Ayurveda

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Ayurveda (Sanskrit: आयुर्वेद; Āyurveda, "the knowledge for long life in Vedas"; /ˌ.ərˈvdə/[1]) or ayurvedic medicine is a Hindu system of traditional medicine native to India and a form of alternative medicine. The earliest literature on Indian medical practice appeared during the Vedic period in India, in Rigved. Some other known written text are Suśruta Saṃhitā and the Charaka Saṃhitā, encyclopedias of medicine compiled from various sources from the mid-first millennium BCE to about 500 CE,[2] and are among the foundational and formally compiled works of Ayurveda. Over the following centuries, ayurvedic practitioners developed a number of medicinal preparations and surgical procedures for the treatment of various ailments.[3] Current practices derived (or reportedly derived) from Ayurvedic medicine are regarded as part of complementary and alternative medicine.[4]

The main classical Ayurveda texts begin with accounts of the transmission of medical knowledge from the Gods to sages, and then to human physicians.[5] In Sushruta Samhita ([Sushruta's Compendium]), Sushruta wrote that Dhanvantari, Hindu god of Ayurveda, incarnated himself as a king of Varanasi and taught medicine to a group of physicians, including Sushruta.[6][7] Ayurveda therapies have varied and evolved over more than two millennia.[8] Therapies are typically based on complex herbal compounds, minerals and metal substances (perhaps under the influence of early Indian alchemy or rasa shastra). Ancient Ayurveda texts also taught surgical techniques, including rhinoplasty, kidney stone extractions, sutures, and the extraction of foreign objects.[9][10]

Some scholars assert that Ayurveda originated in prehistoric times,[11] and that some of the concepts of Ayurveda have existed from the time of the Indus Valley Civilization or even earlier.[12] Ayurveda developed significantly during the Vedic period and later some of the non-Vedic systems such as Buddhism and Jainism also developed medical concepts and practices that appear in the classical Ayurveda texts.[12][13] Humoral balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness.[14] Ayurveda names three elemental substances, the doshas (called Vata, Pitta and Kapha), and states that a balance of the doshas results in health, while imbalance results in disease. Ayurveda has eight canonical components, which are derived from classical Sanskrit literature. Ayurveda practitioners had developed various medicinal preparations and surgical procedures by the medieval period.[15]

Eight components[edit]

At an early period[when?], Ayurveda adopted the physics of the "five elements" (Devanāgarī: [महा] पञ्चभूत); earth (Pṛthvī), water (Jala), fire (Agni), air (Vāyu) and space (Ākāśa) that compose the universe, including the human body.[16] Ayurveda describes seven types of tissues of the body, known as the saptadhātu (Devanāgarī: सप्तधातु). They are plasma (rasa dhātu), blood (rakta dhātu), flesh (māṃsa dhātu), adipose (medha dhātu), bone (asthi dhātu), marrow and nervous (majja dhātu), and reproductive (semen or female reproductive tissue) (śukra dhātu).[17] Ayurvedic literature deals elaborately with measures of healthful living during the entire span of life and its various phases. Ayurveda stresses a balance of three elemental energies or humors: Vāyu / vāta (air & space – "wind"), pitta (fire & water – "bile") and kapha (water & earth – "phlegm"). According to ayurvedic medical theory, these three substances — doṣas (Devanāgarī: दोष)—are important for health, because when they exist in equal quantities, the body will be healthy, and when they are not in equal amounts, the body will be unhealthy in various ways. One ayurvedic theory asserts that each human possesses a unique combination of doṣas that define that person's temperament and characteristics. Another view, also present in the ancient literature, asserts that humoral equality is identical to health, and that persons with preponderances of humours are proportionately unhealthy, and that this is not their natural temperament. In ayurveda, unlike the Sāṅkhya philosophical system, there are 20 fundamental qualities, guṇa (Devanāgarī: गुण, meaning qualities) inherent in all substances.[18] While surgery and surgical instruments were employed from a very early period, Ayurvedic theory asserts that building a healthy metabolic system, attaining good digestion, and proper excretion lead to vitality.[18] Ayurveda also focuses on exercise, yoga, and meditation.[19]

The practice of panchakarma (Devanāgarī: पंचकर्म‌) is a therapeutic way of eliminating toxic elements from the body.[20]

As early as the Mahābhārata, ayurveda was called "the science of eight components" (Skt. aṣṭāṅga, Devanāgarī: अष्टांग), a classification that became canonical for ayurveda. They are:[21]

  1. Internal medicine (Kāya-cikitsā)
  2. Paediatrics (Kaumārabhṛtyam)
  3. Surgery (Śalya-cikitsā)
  4. Ophthalmology and ENT (Śālākya tantra)
  5. Psychiatry has been called Bhūta vidyā.
  6. Toxicology (Agadatantram)
  7. Prevention of diseases and improving immunity and rejuvenation (rasayana)
  8. Aphrodisiacs and improving health of progeny (Vajikaranam)

In Hindu scriptures, the origin of ayurvedic medicine is attributed to Dhanvantari, the physician of the gods.[7]

The earliest classical Sanskrit works on Ayurveda describe medical science as being divided into eight components (Skt. aṅga).[22][23] This characterization of the physicians' art, "the medicine that has eight components" (Skt. cikitsāyām aṣṭāṅgāyāṃ चिकित्सायामष्टाङ्गायाम्), is first found in the Sanskrit epic the Mahābhārata, ca 4th cenury BCE.[24] The components are:[25][need quotation to verify], [26]

  • Kāyacikitsā: general medicine, medicine of the body
  • Kaumāra-bhṛtya: the treatment of children, paediatrics
  • Śalyatantra: surgical techniques and the extraction of foreign objects
  • Śālākyatantra: treatment of ailments affecting ears, eyes, nose, mouth, etc. ("ENT")
  • Bhūtavidyā: pacification of possessing spirits, and the people whose minds are affected by such possession
  • Agadatantra: toxicology
  • Rasāyanatantra: rejuvenation and tonics for increasing lifespan, intellect and strength
  • Vājīkaraṇatantra: aphrodisiacs and treatments for increasing the volume and viability of semen and sexual pleasure.

Principles and terminology[edit]

File:Nagarjuna.gif
Several philosophers in India combined religion and traditional medicine—notable examples being that of Hinduism and Ayurveda. Shown in the image is the philosopher Nagarjuna, known chiefly for his doctrine of the Madhyamaka (middle path). He wrote the medical works The Hundred Prescriptions and The Precious Collection, among others.[27]
File:Ayurveda humors.svg
The three doṣhas and the five elements from which they are composed.

The central theoretical ideas of Ayurveda developed in the mid-first millennium BCE, and show parallels with Sāṅkhya and Vaiśeṣika philosophies, as well as with Buddhism and Jainism.[28][29] Balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness.[14] For example, to suppress sneezing is said to potentially give rise to shoulder pain.[30] However, people are also cautioned to stay within the limits of reasonable balance and measure when following nature's urges.[14] For example, emphasis is placed on moderation of food intake,[16] sleep, and sexual intercourse.[14]

Ayurveda names seven basic tissues (dhatu), which are plasma (rasa), blood (rakta), muscles (māmsa), fat (meda), bone (asthi), marrow (majja), and semen (shukra). Like the medicine of classical antiquity, Ayurveda has historically divided bodily substances into five classical elements (Sanskrit [maha]panchabhuta, viz. earth, water, fire, air and ether.[17] There are also twenty gunas (qualities or characteristics) which are considered to be inherent in all substances. These are organized in ten pairs: heavy/light, cold/hot, unctuous/dry, dull/sharp, stable/mobile, soft/hard, non-slimy/slimy, smooth/coarse, minute/gross, and viscous/liquid.[18]

Ayurveda also names three elemental substances, the doshas (called Vata, Pitta and Kapha), and states that a balance of the doshas results in health, while imbalance results in disease. One Ayurvedic view is that the doshas are balanced when they are equal to each other, while another view is that each human possesses a unique combination of the doshas which define this person's temperament and characteristics. In either case, it says that each person should modulate their behavior or environment to increase or decrease the doshas and maintain their natural state.

In medieval taxonomies of the Sanskrit knowledge systems, Ayurveda is assigned a place as a subsidiary Veda (upaveda).[31] Some medicinal plant names from the Atharvaveda and other Vedas can be found in subsequent Ayurveda literature.[32] The earliest recorded theoretical statements about the canonical models of disease in Ayurveda occur in the earliest Buddhist Canon.[33]

Practice[edit]

Ayurvedic doctors regard physical existence, mental existence, and personality as a unit, with each element being able to influence the others.[clarification needed] This is a holistic approach used during diagnosis and therapy, and is a fundamental aspect of Ayurveda. Another part of Ayurvedic treatment says that there are channels (srotas) which transport fluids, and that the channels can be opened up by massage treatment using oils and Swedana (fomentation). Unhealthy channels are thought to cause disease.[34]

Diagnosis[edit]

Ayurveda has eight ways to diagnose illness, called Nadi (pulse), Mootra (urine), Mala (stool), Jihva (tongue), Shabda (speech), Sparsha (touch), Druk (vision), and Aakruti (appearance).[35] Ayurvedic practitioners approach diagnosis by using the five senses.[36] For example, hearing is used to observe the condition of breathing and speech.[17] The study of the lethal points or marman marma is of special importance.[18]

File:Ayurweda kopfmassage.JPG
An Ayurvedic practitioner applying oils using head massage.

Treatment and prevention[edit]

Two of the eight branches of classical Ayurveda deal with surgery (Śalya-cikitsā and Śālākya-tantra), but contemporary Ayurveda tends to stress attaining vitality by building a healthy metabolic system and maintaining good digestion and excretion.[18] Ayurveda also focuses on exercise, yoga, and meditation.[19] One type of prescription is a Sattvic diet.

Ayurveda follows the concept of Dinacharya, which says that natural cycles (waking, sleeping, working, meditation etc.) are important for health. Hygiene, including regular bathing, cleaning of teeth, skin care, and eye washing, is also a central practice.[17]

Substances used[edit]

Plant-based treatments in Ayurveda may be derived from roots, leaves, fruits, bark, or seeds such as cardamom and cinnamon. In the 19th century, William Dymock and co-authors summarized hundreds of plant-derived medicines along with the uses, microscopic structure, chemical composition, toxicology, prevalent myths and stories, and relation to commerce in British India.[37] Animal products used in Ayurveda include milk, bones, and gallstones. In addition, fats are prescribed both for consumption and for external use. Consumption of minerals, including sulphur, arsenic, lead, copper sulfate and gold, are also prescribed.[17] The addition of minerals to herbal medicine is called rasa shastra.

Ayurveda uses alcoholic beverages called Madya,[38] which are said to adjust the doshas by increasing Pitta and reducing Vatta and Kapha.[38] Madya are classified by the raw material and fermentation process, and the categories include: sugar-based, fruit-based, cereal-based, cereal-based with herbs, fermentated with vinegar, and tonic wines. The intended outcomes can include causing purgation, improving digestion or taste, creating dryness, or loosening joints. Ayurvedic texts describe Madya as non-viscid and fast-acting, and say that it enters and cleans minute pores in the body.[38]

Purified opium[39] is used in eight Ayurvedic preparations[40] and is said to balance the Vata and Kapha doshas and increase the Pitta dosha.[39] It is prescribed for diarrhea and dysentery, for increasing the sexual and muscular ability, and for affecting the brain. The sedative and pain-relieving properties of opium are not considered in Ayurveda. The use of opium is not found in the ancient Ayurvedic texts, and is first mentioned in the Sarngadhara Samhita (1300-1400 CE), a book on pharmacy used in Rajasthan in Western India, as an ingredient of an aphrodisiac to delay male ejaculation.[41] It is possible that opium was brought to India along with or before the Mohammedan conquest.[40][21] The book Yoga Ratnakara (1700-1800 CE, unknown author), which is popular in Maharashtra, uses opium in a herbal-mineral composition prescribed for diarrhea.[41] In the Bhaisajya Ratnavali, opium and camphor are used for acute gastroenteritis. In this drug, the respiratory depressant action of opium is counteracted by the respiratory stimulant property of Camphor.[41] Later books have included the narcotic property for use as analgesic pain reliever.[41]

Cannabis indica is also absent from the ancient Ayurveda books, and is first mentioned in the Sarngadhara Samhita as a treatment for diarrhea.[41] In the Bhaisajya Ratnavali it is named as an ingredient in an aphrodisiac.[41]

Ayurveda says that both oil and tar can be used to stop bleeding,[17] and that traumatic bleeding can be stopped by four different methods: ligation of the blood vessel, cauterisation by heat, use of preparations to facilitate clotting, and use of preparations to constrict the blood vessels. Oils are also used in a number of ways, including regular consumption, anointing, smearing, head massage, application to affected areas,[42][not in citation given] and oil pulling. Liquids may also be poured on the patient's forehead, a technique called shirodhara.

File:Cataract in human eye.png
Cataract in human eye – magnified view seen on examination with a slit lamp. Cataract surgery is mentioned in the Sushruta Samhita, as a procedure to be performed with a jabamukhi salaka, a curved needle used to loosen the obstructing phlegm and push it out of the field of vision. The eye would later be soaked with warm butter and then bandaged.[43]

Panchakarma[edit]

According to Ayurveda, the technique of panchakarma (Devanāgarī: पंचकर्म‌)) eliminates toxic elements from the body.[20] Panchakarma includes Vamana, Virechana, Basti, Nasya and Raktamokshana. It is preceded by Poorvakarma as a preparatory step, and is followed by Paschatkarma and Peyadikarma.

Current status[edit]

Based on the World Health Assembly resolution on traditional medicine (WHA62.13, compare as well the 2008 Beijing declaration on traditional medicine[44]), the WHO has established a traditional medicine strategy, which involves, among other complementary health systems, Ayurveda.[45][page needed] The first previous global strategy was published in 2002 and dealt especially with herbal medicines. The current version (2014-2023) is beginning to consider aspects of T&CM practices and practitioners and whether and how they should be integrated into overall health service delivery.[45] It is as well part of the 2013 WHO, WIPO, WTO TRIPS study on health innovation and access to medicines.[46]

The WTO[47] mentions Ayurveda in its intellectual property strategy. Traditional medicine, including Ayurveda, contributes significantly to the health status of many communities, and is increasingly used within certain communities in developed countries. Traditional medicine has a long history of use in health maintenance and in disease prevention and treatment, particularly for chronic diseases.[citation needed] Suitable recognition of traditional medicine is an important element of national health policies and has as well important basis for new products with significant export potential.[47] WTO, WIPO and WHO ask for respect for both the economic value and the social and cultural significance of traditional knowledge and supports documentation of traditional medical knowledge and enhanced regulation of quality, safety and efficacy of such products. The WHO paper asks to integrate traditional and complementary medicine services, where appropriate, into health care service delivery and self-health care and to promote an improved universal health coverage by doing so.[45]

India[edit]

According to some sources, up to 80 percent of people in India use some form of traditional medicine, a category which includes Ayurveda.[48][49]

In 1970, the Indian Medical Central Council Act which aimed to standardise qualifications for Ayurveda practitioners and provide accredited institutions for its study and research was passed by the Parliament of India.[50] In 1971, the Central Council of Indian Medicine (CCIM) was established under the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), Ministry of Health and Family Welfare, to monitor higher education in Ayurveda in India.[51] The Indian government supports research and teaching in Ayurveda through many channels at both the national and state levels, and helps institutionalise traditional medicine so that it can be studied in major towns and cities.[52] The state-sponsored Central Council for Research in Ayurvedic Sciences (CCRAS) is designed to do research on Ayurveda.[53] Many clinics in urban and rural areas are run by professionals who qualify from these institutes.[50] As of 2013, India has over 180 training centers offer degrees in traditional Ayurvedic medicine.[19][54]

To fight biopiracy and unethical patents, in 2001 the government of India set up the Traditional Knowledge Digital Library as a repository for formulations of various systems of Indian medicine, such as Ayurveda, Unani and Siddha.[55][56] The formulations come from over 100 traditional Ayurveda books.[57] An Indian Academy of Sciences document quoting a 2003-04 report states that India had 432,625 registered medical practitioners, 13,925 dispensaries, 2,253 hospitals and a bed strength of 43,803. 209 under-graduate teaching institutions and 16 post-graduate institutions.[58] Insurance companies cover expenses for Ayurvedic treatments in case of conditions such as spinal cord disorders, bone disorder, arthritis and cancer. Such claims comprise 5-10 percent of the country's health insurance claims.[59]

Maharashtra Andhashraddha Nirmoolan Samiti, an organisation dedicated to fighting superstition in India, considers Ayurveda to be pseudoscience.[60]

Other countries on the Indian subcontinent[edit]

File:Tulsi-flower.JPG
Tulsi-flower (holy basil), an Ayurvedic herb

About 75%-80% of the population of Nepal use Ayurveda,[61][62] and it is the most practiced form of medicine in the country.[63]

The Sri Lankan tradition of Ayurveda is similar to the Indian tradition. Practitioners of Ayurveda in Sri Lanka refer to Sanskrit texts which are common to both countries. However, they do differ in some aspects, particularly in the herbs used.

In 1980, the Sri Lankan government established a Ministry of Indigenous Medicine to revive and regulate Ayurveda.[64] The Institute of Indigenous Medicine (affiliated to the University of Colombo) offers undergraduate, postgraduate, and MD degrees in Ayurveda Medicine and Surgery, and similar degrees in unani medicine.[65] In the public system, there are currently 62 Ayurvedic hospitals and 208 central dispensaries, which served about 3 million people (about 11% of Sri Lanka's population) in 2010. In total, there are about 20,000 registered practitioners of Ayurveda in the country.[66][67]

According to the Mahavamsa, an ancient chronicle of Sinhalese royalty from the sixth century C.E., King Pandukabhaya of Sri Lanka (reigned 437 BCE to 367 BCE) had lying-in-homes and Ayurvedic hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documented evidence available of institutions dedicated specifically to the care of the sick anywhere in the world.[68][69] Mihintale Hospital is the oldest in the world.[70]

Outside the Indian subcontinent[edit]

Ayurveda is a system of traditional medicine developed during antiquity and the medieval period, and as such is comparable to pre-modern Chinese and European systems of medicine. However, beginning in the 1960s, Ayurveda has been advertised as alternative medicine in the Western world. Due to different laws and medical regulations in the rest of the world, the unregulated practice and commercialisation of Ayurveda has raised ethical and legal issues. In some instances, Ayurvedic practices or terminology have also been adapted specifically for Western consumption, notably in the case of "Maharishi Ayurveda" in the 1980s. In some cases, this involved active fraud on the part of proponents of Ayurveda in an attempt to falsely represent the system as equal to the standards of modern medical research.[71][72][73]

Baba Hari Dass was an early proponent who helped bring Ayurveda to the US in the early 1970s. He taught classes derived from the Suśrutha Saṃhitā and the Charaka Saṃhitha, leading to the establishment of the Mount Madonna Institute, College of Ayurveda, Ayurveda World, and Ayurvedic pharmacy.[clarification needed] He invited several notable Ayurvedic teachers, including Vasant Lad, Sarita Shrestha, and Ram Harsh Singh. The Ayurvedic practitioner Michael Tierra wrote that "[t]he history of Ayurveda in North America will always owe a debt to the selfless contributions of Baba Hari Dass."[74]

In the United States, the practice of Ayurveda is not licensed or regulated by any state. Practitioners of Ayurveda can be licensed in other healthcare fields such as massage therapy or midwifery, and a few states have approved schools teaching Ayurveda.[75]

Classification and efficacy[edit]

Research[edit]

In India, research in Ayurveda is undertaken by the Ministry of AYUSH, an abbreviation for the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, through a national network of research institutes.[76]

In Nepal, the National Ayurvedic Training and Research Centre (NATRC) researches medicinal herbs in the country.[77]

In Sri Lanka, the Ministry of Health, Nutrition and Indigenous Medicine looks after the research in Ayurveda through various national research institutes.

Use of toxic metals[edit]

Rasa shastra, the practice of adding metals, minerals or gems to herbal preparations, may include toxic heavy metals such as lead, mercury and arsenic.[78] The public health implications of metals in rasa shastra in India is unknown.[78] Adverse reactions to herbs are described in traditional Ayurvedic texts, but practitioners are reluctant to admit that herbs could be toxic and that reliable information on herbal toxicity is not readily available. There is a communication gap between practitioners of modern medicine and Ayurveda.[79]

Some traditional Indian herbal medicinal products contain harmful levels of heavy metals, including lead.[80] A 1990 study on Ayurvedic medicines in India found that 41% of the products tested contained arsenic, and that 64% contained lead and mercury.[48] A 2004 study found toxic levels of heavy metals in 20% of Ayurvedic preparations made in South Asia and sold in the Boston area, and concluded that Ayurvedic products posed serious health risks and should be tested for heavy-metal contamination.[81] A 2008 study of more than 230 products found that approximately 20% of remedies (and 40% of rasa shastra medicines) purchased over the Internet from U.S. and Indian suppliers contained lead, mercury or arsenic.[78][82][83]

Heavy metals are thought of as active ingredients by advocates of Indian herbal medicinal products.[80] According to ancient Ayurvedic texts, certain physico-chemical purification processes such as samskaras or shodhanas (for metals) 'detoxicify' the heavy metals in it.[84][85] These are similar to the Chinese pao zhi, although the Ayurvedic techniques are more complex and may involve physical pharmacy techniques as well as mantras. However, these products have nonetheless caused severe lead poisoning and other toxic effects.[82] Between 1978 and 2008, "more than 80 cases of lead poisoning associated with Ayurvedic medicine use [were] reported worldwide".[86] In 2012, the U.S. Centers for Disease Control and Prevention (CDC) linked Ayurvedic drugs to lead poisoning, based on cases where toxic materials were found in the blood of pregnant women who had taken Ayurvedic drugs.[87]

Ayurvedic practitioners argue that the toxicity of bhasmas comes from improper manufacturing processes, contaminants, improper use of Ayurvedic medicine, quality of raw materials and that the end products and improper procedures are used by charlatans.[85]

In India, the government ruled that Ayurvedic products must be labelled with their metallic content.[88] However, in Current Science, a publication of the Indian Academy of Sciences, M. S. Valiathan said that "the absence of post-market surveillance and the paucity of test laboratory facilities [in India] make the quality control of Ayurvedic medicines exceedingly difficult at this time".[88] In the United States, most Ayurvedic products are marketed without having been reviewed or approved by the FDA. Since 2007, the FDA has placed an import alert on some Ayurvedic products in order to prevent them from entering the United States.[89]

History[edit]

The origins of Ayurveda have been traced back to around 5,000 BCE,[90][91][92] when they originated as an oral tradition. Some of the concepts of Ayurveda have existed since the times of Indus Valley Civilization.[92][93] The first recorded forms of Ayurveda as medical texts evolved from the Vedas.[90][91] Ayurveda is a discipline of the upaveda or "auxiliary knowledge" in Vedic tradition. The origins of Ayurveda are also found in Atharvaveda,[94][95] which contains 114 hymns and incantations described as magical cures for disease. There are various legendary accounts of the origin of Ayurveda, e.g. that it was received by Dhanvantari (or Divodasa) from Brahma.[7][17][96] Tradition also holds that the writings of Ayurveda were influenced by a lost text by the sage Agnivesa.[97]

Ayurveda is one of the few systems of medicine developed in ancient times that is still widely practiced in modern times.[98] As such, it is open to the criticism that its conceptual basis is obsolete and that its contemporary practitioners have not taken account of the developments of modern medicine.[99][100] Responses to this situation led to an impassioned debate in India during the early decades of the twentieth century, between proponents of unchanging tradition (śuddha "pure" ayurveda) and those who thought ayurveda should modernise and syncretize (aśuddha "impure, tainted" ayurveda).[101][102][103] The political debate about the place of ayurveda in contemporary India has continued to the present (2015), both in the public arena and in government.[104] Debate about the place of Ayurvedic medicine in the contemporary internationalized world also continues today (2015).[105][106]

Main texts[edit]

There are three principal early texts on Ayurveda, the Charaka Samhita, the Sushruta Samhita and the Bhela Samhita. The Sushruta Samhita is based on an original from the 6th century BCE,[107][108] and was updated by the Buddhist scholar Nagarjuna in the 2nd century CE.[109] The Charaka Samhita, written by Charaka, and the Bhela Samhita, attributed to Atreya Punarvasu, are also dated to the 6th century BCE.[110][111][112] The Charaka Samhita was also updated by Dridhabala during the early centuries of the Common Era.[113]

The Bower Manuscript includes of excerpts from the Bheda Samhita[114] and its description of concepts in Central Asian Buddhism. In 1987, A. F. R. Hoernle identified the scribe of the medical portions of the manuscript to be a native of India using a northern variant of the Gupta script, who had migrated and become a Buddhist monk in a monastery in Kucha. The Chinese pilgrim Fa Hsien (c. 337–422 AD) wrote about the healthcare system of the Gupta empire (320–550) and described the institutional approach of Indian medicine. This is also visible in the works of Charaka, who describes hospitals and how they should be equipped.[115]

Other early texts are the Agnivesha Samhita, Kasyapa Samhita and Harita Samhita. The original edition of the Agnivesha Samhita, by Agnivesa, is dated to 1500 BCE,[116] and it was later modified by Charaka.[117] Kasyapa Samhita includes the treatise of Jivaka Kumar Bhaccha[118] and is dated to the 6th century BCE.[119][120] While Harita Samhita is dated to an earlier period, it is attributed to Harita, who was a disciple of Punarvasu Atreya.[121] Some later texts are Astanga nighantu (8th Century) by Vagbhata, Paryaya ratnamala (9th century) by Madhava, Siddhasara nighantu (9th century) by Ravi Gupta, Dravyavali (10th Century), and Dravyaguna sangraha (11th century) by Cakrapanidatta, among others.[122]

Illnesses portrayed[edit]

Underwood and Rhodes state that the early forms of traditional Indian medicine identified fever, cough, consumption, diarrhea, dropsy, abscesses, seizures, tumours, and leprosy,[17] and that treatments included plastic surgery, lithotomy, tonsillectomy, [123] couching (a form of cataract surgery), puncturing to release fluids in the abdomen, extraction of foreign bodies, treatment of anal fistulas, treating fractures, amputations, cesarean sections,[125][123][disputed ] and stitching of wounds.[17] The use of herbs and surgical instruments became widespread.[17] During this period, treatments were also prescribed for complex ailments, including angina pectoris, diabetes, hypertension, and stones.[3][126]

Further development and spread[edit]

Ayurveda flourished throughout the Indian Middle Ages. Dalhana (fl. 1200), Sarngadhara (fl. 1300) and Bhavamisra (fl. 1500) compiled works on Indian medicine.[127] The medical works of both Sushruta and Charaka were also translated into the Chinese language in the 5th century,[128] and during the 8th century, they were translated into the Arabic and Persian language.[129] The 9th-century Persian physician Muhammad ibn Zakariya al-Razi was familiar with the text.[130][131] The Arabic works derived from the Ayurvedic texts eventually also reached Europe by the 12th century.[132][133] In Renaissance Italy, the Branca family of Sicily and Gaspare Tagliacozzi (Bologna) were influenced by the Arabic reception of the Sushruta's surgical techniques.[133]

British physicians traveled to India to observe rhinoplasty being performed using native methods, and reports on Indian rhinoplasty were published in the Gentleman's Magazine in 1794.[134] Instruments described in the Sushruta Samhita were further modified in Europe.[135] Joseph Constantine Carpue studied plastic surgery methods in India for 20 years and, in 1815, was able to perform the first major rhinoplasty surgery in the western world, using the "Indian" method of nose reconstruction.[136] In 1840 Brett published an article about this technique.[137]

During the period of colonial British rule of India, the practice of Ayurveda was neglected by the British Indian Government, in favor of modern medicine. After Indian independence, there was more focus on Ayurveda and other traditional medical systems. Ayurveda became a part of the Indian National health care system, with state hospitals for Ayurveda established across the country. However, the treatments of traditional medicines were not always integrated with others.[138]

Traditions of Ayurveda[edit]

Template:References Three traditions of Ayurveda exist today — two of them based on the compendia of Charka and Sushruta Samhitās, and a third tradition known as Kāshyapas. However, Ayurvedic remedies prior to these traditions also exist, as mentioned in the earlier Vedic literature (2nd millennium BC). Both the Sushruta and the Charaka Samhitās are the product of several scholars, having been revised and supplemented over a period of several hundred years. The scholar Vāgbhata, who lived in Sindh at the beginning of the 7th century AD, wrote a synthesis of earlier Ayurvedic materials in a collection of verses called the Ashtānga Hridayam. Another work associated with the same author, the Ashtānga Samgraha, contains much of the same material in a more diffuse form, written in a mixture of prose and verse. The relationship between these two works, and a third intermediate compilation, is still a topic of active research. The works of Charaka, Sushruta, and Vāgbhata are considered canonical and reverentially called the Vriddha Trayi, "The Triad of Ancients"; or Brhat Trayi, "The Greater Triad." In the early 8th century, Mādhav wrote his Nidāna, a work on etiology, which soon assumed a position of authority. In the 79 chapters of this book, he lists diseases along with their causes, symptoms, and complications.

Post Brhat Trayi period[edit]

The Brhat Trayi (literally "the three great compositions") is a classic Ayurvedic literary work, which was composed, compiled, and edited by Vagbhatta II, under the title Ashtānga Samgraha. At one time, it was believed that those who read and fully understood the contents of Vriddha Trayi and the Brhat Trayi, were good practitioners of Ayurveda. Legends concerning the origins of the text refer to the Ayurvedic practitioner Vāgbhata who lived during the time of the epic Mahabharata and was the chief physician of king Yudhisthir. Most believe that the author of the Ashtānga Samgraha was born before 200 AD and is properly known as Vāgbhata the 1st. Another man named Vāgbhata (who was born about 100 BC) recomposed the text, including the writings of Charaka, Sushruta under a new title Astang Hridaya.

Mythology also refers to another Ayurvedic physician known as Vangsen. Myths place him in ancient Bengal where he wrote a classic Ayurvedic book, simply called Vangsen. The book is written in easy and understandable language and adds many new chapters to the previous texts.

After Vangsen, a scholar by the name of Madhavacharya composed the book, Madhav Nidan. He is thought to have been the prime minister for the Emperor of Vijaynagara. Madhav Nidan is widely considered the best Ayurvedic book for the diagnosis of some diseases known during that period.

After Madhav Nidan, the next in line of famous Ayurvedic books Bhav Prakash was written during the time that the Portuguese first came to India in 1498 by a man named Bhav Mishra of Madras. The period in which he wrote can be pinpointed accurately because in the Bhav Prakash, he described the symptoms of a disease called "Firang" (Gonorrhoea and Syphilis), which was introduced to the subcontinent through contact with Europeans. ("Firangi" was a Persian-derived pejorative for Europeans in India, who brought the diseases with them). Bhav Mishra's other contribution to Ayurvedic medicine was the introduction of pulse examination / pulse diagnosis.

Many writers after Bhav Mishra contributed to Ayurvedic literature. Among them Sharangdhar, Chakra Dutta, Vaidya Vinod, Vaidya Vamanotsava, Bhaisajya Ratnawali, and the Lolimb Raj, who wrote the Vaidya Jeevan in verse form. The first lines of the verses of the Vaidya Jeevan are addressed to the author's "beloved", while the rest of the verse has contains information about curing diseases.

About 200 years ago, Pranacharya Shri Sadanand Sharma wrote the Ras Tarangini, which was the "base book" for modernizing Ayurveda practices. In this book, advances in chemistry are included. The book describes the use of many chemical substances as medicine and their successful uses. Upon considering the advice of this book, Ayurvedic practitioners began to process the traditional herbs in sulphate, nitrate, muriate, phosphate and nitromuriate forms. Sarpagandha [Latin: Rauwolfia Serpentina] Muriate, Sarpagandha Sulphate, Sarpagandha Phosphate, Sarpagandha Nitrate, Sarpagandha nitromuriate and many others have been prepared and tested on patients.The Ras Tarangini mentiones "Shankhadrav", which is a medicine used internally and externally in many disease conditions. Shankhadrav-based herbal medicine, invented by an Indian physician, is regarded by the National Innovation Foundation, Ahmedabad, India.

Anti-Ayurveda bias[edit]

See Anti-Ayurveda bias

See also[edit]

The three humors of the body (tri-dosha) are: Vata (Wind, Indra, Vata) Pitta (Gall, Agni, pitta, fire) Kapha (Phlegm, Soma, Kapha, Water)

Further reading[edit]

See Bibliography on Ayurveda

References[edit]

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Cited references

External links[edit]

http://ayush.gov.in/sites/default/files/Ayurvedic%20Pharmacopoeia%20of%20India%20part%201%20volume%20IX.pdf https://nccih.nih.gov/health/ayurveda/introduction.htm

https://www.exploremyindia.in/ancient-indian-medicine-torch-bearer-to/


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