Ayurveda - The Oldest Medical System

By Lynn Miller, JD, CYT, CHC

Ayurveda is considered the oldest medical system in the world because it is extensively described in the Rigveda, (ancient Sanskrit text 4500 BC to 1600 BC) and the complete medical texts are still extant. [1] Although it dates back to ancient times, it is very much in daily practice today by millions in India, Nepal and Sri Lanka, and becoming increasingly popular in the United States.

The translation of Ayurveda is the “science of life or longevity.” It is considered the sister science to Yoga, the science of Self-realization. According to Dr. David Fawley, OMD, one of the foremost American Vedic scholars, traditionally, yoga dealt with the spiritual side of life, while Ayurveda deals with both physical and mental disease as well the prescription of lifestyle regimens. That may come as a surprise to most Americans who have been introduced to yoga as a physical discipline. And yet yoga, as a therapy or exercise was traditionally prescribed in the context of Ayurvedic medicine. Together, they are primarily concerned with restoring wholeness in body, mind and spirit. To quote the Sutrasthana of the Charaka Samhita , a much referred Ayurvedic text; "The three—body, mind and soul—are like a tripod, the world stands by their combination; in them everything abides…."(1.46-47). Conceptually, both Yoga and Ayurveda are part of the larger system of Vedic knowledge, the sacred scriptures written in Sanskrit which are said to have been revealed to the sages of ancient India.

Although Ayurveda is arguably the oldest continuously practiced medical system in the world, it is considered an alternative medical system in the United States , and classified as such by the National Institutes of Health, National Center for Complementary and Alternative Medicine. Over the centuries that Ayurveda has been practiced, it has evolved and has spread along with Buddhism to many different countries, forming the basis of their healing systems and influencing Chinese medicine. In addition, people from numerous countries came to Indian to learn Ayurvedic medicine. Paracelsus, who is known as the father of modern Western medicine, is said to have practiced and propagated a system of medicine in 16th Century Europe which borrowed heavily from Ayurveda.

We tend to think of surgery as a relatively modern phenomenon, but Ayurvedic medicine developed a sophisticated system of surgery (salya-chikitsa) which dates back to the Samhita, which was written, or more accurately, compiled, in approximately 600 BC. An 18 th century British surgeon, Sir W. Hunter, is quoted as having said, "The surgery of the ancient Indian physicians was bold and skillful. A special branch of surgery was devoted to rhinoplasty or operations for improving deformed ears, noses and forming new ones, which European surgeons have now borrowed".

This branch of medicine is believed to have arisen in part from the exigencies of dealing with the effects of war and antiquated punishments. In fact, the Samhita, which again dates back to 600 BC, discussed in great detail how to perform prosthetic surgery to replace limbs, cosmetic surgery of the nose and on other parts of the body, cesarean sections, setting of compound fractures, and even brain surgery. For instance, rhinoplasty for a cut nose, (a common punishment) is described as follows: [2]

1) The leaf of a creeper, long and broad enough to fully cover the whole of the severed or clipped off part, should be gathered,
2) A patch of living flesh, equal in dimension to the preceding leaf should be sliced off from the region of the cheek.
3) After scarifying the severed nose with a knife, the flesh is swiftly adhered to it.
4) Insert two small pipes in the nostrils to facilitate respiration and to prevent flesh from hanging down.
5) The adhesioned part is dusted with the powders of Pattanga, Yashtimadhukam and Rasanjana pulverized together.
6) The nose should be enveloped in Karpasa cotton and several times sprinkled over with the refined oil of pure sesamum.
7) When the healing is complete and parts have united, remove the excess skin.”

Surgery is one of eight branches of Aruyvedic Medicine. The other seven are: Internal Medicine

(Kaya chikitsa), Ophthalmology & Otorhinolaryngology (Shalakya tantra) Pediatrics (Kaumara britya), Toxicology (Agada tantra) and Psychology (Bhuta vidya) Rejuvenation (Rasayana) and Revitalization (Vajikaran). Although many of these aspects of Ayurveda are similar to western medicine, the premises upon which Ayurveda is based differ substantially from modern western medicine. For instance, one of the main distinguishing features is the concept of prakriti or constitution.

Ayurveda begins with the premise that everyone is born with a particular prakriti or constitution, which is determined by which dosha or doshas (or humors) predominate in that individual at birth. According to Ayurveda, everything in the universe, including our bodies are made from five great elements. These elements combine in different proportions in different people, giving rise to an endless variety of individual differences, and thus determining their unique constitution. (A parallel five element theory exists in Chinese medicine.)

These five elements, although they translate into familiar sounding names, are really universal forces rather than physical substances. They are: Earth, the principal of solidity and stability; water, the principal of ebb and flow; fire, the transformative principal; air or the principal of subtle mobility and change; and ether, the subtle space which holds everything else. These elements combine to form three basic doshas: Vata, Pitta and Kapha. Vata is the combination of the space and air elements, Pitta is composed mainly of the fire element, and Kapha is a combination of the water and earth elements.

Health is seen as maintaining the original balance that a person is born with– not always an easy proposition, particularly in the case of Vata, as Vata is the prinicipal of change itself. The different doshas have different qualities that can be discerned through the pulse. Taking the pulse the Ayurvedic way is a skill that may take years to master, as it gives clues as to the functioning of the entire mind body constitution, including the health of the various organs. Along with other diagnostic techniques, this allows an Aruvedic doctor not only to know a person's prakriti (constitution) but also to understand which doshas are out of balance. Each dosha tends to correspond with a certain body type and personality type, and with a greater chance for certain types of health problems. An imbalance in a dosha can be caused by an unhealthy lifestyle or diet, too much or too little mental and physical activity, or not being properly protected from the weather, chemicals, or germs. [3]

Arurveda takes a preventative approach to health, but when an imbalance manifests in disease, it is not afraid to use many different types of interventions or treatments to bring an individual's constitution back into balance. [4] These include:

1. Shodhana therapy (Purification Treatment)

2. Shamana therapy (Palliative Treatment)

3. Pathya Vyavastha (Prescription of diet and activity)

4. Nidan Parivarjan (Avoidance of disease causing and aggravating factors)

5. Satvavajaya (Psychotherapy)

6. Rasayana therapy (use of immunomodulators and rejuvenation medicines)

In addition to its herbal formulas, perhaps the greatest contribution of Ayurveda is its techniques for achieving and maintaining balance and harmony within the body-mind complex, particularly through diet, oil massage, and lifestyle. For example, people with Pitta dispositions who tend to be hot-blooded are advised against over-heating or eating overly spicy foods that will aggravate that aspect. On the other hand, Vatas, who tend to be dry and cold, do best to drink warm teas and avoid iced beverages and salads, particularly in the winter. Regularity in routine is key, and from personal experience, I can attest to the fact that sesame oil massages work wonders to warm up Vata types. Kaphas who tend to be put on weight easily may find it best to rise before sunrise, and although it may run counter to popular wisdom, to eat only a light breakfast or even wait to eat until after the Kapha time of day (6am-10am) has passed, and to exercise vigorously. 

Research into Ayurveda is relatively new as compared to Ayurvedic itself, and more research is needed. Thus far, research has focused on the efficacy of Ayurvedic preparations for the treatment such conditions as bronchial asthma, ischemic heart disease and hyperlipidaemia, rheumatoid arthritis, acute viral hepatitis, non-insulin-dependent diabetes mellitus, fistula-in-ano, and diminished memory associated with mental retardation. The results have been promising, and the government in India as well as the NIH is funding additional research into Ayurveda.

Lynn R. Miller, JD, CYC, CHC , is the Director of Education for the Institute of Complementary and Alternative Medicine. She is also a licensed attorney, a certified yoga teacher and health coach, who lectures on self-care, wellness and stress management.

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[1] Mishra, Lakshmi-chandra Dagenais, Simon , Ayurveda: A Historical Perspective And Principles Of The Traditional Healthcare System In India , Alternative Therapies in Health & Medicine; Mar 2001, Vol. 7 Issue 2, p36, 6p, 1 graph

[2] Rana RE, Arora BS. History of plastic surgery in India . J Postgrad Med [serial online] 2002 [cited 2007 Sep 13];48:76-8. Available from:  http://www.jpgmonline.com/text.asp?2002/48/1/76/144

[3] NCCAM newsletter, Volume XII , Number 4: Fall 2005/Winter 2006

http://nccam.nih.gov/news/newsletter/2006_winter/ayurveda.htm

[4] See website of the Dept of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy, Ministry for Health & Family Welfare, Govt of India http://indianmedicine.nic.in/html/ayurveda/ayurveda.htm