This is the full text of the author’s paper presented at the National Seminar of the Indian Council of Philosophical Research held in Bangalore in September 2016.
Ayurveda, like any other science, is not a finished product; it is an evolving medical tradition. Its evolution has been characterised, since inception, by two fundamental attributes – one, a natural alignment with the Vedic worldview of Sanatana-Dharma in matters relating to both health-promotion and illness-management; and two, an unmistakable emphasis upon rationality (yukti-vyapashraya) in both science-making and medical practice. These two attributes may together be taken as constituting the guiding philosophy of Ayurveda.
Ayurveda’s Natural Alignment with the Vedic Sanatana-Dharma
The cultural milieu in which Ayurveda originated and flourished has had a ubiquitous influence upon all its aspects. It reverentially acknowledges this influence by calling itself the upaveda of Atharvana-Veda. Classical liberalism that marks Vedic culture provided Ayurveda with the most fertile ground for the development and ripening of its scientific thought. Ayurveda's approach to its central concerns of health-promotion and illness-management is reflective of this philosophical influence.
Though health, for all practical purposes, has been seen as a state of psycho-somatic wellness, it is in its pinnacle recognised to be a spiritual phenomenon. This phenomenon, identical with the Vedic ideal of atma-jnana (self-discovery), is the irrevocable state of complete fulfilment and as such is reckoned to be the absolute state of health, distinguishable from its relative variant that Ayurveda generally concerns itself with.(1)
The practical bearing of this idealistic view is that it makes healthy living inextricable from righteous living (dharma). It should be noted here that Ayurveda’s conception of dharma, like that of Vedic culture, is not bound up with any rigid system of belief. That the best traditions of Indian thought have never adopted a dichotomous approach to science and religion, that Vedanta, for instance, has been seen as the science of religion, accounts for this universal character of dharma.(2) Vagbhata succinctly casts the idea by saying that dharma acquires its validity primarily by its being conducive to man’s abiding happiness.(3) It is this harmonious pursuit of dharma, artha and sukha that is pivotal to Ayurveda’s conception of right living.(4) That Rasayana and Vajeekarana tantras devoted respectively to ensure youthful ageing and sexual fulfilment exist as two full-fledged medical branches eloquently attests to the fact that classical Ayurveda advocated a zestful pursuit of life and its pleasures. But, this pursuit is to be tempered by an incremental understanding that “all world is pain” and that abiding happiness is to be found only in self-knowledge. Both Charaka and Vagbhata expressly state that this inward march towards self-discovery is the real key to mental wellness.(5)
Ayurveda’s approach towards illness-management is also reflective of its philosophical alliance with Vedic culture. An aggressive conquest of nature or a life-negating escape from it have never been cherished Vedic ideals. Transcending the limitations of nature, on the other hand, by self-enhancement is the ideal that the Vedas uphold. This self-enhancement, it is vital to note, is to be accomplished by a worshipful reliance upon the more abiding aspects of nature itself.(6) Culture is the fulfilment of nature and not its negation. This philosophical ripeness operating in the medical context produced the central doctrine of Ayurveda in illness-management:
बलाधिष्ठानमारोग्यमारोग्यार्थ: क्रियाक्रम:।। (अहृ.चि.१)
Illness is to be approached first by trying to support and induce the natural self-healing processes (bala) of the body. It is this orientation towards salutogenesis rather than pathogenesis that makes Ayurvedic treatment gentle and holistic.(7) Medicine is meant to assist and not substitute the body’s natural healing processes. The importance of this orientation in this age of medical aggression and iatrogenic ailments cannot be over emphasised.
The thrust upon salutogenesis ipso facto denounces the unipronged reductionist approach of ‘a pill for every ill’. It leads to a holism that shifts emphasis from medical treatment to patient benefit. Anything that can ensure patient benefit, from diet and literature to space and time, become medically employable.(8) That Ayurveda can realise this employability in a manner that is rational is one of the great triumphs of its tridosha theory and the related concept of dosha-prakriti.
Ayurveda’s approach to illness-management is characterised by another important feature – compassion towards all life. Ayurveda had its genesis, as it were, in compassion.(9) The science of healing attains meaning only when it functions as a compassionate art. Vagbhata glorified this ethical dimension in a memorable line: “A mind soaked in compassion is the best febrifuge.”
करुणार्द्रं मन:शुद्धं सर्वज्वरविनाशनम्।। (अहृ.चि.१)
Yukti-Vyapashraya – The Philosophy of Rational Medicine
The intellectual attitude of valuing human experience and rationality as the tools of acquiring trustworthy knowledge is called yukti-vyapashraya.(10) Charaka extols Medicine built and administered on this basis as being drishtaphala (evidential).(11) He further clarifies that the sole ccondition for an intervention to qualify as therapy is its proven ability to restore health, thus making his system strikingly non-ideological.(12)
The switch from the erstwhile daiva-vyapashraya (faith-based) to the rational yukti-vyapashraya (evidence-based) medical practice is one of the great, but ill-acknowledged landmarks in the scientific history of mankind. The obvious philosophical message of this landmark switch holds the key for Ayurveda’s revitalisation and progress.
Philosophical Imperatives for Ayurveda’s Progress
Classical Ayurveda employed the sankhya-yoga system mostly to rationalise its metaphysical view(13); the nyaya-vaisheshika was likewise employed to rationalise medical experience. Succinctly stated, the philosophical imperatives for Ayurveda’s progress are an enhancement of its sankhya with Vedanta, of its nyaya with mathematical reasoning and of its vaisheshika with physiology and chemistry.(14) (Vagbhata himself inaugurated this process when he chose not to even passingly refer to the sankhya cosmogony in his classic.) But, Ayurveda shall not be a passive appropriator of these sciences; it will enhance them as much because explanation of observations can scarcely be accomplished without augmenting science.(15) While retaining its cultural traits of compassion, gentleness and holism, Ayurveda will march towards acquiring greater scientific robustness.
Sadly, these obvious implications have not been adequately recognised. The science-killing idea of textual immortality, the view that ancient medical texts being divined(16) by sages are finished products requiring neither modification nor advancement, is a major cause of Ayurveda’s unimpressive progress after the Classical Era.(17) Illusion of knowledge, history proves, is the most tenacious form of ignorance. Vagbhata’s magnum opus too faced resistance from such an ignorant view about 1500 years ago. He was courageous and history has reassuringly crowned his scientific courage with victory. He clarified illuminatingly, through word and deed, the primacy of ‘science as a state of mind’ (shastra-sadbhava) over ‘science as a body of facts’ (shastra-matra).(18) It is best to end this essay with his immortal words that exemplify scientific straight-thinking - “Ayurveda does not derive its authority by the fact of its being divined by Brahma; its merit comes simply from the verifiable truths it contains”.
वाते पित्ते श्लेष्मशान्तौ च पथ्यं
तैलं सर्पिर्माक्षिकं च क्रमेण।
एतद् ब्रह्मा भाषतां ब्रह्मजो वा
का निर्मन्त्रे वक्तृभेदोक्तिशक्ति:।।
Notes and References
- विकारो धातुवैषम्यं साम्यं प्रकृतिरुच्यते। सुखसंज्ञकमारोग्यं विकारो दु:खमेव च।। (च.सू.९) संज्ञकग्रहणेन लौकिकसुखं न परमार्थत: सुखमिति दर्शयति, यतो वक्ष्यति “सर्वं कारणवद्दु:खं” इत्यादि। (चक्र:) चिकित्सा तु नैष्ठिकी या विनोपधाम्। (च.शा.१) निष्ठा अत्यन्तदु:खमोक्षो मोक्षरूप:। (चक्र:)
- Vedanta or the Science of Reality by K A Krishnaswamy Iyer
- सुखार्था: सर्वभूतानां मता: सर्वा: प्रवृत्तय:। सुखं च न विना धर्मात् तस्माद्धर्मपरो भवेत्।। (अहृ.सू.२)
- त्रिवर्गशून्यं नारम्भं भजेत्तं चाविरोधयन्। (अहृ.सू.२)
- सर्वं कारणवद्दु:खं। (च.शा.१) मानसो ज्ञानविज्ञानधैर्यस्मृतिसमाधिभि:। (च.सू.१) ज्ञानम् अध्यात्मज्ञानं, समाधि: आत्मनि मनसो नियमनम्। (चक्र:)
- महात्मानस्तु मां पार्थ दैवीं प्रकृतिमाश्रिता:। भजन्ति...।। (भगवद्गीता)
- प्रयोग: शमयेद्व्याधिमेकं योऽन्यमुदीरयेत्। नासौ विशुद्ध: शुद्धस्तु शमयेद्यो न कोपयेत्।। (अहृ.सू.१३)
- न चाहारसमं किंचित् भैषज्यमुपलभ्यते। (का.सं)
स्निग्धवृद्धद्विजातीनां कथा: शृण्वन् मन:प्रिया:। आशावान् व्याधिमोक्षाय क्षिप्रं व्रणमपोहति।। (अहृ.सू.२९)
कालो भेषजयोगकृत्। (अहृ.सू.१)
- भगवन्! शारीरमानसागन्तुव्याधिभिर्विविधवेदनाभिघातोपद्रुतान् सनाथानप्यनाथवद्विचेष्टमानान् विक्रोशतश्च मानवानभिसमीक्ष्य मनसि न: पीडा भवति। तेषां रोगोपशमनार्थमात्मनश्च प्राणयात्रार्थं प्रजाहितहेतोरायुर्वेदं श्रोतुमिच्छाम इहोपदिश्यमानम्। (सु.सू.१)
- द्विविधा हि परीक्षा ज्ञानवतां प्रत्यक्षमनुमानं च। (च.वि.४)
- दृष्टद्वारोपकारी युक्तिव्यपाश्रये, अदृष्टद्वारोपकारी दैवव्यपाश्रये। (चक्र: च.वि.८)
- तदेव युक्तं भैषज्यं यदारोग्याय कल्पते। (च.सू.१)
Note the striking difference of this stance from that of an ideological system like Homeopathy.
- The tridosha theory of Ayurveda seems to be modelled after the triguna theory of the Sankhya. Though pranayama, samadhi and ashta-siddhis of the yoga system have been alluded to in the Ayurvedic classics, there is no reference to the healing power of yogasanas.
- न मानेन विना युक्ति: द्रव्याणां जायते क्वचित्। (शा.पू.)
The value of the science contained in the systems cannot be great now when experimental methods of investigation have advanced so much. (M Hiriyanna in Outlines of Indian Philosophy p. 184)
- Towards Ayurvedic Biology – A decadal vision document by M S Valiathan
- “Intuition has played the basic role in the development of Ayurvedic concepts. The concepts of modern science, on the other hand, are based on experimental observations. It is difficult for the two different patterns of concepts based on intuition and experimentation respectively to become absolutely identical with each other”. (Pandit Shiv Sharma in Ayurvedic Medicine – Past and Present).The tridosha concept of Ayurveda, as has been noted earlier, seems to be modelled after the triguna concept of the Sankhya system. Speaking about the basis of the Sankhya concepts, M Hiriyanna contrastingly writes, “In fact, it is by a proper synthesis of the common and enduring features of the things of experience that the conception of Prakriti has been reached as the idea of gold, for instance, is reached by a comparison of golden things like bracelets and rings.”(Popular Essays in Indian Philosophy)
- A greater reason was of course the socio-political unrest that India faced during the last millennium.
- अज्ञातशास्त्रसद्भावान् शास्त्रमात्रपरायणान्। त्यजेद्दूराद् भिषक्पाशान् पाशान् वैवस्वतानिव।। (अहृ.उ.४०) अर्थरूपस्यायुर्वेदस्य नित्यत्वं, न शब्दरूपस्य। (चक्र: च.सू.४०)