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Ayurveda (/ˌɑːjʊərˈvdə, -ˈv-/)[1] is an alternative medicine system with historical roots in the Indian subcontinent.[2] The theory and practice of Ayurveda is pseudoscientific.[3][4][5] The Indian Medical Association (IMA) characterises the practice of modern medicine by Ayurvedic practitioners as quackery.[6]

The main classical Ayurveda texts begin with accounts of the transmission of medical knowledge from the gods to sages, and then to human physicians.[7] In Sushruta Samhita (Sushruta's Compendium), Sushruta wrote that Dhanvantari, Hindu god of Ayurveda, incarnated himself as a king of Varanasi and taught medicine to a group of physicians, including Sushruta.[8][9] Ayurveda therapies have varied and evolved over more than two millennia.[2] Therapies are typically based on complex herbal compounds, minerals and metal substances (perhaps under the influence of early Indian alchemy or rasa shastra). Ancient Ayurveda texts also taught surgical techniques, including rhinoplasty, kidney stone extractions, sutures, and the extraction of foreign objects.[10][11] Ayurveda has been adapted for Western consumption, notably by Baba Hari Dass in the 1970s and Maharishi Ayurveda in the 1980s.

Some scholars assert that Ayurveda originated in prehistoric times,[12][13] and that some of the concepts of Ayurveda have existed from the time of the Indus Valley Civilization or even earlier.[14] Ayurveda developed significantly during the Vedic period and later some of the non-Vedic systems such as Buddhism and Jainism also developed medical concepts and practices that appear in the classical Ayurveda texts.[14] Doṣa balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness.[15] Ayurveda treatises describe three elemental doṣas viz. vāta, pitta and kapha, and state that balance (Skt. sāmyatva) of the doṣas 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.[16]

There is no good evidence that Ayurveda is effective for treating any disease.[17] Ayurvedic preparations have been found to contain lead, mercury, and arsenic,[18] substances known to be harmful to humans. In a 2008 study, close to 21% of U.S. and Indian-manufactured patent Ayurvedic medicines sold through the Internet were found to contain toxic levels of heavy metals, specifically lead, mercury, and arsenic.[19] The public health implications of such metallic contaminants in India are unknown.[19]

Charaka

Main texts

There are three principal early texts on Ayurveda, 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.[2] After considering the evidence and arguments concerning the Suśrutasaṃhitā, Meulenbeld states (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 ident

Ayurveda is one of the few systems of medicine developed in ancient times that is still widely practiced in modern times.[120] 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 of modern medicine.[121][122] 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 modernise and syncretize (aśuddha "impure, tainted" ayurveda).[123][124][125] The political debate about the place of ayurveda in contemporary India has continued to the present (2015), both in the public arena and in government.[126] Debate about the place of Ayurvedic medicine in the contemporary internationalized world also continues today (2015).[127][128]

There are three principal early texts on Ayurveda, 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.[2] After considering the evidence and arguments concerning the Suśrutasaṃhitā, Meulenbeld states (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 BC was first proposed by Hoernle over a century ago,[129] 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.[2][16] The view that the text was updated by the Buddhist scholar Nagarjuna in the 2nd century CE[130] has been disproved, although the last chapter of the work, the Uttaratantra, was added by an unknown later author before 500 CE.[2]

Similar arguments apply to the Charaka Samhita, written by Charaka, and the Bhela Samhita, attributed to Atreya Punarvasu, that are also dated to the 6th century BCE by non-specialist scholars[131][132][133] but are in fact, in their present form, datable to a period between the second and fifth centuries CE.[2]Charaka, and the Bhela Samhita, attributed to Atreya Punarvasu, that are also dated to the 6th century BCE by non-specialist scholars[131][132][133] but are in fact, in their present form, datable to a period between the second and fifth centuries CE.[2][16][10] The Charaka Samhita was also updated by Dridhabala during the early centuries of the Common Era.[134]

The Bower Manuscript (dated to the Gupta era, between the 4th and the 6th century CE) includes of excerpts from the Bheda Samhita[135] 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 AD) 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.[136]

Other early texts are the Agnivesha Samhita, Kasyapa Samhita and Harita Samhita. The original edition of the Agnivesha Samhita, by Agnivesa, is dated to 1500 BCE,[137] and it was later modified by Charaka.[138] Kasyapa Samhita includes the treatise of Jivaka Kumar Bhaccha[139] and is dated to the 6th century BCE.[140][141] While Harita Samhita is dated to an earlier period, it is attributed to Harita, who was a disciple of Punarvasu Atreya.[142] Some later texts are 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.[143]

Underwood and Rhodes state that the early forms of traditional Indian medicine identified fever, cough, consumption, diarrhea, dropsy, abscesses, seizures, tumours, and leprosy,[33] and that treatments included plastic surgery, lithotomy, tonsillectomy,[144] couching (a form of cataract surgery), puncturing to release fluids in the abdomen, extraction of foreign bodies, treatment of anal fistulas, treating fractures, amputations, cesarean sections,[Vagbhata 1][144][disputed ] and stitching of wounds.[33] The use of herbs and surgical instruments became widespread.[33] During this period, treatments were also prescribed for complex ailments, including angina pectoris, diabetes, hypertension, and stones.[146][147]

Further development a

Ayurveda flourished throughout the Indian Middle Ages. Dalhana (fl. 1200), Sarngadhara (fl. 1300) and Bhavamisra (fl. 1500) compiled works on Indian medicine.[148] The medical works of both Sushruta and Charaka were also translated into the Chinese language in the 5th century,[149] and during the 8th century, they were translated into the Arabic and Persian language.[150] The 9th-century Persian physician Muhammad ibn Zakariya al-Razi was familiar with the text.[151][152] The Arabic works derived from the Ayurvedic texts eventually also reached Europe by the 12th century.[153][154] In Renaissance Italy, the Branca family of Sicily and Gaspare Tagliacozzi (Bologna) were influenced by the Arabic reception of the Sushruta's surgical techniques.[154]

British physicians traveled to India to observe rhinoplasty

British physicians traveled to India to observe rhinoplasty being performed using native methods, and reports on Indian rhinoplasty were published in the Gentleman's Magazine in 1794.[155] Instruments described in the Sushruta Samhita were further modified in Europe.[156] 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.[157] In 1840 Brett published an article about this technique.[158]

During the period of colonial British rule of India, the practice of Ayurveda was neglected by the British Indian Government, in favor of modern medicine. After Indian independence, there was more focus on Ayurveda and other traditional medical systems. Ayurveda became a part of the Indian National health care system, with state hospitals for Ayurveda established across the country. However, the treatments of traditional medicines were not always integrated with others.[159]