THE ROOT CAUSE DELUSION

The “Root Cause” Delusion: Same Sh*t, Different Day

Why the Ayurvedic Fraternity’s Favourite Deflection is Intellectually Bankrupt—and Why They Keep Using It Anyway

By Dr. Aakash Kembhavi ****MD, PGDMLS, MS(Counseling & Psychotherapy)**

Disclaimer and Author’s Note

The views expressed in this article are entirely my personal opinions. They are not intended to harm, defame, or disrespect any individual, institution, or system of medicine. My purpose is solely to raise questions that I personally believe are valid and necessary for the growth and credibility of Ayurveda as a discipline.

I do not presume to question the legitimacy or authority of regulatory bodies such as NCISM, our esteemed universities, or the respected gatekeepers of Ayurvedic tradition. Rather, I humbly pose honest questions that I believe deserve thoughtful consideration and open dialogue within our community.

Readers have every right to differ with my views. Healthy disagreement is the foundation of intellectual progress. I welcome constructive critique and alternative perspectives. My intention is not to provoke but to stimulate reflection on issues that I feel are critical to the future of our profession.

Transparency regarding AI collaboration: This article has been generated in collaboration with artificial intelligence (Claude by Anthropic). The ideas, arguments, and perspectives are my own; AI has assisted in articulating and structuring these thoughts. I believe in transparency about the tools we use, and I see no contradiction between embracing modern technology and advocating for traditional knowledge systems—provided both are held to standards of honesty and evidence.

A note on my own limitations: I do not claim to possess evidence that would refute the criticisms leveled against Ayurveda. What I do possess is the honesty to admit that Ayurveda has limitations, and that its claims to scientific validity must be questioned rigorously and openly. This admission is not a betrayal of our tradition—it is fidelity to its deepest spirit.

The great Acharyas of the past—Charaka, Sushruta, Vagbhata—were not dogmatists who demanded blind acceptance. They were seekers, innovators, and questioners. “Yuktiyuktam vachaḥ grāhyam”—accept what is supported by reason. They encouraged curiosity, welcomed development, and understood that knowledge must evolve. I believe they would have appreciated this effort to hold their legacy to higher standards rather than defend it with intellectual dishonesty. To question is not to disrespect; to demand evidence is not to abandon tradition. It is, in fact, to honour the very spirit of inquiry that gave birth to Ayurveda in the first place.

The Question That Refuses to Die

“Does allopathy fix the root cause?”

There it is again. The question that alternative medicine apologists trot out with the predictability of a monsoon, believing they have delivered some devastating philosophical blow to scientific medicine. Dr. Cyriac Abby Philips, TheLiverDoc, recently received this tired query from a Twitter user who added, with apparent profundity: “Of course it’s all lifestyle.”

Same question. Same ignorance. Same deflection. SSDD—Same Sh*t, Different Day.

To the stalwarts of Ayurveda, to the authorities at NCISM, to the Vice-Chancellors of our Ayurveda universities, to the research scholars churning out worthless papers, to the practitioners who nod sagely when patients parrot this “root cause” nonsense—I have a question for you:

When will you stop hiding behind this intellectually bankrupt argument and actually produce evidence for your claims?

First, Let Us Correct Your Terminology

The term “allopathy” is itself a relic of ignorance. It was coined by Samuel Hahnemann—the inventor of homeopathy, that “extreme form of quackery” as Dr. Philips accurately describes it—as a derogatory term for the heroic medicine practices of 18th-century Europe. Bloodletting. Mercury purges. Treatments that often killed faster than the disease.

Nobody practices “allopathy” today.

What we have now is evidence-based scientific medical practice. Or simply: medicine. Everything else—Ayurveda, homeopathy, naturopathy, Siddha, Unani—is either “not medicine” or “alternative medicine.” Alternative to what? Alternative to evidence. Alternative to efficacy. Alternative to accountability.

When you use the term “allopathy,” you reveal either your ignorance of medical history or your deliberate attempt to create a false equivalence between a modern evidence-based system and a pre-scientific relic. Neither reflects well on you.

The “Root Cause” Argument: A Masterclass in Projection

Let us dissect this beloved talking point with the clinical precision it deserves.

Scientific Medicine Actually Identifies Root Causes

The scientific study of disease causation is called etiology. The study of how those causes lead to disease is called pathogenesis. Together, they form the foundation of modern medical understanding and treatment.

Consider diabetes mellitus. Through rigorous scientific research, we now know:

  • Type 1 diabetes results from autoimmune destruction of pancreatic beta cells—genetic predisposition plus environmental triggers leading to immune dysregulation
  • Type 2 diabetes involves insulin resistance and relative insulin deficiency—driven by genetic factors, epigenetic modifications, obesity, sedentary lifestyle, and metabolic dysfunction
  • Gestational diabetes relates to placental hormones affecting insulin sensitivity
  • MODY (Maturity Onset Diabetes of the Young) involves specific monogenic mutations—at least 14 different subtypes identified
  • LADA (Latent Autoimmune Diabetes in Adults) represents slow-onset autoimmune destruction
  • Secondary diabetes can result from pancreatitis, cystic fibrosis, hemochromatosis, Cushing’s syndrome, acromegaly, and various medications

Each type has specific diagnostic criteria, distinct pathophysiological mechanisms, and targeted treatment approaches. This is what understanding “root causes” actually looks like.

What does Ayurveda offer? Prameha. Twenty types classified by urine characteristics—whether it looks like honey, whether ants are attracted to it, whether it resembles cane juice. No understanding of glucose metabolism. No concept of insulin. No differentiation between autoimmune destruction and insulin resistance. No recognition of genetic subtypes.

And yet Ayurveda claims to treat the “root cause”?

The Irony is Exquisite

Here is the beautiful irony that seems lost on alternative medicine advocates: Ayurveda treats with roots, but cannot identify root causes.

When an Ayurvedic practitioner prescribes Guduchi or Meshashringi or some polyherbal formulation for a diabetic patient, what “root cause” are they addressing? Kapha vitiation? Medodhatwagnimandya? These are not causes—they are pre-scientific philosophical constructs that have no correlation with actual disease mechanisms.

An Ayurvedic practitioner cannot:

  • Diagnose Type 1 vs. Type 2 diabetes
  • Identify autoimmune markers
  • Detect genetic mutations
  • Measure insulin levels or insulin resistance
  • Assess beta cell function
  • Identify secondary causes requiring specific interventions

They cannot identify the root cause because they lack the conceptual framework, the diagnostic tools, and the scientific understanding to do so. They prescribe herbs based on textual descriptions written millennia before anyone understood what a pancreas does.

This is not treating root causes. This is treating symptoms (poorly) while remaining willfully ignorant of underlying mechanisms.

“It’s All Lifestyle” — The Second Deflection

The Twitter user confidently declared: “Of course it’s all lifestyle.”

This is the companion myth to the “root cause” fallacy—that diseases are simply lifestyle problems, and if only people ate right and exercised, they wouldn’t need “chemicals” from Big Pharma.

Let me disabuse you of this dangerous oversimplification.

Disease causation involves:

  • Genetics: Your inherited DNA sequence, including mutations, polymorphisms, and copy number variations
  • Epigenetics: How gene expression is modified by environmental factors—methylation patterns, histone modifications, microRNA regulation
  • Predisposition: Complex polygenic risk factors that increase susceptibility
  • Familial factors: Both genetic inheritance and shared environmental exposures within families
  • Infectious agents: Bacteria, viruses, fungi, parasites—each with specific mechanisms of pathogenesis
  • Environmental exposures: Toxins, radiation, carcinogens, pollutants
  • Immunological factors: Autoimmunity, immunodeficiency, hypersensitivity
  • Lifestyle factors: Yes, including diet, exercise, smoking, alcohol—but as part of a complex web, not the sole determinant
  • Socioeconomic determinants: Access to healthcare, nutrition, sanitation, education
  • Stochastic factors: Random cellular errors, somatic mutations, chance events

A child born with Type 1 diabetes did not cause their disease through poor lifestyle choices. A young woman with systemic lupus erythematosus did not eat her way into autoimmunity. A man with Huntington’s disease cannot exercise away his genetic destiny. A patient with hepatitis B acquired through vertical transmission did not choose their infection.

To reduce all disease to “lifestyle” is not wisdom—it is ignorance parading as profundity. It is victim-blaming dressed in pseudo-spiritual robes.

And here is another inconvenient truth for the “lifestyle” champions: Scientific medicine already incorporates lifestyle interventions as a cornerstone of treatment.

Open any clinical practice guideline—for diabetes, hypertension, cardiovascular disease, obesity, fatty liver disease—and you will find detailed recommendations on:

  • Dietary modifications (evidence-based, not arbitrary food combinations based on “cooling” or “heating” properties)
  • Physical activity prescriptions
  • Weight management strategies
  • Smoking cessation
  • Alcohol moderation
  • Stress management
  • Sleep hygiene

These are not afterthoughts. They are first-line interventions. The difference is that scientific medicine studies these interventions systematically, quantifies their effects, and integrates them with pharmacological and procedural treatments based on evidence of benefit.

Ayurveda does not own lifestyle medicine. It has merely repackaged common-sense health advice with mystical terminology and claimed exclusive rights to wisdom that is actually universal.

“Can the Patient Stop the Meds?”

The questioner asks whether there is a point where patients can stop medications and rely solely on lifestyle changes.

This question reveals a fundamental misunderstanding of what medicine aims to achieve.

Modern medical practice does not aim to “fix” everything. The goals of treatment include:

  • Cure: Where possible and achievable—such as with many infections, some cancers, and certain surgical conditions
  • Remission: Achieving disease-free states that may be sustained—as in many cancers and autoimmune conditions
  • Control: Managing chronic conditions to prevent progression and complications—as in hypertension, diabetes, and epilepsy
  • Palliation: Reducing suffering when cure is not possible—improving quality of life in terminal illness
  • Prevention: Stopping disease before it starts or preventing recurrence

Sometimes patients can indeed stop medications. A patient with Type 2 diabetes who achieves significant weight loss through bariatric surgery or intensive lifestyle intervention may achieve remission and discontinue glucose-lowering medications. A patient with hypertension who loses weight, reduces sodium intake, and increases physical activity may normalize blood pressure without drugs. This happens regularly in clinical practice.

But for many conditions—Type 1 diabetes, many genetic disorders, advanced organ damage—lifelong treatment is necessary not because medicine has “failed” but because that is the nature of the disease.

What can Ayurveda offer these patients?

Can Ayurveda cure Type 1 diabetes? Can it regenerate destroyed beta cells? Can it correct genetic mutations? Can it reverse cirrhosis or restore kidney function in end-stage renal disease? Can it shrink malignant tumors? Can it cure HIV?

The honest answer is no.

The dishonest answer is what patients receive when they visit Ayurvedic practitioners—false hope, delayed appropriate treatment, progression of disease, and sometimes death.

The Challenge to Ayurveda’s Gatekeepers

To the National Commission for Indian System of Medicine: You regulate our profession. When will you require evidence of efficacy before permitting treatment claims?

To the Vice-Chancellors of Ayurveda Universities: You award degrees. What evidence do your graduates produce that would survive scrutiny in any legitimate scientific forum?

To the Research Scholars: You publish papers. Of the 225 Ayurvedic clinical trials reviewed in one analysis, 90% had unsatisfactory diagnosis and ambiguous outcomes. When will you learn proper research methodology? When will you understand that a p-value without proper study design, sample size calculation, appropriate statistical tests, and clinically meaningful endpoints is worthless?

To the Practitioners: You see patients daily. When they come to you with diabetes, can you actually identify the type? Can you distinguish autoimmune from metabolic disease? Can you recognize when urgent insulin therapy is life-saving versus when lifestyle modification is appropriate first-line treatment? Or do you just prescribe the same herbal combinations for everyone and call it “individualized treatment”?

To the Keyboard Warriors who respond to every criticism of Ayurveda with the “root cause” deflection: This intellectual laziness is destroying whatever credibility our system might have. You are not defending Ayurveda—you are exposing its bankruptcy.

Open Mind, Closed Eyes

There is a saying worth remembering: “Many people open their minds so much that their brains fall off.”

This happens when one keeps an “open mind” to alternative therapies while keeping eyes firmly closed to evidence, to critical thinking, to the documented harms caused by unregulated and untested interventions.

Being open-minded does not mean accepting every claim without scrutiny. It means being willing to change your beliefs when presented with evidence. And the evidence is clear: Ayurveda, as currently practiced, cannot deliver what it promises.

Dr. Philips has stated repeatedly: show him irrefutable evidence, and he will be Ayurveda’s advocate. This is the hallmark of a scientific mind—openness to evidence, not blind faith.

What is our response? Legal notices. Death threats. Character assassination. Accusations of “Hinduphobia.” Anything except the one thing that would actually settle the matter: evidence.

The Real Root Cause

The real root cause of Ayurveda’s credibility crisis is not Western bias, not colonial mentality, not Big Pharma conspiracy, not Hinduphobia.

The root cause is simple: We have failed to produce evidence for our claims, and we attack those who point this out rather than doing the work to prove ourselves.

Until we acknowledge this, every iteration of the “root cause” argument is simply confirmation of our collective intellectual dishonesty.

Same sh*t, indeed. Different day.

The question is: will tomorrow be any different?

The author invites substantive responses from the Ayurvedic community. Bring data, not deflections. Bring evidence, not excuses. Bring studies, not Sanskrit shlokas. The world—and our patients—deserve better.

Share your thoughts in the comments below.