It was in March this year that the Indian government had begun a clinical trial to see whether practising pranayam, a breathing exercise, and chanting Gayatri Mantra, a sacred Hindu invocation, could help treat Covid. The trial, sponsored by the science of technology ministry and with the Clinical Trial Registry of India, or CTRI, was supposed to last two weeks. It’s been over two months, the Covid pandemic has devastated India, but we have still not received any word on the results of the study.
I have previously about the manner in which Indian law encourages traditional medicine to stay unscientific, the broad argument being that in order to be scientific a treatment method must be tested using the scientific method, and the results published to invite peer and public review. However, under the Indian legal regime, the scientific method is applicable only to pharmaceutical treatments, not to Ayurvedic, Unani or Siddha drugs. I argued that scientific testing isn’t anathema to traditional knowledge, it can actually be an ally in establishing its legitimacy.
Is then the present attempt to study the effect of the Gayatri Mantra on Covid patients a step in this direction, although it’s unclear whether chanting the mantra even qualifies as a treatment method at all, whether under evidence-based medicine or under Ayush systems? Pranayam has been advised for boosting immunity by the Ayush ministry in its Covid and , but Gayatri Mantra has failed to find mention as a potential treatment method in any form, even in the Ayush ministry’s literature.
How ‘scientific’ is this study?
The methodology stated for the trial is fairly straightforward. Twenty Covid patients are divided into two groups of 10 each, one called the intervention group and the other control group. Both groups get regular medical treatment for Covid, but those in the intervention group switch on their webcams twice daily for an hour each, get on a video call with a certified yoga practitioner, practise pranayam and chant Gayatri Mantra. The control group doesn’t receive the benefit of pranayam and the chant.
The biggest concern with the science aspect of this study is the shockingly low sample size. Only 10 of the patients get to recite the mantra and practise pranayam. It is difficult to see how a sample size of 10 can provide reliable answers about the efficacy of these techniques given that it’s impossible to differentiate between causation and coincidence, and the results are unlikely to be very useful. The patients chosen for the trial have “moderate” symptoms, there are no serious or severe cases. Since patients with moderate symptoms of Covid are more likely to recover on their own with existing treatment, but at varying rates, it becomes impossible to solve the issue of uniformity with such small numbers.
The CTRI registration claims the study is “outcome assessor blinded” and randomised. So, this is a randomised controlled blind study. To explain, “controlled” means the method being tested is evaluated against a standard. For completely new treatments, the control is usually a placebo; for additional or improved treatments it’s usually the existing standard of treatment. In this case, the control is the existing standard of treatment. It’s not the case that pranayam and Gayatri Mantra are being used as the only forms of treatment, thereby potentially risking the lives of the patients in the control group. Pranayam and the mantra are only being tested as additions to existing forms of treatment. “Randomised” means patients are assigned to the intervention and control groups by a computer at random. This is done to eliminate potential bias creeping into the study on part of the test subjects. Finally, “blind” means that identities of the test subjects aren’t revealed to the researchers assessing the outcome data.
Studies are also often “double blind” where even the test subjects aren’t made aware of whether they received treatment being tested, or a placebo. That would be impossible in this case, since most patients are likely to figure out fairly soon if they are in the group chanting Gayatri Mantra twice a day.
What is the problem?
If the concern about the dismally small sample size could be fixed, it appears that the study could be made scientific. So, what’s the problem? While the study’s low sample size has been widely criticised, if successful, a larger version of the trial could be done to get more meaningful data. After all, many scientific studies have been conducted on the health benefits of yoga, and the results have .
However, a big problem with this study is that it appears to have already declared itself scientific. “The Gayatri Mantra is the most sacred prayer of the Hindus. There is no effective treatment or vaccine for this virus as yet,” the summary of the trial states. “In this scenario the role of pranayama and Gayatri Mantra chanting which has been used in other diseases and has shown promising effects becomes vital.”
The trial summary, though, doesn’t provide any evidence of the mantra having shown promising results in treating any disease, as claimed.
Such pre-trial confidence is a matter of concern because the researchers ought to approach a hypothesis dispassionately before conducting the experiment and making their conclusions.
Ayush or science?
The study is sponsored by the science and technology ministry, not the Ayush ministry, formed in 2014 by amending the Government of India Allocation of Business Rules, 1961.
The Allocation of Business Rules list the domains of power of each ministry and its various departments. The function of the Ayush ministry is to formulate policy, implement programmes and coordinate research for development and propagation of Ayush systems. In contrast, the science ministry is responsible for formulating policies and promoting new areas of science and technology, and for inter-departmental coordination to steer science and technology missions.
The Allocation of Business Rules, however, are not mandatory and function more as guidelines on the functions of ministries. The question still remains whether pranayam and the chanting of Gayatri Mantra to help cure Covid is a matter of Ayush or of science, though some may argue they are one and the same and any argument to the contrary is futile. Since Ayush encompasses Ayurveda, Yoga, Unani, Siddha, Homeopathy and Naturopathy, it can be argued that pranayam is within the domain of the Ayush ministry, being as it is a part of yoga. Indeed, the ministry listed pranayam as a means to boost immunity in its Covid guidelines for ayurveda and yoga practitioners. But it’s not clear under which head of the Ayush acronym the Gayatri Mantra falls.
A violation of the Allocation of Business Rules will not vitiate the study, but the positions of the researchers, the CTRI and the government seem clear. In the tussle between two ministries that never happened, Gayatri Mantra belongs to science. The question of whether it constitutes “propagation of Ayush systems” or “promotion of new areas of science” has been answered.
This is a matter of science, the government seems to be saying, and if it isn’t, we’ll make it so.
Tanmay Singh is a lawyer in Delhi.