Future of Ayurveda

Lucia Tommasini Marriucci, Rome, Italy

 

Caraka (3.8.3) says :
‘A discerning person who wants to become a physician should start by selecting a text based on a consideration of his ability to cope with hard or easy tasks, the results he is after, the likely aftermath, the place and the time. After all, there are numerous physicians’ manuals in circulation in the world, so he should apply himself only to a text which is extremely famous, which is used by scholars, which covers
a lot of topics, and is respected by qualified people. It has to be for pupils of all three levels of ability, and it should not be flawed by repetitiousness. It should be derived from the tradition of the saints. The sequence of its text, commentary, and summary should be well organized. It should be solidly based, and have no corrupt or missing words. It should be full of significance, it’s ideas should follow in sequence and it should give importance to determining the truth about things. Its ideas should be coherent, and its topics should not be haphazard. It should communicate its meaning rapidly, and it should have both definitions and examples. This type of text is like a flawless sun: it dispels darkness and throws light on everything.’
It is impossible to imagine a more apposite observation for the present day. It is surprising how current Caraka’s thinking is, like the repetitiveness of human behaviour. Modern day life probably has many things in common with life in the past with just one major difference: the speed of communication. If previously errors were identified and maybe corrected automatically, an error made today spreads quickly and a long time must pass before it will be forgotten.
Ayurveda is an open philosophy which comprises a vast, well-structured knowledge of the ways and means for living a long life. Longevity refers to the possible duration of life and to this end Ayurveda, considered as an upaveda, describes the elements which represent a human being, his/her makeup, how he/she should live, his/her position in relation to nature.
I would like to draw your attention to the fact that, due to cultural and social lifestyles, in this day and age some aspects of Ayurveda risk being misinterpreted, even if they represent some of the fundamental and inalienable characteristics of this extensive, specialist body of knowledge.

Our most honourable teacher, Prof. P.H. Kulkarni ji, has taught us that Ayurveda has four key objectives : Dharma (virtuous, moral, fair living) Artha (fulfilment of the self through family, the material aspects connected to this fulfilment extend to work and material goods) Kama (emotional and sensual fulfilment) Moksha (liberation, abandonment, fulfilment of the self) These are the four Purushartha, the most important goals or principles for spiritual fulfilment that we can only achieve through maintaining balance and having respect for our bodies and minds. Talking about classical Ayurveda during a discussion, Cakrapanidatta once said: The recommendations of medicine are not intended to help someone achieve virtue (dharma). What are they for, then? They are aimed to achieve health. Without health we cannot fulfill the Purusharha. This summarises the dilemma proposed by Ayurveda and which is dramatically present today : What does staying healthy mean, why do we lose health and what do we have to do
to regain it.
In the modern age and beyond the borders of India, the information handed down by Caraka, Sushruta which makes up Ayurveda, have been placed by the WHO within the framework of traditional complementary medicine, which is not taught at university level in any European country. The World Heath Organization has a road map for the next 10 years (2014-2013) regarding the integration, academic teaching and supervision of these approaches in order to integrate these forms of medicine with the national health system. What does Traditional Medicine and Complementary Medicine mean for the WHO?
It is important to understand what the words mean.

By ‘traditional’ the WHO means all those bodies of knowledge, theories and local experiences used to maintain health, to prevent and treat physical and mental illnesses. The term ‘complementary’ indicates a series of health care practices which do not form part of the culture of conventional medicine in that specific country and which are therefore not integrated into the local health system of the country. These practices can therefore be defined traditional in relation to the country of origin and complementary when integrated in the national health system Ayurveda and Chinese medicine belong to traditional medicines and are sometimes also called complementary when they are used outside the context of their country of origin (traditional). The effort required to significantly raise awareness of traditional medicine is not always supported by individual countries either in Europe or the rest of the world. The WHO is aware of the difficulties involved in the delicate work of cultural integration and has come up with a strategy :
1) Building the knowledge base and formulating national policies;
2) Strengthening safety, quality and effectiveness through regulation;
3) Promoting universal health coverage by integrating T&CM services and self healthcare into national health systems.

The strategy is very clear but its application depends on the willingness of each country. All countries in Europe have accepted Ayurveda as a traditional medicine and it is rarely considered as complementary. It has been culturally accepted and not  integrated as complementary in the national health system. There are no university courses anywhere in Europe which teach Ayurveda or Indian medical science in spite of the fact that some universities offer short taught masters on Ayurvedic concepts. The Third University of Rome has set up a taught masters on the subject held by Dr Daniela Giannandrea, student of Prof Kulkarni. However it is obvious that a possible integration of the various systems of medicine, including Ayurveda, will take a long time and require a different evaluation of what is currently called science and experimentation. The courses set up by some groundbreaking universities in Europe are aimed at the field of nursing and in some cases of nutrition.

At naturopathy institutes in Europe, Ayurveda is taught as part of naturopathy studies and therefore as part of naturopathy concepts. Ayurveda is not studied in any European university for an academic qualification. In Italy, Ayurveda is recognised by the Federation of the Order of Physicians but not by the national academic system therefore any qualification obtained by a doctor, if it is in line with the Benchmark of the WHO, will only be considered as part of one’s personal store of knowledge. The WHO has also drawn up a programme for non-medical ayurvedic operators. This programme has been specifically prepared for nursing staff, for panchakarma therapists and for dietologists. It involves approximately 1400 hours of study and practice. Naturopathy, a sector which is recognised in Italy under legislative decree number 4/2013, has already been regulated for many years in Great Britain, Germany and France, and also includes the study of Ayurveda in the curriculum, within the context
of knowledge of traditional medicines. A new phenomenon known as Ayurveda Marishi has arrived in Italy and other countries all over the world and has attracted followers and doctors who make use
of ayurvedic concepts called ‘maharishi’ in curing illness. The focus is always on the illness, rarely on the person who is ill and the objective and subjective significance of the illness. Even if only in a private capacity, the teaching given to doctors and that proposed by official European bodies makes reference to the Benchmark for training in Ayurveda drawn up by the WHO. This uniform approach allows appropriate communication between medical and non-medical practitioners. While this uniform profile is applied in the training of the medical profession, this is not the case in the non-medical sector.
There are often discrepancies in the teaching approach. Often too much attention is given to the energy principles of Ayurveda, Vata, Pitta e Kapha, neglecting the significance of the energy principle and its action, as amply demonstrated today by quantum physics. Thr focus is always on the illness and rarely on the person who is ill. No importance is given to the objective and subjective significance of illness.
The panorama is extremely confused, with the risk of making the vedic message of Ayurveda unclear. The complexity of Ayurveda is easily hidden by its apparent simplicity.

It is the science of becoming and this concept is nullified by the treatment of symptoms whether this is based on bacteria or dosha. Traditionally Ayurveda has welcomed theories and practices as long as they fit in with Purushartha and the triad Avyakta, Mahat, Ahamkara. Alongside the officialdom of the WHO which tries to protect the integrity of traditional medicines, I believe that it is necessary for the  dissemination of this teaching to take account of the knowledge of the individual, a knowledge of the dual nature of matter (as proposed by quantum physics), of being and becoming. There must be respect for the complex message behind maintaining and regaining health, as pointed out by Caraka. We must learn to speak to Vata, to Pitta,to Kapha. We must learn to speak to the five bhuta, the three mala, the seven dhatu. We must lead the body to recognise its divine essence. We cannot all be philosophers or saints but we should all study to understand the meaning of life. We cannot only draw health treatments from Ayurveda. Caraka himself hopes that herbs which grow in the area where the sick person lives will be studied, and believes that the curative power of a treatment must be in harmony with the person who
comes from that area. Nowadays industry produces medicines which are exported all over the world, eliminating key ingredients from the formulae to make it possible to sell or export them in accord with local health laws. Maitreia says that treating with medicines is of little use because it has been seen that people who take medicines die, and others who do not, live. For this reason he holds that there is no point in treating illness with medicine. Atreya’s response is more moderate: he says that whatever the outcome of the illness, medicine helps even if it does not heal.

Sometimes we talk about the allopathisation of Ayurveda when we want to correct a symptom by using medicine. This is the current trend but we are still in time to change it. The situation in Italy today is not very different from other European countries and needs to be regulated. There are strong cultural, social and economic interests and these create conflicts and discrepancies with the founding principles of Ayurveda.

In order to protect and pass on the vast body of Ayurvedic knowledge, a programme should be created which is supported by Indian Academic Authorities. This programme should indicate how an ancient text should be studied from a modern perspective. We are losing contact with our identity, with the triad which we represent, body mind and spirit and we are focusing on the part of the body, or rather with the cry of alarm sent out by that part: the illness and the symptoms connected with it. Every body is different from every other body, every individual has their own constitution, Sharir and Manas Prakruti, which is unique and unrepeatable. Studying Prakruti we necessarily come into contact with the key principles of Ayurveda and their form and expression which are at the same time both concrete and dynamic.
Ayurveda was taught by Brahma, and as they have been handed down to us, ayurvedic principles existed long before the birth of man. Our main duty today is to know man and help him to return to his origins.
Many centuries ago, because of mankind’s physical and mental suffering, Baradvaja went to ask Brahma for the means to cure humanity.
Today I ask the Indian Authorities who practise and live Ayurveda to indicate clearly the path we should follow in order to know and practice Ayurveda, spiritually as well as physically. There should be a programme created by the Indian Authorities which safeguards tradition by indicating the subjects to be studied, the training and the specialisations to be applied in various European countries. This is not a question of influencing the idea of national culture, it must be achieved through an understanding which facilitates the flow of ideas and information and preserves the value of knowledge. It should be an honour for the various schools to align themselves with those principles which favour communication which respects tradition. Ayurveda has stayed alive because it asks the individual to face up to his responsibilities as determined by matter, mind and spirit.

The survival of Ayurveda does not depend on medicines but on an understanding of what we are, and, through the word, the highest expression of energy, helping the individual to rediscover the means for applying Purusharta.