Ayurveda: Looking Into The Past For The Future

 

A large body of knowledge and experience has been preserved in texts written by practitioners of yore and successive physicians, indicating the continuity of this indigenous medical system.

By Rama Jayasundar

A group of excited students and erudite-looking scholars make their way to the picturesque foothills of Himalayas. The curious onlookers whisper among themselves:  “Look! There goes the famous Punarvasu Atreya, the eminent disciple of great Bharadvāja, leading the international congregration of ayurvedic physicians from across the country and beyond”. The crowd hears Agnivesha, one of the student, say: “Our teacher Atreya has asked the six of us, his students, to record the proceedings. In the very first chapter, you will find mention of all the names of the participating ayurvedic physicians. My work will be called Agnivesha Tantra”. Agnivesha leaves in a hurry as his other classmates Bhela, Jatūkarna, Parāśara, Hārita and Kşārapāņi call out to him. Little did he realise then that his work would be redacted centuries later by Charaka and come to be known as Charaka Samhita!


Figure 1Figure 2

The world is waking up to the well documented clinical experience and pharmacopoeia of ayurveda, the basic aim of which is to maintain the health of a healthy person and treat a diseased individual.

स्वस्थस्य स्वास्थ्य रक्षणम्       – maintain the health of the healthy individual

आतुरस्य विकार प्रशमनं च॥ – cure the disease of a patient

Historical impact of Ayurveda

Long the main healthcare system in India, the origin of ayurveda is lost in the mists of antiquity. It suffices to say that codified ayurveda would antedate Hippocrates by many centuries. Ayurveda’s history and development are closely interwoven with India’s, to the extent that ayurvedic knowledge has had a very deep impact on the lifestyle of its people.

In almost every household, there was  (and still is)  knowledge  of ayurvedic treatment for common ailments. Handed down through generations, every family had its own time-tested formulations for a wide range of health conditions. A number of medicines could be prepared at home from commonly available ingredients and herbs. Ayurvedic principles of healthy living were incorporated into daily routines, as was reflected in the daily regimens, traditional use of spices and medicinal ingredients in cuisines, and even religious rituals. Ayurveda has thus had a pervasive influence on the daily life of Indians and is perhaps the longest unbroken health tradition in the world.

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A large body of ayurvedic knowledge and experience has been preserved in texts written not only by practitioners of yore, but also successive physicians, indicating the continuity of this indigenous medical system.

The wider historical context

Ayurveda has its roots in the Veda from which many Indian philosophies have sprung. Ayurvedic terminologies, names, therapeutic properties and use of more than 360 plants are mentioned in Vedas [289 in Atharva, 67 in Oushadhi Sukta of Rg and 82 in Yajur]. Ayurvedic subjects are also dealt with in the Aranyakas, Brahmanas, and Upanishads. For example, the Garbhopanisad discusses growth of foetus and mentions the three dosha (vata, pitta, kapha) and dhatu (tissue elements). Ayurvedic terms, plants, their medicinal properties and formulations such as mrtasanjeevani and vishalyakarani find mention in Ramayana and Mahabharata.

Blurring the boundaries, sharpening the focus: contextual association with other Indian knowledge systems

Ayurveda is a melting pot and sandhi of a number of disciplines, a proof that knowledge was not compartmentalised in ancient India. Ayurveda is associated with and draws from wide-ranging subjects. For example, vrksha ayurveda (plant science), mrga ayurveda (veterinary science), yoga, philosophy, metallurgy (for making surgical instruments), civil engineering and architecture (construction of hospitals and pharmacies), astronomy, ethics, water management, mathematics (calculations, units of measurements, weights and measures, concept of time, etc.), culinary science, chemistry and pharmacology (for preparing medicines), diet and nutrition and agriculture. Just as allopathy has drawn from the basic sciences (physics, chemistry and mathematics), ayurveda uses ‘darshana’, namely Kanāda’s Vaiseshika, Gautamā’s Nyāya, Jaimini’s Purva Mimāmsa, Kapilā’s Sānkhya, Patanjali’s Yogā and Vyāsa’s Uttara Mimāmsa.

Some of these logical and philosophical schools of thought of ancient India are concerned with the organic structure of the universe while others deal with evolution and their philosophical implications. The systematised science of ayurveda epitomises their practical applications by using the traditional theories such as evolution, tridosha, triguna, panchamahabhuta, karma (cause-effect relationship), anu and paramanu (analogous to ‘atoms’ in the sense of the building blocks of physical matter), interrelatedness, and methods to analyse problems in a scientific and logical manner (Nyāya and Mimāmsa darshana). Based on Tarka shastra (science of dialectics, logic and reasoning), Ayurveda stresses the importance of rational thinking and discourages blind dogmatic acceptance.

These various theories and concepts have given rise to ayurveda’s theoretical framework, under which it has put together an enormous body of observational data. These theories and practices forming the backbone of ayurveda have been documented, validated by practice over many centuries and continue to be validated, and have thus stood the test of time. Just as modern medical texts do not discuss individual cases but present consolidated results, ayurvedic texts also present consolidated observations spanning over many centuries. A chronological analysis of these texts shows an increasing knowledge of diseases, pharmacopoeia and treatment regimens.

Theory of ayurveda in brief

The human body is a complex biological entity providing a wide scope for multiple perspectives. In Western medicine’s predominantly structural hierarchical viewpoint, atom is at the lowest level forming the basic building block of the human body. Atoms make molecules, which in turn progressively form cells, tissues, organs and organ systems such as skeletal, endocrine and reproductive. The entire human system is reduced to the fundamental unit of matter, for which reason this is known as a reductionist standpoint.

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Ayurveda’s perspective of the human body is predominantly functional. Although, a number of theories contribute to ayurveda, the theory of tridosha [Vata (V), Pitta (P) and Kapha (K)] runs as an undercurrent to its understanding of health and ill-health. Ayurveda has identified three key functions, namely, movement (Vata), transformation (Pitta), and growth & support (Kapha). VPK also includes parameters which are biophysical, chemical and physiological in nature, contributing to the core function of that particular category. For example, dryness is included in V, increased temperature in P and unctuousness in K. All the parameters under V, P and K are intra- and inter-connected forming a network (shown in the Figure below). The key to health is the stability of these factors in the network, with disease perceived as their perturbation.

Figure 5

The concept of innate unity and mutual interrelationship of everything in the universe is central to Uttara Mimāmsa darshana. Ayurveda has integrated this concept of interconnectedness into its understanding of health and disease by considering the human body as an indivisible whole with a network of interrelated functions, mind and consciousness. The hypothesis of interrelatedness elaborated in Uttara Mimāmsa thus finds practical expression in ayurveda.

The core idea of the human system as interconnected functions and system properties, and not merely a structure made of atoms and molecules, is unique and gives ayurveda an enormous advantage in dealing with the human body in a holistic way. That ayurveda recognises the importance of the mechanical aspects of human body can be inferred from the well developed branch of surgery in those days. Sushruta, the ayurvedic surgeon is acknowledged even by present day surgeons. Yet, ayurveda is based on principles that go beyond the purely mechanical view, i.e. a vision of wholeness, functional interdependence and unity.

Theory to clinical practice

Ayurveda  has  incorporated  the  theory  of  V, P and K  in  an interesting  way  into  its diagnosis and therapeutic management. Factors such as dietary ingredients, plants, physical & mental activities, seasons and clinical symptoms, all of which have a role in health, disease and treatment are also classified and explained in terms of V, P and K. For instance, the dietary ingredient of wheat increases K; activity such as exercise increases V; and autumn season increases P. Example of classification of clinical symptoms in terms of V, P and K: skin disorder – dryness indicates involvement of V, reddishness and burning sensation that of P, and pruritus and exudation that of K. VPK provides a theoretical framework within which all clinical symptoms can be interpreted – no clinical symptoms lie outside the purview of VPK.

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VPK thus serves as a common platform for all the factors (plants, food ingredients, activities, seasons, clinical symptoms, etc.) contributing to health and disease. From a clinical stance, it provides a common interface facilitating easy conversion of all diagnostically and therapeutically relevant parameters to a common denominator, enabling a VPK-based diagnosis and treatment. The ayurvedic therapeutic strategy is, therefore, different but comprehensive, addressing all causative factors and incorporating all the therapeutically relevant parameters such as medicines, diet and activities.

Some lesser known facts

From inception, Ayurveda has recognised eight main specialities.

1.  Kaya chikitsa – internal medicine

2. Shalakya tantra – diseases of head and neck. This branch is roughly equivalent to Ophthalmology and Otorhinolaryngology (ENT) medicine. Surgical techniques as well as herbal treatments for conditions such as cataracts are included in this.

3. Shalya tantra –surgery. Surgery had a very important place in ayurvedic medicine. It covers topics such as anatomy, physiology and surgical interventions such as cataract, rhinoplasty, otoplasty, etc.

4. Agada tantra -toxicology. It deals with classification and treatment of all types of toxins, including air and water pollution, and bites of poisonous animals.

Figure 7

5. Kaumarabhrtya – paediatrics. All topics related to children, their pre- and post-natal health, growth and childhood diseases are discussed. It also covers extensively, health and diseases afflicting women. Ayurveda gives utmost importance to health of women since their health determines and influences the health of a child not only while in the womb but also later on. Therefore, the subjects concerned with conception and its protection, support and nourishment, and delivery come under the purview of kaumarabhrtya. This is equivalent to today’s speciality of Obstetrics and Gynaecology.

6. Rasayana – rejuvenation. This branch deals with prevention of diseases and ensures long, healthy life. It is concerned with healthy diet, lifestyle and codes of behavioural conduct.

7. Vajikarana –this branch deals with producing physically, mentally and emotionally healthy progeny.These medicines rejuvenate, increase sexual potency and efficiency, and also treat infertility.

8. Bhutavidya – deals with diseases caused by unseen and invisible factors. This includes infections and psychiatric disorders.

Ancient rishis studied nature for its underlying patterns and ayurveda has accepted the Vedic hypothesis that there are common principles underlying the microcosm (individual) and macrocosm (universe). According to them, humans (animals and even plants) and the universe are composed of the same basic elements and follow the same physical laws. Ayurveda deals with manushya ayurveda (dealing with humans), mrga ayurveda (veterinary science) and vrksha ayurveda (plant science/botany). The same fundamental principles of V, P and K apply to all of them (humans, animals and plants).

In ancient India, equal importance was given to the maintenance of health of humans, animals and plants alike. Vrksha Ayurveda describes the entire life-cycle of plants in addition to prevention and cure of plant diseases. It discusses the origin of plant from seed, different parts of plants, their structure and functions, and diseases afflicting them, rules of plantation, seasons ideal for plantation and harvesting and ideal agricultural practices.

Present day relevance

Allopathy is successful in dealing with surgical conditions and medical emergencies. However, there are increasing number of diseases, which are no more single entities, but complex with one leading to another. The best example is obesity, which leads to a number of other diseases such as cardiovascular disease, diabetes, cancer, osteoarthritis and sleep apnoea. As the world faces increasing chronic, psychosomatic, stress and lifestyle-related disorders, ayurveda with its unique approach, holistic perspective, emphasis on diet and lifestyle activities, and time-tested clinical practices can play a crucial role.

As a healthcare system, it can empower the individual with a healthy way of life. Ayurveda is not a reminder of a past glory but an example of Indian knowledge system having contemporary and increasing relevance. Its experience and expertise accumulated over several millennia should be used to benefit suffering people.

— Dr Rama Jayasundar is one of the most erudite, articulate and widely travelled ambassadors of ayurveda today. This article is a revised and enlarged version of an earlier article published in the magazine Financial Chronicle.

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