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Understanding AyurvedaBy Vaidya Dilip P. Gadgil
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Ayurveda needs to achieve its full potential both in India and globally. This requires imparting to its students full appreciation of Ayurveda’s power and strength, particularly proper understanding of the advantages of applying it to treat chronic and acute diseases. To this end, we explain the necessity of learning Sanskrit as a medium of study, and the advantages of learning the Texts in the traditional way, rather than relying on translations with all the loss of meaning and precision, which that entails. We emphasize the use of Triskandhakosha as a means to fully understand Ayurveda fundamental concepts and technical terms, so that all their shades of meaning are fully understood, and all their usages given in different places in the texts. Only by such methods can full appreciation of Ayurvedic wisdom be achieved, and the full depth and power of its knowledge be applied. Only then will its true status among systems of medicine come to be appreciated, either in India or more widely in the world as a whole.
Healthcare problems in contemporary India In India today, health levels are decreasing. This can largely be attributed to the shortcomings of the dominant allopathic system of medicine. In spite of Allopathy’s very real achievements in accident and emergency (A and E), intensive care, surgery and so on, once its hazards are experienced, many people search for an effective alternative.For many pathologies, Allopathic medicine obtains poor results. These include various chronic diseases such as allergies, arthritis, hyperacidity, digestive problems, gynecology and so on - and, many acute conditions, particularly chief killers like cancer and heart disease. All of these cry out for a safe, sure and cost-effective alternative.The basic reasons are allopathic medicine’s inability to reach the root causes of chronic disease, and its general failure to nd safe, economical cures. As a result, India today is in desperate need of a sound, safe and economic medical system that can be made widely available. The need is not felt just in India, nor is it conned to South Asia, it is global. The world is also in need of a system of medicine that can treat chronic and degenerative diseases effectively. Ayurveda, though having strong potential, is not adequately appreciated. Well practiced it is extremely effective. If well implemented, it could fulll the needs of the nation. Ayurveda should not be reduced to being an ‘alternative’, at least not in its own country.Fullling this need, requires deep understanding of the reasons behind the situation, particularly those arising in Ayurvedic training and education programs, and then taking appropriate steps for their rectication. If Ayurveda is to accept the challenge at the global level, there has to be a complete change in mindset of Ayurvedic community.This article therefore concerns ways to improve the general understanding of Ayurveda among Ayurvedic students at undergraduate and post-graduate levels in India today.
PROBLEMS IN CONTEMPORARY AYURVEDA EDUCATION – DIFFICULTIES IN STUDY
The fundamental, problem is that up to the 12th standard nothing is imparted about ancient Indian wisdom and its knowledge systems like Ayurveda. Secondly, many students who have not studied any Sanskrit, are admitted to Ayurvedic degree courses. Thirdly, students taking Ayurveda in Ayurveda colleges and courses are often there as a second option: they failed to gain admission to medical school. To those, Ayurveda is only an alternative to what they really want to study; just a means of obtaining an alternative medical degree. Once they have been admitted and start their course, the result is frustration.
Even after admission, considerable barriers to the proper study of Ayurveda are evidenced:
a. Syllabus structure and choice of subjects are more in accordance with MBBS courses;
b. Instead of a nourishing learning environment as in traditional education, students are faced with western examination-oriented education, and all the stress that entails;
c. Due to lack of previous exposure to Sanskrit, the language presents a barrier rather than an effective tool to understanding Ayurveda;
d. Pejorative comparison of the Sanskrit term ‘Sharira’ with modern anatomy creates bad impressions about Ayurveda;
e. Basic, underlying subjects like Padartha vigyan (the six systems of Indian Philosophy or ‘Darshanas’) are completely neglected.
For these and other reasons, such as the importance paid to anatomy in the first year, learning and understanding Ayurveda basic concepts is made unnecessarily challenging.
As a result of these fundamental flaws in the structure of their syllabus, students effectively gain less knowledge about Ayurveda theory and practice than about allopathy. Most aim only to get through their exams and obtain registration. Afterwards, having managed, either during their course or during their internship, to learn enough about General Practice to appear to be an allopathic doctor, they practice modern medicine throughout their professional careers, and are completely lost to Ayurveda.Most of the reasons behind this trend are attributable to mode of instruction, lack of quality teaching faculty, particularly teacher apathy:a. Shortage of teachers who are motivated themselves, and have the enthusiasm to motivate students to study Ayurveda properly;b. Presence of teachers who create negative impact and demoralize students about learning Ayurveda.Other problems arise because the curriculum structure is,a. Not in accordance with the structure of Ayurveda or Ayurvedic texts, andb. Examination-oriented, rather than knowledge / proper learning-oriented.It is therefore of prime importance to transmit the vision that will correctly motivate Ayurveda teachers to set students on the path of proper subject oriented learning. We argue that Ayurveda itself offers ways to achieve this.
The present need is to rectify past damages, and to tackle the problems inflicted on students, by creating programs at three or four levels for those:
a. Still in school but planning to join Ayurveda colleges in coming years;
b. Now in UG training;
c. Who have recently graduated and now want to start practice;
d. Who have already been practicing the Allopathic system for some years (at least those not so much against Ayurveda as to be irredeemable!)
Fundamental tools for incorporation in such programs are set out below. They have to be centered on returning to original sources for instruction in the subject, the Textual Way. Concerning this approach, the texts themselves say the following:
• Adhyayanam (reading again and again to deeply understand the meaning),
• Adhyapanam (teaching),
• Tad-vid-sambhashanam (Proper dialog/discussions with learned scholars).
These, according to the texts, are the proper methods of study.Study of the Ayurvedic texts depends on knowledge, rstly, of the Sanskrit language; secondly, of the six Darshanas - the systems of Vedic philosophy constituting the ground, on which Ayurvedic theory and understanding are built; thirdly, on correct use of commentaries; fourthly, on use of Kosha, either old Koshas like Amarakosha and others, or, in particular, Triskandhakosha (see below) and fifthly, on learning by heart - word by word memorization.In this regard, study of the original texts such as Charaka, Sushruta and Vagbhata has considerable advantages. Firstly, due to their compact structure, they are easy to remember. Secondly, the available translations are not at all accurate; even the best do not explain all shades of meanings, for technical reasons concerned with the range of primary and secondary meanings covered by particular words. Thirdly, the sutras are constructed in such a way, that the same sutra can reveal different meanings in different contexts, or when read from different viewpoints. Etani khalu doshasthanani eshu sanciyate doshah-su. Su21/18.
The following quotation illustrates the value of reading the original texts many times due to their compact nature. “These are sites where doshas ‘accumulate’ (Sanchaya). Vaidya Kolhatkar was able to realize the importance of Vihara (causative factors associated with activities and behaviors such as exposure to wind or cold giving rise to earache etc.) At a particular moment, this meaning was revealed, although the sutra had been read many times previously.”Finally, the use of commentaries is important, because they help bridge the gap between the ancient sages and ourselves in the 21st century. In this respect, Sanskrit is essential to properly understand the commentaries. Also, knowledge of Sanskrit is necessary to understand the underlying philosophies of Nyaya, Vaisheshika and Samkhya (The first 3 darshanas), which are also needed in order to fully understand Ayurveda.Texts produce insight when used in this way. They have considerable advantages: they can indicate the right path to take in difficult cases; they are powerful teachers, and merit respect traditionally reserved for Gurus. Regular practice of reading a text makes a huge difference, because one can then find the right section for guidance without difficulty. For this kind of use, understanding the basic theme behind each text is essential.
ACHIEVING THE FIRST GOAL – UNDERSTANDING AYURVEDA
Once the texts have been learned, the whole field of Ayurveda is opened to the student. That is the purpose - total understanding of Ayurveda. This is fully achieved by exploring textual information through Tantrayukti, the means of understanding the texts, which provides keys to linkages and interrelations between one term or sutra, and other related parts of the texts, a field almost totally neglected today.
One characteristic which distinguishes Ayurveda completely from Allopathic medicine, is clear understanding of ‘Health’. Ayurveda clearly defines the state of perfect health; its technical terms distinguish healthy from unhealthy states with the utmost clarity. The chief tool in achieving this lies in the Sanskrit Slokas themselves, even in translation. For example, elaboration of Svasthavritta for maintenance of health, understanding the importance of this knowledge and the consequences of deviating from it, brings a deep understanding of the possibility of a state of perfect health. Of prime importance in this context is the systematic classification of all diseases in terms of imbalances of Tridosha (Vata, Pitta and Kapha Doshas), and their various subdoshas (doshaprakar).
In this context, Ayurveda clearly states two objectives: a) to maintain the health of healthy persons; and b) to cure the sick. In pursuit of the former, the texts elaborately describe ‘Swasthavritta’, the state of perfect health (compared to their elaborations in pursuit of curing sickness, this consideration is tiny). Even so, by focusing on this, first part, we can fully understand the consequences of deviating from a healthy lifestyle, and how that leads down the pathways to disease.
Conversely, the roles of various kinds of treatment, which can restore doshas to their state of balance is of absolutely fundamental importance. This series of concepts, doshas, their levels of imbalance, their diagnosis and the various means appropriate to different patients to remedy imbalances and so restore them to balance, together constitute an essential part of Ayurvedic theory and practice, with no corresponding elements in allopathic medicine. This fundamentally distinguishes the two, completely explaining why the former system can treat so many conditions, which the latter can only palliate.
In this context, in order for Ayurveda to treat diseases, for which Allopathy has no remedy, whether chronic or acute, their detailed causes, symptoms and treatment have to be worked out from scratch in Ayurvedic terms. Otherwise, practically speaking, there is no effective way to treat them. For Ayurveda to achieve its cures, it has to treat pathologies in its own terms.
For the next generation to learn to understand and practice Ayurveda as it should be practiced, this kind of information has to be transmitted along with detailed practical experience of its use. To achieve this, it is essential that the texts be studied thoroughly and repeatedly, so that their basic, overall theme is grasped in their totality. When particular terms occur with particular usages in particular places, it is important that such usages are understood in light of the term’s overall application. Each part must be understood in the context of the whole.
In this context, we arrive at Triskandhakosha, Ayurveda’s basic approach to understanding the overall relationship between health and disease, and their various states and subdivisions.
UNDERSTANDING THE PARTS IN THE CONTEXT OF THE WHOLE
The use of Triskandha Kosha aims to achieve total understanding of each concept. Terms such as Agni, milk, and so on, may be used in many different places in a text with subtly different shades of meaning. In order to grasp their importance and significance in each particular place, Triskandhakosha can prove invaluable. Study of both triskandakosha & basic texts together is the most beneficial approach.
The term ‘Triskandhakosha’ refers to a compilation of every sutra from the Brihattrayi, Charaka, Sushruta and Vagbhata Samhitas. The whole information is classified into three databases:
1. Hetukosha, which elaborates on the spectrum of causative relationships between diet, behavior etc. and health and disease;
2. Lakshanakosha, which elaborates symptom-disease-health relationships; and
3. Aushadhakosha, which elaborates all such relationships from the perspective of treatment.
This has resulted in the following publications: Hetukosha in 3 volumes (3200 pps.), Lakshanakosha in 3 volumes (3200 pps.) and Aushadhakosha in 7 volumes (8000 pps.), together with diagnostic and treatment software. Triskandhakosha thus involves a blend of Ayurveda, Sanskrit and information technology. It comprises a complete listing of textual information classied according to causes (Hetu), symptoms (Lakshana) and treatments (Aushadha) of health and disease.
Out of Triskandhakosha emerge sets of relationships that are both one to one and one to many, covering
(i) underlying causes like food, lifestyle and psychological factors, and their effects, such as imbalances in tissues and doshas (Karya), eventually leading to manifestation of pathology;
(ii) symptoms, or sets of symptoms (Lakshana), and how they indicate particular diseases, or possible disease conditions (Lakshya);
(iii) conditions of health, failing health, or manifest pathology (Chikitsya), and various choices of treatment (Aushadha).
The Texts explain the same things from various different perspectives. When studied in the prescribed manner, combining these perspectives, more complete results will be obtained for each textual term or concept. By knowing and understanding each term, together with the terms most closely associated with it, whether one or many, the student begins to grasp both the scope and entirety (‘sakalajnana’) of the concept in question more fully. When all these are put together, the student gains full knowledge and understanding of Ayurveda in its totality.
The ultimate goal is to enable all students of Ayurveda to learn to use the system properly and fully, so that it can be used to treat both chronic and acute conditions with the efficacy achieved by its most experienced practitioners. This is the essential need in India today: the crisis in chronic disease otherwise promises to reverse all improvements in quality of life achieved by economic growth.
When fully applied in India, the land of its origin, Ayurveda should be able to demonstrate its potential to all. Once that has been achieved, it could be considered for similar use on a world level. Once its virtues are realized, it could even achieve the position of becoming globally regarded as the medical system of first choice for many different pathologies.
1. Acharya YT. editor. Charaka Samhita. Varanasi: Chowkhamba Surbharati 2000 (reprint).
2. Acharya YT, editor. Susrutha Samhitha of Susrutha with Dalhana Tika. Varanasi: Chaukhambha Orientalia 1992.
3. Paradkar H, editor. Ashtanga Hridaya - Hemadri and Arunadatta commentary. Varanasi: Chowkhamba Krishnadas Academy 2000 (reprint).
4. Athawale, AD, editor, Ashtangasangrahasamhita, Pune: Shrimad Atreya Prakashana 1980.
5. Vidyabhushana SC. (Tr.) Nyayadarshana: The Nyaya Sutras of Gotama. Delhi: Motilal Barnassidas,1990.
6. Bahadur KP. Vaisheshikadarshana: The wisdom of Vaisheshika. Delhi : Orient Book Distributors, 1979.
7. Bahadur KP. Samkhyakarika: The wisdom of Saankhya. Delhi: Orient Book Distributors, 1978.
8. Gadgil, D.P., editor. Hetukosha, Pune : Tilak Maharashtra Vidyapeeth, 2004.
9. Gadgil, D.P., editor. Lakshanakosha, Pune : Tilak Maharashtra Vidyapeeth, 2004.
10. Gadgil, D.P., editor. Aushadhakosha, Pune : Tilak Maharashtra Vidyapeeth, 2004.
11. Ayuta Nidana (Ayurvedic Diagnostic Software)
12. Ayuta Upachara (Ayurvedic Treatment Software)