By the medieval period, ayurvedic practitioners developed a number of medicinal preparations and surgical procedures for the treatment of various ailments.* Current practices derived (or reportedly derived) from ayurvedic medicine are regarded as part of complementary and alternative medicine,* and, along with siddha and Traditional Chinese medicine, form the basis for systems medicine.*Safety concerns have been raised about Ayurveda; for instance, two U.S. studies found that about 20 percent of Ayurvedic US and Indian-manufactured patent medicines sold via internet contained toxic levels of heavy metals such as lead, Mercury (element)|mercury and arsenic. Other concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.*In classical Sanskrit literature, Ayurveda was called "the science of eight components" (Sanskrit a?a?ga ?), a classification that became canonical for ayurveda. They are:*
Principles and terminologySince Ayurveda is really the generic term for "traditional medicine" in India, actual practice may be widely divergent. Descriptively, one may either focus on the historical foundation from the evidence of the earliest ayurvedic texts of the early centuries of the Common Era, or alternatively a description may take an ethnographic approach and focus on the forms of traditional medicine prevalent across India today.
Much like the medicine of classical antiquity, Ayurveda has historically taken the approach of enumerating bodily substances in the framework of the five Classical element#Classical elements in Hinduism|classical elements (Sanskrit [maha]panchabhuta [?] ?), viz. Prithvi|earth, Ap (water)|water, fire, Vayu|air and Akasa|aether, considering the seven "tissues" Dhatu (Ayurveda)|dhatu (Devanagari: saptadhatu ? of plasma (rasa dhatu), blood (rakta dhatu), flesh (ma?sa dhatu), adipose (medha dhatu), bone (asthi dhatu), Bone marrow|marrow (majja dhatu), and reproductive (sukra dhatu).*
Ayurveda stresses a balance of three elemental substances (do?a ?), analogous to classical humorism: Vayu / vata (air & space – "wind"), pitta (fire & water – "bile") and kapha (water & earth – "phlegm"). One ayurvedic theory asserts that each human possesses a unique combination of do?as that define that person's temperament and characteristics. Each person has a natural systems state, or natural combination of the three elements, and should seek balance by structuring their behavior or environment to provide more of the element(s) they lack.* Another view, also present in the ancient literature, asserts that humoral equality is identical to health, and that persons with preponderances of humours are proportionately unhealthy, and that this is not their natural temperament.
In Ayurveda there are 20 fundamental qualities ( gu?a ?) inherent in all substances, arranged in ten pairs of antonyms: heavy/light, cold/hot, unctuous/dry, dull/sharp, stable/mobile, soft/hard, non-slimy/slimy, smooth/coarse, minute/gross, viscous/liquid.*Ensuring the proper functions of channels (srotas) that transport fluids from one point to another is a vital goal of ayurvedic medicine, because the lack of healthy srotas is thought to cause rheumatism, epilepsy, autism, paralysis, convulsions, and insanity. Practitioners induce sweating, which is termed as Svedana and prescribe steam-based treatments as a means to open up the channels and dilute the do?as that cause the blockages and lead to disease.*Prakriti is an important concept in Ayurveda.
Hinduism and Buddhism have been an influence on the development of many of ayurveda's central ideas – particularly its fascination with balance, known in Buddhism as Madhyathmaka (Sanskrit madhyatmika ?).* Balance is emphasized; suppressing natural urges is seen to be unhealthy, and doing so claimed to lead to illness.* However, people are cautioned to stay within the limits of reasonable balance and measure.* For example, emphasis is placed on moderation of food intake,* sleep, sexual intercourse.*
PracticeAyurvedic practitioners approach diagnosis by using five senses.* Hearing is used to observe the condition of breathing and speech.* The study of the lethal points or marman marma is of special importance.* Ayurvedic doctors regard physical and mental existence together with personality as a unit, each element having the capacity to influence the others. One of the fundamental aspects of ayurvedic medicine is to take this into account during diagnosis and therapy. Concepts of Dinacharya are followed in Ayurveda. Practices like Oil pulling are practiced.
Hygiene is a central practice of ayurvedic medicine. Hygienic living involves regular bathing, cleansing of teeth, skin care, and eye washing.*
Ayurveda stresses the use of plant-based medicines and treatments. Hundreds of plant-based medicines are employed, including cardamom and cinnamon. Some animal products may also be used, for example milk, bones, and gallstones. In addition, fats are used both for consumption and for external use. Minerals, including sulfur, arsenic, lead, copper sulfate and gold are also consumed as prescribed.* This practice of adding minerals to herbal medicine is known as rasa shastra.
In some cases, alcohol was used as a narcotic for the patient undergoing an operation. The advent of Islam introduced opium as a narcotic.* Both oil and tar were used to stop bleeding.* Traumatic bleeding was said to be stopped by four different methods: ligature (medicine)|ligation of the blood vessel; cauterisation by heat; using different herbal or animal preparations locally which could facilitate Blood clot|clotting; and different medical preparations which could Vasoconstriction|constrict the bleeding or oozing vessels. Various oils could be used in a number of ways, including regular consumption as a part of food, anointing, smearing, head massage, and prescribed application to infected areas.*
While two of the eight branches of classical Ayurveda deal with surgery ( Salya-cikitsa, Salakya-tantra), contemporary Ayurvedic theory tends to emphasise that building a healthy metabolism|metabolic system, attaining good digestion, and proper excretion lead to vitality.* Ayurveda also focuses on exercise, yoga, and meditation.* In ayurveda, liquids may be poured on the patient's forehead, a technique which is called Shirodhara. To maintain health, a Sattvic diet is prescribed to the patient.
PanchakarmaAccording to some experts, the practice of panchakarma (Devanagari: ?)) is a therapeutic way of eliminating toxic elements from the body.* Panchakarma includes Vamana, Virechana, Basti (Panchakarma)|Basti, Nasya and Raktamokshana.
DiagnosisAyurveda has 8 ways of diagnosis. They are Nadi (Pulse), Mootra (Urine), Malas (Ayurveda)| Mala (Stool), Jinvha (Tongue), Shabda (Speech), Sparsha (Touch), Druk (Vision), Aakruti (Appearance).*
HistoryAyurveda is a discipline of the upaveda or "auxiliary knowledge". It is treated as a supplement or appendix of the Vedas themselves, usually either the Rigveda or the Atharvaveda. The samhita of the Atharvaveda itself contains 114 hymns or incantations for the magical cure of diseases. There are various legendary accounts of the "origin of ayurveda", e.g. that the science was received by Dhanvantari (or Divodasa) from Brahma * Tradition also holds that a lost text written by the sage Agnivesh, a student of the sage Bharadwaja, influenced the writings of ayurveda.*There are three principal early texts on Ayurveda, all dating to the early centuries of the Common Era. These are the Charaka Samhita, the Sushruta Samhita and the medical portions of the Bower Manuscript (a.k.a.. the Bheda Samhita). The relative chronology of these texts is not entirely clear. The Charaka Samhita is often cited as primary; although it survives in a recension of about the 4th or 5th century, it may be based on an original written between 100 BCE and 100 CE, which would have predated the other two texts. The Sushruta Samhita was written in the 3rd or 4th century. The Bower Manuscript is of particular interest because in this case the manuscript itself is ancient, dated to the early 6th century.* The earliest surviving mention of the name Sushruta is from the Bower Manuscript.* The medical portions of the Bower Manuscript constitutes a collection of recipes which are connected to numerous ancient authorities, and may be based on an older medical tradition practiced during the Maurya period, antedating both the Charaka and the Sushruta Samhitas.
The Bower Manuscript is also of special interest to historians due to the presence of Indian medicine and its concepts in Central Asian Buddhism. A. F. R. Hoernle in his 1897 edition identified the scribe of the medical portions of the manuscript as 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 (ca. 337–422 AD) wrote about the health care system of the Gupta empire (320–550) and described the institutional approach of Indian medicine, also visible in the works of Charaka, who mentions a clinic and how it should be equipped.*Other early texts, sometimes mentioned alongside the Sushruta, Chakaka and Bheda texts, are the Kasyapa Samhita|Kasyapa and the Harita Samhita|Harita samhitas, presumably dating to the later Gupta period (ca. 6th century). Ayurvedic authors of the 7th or 8th century include Vagbhata* and Madhava.
Underwood & Rhodes (2008) hold that this early phase of traditional Indian medicine identified "fever (takman), cough, Tuberculosis|consumption, diarrhea, dropsy, abscesses, seizures, tumours, and skin diseases (including leprosy)".* Treatment of complex ailments, including angina pectoris, diabetes, hypertension, and Calculus (medicine)|stones, also ensued during this period.* Plastic surgery, couching (ophthalmology)|couching (a form of cataract surgery), puncturing to release fluids in the abdomen, extraction of foreign elements, treatment of anal fistulas, treating fractures, amputations, cesarean sections, and stitching of wounds were known.* The use of herbs and surgical instruments became widespread.*The field of 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 Arabic language during the 8th century.* The 9th-century Persian physician Muhammad ibn Zakariya al-Razi|Rhazes was familiar with the text.* The Arabic works derived from the Gupta era Indian texts eventually also reached a European audience by the end of the medieval period.* In Renaissance Italy, the Branca family of Sicily and Gaspare Tagliacozzi (Bologna) are known to have been influenced by the Arabic reception of the surgical techniques of Sushruta.*British physicians traveled to India to see rhinoplasty being performed by native methods.* Reports on Indian rhinoplasty were published in the Gentleman's Magazine in 1794.* Joseph Constantine Carpue spent 20 years in India studying local plastic surgery methods.* Carpue was able to perform the first major surgery in the western world in 1815.* Instruments described in the Sushruta Samhita were further modified in the Western World.* Joseph Constantine Carpue based on this article was able to perform the "Indian" method of nose reconstruction and publish it in 1815.;*
IndiaAccording to some sources up to 80 percent of people in India use some form of traditional medicines, a category which includes Ayurveda.*In 1970, the Indian Medical Central Council Act which aims to standardizequalifications for ayurveda and provide accredited institutions for its study and research was passed by the Parliament of India.* In India, over 100 colleges offer degrees in traditional ayurvedic medicine.* The Indian government supports research and teaching in ayurveda through many channels at both the national and state levels, and helps institutionalize traditional medicine so that it can be studied in major towns and cities.* The state-sponsored AYUSH|Central Council for Research in Ayurvedic Sciences (CCRAS) has been set up to research the subject.* To fight biopiracy and unethical patents, the Government of India, in 2001, set up the Traditional Knowledge Digital Library as repository of 1200 formulations of various systems of Indian medicine, such as ayurveda, unani and Siddha medicine|siddha.* The library also has 50 traditional ayurveda books digitized and available online.*Central Council of Indian Medicine (CCIM) a statutory body established in 1971, under AYUSH|Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), Ministry of Health and Family Welfare, Government of India, monitors higher education in ayurveda.* Many clinics in urban and rural areas are run by professionals who qualify from these institutes.*
Sri LankaThe Sri Lankan tradition of Ayurveda is very similar to the Indian tradition. Practitioners of Ayurveda in Sri Lanka refer to texts on the subject written in Sanskrit, which are common to both countries. However, they do differ in some aspects, particularly in the herbs used.
The Sri Lankan government has established a Ministry of Indigenous Medicine (established in 1980) to revive and regulate the practice within the country* The Institute of Indigenous Medicine (affiliated to the University of Colombo) currently offers undergraduate, postgraduate, and MD degrees in the practice of Ayurveda Medicine and Surgery, and similar degrees in unani medicine.*There are currently 62 Ayurvedic Hospitals and 208 central dispensaries in the public system, and they served almost 3 million people (approximately 11 percent of Sri Lanka's total population) in 2010. In total there are currently approximately 20,000 registered practitioners of Ayurveda in the country.*According to the Mahavamsa, the ancient chronicle of Sinhalese people|Sinhalese royalty, written in the sixth century A.D., King Pandukabhaya of Sri Lanka (reigned 437 BC to 367 BC) had lying-in-homes and Ayurvedic hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documentary evidence we have of institutions specifically dedicated to the care of the sick anywhere in the world.* Mihintale Hospital is the oldest in the world.*Many Sri Lankan hotels and resorts offer Ayurveda themed packages, where guests are treated to a wide array of Ayurveda treatments during their stay.
Outside South AsiaAyurveda is a system of traditional medicine developed during antiquity and the medieval period, and as such comparable to pre-modern traditional Chinese medicine|Chinese and Medieval medicine of Western Europe|European systems of medicine. However, beginning in the 1960s, Ayurveda has begun to be advertised as "alternative medicine" in the West. Due to different laws and medical regulations in the rest of the world, the unregulated practice and commercialization of ayurvedic medicine has raised ethical and legal issues. In some instances, ayurvedic practices or terminology have also been adapted specifically for Western consumption, notably in the case of "Maharishi Vedic Approach to Health|Maharishi Ayurveda" in the 1980s; in some cases, this has involved active fraud on the part of proponents of Ayurveda in an attempt to falsely represent the system as amenable to the standards of modern medical research.*
Scientific appraisalAs a traditional medicine, many ayurveda products have not been tested in rigorous scientific studies and clinical trials. In India, research in ayurveda is undertaken by the statutory body of the Government of India|Central Government, the Central Council for Research in Ayurveda and Siddha (CCRAS), through a national network of research institutes.* A systematic review of ayurveda treatments for rheumatoid arthritis concluded that there was insufficient evidence, as most of the trials were not done properly, and the one high-quality trial showed no benefits.* A review of ayurveda and cardiovascular disease concluded that the evidence for ayurveda was not convincing, though some herbs seemed promising.*Two varieties of Salvia have been tested in small trials; one trial provided evidence that Salvia lavandulifolia (Spanish sage) may improve word recall in young adults,* and another provided evidence that Salvia officinalis (Common sage) may improve symptoms in Alzheimer's disease|Alzheimer's patients.* Many plants used as rasayana (rejuvenation) medications are potent antioxidants.* Neem appears to have beneficial pharmacological properties.* Turmeric and curcumin have shown effectiveness in preventing cancer in vitro.*Recently, there are some PubMed indexed journals being published in the field of Ayurveda.*
Use of toxic metals in AyurvedaRasa shastra, the practice of adding metals, minerals or gems to herbs, may have toxic heavy metals such as lead, Mercury (element)|mercury and arsenic.* Adverse reactions to herbs due to their pharmacology are described in traditional ayurvedic texts, but ayurvedic practitioners are reluctant to admit that herbs could be toxic and that reliable information on herbal toxicity is not readily available; there is communication gap between modern medicine practitioners and Ayurvedic practitioners. *According to a 1990 study on ayurvedic medicines in India, 41 percent of the products tested contained arsenic, and 64 percent contained lead and mercury.* A 2004 study found toxic levels of heavy metals in 20 percent 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 percent of remedies (and 40 percent of rasa shastra medicines) purchased over the Internet from both US and Indian suppliers contained lead, mercury or arsenic.* In 2012 the U.S. Centers for Disease Control and Prevention (CDC) stated that Ayurvedic drugs have been linked to lead poisoning on the basis of some cases where pregnant women had taken Ayurvedic drugs and toxic materials were found in their blood.*Ayurvedic proponents believe that the toxicity of these materials is reduced through purification processes such as Samskara (ayurvedic)|samskaras or shodhanas (formetals), similar to the Chinese pao zhi, although the ayurvedic technique is more complex and may involve prayers as well as physical pharmacy techniques. However, these products have nonetheless caused severe lead poisoning and other toxic effects.*Due to these concerns, the Government of India ruled that ayurvedic products must specify their metallic content directly on the labels of the product,* but, writing on the subject for Current Science, a publication of the Indian Academy of Sciences, M. S. Valiathan noted that "the absence of post-market surveillance and the paucity of test laboratory facilities [in India] make the quality control of Ayurvedic medicines exceedingly difficult at this time.*
World Health Organisation on AyurvedaAyurveda is not only a system of medicine, but also a way of living. It is used to both prevent and cure diseases. The most commonly reported reasons for using traditional and complementary/alternative medicine such as Ayurveda are that it is more affordable, more closely corresponds to the patient's ideology, and is less paternalistic than allopathic medicine. Regardless of why an individual uses it, traditional and complementary/alternative medicine provides an important health care service to persons both with and without geographic or financial access to allopathic medicine.Traditional and complementary/alternative medicine has demonstrated efficacy in areas such as mental health, disease prevention, treatment of non-communicable diseases, and improvement of the quality of life for persons living with chronic diseases as well as for the ageing population. Although further research, clinical trials, and evaluations are needed, traditional and complementary/alternative medicine has shown great potential to meet a broad spectrum of health care needs.In some countries, the legal standing of complementary/alternative medicine is equivalent to that of allopathic medicine, many practitioners are certified in both complementary/alternative medicine and allopathic medicine, and the primary care provider for many patients is a complementary/alternative practitioner.
Legal Status of Traditional Medicine and Complementary/Alternative Medicine:
A Worldwide Review-
World Health Organization 2001 Report .
World Health Organization: Benchmarks for Training in Ayurveda: http://apps.who.int/medicinedocs/documents/s17552en/s17552en.pdf