Ayurveda - The Science of Life
What is Ayurvedic Medicine?
Ayurvedic medicine (also called Ayurveda) is one
of the world's oldest medical systems. It originated in India and
has evolved there over thousands of years. In the United States,
Ayurveda is considered complementary and alternative medicine
(CAM)--more specifically, a CAM whole medical system.(1) Many
therapies used in Ayurveda are also used on their own as CAM--for
example, herbs, massage, and yoga. This will introduce
you to Ayurveda's major ideas and practices and provide sources for
more information on these and other CAM therapies.
CAM is a group of diverse medical and health care systems,
practices, and products that are not presently considered to be part
of conventional medicine. Complementary medicine is used together
with conventional medicine, and alternative medicine is practiced in
place of conventional medicine. Conventional medicine is medicine as
practiced by holders of M.D. (medical doctor) or D.O. (doctor of
osteopathy) degrees and by their allied health professionals, such
as physical therapists, psychologists, and registered nurses. Some
health care providers practice both CAM and conventional medicine.
|The aim of Ayurveda is to integrate and
balance the body, mind, and spirit. This is believed to help
prevent illness and promote wellness.|
|In Ayurvedic philosophy, people, their
health, and the universe are all thought to be related. It is
believed that health problems can result when these
relationships are out of balance.|
|In Ayurveda, herbs, metals, massage, and
other products and techniques are used with the intent of
cleansing the body and restoring balance. Some of these products
may be harmful when used on their own or when used with
|Before you seek care from an Ayurvedic
practitioner, ask about the practitioner's training and
|Tell your health care providers about any
complementary and alternative practices you use. Give them a
full picture of what you do to manage your health. This will
help ensure coordinated and safe care.|
What is Ayurvedic medicine?
Ayurvedic medicine is also called Ayurveda. It is a system of
medicine that originated in India several thousand years ago. The
term Ayurveda combines two Sanskrit words--ayur, which means life,
and veda, which means science or knowledge. Ayurveda means "the
science of life."
In the United States, Ayurveda is considered a type of CAM and a
whole medical system. As with other such systems, it is based on
theories of health and illness and on ways to prevent, manage, or
treat health problems. Ayurveda aims to integrate and balance the
body, mind, and spirit (thus, some view it as "holistic"). This
balance is believed to lead to contentment and health, and to help
prevent illness. However, Ayurveda also proposes treatments for
specific health problems, whether they are physical or mental. A
chief aim of Ayurvedic practices is to cleanse the body of
substances that can cause disease, and this is believed to help
reestablish harmony and balance.
What is the history of Ayurvedic medicine?
Ayurveda is based on ideas from Hinduism, one of the world's oldest
and largest religions. Some Ayurvedic ideas also evolved from
ancient Persian thoughts about health and healing.
Many Ayurvedic practices were handed down by word of mouth and were
used before there were written records. Two ancient books, written
in Sanskrit on palm leaves more than 2,000 years ago, are thought to
be the first texts on Ayurveda--Caraka Samhita and Susruta Samhita.
They cover many topics, including:
|Pathology (the causes of illness)|
|Surgery (this is no longer part of standard Ayurvedic practice)|
|How to care for children|
|Advice for practitioners, including medical ethics|
Ayurveda has long been the main system of health care in India,
although conventional (Western) medicine is becoming more widespread
there, especially in urban areas. About 70 percent of India's
population lives in rural areas; about two-thirds of rural people
still use Ayurveda and medicinal plants to meet their primary health
care needs. In addition, most major cities have an Ayurvedic college
and hospital. Ayurveda and variations of it have also been practiced
for centuries in Pakistan, Nepal, Bangladesh, Sri Lanka, and Tibet.
The professional practice of Ayurveda in the United States began to
grow and became more visible in the late 20th century.
How common is the use of Ayurveda in the United States?
The first national data to answer this question are from a survey
released in May 2004 by the National Center for Health Statistics
and the National Center for Complementary and Alternative Medicine (NCCAM).
More than 31,000 adult Americans were surveyed about their use of
CAM, including specific CAM therapies such as Ayurveda. Among the
respondents, four-tenths of 1 percent had ever used Ayurveda, and
one-tenth of 1 percent had used it in the past 12 months. When these
percentages are adjusted to nationally representative numbers, about
751,000 people in the United States had ever used Ayurveda, and
154,000 people had used it within the past 12 months.
What major beliefs underlie Ayurveda?
Here is a summary of major beliefs in Ayurveda that pertain to
health and disease.
Ideas about the relationships among people, their health, and the
universe form the basis for how Ayurvedic practitioners think about
problems that affect health. Ayurveda holds that:
|All things in the universe (both living and
nonliving) are joined together.|
|Every human being contains elements that can
be found in the universe.|
|All people are born in a state of balance
within themselves and in relation to the universe.|
|This state of balance is disrupted by the
processes of life. Disruptions can be physical, emotional,
spiritual, or a combination. Imbalances weaken the body and make
the person susceptible to disease.|
|Health will be good if one's interaction with
the immediate environment is effective and wholesome.
|Disease arises when a person is out of harmony
with the universe.|
Constitution and Health
Ayurveda also has some basic beliefs about the body's constitution.
"Constitution" refers to a person's general health, how likely he is
to become out of balance, and his ability to resist and recover from
disease or other health problems. An overview of these beliefs
|The constitution is called the prakriti. The prakriti is thought to
be a unique combination of physical and psychological
characteristics and the way the body functions. It is influenced by
such factors as digestion and how the body deals with waste
products. The prakriti is believed to be unchanged over a person's
|Three qualities called doshas form important characteristics of the
constitution and control the activities of the body. Practitioners
of Ayurveda call the doshas by their original Sanskrit names: vata,
pitta, and kapha. It is also believed that:|
|Each dosha is made up of one or two of the five basic elements:
space, air, fire, water, and earth.|
|Each dosha has a particular relationship to body functions and can
be upset for different reasons.A person has her own balance of the three doshas, although one dosha
usually is prominent. Doshas are constantly being formed and
reformed by food, activity, and bodily processes.|
|Each dosha is associated with a certain body type, a certain
personality type, and a greater chance of certain types of health
|An imbalance in a dosha will produce symptoms that are related to
that dosha and are different from symptoms of an imbalance in
another dosha. Imbalances may be caused by an unhealthy lifestyle or
diet; too much or too little mental and physical exertion; or not
being properly protected from the weather, chemicals, or germs.|
In summary, it is believed that a person's chances of developing
certain types of diseases are related to the way doshas are
balanced, the state of the physical body, and mental or lifestyle
What is each dosha like?
Here are some important beliefs about the three doshas:
How does an Ayurvedic practitioner decide on a person's dosha
|The vata dosha is thought to be a combination of the elements space
and air. It is considered the most powerful dosha because it
controls very basic body processes such as cell division, the heart,
breathing, and the mind. Vata can be thrown out of balance by, for
example, staying up late at night, eating dry fruit, or eating
before the previous meal is digested. People with vata as their main
dosha are thought to be especially susceptible to skin,
neurological, and mental diseases.|
|The pitta dosha represents the elements fire and water. Pitta is
said to control hormones and the digestive system. When pitta is out
of balance, a person may experience negative emotions (such as
hostility and jealousy) and have physical symptoms (such as
heartburn within 2 or 3 hours of eating). Pitta is upset by, for
example, eating spicy or sour food; being angry, tired, or fearful;
or spending too much time in the sun. People with a predominantly
pitta constitution are thought to be susceptible to heart disease
|The kapha dosha combines the elements water and earth. Kapha is
thought to help keep up strength and immunity and to control growth.
An imbalance in the kapha dosha may cause nausea immediately after
eating. Kapha is aggravated by, for example, sleeping during the
daytime, eating too many sweet foods, eating after one is full, and
eating and drinking foods and beverages with too much salt and water
(especially in the springtime). Those with a predominant kapha dosha
are thought to be vulnerable to diabetes, gallbladder problems,
stomach ulcers, and respiratory illnesses such as asthma.|
Practitioners seek to determine the primary dosha and the balance of
doshas through questions that allow them to become very familiar
with the patient. Not all questions have to do with particular
symptoms. The practitioner will:
|Ask about diet, behavior, lifestyle practices, and the reasons for
the most recent illness and symptoms the patient had|
|Carefully observe such physical characteristics as teeth, skin,
eyes, and weight|
|Take a person's pulse, because each dosha is thought to make a
particular kind of pulse|
How else does an Ayurvedic practitioner work with the patient at
In addition to questioning, Ayurvedic practitioners use observation,
touch, therapies, and advising. During an examination, the
practitioner checks the patient's urine, stool, tongue, bodily
sounds, eyes, skin, and overall appearance. He will also consider
the person's digestion, diet, personal habits, and resilience
(ability to recover quickly from illness or setbacks). As part of
the effort to find out what is wrong, the practitioner may prescribe
some type of treatment. The treatment is generally intended to
restore the balance of one particular dosha. If the patient seems to
improve as a result, the practitioner will provide additional
treatments intended to help balance that dosha.
How does an Ayurvedic practitioner treat health problems?
The practitioner will develop a treatment plan and may work with
people who know the patient well and can help. This helps the
patient feel emotionally supported and comforted, which is
Practitioners expect patients to be active participants in their
treatment, because many Ayurvedic treatments require changes in
diet, lifestyle, and habits. In general, treatments use several
approaches, often more than one at a time. The goals of treatment
|Eliminate impurities. A process called panchakarma is intended to be
cleansing; it focuses on the digestive tract and the respiratory
system. For the digestive tract, cleansing may be done through
enemas, fasting, or special diets. Some patients receive medicated
oils through a nasal spray or inhaler. This part of treatment is
believed to eliminate worms or other agents thought to cause
|Reduce symptoms. The practitioner may suggest various options,
including yoga exercises, stretching, breathing exercises,
meditation, and lying in the sun. The patient may take herbs
(usually several), often with honey, with the intent to improve
digestion, reduce fever, and treat diarrhea. Sometimes foods such as
lentil beans or special diets are also prescribed. Very small
amounts of metal and mineral preparations also may be given, such as
gold or iron. Careful control of these materials is intended to
protect the patient from harm.|
|Reduce worry and increase harmony in the patient's life. The patient
may be advised to seek nurturing and peacefulness through yoga,
meditation, exercise, or other techniques.|
|Help eliminate both physical and psychological problems. Vital
points therapy and/or massage may be used to reduce pain, lessen
fatigue, or improve circulation. Ayurveda proposes that there are
107 "vital points" in the body where life energy is stored, and that
these points may be massaged to improve health. Other types of
Ayurvedic massage use medicinal oils.|
How are plant products used in Ayurvedic treatment?
In Ayurveda, the distinction between food and medicine is not as
clear as in Western medicine. Food and diet are important components
of Ayurvedic practice, and so there is a heavy reliance on
treatments based on herbs and plants, oils (such as sesame oil),
common spices (such as turmeric), and other naturally occurring
Currently, some 5,000 products are included in the "pharmacy" of
Ayurvedic treatments. In recent years, the Indian government has
collected and published safety information on a small number of
them. Historically, plant compounds have been grouped into
categories according to their effects. For example, some compounds
are thought to heal, promote vitality, or relieve pain. The
compounds are described in many texts prepared through national
medical agencies in India.
Below are a few examples of how some botanicals (plants and their
products) have been or are currently used in treatment. In some
cases, these may be mixed with metals.
|The spice turmeric has been used for various diseases and
conditions, including rheumatoid arthritis, Alzheimer's disease, and
|A mixture (Arogyawardhini) of sulfur, iron, powdered dried fruits,
tree root, and other substances has been used to treat problems of
|An extract from the resin of a tropical shrub (Commiphora mukul, or
guggul) has been used for a variety of illnesses. In recent years,
there has been research interest in its use to possibly lower
In the United States, how are Ayurvedic practitioners trained
Practitioners of Ayurveda in the United States have various types of
training. Some are trained in the Western medical tradition (such as
medical or nursing school) and then study Ayurveda. Others may have
training in naturopathic medicine, a whole medical system, either
before or after their Ayurvedic training. Many study in India, where
there are more than 150 undergraduate and more than 30 postgraduate
colleges for Ayurveda. This training can take up to 5 years.
Students who receive all of their Ayurvedic training in India can
earn either a bachelor's or doctoral degree. After graduation, they
may go to the United States or other countries to practice. Some
practitioners are trained in a particular aspect of Ayurvedic
practice--for example, massage or meditation--but not in others,
such as preparing botanical treatments.
The United States has no national standard for certifying or
training Ayurvedic practitioners, although a few states have
approved Ayurvedic schools. Some Ayurvedic professional
organizations are collaborating to develop licensing requirements.
Consumers interested in Ayurveda should be aware that not every
practitioner offering services or treatments called "Ayurvedic" has
been trained in an Ayurvedic medical school. Services offered at
spas and salons, for example, often fall into this category. If you
are seeking Ayurvedic medical treatment, it is important to ask
about the practitioner's training and experience (see the NCCAM fact
sheet "Selecting a CAM Practitioner").
Does Ayurveda work?
Ayurveda includes many types of therapies and is used for many
health issues. A summary of the scientific evidence is beyond the
scope of this article. You can consult the PubMed database on
the Internet or contact the NCCAM Clearinghouse for any research
results available on a disease or condition. However, very few
rigorous, controlled scientific studies have been carried out on
Ayurvedic practices. In India, the government began systematic
research in 1969, and the work continues
Are there concerns about Ayurvedic medicine?
Health officials in India and other countries have expressed
concerns about certain Ayurvedic practices, especially those
involving herbs, metals, minerals, or other materials. Here are some
of those concerns:
Ayurvedic medications have the potential to be toxic. Many materials
used in them have not been thoroughly studied in either Western or
Indian research. In the United States,
|Ayurvedic medications are regulated as
dietary supplements (a category of foods; see box below). As
such, they are not required to meet the rigorous standards for
conventional medicines. An American study published in 2004
found that of 70 Ayurvedic remedies purchased over-the-counter
(all had been manufactured in South Asia), 14 (one-fifth)
contained lead, mercury, and/or arsenic at levels that could be
harmful. Also in 2004, the Centers for Disease Control and
Prevention received 12 reports of lead poisoning linked to the
use of Ayurvedic medications.|
|Most Ayurvedic medications consist of
combinations of herbs and other medicines, so it can be
challenging to know which ones are having an effect and why.|
|Whenever two or more medications are used,
there is the potential for them to interact with each other. As
a result, the effectiveness of at least one may increase or
decrease in the body. For example, it is known that guggul lipid
(an extract of guggul) may increase the activity of aspirin,
which could lead to bleeding problems.|
|Most clinical trials of Ayurvedic approaches
have been small, had problems with research designs, lacked
appropriate control groups, or had other issues that affected
how meaningful the results were.|
Sources were drawn primarily from the peer-reviewed
medical and scientific literature in English indexed in the National
Library of Medicine's PubMed database.
Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and
alternative medicine use among adults: United States, 2002. CDC
Advance Data Report #343. 2004.
Bhatt AD. Clinical research on Ayurvedic therapies: myths,
realities, and challenges. Journal of the Associated Physicians of
Centers for Disease Control and Prevention. Lead poisoning
associated with Ayurvedic medications--five states, 2000-2003.
Morbidity and Mortality Weekly Report. 2004;53(26):582-584.
Centers for Disease Control and Prevention. Agency for Toxic
Substances and Disease Registry. Lead Toxicity: Physiologic Effects.
Agency for Toxic Substances and Disease Registry Web site. Accessed
on September 1, 2005.
Chopra A, Doiphode VV. Ayurvedic medicine--core-concept, therapeutic
principles, and current relevance. Medical Clinics of North America.
Courson WA. State licensure and Ayurvedic practice: planning for the
future, managing the present. Newsletter of the National Ayurvedic
Medical Association [online journal]. Autumn 2003. Accessed on
February 22, 2005.
Dodds JA. Know your CAM provider. Bulletin of the American Academy
of Orthopaedic Surgeons/American Association of Orthopaedic Surgeons
[online journal]. December 2002. Accessed on September 12, 2005.
Fugh-Berman A. Herb-drug interactions. Lancet.
Gogtay NJ, Bhatt HA, Dalvi SS, et al. The use and safety of
non-allopathic Indian medicines. Drug Safety. 2002;25(14):1005-1019.
Lodha R, Bagga A. Traditional Indian systems of medicine. Annals of
the Academy of Medicine, Singapore. 2000;29(1):37-41.
Mishra L, Singh BB, Dagenais S. Healthcare and disease management in
Ayurveda. Alternative Therapies in Health and Medicine.
Saper RB, Kales SN, Paquin J, et al. Heavy metal content of
Ayurvedic herbal medicine products. Journal of the American Medical
Shankar K, Liao LP. Traditional systems of medicine. Physical
Medicine and Rehabilitation Clinics of North America.
Subbarayappa BV. The roots of ancient medicine: an historical
outline. Journal of Bioscience. 2001;26(2):135-144.
Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the
treatment of hypercholesterolemia: a randomized controlled trial.
Journal of the American Medical Association. 2003;290(6):765-772.
Thompson Coon J, Ernst E. Herbs for serum cholesterol reduction: a
systematic review. Journal of Family Practice. 2003;52(6):468-478.
World Health Organization Regional Office for South-East Asia.
Health and Behaviours Facts and Figures--Conquering Depression.
World Health Organization Regional Office for South-East Asia Web
site. Accessed on February 16, 2005.
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