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What We Learn from the History of Ayurveda

Introduction

Scientific evidence shows that disease is older than the human race. Studies of ancient fossils demonstrate that arthritis was widespread among a wide range of medium- and large-sized mammals like aardvarks, anteaters, bears and gazelles (Magner 2005). According to some scientists, many modern human infectious diseases arose during the Neolithic period or shortly afterwards due to close contact with domestic animals and their pathogens (Pearce-Duvet 2006; Wolfe et al. 2007; Trueba and Dunthorn 2012; Trueba 2014). Studies of the ancient remains of human bodies confirm that many diseases prevalent today affected ancient human populations as well. Ancient skeletons show signs of diseases like hydrocephalus, spina bifida, congenital clubfoot, Paget’s disease, osteoporosis, rickets, osteomalacia, acromegaly, microencephaly and achondroplasia (Sigerist 1951; Steinbock 1976; Campillo 1983; Priorischi 1995a).

Learning from Animals

Primitive man learned the rudiments of the healing arts from the animals around him. Nonhuman primates, and especially chimpanzees are considered to constitute “living relatives” of Homo sapiens. Their behavior can be interpreted to present an approximate view of the behavior of a common ancestor of man (Fabrega Jr 1997). Chimpanzees in the wild occasionally lick each other’s wounds, and take care of each other’s infirmities like their human counterparts. Chimpanzees have also been recorded squeezing pus from abscesses and removing foreign bodies from each other’s eyes (Priorischi 1995b).

Animals are also known to eat medicinal plants to cure diseases or to prevent their appearance. For example, Phillips-Conroy (1986) suggested that the leaves and nutritious and tasty berries of Balanites aegyptiaca were eaten by the baboon, Papio hamadryas, as a prophylactic agent against schistosomiasis. This plant was observed to be a regular part of their diet along the Awash River in Ethiopia, where schistosomiasis was very much prevalent. Similarly, chimpanzees around the Gombe Stream and Mahale Mountains National Parks, Tanzania swallow Aspilia mossambicensis and Aspilia pluriseta slowly and without chewing (Wrangham and Nishida 1983; Fluffman and Wrangham 1994). A report of a chemical analysis of the plant (Rodriguez et al. 1985) and another report on the plant Lippia plicata eaten in a similar manner at Mahale confirmed the hypothesis of Wrangham and Nishida (1983).

The chimpanzees of Mahale, Tanzania are also reported to chew the pith of ethnomedically important Vernonia amygdalina, suck out and swallow the astringent, bitter-tasting juice, spitting out the fibrous remnants, when they exhibit signs of lethargy, loss of appetite and irregularity of bodily excretions. The symptoms displayed by the sick chimpanzees are the same shown by people throughout tropical Africa (Huffman and Seifu 1989).

Evolution of Medical Systems

The highly developed nervous system of man favored the recognition of changes in one’s own body and perception of behavioral changes in other individuals of the same group (Fabrega 1997). This ability, coupled with the wealth of information gleaned from the behavior of wild animals and his own experiences, formed the basis of the medical system of primitive man. In their search for food, early human beings inevitably encountered toxic or therapeutic plants, depending on the amount ingested and the physique of the person. Herbal medicine can be said to have developed alongside adventures in determining the diet, and it can be inferred that herbal medicine is an offshoot of nutrition (Conway 2011). The primitive knowledge thus gained was expanded upon by learning and social transmission (Hart 2005, 2011). This gave rise to various forms of traditional healing, broadly called folk (traditional) medicine. Traditional medicine is the sum total of the knowledge, skills and practices based on the beliefs and experiences indigenous to various cultures used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness (Anonymous 2013). Folk medical practices do not have a theoretical foundation and are based on empirical knowledge.

Since the days of Descartes and the Renaissance, science has taken a clear path in its analytical evaluation of nature. This approach is rooted in the assumption that complex problems can be solved by dividing them into smaller, simpler, and thus more controllable, units. As the processes are “reduced” into more basic units, this approach is also called “reductionism”. It has been the predominant paradigm of science over the past two centuries (Ahn et al. 2006). Using principles of pharmacognosy, solvent extraction of phytocompounds, pharmacology, pharmacokinetics and pharmacodynamics, Western medicine evaluates the efficacy of folk medical practices. Modern investigations have demonstrated the effectiveness of these forms of phytotherapy (Ramzan and Li 2015).

On the other hand, Ayurveda explains life processes using a doctrine based on the six schools of Hindu philosophy, namely, nydya, vaisisika, samkhya, yoga, mlmamsa and vedanta (Dasgupta 1997). Ayurveda states that the body is made up of pancabhUta or the five primordial elements prdhvi (“earth”), ap (“water”), tijas (“fire”), vdyu (“air”) and акта (“sky”). The ability of the pancabhftta to modulate life processes under the influence of a driving force (dtma) is denoted by the collective term tridosa, which consists of vata, pitta and kapha. The body is said to be in a state of health when the tridosa exist in a steady state. Destabilization of the tridosa causes the appearance of diseases. Herbs and other medicinal substances are identified in Ayurveda on the basis of five characteristics - rasa (taste), guna (qualities), vlrya (potency), vipaka (post-digestive taste) and prabhdva (specific action). These are the ayurvedic counterparts of pharmacological characteristics (Murthy 2017a). Ayurvedic pharmacy makes use of many herbs used in Indian cuisine. Examples are asafetida (Ferula asafoetida), black pepper (Piper nigrum), coriander (Coriandrum sativum), cumin seeds (Cuminum cyminum), curry leaves (Murraya koenigii), bitter gourd (Momordica charantia), drumstick (Moringa oleifera), fenugreek (Trigonella foenum-graecum), ginger (Zingiber officinale), mustard (Brassica juncea), inflorescence and pseudostem of banana (Musa paradisiaca), onion (Allium сера) and turmeric (Curcuma longa) (Kumar 2018). It is quite possible that, in the early stage of its development, Indian medical and culinary traditions worked hand-in-hand with each other (Conway 2011).

Thus, folk medicine, Western medicine and Ayurveda are three different approaches toward health and disease. For example, the tribal communities of India use the plant Adhatoda vasica in several ways to treat respiratory diseases. Flowers, root powder, decoctions of leaves or juice of leaves mixed with goat milk are administered for conditions like cough, cold, fever, bronchitis, malarial fever, asthma, tuberculosis and pneumonia (Arjariya and Chaurasia 2009; Desale et al. 2013). Adhatoda vasica is an important plant in Ayurveda, used in the treatment of coughs and other respiratory disorders. Formulations like Vasaristam (Vaidyan and Pillai 1986), Vasa ghrtam, Vasa khanda ktlsmandakam, Vasa khandam and Khandakadyo lauham are indicated in these conditions (Mishra 1983). Based on the information from Ayurveda, Amin and Mehta (1959) isolated for the first time vasicinone, a compound with bronchodilatory activity, in crystalline form from the leaves of Adhatoda vasica. One of the derivatives of vasicinone is bromhexine or bromhex- ine hydrochloride (N-cyclohexyl-N-methyl-(2-amino-3,5-dibromo-benzyl) amine hydrochloride). It was first introduced into the market in 1963 and has been used in the treatment of a variety of respiratory diseases (Zanasi et al. 2017). When used on the basis of different principles, the same medicinal plant is identified with different medical systems.

India’s Gift to the World

Ayurveda is India’s gift to the world. In the remote past when pen, pencil, paper, printing technology and data-processing systems were non-existent, ascetics conceived a comprehensive medical doctrine, put it to clinical testing and compiled voluminous works dealing with diagnosis and treatment of diseases. Though texts like Kharanadi and Nimitantram are mentioned in latter-day compendia, they are not available anymore. Caraka Samhita, Susruta Samhita, Astaiigasamgraha and Astangahrdaya are now the mainstay of Ayurveda.

As Ayurveda is “sacred knowledge of life” (Gode and Karve 1959) it was intended to be used wisely for the welfare of the world. Therefore, it was traditionally taught only to aspirants who had the required qualities. Great importance was attached to ethical values. This is reflected in the narration on the qualities of an aspiring student of Ayurveda. In the Vimanasthana of Caraka Samhita, it is stated unambiguously that the aspirant should be of noble nature, humble, modest, good-natured, having no greed for wealth, compassionate to all creatures and endowed with good memory (Sharma 1981a). Because of the continuous training imparted by a sage master, a physician acquired spiritual wisdom and perfect knowledge of Ayurveda by the time he completed his studies. It is no wonder that such training equipped the physician to serve society effectively as well as Ayurveda. It also instilled in him the moral strength to undertake arduous missions. The lives of Drdhabala and Vagbhata speak of this.

Dṛḍhabala’s Mission

The oldest classical Ayurveda work in Sanskrit is the Caraka Samhita, believed to have been composed between 100 B.C. and 200 A.D. In olden days, textbooks were customarily memorized by students and scholars. It so happened that by A.D. 500 Caraka Samhita became a difficult-to-find text and the few manuscripts that survived were full of gaps. Reproduction of Caraka Samhita was attempted by Drdhabala, a resident of Pahcanada, in present-day Punjab region (Maas 2010). He travelled extensively in India, met many of the scholars who had memorized the Caraka Samhita in its entirety, and transcribed the various versions. He compared the text stanza by stanza and edited the entire Caraka Samhita. The present-day Caraka Samhita contains 17 chapters of Cikitsasthana, the whole of Kalpasthdna and Siddhisthana composed by Drdhabala himself. Thus was born the present-day Caraka Samhita, which is a creative revision of its forerunner, the Agnivisa Tantra (Valiathan 2006).

The Legacy of Vāgbhaṭa

The most perilous mission for the benefit of Ayurveda was the one undertaken by a young student of Ayurveda, who later became immortal under his pen name, Vagbhata (the one who uses words as his soldiers). Interestingly, this legend is narrated only in the Malayalam literary work Aitihyamdla (Garland of legends), compiled by Kottarathil Sankunni and first published in 1909 (Sankunny 1982).

With the conquest of Sind by Mohammed-bin-Qasim in 712 A.D. (Asif 2016), Muslim supremacy in that region increased. Slowly the medical profession also came under their domination. All the healers of the region were Muslim and most of the Sanskrit texts of Ayurveda had disappeared by that time. There were no physicians among Hindus of that region, as the Muslim hakims (physicians) refused to accept Hindu pupils. Saddened by this state of affairs, members of the priestly class held a conclave by the Sindhu (Indus) river. They decided to depute an intelligent and valiant youth to recover the appropriated sacred knowledge of life. The young son of Simha Gupta was chosen for this mission. He was instructed to disguise himself as a Muslim youth, impress the best hakim and become his pupil. He was assured that a yajha (sacrificial rite) would begin that very day and would be concluded only when his mission came to an end.

Young Vagbhata could identify a learned hakim, who interviewed the young man to ascertain whether he had the required qualities. The hakim was impressed by the knowledge and mental faculties of the newcomer. He accepted him as a pupil. The young man came to his master every morning and after studying for the day, left in the evening, saying that he had a family to look after on the other side of the river. This went on for many months and the master was very happy with his pupil. Then one day the master expressed his willingness to teach him, if he could come back after having supper at home. Vagbhata, who was eager to complete his studies as soon as possible and escape without betraying his identity, happily accepted the offer.

The hakim lived in a palatial manor and the evening session was conducted in his chamber. The special training in the evening was a prerogative offered only to Vagbhata, who mastered most of the medical books in a short time. The hakim would explain late into the night the intricacies of Ayurveda and Vagbhata would listen to him very attentively. Then one night the master felt some uneasiness in his leg. He requested his pupil to sit on the bed and massage his leg for some time. Vagbhata quickly obliged the master, who soon fell asleep because of the relief from the massage. Then a train of thought flashed through the young man’s mind. “I was born in a noble family and have studied the four veda and six sastra. It is really my misfortune to hold the feet of this barbarian”, he bemoaned, unbecoming of a true Hindu, who should view his master (guru) as an equal to his father and mother. The grief caused some teardrops to fall on the hakim’s leg. The hakim woke up from sleep and saw a grief-stricken Vagbhata, with tears rolling down his cheeks. The old man immediately realized that he had been fooled by an imposter. With a revengeful mind he slowly rose from the bed, hoping to catch hold of a sword placed on the wall. At the same time the quick-witted Vagbhata realized that he would soon meet his end if he did not escape. Telling himself that no harm would fall on him if there were a power called Almighty and if the four veda were true, he jumped through a window in the room. He landed on the ground with no serious injury and took to his heels, escaping from his master and the guards.

The priests were holding the yajha, when suddenly Vagbhata appeared in front of them. He narrated to them all that had happened, culminating in his fleeing. They listened to his words and replied, “You still doubt if there is an Almighty and whether the four vida are true. We do not want to associate ourselves with such a person. From now onwards you are an outcast”. Vagbhata accepted the punishment and left the group. However, he started documenting all that he had learnt from the master, so that his hard work would not go in vain. Moreover, it would have been nearly impossible to usurp the knowledge from the Muslims a second time.

The first treatise that Vagbhata recreated is known as Astdhgasamgraha. But as it was composed in prose and poetry, he thought students might find it hard to memorize the text. Therefore, he composed in poetic style Astahgahrdaya, which is a summary of all the earlier Sanskrit works and which is more abridged than Astafigasamgraha. After offering these two texts at the feet of his mentors, Vagbhata left Sind forever (Sankunny 1982).

It is believed that after travelling all over northern India, Vagbhata finally arrived in Kerala, which was part of the Tamil country at that time. He spent the remaining years in the new-found home, disseminating the knowledge enshrined in his treatise. The Astavaidya tradition of Kerala is said to have begun with him. Indu and Jajjata, famous commentators of Astahgahrdaya are said to have been his disciples (Variar 1985, 1987). The Astavaidyas of Kerala chant every day the following dhyana sloka during their daily worship of Vagbhata:

Lamba smasru kalapamambuda nibha chayadyutTm vaidyakanam

Antevasina indu jajjata mukhan addhyapayantam sada

Agulphamala kancukancita tanum laksyopavttojvalam

Kandhasthagaru saramahcita drsam vande gurum vagbhatam!

(I pay obeisance to my guru Vagbhata, who is long-bearded, having bright eyes and the complexion of clouds, who teaches his physician-disciples Indu and Jajjata, wearing a white robe that flows up to the feet, and wearing around his neck, a garland made of sweet-smelling agar и wood!) (Figure 1.1) (Rishikesh, Vayaskara Illam, personal communication).

Members of the Pulamanthole Mooss family in northern Kerala believe that the sepulcher that exists in their estate and which is still venerated, contains the entombed body of Vagbhata (Figure 1.2). The two stone lamps over the sepulcher are lit every evening and special devotional service is held on all full moon days (Anonymous 2019).

Vagbhata teaching Indu and Jajjata- an artist’s impression (Photo courtesy of J. Suryanarayanan, Pattampi)

FIGURE 1.1 Vagbhata teaching Indu and Jajjata- an artist’s impression (Photo courtesy of J. Suryanarayanan, Pattampi).

Some linguistic evidence is also available to adduce the impact of the personage of Vagbhata on the south Indian medical tradition. Vakatam is a word commonly employed in Tamil medical literature. PiHaippini Vakatam (Book of diseases of children) and Kujantai Vakatam (Book of diseases of children) are two examples (see Kasinathan 1955). According to the Tamil-English medical dictionary of T.V. Sambasivam Pillai, the word Vakatam means “a book that describes perfectly the measures to cure diseases” (Pillai 1931a). Dr. Asko Parpola, the Finnish Tamil scholar, is of the opinion that the word Vakatam is derived from the Sanskrit word Vagbhata (Dr. Asko Parpola, personal communication). Physicians of the Astavaidya tradition of Kerala refer to Vagbhata as Vdhata or Vahatan (Mooss 1982).

 
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