Ayurveda - The Indian system of nature

Life is a combination of the body, senses, the mind and the atma (soul). They cannot be separated from each other and none can be neglected. From this combination ensues 'Ayur'- the span of life. Ayurveda- the science of life is the knowledge of this association and of how to maintain it as long as possible. Ayus- means life which is a proper combination of body, mind, sense organs and the soul. Veda- means knowledge. This system of medicine evolved around 600 BC in India. Ayurveda is known to promote positive health, natural beauty and long life.

Ayurveda believes that human beings and nature should be in perfect harmony and that disease occurs when the equilibrium between these two is disrupted. Restoration of this fundamental balance, through the use of nature and its products is the main goal of this medical system. The concept is not just on curing bodily ailments but also on preventing it.

Ayurvedic treatments are person specific rather than disorder specific. The age of the patient, the climate in which he lives, his cultural and social surroundings and his bodily constitution are taken into account before offering a prognosis. Touch, Inspection and interrogation are the main tools of diagnosis. Then the physician emphasizes a regimen of diet with the use of herbal medicines. Herbs are used to eliminate excesses and strengthen deficiencies. Their primary action is to stimulate particular organic functions. Thus Ayurveda aims to solve many health problems, only through the adjustment of diet-so there are no distressing side effects. Such an approach has proven effective over the centuries and has today become an internationally acclaimed form of healing, rejuvenation and healthy living.

Origin

Indian medicine is described as having a divine origin in the different ancient medical texts. Different authors has given different versions of the story. These stories may have been circulated to make the system more acceptable to the people in ancient times. In all these Samhitas or medical texts, 'Brahma' the omniscient Hindu god is said to have originated Ayurveda before the creation of man, for their protection. Brahma first taught Ayurveda to the twin physicians of the gods; the Aswins, and they passed it on to Indra (lord of the sky) and from Indra it was passed on to the different sages who in turn passed it on to their sons and disciples. Thus Ayurveda - the science of longevity spread.

Historically, the origin of Indian medicine can be traced to the Vedic periods or Vedas - especially to 'Atharva Veda' which mentions 2 systems of medicine; first, the system predominantly of charms and magico-religious medicine; second, the system of drugs used on an empirical basis. The change in the outlook of medicine from the magico-religious to the physical causation and theories could be the result of the philosophical concepts of the 'Nyaya Vaisesika' and the 'Samkhya' on which the theoretical structure of the Ayurdeva came to be based.

The 'Atharva Veda' consists pre-dominantly of Bhutavidya (Psychiatry) and Sarpavidya (agada or toxicology). Besides the above two, Rasayana (geriatrics or the science of rejuvenation) and Vajikarana (virilisation therapy) are also traceable in the 'Brahmanas' and the 'Upanishads'. The Ayurveda contains besides the above four divisions, another four namely 'Salya' (surgery), 'Salyaka' (ENT and ophthalmology), 'Kaya-Chikitsa' (internal medicine) and 'Kaumara- Bhrtya' (paediatrics). The knowledge about these latter four divisions did exist before, but it became systemic with the origin of Astanga Ayurveda (Eight-divisional Ayurveda) roughly between 800-600BC.

Another school of thought expressed lately is that, Ayurveda, in its eight Specialities, the 'Ashtangas' was not a direct outcome of the earlier Vedic medicine but must have existed even before the Vedas. The medical knowledge and experience of the Vedic times must have served as a background on which the new knowledge exotic in origin was planted, leading to the synthesis of the two.

Influence of the Indian schools of philosophy

The theory of 'Pramanus' which came to be known as the 'Vaisesika' ('Vaisesa' means peculiarity) theory was propounded by Kanada in the sixth century BC. According to Kanada, everything in the Universe is made up of 'Pramanus'; the real entities which are obtained when a thing is divided and sub-divided until further division is not possible. 'Pramanus' combine together in various fashions and it is by their combination that they give rise to the Universe and all its contents.

According to 'Vaisesika theory', whatever is in the Universe can be broadly placed under six categories (Padarthas), one of these categories is substance (dravya), which can be sub divided into nine entities, five of which are earth (Kshiti), water (apa), fire (teja), air (vayu) and ether (akasa). It is these five types of substance which supplied the 'Panchabhuta' or the five concepts of matter and this forms the basis of the Indian medical system of Ayurveda.

Vaisesika philosophy describes the manner in which combinations of different types of 'Pramanus' occur, producing the various substances that we see around us. This combinations can cause even chemical reactions under the influence of 'Teja' (fire). This chemical reaction, provided the basis for the concept of digestion and metabolism of food and its conversion into 'dhatus' and 'doshas' of the body, upon which was built the theory of 'Tridosha'. Thus the contribution of Vaisesika to the systematization and development of Ayurveda is fundamental.

Another sage, Gotama Aksapada composed 'Nyaya Sutra' which explains all the knowledge needed to establish the identity of a fact or substance. According to 'Nyaya', there are four methods of establishing the true identity of a fact, a phenomenon or an object. They are perception (pratyaksa), inference (anumana), comparison (uhamana) and testimony (aptavakya). These four methods of Nyaya based on the physical experience of things, have been made use of extensively in the study of action of various drugs included in Indian medicine. Thus the contribution of the Nyaya system of philosophy to Ayurvedic medicine in establishing scientific methodology is as great as the contribution of the Vaisesika to Ayurveda.

The contribution of the 'Samkhya' philosophy to the fundamental basis of Ayurvedic medicine is not as much as that of the Nyaya and the Vaisesika, but its basic tenets are woven in different forms around Ayurvedic medicine. According to the Samkhya theory expounded by Kapila around the 6th century BC, the universe evolved out of an un-manifested, undifferentiated, infinite and eternal primordial ground termed 'Prakriti'. This is made up of three basic entities called 'gunas'. There are three gunas. The first guna 'Tamas' or matter, has the property of inertia. The second, 'rajas' or energy, has the property of overcoming resistance. The third, 'Sattva' oressence, has the property to manifest itself to the senses. According to Samkhya, gunas are always uniting, separating and uniting again so that cosmic evolution is a two fold process, creative as well as destructive.

Some of the terms used in these systems of philosophy have been modified in Ayurvedic treatises. It is to the influence of these schools of philosophy that Indian medicine is indebted, which led medical men to gradually substitute causation of disease from spiritual agencies of animism to physical attributes.

Forms of Drugs

In Ayurveda, there are thousands of drugs including herbs, minerals and biological products to be used singly or in the form of compounds. These drugs are used in the form of

Paste - prepared by grinding the fresh vegetable on stone with pressure.

Powder (churnas ) - prepared from dry drugs and usually stored in glass bottles.

Expressed juice (Swarasa) - It is prepared by grinding the fresh vegetables on mortar with a pestle and then expressing the juice by straining through a cloth.

Cold infusion (Sheeta Kashaya) - To one part of powdered herb, 6 parts of water is added in the night and strained in the morning and used.

Infusion (Phanta) - It is prepared by adding one part of powdered herb and 8 parts of hot water, kept at room temperature for some time and strained over a cloth.

Decoction (Quatha or Kashayam) - One part of Vegetable substance is boiled with 16 parts of water and reduced to 1/4th. This can be used upto 12 hrs.

Decoctions in Milk (Ksheera Paka) - To 1 part of drug, 8 parts milk and 32 parts of water are added, boiled and reduced to 8 parts. It can be used up to 12 hrs.

Extracts - The decoctions are boiled to thick paste and are used with sugar.

Pills - These are Vatika and Gutikas.

Boluses - Modaka are prepared by adding powder to cold syrup and stirred till firmly mixed.

Asavas and Arishtas ( Medicated spirited liquid) - These are prepared by fermentation. These drugs are usually kept in water and earthen jars for some days or months. These can be kept for a longer period.

Ghrita (Medicated ghee) - It is nothing but clarified butter gently heated in an earthen pot or pan. Then medicated fluids or pastes are added to it till the water parts evaporates and it is free from froth.

Literature

Charaka Samhita

It is a massive treatise on ancient Indian medicine. It contains 8 divisions (Astanga Sthanas): Sutra, Nidana, Vimana, Sarira, Endriya, Chikitsa, Kalpa and Siddha-Sthanas. Each division is further divided into numerous chapters. It describes not only the existing knowledge about medicine in all aspects but also the logic and philosophy behind the medical system.

The present manuscript of Charaka Samhita has a long history behind it. It was originally composed by Agnivesa, one of the six students of sage Atreya and embodied the latter's teachings. Charaka is one of the best known and the most popular name, in Ayurvedic medicine. During the 7th, 8th and 9th centuries when Arabic scholarship was at its height, Charaka was a revered authority in the Saracen and Latin worlds of medicine. Between the eleventh and sixteenth centuries, Charaka was referred to as a great medical authority. Charaka may have lived between the second century BC to second century AD.

During the ninth Century AD, 'Charaka Samhita' was again edited and reconstructed by a Kashmiri Pandit named Dridhabala, a resident of Panjore, situated 7 miles north of Srinagar. He added 17 chapters in the section on Therapeutics (Chikitsa-sthana) and also the two complete sections on Pharmaceutics (Kalpa sthana) and success in treatment (siddhi sthana) by collecting his data from various treatises on the Ayurvedic science. The present form which Charaka Samhita has, was given to it by Dridhabala. It was first translated from Sanskrit into English by A.C Kaviratna in 1897.

Charaka Samhita deals elaborately with subjects such as foetal generation and development, anatomy of the human body, function and malfunction of the body depending upon the equilibrium or otherwise of the 3 humours of the body; Vata, pitta, and Kapha. It describes etiology, classification, pathology, diagnosis, prognosis, treatment of various diseases and the science of rejuvenation of the body. It discusses elaborately the etiology of diseases on the basis of Tridosha theory. It gives a detailed description of the various diseases including those of the eyes, the female genital organs, normal and abnormal deliveries and diseases of children. Charaka's materia- Medica, consists chiefly of Vegetable products though animal and earthy products are also included in it. All these drugs are classified into 50 groups on the basis of their action on the body.

This Vast treatise also gives an idea of the various categories of doctors specializing in different medical subjects, the physicians and their fees, nursing care, centers of medical learning, schools of philosophy such as 'Nyaya' and 'Vaisesika' which formed the fundamental basis of medical theories, medical botany and classification of the animal kingdom, particularly in regard to properties of their flesh etc. It also describes various customs, tradition, legends, routine of daily life, habits of smoking and drinking, dress and clothing of the people of that era.

Commentary on Charaka Samhita by Chakrapanidatta called 'Charaka-tatparya-tika' or 'Ayurveda Dipika' written in the 11th cent AD(1066AD) is very famous. Other commentaries are by Patanjali (not available), Hair Chandras in AD 111 ( not available), Japjjatas 'Nirantar-Pad-Vyakha', Shiva Das's 'Charaka-tattva-Pradipika' and Ganga Dhar's 'Jalpa-Kalpa-taru' in AD 1879.

Susrutha Samhita

This is the main source of knowledge about surgery in ancient India. Susrutha's original version 'Salya Tantra' was later revised and supplemented by another Susrutha (the younger). It came to be known as 'Susrutha Samhita'. Susrutha's Salya tantra consisted of only 5 divisions. Sutra, nidana, Sarira, Chikitsa and Kalpa. Later additions of 'Uttara Tantra' consisting of 3 divisions called Salyaka (diseases of eye, ear, nose and throat) Bhuta Vidya and Kaumara Bhrtya (diseases peculiar to infants and women ) were done by the younger Susrutha to make 8 divisions in the present 'Susrutha Samhita'.

Susrutha of 'Salya-tantra' was a great surgeon, a teacher of repute and an admirable author. He made great improvements in the general techniques of surgery and performed many new and major operations. He also described a variety of surgical instruments. His technique of dissection is unique, practical and revealing of the structure of the body. His operations for making a new nose or ear lobe of lithotomy, of taking out the dead foetus and abdominal operations are classical marvels.

Of the commentaries on 'Susrutha Samhita', the most renowned is that of Dalhana called 'Nibandha Samgraha' written in the twelfth cent AD. Susrutha Samhita was translated into English in part only by U.C Datta (1883), A Chattopadhyay (1891), Hoernle (1897). K.L Bhisagaratna transalated it in full between the years 1908 and 1917.

Other Medical Texts

The other Samhitas (medical texts) in Ayurveda are 'Bhela Samhita', Kasyapa Samhita which deals in childrens diseases, 'Astanga Samgraha' and 'Astanga Hridya Samhita' by Vagbhata, 'Chikitsa- Kalika' by Tishtacharya, 'Madhavanidana' or 'Nidana' by Madhavakara, 'Kalyana Karaka' by Ugradilyacharya, a Jain scholar, 'Siddha Yoga' by Vrinda. Vangasena and Chakrapanidatta composed their own treatises on the lines of Vrinda's 'Siddha Yoga', Nadipriksha( Pulse examination) was first mentioned in 'Sarangadhara Samhita' by Sarangadhara.

Branches of Ayurveda

There are 8 branches in Ayurveda ('Ashtanga Ayurveda') :

1. Kayachikitsa (Internal Medicine) - It deals with the diseases which are caused by the impairment of digestion and metabolism. 'Kaya' means agni (Digestive fire) or the enzymes responsible for the digestion as well as metabolism.

2. Koumara Brutya (Paediatrics)

3. Bhoota Vaidya (Psychiatry)

4. Agadatantra (Toxicology)

5. Shalakya Tantra (ENT and Ophthalmology)

6. Shalya Tantra (Surgery)

7. Rasayana (Geriatrics) - Science of Rejuvenation. It deals with health and care of old people.

8. Vajeekarana (Virilisation Therapy)

Treatment methods

Therapy or treatment is that which serves as an equipment for a physician to maintain the equilibrium of disturbed dosha. In this point of view treatment methods are divided into three types  i.e., Daivavyapasrayam (Spiritual therapy), Yuktivyapasrayam (Therapy based on reasoning) and Satvavajayam (Psychic therapy).

Treatment methods are again classified into two: (a) Preventive measures and (b) Curative measures

Preventive measures of Ayurveda

The specialty of Indian Medicine lies in the prevention of the disease. Preventive measures consists of mainly three aspects.

• Swastavritta (Personal hygiene) consists of Dinacharya (daily routine of life) including tooth brushing, mouth wash, bath, exercise, meals and sleep etc, Ritucharya which deals with the regimens and diet to be followed in the different seasons of the year, Sadvritta deals with the social behaviour and different conducts of an individual in detail.

• Rasayana and Vajeekarana - Use of rejuvenative and virilising agents to prevent ageing, impact longevity, immunity against diseases and to improve mental faculties. Vajeekarana drugs are special in nature used as aphrodisiac and fertility improving agents.

• Practice of yoga - It is necessary to adopt Yoga therapy in order to keep the body and mind hale and healthy and to prevent diseases.

Curative Measures of Ayurveda

Curative measures are :

1. Internal Medicine

2. External Medicine

3. Surgical Treatment

1. Internal Medicine

It is a major discipline in the practice of Ayurveda. The 2 aspects of Internal medicine are (a) Internal purification (b) curative treatment

Internal Purification or Sodhana consists of the 5 fold purificatory measures known as 'Panchakarma'. This includes Vamana, Virechana, Vasti, Nasya (Watch Video)and Rakthamoksha (blood letting). This therapy has to be done before the administration of drug therapy, rejuvenation therapy and surgery. Ayurveda is of the firm opinion that no drug therapy will yield the desired results without purifying the body properly.

Curative treatment consists of drugs, diet and exercise.

2. External Medicine

It includes Oleation (Snehanam), Sudation (Swedana), bath, medicated gargles, application of paste, powders and other physiotherapeutic measures as an adjunct to internal medicines. These treatments are very popular and are in vogue even today.

3. Surgical Intervention

Ayurveda is the first in the world to practice different types of operations and sixty types of treatment of wounds, classification treatment of fractures and plastic surgery. The earliest Sanskrit treatises on Ayurveda were the 'Samhitas' of the great ancient physicians Bhela, Charaka and Susrutha which date from around the Christian era. The Indian surgeons of that era excelled in operations and their achievements in plastic surgery had no parallels anywhere in the world. Susrutha is called the father of plastic surgery. Sources of the pre-Christian era, such as the Epic 'Ramayana', mention remarkable feats of surgery having taken place in the past. Thus we have reference to the transplantation of an eyeball. The legendary 'Jivaka' a famous physician during the time of Buddha is also reported to have performed remarkable cures involving deep surgery. The circulation of blood was first explained in Ayurvedic system of medicine 4000 years ago, although William Harvey got the credit later on. Even in the 18th century, the Indian art of Rhinoplasty (plastic surgery performed on the nose) was studied by European surgeons.

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