Ayurvedic Medicine: Introduction, Importance, Types and Myths

This introduction to Ayurvedic medicine will help you understand how it has evolved in due course of time, where the research in this field is heading towards, myths that are not in mood to go away from the science of Ayurveda etc. It is the excerpts from the discussion that I conducted with a group of commerce students, recently. 

Introduction to Ayurvedic medicine Video

Origin of Ayurveda

There is a mythological story regarding the origin of Ayurveda, which we shall discuss sometime.
The sages of ancient times during Vedic period were using single herbs. During time of Charaka and Sushruta, at about 2000 -1000 BC, slowly they began trying multiple herbal combinations in different modes (dosage forms). These dosage forms are – paste, powder, water decoction, juice extract etc.
Later they further developed herbal jams, syrups, tablets etc.

They were able to develop this science, with meditation, experience and practice. Read more – how ancient seers acquired Ayurveda knowledge

Ayurveda text books

With their knowledge and expertise, they wrote text books among which, Charaka Samhita, Sushruta Samhita and Ashtanga Hridayam are important. Down the timeline, many others also wrote different text books.

Types of Ayurvedic treatment

Panchakarma therapy –
This is the detoxification therapy to eliminate waste products and toxins from the body. It is the first line of treatment in majority of the cases.
Read more about Panchakarma

Oral Ayurvedic medicine – Used as second line of treatment or as follow up to panchakarma therapy.

Ayurvedic medicines

What is Ayurvedic medicine? 
Ayurvedic medicine is basically the product derived from herbal, animal and mineral origin which is targeted to treat disease/s based on traditional yet scientific principles of Ayurveda.  Ayurveda medicines are grouped into two categories.

2 Types of Ayurvedic medicines in the market –
1. Traditional Ayurvedic medicine
2. Proprietary Ayurvedic medicines.

Traditional Ayurvedic medicine

These are the products that are manufactured based on Ayurvedic textual reference.

Ayurveda, Indian traditional system of medicine,  is based on traditional scientific beliefs, that is recorded in ancient Ayurvedic text books like Charaka Samhita, Sushruta Samhita, Ashtanga Hrudaya etc. The products manufactured based on the formulas of these ancient text books are traditional Ayurvedic medicine.

Here, Ayurvedic Pharmacy takes up a medicine formula from an Ayurveda text book and manufactures the medicine as per the formula.
Example – Dasamoolarishtam, Chyawanaprasha, Trikatu Churna, Triphala etc.
It is a matter of wonder that the formulas that are explained thousands of year ago are still effective in the present times.

Traditional Ayurvedic medicines are in the form of –

• Herbal powders – choorna –  like Triphala choorna
• Simple juice extract – swarasa –  like Tulasi swarasa
• Simple paste form – kalka like neem paste
• Water decoction – kwatha / kashaya like Dashamoola kashaya
• Herbal oils, herbal ghee, tablets, Guggulu tablets,  etc
• Asava and Arishta – alcohol based preparations.

Proprietary Ayurvedic medicine

These are the products that are manufactured based on a company’s experience and experiments. Based on medical experiments and therapeutic properties of different herbs, a herbal combination is planned and formulated into a medicine. This medicine is subjected to experimental and clinical trial and a license is obtained for manufacturing. Such medicines are called proprietary Ayurvedic medicines.

Here, the manufacturer formulates his own combination of Ayurvedic herbs, blends it into his desired form, like syrup, herbal jam, tablet, capsule etc.
He tests the product in his laboratory for safety, conducts clinical trial to know efficacy, applies for a license and then manufactures and sells it.
Example:
Cervilon capsule – for neck pain,
Shatavari Kalpa granules – to improve breast milk production etc.

Proprietary Ayurvedic medicines are also available in ancient dosage forms like tablets. But some advanced dosage forms like capsules, soft gel capsules, syrups, herbal creams, ointments, oral mouthwash, etc are also popular.

How to consume bitter medicines?

Most of the Ayurvedic medicines are bitter or astringent. How to swallow them? 
Dr JV Hebbar
If you find Ayurvedic medicine unpalatable, here are a few tricks to follow – 
1. Water If you are prescribed an herbal powder, mix it with a little water, make it a small ball / tablet and swallow it. For example, Sudarshana Churna is mixed with water and consumed for the treatment of fever. 

2. Honey If you are prescribed a bitter herbal decoction (kashaya) or a powder, ask your doctor if you can mix honey to it. In Kapha dominant diseases such as obesity, cough, cold, high cholesterol etc., honey is a good co-drink. Based on your doctor’s advice, 
for kashaya – mix it with a teaspoon of honey and swallow it. 
for herbal powder – mix honey, turn the powder into a paste, swallow it with water. For example, Triphala churna with honey is often prescribed for obesity management. 
Read related: Co-drink for Ayurvedic medicines – Anupana

3. If you are prescribed with a bitter medicine and a sweet syrup, consume the bitter medicine first and soon after drink the syrup

4. If you are prescribed bitter medicine with a sweet liquid, ask your doctor if you can mix them and consume at once. You can do this with most of the medicines. If your doctor approves, then go ahead and mix and consume. Do not keep two medicines mixed in a bottle. Rather, mix the two medicines just before consuming. 
For example, herbal tea (kashaya) can be mixed with arishta, just before consumption. 

5. Continuing with the above rule, herbal powders can be kept mixed with kashaya or arishta for a few days. But check with your doctor before doing so. 
6. If you are given a bitter herbal tea (kashaya) and a spicy herbal powder, mixing that powder with herbal tea, just before taking, helps to mask the bitterness of the tea.
7. Mixing with food – Some Ayurvedic products can be mixed with food and consumed to mask the taste. For example, Ashta churna (Hingvashtaka), an herbal powder with asafoetida and other spices, used for treating bloating and weak digestion, is administered mixed with ghee along with the first bolus of food. 
Shloka 
prathamakavalaabhojyaḥ sarpiṣā samprayukto |
janayati jaṭharāgniṃ vātagulmaṃ nihanti || 35 ||
Ashtanga Hrudaya Chikitsa Sthana Gulma Chikitsa Adhyaya 14 / 35
Read more about Ashta Choornam
8. Persevere – Best choice is to suffer the bitterness for a week and your tongue will be okay with it. The bitterness has an amazing quality of improving your capacity of taste perception. Though you have a bad time eating bitters, you will start enjoying other flavors better. 
Read related: Bitter taste benefits

FAQs

How Ayurveda is studied today?
It is studied in a 5.5 years course.
4.5 years of study plus 1 year compulsory internship.
The course name is BAMS.
The students study traditional text books like Charaka samhita, Sushruta samhita, etc,.Along with that, they also study modern anatomy, physiology, pathology, patient examination methods etc.

How Ayurveda is different from Allopathy?
Use of natural remedies in healing
Comparatively lesser and milder side effects
Concentrates on root cause of the disease rather than symptomatic management.

Are Ayurvedic medicines slow to act?
No. Even allopathic medicines take 6 – 9 months to treat tuberculosis. Cancer treatment takes months together of time. Does that mean Allopathy is slow?

Ayurveda and Allopathy – both hold their credibility in respective areas.

Are Ayurvedic medicines free of side effects?
Absolutely not! Ayurvedic medicines do have side effects. For example, ginger is good for cough fever etc. But in many, it causes stomach irritation, hence it is a side effect of ginger.

Ayurvedic medicine for cancer?
Research is going on in many fields and some medicines are emerging. Treatment in early stages of cancer have been successful.
Ayurveda holds edge in prevention of cancer with use of herbs like Giloy, Turmeric, Brahma Rasayana etc. Ayurveda also has good treatment for stress management. Stress is a proven precursor of cancer. 
Ayurvedic treatment also helps to rejuvenate and energize patient who is debilitated by chemo and radiation therapies.

Uniqueness of Ayurvedic medicines

5 Factors That Make Ayurvedic Medicines Unique

Most of the ayurvedic medicines contain 3 or more ingredients. Rarely we find medicines prepared out of single herb or two. In fact, many of them contain 10 – 20 medicinal herbs. Around 10-15% of the formulations possess more than 40 herbs.

1. Digestive / carminative ingredients

Ayurveda believes that most of the diseases are caused due to mandagni ( indigestion). So, most of the Ayurvedic medicines contain at least one herb possessing digestive and carminative property. Thus, depending upon the  formulations,
Maricha (black pepper),
Shunti (ginger),
Pippali (long pepper),
Hingu (asafoetida),
Jeeraka (cumin seeds) etc are added in permutation and combinations.

2. Catalyst, bio enhancer

Ayurveda usually prescribes a Yogavahi herb (which carries the active ingredient to the required site of action- target cells). Few of the drugs are well known for this action.
Trikatu Churna  – Combination of pepper, long pepper and ginger Act as bio availability enhancer, when used in combination with other medicinal herbs. They increase the availability of medicinal phyto-chemicals at the site of therapeutic action. (research)
Madhu (honey),
Ghrita – Cow ghee
Yashtimadhu (Indian liquorice),  are included in the formulation for the same reason.

3. Wide variety of herbs

Many herbal ingredients are bitter or astringent in taste, some have offensive smell – like Acorus, Paederia foetida. On the other side, many possess sweetness like sugar candy, jaggery, honey, ghee or else the aromatic substance like cardamomum, bark of cinnamomum, cumin seeds, leaves of cinnamomum etc. In few of the formulations, natural colouring agents are also added like Turmeric, Manjishta, Daruharidra etc.

Along with the above said benefits, they contribute therapeutic action too. Hence, while adding these additives enough care is taken so as to contribute synergetic benefit or else to avoid antagonistic action of the pre existing ingredients of the therapeutic benefits.

Different dosage forms

4. Different dosage forms based on need of the patient: 
Form of medicine too makes the formulation unique. Each kind of pharmaceutical form like
Lehya (herbal jam),
Asava (liquids),
Choorna (herbal powder mix),
Tablet, juice extracts,
Kashaya (herbal decocotion) etc  are advocated with particular intentions. Usually the form of the medicine is selected based upon the stage of the illness.
For example, when digestion strength is good, but patients need nutrition, Avaleha (herbal jams) like Chyawanprash, Agastya Rasayana etc are selected.
When the patient’s digestion strength is low, then spicy Churnas like Hingvashtak Churna or Vaishvanar Churna are administered.

Read more – which Ayurvedic dosage form is most effective

Time of medicine adminsitration

5. The time of intake of medicine also brings significant change in the action of the drug. The medicine which should be prescribed after meals if prescribed in empty stomach may cause gastric irritation. Likewise 11 different specific time duration have been told for the intake of the medicine, depending upon the disease, stage of the illness and type of formulation. Read more

Thus each Ayurvedic medicine is unique in its quality, action and uses depending upon the disease and the individual’s body constitution while prescribing herbal and herbo-mineral preparation. These factors are to be given much emphasize and priority in routine practice.

Expiration date of Ayurvedic Medicine

Does Ayurvedic medicines have expiry date? Because my granny used to say that Ayurvedic medicines get better with each year! 
Dr JV Hebbar 
There are some medicines called Asavas and Arishtas that are fermented products. In these products, self generated alcohol preserves medicinal principles for a very long period of time. Thus, your granny’s statement is applicable to Asavas and Arishtas. 
Some example to these types of liquid medicines are – 
Ashwagandharishta – used for improving physical and mental strength and immunity 
Saraswatarishtam– for brain strength, memory and concentration
Aravindasava  – Children’s tonic used to address common childhood complaints like low appetite, cold, cough etc. 
Click to watch 
Difference Between Asava Arishta Medicines and Wines
Ayurveda talks about metallic preparations called Bhasmas. These Bhasma medicines have longer shelf life. 
Eg: Loha bhasma – Iron calx
Apart from these, rest of the Ayurvedic medicines, mainly of herbal origin have shorter shelf life.
Read: Shelf life or expiration date of Ayurvedic medicine

Can a medicine have hot and cold herbs together?

While formulating a medicine, can we mix herbs with hot and cold potency or herbs of different tastes? 
Dr JV Hebbar 
It is perfectly fine to mix herbs with hotness / coldness or with different tastes as long as the logic of the combination makes sense. 
The Vaidya should know the utility of each herb that he is mixing together and he should be intelligent enough to estimate the efficacy of the final product. 
For example, in Triphala, Amla is coolant whereas Haritaki and Vibhitaki are hot 
Dashamoola is a mix of hot and cold herbs
Chyawanprash is another example. 

Single Herb Medicine Vs Many Herbs in an Ayurvedic Medicine

It seems to me that most BAMS doctors prescribe only classical or proprietary medicines, and not single herb formulations individualized for a specific patient. Is the single herb formula method considered “old school”?. 
Dr JV Hebbar 
In the times of Vedas, single herbs are explained. In some contexts, prayers are offered to plants to heal certain diseases.
Read related: Veda, Upaveda – Introduction
 After Vedas, we have Samhita (Sushruta, Charaka Samhita). In these texts, maximum medicines are poly-herbal in nature. Eg; Brahma rasayana, chyavanprash (35+ herbs) etc.

But they also have explained single herbs also. Eg: 
medhya rasayana –  brain tonic

Shankhapushpi – Convolvulus pluricaulis 
Mandukaparni – Gotu kola for brain power and memory. 

Gradually we started facing herb identification problems and we also started having herb sourcing problems. 
Then again, in Sharangdhara Samhita Bhaishajya ratnavali etc. – 4 -5 ingredient medicines started to show up. 
Eg: Panchakola churna, 
Triphala – Amalki, Haritaki, Vibhitaki, 
Saptamrita lauha (5 ingredients + honey and ghee) 
Influenced by the western way of herbalism we adopted the single herb therapy as well.  

Are single herb formulations (when skillfully prepared) as potent/effective as classical formulations? Is it a dying art?
Dr JV Hebbar 
Single herb medicines practice is still largely prevalent and in fact it is growing in popularity especially among westerners. Western practitioners whey they start practice with basic Ayurveda knowledge, they start using single herbs. Slowly as they gain more expertise in Ayurveda, start trying polyherbal Ayurvedic products. 
Single herb practice is definitely not a bad thing. But if the number of single herbs increases, (due to multiple disorders), then better to go for a polyherbal combination. 
Eg: fever with headache with cough and cold 
Guduchi 
Shallaki 
Ginger capsule 
Vasaka capsule 
Rather than giving them differently, we can think of 
Amrutottara Kashayam 
or 
Dashamoola Katutraya Kashayam etc.