Dominik Wujastyk: A medicine that has stood the test of time

From a talk given at Asia House by the Associate Curator for South Asian Collections at the Wellcome Library in London

The classical medicine of India, ayurveda in Sanskrit, is highly systematic. Today, ayurveda is beginning to take a place in the West alongside other complementary and alternative therapies. This is happening fast, and as it does so, ayurveda is changing, and to some extent being dumbed down. Thus, what we can easily find out about it today is often only its teaching that the body's wellbeing is a function of three humours, wind, bile and phlegm. There is a great deal more to ayurveda than this, and I would like to convey, if I can, a sense of the complexity and subtlety of this medical system in its original setting.

Ayurvedic medicine is old, with roots going back to the time of the Buddha, who – according to the latest scholarship – probably died in about 400 BC. From its beginnings at this time, ayurvedic theory and practice was gradually developed and formalised until, about 2,000 years ago, several huge medical encyclopedias were compiled in Sanskrit, the precise and beautiful classical language of India. Three of these have survived up to the present; several other major works have been lost forever. But the works that survived are substantial, and cover a wide range of topics, from diagnosis through therapy, herbal medicine, and even refined surgery. In subsequent centuries, ayurvedic literature and practice continued to evolve, with thousands of textbooks, monographs, dictionaries, and other works being written, right up to the 19th century. New ayurvedic works in Sanskrit are occasionally composed even now, though they are virtuoso gestures to a glorious tradition rather than organic products of a living system of medicine.

In addition to the extensive formal herbal knowledge available in the ayurvedic tradition, therapies such as oil massage, evacuations, cleansing, and exercise are all discussed in detail. Great attention is paid to the interaction between the personal constitution of the patient, the time, and the diet. The patient's regimen must change with the time of the year, and the food eaten and the exercise taken must be in sympathy with it. Thus, hot foods are prescribed for winter, and cooling foods for summer. Ayurveda is not homeopathic: treatment is a matter of balancing out opposing forces in the body, and restoring equilibrium.

These ideas are not, however, just vague well-meaning suggestions. Traditionally, it took 12 years to train an ayurvedic physician. In this time, the physician would become extremely proficient in herbal lore, but would also learn about the six flavours that are present in every food, and how these flavours can inflame or pacify the humours. The student would learn about the 20 physical qualities of every medicinal substance, and about its two potencies, and the changes that would take place in the effect of a medicine as it underwent digestion.

It is only in the last few decades that the traditional medicine of India itself has begun to find a wide and receptive audience outside India, especially in the United States, Britain, Italy, and Germany. But only a fraction of the medical wisdom of ayurveda is represented as it comes into our shops in London and Manhattan.

In both India and Sri Lanka today, ayurveda is officially supported at the government level. It forms a respected component of national healthcare provision, although the proportion of the health budget spent on ayurveda is small compared with that spent on biomedicine. There are government colleges, clinics, hospitals, and accredited programs of professional training, qualification and licensing.

Outside South Asia, ayurveda is having to find its place in a different marketplace, that of complementary and alternative medicine. As this happens, it is becoming imperative that practitioners and medical suppliers organise into professional associations in order to provide the accreditation and validation necessary to participate in the modern medical marketplace.