For over a century various physicians, philosophers and scholars have used medicine or medical science to define health. This has contributed to the emerging issues around medicalisation of human experience and changed the dynamics around control and power within the health system. While modern biomedicine has made immense strides in medicine and surgery, it has overshadowed traditional forms of medicine, until more recent times when traditional medicine has witnessed a resurgence in popularity. Although the roots of modern medicine can be traced back to various medical traditions the current “modern medicine” approaches view traditional medicine with suspicion. However, due to increased interactions (interestingly, also due to ‘globalisation’) and geopolitical changes (with the rise of China and India, among others), we see a growing demand and spread of various health traditions globally – see for example this Nature news report from last year. Traditional forms of health care often take different – very diverse – approaches to bringing the person to a state of “good health,” and customisation would take into account diverse components in terms of food, medicine, lifestyle and cultural aspects.
The Indian health system recognises seven traditional systems: Ayurveda, Siddha, Unani, Yoga, Naturopathy, Homoeopathy and more recently Sowa-Rigpa (Tibetan system of medicine). Of these, Ayurveda is probably one of the best known. It has even spread to neighboring countries like Sri Lanka and Nepal and has influenced other traditional systems in South Asian countries like Thailand and Tibet. In recent years, Ayurveda has gained popularity and recognition as a complementary or alternative approach to modern medicine in western countries.
As a practitioner of Ayurveda myself I am well-acquainted with its benefits, and yet acknowledge the controversies surrounding this system of health. In this piece I put across my arguments for why I believe Ayurveda can play a role in health and wellbeing of people in the 21st century.
I’d like to begin my argument with our lifestyle. Our modern-day pace of life is increasingly having a negative impact on our physical, mental, social and spiritual health which is manifesting itself in symptoms such as burn-out, anxiety, loneliness, etc. Ayurveda can help to guide us to addressing some of these issues. But first, what is Ayurveda?
The term Ayurveda consists of two words, ayu (life) and veda (knowledge) and deals with health and well-being. Although the word ayu is loosely translated as ‘life’, Dr. Ram Manohar (Ayurveda scholar) gives better insight into its meaning. Ayu is derived from the (Sanskrit) root ‘iṇ gatau’ or Gati, which means movement, the movement of going away as well as the movement of change. The word Gati also indicates the dynamic and adaptive nature of life. The key to health and longevity is flexibility and constant adaptation, and as long as this ability to adapt remains, life continues. The goal of Ayurveda is to preserve life, and restore health and well-being. Ayurveda’s understanding of health is considered to be comprehensive and dynamic in nature and explains health in its entirety as a “many-sided equilibrium” (samya), which results, in turn, from balanced interaction and interrelations with living beings and their environment. Although the absence of disease (Arogya) is considered as good health, it’s not a key defining element of health or the definitive state of health. The term Swasthya brings a clearer understanding of how Ayurveda understands health. This Sanskrit word defines health as ‘being rooted within one’s own inner self’. The interpretation of this term is that the “self”can be realised through a harmonious balance between body, mind and spirit. This means even when there is some dis-ease, a well-balanced ‘self’ has the ability to cope with the stress of dis-ease and achieve health and wellness.
The potential impact of Ayurveda, also in this day and age, I’m convinced, rests on its basic principles and a rather unique concept of health, that include the understanding of five elements (panchamahabhuta- ether or space, air, fire, water and earth), constitutional types (Prakriti – Vata, Pitta and Kapha) , as well as in its personalised approach to diagnostics and treatment. The study of Prakriti evaluation has indicated that Ayurveda can easily classify humans into phenotypes irrespective of ethnicity, geography and race. This way of understanding the human constitution leads to a better understanding of health and well-being. In order to achieve health, Ayurveda not only deals with the physical and the mental aspects, but also incorporates spiritual, social and environmental aspects. While dealing with issues of health it considers several related (non-drug) approaches like lifestyle modification, personal hygiene, dietary adjustments, exercise and social and environmental relationships. There is a great focus on a person’s daily and seasonal regimen (Dinacharya and Ritucharya), and Ayurveda practitioners thus provide strict guidelines on food and nutrition, lifestyle and even deal with psychosocial health.
While dealing with the mental, social and environmental aspects of health, Ayurveda proposes concepts like svasthavratta (code of conduct) and achar Rasayana (social behaviour), dharanneyavega (urges needing control eg. anger, greed), pragnaparadha (an offense against wisdom), and Yoga (Yama, niyama, asana, etc). This overall Ayurveda strategy helps to achieve personal transformation and regulate behavioural (social) conduct, which in turn helps ensure the development of the community and ability to adapt in a changing environment, leading, ideally, to a ‘healthy society’. This is achieved through promoting lifestyle with ethical conduct and by cultivating virtues like truthfulness, modesty, courage, forgiveness and kinship to all forms of life. Ayurveda perceives human beings as the microcosm of the macrocosm, and highlights our interconnection and interdependence with nature. In achieving health it always stresses this connection and uses strategies which link us (back) to nature. Ayurveda assists individuals to take control of their own health and increase self-reliance and re-establishes our connection to the environment. Ayurveda is not limited to medicine or therapy; instead it implies a holistic approach to life and living in harmony with nature.
Sadly, current strategies used to “modernise” Ayurveda are based on human-centric biomedical approaches leading to the medicalisation of Ayurveda. These modern strategies have neglected the ancient multidisciplinary and holistic approach which not only considered health and well-being of humans but also of plants, animals and environment. Ayurveda branches like Vrukshayurveda (Ayurveda for plants), Pashuayurveda (Ayurveda for farm animals), Hastiayurveda (Ayurveda for elephants), have lost their place in this approach. It is clear that this medicalisation has narrowed the holistic perspective and potential of Ayurveda. Processes like standardisation and unification of Ayurveda education have neglected the local and regional variation and pharmaceuticalisation has reduced diversity and availability of medicine to less than 10%. We need to bring back this lost perspective not only to Ayurveda but also to use this holistic way of thinking to fill gaps in our current biomedical model of health care delivery. The ancient knowledge of Ayurveda is as relevant today as when it was recommended for the first time.