The conceptual and operational framework of Ayurveda is wide enough to include all that is essential to make a man healthy and happy. It includes the study of right conduct (dharma), which is necessary for the healthy growth of society in which the man lives. Further it deals with the philosophical aspect of life, the knowledge of which contributes greatly to the comfort and happiness of all human beings. Ayurveda philosophically understands the limitation of human efforts. Still it talks about the means of prolonging life and the methods of invigorating it.
The objectives of Ayurveda are mainly two, the first being the maintenance of positive health, and the other treatment of diseases. These clearly defined objectives are achieved through logically developed means in a classical way. On the basis of objectives defined, the sum and substance of Ayurveda can be classified into two parts -
Healthy man’s regimen - the science of positive health (svasthavrittam)
Patient’s regimen (aturavrittam).
Healthy man’s regimen
The emphasis on the concept of positive health is a unique feature of Ayurveda. The radical shift occurred in defining health encourages the medical fraternity of modern times to look deeply into empirically evolved ayurvedic techniques for the maintenance of positive health. The recommendations that Ayurveda puts forth in this regard include the observance of systematized daily routine (Dinacharya), life in accordance with seasons (ritucharya) and well planned schedules of diet and exercise. Ayurveda stresses on the need of maintaining personal, social and civic hygiene for the orderly upkeep of positive health.
Ayurveda recognizes that mind is very powerful both in the causation and cure of diseases. So, strict mental discipline and adherence to moral values are considered a pre-requisite for health. Therefore, ethical basis of life (sadvrttam) is described as an important health support system.
The innate strength of an individual to resist the affliction of disease - Vyadhikshamatvam - is well considered and its positive and negative influence on health understood. The techniques evolved in this regard are the boosters of human immune system.
Experts view the recommendations suggested for maintenance of positive health as protective measures against endogenous - eg. ageing - and exogenous - eg. Environmental pollution - afflictions and point out their efficacy in strengthening the cellular function in human body. These observations are comparable with modern concept of Prohost Therapy and use of Cyto-protective Agents of contemporary.
Obviously regular or periodic use of rejuvenative therapy (rasayanachikitsa) also finds a place in the maintenance of positive health because of its therapeutic potentials to delay the process of ageing and also to improve quality of life.
In a nutshell, Ayurveda recommends socio-economic adjustments, modification of personal habits, protection against trauma, control of infection, control of pollution, and prophylactic medication for the maintenance of positive health.
Patient’s regimen (aturavrttam) deals with the curative and palliative measures employed for the medical and emotional care of the patient. It includes definition of the disease, etiology, clinical picture, patho-physiology, prognosis and line of treatment consisting of drugs, diet and life style..
In patient's regimen
A condition of disease is caused by either internal (bodily) or external (environmental) factors. Diseases can have somatic or psychic cause factors. Ayurveda insists that more often than not every ailment will have a psychosomatic etiology. More importantly, the therapeutic approach is focused not exclusively at the ailment as such, but it is directed at the patient as a human being. Thus, the Ayurvedic approach to a patient and his cure is often termed as holistic.
The Ayurvedic therapy is either palliative (samanam) or purificatory (sodhanam). The palliative approach stresses on the use of medicaments. The famous Panchakarma therapies and the supportive Kerala special therapies belong to the purificatory approach. In both cases, proper control of food and behavioral habits is a necessary component for achieving perfect cure.
The human constitution and the condition of his ailment are ensconced in a three-factorial humoural (tridosha) frame-work which itself is a derivation from the five-factorial (panchabhautic) macrocosmic frame-work. Medicaments, the tools for dealing with a condition of ailment, are also perceived to belong to these two axiomatic frame-works.
Ayurveda is a monumental contribution of India to the world. As the name implies, Ayurveda (ayuh: life, veda: knowledge) is an organized body of knowledge of healthy living. Systematized knowledge is science, and it is an expression of human creativity. Since creativity has diverse expressions science is a multifaceted enterprise, which refers to different ways of knowing. So the term science need not be confined to the sense of the term used in modern western culture, where it is an institutionalized practice conditioned by a set of conventional rules.
This realization about the vast conceptual framework of science is mandatory for the appraisal of Ayurveda, which represents a well-codified human care system and speaks of the art and science of health and healing.
From where and when the stream of Ayurveda started flowing still remains unanswered. However, it has an uninterrupted history of more than 3000 years. The historians and scholars have their own arguments and reasons in fixing up different time frames. Anyway, one thing can be said for certain that there is no civilization in the world, which has not developed some system of medicine or the other. It was the periodic systematization of such medical knowledge and practice, which led to the development of medical science. The same is the story of Ayurveda with its own variations.
It could be seen that Ayurveda is rooted in the knowledge revealed by ancient seers whose insights and visions are compiled in the vedas. Vedas are the earliest forms of documented knowledge. The six systems of Indian philosophy - nyaya, vaiseshika, sankhya, yoga, mimamsa and vendanta acknowledged the authority of vedas. Of the four vedas, Atharvaveda contain more intimate reference to medical knowledge and practice. Ayurveda is therefore considered as an auxiliary limb (upaveda) of Atharvaveda. Similarly, the influence of classical Indian Philosophies, especially of sankhya and vaiseshika is apparent in ayurvedic literature. These philosophical moorings make Ayurveda more than a medical manual though it is radically health oriented.
Ayurveda does not go deep into philosophy after a certain stage and is more concerned with function and dysfunction of the human body, the orderly up keep of which is the prime requisite to fulfill the human aspirations and to achieve the ultimate goals of life. Ayurveda can thus be introduced as a system of medicine built on philosophical foundation that does not go on changing over time. Ayurveda, as any other biological discipline, is dynamic at operational level. Obviously the super structure of Ayurveda is flexible and flexible enough for appropriate extrapolation. This unique feature makes the art of healing down to earth practical in tune with the changing trends and needs of the human life.
In short, Ayurveda has a unique self-designed axiomatic framework as its foundation, which remarkably holds out a truly global vision. It assumes fundamental continuity between all elements of universe and as a natural extension of this ideology perceives man as an integral part of nature. Ayurveda underscores the fundamental commonalties observed in man and nature and attempts to explain the human life in its totality.
It starts by saying that purusha, the individual being, is a blend of soul, mind, sense organs and body. The structural and functional units of the human body are categorized and represented in Ayurveda in terms of bio physico chemical energies of the living body (doshas), tissues (dhatus) and metabolic end products (malas).
Health is defined as a state wherein the dynamic balance of doshas, dhatus and malas is maintained, the metabolism is at optimum level and soul, mind and sense organs assume sublime position. This definition fully agrees with the integral vision of health envisaged by WHO; the former has an additional dimension of sound spirituality.
The structural and functional units of human body are composed of five basic elements known as panchabhutas. Panchabhutas literally mean the five elements, which include the earth, the water, the fire, the wind and the space. Each one of them wields an influence on certain part of the human constitution. For example, every opening in the body, the ears and the voids and internal sounds of the body are all belonging to the element of space. The element of fire influences the human form and its glow, the eyes, the bodily heat, the digestive activity and also the feelings of anger and valour. Recognition of this identical elemental basis of human body and outside world has profound implications in the practice of medicine.
Diseases are the manifestations of perturbations in the equilibrium of body constituents including doshas. Perturbation involves the increase or decrease of body constituent as the case may be.
According to Ayurveda, medicine is that which being well administered becomes an equalizer of increased or diminished elements, that brings down the excessive one and augments the deficient one thus restoring the pre-morbid condition of the body. This concept leads to the realization that there is nothing in the world, which cannot be used as medicament
Ayurveda considers him as the best physician who knows the science of administration of drugs with due reference to clime, and who applies it only after examining each and every patient individually. To acquire this proficiency and competency, a comprehensive knowledge of human anatomy and physiology, disease process, medical and surgical treatment, psychiatry, preventive medicine, medical ethics, materia medica and pharmacology is indispensable. The content of Ayurveda embraces all the spheres separately, but emphasizing on a holistic vision.
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The ideal geographic location of Kerala and its salubrious climate has made external purification and rejuvenation therapies most effective for treatment of many psychosomatic disorders
The high humidity in Kerala helps to open up the body pores and the medicinal oils used in massaging get easily absorbed into the body there by increasing the effectiveness of the treatment
Sirodhara, Pizhichil, Navarakizhi, Thalapothichil, Pachakizhi and Podikizhi are some of the Kerala special ayurvedic procedures
The fundamentals of Ayurveda being practised and taught in Kerala are not different from those of the rest of the country, in their essence and philosophy. But in the present days, there indeed is a notable difference in certain aspects of Kerala tradition of Ayurveda. This difference pertains to the importance given to Vagbhata's Ashtangahridayam in preference to other classical texts by Kerala traditional physicians, the uninterrupted history of practising the classical panchakarma therapies in all their authentic fidelity, the innovative development of the reputed Kerala preparatory therapies and finally the wide variety of exclusive herbal based formulations overshadowing the use of metal and mineral based drugs.
The development of Ayurveda in Kerala is particularly noted for its origins in non-brahminical traditions even before the entry of classical Ayurveda in the early centuries of the Christian era. These two streams subsequently blended so well that it gave a unique strength to the health care tradition of Kerala. Selected few brahmin households, named generally as Ashtavaidyas, were bestowed with the responsibility of maintaining the Ayurvedic tradition by practising it as a health care service as well as by teaching its principles in the unique gurukula tradition. The traditional practitioners of Ayurveda considered Ashtangahridaya as a primary text. Several commentaries were written by experts here. More importantly, new texts were written in Kerala both in Malayalam and Sanskrit. Sahasrayogam, Chikilsamanjari, Vaidyamanorama are just a few examples. These and similar other Kerala texts still remain sources of very useful information on formulation, medicinal plants and therapies.
Another very important contribution by Kerala physicians is the continued practice and enrichment of the panchakarma therapy. Even when they became defunct in the rest of the country due to socio-political reasons, Kerala retained this therapeutic wealth in all its pristine essence. Texts were written here on its practical aspects. More importantly, the famous Kerala special therapies were evolved by the practitioners here. They are essentially preparatory in nature. Dhara, mukkippizhichil, navarakkizhi, etc are typical examples. As the practice of Ayurveda expanded in popular acceptance in the recent past, these treatment modalities have also become more prevalent.
There are several unique herbal formulations described in Kerala texts. Many of them have now received national level acclaim and they are included in the Ayurvedic Formulary of India. One important aspect of Kerala formulations is that the stress is more on herbal components rather than on metals or minerals. There is also the history of Ayurvedic physicians developing some areas of specialisations like paediatrics, ophthalmology, martial therapy, etc.
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