Ayurveda
Ayurveda is a traditional system of medicine that has its historical origins in the Indian subcontinent. It continues to be widely practiced in India and Nepal, where a significant portion of the population relies on it for healthcare. This ancient medical practice is deeply embedded in the cultural and spiritual traditions of the region, yet it remains a subject of debate due to its classification as a pseudoscientific system by modern medical standards. Ayurveda’s use of metal-based preparations, which sometimes include toxic substances like lead and mercury, has raised concerns about its safety.
Over more than two millennia, Ayurvedic therapies have undergone extensive evolution and adaptation. These therapies encompass a wide range of treatments, including herbal medicine, dietary regimens, meditation, yoga, massages, and procedures such as enemas and medical oil applications. Ayurveda’s use of complex herbal formulations and mineral substances suggests influences from early Indian alchemy, known as Rasashastra. Furthermore, ancient Ayurvedic texts describe various surgical procedures, including rhinoplasty, lithotomy, suturing techniques, cataract surgeries, and the extraction of foreign objects, indicating an advanced understanding of medical procedures in historical India.
The historical roots of Ayurveda can be traced back to the middle of the first millennium BCE, when Ayurvedic texts, terminology, and concepts began to appear. The foundational Ayurvedic literature includes accounts of divine transmission of medical knowledge. Many texts describe the teachings of Ayurveda as originating from Hindu deities and sages, eventually reaching human practitioners. For example, the Sushruta Samhita, one of the most important texts of Ayurveda, is framed as the teachings of Dhanvantari, the Hindu deity associated with medicine, who imparted knowledge to King Divodasa of Varanasi and his group of physicians, including Sushruta. However, the oldest manuscripts of this text do not contain this divine narrative, instead attributing the work directly to King Divodasa himself.
A core principle of Ayurveda is the balance of the three doshas: Vata, Pitta, and Kapha. According to Ayurvedic thought, maintaining a harmonious balance among these elements is essential for health, while an imbalance results in disease. Ayurveda considers the suppression of natural bodily urges to be harmful, as it is believed to disrupt the body’s equilibrium and lead to illness. Ayurvedic medicine is traditionally divided into eight branches, each addressing different aspects of health and disease. These include internal medicine, surgery, ophthalmology, toxicology, psychiatry, pediatrics, rejuvenation therapy, and aphrodisiac therapy. From the early Common Era onward, Ayurvedic practitioners have developed a wide range of medicinal preparations and surgical techniques.
In modern times, Ayurveda has been adapted for a global audience. Prominent figures such as Baba Hari Dass in the 1970s and Maharishi Ayurveda in the 1980s played key roles in popularizing Ayurveda outside India. Despite its popularity, Ayurveda has not been scientifically validated as an effective treatment for serious diseases such as cancer. While some Ayurvedic treatments may provide symptom relief, there is no reliable evidence supporting their efficacy in curing diseases.
Concerns regarding the safety of Ayurvedic medicines have emerged, particularly in relation to the presence of heavy metals such as lead, mercury, and arsenic in certain formulations. A 2008 study found that approximately 21% of Ayurvedic medicines sold online, both from India and the United States, contained these toxic elements. The full extent of the public health implications in India remains unclear, but the presence of such contaminants poses potential risks to consumers.
Some scholars suggest that Ayurvedic concepts may date back to the Indus Valley Civilization, though the lack of deciphered written records makes this assertion speculative. The Atharvaveda, one of the four Vedas, contains prayers and hymns related to healing, indicating an early presence of medical traditions in ancient India. Ayurveda is traditionally believed to have been transmitted by Dhanvantari or Divodasa from the god Brahma. Additionally, some traditions hold that Ayurveda was influenced by a lost medical text attributed to the sage Agnivesha.
Despite being an ancient system of medicine, Ayurveda continues to be widely practiced today. This longevity has sparked debates about its relevance and modernization. Critics argue that its conceptual foundations are outdated and that Ayurvedic practitioners have not sufficiently integrated modern medical advances. This issue led to a major debate in India during the early twentieth century between those advocating for a “pure” Ayurveda (śuddha Ayurveda) and those supporting a more modernized and integrated approach (aśuddha Ayurveda). The discussion about Ayurveda’s role in contemporary Indian healthcare persists to this day, with political and public debates shaping its status within government policies and medical regulations. Similar discussions are ongoing in the global context regarding the integration of Ayurveda with contemporary medical practices.
Many ancient Ayurvedic texts have been lost over time, but three principal works have survived: the Charaka Samhita, the Sushruta Samhita, and the Bhela Samhita. Dating these texts has been challenging, as they were compiled over long periods and edited by multiple scholars. Gerrit Jan Meulenbeld, in his comprehensive study on the history of Indian medical literature, analyzed the evidence and concluded that the Sushruta Samhita was most likely composed by an unknown author who drew from multiple earlier sources. The text evolved over time, with different scholars contributing to its development. Early claims by Rudolf Hoernle in the late 19th century suggested that the Sushruta Samhita was written around 600 BCE. However, more recent historical research has revised this view, dating its compilation to a period beginning a few centuries BCE and extending to approximately 500 CE. The claim that the Buddhist scholar Nagarjuna edited the text in the 2nd century CE has been debunked, though the Uttaratantra, its final chapter, was added by an unknown author before 500 CE.
Similar historical complexities apply to the Charaka Samhita, attributed to the physician Charaka, and the Bhela Samhita, linked to Atreya Punarvasu. While some scholars have dated these texts to the 6th century BCE, contemporary research suggests that their present forms were finalized between the 2nd and 5th centuries CE. The Charaka Samhita underwent significant revisions, with an early edition updated by Dridhabala during the early centuries of the Common Era.
The Bower Manuscript, dated to the early 6th century CE, provides additional insights into the evolution of Ayurveda. This manuscript includes excerpts from the Bheda Samhita and reflects Buddhist influences on medical concepts in Central Asia. A. F. R. Hoernle identified the scribe of the medical portions as an Indian Buddhist monk who had migrated to Kucha, a significant center of Buddhist learning. Chinese traveler Fa Hsien (c. 337–422 CE) also documented the healthcare system of the Gupta Empire, describing institutionalized medicine, hospitals, and medical facilities. These accounts align with descriptions in the Charaka Samhita regarding hospital infrastructure and patient care.
Later Ayurvedic literature includes dictionaries of medicinal substances, such as the 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. These texts expanded upon earlier knowledge and contributed to the ongoing evolution of Ayurvedic pharmacology.
Today, Ayurveda remains a widely practiced system of traditional medicine, but it continues to face scrutiny and debate regarding its scientific validity and safety. As modern medicine advances, discussions about integrating Ayurveda with evidence-based approaches persist, shaping its role in the future of healthcare.