Ayurveda, translated as “the science of life”, is a traditional medicine of India, although it has been influenced by other cultures over the past 4,000 years. It is claimed that Ayurveda originated before 2000 BC (Frawley, 1992) and was codified in primary texts, said to date from the 6th Century BC. In these texts, the concept of health can be summarised as “soundness of body, mind and soul”.

Ayurveda incorporates eight areas of medicine, including internal medicine, which uses substances derived from plants, animals and minerals. Traditional Indian surgery, one branch of Ayurveda, provides the initial information for this research. References have been found in classical texts which discuss marman (acupoints) and support contemporary Indian theories of marman therapeutics. The word marman, from the Sanskrit root “m.r” means “a mortal spot, a vulnerable point of secret quality and hidden meaning” (Cologne Digital Sanskrit Lexicon). Marman are influential in the human body through their associated channels called nadi. The Sanskrit word nadi is translated as “stream” (Macdonnell and Keith, 1989). These “streams” or channels are thought to carry fluids and the life-force, the active energy of the body, which is called prana. Prana appears to share the attributes assigned to qi in the Chinese system and is believed to make possible metabolic functions within the human body. When interpreted as “nerve impulse” (Nair, interview, 14/9/1998), prana is claimed to be the mechanism which normalises nervous disorders and is therefore a key feature of marman (acupoint) massage. The stimulation of these vital points is believed to affect the prana of a patient and thus effect a recovery from disease. Stimulation is achieved through massage, by indirect methods such as heating the marman points (similar to Chinese moxibustion), or by directing vital energy through breathing exercises that may be compared to qi gong – Chinese breathing exercises.

The Vedas are the earliest extant writings of ancient India. In one, the Atharva Veda, there are references to the medical system Ayurveda, incorporating layers of information, commentaries and experiential observation by practitioners over many centuries. Primary to the philosophy of classical Ayurveda is the concept of “unity and the sacred nature of all life” (Frawley, 1992, p xix). Vedanta Sutra refers to this concept as “One absolute truth” (Bhaktivedanta, 1987).

In this philosophical model, the one “absolute truth” divides into two natures – non-manifest energy (purusha) and manifested nature (prakritti). Life is believed to form through the interaction of these two principles via the medium of “universal breath” (prana). These principles may equate with the Chinese model of yang (energy), yin (matter) and the role of qi. The three theoretical states of creation, maintenance and destruction are supported by the primal prana and provide a triadic structure which is basic to Indian philosophy and medicine. Vedanta, the philosophical foundation of Ayurveda, presents this triadic nature in the symbol AUM which precedes most classical Sanskrit verses.

Ayurveda recognises three subtle qualities (guna) which manifest in health as pleasurable, neutral or painful experiences, and which form a foundation to the three dosha (kapha, pitta and vata). The three dosha represent influences produced by the interaction Earth, Water, Fire, Air and Ether (see Figure 6). Illness is a sign that the three dosha are vitiated. The prime directive of Ayurveda therefore is “to gain a balance of the dosha and thus return the patient to health” (Thakkur, 1974, p 2).

Dosha Constitution Effects
Vata Ether and Air Neurological movements – activities of body and mind
Pitta Fire and Water Digestion – metabolism and temperature regulation
Kapha Earth and Water Stability – builds body tissue and gives protection

Figure 6: The three dosha relationships within the five basic elements

Vata-type disorders include muscle and nerve pain, convulsions, cramps and paralysis.
Pitta-type disorders are characterised by inflammations and infections with excess heat.
Kapha-type disorders manifest as respiratory, urogenital, secretory and metabolic dysfunction.

Diagnostically, the condition of the three dosha is assessed by pulse and tongue inspection, demonstrating a similarity with TCM and Tibetan diagnostic approaches. Observations are made by the Ayurvedic practitioner regarding ten pairs of opposites within the constitution of the patient. These pairs are concordances assigned to the five basic elements and help the practitioner to determine the cause of disruption to human physiology. This system of associations enables the practitioner to link physical and mental functions in diagnostic terms and to treat accordingly. It is said that through the assessment of the ten pairs of opposites, an Ayurvedic practitioner is able to determine the abnormal dosha, and return it to normality using the “eight branches of Ayurvedic medicine” (Majumdar, 1998, p 100).

The traditional practitioners of southern India form another branch of Indian medicine, the Dravidian School, which includes most Ayurvedic theories but also some aspects unique to this school. Practitioners of Dravidian medicine in the states of Tamil Nadu and Kerala claim to have secret information that relates to the actions and usage of marman. This information is unknown to traditional Ayurveda, having been preserved in unpublished texts, reportedly handed down over a period of more than 2000 years. Both branches of traditional Indian medicine share a common belief system regarding the origin of life. The dual nature of spirit and matter is understood to be homogenous in the absolute sense. The origin of life is believed to be “absolute spirit” (brahman) and illness is believed to be due to actions which do not reflect harmony with the natural laws (prakritti) originating in “absolute spirit”. It is for this reason that much Indian medicine is dedicated to improving the quality of life through practices such as yoga and meditation.

According to some historians, Ayurveda has developed its ideas on the treatment of disease states over the centuries by absorbing the ideas of other medical systems (Zysk, 1998). These may include influences from Persia, Greece, Mongolia, and the cross-pollination of ideas and medicines with those of China, via the early Himalayan trade routes. It is also claimed that many aspects of early Indian medicine were taken to Tibet and southern India in an attempt to protect Ayurveda from invaders (Nair, private communication, 27/8/98). The passage to China of Buddhist monks, such as Jivaka, also carried the influence of Ayurveda in the form of Buddhist medicine (Unschuld, 1985). On the other hand, the passage of the historical figure Lao Tsu, who “disappeared into the west” from China (Unschuld, 1985), indicates the possible introduction of Chinese ideas into Tibet, and possibly into India.

The idea of an independent and parallel development of Chinese and Indian energetic theories is not widely held by historians (indologists). It seems clear that there were cultural exchanges of early ideas between India and China, including those of a martial and medical nature (Zysk, 1998), and that such exchanges may have provided a foundation of thought which later developed into commonly held medical theories.