The Sri Lankan Ayurvedic tradition

P.L.N. de Silva

Definition: Ayurveda means Ayu (life) and Veda (knowledge). Hence it means the Science of life. The main objective of Ayurveda according to Pandit Shiva Sharma is, "to maintain and promote physical, mental and spiritual health of the individual and the community".

The other objective is, "to prevent disease and to treat, and to cure it when it appears". Even though the primary purpose of Ayurveda is to serve mankind, there are Ayurvedic texts that deal with the treatment of elephants, horses, cows and other animals (Salihotra Samhita), and also Vruksha Ayurveda that deals with the art of preservation and healing of plants.

Even today in our villages there are unregistered physicians who treat cattle and dogs using herbal medicines learnt from their fore-fathers. They serve in addition to western-trained veterinary surgeons who are posted by government to the major towns.

Ayurveda recognizes a fourfold categorization of disease, as

a) Adventitious (eg. cuts, bites, stings, infections)

b) Physical (eg. endocrinological, nutritional, organic, functional)

c) Mental (e.g. greed, avarice, jealousy, fear, anger)

d) Natural (e.g. bondage of birth, death, old age, hunger, thirst, sleep)

Roughly speaking, adventitious diseases are treated surgically, physical diseases medically, mental disease psycho-analytically, and natural disease spiritually (Pandit Shiva Sharma). Mental disease and mental hygiene in Ayurveda go far beyond the scope of their meanings in other systems of medicine.

The development of the higher moral and cultural approach to life as described at length in Ayurveda as a specific preventive measure against a number of personal and mass evils, find exclusive mention only in Ayurveda.

According to Charaka, "When leaders take to injustice in dealing with their public, then their camp followers aggravate to make injustice eclipse justice and thus the land becomes godforsaken".

Hence Ayurveda is a system of medicine that concerns itself not only with disease but also with the general welfare of mankind. Dr. R.T.Troll amply demonstrates this difference in the basic attitudes in the following comment. "There are two methods of treatment.

One aims at curing the disease, the other at curing the patient. We profess to cure the disease, and we can do it, whatever happens to the patients." As Ayurveda follows a holistic approach and treats the patient by strengthening the immune system to cure disease, there are no significant side effects.

Ayurveda in Sri Lanka

The Indian system of medicine (Ayurveda) was a highly developed and universally accepted form of treatment when it was brought to Sri Lanka (SL) by Rev. Mahinda the son of King Asoka in the 3rd century B.C. At that time Sri Lanka too had a developed civilization.

Rev. Mahinda was able to learn the language of this country and produce commentaries to the Buddhist scriptures in the Sinhala language and that was a massive undertaking. Sri Lanka had also a well-developed system of medicine called, "Desiya Vaidya Chikithsava" (Traditional System of Medicine).

However, as Ayurveda was the system of medicine of the most powerful country in the world of that time, it absorbed the native system of medicine and this resulted in a complementary mixture of both systems.

However, even today there are time honoured and popular medicines used in Sri Lanka, which are not found in the Indian pharmacopoeia (e.g. Sitarama Vati, Jeevananda Vati, Desadun Kalka, Buddharaja Kalka, Navaratne Kalka, Siddhartha Oil and Seethodaka Oil etc.)

Mythical beginnings of the Sri Lankan system of medicine

Indian tradition says that the mythical king of Sri Lanka Ravana was a great physician and credits him with the authorship of five books on medicine. Arkaprakash, one of the five books in a later edition is available in Sanskrit even today. Strangely enough eastern musicologists mention Ravana as the creator of a stringed instrument. He was also the most powerful and feared king, in the world of his time.

Rarely do we get medical knowledge, musical talent and political power at the highest level in one single individual anywhere. Furthermore, in the war between an Indian prince and the son of Ravana, the Indian prince was seriously injured in the battlefield. Only a Sri Lankan physician could cure him.

At the request of the invading army with the approval of the king, the physician went to the battlefield and cured the Indian prince. This is the role of the Red Cross today, and the practice of helping an enemy in distress was started by a Sri Lankan physician (Dr. Reghuvir Prasad Trivedi in the Ceylon Daily News of Sept 15th, 1985).

All these incidents are from Indian records, and though the word mythical has been used in this section, millions of Indians even today believe them to be true incidents, because they are reported in their sacred book, Ramayana.

Hospitals in ancient India and Sri Lanka

The edicts of King Asoka records for the first time in history that he built hospitals for men and animals in the 3rd century B.C. The British Medical Journal accepted in 1928, "it is to Gautama and his followers that we owe apparently the hospital idea." There are inscriptions and literary evidence in support of the establishment of hospitals in the Anuradhapura and Polonnaruwa periods.

King Pandukabhaya built a hospital in the 4th century B.C. Specialized hospitals were also built by the Sinhala kings. King Buddhadasa (4th century A.D) built a hospital for cripples. King Dhatusena built one for them in the 5th century A.D. King Buddhadasa and King Uptissa in the 5th century A.D. built hospitals for the blind.

King Upatissa the 2nd established a maternity home. King Kassapa IV built a hospital in the 9th century A.D. to combat epidemic diseases. In the 4th century B.C., the Sri Lankan King, had built a hall for those recovering from illness.

In the 12th century A.D in consultation with the high priests, king Parakramabahu gave instructions on a slab inscription that the monks should rise at dawn, do walking exercises and should clean their teeth.

In an edict of Parakramabahu 2nd in the 13th century A.D. it is laid down, that anyone seeking admission to the Sangha should satisfy the elders that he was free of disease. This was perhaps the earliest record of a pre-recruitment medical test. In several ancient sites medicine troughs made of stone have been found. They were used for immersion therapy.

A pillar inscription of king Kassapa IV (10th century A.D) mentions immunities granted to a dispensary. No offender could be arrested within the precincts of the dispensary. Today, embassies have this privilege.

There are large forests with cultivation of trees used for the production of Ayurvedic drugs. King Agrabodhi 7, in the 8th century A.D., "Studied medicinal plants over the whole island to ascertain whether they were wholesome or harmful to the sick." This is the 1st record of a medical research project on a national scale.

Weights and measures in ayurveda

In view of the large variety of medicines used in Ayurveda there was the need amongst Ayurvedic practitioners, for an elaborate system of weights and measures. The practitioners resolved the problem of weighing very small quantities of the ingredients of a drug by utilizing seeds.

The mustard seeds, sesame seeds, grains of paddy and madatiya seeds were the seeds commonly used to weigh, small quantities of Ayurvedic medicines. The madatiya seeds are universally used by the Ayurvedic practitioners in Sri Lanka even today to weigh small quantities of raw materials.

At the ancient Mihintale hospital site, two blue glazed jars of Persian origin were found. They were used to store medicinal spirits. There were also beautifully designed boxes at that time for storing pills etc.

These beautifully carved boxes were made of ivory. They are similar in purpose to the physician's bag that is taken to private patients by allopathic doctors today.

The significance of ancient ayurvedic knowledge

There is no doubt that ancient Hindus had advanced skills in the sphere of surgery and pioneered many surgical procedures. Sushruta describes diverse surgical operations e.g. Cataract, hernia, lithotomy, caesarian section etc.

Additionally he describes 121 surgical instruments including lancets, sounds, forceps, catheters, rectal and vaginal specula etc. The ancient Hindus, says Garrison, performed almost every major operation, i.e. limbs were amputated, abdominal sections were performed, fractures were set and hemorrhoids and fistulas were removed.

Susrutha and Charaka mention the use of medicinal liquors to produce insensibility to pain. In the 10th Century, two surgeons did an operation on a king's head by using an anesthetic called Samohini.

Vaccination unknown to Europe before the 18th century was practised in India in the 6th century according to Will Durant. There is evidence that patients were given medicine in cups turned out of sandalwood.

Sushruta, describes the basic qualities that a nurse should have "A person is fit to nurse or to attend the bedside of a patient if that person is cool headed, pleasant in demeanor, does not speak ill of anybody, is strong and attentive to all requirements of the sick, and finally follows the instructions of the physician."

The above comments give a brief insight into the running of hospitals and the principles followed by the qualified staff of those hospitals and of course acceptance of the medical services by the community.

During the Portuguese and Dutch period, Ayurveda underwent a period of neglect. Evidence of some health activity is available in the Dutch period.

Ayurveda in the Portuguese period and thereafter.

Even after the British were selected to rule this country, Ayurveda did not progress as the British concentrated on allopathic system of treatment. However, people of the country used Ayurvedic physicians even though those physicians had no assistance from the state.

Anthropologists say that the village evolved as a unit, which provided its own needs. It maintained a carpenter, a barber and an Ayurvedic physician for its use. Sometimes these individuals served several villages.

The Ayurvedic practitioner was available when any family needed his services. An Ayurvedic practitioner in the village in addition to being a physician had also to be a producer of Ayurveda medicines. Generally speaking a physician produces about 25 bottles of medicinal spirits, 10 bottles of medicinal oils of each kind and of course tablets, pills and powders as required.

This is the situation even today in the rural areas. The forests are able to provide all raw materials an average practitioner needs. The Ayurveda doctors in the cities purchase their requirements from the major producers of Ayurvedic drugs.

The Sri Lanka Ayurveda Drugs Corporation sited at Nawinna was established in 1969, and it produces all the Ayurvedic Drugs required by the Government Ayurvedic Hospitals in the island. It is the biggest producer of Ayurvedic Drugs and is in a position to meet outside demands as well. It imports its raw materials from India, Middle East, Australia, etc.

The Indian authorities mention three of the greatest names in ancient Ayurveda, Sushruta Charaka and Vagbhata. King Buddhadasa of Sri Lanka, perhaps, was a senior contemporary, of Vagbhata produced a book in Sanskrit verse named Sarartha Sangrahaya, containing most of the Ayurvedic medical knowledge available at that time in Sri Lanka. 4th century A.D. Mahawamsa credits him with a number of fantastic operations on both animals and men.

Sri Lankan medicine taught by that king, had the advantage of Indian Ayurveda as well. Therefore, until about the 13th century A.D. Ayurveda flourished in Sri Lanka with Royal patronage. However, with the foreign invasions, Ayurveda as well as Buddhist scholarship underwent a period of decadence.

Fortunately, the monks during that period preserved the priceless books on Buddhism and Ayurveda.

The 20th century has seen remarkable progress in Ayurveda in Sri Lanka. The Ayurvedic practitioners in the rural areas continued to serve the people. As Medical knowledge was bequeathed from father to son, and as the Ayurvedic physician produced his own drugs, this system continued even without royal or state patronage.

Hence, there are practitioners with long experience who are able to help patients who have chronic diseases e.g. persistent backache, continuous stress problems, arthritis, kidney stones etc. Already 1000's of tourists to Sri Lanka have had access to these benefits of Ayurveda and are now leading healthy and painless lives.

Any information on Ayurveda and its practitioners can be obtained from the Director of BMARI, Nawinna, Sri Lanka. This modern institute employs a team of highly qualified Ayurvedic research scholars.

Herbal wines

Sri Lanka has a tradition of scientific wine manufacture that hails from pre-Christian times. For the Sri Lankans, these wines have been multipurpose in their usefulness.

The following Herbal Wines were produced by the Sri Lanka Ayurvedic Drug Corporation, [under the direction of the writer of this article. All the wines are sweet red wines]

Ashwagandha

Contents: Withania Sominifera, Iramusu, Red & White Sandalwood, Bees Honey etc. Indications: Aphrodisiac, Strengthens body, Improves Appetite, Used as a General Tonic, Improves Virility and Rejuvenates.

Dosage: One oz. before meals.

Dasamoola

Contents: 10 Medicinal Herbs, Pepper, Black Raisins, Bees Honey, Cloves etc. Indications: General Nerve Tonic Strengthens Body, Improves Appetite. Relieves aches & pains. Cures Lung Ailments.

Dosage: One oz. before meals. The most popular Herbal Wine in Sri Lanka.

Draksha

Contents: Ginger, Pepper, Tippili, Black Raisins etc. Indications: Improves Digestion, useful in Asthma, Cough and Lung Ailments.

Dosage: One oz. before meals.

Chandana

Contents: White Sandalwood, Red Sandalwood, Black Raisins etc. Indications: Improves Appetite, Cools the body, purifies the Urinary system Dosage: One oz. before meals.

Pippali

Contents: Pepper, Thippili, Cardamom, White Sandalwood etc.

Indications: Improves Appetite, effective in Indigestion, Used in Cough and all types of Lung Ailments.

Dosage: One oz. before meals.

Popular oils and Arishtas produced by the major producers of Ayurvedic drugs in Sri Lanka.

Ayurveda has never been considered as a business. It was, always reckoned as a service to mankind, by healing hands, directed by a penetrative intelligence but nurtured by a warm heart.

The writer Former Chairman, Sri Lanka Ayurvedic Drugs Corporation.