In the following discussions we intend to present a scientific, objective view of amaroli - assessing all the points on the kidney, urine and its uses - in order to approach the subject with adequate understanding and a more balanced perspective. Much of this material has been collated from the seminar on amaroli held at the Bihar School of Yoga, IYFM Research Coordinating Center, in March 1978. The panel included Dr. Swami Shankardevananda Saraswati, MB, BS (Syd); Dr. Swami Vivekananda Saraswati, MB, BS (Syd), MANZCP, DPM; and Swami Buddhananda Saraswati, BA, Dip. Ac. (HK & Aust), DNMN, all of whom have had experience with amaroli. In the text they are referred to as Dr. S; Dr. V; and Sw. B respectively. Many of the swamis and visitors to the ashram who participated in the seminar also contributed their experiences, some of which have been recorded here. Other material was collated from various scriptures, books and magazines.
Dr. V: The critical question is, has anyone proved that amaroli works or, for that matter, has anyone proved that it doesn't? The many case histories cited are alright as far as showing us that this field may need researching, but they are not valid proof. We know that:
The best technique to rule out 1 and 2 is the double-blind cross-over clinical trial. However, even this doesn't fully eliminate the time factor. If amaroli could stand up to such a test, then it will definitely have something to offer humanity.
Dr. S: I agree with you, even though I have personally seen and felt the efficacy of urine in neti for stopping colds, for sinusitis and in other situations. Once we know if amaroli really works, then we can start to combine it with asanas, pranayama, hatha yoga and other healing techniques to produce more and more effective means of eradicating disease.
Actually, this is a very important point, and it may be the crux of the whole amaroli debate. Once we have definite proof about the efficacy of urine, either for or against, then the argument is finished. Definite, scientifically controlled therapy may start - or amaroli can be abandoned altogether.
Sw. B: If we are going to evaluate amaroli in the light of our present knowledge, there are certain things we have to know. Let's face facts. We are not going to see a double-blind clinical trial on amaroli for some time.
From the way I understand it this would require two large groups of people, matched for certain characteristics, most important of which would be that they all share the same basic complaint; The only way I can envisage such a large experiment being conducted is with the cooperation of a large hospital with the appropriate laboratory facilities. For such an institution to accept any plan we might pre-test them, we have to provide some tangible evidence so that they have something solid to go on.
We have seen the work already done on amaroli, such as Armstrong's The Water of Life, but all these works are by non-medical men. This in itself presents a huge problem in terms of gaining recognition from the medical profession. Natural healers do a good job in many cases, but there is often an inherent rivalry between doctors and other healers. To overcome this barrier, doctors have to start working in the field of natural healing, doing some sound research and sharing their results. Apart from experiments and pure science, case histories certified by medical scientists and backed up by as many investigations as possible may at least give us a direction to work in.
Dr. V: Until now we have not had any evidence to support the claims by practitioners that amaroli works. They maintain that it does and present case histories to back up their statements, but these are next to worthless in the eyes of doctors and scientists. We might as well take the word of two women gossiping over the garden fence. These enthusiasts are almost demanding acceptance from doctors, and when they are rejected or asked for evidence, they say: "Well, if you don't believe that urine works? Why don't you prove otherwise?"
It seems to me that the onus is on those who practice amaroli to prove that it works, rather than on the doctors. Scientifically minded people want proof that it works, otherwise they are not interested. Why should they waste their time on something if they are not convinced that it will work? Can doctors prescribe' amaroli for their patients if they are not sure of its efficacy? Perhaps this is acceptable in chronic illness where all other remedies have failed, but definitely not in acute illness where one's life hangs in the balance. Do we not have a moral obligation to offer only the best to those people who come to us for help? Are we sure that amaroli, even supposing it works, is the best?
Each person has to answer these questions for himself. For my part, before I prescribe amaroli, and I have nothing whatsoever against it, I will need to have concrete evidence that it works. This will mean a double-blind cross-over trial conducted by those advocates with the impetus, inspiration and honesty to undertake such a task.
Dr. S: What does such a trial involve?
Dr. V: The aim of the experiment should be to see whether or not amaroli can cure disease. We want to eliminate all the psychological, faith healing and placebo aspects - from both the patient side and the therapist's side. To remove all expectations and suggestions from the experiment we need three groups of people:
Group 1 designs the way the experiment will run, then leaves the instructions to be carried out by the other two groups. It has no contact with 2 and 3 until after the experiment is concluded. In this particular trial, the designer would have to prepare two fluids. They would have to appear identical in terms of colour, taste, smell and touch. The fluids would be put into identical bottles and labelled Al, A2, Bl, B2, etc. The bottles are filled at random, and only group 1 knows whether any particular bottle contains urine or the control fluid.
Group 1 is not involved in the actual experiment so it cannot influence the experimenters or the subjects in any way, consciously or unconsciously. This unconscious influence is seen quite often in experiments which are not properly controlled. When the technician in the white lab coat gives you a substance to test its effects on your mind and body, it is not a totally neutral situation. It is a form of communication, albeit a very subtle one. The laboratory technician projects his attitudes and expectations to the subject, and thus introduces a bias into the experimental set-up. The experiment then becomes worthless because the subject's attitude is no longer neutral; it has been manipulated by the conscious or unconscious cues of the researcher.
In a double-blind trial, both patient and technician are 'blind'. That is, group 3 does not know whether it is receiving normal medication, coloured fluid, or urine. Nor does group 2. The technician is instructed to give bottle Al to patient 1; he doesn't know what is in bottle Al, so he cannot form or convey any judgement about its contents. Only the designer has a record of what is in each bottle, and he is not present. So the situation remains neutral.
Group 3 consists of those people who will actually take the fluids. They are divided into two groups. The larger the group, the greater is the accuracy of the trial and the more dependable are the results. However, in an experiment of this kind, two groups of twenty five people would be sufficient. These subjects would be matched for age, sex, social and marital status, and, of course, the nature of their illness. As far as possible, both groups are identical. The only difference is that one group receives urine, and the other receives the control fluid.
Half way through the experiment, the 'cross -over' occurs. Supposing that a patient has been receiving a bottle that actually contains his urine for, say, two weeks depending on the chronicity of the illness. Next he will receive not urine, but the control fluid, also for two weeks. Neither the technician nor the patient knows about this change, which has been programmed in advance by group 1. If such a clinical trial is to prove that amaroli effects a cure, it would show the following results:
Such an experiment rules out psychological factors, faith healing, cheating, manipulation of the subjects and so on - this if the only way to convince scientifically minded people that amaroli works.
Dr. S: So far no one has done this sort of thing. The supporters of amaroli are waiting for the scientists and the scientists are waiting for the urine therapists. We have countless case histories but no one has, as yet, found them sufficiently inspiring to provide the impetus for a clinical trial of the kind we have been discussing.