Ayurveda (Sanskrit: आयुर्वेद;
Āyurveda, "the knowledge for long life"; /ˌaɪ.ərˈveɪdə/) 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, i.e., in the
mid-second millennium BCE. The Suśruta Saṃhitā and the Charaka Saṃhitā,
encyclopedias of medicine compiled from various sources from the
mid-first millennium BCE to about 500 CE, are among the foundational
works of Ayurveda. Over the following centuries, ayurvedic practitioners
developed a number of medicinal preparations and surgical procedures
for the treatment of various ailments. Current practices derived (or
reportedly derived) from Ayurvedic medicine are regarded as part of
complementary and alternative medicine. Dhanvantari (धन्वंतरी), known as an avatar of Vishnu is the Hindu god associated with Ayurveda.
Safety concerns have been
raised about Ayurveda, with two U.S. studies finding about 20 percent
of Ayurvedic Indian-manufactured patent medicines contained toxic levels
of heavy metals such as lead, mercury and arsenic. Other concerns
include the use of herbs containing toxic compounds and the lack of
quality control in Ayurvedic facilities.
Approach
The three doṣas and the 5 elements from which they are composed.
At
an early period, 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. 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). 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. 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.
Ayurveda also focuses on exercise, yoga, and meditation.
The practice of panchakarma (Devanāgarī: पंचकर्म) is a therapeutic way of eliminating toxic elements from the body.
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:
Internal medicine (Kāya-cikitsā)
Paediatrics (Kaumārabhṛtyam)
Surgery (Śalya-cikitsā)
Opthalmology and ENT (Śālākya tantra)
Psychiatry has been called Bhūta vidyā .
Toxicology (Agadatantram)
Prevention of diseases and improving immunity and rejuvenation (rasayana)
Aphrodisiacs and improving health of progeny (Vajikaranam)
In Hindu mythology, the origin of ayurvedic medicine is attributed to Dhanvantari, the physician of the gods.
Practices
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)—who wrote medical works The Hundred
Prescriptions and The Precious Collection, among others.
Balance
Hinduism
and Buddhism have been an influence on the development of many of
ayurveda's central ideas – particularly its fascination with balance,
known in Buddhism as Madhyathmaka (Devanāgarī: माध्यात्मिक). Balance is
emphasized; suppressing natural urges is seen to be unhealthy, and doing
so claimed to lead to illness. However, people are cautioned to stay
within the limits of reasonable balance and measure. For example,
emphasis is placed on moderation of food intake, sleep, sexual
intercourse.
Diagnosis
Ayurvedic practitioners approach
diagnosis by using all five senses. Hearing is used to observe the
condition of breathing and speech. The study of the lethal points or
marman marma is of special importance. Ayurvedic doctors regard physical
and mental existence together with personality as a unit, each element
having the capacity to influence the others. One of the fundamental
aspects of ayurvedic medicine is to take this into account during
diagnosis and therapy.
Hygiene
Hygiene is a central practice
of ayurvedic medicine. Hygienic living involves regular bathing,
cleansing of teeth, skin care, and eye washing.
Treatments
Head massage is used to apply oils.
Ayurveda
stresses the use of plant-based medicines and treatments. Hundreds of
plant-based medicines are employed, including cardamom and cinnamon.
Some animal products may also be used, for example milk, bones, and
gallstones. In addition, fats are used both for consumption and for
external use. Minerals, including sulfur, arsenic, lead, copper sulfate
and gold are also consumed as prescribed. This practice of adding
minerals to herbal medicine is known as rasa shastra.
In some
cases, alcohol was used as a narcotic for the patient undergoing an
operation. The advent of Islam introduced opium as a narcotic. Both oil
and tar were used to stop bleeding.[10] Traumatic bleeding was said to
be stopped by four different methods: ligation of the blood vessel;
cauterisation by heat; using different herbal or animal preparations
locally which could facilitate clotting; and different medical
preparations which could constrict the bleeding or oozing vessels.
Various oils could be used in a number of ways, including regular
consumption as a part of food, anointing, smearing, head massage, and
prescribed application to infected areas.
Srotas
Ensuring the
proper functions of channels (srotas) that transport fluids from one
point to another is a vital goal of ayurvedic medicine, because the lack
of healthy srotas is thought to cause rheumatism, epilepsy, autism,
paralysis, convulsions, and insanity. Practitioners induce sweating and
prescribe steam-based treatments as a means to open up the channels and
dilute the doshas that cause the blockages and lead to disease.
History
The
mantra Om mani padme hum written on rocks. Chanting mantras has been a
feature of ayurveda since the Atharvaveda, the vedic spiritual text, was
compiled.
One view of the early history of ayurveda asserts that
around 1500 BC, ayurveda's fundamental and applied principles got
organized and enunciated. In this historical construction, Ayurveda
traces its origins to the Vedas, Atharvaveda in particular, and is
connected to Hindu religion. Atharvaveda (one of the four most ancient
books of Indian knowledge, wisdom and culture) contains 114 hymns or
formulations for the treatment of diseases. Ayurveda originated in and
developed from these hymns. In this sense, ayurveda is considered by
some to have divine origin. Indian medicine has a long history, and is
one of the oldest organised systems of medicine. Its earliest concepts
are set out in the sacred writings called the Vedas, especially in the
metrical passages of the Atharvaveda, which may possibly date as far
back as the 2nd millennium BC. According to a later writer, the system
of medicine was received by Dhanvantari from Brahma, and Dhanvantari was
deified as the god of medicine. In later times his status was gradually
reduced, until he was credited with having been an earthly king named
Divodasa.
Cataract in human eye – magnified view seen on examination
with a slit lamp. Cataract surgery was known to the physician Sushruta
in the early centuries of the first millennium AD, and was performed
with a special tool called the 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.
Underwood
& Rhodes (2008) hold that this early phase of traditional Indian
medicine identified "fever (takman), cough, consumption, diarrhea,
dropsy, abscesses, seizures, tumours, and skin diseases (including
leprosy)". Treatment of complex ailments, including angina pectoris,
diabetes, hypertension, and stones, also ensued during this period.
Plastic
surgery, couching (a form of cataract surgery), puncturing to release
fluids in the abdomen, extraction of foreign elements, treatment of anal
fistulas, treating fractures, amputations, cesarean sections, and
stitching of wounds were known. The use of herbs and surgical
instruments became widespread. The Charaka Samhita text is arguably the
principal classic reference. It gives emphasis to the triune nature of
each person: body care, mental regulation, and spiritual/consciousness
refinement.
Other early works of ayurveda include the Charaka
Samhita, attributed to Charaka. The earliest surviving excavated written
material which contains references to the works of Sushruta is the
Bower Manuscript, dated to the 6th century AD. The Bower manuscript is
of special interest to historians due to the presence of Indian medicine
and its concepts in Central Asia. Vagbhata, the son of a senior doctor
by the name of Simhagupta, also compiled his works on traditional
medicine. Early ayurveda had a school of physicians and a school of
surgeons. Tradition holds that the text Agnivesh tantra, written by the
sage Agnivesh, a student of the sage Bharadwaja, influenced the writings
of ayurveda.
The Chinese pilgrim Fa Hsien (ca. 337–422 AD) wrote
about the health care system of the Gupta empire (320–550) and
described the institutional approach of Indian medicine, also visible in
the works of Charaka, who mentions a clinic and how it should be
equipped. Madhava (fl. 700), Sarngadhara (fl. 1300), and Bhavamisra (fl.
1500) compiled works on Indian medicine. The medical works of both
Sushruta and Charaka were translated into the Arabic language during the
Abbasid Caliphate (ca. 750). These Arabic works made their way into
Europe via intermediaries. In Italy, the Branca family of Sicily and
Gaspare Tagliacozzi (Bologna) became familiar with the techniques of
Sushruta.
British physicians traveled to India to see rhinoplasty
being performed by native methods. Reports on Indian rhinoplasty were
published in the Gentleman's Magazine in 1794. Joseph Constantine Carpue
spent 20 years in India studying local plastic surgery methods. Carpue
was able to perform the first major surgery in the western world in
1815. Instruments described in the Sushruta Samhita were further
modified in the Western World.
Current status
A typical ayurvedic Pharmacy, Rishikesh.
India
According
to some sources up to 80 percent of people in India use some form of
traditional medicines, a category which includes Ayurveda.
In
1970, the Indian Medical Central Council Act which aims to standardize
qualifications for ayurveda and provide accredited institutions for its
study and research was passed by the Parliament of India. In India, over
100 colleges offer degrees in traditional ayurvedic medicine. The
Indian government supports research and teaching in ayurveda through
many channels at both the national and state levels, and helps
institutionalize traditional medicine so that it can be studied in major
towns and cities. The state-sponsored Central Council for Research in
Ayurvedic Sciences (CCRAS) has been set up to research the subject. To
fight biopiracy and unethical patents, the Government of India, in 2001,
set up the Traditional Knowledge Digital Library as repository of 1200
formulations of various systems of Indian medicine, such as ayurveda,
unani and siddha.[36][37] The library also has 50 traditional ayurveda
books digitized and available online.
Central Council of Indian
Medicine (CCIM) a statutory body established in 1971, under Department
of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy
(AYUSH), Ministry of Health and Family Welfare, Government of India,
monitors higher education in ayurveda. Many clinics in urban and rural
areas are run by professionals who qualify from these institutes.
Sri Lanka
The
Sri Lankan tradition of Ayurveda is very similar to the Indian
tradition. Practitioners of Ayurveda in Sri Lanka refer to texts on the
subject written in Sanskrit, which are common to both countries.
However, they do differ in some aspects, particularly in the herbs used.
The
Sri Lankan government has established a Ministry of Indigenous Medicine
(established in 1980) to revive and regulate the practice within the
country The Institute of Indigenous Medicine (affiliated to the
University of Colombo currently offers undergraduate, postgraduate, and
MD degrees in the practice of Ayurveda Medicine and Surgery, and similar
degrees in unani medicine.
There are currently 62 Ayurvedic
Hospitals and 208 central dispensaries in the public system, and they
served almost 3 million people (approximately 11 percent of Sri Lanka's
total population) in 2010. In total there are currently approximately
20,000 registered practitioners of Ayurveda in the country.
Many
Sri Lankan hotels and resorts offer Ayurveda themed packages, where
guests are treated to a wide array of Ayurveda treatments during their
stay.
Outside South Asia
Due to different laws and medical
regulations in the rest of the world, the unregulated practice and
commercialization of ayurvedic medicine has raised ethical and legal
issues; in some cases, this damages the reputation of ayurvedic medicine
outside India.
Scientific appraisal
In studies in mice, the leaves of Terminalia arjuna have been shown to have analgesic and anti-inflammatory properties.
As
a traditional medicine, many ayurveda products have not been tested in
rigorous scientific studies and clinical trials. In India, research in
ayurveda is undertaken by the statutory body of the Central Government,
the Central Council for Research in Ayurveda and Siddha (CCRAS), through
a national network of research institutes.[48] A systematic review of
ayurveda treatments for rheumatoid arthritis concluded that there was
insufficient evidence, as most of the trials were not done properly, and
the one high-quality trial showed no benefits. A review of ayurveda and
cardiovascular disease concluded that the evidence for ayurveda was not
convincing, though some herbs seemed promising.
Two varieties of
Salvia have been tested in small trials; one trial provided evidence
that Salvia lavandulifolia (Spanish sage) may improve word recall in
young adults, and another provided evidence that Salvia officinalis
(Common sage) may improve symptoms in Alzheimer's patients. Many plants
used as rasayana (rejuvenation) medications are potent antioxidants.
Neem appears to have beneficial pharmacological properties.
Safety
Rasa
shastra, the practice of adding metals, minerals or gems to herbs, may
have toxic heavy metals such as lead, mercury and arsenic.
Adverse
reactions to herbs due to their pharmacology are described in
traditional ayurvedic texts, but ayurvedic practitioners are reluctant
to admit that herbs could be toxic and that reliable information on
herbal toxicity is not readily available. And there is communication gap
between modern medicine practitioners and Ayurvedic practitioners
According
to a 1990 study on ayurvedic medicines in India, 41 percent of the
products tested contained arsenic, and 64 percent contained lead and
mercury.
A 2004 study found toxic levels of heavy metals in 20
percent 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.
A 2008
study of more than 230 products found that approximately 20 percent of
remedies (and 40 percent of rasa shastra medicines) purchased over the
Internet from both US and Indian suppliers contained lead, mercury or
arsenic.
In 2012 Center for Disease Control and Prevention (CDC)
in Washington states in its report that Ayurvedic drugs has links to
lead poisoning on the basis of some cases presented where some pregnant
woman had taken Ayurvedic drugs toxic materials were found in their
blood.
Ayurvedic proponents believe that the toxicity of these
materials is reduced through purification processes such as samskaras or
shodhanas (for metals), similar to the Chinese pao zhi, although the
ayurvedic technique is more complex and may involve prayers as well as
physical pharmacy techniques. However, these products have nonetheless
caused severe lead poisoning and other toxic effects.
Due to
these concerns, the Government of India ruled that ayurvedic products
must specify their metallic content directly on the labels of the
product, but, writing on the subject for Current Science, a publication
of the Indian Academy of Sciences, M. S. Valiathan noted 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. |
