Integrating modern medicine with ancient wisdom

The Hindu

3 days ago

There has always been a gulf, and perceived incompatibility, between modern medicine and integrative medicine. While modern medicine is focused largely on abnormalities and finding cures for them, integrative medicine is focused on the entire continuum of human healthcare engagement: prevention, maintenance and cure, or to put it more specifically in medical treatment terms, rejuvenation, restoration and rehabilitation.
Ancient medical systems such as ayurveda, yoga, acupuncture and tai chi have great potential for the human body, brain and mind, as many research papers have revealed. It has been pointed out too, that we may be erroneous in calling these older systems complementary, as they not only preceded much of modern medicine as we know it but have stood the test of time.
Integrative medicine sits well within the philosophy that healthcare must be pluralistic, inclusive and adopt complementary approaches that restore equilibrium (the healthy condition) in an individual. The National Center for Complementary and Integrative Health, United States, emphasises that integrative medicine is a holistic approach to health and well-being, using a coordinated and conjoint but optimal use of allopathy and complementary medicines. Integrative medicine may be defined as a 'single-window' healthcare service that adopts an evidence-based blend of traditional and modern medicines, with optimal use as either a combination or as monotherapy.
Here we present one client's healing journey from a plethora of long COVID symptoms, to a state of well-being, with an approach that combines the best of modern science and the wisdom of ancient medical traditions.
Mr. S and his healing journey
Mr. S, a 52-year-old businessman, consulted us, burdened as he was by a complex web of physical and psychological challenges. Following a COVID-19 infection two years ago, he had begun experiencing persistent cognitive lapses, fluctuating moods ranging from irritability to agitation, muscular stiffness, low back pain, and a host of gastrointestinal issues including bloating and acid reflux. Compounding these problems were fatigue, palpitations, dizziness, sleep disturbances, and increased sensitivity to noise and light — symptoms that, taken together, seriously eroded his capacity to function both at work and at home.
A comprehensive multidisciplinary evaluation conducted by our team of a physician, a psychologist, a physical therapist, and an electrophysiologist uncovered several key findings. Although Mr. S's EEG and ECG were normal, precision tests revealed significant autonomic dysfunction detected as Postural Orthostatic Tachycardia Syndrome (POTS). POTS is diagnosed through a significant increase in heart rate on changing postures (usually 30 beats or more when one progresses from lying to standing) accompanied as well in some cases by a drop in blood pressure (systolic > 20 mmHG and diastolic > 10 mmHG) on standing up.
Mr. S also suffered from marked anxiety, moderate depressive symptoms, and mild cognitive impairment. His score of 17 out of 30 on our comprehensive autonomic symptom checklist highlighted the extent of his dysautonomia. In light of these findings, the care team decided on an integrated treatment strategy, merging established modern medical practices with ancient healing wisdom to holistically address both his physical and psychological ailments.
Central to his modern medical management was the judicious use of pharmacotherapy to stabilise autonomic imbalances, manage mood-related symptoms, and alleviate discomfort. The autonomic nervous system takes its origins in our limbic (emotional) brain, and the use of drugs that stabilise brain activity is, therefore, both logical and necessary. Augmenting this approach was a cutting-edge novel intervention Transcutaneous Auricular Vagus Nerve Stimulation (taVNS). Vagus nerve stimulation has long been studied for its role in modulating the balance between the body's sympathetic ('fight or flight') and parasympathetic ('rest and digest') systems. In taVNS, a small electrode stimulates the auricular branch of the vagus nerve near the ear. These sessions, administered four times weekly for 20 minutes each, are designed to prompt a parasympathetic response, helping to calm hyperactive stress circuits in the body. Research increasingly indicates that taVNS can reduce heart rate variability issues, lower inflammation, and alleviate mental health symptoms — making it particularly relevant for managing complex dysautonomia. Neuromodulation of this kind 'paces' the nervous system, like the cardiac pacemaker.
Mr. S's psychological care included 10 hours of Cognitive Behavioral Therapy (CBT) to mitigate severe anxiety and moderate depression including cognitive retraining exercises to help his neurocognitive symptoms. It is well known that neurocognitive dysfunction that is perceived but not detected in formal testing, also called subjective cognitive dysfunction, is a common outcome of depression and anxiety. Under the guidance of a clinical psychologist, he learned to identify distorted thought patterns, improve stress management skills, and adopt healthier coping strategies. Muscle relaxation techniques further supported this process, helping him gain mastery over the physiological manifestations of anxiety — such as muscle tension and shallow breathing. His practice of cognitive retraining also helped in his gaining confidence about his cognitive performance. Physical therapy formed another pivotal dimension of his treatment. Through manual therapy, electrotherapy, and graduated exercise regimens, Mr. S found relief from muscle spasms, built endurance, and improved both gait and coordination.
Meanwhile, complementary approaches from naturopathy and ayurveda provided a well-rounded, integrative model of care. Treatments such as acupressure, reflexology, and abdominal mud packs helped stabilise his digestive system and offered a soothing counterpoint to the physical and psychological stresses he had been enduring. Shiroabhyangam—a gentle ayurvedic head massage with warm kshirabala oil — further enhanced relaxation, improved sleep initiation, and encouraged a sense of inner calm.
A structured yoga regimen completed his mind-body therapeutic journey. Incorporating pranayama (breathing exercises), sukshma vyayama (gentle stretches), chanting, and yoga nidra (deep relaxation), the programme empowered Mr. S to calm his overactive sympathetic drive and strengthen his parasympathetic tone. In tandem with a balanced, gut-friendly dietary approach, his digestive issues were addressed by reducing acid reflux triggers, incorporating probiotics to support healthy gut flora, and adopting smaller, more frequent meals to alleviate bloating.
After five weeks, Mr. S reported markedly reduced dizziness, numbness, and muscular pain; substantial improvement in mood and sleep; and greater overall resilience. With his autonomic dysfunction significantly mitigated, he returned to a more productive and satisfying daily routine, bolstered by sensible nutrition, regular exercise, and continued yoga practice.
Integrative medicine & the McDonald's paradigm
Comprehensive and integrated care, including but not restricted to yoga, tai chi, qigong, acupuncture and other mind-body practices, are recommended as add-on interventions in mainstream care and such an approach is rapidly gaining application globally for persons with chronic diseases. In a large study of people with chronic neuropsychiatric symptoms in the U.S., it was found that 43.8% of U.S. adults with at least one neuropsychiatric symptom, used at least one Complementary and Alternative Medicine (CAM) therapy. The multiplicity of symptoms appeared to be an important predictor of integrative medicine being considered. Other important considerations were the duration and chronicity of the complaints and the recommendation of the conventional care provider to consider CAM. Twenty per cent of patients used CAM because standard treatments were either too expensive or ineffective, while 25% used CAM because it was recommended by a conventional health care provider. Adults with at least one neuropsychiatric symptom were more likely to disclose the use of CAM to a conventional healthcare provider (47.9%).
Our experience with Mr. S, one of over 15,000 people with chronic disease that we have treated using integrative medical therapy, indicates that such an approach holds promise for individuals experiencing dysautonomia as part of long COVID, and indeed a plethora of other chronic symptoms and diseases, especially in our experience, those affecting the brain and mind.
Emerging data globally indicates that post-viral syndromes can involve persistent autonomic disruptions — symptoms such as palpitations, fatigue, and orthostatic intolerance often linger, long after the acute infection has remitted. Combining modern techniques such as taVNS, targeted medications, and structured rehabilitation with holistic therapies — yoga, meditation, acupuncture, and evidence-based traditional remedies — can help recalibrate the autonomic nervous system and foster a meaningful recovery.
Reviewing the available research data including discussions at expert forums such as the World Congress of Neurorehabilitation (Vancouver, Canada, May 2024), where Buddhi Clinic had the opportunity to present a full symposium on integrative approaches to neurorehabilitation, the consensus appears to be that integrative medicine is the need of the hour, in an ageing world burdened by chronic disease. Bringing complementary and alternative treatments into the mainstream and seamlessly integrating them with modern (allopathic) medicine and treatments is therefore not just desirable, but essential.
Integrative medical practice is criticised in some quarters. These criticisms arise from safety concerns, lack of well-designed efficacy studies, limited knowledge about drug interactions, less robust regulatory controls over products, perceived bias against CAM in mainstream medical journals, and conflict between research and clinical practice. Research in complementary and alternative healthcare approaches has increased in recent years, and sufficient data that support the benefits of certain practices in some illnesses are being reported. In addition, work in the field of non-pharmacological care research for conditions like cancer points out that these practices have become 'essential and critical' in providing optimal care and support to elders with this condition. With the support for integrative medicine by the Government of India, the future growth of such research appears bright.
In our experience, the service paradigm has to be based on a McDonald's model: combining prescription (the Mac meal) with choice (just fries or a burger as one deems fit). For conditions of health and mild impairment, the choice model may work well, as it encourages patient autonomy; but in conditions of disease, where restoration and rehabilitation are required, a prescription model drawn up by the healthcare team may work better.
The core of integrative medicine lies in its unique ability to encourage patient choice and participation in care; to be complementary (combining the modern with the traditional, seamlessly); to support in acute conditions and take the lead in chronic conditions; to focus on symptoms rather than diagnosis; and to take a practical, problem-solving approach to health and wellness. Most importantly, perhaps, combining modern medicine with ancient wisdom, leverages the power of human touch and communication, both powerful tools in the journey to health and well-being.
Thus, as Mr. S's journey reveals, the synergy of modern medicine and ancient wisdom offers great hope for individuals confronting chronic diseases including those dealing with the complex aftermath of viral illnesses such as Covid. A truly holistic path to restored health and well-being has been brought to life by bringing together healing traditions, both modern and ancient.
(Dr. Ennapadam S Krishnamoorthy is founder and CEO, behavioural neurologist & neuropsychiatrist, Buddhi Clinic, Chennai. Dr. Rema Raghu is co-founder & chief clinical officer, Buddhi Clinic, Chennai.)