A glimpse of Ayurveda – The forgotten history and principles of Indian traditional medicine
By -Pooja Kumari
1. Introduction
Ayurveda is one of the most renowned traditional systems of medicine that has survived and flourished from ages till date. With the enormous knowledge of nature based medicine, the relationship of human body constitution and function to nature and the elements of the universe that act in coordination and affect the living beings, this system will continue to flourish in ages still to come. There are many avenues still to be explored by the researchers, practitioners and experts in the field who carry the responsibility of keeping the traditional systems of medicine (TSMs) alive and contributing to their growth in the future. However, due to many barriers such as lack of literature sources in different languages and insufficiency of awareness about the basic principles and histories of the systems from different ethnic origins, there is a lacuna of exchange of information from systems around the globe. Knowledge of systems from different ethnic origins would bring about interchange of knowledge and increase the understanding of different systems, and this can ultimately contribute to integration and advancement of herbal drug research when accompanied by collaborative work of researchers from different countries. These futuristic goals can be accomplished when one gains insights about the systems, the principles and histories and works upon the strengthening aspects common between the various TSMs. In this review, we have made an attempt to put forth the basic principles of doctrine and history of Ayurveda to contribute to the above said perspectives.
2. History of Ayurveda
Ayurveda has an age old history since the 2nd Century BC. Ayurveda has its foundations laid by the ancient schools of Hindu Philosophical teachings named Vaisheshika and the school of logic named as Nyaya. It is also related to the manifestation framework, well-known as Samkhya, and it was established in the same period when schools of Nyaya and Vaisheshika flourished.
The Vaisheshika School preached about inferences and perceptions that should be obtained about a patient’s pathological condition for treatment. Whereas, Nyaya school propagated its teachings on the basis that one should have an extensive knowledge of the patient’s condition, and the disease condition before proceeding for treatment. The school of Vaisheshika, classifies the attributes of any object into six types: substance, particularity, activity, generality, inherence and quality called as Dravya, Vishesha, Karma, Samanya, Samavaya and Guna respectively, in Sanskrit language.2, 3 Later, Vaisheshika and Nyaya schools worked together and jointly founded the nyāya–vaiśeṣika school. The nyāya–vaiśeṣika school, in the later years brought glory to the ancient knowledge and helped in disseminating the knowledge about Ayurveda. Even before these schools were established and also today, the origin of Ayurveda is considered to be divine, from the Hindu God, Brahma who is called as the creator of the universe.4, 5 It is believed that the creator of the universe passed on this holistic knowledge of healing onto the sages for the well-being of mankind. From the sages the knowledge of traditional medicines was passed on to the disciples and then to the common man by various writings and oral narrations. The information about the healing properties of the herbs was composed in the form of poems, called “Shlokas”. These were used by sages to describe the use of medicinal plants. The Hindu system of healing is believed to be based on four eminent compilations of knowledge (Vedas) called as Yajur Veda, Rig Veda, Sam Veda, and Atharva Veda. The Rig Veda is the most well-known of all the four Vedas and describes 67 plants and 1028 Shlokas. The Atharva Veda and Yajur Veda describe 293 and 81 medicinally useful plants. The practice of Ayurveda is based upon the knowledge gained from these Vedas. The writings in Rig Veda and Atharva Veda are attributed to “Atreya” who is believed to have been conferred with this knowledge from Lord Indra, who initially received it from Lord Brahma.6, 7 Agnivesha compiled the knowledge from the Vedas, and it was edited by Charaka and some other scholars and is presently called as “Charaka Samhita”. Charaka Samhita describes all aspects of Ayurvedic medicine and Sushruta Samhita describes the Science of Surgery.8, 9, 10, 11 Both these legendary compilations are still used by practitioners of traditional medicine. These ancient texts are available in various translations and languages like Tibetan, Greek, Chinese, Arabic and Persian.12 There are several other allied minor compilations like Nighantu Granthas, Madhava Nidana and Bhava Prakasha from the contributions of various scholars, however Charaka Samhita is the most respected of all the records
3. Basic doctrine principles of Ayurveda
Ayurveda believes that the entire universe is composed of five elements: Vayu (Air), Jala (Water), Aakash (Space or ether), Prithvi (Earth) and Teja (Fire). These five elements (referred to as Pancha Mahabhoota in Ayurveda) are believed to form the three basic humors of human body in varying combinations. The three humors; Vata dosha, Pitta dosha and Kapha dosha are collectively called as “Tridoshas” and they control the basic physiological functions of the body along with five sub-doshas for each of the principal doshas. Ayurveda believes that the human body consists of Saptadhatus (seven tissues) Rasa (tissue fluids), Meda (fat and connective tissue), Rakta (blood), Asthi (bones), Majja (marrow), Mamsa (muscle), and Shukra (semen) and three Malas (waste products) of the body, viz. Purisha (faeces), Mutra (urine) and Sweda (sweat). Vata dosha maintains the cellular transport, electrolyte balance, elimination of waste products and its effect is increased by dryness. Pitta dosha regulates the body temperature, optic nerve coordination and hunger and thirst management. Heat conditions of the body aggravate Pitta. Kapha dosha is increased due to sweet and fatty food and it provides lubrication to the joints for proper functioning. The catabolism of the body is believed to be governed by Vata, metabolism by Pitta and anabolism by Kapha. For a healthy state of health, a balance between the three doshas and other factors should be maintained. Any imbalance between the three causes a state of illness or disease.
4. Allied systems of medicine in Ayurveda – a brief overview
India has a rich history of traditional system of medicine based upon six systems, out of which Ayurveda stands to be the most ancient, most widely accepted, practiced and flourished indigenous system of medicine. The other allied systems of medicine in India are Unani, Siddha, Homeopathy, Yoga and Naturopathy.23 Ayurveda is the most dominant system amongst the other Indian systems of medicine and finds its prevalence globally since centuries. In this paper, we have restricted the detailed discussion of various aspects of Indian systems of Medicine (ISM) to Ayurveda alone, and only a comprehensive overview of the other systems is provided in the text. After Ayurveda, the Siddha, Homeopathy and Unani system of medicine are widely used. Naturopathy is still developing and in future it may emerge as a flourished system of medicine. Yoga, is a system of allied medicine that deals with physical, mental and spiritual state of an individual.
5. Current status of Ayurveda and perspectives for its future applications
In the recent decades, Ayurveda has experienced a considerable shift in its paradigm and a significant change in the outlook of researchers, towards its applications has occurred. The therapeutic principles of Ayurveda focus on prakriti and tridoshas, and these principles explain that every individual has his unique constitution called as prakriti. Prakriti determines the characteristic response of each individual to medications, environmental conditions and dietary factors. ‘Ayurgenomics’ a recently introduced research field, bridges this gap between genomics and Ayurveda and serves as an aid in understanding of inter-individual differences in responses to therapies in various diseases.29 It especially emphasizes on studying inter-individual variances in patients from identical ethnic backgrounds. TSMs are now been looked upon for recourse to some limitations faced by western medicine, such as the need for individualized therapies, potential side effects and lack of desired therapeutic efficacy.
6. Summary
Ayurveda has a rich history; however there were certain drawbacks in approaches towards it, which inhibited its growth like the western system of medicine. The active components of the herbal drugs prescribed were not known, and even today many drugs still need further exploration for their active constituent characterization and elucidation of the mechanism of action. Even after decades of applying advanced analytical techniques for drug analysis, herbal drugs still face some drawbacks. The administration of combinations of several drugs adds to the complexity of study of the activity of these medications. A merit of traditional medicine systems as discussed earlier is that, they consider every individual as the prime focus of treatment rather than the disease. But this factor also possesses a hurdle to the applicability of medications on a general population basis. Several issues like, the variation in the potency due to difference in species, absence of an integrated coding for every species used commonly in TSMs, varying geographical location of growth, and incorrect identification and adulteration of drugs, non-uniform quality control standards, differences in processing methods, direct an alarming need towards comparative study of drugs used in both these system of medicine.