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Ayurveda () is an alternative medicine system with historical roots in the Indian subcontinent. The theory and practice of Ayurveda is pseudoscientific. Ayurveda is heavily practiced in India and Nepal, where around 80% of the population report using it. Ayurveda therapies have varied and evolved over more than two millennia. Therapies include herbal medicines, special diets,
meditation Meditation is a practice in which an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm ...
,
yoga Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consciou ...
, massage,
laxatives Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation. Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lub ...
, enemas, and medical oils. Ayurvedic preparations are typically based on complex herbal compounds, minerals, and metal substances (perhaps under the influence of early Indian alchemy or '' rasashastra''). Ancient Ayurveda texts also taught surgical techniques, including rhinoplasty, kidney stone extractions, sutures, and the extraction of foreign objects. The main classical Ayurveda texts begin with accounts of the transmission of medical knowledge from the gods to sages, and then to human physicians. Printed editions of the '' Sushruta Samhita'' (''Sushruta's Compendium''), frame the work as the teachings of
Dhanvantari Dhanvantari () is the physician of the devas in Hinduism. He is regarded to be an avatar of Vishnu. He is mentioned in the Puranas as the god of Ayurveda. During his incarnation on earth, he reigned as the King of Kashi, today locally refe ...
,
Hindu god Hindu deities are the gods and goddesses in Hinduism. The terms and epithets for deities within the diverse traditions of Hinduism vary, and include Deva, Devi, Ishvara, Ishvari, Bhagavān and Bhagavati. The deities of Hinduism have evolved ...
of Ayurveda, incarnated as King
Divodāsa Divodāsa ("heaven's servant") is a king in the Rigveda (celebrated for his liberality and protected by Indra and the Ashvins in the Rigveda, RV 1.112.14; 1.116.18), the son of Vadhryashva RV 6.61.5. Further, the Mandala 9 of Rigveda mentions D ...
of Varanasi, to a group of physicians, including Sushruta. The oldest manuscripts of the work, however, omit this frame, ascribing the work directly to King Divodāsa. Through well-understood processes of modernization and globalization, Ayurveda has been adapted for Western consumption, notably by Baba Hari Dass in the 1970s and Maharishi Ayurveda in the 1980s. Historical evidence for Ayurvedic texts, terminology and concepts appears from the middle of the first millennium BCE onwards. In Ayurveda texts, '' Dosha'' balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness. Ayurveda treatises describe three elemental ''doshas'' ''viz.'' ''vāta'', ''pitta'' and ''kapha'', and state that balance ( Skt. ''sāmyatva'') of the ''doshas'' results in health, while imbalance (''viṣamatva'') results in disease. Ayurveda treatises divide medicine into eight canonical components. Ayurveda practitioners had developed various medicinal preparations and surgical procedures from at least the beginning of the
common era Common Era (CE) and Before the Common Era (BCE) are year notations for the Gregorian calendar (and its predecessor, the Julian calendar), the world's most widely used calendar era. Common Era and Before the Common Era are alternatives to the or ...
. There is no good evidence that Ayurveda is effective to treat or cure cancer. Some Ayurvedic preparations have been found to contain
lead Lead is a chemical element with the symbol Pb (from the Latin ) and atomic number 82. It is a heavy metal that is denser than most common materials. Lead is soft and malleable, and also has a relatively low melting point. When freshly cut, ...
, mercury, and
arsenic Arsenic is a chemical element with the symbol As and atomic number 33. Arsenic occurs in many minerals, usually in combination with sulfur and metals, but also as a pure elemental crystal. Arsenic is a metalloid. It has various allotropes, b ...
, substances known to be harmful to humans. A 2008 study found the three substances in close to 21% of U.S. and Indian-manufactured patent Ayurvedic medicines sold through the Internet. The public health implications of such metallic contaminants in India are unknown.


Etymology

The term ''Āyurveda'' ( sa, आयुर्वेद) is composed of ''āyus'', आयुस्, "life" or "longevity", and ''veda'', वेद, "knowledge", translated as "knowledge of longevity" or "knowledge of life and longevity".


Eight components

The earliest classical
Sanskrit Sanskrit (; attributively , ; nominally , , ) is a classical language belonging to the Indo-Aryan languages, Indo-Aryan branch of the Indo-European languages. It arose in South Asia after its predecessor languages had Trans-cultural diffusion ...
works on Ayurveda describe medicine as being divided into eight components (Skt. ''aṅga''). This characterization of the physician's art, "the medicine that has eight components" (Skt. ''cikitsāyām aṣṭāṅgāyāṃ'' चिकित्सायामष्टाङ्गायाम्), is first found in the Sanskrit epic the ''Mahābhārata'', c. 4th century BCE. The components are: * ''Kāyachikitsā'': general medicine, medicine of the body * ''Kaumāra-bhṛtya'' (Pediatrics): Discussions about prenatal and postnatal care of baby and mother; methods of conception; choosing the child's sex, intelligence, and constitution; childhood diseases; and midwifery * ''Śalyatantra'': surgical techniques and the extraction of foreign objects * ''Śhālākyatantra:'' treatment of ailments affecting openings or cavities in the upper body: ears, eyes, nose, mouth, etc. * ''Bhūtavidyā'': pacification of possessing spirits, and the people whose minds are affected by such possession * '' Agadatantra''/''Vishagara-vairodh Tantra'' (Toxicology): includes epidemics; toxins in animals, vegetables and minerals; and keys for recognizing those anomalies and their antidotes * ''Rasāyantantra'': rejuvenation and tonics for increasing lifespan, intellect and strength * ''Vājīkaraṇatantra'':
aphrodisiacs An aphrodisiac is a substance that increases sexual desire, sexual attraction, sexual pleasure, or sexual behavior. Substances range from a variety of plants, spices, foods, and synthetic chemicals. Natural aphrodisiacs like cannabis or cocain ...
; treatments for increasing the volume and viability of semen and sexual pleasure; infertility problems; and spiritual development (transmutation of sexual energy into spiritual energy)


Principles and terminology

The central theoretical ideas of Ayurveda show parallels with Samkhya and Vaisheshika philosophies, as well as with
Buddhism Buddhism ( , ), also known as Buddha Dharma and Dharmavinaya (), is an Indian religion or philosophical tradition based on teachings attributed to the Buddha. It originated in northern India as a -movement in the 5th century BCE, and ...
and
Jainism Jainism ( ), also known as Jain Dharma, is an Indian religion. Jainism traces its spiritual ideas and history through the succession of twenty-four tirthankaras (supreme preachers of ''Dharma''), with the first in the current time cycle bein ...
. Balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness. For example, to suppress sneezing is said to potentially give rise to shoulder pain. However, people are also cautioned to stay within the limits of reasonable balance and measure when following nature's urges. For example, emphasis is placed on moderation of food intake, sleep, and sexual intercourse. According to Ayurveda, the human body is composed of tissues ('' dhatus''), waste (''malas''), and humoral biomaterials ('' doshas''). The seven ''dhatus'' are chyle (''rasa''), blood (''rakta''), muscles (''māmsa''), fat (''meda''), bone (''asthi''), marrow (''majja''), and semen (''shukra''). Like the medicine of classical antiquity, the classic treatises of Ayurveda divided bodily substances into five classical elements ('' panchamahabhuta'') ''viz.''
earth Earth is the third planet from the Sun and the only astronomical object known to harbor life. While large volumes of water can be found throughout the Solar System, only Earth sustains liquid surface water. About 71% of Earth's sur ...
,
water Water (chemical formula ) is an inorganic, transparent, tasteless, odorless, and nearly colorless chemical substance, which is the main constituent of Earth's hydrosphere and the fluids of all known living organisms (in which it acts as ...
,
fire Fire is the rapid oxidation of a material (the fuel) in the exothermic chemical process of combustion, releasing heat, light, and various reaction products. At a certain point in the combustion reaction, called the ignition point, flames ...
, air and
ether In organic chemistry, ethers are a class of compounds that contain an ether group—an oxygen atom connected to two alkyl or aryl groups. They have the general formula , where R and R′ represent the alkyl or aryl groups. Ethers can again ...
. There are also twenty gunas (qualities or characteristics) which are considered to be inherent in all matter. 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., citing Sushrutasamhita 25.36. The three postulated elemental bodily humors, the '' doshas'' or ''tridosha'', are ''vata'' (air, which some modern authors equate with the nervous system), ''pitta'' (bile, fire, equated by some with enzymes), and ''kapha'' (phlegm, or earth and water, equated by some with mucus). Contemporary critics assert that ''doshas'' are not real, but are a fictional concept. The humours (''doshas'') may also affect mental health. Each ''dosha'' has particular attributes and roles within the body and mind; the natural predominance of one or more ''doshas'' thus explains a person's physical constitution (''prakriti'') and personality. Ayurvedic tradition holds that imbalance among the bodily and mental ''doshas'' is a major etiologic component of 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. Practitioners of Ayurveda must determine an individual's bodily and mental ''dosha'' makeup, as certain ''prakriti'' are said to predispose one to particular diseases. For example, a person who is thin, shy, excitable, has a pronounced
Adam's apple The Adam's apple or laryngeal prominence is the protrusion in the human neck formed by the angle of the thyroid cartilage surrounding the larynx, typically visible in men, less frequently in women. Structure The topographic structure which is e ...
, and enjoys of esoteric knowledge is likely ''vata prakriti'' and therefore more susceptible to conditions such as flatulence, stuttering, and rheumatism. Deranged ''vata'' is also associated with certain mental disorders due to excited or excess ''vayu'' (gas), although the Ayurvedic text '' Charaka Samhita'' also attributes "insanity" (''unmada'') to cold food and possession by the ghost of a sinful Brahman (''
brahmarakshasa Brahmarakshasas (Sanskrit: ब्रह्मराक्षस) are fierce demons in Hindu Itihasa. Explanation A Brahma Rakshasa is actually the reference to curse of Brahma, to those, who has done evil things in his life or has misused his kn ...
''). Ama (a
Sanskrit Sanskrit (; attributively , ; nominally , , ) is a classical language belonging to the Indo-Aryan languages, Indo-Aryan branch of the Indo-European languages. It arose in South Asia after its predecessor languages had Trans-cultural diffusion ...
word meaning "uncooked" or "undigested" ) is used to refer to the concept of anything that exists in a state of incomplete transformation. With regards to
oral hygiene Oral hygiene is the practice of keeping one's mouth clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth (dental hygiene) and cleaning between the teeth. It is important that oral hygiene be carried ou ...
, it is claimed to be a toxic byproduct generated by improper or incomplete digestion. The concept has no equivalent in
standard medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
. In medieval taxonomies of the Sanskrit knowledge systems, Ayurveda is assigned a place as a subsidiary Veda (
upaveda upright=1.2, The Vedas are ancient Sanskrit texts of Hinduism. Above: A page from the '' Atharvaveda''. The Vedas (, , ) are a large body of religious texts originating in ancient India. Composed in Vedic Sanskrit, the texts constitute the ...
). Some medicinal plant names from the '' Atharvaveda'' and other Vedas can be found in subsequent Ayurveda literature. Some other school of thoughts considers 'Ayurveda' as the ' Fifth Veda'. The earliest recorded theoretical statements about the canonical models of disease in Ayurveda occur in the earliest Buddhist Canon.


Practice

Ayurvedic practitioners regard physical existence, mental existence, and personality as three separate elements of a whole person with each element being able to influence the others. This holistic approach used during diagnosis and healing 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, or blocked, channels are thought to cause disease.


Diagnosis

Ayurveda has eight ways to diagnose illness, called Nadi (pulse), Mootra (urine),
Mala Mala may refer to: Comics * Mala (Amazon), an Amazon from Wonder Woman's side of the DC Universe * Mala (Kryptonian), a villain from Superman's corner of the DC Universe Films and television * ''Mala'' (1941 film), a Bollywood drama film * , ...
(stool), Jihva (tongue), Shabda (speech), Sparsha (touch), Druk (vision), and Aakruti (appearance). Ayurvedic practitioners approach diagnosis by using the five senses. For example, hearing is used to observe the condition of breathing and speech. The study of the lethal points or ''marman marma'' is of special importance.


Treatment and prevention

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. Ayurveda also focuses on exercise,
yoga Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consciou ...
, and
meditation Meditation is a practice in which an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm ...
. 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,
oil pulling Oil pulling is an alternative medical practice in which an edible oil is swished around the mouth for a period of time and then spat out, similar to mouthwash. It originates from Ayurvedic medicine. Practitioners of oil pulling claim it is ca ...
, tongue scraping, skin care, and eye washing, is also a central practice.


Substances used

The vast majority (90%) of Ayurvedic remedies are plant based. Plant-based treatments in Ayurveda may be derived from roots, leaves, fruits, bark, or seeds; some examples of plant-based substances include
cardamom Cardamom (), sometimes cardamon or cardamum, is a spice made from the seeds of several plants in the genera '' Elettaria'' and '' Amomum'' in the family Zingiberaceae. Both genera are native to the Indian subcontinent and Indonesia. They ar ...
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 The provinces of India, earlier presidencies of British India and still earlier, presidency towns, were the administrative divisions of British governance on the Indian subcontinent. Collectively, they have been called British India. In one ...
. Triphala, an herbal formulation of three fruits, Amalaki, Bibhitaki, and Haritaki, is one of the most commonly used Ayurvedic remedies. The herbs '' Withania somnifera'' (Ashwagandha) and ''
Ocimum tenuiflorum ''Ocimum tenuiflorum'', commonly known as holy basil, ''tulsi'' or ''tulasi'', is an aromatic perennial plant in the family Lamiaceae. It is native to the Indian subcontinent and widespread as a cultivated plant throughout the Southeast Asian ...
'' (Tulsi) are also routinely used in Ayurveda. 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 Arsenic is a chemical element with the symbol As and atomic number 33. Arsenic occurs in many minerals, usually in combination with sulfur and metals, but also as a pure elemental crystal. Arsenic is a metalloid. It has various allotropes, b ...
, lead,
copper sulfate Copper sulfate may refer to: * Copper(II) sulfate, CuSO4, a common compound used as a fungicide and herbicide * Copper(I) sulfate Copper(I) sulfate, also known as cuprous sulfate, is an inorganic compound with the chemical formula Cu2 SO4. It ...
and gold, are also prescribed. The addition of minerals to herbal medicine is called '' rasashastra''. Ayurveda uses alcoholic beverages called ''Madya'', which are said to adjust the ''doshas'' by increasing ''pitta'' and reducing ''vatta'' and ''kapha''. 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. Purified opium is used in eight Ayurvedic preparations and is said to balance the ''vata'' and ''kapha'' ''doshas'' and increase the ''pitta'' ''dosha''. 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 considered in Ayurveda. The use of opium is found in the ancient Ayurvedic texts, and is first mentioned in the ''Sarngadhara Samhita'' (1300–1400 CE), a book on pharmacy used in
Rajasthan Rajasthan (; lit. 'Land of Kings') is a state in northern India. It covers or 10.4 per cent of India's total geographical area. It is the largest Indian state by area and the seventh largest by population. It is on India's northwestern ...
in Western India, as an ingredient of an aphrodisiac to delay male ejaculation. It is possible that opium was brought to India along with or before Muslim conquests. The book ''Yoga Ratnakara'' (1700–1800 CE, unknown author), which is popular in Maharashtra, uses opium in a herbal-mineral composition prescribed for diarrhea. 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. Later books have included the narcotic property for use as analgesic pain reliever. '' Cannabis indica'' is also mentioned in the ancient Ayurveda books, and is first mentioned in the ''Sarngadhara Samhita'' as a treatment for diarrhea. In the ''Bhaisajya Ratnavali'' it is named as an ingredient in an aphrodisiac. Ayurveda says that both oil and tar can be used to stop bleeding, and that traumatic bleeding can be stopped by four different methods:
ligation Ligation may refer to: * Ligation (molecular biology), the covalent linking of two ends of DNA or RNA molecules * In medicine, the making of a ligature (tie) * Chemical ligation, the production of peptides from amino acids * Tubal ligation, a meth ...
of the
blood vessel The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide awa ...
, cauterisation by heat, use of preparations to facilitate clotting, and use of preparations to constrict the blood vessels. Massage with oil is commonly prescribed by Ayurvedic practitioners. Oils are used in a number of ways, including regular consumption, anointing, smearing, head massage, application to affected areas, and
oil pulling Oil pulling is an alternative medical practice in which an edible oil is swished around the mouth for a period of time and then spat out, similar to mouthwash. It originates from Ayurvedic medicine. Practitioners of oil pulling claim it is ca ...
. Liquids may also be poured on the patient's forehead, a technique called shirodhara.


Panchakarma

According to Ayurveda, panchakarma are techniques to eliminate toxic elements from the body. Panchakarma refers to five actions, which are meant to be performed in a designated sequence with the stated aim of restoring balance in the body through a process of purgation.


Current status

Ayurveda is widely practiced in India, Bangladesh, Sri Lanka, and Nepal where public institutions offer formal study in the form of a
Bachelor of Ayurvedic Medicine and Surgery Bachelor of Ayurvedic Medicine and Surgery (B.A.M.S.) is a professional degree focused on Ayurveda offered in India, Nepal, Bangladesh, and Sri Lanka. Ayurveda is a type of alternative medicine, and the study of Ayurveda is pseudoscientific while ...
(BAMS) degree. In certain parts of the world, the legal standing of practitioners is equivalent to that of conventional medicine. Several scholars have described the contemporary Indian application of Ayurvedic practice as being "biomedicalized" relative to the more "spiritualized" emphasis to practice found in variants in the West. Exposure to European developments in medicine from the nineteenth century onwards, through European colonization of India and the subsequent institutionalized support for European forms of medicine amongst European heritage settlers in India were challenging to Ayurveda, with the entire epistemology called into question. From the twentieth century, Ayurveda became politically, conceptually, and commercially dominated by modern biomedicine, resulting in "Modern Ayurveda" and "Global Ayurveda". Modern Ayurveda is geographically located in the
Indian subcontinent The Indian subcontinent is a physiographical region in Southern Asia. It is situated on the Indian Plate, projecting southwards into the Indian Ocean from the Himalayas. Geopolitically, it includes the countries of Bangladesh, Bhutan, In ...
and tends towards secularization through minimization of the magic and mythic aspects of Ayurveda. Global Ayurveda encompasses multiple forms of practice that developed through dispersal to a wide geographical area outside of India. Smith and Wujastyk further delineate that Global Ayurveda includes those primarily interested in the Ayurveda
pharmacopeia A pharmacopoeia, pharmacopeia, or pharmacopoea (from the obsolete typography ''pharmacopœia'', meaning "drug-making"), in its modern technical sense, is a book containing directions for the identification of compound medicines, and published by ...
, and also the practitioners of New Age Ayurveda (which may link Ayurveda to
yoga Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consciou ...
and Indian spirituality and/or emphasize preventative practice, mind body medicine, or Maharishi Ayurveda). Since the 1980s, Ayurveda has also become the subject of interdisciplinary studies in ethnomedicine which seeks to integrate the biomedical sciences and humanities to improve the pharmacopeia of Ayurveda. According to Industry Research, the global Ayurveda market was worth US$4.5 billion in 2017.


The Indian subcontinent


India

It was reported in 2008 and again in 2018 that 80 percent of people in India used Ayurveda exclusively or combined with conventional Western medicine. A 2014 national health survey found that, in general, forms of the Indian System of Medicine or AYUSH (Ayurveda, Yoga and naturopathy, Unani, Sidha, and Homeopathy) were used by about 3.5% of patients who were seeking outpatient care over a two-week reference period. In 1970, the
Parliament of India The Parliament of India ( IAST: ) is the supreme legislative body of the Republic of India. It is a bicameral legislature composed of the president of India and two houses: the Rajya Sabha (Council of States) and the Lok Sabha (House of ...
passed the Indian Medical Central Council Act which aimed to standardise qualifications for Ayurveda practitioners and provide accredited institutions for its study and research. In 1971, the Central Council of Indian Medicine (CCIM) was established under the Department of Ayurveda,
Yoga Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consciou ...
and naturopathy, Unani, Siddha medicine and Homoeopathy (AYUSH), Ministry of Health and Family Welfare, to monitor higher education in Ayurveda in India. 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. The state-sponsored Central Council for Research in Ayurvedic Sciences (CCRAS) is designed to do research on Ayurveda. Many clinics in urban and rural areas are run by professionals who qualify from these institutes. , India had over 180 training centers that offered degrees in traditional Ayurvedic medicine. To fight
biopiracy Biopiracy (also known as scientific colonialism) is defined as the unauthorized appropriation of knowledge and genetic resources of farming and indigenous communities by individuals or institutions seeking exclusive monopoly control through patent ...
and unethical patents, the
government of India The Government of India ( ISO: ; often abbreviated as GoI), known as the Union Government or Central Government but often simply as the Centre, is the national government of the Republic of India, a federal democracy located in South Asia, ...
set up the Traditional Knowledge Digital Library in 2001 to serve as a repository for formulations from systems of Indian medicine, such as Ayurveda,
Unani Unani or Yunani medicine ( Urdu: ''tibb yūnānī'') is Perso-Arabic traditional medicine as practiced in Muslim culture in South Asia and modern day Central Asia. Unani medicine is pseudoscientific. The Indian Medical Association describes ...
and Siddha. The formulations come from over 100 traditional Ayurveda books. 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 undergraduate teaching institutions and 16 postgraduate institutions. In 2012, it was reported that insurance companies covered expenses for Ayurvedic treatments in case of conditions such as spinal cord disorders, bone disorder, arthritis and cancer. Such claims constituted 5-10 percent of the country's health insurance claims.
Maharashtra Andhashraddha Nirmoolan Samiti Maharashtra Andhashraddha Nirmulan Samiti (MANS; or Committee for Eradication of Blind Faith, CEBF) is an organisation dedicated to fighting superstition in India, particularly in the state of Maharashtra. It was founded by Narendra Dabholkar in 1 ...
, an organisation dedicated to fighting
superstition in India Superstition refers to any belief or practice that is caused by supernatural causality, and which contradicts modern science. Superstitious beliefs and practices often vary from one person to another or from one culture to another. Common examp ...
, considers Ayurveda to be pseudoscience. On 9 November 2014, India formed the Ministry of AYUSH. National Ayurveda Day is also observed in India on the birth of
Dhanvantari Dhanvantari () is the physician of the devas in Hinduism. He is regarded to be an avatar of Vishnu. He is mentioned in the Puranas as the god of Ayurveda. During his incarnation on earth, he reigned as the King of Kashi, today locally refe ...
that is
Dhanteras Dhanteras ( hi, धनतेरस), also known as Dhanatrayodashi ( sa, धनत्रयोदशी), is the first day that marks the festival of Diwali in most of India. It is celebrated on the thirteenth lunar day (Trayodashi) of Krishn ...
. In 2016, the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...
(WHO) published a report titled "The Health Workforce in India" which found that 31 percent of those who claimed to be doctors in India in 2001 were educated only up to the secondary school level and 57 percent went without any medical qualification. The WHO study found that the situation was worse in rural India with only 18.8 percent of doctors holding a medical qualification. Overall, the study revealed that nationally the density of all doctors (mainstream, ayurvedic, homeopathic and unani) was 8 doctors per 10,000 people compared to 13 per 10,000 people in China.


Nepal

About 75%-80% of the population of Nepal use Ayurveda. As of 2009, Ayurveda was considered to be the most common and popular form of medicine in Nepal.


Sri Lanka

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. 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. In 2010, the public system had 62 Ayurvedic hospitals and 208 central dispensaries, which served about 3 million people (about 11% of Sri Lanka's population). There are an estimated 20,000 registered practitioners of Ayurveda in Sri Lanka. According to the Mahavamsa, an ancient chronicle of Sinhalese royalty from the sixth century CE, King
Pandukabhaya Pandukabhaya (474 BC – 367 BC) was King of Upatissa Nuwara and the first monarch of the Anuradhapura Kingdom and 6th over all of the island of Sri Lanka since the arrival of the Vijaya; he reigned from 437 BC to 367 BC. According to many hi ...
(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. The hospital at Mihintale is the oldest in the world.


Outside the Indian subcontinent

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. In the 1960s, Ayurveda began to be advertised as alternative medicine in the Western world. Due to different laws and medical regulations around the globe, the expanding practice and commercialisation of Ayurveda raised ethical and legal issues. Through well-understood processes of modernization and globalization, Ayurveda was adapted for Western consumption, notably by Baba Hari Dass in the 1970s and by 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.


United States

Baba Hari Dass was an early proponent who helped bring Ayurveda to the United States in the early 1970s. His teachings led to the establishment of the Mount Madonna Institute. He invited several notable Ayurvedic teachers, including Vasant Lad, Sarita Shrestha, and
Ram Harsh Singh Ram Harsh Singh is an Indian practitioner of the Ayurveda system of alternative medicine and the founder vice chancellor of Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University. An Emeritus Professor of Banaras Hindu University and a Natio ...
. The Ayurvedic practitioner Michael Tierra wrote that the "history of Ayurveda in North America will always owe a debt to the selfless contributions of Baba Hari Dass." In the United States, the practice of Ayurveda is not licensed or regulated by any state. The National Center for Complementary and Integrative Health (NCCIH) stated that "Few well-designed clinical trials and systematic research reviews suggest that Ayurvedic approaches are effective". The NCCIH warned against the issue of heavy metal poisoning, and emphasised the use of conventional health providers first. As of 2018, the NCCIH reported that 240,000 Americans were using Ayurvedic medicine.


Europe

The first Ayurvedic clinic in Switzerland was opened in 1987 by Maharishi Mahesh Yogi. In 2015, the government of Switzerland introduced a federally recognized diploma in Ayurveda.


Classification and efficacy

Ayurvedic medicine is considered pseudoscientific because its premises are not based on science. Both the lack of scientific soundness in the theoretical foundations of Ayurveda and the quality of research have been criticized. Although laboratory experiments suggest that some herbs and substances in Ayurveda might be developed into effective treatments, there is no evidence that any are effective in themselves. There is no good evidence that Ayurvedic medicine is effective to treat or cure cancer in people. Although Ayurveda may help "improve quality of life" and Cancer Research UK also acknowledges that "researchers have found that some Ayurvedic treatments can help relieve cancer symptoms," the organization warns that some Ayurvedic drugs contain toxic substances or may
interact Advocates for Informed Choice, doing business as, dba interACT or interACT Advocates for Intersex Youth, is a 501(c)(3) nonprofit organization using innovative strategies to advocate for the legal and human rights of children with intersex trai ...
with legitimate cancer drugs in a harmful way. Ethnologist Johannes Quack writes that although the rationalist movement
Maharashtra Andhashraddha Nirmoolan Samiti Maharashtra Andhashraddha Nirmulan Samiti (MANS; or Committee for Eradication of Blind Faith, CEBF) is an organisation dedicated to fighting superstition in India, particularly in the state of Maharashtra. It was founded by Narendra Dabholkar in 1 ...
officially labels Ayurveda a pseudoscience akin to
astrology Astrology is a range of divinatory practices, recognized as pseudoscientific since the 18th century, that claim to discern information about human affairs and terrestrial events by studying the apparent positions of celestial objects. Di ...
, these practices are in fact embraced by many of the movement's members. A review of the use of Ayurveda for cardiovascular disease concluded that the evidence is not convincing for the use of any Ayurvedic herbal treatment for heart disease or hypertension, but that many herbs used by Ayurvedic practitioners could be appropriate for further research.


Research

In India, research in Ayurveda is undertaken by the Ministry of AYUSH through a national network of research institutes. In Nepal, the National Ayurvedic Training and Research Centre (NATRC) researches medicinal herbs in the country. 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

''Rasashastra'', the practice of adding metals, minerals or gems to herbal preparations, may include toxic heavy metals such as lead, mercury and arsenic. The public health implications of metals in ''rasashastra'' in India is unknown. 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 medicine and Ayurveda. Some traditional Indian herbal medicinal products contain harmful levels of heavy metals, including lead. For example, ghasard, a product commonly given to infants for digestive issues, has been found to have up to 1.6% lead concentration by weight, leading to
lead encephalopathy Toxic encephalopathy is a neurologic disorder caused by exposure to neurotoxic organic solvents such as toluene, following exposure to heavy metals such as manganese, as a side effect of melarsoprol treatment for African trypanosomiasis, adverse ...
. A 1990 study on Ayurvedic medicines in India found that 41% of the products tested contained arsenic, and that 64% contained lead and mercury. 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. A 2008 study of more than 230 products found that approximately 20% of remedies (and 40% of ''rasashastra'' medicines) purchased over the Internet from U.S. and Indian suppliers contained lead, mercury or arsenic. A 2015 study of users in the United States found elevated blood lead levels in 40% of those tested, leading physician and former U.S. Air Force flight surgeon
Harriet Hall Harriet A. Hall (born July 2, 1945) is a U.S. retired family physician, former U.S. Air Force flight surgeon and skeptic who writes about alternative medicine and quackery for '' Skeptic'' and ''Skeptical Inquirer''. She writes under the name ...
to say that "Ayurveda is basically superstition mixed with a soupçon of practical health advice. And it can be dangerous." Heavy metals are thought of as active ingredients by advocates of Indian herbal medicinal products. According to ancient Ayurvedic texts, certain physico-chemical purification processes such as ''
samskaras Samskara, saṃskāra, saṅskāra or sanskara may refer to: * Sanskara (rite of passage), Hindu and Jain rites of passage * Samskara (ayurvedic), a technique in ayurvedic medicine * Samskara (Indian philosophy), the concept of imprints or impress ...
'' or '' shodhanas'' (for metals) 'detoxify' the heavy metals in it. 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. Between 1978 and 2008, "more than 80 cases of lead poisoning associated with Ayurvedic medicine use erereported worldwide". 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. Ayurvedic practitioners argue that the toxicity of bhasmas (ash products) 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. In India, the government ruled that Ayurvedic products must be labelled with their metallic content. However, in ''
Current Science ''Current Science'' is an English-language peer-reviewed multidisciplinary scientific journal. It was established in 1932 and is published by the Current Science Association along with the Indian Academy of Sciences. According to the '' Journal ...
'', 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 n Indiamake the quality control of Ayurvedic medicines exceedingly difficult at this time". 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. A 2012 toxicological review of mercury-based traditional herbo-metallic preparations concluded that the long-term pharmacotherapeutic and in-depth toxicity studies of these preparations are lacking.


History

Some scholars assert that the concepts of traditional Ayurvedic medicine have existed since the times of the Indus Valley civilisation but since the Indus script has not been deciphered, such assertions are moot. The Atharvaveda contains hymns and prayers aimed at curing disease. There are various legendary accounts of the origin of Ayurveda, such as that it was received by
Dhanvantari Dhanvantari () is the physician of the devas in Hinduism. He is regarded to be an avatar of Vishnu. He is mentioned in the Puranas as the god of Ayurveda. During his incarnation on earth, he reigned as the King of Kashi, today locally refe ...
(or Divodasa) from
Brahma Brahma ( sa, ब्रह्मा, Brahmā) is a Hindu god, referred to as "the Creator" within the Trimurti, the trinity of supreme divinity that includes Vishnu, and Shiva.Jan Gonda (1969)The Hindu Trinity Anthropos, Bd 63/64, H 1/2, pp ...
. Tradition also holds that the writings of Ayurveda were influenced by a lost text by the sage
Agnivesa Agnivesha ( sa, अग्निवेश, translit=Agniveśa) is a legendary rishi (sage) in Hinduism, reputedly one of the earliest authors on Ayurveda (Indian alternative medicine). He is described to have codified the knowledge of his prece ...
. Ayurveda is one of the few systems of medicine developed in ancient times that is still widely practiced in modern times. 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 in medicine. 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 modernize and syncretize (''aśuddha'' "impure, tainted" Ayurveda). The political debate about the place of Ayurveda in contemporary India has continued to the present, both in the public arena and in government. Debate about the place of Ayurvedic medicine in the contemporary internationalized world also continues today.


Main texts

Many ancient works on Ayurvedic medicine are lost to posterity, but manuscripts of three principal early texts on Ayurveda have survived to the present day. These works are the Charaka Samhita, the Sushruta Samhita and the Bhela Samhita. The dating of these works is historically complicated since they each internally present themselves as composite works compiled by several editors. All past scholarship on their dating has been evaluated by Meulenbeld in volumes IA and IB of his ''History of Indian Medical Literature''. After considering the evidence and arguments concerning the ''Suśrutasaṃhitā'', Meulenbeld stated (IA, 348),
The ''Suśrutasaṃhitā'' is most probably the work of an unknown author who drew much of the material he incorporated in his treatise from a multiplicity of earlier sources from various periods. This may explain that many scholars yield to the temptation to recognize a number of distinct layers and, consequently, try to identify elements belonging to them. As we have seen, the identification of features thought to belong to a particular stratum is in many cases determined by preconceived ideas on the age of the strata and their supposed authors.
The dating of this work to 600 BCE was first proposed by Hoernle over a century ago, but has long since been overturned by subsequent historical research. The current consensus amongst medical historians of South Asia is that the ''Suśrutasaṃhitā'' was compiled over a period of time starting with a kernel of medical ideas from the century or two BCE and then being revised by several hands into its present form by about 500 CE. The view that the text was updated by the Buddhist scholar
Nagarjuna Nāgārjuna . 150 – c. 250 CE (disputed)was an Indian Mahāyāna Buddhist thinker, scholar-saint and philosopher. He is widely considered one of the most important Buddhist philosophers.Garfield, Jay L. (1995), ''The Fundamental Wisdom of ...
in the 2nd century CE has been disproved, although the last chapter of the work, the Uttaratantra, was added by an unknown later author before 500 CE. Similar arguments apply to the Charaka Samhita, written by Charaka, and the Bhela Samhita, attributed to
Atreya Punarvasu Atreya (आत्रेय) Rishi, or Atreya Punarvasu, was a descendant of Atri, one of the great Hindu sages (rishis) whose accomplishments are detailed in the Puranas. Sage Atreya was a renowned scholar of Ayurveda and six schools of early Ay ...
, that are also dated to the 6th century BCE by non-specialist scholars but are in fact, in their present form, datable to a period between the second and fifth centuries CE. The Charaka Samhita was also updated by Dridhabala during the early centuries of the Common Era. The Bower Manuscript (dated to the early 6th century CE) includes of excerpts from the ''Bheda Samhita'' 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 CE) 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. Some dictionaries of materia medica include ''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 Chakrapani Datta, among others.


Illnesses portrayed

Underwood and Rhodes state that the early forms of traditional Indian medicine identified fever, cough, consumption, diarrhea, dropsy, abscesses, seizures, tumours, and
leprosy Leprosy, also known as Hansen's disease (HD), is a long-term infection by the bacteria '' Mycobacterium leprae'' or '' Mycobacterium lepromatosis''. Infection can lead to damage of the nerves, respiratory tract, skin, and eyes. This nerve d ...
, and that treatments included plastic surgery, lithotomy,
tonsillectomy Tonsillectomy is a surgical procedure in which both palatine tonsils are fully removed from the back of the throat. The procedure is mainly performed for recurrent tonsillitis, throat infections and obstructive sleep apnea (OSA). For those w ...
,
couching In embroidery, couching and laid work are techniques in which yarn or other materials are laid across the surface of the ground fabric and fastened in place with small stitches of the same or a different yarn. The couching threads may be eith ...
(a form of cataract surgery), puncturing to release fluids in the
abdomen The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the to ...
, extraction of foreign bodies, treatment of
anal fistula Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin. An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its externa ...
s, treating fractures, amputations, cesarean sections, and stitching of wounds. The use of herbs and surgical instruments became widespread.Underwood & Rhodes (2008) During this period, treatments were also prescribed for complex ailments, including angina pectoris, diabetes, hypertension, and stones. (Republished by
National Informatics Centre The National Informatics Centre (NIC) is an Indian government department under the Ministry of Electronics and Information Technology (MeitY). The NIC provides infrastructure, IT Consultancy, IT Services including but not limited to architect ...
, Government of India.)
Lock ''et al.'', p. 836


Further development and spread

Ayurveda flourished throughout the Indian Middle Ages. Dalhana (fl. 1200), Sarngadhara (fl. 1300) and Bhavamisra (fl. 1500) compiled works on Indian medicine. The medical works of both Sushruta and Charaka were also translated into the Chinese language in the 5th century, and during the 8th century, they were translated into the Arabic and
Persian language Persian (), also known by its endonym Farsi (, ', ), is a Western Iranian language belonging to the Iranian branch of the Indo-Iranian subdivision of the Indo-European languages. Persian is a pluricentric language predominantly spoken an ...
. The 9th-century Persian physician Muhammad ibn Zakariya al-Razi was familiar with the text.Ramachandra S.K. Rao, Encyclopaedia of Indian Medicine: historical perspective, Volume 1, 2005
94–98
/ref> The Arabic works derived from the Ayurvedic texts eventually also reached Europe by the 12th century. In Renaissance Italy, the Branca family of Sicily and Gaspare Tagliacozzi (
Bologna Bologna (, , ; egl, label= Emilian, Bulåggna ; lat, Bononia) is the capital and largest city of the Emilia-Romagna region in Northern Italy. It is the seventh most populous city in Italy with about 400,000 inhabitants and 150 different na ...
) were influenced by the Arabic reception of the Sushruta's surgical techniques. British physicians traveled to India to observe rhinoplasty being performed using Indian methods, and reports on their rhinoplasty methods were published in the '' Gentleman's Magazine'' in 1794. Instruments described in the ''Sushruta Samhita'' were further modified in Europe. 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. In 1840 Brett published an article about this technique. The British had shown some interest in understanding local medicinal practices in the early nineteenth century. A Native Medical Institution was setup in 1822 where both indigenous and European medicine were taught. After the English Education Act 1835, their policy changed to champion European medicine and disparage local practices. After Indian independence, there was more focus on Ayurveda and other traditional medical systems. Ayurveda became a part of the Indian National healthcare system, with state hospitals for Ayurveda established across the country. However, the treatments of traditional medicines were not always integrated with others.


See also

* Acupuncture * Ashvins * Bachelor of Ayurveda, Medicine and Surgery * Bhaisajyaguru * Dhātu (Ayurveda) * History of alternative medicine * Homeopathy * List of unproven and disproven cancer treatments *
Ramuan Ramuan is an Indonesian- Malay term referring to a blend of ingredients (e.g. plants or plant organs) selected to provide health benefits in the preparation of food or the creation of herbal medicines. Ramuan is mostly a holistic formulation of ...
* Medical ethnobotany of India


Footnotes


References


Cited references

* * (Republished by
National Informatics Centre The National Informatics Centre (NIC) is an Indian government department under the Ministry of Electronics and Information Technology (MeitY). The NIC provides infrastructure, IT Consultancy, IT Services including but not limited to architect ...
, Government of India.) * * * * *


Further reading

* * * * Pattathu, Anthony George (2018). Ayurveda and Discursive Formations between Religion, Medicine and Embodiment: A Case Study from Germany. In: Lüddeckens, D., & Schrimpf, M. (2018)
Medicine - religion - spirituality: Global perspectives on traditional, complementary, and alternative healing
Bielefeld: transcript Verlag. , pp. 133–166. * * * . A bibliographical survey of the history of Indian medicine.
WHO guidelines on safety monitoring of herbal medicines in pharmacovigilance systems

Use Caution With Ayurvedic Products
- US Food and Drug Administration.


External links


WHO benchmarks for the training of Ayurveda
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...
(WHO), Geneva, 2022. {{Authority control Hindu philosophical concepts History of ancient medicine Massage therapy Pseudoscience South Asian traditional medicine Vedic period