Background

Ayurveda literally meaning the science of life is a comprehensive system of health care indigenous to India. The earliest documented evidence of this science is in compendia of Indian wisdom called Vedas, which are believed to be documented around 6000 years back. Rigveda and Atharveda are replete with information on health and maladies and their management with natural modes and modalities. The knowledge expanded further with laying down of fundamentals and concepts of Ayurveda and systematization in classical texts like Charak Samhita, Sushruta Samhita and Astanga Sangraha. Present form of Ayurveda is the outcome of continued scientific inputs that has gone into the evolution of its principles, theories and guidelines of healthy living and disease management. Considering health of an individual as dynamic integration of environment, body mind and spirit, Ayurveda lays great emphasis on preservation and promotion of health and prevention of occurrence of diseases. Besides, it advocates holistic approach to understand all aspects of human life including diagnosis and management of disease.

Strength of Ayurveda

Ayurveda attributes primary importance to preventive medicine and the maintenance of positive health. Ayurveda addresses all aspects of life--the body, mind, soul and environment. It recognizes that each of us is unique, each responds differently to the many aspects of life, each possesses different strengths and weaknesses. Through insight, understanding and experience Ayurveda presents a vast database of the relationships between cause and the affect, both immediate and subtle, for each individual.

Basic principles

The objective of Ayurveda is preservation and promotion of the health of a healthy person and restoration of health in the diseased. Good health is the fundamental prerequisite to acquire materialistic, social and spiritual upliftment of human being.
The Universe, according to Ayurveda is composed of five basic elements - Pancha Mahabhootas viz. Space (Akasha), Air (Vayu), Fire (Agni), Water (Jala) and Earth (Prithvi). As the human body is similarly constituted, there is a fundamental similarity between universe and man. A healthy balance between the microcosm (human being) and the macrocosm (universe) is the basis of health.
Ayurveda is based on the theory of three biological humours (Tridosha) i.e. Vata, Pitta and Kapha, seven body tissues (Saptadhatu) viz., fluid components of the body (Rasa), Blood (Rakta), Muscle tissue (Mamsa), Adipose tissue (Medas), Bone tissue (Asthi), Bone marrow (Majja) and reproductive elements (Sukra) and three bio-wastes (Trimala) i.e. Urine (Mootra), Faeces (Pureesha) and Sweat (Sweda). The essence of saptadhatu called Ojas is responsible for the immunity and strength of the individual.

Diagnostics

Every individual has a peculiar body-mind constitution which is responsible for the health or disease pattern of an individual. Ayurvedic concept of examination of constitution (Prakriti pareeksha) is to know body- mind constitution while selecting diet, medicine or treatment regimen. Human mind has three components (triguna) i.e. Sattva (pure state of mind), Raja (passion/ desire) and Tama (inertia/ ignorance), which interact with the biological components Vata, Pitta & Kapha and decides the psychosomatic constitution of an individual (Prakriti).

The diagnosis in Ayurveda is based on two-fold approach to diagnostics viz.
(1) Examination of the patient i.e., Rogi-pareeksha; and
(2) Understanding of the disease right from the exposure to the etiology till its manifestation i.e., Roga- pareeksha.

The Rogi- pareeksha is essentially concerned with ascertaining the constitution of the individual and status of his health and vitality. This is achieved through ten fold examinations of the patient (Dasavidha pareeksha) comprising of
(1) Constitution (Prakriti)
(2) Disease susceptibility (Vikriti),
(3) Essence (Sara),
(4) Compactness (Samhanana),
(5) Anthropometry (Pramana),
(6) Compatibility (Satmya),
(7) Mind (Sattwa),
(8) Digestion capacity of food (Aharasakti),
(9) Physical strength (Vyayamasakti) and
(10) Age (Vaya).

The general examination is made through popular eight types of examination of patient (Ashtasthana pareeksha) comprising examination of pulse (Nadi), urine (Mootra), faeces (Mala), tongue (Jihva), voice (Sabda), touch (Sparsha), eye/vision (Drik) and stature (Akriti) and also considering the state of pathways of internal transport systems (Srotas) and digestive faculty (Agni).

Concept of health

Health is a state of complete physical, mental and social well being and not merely absence of disease. Attributes of healthy human being are indicated in Ayurveda as ability to perform daily chores without any difficulty, desire to eat in time, proper and timely digestion of food, feeling of freshness after waking up in the morning, regular and proper defecation and micturition, optimal functioning of all the sense organs, pleasant, calm , happy and contented state of mind. The healthy state of a person is often disrupted by faulty lifestyle, diet, physical activity, emotions and behaviour.
The diseases are caused due to imbalance of Tridosha caused from various reasons like hereditary, faulty food habits and life style, seasonal variations, vitiated atmosphere, or injury. The entire phase right from the exposure to causative factors to the production of disease is known as Samprapti. Vitiation of Agni, the digestive and metabolic energy is mainly responsible for causation of systemic diseases.

Approach to health

The major preventive approaches for maintaining and improving the quality of life include individualized specific daily regimen (Dinacharya), seasonal regimen (Ritucharya), behavioral and ethical considerations (Sadvritta). Healthy lifestyle is emphasized as the determinant of longevity of life, which by and large depends on the Prakriti (bio – identity i.e. body – mind constitution) of an individual. Proper understanding of Prakriti helps the physician in making right diagnosis, prognosis and treatment plan including lifestyle recommendations for restoration and maintenance of health.
The therapeutic streams advocated in Ayurveda comprise of Spiritual measures (Daivavyapasraya chikitsa), Pharmacological therapies (Yuktivyapasraya chikitsa) and Non – pharmacological psychotherapies (Satvavajaya). The treatment plan is worked out on the basis of underlying morbidity keeping in mind the strength of the disease and the tolerability of the patient. Four – pronged treatment plan consisting of avoidance of causative and precipitating factors of disease (Nidan Parivajan), bio – purification (Samshodhan), use of palliative remedies (Samshamana) and health – promoting regimen (Pathya Vyavastha) is the hall mark of Ayurvedic therapeutics recommended for physicians to prescribe, specific diet and lifestyle guidelines are always prescribed along with the drugs and therapies so as to facilitate restoration of bio – humoral balance (dhatu samyata) and health status.

Specialized Therapeutic Procedures

Ayurveda emphasizes on preventative and healing therapies along with various methods of purification and rejuvenation. Scientific studies have validated the efficacy and acceptability of these procedures.

Panchakarma

Panchakarma comprising of five major procedures is basically a bio-cleansing regimen, which facilitates the body system for better bioavailability of the pharmacological therapies. These therapies help in the elimination of disease-causing factors and maintain the equilibrium of body tissues (dhatus) and humours (doshas) in the body. This is used both for prevention, management and rehabilitation in chronic and debilitating diseases. Presently in many countries oil massage, shirodhara (pouring of medicated liquid on forehead) and some other procedures are popularly practiced as Panchakarma but those are not the actual Panchakarma, which is classically practiced in Ayurveda. Panchakarma has wide dimension and scientific approach. The comprehensive description is available in the classical texts about the indications, contraindications, methods, possible complications and their management, possible errors in performing the Panchakarma procedures etc. Panchakarma therapy has three major components :

(a) Preparatory procedures (Poorvakarma) for Panchakarma therapy:before performing Panchakarma, preparatory procedures are essential. These are :
1. Internal medication for increasing the digestive process (Pachana- Deepana).
2. Internal use of medicated oil/ghee and external application of oils (Snehana).
3. Medicated Sudation- fomentation (Swedana).

(b) Main procedures (Pradhanakarma) of Panchakarma therapy :
1. Vamana karma (Therapeutic emesis)
2. Virechana karma (Therapeutic purgation)
3. Anuvasana vasti (Oil/unctuous enema)
4. Asthapana vasti (Decoction based enema)
5. Nasya karma (Nasal administration of medicaments)

(c) Post therapeutic procedures (Paschatkarma) :
1. Dietary regimen (Samsarjana karma)
2. Regulated lifestyle

Benefits:

The textual recommendation of Panchakarma for various below mentioned areas have been validated through research :
1. For preventive, promotive health purpose
2. Management of various systemic disease viz. joint disorders, musculoskeletal, dermatological, neurological, psychiatric, geriatric, gynecological disorders, respiratory disorders etc.
3. The regimen is also widely prescribed in chronic incurable diseases for improving the quality of life.

Kshara Sutra

A procedure using medicated thread is a unique minimal invasive para-surgical approach being successfully practiced as promising therapy for ano-rectal disorders since time immortal by Indian surgeons ,widely cited in ancient medical literatures for its safety and efficacy. This technique was practiced by Sushruta (1000-600 B.C.), the famed ancient Indian surgeon. This technique was revived, developed and standardized in early seventies by eminent scientists like Prof.P.J.Deshpande, Dr.P.S.Shankaran (Banaras Hindu University, Varanasi ).

Rasayana

Literally, rasayana means the augmentation of rasa, the vital fluid produced by the digestion of food. It is the rasa flowing in the body which sustains life. Rasayana in ayurveda is, the method of treatment through which the rasa is maintained in the body. This is a specialized branch of clinical medicine meant for preventing the effect of ageing and to improve memory, intelligence complexion, sensory and motor functions. Numerous rasayana medicines are reported for possessing diversified actions like immuno-enhancement, free radical scavenging, adaptogenic or antistress and nutritive effect.

Ancient literatures of Ayurveda

The main source of knowledge of Ayurveda today is two sets of texts each consisting of three books which are named after the authors viz.

Brihattrayi (three major classics)

i. Charaka Samhita - (1500-1000 B.C.) written by Charaka- The famous philosopher and physician is the writer of charaka samhita which is mainly devoted to preventive and curative internal medicine. The original source of this book is agnivesha samhita, based on the teachings of Punarvasu Atreya.

ii. Susruta Samhita (1500-1000 B.C.) written by Sushruta- Famous Physician & Surgeon. He also wrote a book named as Sushrut Samhita. It is a compendium of surgery and military medicine. It deals with all the eight branches of Ayurveda elaborately that includes toxicology. Cadaver dissection, Practical surgical training and major surgeries for impacted foreign body Arbuda (different types of tumors), Aghata (trauma injuries), dushta vrana (non healing wounds), Udar (ascitis), Asthi bhang (Fractures of bones) urinary stones, intestinal obstruction, perforation of intestine etc. In addition Sushruta and his followers have suggested procedures, which deal with complications during pregnancy and labour. Sushrut sanhita gives directive principles in case of obstruction in intestinal loop. for obstructed labour. The rhinoplasty, earlobe correction and catarectomy are also explained in this text.

iii. Vagbhata (600 A.D.) Vagbhata is one of the three classic writers of Ayurveda, who wrote the Ashtanga Sangraha and the Ashtanga Hridaya Samhita

Laghuttrayi (three minor classics)

i. Madhava Nidana (700 A.D.), written by Madhava is a most referred treatise for etiopathogenesis of the diseases.

ii. Sarangdhara Samhita (1300 A.D) written by sharangdhara is a abridged version of earlier samhitas

iii. Bhava Prakasha (1600 A.D) written by Bhava Mishra.

The practitioners and visionaries like Kashayapa, Bhela, Hareeta also wrote their respective Samhitas (treatises). The ancient texts were updated and methodically written by many authors from time to time in later period.

National scenario

More than 80% of population in India is reported to use Ayurveda and MEDICINAL PLANTS to meet their primary health care needs & the health care services are being extended to the masses through a huge network of 4,60,001 qualified Ayurveda practitioners, 2416 Ayurveda hospitals, 13989 dispensaries, 241 undergraduate and 64 post graduate colleges with total admission capacity of 12,427 and 7910 drug manufacturing units producing classical & proprietary Ayurvedic products (Ref. AYUSH in India 2008).

Ministry of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy )

The Ministry of AYUSH was formed on the 9th of November 2014 with a vision of reviving the profound knowledge of our ancient systems of medicine and ensuring the optimal development and propagation of the Ayush systems of healthcare. Earlier, the Department of Indian Systems of Medicine and Homoeopathy (ISM&H) was created in March,1995 under the ministry of health and family welfare, Government of India and re-named as department of AYUSH in November, 2003 with a view to providing focused attention to development of Education, health care & Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy systems. The Department continued to lay emphasis on upgradation of AYUSH educational standards, quality control and standardization of drugs, improving the availability of medicinal plant material, research and development and awareness generation about the efficacy of the systems domestically and internationally. There are State Directorates/State Boards/Councils in the states which act as regional governance in regulating AYUSH issues like education, practice, research and manufacturing of medicines.