Kottarappat N. Dileepan

Kottarappat N. Dileepan, MSc, PhD and Kanakam Dileepan, MD
Overland Park, KS, USA

Ayurveda is a comprehensive medical system that originated in India several thousand years ago.  The word Ayurveda, which means ‘the science of life’, came from two Sanskrit words, Ayu (life) and Veda (knowledge). During 2500-600 BC, this medical systemevolved into two distinct schools, namely, the school of physicians and the school of surgeons.  Interestingly, some of the very early written documentations on the practice of Ayurveda can be traced back to the verses in Rig Veda (1500 BC). The scriptures systematically described the characteristics of health and disease, causes of disease progression, as well as therapeutic approaches for the management of diseases. Charaka Samhita, Sushruta Samhita and Ashtanga Hridayam have been the three classic text books used in Ayurveda.As early as 800 BC, Ayurveda had recognized the complexities of medical system and divided it into eight specialties (Ashtanga). These specialties are Kayachikitsa (Internal Medicine), Shalya-tantra (General Surgery), Shalakya chikitsa (Ophthalmology and Otorhinolaryngology), Bhut vidya (Psychiatry), Kaumara bhritya (Pediatrics, Obstetrics and Gynecology), Agata tantra (Toxicology), Rasayana tantra (Geriatrics), and Vajikarana tantra (Science of fertility and virility).godAccording to Ayurveda, good health is soundness of the body and mind.  Based on this principle, the treatments of disease integrate modalities that can normalize the balance of the body, mind, spirit and environment.  The fundamental concept is that the Universe is constituted of five elements of nature (Pancha Mahabhutas) namely; air, ether (space), fire, water and earth, and the characteristic trait of an individual is determined by the distinct combination of these five elements and their predominance. A person’s constitution is called Prakriti and itis comprised of the following:

  • three body dosha (humors), namely, Vata (space, air), Pitta (fire, water) and Kapha (water, earth)
  • three mental guna (attributes), namely, Sattwa, Rajas and Tamas
  • seven dhatu (tissues), namely, raktha (blood), mamsa (muscles), medas(fat), asthi (bones), majja (bone marrow), rasa (chyle or lymph) and shukla (reproductive tissue);
  • mala (waste products)
  •  srotas (channels of transportation)
  • agni (digestive fire or enzymes)

The three body dosha (vata, pitta, kapha) are regulators of cell functions in a variety of ways. Most people have one dominant dosha. The specific balance of dosha is unique to each person. The three mental guna namely, Satogun (Godly) generates purity, illumination and harmony, Rajogun (Kingly) generates passion, activity and motion, and Tamogun (darkness) generates inertia, depression, inactivity and dullness.

The origin of disease is considered to be due to an imbalance in the Tri-doshas resulting from stress or the inherent or acquired weakness of tissues. A disease is diagnosed using three methods: darshana pareeksha (inspection and observation), sparsana pareeksha (palpation, percussion and auscultation) and prasna pareeksha (interviewing the patient). Ayurveda describes an elaborate system for assessing both the trait of the patient (Rogi) and the pathobiology of disease (Roga). Thus, the treatment is customized to fit the individual constitution of the patient. Ayurveda emphasizes the importance of diet (ahara), physical activities (vihara), sleep (nidra), and sexual habit (maithuna) to maintain the balance and equanimity of the body and mind.

Disease prevention and treatment modalities are focused on normalizing the harmony of doshas and improving tissuesthrough lifestyle interventions, diet, medicine, massages, yoga and spiritual practices.  Ayurvedic therapeutics can be broadly classified into two categories; reduction and tonification. Reduction therapies have two parts: shamana (pacification)and shodhana (purification) to reduce excesses in the body. Tonification (rasayana) therapies improve insufficiencies in the body. Satvajaya (mental hygiene) through use of mantra, yantra and tantra is emphasized.  Many treatment modalities including dhara, vasthy, nasya, pizhichil, navarakizhi, and panchakarma are applied in Ayurvedic physical therapy practice.


     More than two millennia ago,  Ayurveda emphasized the importance of surgery for treating diseases. Susrutha (600BC) described in his surgical compilation Susrutha samhita more than 120 surgical instruments and 300 surgical procedures. The surgical procedures had three parts (trividha karma), namely purva karma (pre-operative measures), pradhan karma (operative measures) and paschat karma (post-operative measures). Under the operative measures Susrutha describes eight types of surgical procedures. They are chedanam (excision), bhedanam (incision), lekhanam (scraping or curettage), vyadhanam (puncturing), visravanam (drainage), esanam (probing), aharanam (extraction by sharp hooks), and sivanam (suturing). Procedures of rhinoplasty (plastic surgery of nose), cataract removal, setting broken bones and the study of human anatomy using cadavers are meticulously explained in Susrutha samhita.


During the Buddhist Era (500BC- 400AD) Ayurveda flourished. Ayurvedic works were translated into Chinese by 700 A.D and Chinese scholars were studying medicine in India at NalandaUniversity. In 800 A.D. Ayurvedic compilations were translated into Arabic.  The prominence of Ayurveda began to decline in India around 1100 A.D. during the period of Mughal Empire.  After a transient revival, Ayurveda further lost its role as the major medical system during the British rule in India. After India’s independence in 1947, Ayurveda was nurtured and rejuvenated. Since then, Ayurveda continues to gain significant attention throughout the world.


Drug therapy is a well-developed branch of science in Ayurveda.  There are more than 8,000 therapeutic combinations that are commonly used for treating diseases.  Ayurvedic medicines are mostly derived from plants, minerals and dairy products.  A variety of formulations including distillates, decoctions, powders, pills, fermented products, medicated oils and injections are available. The process of incorporating drugs into lipid emulsions (ghrita and taila) is the basis for the development of drug-embedded liposomes used in modern medicine.  Most of the herbs used in Ayurvedic preparations undergo purification to remove toxic chemicals by a process called shuddhi.  Drugs are usually administered in combinations in order to reduce the toxicity of the active principle as well as to synergize its efficacy by the accessory ingredients.  Many herbal preparations are prescribed in Ayurveda to strengthen body’s defense mechanisms and enhance longevity.


Although Ayurvedic medicines have been effectively used for many centuries, the modern medicine failed to recognize their pharmacological basis and mode of actions.  For example, Reserpine, the well-known antihypertensive drug, is derived from Rauwolfia Serpentine or sarpagandha which is prescribed by Ayurvedic physicians for hypertension. Similarly, the foxglove, which contains Digitalis, is effectively used in treating heart disease.  Phyllanthus amarus, the popular plant used in Ayurveda for treating viral hepatitis, contains potent ingredients that prevent replication of hepatitis B virus in humans by inhibiting the viral DNA polymerase.  Many Ayurvedic herbs used for treating neurological disorders contain anticholinergics (datura stramonium), levodopa (Mucuna pruriens, Vicia faba), dopamine agonists (Claviceps purpura) and monoaminooxidase (MAO) inhibitors (Banisteria caapi).  A recent clinical trial of a preparation from Mucuna pruriens showed significant improvement of symptoms in patients with Parkinsonism.  Several botanicals, including Cataegus oxycantha, Terminalia arjuna, Inula racemosa, and Astragalus membranaceous, havebeen found to have therapeutic benefits in cardiovascular diseases. Curcumin, the active ingredient of turmeric, has been found to be effective in treating certain types of cancer, Alzheimer’s disease, skin diseases and inflammation.  The studies conduced at the University of Kansas Medical Center in early ‘90s show that certain Ayurvedic Rasayana preparations increase body’s immune surveillance by regulating the functions of specific immune cells that fight infection and cancer. These rasayana preparations have become constituents of a US patented formulary for the treatment of multiple myeloma, a bone marrow cancer.  Hopefully, many ongoing research programs on the therapeutic potential of natural products will further enhance our understanding of the mechanism of action of many Ayurvedic drugs, and the modern medicine will advocate this comprehensive health care system whenever applicable.  It is noteworthy that, many centuries before the modern world contemplated on the concept of personalized medicine, Ayurveda practiced it by customizing treatment modalities based on individual’s body composition, trait and drug tolerance.