce, puts the Indus Valley civilization pre-Aryan. This was very convenient
for westerners to divide India into the Aryan North and the Dravidian South, a good divide at that,
citing our colour differences to divide us further. It is a pity that they did not understand science at
that time, to know that the color changes are basically climatic in origin, like the black Africans and
the white Europeans, despite the fact that all mankind was originally derived from a single source!

Muller deduced that the Vedas and the Upanishads were composed in a period of about 200 years
before the time of Buddha at 500 BC. This in itself is wrong as the Indian Vedas and the Upanishads
could havetogether taken several centuries to be fully formed.They also presumed that the Vedic
culture was that of the primitive nomads from Central Asia, hence they could not have created an
urban culture like the Indus Valley culture. This was based on a rather crude interpretation of the Rg
Veda.Whereas it is true that in the second millennium BC, a number of Indo-European invasions
occurred in the Middle East, where Hittites, Mittani, and Kassites conquered and ruled Mesopotamia
for some centuries, the Aryan invasion theory could have been an extension of that period.

Another theory of the Aryan invasion was the finds of excavators like Wheeler, of the evidence of a
foreign invasion of the Indus valley. The presence of horse-drawn chariots and iron weapons and
superior war tactics of the Aryans from Central Asia were cited as important evidence, while Wheeler
and others at that time did not find evidence of Iron and the horse in Indus Valley finds. Further
excavations, however, showed horses not only in the Indus valley but even in the pre-Indus period in
India. The Vedic word Ayas was given as evidence that it meant iron, and that was introduced for the
first time around 1500 BC and therefore, the Vedas must be that old. This word ayas has different
colours in the Yajur Veda and Atharva Veda showing that it just means the generic term metal and not
necessarily iron. Even in other Indo-European languages like Latin and German the word ayas means
ore, iron, bronze or copper. It is satisfying to note that the Websters Dictionary Foundation now
accepts Sanskrit as the mother of all Indo-European languages. The word ayas should mean metal
and not necessarily iron.

It is also cited that the Rg Veda, at places, describes Gods as the destroyers of Cities; hence the
proof to show that the Aryan nomadic invaders destroyed the more developed Indus valley cities.
Deeper analysis of the Rg Veda does show that cities were an integral part of the Vedas.Indra, Agni,
Saraswati and, Adityas are all praised as being like a city. To say that all those who destroy cities are
nomads would make the present day Americans, who destroyed many cities in Iraq lately, as nomadic,
if not barbaric. I do not think the western scholars would want to do that!

Further excavatory evidence is accumulating that the Indus Valley civilization was not destroyed by
outsiders, but by internal causes, most likely floods. Recently S.R.Rao and colleagues have found new
cities in India between those of Indus period and later ancient India (visited by the Greeks); hence
there is no question of our having had a Dark Age after the destruction of Indus valley by invading
Aryans. Cities have flourished for all times in ancient India. Wheeler also wrote that the religion of the
Indus valley was pre-Vedic!This does not hold water, as later discoveries in Indus valley, Lothal in
Gujarat, and Kalibangan in Rajasthan have shown large number of vedic alters and many other items
used in Vedic Bramhanaas. There is no racial evidence of any such Indo-Aryan invasion.

There are many other evidences to show the Vedic culture in the Indus valley. In the Vedic period the
river Saraswati was venerated. The present land studies show river Saraswati to be the largest river in
India, which is not seen now. This is supposed to have dried before 1500 BC.How could the Aryan
invaders, coming after that, have thought of the river in their literature? Manu is said to have
established his treatise on the banks of the rivers Saraswati and Drishadvati.Saraswati is also
described in the Rg Veda as the naditama, the main river. This could have had the great floods that
destroyed the Indus Valley civilization; the latter was not destroyed by the imaginary invading Aryans.

David Frawley graphically describes the astronomical evidence, in addition, thus: The Vedic calendar
was based upon astronomical sightings of the equinoxes and solstices. Vedanga Jyothish speaks of a
time when the vernal equinox was in the middle of the Nakshatra Aaslesha (about 23 degrees 20
minutes Cancer). This gives a date of 1300 BC. The yajur and atharva vedas speak of the vernal
equinox in the Krittikas (Pleides; early Taurus) and the summer solstice (ayana) in Megha (early Leo).
This gives the date as 2400 BC..This amply proves that the vedic culture existed in those periods
and already had a sophisticated system of astronomy. Such references were merely ignored or
pronounced unintelligible by western scholars because it yielded very early date for the Vedas than
what they presumed, not because such references did not exist.

According to the prevailing western theory the Vedic people were nomads in Punjab, coming down
from Central Asia.Rg Veda alone has more than hundred references to the sea (Call of the Vedas by
A.C.Bose), the Vedic God Varuna of the sea and, the Saraswati river as the great river, makes a
mockery of the Central Asian origin of the Aryans. If true the Aryans could not have seen the sea at
all. Recent French excavations at Mehragarh have shown that all antecedents of the Indus Valley
culture could be found within the sub-continent and must have been as old as 6000 BC.
David Frawley makes some more relevant observations:

The deeper study of the whole suggests that Indo-Europeans and other Aryan people were migrants
from India rather than migrants into India.

Dravidians were early offshoots of the Vedic people through the seer Agasthya, and not un-Aryan
people.

The western concept served the purpose of dividing India into the Northern Aryan and Southern
Dravidian culture, which were made hostile to each other.

This gave the Britishers an excuse to conquer India. They could claim that they were just repeating
what their Aryna ancestors did earlier.

It made Vedic culture later than and possibly derived from, the Middle Eastern culture, thereby
showing Indian culture closer to the western religions.

It allowed the great sciences of India to be given a Greek basis; while the reverse is probably true.
( underlined portion is mine)

It turned great Indian tradition and literature into fantasies and exaggerations.

This served the social, political, and economic domination, giving superiority to the western culture.

He calls this the cultural imperialism.

Even though Aurobindo, Dayananda Saraswati, and Bala Gangadhar Tilak had rejected the western
view earlier, the majority of us have accepted it. Unfortunately, even our great Universities use
western textbooks as gospel truth, in all areas of humanities and science.

Even in science the new meaning of the word science derived from the Indo-European Sanskrit root is
skei cut into. If one cuts into the latest quantum physics, one quickly comes to the Vedic view that
all of us are but dancing Lepto-quarks at the sub-cellular level.We can not harm someone, without
harming ourselves, in the bargain, and vice-versa. Reductionist science has come to a point of no
return. The great science of the whole the science of CHAOS, of fractals and non-linear
mathematics, is taking over. The latter has been the basis of Vedic science.

All kinds of artificial divisions between man and man must be undone for uniting mankind as one large
single family. Vasudaiva Kutumbakam ( the world is but one large family) is our only solution. Religion
is a personal matter. God loves everyone and loves those who love their fellowmen. The theme of
John Leighs poem Abu Ben Adam is also the same. If man does not hate man, mankind could exist
on this planet for all times to come. Otherwise, we will soon destroy ourselves and also our future, yet
to be born, generations as well. This could easily be done by our nuclear, and germ warfare tactics,
not to mention the star-war plans, originating in the Jacob-Crutzfeld affected brains of some western
politicians. The latter are there to make hay when the sun shines, they do not think of the future
generations. George Orwell was dead right when he said: Politician is one who makes a lie look
respectable..He could even give solidity to pure air.If Orwell were alive today the Monicagate
would not have surprised him.
Let us love one another and live happily. Let us also save our planet for the future generations. We
have to suppress our proclivity for comfort and our greed, in the bargain. This could easily be done, if
we realize that the only certainty in this world is uncertainty. God should save man!It was Voltaire, an
atheist, who lamented: I do not know if God exists; if He doesnt, it is time we invented one!

ASPIRIN AND HEALTH

There is a great enthusiasm now among the informed public that every adult should take a daily small
dose of aspirin to keep the deadly heart disease and thrombotic stroke at bay. Millions are swallowing
the small pill daily. This drug has been with mankind for hundreds of years, originally having been
obtained from the European Willow bark. The first drug company that manufactured aspirin as such
was the Bayer Company in Germany. The then chief of Bayer was a Jew in the 30s. Hitler threw him
into the prison and gave the company to one of the junior technicians who was a Nazi. The latter
copied the original notes of his erstwhile boss and made the drug in his own name.

Introduced as an anti-pyretic to reduce fever and a painkiller, this has now been known to be a very
useful adjunct to heart and vessel disease patients, as a long term preventive measure. However,
many questions still remain to be answered. After hundreds of years of use we still do not know the
ideal dose of aspirin fo many conditions! Ever since it was found that aspirin could prevent intra-
vascular clotting, it was used in many conditions where clotting is the main cause of the final assault
on the blood vessels. The interesting aspect of this is that blood has to clot sometimes inside the
vessel when the need arises. If this is also prevented it may result in abnormal bleeding giving rise to
other complications. One is between the devil and the deep-sea situation. Drug companies have been
trying to sell this as a panacea for all vascular diseases. There has been a large-scale propaganda that
if an adult takes a small dose of aspirin every day he/ she could avoid serious damages like heart
attacks and thromobtic strokes. The latter is not borne out by scientific evidence. In fact, a study by
John Cleland showed that while a small dose of aspirin in apparently healthy people might or might
not reduce the incidence of non-fatal heart attacks, it certainly increases, marginally though, the
incidence of hemorrhagic stroke in those individuals.

There are lots of advertisements that exhort people to take this or that drug to keep certain diseases
at bay. If one understands the business behind this kind of a propaganda one quickly realizes the
reasons why this kind of hype continues. If a drug is being marketed for the relief of symptoms of any
disease its marketability is limited to a few days to a few months only, but if a drug could be sold for
preventing deadly diseases people would be enticed to take the drug for the rest of their lives. That
apart, at a given time there may be a few million ill people qualifying for any drug intake or surgical
intervention; but if we could advertise a drug or an operation as a preventive in an otherwise healthy
person there are six billion customers on a give day. Thelatter makes better business sense. In the
monetary economy what matters is marketability and successful is the enterprise that sells more!

All science in the twentieth century has been using reductionism as the basis where the world is split
into its bits and parts and the latter are studied in great detail to understand the world. So also in
biological sciences the body is split into its cells and the latter are studied for their function and
structure to know their collective function as a part of the organism. How I wish this were true! More
we study and the deeper we go the more obvious is the finding that what happens in a bit may not
replicate in the whole. This concept of holism is the basis of Indian thought and Indian mathematics
(Vedic mathematics). If one follows this science of CHAOS one realizes the fallibility of predicting the
future with inadequate knowledge of the initial state of the organism.
Medical research so far had been beset by this curse. We have to change the route now. Let us take
the Indian route to truth. So far science has been change. Todays wisdom could be tomorrows folly in
science. Now on we should strive for trying to understand the whole that might give us a better insight
into human affairs both of the mind and the body. All rules of linear mathematics may have to change.
Therefore there is no way you could take a drug when you are healthy to avoid future maladies,
irrespective of what drug it is. Almost all drug treatment of apparently healthy has been shown to be
futile by serious audits. Common man and, even, doctors in practice, do not come to know of this:
even if they did it would take a long time to sink in!

AUTOBIOGRAPHY OF A SMALL CAR.

My ancestors came from Japan. I was born in Gurgoan near Delhi. When I came onto the Indian roads
there were only the old dilapidated cousins of mine who traced their roots to distant Italy or England.
They were so old that they could hardly run on the roads; yet they were being whipped to do their
work, which they did very faithfully. I was a great attraction in the beginning. I looked cute and I had
a long line of waiting suitors those days. The Indian dowry system works in the opposite direction in
my case. In addition to the usual dowry amount, which in itself was very heavy, my suitors used to
pay black money to get me, out of turn. They even prostituted me, at times. I used to have many
suitors at a given time. Even when I was done with my first husband, I had a great demand in the
olden days. People paid almost the same dowry amount to repurchase me in the open market!

All that has changed after the liberalization policy of the Indian government. Lot of my kith and kin
from Japan, amounting almost to a whole Japanese Diaspora into India, my first cousins from Korea,
and even my distant cousins from Italy and Germany have invaded the Indian markets in a big way
and there are many others wanting to get in. They all like the Indian dowry system and the sheer
numbers of suitors in the affordable middle class market in India. But the number of lovers I used to
have in the good old days has dried up now. Could this be due to more beautiful cousins getting into
the market with shapely figures? I no longer have the long queue of men waiting to woo me. To make
matters worse there is a beautiful young Indian maiden ready to compete with all of us. She has an
edge over most of us both in dowry, which is very low, compared to us, in addition to her being more
attractive. She is very well endowed, coming as she does from a purely Indian stock, having no
foreign blood. With her coming on to the scene the Indian men seem to be fascinated by her and
despite all of us here to be wooed, men and even women are waiting in long queues to get her. Come
to think of it, there is a lot of homosexuality in India in this field at least. Lots of young ladies try to
befriend us on the road! While some men are very caring and look after us very well with tender
loving care, yet others are downright rude and crude in their lovemaking. They want us to come fast;
they do not care for our comforts and needs.

Up until the Indian lady came on the scene, my Indian parents really fleeced the people of India by
charging exorbitant rates of dowry for me. They even robbed the poor men. Now that Indian girls rate
has come down, our parents have realized that they could no longer fool the public by their bloated
prices, and have cut the dowry rates drastically. It is no longer the sellers market, but predominantly
a buyers market. There are also the elder cousins of ours, the buses and the larger trucks that have
invaded the Indian market in a big way lately. Some of them are so big that they look like monsters
on the fifteenth century Indian roads. They have become a real menace to smaller players like me on
the road. There is an inverse-law operating here. Whereas the Indian roads have hardly changed since
the eighteenth century, the vehicles that invade India today are the twenty-first century makes!

The Indian roads are a nightmare for me almost everyday. My man is a resident of this beautiful
coastal district of Udupi, where most Indian Gods and Goddesses have come to stay. It must have
been a safe haven for all of them in the good old days. People here must have been good too in the
distant past. Not any more, though! The way they behave with frail ladies like me on their roads
makes me feel, at times, that they are not human at all. They come out with all their demonic
features while on the road. If they sit at the wheel of one of those juggernauts, they could not care
less for the lesser mortals. To cap it, this part of the country has a very liberal supply of their
intoxicant, the arrack, which has become a pre-requisite for driving large vehicles. You hardly find a
driver who has not had his fill of this heavenly liquid before climbing on to the drivers seat. In
essence arrack is more important for the drivers than the diesel for their vehicles.

I shall now narrate a nightmarish experience that I had on the main highway in this part, the NH 17,
running between Mangalore, the port city of Karnataka, and Udupi the Temple City. It was mid day
and the sun was unusually hot. On my way up I had witnessed three gruesome accidents where the
huge giants themselves had kissed one another head on like the Clinton-Monica kiss, described by the
latter as the most intimate and pleasing. Next was the somersault of another lorry, which must have
sent its driver to meet his maker without any hitch! The third was really queer. The bus had tried to
go up a roadside tree. The poor tree was all but uprooted, but had sacrificed its life to save at least
the majority of human beings inside the large bus. The tree showed the true Indian spirit of
paropakaaraartham idam shareeram, while the bus and its driver were swearing by the opposite
slogan paraapakaaraartham idam shareeram. The latter seems to be the slogan of the large bus
cousins of mine on the NH 17. They are there mainly to kill people. I strongly feel that the government
departments, looking after the transport system, must have sent a secret circular to kill as many
people on the roads as possible and as quickly as possible, to reduce the exponential growth of the
population!

Corruption being the order of the day, no one seems to bother about the rules and traffic regulations
on these roads. Indians are said to be literate and this district is supposed to have one hundred per
cent literacy, but the way they behave on the road looks as if they have no culture at all. Rules are
obeyed because of fear of punishment; culture makes one obey the rules because of the sheer love for
others. Uncultured people in India need not bother about the rules at all. If you know which palms to
grease at the appropriate time you could easily get away with even murder. In the adversarial judicial
system that we have inherited from the British, if one could engage the cleverest lawyer in town to
make the truth look respectable and murder acceptable, one could get away with the worst crime.
These people could even give solidity to pure air! Consequently, the drivers of these large vehicles
commit any number of mistakes, including fatal accidents, but they will be at the wheel the following
day. I had a taste of that yesterday while my husband was driving me mad on the NH 17. We just
escaped death by the skin of our teeth thrice between Udupi and Mangalore. Once it was an oncoming
bus trying to overtake two vehicles at a bend in the road where the overtaking driver could hardly see
beyond 100 yards ahead of him! We were very lucky, as we had no gutter on the left edge of the road
and there was a large road shoulder at that spot. Next was the large bus trying to overtake us while
we had signaled to turn right. While we just about brushed with death in that instance, the driver of
the bus abused us in the filthiest language telling us that we have flouted his new rule that the signal
to the right means our permitting him to overtake us. This seems to be the modern addition to the
Indian penal code! This kind of a rule does not hold good in any other part of the civilized world! Third
time it was the driver of a fast moving bus coming to a dead stop right in the middle of the road to
pick up a passenger on the roadside, although it claimed to be a non-stop express bus.

Of course, stopping a vehicle at the entrance to a side road, at the convexity of a bend in the road, in
the middle of the road, in front of some other parked vehicle, in front of someones house, in a round-
about, and in all the prohibited areas is supposed to be a sign of greatness in India. Indulgent sons of
wealthy parents, drivers of large buses, and the official drivers of the great government babus are the
ones who follow this parking dictum without fail. No one dare talk to them. He is sure to suffer for it.
One can not complain to the police, either. It is a sight for the Gods to watch an occasional altercation
between the bus driver and the poor police constable. It is an unequal argument with the poor
policeman, at the receiving end. The driver always has his way, using some of the chaste adjectives
aimed at the policeman, because the driver knows that the latter is on his maamuul and, literally, lives
on it. Less said about it the better for society.

Maamuul culture has become a rule rather than an exception in every field, no part of the plutocratic
government being an exception to this golden rule. The transport authorities issue licenses on
pressure, and the drivers drive their vehicles under pressure from the owners to make more money.
At the end of the day it is money that runs this world. All the rules are bent to suit the moneymaking
tricks. With the monetary economy getting entrenched, society changed its moorings and has lost all
the virtues enshrined on it by the tenets of the religious leaders of yore in every religion. There are no
bad religions, there are only bad people making a living out of twisting religious tenets. In this context
a peep into our ancestry may not be out of place.

Time was when the golden rule of the business in motor cars, nay in any other area, was basically a
loving relationship between the maker and the buyer who needed the article. He had to wait for it to
be manufactured to his specifications from the manufacturer. Enter Henry Ford (1863-1947) into this
business in the year 1908, and the whole scene changes to that of mass production. This resulted in
cars being manufactured in thousands and they had to look for a market. They had to make people
buy cars even when they did not need them. Although this goes against the Ten Commandments of a
great thinker, who said: never buy anything that you do not need and also do not buy anything
without your having the money in hand. The new business philosophy changed all that and made
people buy things which they did not need and also to buy now and pay later. This seems to have
been one of the major causes of the modern epidemic of suicides in the West.

Henry Ford had to get his friends in the government to build bigger roads to accommodate the larger
load of cars and also to start motor financing in a big way. Earlier in the year 1885 the German
inventor, Karl Benz (1844-1929) announced his motor wagon, a single-cylinder petrol engine, and the
tricycle. Cars became the toys and status symbol for the rich; in fact it is so even now for the newly
rich. The real break through came in 1906 when Rolls-Royce produced their Silver Ghost. But my real
ancestor is the brainchild of a great Greek-born thinker technocrat, Sir Alexander Issigonis, who when
employed by the British Motor Corporation after the Suez crisis in 1959 to innovate a fuel friendly
small car, came up with the transverse engine space saving and fuel friendly Austin Mini in the year
1959. It was the real birth of a small car.

We did not look back since then and even the American market is now competing for the small cars.
That is how Japan overtook the American giant even in this business. America is paying very heavily
for its mistake by way of pollution from petrol and diesel. India can not lag behind, as many literate
Indians are only RNIs, resident non-Indians. They think with the American mind, sitting in their air-
cooled drawing rooms in our mega cities, least mindful of, neither even aware of, the ground realities
in our far-flung villages. There are, in all, about 575,000 villages in India, where more than 80% of
Indians live in a hand to mouth existence.

Acculturation, migration of populations in search of greener pastures, to larger cities is our biggest
curse. That has resulted in unmanageable congestion in our cities that adds to the traffic pollution.
Our roads are still the same with potholes and badly maintained narrow lanes. They would surely find
it impossible to accommodate the new wave of vehicles driving madly all over them. The NH17 is a
very good example of what a road should not be. If I did survive yesterday it was definitely due to my
good Indian horoscope. Logically and rationally, according to the linear mathematics, I should have
been smashed into bits and pulverized under one of those large monsters on the highway. We do not
pass a day without deaths and disability produced on the NH 17. Is it the only jinxed road or are all
roads in India potentially the dangerous deathtraps?

God saves mankind! In their madness for comfort and their greed they will eventually destroy
themselves. Oh God, if you are still on duty do something before it is too late. You will certainly repent
for having not put that one stitch in time! I hope my progeny, at least, would have wider and safer
roads and more sane husbands to manage. Hope to see a new breed of bus and truck owners who are
needy but not greedy, and the drivers of the larger monsters who are human and humane.

The dead are only a statistic for the police and the government, but they are one hundred per cent
irreparable loss for the near and dear ones. All that the latter could do is to keep the memory of the
dead alive and love them as long as they live. After all there are two worlds, one of the living and
another of the dead. There is a bridge between the two. That is the bridge of human love. Let us love
our departed souls as long as we live. Let us hope that our roads will not be used to send more people
to meet their makers in heaven! Would man see reason and act with compassion? Let us pray for that
day and live on hope till then. Man lives on hope, anyway.

AUTOBIOGRAPHY OF DIABETES MELLITUS.

Knowledge of what is possible is the beginning of happiness.

George Santayana.

I am not a disease. I am only an abnormality of glucose (sugar) metabolism in the human body with
associated changes in other functions. While blood sugar is the vital need for humankind to survive,
when the body finds it difficult to keep sugar under control, they label me as the cause. In fact, it is
their pancreas that is at fault. I need the hormone, Insulin, secreted by human pancreas, to keep me
under check. If there is not enough to go round and control me then I will have to go astray and at
times, I might even cause harm. But the commonest cause is that affluent humankind today seems to
have put itself in the midst of food plenty atmosphere where the pancreas of man, poor thing that it
is, finds it difficult to cope with the enormous amount of junk food calories that man eats daily. While
high blood sugar might harm in the very long run, overzealous lowering of blood sugar to ridiculously
low levels, in the fond hope of controlling me adequately, might even kill the person instantaneously!

Do I go by hereditary rules?

Yes, and no. I, like any other abnormality in the human system, depend on the human genes. When
there is a diabetic gene inherited by mankind, I could penetrate to produce my symptoms in any one.
But the most important thing to remember about me is that I do not and, can not; show my powers
unless the owner of the gene puts himself in an unfriendly atmosphere. If he eats too much and
becomes obese and does not bother even to get up from his easy chair, then he has no control over
his blood sugar and the poor pancreas finds it difficult to control the sugar level and I will have to
appear there for certain. But if another person with a similar gene acts to control his blood sugar right
from younger days by being very careful in his/her diet and works very hard to expend sugar in his
skeletal muscles, then the gene will not be able to penetrate and invite me there. Both the gene and I
can not show our power in such individuals for a long time. Then, in old age every one will be a
diabetic, anyway, with or without the gene, due mainly to the exhaustion of the pancreas.

Do I have different types?

Yes, sometimes children are born with very poor pancreatic function and they do not secrete enough
Insulin. Then I appear in the form of Insulin dependent diabetes.

Rarely, do I present as the usual adult onset diabetes in the young but with enough Insulin still
present there to do its job. I am then called Maturity onset diabetes of the young. (MODY)

But the usual presentation is in obese middle aged people who eat a lot and exercise very little, the so
called adult onset diabetes.

Then some of the drugs that doctors give to their patients for various illnesses might provoke me to
appear, called secondary diabetes, for which there could be other endocrine causes as well. Steroids
are one such class of drugs and some anti-psychotic do that as well with many other drugs rarely.

Have I become an epidemic in India?

That is what some vested interests seem to be trying to sell to the gullible public to make them get
frightened. Fear is one of the reasons why human blood sugar goes up temporarily. It was meant to
go up, when we were still hunter-gatherers in the forests, in any dangerous situation to run away from
the danger. Today the danger seems to be inside our civilized society itself from where one can not
run away, where people who want to sell their drugs to control diseases either invent new diseases or
spread the scare of epidemics of old well known abnormalities like me.

Drug companies entice some gullible doctors to do research for them. They then collect the data to
sex it up and doctor it to be published as they wish, of course, with those doctors as authors. The
doctors ego is satisfied. Some of them get many other perks because of these drug company
connections. Many sincere researchers have even warned the health organizations that the scenario is
not that sweet after all. Most of those studies are done very badly and the statistics used could be
called science without sense.

Many of the subjects for research are those that are frightened first and then tested for blood sugar. If
one reading happens to be high (it should be high if the person is normal and has the normal
autonomic nervous system under fear) then the hapless person is labeled a diabetic for the rest of
his/her life. The normality definition in medical science is flawed. When we apply disease statistics to
healthy people 5-25% of the normals become abnormal, the so called false positives! For the purpose
of selling the idea of an epidemic these results are very helpful. Doctors must have read that beautiful
editorial in The Lancet entitled Do Epidemiologists cause Epidemics? They unnecessarily bring a bad
name for me in the bargain, as if I am interested in annihilating mankind. No- never, I do not do that.
If there is any real increase in the incidence of diabetes, I doubt it, it is because people in general
have become affluent and have started eating a lot of junk food and become obese in addition to
being sedentary couch potatoes! Their own pancreas finds it difficult. It is no fault of mine at all.
The other important reason for young people to get maturity onset diabetes is their family
background. When they are born to poor mothers who did not have good nutrition during the first
trimester of pregnancy, offsprings develop very small pancreas to begin with which only could produce
limited amount of Insulin. If such babies survive and grow up and then put themselves in a food
plenty atmosphere, they become diabetics very young. This is called gene-food mismatch.

How do patients satisfy you and live a normal life?

My suggestion to them is very simple, unless they belong to the Insulin dependent variety discussed
above.

Get your weight to normal and try to keep it there mainly by eating less and working more. If they
walk for one hour at their own pace, they will have spent 350 calories. That by itself will prevent me
from showing my powers. They need not have any special diets. They could eat less of what they have
been eating if they have been obese. If they have been thin they need to have special diet advice to
put on weight to reach the normal mark and then also control their sugar levels.

Eating must be small at a given time and more number of times in a day. Six small meals a day is
ideal. Hunger does not bother them then and they could eat their small portions frequently. Mental
relaxation is as important to keep the sugar under control as are all the other methods.

If after doing all these and, only then, if the sugar has not been under control they could try to follow
their doctors advice about drugs. There again one has to be careful to be an informed partner in
his/her treatment as many of the drugs are not good in the long run. Your doctor is your best friend
and you should be his/her partner in management.

If there is an epidemic what is the remedy?

The remedy is not screening the entire population for diabetes and then drugging them. Adverse Drug
Reactions (ADR) has been found to be the fourth important cause of human death in the USA lately.
None of the drugs are safe in the long run although they might be indicated in an emergency where
they might not harm and might help. The best solution would be to educate the population about the
dangers of junk food and over eating. The present technological revolution has also produced another
curse of human inactivity that adds to the problems of all human organs to do their function properly,
the main culprit being the pancreas. In the name of globalization we should not leave our ancient
eating habits and jump on to the bandwagon of preserved foods that are very rich in calories and salt,
both of whom will eventually destroy human health. In addition, the preservatives in many of them
will help cancers to grow also. Many of the sugar equivalents that diabetics use are equally dangerous.

In conclusion, I am a friend of mankind and do not intend to harm them, if I could help that. Mankind
should help me to help them by behaving as they should. Modernity and affluence has taken them to
this pass. Their preserved junk foods are their enemy numero uno and their sedentary life style is
killing them. They should not blame me for that. Look after yourself and I shall not trouble you. If you
act wisely you could have a normal life expectancy even with me as your friend.

I would rather be strongly wrong than weakly right.

Tallulah Bankhead.

AYURVEDA-THE MOTHER OF ALL MEDICAL WISDOMS

If you do not learn from history,

You will relive history

Cicero, the Roman thinker.

Ayurveda (ayush=life; vid=wisdom-Sanskrit) is said to be the most ancient of medical systems. The
ancient Vedic tradition, cognized by the Great Indian seers, offers a wealth of knowledge for healthy
and meaningful life.1 Since Ayurveda (Part of Atharvaveda, the last of the four Vedas) is timeless and
unbounded it has relevance even to the present day. It was Mark Twain who once said: So far as I
am able to judge, nothing has been left undone, either by man or nature, to make India the most
extraordinary country that the sun visits on his rounds. Nothing seems to have been forgotten,
nothing overlooked.

The philosophy of Ayurveda believes that everything in this Universe is composed of five elements, the
panchbhootas. They, in turn, constitute the three doshas or bio-energetic forces that govern our
health and determine our constitution. The trigunas or psychic forces determine our mental and
spiritual health. Ayurveda teaches us to balance all these to live a healthy, happy and contented life.

Unlike modern medicine, Ayurveda recognizes that the mind and body are but the two manifestations
of the same consciousness-mind as the field of ideas and the body as the field of molecules and
organs. Each tries to help keep the other working and healthy extracting nourishment from the
environment. Elimination of impurities of the emotional wounds are as important as the elimination of
the waste matter from the body to have true physical, emotional and spiritual health.

Modern risk factor hypothesis pales into insignificance in view of the most elaborate knowledge in
Ayurveda. Some of the recent additions to the modern medical list like hostility form the basis of the
Ayurvedic risk factors. Viz.

Khrodha, shoka, bhaya, aayaasa, virudhaanna bhojana,

Thaponnalaan, lavanakshararakta pitta prakopayeth

(Anger, depression and sorrow, extreme fear, exhaustion, wrong foods, sedentary living, too much
salt and spices lead to most major killer diseases)

The solution is also simple:

Nithya hitha, mitha aahaara sevi, sameekshkaari, dhata samaha sathyapara

kshamavaan aapthopasevi aarogyam.

(Have food in moderation and that which pleases the mind. Do not cheat or tell lies. Work very hard.
Forgive others even if they hurt you. Treat all as your own kith and kin. Health would be yours
always.) 2

Vedic wisdom follows non-linear mathematics (Vedic Mathematics) and the laws akin to modern
quantum physics. It is, therefore, the right approach for holistic assessment of health and disease. Its
aims are not only to heal the sick, but also to preserve life by preventing illness-most complete
system of health care known.2

Ayurvedic treatment is based on restoring the disturbed balance of the three doshas-vata, pitta, and
kapha - very much like the humors theory of Hippocrates. It takes into consideration the whole human
being, and not just the phenotype. The tridosha concept takes into consideration the phenotype,
genotype as also the mind, in classifying patients. Consequently, treatment differs even for the same
disease from individual to individual, based on the constitutional types.

Whereas billions of tons of water get displaced during the tidal changes in the oceans due to the
gravitational pull of the moon, the human body, which is mostly water, could not be exempt from the
effects of the planets. Ayurvedic astrology plays a large part in the total picture of disease and its
cure. Many of us scientists who feel nauseated at the very mention of the word astrology would do
well to know that Isaac Newton and Gelileo were both practising astrologers. The science of astrology
is good but not the astrologers predictions! Most predictions, including the ones we make in scientific
medicine, are just predicting the unpredictable.3

Empirical knowledge, derived from long term prospective studies, form the basis of therapy in
Ayurveda, unlike the short term case-control studies or, even, cohort studies based on matching the
controls, based on phentotypical features alone, as is done in modern medicine. Treatment is tailored
to individual needs and could be broadly grouped into the following:

* Detoxification-panchakarmas

* Diet.

* Yoga.

* Herbal Medications.

* Meditation and Prayer (No particular God or Book prescribed)

* Ayurvedic Surgery.

Advances in Ayurvedic surgery could be gauged from the intricate rhinoplasty described thousands of
years ago by Shushruta. Trephining, stone removal from various sites, abdominal childbirth,
hysterectomy, episiotomy, fracture setting, tumour surgery, and many minor surgical procedures had
been described. They had 127 instruments and suture materials. Anaesthesia, sanmohini, was very
much advanced. Aseptic methods looked most modern.

The lancet used for small pox vaccination closely resembles the one used in modern medicine. In fact,
the authentication for Jenners vaccination came from the ancient Ayurvedic vaccinations proven track
record. A Fellow, Dr. T.Z.Holwell, who personally had ten-year follow up experience in The Bengal
Province, presented the details of ancient Indian vaccination methods to the London Royal College of
Physicians in 1747. 4
Training of a physician was very rigorous lasting for several years. The problem-based learning was
used while the student resided with the teacher.

Picture of students and teacher here. (attachment)

Dead body dissection was compulsory to achieve mastery in anatomy. Thousands of years before the
advent of the microscope Charaka Samhita explained how the body was made of cells in every organ.
It also described twenty microorganisms that could cause disease.5

Graphic descriptions of the various organs, especially the heart were remarkable.6

picture of heart and lotus here. (attachment)

(The heart is supposed to resemble a lotus bud kept upside down, twelve fingerbreadths above the
navel in the chest with its tip slightly to the left of the midline. A large vessel takes blood (gods
power) from the heart to all parts of the body from the tip of the toe to the top of the head. Heart not
only pumps blood with each beat, but sucks blood with each diastole, and hence the name Hridaya
(hrit=suck; dadaathi=give)

Detailed texts existed for physiology, symptomatology, surgery, drug therapy and diet. The graphic
description of the anginal pain and its origin was amazing.7

Athaatho hradrogaprathishedam vyakyaswamyah

Yathovaacha Baghavan Dhanvantharim:

Ayaammyathe Maaruthaje Hradayam Thudyathe,

Nirmaathyathe Dheeryathe Cha Spotyathe,

Paaticha Thrishnoshadaahachoshaam syuhu Paithikecha,

Dhoomaayam Cha Moorchaa Cha Swedhahako.

(In this chapter Baghavan Dhanvanthari (God of Healing) personally describes the symptoms of heart
disease and impending death by heart attacks. Patient might, at times, only feel pricking pain in the
chest, vibrations (palpitations), burning pain, or at other times the pain may be so severe, resembling
the pain of splitting the chest into two halves with an axe! Patient may have unusual thirst, burning all
over the body, breathlessness, extreme exhaustion, mouth breathing as the patient feels that the
nostrils are not enough to breathe, profuse sweating, pale face, stiffness of the body, and, finally,
even unconsciousness might result.)

There are eight branches of Ayurveda integrated at all levels: surgery, medicine, gynaecology,
paediatrics, toxicology, otorhinolaryngology, rejuvination, and virilification therapy. Medical ethics
were discussed in great detail. The oath of the Indian physician is much more elaborate compared to
the Hippocratic oath.

History has enough data to show how the ancient Indian texts and pundits were taken to Greece by
the army of Alexander the Great. In a classic, India in Greece, Pococke, the Greek historian, described
how Aryans (cultured men-Sanskrit) migrated from India to Greece via Sumeria and many other
countries.1

The most famous of all the texts are the Charaka Samhitha and the Shushruta Samhita, while there
are many others of significance like Madhava Nidhaana. The myriad cultures, languages and beliefs, as
diverse as Indian philosophy and religion, are all intertwined encompassing her vast history with
Ayurveda getting mentioned everywhere as an inseparable part of human life in India, show the
greatness of Ayurveda.

There is an awareness of the growing importance of this system of sustaining life in various parts of
Europe, North America, South East Asia, and Japan where they have started medical schools in
Ayurvedic system. Many of the ancient methods could be studied using the modern methods of
inquiry. Thousands of medicinal plants mentioned in the ancient texts could hold the key to future
inexpensive pharmacology!

Charaka, the great Ayurvedic sage wrote. That is designated as Ayurveda or the science of life
wherein are laid down the good and bad of life, the happy and unhappy life, and what is wholesome
and what is unwholesome of life, as also the measure of life. 8
Modern medicine, having become prohibitively expensive by going to the market place riding
piggyback on technology, is beyond the reach of the common man even in advanced countries. This
does not take into consideration of the cost of defensive medicine being practised in the West to keep
the insurance companies at a distance! While we need to complement modern medicine, which is
exceedingly effective for emergency care, with less expensive but equally effective methods good for
long term care, Ayurveda fits the bill perfectly. It is both authentic and scientific. In addition, it is
highly effective.

It is never too late to give up your prejudices

Henry David Thoreau.

BIOLOGYS HOLY GRAIL- CURIOUS MEDICAL STUDENTS

NOTEBOOK.
Has biology, the mother of modern medicine, found its Holy Grail, leave alone drinking from it? As a
medical student at the Stanley Medical College, Madras, I got the impression that what I was taught
was the whole truth and nothing but the truth. That was long time ago, in fact, in the last century, to
be precise in 1956 AD. Since then a lot of water has flowed down the Cooam Bridge on the Marina
Beach. Unfortunately, nothing much has changed in our thinking in the medical field in the last half a
century although lots of new technology that I did not even hear about during my student days have
come into the picture and some of them have been since abandoned as they produced more suffering
in their wake compared to the relief that they gave. Lot more new drugs have come and gone and are
making media news almost everyday of a breakthrough or of a life saving drug.

Shaken to my bones by some of the events in my medical life since then, I have tried to unlearn what
I had learnt as an examination going student, almost for a decade from the time I entered the medical
school, only to relearn the realities in the field sans the claptrap. It has not been an easy task, an
uphill task at that, at great risk to my career even. But now after more than half a century I feel it has
been time well spent. I deem it my duty to share my arduous journey with the newer breed of
doctors, trained in the present five-star, hi-tech atmosphere under the glare of an array of scopes and
scanners and breathtaking heroic (the hapless patient as the hero) surgical feats. I would like to share
my joys and sorrows with them lest they should also go through the same process that I went through
and waste their time.

Medical literature today is like a thick jungle, what with 7.5 % new information pouring into biology
through, well over forty thousand bio-medical journals all over the world, every month, the novice
would find it difficult to separate the wheat from the chaff. In fact, that is the job of an ideal teacher
to guide the novice in this thick jungle of mostly dead wood to the real useful rose wood or the teak
for his/her benefit. Otherwise, the novice would not reach the real stuff and might get lost in the
jungle for ever. I wish to share that with the readers through these columns. David Eddy, a former
professor of cardiovascular surgery at the Stanford, changed his profession after having gone deep
into the realities (or otherwise) of medical science and trained to be a mathematics teacher at the
Dukes University after his Ph.D in mathematics! I did not do that as I found it difficult to study
advanced mathematics. I tried to swim along and see how we could change things if we can or bear
with things that need no change and also to have the wisdom to know the difference. I do not know if
I have reached my goal and that is why I consider myself a medical student even today.

Human body does not follow the linear rules of conventional mathematics and time evolution in man
depends on the whole man (his genes, phenotype as well as his consciousness) and not on a few
parameters of the phenotype. This is where our predicting mans (patients) future rarely comes true.
We have been predicting the unpredictable and intervening unnecessarily in apparently healthy
people. This is precisely the reason for death and disability rates to plummet in Israel recently when
doctors struck work for three months. Similar experience was reported from Saskatchewan in Canada
twenty years ago and from Los Angeles country ten years ago when doctors went on strike. There has
been hardly any difference in the per capita deaths due to chronic myeloid leukemia at the Christys
Hospital, Manchester, during the two time slots, 1900-1940 and 1950-1990, although there were sea
changes in our approach during the latter period.

The basic tenet to understand is that our body cells, of which there are about one hundred thousand
billion in all, love one another so much that they would like to work as one whole. Even the cells of all
sentient beings do the same. But for evolution (nature) developing the most powerful immune system
all living things (humans included) would have been one large mass of a cell syncitium. Thank God for
that. With that background in view, our organ based specialties and therapeutic measures would have
to have problems on a long term basis. While modern medical quick fixes could be useful in an
emergency, they would come to grief on long term use.

Another bane of modern medical thinking is the definition of normality. In a bell shaped Gaussian
graph of any measure in the human system, normal human beings are those who fall within the
mean+- two SD (standard deviations). This automatically brings in the issue of false positives. In
every parameter thus measured, 5% of normal population would, per force, be declared abnormal
(false positives). This five per cent suffers the long term consequences of our interventions, anyway.
Be that as it may, now with the new Total Body Scanner, threatening to invade India in a big way in
the near future, one shudders to think of the future of Indians. Total body scanners would measure
five-hundred body parameters in one sitting. Now think of the mind boggling 5% of the five hundred
measures making a total of 2500 false positive measures for every one hundred people that go for a
routine screening! Any one that sees the doctor for a check up when apparently healthy, after the
TBS, would have, on an average, 2.5 abnormal reports. There will be no NORMAL HUMAN BEING AT
ALL. Although it is a very good business proposition, it is bad for mankind. Even at the present day it
takes one thousand healthy women to be screened for cervical smear for forty long years to save one
woman from cancer cervix! A sizeable per cent of those women would have lost their organs for no
fault of theirs, as nearly 75 women in this group would have had abnormal smears with normal cervix
and so on. Similar is the story of prostate, breast and many other cancers. The MRC study of mild-
moderate hypertension showed that it takes 850 innocent normal people to be drugged for a period of
five years to, probably, save one stroke.

So read on to know the other hidden face of the moon (medical science) bereft of all the dressings and
frills in medical science, and, in the bargain, get a glimpse of the new science in the horizon of holism
(in place of reductionism), CHAOS and fractals, without any heavy dose of mathematics that we
doctors generally are not good at (I am talking for myself). Happy reading folks!

BATH FOR THE MIND.

All of us take bath daily, may be even twice daily, to get rid of the dirt, grime, germs and the all the
unwanted things from our bodys outer surface to keep ourselves healthy. However, we never try and
cleanse the mind, which harbours more deadly poisons that could destroy us very easily. Most of us
wonder as to where the human mind is, knowing full well that we can not see the mind as we see our
hands or feet.

The mind is an integral part of the body and resides in every cell in the subatomic quantum level. This
quantum concept of the mind explains many of the intricacies of the mind that were hitherto a
mystery and did not come under scientific scrutiny. With the advances in quantum physics and the
realisation that the mind (consciousness) is the one, which observes everything; even in the most
complicated scientific experiments. The Schrodingers Cat Hypothesis and Werner Heisenbergs
Uncertainty Principle have brought to fore the importance of the observer. Each and every
experiment depends on the eye of the beholder. No physicist has seen the Lepto-Quark, the last bit of
the atomic split, although most have felt its impact. Mind only feels what the external sensory organs
see and observe.

The mind, thus defined, is the source of all our thoughts that, in turn, direct all our actions. Actions
and reactions being equal and opposite, our actions beget their consequences, good as well as bad.
There are basically two kinds of thoughts-positive and negative. While the former help the growth and
development of the organism, the latter, the negative thoughts, are now known to be at the root of all
our ills on this planet, beginning with the simple common cold to the deadly heart attacks, strokes,
and even cancer, the all pervasive destroyer!

Study after study of the risk factor hypotheses has revealed the vital role played by negative
destructive emotions on the major killers. The Johns Hopkins student study, the London White Hall
study, and the Scandinavian study of men with heart attacks showed the major role played by
frustration, hostility and depression in this disease. Similarly depression, with or without treatment,
came up as the single most dangerous predisposing factor for growth and maintenance of cancers,
with anger as the leading cause of stroke! The simple summary is that it is not what one eats that kills
him, but it is what eats one that kills him.
Having thus made sure that it is the mind with negative thoughts that is at the root of all human ills,
let us try to find out the source of those negative thoughts and the way they could be cleansed from
the mind. Man is born with only two basic instincts-the instinct of self-preservation and that of
procreation. The rest of our instincts are acquired after birth. The innocent God like child has a mind
full of universal compassion and love along with the other two necessary basic traits mentioned
earlier.

All the negative emotions are fed into our minds after we come into existence. In the name of
civilization our environment makes an effort to inject all these negative feelings, basically related to
the monetary economy that we inherited in the last few hundred years. Our ancestors, that lived in
the forests for thousands of years, were innocent people without any of these negative thoughts but
could have been physically more cruel when in danger. Emerson was not wrong when he said, if
mankind would have an end it would be as a result of our present civilization. Today mans greatest
enemy is man himself!

The basis of monetary economy is competition. Competing with others is mediocrity, but competing
with oneself is excellence. The present society has evolved to respect money and power, thus making
man hate another of his species, even when not in danger, leading to unhealthy competition. In a
quest for achievement we drive our younger generation into the bottomless pit of hatred. Our
educational system does not inculcate values in the young mind. Spiritual quotient is as important as
the intelligent quotient and emotional quotient in education but the first and the last are totally
missing in the present system. When the negative feelings have taken root firmly, even if one realises
the mistake, it takes a long time to flush ones mind of those devils.

For the future generation at least the educational system, for children below the age of fifteen, should
avoid competitive ethos. For all of us who have been brought up in the existing system a different
approach needs to be thought of. How do we cleanse our mind of the poison already inside? Indian
ancient wisdom (not religion, lest it should be misinterpreted by vested interests) has many antidotes
for the negative feelings in the mind. The best among them is the correct breathing technique.

There are enough scientific studies available today to show how this seemingly simple method could
have such profound changes on the human mind. Yogic breathing techniques that use abdominal
breathing (belly breathing) methods in place of the inadequate upper chest breathing used by most of
us in this busy world, caught in the day-to-day rat race, would make a world of difference.

The method of belly breathing brings on basically two changes inside the system. The first is that it
reduces the rate of breathing. This in itself improves tissue oxygenation, reduces heart rate, decreases
aortic pressure (thereby blood pressure) and also reduces the pressure in the lung artery (pulmonary
artery) taking blood out of the right heart to the lungs. While aorta takes blood out of the left heart,
the pulmonary artery does the same to the right heart. Both sides, thus, get relieved of their extra
load to that extent. This has been shown even to help patients with advanced heart failure. (Failure of
the heart to pump blood adequately to all parts of the body)

The second change happens in the amount of lung tissue that is available for air exchange in the lungs
when one takes a deep slow breath using the abdomen. In this method when one draws air inside the
lungs, the diaphragm moves so far down into the abdomen pushing the anterior abdominal wall
forwards. The lungs now distend fully and oxygenate the blood many times better than in the shallow
breathing of anxiety and stressful living. Although this effort, twice a day for as short as fifteen
minutes, does a world of difference to our well being by soothing the nerves reducing negative
thoughts, making a habit of using belly breathing routinely is a great help! Bodys wisdom, in those of
us using shallow breathing, compensates the loss of oxygenation by increasing the functioning of the
heart to pump that much more blood every minute to make up for the loss of lost lung area. This
latter is the cause of all misery. Shallow breathing, therefore, increases heart rate and blood pressure
to make one feel tired easily. This is like burning our life unnecessarily.

Inadequate oxygenation of the brain added to the above sequence leads to perpetuation of negative
thoughts. One small example would suffice. When you are very angry ask someone to watch your
breathing and ask them to remind you to belly breathe for a while. If you did that you would be
surprised to see how quickly you get rid of the hatred that brought on the anger in the first place.
Many a time you wonder why you became angry at all. Anger and danger are but just one letter (D)
apart. Anger and happiness are but a few belly breaths away.

Regular breathing exercise added to a session of shavasana for ten minutes makes you very tranquil
and could bring on good sleep as a bonus. Philosophic outlook in life with the awareness of the
insignificance of the human organism in the working of the macrocosm would make one humble,
reducing pride and jealousy that eat into our minds. Hostility is our biggest enemy. The above simple
methods help get rid of all the dangerous negative thoughts

Regular physical exercise, especially outdoor walking, enjoying the bounties of Nature en route would
add to the perks. Diet enriched with fruits and vegetables could be an added bonus. Small regular
meals four to five times a day help keep the internal environment within the limits of healthy
fluctuations of the multifarious functions of the body.

Mind could never be forced to do anything but could be indirectly taught to be tranquil through regular
breathing exercises and following certain simple rules of the game. Man lives for others. Helping
others is the rent one pays for the comforts one enjoys in society. Molecular biology has taught us
that even the thought of helping others brings on favourable changes in the cells of the immune
system to prevent diseases! Praying for others is very effective as shown by a couple of well controlled
prospective studies done in the US. In addition, praying for others helps one to see life in a better
perspective. It gives purpose to life and makes life worth living avoiding depression. The latter is the
greatest epidemic of the West these days. Breathe away to happiness and glory!

CARDIOLOGY IN THE MILLENNIUM.

The man who never alters his opinion is like standing water,

and breeds reptiles of the mind...Blake.

Heart diseases became big news in the twentieth century. As with many other areas of modern
medicine, hi-tech cardiology has been the main till-mover in the medical world, especially in the fee-
for-service system. In fact, many of the interventional procedures, when audited, showed that they
were carried out mainly because they could net billions of dollars in cash, prestige and status for the
doctors, hospitals and the manufacturers of electronic equipment wrote Prof. Krumholz of the Yale
University recently.1

William Osler described coronary artery disease in 1892 as a relatively rare disease. In less than two
decades it was reported that one in eight deaths in the western world were due to heart disease.
Lately even lay people think that there is an epidemic of heart diseases especially coronary heart
disease. But a serious study by Professor Stehabens showed no absolute increase in the incidence of
coronary artery disease in the last one hundred years! The apparent increase was mainly due to the
ageing population and also better labelling methods in recent times!2

Knowledge of cardiovascular diseases grew in this century rather fast. John Hunter studied the blood.
The physiological basis of high blood pressure was enunciated by Bernard and Brown-Sequard
regarding vasoconstriction and vasodilation. Reverend Stephen Hales recorded the arterial pressure in
the year 1733, in his illustrious mare.

Michael Foster in the year 1859 showed that the snails heart showed rhythmic contractions and later
Gaskell, using the frogs heart, proved that the heart beat was myogenic in origin. This had been
suggested by Haller earlier; but was not proved until Gaskells experiments.

Jean-Baptiste Senac first recorded symptoms of heart disease in a textbook Traite de la structure du
coeur in 1749. Morgagni had published his morbid anatomy in 1768. In 1768 William Heberden coined
the term angina pectoris to describe the typical choking pain. (angere in Latin means choking):
 They who are afflicted with it, are seized while they are walking, (more especially if it be uphill, and
soon after eating) with painful and most disagreeable sensation in the breast, which seems as if it
would extinguish life, if it were to continue or increase; but the moment they stand still, all this
uneasiness vanishes.

William Heberden 1768.

One must remember here that the first authentic description of angina was given in the Shushruta
Samhita in much more graphic way than described above. The curious thing is that Shushruta knew
that the pain came from the heart, whereas Heberden was not aware of its origin. It was much later in
1905 that William Osler thought that it could have come from the heart!

Celeb Parry wrote Inquiry into the Symptoms and Causes of the Syncope Anginosa commonly called
angina pectoris in 1799, where he talked about ossification and obstruction to the coronaries. It was
Antonio Scarpa who described arteriosclerosis in 1812. Virchow pointed out the first evidence of clots
in the pulmonary artery and introduced the concept of thrombosis.

Diagnostic methods were also refined in this century. Corvisart, Laennec, and Bayle listened to the
heart and showed how damaged valves produced murmurs. These were proved by postmortem
studies. Examination of the pulse was refined very much. Two Dublin physicians Robert Adams and
William Stokes identified very slow pulse resulting in syncope, complete heart block, which condition is
named after them. It was Julius Cohnheim, who first thought of ischaemia of the heart muscle; he
showed the presence of heart aneurysm with coronary obstructions around 1839 and 1884. It was in
the year 1880 Carl Weigert gave the classic description of a heart attack.

Newer measurements started with Karl Vierordts (1818-84) sphygmograph and Scipione Riva-Roccis
(1863-1937) sphygmomanometer in 1896. In the year 1859 Etienne-Jules Marey (1830-1904)
modified Ludwigs kymograph to give us the permanent record of the pulse on a moving drum. James
Mackenzie (1853-1925) was responsible for the polygraph.

I think the greatest credit for credible advances in cardiology should go to Mackenzie. In his Diseases
of the Heart, Mackenzie rightly emphasized the importance of clinical features in the diagnosis; he was
feeling sorry that the technology-oriented diagnosis missed many important aspects of the patients
illness. He emphasized the dangers of mechanistic- technology driven diagnosis. This book is
relevant even today, what with all the array of scanners and scopes and angiograms, the patient and
his symptoms still form the basis of diagnosis in cardiology. Both during Mackenzies time and even
today management of patients in cardiology remains only palliative! What are we palliating if we do
not assess the patients symptoms on the bedside? Mackenzies advice, as also that of Paul Wood, who
was the next great cardiologist that Britain had produced, is relevant to the present times.3

Recent studies in the field of heart muscle disease did show that it is the patients symptoms and
family history that determine the fate of the patient and, not the sophisticated left ventricular function
tests. This holds good for coronary artery disease as well. Diagnosis and the management strategies
in this field also depend on the patients symptoms, more than all the technology put together. Still
the medi-business insists on tests for everything under the sun, to the exclusion of talking with the
patient. The latter is not a good business proposition, anyway!

Willem Einthoven (1860-1927) was the first to record the electrical events inside the heart muscle cell,
with the help of a galvanometer in 1903 in Leiden. The machine was a huge contrivance to begin with
and has become a small tool now totally computerized! The whole credit for putting cardiology on the
scientific pedestal should certainly go to that enigmatic British physician, Sir Thomas Lewis, a great
aficianado. His tireless work with this huge contrivance, parked behind the lift shaft at the London
Hospital, helped bring out his first book on the Electrocardiogram in 1926 which, even today, stands
out as a classic. It was a Chicago physician, James Herrick (1861-1954) who clarified the ECG changes
of a heart attack.

By this time high blood pressure made its mark as a killer disease, although even to this day it
remains an enigma! Enormous progress has taken place in the drug treatment to lower blood
pressure; but one is not sure if all this results in lasting good to the patient, except in those with
severe hypertension and/or organ damage. Newer problems crop up daily!

War years in the 1940s saw a quantum jump in cardiology. One of the stars in the firmament at that
time was Paul Wood, who during his relatively short life span of 52 years, did more than all his
predecessors put together in placing cardiology, especially clinical cardiology, on a scientific pedestal.
His treatise Diseases of the Heart and Circulation is a treat for all times. After his death this book saw
only one more edition, helped by Paul Woods friends and colleagues and edited by Walter Somerville,
the then editor of the British Heart Journal. Progress was in evidence on the other side of the Atlantic
as well at that time with people like Paul Dudley White and Sam Levine, the two New England giants
leading the way.

When Americans come on the scene one sees big money playing havoc in the field. This happened to
cardiology in no small measure. Every single scientific discovery, of which there were quite a few
daring ones, like the first catherterization of his own heart by a young German intern, Werner
Forssmann in 1929, (Altman LK. Dont touch the Heart. Book On Doctoring. 1991. Ed: Reynolds R AND
Stone J Simon and Schuster, NewYork London) and the self-catheterization by Sir John McMichael in
England, and other related technologies are now being used to collect billions of dollars in cash and
prestige to doctors and hospitals. Today cardiac care in the West has become very expensive. The
contagion is making its way into the developing world as well.

Angiocardiography was followed by computerized tomography of the heart and fast CT. Ultrasound
examination of the heart, magnetic resonance imaging as also positron emission tomography followed
them.

With better diagnostic methods came better and more expensive medical treatments for hypertension,
heart failure and also coronary artery disease. The single most important drug discovery, after the
advent of digoxin by William Withering in the mid eighteenth century, was the introduction of diuretics
for the treatment of heart failure. The latter also helped treat hypertension. Sir James Black was the
first to introduce beta-blockers, which remain the mainstay of the management of hypertension and a
host of other conditions, including heart failure!

Newer agents like angiotensin converting enzyme inhibitors, their receptor blockers, the alpha-
blockers, calcium channel blockers and many other newer drugs have since been introduced. Another
money-spinner seems to be the lipid lowering agent. The risk factor hypothesis has been taken to
ridiculous levels and lipid-lowering drugs themselves must be a billion-dollar industry, despite the fact
that most of them, if not all of them, result in higher total mortality at the end of the day.

Digoxin, which has been there for more than two hundred years, is being still evaluated, and the latest
study, DIG, gave surprising new data. Most other drugs in cardiology await such audit. Another class
of drugs, introduced in the last two decades to control abnormal cardiac rhythms, has not done well! 4

Diet and life style changes have come to fore lately in the treatment both of coronary heart disease
and hypertension. Many other relaxation methods have also been introduced with varying degrees of
success, their main drawback being compliance; not that compliance is not a problem with drug
treatment.5

The other major group of drugs that came on the scene is the blood thinners and clot busters. Both
came in with a bang and have remained there in some measure but they did not make a big dent in
total mortality although they did reduce in-hospital mortality. Started in Kansas City in 1962, the
special area for care of the heart attack patients, the Coronary Care Units, have now mushroomed
even into remote villages. A recent audit did not show them in very good light. The conventional CCUs
might not have been very useful!
Pace makers, implanted defibrillators, and cardioverters have all made life easier for the cardiac
patient. Many of them have not been audited. The Swan-Ganz catheters, introduced to study the
pressures, have possibly done more harm! Electrophysiological studies have given better insight into
the cardiac rhythm abnormalities. Cardiopulmonary resuscitation methods have developed very well
and even non-medical ambulance personnel have been trained in this life saving method. Mobile
CCUs, mounted inside ambulances, have taken emergency care of heart attack patients to their
doorsteps.

Starting with the discovery of the nucleic acid by the Swiss biochemist Friedrich Miescher in 1869,
research has now led to the launching of the Human Genome Project. They predict that the genome
would be ready by the year 2001. Newer genes are being reported daily. When the full human genome
becomes a reality man would not be very happy, but could even be miserable.6 Genes may not make
us realize all our dreams in reality. However, genetic engineering is being used in experimental set up
now for treating vessel diseases with promising results.

In the year 1896 Sir Stephen Paget wrote: surgery of the heart has probably reached the limits set
by Nature to all surgery; no new method, and no new discovery, can overcome the natural difficulties
that attend a wound of the heart. Twentieth century proved him wrong. Operations on the heart are a
common thing now, even in smaller places. Even complicated congenital defects are being repaired
with ease now, thanks to advances in anesthesia and the heart lung machine. A great surgeon from
Lyons, Alexis Carrel (1873-1948), perfected the technique of vascular surgery and showed how to
anastamose vessels. He also showed that the animals grafted with their own organs thrived while
those grafted from other animals did not!

The ghost of rejection that raised its ugly head then has not completely died down and is bugging
transplant surgeons even today. There are a host of immuno-suppressive drugs. They are both
expensive and have side effects in the long run. Boston surgeon Dwight Harken and Sir Russel Brock
of London were the pioneers in many areas of heart surgery. Other great names are that of Michael
DeBakey of Texas and Norman Shumway of Stanford. Unlike what is reported, it was DeBakey who
accidentally used the saphenous vein to bypass blocked coronary ostia in 1964. He did not report that
till 1967 to see if it works. By then Rene Favaloro of Cleveland Clinic had reported one case done by
him 1967. Now thousands of them are being done all over the world. A recent audit showed that 84%
of those so bypassed, in their asymptomatic stage, did not get any survival benefit.7 Transplant
surgery of the heart is also being done more frequently, but rejection remains the surgeons
nightmare even now. The development of the heart-lung machine in 1950 by John Gibbons (1903-
1973) was a mile stone in heart surgery. Use of low temperature techniques made cardiac surgery
progress faster.

The Future:
Take care of the present and the future will take care of itself.

Predicting the future is impossible, but some guesses could be made, however. We have been using
the linear mathematics in medicine and have now realized that this kind of linear relationships do not
hold good in a dynamic system like the human body. Human body, like any other dynamic system in
the Universe, follows the non-linear mathematics and the science of CHAOS and fractals. This is
dawning on us now and the whole of human physiology; cardiac physiology included, has to change
and would do so in the next millennium.

One example would suffice for want of space. We teach students that blood pressure is a product of
cardiac output and peripheral resistance. This rule follows the Ohm's law. The latter states that only in
straight tubes flow pressure is a product of flow volume and flow resistance. Where is the straight
tube in the human body? The blood vessels bend and fold and are a closed system. Hence a lot of
changes in the so-called risk factor hypothesis also will have to come about.

This is the reason why we have come to grief in predicting the future of a patient based on the data of
the body (phenotype). To predict the future of an organism (man) we have to have the full knowledge
of the initial state of the organism; the latter includes its genotype as also the consciousness! Pooling
Project data showed that those who had a heart attack had one or less than one risk factor, whereas
only 10% of those with more than five risk factors did get a heart attack as time evolved.8 Very well
controlled hypertensives had higher death rates than their normotensive cousins did on a long-term
basis. Total cholesterol distribution remains the same in those who have had vascular diseases as
compared to those that did not have them.9

Another mistake that we have been making is to believe in changing the initial state of the phenotype
to get benefit in the long run. In the Helsinki study there were more deaths in a cohort of healthy
people who had regular check ups and interventions carried out on them, compared to those who
went about their work as usual without any interventions, in the absence of symptoms. All these point
to the futility of using linear relations in predicting the unpredictable future.10 The next millennium
would certainly refine this technique.

Technology will certainly progress further as big money is involved in hi-tech medicine. Newer left
ventricular assist devices, artificial hearts; endoscopic vascular surgery, angioscopy, keyhole surgery
of the heart and xeno-transplantation etc. would be the future. Interventional cardiology would be in
the forefront of management of heart diseases along with genetic engineering. Newer drugs would be
introduced. There are many newer molecules of beta-blockers, calcium channel blockers, ACE
inhibitors, clot busters, and blood thinning agents in the pipeline.

I have a hunch that clinical cardiology will come back to get its due place in the management of heart
diseases in a big way. Preventive cardiology, starting with primordial prevention of even foetal causes
of heart diseases, would be pursued more vigorously in the next millennium. Poverty eradication,
more sensible diet based on fruits and vegetables, avoidance of alcohol and tobacco and the liberal
use of relaxation techniques would be intensified.

Recent reports about the vital role played by the human mind in the causation of serious heart
diseases would change the scenario drastically.11 The role of the mind in the causation of diseases
should make todays arrogant cardiac technician a better clinician. Medicine would still be doing what
Hippocrates wrote years ago: cure rarely, comfort mostly, but console always. Most of our hi-tech
methods would only be palliative even in the next millennium!

That said, I am reminded of the danger of talking of the future. Write I must as the editor has
ordered. I am reminded of the lines of the poem The Road Not Taken by Robert Frost (1874-1963).

I shall be telling this with a sigh,

Somewhere ages and ages hence:

Two roads diverged in a wood, and I-

I took the one less travelled by,

And that has made all the difference.

Robert Frost.

The greatest discovery of this century has been the discovery of mans ignorance.

CHOLESTEROL GHOST EVERYWHERE

This white, powdery, odourless and waxy substance does not even have any taste, but causes so
much trouble for almost all those who have the habit of reading today's health magazines. It does not
cause so much havoc for human health as it does to human happiness, as no literate man, woman or
child escapes its horrors in print and electronic media. The headlines scream: "Cholesterol is one of
the three controllable risks for heart attacks"-"You could be the next person to get the heart
attack"-"Heart attacks are the biggest widow makers" etc. In addition, the Task Force on cholesterol
screening divides human levels as desirable, borderline high and high. Who can escape the mental
torture of all this propaganda?

Where is the truth? Truth always is the casualty when money business gets into any field, medicine
not excluded. The business of cholesterol research and the cholesterol lowering drugs runs into billions
of dollars. As Professor Pickering wrote years ago about the business of anti-hypertensive drugs, more
people make a living off cholesterol than dying of it. Some of the researchers have built their empires
on this substance. They are the same people who sit in committees of research, or the watch dog
bodies overseeing research and also in the advisory panels (pay roll) of big drug companies. They are
the ones who make the rules for screening, testing, research grant giving and also drug advice to
patients and their doctors. This is a close knit circle of fellow travellers!

There are a few who see through their game but do not have the money, time and also the academic
support to pursue their intuition further into the complicated research web that the vested interests
have woven around them to protect themselves with that magic word "science". Occasional ones who
dare to take them head on are being frustrated. In their heartland, the USA, a layman declared war on
the establishment by publishing a direct assault on the academia in the national press ten years ago.
He was Thomas Moore.1 Interestingly a practicing cardiologist, Randall Marsh, from Greeley in
Colorado wrote to support Moore's contentions ten years later.2 I wonder how many of you have read
my repeated assaults on the cholesterol myth in many of my writings, books and innumerable medical
talks to the establishment, long before Moore, both in India and abroad. Most of the readers take me
to be a "therapeutic nihilist" or a cynic. Drug companies have an eye on me.3

The fundamental economics of all this boils down to the fact that anti-hypertensive and anti-
cholesterol drugs are the two classes of drugs that the hapless victims have to take for the rest of
their lives, a good business proposition for the drug manufacturers. Rest of the drugs are used to treat
symptoms of diseases and they are used for a short time and when the symptoms disappear they are
no longer used. So the companies bend over backwards to sell the former two classes of drugs. The
latest craze in America is in the vitamin market. They are also to be taken life long from childhood to
the time of death. Most of the companies are in this business. Every house has a large stock of all
kinds of vitamins, although studies have shown that these do not do much good compared to extra
intake of fruits and vegetables. The latter have many other hidden anti-oxidants in them compared to
the known A,C, and E vitamins sold in the pills.

In fact, I am only worrying about the millions of people who fall a prey to the blatant misuse of the
academic machinery that pours fourth half truths, falsehoods and fearful misrepresentation of the
truth in this field. May be they believe in the old saying that a lie repeated thousand times could be
passed off as truth. "Truth could influence only half a score of men in a century while falsehoods and
mystery will drag millions by the nose", said Aristotle centuries ago. Having met with Marsh recently
and having studied Thomas Moore carefully, I think time has come for me to update the readers in
this field.

Cholesterol is found in all foods of animal origin. There is no cholesterol in anything vegetarian. It is
an integral part of the animal cell wall. If one remembers that millions of cells die everyday in the
human body to be replaced by new ones, one would quickly realize the importance and need for
cholesterol for man. Various hormones in the body are manufactured from cholesterol. Even if one
does not eat cholesterol at all, human liver could make enough for the body's needs. 90% of the total
cholesterol is made inside our liver and only 10% of it comes from the diet. Since cholesterol does not
dissolve in water its transport inside the body needs a vehicle. The latter is usually the protein
package-the lipoprotein. Cholesterol is found in all major lipoproteins, the Low Density Lipoprotein
(LDL) and the High Density Lipoprotein (HDL).

Usual range of normal cholesterol has been, since my college days, between 150-250 mg per deciliter.
Recently the American bosses of cholesterol research thought it fit to change this time honoured
normal range by declaring three levels for humans thus:4

less than 200 mg/dl.................DESIRABLE.

200-239 mg/dl.........................BORDERLINE-HIGH.

More than 240 mg/dl...............HIGH.

The story behind this is intriguing. My hunch is that there are at least 50-60 million Americans in the
normal range of 200-250 mg, who by the above classification are not only frightened out of their wits,
but come under the net for life long anti-cholesterol drug therapy. With the present drugs being sold
at such phenomenal prices the catch would not be less than 10 billion dollars per year for the drug
companies. Apart from this there does not seem to be any other valid reason in the medical literature
to support this new found wisdom on the part of the cholesterol pundits!

Americans are tormented by reports that swear that if only every one of them either ate very low fat
diet or took the wonder drugs to lower their cholesterol levels they would survive for all times. If not
30% of the two million deaths in America per year due to heart attacks would eat them up as well.
The pamphlets tell them "THE ARTERIES BECOME NARROWER AND NARROWER, MUCH AS OLD
WATER PIPES BUILD UP SCALY MINERAL DEPOSITS".

This analogy also helps another money spinner of coronary revascularisation. Lay people think that
blocked coronaries are like blocked toilet pipes to be bypassed. Never do they realize that the body
has its own wisdom to compensate for those long standing blocks, many of which start in early
childhood, by providing collateral vessels and also remodeling the blocked vessels.

The blood supply to the heart muscle does not as much depend on the blocked four large coronaries
on the surface of the heart that your doctor shows you on the x-ray(angiogram) as it does on the
capacity of the millions of small vessels going directly into the muscle of the heart having a wide
capacity to dilate excessively in case of reduced supply from the larger vessels. This Flow Fraction
Ration (FFR) is called CORONARY RESERVE, the latter could vary from one to another, the large
surface vessel patency notwithstanding!

It is not the science of medicine that is bad but it is the "scientist" that twists the facts to suit his
convenience that is bad and is the pain in the neck. Thomas Moore was bold enough to take them
head on. Years later he was joined by the American College of Physicians (ACP) who had their own
guidelines-much more saner than the horrendous guidelines of the Task Force- the Force put together
to fight the cholesterol war-may be against the gullible public!5 The ACP guideline tried to correct the
mistake done by the task force, but was severely criticized by the latter in no uncertain terms. If an
equally qualified body like the ACP could come forward to rubbish the earlier guidelines on their own
turf without much success, lesser mortals like me and Mr. Moore have very little hope of succeeding in
our uphill task. But fight we must for the truth to come out. Here are the facts for all to see.

In the late eighty's a thinking American cardiologist, and a respected one at that, Eliot Corday, wrote
an article in the American College of Cardiology Journal warning his colleagues about the fallibility of
the task force guidelines. He said " if one were to very strictly follow the guidelines and eat no fat at
all or take drugs to lower his cholesterol all his life, one could hope to live only for three days to three
months extra on this planet!" Another great British expert on cholesterol, and a most respected one at
that, Sir Michael Oliver, was so upset about the task force misrepresenting the Transatlantic
Consensus Conference Data, wherein he was an important invited member, wrote an editorial in The
Lancet, after coming back from the USA, entitled "Consensus or Non-senses Conference."

Let us look at the genesis of this myth.

Lowering your cholesterol is next to impossible with diet, and often dangerous with drugs-and it wont
make you live any longer said Thomas Moore in his article in the September 1989 issue of The
Atlantic.

One morning in early October 1987 The US Health Department made a significant announcement that
25% of the US adult population had a very dangerous condition that has no symptoms, needing
urgent medical treatment. Since there were no symptoms there is need to screen the whole
population to identify those in danger. One in four adults would be on drugs for the rest of their lives.
This was called the National Cholesterol Education programme.

At this stage no unequivocal evidence existed in science that lowering cholesterol would save lives!
The National Heart, Lung, and Blood Institute must have spent about $ 300 million to get to this
inconclusive stage of research. The total human subjects involved in research was a staggering
3,61,622 men and 60% of the Institutes budget! At that point in time the only drug available was
potentially dangerous and had no track record at all (Cholestyramine). In addition, the testing
laboratories, even controlled by research bodies, could not deliver identical cholesterol reports, not to
speak of the thousands of laboratories in the periphery.

Nations clinical laboratories performance was so poor that millions of normal people were labeled
high cholesterol victims. wrote Moore.

This drama began in 1951 when Pentagon dispatched a team of pathologists to Korean war zone to
study the autopsies of the young soldiers who were killed in the war. A large percentage of them had
blocks of the coronary vessels at the young age of 22 years. This report by Major William F. Enos and
Lieutenant Colonel Robert H. Holmes was the beginning of this sordid cholesterol drama. In Europe it
had started after the second world war. 77% of the Korean war victims at the tender age of 20 had
severe coronary artery blocks, which by todays x-ray standards, would have warranted coronary
artery bypass surgery. They were all very fit to be in the American army though and were
unfortunately killed by the bullet!

Another drama was unfolding in yet another set up. Epidemiology has served medical science very
well in detecting the cause of epidemics of infectious diseases. Cholera in London, typhoid Mary and
many other examples could be given here. The same epidemiology applied to chronic degenerative
diseases tells nothing about whether a particular person gets a particular disease; but it may identify
groups of men at risk. However this was overlooked in all epidemiological diseases and today
epidemiologists at times cause epidemics!

Such a scenario started in a remote small town of Framingham in Massachusetts way back in
1948.The Framingham experiments now being quoted everywhere in the world, built a detailed
portrait of coronary artery disease from a very small sample of just 5,127 adults, of whom 404 died
of heart attacks over a period of twenty-four years! There were so many loopholes that even the
medical profession is not aware of. Many of the people did not come for regular check ups, the
laboratory reports were not controllable over such a long period of time, while major changes took
place in the laboratory technics themselves, so that their uniformity was lost completely. Although it
was a sound study, its limitations in projecting it on to the world population are phenomenal, to say
the least. While tidy mathematical charts and graphs using linear mathematics tell the tale of
Framingham for lectures, lot of medical guess work went into the final conclusions.6, 7

A series of risk factors emerged out of this study, almost all of which have been shown to have no
predictability for the future even for groups, leave alone individuals. Two of the major risk factors
could never be changed- male sex and old age! So the war against all the minor and relative risk
factors began from then on; one of them being the ghost of cholesterol which haunts every one even
to this day, based on a study whose scientific validity is open to question. Advertisements, newspaper
articles, books, and television talk shows kept up the tempo all over the world.

Life depends on cholesterol. All the life giving substances are derived from that chemical and that is
why it is found in abundance in a hens egg. While it is true that all studies showed a direct
relationship between rising cholesterol and heart attacks they also showed that extensive and fatal
heart attacks could occur even in those with low cholesterol.

Be that as it may, the variations from laboratory to laboratory, even in the small group of research
laboratories of the Task Force, were significant. The time of the day, the way blood is collected,
whether taken sitting or supine, how long after collection was the analysis done, and even using
diluants in blood, the diet that the patient was on just before taking blood and, of course, the
laboratory which does the testing, could all change the results by as much as 10-18%. That, in itself,
would make a man go from low to dangerously high levels, creating anxiety strong enough to provoke
a heart attack!

The above statement does not take into consideration the quality of laboratories in the far flung areas
of the world. Dr. D.M.Hegsted, of Harvard University, showed that a variation of 5-9% in serum
cholesterol levels even in hospitalized patients, on uniform diet, was not unusual! The sub-fraction
measurement of HDL and LDL was of no significance for use in clinical setting as shown by a group of
researchers in Stanford where they found that 39% of the laboratories tested showed an error rate of
31%.

Then started the saga of lowering elevated cholesterol in the population. First attempts were by diet
control. Very soon studies done even by the Framingham study group concluded: There is, in short,
no suggestion of any relation between diet and the subsequent development of coronary disease in
the study group. We have many other studies subsequently giving varied conclusions. Even the
Heat-Diet Pilot of 1971 did not achieve significant success.

Then started the intervention trials with drugs. To sum up, all of them while showing a fall in fatal and
non-fatal heart attacks in those whose cholesterol levels were significantly lowered by drugs, also
showed a higher total death in the treated cohorts. The largest and the most expensive of them was
the MRFIT study which cost $ 115 million and involved 250 researchers. The following facts emerged.8

* Behaviour of large groups of people could be changed.

* Drastic changes that the participants were made to make in their diets did not have any effect on
the levels of cholesterol in their blood.

* No significant difference in deaths could be found in the treated group and the control after nine
years of follow up as on 28th February 1982.

* In fact, slightly more deaths occurred in the treated group!

* In the control group deaths from heart attacks were 40% lower than expected in the beginning,
showing how fallacious future predictions in linear mathematics could be. Doctors have been
predicting the unpredictable.

At this point in time there was no scientific validity for all the advice given to patients. More studies
followed. Another mile stone and expensive study was the Coronary Primary Prevention Trial (CPPT).
It screened 4,80,000 middle aged men to select 3,810 subjects for this study over a period of three
years. Cholestyramine was the drug used in this study, but even the placebo used did have side
effects. The drug, of course, had significant side effects. In Europe clofibrate was being used at the
same time for the first large study, The Newcastle Edinburgh Study. CPPT and the MRFIT together cost
the NIH a total of $ 494 million dollars! The CPPT trial did not show any significant benefit in the
treatment group compared to the control group at 99% or even at 95% significant levels. Instead of
admitting that, the researchers went in for a less exacting one-tailed test to compare the groups and
came up with the startling statement that the study leaves little doubt about the benefit of
cholestyramine therapy. 9

Although there were dissenting voices at that stage, the Heart Institute went ahead and bulldozed the
population with the National Cholesterol Education Programme. The American Medical Association and
many drug companies assisted the Heart Institutes efforts. While we believe that lowering ones
cholesterol is good there are disquieting reports that lowered cholesterol levels could be associated
with cancer.10 While there is a possibility that it could be due to the original cancer itself, studies have
shown low cholesterol levels in those who developed cancer even after 5-7 years. Japanese studies
have also shown a higher rate of stroke in people with very low cholesterol levels.

Many powerful drugs have come on the scene since then, but almost all of them showed a higher total
death at the end of the day in treated groups compared to the controls.11,12,13 The latest are the
statins. They have not been there for long enough to be really tested like their predecessors. Among
the cholesterol-synthesis inhibitors like lovastatin, were triparanol and compactin. The first was
withdrawn hastily because it produced severe side effects like rapid cataracts, severe skin rashes and
heavy loss of hair. Compactin was also withdrawn under a veil of secrecy, but thought to have given
rise to high cancer rate in dogs. Europe had by then gone ahead with another drug Gemfibrozil with
the same results- good effect on the cholesterol levels in the laboratory reports but slightly higher
death rate in the treated group!

The original screenees of the MRFIT study have been followed up, all 3,61,662 of them by a group led
by Jeremiah Stamler at the Northwestern University, 70 times larger than the Framingham data and
people coming from eighteen US cities. Although the data here are not reliable as it depended on
death certificates it did show that the hazards of high cholesterol are, if anything, only modest. The
study, however, put out one statement which is being used and reused by all and sundry all over the
world. The statement goes thus: Each one per cent reduction in cholesterol will lead to two percent
reduction in death due to coronary disease. The truth is that this result was never seen in this study.
What was observed was: For each one percent increase in cholesterol level the risk of coronary
disease could go up by two percent. 1 The difference in these two statements is like the difference
between lightening and the lightening bug!

Much water has flown under the bridge since these studies and there have been many more small big
and medium studies carried out in many other parts of the world, but even today the wisdom of the
medical profession could be summed up in the words of Eliot Corday in his article in the Journal of the
American College of Cardiology in 1989.

* Cholesterol should be checked only if there are sound clinical indications.

* A mixed diet low in calories and saturated fat should be recommended along with some physical
exercise.

* It is irresponsible to force public into a costly cholesterol reducing programme without firm scientific
evidence.

To that I add mine:14

* Do not rely on one reading of the fat profile, check at least five to six times from different
laboratories, if the original result was high.

* Indian vegetarian diet without much fried foods and other saturated fats and low salt is the ideal
one for most people.

* Avoiding alcohol and tobacco is as important if not more important than worrying about cholesterol
* Recent studies show the mind and its effects on the heart as more important risk factors than all the
above mentioned ones. Keep your mind at peace. Hostility and depression are real culprits for heart
attacks.

* Future prediction, using linear mathematics, as we do now in medicine is only a part time job, as the
rest of the time you will have to try and keep your foot out of your mouth.

* Epidemiology does not tell us who in society would get any disease, as time evolves.

Acknowledgement:

I am grateful to Prof. Bryan Cooke of the University of Northern Colorado, for getting me the article by
Thomas Moore and also introducing me to Dr. Randall Marsh.

COCOANUT OIL-IDEAL FAT NEXT ONLY TO MOTHERS MILK.

Opinions cannot survive if one has no chance to fight for them.

Thomas Mann.

Up until the 1930s every American food manufacturer used only cocoanut oil in food preparation. Palm
oils had to be imported as little cocoanut grew in the US. The local farmers, after the economic
depression of the 1930s, insisted that there should be no import of edible oils. Around that time, may
be a little later, after the second world war, a new disease was born-the fat theory of atherosclerosis.1
Many factors contributed to its success, least of all the affluence of Europe and increased food
consumption there. Concurrently, there was a parallel effort at disease labeling (inventions) going on.
2 Scientific research had better backing from the governments and there was money available for
research. New theory of risk factors was born. Reductionist science is blind to its own inherent
lacunae of looking at bits and pieces and not the whole. We have seen the birth of evidence based
medicine full of problems with its evidence base.3

Epidemiology did serve us well in the arena of contagious disease control. Sadly, the same was
applied to chronic degenerative disease field without much scientific foundation, resulting in
epidemiologists creating imaginary epidemics! One such was coronary artery disease, which was with
mankind from times out of mind. A Chinese lady, aged 39, was recently discovered buried twelve
feet deep in the snow in northern China. It is estimated that she should have died around 2500 years
ago. Her heart had a large myocardial infarct associated with a fully blocked left anterior descending
artery! The best description of angina pectoris was given thousands of years ago in the Indian
Ayurvedic text, Madhava Nidhana, which could never be bettered even today. Curious are the ways of
the world of science! 4

Whereas Heberden only guessed that his chest pain could have come from his heart, while his own
student thought that the teacher must have had syphilitic aortitis, Madhavan Nidhana, an Ayurvedic
text, clearly stated that angina was a classical disease of the heart. Unfortunately, modern medicine
labels this disease as Heberdens angina. It is, in fact, a truly Indian disease. A study published in The
Lancet in 1987 by Stehabens found no evidence of even one per cent absolute recent epidemic rise or
a later fall in this disease in the last one hundred years. The apparent relative increase was found to
be due to labeling errors, advancing age of the population and wrong death certification without
postmortem confirmation.5 In fact, many sudden (electrical) deaths, due to alcoholic cardio-
myopathy, had been (I think are still being) labeled as heart attacks!

Despite all these evidences to the contrary, epidemiologists went ahead and produced a monster,
coronary artery disease epidemic, and discovered as many as two hundred forty odd risk factors.
Steven Milloy, a renowned American epidemiologist, writing in his book Science without Sense, goes
to prove that epidemiology in chronic disease scenario is a curse.6 If I, for example, were to state that
wearing a tight brasserie daily is a risk factor for cancer breast, it would take epidemiologists to study
five hundred million women (double the population of the US) to disprove that hypothesis-a task
impossible. Similar is the fat hypothesis for atherosclerosis.

The first ever Diet-Heart Study in Framingham, which began in 1954 ending in 1959, after having
spent $110 million American tax payers money, only showed that the two are not connected! Alas,
the study did not see the light of the day in print as the vested business interests, who by then had
already established billion dollar business on food fats and heart healthy foods etc, saw that the
results never got published.7 A recent study of elderly French women living in a nursing home showed
that those with the highest cholesterol levels lived the longest; the death rate was more than five
times higher for women with very low cholesterol.8 One has to remember, though, that cholesterol
lowering agents net billions of dollars in cash to the Pharma lobby annually.

The MRFIT study (1976-80), which initially screened 360,000 Americans to get a sample of around
12,000 high risk subset for studying coronary risk factor control. It used 250 researchers in 22 centres
in 18 US cities spending around $ 150 million. After all that effort the result is here for all to see. "In
conclusion, we have shown that it is possible to apply an intensive long-term intervention program
against three coronary risk factors with considerable success in terms of risk factor changes. The
overall results do not show a beneficial effect on CHD or total mortality from this multifactor
intervention.9 They do not want to destroy their rice bowl, at any cost.

With this background the poor cocoanut oil got the boot in the west as newer polyunsaturated fats
came in a big way and thousands of industry funded scientific studies had proclaimed to the world
that cocoanut oil is very bad because it is a saturated fat. Misinformed lay press and the public
believed the scientific world. All saturated fats were said to be the reason for the cholesterol induced
epidemic of coronary disease. This powerful lobby could influence the thinking of the medical world
through a plethora of studies, all of which when scrutinized scientifically fall by the way side.1, 3, 7, 8
Cocoanut lobby was not there and even a few individuals who thought otherwise were silenced
effectively by the vested interests. Truth can not be suppressed for all times. Most, if not all, of the
polyunsaturated fats sold to the gullible public have been shown to be dangerous and a search for
better fats landed researchers in the backyard of cocoanut palms, the cholesterol myth
notwithstanding.

Let us analyze cocoanut oils horoscope scientifically. Cocoanut oil had the bad Shani Desha since the
1930s, but the times have changed and it is going on to the Guru Desha now. Hopefully it will have
this good Desha for all times to come. Fats are more scientifically classified into three varieties based
mainly on the number of carbon atoms they posses and the length of the chain-Short Chain having
between C4-C6 carbon atoms, Medium Chain having between C6-C10 or so and Long Chain with C11-
C24 atoms. The saturated, unsaturated classification is for the convenience of the fat lobby to sell
their wares. Science is what scientists do. Science is only curiosity and, as such,

could never be bad, but scientists could definitely be bad when the circumstances warranted. The
problems for man would not cease as long as the present market economy lasts. God help mankind!

Little over 50% of cocoanut oil is medium chain fatty acid, Lauric acid and another 7-10% is a medium
chain Capric acid. Lauric acid gets converted inside the human system into MonoLaurins. the best fat
that mothers milk has.10 Other than mothers milk monolaurins are found only in cocoanut oil. New
born babies and infants depend on the monolaurins for their immune system development and their
capacity to withstand any infection.11 In addition, cocoanut oil can be digested by the salivary lipase,
getting absorbed very fast to give energy like carbohydrates. All other fats need the pancreatic lipase
for digestion that the infants do not have. The best alternative food fat for the infant when mothers
milk is not available is cocoanut oil. (In baby foods). Other fats might be dangerous.12 Just this week
there is a report published in the British Medical Journal showing the dangers of using Soya fat for
babies. The report also warns adults to take Soya oils cautiously!13

Cocoanut oil is a low calorie fat and as such helps control body weight. In addition, cocoanut oil
stimulates metabolism to get itself metabolized fast to supply quick energy unlike all other fats. This
also helps control body weight. Changing the food fat to cocoanut oil could help reduce weight in
obese individuals.14 It also helps to control blood fat levels in diabetics. Because most of cocoanut oil
is medium chain fat it gets absorbed and metabolized so fast that it rarely gets transported to fat
depots like other fats, altering the lipoprotein fractions of blood, another great boon. Cocoanut oil
contains so many anti-oxidants that it resists oxidation even if it is preserved for as long as a year
whereas all other fats would have been already oxidized and have become Trans fatty acids by the
time they come on the food store shelves! Cocoanut oil resists oxidation even on boiling at 76 degree
centigrade. So there are no Trans fats in cocoanut oil.15 While fried foods are not good for health, if
fried in cocoanut oil, fried foods are not that bad, after all.

The monolaurins in the cocoanut oil have been found to be very powerful anti bacterial, antiviral and
antifungal agents. Most viruses, including the retrovirus HIV, are sensitive to cocoanut oil. Cocoanut
oil has been found to be an excellent moisturizer for dry skin conditions and is known to be even
absorbed from the skin surface of preterm babies. A diet rich in coconut oil reduces diurnal
postprandial variations in circulating tissue plasminogen activator antigen and fasting lipoprotein (a)
compared with a diet rich in unsaturated fat in women.16 Cocoanut oil is said to penetrate hair roots
to keep hair healthy and clean.17 They have even found some very interesting therapeutic values in
cocoanut oil.18 A recent report shows how it could be used to treat aluminum oxide poisoning
(agricultural pesticide content) for which there had never been any specific antidote so far.19

Cocoanut oils regular use in diet would regularize blood fats and is known to increase the HDL
cholesterol fraction while decreasing the LDL and triglycerides significantly; disproving the myth that
cocoanut oil increases cholesterol and triglycerides.15, 20 Cocoanut oil has been now classified as a
functional food. Functional food was defined as "food that provides health benefits over and above the
basic nutrients. No other fat could claim that status except the Indian clarified butter-ghee, which
according to Ayurveda is an excellent food for good health and strength. Even the west has now learnt
a bitter lesson. After having realized the dangers of polyunsaturated fats in margarine they have
coined a new slogan: butter is better.

In conclusion, one could easily surmise that cocoanut oil that has been our staple food for thousands
of years could not have suddenly become so bad in the 1930s that it had to be thrown out of the
window. Our thousands of years of observational research is any day more reliable compared to the
short term cross sectional motivated research today. Although Aristotle did say that truth could only
influence half a score of men in a Century, truth will have to triumph at the end. The sad state of the
Polynesian migrants to the west coast of America is there for all to see. Prof. Castles elegant studies
did show the curse of acculturation of these long living sturdy people whose main food was cocoanut
till they became American citizens. With modernity Polynesians were succumbing to all the
degenerative diseases precociously. They never had atherosclerosis in their natural habitat what with
80% of their calories coming from cocoanut. Long live the cocoanut tree, the venerated kalpavriksha,
for the common good of humankind.

Free man is by necessity insecure; thinking man is by necessity uncertain.

Eric Fromm.

CORRUPTION-THE NEW EPIDEMIC.

The curse of corruption is felt in every circle. We are told that this new epidemic is spreading like wild
fire in India in every sphere of activity; from the bottom rung of a low paid worker to the highest
strata of society-the judiciary. After all man is the same wherever he is. Michael de Montaigne, the
great French philosopher, had once said, "we are all the same wherever we are seated, but upon our
own arses. How true! Even Shakespeare must have had the taste of this human malady when he
said: "Man whether in the palace or pad, castle or cottage, is governed by the same emotions and
passions.
Many of us think that this is an Indian disease. A good look at the world gives us a better picture. Only
this week Hermedt Kohl, the former German Chancellor of great repute, has been stripped of even the
Party post, because of large scale bribes he is said to have received while in office from time to time,
running into millions of dollars. Following on the heals of that news comes the suicidal death of the
secretary of the same Christian Democratic Party in Germany as he was also involved in millions of
dollars of money scandals. Christian Democrats in Italy have, of course, been in the forefront of all
this for many years.

Now it is the turn of the Israeli President, a nation that boasts of only patriots. He is reported to have
received two million dollars from a French business friend in return for some favours. A fighter pilot in
the Israeli airforce, the President, even in old age was consumed by this lust for money. A man who
almost gave his life for the country when he was young, in his evening of life becoming greedy is a
good example how even the apparently clean people could become corrupt under temptation!

American Presidents have not been exceptions to this rule, either. Many of them had to face inquiries
against them and some had even to relinquish their positions, although many of them must have got
away with their booty. While familial corruption is the rule in India, it is not very rare in America
either. President Bushs son had swindled the Savings and Loans Bank of 800 million dollars.

Many heads have rolled because of corruption even in a very efficient country like Japan, not to speak
of the lesser mortals in Latin American, Oriental and African nations. Mother of democracies, with an
unwritten constitution, Britain was not bereft of this malady.

Root Cause of corruption:

It is all in the human nature. The monetary economy of competition breeds corruption in a big way.
The ego, the constant manifestation of the impurities and inadequacies of the ones mental attitude,
makes one forget his true nature-Godliness; man being the true image of God, the compassionate, all
pervading, helping, and giving self. Better interpersonal relationships, emotional independence and
tolerance should be the basis of mental peace, and not hatred, greed and one-upmanship.
Unfortunately the present atmosphere of competition in the monetary economy makes man forget his
true nature while trying to acquire wealth by fair means and foul.

Slowly the new awakening is palpable in the distant horizon. The worlds richest man, Bill Gates has
donated a whooping sum of a billion dollars for charity. It is not for nothing that he has done that
except to get mental peace. Tatas, Birlas, Rockefellers, Nobels, Fords and many others in the past did
just that to get peace of mind. Ego shrinking is said to be the new mantra for the younger generation
all over the world. They have seen the destruction and carnage of their elders in search of money and
fame and they would want a more peaceful life for themselves.

If this catches on, may be, a day would soon come when making money no longer would be our sole
religion. Prof. Hubbells telescope and the advances in quantum physics should teach the future
generation that our physical and mental self, the basis of all our ego problems, is only an apparent
reality. Interdependence would be the order of the day following on the networking of the computer
era. Rather than decreasing personal freedom, it would respect the right for freedom of others equally
important. That would take away the wind out of the sail of this ship of corruption, which seems to
circle the world over and over again.

Indian Malady:

Soon after independence the leaders very quickly lost the patriotic fervor that brought them together
to fight the British. Unfortunately, the anti-establishment mind set did not change very much and even
the common man did not look upon his own government as friendly. The multitude of rules and
regulations made matters worse. A vicious cycle started functioning. The unscrupulous used the very
rules to help them get what they want by bending the rules and they took the help of the politicians
and the bureaucrats to do just that. The politicians could see their fortune for the future elections to
keep their seats of power intact. They needed money and this was the easy way of getting that
money. As a quid pro quo monetary gratification must have started. The officers, the ones who did not
have a conscience, could also cash in on this golden opportunity. Together they built up this devil of
corruption.

Mans greed and his proclivity for comfort gradually got the better of his judgement and his ethical
considerations. Later leaders thus institutionalized corruption of political parties. Late sixties and
seventies saw the rise of this breed with the then rulers using dubious methods of ruling the country.
Their minions grew like mushrooms all over the country, some of them past masters in the art of
corruption. They were all over the country but some states had more of them. Gradually the system
marginalized the good ones among the politicians and the officers. A few of them, per force, had to
get away, as they were unable to bear the suffocating atmosphere.

Today it is respectable to be corrupt. Nobody bothers about being corrupt and the common man many
a time likes the corrupt politician and the officer, as the latter are easily amenable to get his wants
howsoever sinful they could be. In todays scenario the truly honest politician or officer could never
survive. The adult franchise system that we have adopted from the British is a boon to these anti-
social elements to get elected with money and muscle power. This has become a mouth-eating-the-
tail business with more and more corrupt politicians and criminals entering the hallowed portals of our
Parliament and the assemblies.

The laws of the country to punish the guilty are adequate to catch these, but the implementation of
the rules depends on the men and women who seem to have lost their moral fibre soon after we
became independent. Naked corruption talked about even inside legal temples makes one shudder to
think of the future of this country. If the custodians of the law themselves start eroding into its core,
resulting in the common man losing faith in the judiciary, would be a sad day for all of us. The whole
system becomes a mockery of keeping up the hoary tradition of this great country.

An occasional small fish is caught and paraded and made much of in the media and that is the last
that one hears about the story. What happens to that man at the end of the day is another sad story?
The various wings of the law enforcing machinery themselves have become experts in making black
money through corrupt practices. They have also devised ways and means of getting out of the net of
the law. Recent reports of the customs officials in airports trying to cover the closed circuit television
monitors in the customs area is ample proof that many others are using similar methods to operate
freely.

Anatomy of Corruption:

There are different breeds of the corrupt.

Casual converts:

This breed is less these days. They are not perennially corrupt but succumb to temptation on and off.
They are not very dangerous as they have corruption free interludes where they might attempt to do
good.

Congenitally Corrupt:

This is a dangerous variety. Corruption is in their genes. The environment today makes the gene
penetrate very well and this manifests in the hard core corruption. These are very difficult to treat and
they would be very good in escaping the anti-corruption dragnet. The gene could only penetrate in a
conducive atmosphere. Our only hope of reforming these is the possibility of the change in the
environment.

Compulsive behaviour:

This is a mental state where they have an irresistible urge to be corrupt. Whether they like it or not
they have to take money. I was told that there was a Chief Minister of a state who would not get sleep
unless his daily booty has been more than a crore of rupees! Such are the people who even get
awards in our country if there is any political expediency!

Criminally Corrupt:

This has a dignified name in our set up. They are called extortionists. They strike unheralded, but
mostly catch the large sharks in big cities. They could eventually percolate down to smaller targets if
the bigger fish disappear from the waters! Unlike them the white-collar extortionists, the corrupt
politicians and officers have no ethics in their trade!

Corruption Generators:

These are the wheeler-dealers, called the middlemen. They entice the politicians and the officialdom
into their net to get their work done. These are the most dangerous variety. They are like poisonous
snakes lurking in our midst. They are usually very respectable people who mingle with the rich and
powerful and strike in broad daylight to catch their prey. These operate internationally and they know
no boundaries. They would go to any extent to get at their target. They could even be a national
security risk.

Management of the Disease:

What would be the remedy for this cancer? There is no cure for cancer. We could, however, try and
prevent cancer, if possible. As a palliative measure we could make the cancer grow slower than its
pace and ease the disabling symptoms of cancer.
That should be our strategy for the future. Immediately we should apply all the palliative measures.
Some of them could be as harsh as the radiation and chemotherapy of cancer with all their attendant
side effects.

The radiation therapy for corruption should take its lessons from the underworld dons. When these
dons want to extort money from some one they threaten him first and when the victim does not
respond positively he is shot at and if possible killed. On the surface of it may look preposterous that
they are killing the hen that could lay the golden egg. But in the long run they are doing their job very
systematically. The underworld wants every one to know that they mean business and they sacrifice
this golden egg-laying hen to frighten all the future hens so that they could collect the eggs before
they hatch! What a strategy! One or two corrupt politicians should be sent to jail for life and made to
do hard work. The latter should be publicized so much that all the others must get the message.

What we do today is the opposite. We advertise the act of corruption so much that people get fed up
with it and at the end no one is really caught and the whole episode is forgotten. No politician or
senior officer one so far has been sent to jail for corruption among politicians although it is common
knowledge that most of them, if not all of them, are corrupt.

Every case, including the Bofors case, would eventually come to naught. The adversarial judicial
system that we have inherited from the British could never get at the true culprits if they could hire an
excellent lawyer to defend them. Many corrupt politicians even celebrate their acquittal by the courts.
This is the best encouragement for the novice in the field to get into this habit.

If a few genuinely corrupt people are given the capital punishment it will work wonders to lessen the
menace in society. Then we have to have devise palliative treatments like effective measures to
contain the disease and treat its symptoms.

Long term measures should start in the elementary schools where the true Indian ethos of dharma
should be inculcated into the virgin fertile but innocent minds. Macaulays system of education that we
use today is the cause of all our troubles. He had contempt for us in India when he wrote: West is
best and the East is only beast. He must have evolved the educational system for the beasts in the
East, which we, unfortunately, follow in principle even today. This must change to the Indian style of
education of the timeless Vedic wisdom; the latter has no religion or God attached to it, as many
would want us to believe. It proclaims the Dharma (not religion); the obligations of an individual to
society. If one knows that he is a part of society and is what he is because of society, he would never
resort to such base instincts like corruption.
This awakening should start in childhood. It is very difficult to convert a convert later in life. The
Indian wisdom and learning have been the basis of all wisdom in the world although the West has now
distorted that in their favour. In a classical book, India in Greece written in 1852 in England, a Greek
author E. Pococke clearly provides evidence to show how the Greek civilization was the result of
different groups of migrants from India who brought the Vedic wisdom to Greece to start the so called
western wisdom. All that is history now.

The next generation, at least, should have exposure to the truth. The Vedic wisdom proclaims that it is
for the whole world and all the future religions should also be respected equally. This idea of universal
brotherhood, coupled with the modern scientific discovery that the egocentric attitude of the mind with
the "I concept is detrimental to mental peace should give enough courage for the future generation to
abhor corrupt practices.

DARING HEROES OF THE DISTANT PAST.

One man with courage makes a majority.

Andrew Jackson.

Our younger generation in medicine looks up to the present day divine interventionalists and the
heroic surgeons, who are all over the media, both print and electronic, to emulate and follow on their
footsteps. Modern medicine is suffering because we have been following what others have been doing
elsewhere. Such copy-cat procedures and interventions do not take knowledge forwards in any field.
India needs to progress by taking the present inadequate knowledge forwards in modern medicine.
That needs a different kind of research, called refutative research, wherein one tries to refute false
dogmas that do not stand on very firm grounds. We should not waste time copying others by
repeating known facts-repetitive research.

History of modern medicine is replete with such mistakes. One example would suffice. It was in the
year 127 AD that the great guru of medicine of those days, Galen, thought that blood circulated from
the liver. This was repeated by all and sundry for well over one thousand five hundred years till 1628
AD when a thinker refuted that claim and showed that blood circulates from the heart- De Motu
Cordis- of William Harvey. Many such instances could be cited. One, therefore, needs to look back at
the past history to learn from it and stimulate the latent curiosity in our younger generation, lest one
should be condemned to relive history. We have no dearth of copy-cats in modern medicine who
claim glory and fame copying others and not taking knowledge forwards. Some of them are labeled
heroic doers; the hero, however, is the hapless patient who has subjected himself for their
misadventures. If the patient survives they claim all the credit; if, on the other hand, the patient
meets his maker, we could always blame fate.
Here is the true story of one such real daring hero of the distant past, who started life as a poor boy
and ended up getting the Nobel Prize. He refuted the existing wisdom of his time by his daring. The
notable feature of his daring is his offering himself as the experimental subject instead of using a poor
patient. Werner Forssmann in his brilliant book Experiments on Myself, first published in German in
1972 and, later translated to English by Hillary Davies in 1974, published by Saint Martins Press in
New York, echoes the sentiments expressed by me earlier thus: In my life time powerful men have
managed to determine not only political events but also peoples personal lives and the progress of
science by practising deception. Their methods were sometimes primitive but always effective.
(Italics mine)

This is more so in the present time when the whole field of modern medicine is vitiated by deception
of the highest order. A recent daring report from the US (JAMA 2000; 284: 483-485) showed that
more than 2,25,000 people are killed by the establishment in the name of doing good to the public.
Doctors have been the first most important cause of death in the US followed by heart attacks and
cancer! Forssmanns life changed because of the events at that time. The First World War made him
hate the monarchy and the Second World War made him an ardent pacifist. His seniors, many of them
celebrated medical men of his time, were men with feet of clay. The greatest of them all at that time
(1929 AD) was the celebrated Herr Geheimrat Sauerbruch, the then great general and cardiac
surgeon, who went on operating well into his 80s killing hundreds of hapless patients but, patients still
flocked to him even in is home where he operated upon them on his kitchen table even after the
hospital in the then Mecca of German surgery, the Charite in Berlin, compelled him to retire gracefully.

When the young Forssmann knocked on the door of the great mans office, his secretary, Frau
Rogetzki, looked at him from top to bottom and stopped polishing her nails to tell him: In this
hospital one does not present oneself to the Herr Geheinmrat; one waits to be summoned. Those
were the days. The present reader might feel that things have not changed very much in all these
years. Getting a job at the Charite was a very great achievement those days. It would not have been
possible for the young Forssmann to get anywhere near there, although he studied in the famous
medical school in Berlins Friederich Wilhelm University. He was brought up by his mother after his
fathers death in the First World War. He and his mother lived on a hand-to-mouth existence, when all
the other students came from very affluent families. His teachers, some of them great men of
learning, were the ones that motivated him to be what he became later in life.

Having seen the ravages of the two world wars and the rise of Hitler, Forssmann later in life, became a
citizen of the Federal Republic of Germany. Forssmann is known for his daring act of challenging the
medical taboo of his time that the heart can never be entered into to study its function. Determined
and very courageous, Forssmann, then a surgeon in training, opened a vein in his forearm, inserted
the tip of a long, thin tube, and pushed it along the vein into his own heart. Standing in front of a
fluoroscope machine he could see the tip of the catheter in his heart and then he got an x-ray taken to
record the tubes presence in the heart for the first time in man, when at a time such an act was
thought to be fatal.
Forssmann did not invent the method, though. In the year 1840 the great French physiologist, Claude
Bernard, developed the technique for use in animals. Later physiologists, Chauveau, Marey, A. Fick,
and N Zuntz developed it further and studied the pressures in the various chambers of the heart as
also analyzed the blood samples from those chambers. Despite these reports Forssmann was severely
criticized for what he did and was ignored by those powers-that-be in medicine in Germany those
days. Undaunted by the hostility Forssmann went on to inject a radio-opaque dye into his own heart
and larger vessels and laid the foundation for what we now call angiography. This initiative was picked
up by others elsewhere and the methods were perfected to the level that we see today. Discouraged
by strong opposition Forssmann stopped being a researcher and trained to be an urologist and
practised that art in a small place in Rhineland.

Fate finally rewarded him, nearly quarter of a century later, when he was awarded the Nobel Prize for
Medicine and Physiology along with two other Americans who had later perfected the technique. When
a reporter went to inform Forssmann of his getting the Nobel, he is said to have joked: I feel like a
village parson who has just learnt that he has been made the Bishop. As a young surgeon Forssmann
had to bear the brunt of the war and was imprisoned by the Russians from where he escaped under
fire to cross the river Elbe to finally practise urology in a small Rhineland spa. After getting the Nobel
he tried to establish himself as the chief surgeon in a voluntary hospital without much success. This
book gives the reader a varied picture of a young brilliant student, a nationalist to the core, a
dissenter who dared to risk his career for finding the truth, and a man endowed with abundant
physical courage if not political sagacity. His wife, also a physician, was a quiet lady who mothered
their six children. She was also a wise and dignified lady. They eventually retired to a quiet life in a
large cottage in the Black Forest.

Before I close, I must give the reader the first hand version of what happened that fateful day in the
operating theatre of Eberswalde, a small Prussian town northeast of Berlin. This account would show
the rare courage that the man exhibited risking his own life, the real heroic surgeon-the hero being
himself. With great difficulty, and after much influence (even those days!) Frossmann managed to get
an unpaid job as a surgeon under Dr. Richard Schneider, a kind hearted man known to Frossmanns
aunt. When Frossmann presented his idea of studying the hearts function more clearly by entering
the heart with a catheter, Schneider mildly rebuked him and passed an order that Frossmann should
not be let into any theatre.

Not to be put off by such acts, Frossmann started to prowl around a beautiful theatre Nurse Gerda
Ditzen like a sweet toothed cat around the cream jug. He wanted to slyly carry out his black deed
during the afternoon siesta when the whole hospital would be sleeping. Nurse Gerda was suspicious in
the beginning but later, after much flirting, she became very friendly and almost became his close
confidant. However, Forssmann did not have romantic ideas at all. She, on the contrary, was living in
a romantic world. He used to take her out, give her books to read and one day told her his real plans.
Immediately she became very serious and refused point blank.
He told her one day Nurse Gerda, you need know nothing about what I am going to do. But
supposing I were to do the experiment it would be quite safe. She eyed him closely and said Are you
absolutely sure there is no danger? Absolutely he answered.

All right then do it to me, I put myself in your hands," she said.

That is what he wanted.

Well, you will be the first person in the world to have the catheter in your heart he told her.

His ruse was to get all the instruments. When all the instruments were laid on the table he asked her
to lie down. He firmly tied her hands and legs to the operating table and told her his real intentions of
doing it on himself with her safely tied down to the table. Of course, history was made in Eberswalde
that fateful day in 1929. Rest is history.

Here is the story of a great surgeon, whose extraordinary talents were not recognized by his seniors,
many of whom did not allow him to publish his data saying that he has no right to publish. They also
told him, led by Sauerbruch himself, that he has to include them in the publication, reminiscent of
todays world. The only person who encouraged him after the act was Schneider, who had a soft
corner for this young man. With all this the poor Frossmann had to go into oblivion in Germany until
the Nobel Committee picked him to share this great honour with two Americans. Lesser mortals have
got away with the Nobel for not so good reasons. Such is the power of mystery and falsehood.
However, people like Forssmann are rare and they are the real heroes of the distant past who could
motivate generations of young men and women in medicine. May their tribe increase? The message
Frossmann gave to the world, in the words of a friend of mine, is Learn to be wise; if not, you will be
otherwise.

Opinions can not survive if one has no chance to fight for them.