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{{Short description|Alternative medicine with roots in India}}
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{{EngvarB|date=October 2013}} {{EngvarB|date=October 2013}}
{{Use dmy dates|date=October 2013}} {{Use dmy dates|date=September 2020}}
], an avatar of ], is the Hindu god associated with ayurveda.]]
{{Alternative medical systems
{{Alternative medical systems| traditional}}{{Hinduism|scriptures}}
| image = ]
'''Ayurveda''' ({{IPAc-en|ˌ|ɑː|j|ʊər|ˈ|v|eɪ|d|ə|,_|-|ˈ|v|iː|-}}; {{IAST3|āyurveda}}<ref name="oxford">{{Cite web |title=Ayurveda |url=https://en.oxforddictionaries.com/definition/ayurveda |url-status=dead |archive-url=https://web.archive.org/web/20161210124157/https://en.oxforddictionaries.com/definition/Ayurveda |archive-date=10 December 2016 |website=Oxford University Press}}</ref>) is an ] system with historical roots in the Indian subcontinent.<ref name=HIML-intro>{{cite book|last1=Meulenbeld|first1=Gerrit Jan|title=A History of Indian Medical Literature|date=1999|publisher=Egbert Forsten|location=Groningen|isbn=978-90-6980-124-7|chapter=Introduction}}<!--|access-date=16 October 2015--></ref> It is heavily practiced throughout India and Nepal, where as much as 80% of the population report using ayurveda.<ref name="who01"/><ref>{{Cite web |year=2009 |title=Backgrounder. Ayurvedic Mecicine: an Introduction |url=https://www.govinfo.gov/content/pkg/GOVPUB-HE20-PURL-gpo29672/pdf/GOVPUB-HE20-PURL-gpo29672.pdf |access-date=2024-06-03 |publisher=US Department of Health and Human Services |id=D287 |agency=GovInfo: Discover U.S. Government Information}}</ref><ref name=":1" /><ref name=":3" /> The theory and practice of ayurveda is ] and toxic metals such as lead are used as ingredients in many ayurvedic medicines.<ref name="kaufman">{{Cite book |last=Beall |first=Jeffrey |title=Pseudoscience: The Conspiracy Against Science |publisher=MIT Press |year=2018 |isbn=978-0-262-03742-6 |editor-last=Kaufman |editor-first=Allison B. |page=293 |chapter=Scientific soundness and the problem of predatory journals |quote=Ayurveda, a traditional Indian medicine, is the subject of more than a dozen, with some of these 'scholarly' journals devoted to Ayurveda alone&nbsp;..., others to Ayurveda and some other pseudoscience.&nbsp;... Most current Ayurveda research can be classified as 'tooth fairy science,' research that accepts as its premise something not scientifically known to exist.&nbsp;... Ayurveda is a long-standing system of beliefs and traditions, but its claimed effects have not been scientifically proven. Most Ayurveda researchers might as well be studying the tooth fairy. The German publisher Wolters Kluwer bought the Indian open-access publisher Medknow in 2011....It acquired its entire fleet of journals, including those devoted to pseudoscience topics such as ''An International Quarterly Journal of Research in Ayurveda''. |author-link=Jeffrey Beall |editor-last2=Kaufman |editor-first2=James C. |chapter-url=https://books.google.com/books?id=dwFKDwAAQBAJ&pg=PA293 |access-date=11 September 2020 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105226/https://books.google.com/books?id=dwFKDwAAQBAJ&pg=PA293 |url-status=live }}</ref><ref name="Quack-2011" /><ref name="Dargan" /><ref>{{Cite journal |last=Saper |first=Robert B. |date=2008-08-27 |title=Lead, Mercury, and Arsenic in US- and Indian-Manufactured Ayurvedic Medicines Sold via the Internet |journal=JAMA |language=en |volume=300 |issue=8 |pages=915–923 |doi=10.1001/jama.300.8.915 |issn=0098-7484 |pmc=2755247 |pmid=18728265}}</ref>
| caption = ], the god of Ayurveda worshipped at an Ayurveda expo, ].
}}
{{Hinduism}}
'''Ayurveda''' (] {{lang|sa| ''Āyurveda'' आयुर्वेद}}, "]-]"; English pronunciation {{IPAc-en|ˌ|aɪ|.|ər|ˈ|v|eɪ|d|ə|}}<ref>{{cite book | last1 = Wells | first1 = John C. | authorlink1 = John C. Wells | title = Longman Pronunciation Dictionary | publisher = Pearson Longman | year = 2009 | location = London | accessdate = 31 May 2011}}</ref>) or '''Ayurvedic medicine''' is a system of ] ],<ref></ref> is native to the ], and is a form of ]. The oldest known Ayurvedic texts are the '']'' and the '']''. These ] texts are among the foundational and formally compiled works of Ayurveda.
]]]


Ayurveda therapies have varied and evolved over more than two millennia.<ref name="HIML-intro" /> Therapies include ]s, ], ], ], ], ], ], and medical oils.<ref name="WebMD" /><ref name="cruk" /> Ayurvedic preparations are typically based on complex herbal compounds, minerals, and metal substances (perhaps under the influence of early Indian alchemy or '']''). Ancient ayurveda texts also taught surgical techniques, including ], ], sutures, ], and the extraction of foreign objects.{{sfn|Wujastyk|2003a}}<ref name="mukh-surg">{{Cite book |last=Mukhopadhyaya |first=Girindranath |url=https://archive.org/details/cu31924012165522 |title=The Surgical Instruments of the Hindus, with a Comparative Study of the Surgical Instruments of the Greek, Roman, Arab, and the Modern European Surgeons |date=1913 |publisher=Calcutta University |location=Calcutta |access-date=16 October 2015}}</ref>
By the medieval period, Ayurvedic practitioners developed a number of medicinal preparations and surgical procedures for the treatment of various ailments.<ref name="Dwivedi&Dwivedi07">Dwivedi & Dwivedi (2007)</ref> Practices that are derived from Ayurvedic medicine are regarded as part of ],<ref name="nccam1">{{cite journal |url= http://nccam.nih.gov/news/newsletter/2006_winter/ayurveda.htm |title=A Closer Look at Ayurvedic Medicine |journal=Focus on Complementary and Alternative Medicine |volume=12 |issue=4 |date=Fall 2005 – Winter 2006 |publisher=] (NCCAM), ] (NIH) |location=Bethesda, Maryland |archiveurl= https://web.archive.org/web/20061209114559/http://nccam.nih.gov/news/newsletter/2006_winter/ayurveda.htm |archivedate= 2006-12-09 }}</ref> and along with ] and ], forms the basis for ].<ref name=Chopra>{{cite web|url=http://www.chopra.com/systemshealth-shiva|title=About VA Shiva Ayyadurai| accessdate=14 February 2013}}</ref>


Historical evidence for ayurvedic texts, terminology and concepts appears from the middle of the first millennium BCE onwards.<ref>{{Cite book |last=Meulenbeld |first=G. Jan |title=A history of Indian medical literature |publisher=Egbert Forsten; Brill |year=1999–2000 |isbn=90-6980-124-8 |location=Groningen |pages=passim |oclc=42207455}}</ref> The main classical ayurveda texts begin with accounts of the transmission of medical knowledge from the gods to sages, and then to human physicians.<ref name="zysk-myth">{{cite book|last1=Zysk|first1=Kenneth G.|editor1-last=Josephson|editor1-first=Folke|title=Categorisation and Interpretation|date=1999|publisher=Meijerbergs institut för svensk etymologisk forskning, Göteborgs universitet|isbn=978-91-630-7978-8|pages=125–145|chapter=Mythology and the Brāhmaṇization of Indian medicine: Transforming Heterodoxy into Orthodoxy}}<!--|access-date=16 October 2015--></ref> Printed editions of the '']'' (''Sushruta's Compendium''), frame the work as the teachings of ], the ] of ayurveda, incarnated as King ] of Varanasi, to a group of physicians, including ].<ref>{{Cite book |last=Bhishagratna |first=Kaviraj Kunjalal |url=https://archive.org/stream/b24758619_0001#page/n103/mode/2up |title=An English Translation of the Sushruta Samhita Based on Original Sanskrit text |date=1907 |publisher=K. K. Bhishagratna |location=Calcutta |page=1 |access-date=16 October 2015}}</ref><ref name="britannica">{{Cite web |title=Dhanvantari. (2010). In Encyclopædia Britannica. Retrieved 4 August 2010, from Encyclopædia Britannica Online |url=https://www.britannica.com/EBchecked/topic/160641/Dhanvantari |url-status=live |archive-url=https://web.archive.org/web/20150427134748/http://www.britannica.com/EBchecked/topic/160641/Dhanvantari |archive-date=27 April 2015 |access-date=2 June 2022}}</ref> The oldest manuscripts of the work, however, omit this frame, ascribing the work directly to King Divodāsa.<ref>{{Cite journal |last1=Birch |first1=Jason |last2=Wujastyk |first2=Dominik |last3=Klebanov |first3=Andrey |last4=Parameswaran |first4=Madhu |last5=Rimal |first5=Madhusudan |last6=Chakraborty |first6=Deepro |last7=Bhatt |first7=Harshal |last8=Shenoy |first8=Devyani |last9=Lele |first9=Vandana |date=2021 |title=Further Insight into the Role of Dhanvantari, the physician to the gods, in the Suśrutasaṃhitā |url=https://www.academia.edu/56668282 |journal=Academia Letters |doi=10.20935/al2992 |s2cid=238681626 |access-date=2 May 2022 |archive-date=15 April 2023 |archive-url=https://web.archive.org/web/20230415232626/https://www.academia.edu/56668282 |url-status=live }}</ref>
Ayurveda is at present well integrated into the Indian National health care system, with state hospitals for Ayurveda established across the country.<ref name="who01">"Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review". ] (WHO) Source: (accessed: Tuesday June 24, 2014), c.8.5</ref> In the United States, the practice of Ayurveda is licensed in complementary heath care.<ref name ="nihintro">http://nccam.nih.gov/health/ayurveda/introduction.htm</ref>


In ayurveda texts, '']'' balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness.<ref name="WujastykXVIII" /> Ayurveda treatises describe three elemental ''doshas'': ''vāta'', ''pitta'' and ''kapha'', and state that balance (] ''sāmyatva'') of the ''doshas'' 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 ].<ref name="shar-hist">{{Cite book |last=Sharma |first=Priya Vrat |title=History of Medicine in India |date=1992 |publisher=Indian National Science Academy |location=New Delhi}}</ref>
There is no scientific evidence for the effectiveness of Ayurvedic medicine for the treatment of any disease.<ref name=cruk>{{cite web |title=Ayurvedic medicine |publisher=] |url=http://www.cancerresearchuk.org/cancer-help/about-cancer/treatment/complementary-alternative/therapies/ayurvedic-medicine |accessdate=August 2013}}</ref> Concerns have been raised about Ayurvedic products; ] studies showed that up to 20% of Ayurvedic U.S. and Indian-manufactured ]s sold through internet contained toxic levels of heavy metals such as ], ] and ].<ref name="Valiathan06">{{cite journal|last=Valiathan|first=MS|title=Ayurveda: putting the house in order |journal=Current Science |volume=90 |issue=1|pages=5–6|year=2006|publisher=]|url=http://www.currentscience.ac.in/Downloads/article_id_090_01_0005_0006_0.pdf|format=pdf}}</ref><ref name="Saper2008">{{cite journal |author1=Saper RB |title=Lead, mercury, and arsenic in US- and Indian-manufactured medicines sold via the internet |journal=JAMA |volume=300 |issue=8 |pages=915–923 |year=2008 |pmid=18728265 |doi=10.1001/jama.300.8.915 |pmc=2755247 |author2=Phillips RS |author3=Sehgal A |display-authors=2 |last4=Khouri |first4=N |last5=Davis |first5=RB |last6=Paquin |first6=J |last7=Thuppil |first7=V |last8=Kales |first8=SN}}</ref>


Ayurveda has been adapted for Western consumption, notably by ] in the 1970s and ] in the 1980s.<ref name=":9">{{Cite book |last1=Wujastyk |first1=Dagmar |url=https://books.google.com/books?id=M3XBu-vpXgoC&pg=PP1 |title=Modern and Global Ayurveda: Pluralism and Paradigms |last2=Smith |first2=Frederick M. |date=2013-09-09 |publisher=SUNY Press |isbn=978-0-7914-7816-5 |language=en |access-date=10 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105230/https://books.google.com/books?id=M3XBu-vpXgoC&pg=PP1 |url-status=live }}</ref>
== Eight components of Ayurveda ==
In classical Sanskrit literature, Ayurveda was called "the science of eight components" (Sanskrit ''aṣṭāṅga'' अष्टांग), a classification that became canonical for Ayurveda:<ref name="Chopra80">{{harvnb|Chopra|2003|p=80}}</ref><ref>], ''A Sanskrit Dictionary'' (1899), s.v. "Āyurveda" {{OL|7164320M}}</ref>
*(]) – ''Kāya-chikitsā'': "cure of diseases affecting the body"<ref>{{cite book|title=Encyclopaedia of Indian Medicines (3 Volume Set)|author=Usha Srivastava|page=255|publisher=Pinnacle}}</ref>
*(]) – ''Kaumāra-bhṛtya'': "treatment of children"<ref>{{cite book|title=Children's Surgery: A Worldwide History|author=John G. Raffensperger, M.D|page=21|publisher=McFarland}}</ref>
*(]) – ''Śhalya-chikitsā'': Removal of any substance which has entered the body (as extraction of darts, of splinters, etc.)"<ref>{{cite book|title=Encyclopaedia of Indian Medicines (3 Volume Set)|author=Usha Srivastava|page=256-257|publisher=Pinnacle}}</ref>
*(] / ]/]) – ''Śālākya-tantra'': "cure of diseases of the teeth, eye, nose or ear etc. by sharp instruments" {{dubious|date=January 2013}}<ref>{{cite book|title=Encyclopaedia of Indian Medicines (3 Volume Set)|author=Usha Srivastava|page=257|publisher=Pinnacle}}
*(] / ] / ]) – '']-vidyā'': "treatment of mental diseases"<ref>{{cite book|title=Psychiatric Mental Health Nursing|author=B. T. Basavanthappa|page=35|publisher=Jaypee Brothers Publishers}}</ref><ref>{{cite book|title=Shamans, Mystics, and Doctors|author=Sudhir Kakar|page=243|publisher=Knopf Doubleday Publishing Group}}</ref>
*(]) – '']-tantra'':Gada means Poison. "doctrine of antidotes"<ref>{{cite book|title=Basic Principles of Āyurveda: Based on Āyurveda Saukhyaṁ of Ṭoḍarānanda|author=Bhagwan Dash, Lalitesh Kashyap|page=46|publisher=Concept Publishing Company}}</ref>
*(]s) – '']-'' ''Rasayana-tantra'': "doctrine of ]"/]<ref>{{cite book|title=Encyclopaedia Of Indian Medicine -, Volume 1|author=Ramachandra S.K. Rao|page=78|publisher=Concept publication}}</ref><ref>{{cite book|title=Fundamentals of Oral Medicine and Radiology|page=417-419|publisher=]|author=Durgesh M. Bailoor}}</ref>
*(]) – '']-Vajikarana tantra. ''It deals with healthy and desired progeny.<ref>{{cite book|title=Ayurvedic Medicine: The Principles of Traditional Practice |publisher=Singing Dragon|page=106|author=Sebastian Pole}}</ref><ref>{{cite book|title=Fundamental Maxims of Ayurveda|page=13|publisher=Abhinav Publications|author=Mr. S. V. Givindan}}</ref>


Although some Ayurvedic treatments can help relieve the symptoms of cancer, there is no good evidence that the disease can be treated or cured through ayurveda.<ref name="cruk" />
==Principles and terminology==
] and Ayurveda. Shown in the image is the philosopher ]—known chiefly for his doctrine of the '']'' (middle path)—who wrote medical works ''The Hundred Prescriptions'' and ''The Precious Collection'', among others.<ref name="CliffordMLBD">Clifford, Terry (2003). ''Tibetan Buddhist Medicine and Psychiatry''. 42. Motilal Banarsidass Publications. ISBN 81-208-1784-2.</ref>]]
]


Some ayurvedic preparations have been found to contain ], ], and ],<ref name="WebMD">{{Cite web |last=Miller |first=Kelli |date=March 20, 2021 |others=Medically Reviewed by Melinda Ratini |title=What Is Ayurveda? |url=https://www.webmd.com/balance/qa/is-ayurveda-treatment-approved-in-the-us |website=WebMD |access-date=16 August 2020 |archive-date=4 July 2020 |archive-url=https://web.archive.org/web/20200704232004/https://www.webmd.com/balance/qa/is-ayurveda-treatment-approved-in-the-us |url-status=live }}</ref><ref name=":11">{{Cite journal |last1=Bhalla |first1=A |last2=Pannu |first2=A K |date=2022-01-15 |title=Are Ayurvedic medications store house of heavy metals? |journal=Toxicology Research |publisher=Oxford University Press |publication-date=February 2022|volume=11 |issue=1 |pages=179–183 |doi=10.1093/toxres/tfab124 |pmid=35237422|pmc=8882783 }}</ref> substances known to be ]. A 2008 study found the three substances in close to 21% of U.S. and Indian-manufactured patent ayurvedic medicines sold through the Internet.<ref name="Saper2008">{{Cite journal |last1=Saper RB |last2=Phillips RS |last3=Sehgal A |last4=Khouri |first4=N |last5=Davis |first5=RB |last6=Paquin |first6=J |last7=Thuppil |first7=V |last8=Kales |first8=SN |display-authors=2 |year=2008 |title=Lead, mercury, and arsenic in US- and Indian-manufactured medicines sold via the internet |journal=JAMA |volume=300 |issue=8 |pages=915–923 |doi=10.1001/jama.300.8.915 |pmc=2755247 |pmid=18728265}}</ref> The public health implications of such metallic contaminants in India are unknown.<ref name="Saper2008" />
There are two ways in which to approach Ayurvedic principles and terminology: one may either focus on the historical foundation (as evidenced in the oldest Ayurvedic texts, going back to the early centuries of the ]) or, alternatively, a description may take an ] approach and focus on the forms of traditional medicine prevalent across India today.


== Etymology ==
Much like the medicine of classical antiquity, Ayurveda has historically taken the approach of enumerating bodily substances in the framework of the five ] (Sanskrit ''panchabhuta'', viz. ], ], ], ] and ]. Moreover, Ayurveda names seven basic tissues (]). They are plasma (''rasa''), blood (''rakta''), muscles (''māmsa''), fat (''meda''), bone (''asthi''), ] (''majja''), and semen (''shukra'').<ref name="Underwood&Rhodes(2008)" />
The term ''āyurveda'' ({{langx|sa|]}}) is composed of two words, ''āyus'', {{Lang|sa|आयुस्}}, "life" or "longevity", and ''veda'', {{Lang|sa|वेद}}, "knowledge", translated as "knowledge of longevity"<ref name="MaasCambridge_2018">{{Cite book |last=Maas |first=Philipp A. |title=The Cambridge History of Science: Volume 1, Ancient Science |date=2018 |publisher=Cambridge University Press |isbn=978-1-108-68262-6 |editor-last=Jones |editor-first=Alexander |pages=532–550 |language=en |chapter=27. Indian Medicine and Ayurveda |doi=10.1017/9780511980145.029 |editor-last2=Taub |editor-first2=Liba |chapter-url=https://books.google.com/books?id=DWV9DwAAQBAJ&dq=The+Cambridge+History+of+Science+vol+1+Indian+Medicine+and+Ayurveda&pg=PT727 |s2cid=209267391 |access-date=24 April 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105227/https://books.google.com/books?id=DWV9DwAAQBAJ&dq=The+Cambridge+History+of+Science+vol+1+Indian+Medicine+and+Ayurveda&pg=PT727 |url-status=live }}</ref><ref name="Smith+Wujastyk" /> or "knowledge of life and longevity".<ref name="GregoryFields">{{Cite book |last=Fields |first=Gregory P. |url=https://books.google.com/books?id=rvQhuyGpB3wC&pg=PA37 |title=Religious Therapeutics: Body and Health in Yoga, Ayurveda, and Tantra |date=2001 |publisher=SUNY Press |isbn=978-0-7914-4915-8 |page=36 |access-date=10 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105227/https://books.google.com/books?id=rvQhuyGpB3wC&pg=PA37 |url-status=live }}</ref>

== Eight components ==
], known for the '']'' (middle path), wrote the medical works ''The Hundred Prescriptions'' and ''The Precious Collection''.<ref name="CliffordMLBD">Clifford, Terry; Chandra, Lokesh (2017). {{Webarchive|url=https://web.archive.org/web/20230508175039/https://books.google.com/books?id=FiEzEAAAQBAJ&q=Ayurveda |date=8 May 2023 }} 42. Motilal Banarsidass Publications. {{ISBN|978-8120812055}}.</ref>|left]]

The earliest classical ] works on ayurveda describe medicine as being divided into eight components (Skt. ''aṅga'').<ref>{{Cite book |title=Suśrutasaṃhitā |publisher=Nirṇayasāgara Press |year=1945 |editor-last=Ācārya |editor-first=Yādava Trivikramātmaja |location=Bombay |pages=2–3 |chapter=Sūtrasthāna 1.7–9 |chapter-url=https://archive.org/stream/sushrutasamhita/sushruta_samhita_critical#page/n229/mode/2up}}</ref><ref>{{Cite book |title=The Carakasaṃhitā of Caraka, with the commentary by Cakrapāṇidatta, edited by Yadavaśarman Trivikarama Ācārya |publisher=Nirṇayasāgara Press |year=1941 |editor-last=Ācārya |editor-first=Yādava Trivikramātmaja |location=Bombay |pages=189 |chapter=Sūtrasthāna 30.28 |chapter-url=https://archive.org/stream/TheCarakasahitOrCharakasamhitaOfCarakaEditedByYadavaarman/Carakasamhita-Trikamji1941#page/n253/mode/2up}}</ref> This characterization of the physician's art, "the medicine that has eight components" ({{Langx|sa|चिकित्सायामष्टाङ्गायाम्|translit=cikitsāyām aṣṭāṅgāyāṃ}}), is first found in the Sanskrit epic the ], c. 4th century BCE.<ref>{{Cite book |last=Wujastyk |first=Dominik |title=The Blackwell Companion to Hinduism |publisher=Blackwell |year=2003b |isbn=978-1-4051-3251-0 |editor-last=Flood |editor-first=Gavin |location=Oxford |pages=394 |chapter=Indian Medicine}}</ref> The components are:<ref>{{Cite book |last=Sharma |first=Priya Vrat |title=Suśruta-Samhitā With English Translation of text… |publisher=Chaukhambha Visvabharati |year=1999 |volume=1 |location=Varanasi |pages=7–11}}{{Request quotation|date=November 2015}}</ref><ref name="GregoryFields" /><ref>{{Cite book |last=Bhishagratna |first=Kaviraj Kunja Lal |url=https://archive.org/stream/englishtranslati01susruoft#page/2/mode/2up |title=An English Translation of the Sushruta Samhita Based on Original Sanskrit Text |publisher=The Author |year=1907 |volume=1 |location=Calcutta |pages=2–6}}</ref>
* ''Kāyachikitsā'': general medicine, medicine of the body
* ''Kaumāra-bhṛtya'' (Pediatrics): Discussions about prenatal and postnatal care of baby and mother; methods of conception; choosing the child's sex, intelligence, and constitution; childhood diseases; and midwifery<ref>{{Cite book |last=Swami Sadashiva Tirtha |url=https://archive.org/details/ayurvedaencyclop00tirt |title=The Ãyurveda Encyclopedia: Natural Secrets to Healing, Prevention & Longevity |publisher=Ayurveda Holistic Center Press |year=1998 |isbn=0-9658042-2-4 |url-access=registration}}</ref>
* ''Śalyatantra'': ] and the extraction of foreign objects
* ''Śhālākyatantra:'' treatment of ailments affecting openings or cavities in the upper body: ears, eyes, nose, mouth, etc.
* ''Bhūtavidyā'': pacification of possessing spirits, and the people whose minds are affected by such possession
* '']tantra''/''Vishagara-vairodh Tantra'' (Toxicology): includes epidemics; toxins in animals, vegetables and minerals; and keys for recognizing those anomalies and their antidotes
* ''Rasāyantantra'': ] and tonics for increasing lifespan, intellect and strength
* ''Vājīkaraṇatantra'': ]; treatments for increasing the volume and viability of semen and sexual pleasure; infertility problems; and spiritual development (transmutation of sexual energy into spiritual energy)

== Principles and terminology ==
{{further|Mahābhūta}} {{further|Mahābhūta}}
The central theoretical ideas of ayurveda show parallels with ] and ] philosophies, as well as with ] and ].<ref>{{Cite book |last=Comba |first=Antonella |url=https://books.google.com/books?id=xDvbumli2i0C |title=Studies on Indian Medical History |publisher=Motilal Banarsidass |year=2001 |isbn=978-8120817685 |editor-last=Meulenbeld |editor-first=Gerrit Jan |location=Delhi |pages=39–55 |chapter=Carakasaṃhitā, Śārīrasthāna~I and Vaiśeṣika Philosophy |editor-last2=Wujastyk |editor-first2=Dominik |access-date=9 April 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105227/https://books.google.com/books?id=xDvbumli2i0C |url-status=live }}</ref><ref>{{Cite book |last=Basham |first=A. L. |url=https://www.degruyter.com/document/doi/10.1525/9780520322295-005/html |title=Asian Medical Systems |publisher=University of California Press |year=1976 |isbn=978-0-520-32229-5 |editor-last=Leslie |editor-first=Charles |location=Berkeley |pages=18–43 |chapter=The Practice of Medicine in Ancient and Medieval India |doi=10.1525/9780520322295-005 |access-date=1 March 2022 |archive-date=1 March 2022 |archive-url=https://web.archive.org/web/20220301041952/https://www.degruyter.com/document/doi/10.1525/9780520322295-005/html |url-status=live }}</ref> Balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness.<ref name="WujastykXVIII" /> For example, to suppress sneezing is said to potentially give rise to shoulder pain.<ref>{{Cite journal |last1=Pathak |first1=Namyata |last2=Raut |first2=Ashwinikumar |last3=Vaidya |first3=Ashok |date=2008-10-01 |title=Acute cervical pain syndrome resulting from suppressed sneezing |url=https://www.researchgate.net/publication/23670923 |journal=The Journal of the Association of Physicians of India |volume=56 |pages=728–9}}</ref> However, people are also cautioned to stay within the limits of reasonable balance and measure when following nature's urges.<ref name="WujastykXVIII" /> For example, emphasis is placed on moderation of food intake,<ref name="Chopra75">{{Harvnb|Chopra|2003|p=75}}</ref> sleep, and sexual intercourse.<ref name="WujastykXVIII">{{harvnb|Wujastyk|2003a|page=xviii}}</ref>


]s and the five elements from which they are composed]]
Ayurveda states that a balance of the three elemental substances, the '']''s, equals health, while imbalance equals disease. There are three ''dosha''s: Vata, Pitta and Kapha. One Ayurvedic theory states that each human possesses a unique combination of these ''doshas'' which define this person's temperament and characteristics. Each person has a natural state, or natural combination of these three elements, and should seek balance by modulating their behavior or environment. In this way they can increase or decrease the doshas they lack or have an abundance of them respectively. Another view present in the ancient literature states that dosha equality is identical to health, and that persons with imbalance of dosha are proportionately unhealthy, because they are not in their natural state of balance. ] is one of the most important concepts in Ayurveda.
According to ayurveda, the human body is composed of tissues ('']''), waste (''malas''), and humeral biomaterials ('']s'').<ref name="Mishra" /> The seven ''dhatus'' are chyle (''rasa''), blood (''rakta''), muscles (''māmsa''), fat (''meda''), bone (''asthi''), ] (''majja''), and semen (''shukra''). Like the medicine of classical antiquity, the classic treatises of ayurveda divided bodily substances into five ] ('']'') viz. ], ], ], ] and ].<ref name="Underwood&Rhodes(2008)" /> There are also twenty ]s (qualities or characteristics) which are considered to be inherent in all matter. These are organized in ten pairs: heavy/light, cold/hot, unctuous/dry, dull/sharp, stable/mobile, soft/hard, non-slimy/slimy, smooth/coarse, minute/gross, and viscous/liquid.<ref name="Chopra76">{{harvnb|Chopra|2003|p=76}}, citing Sushrutasamhita 25.36.</ref>
{{further|Dosha}}


{{Anchor|Tridosha system}}The three postulated elemental bodily humours, the ''doshas'' or ''tridosha'', are ''vata'' (air, which some modern authors equate with the nervous system), ''pitta'' (bile, fire, equated by some with enzymes), and ''kapha'' (phlegm, or earth and water, equated by some with mucus). Contemporary critics assert that ''doshas'' are not real, but are a fictional concept.<ref name="sn">{{Cite web |date=21 November 2019 |title=Ayurvedic practitioners push for licensing in Colorado |url=https://sciencebasedmedicine.org/ayurvedic-practitioners-push-licensing-in-colorado/ |publisher=] |vauthors=Novella S |access-date=27 March 2022 |archive-date=27 March 2022 |archive-url=https://web.archive.org/web/20220327035944/https://sciencebasedmedicine.org/ayurvedic-practitioners-push-licensing-in-colorado/ |url-status=live }}</ref> The humours (''doshas'') may also affect mental health. Each ''dosha'' has particular attributes and roles within the body and mind; the natural predominance of one or more ''doshas'' thus explains a person's physical constitution (''prakriti'') and personality.<ref name="Mishra">{{Cite journal |last1=Mishra |first1=Lakshmi-chandra |last2=Singh |first2=Betsy B. |last3=Dagenais |first3=Simon |date=March 2001 |title=Ayurveda: a historical perspective and principles of the traditional healthcare system in India |url=https://www.researchgate.net/publication/12079939 |journal=Alternative Therapies in Health and Medicine |volume=42 |issue=2 |pages=36–42 |pmid=11253415}}</ref><ref name="Payya">{{Cite journal |last1=Payyappallimana |first1=Unnikrishnan |last2=Venkatasubramanian |first2=Padma |date=31 March 2016 |title=Exploring Ayurvedic Knowledge on Food and Health for Providing Innovative Solutions to Contemporary Healthcare |journal=Frontiers in Public Health |volume=4 |issue=57 |page=57 |doi=10.3389/fpubh.2016.00057 |pmc=4815005 |pmid=27066472 |doi-access=free}}</ref><ref>{{Cite journal |last1=Shilpa |first1=S |last2=Venkatesha Murthy |first2=C.G. |date=January 2011 |title=Understanding personality from Ayurvedic perspective for psychological assessment: A case |journal=AYU |publisher=Institute for Post Graduate Teaching & Research in Ayurveda |volume=32 |issue=1 |pages=12–19 |doi=10.4103/0974-8520.85716 |pmc=3215408 |pmid=22131752 |doi-access=free}}</ref> Ayurvedic tradition holds that imbalance among the bodily and mental ''doshas'' is a major etiologic component of disease. One ayurvedic view is that the ''doshas'' are balanced when they are equal to each other, while another view is that each human possesses a unique combination of the ''doshas'' which define this person's temperament and characteristics. In either case, it says that each person should modulate their behavior or environment to increase or decrease the ''doshas'' and maintain their natural state. Practitioners of ayurveda must determine an individual's bodily and mental ''dosha'' makeup, as certain ''prakriti'' are said to predispose one to particular diseases.<ref name="mental" /><ref name="Mishra" /> For example, a person who is thin, shy, excitable, has a pronounced ], and enjoys esoteric knowledge is likely ''vata prakriti'' and therefore more susceptible to conditions such as flatulence, stuttering, and rheumatism.<ref name="Mishra" /><ref>{{Cite book |last=Bhagwan Dash |first=Vaidya |title=Fundamentals of Ayurvedic Medicine |publisher=Lotus Press |year=1995 |isbn=978-81-220-0117-4}}</ref> Deranged ''vata'' is also associated with certain mental disorders due to excited or excess ''vayu'' (gas), although the ayurvedic text '']'' also attributes "insanity" (''unmada'') to cold food and possession by the ghost of a sinful Brahman ('']'').<ref name="Mishra" /><ref name="mental">{{Cite journal |last1=Ramu |first1=M.G. |last2=Venkataram |first2=B.S. |date=January 1985 |title=Manovikara (mental disorders) in Ayurveda |journal=Ancient Science of Life |publisher=Wolters Kluwer Medknow Publications |volume=4 |issue=3 |pages=165–73 |pmc=3331508 |pmid=22557473}}</ref><ref>{{Cite web |date=21 September 2009 |title=Ayurvedic & Western approaches to the treatment of Schizophrenia |url=https://www.ayurvedacollege.com/blog/schizophrenia/#Types_of_insanity_unmada |access-date=6 July 2020 |website=ayurvedacollege.com |archive-date=8 July 2020 |archive-url=https://web.archive.org/web/20200708155617/https://www.ayurvedacollege.com/blog/schizophrenia/#Types_of_insanity_unmada |url-status=live }}</ref><ref>{{Cite book |last=Acharya |first=YT |title=Charaka samhita. Commentary of Chakrapani |date=1941 |publisher=Nirnayasagar Press |location=Bombay}}</ref>
In Ayurvedic theory, there are 20 qualities or characteristics (]s), which are inherent in all substances. They can be 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.<ref name="Chopra76">{{harvnb|Chopra|2003|p=76}}, citing Sushrutasamhita 25.36.</ref>
{{further|Guna}}


Ama (a Sanskrit word meaning "uncooked" or "undigested") is used to refer to the concept of anything that exists in a state of incomplete transformation. With regards to ], it is claimed to be a toxic byproduct generated by improper or incomplete ].<ref>{{Cite book |last=Kacera |first=Walter |url=https://books.google.com/books?id=0aQmGnxBmioC&q=Ayurvedic+Tongue+Diagnosis |title=Ayurvedic Tongue Diagnosis |publisher=Lotus Press |year=2007 |isbn=978-0-940985-77-3 |pages=159–176 |chapter=Ama and Disease}}</ref><ref>{{Cite journal |last=Amruthesh |first=Sunita |date=1 January 2008 |title=Dentistry and Ayurveda – IV: Classification and management of common oral diseases |journal=Indian Journal of Dental Research |volume=19 |issue=1 |pages=52–61 |doi=10.4103/0970-9290.38933 |pmid=18245925 |doi-access=free}}</ref><ref>{{Cite journal |last=Amruthesh |first=Sunita |date=2007 |title=Dentistry and Ayurveda-III (basics – ama, immunity, ojas, rasas, etiopathogenesis and prevention) |journal=Indian Journal of Dental Research |volume=18 |issue=3 |pages=112–9 |doi=10.4103/0970-9290.33786 |pmid=17687173 |doi-access=free}}</ref> The concept has no equivalent in ].
Ensuring the proper functions of channels (''srotas'') that transport fluids is one part of Ayurvedic treatment, because a lack of healthy channels is thought to cause diseases. Practitioners treat patients with massages using oils and ] (fomentation) to open up these channels.<ref name="WujastykXIX-XX">Wujastyk, pp. XIX-XX</ref>


In medieval taxonomies of the Sanskrit knowledge systems, ayurveda is assigned a place as a subsidiary ] (]).<ref>{{Cite book |last=Madhusūdanasarasvatī |url=https://archive.org/stream/Prasthanabheda.by.Madhusudana.Sarasvati#page/n15/mode/2up |title=प्रस्थानभेदः श्रीमधुसूदनसरस्वत्या विरचितः |date=1912 |publisher=श्रीवाणिविलासमुद्रायन्त्रालय |location=श्रीरङ्गम् |page=14 |language=sa |access-date=16 October 2015}}</ref> Some medicinal plant names from the '']'' and other Vedas can be found in subsequent ayurveda literature.<ref name="zysk-veda">{{cite book |last1=Zysk |first1=Kenneth G. |title=Medicine in the Veda: Religious Healing in the Veda with Translations and Annotations of Medical Hymns from the Rgveda and the Atharvaveda and Renderings from the Corresponding Ritual Texts |date=2010 |publisher=Motilal Banarsidass |isbn=978-81-208-1401-1 |location=New Delhi}}<!--|access-date=16 October 2015--></ref> Some other school of thoughts considers 'ayurveda' as the ']'.<ref>{{Cite book |last=Sengupta |first=Pradip Kumar |url=https://books.google.com/books?id=VNc9QvzCfLYC&pg=PA486 |title=History of Science and Philosophy of Science: A Philosophical Perspective of the Logic of Ideas in Science |date=2012 |publisher=Longman |isbn=978-81-317-1931-2 |pages=486 |language=en |quote=Sometimes Ayurveda is also considered as the fifth Veda or Pañcama Veda. |access-date=25 October 2021 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105800/https://books.google.com/books?id=VNc9QvzCfLYC&pg=PA486 |url-status=live }}</ref> The earliest recorded theoretical statements about the canonical models of disease in ayurveda occur in the earliest ].<ref name="zysk-asce">{{Cite book |last=Zysk |first=Kenneth G. |url=https://books.google.com/books?id=BAFndFpP4oUC&pg=PP9 |title=Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery |publisher=Motilal Banarsidass Publishers |year=1998 |isbn=978-81-208-1507-0 |series=Indian Medical Tradition |volume=2 |location=Delhi |access-date=February 28, 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105729/https://books.google.com/books?id=BAFndFpP4oUC&pg=PP9 |url-status=live }}</ref>
] and ] have had an influence on the development of many of Ayurveda's central ideas.<ref name="WujastykXVIII" /> Balance is emphasised; suppressing natural urges is considered unhealthy and claimed to lead to illness;<ref name="WujastykXVIII" /> to suppress sneezing, for example, may give rise to shoulder pain.<ref>Namyata Pathak, A Raut, ] (Accessed on 29 Oct 2013)</ref> However, people are also cautioned to stay within the limits of reasonable balance and measure when following nature's urges.<ref name="WujastykXVIII" /> For example, emphasis is placed on moderation of food intake,<ref name="Chopra75">{{Harvnb|Chopra|2003|p=75}}</ref> sleep, and sexual intercourse.<ref name="WujastykXVIII">Wujastyk, p. XVIII</ref>


==Practice== == Practice ==
]
Ayurvedic doctors regard physical and mental existence as well as 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 ] approach into account during diagnosis and therapy.
Ayurvedic practitioners regard physical existence, mental existence, and personality as three separate elements of a whole person with each element being able to influence the others.<ref>{{Cite book|author=<!--Staff writer(s); no by-line.--> |editor-last1=Cornelissen |editor-first1=R. M. Matthijs |editor-last2=Misra |editor-first2= Girishwar |editor-last3=Varma |editor-first3=Suneet |date=2013 |chapter=The blending of healing and pedagogy in Āyurveda |title=Foundations and Applications of Indian Psychology |language=en |edition=2nd |publication-place=New Delhi|publisher=Pearson Education India |isbn=9789-332537460 |oclc=987023188 |quote=Central to Āyurvedic healing is the notion of the human persona as a three-dimensional composite of body, mind and self. Āyurveda aims to empower the body to invigorate the mind and, consequently, to use the invigorated mind to generate self-awareness. }}</ref> This ] approach used during diagnosis and healing is a fundamental aspect of ayurveda. Another part of ayurvedic treatment says that there are channels (''srotas'') which transport fluids, and that the channels can be opened up by massage treatment using oils and ] (fomentation). Unhealthy, or blocked, channels are thought to cause disease.<ref name="WujastykXIX-XX">{{harvnb|Wujastyk|2003a|pages=xix–xx}}</ref>


=== Diagnosis === === Diagnosis ===
]
Ayurveda has 8 ways of diagnosis. They are ] (Pulse), Mootra (Urine), ] (Stool), Jihva (Tongue), Shabda (Speech), Sparsha (Touch), Druk (Vision), Aakruti (Appearance).<ref>{{cite pmid|11253416}}</ref>
Ayurveda has eight ways to diagnose illness, called '']'' (pulse), ''mootra'' (urine), '']'' (stool), ''jihva'' (tongue), ''shabda'' (speech), ''sparsha'' (touch), ''druk'' (vision), and ''aakruti'' (appearance).<ref>{{Cite journal |last1=Mishra |first1=Lakshmi-chandra |last2=Singh |first2=Betsy B. |last3=Dagenais |first3=Simon |year=2001 |title=Healthcare and disease management in Ayurveda |url=https://www.researchgate.net/publication/12079940 |journal=Alternative Therapies in Health and Medicine |volume=7 |issue=2 |pages=44–50 |pmid=11253416}}</ref> Ayurvedic practitioners approach diagnosis by using the five senses.<ref name="Chopra79">{{Harvnb|Chopra|2003|p=79}}</ref> For example, hearing is used to observe the condition of breathing and speech.<ref name="Underwood&Rhodes(2008)" /> The study of vulnerable points, or ''marma'', is particular to ayurvedic medicine.<ref name="Chopra76" />
]


=== Treatment and prevention ===
]
Two of the eight branches of classical ayurveda deal with surgery (''Śalya-cikitsā'' and ''Śālākya-tantra''), but contemporary ayurveda tends to stress attaining vitality by building a healthy ] and maintaining good digestion and ].<ref name="Chopra76" /> Ayurveda also focuses on exercise, ], and ].<ref name="encarta-ayurveda">{{Cite encyclopedia |year=2008 |title=Ayurveda |encyclopedia=] |publisher=] |location=Redmond, WA |url=http://encarta.msn.com/encyclopedia_761596196/Ayurveda.html |archive-url=https://web.archive.org/web/20091028105549/http://encarta.msn.com/encyclopedia_761596196/Ayurveda.html |archive-date=28 October 2009}}</ref> One type of prescription is a ].


Ayurveda follows the concept of ], which says that natural cycles (waking, sleeping, working, meditation etc.) are important for health. Hygiene, including regular bathing, cleaning of teeth, ], ], skin care, and eye washing, is also a central practice.<ref name="Underwood&Rhodes(2008)" />
Ayurvedic practitioners approach diagnosis by using the five senses.<ref name="Chopra79">{{Harvnb|Chopra|2003|p=79}}</ref> Hearing is used to observe the condition of breathing and speech.<ref name="Underwood&Rhodes(2008)" /> The study of the lethal points or ''marman marma'' is of special importance.<ref name="Chopra76" />


=== Substances used ===
]
{{See also|Medical ethnobotany of India}}
]
The vast majority (90%) of ayurvedic remedies are plant based.<ref name=":7">{{Cite journal |last1=Kumar |first1=Syal |last2=Dobos |first2=Gustav J. |last3=Rampp |first3=Thomas |date=July 2017 |title=The Significance of Ayurvedic Medicinal Plants |journal=Journal of Evidence-Based Complementary & Alternative Medicine |volume=22 |issue=3 |pages=494–501 |doi=10.1177/2156587216671392 |issn=2156-5872 |pmc=5871155 |pmid=27707902}}</ref> Plant-based treatments in ayurveda may be derived from roots, leaves, fruits, bark, or seeds; some examples of plant-based substances include ] and ]. In the 19th century, William Dymock and co-authors summarized hundreds of plant-derived medicines along with the uses, microscopic structure, chemical composition, toxicology, prevalent myths and stories, and relation to commerce in ].<ref> {{Webarchive|url=https://web.archive.org/web/20170705180847/http://www.biodiversitylibrary.org/item/36345#page/1/mode/1up |date=5 July 2017 }}, A history of principal drugs of vegetable origin in British India – Volume 1, William Dymock et al. (1890), London</ref> ], an herbal formulation of three fruits, ], ], and ], is one of the most commonly used<ref>{{Cite news |last=O'mathuna |first=Donal |date=April 12, 2011 |title=Does it work? Can triphala act as an antimicrobial? |language=en |newspaper=] |url=https://www.irishtimes.com/news/health/does-it-work-can-triphala-act-as-an-antimicrobial-1.570237 |access-date=2022-03-01 |archive-date=7 July 2022 |archive-url=https://web.archive.org/web/20220707013905/https://www.irishtimes.com/news/health/does-it-work-can-triphala-act-as-an-antimicrobial-1.570237 |url-status=live }}</ref> Ayurvedic remedies.<ref>{{Cite web |last=Berry |first=Jennifer |date=2019-10-03 |others=Medically reviewed by Zara Risoldi Cochrane |title=What are the benefits of triphala? Uses, evidence, and risks |url=https://www.medicalnewstoday.com/articles/326547 |access-date=2022-03-01 |website=Medical News Today |language=en |archive-date=1 March 2022 |archive-url=https://web.archive.org/web/20220301194929/https://www.medicalnewstoday.com/articles/326547 |url-status=live }}</ref><ref>{{Cite journal |last1=Peterson |first1=Christine Tara |last2=Denniston |first2=Kate |last3=Chopra |first3=Deepak |date=2017-08-01 |title=Therapeutic Uses of Triphala in Ayurvedic Medicine |journal=Journal of Alternative and Complementary Medicine |volume=23 |issue=8 |pages=607–614 |doi=10.1089/acm.2017.0083 |issn=1075-5535 |pmc=5567597 |pmid=28696777}}</ref> The herbs '']'' (Ashwagandha)<ref>{{Cite web |last=Goldman |first=Rena |date=September 29, 2020 |others=Medically reviewed by Debra Rose Wilson |title=What are the benefits of ashwagandha? |url=https://www.medicalnewstoday.com/articles/318407 |access-date=2022-03-15 |website=Medical News Today |language=en |archive-date=15 March 2022 |archive-url=https://web.archive.org/web/20220315210501/https://www.medicalnewstoday.com/articles/318407 |url-status=live }}</ref> and '']'' (Tulsi)<ref name=":7" /> are also routinely used in ayurveda.
]), an ayurvedic herb|left|220x220px]]
Animal products used in ayurveda include milk, bones, and ]s.<ref>{{Cite book |last1=Ng |first1=P.K.L. |url=https://books.google.com/books?id=D1oW0EquxDAC |title=Singapore Biodiversity: An Encyclopedia of the Natural Environment and Sustainable Development |last2=Corlett |first2=R. |last3=Tan |first3=H.T.W. |last4=Raffles Museum of Biodiversity Research |publisher=Editions Didier Millet |year=2011 |isbn=978-981-4260-08-4 |page=164}}</ref> In addition, fats are prescribed both for consumption and for external use. Consumption of minerals, including ], ], lead, ] and gold, are also prescribed.<ref name="Underwood&Rhodes(2008)" /> The addition of minerals to herbal medicine is called '']''.


Ayurveda uses alcoholic beverages called ''Madya'',<ref name="IJTNJAN07">{{Cite journal |last=Sekar, S. |year=2007 |title=Traditional alcoholic beverages from Ayurveda and their role on human health |url=http://www.niscair.res.in/sciencecommunication/ResearchJournals/rejour/ijtk/Fulltextsearch/2007/January%202007/IJTK-Vol%206%281%29-January%202007-pp%20144-149.htm |url-status=live |journal=Indian Journal of Traditional Knowledge |volume=6 |issue=1 |pages=144–149 |archive-url=https://web.archive.org/web/20141218110751/http://www.niscair.res.in/sciencecommunication/ResearchJournals/rejour/ijtk/Fulltextsearch/2007/January%202007/IJTK-Vol%206%281%29-January%202007-pp%20144-149.htm |archive-date=18 December 2014}}</ref> which are said to adjust the ''doshas'' by increasing ''pitta'' and reducing ''vatta'' and ''kapha''.<ref name="IJTNJAN07" /> Madya are classified by the raw material and fermentation process, and the categories include: sugar-based, fruit-based, cereal-based, cereal-based with herbs, fermentated with vinegar, and tonic wines. The intended outcomes can include causing purgation, improving digestion or taste, creating dryness, or loosening joints. Ayurvedic texts describe Madya as non-viscid and fast-acting, and say that it enters and cleans minute pores in the body.<ref name="IJTNJAN07" />
=== Treatment and health protection ===
While two of the eight branches of classical Ayurveda deal with surgery (''Śalya-cikitsā'', ''Śālākya-tantra''), contemporary Ayurvedic theory tends to emphasise that building a healthy ], attaining good ] and proper ] lead to vitality.<ref name="Chopra76" /> Ayurveda also focuses on exercise, ], and ].<ref name="encarta-ayurveda">{{cite encyclopedia|encyclopedia=]|year=2008|url= http://encarta.msn.com/encyclopedia_761596196/Ayurveda.html |publisher=]|location=Redmond, WA|title=Ayurveda|archiveurl=http://www.webcitation.org/5kwKte2HR|archivedate=31 October 2009|author1=<Please add first missing authors to populate metadata.>}}</ref> To maintain health, a ] can be prescribed to the patient.


Purified ]<ref name="ISHS1036">{{Cite journal |last1=Mani, Dayanandan |last2=Dhawan, Sunita S. |year=2011 |title=Scientific basis of therapeutic uses of opium poppy (''Papaver somniferum'') in Ayurveda |url=http://www.actahort.org/books/1036/1036_20.htm |journal=Acta Horticulturae (International Symposium on Papaver) |issue=1036 |pages=175–180 |url-access=subscription |access-date=7 December 2014 |archive-date=12 January 2015 |archive-url=https://web.archive.org/web/20150112141320/http://www.actahort.org/books/1036/1036_20.htm |url-status=live }}</ref> is used in eight ayurvedic preparations<ref name="UNODC">{{Cite web |last1=Ram Nath Chopra |last2=I. C. Chopra |date=January 1, 1955 |title=UNODC – Bulletin on Narcotics – 1955 Issue 3 – 001 |url=https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1955-01-01_3_page002.html |access-date=27 December 2015 |archive-date=5 January 2016 |archive-url=https://web.archive.org/web/20160105082733/https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1955-01-01_3_page002.html |url-status=live }}</ref> and is said to balance the ''vata'' and ''kapha'' ''doshas'' and increase the ''pitta'' ''dosha''.<ref name="ISHS1036" /> It is prescribed for diarrhea and dysentery, for increasing the sexual and muscular ability, and for affecting the brain. The sedative and pain-relieving properties of opium are considered in ayurveda. The use of opium is found in the ancient ayurvedic texts, and is first mentioned in the ''Sarngadhara Samhita'' (1300–1400 CE), a book on pharmacy used in ] in Western India, as an ingredient of an aphrodisiac to delay male ejaculation.<ref name="IJHS051981">{{Cite journal |last1=Chaturvedi |first1=G. N. |last2=Tiwari |first2=S. K. |last3=Rai |first3=N. P. |date=May 1981 |title=Medicinal Use of Opium and Cannabis in Medieval India |url=http://www.new1.dli.ernet.in/data1/upload/insa/INSA_1/20005af3_31.pdf |journal=Indian Journal of History of Science |volume=16 |pages=31–35 |archive-url=https://web.archive.org/web/20141028125555/http://www.new1.dli.ernet.in/data1/upload/insa/INSA_1/20005af3_31.pdf |archive-date=2014-10-28 |access-date=2014-10-28 |number=1}}</ref> It is possible that opium was brought to India along with or before ].<ref name="UNODC" /><ref name="Chopra80">{{harvnb|Chopra|2003|p = 80}}</ref> The book ''Yoga Ratnakara'' (1700–1800 CE, unknown author), which is popular in ], uses opium in a herbal-mineral composition prescribed for diarrhea.<ref name="IJHS051981" /> In the ''Bhaisajya Ratnavali'', opium and ] are used for acute gastroenteritis. In this drug, the respiratory depressant action of opium is counteracted by the respiratory stimulant property of camphor.<ref name="IJHS051981" /> Later books have included the narcotic property for use as analgesic pain reliever.<ref name="IJHS051981" />
Concepts of ] are followed in Ayurveda; dinacharya stresses the importance of natural cycles (waking, sleeping, working, meditation etc.) for a healthy living. ], too, is a central practice of Ayurvedic medicine. Hygienic living involves regular bathing, cleansing of teeth, skin care, and eye washing.<ref name="Underwood&Rhodes(2008)" />


'']'' is also mentioned in the ancient ayurveda books, and is first mentioned in the ''Sarngadhara Samhita'' as a treatment for diarrhea.<ref name="IJHS051981" /> In the ''Bhaisajya Ratnavali'' it is named as an ingredient in an aphrodisiac.<ref name="IJHS051981" />
===Natural medical substances used===
Ayurveda stresses the use of plant-based medicines and treatments. Plant-based medicines are derived from roots, leaves, fruits, barks and seeds such as ] and ]. William Dymock and co-authors summarized hundreds of plant-derived medicines in 19th century, along with the prevalent myth, stories, uses, microscopic structure, chemical composition, toxicology and commerce in British India.<ref>, A history of principal drugs of vegetable origin in British India - Volume 1, William Dymock et al. (1890), London</ref> Some animal products may also be used, for example milk, ]s, and ]s. In addition, fats are used both for consumption and for external use. Minerals, including ], ], lead, ] and gold are also consumed as prescribed.<ref name="Underwood&Rhodes(2008)" /> This practice of adding minerals to herbal medicine is known as '']''.


In some cases, alcohol was used as a ] for patients undergoing operation. The advent of Islam introduced ] as a narcotic.<ref name="Chopra80" /> Both oil and tar were used to stop bleeding.<ref name="Underwood&Rhodes(2008)" /> Traumatic bleeding was said to be stopped by four different methods: ] of the ]; ] by heat; using different herbal or animal preparations locally which could facilitate ]; and different medical preparations which could ] 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, ], prescribed application to affected areas,<ref name="WujastykXX">Wujastyk, p. 20</ref> and ]. Also, liquids may be poured on the patient's forehead, a technique which is called ]. Ayurveda says that both oil and tar can be used to stop bleeding,<ref name="Underwood&Rhodes(2008)" /> and that traumatic bleeding can be stopped by four different methods: ] of the ], ] by heat, use of preparations to facilitate ], and use of preparations to ] the blood vessels.
], 2017]]

Massage with oil is commonly prescribed by ayurvedic practitioners.<ref>{{Cite web |last1=Satake |first1=Alison |last2=McDaniel |first2=Andi |title=Frontline World India: A Second Opinion: Ayurveda 101 |url=https://www.pbs.org/frontlineworld/stories/india701/interviews/ayurveda101.html |access-date=2022-04-24 |website=PBS |archive-date=26 October 2021 |archive-url=https://web.archive.org/web/20211026153917/https://www.pbs.org/frontlineworld/stories/india701/interviews/ayurveda101.html |url-status=live }}</ref> Oils are used in a number of ways, including regular consumption, anointing, smearing, head massage, application to affected areas,<ref name="WujastykXX">{{harvnb|Wujastyk|2003a|page=20}}</ref>{{failed verification|date=January 2015}} and oil pulling. Liquids may also be poured on the patient's forehead, a technique called shirodhara.<ref name="Cacho Lum">{{Cite book |last1=Cacho |first1=V. |url=https://books.google.com/books?id=qm8vEAAAQBAJ&pg=PA296 |title=Integrative Sleep Medicine |last2=Lum |first2=E. |publisher=Oxford University Press |year=2021 |isbn=978-0-19-088542-7 |series=Weil Integrative Medicine Library |page=296 |quote=Shirodhara massage is an Ayurvedic oil- dripping treatment that is often used to treat sleep problems. It consists of pouring a gentle stream of warm oil (sesame or herbal oil) over the forehead |access-date=2023-07-10 |archive-date=10 July 2023 |archive-url=https://web.archive.org/web/20230710050651/https://books.google.com/books?id=qm8vEAAAQBAJ&pg=PA296 |url-status=live }}</ref>
] in human eye&nbsp;– magnified view seen on examination with a slit lamp. Cataract surgery is mentioned in the ] in the early centuries of the first millennium AD, as performed with a special tool called the ''jabamukhi salaka'', a curved needle used to loosen the obstructing phlegm and push it out of the field of vision. The eye would later be soaked with warm butter and then bandaged.<ref name="finger66">Finger, p. 66</ref>]]


=== Panchakarma === === Panchakarma ===
{{further|Panchakarma}}
{{anchor|Panchakarma}}According to some experts, the practice of the cleansing practices known as ] (Devanāgarī: पंचकर्म‌)) is a therapeutic way of eliminating toxic elements from the body.<ref name="A. K. Sharma">{{cite book|last=Sharma|first=A. K.|year=2003|chapter=Panchkarma Therapy in Ayurvedic Medicine|title=Scientific Basis for Ayurvedic Therapies|editor=Mishra, Lakshmi Chandra|page=43|publisher=CRC Press|location=Boca Raton, FL|isbn=0-8493-1366-X}}</ref> Panchakarma includes ], ], ], ] and ].
Panchakarma is preceded by Poorva karma (Preparatory Step)and is followed by Paschat karma and Peyadi karma.


According to ayurveda, panchakarma are techniques to ].<ref>{{Cite journal |last1=Ajanal |first1=M |last2=Nayak |first2=S |last3=Prasad |first3=BS |last4=Kadam |first4=A |date=December 2013 |title=Adverse drug reaction and concepts of drug safety in Ayurveda: An overview. |journal=Journal of Young Pharmacists |volume=5 |issue=4 |pages=116–120 |doi=10.1016/j.jyp.2013.10.001 |pmc=3930110 |pmid=24563588}}</ref> Panchakarma refers to five actions, which are meant to be performed in a designated sequence with the stated aim of restoring balance in the body through a process of purgation.<ref name="Sujatha_UniversalGlobal_2020" />
==History==


=== Origins === == Current status ==
Ayurveda is widely practiced in India and Nepal<ref name="who01" /> where public institutions offer formal study in the form of a ] (BAMS) degree. In certain parts of the world, the legal standing of practitioners is equivalent to that of conventional medicine.<ref name="who01" /> Several scholars have described the contemporary Indian application of ayurvedic practice as being "biomedicalized" relative to the more "spiritualized" emphasis to practice found in variants in the West.<ref name="london \2">{{Cite journal |last=Warrier |first=Maya |date=January 2009 |title=Seekership, Spirituality and Self-Discovery: Ayurveda Trainees in Britain |journal=Asian Medicine |volume=4 |issue=2 |pages=423–451 |doi=10.1163/157342009X12526658783691 |issn=1573-420X |pmc=2898496 |pmid=20617123}}</ref><ref name="Sujatha_UniversalGlobal_2020">{{Cite journal |last=Sujatha |first=V. |date=January 2020 |title=The Universal and the Global: Contextualising European Ayurvedic Practices |url=https://journals.sagepub.com/doi/full/10.1177/2393861719883067 |journal=Society and Culture in South Asia |volume=6 |issue=1 |pages=52–73 |doi=10.1177/2393861719883067 |issn=2393-8617 |s2cid=213828818 |via=Sage |access-date=25 March 2022 |archive-date=15 April 2023 |archive-url=https://web.archive.org/web/20230415231802/https://journals.sagepub.com/doi/full/10.1177/2393861719883067 |url-status=live }}</ref>
Ayurveda is a discipline of the ] or "auxiliary knowledge" in Vedic tradition. It is treated as a supplement or appendix of the '']''. However, some believed that Atharva-Veda is the prime origin of Ayurveda. The samhita of the ''Atharvaveda'' itself contains 114 hymns or incantations for the magical cure of diseases. Charak has advised in his samhita that physicians should adhere to Atharva-Veda. Origins of Ayurveda have been traced back to 5,000 ], originating as an oral tradition and later as medical texts, Ayurveda evolved from the Vedas.<ref>{{cite book|title=Safe Use of Chemicals: A Practical Guide|author=T.S.S. Dikshith|publisher=CRC Press|year=2008|page=16}}</ref><ref>{{cite book|title = Complementary and Alternative Medicine for Older Adults: A Guide to Holistic Approaches to Healthy Aging|author = Elizabeth R. Mackenzie, Birgit Rakel|publisher = Springer|year = 2006|page = 215|isbn = 9780826138064}}</ref>
There are various legendary accounts of the "origin of Ayurveda", e.g., that the science was received by ] (or ]) from ].<ref name="Underwood&Rhodes(2008)" /><ref name="singhguide">{{cite book |title=Banaras Region: A Spiritual and Cultural Guide |last=Singh |first=P.B. |author2=Pravin S. Rana |year=2002 |publisher=Indica Books |location=Varanasi |isbn=81-86569-24-3 |page=31|accessdate=1 April 2011}}</ref><ref name=britannica>Dhanvantari. (2010). In Encyclopædia Britannica. Retrieved 4 August 2010, from Encyclopædia Britannica Online: http://www.britannica.com/EBchecked/topic/160641/Dhanvantari</ref> Tradition also holds that a lost text written by the sage ], a student of the sage ], influenced the writings of Ayurveda.<ref name="Thakara">{{cite book|first=Vināyaka Jayānanda|last=Ṭhākara|year=1989|title=Methodology of Research in Ayurveda|page=7|publisher=] Press|location=Jamnagar, India}}</ref>


Exposure to European developments in medicine from the nineteenth century onwards, through ] and the subsequent institutionalized support for European forms of medicine amongst European heritage settlers in India<ref>{{Cite journal |last1=Sriram |first1=Veena |last2=Keshri |first2=Vikash R. |last3=Kumbhar |first3=Kiran |date=2021-08-18 |title=The impact of colonial-era policies on health workforce regulation in India: lessons for contemporary reform |journal=Human Resources for Health |volume=19 |issue=1 |pages=100 |doi=10.1186/s12960-021-00640-w |issn=1478-4491 |pmc=8371885 |pmid=34407831 |quote=Traditional practitioners of medicine were at the mercy of the ‘newly’ imposed system of modern medicine that arrived with colonialism. Despite some early efforts to understand the value of traditional medicine and some efforts at exchange between the systems, “British criticisms of indigenous medicine became increasingly strident and intolerant”. |doi-access=free}}</ref> were challenging to ayurveda, with the entire ] called into question. From the twentieth century, ayurveda became politically, conceptually, and commercially dominated by modern ], resulting in "modern ayurveda" and "global ayurveda".<ref name="MaasCambridge_2018" /> Modern ayurveda is geographically located in the ] and tends towards secularization through minimization of the magic and mythic aspects of ayurveda.<ref name="MaasCambridge_2018" /><ref name="Smith+Wujastyk" /> Global ayurveda encompasses multiple forms of practice that developed through dispersal to a wide geographical area outside of India.<ref name="MaasCambridge_2018" /> Smith and Wujastyk further delineate that global ayurveda includes those primarily interested in the ayurveda ], and also the practitioners of ] ayurveda (which may link ayurveda to yoga and Indian spirituality and/or emphasize preventative practice, mind body medicine, or ]).<ref name="Smith+Wujastyk" />
===Main Texts===
There are three principal early texts on Ayurveda, all dating to the early centuries of the ].
These are the ], the ] and the medical portions of the ] (also known as the ''Bheda Samhita''). The relative chronology of these texts is not entirely clear. The ''Charaka Samhita'' is often cited as primary; although it survived only as a recension dating to the 4th or 5th century, it may be based on an original written between 100 ] and 100 ], in which case it would predate the other two texts. The Sushruta Samhita was written in the 3rd or 4th century. The Bower Manuscript is of particular interest because here the manuscript itself is ancient, dated to the early 6th century.<ref>The 1897 edition by ] suggested a 4th-century date, but this was superseded by later studies, Dani, Ahmad Hasan. Indian Palaeography. (2nd edition New Delhi: Munshiram Manoharlal, 1986); Sander, Lore, "Origin and date of the Bower Manuscript, a new approach" in M. Yaldiz and W. Lobo (eds.), Investigating the Indian Arts (Berlin: Museum Fuer Indische Kunst, 1987).</ref> The earliest documented mention of the name ''Sushruta'' is found in the Bower Manuscript.<ref name="WujastykXXVI" /> 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 ], antedating both the Charaka and the Sushruta Samhitas.


Since the 1980s, ayurveda has also become the subject of interdisciplinary studies in ] which seeks to integrate the biomedical sciences and humanities to improve the pharmacopeia of ayurveda.<ref name="Smith+Wujastyk" /> According to industry research, the global ayurveda market was worth US$4.5 billion in 2017.<ref name="market">{{Cite web |date=8 April 2019 |title=Global Ayurvedic Market |url=https://www.industryresearch.biz/global-ayurvedic-market-14143828 |publisher=Industry Research |access-date=27 March 2022 |archive-date=15 April 2023 |archive-url=https://web.archive.org/web/20230415231804/https://www.industryresearch.biz/global-ayurvedic-market-14143828 |url-status=live }}</ref>
The Bower Manuscript is also of special interest to historians due to the presence of Indian medicine and its concepts in Central Asian Buddhism. ] 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 ], who had migrated and become a Buddhist monk in a monastery in ]. The Chinese pilgrim ] (c. 337–422 AD) wrote about the health care system of the ] (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.<ref name="WujastykXV-XVI">Wujastyk, pp. XV-XVI</ref>


=== The Indian subcontinent ===
Other early texts, sometimes mentioned alongside the Sushruta, Chakaka and Bheda texts, are the ] and the ] samhitas, presumably dating to the later Gupta period (ca. 6th century). Ayurvedic authors of the 7th or 8th century include ] and Madhava.<ref name="Wujastyk224">Wujastyk, p. 224</ref>
]]]


===Illnesses portrayed=== ==== India ====
{{See also|Healthcare in India}}
Underwood & Rhodes (2008) hold that this early phase of traditional Indian medicine identified "fever (takman), cough, ], diarrhea, ], ], ]s, tumours, and skin diseases (including ])".<ref name="Underwood&Rhodes(2008)" /> Treatment of complex ailments, including ], ], ], and ], also ensued during this period.<ref name="Dwivedi&Dwivedi07" /><ref name="Lock836">Lock ''et al.'', p. 836</ref> ], ] (a form of cataract surgery), puncturing to release fluids in the ], extraction of foreign elements, treatment of ]s, treating fractures, ]s, ], and stitching of wounds were known.<ref name="Underwood&Rhodes(2008)" /> The use of herbs and surgical instruments became widespread.<ref name="Underwood&Rhodes(2008)">Underwood & Rhodes (2008)</ref>
It was reported in 2008<ref name="Dargan">{{Cite journal |last1=Dargan |first1=Paul I. |last2=Gawarammana |first2=Indika B. |last3=Archer |first3=John R.H. |last4=House |first4=Ivan M. |last5=Shaw |first5=Debbie |last6=Wood |first6=David M. |year=2008 |title=Heavy metal poisoning from Ayurvedic traditional medicines: An emerging problem? |journal=International Journal of Environment and Health |volume=2 |issue=3/4 |pages=463 |citeseerx=10.1.1.561.9726 |doi=10.1504/IJENVH.2008.020936|bibcode=2008IJEH....2..463D }}</ref> and again in 2018<ref name=":0">{{Cite web |last=Bhowmick |first=Nilanjana |date=2021-06-02 |title=Indian doctors protest herbal treatments being touted for COVID-19 |url=https://www.nationalgeographic.com/science/article/indian-doctors-protest-herbal-treatments-being-touted-for-covid-19 |access-date=2022-03-21 |website=National Geographic |language=en |archive-date=21 March 2022 |archive-url=https://web.archive.org/web/20220321001519/https://www.nationalgeographic.com/science/article/indian-doctors-protest-herbal-treatments-being-touted-for-covid-19 |url-status=dead }}</ref> that 80 percent of people in India used ayurveda exclusively or combined with conventional Western medicine.<ref name="Dargan" /><ref name=":0" /> A 2014 national health survey found that, in general, forms of the Indian system of medicine or ] (ayurveda, yoga and naturopathy, ], ], and homeopathy) were used by about 3.5% of patients who were seeking outpatient care over a two-week reference period.<ref>{{Cite journal |last1=Rudra |first1=Shalini |last2=Kalra |first2=Aakshi |last3=Kumar |first3=Abhishek |last4=Joe |first4=William |date=2017 |title=Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014 |journal=PLOS ONE |volume=12 |issue=5 |pages=e0176916 |bibcode=2017PLoSO..1276916R |doi=10.1371/journal.pone.0176916 |pmc=5417584 |pmid=28472197 |doi-access=free}}</ref>


In 1970, the ] passed the Indian Medical Central Council Act which aimed to standardise qualifications for ayurveda practitioners and provide accredited institutions for its study and research.<ref name="WujastykXXII" /> In 1971, the ] (CCIM) was established under the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha medicine and Homoeopathy (AYUSH), ], to monitor higher education in ayurveda in India.<ref>{{Cite web |title=Introduction to Central Council of Indian Medicine |url=http://ccimindia.org/introduction.html |url-status=dead |archive-url=https://web.archive.org/web/20141218132643/http://ccimindia.org/introduction.html |archive-date=18 December 2014 |publisher=Central Council of Indian Medicine (CCIM)}}</ref> The Indian government supports research and teaching in ayurveda through many channels at both the national and state levels, and helps institutionalise traditional medicine so that it can be studied in major towns and cities.<ref name="WujastykXVI">{{harvnb|Wujastyk|2003a|page=XVI}}</ref> The state-sponsored Central Council for Research in Ayurvedic Sciences (CCRAS) is designed to do research on ayurveda.<ref>{{Cite web |title=Welcome to Central Council for Research in Ayurveda and Siddha (India) |url=http://ccras.nic.in/ |access-date=21 June 2012 |publisher=Ccras.nic.in |archive-date=28 July 2011 |archive-url=https://web.archive.org/web/20110728084859/http://www.ccras.nic.in/ |url-status=live }}</ref> Many clinics in urban and rural areas are run by professionals who qualify from these institutes.<ref name="WujastykXXII">{{harvnb|Wujastyk|2003a|page=XXII}}</ref> {{As of|2013}}, India had over 180 training centers that offered degrees in traditional ayurvedic medicine.<ref name="encarta-ayurveda" />
===Further development and spread===
The field of Ayurveda flourished throughout the Indian Middle Ages; ] (fl. 1200), Sarngadhara (fl. 1300) and Bhavamisra (fl. 1500) compiled works on Indian medicine.<ref name="WujastykXXVI">Wujastyk, p. XXVI</ref>


To fight ] and unethical patents, the ] set up the ] in 2001 to serve as a repository for formulations from systems of Indian medicine, such as ayurveda, ] and siddha medicine.<ref>{{Cite web |title=About TKDL |url=http://www.tkdl.res.in/tkdl/LangDefault/Common/Abouttkdl.asp?GL=Eng |url-status=live |archive-url=https://web.archive.org/web/20140704022336/http://www.tkdl.res.in/tkdl/langdefault/common/Abouttkdl.asp?GL=Eng |archive-date=4 July 2014 |website=Traditional Knowledge Digital Library}}</ref><ref name="pt">{{Cite web |date=6 May 2010 |title=Know Instances of Patenting on the UES of Medicinal Plants in India |url=http://pib.nic.in/release/release.asp?relid=61511 |url-status=live |archive-url=https://web.archive.org/web/20100510005340/http://pib.nic.in/release/release.asp?relid=61511 |archive-date=10 May 2010 |access-date=22 May 2010 |publisher=PIB, Ministry of Environment and Forests}}</ref> The formulations come from over 100 traditional ayurveda books.<ref>{{Cite web |title=Source of Information |url=http://www.tkdl.res.in/tkdl/langdefault/common/sourceinfo.asp |website=] (Government of India) |access-date=25 May 2010 |archive-date=13 June 2010 |archive-url=https://web.archive.org/web/20100613050253/http://www.tkdl.res.in/tkdl/langdefault/common/sourceinfo.asp |url-status=live }}</ref>
The medical works of both Sushruta and Charaka were also translated into the ] during the 8th century.<ref name="Lock607" /> The 9th-century Persian physician ] was familiar with the text.<ref name="Rao">Ramachandra S.K. Rao, Encyclopaedia of Indian Medicine: historical perspective, Volume 1, 2005, .</ref> The Arabic works derived from the Gupta-era Indian texts eventually also reached a European audience by the end of the medieval period.<ref name="Lock607" />
An ] document quoting a 2003–04 report states that India had 432,625 registered medical practitioners, 13,925 dispensaries, 2,253 hospitals and a bed strength of 43,803. 209 undergraduate teaching institutions and 16 postgraduate institutions.<ref name="IAS-20150613">{{Cite web |last=Valiathan |first=M. S. |title=Towards Ayurvedic Biology |url=http://www.ias.ac.in/academy/dvdocs/ayurvis.pdf |url-status=dead |archive-url=https://web.archive.org/web/20150513230414/http://www.ias.ac.in/academy/dvdocs/ayurvis.pdf |archive-date=13 May 2015 |access-date=13 June 2015 |publisher=]}}</ref> In 2012, it was reported that insurance companies covered expenses for ayurvedic treatments in case of conditions such as spinal cord disorders, bone disorder, arthritis and cancer. Such claims constituted 5–10 percent of the country's health insurance claims.<ref name="Hindu-20120328">{{Cite news |last=Roy |first=Shobha |date=2012-03-28 |title=Insurers stepping up cover for ayurveda treatment |work=] |url=http://www.thehindubusinessline.com/industry-and-economy/banking/insurers-stepping-up-cover-for-ayurveda-treatment/article3254964.ece |access-date=13 June 2015 |archive-date=11 December 2013 |archive-url=https://web.archive.org/web/20131211233024/http://www.thehindubusinessline.com/industry-and-economy/banking/insurers-stepping-up-cover-for-ayurveda-treatment/article3254964.ece |url-status=live }}</ref>


], an organisation dedicated to fighting ], considers ayurveda to be pseudoscience.<ref name="Quack-2011" />
In ], the Branca family of ] and Gaspare Tagliacozzi (]) are known to have been influenced by the Arabic reception of the surgical techniques of Sushruta.<ref name="Lock607">Lock ''et al.'', p. 607</ref>


On 9 November 2014, India formed the ].<ref>{{Cite web |date=2021-04-01 |title=Prime Minister's Yoga Awards on International Day of Yoga 2021 |url=https://www.thestatesman.com/india/prime-ministers-yoga-awards-on-international-day-of-yoga-2021-1502960394.html |access-date=2022-02-12 |website=The Statesman |language=en-US |archive-date=13 February 2022 |archive-url=https://web.archive.org/web/20220213005850/https://www.thestatesman.com/india/prime-ministers-yoga-awards-on-international-day-of-yoga-2021-1502960394.html |url-status=live }}</ref><ref>{{Cite web |date=2014-11-10 |title=Modi allocates 'AYUSH' department to MoS |url=https://www.indiatvnews.com/politics/national/modi-allocates-ayush-department-to-mos-independent-charge-22124.html |access-date=2022-02-13 |website=India TV News |language=en |archive-date=13 February 2022 |archive-url=https://web.archive.org/web/20220213005849/https://www.indiatvnews.com/politics/national/modi-allocates-ayush-department-to-mos-independent-charge-22124.html |url-status=live }}</ref> National Ayurveda Day is also observed in India on the birth of ] that is ].<ref>{{Cite web |title=National Ayurveda Day – Vikaspedia |url=http://vikaspedia.in/health/ayush/ayurveda-1/national-ayurveda-day |access-date=2018-12-20 |website=vikaspedia.in |archive-date=20 December 2018 |archive-url=https://web.archive.org/web/20181220230322/http://vikaspedia.in/health/ayush/ayurveda-1/national-ayurveda-day |url-status=live }}</ref>
British physicians travelled to India to see ] being performed using native methods; reports on Indian rhinoplasty were published in the '']'' in 1794.<ref name="Lock651">Lock "et al.'', p. 651''</ref> Instruments described in the ''Sushruta Samhita'' were further modified in the Western World.<ref name="Lock652" />
] spent 20 years in India studying local plastic surgery methods and was able to perform the first major surgery in the western world, the "Indian" method of nose reconstruction, in 1815.<ref name="Lock651" /><ref name="Lock652">Lock ''et al.'', p. 652</ref> He published an article about his research and experience.<ref>A practical essay on some of the principal surgical diseases of India (1840) http://archive.org/stream/practicalessayon00bretuoft#page/n556/mode/1up</ref><ref>http://archive.org/stream/practicalessayon00bretuoft#page/458/mode/2up</ref>


In 2016, the ] (WHO) published a report titled "The Health Workforce in India" which found that 31 percent of those who claimed to be doctors in India in 2001 were educated only up to the secondary school level and 57 percent went without any medical qualification.<ref name=":6">{{Cite news |last=Bansal |first=Samarth |date=2016-07-18 |title=WHO report sounds alarm on 'doctors' in India |language=en-IN |work=The Hindu |url=https://www.thehindu.com/data/WHO-report-sounds-alarm-on-%E2%80%98doctors%E2%80%99-in-India/article14495884.ece |access-date=2022-02-06 |issn=0971-751X |archive-date=6 February 2022 |archive-url=https://web.archive.org/web/20220206183331/https://www.thehindu.com/data/WHO-report-sounds-alarm-on-%E2%80%98doctors%E2%80%99-in-India/article14495884.ece |url-status=live }}</ref> The WHO study found that the situation was worse in rural India with only 18.8 percent of doctors holding a medical qualification.<ref name=":6" /> Overall, the study revealed that nationally the density of all doctors (mainstream, ayurvedic, homeopathic and unani) was 8 doctors per 10,000 people compared to 13 per 10,000 people in China.<ref name=":6" /><ref>{{Cite web |last1=Anand |first1=Sudhir |last2=Fan |first2=Victoria |date=2016 |title=The Health Workforce in India |url=https://www.who.int/hrh/resources/16058health_workforce_India.pdf |website=World Health Organization |access-date=13 February 2022 |archive-date=28 March 2022 |archive-url=https://web.archive.org/web/20220328000701/https://www.who.int/hrh/resources/16058health_workforce_India.pdf |url-status=live }}</ref>
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 has been more focus on Ayurveda and other traditional medical systems. Ayurveda is at present well integrated into the Indian National health care system, with state hospitals for Ayurveda established across the country.<ref name="who01" />


==== Nepal ====
In last few decades Ayurveda has spread around the world.<ref>{{cite book|title=Healing Your Life: Lessons on the Path of Ayurveda|page=7|year=2012}} Written by Marc Halpern, Published by Lotus Press, year 2012 </ref><ref>"Textbook of Pharmacognosy and Phytochemistry", Written by Biren Shah, page 455, published by Elsevier, year 2009, </ref>
About 75% to 80% of the population of Nepal use ayurveda.<ref name=":1">{{Cite news |date=28 October 2013 |title=Weeklong programme to observe Health Day |work=] |url=http://thehimalayantimes.com/fullNews.php?headline=Weeklong+programme+to+observe+Health+Day&NewsID=395245 |url-status=dead |access-date=7 January 2015 |archive-url=https://web.archive.org/web/20170323212717/http://thehimalayantimes.com/fullNews.php?headline=Weeklong+programme+to+observe+Health+Day&NewsID=395245 |archive-date=23 March 2017 |quote=In Nepal, 80 per cent of the population receives Ayurvedic medicine as first aid treatment.}}</ref><ref name=":3">{{Cite book |last=Alam |first=Zulfeequar |url=https://books.google.com/books?id=R5PfzF86mtEC&q=Ayurveda&pg=PA10 |title=Herbal Medicines |publisher=A.P.H. Publishing |year=2008 |isbn=978-81-313-0358-0 |location=New Delhi, India |pages=8–13, 122 |access-date=15 February 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110230/https://books.google.com/books?id=R5PfzF86mtEC&q=Ayurveda&pg=PA10 |url-status=live }}</ref> As of 2009, ayurveda was considered to be the most common and popular form of medicine in Nepal.<ref>{{Cite book |last=Guneratne |first=Arjun |url=https://books.google.com/books?id=L2qLAgAAQBAJ&pg=PP1 |title=Culture and the Environment in the Himalaya |publisher=Routledge |year=2009 |isbn=978-0-415-77883-1 |series=Routledge contemporary South Asia series, #24 |location=New York |pages=84–85 |access-date=23 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110230/https://books.google.com/books?id=L2qLAgAAQBAJ&pg=PP1 |url-status=live }}</ref>


==Current status== ==== Sri Lanka ====
]
].]]
The Sri Lankan tradition of ayurveda is similar to the Indian tradition. Practitioners of ayurveda in Sri Lanka refer to Sanskrit texts which are common to both countries. However, they do differ in some aspects, particularly in the herbs used.


In 1980, the Sri Lankan government established a ] to revive and regulate ayurveda.<ref>{{Cite web |title=Ministry of Indigenous Medicine |url=http://www.ayurveda.gov.lk/dept.html |url-status=dead |archive-url=https://web.archive.org/web/20121214094513/http://www.ayurveda.gov.lk/dept.html |archive-date=14 December 2012 |access-date=2 December 2012}}</ref> The ] (affiliated to the ]) offers undergraduate, postgraduate, and MD degrees in ayurveda medicine and surgery, and similar degrees in unani medicine.<ref>{{Cite web |title=Institute of indigenous Medicine |url=http://iim.cmb.ac.lk/ |access-date=21 June 2012 |publisher=Iim.cmb.ac.lk |archive-date=16 June 2012 |archive-url=https://web.archive.org/web/20120616065626/http://iim.cmb.ac.lk/ |url-status=live }}</ref> In 2010, the public system had 62 ayurvedic hospitals and 208 central dispensaries, which served about 3 million people (about 11% of Sri Lanka's population). There are an estimated 20,000 registered practitioners of ayurveda in Sri Lanka.<ref>{{Cite web |date=November 2011 |title=Statistics Report |url=http://www.indigenousmedimini.gov.lk/Downloads/Statistics%20Report%20Final%202011.%20November.pdf |url-status=dead |archive-url=https://web.archive.org/web/20120424031013/http://www.indigenousmedimini.gov.lk/Downloads/Statistics%20Report%20Final%202011.%20November.pdf |archive-date=24 April 2012 |publisher=Sri Lanka Institute of Indigenous Medicine}}</ref><ref>{{Cite web |date=14 February 1980 |title=About Us |url=http://www.indigenousmedimini.gov.lk/About_us.html |url-status=dead |archive-url=https://web.archive.org/web/20111108121932/http://www.indigenousmedimini.gov.lk/About_us.html |archive-date=8 November 2011 |access-date=11 December 2011 |publisher=The Ministry of Indigenous Medicine (Sri Lanka)}}</ref>
===India===
According to some sources, up to 80 percent<!--This is the article's phrasing--> of people in India use some form of traditional medicine, a category which includes Ayurveda.<ref name=Dargan>{{cite journal |author=Paul I. Dargan, et al.|year=2008 |title=Heavy metal poisoning from Ayurvedic traditional medicines: an emerging problem? |journal=Int. J. Environment and Health |volume=2 |issue=3/4 |pages=463–74 |publisher=Inderscience Enterprises Ltd. |doi=10.1504/IJENVH.2008.020935 |url=http://www.sactrc.org/IJEnvH203-415_Dargan%20et%20al.pdf |accessdate=5 October 2011}}</ref><ref>U.S. Department of Health & Human Services, National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM) (Archived on 26 May 2013)</ref>


According to the ], an ancient chronicle of ] royalty from the sixth century CE, King ] (reigned 437 BCE to 367 BCE) had lying-in-homes and ayurvedic hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documented evidence available of institutions dedicated specifically to the care of the sick anywhere in the world.<ref>{{Cite journal |last=Aluvihare |first=Arjuna |date=November 1993 |title=Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo |journal=Vidhusara Science Magazine}}</ref><ref>{{Cite web |last1=Rannan-Eliya, Ravi P. |last2=De Mel, Nishan |date=February 1997 |title=Resource Mobilization in Sri Lanka's Health Sector |url=http://www.hsph.harvard.edu/ihsg/publications/pdf/No-42.PDF |access-date=17 December 2014 |publisher=] & Health Policy Programme, Institute of Policy Studies |page=19 |archive-date=7 July 2017 |archive-url=https://web.archive.org/web/20170707134047/https://www.hsph.harvard.edu/ihsg/publications/pdf/No-42.PDF |url-status=live }}</ref> The hospital at ] is the oldest in the world.<ref>{{Cite journal |last=Müller-Dietz, Heinz E. |year=1975 |title=Die Krankenhaus-ruinen in Mihintale (Ceylon) |journal=Historia Hospitalium |volume=10 |pages=65–71 |pmid=11627253}}</ref>
In 1970, the Indian Medical Central Council Act which aimed to standardise qualifications for Ayurveda practitioners and provide accredited institutions for its study and research was passed by the ].<ref name="WujastykXXII" /> In India, over 100 colleges offer degrees in traditional Ayurvedic medicine.<ref name="encarta-ayurveda" /> The Indian government supports research and teaching in Ayurveda through many channels at both the national and state levels, and helps institutionalise traditional medicine so that it can be studied in major towns and cities.<ref name="WujastykXVI">Wujastyk, p. XVI</ref> The state-sponsored ] (CCRAS) has been set up in order to do extensive research on the subject.<ref>{{cite web|url=http://ccras.nic.in/ |title=Welcome to Central Council for Research in Ayurveda and Siddha ( India ) |publisher=Ccras.nic.in |accessdate= 21 June 2012}}</ref> To fight ] and unethical patents, the ], in 2001, set up the ] as repository of 1200 formulations of various systems of Indian medicine, such as Ayurveda, ] and ].<ref> website.</ref><ref name="pt">{{cite web|url=http://pib.nic.in/release/release.asp?relid=61511|title=Know Instances of Patenting on the UES of Medicinal Plants in India|date=6 May 2010|publisher=PIB, Ministry of Environment and Forests|accessdate=22 May 2010| archiveurl= http://web.archive.org/web/20100510005340/http://pib.nic.in/release/release.asp?relid=61511| archivedate= 10 May 2010 | deadurl= no}}</ref> The library also possesses 50 traditional Ayurveda books in a digitised form, made available online.<ref> ] (])</ref>


=== Outside the Indian subcontinent ===
The ] (CCIM) a statutory body established in 1971, under ] (]), ], ], monitors higher education in Ayurveda.<ref>. Ccimindia.org. Retrieved on 29 August 2011.</ref> Many clinics in urban and rural areas are run by professionals who qualify from these institutes.<ref name="WujastykXXII">Wujastyk, p. XXII</ref>
] in Amsterdam in 1967]]
Ayurveda is a system of traditional medicine developed during antiquity and the medieval period, and as such is comparable to pre-modern ] and ]. In the 1960s, ayurveda began to be advertised as ] in the Western world. Due to different laws and medical regulations around the globe, the expanding practice and commercialisation of ayurveda raised ethical and legal issues.<ref name=":10" /> Ayurveda was adapted for Western consumption, particularly by Baba Hari Dass in the 1970s and by Maharishi Ayurveda in the 1980s.<ref name=":9" /> In some cases, this involved active fraud on the part of proponents of ayurveda in an attempt to falsely represent the system as equal to the standards of modern ].<ref name=":10">{{Cite journal |last=Skolnick, Andrew A. |author-link=Andrew A. Skolnick |year=1991 |title=The Maharishi Caper: Or How to Hoodwink Top Medical Journals |url=http://www.aaskolnick.com/naswmav.htm |format=print |journal=ScienceWriters: The Newsletter of the National Association of Science Writers |issue=Fall |archive-url=https://web.archive.org/web/20080716041551/http://www.aaskolnick.com/naswmav.htm |archive-date=16 July 2008 |access-date=23 January 2016 |url-status=usurped |quote=From time to time, even the most prestigious science journals publish erroneous or fraudulent data, unjustified conclusions, and sometimes balderdash. Balderdash was the right word when The ] (JAMA) published the article, 'Maharishi Ayur-Veda: Modern Insights Into Ancient Medicine,' in its 22/29 May issue. Discovering that they had been deceived by the article's authors, the editors published a correction in the 14 August issue, which was followed on 2 October by a six-page exposé on the people who had hoodwinked them.}}</ref><ref>{{Cite journal |last=Skolnick |first=Andrew A. |author-link=Andrew A. Skolnick |year=1991 |title=Maharishi Ayur-Veda: Guru's marketing scheme promises the world eternal 'perfect health' |journal=JAMA |volume=266 |issue=13 |pages=1741–2, 1744–5, 1749–50 |doi=10.1001/jama.1991.03470130017003 |pmid=1817475}}</ref><ref>{{Cite web |date=May 2005 |title=National Policy on Traditional Medicine and Regulation of Herbal Medicines |url=http://apps.who.int/medicinedocs/pdf/s7916e/s7916e.pdf |url-status=dead |archive-url=https://web.archive.org/web/20090927001412/http://apps.who.int/medicinedocs/pdf/s7916e/s7916e.pdf |archive-date=27 September 2009 |publisher=World Health Organization}}</ref>


===Nepal=== ==== United States ====
] was an early proponent who helped bring ayurveda to the United States in the early 1970s. His teachings led to the establishment of the Mount Madonna Institute.<ref>{{Cite book |last1=Jones |first1=Constance |url=https://books.google.com/books?id=OgMmceadQ3gC&pg=PP1 |title=Encyclopedia of Hinduism |last2=Ryan |first2=James D. |publisher=Infobase Publishing |year=2006 |isbn=978-0-8160-7564-5 |editor-last=Melton |editor-first=J. Gordon |series=Encyclopedia of World Religions |page=179 |access-date=23 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110231/https://books.google.com/books?id=OgMmceadQ3gC&pg=PP1 |url-status=live }}</ref> He invited several notable ayurvedic teachers, including Vasant Lad, Sarita Shrestha, and ]. The ayurvedic practitioner Michael Tierra wrote that the "history of Ayurveda in North America will always owe a debt to the selfless contributions of Baba Hari Dass".<ref>{{Cite book |last1=Khalsa |first1=Karta Purkh Singh |url=https://books.google.com/books?id=fOK33vv_29UC&pg=PP1 |title=The Way of Ayurvedic Herbs: The Most Complete Guide to Natural Healing and Health with Traditional Ayurvedic Herbalism |last2=Tierra |first2=Michael |date=2008 |publisher=Lotus Press |isbn=978-0-940985-98-8 |pages=x |language=en |quote=Independently, we both first learned Ayurvedic medicine from our respective spiritual mentors – myself with Baba Hari Dass and K.P., with Yogi Bhajan. |access-date=23 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110311/https://books.google.com/books?id=fOK33vv_29UC&pg=PP1 |url-status=live }}</ref>


In the United States, the practice of ayurveda is not licensed or regulated by any state. The ] (NCCIH) stated that "Few well-designed clinical trials and systematic research reviews suggest that Ayurvedic approaches are effective". The NCCIH warned against the issue of heavy metal poisoning, and emphasised the use of conventional health providers first.<ref name=":5">{{Cite web |date=December 2018 |title=Ayurvedic Medicine: In Depth |url=https://www.nccih.nih.gov/health/ayurvedic-medicine-in-depth |access-date=23 August 2020 |website=National Center for Complementary and Integrative Health |archive-date=13 August 2020 |archive-url=https://web.archive.org/web/20200813090253/https://www.nccih.nih.gov/health/ayurvedic-medicine-in-depth |url-status=live }}</ref> As of 2018, the NCCIH reported that 240,000 Americans were using ayurvedic medicine.<ref name=":5" />
According to a WHO survey, about 75% of the population of ] uses herbal medicines.<ref>{{cite book|title=Herbal Medicines|author=Dr. Md. Zulfeequar Alam|page=122|isbn=APH Publishing|isbn=9788131303580|year=2008}}</ref> Ayurveda remains the most practiced form of medicine in the country.<ref>{{cite book|title=Culture and the Environment in the Himalaya|pages=84–85|author=Arjun Guneratne|publisher=routledge|year=2009}}</ref>


===Sri Lanka=== ==== Europe ====
The first ayurvedic clinic in Switzerland was opened in 1987 by ].<ref>{{Cite book |last1=Wujastyk |first1=Dagmar |url=https://books.google.com/books?id=M3XBu-vpXgoC&pg=PP1 |title=Modern and Global Ayurveda: Pluralism and Paradigms |last2=Smith |first2=Frederick M. |date=September 9, 2013 |publisher=SUNY Press |isbn=978-0-7914-7816-5 |pages=285 |language=en |access-date=10 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105230/https://books.google.com/books?id=M3XBu-vpXgoC&pg=PP1 |url-status=live }}</ref> In 2015, the government of Switzerland introduced a federally recognized diploma in ayurveda.<ref name=":8">{{Cite web |last=Chandrasekhar |first=Anand |date=June 4, 2017 |title=Ayurveda seeks respectability through Swiss diploma |url=https://www.swissinfo.ch/eng/society/traditional-indian-medicine_ayurveda-seeks-respectability-through-swiss-diploma/43189578 |access-date=2022-03-16 |website=SWI |language=en |archive-date=16 March 2022 |archive-url=https://web.archive.org/web/20220316015131/https://www.swissinfo.ch/eng/society/traditional-indian-medicine_ayurveda-seeks-respectability-through-swiss-diploma/43189578 |url-status=live }}</ref>
]—a well known Ayurvedic herb)]]
The 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 ], which are common to both countries. However, they do differ in some aspects, particularly in the herbs used.


== Classification and efficacy ==
The Sri Lankan government has established a Ministry of Indigenous Medicine (established in 1980) to revive and regulate the practice within the country.<ref>{{cite web|url=http://www.ayurveda.gov.lk/dept.html |title=Ministry of Indigenous Medicine |accessdate= 2 December 2012}}</ref> The Institute of Indigenous Medicine (affiliated to the ]) currently offers undergraduate, postgraduate, and MD degrees in the practice of Ayurveda Medicine and Surgery, and similar degrees in ] medicine.<ref>{{cite web|url=http://iim.cmb.ac.lk/ |title=Institute of indigenous Medicine |publisher=Iim.cmb.ac.lk |accessdate= 21 June 2012}}</ref>
Ayurvedic medicine is considered ] because its premises are not based on science.<ref name="oxpsych">{{Cite book |title=Oxford Handbook of Psychiatry |vauthors=Semple D, Smyth R |publisher=Oxford University Press |year=2019 |isbn=978-0-19-879555-1 |edition=4th |page=24 |chapter=Chapter 1: Thinking about psychiatry |doi=10.1093/med/9780198795551.003.0001 |quote=These pseudoscientific theories may&nbsp;... confuse metaphysical with empirical claims (e.g.&nbsp;... Ayurvedic medicine) |access-date=3 July 2020 |chapter-url=https://books.google.com/books?id=626fDwAAQBAJ&pg=PA24 |archive-url=https://web.archive.org/web/20230907105316/https://books.google.com/books?id=626fDwAAQBAJ&pg=PA24 |archive-date=7 September 2023 |url-status=live}}{{subscription required}}</ref><ref name="kaufman" /> Both the lack of scientific soundness in the theoretical foundations of ayurveda and the quality of research have been criticized.<ref name="oxpsych" /><ref name="Sujatha2011">{{Cite journal |last=Sujatha |first=V |date=July 2011 |title=What could 'integrative' medicine mean? Social science perspectives on contemporary Ayurveda |journal=Journal of Ayurveda and Integrative Medicine |volume=2 |issue=3 |pages=115–23 |doi=10.4103/0975-9476.85549 |pmc=3193682 |pmid=22022153 |doi-access=free}}</ref><ref name="Manohar2013">{{Cite journal |last=Manohar |first=PR |date=April 2013 |title=Uniform standards and quality control of research publications in the field of Ayurveda |journal=Ancient Science of Life |volume=32 |issue=4 |pages=185–6 |doi=10.4103/0257-7941.131968 |pmc=4078466 |pmid=24991064 |doi-access=free}}</ref><ref name="Bausell">{{Cite book |last=Bausell |first=R. Barker |url=https://archive.org/details/isbn_9780195313680 |title=Snake Oil Science: The Truth About Complementary and Alternative Medicine |date=2007 |publisher=] |isbn=978-0-19-538342-3 |page= |author-link=R. Barker Bausell |url-access=registration}}</ref>


Although laboratory experiments suggest that some herbs and substances in ayurveda might be developed into effective treatments, there is no evidence that any are effective in themselves.<ref name="ACS2011">{{Cite web |date=26 August 2011 |title=Ayurveda |url=http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/mindbodyandspirit/ayurveda |url-status=live |archive-url=https://web.archive.org/web/20140222053347/http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/mindbodyandspirit/ayurveda |archive-date=22 February 2014 |access-date=7 January 2015 |publisher=American Cancer Society |quote=The effectiveness of Ayurveda has not been proven in scientific studies, but early research suggests that certain herbs may offer potential therapeutic value&nbsp;... Although Ayurveda has been largely untested by Western researchers, there is a growing interest in integrating some parts of the system into medical practice. In fact, a few of the herbs and substances have been purified into drugs that are used (along with other medicines) to treat cancer. Early studies suggest that other parts of Ayurveda may have potential therapeutic value.}}</ref><ref>{{Cite journal |last=Patwardhan |first=Bhushan |date=2014-11-01 |title=Bridging Ayurveda with evidence-based scientific approaches in medicine |journal=The EPMA Journal |volume=5 |issue=1 |pages=19 |doi=10.1186/1878-5085-5-19 |issn=1878-5077 |pmc=4230501 |pmid=25395997 |doi-access=free}}</ref> There is no good evidence that ayurvedic medicine is effective to treat or cure cancer in people.<ref name="cruk" /> Although ayurveda may help "improve quality of life" and ] also acknowledges that "researchers have found that some Ayurvedic treatments can help relieve cancer symptoms", the organization warns that some ayurvedic drugs contain toxic substances or may ] with legitimate cancer drugs in a harmful way.<ref name="cruk">{{Cite web |title=Ayurvedic medicine |url=https://about-cancer.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/ayurvedic-medicine |access-date=18 April 2022 |website=] |quote=There is no scientific evidence to prove that Ayurvedic medicine can treat or cure cancer. Researchers have found that some Ayurvedic treatments can help relieve cancer symptoms. It can also improve quality of life. |archive-date=24 November 2020 |archive-url=https://web.archive.org/web/20201124090704/https://about-cancer.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/ayurvedic-medicine |url-status=live }}</ref>
There are currently 62 Ayurvedic Hospitals and 208 central dispensaries in the public system, and they served almost 3 million people (approximately 11% of Sri Lanka's total population) in 2010. In total there are currently approximately 20,000 registered practitioners of Ayurveda in the country.<ref>http://www.indigenousmedimini.gov.lk/Downloads/Statistics%20Report%20Final%202011.%20November.pdf</ref><ref>{{cite web|url=http://www.indigenousmedimini.gov.lk/About_us.html |title=:: Indigenous-Medicine |publisher=Indigenousmedimini.gov.lk |date=14 February 1980 |accessdate= 21 June 2012}}</ref>


Ethnologist ] writes that although the rationalist movement Maharashtra Andhashraddha Nirmoolan Samiti officially labels ayurveda a pseudoscience akin to ], these practices are in fact embraced by many of the movement's members.<ref name="Quack-2011">{{Cite book |last=Quack |first=Johannes |author-link=Johannes Quack |url=https://books.google.com/books?id=55wFpydSZ8oC |title=Disenchanting India: Organized Rationalism and Criticism of Religion in India |publisher=] |year=2011 |isbn=978-0-19-981260-8 |quote-page= 213 |quote= There are some ideological realms where the official agenda of ANiS is not applied in the ideal way by the majority of its members. Two of these are summarized here under Astrology and Ayurveda Both are labeled "pseudosciences" in the official agenda of the rationalists Rationalists told me openly many times that against the official agenda of the movement, they consider Ayurveda highly scientific and that they refuse to call it a pseudoscience. During the FIRA conference this official perspective was represented by several of the speakers, while ordinary members told me how they practice some of these pseudosciences, either privately or as certified doctors themselves, most often Ayurveda. |access-date=6 February 2022 |archive-url=https://web.archive.org/web/20230907113453/https://books.google.com/books?id=55wFpydSZ8oC |archive-date=7 September 2023 |url-status=live}}</ref>
According to the ], the ancient chronicle of ] royalty written in the sixth century A.D., King ] (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 documented evidence available of institutions dedicated specifically to the care of the sick anywhere in the world.<ref>Prof. Arjuna Aluvihare, "Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo" ''Vidhusara Science Magazine'', Nov. 1993.</ref><ref>'''' – Rannan-Eliya, Ravi P. & De Mel, Nishan, ] & Health Policy Programme, Institute of Policy Studies, February 1997, Page 19. Accessed 22 February 2008.</ref> ] Hospital is the oldest in the world.<ref>Heinz E Müller-Dietz, ''Historia Hospitalium'' (1975).</ref>


A review of the use of ayurveda for ] concluded that the evidence is not convincing for the use of any ayurvedic herbal treatment for heart disease or hypertension, but that many herbs used by ayurvedic practitioners could be appropriate for further research.<ref name="Mamtani2005">{{Cite journal |last1=Mamtani |first1=R. |last2=Mamtani, R. |year=2005 |title=Ayurveda and Yoga in Cardiovascular Diseases |journal=Cardiology in Review |volume=13 |issue=3 |pages=155–162 |doi=10.1097/01.crd.0000128730.31658.36 |pmid=15834238 |s2cid=27195105}}</ref>
===Outside the Subcontinent===
{{see also|Ayurveda in America}}


=== Research ===
Ayurveda is a system of traditional medicine developed during antiquity and the medieval period, and as such comparable to pre-modern ] and ] systems of medicine. However, beginning in the 1960s, Ayurveda has begun to be advertised as "]" in the Western world. Due to different laws and medical regulations in the rest of the world, the unregulated practice and commercialisation 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 "]" 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 equal to the standards of modern ].<ref>"From time to time, even the most prestigious science journals publish erroneous or fraudulent data, unjustified conclusions, and sometimes balderdash. Balderdash was the right word when The Journal of the American Medical Association (JAMA) published the article, "Maharishi Ayur-Veda: Modern Insights Into Ancient Medicine," in its 22/29 May issue. Discovering that they had been deceived by the article's authors, the editors published a correction in the 14 August issue, which was followed on 2 October by a six-page expose on the people who had hoodwinked them."
] (1991). . ScienceWriters (New York, NY: National Association of Science Writers) Fall. Archived from the original on 16 July 2008. Retrieved 6 July 2010.</ref><ref>{{cite journal|last1=Skolnick|first1=A. A.|title=Maharishi Ayur-Veda: Guru's marketing scheme promises the world eternal 'perfect health'|journal=JAMA: the Journal of the American Medical Association|volume=266|pages=1741–2|year=1991|doi=10.1001/jama.1991.03470130017003|pmid=1817475|issue=13}}</ref><ref>National Policy on Traditional Medicine and Regulation of Herbal Medicines&nbsp;– </ref>


In India, research in ayurveda is undertaken by the Ministry of AYUSH through a national network of research institutes.<ref name="ccras">{{Cite web |title=Research in Ayurveda – About CCRAS |url=http://ccras.nic.in/about_ccras/about_research_in_ayurveda.htm |url-status=dead |archive-url=https://web.archive.org/web/20140530011813/http://ccras.nic.in/about_ccras/about_research_in_ayurveda.htm |archive-date=30 May 2014 |website=Central Council for Research in Ayurveda and Siddha |publisher=Department of AYUSH, Ministry of Health and Family Welfare}}</ref>
] was one of the early proponents who helped bring Ayurveda to the US in the beginning of 1970s. He taught classes in the ''three-dosha'' theory derived from the classic scriptures the ''Suśrutha Saṃhitā'' and the ''Charaka Saṃhitha'', leading to the establishment of the ], College of Ayurveda, Ayurveda World, and Ayurvedic pharmacy. He invited several notable Ayurvedic teachers (Dr. ], Sarita Shrestha, M.D., Professor Ram Harsh Singh, Ph.D, and others). Michael Tierra, Ayurvedic medicine practitioner, wrote: "The history of Ayurveda in North America will always owe a debt to the selfless contributions of Baba Hari Dass" (''The way of Ayurvedic Herbs'', Lotus Press, 2008, XIV).<ref>Karta Purkh Singh Khalsa and Michael Tierra: “Independently, we both first learned Ayurvedic medicine from our respective spiritual mentors – myself with Baba Hari Dass and K.P., with Yogi Bhajan.“ (p.X); ''The way of Ayurvedic Herbs'', Lotus Press, 2008, ]</ref>


In Nepal, the National Ayurvedic Training and Research Centre (NATRC) researches medicinal herbs in the country.<ref>{{Cite news |title=China hands over Ayurveda research centre to govt |publisher=Kantipur Publications |agency=The Kathmandu Post |url=http://www.ekantipur.com/the-kathmandu-post/2011/04/03/nation/china-hands-over-ayurveda-research-centre-to-govt/220180.html |url-status=dead |access-date=7 January 2015 |archive-url=https://web.archive.org/web/20150121053833/http://www.ekantipur.com/the-kathmandu-post/2011/04/03/nation/china-hands-over-ayurveda-research-centre-to-govt/220180.html |archive-date=21 January 2015 |quote=The centre will play a positive role in promotion and utilisation of Ayurveda in the country, by conducting research on medicinal herbs available here.}}</ref>
==Efficacy==
No significant scientific evidence has shown effectiveness of Ayurvedic medicine for the treatment of any disease, although massage and relaxation are often beneficial and there are indications of health effects from some herbal products used.<ref name="cruk"/>


In Sri Lanka, the ] looks after the research in ayurveda through various national research institutes.<ref>{{Cite journal |date=21 September 2015 |title=Part I: Section (I) — General Government Notifications The Constitution of the Democratic Socialist Republic of Sri Lanka Notification |url=http://www.documents.gov.lk/files/egz/2015/9/1933-13_E.pdf |journal=The Gazette of the Democratic Socialist Republic of Sri Lanka Extraordinary |location=Colombo, Sri Lanka |volume=1933/13 |access-date=25 March 2022 |archive-date=19 January 2022 |archive-url=https://web.archive.org/web/20220119072852/http://www.documents.gov.lk/files/egz/2015/9/1933-13_E.pdf |url-status=live }}</ref>
Some Ayurvedic products have been scientifically tested.<ref>{{cite book|title=Complementary and Alternative Medicine for Health Professionals: A Holistic Approach to Consumer Health|author=Linda Baily Synovitz, Karl L. Larson|page=90|year=2013|publisher=Jones & Bartlett Publishers}}</ref> Many plants used as '']'' (rejuvenation) medications are potent ].<ref name="Govindarajan2005">{{cite journal |last=Govindarajan|first=R.|author2=Vijayakumar, M.|author3= Pushpangadan, P. |title=Antioxidant Approach to Disease Management and the Role of 'Rasayana' Herbs of Ayurveda |journal=Journal of Ethnopharmacology |volume=99 |issue=2 |pages=165–178 |year=2005 |pmid=15894123 |doi=10.1016/j.jep.2005.02.035}}</ref> ] appears to have beneficial pharmacological properties.<ref name=Subapriya2005>{{cite journal |last=Subapriya|first=R.|author2=Nagini, S. |title=Medicinal Properties of Neem Leaves: A Review |journal=Curr Med Chem Anticancer Agents |volume=5 |issue=2 |year=2005 |pmid=15777222 |doi= 10.2174/1568011053174828 |pages=149–6}}</ref> In India, research in Ayurveda is undertaken by the statutory body of the ], the ] (CCRAS), through a national network of research institutes.<ref name="ccras">{{cite web | title=Central Council for Research in Ayurveda and Siddha (Government of India)| url= http://www.ccras.nic.in/}}</ref> A systematic review of Ayurveda treatments for rheumatoid ] concluded that there was insufficient evidence, as most of the trials were not done properly, and the one high-quality trial showed no benefits.<ref name="Park2005">{{cite journal |last=Park|first=J.|author2=Ernst, E. |title=Ayurvedic Medicine for Rheumatoid Arthritis: A Systematic Review |journal=Seminars in Arthritis and Rheumatism |volume=34 |issue=5 |pages=705–713 |year=2005|pmid=15846585 |doi=10.1016/j.semarthrit.2004.11.005}}</ref> A review of Ayurveda and ] concluded that the evidence for Ayurveda was not convincing, though some herbs seemed promising.<ref name="Mamtani2005">{{cite journal |last=Mamtani|first=R.|author2=Mamtani, R. |title=Ayurveda and Yoga in Cardiovascular Diseases |journal=Cardiology Review |volume=13 |issue=3 |pages=155–162 |year=2005 |pmid=15834238 |doi= 10.1097/01.crd.0000128730.31658.36}}</ref>
{{anchor|Safety}}


==Use of toxic metals== ==== Use of toxic metals ====
], the practice of adding metals, minerals or gems to herbs, may include toxic heavy metals such as lead, ] and ].<ref name="Saper2008"/> 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 a communication gap between modern medicine practitioners and Ayurvedic practitioners.<ref name="Urmila2008">{{cite journal | author1=Urmila T |author2=Supriya B |year=2008 |title=Pharmacovigilance of ayurvedic medicines in India | journal=Indian Journal of Pharmacology | volume=40 | issue=S1 |pages =10–12 |url = http://www.bioline.org.br/request?ph08015}}</ref> ''Rasashastra'', the practice of adding metals, minerals or gems to herbal preparations, may include ]s such as lead, ] and arsenic.<ref name="Saper2008" /> The public health implications of metals in ''rasashastra'' in India is unknown.<ref name="Saper2008" /> Adverse reactions to herbs are described in traditional ayurvedic texts, but practitioners are reluctant to admit that herbs could be toxic and that reliable information on herbal toxicity is not readily available. There is a communication gap between practitioners of medicine and ayurveda.<ref name="Urmila2008">{{Cite journal |last1=Urmila, T. |last2=Supriya, B. |year=2008 |title=Pharmacovigilance of ayurvedic medicines in India |url=http://www.bioline.org.br/request?ph08015 |journal=Indian Journal of Pharmacology |volume=40 |issue=S1 |pages=10–12 |doi=10.4103/0253-7613.40236 |doi-access=free |access-date=15 January 2009 |archive-date=30 March 2009 |archive-url=https://web.archive.org/web/20090330004810/http://www.bioline.org.br/request?ph08015 |url-status=live |hdl=1807/59467 |hdl-access=free }}</ref>


According to a 1990 study on Ayurvedic medicines in India, 41% of the products tested contained arsenic, and 64% contained lead and mercury.<ref name=Dargan /> A 2004 study found toxic levels of heavy metals in 20% of Ayurvedic preparations made in South Asia and sold in the Boston area; it concluded that Ayurvedic products posed serious health risks and should be tested for heavy-metal contamination.<ref name="pmid15598918">{{cite journal |last=Saper|first=R. B. |title=Heavy metal content of ayurveda herbal medicine products |journal=Journal of the American Medical Association |volume=292 |issue=23 |pages=2868–2673 |year=2004 |pmid=15598918 |doi=10.1001/jama.292.23.2868 |author2=Kales SN |last3=Paquin |first3=J |display-authors=3 |last4=Burns |first4=MJ |last5=Eisenberg |first5=DM |last6=Davis |first6=RB |last7=Phillips |first7=RS }}</ref> A 2008 study of more than 230 products found that approximately 20% of remedies (and 40% of ''rasa shastra'' medicines) purchased over the Internet from U.S. and Indian suppliers contained lead, mercury or arsenic.<ref name="Saper2008" /><ref name="NewYorkTimes2008-09-17">{{cite news| url=http://www.nytimes.com/2008/09/18/fashion/18skin.html| title=Skin deep: ancient, but how safe? |work=New York Times |last=Ellin |first=Abby |date=17 September 2008| accessdate=19 September 2008 |quote=A report in the August 27 issue of '']'' found that nearly 21 percent of 193 ayurvedic herbal supplements bought online, produced in both India and the United States, contained lead, mercury or arsenic.| archiveurl= http://web.archive.org/web/20080918203119/http://www.nytimes.com/2008/09/18/fashion/18skin.html |archivedate=18 September 2008 |deadurl=no }}</ref><ref name="Szabo">{{cite news |url=http://www.usatoday.com/news/health/2008-08-26-ayurvedic-medicines_N.htm |last=Szabo |first=Liz |title=Study finds toxins in some herbal medicines |work=]|date=26 August 2008}}</ref> In 2012 the ] (CDC) linked Ayurvedic drugs to lead poisoning, based on some cases where toxic materials were found in the blood of pregnant women who had taken Ayurvedic drugs.<ref>, ''The Financial Express'', Washington edition (24 August 2012) (accessed on 25 Sep 2012)</ref> Some traditional Indian herbal medicinal products contain harmful levels of heavy metals, including lead.<ref name="Ernst2002" /> For example, ghasard, a product commonly given to infants for digestive issues, has been found to have up to 1.6% lead concentration by weight, leading to ].<ref>{{Cite journal |last1=Karri |first1=Surya K. |last2=Saper |first2=Robert B. |last3=Kales |first3=Stefanos N. |date=January 2008 |title=Lead Encephalopathy Due to Traditional Medicines |journal=Current Drug Safety |volume=3 |issue=1 |pages=54–59 |doi=10.2174/157488608783333907 |issn=1574-8863 |pmc=2538609 |pmid=18690981}}</ref> A 1990 study on ayurvedic medicines in India found that 41% of the products tested contained arsenic, and that 64% contained lead and mercury.<ref name="Dargan" /> A 2004 study found toxic levels of heavy metals in 20% 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.<ref name="pmid15598918">{{Cite journal |last1=Saper |first1=R. B. |last2=Kales SN |last3=Paquin |first3=J |last4=Burns |first4=MJ |last5=Eisenberg |first5=DM |last6=Davis |first6=RB |last7=Phillips |first7=RS |display-authors=3 |year=2004 |title=Heavy metal content of ayurveda herbal medicine products |journal=Journal of the American Medical Association |volume=292 |issue=23 |pages=2868–73 |doi=10.1001/jama.292.23.2868 |pmid=15598918 |s2cid=9914911}}</ref> A 2008 study of more than 230 products found that approximately 20% of remedies (and 40% of ''rasashastra'' medicines) purchased over the Internet from U.S. and Indian suppliers contained lead, mercury or arsenic.<ref name="Saper2008" /><ref name="NewYorkTimes2008-09-17">{{Cite news |last=Ellin |first=Abby |date=17 September 2008 |title=Skin deep: ancient, but how safe? |work=] |url=https://www.nytimes.com/2008/09/18/fashion/18skin.html |url-status=live |access-date=19 September 2008 |archive-url=https://web.archive.org/web/20110430050703/http://www.nytimes.com/2008/09/18/fashion/18skin.html |archive-date=30 April 2011 |quote=A report in the August 27 issue of '']'' found that nearly 21 percent of 193 ayurvedic herbal supplements bought online, produced in both India and the United States, contained lead, mercury or arsenic.}}</ref><ref name="Szabo">{{Cite news |last=Szabo |first=Liz |date=26 August 2008 |title=Study finds toxins in some herbal medicines |work=] |url=https://www.usatoday.com/news/health/2008-08-26-ayurvedic-medicines_N.htm |url-status=live |archive-url=https://web.archive.org/web/20121008031004/http://usatoday30.usatoday.com/news/health/2008-08-26-ayurvedic-medicines_N.htm |archive-date=8 October 2012}}</ref> A 2015 study of users in the United States found elevated blood lead levels in 40% of those tested, leading physician and former U.S. Air Force ] ] to say that "Ayurveda is basically superstition mixed with a soupçon of practical health advice. And it can be dangerous."<ref>{{Cite web |last=Hall |first=Harriet |author-link=Harriet Hall |date=14 December 2017 |title=Ayurveda: Ancient Superstition, Not Ancient Wisdom |url=https://www.csicop.org/specialarticles/show/ayurveda_ancient_superstition_not_ancient_wisdom |access-date=1 February 2018 |website=Skeptical Inquirer |archive-date=14 December 2017 |archive-url=https://web.archive.org/web/20171214200609/https://www.csicop.org/specialarticles/show/ayurveda_ancient_superstition_not_ancient_wisdom |url-status=live }}</ref><ref>{{Cite journal |vauthors=Breeher L, Mikulski MA, Czeczok T, Leinenkugel K, Fuortes LJ |date=6 Apr 2015 |title=A cluster of lead poisoning among consumers of Ayurvedic medicine. |journal=International Journal of Occupational and Environmental Health |volume=21 |issue=4 |pages=303–307 |doi=10.1179/2049396715Y.0000000009 |pmc=4727589 |pmid=25843124}}</ref> A 2022 study found that ayurvedic preparations purchased over-the-counter in Chandigarh, India, had levels of zinc, mercury, arsenic and lead over the limits set by the Food and Agriculture Organisation / World Health Organisation. 83% exceeded the limit for zinc, 69% for mercury, 14% for arsenic and 5% for lead.<ref name=":11" />


Ayurvedic proponents believe that the toxicity of these materials is reduced through purification processes such as '']'' or ''shodhanas'' (for metals), similar to the Chinese '']'', although the Ayurvedic technique is more complex and may involve prayers as well as physical pharmacy techniques. However, these products have nonetheless caused severe ] and other toxic effects.<ref name="NewYorkTimes2008-09-17" /><ref name=autogenerated1>{{Cite journal|author1=Saper RB|author2=Phillips RS |author3=Sehgal A |display-authors=3 |title=Lead, mercury, and arsenic in US- and Indian-manufactured ayurvedic medicines sold via the internet |journal=JAMA |volume=300 |issue=8 |pages=915–923 |date=August 2008 |pmid=18728265 |doi=10.1001/jama.300.8.915 |pmc=2755247}}</ref> Heavy metals are thought of as active ingredients by advocates of Indian herbal medicinal products.<ref name="Ernst2002">{{Cite journal |last=Ernst |first=Edzard |year=2002 |title=Heavy metals in traditional Indian remedies |journal=European Journal of Clinical Pharmacology |volume=57 |issue=12 |pages=891–896 |doi=10.1007/s00228-001-0400-y |issn=0031-6970 |pmid=11936709 |s2cid=1698767}}</ref> According to ancient ayurvedic texts, certain physico-chemical purification processes such as '']'' or '']s'' (for metals) 'detoxify' the heavy metals in it.<ref>{{Cite journal |last=CCRAS |title=Guidelines for toxicity / safety profile evaluation of Ayurveda & Siddha plant drugs |url=http://www.ccras.nic.in/pdf/Guidelinesfortoxicity.doc |url-status=dead |journal=CCRAS Guidelines |archive-url=https://web.archive.org/web/20130311194713/http://ccras.nic.in/pdf/Guidelinesfortoxicity.doc |archive-date=11 March 2013}}</ref><ref name=":4">{{Cite journal |last=Katiyar |first=C. K. |year=2006 |title=Safety Aspects of Ayurveda |url=http://www.yieldopedia.com/paneladmin/reports/ddd5b6c170eb4b6f1e956edf7e6b7904.pdf |journal=Ranbaxy Research Laboratories |access-date=25 January 2017 |archive-date=2 February 2017 |archive-url=https://web.archive.org/web/20170202102354/http://www.yieldopedia.com/paneladmin/reports/ddd5b6c170eb4b6f1e956edf7e6b7904.pdf |url-status=live }}</ref> These are similar to the Chinese '']'', although the ayurvedic techniques are more complex and may involve physical pharmacy techniques as well as ]s. However, these products have nonetheless caused severe ] and other toxic effects.<ref name="NewYorkTimes2008-09-17" /> Between 1978 and 2008, "more than 80 cases of lead poisoning associated with Ayurvedic medicine use reported worldwide".<ref name="autogenerated1">{{Cite journal |last1=Saper RB |last2=Phillips RS |last3=Sehgal A |date=August 2008 |title=Lead, mercury, and arsenic in US- and Indian-manufactured ayurvedic medicines sold via the internet |journal=JAMA |volume=300 |issue=8 |pages=915–923 |doi=10.1001/jama.300.8.915 |pmc=2755247 |pmid=18728265}}</ref> In 2012, the ] (CDC) linked ayurvedic drugs to lead poisoning, based on cases where toxic materials were found in the blood of pregnant women who had taken ayurvedic drugs.<ref>{{Cite news |date=24 August 2012 |title=Ayurveda linked to lead poisoning in US women |edition=Washington |work=The Financial Express |url=http://www.financialexpress.com/news/ayurveda-linked-to-lead-poisoning-in-us-women/992558/0 |url-status=dead |archive-url=https://web.archive.org/web/20141209174803/http://archive.financialexpress.com/news/ayurveda-linked-to-lead-poisoning-in-us-women/992558/0 |archive-date=9 December 2014}}</ref>


Ayurvedic practitioners argue that the toxicity of bhasmas (ash products) comes from improper manufacturing processes, contaminants, improper use of ayurvedic medicine, quality of raw materials and that the end products and improper procedures are used by charlatans.<ref name=":4" />
Due to these concerns, the government of India ruled that Ayurvedic products must specify their metallic content directly on the labels of the product.<ref name="Valiathan06"/> But, writing on the subject for '']'', a publication of the ], M. S. Valiathan noted that "the absence of post-market surveillance and the paucity of test laboratory facilities make the quality control of Ayurvedic medicines exceedingly difficult at this time."<ref name="Valiathan06" />


In India, the government ruled that ayurvedic products must be labelled with their metallic content.<ref name="Valiathan06">{{Cite journal |last=Valiathan |first=MS |year=2006 |title=Ayurveda: putting the house in order |url=http://www.currentscience.ac.in/Downloads/article_id_090_01_0005_0006_0.pdf |journal=Current Science |volume=90 |issue=1 |pages=5–6 |access-date=27 October 2013 |archive-date=9 October 2022 |archive-url=https://ghostarchive.org/archive/20221009/http://www.currentscience.ac.in/Downloads/article_id_090_01_0005_0006_0.pdf |url-status=live }}</ref> However, in '']'', a publication of the Indian Academy of Sciences, M. S. Valiathan said that "the absence of post-market surveillance and the paucity of test laboratory facilities make the quality control of Ayurvedic medicines exceedingly difficult at this time".<ref name="Valiathan06" /> In the United States, most ayurvedic products are marketed without having been reviewed or approved by the FDA. Since 2007, the FDA has placed an import alert on some ayurvedic products in order to prevent them from entering the United States.<ref>{{Cite web |title=Use caution with Ayurvedic products |url=https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm050798.htm |access-date=17 December 2014 |publisher=US FDA |archive-date=23 April 2019 |archive-url=https://web.archive.org/web/20190423055002/https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm050798.htm |url-status=live }}</ref> A 2012 toxicological review of mercury-based traditional herbo-metallic preparations concluded that the long-term pharmacotherapeutic and in-depth toxicity studies of these preparations are lacking.<ref>{{Cite journal |last1=Kamath |first1=Sushant U. |last2=Pemiah |first2=Brindha |last3=Sekar |first3=Rajan K. |last4=Krishnaswamy |first4=Sridharan |last5=Sethuraman |first5=Swaminathan |last6=Krishnan |first6=Uma Maheswari |date=2012-06-01 |title=Mercury-based traditional herbo-metallic preparations: a toxicological perspective |journal=Archives of Toxicology |language=en |volume=86 |issue=6 |pages=831–838 |doi=10.1007/s00204-012-0826-2 |issn=1432-0738 |pmid=22441626 |bibcode=2012ArTox..86..831K |s2cid=13947298}}</ref>
Most Ayurvedic products are labelled either for drug use (not FDA approved) or as dietary supplements. There is an import alert on some medicines issued by the FDA since 2007 which prevents these products entering the United States.<ref>US FDA website (Accessed on 27 October 2013)</ref>


==See also== == History ==
{{Unreliable sources|section|date=April 2018}}
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Some scholars assert that the concepts of traditional ayurvedic medicine have existed since the times of the ] but since the ] has not been deciphered, such assertions are moot.<ref name="MaasCambridge_2018" />{{rp|p=535–536|quote=nothing definite can be said about the religion of the Indus Valley civilization due to the absence of intelligible written sources.&nbsp;... All attempts to decipher these symbols consistently have failed so far.&nbsp;... Although this can hardly be disputed with historical arguments, we find the anachronistic claim in some currents of modern Ayurveda that Ayurveda originated in the peak period of the Indus Valley civilization.}} The ] contains hymns and prayers aimed at curing disease. There are various legendary accounts of the origin of ayurveda, such as that it was received by Dhanvantari (or ]) from ].<ref name="britannica" /><ref name="Underwood&Rhodes(2008)" /> Tradition also holds that the writings of ayurveda were influenced by a lost text by the sage ].<ref name="Thakara">{{Cite book |last=Ṭhākara |first=Vināyaka Jayānanda |title=Methodology of Research in Ayurveda |publisher=] Press |year=1989 |location=Jamnagar, India |page=7}}</ref>
==References==
{{Reflist|30em}}


Ayurveda is one of the few systems of medicine developed in ancient times that is still widely practised in modern times.<ref name="Smith+Wujastyk">{{Cite book |last1=Smith |first1=Frederick M. |title=Modern and Global Ayurveda: Pluralism and Paradigms |last2=Wujastyk |first2=Dagmar |publisher=] |year=2008 |isbn=978-0-7914-7816-5 |editor-last=Smith |editor-first=Frederick M. |location=New York |pages=1–28 |chapter=Introduction |oclc=244771011 |editor-last2=Wujastyk |editor-first2=Dagmar |chapter-url=https://books.google.com/books?id=M3XBu-vpXgoC&pg=PP1 |access-date=10 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907105230/https://books.google.com/books?id=M3XBu-vpXgoC&pg=PP1 |url-status=live }}</ref> 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 in medicine.<ref>{{Cite book |url=https://books.google.com/books?id=jjDo1Xxj4XUC&pg=PP1 |title=Asian Medical Systems |publisher=University of California Press |year=1976 |isbn=978-0-520-03511-9 |editor-last=Leslie |editor-first=Charles |location=Berkeley |pages=passim |ref=lesl-asia |access-date=10 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110231/https://books.google.com/books?id=jjDo1Xxj4XUC&pg=PP1 |url-status=live }}</ref><ref>{{Cite book |last=Taylor |first=Carl |url=https://books.google.com/books?id=jjDo1Xxj4XUC |title=Asian Medical Systems |publisher=University of California Press |year=1977 |isbn=978-0-520-03511-9 |editor-last=Leslie |editor-first=Charles |pages=285–292 |chapter=The Place of Indigenous Medical Practitioners in the Modernization of Health Services |ref=lesl-asia |access-date=1 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110735/https://books.google.com/books?id=jjDo1Xxj4XUC |url-status=live }}</ref> 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 modernize and syncretize (''aśuddha'' "impure, tainted" ayurveda).<ref>{{Cite book |last=Leslie |first=Charles |url=https://doi.org/10.1525/9780520322295-022 |title=The Ambiguites of Medical Revivalism in Modern India |chapter=The Ambiguities of Medical Revivalism in Modern India |work=Asian Medical Systems: A Comparative Study |publisher=University of California Press |year=1976 |pages=356–367 |doi=10.1525/9780520322295-022 |isbn=978-0-520-32229-5 |ref=lesl-asia |access-date=1 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110736/https://www.degruyter.com/document/doi/10.1525/9780520322295-022/html |url-status=live }}</ref><ref>{{Cite book|title = Ayurvedic Medicine: Past and Present|last = Sharma|first = Shiv|publisher = Dabur (S. K. Burman)|year = 1975|location = Calcutta}}</ref><ref>{{Cite book |last=Berger |first=Rachel |url=https://link.springer.com/book/10.1057/9781137315908 |title=Ayurveda Made Modern: Political Histories of Indigenous Medicine in North India, 1900–1955 |publisher=Palgrave Macmillan |year=2013 |isbn=978-0-230-28455-5 |location=New York, NY |doi=10.1057/9781137315908 |access-date=1 March 2022 |archive-date=1 March 2022 |archive-url=https://web.archive.org/web/20220301185715/https://link.springer.com/book/10.1057/9781137315908 |url-status=live }}</ref> The political debate about the place of ayurveda in contemporary India has continued to the present, both in the public arena and in government.<ref>{{Cite book |last=Wujastyk |first=Dominik |url=https://doi.org/10.7939/r3-xjj8-cg73 |title=Modern and Global Ayurveda: Pluralism and Paradigms |publisher=SUNY Press |year=2008 |isbn=978-0-7914-7490-7 |pages=43–76 |chapter=The Evolution of Indian Government Policy on Ayurveda in the Twentieth Century |doi=10.7939/r3-xjj8-cg73 |ref=smit-mode |access-date=1 March 2022 |archive-date=7 September 2023 |archive-url=https://web.archive.org/web/20230907110842/https://era.library.ualberta.ca/items/e9860956-f2bf-4081-a31e-31e0ee0acf50 |url-status=live }}</ref> Debate about the place of ayurvedic medicine in the contemporary internationalized world also continues today.<ref>{{Cite journal|url = http://discovery.ucl.ac.uk/1066/1/submission-article.pdf|title = Policy Formation and Debate Concerning the Government Regulation of Ayurveda in Great Britain in the 21st Century|last = Wujastyk|first = Dominik|date = 2005|journal = Asian Medicine|doi = 10.1163/157342105777996719|pages = 162–184|volume = 1|s2cid = 71229532|access-date = 28 January 2019|archive-date = 22 September 2017|archive-url = https://web.archive.org/web/20170922160922/http://discovery.ucl.ac.uk/1066/1/submission-article.pdf|url-status = live}}</ref><ref>{{Cite journal |last=Redy |first=Sita |date=2002 |title=Asian Medicine in America: The Ayurvedic Case |url=https://www.researchgate.net/publication/249666385 |journal=Annals of the American Academy of Political and Social Science |volume=583 |pages=97–121 |doi=10.1177/000271620258300107 |jstor=1049691 |s2cid=145626093}}</ref>
;Cited references

=== Main texts ===
Many ancient works on ayurvedic medicine are lost to posterity,<ref>{{Cite book|last=Meulenbeld|first=G. Jan|url=https://www.worldcat.org/oclc/42207455|title=A history of Indian medical literature|date=1999–2000|isbn=90-6980-124-8|volume=IA|location=Groningen|pages=689–699|oclc=42207455}}</ref> but manuscripts of three principal early texts on ayurveda have survived to the present day. These works are the Charaka Samhita, the ] and the ]. 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''.<ref name="HIML-intro" /> After considering the evidence and arguments concerning the ''Suśrutasaṃhitā'', Meulenbeld stated (IA, 348), <blockquote>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.</blockquote> The dating of this work to 600 BCE was first proposed by Hoernle over a century ago,<ref>{{Cite book|last=Hoernle|first=A. F. Rudolf|title=Osteology or the bones of the human body.|date=1907|publisher=Clarendon P.|location=Oxford|language=en|oclc=28563136}}</ref> 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.<ref name="HIML-intro" /><ref name="shar-hist" /> The view that the text was updated by the Buddhist scholar ] in the 2nd century CE<ref>{{cite book|title=India and Central Asia: Classical to Contemporary Periods|author1=J. N. Roy |author2=Braja Bihārī Kumāra |page=103|publisher=Concept Publishing Company}}</ref> has been disproved, although the last chapter of the work, the Uttaratantra, was added by an unknown later author before 500 CE.<ref name="HIML-intro" />

Similar arguments apply to the Charaka Samhita, written by ], and the Bhela Samhita, attributed to ] Punarvasu, that are also dated to the 6th century BCE by non-specialist scholars<ref>{{cite book|title=Spirit Versus Scalpel: Traditional Healing and Modern Psychotherapy|page=76|author1=Leonore Loeb Adler |author2=B. Runi Mukherji |publisher=Greenwood}}</ref><ref>{{cite book|title=Development of Plant-Based Medicines: Conservation, Efficacy and Safety|first=Praveen K.|last=Saxena|publisher=Springer|page=48}}</ref><ref>{{cite book|url=https://books.google.com/books?id=v56tj2EPZ-YC&pg=PA116|page=116|author1=Mohammad Ali Jazayery |first2=Werner |last2=Winter |publisher=Walter de Gruyter|year=1988|title=Languages and Cultures: Studies in Honor of Edgar C. Polomé|isbn=978-3-11-010204-8}}</ref> but are in fact, in their present form, datable to a period between the second and fifth centuries CE.<ref name="HIML-intro" /><ref name="shar-hist" />{{sfn|Wujastyk|2003a}} The ] was also updated by ] during the early centuries of the Common Era.<ref>{{cite book|author=Glucklich, Ariel|year=2008|title=The Strides of Vishnu: Hindu Culture in Historical Perspective|location=Oxford, England|publisher=Oxford University Press|page=|isbn=978-0-19-531405-2}}</ref>], ancient Indian physician, in ], India]]

The ] (dated to the early 6th century CE<ref>{{Cite book |last=Sander |first=Lore |title="Origin and Date of the {Bower Manuscript}, a New Approach" in Investigating Indian Art: Proceedings of a Symposium on the Development of Early Buddhist and Hindu Iconography Held at the Museum of Indian Art, Berlin, in May 1986 |publisher=Museum Fuer Indische Kunst |year=1987 |location=Berlin |pages=313–323}}</ref>) includes of excerpts from the ''Bheda Samhita''<ref>{{cite book|title=History of Science and Technology in Ancient India: Formation of the theoretical fundamentals of natural science|page=153|first=Debiprasad|last=Chattopadhyaya|year=1991}}</ref> 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 ] (c. 337–422 CE) 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.<ref>{{cite book|title=A History of Ancient and Early Medieval India: From the Stone Age to the 12th Century|url=https://books.google.com/books?id=H3lUIIYxWkEC&q=Charaka+hospital&pg=PA543|first=Upinder|last=Singh|publisher=Pearson|year=2008|isbn=978-81-317-1120-0}}</ref>

Some dictionaries of materia medica include ''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 ], among others.<ref>{{cite book|title=Materia Medica of Ayurveda: Based on: Madanapala's Nighantu|page=14|author=Vaidya Bhagwan Dash|publisher=B. Jain Publishers}}</ref><ref>{{Cite web |last=AYUSH |title=e-Nighantu |url=https://niimh.nic.in/ebooks/e-Nighantu/ |access-date=2 May 2022 |archive-date=2 March 2022 |archive-url=https://web.archive.org/web/20220302142032/https://niimh.nic.in/ebooks/e-Nighantu/ |url-status=live }}</ref>

=== Illnesses portrayed ===
] surgery is mentioned in the '']'', to be performed with a ''jabamukhi salaka'', a curved needle used to loosen and remove the obstructing phlegm,{{clarify |date=November 2023 |reason=Is this talking about removing the lens? Cataracts are not caused by 'phlegm'.}} with eye soaked with warm butter and bandaged afterward.<ref name="finger66">Finger, p. 66</ref>|left|200x200px]]Underwood and Rhodes state that the early forms of traditional Indian medicine identified fever, cough, ], diarrhea, ], ], ]s, tumours, and ],<ref name="Underwood&Rhodes(2008)" /> and that treatments included ], ], ],<ref name=":2" /> ] (a form of cataract surgery), puncturing to release fluids in the ], extraction of foreign bodies, treatment of ]s, treating fractures, ]s, ],{{refn|group=Vagbhata|Vāgbhaṭa's Aṣṭāṅgahṛdayasaṃhitā describes a procedure for the removal of a dead foetus from the womb of a living mother, and of a living child from the womb of a mother who has died (शारीरस्थान २, गर्भव्यापद्, २.२६-२७, २.५३).<ref>{{Cite book|last1=Vāgbhaṭa|title=Ashtanga Hridaya|url=https://archive.org/stream/Ashtanga.Hridaya.of.Vagbhata#page/n567/mode/2up|via=archive.org|access-date=2 January 2017|year=1939}}</ref> Both these descriptions speak of removal of the fetus through the uterine passage, rather than from the front lower abdomen as with the caesarian section procedure. The earlier description of the Suśrutasaṃhitā (चिकित्सास्थान १५ "मूढगर्भ") is similar. A dead fetus is removed through the uterine passage and vagina. Although Suśruta does not describe removing a living child from a dead mother.}}<ref name=":2">{{cite book|last1=Magner|first1=Lois N.|title=A History of the Life Sciences, Revised and Expanded|date= 2002|publisher=CRC Press|isbn=978-0-8247-0824-5|page=6|url=https://books.google.com/books?id=YKJ6gVYbrGwC&pg=PA6|access-date=26 December 2016}}</ref>{{disputed inline|date=December 2016}} and stitching of wounds.<ref name="Underwood&Rhodes(2008)" /> The use of herbs and surgical instruments became widespread.<ref name="Underwood&Rhodes(2008)">Underwood & Rhodes (2008)</ref> During this period, treatments were also prescribed for complex ailments, including ], ], ], and ].<ref name="Dwivedi&Dwivedi07">{{cite journal|last=Dwivedi |first=Girish |author2=Dwivedi, Shridhar |year=2007 |url=http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |title=History of Medicine: Sushruta&nbsp;– the Clinician&nbsp;– Teacher par Excellence |journal=Indian Journal of Chest Diseases and Allied Sciences |volume=49 |pages=243–244 |url-status=dead |archive-url=https://web.archive.org/web/20081010045900/http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |archive-date=10 October 2008}} (Republished by ], Government of India.)</ref><ref name="Lock836">Lock et al., p. 836</ref>

=== Further development and spread ===

Ayurveda flourished throughout the Indian Middle Ages. ] (fl. 1200), Sarngadhara (fl. 1300) and Bhavamisra (fl. 1500) compiled works on Indian medicine.<ref name="WujastykXXVI">{{harvnb|Wujastyk|2003a|page=XXVI}}</ref> The medical works of both Sushruta and Charaka were also translated into the Chinese language in the 5th century,<ref>{{cite book|title=Well-Mannered Medicine: Medical Ethics and Etiquette in Classical Ayurveda|url=https://books.google.com/books?id=6-BoAgAAQBAJ&q=ayurveda+translated+5th+chinese+CE&pg=PA17|first=Dagmar|last=Wujastyk|publisher=Oxford University Press|year=2002|isbn=978-0-19-985627-5|access-date=8 November 2020|archive-date=7 September 2023|archive-url=https://web.archive.org/web/20230907111248/https://books.google.com/books?id=6-BoAgAAQBAJ&q=ayurveda+translated+5th+chinese+CE&pg=PA17|url-status=live}}</ref> and during the 8th century, they were translated into the Arabic and ].<ref>{{cite book|title=Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures|publisher=Springer|url=https://books.google.com/books?id=kt9DIY1g9HYC&pg=PA168|isbn=978-1-4020-4559-2|date=2008|bibcode=2008ehst.book.....S|access-date=22 January 2015|archive-date=7 September 2023|archive-url=https://web.archive.org/web/20230907111245/https://books.google.com/books?id=kt9DIY1g9HYC&pg=PA168|url-status=live}}</ref> The 9th-century Persian physician ] was familiar with the text.<ref>{{cite book|title=Ayurveda: The Gentle Health System|page=15|publisher=]|first=Hans H.|last=Rhyner|url=https://books.google.com/books?id=HlJ-20_iP6wC|isbn=978-81-208-1500-1|year=1994|access-date=22 January 2015|archive-date=7 September 2023|archive-url=https://web.archive.org/web/20230907111247/https://books.google.com/books?id=HlJ-20_iP6wC|url-status=live}}</ref><ref name="Rao">Ramachandra S.K. Rao, Encyclopaedia of Indian Medicine: historical perspective, Volume 1, 2005, {{Request quotation|date=January 2015}}</ref> The Arabic works derived from the ayurvedic texts eventually also reached Europe by the 12th century.<ref>{{cite book|title=Pharmacognosy: An Indian perspective|page=54|url=https://books.google.com/books?id=2UQ8BAAAQBAJ&pg=PA54|author=K. Mangathayaru|publisher=Pearson education|isbn=978-93-325-2026-4|year=2013|access-date=22 January 2015|archive-date=7 September 2023|archive-url=https://web.archive.org/web/20230907111246/https://books.google.com/books?id=2UQ8BAAAQBAJ&pg=PA54|url-status=live}}</ref><ref name="Lock607">{{harvnb|Lock|2001|page=607}}</ref> In ], the Branca family of Sicily and Gaspare Tagliacozzi (]) were influenced by the Arabic reception of the Sushruta's surgical techniques.<ref name="Lock607" />

British physicians traveled to India to observe ] being performed using Indian methods, and reports on their rhinoplasty methods were published in the '']'' in 1794.<ref name="Lock651">{{harvnb|Lock|2001|page=651}}</ref> Instruments described in the ''Sushruta Samhita'' were further modified in Europe.<ref name="Lock652">{{harvnb|Lock|2001|page=652}}</ref> ] 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.<ref name="Lock651/2">{{harvnb|Lock|2001|pages=651–652}}</ref> In 1840 Brett published an article about this technique.<ref>{{cite book|author=Brett, F. H. |year=1840 |title=A practical essay on some of the principal surgical diseases of India|location=Calcutta, India|publisher=W. Thacker & Company|page=458|url=https://archive.org/stream/practicalessayon00bretuoft#page/458/mode/2up |access-date=6 January 2015}}</ref>

The British had shown some interest in understanding local medicinal practices in the early nineteenth century. A Native Medical Institution was setup in 1822 where both indigenous and European medicine were taught. After the ], their policy changed to champion European medicine and disparage local practices.<ref name="Hardiman2009">{{cite journal |last1=Hardiman |first1=David |title=Indian Medical Indigeneity: From Nationalist Assertion to the Global Market |journal=Social History |date=2009 |volume=34 |issue=3 |pages=263–283 |doi=10.1080/03071020902975131 |jstor=25594366 |s2cid=144288544 |url=https://www.jstor.org/stable/25594366 |issn=0307-1022 |quote=On the whole, such courses provided a back door into a career of improvised and only half-understood biomedical practice. Indeed, for biomedical practitioners, such self-titled 'doctors' are no more than quacks. |access-date=7 May 2022 |archive-date=7 May 2022 |archive-url=https://web.archive.org/web/20220507083111/https://www.jstor.org/stable/25594366 |url-status=live }}</ref> After Indian independence, there was more focus on ayurveda and other traditional medical systems. Ayurveda became a part of the Indian National healthcare system, with state hospitals for ayurveda established across the country. However, the treatments of traditional medicines were not always integrated with others.<ref name="who01">{{cite web |last=Xiaorui Zhang |date=2001 |title=Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review |url=http://apps.who.int/medicinedocs/en/d/Jh2943e/8.4.html |url-status=dead |archive-url=https://web.archive.org/web/20090831034622/http://apps.who.int/medicinedocs/en/d/Jh2943e/8.4.html |archive-date=31 August 2009 |access-date=24 June 2014 |publisher=] (WHO) |page=}}</ref>

== See also ==
{{Div col|small=yes}}
* ]
* ]
* ]
* ]
* ]
* ]
* ]
* ]
* ]
* ]
* ]
* ]
* ]
{{div col end}}

== Footnotes ==
{{Reflist|group=Vagbhata}}

== References ==
{{Reflist}}

=== Cited references ===
{{refbegin}} {{refbegin}}
* {{cite book|last=Chopra|first=Ananda S.|year=2003|chapter=Āyurveda|title=Medicine Across Cultures: History and Practice of Medicine in Non-Western Cultures|editor=Selin, Helaine|editor-link=Helaine Selin|pages=75–83|publisher=]|location=Norwell, MA|isbn=1-4020-1166-0|url=http://books.google.com/books?id=of-gv8-pPcsC&pg=PA75|ref=harv}} * {{cite book|last=Chopra|first=Ananda S.|year=2003|chapter=Āyurveda|title=Medicine across cultures: history and practice of medicine in non-western cultures|editor=Selin, Helaine|editor-link=Helaine Selin|pages=75–83|publisher=]|isbn=978-1-4020-1166-5|chapter-url=https://books.google.com/books?id=of-gv8-pPcsC&pg=PA75|access-date=15 November 2015|archive-date=7 September 2023|archive-url=https://web.archive.org/web/20230907111253/https://books.google.com/books?id=of-gv8-pPcsC&pg=PA75|url-status=live}}
* {{cite journal|last=Dwivedi|first=Girish|author2=Dwivedi, Shridhar|year=2007|url= http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |title=History of Medicine: Sushruta&nbsp;– the Clinician&nbsp;– Teacher par Excellence|journal=Indian Journal of Chest Diseases and Allied Sciences|volume=49|pages=243–244|location=Delhi, India|publisher=Vallabhbhai Patel Chest Institute, ] / National College of Chest Physicians}} (Republished by ], Government of India.) * {{cite journal |last=Dwivedi |first=Girish |author2=Dwivedi, Shridhar |year=2007 |url=http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |title=History of Medicine: Sushruta&nbsp;– the Clinician&nbsp;– Teacher par Excellence |journal=Indian Journal of Chest Diseases and Allied Sciences |volume=49 |pages=243–244 |url-status=dead |archive-url=https://web.archive.org/web/20081010045900/http://medind.nic.in/iae/t07/i4/iaet07i4p243.pdf |archive-date=10 October 2008 }} (Republished by ], Government of India.)
* {{cite book|last=Finger|first=Stanley|year=2001|title=Origins of Neuroscience: A History of Explorations into Brain Function|publisher=Oxford University Press|location=Oxford, England/New York, NY|isbn=0-19-514694-8}} * {{cite book|last=Finger|first=Stanley|year=2001|title=Origins of Neuroscience: A History of Explorations into Brain Function|publisher=Oxford University Press |isbn=978-0-19-514694-3}}
* {{cite book|last=Kutumbian|first=P.|year=1999|title=Ancient Indian Medicine|publisher=]|location=Andhra Pradesh, India|isbn=978-81-250-1521-5}} * {{cite book|last=Kutumbian|first=P.|year=1999|title=Ancient Indian Medicine|publisher=]|location=Andhra Pradesh|isbn=978-81-250-1521-5}}
* {{cite book|last=Lock|first=Stephen|year=2001|title=The Oxford Illustrated Companion to Medicine|publisher=Oxford U. Pr|isbn=0-19-262950-6|display-authors=1}} * {{cite book|last=Lock|first=Stephen|year=2001|title=The Oxford Illustrated Companion to Medicine|url=https://archive.org/details/oxfordillustrate00step|url-access=registration|publisher=Oxford University Press|isbn=978-0-19-262950-0|authorlink=Stephen Lock}}
* {{cite encyclopedia|last=Underwood|first=E. Ashworth|author2=Rhodes, P.|year=2008|title=Medicine, History of|encyclopedia=Encyclopædia Britannica|edition=2008}} * {{cite encyclopedia|last=Underwood|first=E. Ashworth|author2=Rhodes, P.|year=2008|title=History of Medicine |encyclopedia=Encyclopædia Britannica|edition=2008}}
* {{cite book|last=Wujastyk|first=D.|year=2003|title=The Roots of Ayurveda: Selections from Sanskrit Medical Writings''|publisher=Penguin Books|isbn=0-14-044824-1}} * {{cite book|last=Wujastyk|first=D.|year=2003a|title=The Roots of Ayurveda: Selections from Sanskrit Medical Writings|publisher=Penguin Books|isbn=978-0-14-044824-5|url=https://books.google.com/books?id=sJOEMwrVyRcC&q=The+Roots+of+Ayurveda:+Selections+from+Sanskrit+Medical+Writings.&pg=PR1|access-date=8 November 2020|archive-date=7 September 2023|archive-url=https://web.archive.org/web/20230907111402/https://books.google.com/books?id=sJOEMwrVyRcC&q=The+Roots+of+Ayurveda:+Selections+from+Sanskrit+Medical+Writings.&pg=PR1|url-status=live}}
{{refend}} {{refend}}


==Further reading== == Further reading ==
* {{cite book|last= Drury |first= Heber|title=The Useful plants of India |url=https://archive.org/stream/usefulplantsind01drurgoog#page/n5/mode/2up|year=1873|publisher=William H Allen & Co., London|isbn= 978-1-4460-2372-3}}
*, A history of principal drugs of vegetable origin in British India - Volume 1, William Dymock et al. (1890), London
* {{cite book|url=https://www.biodiversitylibrary.org/item/36345#page/1/mode/1up |title=Pharmacographia Indica A history of principal drugs of vegetable origin in British India | volume =1|first=William|last=Dymock |year=1890 |location=London, Bombat, Calcutta|display-authors=etal|publisher=], Education Society Press, Byculla, Thacker, Spink and Co}}
*{{cite book |title=Commentary on the Hindu System of Medicine|author=Thomas T. Wise |publisher=Thacker & Co., Calcutta |year=1845|url=http://archive.org/stream/commentaryonhind00wise#page/n3/mode/2up |ref= }}
*{{cite book|last= Drury |first= Col. Heber|title=The Useful plants of India |url=http://www.archive.org/stream/usefulplantsind01drurgoog#page/n5/mode/2up|year=1873|publisher=William H Allen & Co., London|isbn= 1-4460-2372-9}} * {{cite book|last=Hoernle |first=Rudolf August Friedrich |title=Studies in the Medicine of Ancient India: Part I: Osteology |url=https://archive.org/stream/studiesinmedicin01hoeruoft#page/n3/mode/2up|year=1907|publisher=Clarendon Press, Oxford }}
* Pattathu, Anthony George (2018). Ayurveda and Discursive Formations between Religion, Medicine and Embodiment: A Case Study from Germany. In: Lüddeckens, D., & Schrimpf, M. (2018). . Bielefeld: transcript Verlag. {{ISBN|978-3-8376-4582-8}}, pp.&nbsp;133–166.
*{{cite book|last=Hoernle |first=Rudolf August Friedrich |title=Studies in the Medicine of Ancient India: Part I: Osteology|url=http://www.archive.org/stream/studiesinmedicin01hoeruoft#page/n3/mode/2up|year=1907|publisher=The Clarendon Press, Oxford }}
* Kishor Patwardhan 2008. Concepts of Human Physiology in Ayurveda, in ''Sowarigpa and Ayurveda'', Central Institute of Higher Tibetan Studies, Sarnath, Varanasi. Samyak Vak Series-14, Editor: Pabitra Kumar Roy, pp.&nbsp;53–73. ISBN 978-81-87127-76-5 Kishor Patwardhan * {{cite book |last=Patwardhan|first=Kishore|year=2008|title=Concepts of Human Physiology in Ayurveda|work=Sowarigpa and Ayurveda |publisher=Central Institute of Higher Tibetan Studies|location=Sarnath, Varanasi|series=Samyak Vak Series-14|editor=Pabitra Kumar Roy|pages=53–73|isbn=978-81-87127-76-5 |url=http://cogprints.org/7033/1/Chapter_in_sowarigpa_and_ayurveda.pdf }}
* {{cite book |title=Commentary on the Hindu System of Medicine|first=Thomas T.|last=Wise|publisher=Thacker & Co.|location=Calcutta |year=1845|url=https://archive.org/stream/commentaryonhind00wise#page/n3/mode/2up }}
*
* {{Cite journal|last1=Wujastyk|first1=Dominik|title=Indian Medicine|url=http://www.oxfordbibliographies.com/document/obo-9780195399318/obo-9780195399318-0035.xml|website=Oxford Bibliographies|publisher=Oxford University Press|doi=10.1093/obo/9780195399318-0035|year=2011}}. A bibliographical survey of the history of Indian medicine.
* – Guidelines by US FDA.
*
* – ].


==External links== == External links ==
{{Sister project links|Ayurveda}} {{Sister project links|Ayurveda}}
* ] (WHO), Geneva, 2022.
*{{dmoz|Health/Alternative/Ayurveda/}}
* – document from the World Health Organization (WHO)
*


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Latest revision as of 22:17, 20 December 2024

Alternative medicine with roots in India

Dhanvantari, an avatar of Vishnu, is the Hindu god associated with ayurveda.
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Ayurveda (/ˌɑːjʊərˈveɪdə, -ˈviː-/; IAST: āyurveda) is an alternative medicine system with historical roots in the Indian subcontinent. It is heavily practiced throughout India and Nepal, where as much as 80% of the population report using ayurveda. The theory and practice of ayurveda is pseudoscientific and toxic metals such as lead are used as ingredients in many ayurvedic medicines.

Ayurveda therapies have varied and evolved over more than two millennia. Therapies include herbal medicines, special diets, meditation, yoga, massage, laxatives, enemas, and medical oils. Ayurvedic preparations are typically based on complex herbal compounds, minerals, and metal substances (perhaps under the influence of early Indian alchemy or rasashastra). Ancient ayurveda texts also taught surgical techniques, including rhinoplasty, lithotomy, sutures, cataract surgery, and the extraction of foreign objects.

Historical evidence for ayurvedic texts, terminology and concepts appears from the middle of the first millennium BCE onwards. The main classical ayurveda texts begin with accounts of the transmission of medical knowledge from the gods to sages, and then to human physicians. Printed editions of the Sushruta Samhita (Sushruta's Compendium), frame the work as the teachings of Dhanvantari, the Hindu deity of ayurveda, incarnated as King Divodāsa of Varanasi, to a group of physicians, including Sushruta. The oldest manuscripts of the work, however, omit this frame, ascribing the work directly to King Divodāsa.

In ayurveda texts, dosha balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness. Ayurveda treatises describe three elemental doshas: vāta, pitta and kapha, and state that balance (Skt. sāmyatva) of the doshas 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.

Ayurveda has been adapted for Western consumption, notably by Baba Hari Dass in the 1970s and Maharishi ayurveda in the 1980s.

Although some Ayurvedic treatments can help relieve the symptoms of cancer, there is no good evidence that the disease can be treated or cured through ayurveda.

Some ayurvedic preparations have been found to contain lead, mercury, and arsenic, substances known to be harmful to humans. A 2008 study found the three substances in close to 21% of U.S. and Indian-manufactured patent ayurvedic medicines sold through the Internet. The public health implications of such metallic contaminants in India are unknown.

Etymology

The term āyurveda (Sanskrit: आयुर्वेद) is composed of two words, āyus, आयुस्, "life" or "longevity", and veda, वेद, "knowledge", translated as "knowledge of longevity" or "knowledge of life and longevity".

Eight components

Nagarjuna, known for the Madhyamaka (middle path), wrote the medical works The Hundred Prescriptions and The Precious Collection.

The earliest classical Sanskrit works on ayurveda describe medicine as being divided into eight components (Skt. aṅga). This characterization of the physician's art, "the medicine that has eight components" (Sanskrit: चिकित्सायामष्टाङ्गायाम्, romanizedcikitsāyām aṣṭāṅgāyāṃ), is first found in the Sanskrit epic the Mahābhārata, c. 4th century BCE. The components are:

  • Kāyachikitsā: general medicine, medicine of the body
  • Kaumāra-bhṛtya (Pediatrics): Discussions about prenatal and postnatal care of baby and mother; methods of conception; choosing the child's sex, intelligence, and constitution; childhood diseases; and midwifery
  • Śalyatantra: surgical techniques and the extraction of foreign objects
  • Śhālākyatantra: treatment of ailments affecting openings or cavities in the upper body: ears, eyes, nose, mouth, etc.
  • Bhūtavidyā: pacification of possessing spirits, and the people whose minds are affected by such possession
  • Agadatantra/Vishagara-vairodh Tantra (Toxicology): includes epidemics; toxins in animals, vegetables and minerals; and keys for recognizing those anomalies and their antidotes
  • Rasāyantantra: rejuvenation and tonics for increasing lifespan, intellect and strength
  • Vājīkaraṇatantra: aphrodisiacs; treatments for increasing the volume and viability of semen and sexual pleasure; infertility problems; and spiritual development (transmutation of sexual energy into spiritual energy)

Principles and terminology

Further information: Mahābhūta

The central theoretical ideas of ayurveda show parallels with Samkhya and Vaisheshika philosophies, as well as with Buddhism and Jainism. Balance is emphasized, and suppressing natural urges is considered unhealthy and claimed to lead to illness. For example, to suppress sneezing is said to potentially give rise to shoulder pain. However, people are also cautioned to stay within the limits of reasonable balance and measure when following nature's urges. For example, emphasis is placed on moderation of food intake, sleep, and sexual intercourse.

The three doshas and the five elements from which they are composed

According to ayurveda, the human body is composed of tissues (dhatus), waste (malas), and humeral biomaterials (doshas). The seven dhatus are chyle (rasa), blood (rakta), muscles (māmsa), fat (meda), bone (asthi), marrow (majja), and semen (shukra). Like the medicine of classical antiquity, the classic treatises of ayurveda divided bodily substances into five classical elements (panchamahabhuta) viz. earth, water, fire, air and ether. There are also twenty gunas (qualities or characteristics) which are considered to be inherent in all matter. These are organized in ten pairs: heavy/light, cold/hot, unctuous/dry, dull/sharp, stable/mobile, soft/hard, non-slimy/slimy, smooth/coarse, minute/gross, and viscous/liquid.

The three postulated elemental bodily humours, the doshas or tridosha, are vata (air, which some modern authors equate with the nervous system), pitta (bile, fire, equated by some with enzymes), and kapha (phlegm, or earth and water, equated by some with mucus). Contemporary critics assert that doshas are not real, but are a fictional concept. The humours (doshas) may also affect mental health. Each dosha has particular attributes and roles within the body and mind; the natural predominance of one or more doshas thus explains a person's physical constitution (prakriti) and personality. Ayurvedic tradition holds that imbalance among the bodily and mental doshas is a major etiologic component of disease. One ayurvedic view is that the doshas are balanced when they are equal to each other, while another view is that each human possesses a unique combination of the doshas which define this person's temperament and characteristics. In either case, it says that each person should modulate their behavior or environment to increase or decrease the doshas and maintain their natural state. Practitioners of ayurveda must determine an individual's bodily and mental dosha makeup, as certain prakriti are said to predispose one to particular diseases. For example, a person who is thin, shy, excitable, has a pronounced Adam's apple, and enjoys esoteric knowledge is likely vata prakriti and therefore more susceptible to conditions such as flatulence, stuttering, and rheumatism. Deranged vata is also associated with certain mental disorders due to excited or excess vayu (gas), although the ayurvedic text Charaka Samhita also attributes "insanity" (unmada) to cold food and possession by the ghost of a sinful Brahman (brahmarakshasa).

Ama (a Sanskrit word meaning "uncooked" or "undigested") is used to refer to the concept of anything that exists in a state of incomplete transformation. With regards to oral hygiene, it is claimed to be a toxic byproduct generated by improper or incomplete digestion. The concept has no equivalent in standard medicine.

In medieval taxonomies of the Sanskrit knowledge systems, ayurveda is assigned a place as a subsidiary Veda (upaveda). Some medicinal plant names from the Atharvaveda and other Vedas can be found in subsequent ayurveda literature. Some other school of thoughts considers 'ayurveda' as the 'Fifth Veda'. The earliest recorded theoretical statements about the canonical models of disease in ayurveda occur in the earliest Buddhist Canon.

Practice

Physician taking pulse, Delhi, c. 1825

Ayurvedic practitioners regard physical existence, mental existence, and personality as three separate elements of a whole person with each element being able to influence the others. This holistic approach used during diagnosis and healing is a fundamental aspect of ayurveda. Another part of ayurvedic treatment says that there are channels (srotas) which transport fluids, and that the channels can be opened up by massage treatment using oils and Swedana (fomentation). Unhealthy, or blocked, channels are thought to cause disease.

Diagnosis

An ayurvedic practitioner applying oil using head massage

Ayurveda has eight ways to diagnose illness, called nadi (pulse), mootra (urine), mala (stool), jihva (tongue), shabda (speech), sparsha (touch), druk (vision), and aakruti (appearance). Ayurvedic practitioners approach diagnosis by using the five senses. For example, hearing is used to observe the condition of breathing and speech. The study of vulnerable points, or marma, is particular to ayurvedic medicine.

Treatment procedures

Treatment and prevention

Two of the eight branches of classical ayurveda deal with surgery (Śalya-cikitsā and Śālākya-tantra), but contemporary ayurveda tends to stress attaining vitality by building a healthy metabolic system and maintaining good digestion and excretion. Ayurveda also focuses on exercise, yoga, and meditation. One type of prescription is a Sattvic diet.

Ayurveda follows the concept of Dinacharya, which says that natural cycles (waking, sleeping, working, meditation etc.) are important for health. Hygiene, including regular bathing, cleaning of teeth, oil pulling, tongue scraping, skin care, and eye washing, is also a central practice.

Substances used

See also: Medical ethnobotany of India
Ayurvedic preparations displayed in Delhi in 2016

The vast majority (90%) of ayurvedic remedies are plant based. Plant-based treatments in ayurveda may be derived from roots, leaves, fruits, bark, or seeds; some examples of plant-based substances include cardamom and cinnamon. In the 19th century, William Dymock and co-authors summarized hundreds of plant-derived medicines along with the uses, microscopic structure, chemical composition, toxicology, prevalent myths and stories, and relation to commerce in British India. Triphala, an herbal formulation of three fruits, Amalaki, Bibhitaki, and Haritaki, is one of the most commonly used Ayurvedic remedies. The herbs Withania somnifera (Ashwagandha) and Ocimum tenuiflorum (Tulsi) are also routinely used in ayurveda.

Tulsi-flower (holy basil), an ayurvedic herb

Animal products used in ayurveda include milk, bones, and gallstones. In addition, fats are prescribed both for consumption and for external use. Consumption of minerals, including sulphur, arsenic, lead, copper sulfate and gold, are also prescribed. The addition of minerals to herbal medicine is called rasashastra.

Ayurveda uses alcoholic beverages called Madya, which are said to adjust the doshas by increasing pitta and reducing vatta and kapha. Madya are classified by the raw material and fermentation process, and the categories include: sugar-based, fruit-based, cereal-based, cereal-based with herbs, fermentated with vinegar, and tonic wines. The intended outcomes can include causing purgation, improving digestion or taste, creating dryness, or loosening joints. Ayurvedic texts describe Madya as non-viscid and fast-acting, and say that it enters and cleans minute pores in the body.

Purified opium is used in eight ayurvedic preparations and is said to balance the vata and kapha doshas and increase the pitta dosha. It is prescribed for diarrhea and dysentery, for increasing the sexual and muscular ability, and for affecting the brain. The sedative and pain-relieving properties of opium are considered in ayurveda. The use of opium is found in the ancient ayurvedic texts, and is first mentioned in the Sarngadhara Samhita (1300–1400 CE), a book on pharmacy used in Rajasthan in Western India, as an ingredient of an aphrodisiac to delay male ejaculation. It is possible that opium was brought to India along with or before Muslim conquests. The book Yoga Ratnakara (1700–1800 CE, unknown author), which is popular in Maharashtra, uses opium in a herbal-mineral composition prescribed for diarrhea. In the Bhaisajya Ratnavali, opium and camphor are used for acute gastroenteritis. In this drug, the respiratory depressant action of opium is counteracted by the respiratory stimulant property of camphor. Later books have included the narcotic property for use as analgesic pain reliever.

Cannabis indica is also mentioned in the ancient ayurveda books, and is first mentioned in the Sarngadhara Samhita as a treatment for diarrhea. In the Bhaisajya Ratnavali it is named as an ingredient in an aphrodisiac.

Ayurveda says that both oil and tar can be used to stop bleeding, and that traumatic bleeding can be stopped by four different methods: ligation of the blood vessel, cauterisation by heat, use of preparations to facilitate clotting, and use of preparations to constrict the blood vessels.

Ayurvedic treatment set up used for applying oil to patients, Kerala, 2017

Massage with oil is commonly prescribed by ayurvedic practitioners. Oils are used in a number of ways, including regular consumption, anointing, smearing, head massage, application to affected areas, and oil pulling. Liquids may also be poured on the patient's forehead, a technique called shirodhara.

Panchakarma

According to ayurveda, panchakarma are techniques to eliminate toxic elements from the body. Panchakarma refers to five actions, which are meant to be performed in a designated sequence with the stated aim of restoring balance in the body through a process of purgation.

Current status

Ayurveda is widely practiced in India and Nepal where public institutions offer formal study in the form of a Bachelor of Ayurvedic Medicine and Surgery (BAMS) degree. In certain parts of the world, the legal standing of practitioners is equivalent to that of conventional medicine. Several scholars have described the contemporary Indian application of ayurvedic practice as being "biomedicalized" relative to the more "spiritualized" emphasis to practice found in variants in the West.

Exposure to European developments in medicine from the nineteenth century onwards, through European colonization of India and the subsequent institutionalized support for European forms of medicine amongst European heritage settlers in India were challenging to ayurveda, with the entire epistemology called into question. From the twentieth century, ayurveda became politically, conceptually, and commercially dominated by modern biomedicine, resulting in "modern ayurveda" and "global ayurveda". Modern ayurveda is geographically located in the Indian subcontinent and tends towards secularization through minimization of the magic and mythic aspects of ayurveda. Global ayurveda encompasses multiple forms of practice that developed through dispersal to a wide geographical area outside of India. Smith and Wujastyk further delineate that global ayurveda includes those primarily interested in the ayurveda pharmacopeia, and also the practitioners of New Age ayurveda (which may link ayurveda to yoga and Indian spirituality and/or emphasize preventative practice, mind body medicine, or Maharishi ayurveda).

Since the 1980s, ayurveda has also become the subject of interdisciplinary studies in ethnomedicine which seeks to integrate the biomedical sciences and humanities to improve the pharmacopeia of ayurveda. According to industry research, the global ayurveda market was worth US$4.5 billion in 2017.

The Indian subcontinent

A typical ayurvedic pharmacy, Rishikesh

India

See also: Healthcare in India

It was reported in 2008 and again in 2018 that 80 percent of people in India used ayurveda exclusively or combined with conventional Western medicine. A 2014 national health survey found that, in general, forms of the Indian system of medicine or AYUSH (ayurveda, yoga and naturopathy, unani, siddha, and homeopathy) were used by about 3.5% of patients who were seeking outpatient care over a two-week reference period.

In 1970, the Parliament of India passed the Indian Medical Central Council Act which aimed to standardise qualifications for ayurveda practitioners and provide accredited institutions for its study and research. In 1971, the Central Council of Indian Medicine (CCIM) was established under the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha medicine and Homoeopathy (AYUSH), Ministry of Health and Family Welfare, to monitor higher education in ayurveda in India. The Indian government supports research and teaching in ayurveda through many channels at both the national and state levels, and helps institutionalise traditional medicine so that it can be studied in major towns and cities. The state-sponsored Central Council for Research in Ayurvedic Sciences (CCRAS) is designed to do research on ayurveda. Many clinics in urban and rural areas are run by professionals who qualify from these institutes. As of 2013, India had over 180 training centers that offered degrees in traditional ayurvedic medicine.

To fight biopiracy and unethical patents, the government of India set up the Traditional Knowledge Digital Library in 2001 to serve as a repository for formulations from systems of Indian medicine, such as ayurveda, unani and siddha medicine. The formulations come from over 100 traditional ayurveda books. An Indian Academy of Sciences document quoting a 2003–04 report states that India had 432,625 registered medical practitioners, 13,925 dispensaries, 2,253 hospitals and a bed strength of 43,803. 209 undergraduate teaching institutions and 16 postgraduate institutions. In 2012, it was reported that insurance companies covered expenses for ayurvedic treatments in case of conditions such as spinal cord disorders, bone disorder, arthritis and cancer. Such claims constituted 5–10 percent of the country's health insurance claims.

Maharashtra Andhashraddha Nirmoolan Samiti, an organisation dedicated to fighting superstition in India, considers ayurveda to be pseudoscience.

On 9 November 2014, India formed the Ministry of AYUSH. National Ayurveda Day is also observed in India on the birth of Dhanvantari that is Dhanteras.

In 2016, the World Health Organization (WHO) published a report titled "The Health Workforce in India" which found that 31 percent of those who claimed to be doctors in India in 2001 were educated only up to the secondary school level and 57 percent went without any medical qualification. The WHO study found that the situation was worse in rural India with only 18.8 percent of doctors holding a medical qualification. Overall, the study revealed that nationally the density of all doctors (mainstream, ayurvedic, homeopathic and unani) was 8 doctors per 10,000 people compared to 13 per 10,000 people in China.

Nepal

About 75% to 80% of the population of Nepal use ayurveda. As of 2009, ayurveda was considered to be the most common and popular form of medicine in Nepal.

Sri Lanka

Practitioners in 2017 in Sri Lanka, where ayurveda spas are common

The Sri Lankan tradition of ayurveda is similar to the Indian tradition. Practitioners of ayurveda in Sri Lanka refer to Sanskrit texts which are common to both countries. However, they do differ in some aspects, particularly in the herbs used.

In 1980, the Sri Lankan government established a Ministry of Indigenous Medicine to revive and regulate ayurveda. The Institute of Indigenous Medicine (affiliated to the University of Colombo) offers undergraduate, postgraduate, and MD degrees in ayurveda medicine and surgery, and similar degrees in unani medicine. In 2010, the public system had 62 ayurvedic hospitals and 208 central dispensaries, which served about 3 million people (about 11% of Sri Lanka's population). There are an estimated 20,000 registered practitioners of ayurveda in Sri Lanka.

According to the Mahavamsa, an ancient chronicle of Sinhalese royalty from the sixth century CE, King Pandukabhaya (reigned 437 BCE to 367 BCE) had lying-in-homes and ayurvedic hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documented evidence available of institutions dedicated specifically to the care of the sick anywhere in the world. The hospital at Mihintale is the oldest in the world.

Outside the Indian subcontinent

Maharishi Mahesh Yogi in Amsterdam in 1967

Ayurveda is a system of traditional medicine developed during antiquity and the medieval period, and as such is comparable to pre-modern Chinese and European systems of medicine. In the 1960s, ayurveda began to be advertised as alternative medicine in the Western world. Due to different laws and medical regulations around the globe, the expanding practice and commercialisation of ayurveda raised ethical and legal issues. Ayurveda was adapted for Western consumption, particularly by Baba Hari Dass in the 1970s and by Maharishi Ayurveda in the 1980s. In some cases, this involved active fraud on the part of proponents of ayurveda in an attempt to falsely represent the system as equal to the standards of modern medical research.

United States

Baba Hari Dass was an early proponent who helped bring ayurveda to the United States in the early 1970s. His teachings led to the establishment of the Mount Madonna Institute. He invited several notable ayurvedic teachers, including Vasant Lad, Sarita Shrestha, and Ram Harsh Singh. The ayurvedic practitioner Michael Tierra wrote that the "history of Ayurveda in North America will always owe a debt to the selfless contributions of Baba Hari Dass".

In the United States, the practice of ayurveda is not licensed or regulated by any state. The National Center for Complementary and Integrative Health (NCCIH) stated that "Few well-designed clinical trials and systematic research reviews suggest that Ayurvedic approaches are effective". The NCCIH warned against the issue of heavy metal poisoning, and emphasised the use of conventional health providers first. As of 2018, the NCCIH reported that 240,000 Americans were using ayurvedic medicine.

Europe

The first ayurvedic clinic in Switzerland was opened in 1987 by Maharishi Mahesh Yogi. In 2015, the government of Switzerland introduced a federally recognized diploma in ayurveda.

Classification and efficacy

Ayurvedic medicine is considered pseudoscientific because its premises are not based on science. Both the lack of scientific soundness in the theoretical foundations of ayurveda and the quality of research have been criticized.

Although laboratory experiments suggest that some herbs and substances in ayurveda might be developed into effective treatments, there is no evidence that any are effective in themselves. There is no good evidence that ayurvedic medicine is effective to treat or cure cancer in people. Although ayurveda may help "improve quality of life" and Cancer Research UK also acknowledges that "researchers have found that some Ayurvedic treatments can help relieve cancer symptoms", the organization warns that some ayurvedic drugs contain toxic substances or may interact with legitimate cancer drugs in a harmful way.

Ethnologist Johannes Quack writes that although the rationalist movement Maharashtra Andhashraddha Nirmoolan Samiti officially labels ayurveda a pseudoscience akin to astrology, these practices are in fact embraced by many of the movement's members.

A review of the use of ayurveda for cardiovascular disease concluded that the evidence is not convincing for the use of any ayurvedic herbal treatment for heart disease or hypertension, but that many herbs used by ayurvedic practitioners could be appropriate for further research.

Research

In India, research in ayurveda is undertaken by the Ministry of AYUSH through a national network of research institutes.

In Nepal, the National Ayurvedic Training and Research Centre (NATRC) researches medicinal herbs in the country.

In Sri Lanka, the Ministry of Health, Nutrition and Indigenous Medicine looks after the research in ayurveda through various national research institutes.

Use of toxic metals

Rasashastra, the practice of adding metals, minerals or gems to herbal preparations, may include toxic heavy metals such as lead, mercury and arsenic. The public health implications of metals in rasashastra in India is unknown. Adverse reactions to herbs are described in traditional ayurvedic texts, but practitioners are reluctant to admit that herbs could be toxic and that reliable information on herbal toxicity is not readily available. There is a communication gap between practitioners of medicine and ayurveda.

Some traditional Indian herbal medicinal products contain harmful levels of heavy metals, including lead. For example, ghasard, a product commonly given to infants for digestive issues, has been found to have up to 1.6% lead concentration by weight, leading to lead encephalopathy. A 1990 study on ayurvedic medicines in India found that 41% of the products tested contained arsenic, and that 64% contained lead and mercury. A 2004 study found toxic levels of heavy metals in 20% 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% of remedies (and 40% of rasashastra medicines) purchased over the Internet from U.S. and Indian suppliers contained lead, mercury or arsenic. A 2015 study of users in the United States found elevated blood lead levels in 40% of those tested, leading physician and former U.S. Air Force flight surgeon Harriet Hall to say that "Ayurveda is basically superstition mixed with a soupçon of practical health advice. And it can be dangerous." A 2022 study found that ayurvedic preparations purchased over-the-counter in Chandigarh, India, had levels of zinc, mercury, arsenic and lead over the limits set by the Food and Agriculture Organisation / World Health Organisation. 83% exceeded the limit for zinc, 69% for mercury, 14% for arsenic and 5% for lead.

Heavy metals are thought of as active ingredients by advocates of Indian herbal medicinal products. According to ancient ayurvedic texts, certain physico-chemical purification processes such as samskaras or shodhanas (for metals) 'detoxify' the heavy metals in it. These are similar to the Chinese pao zhi, although the ayurvedic techniques are more complex and may involve physical pharmacy techniques as well as mantras. However, these products have nonetheless caused severe lead poisoning and other toxic effects. Between 1978 and 2008, "more than 80 cases of lead poisoning associated with Ayurvedic medicine use reported worldwide". In 2012, the U.S. Centers for Disease Control and Prevention (CDC) linked ayurvedic drugs to lead poisoning, based on cases where toxic materials were found in the blood of pregnant women who had taken ayurvedic drugs.

Ayurvedic practitioners argue that the toxicity of bhasmas (ash products) comes from improper manufacturing processes, contaminants, improper use of ayurvedic medicine, quality of raw materials and that the end products and improper procedures are used by charlatans.

In India, the government ruled that ayurvedic products must be labelled with their metallic content. However, in Current Science, a publication of the Indian Academy of Sciences, M. S. Valiathan said that "the absence of post-market surveillance and the paucity of test laboratory facilities make the quality control of Ayurvedic medicines exceedingly difficult at this time". In the United States, most ayurvedic products are marketed without having been reviewed or approved by the FDA. Since 2007, the FDA has placed an import alert on some ayurvedic products in order to prevent them from entering the United States. A 2012 toxicological review of mercury-based traditional herbo-metallic preparations concluded that the long-term pharmacotherapeutic and in-depth toxicity studies of these preparations are lacking.

History

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Some scholars assert that the concepts of traditional ayurvedic medicine have existed since the times of the Indus Valley civilisation but since the Indus script has not been deciphered, such assertions are moot. The Atharvaveda contains hymns and prayers aimed at curing disease. There are various legendary accounts of the origin of ayurveda, such as that it was received by Dhanvantari (or Divodasa) from Brahma. Tradition also holds that the writings of ayurveda were influenced by a lost text by the sage Agnivesha.

Ayurveda is one of the few systems of medicine developed in ancient times that is still widely practised in modern times. 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 in medicine. 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 modernize and syncretize (aśuddha "impure, tainted" ayurveda). The political debate about the place of ayurveda in contemporary India has continued to the present, both in the public arena and in government. Debate about the place of ayurvedic medicine in the contemporary internationalized world also continues today.

Main texts

Many ancient works on ayurvedic medicine are lost to posterity, but manuscripts of three principal early texts on ayurveda have survived to the present day. These works are 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. After considering the evidence and arguments concerning the Suśrutasaṃhitā, Meulenbeld stated (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 BCE was first proposed by Hoernle over a century ago, 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. The view that the text was updated by the Buddhist scholar Nagarjuna in the 2nd century CE has been disproved, although the last chapter of the work, the Uttaratantra, was added by an unknown later author before 500 CE. 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 but are in fact, in their present form, datable to a period between the second and fifth centuries CE. The Charaka Samhita was also updated by Dridhabala during the early centuries of the Common Era.

Statue of Charaka, ancient Indian physician, in Haridwar, India

The Bower Manuscript (dated to the early 6th century CE) includes of excerpts from the Bheda Samhita 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 CE) 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.

Some dictionaries of materia medica include 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.

Illnesses portrayed

Cataract surgery is mentioned in the Sushruta Samhita, to be performed with a jabamukhi salaka, a curved needle used to loosen and remove the obstructing phlegm, with eye soaked with warm butter and bandaged afterward.

Underwood and Rhodes state that the early forms of traditional Indian medicine identified fever, cough, consumption, diarrhea, dropsy, abscesses, seizures, tumours, and leprosy, and that treatments included plastic surgery, lithotomy, tonsillectomy, 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, and stitching of wounds. The use of herbs and surgical instruments became widespread. During this period, treatments were also prescribed for complex ailments, including angina pectoris, diabetes, hypertension, and stones.

Further development and spread

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 Chinese language in the 5th century, and during the 8th century, they were translated into the Arabic and Persian language. The 9th-century Persian physician Muhammad ibn Zakariya al-Razi was familiar with the text. The Arabic works derived from the ayurvedic texts eventually also reached Europe by the 12th century. In Renaissance Italy, the Branca family of Sicily and Gaspare Tagliacozzi (Bologna) were influenced by the Arabic reception of the Sushruta's surgical techniques.

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

The British had shown some interest in understanding local medicinal practices in the early nineteenth century. A Native Medical Institution was setup in 1822 where both indigenous and European medicine were taught. After the English Education Act 1835, their policy changed to champion European medicine and disparage local practices. After Indian independence, there was more focus on ayurveda and other traditional medical systems. Ayurveda became a part of the Indian National healthcare system, with state hospitals for ayurveda established across the country. However, the treatments of traditional medicines were not always integrated with others.

See also

Footnotes

  1. Vāgbhaṭa's Aṣṭāṅgahṛdayasaṃhitā describes a procedure for the removal of a dead foetus from the womb of a living mother, and of a living child from the womb of a mother who has died (शारीरस्थान २, गर्भव्यापद्, २.२६-२७, २.५३). Both these descriptions speak of removal of the fetus through the uterine passage, rather than from the front lower abdomen as with the caesarian section procedure. The earlier description of the Suśrutasaṃhitā (चिकित्सास्थान १५ "मूढगर्भ") is similar. A dead fetus is removed through the uterine passage and vagina. Although Suśruta does not describe removing a living child from a dead mother.

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