In Asia, especially in India, Ayurveda is also scientifically taught as a healing method and accepted by the population. In the western culture, however, Ayurveda is mostly used for wellness purposes, which in Asia only became an issue due to the growing tourism . Ayurveda is not a single therapeutic measure, but a holistic system and belongs to the field of traditional alternative medicine . Ayurveda is often incompatible with scientific findings. Proof of effectiveness according to the basic principles of evidence-based medicine is hardly or not available.
The oldest notions of medicine in India are from the Vedic period from around the middle of the 2nd millennium BC. BC, especially in the Atharvaveda , handed down. This developed from around 500 BC. The medical system of Ayurveda, which can be distinguished from it, whose eight treatises are no longer preserved as a complete text. A phase of medical Sanskrit literature, also called Ayurveda, begins with the Christian era and is first included in Samhitas , which are ascribed to doctors such as Charaka and Sushruta . The contents of Ayurvedic texts can be found in the works of Sushrutas, Charakas and later in Vagbhatas , who taught in the 7th century.
Literally translated, Ayurveda means wisdom or life science . The term comes from Sanskrit and is made up of the words Ayus (life) and Veda (knowledge). Ayurveda is a combination of empirical values and philosophy that focuses on the physical, mental, emotional and spiritual aspects that are important for human health and illness. Ayurveda therefore has a holistic approach .
Central elements of Ayurveda are:
- Ayurvedic massage and cleansing techniques
- spiritual yoga practice
- Herbal medicine
David Frawley , a contemporary American Ayurveda expert, writes: "The basic rule is: whatever we can do ourselves to strengthen our own health is better than what others do for us." Illness becomes "as the highest form of asceticism ”.
Three principles of life (doshas)
In the typology one speaks of three different life energies, the so-called doshas :
- Vata (wind, air and ether), the principle of movement
- Pitta (fire and water), the fire or metabolic principle
- Kapha (earth and water), the structural principle
Dosha (or Doscha) literally means "error (potential)". According to Ayurvedic belief, these occur in every organism, since together they enable all processes of the organism. In a healthy organism these “energies” should be in a harmonious balance, otherwise they could cause errors in the system. In the overall impression, there are one or two generally predominant doshas for each individual, less often all three are equally pronounced. It is important for the practitioner to know which doshas are predominant in a person because each type requires different medications and treatments.
The practitioner determines the current relationship between the doshas by means of eye diagnosis, questioning and Ayurvedic pulse diagnosis (Nadivigyan, described in the Sharagadhara Samhita). In India, the relationship between the Doshas is also derived from the patient's astrological horoscope (Prakriti analysis). In order to restore this right balance and to remove accumulated waste products, nutritional therapy, order therapy, herbal medicine and certain purification methods ( Panchakarma ) are used. These panchakarma include fasting , baths, enemas , therapeutic vomiting and bloodletting , as well as massages, yoga and breathing exercises, color and music therapy and the use of many Ayurvedic medicines.
According to the Ayurveda interpretation, life is a unity of body, senses, mind and soul. Humans are made up of the three doshas, the seven basic substances (Rasa, Rakta, Mansa, Meda, Asthi, Majja and Shukra) and the body's waste materials (feces, urine, sweat). The growth and decay of man and his constituents are related to the food from which basic substances, dhatus , and waste products, mala , arise. Ingestion, processing, absorption, assimilation and metabolism have effects on health and illness, which are significantly influenced by physiological and psychological mechanisms and by the element fire ( Agni ).
In Ayurveda everything in the universe is composed of the so-called nine substances (Dravyas): the five elements ("Pancamahabhutas"), plus the spirit "Manas", the soul "Atman", the space "Dik" and the time "Kala" . The five elements - water, earth, fire, air and ether - are represented in every substance in different proportions, so that every substance can be categorized by its proportions of these elements. As a result, all living beings are composed of these elements.
Health and illness depend on the existence of an equilibrium between the whole and its components. Internal and external influences can be responsible for the imbalance. Loss of balance can result from dieting, unwanted habits, failure to follow the rules of healthy living, and many other reasons.
The aim of Ayurvedic healing is to avoid serious illnesses by trying to understand the cause of the illness, to recognize the first, unspecific signs and to remove the ground for an outbreak. This is done primarily through the effort to find the "right" diet and lifestyle for the respective patient, as well as the goal of giving up unhealthy habits. There are also a number of treatments that are primarily intended to help the body maintain or regain the correct ratio of the three doshas. The various oil and powder massages and the Panchakarma , a cleansing program consisting of five parts ( Panch means “five” in Hindi , karma means “action, treatment”), are known.
Diagnosis and treatment
The diagnosis is carried out on the patient as a whole. These include B. a general physical examination, pulse and urine tests and an examination of the tongue and eyes, regardless of the part of the body in which the symptoms are present. This is not only used to make a diagnosis, but also to determine the individual constitution, i.e. the relationship of the doshas in the patient to one another. This information is used to determine the therapy displayed for this patient.
Treatment involves avoiding causal factors that are responsible for the imbalance of the doshas. Treatment usually consists of medicine, manual therapy, a special diet, and a prescribed daily routine. In Ayurveda, the individual diet is the main pillar of therapy. There are two reasons for this: only qualitatively and quantitatively high quality food can be metabolized by the body into qualitatively and quantitatively high quality tissue; Secondly, every substance added influences the physical organism through its own composition of elements, so the patient must ensure that the elements are supplied in the correct ratio.
General recommendations that apply to all people are:
- only eat when you are hungry
- eat again only after the last meal has been digested
- eat the main meal at noon when digestion is at its best
- never eat in a restless state of mind, not while standing, in a hurry
- do not eat completely full : "only two handfuls"
- Eat fresh food that is appropriate to your constitution, the season and the location
- Drink water (boiled, never cold) and herbal tea , but only when you are thirsty
- Consume all six Ayurvedic flavors (Rasa) in every meal: these are sweet, sour, salty, hot, bitter and tart (or astringent)
- do not suppress natural needs (i.e. bowel movements, micturition , winds, belching, yawning, crying etc.).
Metabolism and Tissue Structure (Dhatu)
The composition of food in terms of the elements has a direct influence on the organism: it is from it that all tissues of the body are formed and maintained. There are seven tissue groups Saptadhatu ("seven tissues"), which are graded in ascending order according to the duration of their renewal cycle and other criteria: Rasa (interstitial fluid, lymph), Rakta (the cellular part of the blood, tendons and veins), Mamsa (muscle tissue, Skin), Meda (fatty tissue in general), Asthi (bone tissue, of which the stabilizing part), Majja (bone marrow and nerve tissue), Shukra (reproductive tissue in the narrower sense, but also the ability of cell renewal in the whole organism).
The “eighth dhatu” ideally arises from the Dhatus Ojas , an immaterial subtle substance that also arises from positive experiences, according to the teaching. Ojas therefore strengthens the body's defenses and connects body and mind. A prerequisite for the formation of Ojas , however, is a good “digestive fire”, called Agni . This is influenced, among other things, by the quality of the food.
Agni interferences manifest themselves as flatulence , bloating, heartburn or cravings. During digestion, nutrients are separated into useful substances and waste, mala . A bad digestion not only produces insufficient quality tissue but also Ama ( "incompletely digested") that accumulates According to Ayurveda in the body, all metabolic processes may suffer, but also on the emotional level, by "undigested" events and problems Ama arise.
Three classes (gunas) of food
Food is basically divided into three classes (Gunas):
- Sattva Guna : Dairy products, grains, fruits and vegetables. They are sweet, juicy or oily and, according to Ayurveda, can extend the lifespan and optimize the lifestyle.
- Rajo-Guna : Bitter, sour, salty, spicy, hot or dry foods that include chilli, onion and garlic. According to the teaching, these heat up the body and mind and can cause aggression.
- Tamo-Guna : meat, fish and poultry. They draw a lot of energy from the body and can be the cause of pain and illness.
Meat and alcohol
A balanced diet in the sense of Ayurveda is called sattvik . Meat consumption should be done carefully. The consumption of meat is indicated for emaciated people and people with a Vata constitution. The claim that Ayurvedic nutrition is vegetarian is clearly refuted in the three great classics (Caraka, Vagbhata, Susruta). There is also no general rejection of alcohol: Wine in small quantities is considered the best medicine to drive away tiredness (Caraka-Samhita).
In addition, there are special recommendations for the individual Dosha types:
- According to Ayurveda, Vata types tend to have digestive disorders, constipation and underweight and should therefore - absolutely regularly - prefer cooked and nourishing food and consume warm drinks. Meals should also be warm and contain some fat. The recommended flavors are salty, sour, and sweet as they counteract Vata.
- According to Ayurveda, Pitta types have a strong “digestive fire” and therefore tend to be ravenous; You can eat cold and warm food, but you have to be careful not to eat too much at once and to avoid fried and fried foods. The flavors that reduce pitta are bitter, sweet, and tart.
- Kapha types tend to digest slowly and have a low turnover, which is why they tend to become overweight with insufficient exercise. Warm food and drinks, little meat, lots of vegetables with a bitter and tart taste and spicy things counteract these tendencies.
- In childhood, Kapha is the dominant Dosha due to growth. Since growth is of course desirable here, Kapha should not be slowed down, but only kept within limits: Children need sweet (carbohydrates, no sugar!), Salty, sour (cooked or fresh fruit, depending on the age and condition of the Agni ). It is also important to introduce children to the ability to perceive and assess their personal taste preferences, their feeling of hunger and especially how they are feeling.
The age of Ayurveda is unknown. Ayurveda has its origins in the Vedic high culture of ancient India. The oldest known records ( Agnivesha Tantra or Agnivesha Samhita ) are about 3000 years old. Early sources include Arthashastra (treatises on the art of governance), which contained many medical references , a collection of texts that was completed by 300 AD at the latest.
The Samhitas (hymns) of the Rig Veda mention the use of medicinal herbs . Within the mythological accounts of miraculous healings by the Ashvins , a pair of twin gods who, according to legend, made the blind see and lame, one passage can be interpreted as a reference to the use of prosthetic legs. Some people understand Rigveda 1,34,6 de sa as an early reference to the concept of the so-called three doshas.
The Atharvaveda , on the other hand, contains a large number of magic formulas (Bhaishagykni) to combat diseases with magical means, either by conjuring up the gods, amulets or certain medicinal plants. The cause of the disease is understood to be punishment by a god, attack by a demon or enchantment by an enemy.
In the oldest surviving medical work, the Charaka Samhita (see below), illnesses are primarily attributed to mistakes (doshas) or behavior against better judgment ( prajna paradha ) of people; however, the term Dosha was later reinterpreted by Ayurveda followers.
References to medical knowledge can be found as early as the Stone Age . In 2001, Professor Andrea Cucina, University of Missouri - Columbia , made the discovery that the ancient Indians of Mehrgarh (in what is now Pakistan) existed between 7000 and 6000 BC. Have had dental knowledge. Teeth were found with small holes (about 2.5 mm in diameter) drilled into them that were presumably filled with vegetable pastes or other substances.
Already in the 6th century BC The Indian doctors described the human anatomy (tendons, nerve plexus, muscles, etc.) very precisely and had a good understanding of human digestion and blood circulation. In Sri Lanka there was in 427 BC The first hospitals. The Buddhist king Ashoka had in the 3rd century BC In the second edict of the rocks, write that hospitals for humans and animals were built and that medicinal plants were imported and cultivated for this purpose. According to Butzenberger and Fedorova, classical Indian medicine has clear references to Buddhism.
Parallels to European antiquity
Plato had a theory similar to the Ayurvedic theory of Tridosha . The Timaeus mentions a disease that arises from pneuma ("air" or Vata) and the two bodily fluids chole ("gall" or pitta) and phlegm ("phlegm", "fire" or kapha). As the French Indologist Jean Filliozat wrote, this theory is possibly of Vedic origin, since these doshas and especially the relationship between bile and fire were already known in Vedic literature. Also, he says, there are several direct references in the Hippocratic collection that suggest that some Indian medicines and medical prescriptions were adopted in Greece .
Partial loss of teaching
Many aspects of Ayurveda have almost been lost with the demise of Vedic culture over the millennia. In the Middle Ages many foreign powers brought their own medicine with them to the Indian subcontinent, where Ayurveda was banned for almost 150 years; in Sri Lanka (then Ceylon ), however, this knowledge continued to be applied without any gaps. Even nowadays there are still differences between Ayurveda practiced in India and Sri Lanka, as the lack of knowledge in India was supplemented by individual ways of doing things, while in Sri Lanka the knowledge was continuously continued and taught.
Sri Lanka is the only country in the world that state offers Ayurveda as a complete health system. In India, too, Ayurveda still provides a small part of the supply, but the migration to evidence-based medicine began as early as the 1960s. It still exists in a mixture of herbal medicine and superstition.
The Charaka Samhita and the Sushruta Samhita together with the Vagbhata Samhita form the core of traditional Ayurvedic literature and are standard works in the training of Ayurvedic doctors ( vaidyas ). They are collections ( Samhita ) that contain materials from different epochs. These works are also called brihat trayi , which means the big three .
The works are named after the names of three of the most famous doctors from the Indus Valley (at that time still India, Bangladesh , Pakistan , parts of Afghanistan and Sri Lanka ) and are assigned to the classical period, which began around 500 BC. Lasted until AD 1000. For the sake of completeness, it should be mentioned that, in addition to the Big Three, there are also the Little Three , which, however, were written in a much later period (12th-16th centuries AD). These are: Madhava Nidan , Sharangdhara Samhita and Bhava Prakasha .
- Sushruta Samhita : This book probably dates from around 350 AD and goes back to the physician Sushruta , who probably worked in the early 6th century BC. Lived. Sushruta described many operations and 121 surgical instruments. Among the operations he has described are cataracts , fractures , stone incisions, caesarean sections , etc. Instruments he has described include: a. Probes , forceps , lancets and catheters . He also transferred skin from other parts of the body to a damaged ear and developed nasal plastic surgery . Sushruta Samhita was translated into Arabic before the end of the 8th century AD . It was translated into Latin by Hassler and into German by Ullers.
- Charaka Samhita : The author of this book was Charaka , who, according to a Chinese translation of the Tripitaka, probably lived in the 2nd century AD. It is said to be based on an even older book, the Agnivesha Samhita with 46,000 verses, which no longer exists. Charaka's works were translated into Arabic before the 8th century AD . The name Charakas also appears in many Latin translations of Arabic medicine books.
- Ashtanga Hridaya and Ashtanga Sangraha from Vagbhata (625 AD)
Other important works are:
- Sharangadhara Samhita of Sharangadhara: This book is said to have been written in the 15th century AD. It contains many pharmaceutical prescriptions and also deals with diagnosis using pulse measurement .
- Bhava Prakash: This book dates from the 16th century AD and contains 10,268 verses.
- Madhava Nidanam: This book is said to date from the 7th century AD.
Heavy metal poisoning
The chief physician of the nephrology department at the Asklepios Clinic Barmbek in Hamburg warns against taking Ayurvedic medication. This could lead to severe neurological damage and life-threatening poisoning with heavy metals. Heavy metals , especially lead , often contaminate drugs used in traditional Indian medicine; There are medical reports of poisoning from Ayurvedic drugs. Apparently, some manufacturers in India do not adequately control the preparations obtained using vegetable ashes for heavy metal contamination. In a case illustrated seven months were long incense pills from India against chronic polyarthritis taken and led to the image of a serious lead poisoning with digestive disorders, hemolytic anemia and paralysis with a lead content of the blood of 852 g / l; the upper limit is 100 µg / l. Random samples from the ARD magazine Plusminus revealed toxic concentrations of arsenic and mercury several times in 2006 and 2007 . In August 2015, it was reported that a 55-year-old woman was severely poisoned by mercury and lead from Ayurveda medication in Sri Lanka. In February 2018, a case became known in Upper Austria in which a woman poisoned herself and her environment by using a paste to be applied to the skin that contained over a third of pure mercury.
Lack of quality control
In India too, efforts are now being made to comply with internationally recognized quality standards, particularly with a view to the growing global market for indigenous medicines. In Central Europe, for example, there are already Indian products that comply with various national and international standards, such as hazard analysis and critical control points (HACCP), BDIH, ISO 9000/9001 and ISO / IEC 17025 . With regard to the control of heavy metal pollution, however, good manufacturing practice (GMP) is particularly decisive.
American researchers examined 193 Ayurveda products from the Internet. Almost 17% of these were rasa-shastra drugs, in which plants are combined with metals. The aim of the investigation was to determine the prevalence of preparations containing heavy metals (lead, mercury, arsenic), to find out differences between Indian and American products and to compare Rasa-shastra with non-Rasa-shastra medicine. In total, metals were found in 20% of all products, lead being the most common. There was no significant difference between Indian and American providers.
Almost all of the conspicuous items were sold via US websites and a total of three quarters of all manufacturers stated that they manufacture according to strict guidelines. As expected, the proportion of metal in Rasa-shastra substances was significantly higher (just under 41% vs. 17%). Particularly noticeable here - especially in Indian products - in addition to an average lead content of 11.5 µg / g, was the high mercury content of an average of 20,800 µg / g. The lead and mercury levels of some Rasa-shastra products were 100 to 10,000 times above the limit. It is claimed that the mercury is converted into a non-toxic but highly effective “silver medicine” (bhasma) through a complicated “distillation process”; This "conversion process" consists of heating the substance and then mixing it with oil, buttermilk or similar. Arsenic, lead and other toxic substances are also allegedly detoxified in this way.
These heavy metal-containing products are generally not available in Germany.
Training as a therapist
In India and Sri Lanka, Ayurveda doctors, as well as Western-trained doctors, must have studied for five and a half years in order to then pass a state examination in Ayurvedic healing. It is a separate, complete degree program (BAMS, the abbreviation for Bachelor of Ayurvedic Medicine and Surgery , Ayurvedacharya course) and is taught at many Indian and several Sri Lankan universities. It includes four and a half years of study and a year of practical experience in the hospital affiliated with the educational institution.
After this bachelor's degree , one has the right to practice in India as a Doctor of Ayurveda or Vaidya (German: traditional Ayurveda doctor; but also healer or scholar; the female form of Vaidya is Vaidye ) and, in addition to Ayurveda Preparations, including prescription drugs. After studying at BAMS, there is the opportunity to specialize in a subject of Ayurveda and thus to acquire the title of MD ( Doctor of Medicine ) after a further three years of study (Ayurvedavachaspati course) . This, in turn, is the prerequisite for the Ayurvidya Varidhi course, which lasts two years and aims at the Ph. D. ( Doctor of Philosophy ). In India several thousand medical professionals receive their Ayurveda approval every year.
Ayurveda education, its state recognition, training standards and curricula are regulated in India by the CCIM ( Central Council for Indian Medicine ).
Prospective students who do not have an Indian passport can apply for a scholarship for the BAMS course in India at the ICCR ( Indian Council for Cultural Relations ) through the Indian embassy in Germany.
In Germany, too, there are now some Ayurveda institutes which, according to their own statements, offer well-founded Ayurveda training according to Indian standards.
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