Ayurveda the Ancient Science of Healing: An Insight

The term Ayurveda, a Sanskrit word, translates into knowledge (Veda) of life (Ayur); Veda also means science. After being transmitted orally for thousands of years, the ancient Ayurvedic texts finally were written and preserved in Sanskrit (an ancient Indian language). Founded on the collective wisdom of ancient Hindu saints and healers, Ayurveda grew into a medicinal science. Ancient Ayurveda was meant essentially to promote health, however, rather than fight disease. The Ayurvedic text, an offspring of the Atharvaveda, appeared sometime in 1500 to 1000 BC and described two schools of learning physicians Atreya and surgeons Dhanvantari. Charak Samhita (1000 BC) and Sushrut Samhita (100 AD) are the main classics. Ayurveda materia medica gives detailed descriptions of over 1500 herbs and 10,000 formulations. Madhav Nidan (800 AD) a diagnostic classic provides over 5000 signs and symptoms. There are eight branches of study in Ayurveda: Kaya Chikitsa (General Medicine), Kaumara Bhruthya (Paediatrics), Bhutha Vidhya (Psychiatry), Salakya (ENT and Ophthalmology and dentistry), Shalya (Surgery), Agada Tantra (Toxicology), Rasayana (Rejuvenation Therapy) and Vajeekarana (sexual vitality) (Lad, 1995; Agnihotri, 2000; Chopra and Doiphode, 2002; Mukherjee and Wahile, 2006; WHO, 2010; Balasubramani et al., 2011).


Introduction
The term Ayurveda, a Sanskrit word, translates into knowledge (Veda) of life (Ayur); Veda also means science. After being transmitted orally for thousands of years, the ancient Ayurvedic texts finally were written and preserved in Sanskrit (an ancient Indian language). Founded on the collective wisdom of ancient Hindu saints and healers, Ayurveda grew into a medicinal science. Ancient Ayurveda was meant essentially to promote health, however, rather than fight disease. The Ayurvedic text, an offspring of the Atharvaveda, appeared sometime in 1500 to 1000 BC and described two schools of learning physicians Atreya and surgeons Dhanvantari. Charak Samhita (1000 BC) and Sushrut Samhita (100 AD) are the main classics. Ayurveda materia medica gives detailed descriptions of over 1500 herbs and 10,000 formulations. Madhav Nidan (800 AD) a diagnostic classic provides over 5000 signs and symptoms. There are eight branches of study in Ayurveda: Kaya Chikitsa (General Medicine), Kaumara Bhruthya (Paediatrics), Bhutha Vidhya (Psychiatry), Salakya (ENT and Ophthalmology and dentistry), Shalya (Surgery), Agada Tantra (Toxicology), Rasayana (Rejuvenation Therapy) and Vajeekarana (sexual vitality) (Lad, 1995;Agnihotri, 2000;Chopra and Doiphode, 2002;Mukherjee and Wahile, 2006;WHO, 2010;Balasubramani et al., 2011).

Core concept of ayurveda
In Ayurveda, health is defined as the state where physical body, senses, and psyche are in original or natural state with respect to body and function. Ayurveda believes that both world and human body are made up of five elements earth, water, fire, air, and space (ether) called as Panch-mahabhuta. While we are a composite of these five primary elements, certain elements are seen to have an ability to combine to create various physiological functions (Mishra, 2004).
Vata: Ether and air combine to form what is known in Ayurveda as the Vata dosha, vata governs the principle of movement and therefore can be seen as the force which directs nerve impulses, circulation, respiration, and elimination. Vata is dry, cold and light and correspond to the element air. Pitta: Fire and water are the elements that combine to form the Pitta dosha. The Pitta dosha is the process of transformation or metabolism. The transformation of foods into nutrients that our bodies can assimilate is an example of a pitta function. Pitta is also responsible for metabolism in the organ and tissue systems as well as cellular metabolism. Pitta is oily, hot and light and correspond to the element fire.
Kapha: Water and earth elements combine to form the Kapha dosha. Kapha is responsible for growth, adding structure unit by unit. Another function of the Kapha dosha is to offer protection. Cerebro-spinal fluid protects the brain and spinal column and is a type of Kapha found in the body. Also, the mucousal lining of the stomach is another example of the Kapha dosha protecting the tissues. Kapha is wet, cold and heavy and corresponds to the element water (Sebastian, 2006;Walter, 2006). These three dosas coexist in a predetermined proportion and function in a complementary manner to overall function of the total organism in spite of their opposite properties and functions. The existence of the dosas can be understood at both the macromolecular and micromolecular levels. A balance in the activity of these dosas is necessary for health.

Pathogenesis of disease
According to Ayurveda, there are three main causes of disease, namely asatmyendriyartha samyoga (indiscriminate use of senses and their objects), prajna-aparadha (error of intellect resulting in a loss of discrimination between wholesome and unwholesome with subsequent indulgence in unwholesome diets and behaviour) and kala-parinama (seasonal variation, cosmic effects and the effects of time) (Frank, 2001).
Samprapti: The concept of six stages of pathogenesis is vital for an understanding of the pathological states of the doshas that result in disease. First stage is called as Sanchaya (accumulation), due to weak digestive power and accumulation of ama (toxins) causes imbalance in doshas. The second stage is Prokapa (aggravation), the accumulated, stagnant doshas are excited by factors as ahara, vihara and seasons. Stage three called as prasara (overflowing/ spread), in this stage, the toxins accumulated start overflowing. Generally, up to this stage the damage is entirely reversible and restoration of doshas balance can be achieved with proper measures.
Sthanasamsraya (localization/ agumentation) is stage four characterized by migration of overflowing toxins in localized weak or defective dhatus thereby leading to malfunction and structural damage.
Vyakti (manifestation) and bheda (chronic complications) are fifth and sixth stages of pathogenesis, characterized by appearance of symptoms of diseases and chronic manifestation respectively.

Dravyaguna vigyan (ayurvedic pharmacology)
In Ayurveda, substances of natural origin, including whole plants or their parts, animal parts and minerals, are used as medicines, either alone or in combination. In addition, various other measures are used in an attempt to maintain health in a healthy person and alleviate disorders of the body and mind. These substances act on the principles of samanya (homologous) and visesha (antagonistic) action.
Substances possessing homologous properties and actions increase the relevant elemental properties or constituents of the body while those having antagonistic properties or actions decrease those properties or constituents. In cases of disease or imbalance of dosha, dhatu and mala, the rational use of naturally available substances aims to restore normality.
The composition of elements in medicines and the diet is studied in terms of various properties, referred to as rasa, guna, virya, vipaka and prabhava. The effect and action of the medicines or diet depends on these properties. Rasa (taste): Taste of medicine as perceived by tongue.
There are six different tastes, each with a predominance of two elements and showing the characteristics of these elements. Administration of a medicine featuring a particular rasa enhances that property in the body and decreases its opposite. The six tastes are madhura (sweet), amla (sour), lavana (salty), katu (pungent), tikta (bitter) and kashaya (astringent). Tastes provide varying degrees of nourishing strength. Sweet taste is the most nourishing, and as each taste becomes less nourishing, it becomes more bitter, until it is astringent and the least nourishing.
Guna (attributes): Not be measurable but inferred through their pharmacological action, guna is property of a medicine detected by sense organs other than the tongue. It appears that guna are intimately related to rasa it is a fact that both are separate principles co-existent in the dravya (substance). They are 20 in number and represent the characteristics of the elements. There are 10 pairs of contrasting characteristics -guru (heavy)/ laghu (light), Virya: Denotes the potency of the medicine. There are eight virya namely mridu, teekshana, guru, laghu, snigdha, ruksha, ushna and sita, representing the active gunas. These can be put into two broad categories -sita (cooling) and ushna (heating).
Vipaka (postdigestive effect): It is the postdigestive effect of rasas, the same elements predominate as in the original rasas, with the corresponding action. There are three vipakas. A sweet taste becomes madhura vipaka; sour and salty tastes become amla vipaka and pungent, bitter and astringent tastes become katu vipaka.
Prabhava (pharmacological action): Prabhava has been defined as the special property of a substance which produces actions different from and contrary to those ascribed to rasa, guna, virya and vipaka. The chemical composition which largely determines the secondary qualities of a dravya (substance) such as rasa, guna, virya and vipaka does not determine a chemical compound. The rasa, guna, virya and vipaka of Danti (Baliospermum montanum.) and Chitraka (Plumbago zeylanica) being apparently identical, the former produces purgation, whereas the latter does not produce this action and the specific purgative action of Danti is attributed to its prabhava (inexplicable nature) (Paranjpe, 2001;Nishteswar, 2007).

Ayurvedic chikitsa (therapeutics)
Ayurveda says that healthy of an individual is preserved due to equilibrium of the doshas. In diseased people, treatment eliminates the disequilibrium between the doshas, and the body is restored to normality. The body has its own intelligence to create balance, ayurvedic treatments helps in that process.

Shodhana karma (purifying therapy)
Formation of toxins reduces that natural capacity of body for healing and rejuvenating. The shodhan karma such as panchakarma enables the body to release excess doshas and ama (toxins) from cells.
Panchakarma: Is the method of shodhana/detoxification or elimination of toxins from the body. It is divided in three stages poorvakarma (preparatory procedures) pradhan karma (main therapy) and uttara karma (post therapy care).

Poorvakarma (preparatory procedures) includes snehana (oelation therapy) and swedana (fomentation therapy).
Snehana or oelation therapy involves saturation of the body with herbal & medicated oil via external & internal oelation to make body soft and disintegrate the doshas. Shirodhara is the most commonly employed pre-procedure; it means the dripping of oil like a thread (dhara) on the head (shiro). This treatment drips warm oil in a steady stream on the forehead, particularly on the brow and in the region between the eyes. It is often added to the panchakarma regimen because it pacifies vata and calms the central system. It cleans both the mind and the senses which allow the body's natural healing mechanisms to release stress from the nervous systems.
Swedana/ fomentation or sweating is necessarily follows oleation, Swedana is induced by heat from different sources it brings sweat on the skin through hair follicles by opening the pores of the skin. Fomentation increases the agni (biofire) and the fatty tissue gets mobilised. It also throws out ama (toxins/waste) through the skin and helps in liquefying aggravated doshas. Swedana has two main types, agni sweda wherein heat is applied directly as steam and anagni sweda where no external heat source is necessary e.g exercises, fighting, walking, lifting heavy loads, exposure to sunlight, putting heavy blankets over the body etc.
Vamana (emesis): It is therapeutic emesis; done regularly to cleanse the stomach and remove áma (toxins) and mucus from chest. It is used for relieving recent fever, diarrhea, pulmonary infections, skin diseases, diabetes mellitus, goiter, and obesity. Vamana is induced using herbs such as vacha (Acorus calamus) and licorice (Glycyrrhiza glabra).
Virechan (purgation): This is the simplest method of panchakarma and has most easily observed effects. It is an excellent method to heal various conditions, including abdominal tumors, hemorrhoids, smallpox, patches of skin discoloration on the face, jaundice, chronic fevers and enlarged abdomen. Strong cathartic and laxative herbs such as jaiphal (Croton tiglium), aragwad (Cassia fistula), or castor oil (Ricinus communis) are used for induction of purgation.
Anuvasana and niraha (enemas): For patients emaciated by fever, neither vamana nor virechan is useful. The mala (digestive waste and toxin) of patients is removed by nirha by using decoction enemas. To prevent aggravation of vata, an oil enema (anuvasana basti).
Nasya (Nasal cleansing therapy): Nasya means nasal administration of medicated powders or liquids. It is a procedure in which medicament administered through the nostrils in order to purify the head and neck region. Nasya is useful in relieving stiffness in the head, neck arteries, throat, and jaw obstructions, nasya is useful in disorders of the neck, shoulders, ears, nose, mouth, head, cranium, and scapula.
Raktamokshana (Blood-letting): The small amount of blood is removed intravenously or by leeches, the toxins are removed quickly from systemic circulation. It is useful in blood toxaemia, hypertension and skin disorders. Raktamokshana is contraindicated in anemia and pregnancy.

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Uttara karma: It is important to resume or establish a diet and lifestyle that is harmonious with one's constitution. If a person returns to old, bad habits, they may worsen their condition by suppressing the renewed healing energies. The toxins may then directly enter cleansed tissues and go deeper than before, causing severe diseases. During convalescence, persons avoid loud talking, bumpy rides, long walks, excessive sitting, and eating, if experiencing indigestion. To avoid aggravating the humors, persons also avoid eating unwholesome food, day naps, and sexual relations (Ojha et al., 1978;Joshi, 2005).

Shamana karma (alleviation therapy)
According to Ayurveda, shamana is the balancing and pacification of bodily doshas, shamana is used when panchakarma is inappropriate due to the poor strength of the patient. Shamana consists of dipana, pacana, vrata or ksunnigraha, trsna or ernnigraha Vyayama, Atapasevana and Marutha.
Dipana (enkindling): Dipana means enkindling the digestive fire by using warm meals, hot water, eating a small piece of fresh ginger mixed with lime juice and salt before a meal, having a short walk before meals to stimulate the agni. dipana is absolutely necessary in kapha and vata disorders, where the person has low gastric fire.
Pacana (digestion): Pacana means digesting of ama (toxins) and undigested residues, pacana uses many of the same herbs as dipana but instead of taking them before a meal they are taken afterwards and usually at double the dose. These hot herbs literally burn the ama. The indication for using pacana is when there is hunger but not enough 'fuel' to fan the digestive flames. These spices are the fuel. Of course, when there are already inflammatory conditions, such as ulcers, caution must be taken.
Vrata or ksunnigraha (fasting): Ksunnigraha means to 'hold onto your hunger. Fasting inspire a healthy hunger; a true need for food taken in the balanced quantity. Fasting or monodiet are suggested according to dosha. Vata people can do a short fast on hot liquid soups, pitta constitution can do a liquid fast on fruit juices such as grape or pomegranate and kapha types can do a literal fast; although this is a great struggle for them as it challenges their tendency to hold onto things.
Trsna or Ernnigraha (observing thirst): Not drinking water or fasting from water is known as trsna or ernnigraha. Trsna is beneficial in water diseases such as oedema, diabetes or kidney problems. It reduces the stress on the water channels in the body (ambuvahasrotas).
Vyayama (exercise and yoga): Ayurveda says exercise has such a quality that it strengthen the dhatus, increase agni, improve circulation, accelerates the heart rate, enhances the combustion of calories and also stimulates metabolism, regulates body temperature and maintains body weight. Exercise makes your senses alert and attentive and your mind becomes very sharp and develops keen perception. These qualities of exercise are very important, but again, exercise varies from person to person, Vata types should do more relaxing and gentle exercise. Kapha people can do more vigorous exercise and pitta should exercise regularly but moderate.
Atapa seva (sunbathing): The sun is the source of heat and light. Atapaseva is very useful for lightening the body, increasing the agni and treating bhrajaka pitta. Many conditions are www.intechopen.com improved by sitting in the sun; certain types of eczema, psoriasis, arthritis, depression and water retention to name a few. Lying in the sun and meditating upon the solar plexus, is a wonderful shaman for kapha and vata. It improves circulation, the absorption of vitamin D, and strengthens the bones.
Maruta/ Marutaseva (wind-bathing): Marutaseva is specifically relates to the yogic practice of pranayama and of becoming inherently tuned into deep slow breathing using a deep inhalation and long exhalation. It is about imbibing prana; the life force surfs on the breath and flows deep into our tissues. Specific problems such as asthma, bronchitis and emphysema greatly benefit from this practice. Also people with a tendency to experience excessive anxiety and fear in their lives benefit from watching the breath flow in and out of themselves.

Rasayana (rejuvenative) and vajikarana (aphrodisiac)
Rejuvenation involves brmhana (building therapy) using tonic herbs such as ashwagandha (Withania somnifera), shatavari (Asparagus racemosus) and bala (Sida cordifolia) to nourish all the tissues, build the strength, enhance ojas and strengthen immunity. It also involves eating building foods like nuts, ghee and dairy products.
Rasayana (tonic): In Ayurveda tonics are sweet, heavy and oily in quality. The sweet flavour increases the quantity and quality of the tissues as it is anabolic. So many of the modern wonder herbs that boost immunity are full of immune-enhancing saponins and polysaccharides. The sweet flavour is tonifying and rejuvenating, but it must be of a high quality and fully digested to benefit the whole system. Popular ayurvedic tonics are chayawanaprash, ghee and walnuts (Juglans regia).

Discussion
Ayurveda has been practiced in India for over 5000 years and is recognized as a complete medical system comparable with allopathic medicine by the government of India. In India, Ayurveda has a complete infrastructure, medical colleges, hospitals integrated with allopathic medicine, research institutes, and scientific journals devoted to Ayurveda. In addition, India's Ayurvedic pharmaceutical industry is governed by the same food and drug laws that regulate conventional drugs. Research in pharmacology, biochemistry, phytochemistry, and clinical trials of Ayurvedic therapies currently constitutes a substantial portion of the total research conducted in government institutes and medical colleges in India (Mishra, 2004).
Ayurveda has the potential to develop into a global health-care system. The concepts of proper lifestyles, personal hygiene, daily routine, seasonal corrections, diet, yoga and herbal therapy can be adopted with suitable modification to different countries in different parts of www.intechopen.com the globe after giving due consideration to the culture, life style and available medicinal plant resources of the countries.

Acknowledgment
Authors are grateful to all experts of Ayurveda whose work referred in this article.