By: Dr MS Valiathan National Research Professor Manipal University
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By:
Dr MS Valiathan
National Research Professor
Manipal University
AYURVEDA
Vedic origin
Atharvaveda
6000 verses/1000 prose lines
Bloomfield's selection; dominance of
mundane themes.
Long life
Diseases and treatment; treatment relied
on mantras and ritual.
Anatomy
Medicinal plants
Faith-based practice of medicine.
TREATMENT OF JAUNDICE - ATHARVAVEDIC PERIOD
TREATMENT OF JAUNDICE IN ATHARVAVEDIC PERIOD Hymn chanted during the Vedic ritual “Up to the sun shall go thy heartache and thy jaundice : in the colour of the red bull do we envelop thee. We envelop thee in red tints, unto long life. May this person go Unscathed, and free of yellow colour! The cows whose divinity is Rohini, They who, moreover, are (themselves) red (rohini) – (in their) every form and every strength do we envelop thee 4
TREATMENT OF JAUNDICE IN
ATHARVAVEDIC PERIOD
Into the parrots, into the ropanakas
(thrush) do we put thy jaundice, and,
furthermore, into the haridravas
(yellow wagtail) do we put thy jaundice.
(Bloomfield’s translation)
The ritual was symbolic and aimed at banishing the yellow
colour from the patient to yellow creatures and the sun, where it
properly belongs, and securing for the patient redness from the
red bull where it is peculiarly at home.
5
TREATMENT OF JAUNDICE
ACCORDING TO CHARAKA
Known as “Kāmala”, the disease was well known and
described. Regarded as a manifestation of the
accumulation of disturbed pitta in the gut and blood.
Early stages and terminal stage of liver failure
described.
Cause attributed to eating inappropriate or harmful
food items.
A variety of jaundice with “clay coloured” stools
described (obstructive jaundice of modern medicine).
Treatment by dietary regime, pañcakarma, and a
variety of medicinal formulations which were chosen
to suit individuals.
No role for ritual or hymns
6
TRADITIONAL MEDICINE IN
BUDDHIST INDIA
• Almost thousand years: Hiuen Tsiang’s report
shows signs of decline of Buddhism in 5th century.
• Mantras and rituals of Atharvan medicine largely
disappeared.
• Basic doctrines of Ayurveda – pañcabhūta,
tridosha; human anatomy; herbal drugs; medical
procedures such as basti and vamana; concepts of
hygiene; classification of foods; physician – patient
– attendant triad – these were standard practices.
• The term Ayurveda never used.
7
JIVAKA - BUDDHA’S PHYSICIAN
Buddha, Bimbisara, and Jivaka 8
AYURVEDA
• Traditional medicine practised in the
Buddhist period was the forerunner of
Ayurveda. Vagbhata was a Buddhist.
• Health and recovery from ill-health form
the central theme of Ayurveda; it is
however sustained by a spectacular
background of non-medical subjects.
• The background and central theme are
integral to complete the big picture: this is
the essence of holistic medicine.
9
Last Supper
10BACKGROUND
Enlivened by doctrines, ideas, vision
I. Pañcabhūta (ether, air, fire, water and earth):
• Five bhūtas (elements) constitute the universe
and the human body, which are macro and
microcosms. Their homology determines the
action of external substances on the body in
health and disease.
• Human body as a cosmic resonator: every dhātu
(body component) a cosmic analogue.
Contd….
11BACKGROUND
Enlivened by doctrines, ideas, vision
2. Sāmya:
• Health is a sum of several equilibria; of dhātus
(7 components of the body : dhātu sāmya); of
doshas (vāta, pitta, kapha products of digestion
in the body, which cause disease on breaching
limit, dosha sāmya); of fires in the body (in the
stomach and all 7 components of the body; agni
sāmya); of body and environment (ritu sāmya);
innocuous existence of causes within the body
(hetu sāmya).
• Breakdown of sāmya is vaiṣmya or disease. Contd…
12
12BACKGROUND
Enlivened by doctrines, ideas, vision
3. Destiny:
• Is life span predetermined?
• Can human will and effort neutralise Karmic
effect?
• Does predetermination impinge on the
physician’s effort and patient’s prognosis?
Contd….
13BACK GROUND
4. Prajnāparādha:
A major cause of diseases; corresponds to “life
style diseases”.
Involves error in judgement and imprudent
action.
A reflection of the helplessness of the human
condition.
Contd….
14BACK GROUND
5. Habitat:
Habitat vulnerable to epidemics, floods, draughts
and environmental disasters.
The large scale destruction is traceable ultimately
to the righteous conduct of the rulers and the
ruled. Examples abound in history.
Righteous conduct indispensable for safeguarding
the habitat.
15CHARAKA
16
Nicholas Roerich, Bharat Kala Bhavan, Banaras Hindu UniversityAYURVEDIC MEDICINE
Svasthavṛtta (Health care)
Code for daily life:
Introspection on waking up; oral care; evacuation; oil
massage; bath; wearing adornments and comfortable
clothes; physical activity: worship.
Personal Conduct:
Care of feet; haircut, paring nails; use of cloak,
umbrella, walking stick; comfortable furniture;
guidelines on conversation; guidelines on social
behaviour – covering mouth during cough; not urinating
in public places etc. 17
Contd…AYURVEDIC MEDICINE
Svasthavṛtta (Health care)
Living in harmony with seasons (Ṛtucarya):
Adjustments in food, physical and sexual activity,
clothes, sleep etc., to suit two halves of the year – dry
and wet (ādāna and visarga); seasons influence
medical and surgical treatment.
The dry and wet halves of the year believed to change
the chemical environment in the body (rasa); the
recommended diet and activities were designed to
respond to the changes and maintain sāmya.
18
18
Contd…AYURVEDIC MEDICINE
Svasthavṛtta (Health care)
Life beyond bread :
Truthfulness, forgiveness, compassion, equanimity,
dedicated work with indifference to results.
Seeing oneself in all living beings.
Liberality in views, opinions.
Cheerful, confident attitude which celebrated life; no
gloom, no denigration of the body.
Contd….
19
19AYURVEDIC MEDICINE
Svasthavṛtta (Health care)
Food and Drinks:
Sustenance foremost: but enjoyment was also
commended.
Elaborate classification of foods and drinks:
extensive knowledge of the cultivation of grains,
plants, fruits; characteristics of meats; process of
cooking.
Role of food in nutrition and therapeutics (Patthya).
Culinary arts and etiquette for dining.
20
20GENERAL CLASSIFICATION OF FOODS
• Cereals (dhānya)
• Meats (māmsa)
• Fruits (phala)
• Greens/vegetables (śāka)
• Tubers (kaṇḍas)
• Salts (lavaṇa)
• Prepared Foods (kṛtānnas)
• Sweet edibles
• Postprandial drinks
Each group had many subgroups.
21FOOD (Cereals)
22MEATS OF ANIMALS
MEATS OF BIRDS
23MEATS OF AQUATIC ANIMALS
PROPERTIES OF MILK BASED
ON VESSEL OF BOILING
24AYURVEDIC MEDICINE
Patient care (Āturavṛtta):
Eight fold division:
Surgery (Śalya)
Head and Neck diseases (Śālākya)
General Medicine (Kāyacikitsa)
Children’s diseases (Kaumārabhṛtya)
Possession by evil spirits causing diseases (Bhūtavidya)
Poisoning (Agadatantra)
Rejuvenation in ageing (Rasāyana)
Enhancement of sexual potency and fertility (Vājīkaraṇa)
25DISEASES IN CHARAKA’S PERIOD IN
NORTH-WEST INDIA
Archeo-epidemiology.
Counting of references to infectious (pre-
transition) and 9 non-infectious (post transition)
diseases in a digitized text of Charaka (Professor
Yamashita’s text).
890 references to infectious against 580 for non-
infectious.
Infectious diseases were much more common;
only two references to smallpox!
Many diseases of Charaka’s period persist, but
many are curable and no longer fearsome: new
diseases like AIDS have appeared.
26DIAGNOSIS OF DISEASES
Elaborate and systematic.
Three stages:
• Preliminary assessment (physician’s competence,
adequacy of facilities, purpose of treatment
(cure/palliation), season, place of residence of patient.
• Body features – dosha prakriti, dosha disequilibrium,
measurement of body parts, mental status, digestive
power, exercise tolerance
• Clinical diagnosis by the use of all senses except taste
by the physician.
Determination of the stage of disease (5 stages);
Diagnosis is the determination of dosha perturbation
which occurs when causes are activated by the
breakdown of equilibrium.
27MEDICAL TREATMENT
• Śamana for mild manifestation of
diseases (fasting, rest, simple
medications).
• Śodhana for severe diseases (evacuative
procedures by pañcakarma, formulations
etc.).
• Underestimating Śamana is mistaken: a
good percentage of common ailments
seen by a physician would respond to
simple measures.
28SURGICAL TREATMENT
EIGHT BASIC PROCEDURES
A few Examples:
Excision (chedya) of a piece on a fruit Incision (Bhedya) on a filled leather bag
29
Contd…SURGICAL TREATMENT
BASIC PROCEDURES
Probing (Eṣya) on moth-eaten wood Extraction (Āhārya) on stone inside jackfruit
30PLASTIC RECONSTRUCTION OF THE NOSE
Most famous operation described by Suśruta: labelled
“Indian method of rhinoplasty”.
Suśruta's description was brief, but clear.
Note the tubes inserted to
turned to reconstruct the nose.
Flap from adjacent cheek
keep nasal openings patent.
Nasal defect
Reconstruction of the nose
Nose reconstruction had an interesting history.
31SURGICAL INSTRUMENTS
BLUNT INSTRUMENTS (YANTRAS): Examples
Employed for the extraction of foreign bodies, loosening
foreign bodies, apposing wound edges, pulling out, etc.
An abbreviated list is shown in Table.
TABLE : Forceps (Svastika)
Types Subtypes Functions
Forceps 10 sub types named after Pulling out impacted
(Svastika) animals: Lion forceps, Tiger foreign bodies.
forceps, etc.
Lion face (simhamukha) Tiger face (vyāghramukha)
32SHARP INSTRUMENTS (ŚASTRAS) : Examples
Mouth like śarāri bird (śarārimukha) Puncturing instrument
(kuṭhārika)
Semilunar shaped Three bladed instrument
scissors (antarmukha) (trikūrcaka)
Scissors and other sharp instruments 33TRAINING TO BE A PHYSICIAN
INITIATION INTO TRAINING
A solemn ceremony before a sacrificial fire, attended
by other students and learned men. The preceptor
would pronounce exhortations and the pupil would
comply by saying “I do”.
The exhortation for the medical student was as
follows:
“You should give up lust, anger, avarice, folly, vanity,
pride, envy, rudeness, deception, falsehood, idleness
and all other reprehensible conduct. You should
always have your hair and nails cut short, should put
on red coloured cloth, lead a pure life, avoid sexual
intercourse and be ready to obey your superiors.
Contd….
34INITIATION INTO TRAINING
(Extracts from Oath)
You should remain, go about, lie down, sit down, eat and
study according to my wishes, and you should always be
ready to seek my welfare. thou shouldst speak words that
are soft, unstained by impurity, fraught with righteousness,
incapable of giving pain to others, worthy of praise,
truthful, beneficial and properly weighed and measured;
thou shouldst always conduct thyself taking note of place
and time; thou shouldst always act heedfully; thou
shouldst always strive to acquire knowledge to cast off
sloth, to keep ready with the implements and medicines
thou mayest require; while entering the family dwelling-
place of the patient, thou shouldst do it with notice to the
inmates and with their permission; thou shouldst be
accompanied by some male member of the family;
35EVOLUTION OF SCIENTIFIC
RESEARCH IN AYURVEDA
The history of scientific research in Ayurveda is reminiscent
of the use of different tools for extracting materials from a
mine; different tools picked out different materials.
Garcia da Orta, Van Rheede, Roxburgh represent the use of
botanical approach to Ayurveda; RN Chopra pioneered
pharmacological research; many noted chemists created a
wave in natural products chemistry which dominated
scientific research in Ayurveda throughout 20th Century.
The common thread running through the effort of centuries
in plant science, pharmacology, and natural products
chemistry was the search for drugs for better therapeutics.
36A SCIENCE INITIATIVE IN AYURVEDA (ASIIA)
The advances in molecular biology and immunology in the
twentieth century have provided powerful tools to
investigate the concepts and procedures of Ayurveda,
which could not be done earlier.
ASIIA was launched in 2007 with the support of Department
of Science and Technology, Government of India to repair
the earlier omission. Research projects supported by ASIIA
were no different from conventional basic research, but the
areas selected had to be governed by a national perspective
and had to be based on cues derived from Ayurveda.
37Summary of three Studies
Rasayana:
• A branch of Ayurveda which offers
prevention of the infirmities in ageing.
• Amalaki rasayana (AR) used from
Charaka’s time.
• AR was prepared according to ancient
protocol by Arya Vaidya Sala, Kottakkal.
• Tested in two models:
– Rats: Professor K. Subba Rao, JNTU, Hyderabad.
– Drosophila : Professor SC Lakhotia, BHU, Varanasi.
38EFFECTS OF AR ON GENOMIC
STABILITY IN RAT BRAIN CELLS*
DNA damage expressed as the chain
breaks in brain neurons and astrocytes is
much less in AR fed rats at 3, 9, and 15
months.
Genomic stability is significantly
improved by AR feeding.
*Umakanta Swain, Kiran Kumar Sindhu, Ushasri Boda, Suresh Pothani, Nappan
V. Giridharan, Manchala Raghunath, Kalluri Subba Rao. Studies on the
molecular correlates of genomic stability in rat brain cells following
Āmalakīrasāyana therapy. Mech. Ageing Dev. 2012 Apr;133(4):112-7,
doi:10.1016/j.mad.2011.10.006
39BIOLOGICAL EFFECTS OF AR ON
DROSOPHILA MELANOGASTER*
AR fed flies showed the following significant changes:
Earlier pupation and earlier adult eclosion time.
Increase in the size of salivary glands.
Increase in hatched eggs in female flies fed AR from
larvae stage.
Increase in medium life span.
Increase in tolerance of thermal stress and
starvation.
*Vibha Dwivedi, E. M. Anandan, Rajesh S. Mony, T. S. Muraleedharan, M. S.
Valiathan, Mousumi Mutsuddi, Subhash C. Lakhotia. In Vivo Effects of Traditional
Ayurvedic Formulations in Drosophila melanogaster Model Relate with Therapeutic
Applications. PLoS ONE Volume 7, Issue 5, e37113 May 2012
40III. PHYSICO-CHEMICAL CHARACTERISATION OF
A MERCURY-BASED DRUG (RASASINDŪR)
The observation by Siddha and Ayurvedic
physicians raised the question “whether the
elaborate processing of minerals in the ancient
protocol brings about important physico-chemical
changes including altered micro-structure in an
Ayurvedic mercury-based drug? (Rasasindūr).
For this study, research-grade Rasasindūr was
specially prepared by scientists of Arya Vaidya
Sala, Kottakkal, Kerala according to the ancient
protocol and the characterisation studies were
done at IIT, Kharagpur.
A. Arun., et. al. Mercury Based Drug in Ancient India: The Case of Red
Sulfide Mercury in Nanoscale. Bulletin of Materials Science (Under
Review) 41CHARACTERISATION STUDIES
The following studies were done in IIT, Kharagpur on
the Rasasindūr samples.
Parameters Tests
Elemental composition Energy-dispersion x-ray analysis
(Bulk and point). (SEM-EDS)
Crystalline phase X-ray powder diffraction.
Particle size, morphology, SEM, FESEM, TEM, BET-isotherm.
surface area.
Other spectroscopic FT-IR
studies.
42HIGHLIGHTS OF RESULTS
EDS point analysis showed the absence of
elements other than mercury and sulphur.
All samples contained 4 phases of mercuric
sulphide belonging to hexagonal P3121 space
group. Commercials samples of Rasasindūr
contain traces of HgS as impurity.
Mercuric sulphide samples prepared in IIT,
Kharagpur following modern protocol in chemistry
texts do not contain any of the phases mentioned
above. It shows a single phase belonging to
hexagonal p6/mmm space group.
Contd…
43HIGHLIGHTS OF RESULTS
SEM, TEM, FESEM images of Rasasindūr
samples indicate that particles are in nano-
regime, with varying particle sizes. They are
nano-crystalline.
Rasasindūr shows distinct tendency to form
complexes with serum albumin.
In nano-regime, redox property of a
metal/material changes dramatically. This
could be an answer to the riddle of the “non-
toxicity” of rasasindūr.
44NEW SPROUTS ON AN ANCIENT TREE
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